FIRE HOSE BOX AND FIRE HYDRANT QUARTERLY CHECKLIST

• Conducted on

  Date

• Conducted by

Fire Hose Box/Fire Hydrant Opposite Villa 1 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Opposite Villa 3 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Opposite Villa 7 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Opposite Villa 13 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Opposite Villa 26 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Between Villa 28 and 29 pathway

• Hydrant Condition

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Between Villa 29 and 30 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Beside villa 33 bus stop

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Opposite Villa 35 pathway

• Hydrant Condition

  Yes

  No

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box/Fire Hydrants Opposite Villa 36 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hydrants Opposite Villa 39 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hydrants Opposite Villa 41 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Fire Hose Box Opposite Villa 42 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Opposite Villa 45 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Opposite Villa 47 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Opposite Villa 49 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Opposite Villa 51 pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Opposite Villa 53pathway

• Hydrant Condition

  Good

  Fair

  Poor

  N/A

• Hose Box Condition

  Good

  Fair

  Poor

  N/A

• How many fire hoses and nozzles in the hose box

• Condition of fire hose and nozzle

  Good

  Fair

  Poor

  N/A

Completed

• Date & Time Completed

  Date

• Name & Signature

  Sign