Title Page

  • Job No.

  • Client / Site

  • Work Order #:

  • Purchase Order #:

  • Conducted on

  • Conducted by

    FHR
  • Asset Number

  • Location of Hose Reel (Building or Conveyor)

  • Hose reel is securely mounted on the wall.<br>

  • Check for any visible signs of damage or corrosion.

  • Inspect the hose for cuts, cracks, abrasions, or signs of wear.

  • Check the nozzle for any damage or blockages including leaks

  • Pull out the hose fully to ensure it unwinds without obstruction.

  • Ensure hose reel has required location signage above and is legible

  • Check that the hose reel has an operating instructions label on front of reel

  • Inspect the local isolation valve for signs of wear or corrosion.

  • Verify the valve operates smoothly (opens and closes without resistance).

  • Ensure valve has retainer clip for nozzle retention

  • Is the hose reel functional despite of defects (If defects applicable)

  • Tag out of service

  • Does the hose reel require replacement?

  • Identify the correct type and size of the replacement reel

  • Identify if local isolation is available

  • If major isolation is available note what is required and obtain relevant information from site to facilitate

  • Photos of FHR, defects and isolation points

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.