Fire Safety Equipment Audit - Shock Busters

• Site conducted

• Conducted on

  Date

• Prepared by

• Location
  Address

• All tests are done in accordance with the Australian Standards as shown below;
  AS2444-2001
  AS1851-2012
  AS4265-1995
  AS1841.1-2007
  AS/NZS 1850-2009

• Nominated job contact:

• Phone

• Reports to:

• Email

Special Requirements

• Induction

• Action taken or comments

• Work Permit

• Action taken or comments

• Sensative Areas

• Action taken or comments

• Hazardous Areas

• Action taken or comments

• Other

• Action taken or comments

Service Details

• Service Areas

  Select Fire Extinguishers Hose Reels EM Lighting Fire and Smoke Doors Hydrants Pumpsets Sprinkler Systems CIE and FIP Detectors Seals and Collars

  • Fire Extinguishers
  • Hose Reels
  • EM Lighting
  • Fire and Smoke Doors
  • Hydrants
  • Pumpsets
  • Sprinkler Systems
  • CIE and FIP
  • Detectors
  • Seals and Collars

Fire Extinguishers

• Asset Number

• Location
  Address

• Fire Extinguisher Type

  Select Water Wet Chemical Foam Dry Chemical Powder - ABE Dry Chemical Powder - BE CO2 Vapourising Liquid

  • Water
  • Wet Chemical
  • Foam
  • Dry Chemical Powder - ABE
  • Dry Chemical Powder - BE
  • CO2
  • Vapourising Liquid

• IS this the Annual Level 2 Service?

  Yes

  No

• Time how long it takes to discharge extinguisher completely.

• Did the extinguisher last more than 90 Seconds?

  Yes

  No

• Yes

  No

  N/A

• Weight - Kg/Lt

• Extinguisher Rating (eg. 4a-40B-E)

• Pressure Test Date

  Date

• Last Service Level

  Level 1

  Level 2

  Level 4

  Level 5

  N/A

• Service Level

  Level 1

  Level 2

  Level 4

  Level 5

  N/A

• Easily Accessible

  Yes

  No

• Is signage Compliant? ie. not lower than 2m above ground

  Yes

  No

• Is the exterior in good condition, with legible Instructions?

  Yes

  No

• Is there a compliant service tag?

  Yes

  No

• Anti Tamper Seal?

  Yes

  No

• Is the Outlet Hose assembly in good condition?

  Yes

  No

• Is the Pressure indicator working?

  Yes

  No

  N/A

• Is the support bracket present and secure?

  Yes

  No

• Is the weight within the accepted variance? (5% of labelled approx. Gross Mass)

  Yes

  No

• Does the Actuating device function?

  Yes

  No

• Easily Accessible

  Yes

  No

• Is signage Compliant? ie. not lower than 2m above ground

  Yes

  No

• Is the exterior in good condition, with legible Instructions?

  Yes

  No

• Is there a compliant service tag?

  Yes

  No

• Anti Tamper Seal?

  Yes

  No

• Is the Outlet Hose assembly in good condition?

  Yes

  No

• Is the Pressure indicator working?

  Yes

  No

  N/A

• Is the support bracket present and secure?

  Yes

  No

• Is the weight within the accepted variance? (5% of labelled approx. Gross Mass)

  Yes

  No

• Does the Actuating device function?

  Yes

  No

• Yes

  No

  N/A

• Easily Accessible

  Yes

  No

• Is signage Compliant? ie. not lower than 2m above ground

  Yes

  No

• Is the exterior in good condition, with legible Instructions?

  Yes

  No

• Is there a compliant service tag?

  Yes

  No

• Anti Tamper Seal?

  Yes

  No

• Is the Outlet Hose assembly in good condition?

  Yes

  No

• Is the Pressure indicator working?

  Yes

  No

  N/A

• Is the support bracket present and secure?

  Yes

  No

• Is the weight within the accepted variance? (5% of labelled approx. Gross Mass)

  Yes

  No

• Does the Actuating device function?

  Yes

  No

• Yes

  No

  N/A

• Easily Accessible

  Yes

  No

• Is signage Compliant? ie. not lower than 2m above ground

  Yes

  No

• Is the exterior in good condition, with legible Instructions?

  Yes

  No

• Is there a compliant service tag?

  Yes

  No

• Anti Tamper Seal?

  Yes

  No

• Is the Outlet Hose assembly in good condition?

  Yes

  No

• Is the Pressure indicator working?

  Yes

  No

  N/A

• Is the support bracket present and secure?

  Yes

  No

• Is the weight within the accepted variance? (5% of labelled approx. Gross Mass)

  Yes

  No

• Does the Actuating device function?

  Yes

  No

• Pass or Fail? If fail, provide details

  Pass

  Fail

Fire Blankets

• Asset Number

• Location

• Equipment Brand and Size

• Last Service Level

  Level 1

  Level 2

  N/A

• Service Type

  Level 1

  Level 2

• Check for compliant Signage

  Pass

  Fail

• Check Package is in tact, and in good condition

  Pass

  Fail

• Check Tabs are properly attached

  Pass

  Fail

• Check condition of blanket

  Pass

  Fail

• Is a compliant tag attached?

  Yes

  No

• Check for compliant Signage

  Pass

  Fail

• Check Package is in tact, and in good condition

  Pass

  Fail

• Check Tabs are properly attached

  Pass

  Fail

• Check condition of blanket

  Pass

  Fail

• Is a compliant tag attached?

  Yes

  No

• Result

  Pass

  Fail

• Details

Fire Hose Reels

• Asset Number

• Location

• Equipment Type

  Select 19mm 25mm 30m 36m

  • 19mm
  • 25mm
  • 30m
  • 36m

• Last Service Level

  Level 1

  Level 2

  Level 4

  Level 5

  N/A

• Service Level

  Level 1

  Level 2

  Level 4

• Is hose in good working order?<br>Hose Reel<br>Full length of Hose<br>Interlock Device and Nozzle<br>Water Shut Off Valve

  Yes

  No

  N/A

• What has not operated as designed?

  Select Hose Reel Full lenght of Hose Reel Interlock Device Nozzle Water Shut Off Valve Cabinet (If applicable) Hose Fitting Swing Arm Hose Guide Anchor Points Bearings

  • Hose Reel
  • Full lenght of Hose Reel
  • Interlock Device
  • Nozzle
  • Water Shut Off Valve
  • Cabinet (If applicable)
  • Hose Fitting
  • Swing Arm
  • Hose Guide
  • Anchor Points
  • Bearings

• Flow Rate (Litres / Second)

• Is hose in good working order?<br>Hose Reel<br>Hose Fitting<br>Full length of Hose<br>Interlock Device and Nozzle<br>Water Shut Off Valve<br>Swing Arm<br>Hose Guide<br>Anchor Points<br>Bearings

  Yes

  No

  N/A

• What has not operated as designed?

  Select Hose Reel Full lenght of Hose Reel Interlock Device Nozzle Water Shut Off Valve Cabinet (If applicable) Hose Fitting Swing Arm Hose Guide Anchor Points Bearings

  • Hose Reel
  • Full lenght of Hose Reel
  • Interlock Device
  • Nozzle
  • Water Shut Off Valve
  • Cabinet (If applicable)
  • Hose Fitting
  • Swing Arm
  • Hose Guide
  • Anchor Points
  • Bearings

• Flow Rate (Litres / second)

• Is hose in good working order?<br>Hose Reel<br>Hose Fitting<br>5m of Fire Hose<br>Interlock Device and Nozzle<br>Water Shut Off Valve<br>Swing Arm

  Yes

  No

  N/A

• What has not operated as designed?

  Select Hose Reel 5m of Fire Hose Interlock Device Nozzle Water Shut Off Valve Cabinet (If applicable) Swing Arm Hose Fitting

  • Hose Reel
  • 5m of Fire Hose
  • Interlock Device
  • Nozzle
  • Water Shut Off Valve
  • Cabinet (If applicable)
  • Swing Arm
  • Hose Fitting

• Yes

  No

  N/A

• Pass or Fail

  Pass

  Fail

  N/A

• Comments

Flow Rate of Most Disadvantaged Hose Reel

• ID

• Location

• Flow Rate (Litres per Second)

Emergency and Exit Lighting

• Asset Number

• Location

• Make

• Model

• Date Installed

  Date

• Date LSL

  Date

• Type

  EM Light

  Exit Light

• Maintianed

  Yes

  No

• Lamp Type

• Test Facility

• Maintained

  Yes

  No

• Illumination Type

  External

  Lux

  Internal

• Lamp Type

• Test Facility

  Test Button on Unit

  Power board Test Function

  Emergency Board Test Function

  Circuit Breaker

• Visual Ispection

  Pass

  Fail

• Test Start

  Date

• Test Finish

  Date

• Pass Or Fail

  Pass

  Fail

• Photo

  Media

• Service and maintenance records

  Pass

  Fail

  N/A

• Emergency luminaire, exit and directional signs

  Pass

  Fail

  N/A

• Exit and directional signs-Direction to a required exit

  Pass

  Fail

  N/A

• Exit and directional signs—Sensors or other controls

  Pass

  Fail

  N/A

• Requirements for exit signs

  Pass

  Fail

  N/A

• Automatic test systems, control and indicating equipment—Condition

  Pass

  Fail

  N/A

• Emergency luminaire and exit signs—initiate duration test

  Pass

  Fail

  N/A

• Defined service life

  Pass

  Fail

  N/A

• Check each initiated discharge system is reverted to normal operation

  Pass

  Fail

  N/A

• Check externally illuminated exit sign. Greater than 200 lx is required on face

  Pass

  Fail

  N/A

• Indirect lighting systems—Reflecting surfaces (where fitted)

  Pass

  Fail

  N/A

• Directional beam luminaries (where fitted)

  Pass

  Fail

  N/A

• Normal lighting and emergency operation relationship

  Pass

  Fail

  N/A

• Emergency luminaire and exit signs—Tubular fluorescent lamps

  Pass

  Fail

  N/A

• Exit signs—Performance reduction through light emission depreciation

  Pass

  Fail

  N/A

• Exit signs—Externally illuminated

  Pass

  Fail

  N/A

• LSL (end of light source life)

  Pass

  Fail

  N/A

• Survey—Emergency light and exit sign schedule

  Pass

  Fail

  N/A

• Survey—Fire control centre (where fitted)

  Pass

  Fail

  N/A

• Survey—Emergency Luminaires

  Pass

  Fail

  N/A

• Survey—Exit and directional signs

  Pass

  Fail

  N/A

• LED-maintained emergency luminaires—Performance reduction through light emission depreciation

  Pass

  Fail

  N/A

• Are there Outstanding Defects

  Yes

  No
Outstanding Defects

• Asset No

• Equipment Type

• Defect Description

• Defect Type Critical/Non-critical Non-conformance

  Critical

  Non-Critical

  Non-Conformance

• Comments