Title Page
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Site conducted
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Conducted on
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Prepared by
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1.0 Training Program (Safety / Training Department)
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Are designated employees trained on the proper use of portable fire extinguishers?
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The site has a retraining annually for fire extinguisher usage? 1910.157(g)(2)
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If the site has an Emergency Response team, have they been trained in the use of appropriate equipment? 1910.157(g)(3)
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If Applicable, The emergency response team has been retrained annually? 1910.157(g)(4)
2.0 Fire extinguisher Program (Safety/Medical)
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Does the site designate responsible employees or permit employees to use fire extinguishers/ (If now, then this standard can be skipped provided that an EAP and fire prevention plan are completed). 1910.157(b)(1)
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Is the travel distance to any Class A (wood, wool, etc.) fire extinguisher less that 75 feet? If applicable
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Is the travel distance to any Class B (Gas, alcohol, diesel, etc..) fire extinguisher less that 50 feet? If applicable
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Is the travel distance to any Class C (Electrical) fire extinguisher less that 75 feet? If applicable
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Is the travel distance to any Class D (Combustible metal) fire extinguisher less that 75 feet? If applicable
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Does the program contain fire extinguisher inspections? 1910.157(e)(2)
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Does the site program contain a hydrostatic testing and maintenance procedure?
3.0 Fire Extinguisher Practices (Visual Inspection)
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Are all fire extinguishers fully charged and operable condition and placed in designated locations? 1910.157(c)(4)
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Are fire extinguishers selected, proper for the potential use in the workplace? 1910.157(d)(1)
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Do fire extinguishers been inspected monthly? 1910.157(e)(2)
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Are fire extinguishers inspected annually? 1910.157(e)(3)
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If applicable, are stored pressure dry chemical extinguishers that require a 12-year hydrostatic test, emptied and subjected to maintenance procedures every 6 years? 1910.157(e)(4) When the fire extinguishers are recharged or hydrostatic tested, the requirement begins from that date.
4.0 Employee Knowledge (Employee Questions)
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Do employees know how to use a fire Extinguisher?
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Do employees know what to do with a spent fire extinguisher?
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Do employees know where the nearest fire extinguisher is to their work area?
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Do employees know what type of fire extinguisher they would use in their work area?
5.0 Documentation and Retention (Safety / Medical)
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Are fire extinguisher inspection records maintained for one year after the last entry or the life of the shell (whichever is less)? 1910.157(e)(3)
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Are employee training records maintained for the period of employment?