Title Page
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Client / Site
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Location
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Conducted on
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Prepared by
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INSTRUCTIONS
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1. Start by adding a fire extinguisher and fill out the necessary information.
2. Assess the following by answering: ”Yes or No” on the questions below.
3. Add photos and notes by clicking on the paperclip icon.
4. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date.
5. Complete audit by providing digital signature.
6. Share your report by exporting as PDF, Word, Excel or Web Link -
Click "Add Fire Extinguisher" to list equipment available in the area. You may add multiple items.
Fire Extinguisher
Fire Extinguisher Information
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Location of Extinguisher
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Capture photo of the extinguisher. Make sure the following items are present:
1. Inspection tags to show the dates of conducted monthly inspections.
2. Serial No.
3. Manufacture and Expiry Dates
4. Type and Ratings -
Take a photo
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Does this need Recharging?
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Note:
When extinguishers are recharged, a tag or label must be attached to each extinguisher that indicates the month and year recharging was performed and the name of the person or company performing the service [see NFPA 10(98), Section 4-5.5].
In addition, each extinguisher that has undergone maintenance that includes an internal examination or has been recharged is required to have a “Verification of Service” collar installed around the neck of the extinguisher [see NFPA 10(98), Section 4-4.4.2]. The exception to this rule is carbon dioxide extinguishers that have been recharged without removal of the valve assembly.
The “Verification of Service” collar, usually made of plastic, serves as visual proof that the extinguisher was disassembled and maintenance performed. It must be of a type that cannot be removed without the removal of the valve assembly and must include the month and year the service was performed. -
Please state the recharging details here
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Please state reasons here
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Does this need Hydrostatic Testing?
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What type of cylinder?
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High-pressure cylinders (e.g. carbon dioxide) that pass the hydrostatic test must be stamped with the tester’s identification number and the month and year of the test.
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Low-pressure cylinders (e.g. dry chemical, wet chemical, pressurized water) that pass the hydrostatic test must:<br>- have the test information recorded on a metallic label, or similar durable material, affixed to each extinguisher that indicates the month and year the test was performed,<br>- the test pressure used<br>- the initials or name of the person performing the service <br>- the name of the company they represent [see NFPA 10(98), Section 5-6.4].
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Note:
At certain intervals, fire extinguishers are required to be pressure tested using water or some other noncompressible fluid to help prevent unwanted failure or rupture of the cylinder [see NFPA 10(98), Chapter 5]. This is called hydrostatic testing and includes both an internal and external examination of the cylinder. Because this testing requires special training and equipment, it needs to be performed by an approved extinguisher servicing company.
The exception to the rule for hydrostatic testing is non-rechargeable stored pressure extinguishers (e.g. dry chemical extinguishers), which are required to be removed from service 12 years from the date of manufacture. -
Please state the hydrostatic testing details here
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Please state reasons here
Completion
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Total number of fire extinguishers
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Total number of fire extinguisher recharged
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Total number of fire extinguisher undergone hydrostatic testing
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Overall comment about the internal maintenance
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I hereby confirm that the Internal Fire Extinguisher Inspection was performed by an approved extinguisher servicing company.
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Name and Signature of the Inspector
