MONTHLY FIRE EXTINGUISHER INSPECTION REPORT

FIRE EXTINGUISHER INSPECTION REPORT

• DATE

  Date

• INSPECTOR

• Add location
  Address

• Inspection Location

• EXTINGUISHER

EXTINGUISHER

• Extinguisher location

• Select the Extinguisher size in lbs

• Extinguisher Serial#

• KEY: 1 = GOOD 2 = ATTENTION REQUIRED 3 = IMMEDIATE ATTENTION REQUIRED

• PRESSURE TEST DUE

  Date

• INDICATOR NEEDLE (GREEN SECTOR)

  1

  2

  3

• SAFETY PIN AND SECURITY TIE IN PLACE

  1

  2

  3

• SECURELY MOUNTED

  1

  2

  3

• PLASTIC COVER

  Yes

  No

  N/A

• GENERAL CONDITION

  1

  2

  3

• OTHER

  1

  2

  3

MUST BE SIGNED

• Inspection Time

  Date

• INSPECTED BY

  Sign