MONTHLY FIRE EXTINGUISHER INSPECTION REPORT - duplicate

FIRE EXTINGUISHER INSPECTION REPORT

• DATE

  Date

• INSPECTOR

• Add location
  Address

• Inspection Location

• EXTINGUISHER

EXTINGUISHER

• Extinguisher location

• Type of Extinguisher

• Select the Extinguisher size in litres

• Extended service due

  Date

• INDICATOR NEEDLE (GREEN SECTOR)

  Pass

  Fail

  N/A

• SAFETY PIN AND SECURITY TIE IN PLACE

  Yes

  No

  N/A

• SECURELY MOUNTED

  Yes

  No

  N/A

• GENERAL CONDITION

  Good

  Fair

  Poor

  N/A

MUST BE SIGNED

• Inspection Time

  Date

• INSPECTED BY

  Sign