Information
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SCI- Monthly Respirator Maintenance Record
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SCI Mask No
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Conducted on
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Conducted by
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Operative Name
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RPE Make Model
- Sundström SR100 M/L
- Other - Please list below
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Type of RPE
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SCI - ID Number
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Please check the mask and complete the relevant sections below. If the section is not relevant then please put 'N/A' as the response.
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Is the mask clean?
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Is the storage box clean?
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Are the straps in good working order and damage free?
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Are the buckles working and allow adjustment of straps?
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Are air seals (inlet/outlet) and face seal satisfactory?
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Is the in-house expiry within date (6 month maximum)
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Power assisted respirators
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Battery Pack and charger (working and charging)?
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Motor operating and flow checked?
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Visor clear and free from defects?
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Belt to hold power pack satisfactory?
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Action Required
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I have inspected the above RPE and ticked to indicate that the RPE was found to be in good order and have commented on work need to bring the item up to the required standard
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