Title Page

  • Site conducted

  • Conducted on

  • Prepared by

    Portable Fire Equipment
  • Portable Fire Equipment Type

  • Fire Extinglisher Type

  • Location

  • Is the fire extinguisher unobstructed and accessible?

  • Is the fire extinguisher safely secured/won't fall easily?

  • Is Fire Extinglisher Handle 900-1200mm From The Ground, Base Of Extinglisher Not Less Then 100mm From Ground

  • Sinage Indicator At Least 2000mm Above Floor Level

  • Are the operating instructions on nameplate legible?

  • Is the nozzle intact?

  • Is Safety pin intact?

  • Is the anti-tamper seal intact?

  • Does the gauge show in the green (Fully Charged)?

  • Is the service company tag attached, signed and dated?

  • Is There Damage to Extinglisher or Hose?

  • Equipment Condition Outcome

Closeout

  • Other Concerns Identified?

  • Completed By:

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