Title Page

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Type Of Equipment

  • Manufacturer

  • Serial Number

  • Model Number

  • Equipment Type

  • Maximum Pressure Rating

To be Completed by Inspector, Supervisor or Foreman of Those Performing the Work

Equipment Safety Checks

  • Hoses checked for condition, secured, properly arranged, and rated for a minimum 3 times the highest working pressure.

  • High-pressure hose connections tightened and inspected for cracks, leaks or chips in the housing?

  • High pressure hose has been check for leaks, punctures and breaks?

  • Relief device rating checked against the lowest rated components?

  • Equipment guards in place (trigger guards, rotational guards)?

  • Shut off controls are operating properly?

  • Trigger assembly and pressure gun are in working condition with no breaks, cracks or bad couplings?

  • Pressure wand/gun if free of cracks and in working condition

  • Rotating nozzles have been inspected and are in working condition?

  • Fuel tank is in working condition with no cracks, breaks or leaks?

  • Overall Condition of equipment

  • Recommendation

  • Inspector's Signature Colin Alexis - Certified Inspector

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