Nitai Whitehurst

PM213-IN-1M Manual Fire Fighting Equipment Monthly Inspection

Conduct visual inspection of all manual firefighting equipment such as portable fire extinguishers, hose reels and fire blankets for the following. All variances must be documented below.

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Title Page

Site conducted
PM213
Conducted on
Prepared by
Location

All Equipment

Inspection tag in place and last test within last 6 months.
Comments
All items have not been damaged, used or tampered with
Comments
All items are free from obstruction and accessible
Comments
All item has signage in place and visible
Comments
Photos

Extinguishers

Relevant units are within the correct pressure range
Comment
Image
Locking pins and anti-tamper ties are in place
Comment
Photos

Hose Reels

All hose reels are rolled up and in ready positions
Comments
All hose reels are free from leaks?
Comment
Photo

Actions/Comments

Actions/Comments
Name/Signature:
Date/Time:

Nitai Whitehurst

PM213-IN-1M Manual Fire Fighting Equipment Monthly Inspection

Conduct visual inspection of all manual firefighting equipment such as portable fire extinguishers, hose reels and fire blankets for the following. All variances must be documented below.

Use this Template

Print as PDF

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