Eddie Sawyers

Sapling Grove Surgery Fire Extinguisher Inspection

Monthly inspection of fire extinguishers. Pass/Fail question is mandatory, all other questions optional based on inspection. Signature is required to complete inspection.

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Title Page

Site conducted
Conducted on
Prepared by

#1 - Break Room

Pass / Fail
Replace Date
Corrective Action

#2 - Pre Op

Pass / Fail
Replace Date
Corrective Action

#3 - O.R. Hall

Pass / Fail
Replace Date
Corrective Action

SIGNATURE

This signature certifies that I have reviewed and completed the inspection.

Eddie Sawyers

Sapling Grove Surgery Fire Extinguisher Inspection

Monthly inspection of fire extinguishers. Pass/Fail question is mandatory, all other questions optional based on inspection. Signature is required to complete inspection.

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.