Title Page

  • Site conducted

  • Conducted on

  • Sub Contractor

  • Prepared by

  • Location
  • Extinguisher Identification Numbers

  • Extinguisher ID

  • Type

  • Extinguisher ID

  • Type

  • Extinguisher ID

  • Type

  • Extinguisher ID

  • Type

  • Extinguisher ID

  • Type

  • Inspection

  • Is fire extinguisher in good condition (ANY SIGN OF WEAR, TEAR OR RUST)

  • Is the locking pin intact and tamper seal unbroken

  • Is pressure guage at a safe level

  • Are all warning and instruction labels in good condition and easy to read

  • Date of next annual inspection (ALL FIRE EXTIGUISHERS MUST BE INSPECTED BY A COMPETENT PERSON ANNUALLY)

  • COMMENTS

  • Inspectors signature

  • Add signature

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