Information
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Document No.
VNY WEST Monthly Fire Extinguisher Inspection
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Conducted on
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Prepared by
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Location- Verify you are conducting Monthly Fire Extinguisher Inspection for VNY West by entering "VNY West" below.
FIRE EXTINGUISHER INSPECTION INSTRUCTIONS Each fire extinguisher (Facility and Vehicle) needs to be inspected and signed off each month. The inspections should at a minimum include: o A visual inspection of the overall condition of the extinguisher and bracket. o Is the pressure gauge in the green? o Is the safety pull pin secured and in place? o Look at the discharge hose to be sure it is not pinched or damaged; be sure the end is not clogged, etc. o Is the monthly inspection tag attached and signed each month? o Is the annual inspection label attached? Is the annual inspection past due? o For wall mounted extinguishers there must be a clear path to the fire extinguisher- be sure there is nothing blocking access to the fire extinguisher, is there a sign on the wall identifying the extinguisher location? Is there a red box painted on the floor to show nothing should be stored in this area? o Any spare fire extinguishers should be stored in such a way as they are protected from falling over, and still need to be inspected monthly. o Any used or Out of Service fire extinguishers must be LOTO until they can be properly disposed of, and stored in a location where they will NOT be accessible in case of an emergency.
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FIRE EXTINGUISHER<br>INSPECTION INSTRUCTIONS CON’T<br><br>Answering "S" for Satisfactory means you agree that you have performed the above required monthly inspection and initialed the monthly inspection tag. <br>If you answer "C" for Comment, please add a brief description of what the issue is and remove the fire extinguisher from service. Create a follow up action item to be sure the issue addressed, and replace the fire extinguisher with a spare. <br>Click YES to confirm you understand how to perform the Monthly Fire Extinguisher Inspection.<br>
VNY West Fuel Trucks
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J-30-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-30-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-31-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-31-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-32-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-32-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-304-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-304-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-305-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-305-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-522-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-522-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-94-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-94-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-1242-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-1242-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-1243-Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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J-1243-Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A-15 Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A-15 Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A-43 Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A-43 Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A- 20 -Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A-20 Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A- 202 Left,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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A- 202 -Right,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
VNY WEST Terminal
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Fire Ext. # 1, Supervisor Office,<br>Annual Due in February, <br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 4, Lobby/ Pilot Lounge,<br>Annual Due in February, <br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 6, Hallway to CBP<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 7, 2nd Floor HB,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 8, 2nd Floor Double Door,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 9, 2nd Floor/Stairs to 1st Floor Lobby,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 12, 2nd Floor Hangar Hallway,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 14, 2nd Floor Hallway Machine 1,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 16, 2nd Floor Hallway A1/2 Stairs<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # YY, 2nd Floor Hallway HC Window,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
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Fire Ext. # 18, 2nd Floor Goldstar,<br>Annual Due in February,<br>Hydrostatic Test Due Feb XXXX
VNY WEST Hangar
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Hangar A1/ West Wall-North, Fire Extinguisher #38, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A1/ West Wall-South, Fire Extinguisher #30, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A1/ East Wall-North Door Beam, Fire Extinguisher #H3, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A1/ East Wall-South Door Beam, Fire Extinguisher #H4, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A2/ West Wall-North, Fire Extinguisher #43, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A2/ West Wall-South, Fire Extinguisher #36, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A2/ East Wall-North Door Beam, Fire Extinguisher #41, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A2/ East Wall-South Door Beam, Fire Extinguisher #H4, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar A2/ East Wall-North Door Beam, Fire Extinguisher #41, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar B/ West Wall-North, Fire Extinguisher #58, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar B/ East Wall-North Door Beam, Fire Extinguisher #57, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar B/ West Wall-South, Fire Extinguisher #H3, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar B/ East Wall-South Door Beam, Fire Extinguisher #H4, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar C/ West Wall-North, Fire Extinguisher #62, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar C/ East Wall-North Door Beam, Fire Extinguisher #61, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar C/ West Wall-South, Fire Extinguisher #63, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
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Hangar C/ East Wall-South Door Beam, Fire Extinguisher #60, <br>Annual Due February, <br>Hydrostatic Test Due XXXX
VNY WEST Eye Wash Station Inpsections
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INSPECTION ITEMS:<br>To perform the monthly inspection on the eye wash stations: <br>o Initiate water flow. <br>o Ensure the caps or covers come off by themselves when water begins to flow. <br>o Run water until clear and clean.<br>o Ensure caps or covers are clean and replaced when finished.<br>o Make sure sink is clean. <br>o Verify the path to the eyewash station is clear and not blocked. <br>o Is there a sign above the identifying the location of the eyewash station?<br>o Date and initial the inspection tag attached to the eye wash station. <br>For portable bottles, <br>o Be sure the bottle is in place, <br>o The seal has not been broken, <br>o The expiration date is current, <br>o The exterior of the bottle is wiped clean. <br>Click yes to confirm you understand how to perform the Eyewash Inspection items.<br>
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ENTER EYEWASH LOCATION HERE
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ENTER EYEWASH LOCATION HERE
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ENTER EYEWASH LOCATION HERE
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ENTER EYEWASH LOCATION HERE
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ENTER EYEWASH LOCATION HERE