MONTHLY FIRE EXTINGUISHER INSPECTION RECORD

PROJECT: Construction Of 11 No’s Residential Building - Plot No’s on 8884631 To 8884635, 8884642 to 8884645
At MEYDAN 1st, DUBAI –UAE
FIRE EXTINGUSHER CHECKLIST
Plot no : ……………… DATE: …………………

Service tag sticker

Obstruction free
Identification no

Pressure Guage
Seal (broken?)

Expiry date
Accesibility
Hose/ Horn

Empty
Nozzle
Location

Type

Shell
Sl

i
Inspected By : Acknowledged By : Reviewed By :
Name Name Name
Position Position Position

Signature Signature Signature

PC-HSE-FM 05
 i
Sl

Name
Position

Signature
Inspected By :
Location

Identification no

Name
Type

Position

Signature
Seal (broken?)

Acknowledged By :
Service tag sticker

Nozzle

Hose/ Horn

Pressure Guage

Name
Shell

Position

Signature
Reviewed By :
Accesibility

Obstruction free

Empty

Expiry date

PC-HSE-FM 05