Monthly fire extinguisher inspection

IF ANY ANSWER IS NO, PLEASE INFORM RESPONSIBLE SUPERVISOR IMMEDIATELY

Location of Fire Fire Fire Pressure Nozzle and Pin and No dents, Next
Extinguishing extinguisher extinguisher gauge on rubber tube tamper leaks, rust, Service
Equipment number accessible green area free from sealing chemical Date
and sealing cracks, tears intact deposits or
device intact or obstruction anything
unusual on
the fire
extinguisher
Yes No Yes No Yes No Yes No Yes No

Inspected Payro Signature Date:

by: ll No.

Supervisor Payro Signature Date:

signature ll No

Comments:

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