King Faisal University

SAFETY MANAGEMENT

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Form follow-up fire extinguishers
)01(

Date of examination / Building No / Building Name /

noitacoL The case of extinguisher

Date of the first No
Expiration date Weight Type
examination No nearest Need repair and Empty extinguisher S
roooF Good
room type of
0
2
3
4
5
6
7
8

Maintenance contractor Building representative Safety Specialist

Name : : Name : : Name : :
Signature: : Signature: : Signature: :