FIRE EXTINGUISHER INSPECTION REPORT

Format No. UGEI 01-2020-0001

INSPECTION UNIT INSPECTION INSPECTION REPORT INSPECTED BY SIGN.

DATE FREQUENCY MONTH NO.
1/07/2020 1 MONTHLY JANUARY 0001 MARVIN MONTAGNE ATIENZA

FIRE. LOCATION SIZE TYPE LAST LAST PRESSUR HOSE VISUAL COMMENT /
EX. / AREA OF REFIL SERV E TEST INSPECTIO INSPECTIO SUGGESTIO
NO. FIRE. L . N N N
EX. DATE DATE
FS19C9S9R SALES DEPT 9.08/20LB CLAS AUG JUN PASSED PASSED 100% 13.71/195
S SA 2019 2020 GREEN
FS19D605R OPERATION 9.08/20LB CLAS AUG JUN FAILED PASSED 100% 0 / CHARGE
S DEPT S SA 2019 2020 RED
USED
FS19D084R ENTRANCE 9.08/20LB CLAS AUG JUN PASSED PASSED 100% 13.71/195
S SA 2019 2020 GREEN
FS19D087R WAREHOUS 9.08/20LB CLAS NOV JUN PASSED PASSED 100% 13.71/195
E S SA 2019 2020 GREEN
FS19O698R WAREHOUS 9.08/20LB CLAS AUG JUNE FAILED PASSED 40% O / CHARGE
E S SA 2019 2020 RED
LEAK
FS19D403R WAREHOUS 4.05/10LB CLAS AUG JUNE PASSED PASSED 100% 13.71/195
E S SA 2019 2020 GREEN
FST113O81 WAREHOUS 4.05/10LB CLAS FEB FEB FAILED FAILED 0% EXPIRED
N E S SA 2017 2018
FS19D443R WAREHOUS 4.05/10LB CLAS JUNE JUNE FAILED PASSED 85% 0 / CHARGE
E S SA 2019 2020 LEAK
FS19C762R WAREHOUS 2.27/5LBS CLAS JUNE JUNE PASSED PASEED 95% 13.71/195
E SA 2019 2020 GREEN
FS19C784R WAREHOUS 2.27/5LBS CLAS JUNE JUNE FAILED PASSED 90% O / CHARGE
E SA 2019 2020 LEAK

Comments |Suggestion| Remark by Safety Officer.

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SAFETY OFFICE
SIGNATURE