Document No

MONTHLY FIRE EXTINGUISHER

Revision No
CHECKLIST Issue Date
Page No 1 of 1

Location:

Checked by: (Print name and surname)

Month: Year:

Number of
1 2 3 4 5 6 7 8 9 10
extinguishers
Fire extinguisher No:
Any marking that can
be related back to
extinguisher.
Type
Sign (Y/N)
Accessible (Y/N)
Visible (Y/N)
Seals intact. (Y/N)
Clip intact. (Y/N)
Pressure ok (Y/N)
Condition ok (Y/N)
Hose/nozzle ok (Y/N)
Tampered with (Y/N)
Serviced by: XXXXXXXXXXX
Date serviced
Next service date

Remarks:……………………………… ………………
Signature of person checking: