Document Number

Fire Fighting Equipment PL-HSE-Fi-001

Control Date: 23 January 2022
Next: 23January 2023
Page 1

DEPARTMENT_________________________________________________ YEAR _____________________

ID LOCATION Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec LEGEND
NO

1. Equipment due for service (yearly).

2. Instruction label missing/damaged.

3. Not correctly located/positioned.

4. No/warn "no stacking" demarcation.

5. Wrong type for hazard.

6. Lead seal missing/broken.

7. Corroded or damaged.

8. Missing or damaged symbolic signs.

9. Equipment obstructed/inaccessible.

10. Hose damaged /nozzle missing.

11. Stored pressure - pressure low.

12. Other: Describe.

NOTE

Do not "tick". Write OK or use the number of The specific

deviation
Deviation given in the legend. If the equipment is defective

it must be tagged - Defective and must be reported to the person

Responsible for equipment repair. If the equipment is beyond

repair
Repair it must be Discarded and destroyed. New equipment

Must be installed immediately if old equipment is discarded.

 Document Number
Fire Fighting Equipment PL-HSE-Fi-001
Control Date: 23 January 2022
Next: 23January 2023
Page 1

DATE
INSPECTOR'S