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Appendix A6,

MONTHLY FIRE EXTINGUISHER INSPECTION

Number of Fire Extinguisher


Discrepancies

Location of Fire Extinguisher

Type of Fire Extinguisher

Retaining Pin Intact

Safety Seal not Tampered

Condition of Nozzle

Condition of Hose

Condition of Shell

Condition of Pressure Gauge

Pressure Level

Extinguisher "Not Empty"

Accessibility

Inspected by (Name & Signature): Date Inspected:

Mark’ ‘for ; OK‘X’ for ;Not‘N.OKA’ for Not Applicable


Note:
1. Attached layout / location plan of fire extinguishers and update the Fire Extinguishers Register.

2. Any fire extinguisher that has one or more defect(s) (i.e. has failed one or more of the above conditions checks) shall be withdrawn from service and sent for
repair, servicing or recharge, and a new fire extinguisher shall be replaced at the respective fire extinguisher location.

N111 Health Safety & Environment Management System Appendixes (Rev A)

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