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PORTABLE FIRE EXTINGUISHERS Form 16-A 

Inspection, Maintenance, and Recharge

Date Inspector System

Location

Use (M) for monthly inspections.


Extinguisher Use (A) for annual maintenance check.
Location Use (R) for extinguisher recharge.
Building/ Extinguisher Serial I.D.
J F M A M J J A S O N D
Floor/Area Type Number Number Date Purchased Comments
Comments

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