(Name): : : Line Manager / SIGNED Date Supervisor (Name): : :
Type of Fire Extinguisher (Water, Foam, Dry
Chemical or CO2): ( / X / COMMENTS MONTH: N/A) Instructions: Use a check () mark for YES = acceptable condition
Use an (X) mark for NO or REPLACE = unacceptable
condition 1. Access to or visibility of Fire Extinguisher not obstructed. Operating Instructions on the Fire Extinguisher name 2. plate shall be legible and facing forward. Has the Fire Extinguisher been tampered with? Any seals 3. of tamper indicators that are broken or missing shall be replaced. Visually examine externally, check that there is no visible 4. damage. Check for any evidence of corrosion, leakage or 5. mechanical damage. Check that fire extinguisher is fully charged and operable. 6. Check that nozzle and/or hose is unobstructed. At the Client’s site: have staff been made aware of the 7. location of the Fire Extinguishers? At the Client’s site: have staff been made aware of who 8. the fire fighters are in their area?