PEMADAM API

FIRE EXTINGUISHER

DATE :
LOCATION :
WEIGHT / SERVICE INSPECTION RESULT / HASIL PEMERIKSAAN REMARK /
NO DESCRIPTION / ISI TABUNG TIPE / MERK BERAT POSITION / POSISI DATE / KETERANGAN
(kg) TANGGAL
SERVICE TABUNG SELANG NOZZLE CARTRIDGE PRESSURE ISI TBG LABEL PIN NO. TBG

Inspected by,

HSE
 FIRE EXTINGUISHER
INSPECTION

DATE :
LOCATION :
TIPE :
MERK :
SERIAL NUMBER :
Availability Condition
INSPECTION RESULT / HASIL
No. Yes No Good Fair Poor Remarks
PEMERIKSAAN
Ada Tidak Bagus Sedang Jelek
1 TABUNG
2 SELANG
3 NOZZLE
4 CARTRIDGE
5 PRESSURE
6 ISI TBG
7 LABEL
8 PIN
9 NO. TBG
10 WHEELD
11 WEIGHT / BERAT (kg)
12
13
NOTE :

Inspected by,
 FIRE EXTINGUISHER
INSPECTION

DATE :
LOCATION :
TIPE / MERK :

WEIGHT / INSPECTION RESULT / HASIL PEMERIKSAAN

NO DESCRIPTION / ISI TABUNG BERAT
(kg)
TABUNG SELANG NOZZLE CARTRIDGE PRESSURE ISI TBG LABEL PIN NO. TBG

Inspected by,