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SCBA Inspection Checklist Overview

This inspection report summarizes the inspection of self-contained breathing apparatuses (SCBAs) and fire extinguishers. Key points include: 1. The SCBAs were checked for identification number, location, accessibility, physical damage, pressure levels, regulator function, alarms, and air flow. Deficiencies were noted. 2. The fire extinguishers were checked for location, accessibility, legible instructions, tamper indicators, fullness, physical damage, pressure gauges, and inspection tags. 3. The report form requires notification of the alarm receiving office prior to testing and notes to fully explain any "no" answers. Corrective actions are needed for any deficiencies.

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Aviects Avie Jaro
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136 views5 pages

SCBA Inspection Checklist Overview

This inspection report summarizes the inspection of self-contained breathing apparatuses (SCBAs) and fire extinguishers. Key points include: 1. The SCBAs were checked for identification number, location, accessibility, physical damage, pressure levels, regulator function, alarms, and air flow. Deficiencies were noted. 2. The fire extinguishers were checked for location, accessibility, legible instructions, tamper indicators, fullness, physical damage, pressure gauges, and inspection tags. 3. The report form requires notification of the alarm receiving office prior to testing and notes to fully explain any "no" answers. Corrective actions are needed for any deficiencies.

Uploaded by

Aviects Avie Jaro
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
  • SCBA Inspection Form
  • Fire Extinguisher Inspection Form
  • Inspection Summary Report

Inspection Report

SCBA ( Self-contained Breathing apparatus )


Company Inspected Contract No.
Area/Location Inspection Frequency:
Inspector name: Page: of Date:
OK ( ) NO ( X ) N/A (N/A) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

SCBA ( Self-contained Breathing


apparatus ) Identification Number

1.1 Location in designated place.


1.2 Accessibility / visibility
1.3 Visual Inspection for any physical damage, missing parts.
1.4 Hydrostatic test date validity.
1.5 Visually inspect the cylinder and valve assembly for physical damage.
1.6 Cylinder pressure ("FULL")
1.7 Reducer hose coupling hand tightened to the cylinder valve outlet.
1.8 Regulator purge valve is closed ( full clockwise and pointer upward)
If equipped with Pak-Alert SE-Test alarm manually. Reset manual alarm
1.9
after test.
Fully depress the center of the air saver/donning switch on the top of the
regulator and release. Slowly open the cylinder valve.
2.0
VIBRALERT alarm shall actuate and
then stop.
2.1 The bell alarm shall ring at least once (if equipped).
Pak-Alert SE shall sound 3 quick chirps and the green light on the control
2.2
console shall begin flashing approximately once per second.

2.3 Check Pak-Alert SE pre-alarm function.

Check Pak-Alert SE pre-alarm reset function.


2.4 Make sure to move the respirator every 30 seconds or
less during the rest of operational inspection.

2.5 Perform breathing Test.

2.6 Remove facepiece from face. Air shall freely flow from the facepiece.
2.7 Fully depress the air saver/donning switch and check for leakage.
2.8 Test Purge valve operation ("ON & OFF")

3.0 Check manual reset of pre-alarm (Pak-alert).

3.1 Check Full Alarm (Pak-Alert).

3.2 Check alarm reset (Pak-Alert).


3.3 Check end-of-service (low pressure) alarms.

3.4 Vent residual air in the system. All end-of-service alarms shall stop.

Check continuing operation of the Pak-Alert SE: Do not move respirator until
3.5
pre-alarm occurs. Move respirator slightly to reset.

Turn Pak-Alert SE OFF : Depress reset button twice. The green flashing light
3.6 will go out and a two-tone beep will be heard from the sensor module. The
Pak-Alert SE is now in "OFF" condition.

Pak-Alert battery test: ("OFF" condition) Press and hold the reset button,
3.7
GREEN-OK, RED-Replace batteries.

Remarks (if any):

Corrective action should be taken immediately for any deficiency.


REDA Representative Client Representative
Initial Initial

rbm270404Rev.0
Inspection Report
Fire extinguishers
Company Inspected Contract No. Page: of
Area/Location Inspection Frequency: Date:
Inspector name:
OK ( ) NO ( X ) N/A ( ) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Fire Extinguisher
Identification Number

1.1 Location in designated place

1.2 No obstruction to access or visibility

Operating instructions on nameplate legible and


1.3
facing outward
Safety seals and tamper indicators not broken or
1.4
missing

1.5 Fullness determined by weighing or "hefting"

Examination for obvious physical damage,


1.6
corrosion, leakage, or clogged nozzle

Pressure gauge reading or indicator in the


1.7
operable range or position

Condition of tires, wheels, carriage, hose, and


1.8
nozzle checked (for wheeled units)

*HMIS label in place (*Hazardous material


1.9
identification system)
Mark the date on the inspection tag, provide a
2.0
new tag if necessary

Remarks (if any):

Corrective action should be taken immediately for any deficiency.


REDA Representative Client Representative
Initial Initial Date:
Report of Inspection, Testing & Maintenance

Company Inspected Contract No.


Area/Location
Inspector name: Date:
Page: of Testing Frequency
Mark "X" inside the box
Yes No N/A

Remarks (if any):

NOTIFY THE ALARM RECEIVING OFFICE FOR THE TEST TO BE PERFORMED


( All "NO" answers to be fully explained.)
REDA Client
Representative Representative Date:
Initial Initial

Inspection Report SCBA ( Self-contained Breathing apparatus ) Company Inspected Contract No. Area/Location Inspection Frequ
Inspection Report Fire extinguishers Company Inspected Contract No. Page: of Area/Location Inspection Frequency: Da
Date: REDA Representative Initial Client Representative Initial
Report of Inspection, Testing & Maintenance Company Inspected Contract No. Area/Location Inspector name: Date: Page: of Test
Date: REDA Representative Initial Client Representative Initial

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