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Portable Fire Extinguisher Record

This document records maintenance of portable fire extinguishers at a nursing home facility. It lists the location, type, serial number, date of manufacture, and details of last maintenance, recharge, and hydrotest for each extinguisher. Maintenance includes annual service or 6-year maintenance depending on the extinguisher. One extinguisher was used to put out a dryer fire and was promptly recharged.

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Mohamad Hidayat Zainul Masri
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© © All Rights Reserved
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413 views

Portable Fire Extinguisher Record

This document records maintenance of portable fire extinguishers at a nursing home facility. It lists the location, type, serial number, date of manufacture, and details of last maintenance, recharge, and hydrotest for each extinguisher. Maintenance includes annual service or 6-year maintenance depending on the extinguisher. One extinguisher was used to put out a dryer fire and was promptly recharged.

Uploaded by

Mohamad Hidayat Zainul Masri
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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<<Facility Name>>

PORTABLE FIRE EXTINGUISHER RECORD


All testing and maintenance performed on the facilitys portable fire extinguishers must be documented in this record. Monthly visual
inspections are to be documented on a tag attached to each extinguisher.
Extinguisher
Number

Type

Serial/Model
No.

Date of
Mfr

Last Maintenance
Date

Performed By

Last Recharge
Date

Performed By

Pressure Level
Date

Bar

COMMENTS: _____________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________

ANY TOWN NURSING HOME

PORTABLE FIRE EXTINGUISHER RECORD


All testing and maintenance performed on the facilitys portable fire extinguishers must be documented in this record. Monthly visual
inspections are to be documented on a tag attached to each extinguisher.
Extinguisher
Location
Kitchen
Laundry
First Floor
South Wing
First Floor
North Wing

Type
K-Type
Wet Chem
ABC
Dry Chem
ABC
Dry Chem
ABC
Dry Chem

Last Maintenance

Last Recharge

Serial/
Model
No.

Date of
Mfr

Type

Date

Performed By

Date

xxx/yyy

1996

Annual

12/16/08

ABC Exting. Co.

12/16/08

ABC Exting. Co.

xxx/yyy

2007

Annual

12/16/08

ABC Exting. Co.

6/11/08

ABC Exting. Co.

xxx/yyy

2002

6-year

12/16/08

ABC Exting. Co.

12/16/08

ABC Exting. Co.

xxx/yyy

2002

6-year

12/16/08

ABC Exting. Co.

12/16/08

ABC Exting. Co.

Performed By

Last Hydrotest
Date
12/16/08

Performed By
ABC Exting. Co.

COMMENTS: Extinguisher in laundry used on dryer motor fire on 6/10/08 picked up by ABC Extinguisher Company and recharged on 6/11/08 ______________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________

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