SCBA Inspection Checklist PDF
SCBA Inspection Checklist PDF
Self‐Contained Breathing Apparatus Inspection Checklist
SCBA Make and Model Today’s Date
Cylinder DOT‐E Number Cylinder Serial Number
DOT‐E
Instructions:
1. This checklist shall be used for a Open Circuit Self‐Contained Breathing Apparatus (SCBA) only
2. This inspection complies with the intent of NFPA 1852, Selection, Care, and Maintenance of Open Circuit Self
Contained Breathing Apparatus, 2013 Edition, Chapter 7, Maintenance
3. Units that are soiled or contaminated shall be cleaned prior to inspection
Definitions:
“Soiled” ‐ Soil is easily transferred from one surface to another
“Contaminated” ‐ Presence of a visual or odorous foreign substance
4. Place an X in the appropriate box (P)ass or (F)ail
Facepiece
P F P F
Overall assembly: free from deterioration, Lens: free from cracks, crazing, thermal,
dirt and damage or other damage
Headnet and harness anchors: present,
Exhalation valve: functional and undamaged
functional and undamaged
Regulator connection: functional and Speaking diaphragm: functional and
undamaged undamaged
Rubber Components: free from deformation, Lens Frame Retainer: present and correctly
wear, damage, and cracks installed
Backplate and Harness Assembly
P F P F
Harness and Backframe assemblies: free from Cylinder Retention System: functional and
cuts, tears and damage undamaged
Fastening assemblies: operate properly Straps: extend fully
Cylinder
P F P F
Hydrostatic test: current Threads: serviceable
Gauge: functional and undamaged Valve hand wheel: undamaged
Cylinder: cracks, dents, or damage Burst disc outlet: clear
Composite cylinder: cuts, gouges, or damage Cylinder pressure: full
Construction (Circle) Last Hydro Date Hydro Retest Req. Hydro Due Date Service Life(yrs.) End of Life Date
Steel or Aluminium 5 years Indefinite
Hoop wrapped Alum. 3 years 15 Years
Fiberglass wrapped 3 years 15 Years
Kevlar wrapped 3 years 15 Years
Carbon Fiber wrapped 5 years 15 Years
Effective 02/2016
Hoses
P F P F
Free of cuts, abrasion, or damage Connections tight
External fittings: functional and undamaged Coupling nipple seal; present and undamaged
Pressure Retention Test
Procedure: Close all valves, open cylinder valve fully then close. P F
No audible pressure loss, or visual loss of greater than 100 psi in 10 seconds
End of Service Time Indicator(ESTI)
P F P F
Mount secure and debris free Fitting: functional and undamaged
Proper activation pressure
Regulator Assembly
P F P F
Control: functional and undamaged Pressure relief device: undamaged
Housing: undamaged
No unusual noises while operating Normal and bypass modes functional
Remote Pressure Gauge / Remote Console
P F
Remote gauge and cylinder pressure within
Undamaged
5%
Personal Alert Safety System(PASS)
P F P F
Excessive wear or damage Battery covers secure
Functions properly Low battery warning not present
Other Components
P F P F
Heads Up Display(HUD): functional and
Voice amp serviceable
undamaged
Rapid Intervention Connection/Universal Air Connection(RIC/UAC)storable and serviceable
COMMENTS:
Inspected by: Signature:
Effective 02/2016