FIRE EXTINGUISHER INTERNAL MAINTENANCE SURVEY Internal Maintenance Survey

TYPES OF EXTINGUISHERS 1. What type of extinguisher was inspected?   Stored Pressure ABC   Stored Pressure BC   Presurrized Water   Stored Pressure D Class   Wet Chemical/K Class   Loaded Stream   Water Mist   Foam   Clean Agent   Cartridge Operated   Carbon Dioxide 2. Was the extinguisher a wheeled type unit?   Yes   No EXTINGUISHER EXAMINATION 3. Was the pressure gauge operating?   Yes   No 4. Reason for internal examination:   Scheduled 6yr maintenance   First scheduled 6yr maintenance   Scheduled hydrostatic test   Recharge   Inspection or maintenance concern CONDITIONS OBSERVED (check all that applies) 5. Unit condemned prior to internal   External corrosion   External dent(s) 6. Conditions found during internal:   Internal corrosion or pitting   Agent contaminated   Wrong agent   Foreign material in extinguisher   Dry chemical caked   Siphon tube dislodged   Siphon tube damaged   Spring damaged   Valve stem or O-Ring damaged   Other   None of these conditions found 7. If foreign material found, please explain:   8. If other conditions found, please explain:   9. Please enter your company name and location: