Lumiform
Mobile audits &
inspections

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Turn issues into corrective actions by collaborating with team members.
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Annual Fire Extinguisher Inspection Checklist

Use this template to conduct annual maintenance fire extinguisher inspection. Auditor will check equipment inspection tags and ensure that the equipment has undergone initial inspections.
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Audit
INSTRUCTIONS ------------------------ 1. Start by filling out the necessary information. 2. Assess the following by answering:”Good, Fair or Poor” on the questions below. 3. Add photos, notes and identified defects by clicking on the paperclip icon. 4. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date. 5. Complete audit by providing digital signature. 6. Share your report by exporting as PDF, Word, Excel or Web Link
Extinguishers present in the premise
Water Extinguishers
No. of Water Extinguishers
Take a photo
Maintenance
General Condition of the extinguishers mechanical parts
General Condition of the extinguishers agent
General Condition of the extinguishers expelling means
Foam Extinguishers
No. of Foam Extinguishers
Take a photo
Maintenance
General Condition of the extinguishers mechanical parts
General Condition of the extinguishers agent
General Condition of the extinguishers expelling means
Dry Powder Extinguishers
No. of Dry Powder Extinguishers
Take a photo
Maintenance
General Condition of the extinguishers mechanical parts
General Condition of the extinguishers agent
General Condition of the extinguishers expelling means
Carbon Dioxide Extinguishers
No. of Carbon Dioxide Extinguishers
Take a photo
Maintenance
General Condition of the extinguishers mechanical parts
General Condition of the extinguishers agent
General Condition of the extinguishers expelling means
Wet Chemical Extinguishers
No. of Wet Chemical Extinguishers
Take a photo
Maintenance
General Condition of the extinguishers mechanical parts
General Condition of the extinguishers agent
General Condition of the extinguishers expelling means
Summary and Completion
Total Number of Extinguishers inspected within the premises. (Interior and Exterior)
Total Number of Repaired Extinguishers
Total Number of Replaced Extinguishers
Overall comments of the 12 month inspections
I hereby confirm that the Annual Fire Extinguisher Inspection was performed by an approved extinguisher servicing company.
Name and Signature of Inspector
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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.