Fire Safety Equipment Maintenance Report
Use this form to record inspection and maintenance details for fire safety equipment.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Equipment
*
Type of Equipment
*
Please Select
Fire Extinguisher
Fire Alarm
Fire Hose Reel
Sprinkler System
Emergency Exit Light
Other
Equipment Identification Number
*
Overall Condition of Equipment
*
Good
Requires Maintenance
Needs Replacement
Maintenance Actions Performed
*
Inspected
Cleaned
Recharged/Refilled
Repaired
Replaced
Other
Parts Replaced (if any)
Next Scheduled Maintenance Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector's Full Name
*
First Name
Last Name
Inspector's Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Comments or Observations
Inspector's Signature
*
Submit Report
Submit Report
Should be Empty: