Fire Extinguisher Discharge Cleanup Checklist Form
Document and manage the cleanup process after a fire extinguisher discharge. Complete all sections to ensure thorough reporting.
Date and Time of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Discharge
*
Name of Responsible Staff
*
First Name
Last Name
Type of Fire Extinguisher Used
*
Please Select
Water
Foam
Dry Chemical
CO2
Wet Chemical
Other
Area(s) Affected by Discharge
*
Cleanup Steps Completed
*
Remove debris
Vacuum or sweep residue
Wipe surfaces
Dispose of used materials
Ventilate area
Other
Cleanup Materials Used
*
Hazards or Issues Encountered During Cleanup
Upload Photo(s) of Cleaned Area
Upload a File
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Choose a file
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of
Additional Notes or Comments
Submit Checklist
Should be Empty: