Fire Extinguisher Discharge Time Inspection Form
Complete this form to document the inspection and discharge-time test of a fire extinguisher.
Extinguisher Serial Number
*
Location of Extinguisher
*
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Physical Condition
*
Good
Damaged
Corroded
Other
Pressure Gauge Status
*
In Range
Below Range
Above Range
Hose and Nozzle Condition
*
Good
Obstructed
Damaged
Seal and Tamper Indicator Intact
*
Yes
No
Discharge-Time Test Result (seconds)
*
Additional Remarks
Submit Inspection
Should be Empty: