Carbon Dioxide Fire Extinguisher Inspection Checklist Form
Complete this checklist to document the inspection and readiness of a CO2 fire extinguisher.
Inspector Name
*
First Name
Last Name
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Extinguisher Location or ID
*
Physical Condition (no damage, corrosion, or leakage)
*
Satisfactory
Unsatisfactory
Safety Seal and Tamper Indicator Intact
*
Yes
No
Hose and Nozzle Condition (clear, undamaged, unobstructed)
*
Satisfactory
Unsatisfactory
Labeling and Operating Instructions Legible
*
Yes
No
Extinguisher Accessible and Unobstructed
*
Yes
No
Comments or Corrective Actions Taken
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: