Scuba Cylinder Safety Checklist Form
Complete this checklist to document the safety inspection of a scuba cylinder before use.
Inspector Name
*
Cylinder Serial/ID Number
*
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Checklist: Cylinder Inspection Points (select all that pass)
*
No visible dents, cracks, or corrosion
Valve operates smoothly and is free of leaks
Hydrostatic test date within required interval
Visual inspection sticker present and up to date
O-ring and threads in good condition
Cylinder properly labeled with gas type
Comments or Observations
Is the cylinder approved for use?
*
Cylinder is approved and safe for use
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: