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    SCBA Monthly Inspection Checklist - SafetyCulture

    Uploaded by

    Parag Chandankhede
    This document is an SCBA monthly inspection checklist. It contains sections to inspect the cylinder, backpack and harness, hoses, and perform functional checks of straps, buckles, masks, regulators, emergency valves, alarms, and PASS devices. Inspectors indicate if each part is in acceptable condition. Any deficiencies are noted along with the associated SCBA number. Repairs are documented with the fire chief's sign-off.

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    SCBA Monthly Inspection Checklist - SafetyCulture

    Uploaded by

    Parag Chandankhede
    522 views3 pages
    This document is an SCBA monthly inspection checklist. It contains sections to inspect the cylinder, backpack and harness, hoses, and perform functional checks of straps, buckles, masks, regulators, emergency valves, alarms, and PASS devices. Inspectors indicate if each part is in acceptable condition. Any deficiencies are noted along with the associated SCBA number. Repairs are documented with the fire chief's sign-off.

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    This document is an SCBA monthly inspection checklist. It contains sections to inspect the cylinder, backpack and harness, hoses, and perform functional checks of straps, buckles, masks, regulators, emergency valves, alarms, and PASS devices. Inspectors indicate if each part is in acceptable condition. Any deficiencies are noted along with the associated SCBA number. Repairs are documented with the fire chief's sign-off.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    522 views3 pages

    SCBA Monthly Inspection Checklist - SafetyCulture

    Uploaded by

    Parag Chandankhede
    This document is an SCBA monthly inspection checklist. It contains sections to inspect the cylinder, backpack and harness, hoses, and perform functional checks of straps, buckles, masks, regulators, emergency valves, alarms, and PASS devices. Inspectors indicate if each part is in acceptable condition. Any deficiencies are noted along with the associated SCBA number. Repairs are documented with the fire chief's sign-off.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 3

    6/10/2020 SCBA Monthly Inspection Checklist - SafetyCulture

    GO DIGITAL TODAY
    Convert your paper
    checklists into digital forms
    Scan this QR code to use this
    paper checklist on your
    smartphone or tablet. Visit
    www.iauditor.com

    Audit

    Cylinder Inspection

    Check the cylinder for damage. Is the cylinder in acceptable shape?

    Yes No

    Is current Hydro Test date valid?

    Yes No

    Does cylinder valve function properly?

    Yes No

    Inspection of backpack and harness.

    Inspect all straps for damage. Are they in acceptable condition?

    Yes No

    Inspect the back pack for any damage or missing parts. Is the pack in acceptable
    condition?

    Yes No

    Inspect all hoses for damage/wear. Are the hoses in good shape?

    Yes No

    https://public-library.safetyculture.io/products/scba-monthly-inspection 1/3
    6/10/2020 SCBA Monthly Inspection Checklist - SafetyCulture

    Functional checks.

    Functionally check all of the straps and buckles. Are these moving freely?

    Yes No

    Functional check of the face mask. Are all the straps working and is the mask in
    good condition? Is the nose cup seated properly?

    Yes No

    Functional check of the regulator with the face mask? Doe they
    connect/disconnect easily? Is the regulator cover in good condition?

    Yes No

    Functional check of the Emergency Bypass valve. Is this working correctly and
    freely?

    Yes No

    Functional check of the Low Pressure Alarm. Is this working correctly?

    Yes No

    Activate the PASS device. Is this working correctly? Let the PASS device activate
    on its own to ensure that it is functioning correctly with the escalated alarms.

    Yes No

    De ciencies. Note any other de ciencies below along with the SCBA number associated with it.

    Any additional de ciencies or notes?

    Yes No

    Sign below.

    https://public-library.safetyculture.io/products/scba-monthly-inspection 2/3
    6/10/2020 SCBA Monthly Inspection Checklist - SafetyCulture

    Inspection completed by: 

    De ciency Repairs:
    This portion is to be lled out by the Fire Chief or their designate.

    Have all the de ciencies been repaired for all items noted above?

    Yes No

    Completed on? 

    Additional notes or follow up items list below.

    Enter text

    Completed by: 

    Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things,
    workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to
    determine if the use of such checklist is permissible in your workplace or jurisdiction.

    https://public-library.safetyculture.io/products/scba-monthly-inspection 3/3

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