Scba monthly inspection checklist
Monthly inspection for self contained breathing apparatus
What does this form include?
This form contains 9 sections:
Cylinder Inspection
- Check the cylinder for damage. Is the cylinder in acceptable shape?
- Is current Hydro Test date valid?
- Does cylinder valve function properly?
Inspection of backpack and harness.
- Inspect all straps for damage. Are they in acceptable condition?
- Inspect the back pack for any damage or missing parts. Is the pack in acceptable condition?
- Inspect all hoses for damage/wear. Are the hoses in good shape?
Functional checks.
- Functionally check all of the straps and buckles. Are these moving freely?
- Functional check of the face mask. Are all the straps working and is the mask in good condition? Is the nose cup seated properly?
- Functional check of the regulator with the face mask? Doe they connect/disconnect easily? Is the regulator cover in good condition?
- Functional check of the Emergency Bypass valve. Is this working correctly and freely?
- Functional check of the Low Pressure Alarm. Is this working correctly?
- 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.
Deficiencies. Note any other deficiencies below along with the SCBA number associated with it.
- Any additional deficiencies or notes?
Inspection completed by:
Deficiency Repairs:This portion is to be filled out by the Fire Chief or their designate.
- Have all the deficiencies been repaired for all items noted above?
Completed on? Date
Additional notes or follow up items list below.
Completed by:
Use this template