1 of 10 Revision Date: 10/12/21 Specific Procedures for Use of Self-Contained Breathing Apparatus
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of 10 Revision Date: 10/12/21 SCBA INSPECTION LOG Year: __________ SCBA #: __________ Serial #: __________ Mask #: __________ COMPONENT JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC COMMENTS Air Cylinder No. & Hydrostatic Date Facepiece Lens & Rims Facepiece Head Straps Facepiece Skirt Facepiece Buckles Facepiece Inlet Nozzle HUD / Alarm Battery 1st Stage Reg. & Hose 2nd Stage Reg. & Hose Harness/Frame Location Date Initials NOTE : A check mark “ ” indicates that each component was inspected as per guidelines and that the component passed inspection. An “X” indicates the component failed inspection. ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ____________________________________________ Procedure for Use of SCBA Back to Table of Contents Page 9 of 10 Revision Date: 10/12/21 SCBA AIR CYLINDER TANK INSPECTION LOG Year: __________ Tank #: __________ Hydrostatic Test Date: COMPONENT JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC COMMENTS Air Cylinder & Valve Date Initials COMPONENT JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC COMMENTS Hydrostatic Test History Repair History Tanks must be hydrostatically tested every three (3) years. Tanks must be replaced after 15 years of service. ______________________________________________________________________________________________________________________ __________________________________________________________________________________ ____________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ |