Form Cheklist Inspection APAR

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No FORM-HSE/ARUNG/GEN/015 005
FORMULIR INSPEKSI ALAT PEMADAM API RINGAN Page 1 of 1

FIRE EXTINGUISHER INSPECTION FORM Doc. Class 3

PT. Revision 2
LOCATION :
DATE :

BERAT SERVICE INSPECTION RESULT


NO TAG NO. TYPE POSITION REMARKS
(Kg) EXPIRED TABUNG SELANG NOZZLE PRESSURE ISI TABUNG LABEL PIN

10

11

12

13

14

15

16

17

18

19

20
INSPECTED BY,
Notes :
ü : Oke
û : Bad Condition
HSE DEPARTEMENT

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