INSPECTION & MAINTENANCE CHECK LIST
FOR SELF-CONTAINED BREATHING APPARATUS SERIAL NO.
LOCATION IDENTIFICATION
WEEKLY INSPECTION
DATE
CYLINDER
CYLINDER
DATE
CYLINDER
CYLINDER
DATE
CYLINDER
CYLINDER
DATE
CYLINDER
CYLINDER
INSPECTED
PRESSURE
CHANGED
INSPECTED
PRESSURE
CHANGED
INSPECTED
PRESSURE
CHANGED
INSPECTED
PRESSURE
CHANGED
MONTHLY INSPECTION
DATE
CYLINDER
CYLINDER
REGULATOR
FACEPIECE
CLEANED
ENTIRE
INSPECTED
PRESSURE
CHANGED
OK
& BREATHING
AND
APPARATUS
REMARKS
INSPECTED
TUBE OK
SANITIZED
OK
All inspections should be made in accordance with ANSI Standard Z88.2 & Z88.5
For recommended inspection procedures, see MSA Part No. 462949