Appendix G2: SCBA Respirator Periodic Inspection and Maintenance

Date:_________________________________

Location: ____________________________

Respirator ID #:_______________________

Cylinder #:___________________________

Cylinder Pressure PSIG:______________

Note:

SCBA respirators must be inspected for defects after each use, and at least once monthly if it is not used. The equipment must be repaired as necessary, cleaned and disinfected, and then stored properly to assure that it is maintained in satisfactory working condition. A record must be kept of inspection dates and findings.

If any defects are found, DO NOT use the equipment until it has been repaired by an authorized technician. In many cases, repairs by a factory authorized service center may be necessary. The manufacturer of the equipment must be contacted to obtain specific inspection and maintenance instructions. The manufacturer's instructions must be incorporated into this checklist or must be used to modify it.

General Yes On Order Serviced
1) Is main or reserve air tank filled? _______ _________ ____________
2) Is unit clean? ______ _________ ____________
3) Are all straps on the face piece and backpack fully extended, hooked up and in good condition? _______ _________ ____________
4) Case and Cover ; Free of dents or heat damage? _______ _________ ____________
5) Have air tanks been hydrostatically tested recently? - Check the manufacturer's recommendation for frequency; standard steel cylinders must be tested and internally inspected every 3 years. _______ _________ ____________

Facepiece Yes On Order Serviced
6) Face piece Lens
  1. Is it without nicks, scratches, or abrasions which would impair outward visibility, or, deep gouges/ cracks which would reduce impact resistance?
_______ _________ ____________
7) Head strap Buckles
  1. Have crushed, bent, or corroded buckles been replaced?
_______ _________ ____________
  1. Have damaged, loosened rivets or other fasteners been repaired?
_______ _________ ____________
8) Mask Rims
  1. Are rim screws securely tightened?
_______ _________ ____________
  1. Have deformed broken rim pieces been replaced?
_______ _________ ____________
9) Inlet Nozzle
  1. If there is sticking evident while exhaling through the exhalation valve, has it been corrected?
_______ _________ ____________
  1. Check the following inlet devices:
Screws securing the nozzle _______ _________ ____________
Clamps securing the low pressure hose to the nozzle. _______ _________ ____________
Exhalation valve seat _______ _________ ____________
Damage to the nozzle body such as warping, or cracking. _______ _________ ____________
Nozzle spring. _______ _________ ____________
10) Face piece Skirt
  1. Have sealing lips been checked for cuts, gouges, punctures, tears and nicks?
_______ _________ ____________
  1. Have materials that are hardening or deteriorating been checked?
_______ _________ ____________
11) Convoluted Low Pressure Hose
  1. Have cuts, nicks or punctures in the hose been repaired?
_______ _________ ____________
  1. Has rubber been checked for age or heat-induced cracking, crazing, or hardening?
_______ _________ ____________
  1. Are crushed, broken or cracked parts of quick connect repaired?
_______ _________ ____________
12) Head strap Spider
  1. Is abrasion or nicking of head strap legs repaired?
_______ _________ ____________
  1. Is there age or heat induced hardening of the rubber?
_______ _________ ____________

Second Stage Regulator Yes On Order Serviced
13) Valves _______ _________ ____________
  1. Are both main and bypass valves operational?
_______ _________ ____________
  1. Does the one way quick connect valve assembly operate smoothly, if present?
_______ _________ ____________
  1. Is the main valve open, and the bypass valve closed?
_______ _________ ____________
  1. Is the selector lever, if present, in the "demand on " position?
_______ _________ ____________
14) Pressure gauge
  1. Is it operational? The lens is clear, pointer to zero, and there is no needle deformation.
_______ _________ ____________
15) Hose and fittings; No damaged threads or worn out slots on quick connect adapter? _______ _________ ____________
16) Are the "O" rings in low pressure air outlet and other gaskets flexible? _______ _________ ____________

Audible Alarm, First Stage Regulator, and Intermediate Pressure hose Yes On Order Serviced
17) The bell alarm works. Has debris or water under the bell or dents or deformation of bell been corrected? _______ _________ ____________
18) The hose and end connectors are in good condition. Has abrasion or damage to hose been repaired? _______ _________ ____________
19) Are retaining rings securely fastened to end connectors? _______ _________ ____________
20) The threads and fittings are in good condition. _______ _________ ____________
21) The "O" rings or other gaskets are flexible.> _______ _________ ____________

Backpack and Air Cylinder Yes On Order Serviced
22) Backpack
  1. Cylinder holder properly functions.
_______ _________ ____________
  1. Cylinder is secure in frame and band.
_______ _________ ____________
  1. Buckles, shoulder straps and waist belt stitching of webbing is in good condition.
_______ _________ ____________
23) Air Cylinder
  1. External inspection shows no dents, gouges, blisters, or discolored paint.
_______ _________ ____________
  1. There is no external damage to cylinder valve.
_______ _________ ____________
  1. Hand wheel and ratchet mechanism operates smoothly.
_______ _________ ____________

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