PennsylvaniaStateFireAcademy

SelfContainedBreathingApparatusInspectionChecklist
SCBAMakeandModel TodaysDate

CylinderDOTENumber CylinderSerialNumber

DOTE
Instructions:
1.ThischecklistshallbeusedforaOpenCircuitSelfContainedBreathingApparatus(SCBA)only
2.ThisinspectioncomplieswiththeintentofNFPA1852,Selection,Care,andMaintenanceofOpenCircuitSelf
ContainedBreathingApparatus,2013Edition,Chapter7,Maintenance
3.Unitsthataresoiledorcontaminatedshallbecleanedpriortoinspection
Definitions:
SoiledSoiliseasilytransferredfromonesurfacetoanother
ContaminatedPresenceofavisualorodorousforeignsubstance
4.PlaceanXintheappropriatebox(P)assor(F)ail

Facepiece
P F P F
Overallassembly:freefromdeterioration, Lens:freefromcracks,crazing,thermal,
dirtanddamage orotherdamage
Headnetandharnessanchors:present,
Exhalationvalve:functionalandundamaged
functionalandundamaged
Regulatorconnection:functionaland Speakingdiaphragm:functionaland
undamaged undamaged
RubberComponents:freefromdeformation, LensFrameRetainer:presentandcorrectly
wear,damage,andcracks installed

BackplateandHarnessAssembly
P F P F
HarnessandBackframeassemblies:freefrom CylinderRetentionSystem:functionaland
cuts,tearsanddamage undamaged
Fasteningassemblies:operateproperly Straps:extendfully

Cylinder
P F P F
Hydrostatictest:current Threads:serviceable
Gauge:functionalandundamaged Valvehandwheel:undamaged
Cylinder:cracks,dents,ordamage Burstdiscoutlet:clear
Compositecylinder:cuts,gouges,ordamage Cylinderpressure:full
Construction(Circle) LastHydroDate HydroRetestReq. HydroDueDate ServiceLife(yrs.) EndofLifeDate
SteelorAluminium 5years Indefinite
HoopwrappedAlum. 3years 15Years
Fiberglasswrapped 3years 15Years
Kevlarwrapped 3years 15Years
CarbonFiberwrapped 5years 15Years

Effective02/2016
Hoses
P F P F

Freeofcuts,abrasion,ordamage Connectionstight
Externalfittings:functionalandundamaged Couplingnippleseal;presentandundamaged

PressureRetentionTest
Procedure:Closeallvalves,opencylindervalvefullythenclose. P F
Noaudiblepressureloss,orvisuallossofgreaterthan100psiin10seconds

EndofServiceTimeIndicator(ESTI)
P F P F
Mountsecureanddebrisfree Fitting:functionalandundamaged
Properactivationpressure

RegulatorAssembly
P F P F
Control:functionalandundamaged Pressurereliefdevice:undamaged
Housing:undamaged
Nounusualnoiseswhileoperating Normalandbypassmodesfunctional

RemotePressureGauge/RemoteConsole
P F
Remotegaugeandcylinderpressurewithin
Undamaged
5%

PersonalAlertSafetySystem(PASS)
P F P F
Excessivewearordamage Batterycoverssecure
Functionsproperly Lowbatterywarningnotpresent

OtherComponents
P F P F
HeadsUpDisplay(HUD):functionaland
Voiceampserviceable
undamaged
RapidInterventionConnection/UniversalAirConnection(RIC/UAC)storableandserviceable

COMMENTS:

Inspectedby: Signature:

Effective02/2016