Form OCC-33 "Firefighter Scba After Use/Daily Inspection Checklist" - New Jersey

What Is Form OCC-33?

This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2013;
  • The latest edition provided by the New Jersey Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form OCC-33 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Health.

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Download Form OCC-33 "Firefighter Scba After Use/Daily Inspection Checklist" - New Jersey

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New Jersey Department of Health
PEOSH Unit
FIREFIGHTER SCBA AFTER USE/
DAILY INSPECTION CHECKLIST
Type of Check
Weekly
Monthly
After Use
Checked by
Date
Regulator No.
R-1
R-2
R-3
R-4
R-5
R-6
R-7
R-8
R-9
Bottle No.
B-
B-
B-
B-
B-
B-
B-
B-
B-
Mask No.
M-
M-
M-
M-
M-
M-
M-
M-
M-
Harness Check
Conditions of Straps,
Buckles, Backplate
O-Ring in Place
High Pressure Hose
Low Pressure Hose
Operational Check
Bottle Condition
Cylinder Pressure
(PSI)
Harness Gauge
Pressure
Pressure Function
Bypass Function
Pack Alarm
PASS Device
Mask Check
Regulator
Exhalation Valve
General Condition
Cleanliness
See additional comments on Page 2 of Checklist.
OCC-33
JAN 13
Page 1 of 2 pages.
New Jersey Department of Health
PEOSH Unit
FIREFIGHTER SCBA AFTER USE/
DAILY INSPECTION CHECKLIST
Type of Check
Weekly
Monthly
After Use
Checked by
Date
Regulator No.
R-1
R-2
R-3
R-4
R-5
R-6
R-7
R-8
R-9
Bottle No.
B-
B-
B-
B-
B-
B-
B-
B-
B-
Mask No.
M-
M-
M-
M-
M-
M-
M-
M-
M-
Harness Check
Conditions of Straps,
Buckles, Backplate
O-Ring in Place
High Pressure Hose
Low Pressure Hose
Operational Check
Bottle Condition
Cylinder Pressure
(PSI)
Harness Gauge
Pressure
Pressure Function
Bypass Function
Pack Alarm
PASS Device
Mask Check
Regulator
Exhalation Valve
General Condition
Cleanliness
See additional comments on Page 2 of Checklist.
OCC-33
JAN 13
Page 1 of 2 pages.
FIREFIGHTER SCBA AFTER USE/
DAILY INSPECTION CHECKLIST
(Continued)
1.
__________________________________________________________________
2.
__________________________________________________________________
3.
__________________________________________________________________
4.
__________________________________________________________________
5.
__________________________________________________________________
6.
__________________________________________________________________
7.
__________________________________________________________________
8.
__________________________________________________________________
9.
__________________________________________________________________
10. __________________________________________________________________
SPARE MASKS
Number
Condition
M -
M -
M -
M -
M -
SPARE CYLINDERS
Number
Condition
OCC-33
JAN 13
Page 2 of 2 pages.
Page of 2