BOOK: Blue Book II SECTION: Respiratory Protection Program – Appendix BPg 1 of 3

OKLAHOMA CITY FIRE DEPARTMENT

RESPIRATORY PROTECTION

WRITTEN PROGRAM

(In accordance with 29 CFR 1910.134 and 1910.139)

TABLE OF CONTENTS

APPENDIX B

MONTHLY SCBA INSPECTION AND DAILY & USAGE CHECK SHEET INFORMATION

DAILY & USAGE SCBA CHECK

MONTHLY SCBA INSPECTION

SERIAL NUMBERS & DATES

BREATHING AIR & OXYGEN FORM

APPENDIX B

MONTHLY SCBA INSPECTION AND DAILY & USAGE CHECK SHEET INFORMATION

  1. All SCBA's should be checked every morning and after each use and record the findings on the Daily Inspection Form. The Monthly Inspection Form on the back of the daily inspection form should be completed on the first of the month and turned in to the Air Shop by the fifth of the following month.
  2. Individuals (officers, drivers, and firefighters) will conduct a daily check on their assigned SCBA. Drivers will check their own plus any extra SCBA's. Extra breathing air bottles on the apparatus should be checked for the next hydrostatic test date and pressure, (no form is needed). Personnel not assigned to operations should check their SCBA every Friday and complete the Monthly Inspection on the back on the first of the month and turn in to the Air Shop by the fifth.
  3. On the first of the month, check for and record the next hydrostatic test date of the bottle in the backpack on the monthly inspection form. This will be three years from the date stamped on the side of the bottle covered with a clear protective film. If the bottle is new and has not been tested, the next hydrostatic test date will be three years from the date of manufacture. If the test date is not legible, the bottle needs testing.

Bottles that are within three months of their next test date should be traded out with Air-One at fire scenes, or exchanged at the Air Shop during routine visits for apparatus maintenance.

  1. As the bottles are tested, the Air Shop personnel will date the bottles with a colored tape around the neck of the bottle. This will aid everyone in recognizing and removing from service those bottles that need testing. As bottles are tested, the date put around the neck will be the actual date you need to send the bottle in for testing.
DAILY & USAGE SCBA CHECK
Date / Cylinder / Cylinder PSI / Face
Piece / Cleaned & Sanitized / Inspected by
Example: 7/7/2007
MONTHLY SCBA INSPECTION
Station # / Unit # / Checked by: / Date:
Dist. # / Reducer # / Regulator #
OK / Repair / AIR CYLINDER
Check for physical damage or composite warping
Check the latest cylinder hydrostatic test date (If the next test date is within 3 months, trade it out according to the Respiratory Written Protection Plan)
Check cylinder valve head wheel and threads for damage
Check the relief valve for damage or dirt
Check the cylinder pressure gauge for “Full” indication
HEADS-UP DISPLAY/PAK ALERT
Check operation of heads up display/broken wires
Check operation of pass device/pak alert
Check batteries to ensure charged
REGULATOR
Check operation of the Air Saver Switch
Check operation of the purge valve
FRAME
Check for leak on high pressure hose & reducer
Check gauge and gauge line for leaks
Check frame for cracks
Check cylinder latch assembly
NOTES:
During daily inspection of your personal face piece, you will need to check the following:
Lens for cracks and scratches / Rubber seal around mask for deterioration
Inhalation valves / Pull straps and mesh for deterioration
Nose Cup Assembly

SERIAL NUMBERS & DATES

The date of manufacture is on the top. The bottom label was put on at testing. The retest date is 3 years from that date (April 2000). / / Last Date
Tested April 1997

Date of Next Test
As bottles are being re-tested the Air shop will tape the actual date the bottle needs testing on the neck of the bottle. This will be easier to read and understand.
The Scott Air Packs have a Reducer number as well as a Regulator number. Shown below are the locations on the current SCBA’s in use by the Oklahoma City Fire Department.
/ REGULATOR
Serial Number
REDUCER
Serial Number /

BREATHING AIR & OXYGEN FORM

QNTY. / PART NO. / NAME OF PART / PRICE / BREATHING AIR & OXYGEN
OKLAHOMA CITY FIRE DEPARTMENT
MAINTENANCE FACILITY-AIR SHOP
600 N. PORTLAND
PHONE NO. 297-1300
UNIT NUMBER ______ / DATE______20_____
AIR PACK NUMBER______ / ISI SERIAL # ______
MAKE ______ / MODEL______
REDUCER NUMBER______ / REGULATOR NUMBER______
REPAIR ORDER-LABOR INSTRUCTIONS / DATE / MECH / HOURS
TOTAL PARTS COST
SUBLET REPAIRS
TOTAL HOURS
TOTAL LABOR
TOTAL PARTS
TOTAL SUBLET COST / TOTAL AMOUNT
WORK REQUESTED BY: / ______ / ON DUTY OFFICER: / ______ / SHOP FOREMAN: / ______
Name (Print) / Name (Print)
AIR SHOP COPY

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