Scba Check Sheet

UPDATED: 4 October 2010

SCBA CHECK SHEET

FOR USS ______

DATE:______

REF: (a) PMS 5519/016

(b) TECH MANUAL S6220-EN-MM0-010 Rev 3

(d) NSTM 555 REV. 12

(e) AEL

ENCL: (1) SCBA INSPECTION RECORD SHEET

(2) SPARE CYLINDER INSPECTION RECORD SHEET

SCBA UNIT INSPECTION /
CHECK/INSPECT COMPONET/SUB-COMPONENT / IAW /
A. INSPECT SCBA AIR CYLINDERS:
1. Is the cylinder pressure indicator scratched, cracked, melted/distorted lens or damaged needle. / R-2
2. Does the air cylinder valve show signs of damage, loose rubber guard, or faulty hand wheel operation? / R-2
3. Does the cylinder show signs of exposure to high temperature such as darkened or blistered paint, charred over wrap, or decals? / R-2
4. Does the cylinder show any dents, gouges or cuts, which have penetrated the gel coat and exposed broken or loose fibers and caused separation or unraveling of the fiberglass over wrap? / R-2
5. Is the cylinder pressure 4000 psig (minimum) or greater? / W-1
6. Has the cylinder been hydrostatically tested within periodicity? 3 years for fiberglass? 5 years for Carbon Fiber? / S-1
7. Is the cylinder within the 15 year service life from date of manufacture? Note: If the ship is within 4 months of deployment the cylinders must be removed from service. / S-1
B. SCBA VOICE AMPLIFIER BATTERY:
1. Does the red or green power indicator light work properly?
2. Is the amplified voice output low or distorted? / M-1R
3. Does each SCBA have a voice amplifier attached to the facepiece? Note: Each SCBA stowed without voice amplifier attached to the facepiece assembly shall be considered to be in a degraded condition. / M-1R, Ref (b)
C. SCBA BACKPACK:
1. Is the backpack remote pressure indicator lens and needle damaged? (Gauge face and needle clear) / M-1R
2. Is the wire backpack frame, cylinder hangar plate and hook free of corrosion, cracks, bends or damage? / M-1R
3. Are all backpack air hoses and connectors free from cuts, cracks, abrasions or other damage? / M-1R
4. Is the bell alarm in place located on the side shoulder strap and free of damage? (Note: SCBA’s fabricated to the NFPA 1981, 1992 standard were not equipped with audible bells.) / Ref (b)
5. Is the quick disconnect (QD) fitting or RIC UAC fitting dust cap free from cuts, cracks, abrasions, damage and is the dust cover connected to the pack and installed on the fitting? / M-1R
6. Is the air cylinder coupling nut hand tight and 0-ring free from damage? / M-1R
7. Is the backpack harness straps free from cuts, tears, abrasions or signs of heat or chemical damage? Are all strap fasteners tight? / M-1R
8. Are all harness strap buckles free from damage, corrosion and do they operate properly? / M-1R
9. Is the second stage regulator free from cracks or heat damage? / M-1R
10. Is the second stage regulator face piece connector gasket free from tears, cracks, cuts or other deterioration? / M-1R
11. Is the purge valve and air saver switch free from cracks, deformities, or binding? / M-1R
12. Is the air cylinder band free of damage and holds the cylinder securely to the backpack? / M-1R
13. Has the SCBA been functionally tested within the past 36 months? / 36M-1
14. Are the correct allowance of packs onboard? / Ref (e)
D. SCBA FACE PIECE:
1. Does the face piece lens impair normal vision with scratches and creates loss of tightness with the face piece rubber? Is the lens free or cracks, damage or broken tabs (if installed)? / M-1R
2. Is the correct replacement lens installed in the AV2000 face piece, if applicable? / M-1R
3. Is the head harness free from tears, cracks, and rubber deterioration? / M-1R
4. Is the second stage regulator inlet coupling free from damage? / M-1R
5. Are the inhalation valves and exhalation valve disk (if applicable) installed correctly, clean and free of debris? / M-1R
6. Are there 3 sizes available for use onboard? Note: small (green), large (black), x-large (Red) for AV2000; small (S), medium (M) and large (L) for AV3000. / Ref (e)
F. TEST SCBA IAW PMS
1. AIR TEST
a. If installed, did all of the HUD LED’s illuminate after opening the cylinder valve? / M-1R
b. After approximately 20 seconds, does the HUD LED indicate two green LED’s for a full cylinder, if installed? / M-1R
c. Is the cylinder pressure gage and remote pressure indicator within 500 psig? / M-1R
d. With the face piece donned, does the face piece seal properly to the face without leaking air? / M-1R
e. With the face piece donned and second-stage regulator installed, does the regulator operate properly? / M-1R
f. Does the purge valve operate properly? / M-1R
g. Does the air saver switch operate properly and free of damage? / M-1R
h. Is the pack and cylinder free of air leaks?
i. Leak Test: With cylinder secured, does the remote pressure indicator hold pressure? (Indicated pressure drops less than 500psig in one minute.) Note: Perform the test a total of three times, if required, until the pressure drop is less than 500 psig.) / M-1R
2. ALARM TEST:
a. If installed, does the HUD LED indicate one green LED when the pressure is bled off between 3200 and 3700 psig? / M-1R
b. If installed, does the HUD LED indicate one slowly flashing yellow LED when the pressure is bled off between 2000 and 2500 psig? / M-1R
c. If installed, does the HUD LED indicate one rapidly flashing red LED when the pressure is bled off between 800 and 1300 psig? / M-1R
d. Does the vibralert and bell alarm (if installed) activate when pressure is bled off between 800 and 1300psi? / M-1R
G. INSPECT SPARE SCBA AIR CYLINDERS:
1. Is the cylinder pressure indicator scratched, cracked, melted/distorted lens or damaged needle. / R-2
2. Does the air cylinder valve show signs of damage, loose rubber guard, or faulty hand wheel operation? / R-2
3. Does the cylinder show signs of exposure to high temperature such as darkened or blistered paint, charred over wrap, or decals? / R-2
4. Does the cylinder show any dents, gouges or cuts, which have penetrated the gel coat and exposed broken or loose fibers and caused separation or unraveling of the fiberglass over wrap? / R-2
5. Is the cylinder pressure 4000 psig (minimum) or greater? / W-1
6. Has the cylinder been hydrostatically tested within periodicity? 3 years for fiberglass? 5 years for Carbon Fiber? / S-1
7. Is the cylinder within the 15 year service life from date of manufacture? Note: If the ship is within 4 months of deployment the cylinders must be removed from service. / S-1
8. Are the required number of 30 minute and 45 minute spare cylinders onboard? / Ref (e)
REMARKS:

Assessor(s): ______Date: ______