LifeSafetyWiki · Samektra
Fire extinguisher work-area checkoff
Portable Fire Extinguisher Use — employer practical training and certification record
The employee below completed the online portion of portable fire extinguisher education on LifeSafetyWiki. Cover Parts 1 and 2 in their work area, then sign Part 3. Employees designated to fight fires also need hands-on training.
Part 1 — Your site (filled in by the employer)
| Extinguishers in this area and their typesABC, CO2, clean agent, Class K, Class D | |
|---|---|
| Is this employee expected to use them, or evacuate?Per the emergency action plan (1910.157(b)) | |
| How to raise the alarmPull station, code phrase, phone number | |
| Exit routes from this area | |
| Kitchen hood system pull stationIf the area includes commercial cooking |
Part 2 — Hands-on check (by the supervisor or safety officer)
| The employee showed they can | OK | Not yet |
|---|---|---|
| Point out the nearest extinguisher and say what classes it is forNFPA 10 | ☐ | ☐ |
| Describe when to fight and when to leaveOSHA extinguisher eTool | ☐ | ☐ |
| Show PASS (hands-on with a training unit or live fire, if designated)1910.157(g)(4) | ☐ | ☐ |
| Do a monthly check on one extinguisher1910.157(e)(2) | ☐ | ☐ |
| Show the kitchen hood system pull station, if applicableNFPA 96 | ☐ | ☐ |
Part 3 — Certification
I certify that the employee named above was educated in the general principles of fire extinguisher use and the hazards of fighting incipient fires, as they apply to this workplace (29 CFR 1910.157(g)).
OSHA requires the education at hire and at least annually. Keep a record of who was trained and when. This form does not replace the employer’s own program, and LifeSafetyWiki does not certify competence. Not an OSHA Outreach (10/30-hour) card.