VIPR Fire Equipment Incident Inspection Checklist
April 1, 2015
SUPPORT WATER TENDER INCIDENT INSPECTION CHECKLIST Date: _____ Time: ____
INCIDENT NAME:
___________________ INCIDENT NUMBER: ____________________ RESOURCE #: E-
COMPANY/CONTRACTOR:_________________________________________________________________
AGREEMENT NUMBER: ___________________________________________________________________
EQUIPMENT MAKE: _______________________________ MODEL: _______________________________
VIN/SERIAL #: ____________________________________________________________________________
OPERATOR NAME: ______________________________________________________________________________________
EQUIPMENT and OPERATOR REQUIREMENTS SUPPORT WATER TENDER
Type 1: 4,000+ gallons
Type 2: 2,500 → 3,999 gallons
Type 3: 1,000 → 2,499 gallons
Minimum Requirements
Not all inclusive; for additional clarification refer to agreement (SF-1449 section D)
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is also a business rule that could affect payment.
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Yes
Agreement (One complete copy)
(D.8)
Check-In Process: Completed (Note: Also includes; Finance, and Plans)
(D.6.5.3)
Equipment VIN/Serial # matches Resource Order (may also have to verify on DPL): Note: This
(Schedule of Items) (D.6.3.1)
Incident Pre-Use Inspection Completed
(OF-296 Vehicle/Heavy Equipment Mechanical Inspection)
(D.17) (D.17.1)
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RT-130 Fire Line Refresher including Fire Shelter (current):
(D.3.1_1)
Equipment arrived at incident washed: (Debris and noxious weeds free)
(D.15)
Company Name and Equipment I.D. #: Permanently affixed to both sides of truck (D.2.2.3)
Programmable Radio: If handheld, needs two fully charged battery packs (clamshells) (D.2.3) (Exhibit M)
First aid kit: 5 person minimum
(D.2.1.2) (Exhibit M)
Flashlight/Portable Hand Light (working):
(D.2.1.2) (Exhibit M)
Fire extinguisher: Multi-purpose 2A 10BC securely mounted to the vehicle.
(D.2.1.2)
PPE: Boots
Hard Hat
Gloves
Eye Protection
Hearing Protection
Headlamp with batteries
(D.2.1.2)
Fire Shelter: New generation
(D.2.1.2)
Flame Resistant Clothing (Nomex): Two Full Sets
(D.2.1.2)
Tank baffling: One longitudinal baffle and one transverse baffle every 52” or free floating baffle system
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with data sheets that validates baffling is sufficient to meet manufactures recommendation
Tank: Securely attached to the chassis.
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Equipment Inventory
(Exhibit M)
Equipment inventory: Permanently marked with vendor/company identification. In
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addition, the vendor is to maintain a complete inventory list.
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Nozzle combination Fog/Strait Stream (1 ½ NH female): 1each
Reducer, 1 ½ inch NH female to 1 inch NPSH male: 1 each
Adapters 1 ½ inch NPSH female to 1 ½ inch NH male: 2 each
Adapters 1 ½ inch NH female to 1 ½ inch NPSH male: 2 each
Reducers 2 ½ inch NH female to 1 ½ inch NH male: 2 each
Double male 1 ½ inch NH: 1 each
(D.2.1.2)
(D.2.1.2)
(D.2.1.2)
No
VIPR Fire Equipment Incident Inspection Checklist
April 1, 2015
Double Female 1 ½ inch NH: 1 each
Gated “Y” 1 ½ NH: 1 each
Fire Hose Clamp 2 ½ inch: 1 each
Spanner Wrench, Combination 1 ½ inch to 2 ½ inch: 1 each
Adjustable Hydrant Wrench: 1 each
Shovel – Size 0 or 1: 1 each
Pulaski: 1 each
100 foot – 1 ½ inch Cotton/Synthetic Hose NH Thread
(D.7.1.3)
50 Foot – 2 ½ inch Cotton/Synthetic Hose NH Thread
(D.7.1.3)
Suction hose with strainer or screened foot valve: 20 foot minimum
(D.7.1.3)
Wheel Chocks: At least one pair, meeting specifications
Dump Valve: Minimum 4 inch. Extends past rear of vehicle
(D.2.1.2.2)
Pump: Discharge Pressure Gauge:
(D.2.1.2)
Auxiliary pump (if equipped): Fuel to operate for at least 12 Hours
2 ½ inch Discharge Outlet, national hose thread: 1 each
1 ½ inch Discharge Outlet, national hose thread: 2 each
Spray Bar head(s) operational:
(D.2.1.2.2.1) (Exhibit J) (Exhibit M)
Spray Bar Configuration: Front
Rear
Both
/ Gravity
or Pressure
(D.2.1.2)
41 Back-Up Alarm: Audible reverse warning device.
*Item may be waived if inspection successfully performed on the OF-296
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Equipment meets agreement specifications
Equipment does not meet agreement specifications
Inspector:
Date:
(Print and sign)
Contractor:
Date:
(Print and sign)
Contractor given the opportunity to correct noted deficiencies (See Remarks)
Contactor successfully corrected noted deficiencies
Inspector:
Date:
REMARKS:__________________________________________________________________________________
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