CAPELLA UBUD BALI
FIRE EXTINGHUISER CHECK LIST
DATE :
Condition
NO LOCATION BRAND EXPIRED DATE PRESSURE
Good(v) Poor(v)
1 BOH Lt 1 (Depan Receiving) GUNNEBO v v v
2 BOH Lt 1 (Genset) GUNNEBO v v v
3 BOH Lt 1 (Clinik) GUNNEBO v v v
4 BOH Lt 2(Acconting) GUNNEBO v v v
5 BOH LT 3(Depan Rest Area) GUNNEBO v v v
TYPE FIRE EXTINGUISHER
ABC-90 Powder/4,5kg
ABC-90 Powder/4,5kg
ABC-90 Powder/4,5kg
ABC-90 Powder/4,5kg
ABC-90 Powder/4,5kg
FIRE TROLLEY CHECKLIST
DATE : 7 APRIL 2019
FIRE FIGHTING TOOL EQUIPMENT CONDITION
NO Quantity REMARK
TOOL TYPE Good Poor
1 Self Contained breathing asparatus (SCBA RHZ 6,8/30) 1 Set √
2 Fire Shoes(P 9417/GR 50/Type II) 1 Pair √
3 Fire Suit 1 Pair √
4 Hand Glove 1 Pair √
5 Axe 1 Pcs √
6 Helmet 1 Pcs √
7 LED Flashlight MG 6671 1 Unit √
8 Megaphone TOA ZR-2015 S 1 Unit √
9 Fire Extinguiser MSP 500-5 kg 2 tube √
10 Fire Hose 2,5 " 30 meter √
11 Wooden trolley 1 Unit √
Acknowledged by Cheked by
SUSANTO IGN Gde Juliarta
Loss Prevention Manager Loss Prevention Supervisor
CAPELLA UBUD BALI
CAMERA CHECK LIST
DATE :
CONDITION
NO LOCATION DISPOSITION REMARKS
Good(v) Poor(v)
HYDRANT BOX CHECKLIST
DATE : 07 APRIL 2019
Rack Handle
NO DESCRIPTION LOCATION HOSE NOZZEL SIZE REMARK
Hose Valve
1 Behind of Engineering Office BOH Lt 1 √ √ √ 1,5" x30 m √
2 In Front of Loading dock BOH Lt 1 √ √ √ 1,5" x30 m √
3 In front of FB office BOH Lt 2 √ √ x 1,5" x30 m √
4 Corridor Rest Room area BOH Lt 3 √ √ x 1,5" x30 m √
5 Behind of Retreats #1 (Captain) Public Area √ √ √ 2,5" x30 m √
6 Behind of Retreats # 6 (The logde) Public Area √ √ √ 2,5" x30 m √
7 Above Butler 3 Public Area √ √ √ 2,5" x30 m √
8 Behind Retreats 24 (Arhitect) Public Area √ √ √ 2,5" x30 m √
9 Behind Retreats #28(Upacara) Public Area √ √ √ 2,5" x30 m √
10 In Front SPA (Holandia) Public Area √ √ √ 2,5" x30 m √
11 Behind Retreats #15 (Librarian) Public Area √ √ √ 2,5" x30 m √
12 Below The Station Public Area √ √ √ 2,5" x30 m √
13 In Front Kitchen Bunker FOH √ √ √ 1,5" x30 m √
Checked by
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