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SCUBA CYLINDER VISUAL INSPECTION FORM

Cylinder Owner: Phone: Address: City: I GENERAL Receipt: With Accessories: Under pressure/any leaks? II CYLINDER INFO Markings: Serial Number: Gov't. Specification: Original Hydro: Visible conditions/reason for inspection? Inside contaminants/materials found/odor: III EXTERIOR Any bulges, or bows noted? Any dents, cuts, digs, gouges, scratches? Corrosion? Where/depth/length: IV THREADS Gall? Known leaks? Good threads needed? Kind? Last retest: Province: Postal Code: Date:

Service Pressure:

Where? Where/depth/length:

Good thread count, starting from top: O-Ring gland/face condition: Cracks?

Where/describe: Where? How many threads affected?

Valleys into threads? Thread loss due to valley? General appearance:

V INTERIOR Any cleaning required? Where? Where/depth/length: VI CYLINDER STATUS Accept/Condemn: Explain:

Kind? Corrosion?

Crown cracks/folds found? Kind?

Condemn how? Remarks:

Inspector's signature: Inspection Date:

Location:

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