Fire Extinguisher Replacement/Recharge/Service Request - Safety & Risk Management

Please use this form when reporting a fire extinguisher needing replacement, recharge or service.

denotes required fields.

Personal Information

First Name

Last Name

Phone Number

Email Address

Department

Fire Extinguisher Location Information

Building

Room Number

Explanation of Incident

Was an incident report created?

Yes

I do not have this information

Was anyone harmed?

Yes

I do not have this information

Additional Information

Comments

Fire Extinguisher Replacement, Recharge, or Service Request