氣體鋼瓶作業檢點表
氣體鋼瓶作業檢點記錄表
系所 樓( 實驗室) 檢查日期： 年 月 日
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1.鋼瓶已固定 |
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2.有名稱標示 |
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3.鋼瓶柱塞無洩漏 |
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4.調壓器正常無洩漏 |
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5.高壓橡皮管無損壞 |
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6.有管夾固定 |
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7.流量計無損壞、洩漏 |
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8.共同輸送管路無腐蝕、損壞、洩漏 |
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9.空瓶處理情況正常 |
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10.備用氣體貯放情況正常 |
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11.氣體鋼瓶未使用時，將鋼瓶板手（開瓶器）取下 |
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12.其他 |
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相關人員簽章 |
檢查人員 (每日或作業前) |
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場所負責人： 單位主管： 製表人：
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- 「職業安全衛生管理辦法」第69條第4項辦理。
- 檢查結果：正常打ˇ，異常打×，如無此項檢點項目請以”─”示之。
- 表格保存三年。
氣體鋼瓶作業檢點表.odt