Form
Form - Breathing Air Quality Test Record
Document FSSMS-FRM-12Stage 1Revision 4Version 0.3.3
Topic pages open on your jurisdiction, and requirements tables show its line. You can change this on any page.
One record per sample per air source (compressor outlet, mobile fill unit, cascade bank, purchased air bank). Completed by the fill station operator when the sample is drawn and finished when the laboratory certificate returns; filed with the certificate attached in {{Records system}}; reported in the quarterly update. The purity parameters and the sampling triggers are those of the compressed breathing air standard (CSA Z180.1:19); the department samples quarterly, which also meets the emergency services breathing air standard (NFPA 1989, 2019) and the breathing air requirement of the health and safety standard (NFPA 1550, 2024, s. 9.12).
| Field | Entry |
|---|---|
| Record number | |
| Air source (compressor serial and location / mobile unit / cascade bank / purchased air lot) | |
| Reason for sample (commissioning / scheduled quarterly / after major overhaul / after extensive repair / after filter change / after alarm or event / purchased air verification) | |
| Date and time sample drawn | |
| Sample drawn by (operator name, training reference) | |
| Sampling method and container ID (laboratory kit reference) | |
| Compressor hours at sampling; last filter change date; CO monitor reading at sampling; CO monitor last calibration date | |
| Laboratory (name, accreditation reference) | |
| Date sent; date certificate received; certificate number | |
| Oxygen, percent by volume (limit 20 to 22) | Result: Pass / fail: |
| Carbon monoxide, ppm (limit 5 or less) | Result: Pass / fail: |
| Carbon dioxide, ppm (limit 500 or less) | Result: Pass / fail: |
| Oil and condensed hydrocarbons, mg/m3 (limit 1 or less) | Result: Pass / fail: |
| Particulates, mg/m3 (limit 1 or less) | Result: Pass / fail: |
| Non-methane volatile hydrocarbons (Table 1 limit) | Result: Pass / fail: |
| Halogenated hydrocarbons (Table 1 limit) | Result: Pass / fail: |
| Methane (Table 1 limit) | Result: Pass / fail: |
| Water vapour or dew point (limit for the lowest service temperature) | Result: Pass / fail: |
| Odour (none objectionable) | Result: Pass / fail: |
| Overall result (all parameters within limits: yes / no) | |
| If any parameter failed: filling stopped (date, time); cylinders quarantined (serials or fill log range); cause found; corrective action number; re-test record number; return to service (date, by) | |
| Notified (program administrator, HSO, JOHSC) with dates | |
| Next scheduled sample due | |
| Reviewed by program administrator (name, date) |
| Field | Type | Required | Who completes |
|---|---|---|---|
| Record number | Text, unique | Yes | Program administrator or system |
| Air source | Choice plus identifiers | Yes | Operator |
| Reason for sample | Single choice | Yes | Operator |
| Date and time drawn | Date, time | Yes | Operator |
| Drawn by | Text | Yes | Operator |
| Sampling method and container ID | Text | Yes | Operator |
| Compressor hours; filter change date; CO reading; CO calibration date | Number; date; number; date | Yes for compressor sources | Operator |
| Laboratory and accreditation | Text | Yes | Operator |
| Dates sent and received; certificate number | Dates; text | Yes | Operator; program administrator on receipt |
| Each purity parameter result and pass / fail | Number; choice | Yes | Program administrator from the certificate |
| Overall result | Yes / no | Yes | Program administrator |
| Failure actions | Text, dates, references | Yes if any parameter failed | Operator and program administrator; HSO confirms corrective action |
| Notifications | Text with dates | Yes if any parameter failed | Program administrator |
| Next sample due | Date | Yes | Program administrator |
| Reviewed by | Name, date | Yes | Program administrator |
Retention. Life of the air source plus five years, with the certificate (05 Document Control and Records). Audit use. The auditor checks the last four records per source for interval, completeness, every parameter within limits, and the failure actions where any result was out of limit.
This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it.
| Topic | What to check in your jurisdiction | Page |
|---|---|---|
| Respiratory Protection, Fit Testing and Breathing Air | Which breathing air standard and edition the regulation names, any test interval it sets (the quarterly schedule here is the department’s choice), and the cylinder requalification rules | J14 Respiratory Protection, Fit Testing and Breathing Air |
CSA Group. (2019). CSA Z180.1:19, Compressed breathing air and systems (6th ed.). https://www.csagroup.org/store/product/CSA%20Z180.1:19/
National Fire Protection Association. (2019). NFPA 1989, Standard on breathing air quality for emergency services respiratory protection (last standalone edition; scheduled to consolidate into NFPA 1985). https://www.nfpa.org/codes-and-standards/nfpa-1989-standard-development/1989
National Fire Protection Association. (2024). NFPA 1550, Standard for emergency responder health and safety (consolidates NFPA 1500, 1521 and 1561). https://www.nfpa.org/codes-and-standards/nfpa-1550-standard-development/1550