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NF 57-03-84 (8-19) Emergency Oxygen Kit Inventory, Maintenance, and Order Form

What: This form is an annual record of oxygen kit maintenance and it is used to add additional kits and parts from the Standardized Equipment Program. There are several rows consisting of specific items to inspect on the oxygen kit and columns for every month of the year. There are also blanks to note the date of demand valve tests.

When: Information should be added to this form every month during which diving operations are conducted. However, regular monthly inspection is recommended. This form is also submitted to the SEP Coordinator via the email address when new oxygen kits or parts are ordered. When kits or parts are shipped by SEP, a copy of this form should be included in the shipment.

Record keeping: A digital or printed copy should be retained at the Diving Unit until two (2) years after the checklist has been completed.


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Reviewed: August 14, 2019. Contact us with page issues.

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