Free Routine Outline Maintenance Checklist Template
Routine Outline Maintenance Checklist
Prepared by: [Your Name]
Company: [Your Company Name]
Date: [Date]
I. Task Description
-
Inspect and clean air filters
-
Lubricate moving parts
-
Check and replace worn hoses
-
Test emergency shut-off systems
-
Inspect fire extinguishers
II. Frequency
|
Task Description |
Frequency |
|---|---|
|
Inspect and clean air filters |
Monthly |
|
Lubricate moving parts |
Bi-weekly |
|
Check and replace worn hoses |
Quarterly |
|
Test emergency shut-off systems |
Annually |
|
Inspect fire extinguishers |
Monthly |
III. Responsible Personnel
|
Task |
Responsible Personnel |
|---|---|
|
Air filter inspection |
Maintenance Technician |
|
Lubrication |
Maintenance Technician |
|
Hose inspection |
Facility Engineer |
|
Emergency shut-off test |
Safety Officer |
|
Fire extinguisher inspection |
Safety Officer |
IV. Tools and Materials Needed
-
Air filter cleaner
-
Lubricant spray
-
Replacement hoses
-
Testing equipment for shut-off systems
-
Inspection tag for fire extinguishers
V. Safety Precautions
-
Wear personal protective equipment (PPE) including gloves and safety goggles.
-
Ensure equipment is powered down before maintenance.
-
Follow lockout/tagout (LOTO) procedures.
-
Ensure adequate ventilation when using lubricants and cleaners.
-
Be familiar with the location of fire extinguishers and emergency exits.
VI. Completion Status
-
Task completed:
-
Yes
-
No
-
-
Date of completion: __________
-
Personnel signature:
Harold Abern
-
Supervisor signature:
[Your Name]
