Ainsworth Maintenance Inspection v1.3

• Building #

• Building Name

• Inspected by

• Conducted on

  Date

• What Season is it? (Select Multiple Responses)

  Select Winter Spring Summer Fall

  • Winter
  • Spring
  • Summer
  • Fall

• Location in Building

• Add

Mech Room

• Provide name of the Mech Room

Housekeeping

• Is mechanical room safe? i.e. no trip hazards, floor is dry

  Yes

  No

  N/A

• Is mechanical room clean?

  Yes

  No

  N/A

• Are electrical panels closed?

  Yes

  No

  N/A

• Is the piping free from leaks?

  Safe

  At Risk

  N/A

• Are all pieces of equipment assembled and put together?

  Yes

  No

  N/A

• Is the room well lit?

  Yes

  No

  N/A

• Are fire extinguishers present?

  Yes

  No

  N/A

• How would you rate this mechanical room 1 to 10

Air Handlers

Add Air Handlers

• Are the filters changed?

  Yes

  No

  N/A

• Are the belts free of noise?

  Yes

  No

  N/A

• Are the belts in good shape?

  Yes

  No

  N/A

• Are the belt guards in place?

  Yes

  No

  N/A

• Is the insulation undamaged and in place?

  Yes

  No

  N/A

• Is the fan reasonably quiet?

  Yes

  No

  N/A

• Are the dampers all aligned?

  Yes

  No

  N/A

• Is the ductwork undamaged?

  Yes

  No

  N/A

• Are the valves free of leaks?

  Yes

  No

  N/A

• Is the drain-pan & trap working & clean?

  Yes

  No

  N/A

• Is the Ainsworth Maintenance Card dated and filled out?

  Yes

  No

  N/A

• Input Air Handler names and any comments

• Rate this Air Handler

Exhaust Fan

Add Exhaust Fans

• Belt in good shape?

  Yes

  No

  N/A

• Is the exhaust fan reasonably quiet?

  Yes

  No

  N/A

• Is the Belt guard in place?

  Yes

  No

  N/A

• Is the Ainsworth Maintenance Card dated and filled out?

  Yes

  No

  N/A

• Input Exhaust Fan names and any comments

• Rate these exhaust fans

Rooftop Unit

Add Roof Top Units (RTU)

• Is the belt in good shape?

  Yes

  No

  N/A

• Are the filters cleaned?

  Yes

  No

  N/A

• Are the panels all secure?

  Yes

  No

  N/A

• Is the trap working & clean?

  Yes

  No

  N/A

• Is the gas piping supported?

  Yes

  No

  N/A

• Is the unit free of rust?

  Yes

  No

  N/A

• Is the disconnect operational?

  Yes

  No

  N/A

• Is the roof area clean?

  Yes

  No

  N/A

• Is the Ainsworth Maintenance Card filled out and dated

  Yes

  No

  N/A

• Input Rooftop names and any comments

• Rate these rooftop units

Boilers

Add Boilers

• Is the Boiler flame blue?

  Yes

  No

  N/A

• Is the Boiler free of leaks?

  Yes

  No

  N/A

• Is the insulation undamaged?

  Yes

  No

  N/A

• Is the venting free of leaks and corrosion?

  Yes

  No

  N/A

• Are the pumps relatively quiet?

  Yes

  No

  N/A

• Are the pumps free of leaks?

  Yes

  No

  N/A

• Is the Boiler maintaining the setpoint?

  Yes

  No

  N/A

• What is the boiler setpoint?

• What is the boiler return water temperature?

• Is the Ainsworth Maintenance Card dated and signed?

  Yes

  No

  N/A

• Input Boiler names and any comments

• Pressure Relief PSI & Date?

• Combustion Analysis Date?

• Rate this boiler plant.

Add Chillers

• Is the Chiller running smoothly?

  Yes

  No

  N/A

• Is the Chiller free of leaks and condensate?

  Yes

  No

  N/A

• Is the Chiller maintaining setpoint?

  Yes

  No

  N/A

• What is the chiller setpoint?

• What is the leaving chilled water temperature?

• Are the pumps relatively quiet?

  Yes

  No

  N/A

• Are the pumps free of leaks?

  Yes

  No

  N/A

• Pressure Relief Date:

• Pressure Relief Picture

  Media

• Ozone Depletion Date:

• Photo of ODP Form:

  Media

• Yes

  No

  N/A

• Is the Ainsworth Maintenance Carddated and signed?

  Yes

  No

  N/A

• Input Chiller Names and any comments

• Rate this chiller room

Cooling Tower

Add: Cooling Towers

• Is the cooling tower free of leaks?

  Yes

  No

  N/A

• Is the Fan running smoothly?

  Yes

  No

  N/A

• Is the cooling tower maintaining setpoint?

  Yes

  No

  N/A

• Cooling tower setpoint?

• Cooling tower return water temperature?

• Is the Ainsworth Maintenance Card filled out and dated?

  Yes

  No

  N/A