Title Page
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Site Attended
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Conducted on
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Prepared by
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Location
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Building Number
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Floor Number
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Room Number
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Asset Number
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Asset Manufacture Date
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Install Date
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Power Rating
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Asset Class
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Is Internal Inspection Practical?
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Schedule Internal Inspection?
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Does Maintenance Standard Align to Job Task List?
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How does the Job Plan not meet expectations?
Details of Standards Quality
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Is Job Plan Available
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Job Plan Ref
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Rate the Overall Condition as Found
- 0 Unserviceable
- 1 Dire
- 2 Poor
- 3 Fair
- 4 Good
- 5 Excellent
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Do Belts Appear in Good Condition and Aligned
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Main Failure Modes?
- Fraying
- Slipping
- Flapping
- Mis-Aligned
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Are Fans Clean and Fan Blades Clean?
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Is Motor Vibration Excessive (audibly or visually)
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Is Bearing Noise Excessive
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Are Leaks Visible
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Air
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Liquid
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Is there a Visible Build Up of Grease or Dirt on or Around the Equipment
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Are Gauges Present
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Are Gauges Operational
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Is There Evidence of Calibration
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Are Filters Accessible
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Do Filters Appear in Good Condition Materially?
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Do Filters Appear Excessively Dirty?
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Is Access Required
