Maintenance inspection sheet

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Customer

• Add location
  Address

• Select date

  Date

Plant Type

• System ID

• Serial Number

Maintenance Checks

• Evaporator clean

  Yes

  No

  N/A

• Indoor Unit Clean

  Yes

  No

  N/A

• Filters Clean

  Yes

  No

  N/A

• Filters Replaced

  Yes

  No

  N/A

• Fan drives Checked

  Yes

  No

  N/A

• Fan belts replaced

  Yes

  No

  N/A

• Refrigerant levels checked Visual

  Yes

  No

  N/A

• Refrigerant levels checked Leak detector

  Yes

  No

  N/A

• Operating Pressures correct

  Yes

  No

  N/A

Refrigerant Type

What refrigerant is present

• R410a

• R407c

• R22

• R134a

• Refrigerant Quantity

Condenser

• Dry Cleaned

  Yes

  No

  N/A

• Wet Cleaned<br><br>

  Yes

  No

  N/A

• Water Cooled

  Yes

  No

  N/A

• Compressor functioning correctly

  Yes

  No

  N/A

• Controls operating correctly<br>

  Yes

  No

  N/A

• Report

• Add media

  Media

• Outstanding Items

• Add media

  Media

• Client Name

  Sign

• Engineers Name

  Sign