Gracie Tabanao

Maintenance Report Form - Machine / Equipment Fault

This form is to be used for the reporting of faults found with machinery or equipment. Any faulty equipment or machinery must be isolated from its power source, marked up as unsafe to use and your direct line / department manager informed.

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Title Page

Site Address
Site Number
Prepared by
Title

This form is to be used for the reporting of faults found with machinery or equipment. Any faulty equipment or machinery must be isolated from its power source, marked up as unsafe to use and your direct line / department manager informed.
Description of Machine / Equipment
Photos of the Machine / Equipment
Machine / Equipment Serial Number
Location of machine / equipment - Building, department, bay location, etc
Description of fault found

Details for Maintenance Repair

Equipment Details
Make
Model
Test & Tag Date
Test & Tag Due Date
Condition

Gracie Tabanao

Maintenance Report Form - Machine / Equipment Fault

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.