Title Page

  • Site conductedA

  • Conducted on

  • Prepared by

  • Location

  • Work order number

Untitled Page

(T)ools, (S)afety Equipment and (M)aterials

  • Mechanic's tool set

  • Cleaning equipment and materials

  • Protective coatings and brushes

  • Gasket material

  • Rubber apron, gloves, and boots

  • Full-face shield

  • Respirator

  • Ventilating equipment

  • Toxic gas test meter

Safety Guidelines

  • Follow site safety rules and your supervisor’s instructions

  • Follow Confined Space Entry Procedures.

  • Use personal protective equipment

  • Schedule work with operating personnel

  • Plan maintenance for weekend accomplishment

  • Obtain and review manufacturer's instructions

  • Report any problems you find

  • Check with operating personnel for deficiencies

  • Record the results in the equipment history log

Maintenance Procedures

  • Tag out unit

  • Remove cover plates, flush pit, and pump out

  • Check bail, floats, rods, and switches. Make sure float operates as designed

  • Check the condition of the pump lifting handles and chains

  • Cycle all valves, and check for leaks

  • Inspect check valves

  • Inspect interior of pit for cracks

  • Check for corrosion. Treat and paint as needed

  • Inspect cover plate gaskets, and replace if necessary

  • Close and seal the cover

  • Return lift station to service

Maintenance Hours

  • Estimated time spent on work order?

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.