Title Page

  • Work Order Number

  • Job Start Time

  • Location
  • Customer

  • Service Person

  • Machine

  • Serial Number

Workplace Inspection

  • Inspect work area for Slips, Trips and Fall Hazards

  • Has the Hazard been fixed?

  • Contact your Supervisor for further instruction.

  • Inspect Area for Traffic Hazards

  • Has the Hazard been fixed?

  • Contact your Supervisor for further instruction.

  • Inspect For Electrical Hazards

  • Has the Hazard been fixed?

  • Contact your Supervisor for further instruction.

  • Inspect Unit for Hot Surfaces

  • Has the Hazard been fixed?

  • Contact your Supervisor for further instruction.

Preliminary Machine Inspection

  • Check Earth Continuity (On Pump Out Vacuum Models)

  • Has this Been Rectified?

  • Do not Proceed until this has been rectified.

  • Check Cable and Plug for Wear or Damage

  • Do not Proceed until this has been rectified.

  • Run Machine Up to Establish Condition.

  • Any Apparent Faults Observed?

  • What Were They?

Vacuum Service

  • Service Requested?

  • Check all Switches for Correct Operation

  • Check Hoses and Attachments for Blockages, Wear or Damage

  • Check Wheels for Smooth Operation

  • Clean Collection Tank and Inspect for Damage

  • Check and Clean any Pre Filters (if Applicable)

  • Clean and Inspect Cloth Filter

  • Check that the Float is Operating Correctly and in Good Condition.

  • Fire Flex Inspected and Cleaned?

  • Vacuum Motor(s) Checked for Smooth Operation

  • Check Operation of Sump Pump (if Applicable)

  • Check Operation of Solution Pump (if Applicable)

  • Check that the Quick Connects are Operating Smoothly and Free of Debris (Extraction Machines Only)

  • AMP Draw

Vacuum Repair

  • Repair Requested?

  • What is the Reported Fault(s) with this Vacuum?

  • What is the Action(s) taken to rectify this problem?

  • AMP Draw

Final Inspection

  • Is the Vacuum in Good Working Order?

  • Vacuum in a Clean Condition?

Admin

  • Part Numbers used

  • Picture(s) of Old Parts

  • Picture(s) of New Parts used

  • Labour

  • Warranty Work?

Customer Sign Off

  • Customer Signature (Onsite Only)

  • Stop Time

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.