J-1502000-10__Preventative_Maintenance_Program_-_Checklist.xls

XLS spreadsheet 287 KB Posted Jul 11, 2013

Attached to: Marine Force Reserve (MARFORRES), Facility Maintenance, West Region
Solicitation number: W912HP-13-R-0024
Issued by: Department of the Army Corps of Engineers Engineering District Charleston

About this file

From the source

Section J Preventative Maintenance Checklist

View the file

Other files

File	Type	Posted
Award_NoticeCharleston_MFR_West_Facilities.pdf	PDF	Sep 20, 2013
pd2BB08.pdf	PDF	Aug 8, 2013
J-1502000-13__Equip_Inspection _Test_ _Certification_Program.xls	XLS spreadsheet	Jul 11, 2013
J-1502000-08__San_Bruno _Preventative_Maintenance_Program_-_Index _Detail.xls	XLS spreadsheet	Jul 11, 2013
Section_F.pdf	PDF	Jul 11, 2013
J-1502000-09__Riverton _Preventative_Maintenance_Program_-_Index _Detail.xls	XLS spreadsheet	Jul 11, 2013
Copy_of_Air_Filter_ _Equipment.pdf	PDF	Jul 11, 2013
J-1502000-12__Equipment_Update_Report.xls	XLS spreadsheet	Jul 11, 2013
Section_M.pdf	PDF	Jul 11, 2013
Section_J.pdf	PDF	Jul 11, 2013
J-1502000-05__Service_Call_Report.xls	XLS spreadsheet	Jul 11, 2013
J-1502000-07__Pico_Rivera _Preventative_Maintenance_Program_-_Index _Detail.xls	XLS spreadsheet	Jul 11, 2013
J-1502000-11_Repair_Work_Report.xls	XLS spreadsheet	Jul 11, 2013
Section_C.pdf	PDF	Jul 11, 2013
Schedule_B _CLINs.xls	XLS spreadsheet	Jul 11, 2013
SF_1449.pdf	PDF	Jul 11, 2013
J-1502000-06_Pasadena _Preventative_Maintenance_Program_-_Index _Detail.xls	XLS spreadsheet	Jul 11, 2013

Show all 17

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Index

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
INDEX OF EQUIPMENT SHEETS
Equipment Checklist Sheet	Modification	Explanation
Air Conditioner - Package	Original Award
Air Conditioner - Split System	Original Award
Air Conditioner - Package, Computer	Original Award
Air Conditioner - Package, Gas Heat	Original Award
Air Conditioner-Window	Original Award
Air Filter ( sheet for each Activity)	Original Award
Air Handling Unit	Original Award
Air Handling Unit - Gas Heat Only	Original Award
Boiler	Original Award
Condensing Unit (air cooled)	Original Award
Fan	Original Award
Fan Coil Unit	Original Award
Fan Coil Unit - Computer	Original Award
Furnace - Forced Air, Gas	Original Award
Heat Pump - Split	Original Award
Heat Pump - Package	Original Award
Heater-Unit, Forced Air, Gas	Original Award
Heater-Unit, Forced Air, Water/Steam	Original Award
Heater-Unit, Infra-red, Gas	Original Award
Rooftop Unit	Original Award
Rooftop Unit - Gas Heat	Original Award
Rooftop Unit - Gas Heat Only	Original Award
Terminal-VAV	Original Award
Lighting	Original Award
Panelboards	Original Award
Fire Detection and Alarm System	Original Award
Fire Extinguisher (Portable) - Monthly Inspection (sheet for each Activity)	Original Award
Fire Extinguisher (Portable) - Annual Maintenance (sheet for each Activity)	Original Award
Fire Hydrant	Original Award
Fire Sprinkler - Chemical (Dry/Wet)	Original Award
Fire Sprinkler - Wet Pipe	Original Award
Air Compressor	Original Award
Air Dryer - Refrigerant	Original Award
Air Filter - Compressed Air	Original Award
Door - Overhead	Original Award
Drinking Fountain	Original Award
Emergency Eyewash - Portable	Original Award
Emergency Eyewash & Shower	Original Award
Fire Door/Shutter - Rollup	Original Award
Gutters/Down Spouts Cleaning	Original Award
Oil Water Separator	Original Award
Plumbing Fixtures (by room)	Original Award
Pump	Original Award
Pump Set - Sanitary Lift	Original Award
Refrigerator	Original Award
Shutter-Roll-up	Original Award
Slide Gate Operator & Entry System	Original Award
Water Heater-Gas/Oil	Original Award

Page &P of &N

AC - Package Unit

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
AIR CONDITIONER - PACKAGE UNIT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Clean evaporator coils. Use cleaning solvent that ia approved by equipment manufacturer. Clean blower wheels when coils are cleaned.
6	Clean condenser coils and straighten fins as required. Use cleaning solvent that is approved by equipment manufacturer.
7	Clean heat wheel using soap and water.
8	Inspect for tightness of connection to duckwork.
9	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
10	Inspect piping and valves for leaks and tighten loose connections.
11	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
12	Check all structural components; tighten bolts, nuts, and supports as required.
13	Inspect for rust and corrosion. Apply paint where applicable.
14	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
15	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
16	Inspect controls and unit for proper operation.
17	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Check refrigerant pressures and add refrigerant as required. If a leak is suspected, check all piping and connections for leaks.
2	Check oil level, add oil as required

Page &P of &N

AC - Split Sys

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
AIR CONDITIONER - SPLIT SYSTEM
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades or unbalance; adjust as necessary.
3	Check belts for condition, proper tension, and misalignment; adjust for proper tension and/or alignment.
4	Clean condenser coils and straighten fins as required. Use cleaning solvent that is approved by the equipment manufacturer.
5	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
6	Inspect piping and valves for leaks and tighten loose connections.
7	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
8	Check all structural components; tighten bolts, nuts, and supports as required.
9	Inspect for rust and corrosion. Apply paint where applicable.
10	Inspect controls and unit for proper operation.
11	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
2	Check unit for proper refrigerant charge; add refrigerant, if necessary.

Page &P of &N

AC - Package, Computer

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
AIR CONDITIONER - PACKAGE UNIT, COMPUTER ROOM
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Check humidity lamp, replace if necessary.
9	Inspect humidifer canister for mineral deposits, replace as necessary.
10	Check condition of humidifer electrodes.
11	Inspect humidifer and water make-up hoses, fittings, and valves for leaks and tighten loose connections.
12	Check operation of automatic condensate discharge system.
13	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
14	Check all structural components; tighten bolts, nuts, and supports as required.
15	Inspect for rust and corrosion. Apply paint where applicable.
16	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
17	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
18	Inspect controls and unit for proper operation.
19	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Clean evaporator coil and blower.
2	Clean condenser coils and straighten fins as required.
3	Check refrigerant pressures and add refrigerant as required. If a leak is suspected, check all piping and connections for leaks.

Page &P of &N

AC-Window

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
AIR CONDITIONER - WINDOW UNIT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Check operating temperature.
2	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
3	Inspect motor for excessive heat, noise, and vibration
4	Clean condener and evaporator coils and blower.
5	Inspect for rust and corrosion.
6	Inspect unit for proper operation.
7	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Air Filter (HVAC)

J-1502000-06
MAINTENANCE & INSPECTION SERVICE CHECKLIST
AIR FILTER (HVAC)
ACTIVITY:		MECHANIC SIGNATURE & DATE
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		IF TASK WAS NOT NOT COMPLETED, LIST REASONS WHY
POINT		YES	NO
1	AF-1 (FCU-1)
2	AF-2 (FCU-2)
3	AF-3 (FCU-3)
4	AF-4 (FCU-4)
5	AF-5 (FCU-5)
6	AF-6 (FCU-6)
7	AF-7 (FCU-7)
8	AF-8 (FCU-8)
9	AF-9 (FCU-9)
10	AF-10 (FCU-10)
11	AF-11 (FCU-11)
12	AF-12 (FCU-12)
13	AF-13 (FCU-13)
14	AF-14 (FCU-14)
15	AF-15 (FCU-15)
16	AF-16 (FCU-16)
17	AF-17 (FCU-17)
18	AF-18 (FCU-18)
19	AF-19 (FCU-19)
20	AF-20 (FCU-20)
21	AF-21 (FCU-21)
22	AF-22 (FCU-22)
23	AF-23 (FCU-23)
24	AF-24 (FCU-24)
25	AF-25 (FCU-25)
26	AF-26 (FCU-26)
27	AF-27 (FCU-27)
28	AF-28 (FCU-28)
29	AF-29 (FCU-29)
30	AF-30 (FCU-30)
31	AF-31 (FCU-31)
32	AF-32 (FCU-32)
33	AF-33 (FCU-33)
34	AF-34 (FCU-34)
35	AF-35 (FCU-35)
36	AF-36 (FCU-36)
37	AF-37 (FCU-37)
38	AF-38 (FCU-38)
39	AF-39 (FCU-39)
40	AF-40 (FCU-40)
41	AF-41 (FCU-41)
42	AF-42 (FCU-42)
43	AF-43 (FCU-43)
44	AF-44 (FCU-44)
45	AF-45 (FCU-45)
46	AF-46 (FCU-46)
47	AF-47 (FCU-47)
48	AF-48 (FCU-48)
49	AF-49 (FCU-49)
50	AF-50 (FCU-50)
51	AF-51 (FCU-51)
52	AF-52 (FCU-52)
53	AF-53 (FCU-53)
54	AF-54 (FCU-54)
55	AF-55 (FCU-55)
56	AF-56 (FCU-56)
57	AF-57 (FCU-57)
58	AF-58 (FCU-58)
59	AF-59 (FCU-59)
60	AF-60 (FCU-60)
61	AF-61 (FCU-61)
62	AF-62 (FCU-62)
63	AF-62 (AHU-1)
64	AF-63 (AHU-2)
65	AF-64 (AHU-3)
66	AF-54 (AHU-4)

Page &P of &N

AHU

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
AIR HANDLING UNIT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Check hydronic control valves for proper operation.
9	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
10	Check all structural components; tighten bolts, nuts, and supports as required.
11	Inspect for rust and corrosion. Apply paint where applicable.
12	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
13	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
14	Inspect controls and unit for proper operation.
15	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Clean evaporator coil and blower.

Page &P of &N

AHU - Gas Heat

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
AIR HANDLING UNIT - GAS HEAT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Check hydronic control valves for proper operation.
9	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
10	Check all structural components; tighten bolts, nuts, and supports as required.
11	Inspect for rust and corrosion. Apply paint where applicable.
12	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
13	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
14	Inspect controls and unit for proper operation.
15	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Clean evaporator coil and blower.
TO BE PERFORMED ANUALLY (FALL)
1	Inspect fuel system for leaks.
2	Check burner operation through a complete cycle by turning thermostat to proper setting; adjust if necessary.
3	Check burner flame for proper color; adjust as required.
4	Inspect and clean firebox.
5	Check condition of flue pipe, damper and stack.

Page &P of &N

AHU - Gas Heat Only

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
AHU - GAS HEAT ONLY
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
9	Check all structural components; tighten bolts, nuts, and supports as required.
10	Inspect for rust and corrosion. Apply paint where applicable.
11	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
12	Inspect fuel system for leaks.
13	Check burner operation through a complete cycle by turning thermostat to proper setting; adjust if necessary.
14	Check burner flame for proper color; adjust as required.
15	Inspect and clean firebox.
16	Check condition of flue pipe, damper and stack.
17	Inspect controls and unit for proper operation.
18	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Boiler

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
BOILER -HOT WATER OR STEAM, GAS, OIL OR COMBINATION FIRED
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
WEEKLY (SITES WITH FULL TIME MAINTENANCE STAFFS) OR MONTHLY (REMOTE SITES) DURING HEATING SEASON
1	Check fuel train including pressure regulators, cut-off valves, and associated equipment for leaks and proper operation; tighten connections as required.
2	On condensing boilers, check condensate system neutralizer for marble chips or lime crystals. Replenish marble chips or lime crystals if needed (no smaller than 3/4"). Refill system with water. WARNING: must verify fow of condensate and make sure the cap is connected properly before leaving the boilerunattended.
3	Inspect all water lines, valves, and connections for leaks or damage; repair as necessary.
4	Check feedwater system and feedwater makeup control.
5	Check pressure gauges.
6	Check boiler for proper operation.
MONTHLY AT EACH INSPECTION SERVICE DURING HEATING SEASON
1	Check operation and condition of safety pressure relief valve.
2	Check operation of boiler low water cut off devices.
3	Inspect and clean water column sight glass (or replace).
4	Check main flame failure protection (gas or oil).
5	Check pilot flame failure protection for gas burner equipment.
6	Check main flame detection scanner on boiler equipped with spark ignition (oil burner).
7	Check flame detection sanner (main and pilot) for boiler equipped with pilot flame (gas burner).
QUARTERLY AT EACH INSPECTION SERVICE DURING HEATING SEASON
1	Check electrical system, thermostat, and all operating controls for proper response when operating.
2	Check and lubricate blowers and motors.
3	Check condition of flue pipe, damper and exhaust stack.
4	Inspect boiler pipe insulation for loose, torn, or missing insulation. Repair as needed. Any replacement over two linear feet shall be listed as a repair item
5	Check air intake and exhaust vent outlets for any blockage or restrictions. Clean as needed.
ANNUALLY BEFORE HEATING SEASON
1	Inspect and clean oil burner gun and ignition assembly.
2	Change fuel filter element.
3	On condensing boilers, check condensate system for obstructions, none allowed.
4	On condensing boilers, verify condensate pump is working properly.
5	Check combustion chamber for air or gas leaks.
6	Clean scale and soot from boiler interior heat exchange surfaces.
7	Using boiler stack analyzer, make proper fuel air ratio adjustments to ensure that boiler is operating at peak efficiency.
8	On units utilizing a flame rod, change the rod.
9	Clean/replace flapper valve gasket
10	Change the spark plug.
11	Check boiler operation through complete cycle.
12	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Condensing Unit

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
CONDENSING UNIT (AIR COOLED)
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fans for bent blades, unbalance, excessive noise and vibration.
3	Clean condenser coils in accordance with manufacturer recommendation. Straighten condensing coil fins as required.
4	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches and other electrical deficiencies. Tighten any loose connections.
5	Inspect mounting brackets, bolts, fan guards, etc. Adjust and tighten as required.
6	Inspect for rust and corrosion. Remove rust and corrosion and apply paint when applicable.
7	Inspect all piping for leaks and tighten loose connections.
8	Check unit for proper operation, excessive noise or vibration.
9	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Fan

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
FAN
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Start and stop fan with local switch
2	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers; lubricate pivot points and inspect linkages for tightness.
5	Inspect fan for bent blades, unbalance, excessive noise and vibration.
6	Clean fan.
7	Inspect surrounding ductwork for leakage or unnecessary movement.
8	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
9	Inspect for rust and corrosion. Remove any found and repaint. List any rusted area over two square feet as a repair item.
10	Inspect unit for proper operation.
11	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Fan Coil Unit

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
FAN COIL UNIT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Clean evaporator coil and blower.
6	Inspect for tightness of connection to duckwork.
7	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
8	Inspect piping and valves for leaks and tighten loose connections.
9	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
10	Check all structural components; tighten bolts, nuts, and supports as required.
11	Inspect for rust and corrosion. Apply paint where applicable.
12	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
13	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
14	Inspect controls and unit for proper operation.
15	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Fan Coil Unit-Computer

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
FAN COIL UNIT - COMPUTER ROOM
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Check humidity lamp, replace if necessary.
9	Inspect humidifer canister for mineral deposits, replace as necessary.
10	Check condition of humidifer electrodes.
11	Inspect humidifer and water make-up hoses, fittings, and valves for leaks and tighten loose connections.
12	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
13	Check all structural components; tighten bolts, nuts, and supports as required.
14	Inspect for rust and corrosion. Apply paint where applicable.
15	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
16	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
17	Inspect controls and unit for proper operation.
18	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Clean evaporator coil and blower.
2	Check unit for proper refrigerant charge; add refrigerant, if necessary.

Page &P of &N

Furnace - Gas

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
FURNACE-FORCED AIR, GAS
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Inspect fuel system for leaks.
2	Check burner operation through a complete cycle by turning thermostat to proper setting; adjust if necessary.
3	Check burner flame for proper color; adjust as required.
4	Inspect and clean firebox.
5	Check condition of flue pipe, damper and stack.
6	Clean coils. Use cleaning solvent that is approved by equipment manufacturer. Clean blower wheels when coils are cleaned.
7	Inspect motor for excessive heat, noise, and vibration.
8	Inspect fan for bent blades, unbalance, excessive noise and vibration.
9	Lubricate motor and shaft bearings.
10	Inspect, adjust belts and pulleys. Replace belt as needed.
11	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
12	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
13	Inspect for rust and corrosion. Apply paint where applicable.
14	Inspect exterior piping and valves for leaks; tighten connections as required.
15	Check all structural components; tighten bolts, nuts, and supports as required.
16	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
17	Inspect controls and unit for proper operation.
18	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Heat Pump - Split

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
HEAT PUMP - SPLIT SYSTEM
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades or unbalance; adjust as necessary.
3	Check belts for condition, proper tension, and misalignment; adjust for proper tension and/or alignment.
4	Clean coils and straighten fins as required. Use cleaning solvent that is approved by the equipment manufacturer.
5	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
6	Inspect piping and valves for leaks and tighten loose connections.
7	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
8	Check all structural components; tighten bolts, nuts, and supports as required.
9	Inspect for rust and corrosion. Apply paint where applicable.
10	Cycle the reverse cycle valve to insure proper operation.
11	Inspect controls and unit for proper operation.
12	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Check unit for proper refrigerant charge; add refrigerant, if necessary.

Page &P of &N

Heat Pump - Package Unit

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
HEAT PUMP - PACKAGE UNIT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
	TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Clean evaporator coils. Use cleaning solvent that ia approved by equipment manufacturer. Clean blower wheels when coils are cleaned.
6	Clean condenser coils and straighten fins as required. Use cleaning solvent that is approved by equipment manufacturer.
7	Inspect for tightness of connection to duckwork.
8	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
9	Inspect piping and valves for leaks and tighten loose connections.
10	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
11	Check all structural components; tighten bolts, nuts, and supports as required.
12	Inspect for rust and corrosion. Apply paint where applicable.
13	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
14	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
15	Cycle the reverse cycle valve to insure proper operation.
16	Inspect controls and unit for proper operation.
17	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Check refrigerant pressures and add refrigerant as required. If a leak is suspected, check all piping and connections for leaks.
2	Check compressor oil level; add oil as required.

Page &P of &N

Heater-Unit, Forced, Gas

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
HEATER - UNIT, FORCED AIR, GAS
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Clean dirt from heater using air hose (pressure not to exceed 30 psi).
2	Check operation of gas regulator, adjust as required.
3	Check for gas leaks.
4	Check operation of thermostat.
6	Clean and inspect gas pilot assembly, burner and jets, firebox and flue pipe; adjust burner and pilot flames as necessary.
7	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
8	Inspect fan for bent blades, unbalance, excessive noise and vibration.
9	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
10	Inspect unit for proper operation.
11	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Heater-Unit, Forced, Water

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
HEATER - UNIT, FORCED AIR, WATER/STEAM
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Check heater coils and assocoated piping for leaks or corrision.
2	Check hydronic control valve for proper operation.
3	Clean heating coil.
4	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
5	Inspect fan for bent blades, unbalance, excessive noise and vibration.
6	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
7	Verify proper control by modulating the thermostat through complete cycle.
8	Inspect unit for proper operation.
9	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Heater-Unit, Infra-red, Gas

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
HEATER - UNIT, INFRA-RED RADIANT, GAS
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Clean dirt from heater using air hose (pressure not to exceed 30 psi). Blow out each venturi tube.
2	Check operation of gas valve.
3	Check for gas leaks.
4	Check operation of thermostat.
5	Replace primary air intake filter.
6	Clean spark electrode and reset gap, replace if necessary.
7	Inspect and clean vacuum pump (fan) and flue pipe.
8	Inspect and clean outside air blower and blower intake.
9	Inspect unit for proper operation.
10	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Rooftop Unit

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
ROOFTOP UNIT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Check hydronic control valve for proper operation.
9	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
10	Check all structural components; tighten bolts, nuts, and supports as required.
11	Inspect for rust and corrosion. Apply paint where applicable.
12	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
13	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
14	Inspect controls and unit for proper operation.
15	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED ANNUALLY (SPRING)
1	Clean evaporator coils. Use cleaning solvent that ia approved by equipment manufacturer. Clean blower wheels when coils are cleaned.
2	Clean condenser coils and straighten fins as required. Use cleaning solvent that is approved by equipment manufacturer.
3	Clean heat wheel using soap and water.
4	Check refrigerant pressures and add refrigerant as required. If a leak is suspected, check all piping and connections for leaks.
	Check compressor oil level; add oil as required.

Page &P of &N

Rooftop Unit - Gas Heat

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
ROOFTOP UNIT - GAS HEAT
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Check hydronic control valve for proper operation.
9	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
10	Check all structural components; tighten bolts, nuts, and supports as required.
11	Inspect for rust and corrosion. Apply paint where applicable.
12	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
13	Check the drain pan and condensate piping for blockages. Remove if found. Add treatment to prevent fungus growth. Clean drain pan.
14	Inspect controls and unit for proper operation.
15	Inspect unit for overall condition and recommend for replacement or other needed repairs.
TO BE PERFORMED AT THE BEGINNING OF THE COOLING SEASON (SPRING)
1	Clean evaporator coils. Use cleaning solvent that ia approved by equipment manufacturer. Clean blower wheels when coils are cleaned.
2	Clean condenser coils and straighten fins as required. Use cleaning solvent that is approved by equipment manufacturer.
3	Clean heat wheel in accordance with manufacturer's instructions.
4	Check refrigerant pressures and add refrigerant as required. If a leak is suspected, check all piping and connections for leaks.
5	Check compressor oil level; add oil as required.
TO BE PERFORMED AT THE BEGINNING OF THE HEATING SEASON (FALL)
1	Inspect fuel system for leaks.
2	Check burner operation through a complete cycle by turning thermostat to proper setting; adjust if necessary.
3	Check burner flame for proper color; adjust as required.
4	Inspect and clean firebox.
5	Check condition of flue pipe, damper and stack.

Page &P of &N

Rooftop Unit - Gas Heat Only

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
ROOFTOP UNIT - GAS HEAT ONLY
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Check motor and fan shaft bearings for noise, vibraton, overheating; lubrucate bearings.
2	Inspect fan for bent blades, unbalance, excessive noise and vibration.
3	Inspect, adjust belts and pulleys. Replace belt as needed.
4	Clean dampers, louvers, or shutters; lubricate pivot points and inspect linkages for tightness.
5	Inspect for tightness of connection to duckwork.
6	Inspect wiring and electrical controls for loose connections, charred, frayed or broken insulation, evidence of short circuiting, wrong size fuses, circuit breakers, or switches, and other electrical deficiencies. Tighten any loose connections.
7	Inspect piping and valves for leaks and tighten loose connections.
8	Inspect mounting brackets, bolts, fan guards, etc., adjust and tighten as required.
9	Check all structural components; tighten bolts, nuts, and supports as required.
10	Inspect for rust and corrosion. Apply paint where applicable.
11	Inspect for waterlogged, loose, torn, or missing insulation. Repair as needed.
12	Inspect fuel system for leaks.
13	Check burner operation through a complete cycle by turning thermostat to proper setting; adjust if necessary.
14	Check burner flame for proper color; adjust as required.
15	Inspect and clean firebox.
16	Check condition of flue pipe, damper and stack.
17	Inspect controls and unit for proper operation.
18	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Terminal-VAV

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
TERMINAL-VAV
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Inspect surrounding ductwork for leakage or unnecessary movement.
2	Modulate the thermostat control to verify proper control.
3	Inspect electric controls including the sensors (as applicable) for proper setting, complete connections, condition of contacts and switches, calibration, throttling range, wing range, and operation. adjust as necessary.
4	Check hydronic heater coil and assocoated piping for leaks or corrision.
5	Check hydronic control valve for proper operation.
6	Clean coil.
7	Lubricate drives and actuators as required.
8	Check actuator bracket bolts for tightness.
9	Inspect unit for proper operation.
10	Inspect unit for overall condition and recommend for replacement or other needed repairs.

Page &P of &N

Lighting

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
LIGHTING
(ONE REPORT PER INSPECTION)
ACTIVITY:		MECHANIC SIGNATURE & DATE
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED AT EACH INSPECTION SERVICE
1	Check operation of light fixture, switch, automatic switch (where available). Replace defective switches and/or automatic switches (ie. photo sensor).
2	Check for proper operation of all emergency light fixtures.
TO BE PERFORMED IF BULB IS NON-FUNCTIONAL
1	Replace defective lamp and/or ballast and clean fixture including all reflectors, refractors, glass, diffusers, and bulbs contained in fixture. Recycle/dispose as required.
2	Check for evidence of overheating. Check wiring, contacts, terminals, and sockets if overheating detected. Tighten connection or replace components as necessary to fix problem.

Page &P of &N

Panelboard

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
PANELBOARD
ACTIVITY:		MECHANIC SIGNATURE & DATE
		DESIGNATION:
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
1	Field test panelboard for overheating by feeling all dead front surfaces with palm of hand or by using infrared scan. If high temperature detected, this is an indication of trouble and investigation is necessary.
2	Install missing space blanks.
3	Tighten all loose connections.
4	Clean and check general condition of panel.

Page &P of &N

Fire Detection

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
FIRE DETECTION AND ALARM SYSTEM
ACTIVITY:		INSPECTOR SIGNATURE & DATE
		DESIGNATION:
NOTE: ALL INSPECTION, TESTING AND MAINTENANCE SHALL BE PERFORMED IN ACCORDANCE WITH UFC 3-600-02
CHECK	CHECKPOINT DESCRIPTION	TASK COMPLETE		RECOMMENDATION FOR REPLACEMENT /REPAIR AND COST
POINT		YES	NO	ESTIMATE (Attach additional quote/specification if required)
TO BE PERFORMED ANNUALLY
1	CONTROL PANEL AND ANNUNCIATOR EQUIPMENT (MONITORED) - Test to verify proper receipt of alarm supervisory and trouble signals (inputs) and operarion of notification appliances and auxiliary (outputs). Verify all lamps and LEDs are illuminated. Load test backup batteries (when provided).
2	INITATING DEVICE, MANUAL FIRE ALARM STATIONS - Verify station is accesible (visual). Test to verify operability.
3	INITATING DEVICE, RADIANT ENERGY DETECTORS (OPTICAL DETECTORS) - Test to verify alarm initiation and receipt. Verify no facility change affects performance.
4	INITATING DEVICE, GAS DETECTORS - Test to verify alarm initiation and receipt. Verify no facility change affects performance.
5	NOTIFICATION APPLIANCES AND VOICE COMMUNICATION (telephone, speakers, horns, and strobe lights) - Test to verify operability.
6	DIGITAL ALARM TRANSMITTERS AND RECEIVERS - Test to verify operability.
TO BE PERFORMED EVERY 2 YEARS
1	INITATING DEVICE, MANUAL FIRE ALARM STATIONS - Operate to verify alarm receipt
2	HEAT DETECTORS (RESTORABLE) - Test with a heat source to verify alarm initiating and receipt. Verify no facility change affects performance.
3	SMOKE DETECTORS (SINGLE-ACTION DEYECTORS, SYSTEM DETECTORS, AND AIR SAMPLING DETECTORS) - Test with manufacturer-approved smoke simulant to verify smoke entry and alarm initiation and receipt. Verify no facility change affects performance.
4	SUPERVISORY DEVICES (LOW AIR PRESSURE, TEMPERATURE, WATER LEVEL) - Test to verify alarm initiation and receipt of supervisory alarm.
TO BE PERFORMED EVERY 5 YEARS
1	SMOKE DETECTORS - Test detector sensitivity to ensure that the detector has remained within its listed and marked sensitivity range (or 4 percent obscuration light gray smoke, if not marked)

Page &P of &N

Fire Ext-Monthly

J-1502000-10
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST
FIRE EXTINGUISHER (PORTABLE) - MONTHLY INSPECTION
ACTIVITY:			MECHANIC SIGNATURE & DATE
NOTES
1. Monthly Inspection - Check for obstructions to access or visibility; Verify operating instructions on nameplate legible and facing outward; Check safety seals and tamper indicators are not broken or missing; Detemine fullness (or charge) by weighing or "hefting"; Examine for obvious physical damage, corrosion, leakage, or clogged nozzle; Check pressure gage reading or indicator for proper range or position; Check to see if HMIS label is in place.
2. Corrective Action - When an inspection reveals a deficiency in any conditions listed in Note 1, immediate corrective action shall be taken, including if cost warrants, replacement of the unit.
3. Monthly Inspection Tag - Attach tag or label to each fire extinguisher listing the date the inspection was performed and the initials of the person performing the inspection.
FIRE EXTINGUISHER	TASK COMPLETE		CORRECTIVE ACTION REQUIRED		IF CORRECTIVE ACTION REQUIRED, DESCRIBE ACTION TAKEN
	YES	NO	YES	NO
FE-1
FE-2
FE-3
FE-4
FE-5
FE-6
FE-7
FE-8
FE-9
FE-10
FE-11
FE-12
FE-13
FE-14
FE-15
FE-16
FE-17
FE-18
FE-19
FE-20
FE-21
FE-22
FE-23
FE-24
FE-25
FE-26
FE-27
FE-28

Page &P of &N

Fire Ext-Annual

J-1502000-10
CONTROL INSPECTION CHECKLIST
FIRE EXTINGUISHER (PORTABLE) - ANNUAL MAINTENANCE
ACTIVITY:				MECHANIC SIGNATURE & DATE
NOTES
1. Requirements - All maintenance, recharging, and hydrostatic testing shall be performed in accordance with NFPA 10 - Standard for Portable Fire Extinguishers
2. The notes that follow act as a guideline/checklist for any maintenance, recharging and testing that is performed. All of the following information can be found in NFPA-10.
3. Annual Maintenance - Fire extinguisher shall be subjected to maintenance at intervals of not more than one year, at the time of hydrostatic test, or when specifically indicated by an inspection. Maintenance procedures shall include a thorough examination of mechanical parts, extinguisher agent and expelling means. See Annex I of NFPA 10 for procedure. A conductivity test shall be conducted annually on all carbon dioxide hose assemblies. Hose assemblies found to be nonconductive shall be replaced. Pressure regulators provided with wheel-type fire extinguishers shall be tested annually for outlet static pressure and flow rate in accordance with manufacturer's instructions. Internal examination during annual maintenance shall not be required for nonrechargeable fire extinguishers, carbon dioxide fire extinguishers, or stored-pressure fire extinguishesr except for stored-pressure types of fire extinguishers containing a loaded stream agent. These units shall be disassembled on an annual basis and subjected to completre maintenance.
4. Corrective Action - When maintenance reveals a deficiency in any conditions listed in Note 2, immediate corrective action shall be taken, including if cost warrants, replacement of the unit.

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Nov 14, 2017.