PREVENTIVE MAINTENANCE HVAC CHECKLIST

Company Name: ____
Equipment ID.: ____
Work Order #: ____
SOP No.: ____
Date: ____
SOP Effective Date: / /
Performed By: ____
Reviewed By Client: ____

Section

Complete Check & Initials

6 SAFETY - Check the step performed

• 6.1
• 6.2
• 6.3
• 6.4
• 6.5

____ $ \mathrm{L e v e l}^{(1)} $
□ ____

11 MONTHLY - Check the step performed Level ⁽¹⁾

□ 11.1 □ 11.2 □ 11.3 □ 11.4 □ 11.5 □ 11.6
□ 11.7 □ 11.8 □ 11.9 □ 11.10 □ 11.11 □ 11.12 □ ____

10 QUARTERLY - Check the step performed Level ⁽¹⁾

□ 10.1 □ 10.2 □ 10.3 □ 10.4 □ 10.5 □ 10.6
□ 10.7 □ 10.8 □ 10.9 □ 10.10 □ 10.11 □ 10.12 □ ____

9 SEMIANNUAL - Check the step performed 9.1 9.2 9.3 9.4 9.5 9.7 9.8 9.9 9.10 9.11

Level ⁽¹⁾ 0.6 0.12 □ ____

8 ANNUAL - Check the step performed Level ⁽¹⁾

□ 8.1 □ 8.2 □ 8.3 □ 8.4 □ 8.5 □ 8.6 □ 8.7
□ 8.8 □ 8.9 □ 8.10 □ 8.11 □ 8.12 □ 8.13 □ 8.14 □ ____

Make entry in Equipment Maintenance Log, Form 8.001.1. ____

Record test values (when applicable) in the following tab please continue to record in a blank paper.

If more than three (3) items,

Completion: Does this SOP accurately and maintenance requirements of this equipment explain: ____.
adequately describe the correct nt? Yes ____ No ____ If NOT, please

Note: (1) = Enter the highest step number in each section performed