Date:

Maintenance Checklist
Place:

Register No. Company. Model.

Item Technical Data Tools Used Operational Test

YES NO
Results
1

YES NO
Results
2

YES NO
Results
3

YES NO
Results
4

YES NO
Results
5

YES NO
Results
6

YES NO
Results
7

P/N OFF S/N OFF POS P/N ON S/N ON POS

Start Date Finish Date

Start Time Finish Time

Technician Name, sign and stamp Inspector Name, Sign and Stamp