FORM-JPM-0418-001

JOCKEY PUMP PREVENTIVE MAINTENANCE MONITORING FORM

Brand: Location: Frequency: FOR YEAR
Century Back Quarterly ___________
Mechanical Parts 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter
Check & Clean Motor Body Cover
Check & Clean Float Valve
Check & Clean Lifting Bracket
Check & Clean Ring Stand
Check & Clean Cable Entry
Check & Clean Top Cover
Check & Clean Pressure Gauge

Pressure reading before run test (125 PSI)

Pressure value when pump starts to

run/activate (70 PSI)

Pressure reading after run test (125 PSI)

Electrical Parts 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter
Check Circuit Breaker & Power Supply
Check Wirings & re-thighten
Check Float switch
Check Control Panel
Legend :
OK – Done
CM – Corrective Maint. Findings
PM - Prev.Maintenance
PRM- Pro Active Maint.
NA – Not Applicable Action taken
Remarks
PERSON IN CHARGE / NAME & SIGN.
Checked by Bldg. Admin/Staff

Checked by: Noted by:

Signature over printed name Engr. Gerard Lorenzo P. Rodriguez

Bldg. Administrator Head Office Engineer