Daily, Weekly, and Monthly Equipment Inspection and Maintenance Documentation
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Equipment Name: _______________
Model Number: _________________
Serial Number: ________________
Location: _____________________
Date | Time | Visual Inspection | Functionality Test | Cleaning/Sanitization | Staff Initials | Notes |
---|---|---|---|---|---|---|
Technician: _________________
Date Completed: _____________
Preventive Maintenance:
Service Details:
Date | Issue Description | Action Taken | Resolved (Y/N) | Follow-up Required | Staff Member |
---|---|---|---|---|---|
Last Certification Date: ____________
Next Certification Due: ____________
Certifying Agency: ________________
Equipment Manufacturer: _____________
Service Provider: __________________
Emergency Contact: ________________
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