BRONZE HVAC/EXHUAST & MAKE-UP AIR PM CHECKLIST
Technicians Name
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Time In
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Dispatch #
*
Customer Name & Location
TECHNICIAN MUST CHECK OFF ALL BOXES THAT APPLY AND FILL IN ALL READINGS THAT APPLY!
A/C Systems
A/C 1
A/C 2
A/C 3
A/C 4
A/C 5
A/C 6
A/C 7
Drains & Pans Cleared
Replace Air Filters
Replace Belt
Visual Inspection
Verify Units have ID Tags
Exhaust System
Exhaust 1
Exhaust 2
Exhaust 3
Exhaust 4
Exhaust 5
Exhaust 6
Exhaust 7
Change Belts
Visual Inspection
Verify Unit has ID Tag
Make-up Air
MAU 1
MAU 2
MAU 3
MAU 4
MAU 5
MAU 6
MAU 7
Clean Mesh Filters
Change Belts
Visual Inspection
Verify Unit has ID Tag
Notes:
Time Out
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Submit Form
Should be Empty: