Maintenance Record Template
HVAC
Facility:
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101 TRAFFIC & HEALTH, 101 Consumers Rd., Whitby Ontario L1N 1C4
Equipment
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RTU-1 / 1FL NW Wall / AAON Model:58316 / Serial:200410-AMGE13574 / Filter:4-16x20x2 / Belt:1-B46
RTU-2 Serving North Wall Filters:4-16x20x2 Belts:1-B46
RTU-3 Serving Main Board Room Filters:4-16x20x2 Belts:1-B46
RTU-4 Serving Main Office Centre Cafeteria Filters:6-16x20x2 Belts:1-B70
RTU-6 Serving South Office Filters:4-16x20x2 Belts:1-B46
RTU-8 Serving Sign Shop#1 Filters:4-16x20x2 Belts:1-B46
RTU-9 Serving Stores Office Filters: 4-16x20x2 Belts:1-B46
RTU-10 Serving Washrooms Filters:4-16x20x2 Belts:1-B46, 1-B84
RTU-11 Serving Traffic Control Room Filters:6-16x20x2 Belts:1-B64
RTU-12 Serving 2FL East Health Filters:4-16x20x2 Belts:1-B48
RTU-13 Serving 2FL Centre Health Filters:4-16x20x2 Belts:1-B48
RTU-14 Serving 2FL West Health Filters:4-16x20x2 Belts:1-B48
RTU-15 Serving North Print Room Filters:4-16x20x2 Belts:1-B46
Date
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Month
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Day
Year
Date
Work Order #
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Safety
Follow Lockout / Tagout procedures and wear proper PPE where required
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Yes
No
Belts & Filters
Fan Belts
Ok, in good condition
Replaced with new
Filters
Ok, in good condition
Replaced with new
Sheaves
Fan Sheaves
Ok, in good condition
Adjusted
Replaced
Replacement quantity and size
Motor Sheaves
Ok, in good condition
Adjusted
Replaced
Replacement quantity and size
Back
Next
Blower Motor and Fan Housing
Blower Housing Bearings
Ok, in good condition
Not Ok
Blower Housing Bearings
Ok, in good condition
Not Ok
Alignment
Ok, aligned
Not Ok, performed alignment
Isolators / Support
Ok, in good condition
Not Ok
Grease / Lubricate
Complete
Incomplete
Notes:
Back
Next
Refrigerant Circuit
Check the system without use of gauges unless there is cooling issues.
Visual check for dirt, buildup, spot oil
Clean
Dirty
Check for abnormal sounds, feel the lines and condenser discharge air when approaching the condenser
Ok, normal
Not Ok
Inspect for wire & refrigerant tube rub-outs, discoloured electrical connections, leaking capacitors and condition of electrical whips
Ok, appears in good condition
Not Ok
Check condition of line insulation, torn insulation on drains and suction lines and damaged doors and door seals
Ok, appears in good condition
Not Ok
Notes:
Back
Next
Evaporator Coil
Check coil for signs of leaks
Ok, no leaks
Not Ok
Cleaned coil (sprayed, hosed down)
Complete
Clean, not required at this time
Condensate pan
Clean
Dirty, cleaning required
Condensate drain
Clean
Dirty, cleaning required
Notes:
Back
Next
Gas Burner Heating
Heating Start-Up
Check incoming gas pressure and gas reducing regulator
Complete
Incomplete
Inspect for hazardous debris in flue
Complete
Incomplete
Turn on heat and check proper manifold pressure to burners and adjust as necessary
Complete
Incomplete
Check temperatures across air handler
Ok, temperatures in range
Not Ok
Perform safety test for carbon monoxide (CO)
Complete
Incomplete
Check unit is operating to manufacturer's specification
Complete
Incomplete
Notes:
Back
Next
Economizer
Check economizer actuator operation
Ok, dampers move freely
Not Ok, cleaning and adjustments required
Check minimum damper position
Ok, minimum damper at position
Not Ok, adjustment required
Test enthalpy control
Ok, works as per conditions
Not Ok, operation to be reviewed
BAS Controls
Check temperature & humidity readings at BAS, ensure good reasonable values, replace unreliable sensors
Complete
Incomplete
Check set points at BAS for proper values, make adjustments if required
Complete
Incomplete
Maintenance Completion
If additional parts were required for this maintenance, please list down part, supplier, date of purchase and total cost of parts.
Have all of the maintenance tasks been completed and issues noted?
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Yes
No
HVAC Tech 1
Please Select
Greg Love
Scott Davis
Eric Servito
Scott Goodlet
Jeff Dodd
Rob Taylor
Contractor
HVAC Tech 2
Please Select
Greg Love
Scott Davis
Eric Servito
Scott Goodlet
Jeff Dodd
Rob Taylor
Non HVAC Staff
Contractor
Name of Contractor(s) & Company
Signature
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Submit
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