HVAC Preventive Maintenance Form

HVAC Preventive Maintenance Form
Equipment Information
Location/Building Name
Equipment ID/Serial Number
Date of Maintenance
MonthDayYear
Date
Maintenance Technician Information
Technician Name
First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preventive Maintenance Checklist
Filters
Coils
Blower Motor
Belts and Pulleys
Refrigerant Levels
Thermostat
Electrical Connections
Condensate Drain
Ductwork
Safety Controls
Please provide any additional notes, recommendations, or comments related to the maintenance.
List any recommended actions or repairs that should be addressed in the future.
I confirm that the preventive maintenance of the HVAC system was completed as per the checklist above.
Date
MonthDayYear
Date
Signature
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Equipment Information