Actuator Maintenance Checklist
Complete this checklist to document the inspection and maintenance of actuators.
Date of Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Actuator Identification
*
Location of Actuator
*
Type of Actuator
*
Please Select
Electric
Pneumatic
Hydraulic
Other
Technician Name
*
First Name
Last Name
Checklist of Maintenance Tasks
*
Rows
Completed
Comments
Lubrication checked
1
Electrical connections inspected
2
Physical damage inspected
3
Mounting bolts tightened
4
Position feedback tested
5
Limit switches checked
6
Actuator cycled through full range
7
Unusual noises/vibrations
8
Seals and gaskets inspected
9
Cleanliness verified
10
Overall Actuator Status
*
Operational
Requires Repair
Out of Service
Additional Notes or Observations
Upload Photos (if applicable)
Upload a File
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Choose a file
Cancel
of
Technician Signature
*
Submit Checklist
Submit Checklist
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