Extruder Preventive Maintenance Checklist
Complete this checklist to document the preventive maintenance performed on extruder machines.
Date of Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Extruder Machine ID or Name
*
Maintenance Personnel Name
*
First Name
Last Name
Shift
*
Please Select
Morning
Afternoon
Night
Overall Machine Status Before Maintenance
*
Operational
Requires Attention
Not Operational
Component Inspection Checklist
*
Rows
Checked / OK
Needs Attention
Barrel
1
2
Screw
3
4
Heaters
5
6
Drive Motor & Gearbox
7
8
Cooling System
9
10
Electrical Connections
11
12
Safety Devices
13
14
Lubrication Status
*
Lubrication adequate
Lubrication needed (performed)
Lubrication needed (not performed)
Were any safety devices tested and found working?
*
Yes, all working
Some issues found
Not tested
Issues Found or Observations (if any)
Corrective Actions Taken
Supervisor/Manager Name
First Name
Last Name
Supervisor/Manager Approval Signature
Submit Checklist
Submit Checklist
Should be Empty: