Condition Monitoring and Predictive Maintenance Inspection Form
Use this form to record equipment condition, inspection findings, warning signs, and recommended predictive maintenance actions.
Equipment Details
Equipment / Asset ID
*
Equipment Name
*
Asset Type / Category
*
Please Select
Pump
Motor
Gearbox
Compressor
Conveyor
Valve
Boiler
Generator
Hydraulic System
Pneumatic System
Other
Location / Area / Line
*
Model / Serial Reference
Inspection Context
Inspection Date
*
-
Month
-
Day
Year
Date
Inspection Time
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
First Name
Middle Name
Last Name
Department / Team
Please Select
Maintenance
Operations
Reliability Engineering
Production
Quality
Other
Inspection Type
*
Routine
Follow-up
Post-maintenance
Pre-failure check
Condition Monitoring Readings
Operating Status at Inspection
*
Running
Idle
Shutdown
Abnormal
Other
Condition Indicators Assessment
*
Rows
Status
Reading
Notes
Vibration
1
Temperature
2
Noise
3
Pressure
4
Lubrication
5
Leakage
6
Alignment
7
Vibration Severity
*
Minimal
1
2
3
4
5
6
7
8
9
Severe
10
1 is Minimal, 10 is Severe
Temperature Concern Level
*
No Concern
1
2
3
4
5
6
7
8
9
Critical
10
1 is No Concern, 10 is Critical
Urgency of Required Action
*
Low Urgency
1
2
3
4
5
6
7
8
9
Immediate Action
10
1 is Low Urgency, 10 is Immediate Action
Overall Condition Score
*
1
2
3
4
5
Observed Issues and Maintenance Decision
Observed abnormalities or symptoms
*
Suspected root cause or failure mode
Please Select
Misalignment
Imbalance
Lubrication issue
Wear or abrasion
Loose component
Electrical fault
Contamination
Overheating
Unknown
Other
Immediate action taken
*
Monitored
Adjusted
Lubricated
Escalated
No action taken
Recommended maintenance action
Please Select
Continue monitoring
Schedule maintenance
Repair component
Replace component
Clean or recondition
Further diagnosis needed
Other
Priority or urgency
*
1
2
3
4
5
Follow-up due date or next inspection date
-
Month
-
Day
Year
Date
Submit Inspection
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