Differential Pressure Sensor Replacement Checklist
Use this form to document a differential pressure sensor replacement job from site identification through final verification and sign-off.
Site and Equipment Identification
Site/Facility Name
*
Exact Location / Area
*
Asset / Equipment Tag or ID
*
System or Line Serviced
*
Technician and Replacement Details
Technician Name
*
First Name
Last Name
Replacement Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Replacement Completion Timestamp
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Sensor Make
*
Sensor Model
*
Replacement Part Number
*
Reason for Replacement
*
Failed reading
Drift
Damage
Preventive replacement
Alarm condition
Other
Pre-Replacement Condition and Readings
Existing sensor condition
*
Good
Fair
Poor
Failed
Visible damage or contamination
*
Yes
No
Damage or contamination details
Pre-replacement differential pressure reading
*
Abnormal system notes
Installation and Post-Replacement Verification
Installation and verification checklist
*
Sensor installed
Wiring connections checked
Leak check completed
Calibration/zero check completed
Functional test completed
Sensor installed status
*
Installed
Not installed
Partially installed
Leak check status
*
Pass
Fail
Not applicable
Calibration or zero check status
*
Pass
Fail
Not performed
Post-installation differential pressure reading
*
Functional test result
*
Pass
Fail
Not performed
Notes on adjustments made during installation or testing
Issues, Final Status, and Sign-Off
Issues Encountered During Replacement
Final Job Status
*
Completed
Completed with Issues
Incomplete
Parts or Tools Left Outstanding
Technician Completion Acknowledgment
*
Submit
Submit
Should be Empty: