Usage-Based Maintenance Log Form
Please complete this form to record maintenance activities and equipment usage for tracking and scheduling future maintenance.
Equipment Name / ID
*
Equipment Type
*
Please Select
Generator
Pump
Compressor
Motor
Conveyor
Other
Location
Current Usage Reading
*
Usage Unit
*
Please Select
Hours
Cycles
Miles
Kilometers
Other
Date of Maintenance Activity
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Maintenance Status
*
Completed
Scheduled
Overdue
Equipment Condition
Excellent
Good
Fair
Poor
Next Maintenance Due (Usage or Date)
Notes / Actions Taken
Submit Log
Should be Empty: