Footwear Maintenance Checklist Form
Complete this form to track inspection and maintenance tasks for footwear. Use the checklist to ensure all items are reviewed and maintenance actions are recorded.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Footwear
*
Please Select
Boots
Sneakers
Sandals
Dress Shoes
Work Shoes
Other
Footwear Identification or Serial Number
Inspect Soles for Wear and Tear
*
Good Condition
Minor Wear
Needs Repair
Check Laces or Fasteners
*
Secure and Intact
Loose or Frayed
Missing or Broken
Cleanliness of Footwear
*
Clean
Slightly Dirty
Dirty - Needs Cleaning
Check for Visible Damage (cracks, holes, separations)
*
No Damage
Minor Damage
Major Damage
Odor Check
*
No Odor
Slight Odor
Strong Odor
Overall Footwear Condition
*
1
2
3
4
5
Maintenance Actions Taken or Required
*
Cleaned
Laces/Fasteners Replaced
Soles Repaired
Deodorized
No Action Needed
Other
Additional Comments or Observations
Submit Checklist
Should be Empty: