Sand Filter Maintenance Checklist Form
Complete this form to record routine maintenance and inspection of sand filter equipment.
Equipment ID or Serial Number
*
Location of Sand Filter
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall Maintenance Status
*
Completed - No Issues
Completed - Issues Found
Not Completed
Current Condition of Sand Media
*
Good (No signs of clogging or channeling)
Fair (Minor clogging, needs monitoring)
Poor (Significant clogging or channeling)
Cleaning or Backwash Performed
*
Yes - Manual Cleaning
Yes - Automatic Backwash
No - Not Required
Parts Replaced or Repairs Made
Pressure Gauge Reading (psi)
*
Additional Observations
Recommended Follow-Up Actions
Submit Checklist
Should be Empty: