Post-Maintenance Inspection Checklist Form
Document inspection results, issues found, and corrective actions after maintenance work.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Maintenance Job/Work Order Number
*
Equipment or Area Inspected
*
Inspection Checklist
*
Rows
Pass
Fail
N/A
Visual inspection completed
1
2
3
Safety guards in place
4
5
6
Lubrication as required
7
8
9
No leaks detected
10
11
12
Electrical connections secure
13
14
15
Issues Found (if any)
Corrective Actions Taken
Overall Condition After Maintenance
*
Satisfactory
Requires Follow-up
Not Operational
Additional Comments
Inspector Signature
*
Date of Sign-off
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Inspection
Submit Inspection
Should be Empty: