Oil-Water Separator Maintenance Checklist Form
Complete this checklist during each routine inspection of the oil-water separator system.
Date of Inspection
*
-
Month
-
Day
Year
Date
Facility or Location
*
Separator Unit or Asset ID
*
Inspector/Technician Name
*
First Name
Last Name
Operating Status
*
Operating Normally
Not Operating
Requires Attention
Inlet/Outlet Visual Condition
*
No Blockages
Clean
Debris Present
Corrosion Observed
Other
Oil Layer or Sludge Observation
*
No Oil/Sludge
Minor Accumulation
Significant Accumulation
Requires Immediate Removal
Filter/Skimmer Condition
*
Clean
Dirty
Damaged
Replaced
Other
Leaks, Spills, or Abnormal Odors Observed
*
No Issues
Leaks
Spills
Abnormal Odors
Other
Corrective Actions Taken or Required
Completion Notes / Additional Comments
Submit Checklist
Should be Empty: