Maintenance Discipline Program Checklist Form
Use this Maintenance Discipline Program Checklist Form to track compliance, completion, and findings for maintenance operations.
Maintenance Item
*
Location / Equipment
*
Date of Task
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Responsible Person
*
First Name
Last Name
Checklist Completion Status
*
Completed
In Progress
Not Started
N/A
Checklist Items Completed
Visual Inspection
Functional Test
Parts Replaced
Documentation Updated
Other
Findings / Issues Identified
Follow-up Actions Required
Status of Follow-up Actions
Not Required
Completed
Pending
Additional Comments
Submit Checklist
Should be Empty: