Well Water Pressure Tank Maintenance Checklist Form
Use this form to document routine maintenance of well water pressure tanks. Ensure all checklist items are reviewed and completed for accurate maintenance records.
Date of Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Technician Name
*
First Name
Last Name
Location of Tank
*
Inspect tank for visible leaks or corrosion
*
Completed
Not Completed
N/A
Check tank pressure (psi)
*
Test pressure switch operation
*
Operational
Needs Adjustment
N/A
Inspect and clean pressure gauge
*
Completed
Not Completed
N/A
Drain tank to remove sediment
*
Completed
Not Completed
N/A
Check air charge in tank (if applicable)
*
Within Range
Needs Adjustment
N/A
Additional Notes or Recommendations
Submit Maintenance Record
Should be Empty: