Electrical Switchgear Circuit Breaker Maintenance Checklist
Complete this form to record details of your circuit breaker maintenance inspection. Please fill out all fields accurately.
Technician Name
*
First Name
Last Name
Maintenance Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Equipment/Location Identifier
*
Circuit Breaker Type/Model
*
Breaker Rating (Amps)
*
Maintenance Category / Inspection Type
*
Please Select
Routine Inspection
Preventive Maintenance
Corrective Maintenance
Overhaul
Other
Checklist of Maintenance Tasks Completed
*
Visual inspection of breaker and enclosure
Mechanical operation test
Contact resistance measurement
Tightening of connections
Cleaning of components
Lubrication (if applicable)
Trip function test
Insulation resistance test
Thermal imaging (if performed)
Other
Condition / Observations
*
Issues Found or Corrective Actions Required
*
Technician Signature / Completion Confirmation
*
Submit Maintenance Record
Submit Maintenance Record
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