Campus Preventive Maintenance Checklist Form
Log preventive maintenance tasks for campus facilities with this checklist form.
Staff Name
*
First Name
Last Name
Department or Team
*
Please Select
Maintenance
Electrical
Plumbing
HVAC
Groundskeeping
Other
Date of Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Building or Area
*
Please Select
Main Administration
Library
Science Block
Dormitory
Sports Complex
Cafeteria
Other
Equipment or Asset
*
Maintenance Task Performed
*
Please Select
Inspection
Cleaning
Lubrication
Testing
Adjustment
Other
Task Status
*
Completed
In Progress
Not Completed
Issues Found
Corrective Actions Taken
Additional Comments
Submit Checklist
Should be Empty: