Toilet Flushometer Maintenance Checklist
Document and track maintenance activities performed on toilet flushometers for optimal performance and reliability.
Flushometer Location
*
Date of Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Technician Name
*
First Name
Last Name
General Condition
*
Good
Needs Attention
Requires Repair
Maintenance Actions Performed
Cleaned exterior
Inspected for leaks
Checked water pressure
Replaced gasket/diaphragm
Tightened connections
Other
Issues Found
Parts Replaced (if any)
Actions Taken
Additional Notes
Submit Maintenance Record
Should be Empty: