Revision No. 2.

0
Perkhidmatan Sokongan Klinik Kementerian
Kesihatan Malaysia PLANNED Document No. FM/M02/1-07
PREVENTIVE MAINTENANCE Page of

Asset Category Fire Protection, Suppression, Hydrant Workgroup Mechanical

Work Order No. Frequency Monthly and Quarterly

CAUTION:

Ensure the stipulated safety procedures are followed while carrying out the PPM activities

Comply
A Safety Precautions Remark
YES NO

1 Carry out lock out/ tag out procedures.

2 Use appropriate PPE

Comply
B Performance (Qualitative) Checklist: Frequency Remark
YES NO

Check pillar hydrant and hose cabinet for any damage

1 Monthly
and corrosion. Repaint if necessary.
Clean the surrounding of hydrant from any debris and
2 Monthly
undergrowth.

3 Ensure the valve is visible. Monthly

4 Check valve and observes the discharge Quarterly

Comply
C Checklist for Safety Inspection on Completion of PM: Remark
YES NO

3 Remove Lock out/Tag out.

4 Raise schedule corrective work order if necessary.

D Consumables used during maintenance: E Part Replaced:

 Revision No. 2.0
Perkhidmatan Sokongan Klinik Kementerian
Kesihatan Malaysia PLANNED Document No. FM/M02/1-07
PREVENTIVE MAINTENANCE Page of

Asset Category Fire Protection, Suppression, Hydrant Workgroup Mechanical

Work Order No. Frequency Monthly and Quarterly

F Tools/Equipment used:

PPM has been performed in compliance to the checklist and the plant/equipment function satisfactory to the intended purpose.
Remarks:

Note: Performed by:

1. Any small damage found, the work must be repair Signature:

immediately and the cost will be absorb in the PPM fee.e Name:

Designation:
Company:
Date: