Preventive Maintenance Date:

Checklist Sheet No:

Equipment : Octogonal Blender Installation Date :

Last Inspection Date:
Make / Model:
Equipment Serial No:
Tag Reference:
C = Check; R=Replace
Timeline
Inspected
SI.NO Activity Description Date
1W 1M 3M 6M 1Yr

1 Inlet / Outlet Valve Seals C R

Control Panel Relay &

2 C R
Contactors
Motor Current Rating /
3 C
Heat decipation

4 Pillow Blocks Greasing C

Rotational check for Noise

5 C
(Max 3 RPM)
Rotational Check with Max
6 C
RPM
7 Vibration limit check C
Check for
8 Hardware/Fastners C
tightness
Note:
• All Check need to performed by qualified technical person only
• Incase of abnormality part need to be serviced or replaced immediately
• Machine shall not be operated with defective component

End User : Approver :

Date/Signature: Date/Signature: