PREVENTIVE MAINTENANCE REPORT

DISTRIBUTION PANEL

Manufacture : WON :
Unit / Equip. : Location :
Unit Tag. No : Date :
Model :

1. VISUAL INSPECTION

DESCRIPTION CONDITION
Cubicle Cleanliness
Main Cable Connect
Wiring Control Cable
Cable Marker
Cable Gland
Cable Teghtening
Ground Cable Condition

PICTURE

Prepared by Contracted Witness by PHE Acknowledge by Contracted

Team Member Name : Approved by PHE OIM
Leader Maintenance Leader Coordinator

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Sign & Date Sign & Date Sign & Date Sign & Date
Name Name Name Name : Indra TJ
 PREVENTIVE MAINTENANCE REPORT
DISTRIBUTION PANEL

Manufacture : WON :
Unit / Equip. : Location :
Unit Tag. No : Date :
Model :

2. FUNCTIONAL

CIRCUIT BREAKER CABLE

REMARKS
No. Load Current
Amp Type Tested Type Size Condition
Breaker (Ampere)

3. INFRARED THERMOGRAPHS
Refer to Report PM Infrared Thermographs

PICTURE

Prepared by Contracted Witness by PHE Acknowledge by Contracted

Team Member Name : Approved by PHE OIM
Leader Maintenance Leader Coordinator

1
2
3
4
Sign & Date Sign & Date Sign & Date Sign & Date
Name Name Name Name : Indra TJ