Inventory No. : 40.10.08.7.31.

009 Manufacturer : JORG

Equipment Name : SHEARING MACHINE Location : SHEET METAL SHOP
Model/Part Number : 4053 Insp. Period : 01 JANUARY 2023 - 31 DECEMBER 2023
Note: For Inspection Result, put circle to “A” if Accepted or “R” if Need
Serial Number : 8221206
EQUIPMENT PREVENTIVE Repaired
MAINTENANCE INSTRUCTIONS SHEET INSPECTION
ACCOMPLISHMENT SIGN AND DATE
INTERVAL

NO JOB DESCRIPTION 1M 3M 6M 1Y JAN FEB MAR APRL MAY JUN JUL AUG SEP OCT NOV DEC

1. Check of any physical damage. Repair of

replace as necessary

A R A R A R A R A R A R A R A R A R A R A R A R

2. Check all attaching hardware for looseness,

tighten as necessarys

A R A R A R A R A R A R A R A R A R A R A R A R

3. Check cutting edge, repair or replace as

necessary

A R A R A R A R A R A R A R A R A R A R A R A R

4.      

A R A R A R A R A R A R A R A R A R A R A R A R

5.      

A R A R A R A R A R A R A R A R A R A R A R A R

Form No.: GMF/Q-309 Page 1

of 1