HVAC Preventative Maintenance Service Checklist

Property Address: Service Date:

Completed By: Dispatch Number:

Number of HVAC Systems on Property:
System 1 System 2 System 3
Brand: Brand: Brand:
Estimate Age: Estimate Age: Estimate Age:
Model Number: Model Number: Model Number:


Check box if satisfactory
Tasks

System 1


System 2


System 3

Comments
Check and (if necessary) clean
condenser coil
S U

S U

S U


Check amperage draw of condenser
motor
S U

S U

S U


Check amperage draw of compressor
S U

S U

S U


Check crankcase heater operation for
heat pumps
S U

S U

S U


Check system operating pressures (freon
levels)
S U

S U

S U


Visual inspection of filter; replace if
customer has replacement filter
S U

S U

S U


General inspection of wiring in the
furnace and the AC units
S U

S U

S U


Visual inspection of furnace chambers
and burners
S U

S U

S U


Check controls and safeties on furnace
S U

S U

S U


Check belts and pulleys adjust if
necessary
S U

S U

S U


Check amperage draw of evaporator
motor
S U

S U

S U


Lubricate motors if oil ports are
accessible
S U

S U

S U


Visual inspection of evaporator coil if
accessible
S U

S U

S U


Check and clear primary/ secondary
condensate lines and pans
S U

S U

S U


Visual inspection of exposed flue pipe
S U

S U

S U


Test temperature rise and drop furnace,
AC, and heat pump
S U

S U

S U


Check thermostat operation
S U

S U

S U


Perform Carbon Monoxide Test
S U

S U

S U

Levels:




Retail work performed (Y/ N) If yes, please explain:
By signing this document, I acknowledge the satisfactory completion of the work identified above.


Customer Signature


Service Contractor Signature