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Suspensin y Reprogramacin de

Mantenimiento Preventivo
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Fecha de Programa: ____________________

Registro No. _____________

Fecha de Programacin: ________________

Fecha Registro: __________


Hora Registro: ___________

Favor de Explicar Brevemente la causa por la cual no se aplico el Mantenimiento


Preventivo al Equipo siguiente:
Marca / Tipo: ________________________________
No. De Control/ Clave: ________________________
Serie: _______________________________________
Del Departamento/rea/Local: __________________
Causa:____________________________________________________________
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Recomendacin/Observacion:________________________________________
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Accin Correctiva: _________________________________________________
__________________________________________________________________
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Responsable: ________________________________________
Cargo Puesto: ________________________________________
Fecha Cumplimiento: __________________________________
Firma ____________________
Autoriza
Coordinador de Electromecnica: ____________________________________
Coordinador general del rea tcnica: ________________________________
C.C.P ARCHIVO

REF-004-MANTTO

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