Form library · Facilities and maintenance
Pump maintenance checklist
For maintenance technicians recording pump condition and service results. Record equipment and work, duty and conditions and mechanical checks. Try the form below, see every question or download a blank PDF or Word copy.
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What should guide pump maintenance?
HSE advises competent maintenance, manufacturer instructions and safe isolation. Use a procedure suitable for the pump and fluid handled.
Last updated . Facts checked by the SiteSurvey team on 6 October 2026 against HSE maintenance of work equipment and HSE inspection of work equipment.
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Want to see one filled in? See a completed pump maintenance report (PDF), made by SiteSurvey from a fictional site visit.
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Your team completes the pump maintenance on site in the SiteSurvey app on iPhone, iPad and Android phones and tablets. The project name and address fill in for them, it works without signal, and it syncs when the device is back online with photos kept against the question they answer.
Customers and subcontractors do not need the app: send them a link and they can fill it in from any browser.
Every question in the pump maintenance template
A pump maintenance record covering duty, seals, bearings, coupling, suction and discharge readings, service work, defects and return-to-service limits. 6 sections and 48 questions. Follow-up questions and guidance appear only when an answer calls for them, so the person on site never sees the ones that do not apply.
Make it your own: every question is editable
This is a starting point, not a fixed form. Once it is in your SiteSurvey account you can reword any question, add or remove questions, sections and answer options, and add your own logo, so it fits the way your team works and the jobs you do.
Details you only enter once
Add this form to a project in SiteSurvey and it fills in what the project already knows, so nobody on site retypes it and every form on the job uses the same names. Anything filled in can still be changed.
- Project: the project name
- Site or premises address: the site address, from the space or the project
- Client or organisation: the project's customer
- Manufacturer, model and serial number: the product's model
Record details and scope
- ProjectShort answer
Filled in from the project in SiteSurvey.
Fills in from the project name - Site or premises addressShort answerFills in from the site address, from the space or the project
- Client or organisationShort answerFills in from the project's customer
- Record date*Date
- Person completing the record*Short answer
- CheckFor competent maintainers. This is not a pressure test certificate, hazardous-area approval or permission to open an unisolated system.
- CheckHSE advises competent maintenance, manufacturer instructions and safe isolation. Use a procedure suitable for the pump and fluid handled.
Equipment and work
- Pump asset ID and location*Short answer
- Manufacturer, model and serial number*Short answerFills in from the product's model
- Scan the data plateScan a label: serial number, model number, asset number
Optional. Scan the label or data plate to capture the serial and other numbers.
- Maintenance procedure and revision*Short answer
- Technician and competence reference*Short answer
- Planned work and exclusions*Notes
- Safe isolation or permit reference*Short answer
Duty and conditions
- Fluid, hazards and safety data reference*Short answer
- Duty point and operating range referenceShort answer
- Run hours and duty or standby roleShort answer
- Reported vibration, noise, leakage or loss of performanceNotes
Mechanical checks
For each reading include the location, units, operating condition and comparison criterion. Record an unavailable reading as a limitation.
- Mountings and coupling condition checked*Choose one
- Acceptable
- Action needed
- Not checked
- Not applicable
- Action, limitation or reason not applicable*NotesShown only when the answers above make it relevant
- Seals and visible leakage assessed*Choose one
- Acceptable
- Action needed
- Not checked
- Not applicable
- Action, limitation or reason not applicable*NotesShown only when the answers above make it relevant
- Bearings and lubrication checked to procedure*Choose one
- Acceptable
- Action needed
- Not checked
- Not applicable
- Action, limitation or reason not applicable*NotesShown only when the answers above make it relevant
- Suction and discharge connections and strainers checked*Choose one
- Acceptable
- Action needed
- Not checked
- Not applicable
- Action, limitation or reason not applicable*NotesShown only when the answers above make it relevant
- Guards restored and rotation or function verified safely*Choose one
- Acceptable
- Action needed
- Not checked
- Not applicable
- Action, limitation or reason not applicable*NotesShown only when the answers above make it relevant
- Measured valueRepeat for each measured value. Each one asks:
- Measurement point and parameter*Short answer
- Actual value and unit*Short answer
- Acceptance range and source*Short answer
- Instrument ID and calibration referenceShort answer
- Assessment*Choose one
- Within criterion
- Outside criterion
- Unable to assess
- Response to exception*NotesShown only when the answers above make it relevant
Work and handback
- Work performed and parts usedNotes
- Post-work tests and evidenceNotes
- Equipment handback*Choose one
- Available within recorded limits
- Restricted use
- Out of service
- Restrictions, isolation and person informed*NotesShown only when the answers above make it relevant
- Condition and work evidence photosPhotos
Actions and review
- Are further actions required?*Choose one
- Yes
- No
- Further actionRepeat for each further action. Each one asks:Shown when “Are further actions required?” is “Yes”
- Action and evidence reference*Notes
- Person responsible*Short answer
- Target dateDate
- Action status*Choose one
- Open
- In progress
- Completed
- Completion evidence*NotesShown when “Action status” is “Completed”
- Outstanding limitations and information to pass onNotes
- Record status*Choose one
- Ready for review
- Further work needed
- Work or use stopped
- Reviewed byShort answer
- Review dateDate
- Author signature*Signature
- CheckSigning records the information entered. It does not itself certify legal compliance, remove a limitation or authorise unsafe work.
Scope and responsibility
For competent maintainers. This is not a pressure test certificate, hazardous-area approval or permission to open an unisolated system.
What a useful entry looks like
Measured value
For each reading include the location, units, operating condition and comparison criterion. Record an unavailable reading as a limitation.
Reading taken at test point TP-2 under the recorded duty condition. Instrument and manufacturer criterion are referenced in the measurement record.
Fictional example of record wording. Use the actual evidence and approved arrangements for your job; this is not a completed report or an instruction to carry out the work.
See it filled in
A completed pump maintenance report, made by SiteSurvey from a fictional site visit: every answer, the photos, the guidance that applied and the sign-off, ready to send as a PDF.
Pump Maintenance FAQs
How should I record “Measured value”?
For each reading include the location, units, operating condition and comparison criterion. Record an unavailable reading as a limitation.
Can it cover different pump types?
Identify the type and procedure first. Explain checks that do not apply and add readings required for that pump.
Are pressure or vibration limits built in?
No. Each reading needs its unit and acceptance source.
How is unsafe equipment recorded?
Select out of service or restricted use and record isolation, restrictions and the person informed.
What are the limits of this template?
For competent maintainers. This is not a pressure test certificate, hazardous-area approval or permission to open an unisolated system.
Can I complete this form on site and share the record?
In the SiteSurvey app the form works offline, with photos and signatures recorded against the questions. Share the completed record as a PDF or a link. Dates and action owners are recorded fields; this form does not send reminders or update other systems.
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