ICE & WATER DISPENSER PM

UHN West Park Health Care

SELECT EQUIPMENT FROM WEST PARK ASSET LIST

Level / Location

Pod / Area

Room

Model

West Park ID

Serial Number

Warranty Status

Warranty Start

Warranty Expiry

Work Order

Service Date

Technician

UHN CLIENT COPY

Press UHN Client Copy below to choose one or more UHN contacts from the contact list.

Arrival Time

Completion Time

PM Cycle

#	Inspection / Maintenance Item	Pass	Fail	N/A	Comments / Corrective Action
1	Exterior cabinet, panels and hardware inspected and cleaned
2	Power cord, plug and electrical supply visually inspected
3	Internal wiring/connections inspected for damage or looseness
4	Loose components, fasteners and abnormal conditions checked
5	Air filter inspected and cleaned
6	Condenser inspected and cleaned as required
7	Water supply, hoses and connections inspected for leaks/damage
8	External water filter condition and water pressure checked
9	Water inlet and drain connections inspected
10	Ice storage bin cleaned and sanitized
11	Agitator, drip ring and accessible ice-contact parts sanitized
12	Ice/water dispenser nozzle and dispensing area sanitized
13	Drip tray and tray insert removed and cleaned
14	Evaporator condensate / gear-motor drain pans cleaned
15	Ice dispensing operation tested
16	Water dispensing operation tested
17	Abnormal noise, vibration, leaks or oil residue checked
18	Deficiencies/corrective actions documented and photos taken

SERVICE FINDINGS / CORRECTIVE ACTION

Additional repairs required?

Follow-up service required?

EQUIPMENT PHOTOGRAPHS

BEFORE SERVICE

AFTER SERVICE

SERVICE COMPLETION

Technician

UHN Representative

Asset information incorporated from the supplied West Park Ice & Water Dispenser PM Excel list. Selecting an asset automatically fills model, room, West Park ID, serial number and warranty information. The UHN Client Copy button opens the iPad's email composer using the UHN contact list, with the recipients, subject and service details prepared. Attach the saved PDF service report before sending.

Select UHN Client Contact

Choose one or more people to receive a copy of the completed PM report.