Free template
Updated
Maintenance request form template
A maintenance request form is the sheet anyone in a plant fills in to ask maintenance to look at a problem. It records what is wrong, where, how bad and how urgent, so a technician can find it without a call back. This template has a one-page form with a requester side and a maintenance side, a page on writing a request and setting a priority, and an Excel log that works out how long each request waited for an answer and flags the late ones. A worked example is included.
Free to use: print it, copy it and edit it for your team. Enter your name and work email once to download.
A requester section with request number, equipment, a box for what is wrong, machine state and priority tick boxes, a maintenance section with a priority guide and a decision, and a confirmation strip at the bottom.Requester sideMachine state and riskPriority guideMaintenance answerWork order and target dateRequester confirmationExcel log and summary
When to use it
When to use a maintenance request form
- When operators tell maintenance about problems by word of mouth, and some of them get lost or get told twice.
- To give everyone the same way to raise a problem, whether the plant has a CMMS or not.
- To show a requester that someone has seen the request, with an answer target for each priority.
- To find out how long requests wait and which machines keep coming back.
- For a planned job with parts and a job plan, open a work order once the request is accepted. The request is the first step, not the whole job.
How to fill it in
- 1
Say who, where and which machine
Request number, date and time, your name, the area or line and the equipment ID or tag. Use the ID that is on the machine so the technician goes to the right one. - 2
Describe what you saw, heard or smelled
Write what is different from normal, since when and how often. 'Fill head 3 drips after every cycle, since Monday' can be found. 'Machine broken' cannot. - 3
Tick the machine state and any risk
Running, running badly or stopped. If anyone could be hurt or a guard is missing, stop and tell your supervisor before you write anything else. - 4
Maintenance sets the priority and answers
Use the guide on the form: P1 to P4. Answer within the target for that priority: accept it, ask a question, mark it as a duplicate or decline it with a reason. - 5
Give an accepted request a work order or a date
Write the work order number, who it is assigned to and a target date. A five minute fix can be closed straight from the request. - 6
The requester confirms it is fixed
Close a request only when the person who raised it agrees. If not, write what is still wrong and it stays open. - 7
Review the log once a week
In the Excel file, look at the Summary: new, open and late, and the oldest open request. Ask why each late one was late.
How the answer target works
The priority guide in the Excel log
These are starting values on the Settings sheet. Change the answer days to match your own rules and every status recalculates.
| Priority | Use it when | Answer within |
|---|---|---|
| P1 Emergency | Someone could be hurt, or the line is stopped. | The same day |
| P2 Urgent | Running badly, or product quality is at risk. | 1 day |
| P3 Routine | A nuisance now that will get worse. | 3 days |
| P4 Planned | An improvement or a job that can wait for a planned stop. | 10 days |
P1 Emergency
- Use it when
- Someone could be hurt, or the line is stopped.
- Answer within
- The same day
P2 Urgent
- Use it when
- Running badly, or product quality is at risk.
- Answer within
- 1 day
P3 Routine
- Use it when
- A nuisance now that will get worse.
- Answer within
- 3 days
P4 Planned
- Use it when
- An improvement or a job that can wait for a planned stop.
- Answer within
- 10 days
A filled-in example
Illustrative, not a benchmarkAn example (illustrative): thirteen requests raised between 23 October and 9 November at a made-up plant, with the status shown as at 10 November 2026. The names, equipment and numbers are made up.
- 13 requests: 5 Closed, 3 Open, 2 New, 1 Waiting for requester, 1 Duplicate and 1 Declined.
- The answer targets are the same day for P1, 1 day for P2, 3 days for P3 and 10 days for P4. 9 requests were answered in time, 3 late and 1 is not yet due: 9 ÷ 12 = 75% answered on time.
- The three late ones: request 1 (dock door, P3) was answered 4 days after it came in, request 5 (labeller, P2) after 2 days, and request 11 (aisle light, P3) has had no answer for 4 days.
- All 3 P1 requests were answered the same day. 4 of the 5 P2 requests were answered in time, and 2 of the 4 P3 requests.
- Request 4 is a duplicate of request 2 (fill head 3) and is closed against the same work order instead of being worked twice.
- Request 12 is the second gate interlock request on L1-CONV-04 in 13 days (27 October and 9 November).
- Request 1 has been open 18 days, the only one open for more than 14.
The weekly review starts with the three late answers and request 1, which is 18 days old, then asks why the interlock on L1-CONV-04 has come back.
Common mistakes
One request that covers three problems
Raise one request per problem. Three faults on one sheet get one priority and one close date, and the two that matter less are lost.
'Machine broken' and nothing else
The technician has to walk over and ask. Write where, what you saw, since when and how bad, and a photo or a tag if you can.
Everything is P1
If every request is an emergency the guide stops working. P1 is for someone at risk or a stopped line. A person who knows the machine can change the priority, and says why.
Answering only when the work is done
The answer target is about telling the requester that someone has seen it and what will happen next. That is what stops the same request being written three times.
Closing a request without asking the requester
The person who raised it knows whether the problem has gone. Ask before you close, and leave it open if the answer is no.
Download the template
Free to use: print it, copy it and edit it for your team. Enter your name and work email once to download.
Run this template in LeanSuite
In LeanSuite a professional maintenance tag becomes a work order with photos, location and equipment ID attached, rules route it to the right technician and set its due date by priority, and the technician records the fix and the parts used when closing it.
See it in a 45-minute demoIn the lean glossary
FAQ
Maintenance request form template: common questions
A form anyone can fill in to ask maintenance to look at a problem. It records who is asking, which machine, what is wrong, how urgent it is and what maintenance decided, so the request is not lost and does not depend on who was asked.
The date and time, who raised it, the area and the equipment ID, what is wrong in specific words, the machine state, any safety risk, whether quality is affected and a suggested priority. A photo or a tag on the machine helps.
A request says there is a problem. A work order is the plan to fix it, with a job description, parts, a technician and a date. A request that is accepted and needs more than a quick fix becomes a work order.
Rank by risk first, then by what the problem does to the line and to quality. This template uses four levels: emergency, urgent, routine and planned. They are a starting point: set your own levels and answer times, and let a person who knows the machine change a priority and say why.
It depends on the priority and on your site. This template starts at the same day, 1 day, 3 days and 10 days for P1 to P4. An answer means telling the requester what will happen, not finishing the job. Change the targets on the Settings sheet.
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- Obeya room plannerPlan the walls, owners, cadence, agenda and rules of an obeya, then run the weekly review of KPIs, problems, actions and milestones.
- Paper forms inventory (paperless manufacturing worksheet)Every paper form, checklist and log in one list: hours a month, who acts on it, how long the paper waits, and which forms to move first.
- Continuous improvement software evaluation scorecardCompare CI software vendors: a must-have gate, eight weighted criteria scored 1 to 5, points out of 100 and a rank, with a demo script and reference questions.
- Lean principles assessment templateThe five lean principles as 25 things you can see on one value stream, answered yes, partly or no on a walk, with a score per principle, the next step and a trend over walks.
- Employee engagement survey templateA short anonymous pulse survey for shop floor staff: 14 statements in six drivers, two open questions, results by driver and team, and the actions.
- Hansei reflection sheet (lessons learned)A written look back at one finished project, event or launch: goals against results in numbers, causes rather than blame, lessons to keep or change, and where else they apply.
- Safety cross calendarA month drawn as the green cross, colored each day by the most serious safety event, with totals and days since the last injury.
- Daily kaizen routine boardA team's 10 to 15 minute daily routine at the board: one problem from each person, small fixes with one owner, counted every week.
- Quality circle meeting recordA circle's charter, a one-page record for each meeting and a problem register that follows every problem from selected to closed or escalated.
- Operational excellence assessment templateThe ten principles of operational excellence as 30 behaviors and practices you can see, scored 1 to 5 by several people, with the spread, the three lowest principles and an action plan.
- Scrum meeting agenda templateTimed agendas for the five scrum meetings, a sprint planning sheet, a retrospective sheet, and an Excel sprint backlog with a burndown.
- Toyota Production System (TPS) house templateThe TPS house for one plant or value stream: roof, two pillars and foundation, with what you do today, the evidence, a status and the next step for each element.
- EPEI and batch size calculatorHow often each part can come round on a shared machine (EPEI) and how big each batch must be, from demand, cycle times and changeovers, now and after SMED.
- People, process, technology (PPT) assessmentCheck one change before go-live: 18 people, process and technology statements scored 1 to 4 by the people who will use it, the lowest element and the actions.
- Process capacity sheet templateEach machine in a part's routing with manual, auto and tool change time, its capacity per shift, and the step that limits the cell against demand.
- Jidoka worksheet (stop at abnormality)For one line or cell, every abnormality that should stop the work: how it is detected, how the work stops, who is called, the immediate fix and the root cause step, plus a log of real stops.
- Team charter templateA one-page charter for a standing team: purpose, scope, roles, the KPIs it owns, which decisions it makes itself, norms and cadence.
- Chaku-chaku line plannerPlan a load-load cell: time each machine, load and walk, check that every machine is ready when the operator comes back, compare the cell cycle with takt and size the crew.
- Standard operating procedure (SOP) templateA full SOP in the hierarchical step format, from purpose and scope to the steps, records, revision history and approvals, with review checks and an SOP register.
- Process improvement method selectorEight questions about one problem, an example rule that suggests a method and a matrix of nine methods: when each fits, the usual team and time, and the template to start with.
- X-bar and R control chart template25 subgroups with means and ranges, control limits from A2, D3 and D4, signal flags, both charts and a reaction log.
- Gage R&R study sheet10 parts, 2 or 3 appraisers, 2 or 3 trials: EV, AV, GRR, PV, %GRR and ndc by the average and range method.
- Root cause analysis templateOne report from problem statement to proof: containment, evidence, analysis, verified causes, actions and the effectiveness check.
- Safety pillar 90-day model area planThirteen weeks from the incident pyramid to safety standards on one model area, a KPI board, the day-90 gate and expansion waves.
- Quality control pillar 90-day model area planThirteen weeks from the QA matrix to the QM matrix on one model area, a KPI board, the day-90 gate and expansion waves.
- Environment and energy pillar 90-day model area planThirteen weeks from waste and energy maps to area standards on one model area, a KPI board, the day-90 gate and expansion waves.
- Focused improvement 90-day model area planThirteen weeks from the loss Pareto to standardized fixes on one model line, a KPI board, the day-90 gate and expansion waves.
- Logistics and customer service pillar 90-day model area planThirteen weeks from the current-state map to pull on one model value stream, a KPI board, the day-90 gate and expansion waves.
- People development pillar 90-day model area planThirteen weeks from the skills matrix to trained cover on critical tasks in one model area, a KPI board, the day-90 gate and expansion waves.
- Cost deployment pillar 90-day model area planThirteen weeks from the loss map to costed, ranked projects in one model area, a KPI board, the day-90 gate and expansion waves.
- Moving from Excel to one system checklistA 34-point checklist and a file inventory for moving trackers from spreadsheets to one system: keep, move, connect or retire, clean, pilot, run both, retire.
- Prioritization matrix templateScore up to 20 improvement ideas on weighted criteria, rank them, test the ranking with equal weights and place each one on an effort and benefit grid.
- Cost per unit worksheet (manufacturing cost per good unit)One product's cost per good unit by materials, labor, machine and overhead, the gap to target, and which cost lever is worth most a year.
- Digital manufacturing readiness assessmentScore 24 statements on process, technology and people from 0 to 4, check the balance between them and rank the gaps by what matters in your plant.
- Manufacturing KPI dashboard templateWeekly plant numbers in, 14 KPIs out: OEE and its parts, first pass yield, scrap, on-time delivery, recordable rate, cost and absence, each against a target.
- Error-proofing verification log (daily master-sample check)Each poka-yoke device proved every day or week with a known-bad sample, with missed checks counted and the hours and parts at risk worked out when one fails.
- Training matrix template with expiry datesPeople by required trainings with expiry dates, OK, due, expired and missing flags, compliance by person and area, cover per training and a renewal list.
- Defect catalogue template with boundary samplesEvery defect with a definition, a class and the reason for it, measured accept and reject limits by zone, boundary samples, a defect log with DPU and Pareto, and an inspector agreement check.
- I-MR chart template (individuals and moving range)Up to 100 single readings with moving ranges, limits from a baseline, five run-rule flags, both charts, a second phase and a reaction log.
- Kaizen event preparation checklistEverything that has to be ready before a kaizen event and done after it: 44 items with owners and due dates from 6 weeks before day 1 to 30 days after, five go or no-go gates and a day-by-day agenda.
- Attribute control chart template (p, np, c and u charts)p, np, c and u charts in one workbook: a chart selector, a sample size check, limits for each subgroup, signal flags and four worked examples.
- Tier 2 meeting agenda and escalation sheetA 15-minute tier 2 agenda in ten timed blocks, fixed roles and rules, escalation triggers with time limits, and a log that ages every escalation and sends the answer back down.
- HACCP plan template: hazard analysis and CCP worksheetThe Codex 12 steps in one workbook: team and product, process steps checked on site, hazard analysis with the CCP decision tree, the CCP table with completeness checks, an allergen matrix and a verification schedule.
- Forklift operator training and evaluation recordPer-operator training and evaluation record, a register with three-year due dates and refresher triggers, and a weighted practical evaluation scoresheet.
- REBA worksheet (Rapid Entire Body Assessment)Score up to six postures with REBA: body-part drop-downs, Tables A, B and C as lookups, final score and action level, and a before and after comparison.
- Mock recall template: traceability exercise worksheetTrace a finished lot back to every input lot and forward to every first customer, reconcile the quantities against a tolerance and time it against your target.
- ISO 9001 internal audit checklist (production area)46 audit questions for the production floor in 11 processes, each with its ISO 9001:2015 clause, what evidence to look for and the sample to take, plus five defined grades, a findings log, a finding report and a summary by clause.
- ISO 45001 internal audit checklist44 audit questions for the plant floor in 16 safety topics, each with its ISO 45001:2018 clause, the evidence to look for and the sample to take, plus 12 worker interview prompts, a findings log and a summary by clause.
- Plan for every part (PFEP) templateOne row per part: supplier, pack, container, usage, lead time and locations, with ABC classes, market and line kanban counts and a lineside space check.
- Food plant GMP inspection checklist (21 CFR 117 subpart B)55 checks in the order of 21 CFR 117 subpart B, each citing its paragraph and saying what to look at, with a grade, finding, owner and due date; results by section and grade, a walk route and a bakery example.
- Master sanitation schedule with pre-op verificationA master list of cleaning tasks by area and equipment with frequency, chemical, lockout, who and next due date, a weekly on-time count, and the pre-operational verification log with a release step.
- Changeover matrix templateA from-to matrix of changeover minutes with the clean each transition needs (allergen, colour, format), and a weekly planner that totals the order and suggests a shorter one.
- Measurement uncertainty budget templateA GUM uncertainty budget: Type A and B rows, divisors by distribution, sensitivity coefficients, uc, νeff, k from the t-table, U, TUR and a guard band check.
- Video time study filming checklistA pre-shoot checklist and shot log for filming a time study on video: camera, light, people, settings, power and review.
- Reorder point and safety stock sheet (many parts)Safety stock, reorder point, order quantity and an order list for up to 500 parts, worked out from each part's own demand and lead time history.
- OSHA compliance calendar (general industry)37 recurring federal OSHA duties with the paragraph, interval, owner, next due date and an overdue flag, plus a 12-month view and counts by owner.
- TRIR and DART rate trackerMonthly hours, OSHA 300 case counts and near misses in; rolling 12-month TRIR and DART rate, a case budget against your target and a trend chart out.
- Energy use and EnPI trackerMonthly electricity, gas and fuel in one unit, a 12-month regression baseline, expected against actual energy for each month, an EnPI ratio, the running saving and the tests that say whether the model can be trusted.
- FIFO lane sizing sheetThe maximum for a FIFO lane from the stop it must cover, in whole containers, with length, refill and wait checks for up to eight lanes.
- Pugh matrix templateCompare up to 8 concepts with a datum as better, same or worse on up to 12 criteria, flag must-haves, and carry the strongest into a second round.
- Machine guarding inspection sheetA machine register with due dates and a status per machine, 21 checks tied to OSHA 1910.212, .219 and .147, a guard opening check against Table O-10, and an action log.
- Quad chart templateA project on one page in four boxes: idea and owner, problem, approach, and cost, schedule and result.
- Toolbox talk topics (52 weekly topics)52 weekly toolbox talk topics, each with a one-line key message and a discussion question, and a tracker for the year.
- Defect detection matrix templateMap where each defect is created and where it is found, score the gap and move the check closer to the cause.
- Project savings validation checklistThe gate between a project's claim and a reported saving: 20 checks, a claims register and a six-month sustainment check.
- Life cycle cost analysis templateCompare up to three machines over ten years: price, energy, upkeep, failures and down time, discounted to present value.
- Emergency action plan templateA written emergency plan for a plant: site facts, roles and backups, warden coverage, scenario steps and a drill record.
- Preliminary hazard analysis (PHA) worksheetFind and score the hazards of a new line, machine or process before design is fixed, then choose controls and re-score.
- Risk register templateOne scored list of operational risks with owners, actions and dates, a heat map and a review log.
- Energy loss matrix templateSeven types of energy loss by six energy sources with a cost in each cell, an action plan and an idle-period shutdown checklist.
- Management safety tour formA leader's scheduled safety walk: observation form, operator interview, tally, actions, rota and a tour log with a dashboard.
- Hazard prediction worksheetA pre-task worksheet: score what could go wrong at each step of a job, add a countermeasure and score again.
- Chemical inventory and SDS register templateA register of every chemical on site with its hazard class, safety data sheet and label, and a check that incompatible products are kept apart.
- Safety committee meeting minutes templateMinutes for a safety committee: attendance, nine agenda items, an action log that carries open actions forward, and monthly numbers.
- Environmental compliance audit checklistAn internal environmental audit: 37 questions with what to look for, a findings log with classes and a score by section.
- APQP checklistThe five APQP phases as a checklist: deliverables, owners, due dates, gate reviews and an issues list.
- Out-of-control action plan (OCAP) templateA reaction plan for a control chart: the steps, what each signal means, who to call and a log of events.
- Quality inspection checklistAn in-process and final inspection record: measured characteristics, visual checks, a decision and first pass yield.
- AQL sampling plan templatePick a sample size, read accept and reject numbers, record the defects and decide on the lot.
- MSA study workbookBias, linearity and stability study sheets for a gauge, with the arithmetic done and a guide to which study when.
- Incoming quality control stage sheetA register that shows how much control each purchased part has and plans the move from your dock to the supplier's process.
- Internal audit schedule templateA year of internal audits planned by risk: the programme, the register, the auditors and the findings.
- Approved supplier list templateThe list of suppliers you may buy from, with the evidence behind each, certificate expiry alerts and re-evaluation dates.
- Pest control inspection checklistA pest control walk-round for a food plant, with a log of traps and stations and action levels for each type of device.
- Vehicle inspection checklist53 checks for a truck, tractor or trailer, each tied to the federal rule it comes from, with a defect log.
- Pre-trip inspection checklistA driver's 42-check walk-round in order, with the driver vehicle inspection report for the end of the day.
- Cleanroom audit checklist33 cleanroom checks split by how often they run (each shift, weekly, per plan, system), a gowning order to watch against, a differential pressure log and a findings log, with a worked week of readings.
- GMP audit checklist for drug manufacturing42 self-inspection checks ordered by the subparts of 21 CFR 211, each with its section, the matching EU GMP chapter and whether it is seen on the floor or in records, graded critical, major or minor, with a worked audit of a packaging line.
- Line clearance checklist28 line clearance checks in six sections (area, equipment, materials, printed materials, documents, coder and vision settings), cleared by the operator and verified by a second person, with a printed-materials reconciliation and a worked example that does not balance.
- ISO 13485 internal audit checklist38 questions on ISO 13485 clauses 4 to 8, each with the FDA QMSR section that brings it in or adds to it, a production floor tab (records, current instructions, training, nonconforming product, CAPA) and a worked audit of a catheter line.
- ISO 22716 GMP audit checklist for cosmetics25 cosmetic GMP checks following the sections of ISO 22716, split into a floor walk (people, premises, equipment, materials, production) and system checks (lab, out of specification, deviations, complaints, change control, audits, documents), with a worked audit of a filling line.
- SSOP template: sanitation standard operating procedureOne sanitation SOP sheet per area or machine (steps, chemical, contact time, PPE, lockout, owner), a 23-check pre-op inspection and a verification log for visual, ATP and micro checks.
- SQF internal audit checklist for food manufacturing54 questions in the two parts of the SQF manufacturing code (system elements and GMP), each group mapped to BRCGS and FSSC 22000, graded Conforms to Critical, with findings, a score and a yearly plan.
- Injection molding defects chart16 molding defects with causes by machine, material, mold and method, first checks, and an Excel defect log with a Pareto.
- ESD audit checklist29 checks for an ESD protected area, with daily tests split from periodic verification, a measurement log and a worked audit.
- Management of change formA change request and review form for a plant: what changes, the hazard review, approvals, pre-startup review, training and close-out.
- Silica exposure control plan templateA written silica plan for general industry: tasks, controls and housekeeping, plus monitoring, medical surveillance, training and a 31-check plan audit.
- OKR template for manufacturingObjectives with three or four key results each, scored 0 to 1.0 from baseline and target every month, cascaded to facility, department and person with an Other bucket for work that serves no objective.
- Goal cascade and alignment templateA one-page cascade tree from company to person with the catchball reply on every card, and an initiatives list that shows how much work serves a goal and how much sits in Other.
- Monthly business review template (operations review agenda)A 90-minute operations review in nine timed blocks: who speaks when, the KPIs each block reviews with red or green, a prep checklist for every presenter and a log of decisions and actions.
- Rolling action item list (RAIL) templateA single running list of actions kept from meeting to meeting, with a weekly review sheet and age counts.
- Goods received note templateA one-page goods received note and an Excel register with accepted to date, still to come and an invoice check for each PO line.
- Lessons learned templateA one-page lessons log, a 45 minute session guide and an Excel register that shows which actions are done, open or overdue.
- Packing list templateA one-page packing list with a pack checklist, and an Excel file that works out volume, shipped to date and back order.
- Meeting minutes templateA one-page minutes form and an Excel log of decisions and actions with owners, due dates and status.
- Sign-in sheet templateA training and meeting sign-in sheet, a visitor sign-in and out sheet, and an Excel register of attendance and visitors on site.
- Purchase order templateA one-page purchase order and an Excel version that adds up the lines, checks the approval limit and tracks what is still to come.
- Action plan templateA one-page action plan and an Excel tracker with percent done, status and a weekly timeline.
- Part submission warrant (PSW) templateA PSW working form plus twelve checks before anyone signs, and an Excel that works out whether the warrant is ready.
- Ballooned drawing and dimensional results templateA ballooning guide and a results sheet for six parts per characteristic, with OK, NEAR LIMIT or NOT OK worked out for each row.
- Attribute agreement analysis templateA 30-part, three-appraiser study sheet for pass or fail decisions, with kappa, effectiveness, miss rate and false alarm rate in Excel.
- DVP&R template (design verification plan and report)A design verification plan and report on one sheet: tests, criteria, owners and dates, with status worked out as of a date.
- Special characteristics matrix templateOne row per special characteristic, followed from drawing to PFMEA, control plan, gauge study and capability, with the first gap named.
- Machine setup sheet templateA setup sheet with limits, a first piece check and setup minutes, and an Excel log of setups against a standard.
- Work instruction templateA one-page work instruction with key points and step times, and an Excel training record that flags re-checks.
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A shift handover sheet, a red tag log, a changeover checklist for one machine: if your team uses it on the floor, ask.