F&B Equipment Maintenance Request Form

1. Request Information

Request Date:

Time of Request:

Requested By (Name):

Department/Area:

Contact Phone/Extension:

Email Address:

2. Equipment Details

Equipment Name:

Asset Tag/ID Number:

Manufacturer/Model:

Location of Equipment:

Is the Equipment Currently Operational?

Yes (Minor Issue)

Limited Operation

No (Completely Down)

Is it a Safety Hazard?

Yes

3. Description of Issue

Priority Level:

Emergency (Affects immediate operation/safety): Requires immediate attention (e.g., refrigeration failure, major leak, safety hazard).

High (Significant operational impact): Needs attention within 24 hours (e.g., single oven down, slow leak, intermittent operation).

Medium (Minor operational impact): Standard repair timeline (e.g., light bulb out, squeaky door, cosmetic damage).

Low (Non-critical, aesthetic/future concern): Can wait for scheduled maintenance.

Detailed Description of the Problem: (Please be specific. What happened? When did it start? What exactly is the equipment doing or failing to do?)

What have you already tried to fix the issue? (e.g., Reset power, checked breaker, cleaned filter, replenished water/product)

4. Maintenance Use Only (Do Not Fill)

Maintenance Request #:

Date/Time Assigned:

Assigned Technician/Contractor:

Diagnosis/Root Cause:

Parts Required:

	Part Number	Quantity
1
2
3
4
5

Estimate Completion Date:

Resolution/Action Taken: (Detailed description of work performed)

Date/Time Completed:

Downtime (Total Hours):

Technician/Contractor Signature:

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