CMI 
Management 
Inc. 
SITE AND BLDG #: 
LOCATION/RM #: 
(Text Box comment ny116-01 )
WO# 
PREVENTATIVE MAINTENANCE PROGRAM CHECKLIST 
LIGHTING, OUTSIDE 
MECHANIC 
SIGNATURE: 
ASSET # START TIME: 
(Text Box comment Ramon V )
(Text Box comment June 2021 checklist)
(Text Box comment 10749
10750
10751
10745
10746
10747)
(Text Box comment 13045
13046
13047
13161
13162
13163) 
DATE: 
FINISH TIME: 
(Text Box comment 6-23-2021)


CHECK 
POINT CHECKPOINT DESCRIPTION TASK COMPLETE NOTES/ ACTIONS 
(IF TASK COMPLETE IS CHECKED NO, PROVIDE EXPLANATION) YES NO 
SPECIAL INSTRUCTIONS 
1 In addition to the procedure(s) outlined in this standard, the equipment 
manufacturer’s recommended maintenance procedure(s) and/or instruction(s) 
shall be strictly adhered to. 
(Text Box comment check )
(Text Box comment check )
2 Schedule and coordinate work with operating personnel. 
3 Follow lock out/tag out procedures at all times. De-energize or discharge all 
hydraulic, electrical, mechanical, or thermal energy prior to beginning work. 
(Text Box comment check )
TO BE PERFORMED AT EACH INSPECTION SERVICE 
(Text Box comment check )
1 Open and tag switch. 
2 Inspect visual condition of wiring. Look for evidence of overheating. 
3 Check for proper light operation. 
(Text Box comment check )
(Text Box comment ok)
4 Test operation of automatic switches/ time clock/ photocells if applicable. 
(Text Box comment check )
5 Inspect light pole and mounting devices for deficiencies. 
(Text Box comment check )
6 For any noted deficiency, takes pictures and open corrective maintenance 
ticket. 
(Text Box comment check )


Note: The technician shall perform any repairs identified during PM up to $250 (direct labor and direct material cost) per PM occurrence. For any deficiencies found 
exceeding $250 open a corrective maintenance (CM) ticket and include the Asset #, WO #, photos, and a detailed discription of the deficiency. 
To be perfomed by: General Maintenance Worker 

Additional Notes: 

Page 
1 
of 
1