Equipment Failure Root Cause Analysis Report
Equipment Failure Root Cause Analysis Report
Equipment Name or ID
*
Date and Time of Failure
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Equipment
*
Describe the Failure Event
*
Initial Symptoms Observed
Immediate Actions Taken
Root Cause Identified
*
Corrective or Preventive Actions Recommended
*
Person Completing Report
*
First Name
Last Name
Date of Report
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Report
Should be Empty: