Testing. Advising. Assuring.

Failure Analysis Questionnaire

Client Details
Company Name:
Name of the Contact Person:
Address:
Phone Including Country code: Fax:
E mail:
Your Industry:
Component Details
1.Component name:

2.Application:
3. Service Duration:
4.Suspected Type of Failures: Fracture/Corrosion/Others (Specify):
5.Operaing Conditions:a)Temperature:
b)Pressure:;
c)Environment:
d)Others(Specify):
6.Material Details (also filler details if welding is involved):
7.Manufacturing Process: (Please attach WPS/PQR records, if weld is involved)
8. Brief History of the Failed Component (please include relevant Preventive Maintenance records if available, e.g., NDT,
Vibration Report
9.Any Other remarks:

Note: Attach relevant sketches/drawing/photographs if available.

Please return this form to anil.chikkam@exova.com

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