Breakdown Analysis Worksheet

Machine/equipment Area

Date of occurrence Time

Downtime from Downtime to Total

Issue

Why? Man

Why? Machine

Why? Material

Why? Method

Why? Measurement

Drawing

Root cause

Interim solution Approved by

Time to repair Performed by

Cost

Permanent solution Approved by

Time to repair Performed by

Cost
Closeout
Checklist created? [ ] Yes [ ] No, explain

One-point lesson created? [ ] Yes [ ] No, explain

Include in autonomous [ ] Yes [ ] No, explain

maintenance?
All appropriate personnel [ ] Yes [ ] No, explain
trained
Lessons learned