Formate.No.

:-
OHANA INDUSTRIES LLC Issue Date:-
Rev.Date :
BREAKDOWN MONITORING SLIP
Rev. No :00
Name of the Equipment : -

Section : -

Details of Failure : -

Date of B/D : - Date of resumption :-

Time of B/D :- Time of resumption :-
Correction Details : -

Root cause analysis :-

Corrective & Preventive action : -

Sign of Intimator Sign of acknowledger
 Format.No: Format.No:
OHANA INDUSTRIES LLC OHANA INDUSTRIES LLC
Issue Date:- Issue Date:-
Rev.Date : Rev.Date :
Breakdown Monitoring Slip Breakdown Monitoring Slip
Rev. No :00 Rev. No :00
Name of the Equipment : - Name of the Equipment : -

Section : - Section : -

Details of failure : - Details of failure : -

Date of B/D : - Date of resumption :- Date of B/D : - Date of resumption :-

Time of B/D :- Time of resumption :- Time of B/D :- Time of resumption :-
CORRECTION DETAILS : - CORRECTION DETAILS : -

Root cause analysis :- Root cause analysis :-

Corrective & Preventive actions : - Corrective & Preventive actions : -

Sign of Intimator Sign of acknowledger Sign of Intimator Sign of acknowledger