JESA Asset MAnagement

Maintenance Execution

Intervention Report Intervention Report

Document Number: JESA-AM-Project No.-Asset No.-MX-REP-0001 Function:
Project Details

Project Title Customer Name

Project Number Date DD-MM-YYYY

JESA Owner of this

JESA Project Manager
document
Name Sign Date
JESA Site Manager Reviewed and Approved by

Problem definition Report Number :

Workshop/ Unit: Created by: Creation date :
Name & N° of Equipment : Failure Code : Cause Code :
Sudden shutdown of the workshop: Date & Time of start of Activities : Diagnostic time : Date & Time of Start :
Shutdown Time : Date & Time of the end of Activities : Preparation Time: Total time of Activities Execution :
Problem description

Activities requires Handling ? If yes , please specify nature and time of Handling :

Problem Description Diagram or Picture of the problem ( use the back of the page if necessary)

No If yes ,
Problem occurred before ? N° of previous FAD
Date
Detailed analysis
definition

Who:
Problem

What :
When:
How:
Where:
Possible causes (1 reason) Likelihood Potential causes verification -Checks carried out & results ( OK=Discarded cause) ( No=Identified cause)
1 1 OK/NOK
analysis
Causes

2 2 OK/NOK
3 3 OK/NOK
4 4 OK/NOK
Immediate countermeasures - Actions taken to restore the equipment to working order Is an "immediate risk assessment" necessary before initiating the repair Yes
Contermeasures

procedure?
Item(s) used to execute immediate countermeasures:

Action by:
Due Date: Closure status:Open/Close
Follow up : Yes No Priority : 1 High 2 Medium Weak JESA responsible :

Form: JESA-MS-AM-MX-TEM-0111
JESA Copyright 2021
 JESA Asset MAnagement
Maintenance Execution

Page 1 of 1

Form: JESA-MS-AM-MX-TEM-0111
JESA Copyright 2021
 JESA Asset MAnagement
Maintenance Execution

n Report

OK/NOK
OK/NOK
OK/NOK
OK/NOK
No

Form: JESA-MS-AM-MX-TEM-0111
JESA Copyright 2021
 JESA Asset MAnagement
Maintenance Execution

Page 1 of 1

Form: JESA-MS-AM-MX-TEM-0111
JESA Copyright 2021
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