Equipment Breakdown Log

Breakdown details

Date

Time breakdown discovered

Logged by

Equipment / unit affected

Description of breakdown

Excess emissions — Condition 5d

Did or could this breakdown cause excess emissions?

If yes or unknown: 2-hour EHD notification required — Condition 5d

2-hour notification required
Call (505) 224-6977 AND fax (505) 768-1977 — both simultaneously — within 2 hours.
Document notification details below. Condition 5d.

Corrective actions

Corrective actions taken

Parts / materials used

Repair performed by

Breakdown resolved?

Time operations resumed

Photo — failed component before repair

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Photo — equipment after repair

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Name (print)

Signature

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