Equipment Issue & Breakdown Log

When & who

Date

Time issue discovered

Discovered by

Logged by

What happened

Unit / equipment affected

Issue type

Description

Photo — issue / failed component

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Severity

Did or could this issue cause excess emissions?

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

Did operations stop due to this issue?

EHD notification — Condition 5d

Root cause

Root cause detail

Corrective actions

Corrective actions taken

Parts replaced

Repair performed by

Time operations resumed

Status

Photo — after repair

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Prevention

Actions to prevent recurrence

Maintenance schedule change needed?

I certify that the equipment issue, corrective actions, and all notification details recorded on this form are true, accurate, and complete. This record satisfies the documentation requirements of Air Quality Construction Permit 1634-2AR Condition 1c (equipment deficiency record) and, where applicable, Condition 5d (excess emission event notification record).

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