Machine Breakdown Report Template

Use the Machine Breakdown Report Template to document equipment failures, identify causes, track repair actions, and improve future maintenance strategies.

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Health & Safety
Machine Breakdown Report Template

Machine & Incident Details

Breakdown Description

Safety & Immediate Response

Initial Actions Taken

Root Cause Analysis

Repair & Corrective Actions

Preventive Measures

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Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

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Machine Breakdown Report Template

Use the Machine Breakdown Report Template to document equipment failures, identify causes, track repair actions, and improve future maintenance strategies.

1. What is the machine name, model, and asset/ID number?

2. Where was the machine located at the time of the breakdown?

3. What date and time did the breakdown occur?

1. What was the nature of the breakdown (mechanical, electrical, hydraulic, etc.)?

2. What abnormal signs were observed before or during the breakdown (e.g., noise, vibration, smoke, overheating)?

3. Did the machine stop suddenly or gradually lose performance?

4. Was production halted completely or partially due to the issue?

1. Were there any safety hazards, near misses, or injuries reported?

2. Were emergency shutdown procedures activated successfully?

3. Was the area cordoned off to prevent further risk?

4. Were fire, chemical, or electrical hazards involved?

1. Was the breakdown reported immediately to the supervisor/maintenance team?

2. Was the machine tagged “Out of Service”?

3. Were temporary fixes or adjustments attempted?

4. Was production shifted to another machine or line?

1. Was the breakdown due to wear and tear, operator error, or lack of maintenance?

2. Were faulty parts, loose connections, or misalignments identified?

3. Was there evidence of insufficient lubrication or overheating?

4. Was an external factor (e.g., power fluctuation, material jam) responsible?

1. What parts were repaired or replaced during breakdown recovery?

2. Were new settings, calibrations, or alignments made?

3. Was testing done to confirm the machine is safe and operational again?

1. Should the preventive maintenance schedule be updated based on this breakdown?

2. Are additional operator training or supervision measures required?

3. Do spare parts need to be stocked to reduce downtime in the future?

4. Is a follow-up inspection scheduled to monitor machine performance?