Appendix 2 - FMEA worksheet


Name of system .........................................................................					References .................................................................................
Mode of operation .......................................................................					System block diagrams ..............................................................
Sheet No .....................................................................................					.....................................................................................................
Date ............................................................................................					.....................................................................................................
Name of analyst ..........................................................................					Drawings .....................................................................................

Equipment name or number	Function	Ident No.	Failure mode	Failure cause	Failure effect		Failure detection	Corrective action	Severity of failure effect	Probability of failure (if applicable)	Remarks
Equipment name or number	Function	Ident No.	Failure mode	Failure cause	Local effect	End effect	Failure detection	Corrective action	Severity of failure effect	Probability of failure (if applicable)	Remarks