ADDITIONAL INFORMATION REQUIRED FOR ANALYSIS OF MAJOR OR
SYSTEM RELATED FAILURE
(USE ADDITIONAL PAGES AS NECESSARY)
(1) Single line station diagram showing involved breakers
(2) Operation and timing sequence (including all alarms) of this and related breakers
from last time that conditions were definitely normal
(3) Line conditions before, during, and after failure
(4) Oscillograms - attach with explanation & interpretation
(5) Attach a description of the exact position of all mechanical components from the control solenoid through all
interrupter contacts as applicable (photograph each in detail before mechanisms are moved, supply copies
of photos with report.)
(6) Describe arc damage and location of arc products relative to valve seals, (photograph each in detail before
any clean up or post failure mechanism movement, supply copies of photos with report.)
(This form may be copied)
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