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|  DOE-STD-1052-93
APPENDIX C
PM DOCUMENT VALIDATION AND FEEDBACK FORM
Route to: Maintenance Manager
MJR NUMBER __________
SAFETY CLASS SR ___ QR ___ NNS ___
PROCEDURE NO. __________
EQ __________
COMPONENT TAG NUMBER __________
DISCIPLINE _______________
COMPONENT DESCRIPTION __________
CRAFTSPERSON ____________________
PM TASK NUMBER
_________________
YES
NO
N/A
1.
Is the materials and tools equipment list complete and
___
___
___
adequate?
2.
May PM task be performed as written?
___
___
___
3.
Does the procedure reflect the current "as-built" plant
___
___
___
configuration?
4.
Are referenced parts/equipment correctly identified and easily
___
___
___
located?
5.
Are graphic illustrations accurate, legible, and easy to
___
___
___
understand, and do they indicate enough illustrative detail to
adequately perform the PM task?
6.
Do data sheets follow sequentially with the procedure book?
___
___
___
7.
Are prerequisites, precautions, and limitations clearly identified?
___
___
___
8.
Are tag numbers, nomenclature, and units/symbols identical to
___
___
___
those displayed on the components or instruments?
9.
Is PM frequency adequate?
___
___
___
10.
Are step, caution, and note statements easily understandable?
___
___
___
11.
Are changes to maintenance job request required?
___
___
___
12.
Are manpower/manhour requirements adequate?
___
___
___
13.
Is concurrent maintenance correctly identified?
___
___
___
Editorial/Grammatical errors identified:
Recommended changes to format, flow, or technical content:
Resolution/Justification:
Resolution by:
Signature
Printed Name
Date
C-3
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