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Customer: Location:

Motor ID/Tag#: Serial No.:

Rating: Date Received:

Rating(Hp/kW): Volatge: Current:

RPM: Freq.: Phase:

Type: Insulation Class: Duty Cycle:

Weight: Brand: Model:

INSULATION @ TEST LOCATION Voltage Setting 500V STATOR FIELD 500V ARMATURE FIELD

Insulation Reading in M (Before Repair) (After Repair)

REMARKS (Low Insulation) (OKAY)

MOTOR MISALIGNEMENT COUPLING DEFECTIVE BRAKE WHEEL DEFECTIVE DAMAGE SHAFT MOTOR FRAME DAMAGE BROKEN OR MISSING FEET MOTOR WET MOTOR EXCESSIVELY DIRTY FIELD COILS SHORTED FIELD COILS GROUNDED SHORTED OR GROUNDED ARMATURE MOTOR LAMINATIONS LOOSE EXCESSIVE VIBRATIONS ROTOR DAMAGE MOTOR STALLED

SHORTED OR GROUNDED STATOR COILS COMMUTATOR DAMAGE ROTOR / ARMATURE OUT OF BALANCE MOTOR SINGLE PHASED LAMINATION DAMAGE MOTOR OVERLOADED BEARING FAILURE - INSUFFICIENT LUBRICATION BEARING FAILURE - EXCESSIVE LUBRICATION BEARING FAILURE - DEFECTIVE BEARINGS BEARING FAILURE - AGE (FATIGUE) PULLED FOR PREVENTIVE MAINTENANCE DAMAGE BRUSHHOLDERS DAMAGE ROTOR RINGS DAMAGE LEADS OTHERS:

No. Poles: No. Slots: No. Coils:

No. Groups: Coil Span (PITCH): Coils/Group:

Turns/Coil: Conductor/Turn: Wire Size:

Connection: Coil Shape & Dia.: Lead Wire Size & Length:

STATOR: ROTOR: ARMATURE or FIELDS: LEADS: BRUSH HOLDERS: SLIP RINGS: METAL WORK: ANTIFRICTION BEARINGS:(Indicate Type) SLEEVE BEARINGS: BEARING SEAL: FRAME SEAL:
Fill up by:

Rewind Rebuild Rewind Repair Reinsulate Repair Housing Sealed Rebuild Rebuild Rebuild Approved by:

Retreat Rewind Retreat Replace Repair Rebuild Journal Shielded Replace Replace Replace Scrape Remachine Remachine Replace Replace Other: Retreat

Clean & Paint Clean & Paint Clean & Paint Seal Clean Turn Open Reinsulate Reset Reset Date:

Dept.: