PowerDB AllForms TestingCo PDF

Table of Contents
Job #FORMS - ALL

PAGE
Customer Example Customer Company

Owner
Substation
Asset
Example Owner
BATTERIES
10760 - BATTERY TEST - CELLCORDER
Example Owner
BATTERIES
10757 - BVM VOLTAGE TEST
Example Owner
BATTERIES
10750 - BATTERY IMP/COND TEST
Example Owner
BATTERIES
SEND STRINGS TO BITE3
Example Owner
BATTERIES
10756 - AUTOMATED BATTERY DISCHARGE
Example Owner
BATTERIES
10754 - BASIC BATTERY DISCHARGE
Example Owner
BATTERIES
10500 - UPS BATTERY DISCHARGE
Example Owner
BATTERIES
10050 - BATTERY INSPECTION
Example Owner
BATTERIES
10200 - BATTERY INSPECTION RESISTANCE
Example Owner
BATTERIES
10000 - BATTERY DISCHARGE
Example Owner
BATTERIES
10100 - BATTERY INSPECTION SPECIFIC
Example Owner
CABLES
13300 - TIME DOMAIN REFLECTOMETER
Example Owner
CABLES
13000 - CABLE PI TEST
Example Owner
CABLES
96005 - PF CABLES
Example Owner
CABLES
12000 - LOW VOLT. CABLE INSULATION TEST
Example Owner
CABLES
13090 - TAN DELTA CABLE TEST
Example Owner
CABLES
13101 - CABLE HIGH POTENTIAL WITH TIMER
COPYRIGHT 2002-2014 POWERDB, INC.
Plant
Position
PAGE
NO.
Example Plant
AUTOMATED
Example Plant
AUTOMATED
Example Plant
AUTOMATED
Example Plant
AUTOMATED
Example Plant
AUTOMATED
Example Plant
AUTOMATED
Example Plant
GENERAL
10
Example Plant
GENERAL
12
Example Plant
GENERAL
13
Example Plant
GENERAL
16
Example Plant
GENERAL
18
Example Plant
AUTOMATED
21
Example Plant
AUTOMATED
22
Example Plant
AUTOMATED
24
Example Plant
GENERAL
25
Example Plant
GENERAL
27
Example Plant
GENERAL
29
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REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Asset
Example Owner
CABLES
14000 - BUS DUCT INSULATION TEST
Example Owner
CABLES
13050 - VLF CABLE TEST
Example Owner
CABLES
13100 - CABLE HIGH POTENTIAL
Example Owner
CABLES
13200 - CABLE HIGH POTENTIAL & INSUL RES
Example Owner
CABLES
14100 - SWITCHBOARD BUS CONNECTION TEST
Example Owner
CIRCUIT BREAKER
92525 - PF SF6 LIVE TANK CIRCUIT BREAKER
Example Owner
CIRCUIT BREAKER
92610 - OCR COUNTER
Example Owner
CIRCUIT BREAKER
92550 - PF VACUUM CIRCUIT RECLOSER
Example Owner
CIRCUIT BREAKER
15300 - BREAKER ANALYZER VANGUARD VCBA-2
Example Owner
CIRCUIT BREAKER
15990 - CONTACT RESISTANCE
Example Owner
CIRCUIT BREAKER
92520 - PF SF6 DEAD TANK CIRCUIT BREAKER
Example Owner
CIRCUIT BREAKER
15055 - LOW VOLT. PWR. CKT. BKR. TEST
Example Owner
CIRCUIT BREAKER
92530 - PF VACUUM CIRCUIT BREAKER
Example Owner
CIRCUIT BREAKER
92510 - PF OIL CIRCUIT BREAKER
Example Owner
CIRCUIT BREAKER
92600 - OCR
Example Owner
CIRCUIT BREAKER
15800 - MOLDED CASE CIRCUIT BREAKER INSP
Example Owner
CIRCUIT BREAKER
92529 - PF SF6 LIVE TANK CIRCUIT BREAKER
Position
PAGE
NO.
Example Plant
GENERAL
31
Example Plant
GENERAL
33
Example Plant
GENERAL
35
Example Plant
GENERAL
37
Example Plant
GENERAL
39
Example Plant
AUTOMATED
41
Example Plant
AUTOMATED
43
Example Plant
AUTOMATED
44
Example Plant
AUTOMATED
46
Example Plant
AUTOMATED
47
Example Plant
AUTOMATED
49
Example Plant
AUTOMATED
51
Example Plant
AUTOMATED
53
Example Plant
AUTOMATED
55
Example Plant
AUTOMATED
57
Example Plant
AUTOMATED
59
Example Plant
AUTOMATED
61
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REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Asset
Example Owner
CIRCUIT BREAKER
92500 - PF AIR-MAG CIRCUIT BREAKER
Example Owner
CIRCUIT BREAKER
16300 - OIL CIRCUIT BREAKER DISSIPATION
Example Owner
CIRCUIT BREAKER
16101 - VACUUM CIRCUIT BREAKER
Example Owner
CIRCUIT BREAKER
16500 - MED VOLT. CKT. BKR. INSUL FLUID
Example Owner
CIRCUIT BREAKER
15100 - LOW VOLT. PWR. CKT. BKR. INSP
Example Owner
CIRCUIT BREAKER
15950 - MOLDED CASE CIRCUIT BREAKER
Example Owner
CIRCUIT BREAKER
16201 - OIL CIRCUIT BREAKER TEST
Example Owner
CIRCUIT BREAKER
15000 - LOW VOLT. PWR. CKT. BKR. TEST
Example Owner
CIRCUIT BREAKER
16400 - OIL CIRCUIT BREAKER LIQUID
Example Owner
CIRCUIT BREAKER
16600 - VACUUM IN OIL RECLOSER
Example Owner
CIRCUIT BREAKER
16001 - MEDIUM VOLTAGE AIR CKT. BKR
Example Owner
CIRCUIT BREAKER
15900 - MOLDED CASE CIRCUIT BREAKER TEST
Example Owner
COORDINATION DATA
18200 - RELAY SETTINGS
Example Owner
COORDINATION DATA
18300 - RELAY DATA
Example Owner
COORDINATION DATA
18000 - CIRCUIT BREAKER DATA
Example Owner
COORDINATION DATA
18500 - DEFICIENCIES LOCATED
Example Owner
COORDINATION DATA
18210 - RELAY SETTINGS DATA
Position
PAGE
NO.
Example Plant
AUTOMATED
63
Example Plant
GENERAL
65
Example Plant
GENERAL
67
Example Plant
GENERAL
68
Example Plant
GENERAL
70
Example Plant
GENERAL
72
Example Plant
GENERAL
74
Example Plant
GENERAL
75
Example Plant
GENERAL
77
Example Plant
GENERAL
79
Example Plant
GENERAL
81
Example Plant
GENERAL
82
Example Plant
GENERAL
84
Example Plant
GENERAL
86
Example Plant
GENERAL
88
Example Plant
GENERAL
90
Example Plant
GENERAL
92
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REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Asset
Example Owner
COORDINATION DATA
18400 - CIRCUIT BREAKER SURVEY
Example Owner
COORDINATION DATA
18100 - FUSE DATA
Example Owner
DISCONNECTS
29001 - LOADBREAK DISCONNECT
Example Owner
DISCONNECTS
15510 - LOW VOLTAGE AIR SWITCH
Example Owner
DISCONNECTS
29101 - DISCONNECT SELECTOR SWITCH
Example Owner
DISCONNECTS
15602 - FUSE DISCONNECT INSP. TEST
Example Owner
DISCONNECTS
15501 - BOLTED PRESSURE SWITCH TEST
Example Owner
GENERATORS
19275 - GENERATOR PI TEST
Example Owner
GENERATORS
98000 - PF GENERATOR TIP UP
Example Owner
GENERATORS
19280 - GENERATOR PI TEST
Example Owner
GENERATORS
19200 - GEN SYSTEM STATUS/SHUTDOWN PG1
Example Owner
GENERATORS
19300 - SWITCHGEAR CHECK LIST
Example Owner
GENERATORS
19400 - ANNUAL ENGINE GENERATOR
Example Owner
GENERATORS
19600 - GENERATOR
Example Owner
GENERATORS
19100 - CO-GEN SYSTEM STATUS/SHUTDOWN
Example Owner
GENERATORS
19250 - GEN SYSTEM STATUS/SHUTDOWN PG2
Example Owner
GENERATORS
19500 - BI-ANNUAL ENGINE-GENERATOR
Position
PAGE
NO.
Example Plant
GENERAL
94
Example Plant
GENERAL
96
Example Plant
GENERAL
98
Example Plant
GENERAL
99
Example Plant
GENERAL
101
Example Plant
GENERAL
102
Example Plant
GENERAL
103
Example Plant
AUTOMATED
104
Example Plant
AUTOMATED
106
Example Plant
AUTOMATED
108
Example Plant
GENERAL
110
Example Plant
GENERAL
112
Example Plant
GENERAL
114
Example Plant
GENERAL
116
Example Plant
GENERAL
118
Example Plant
GENERAL
120
Example Plant
GENERAL
122
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REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Asset
Example Owner
GENERATORS
19000 - GENERATOR LOAD TEST REPORT
Example Owner
GROUND FAULT
22900 - GROUND FAULT PROTECTION
Example Owner
GROUND FAULT
22000 - GROUND FAULT RELAY
Example Owner
GROUND MAT (EARTH) GROUNDING TESTS
24480 - EARTH RESISTANCE DET24C
Example Owner
24470 - INTERSECTING CURVES
Example Owner
24400 - FULL FALL OF POTENTIAL
Example Owner
24420 - SIMPLIFIED FALL OF POTENTIAL
Example Owner
24440 - SOIL RESISTIVITY
Example Owner
24460 - 61.8 PERCENT RULE
Example Owner
24410 - FOUR POTENTIAL
Example Owner
24430 - SLOPE
Example Owner
24450 - STAR DELTA
Example Owner
24010 - FALL OF POTENTIAL TEST
Example Owner
24300 - GROUND ROD SURVEY
Example Owner
25100 - GROUNDED SURFACES TEST
Example Owner
24210 - GROUND RESISTANCE TWO TERMINAL
Example Owner
24020 - GROUND MAT TEST - 20
Position
PAGE
NO.
Example Plant
GENERAL
125
Example Plant
GENERAL
127
Example Plant
GENERAL
129
Example Plant
AUTOMATED
131
Example Plant
GENERAL
132
Example Plant
GENERAL
135
Example Plant
GENERAL
137
Example Plant
GENERAL
139
Example Plant
GENERAL
141
Example Plant
GENERAL
143
Example Plant
GENERAL
145
Example Plant
GENERAL
147
Example Plant
OTHER
149
Example Plant
OTHER
151
Example Plant
OTHER
153
Example Plant
OTHER
155
Example Plant
OTHER
157
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REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Asset
Example Owner
26000 - LINE ISOLATION MONITOR TEST
Example Owner
24000 - GROUND MAT TEST
Example Owner
24220 - GROUND POINT CONTINUITY TEST
Example Owner
25000 - GROUNDED SURFACES MULTI-ROOM
Example Owner
24200 - GROUND RESISTIVITY TEST
Example Owner
INFRARED
45444 - INFRARED INSPECTION FLIR P640
Example Owner
INFRARED
45455 - INFRARED INSPECTION FLIR P65
Example Owner
INFRARED
52222 - INFRARED IMAGE CAPTURES
Example Owner
INFRARED
52000 - THERMOGRAPHIC INSPECTION
Example Owner
INFRARED
52230 - INFRARED REPORT
Example Owner
INFRARED
52005 - INFRARED INSPECTION SUMMARY
Example Owner
INSTRUMENT TRANSFORMERS
27610 - PF CURRENT TRANSFORMER
Example Owner
27655 - CURRENT TRANSFORMER (ADWEL DCT)
Example Owner
27800 - MTO CT RESISTANCE TESTS
Example Owner
27600 - PF POTENTIAL TRANSFORMER
Example Owner
27650 - CURRENT TRANSFORMER TEST
Example Owner
27850 - MTO PT RESISTANCE TESTS
Position
PAGE
NO.
Example Plant
OTHER
159
Example Plant
OTHER
161
Example Plant
OTHER
163
Example Plant
OTHER
164
Example Plant
OTHER
166
Example Plant
AUTOMATED
168
Example Plant
AUTOMATED
169
Example Plant
GENERAL
170
Example Plant
GENERAL
172
Example Plant
GENERAL
174
Example Plant
GENERAL
175
Example Plant
AUTOMATED
176
Example Plant
AUTOMATED
178
Example Plant
AUTOMATED
180
Example Plant
AUTOMATED
181
Example Plant
AUTOMATED
182
Example Plant
AUTOMATED
183
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REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Asset
Example Owner
27750 - PT RATIO
Example Owner
27700 - CT RATIO
Example Owner
27660 - MULTI-WINDING CT TEST
Example Owner
27000 - CT PRIMARY INJECTION RATIO
Example Owner
27100 - CT SEC. VLTG INJECTION RATIO
Example Owner
27111 - CT TRANSFORMER RATIO & SAT
Example Owner
27200 - VOLTAGE TRANSFORMER TEST
Example Owner
27400 - CONTROL POWER TRANSFORMER TEST
Example Owner
27500 - CT RATIO & EXCITATION TEST
Example Owner
27010 - CURRENT TRANSFORMER
Example Owner
27110 - CT TRANSFORMER RATIO & SAT
Example Owner
27150 - CT PRI. INJECTION RATIO-MULTIPLE
Example Owner
27300 - VOLTAGE TRANSFORMER APPLIED
Example Owner
27450 - CONTROL POWER TRANSFORMER TEST
Example Owner
INSULATION FLUID
57956 - SDMYERS FLUID TESTING
Example Owner
INSULATION FLUID
57700 - ONCOR INSULATING FLUID ANALYSIS
Example Owner
INSULATION FLUID
57400 - OIL TEST
Position
PAGE
NO.
Example Plant
AUTOMATED
184
Example Plant
AUTOMATED
185
Example Plant
AUTOMATED
186
Example Plant
GENERAL
187
Example Plant
GENERAL
189
Example Plant
GENERAL
191
Example Plant
GENERAL
193
Example Plant
GENERAL
195
Example Plant
GENERAL
197
Example Plant
GENERAL
199
Example Plant
GENERAL
201
Example Plant
GENERAL
203
Example Plant
GENERAL
205
Example Plant
GENERAL
207
Example Plant
AUTOMATED
209
Example Plant
AUTOMATED
212
Example Plant
AUTOMATED
213
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Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Asset
Example Owner
INSULATION FLUID
57952 - WEIDMANN-ACTI DGA
Example Owner
INSULATION FLUID
57850 - TJH2b DGA
Example Owner
INSULATION FLUID
57450 - OIL TEST COMPACT
Example Owner
INSULATION FLUID
57860 - TJH2b INSULATING FLUID
Example Owner
INSULATION FLUID
57390 - OTS OIL TEST
Example Owner
INSULATION FLUID
57150 - OIL CIRCUIT BREAKER FLUID TEST
Example Owner
INSULATION FLUID
57300 - INSULATING EQUIPMENT INSULATING
Example Owner
INSULATION FLUID
57000 - TRANSFORMER LIQUID COOLANT TEST
Example Owner
INSULATION FLUID
5710T - TRANS. LIQUID COOLANT TRENDING
Example Owner
INSULATION FLUID
57200 - DISSOLVED GAS ANALYSIS-INS FLUID
Example Owner
INSULATION FLUID
57500 - TRANSFORMER FURFURAN ANALYSIS
Example Owner
INSULATION FLUID
57100 - TRANS. LIQUID COOLANT ANALYSIS
Example Owner
MISCELLANEOUS
60050 - DD TEST
Example Owner
MISCELLANEOUS
76000 - MICROHMMETER COOLING CURVE
Example Owner
MISCELLANEOUS
60000 - PI TEST
Example Owner
MISCELLANEOUS
60080 - CUSTOM SV TEST
Example Owner
MISCELLANEOUS
91515 - PF BUSHING
Position
PAGE
NO.
Example Plant
AUTOMATED
214
Example Plant
AUTOMATED
217
Example Plant
AUTOMATED
219
Example Plant
AUTOMATED
220
Example Plant
AUTOMATED
221
Example Plant
GENERAL
222
Example Plant
GENERAL
224
Example Plant
GENERAL
226
Example Plant
GENERAL
228
Example Plant
GENERAL
232
Example Plant
GENERAL
234
Example Plant
GENERAL
236
Example Plant
AUTOMATED
237
Example Plant
AUTOMATED
238
Example Plant
AUTOMATED
239
Example Plant
AUTOMATED
241
Example Plant
AUTOMATED
242
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REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE

Owner
Plant
Substation
Position
Asset
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
90512 - MICROHMMETER MEASUREMENTS - DLRO 200/600
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
90511 - MICROHMMETER MEASUREMENTS - DLRO 10X
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
39000 - POWER MULTIMETER 1
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
60010 - IR TEST
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
60070 - SV TEST
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
60100 - RAMP TEST
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
91510 - PF MISCELLANEOUS EQUIPMENT
Example Owner
Example Plant
MISCELLANEOUS
AUTOMATED
90513 - MICROHMMETER MEASUREMENTS - DLRO H200/MOM2
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
28510 - PANEL CURRENT_VOLTAGE(w GROUND)
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
65100 - MANHOLE INSPECTION REPORT
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
55555 - TRENDING
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
28100 - LOAD RECORDINGS
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
81000 - CALIBRATION DATA LOG
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
66500 - INSPECTION SHEET
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
80000 - METER SETTINGS TEST
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
65150 - CAPACITOR BANK TEST
Example Owner
Example Plant
MISCELLANEOUS
GENERAL
28500 - PANEL CURRENT/VOLTAGE
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PAGE
NO.
243
244
245
246
247
249
250
251
252
254
256
258
261
263
264
266
267
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Job #FORMS - ALL
PAGE
10

Owner
Plant
Substation
Asset
Example Owner
MISCELLANEOUS
65000 - DISSIPATION FACTOR TEST
Example Owner
MISCELLANEOUS
34000 - PANEL METER TEST
Example Owner
MISCELLANEOUS
28000 - LOAD RECORDINGS
Example Owner
MISCELLANEOUS
11111 - DOCUMENT
Example Owner
MISCELLANEOUS
77777 - AERIAL BUCKET UNIT
Example Owner
MISCELLANEOUS
80001 - MULTI-METER SETTINGS TEST
Example Owner
MISCELLANEOUS
11112 - DOCUMENT WITH HEADER
Example Owner
MISCELLANEOUS
65500 - LIGHTNING ARRESTER TEST
Example Owner
MOTOR CONTROL
32900 - VARIABLE FREQUENCY DRIVES (VFD)
Example Owner
MOTOR CONTROL
31000 - MOTOR STARTER TEST
Example Owner
MOTOR CONTROL
30000 - MOTOR CONTROL CENTER INSPECTION
Example Owner
MOTOR CONTROL
32950 - 480 VOLT MOTOR CONTROL CENTER PM
Example Owner
MOTOR CONTROL
31300 - MEDIUM VOLTGE VACUUM MOTOR START
Example Owner
MOTOR CONTROL
31001 - MOTOR STARTER TEST
Example Owner
MOTOR CONTROL
30100 - MOTOR CONTROL CENTER INSULATION
Example Owner
MOTOR CONTROL
31301 - MEDIUM VOLTGE VACUUM MOTOR START
Example Owner
MOTOR CONTROL
31200 - MOTOR CONTROL MCC TEST REPORT
Position
PAGE
NO.
Example Plant
GENERAL
268
Example Plant
GENERAL
270
Example Plant
GENERAL
272
Example Plant
GENERAL
275
Example Plant
GENERAL
276
Example Plant
GENERAL
278
Example Plant
GENERAL
280
Example Plant
GENERAL
281
Example Plant
AUTOMATED
283
Example Plant
GENERAL
287
Example Plant
GENERAL
289
Example Plant
GENERAL
291
Example Plant
GENERAL
293
Example Plant
GENERAL
295
Example Plant
GENERAL
296
Example Plant
GENERAL
298
Example Plant
GENERAL
299
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Table of Contents
Job #FORMS - ALL
PAGE
11

Owner
Plant
Substation
Asset
Example Owner
POWER FACTOR TESTS
91000 - INSULATION - MISC. EQUIPMENT
Example Owner
POWER FACTOR TESTS
95000 - AUTO TRANSFORMERS
Example Owner
POWER FACTOR TESTS
93000 - TWO-WINDING TRANSFORMERS
Example Owner
POWER FACTOR TESTS
96000 - CABLES AND POTHEADS
Example Owner
POWER FACTOR TESTS
90000 - EXCITATION - CURRENT TESTS
Example Owner
POWER FACTOR TESTS
92000 - CIRCUIT BREAKERS
Example Owner
POWER FACTOR TESTS
94000 - THREE-WINDING TRANSFORMER
Example Owner
RELAYS
465120 - CO-2
Example Owner
RELAYS
465103 - IAC-53A
Example Owner
RELAYS
465104 - IAC-54A
Example Owner
RELAYS
465122 - CO-6
Example Owner
RELAYS
465106 - IAC-60
Example Owner
RELAYS
465123 - CO-8
Example Owner
RELAYS
43351 - SEL351
Example Owner
RELAYS
462702 - CV-2
Example Owner
RELAYS
465125 - CO-11
Example Owner
RELAYS
462700 - CV-1
Position
PAGE
NO.
Example Plant
DOBLE
300
Example Plant
DOBLE
302
Example Plant
DOBLE
304
Example Plant
DOBLE
306
Example Plant
DOBLE
308
Example Plant
DOBLE
310
Example Plant
DOBLE
312
Example Plant
AUTOMATED
314
Example Plant
AUTOMATED
315
Example Plant
AUTOMATED
316
Example Plant
AUTOMATED
317
Example Plant
AUTOMATED
318
Example Plant
AUTOMATED
319
Example Plant
AUTOMATED
320
Example Plant
AUTOMATED
324
Example Plant
AUTOMATED
325
Example Plant
AUTOMATED
326
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Table of Contents
Job #FORMS - ALL
PAGE
12

Owner
Plant
Substation
Asset
Example Owner
RELAYS
462706 - CV-5
Example Owner
RELAYS
465107 - IAC-80
Example Owner
RELAYS
462710 - CV-7
Example Owner
RELAYS
49550 - CEY51A RELAY
Example Owner
RELAYS
465101 - IAC-51A
Example Owner
RELAYS
465102 - IAC-52
Example Owner
RELAYS
465109 - IAC-66B
Example Owner
RELAYS
465103 - IAC-53B
Example Owner
RELAYS
465121 - CO-5
Example Owner
RELAYS
465105 - IAC-54B
Example Owner
RELAYS
465122 - CO-7
Example Owner
RELAYS
465124 - CO-9
Example Owner
RELAYS
462701 - IJS-51A
Example Owner
RELAYS
462704 - CV-4
Example Owner
RELAYS
45000 - OVERCURRENT RELAY
Example Owner
RELAYS
465106 - IAC-77
Example Owner
RELAYS
462712 - CV-8
Position
PAGE
NO.
Example Plant
AUTOMATED
327
Example Plant
AUTOMATED
328
Example Plant
AUTOMATED
329
Example Plant
AUTOMATED
330
Example Plant
AUTOMATED
332
Example Plant
AUTOMATED
333
Example Plant
AUTOMATED
334
Example Plant
AUTOMATED
335
Example Plant
AUTOMATED
336
Example Plant
AUTOMATED
337
Example Plant
AUTOMATED
338
Example Plant
AUTOMATED
339
Example Plant
AUTOMATED
340
Example Plant
AUTOMATED
341
Example Plant
AUTOMATED
342
Example Plant
AUTOMATED
344
Example Plant
AUTOMATED
345
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Table of Contents
Job #FORMS - ALL
PAGE
13

Owner
Plant
Substation
Asset
Example Owner
RELAYS
465108 - IAC-90
Example Owner
RELAYS
462708 - CV-6
Example Owner
RELAYS
465200 - GENERIC RELAY
Example Owner
RELAYS
465101 - IAC-51B
Example Owner
RELAYS
44000 - MAGNETIC OVERLOAD RELAY
Example Owner
RELAYS
41500 - FREQUENCY RELAY
Example Owner
RELAYS
48510 - BDD TRANSFORMER DIFFERENTIAL
Example Owner
RELAYS
46000 - PERCENTAGE DIFFERENTIAL RELAY PU
Example Owner
RELAYS
44200 - MOTOR PROTECTION CONTROLLER
Example Owner
RELAYS
49500 - O/C RELAY WITH VOLTAGE RESTRAINT
Example Owner
RELAYS
46200 - POLYPHASE POWER DIRECTIONAL GGP
Example Owner
RELAYS
47000 - REVERSE CURRENT RELAY
Example Owner
RELAYS
47200 - REVERSE POWER RELAY
Example Owner
RELAYS
48500 - TRANSFORMER DIFFERENTIAL RELAY
Example Owner
RELAYS
47900 - SYNCHRONISM CHECK RELAY
Example Owner
RELAYS
40950 - DIFFERENTIAL VOLTAGE RELAY
Example Owner
RELAYS
42500 - GROUND DIRECTIONAL OC RELAY
Position
PAGE
NO.
Example Plant
AUTOMATED
346
Example Plant
AUTOMATED
347
Example Plant
AUTOMATED
348
Example Plant
AUTOMATED
349
Example Plant
GENERAL
350
Example Plant
GENERAL
352
Example Plant
GENERAL
354
Example Plant
GENERAL
356
Example Plant
GENERAL
358
Example Plant
GENERAL
360
Example Plant
GENERAL
362
Example Plant
GENERAL
364
Example Plant
GENERAL
366
Example Plant
GENERAL
368
Example Plant
GENERAL
370
Example Plant
GENERAL
372
Example Plant
GENERAL
374
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Table of Contents
Job #FORMS - ALL
PAGE
14

Owner
Plant
Substation
Asset
Example Owner
RELAYS
41200 - DIGITRIP OVERCURRENT RELAY
Example Owner
RELAYS
49000 - VOLTAGE RELAY
Example Owner
RELAYS
44100 - METERING MODULE TEST
Example Owner
RELAYS
44500 - NEGATIVE SEQUENCE O/C 50/51
Example Owner
RELAYS
46100 - PHASE DIRECTIONAL OC RELAY
Example Owner
RELAYS
49900 - GENERIC MULTIFUNCTION RELAY
Example Owner
RELAYS
46400 - POWER DIRECTIONAL RELAY
Example Owner
RELAYS
47800 - STATIC TIMING RELAY
Example Owner
RELAYS
40500 - BALANCED CURRENT RELAY
Example Owner
RELAYS
48000 - TIMING RELAY
Example Owner
RELAYS
41000 - DIFFERENTIAL VOLTAGE RELAY
Example Owner
RELAYS
43351 - SEL 351
Example Owner
ROTATING MACHINERY
98500 - ROTATING MACHINERY STEP VOLTAGE
Example Owner
ROTATING MACHINERY
32000 - MOTOR PI TEST
Example Owner
ROTATING MACHINERY
32450 - SYNCH MOTOR PI TEST ARMATURE
Example Owner
ROTATING MACHINERY
98006 - PF STATOR COIL TIP UP
Example Owner
ROTATING MACHINERY
32400 - SYNCH MOTOR PI TEST
Position
PAGE
NO.
Example Plant
GENERAL
376
Example Plant
GENERAL
378
Example Plant
GENERAL
380
Example Plant
GENERAL
382
Example Plant
GENERAL
384
Example Plant
GENERAL
386
Example Plant
GENERAL
387
Example Plant
GENERAL
389
Example Plant
GENERAL
391
Example Plant
GENERAL
393
Example Plant
GENERAL
395
Example Plant
SEL
397
Example Plant
AUTOMATED
403
Example Plant
AUTOMATED
404
Example Plant
AUTOMATED
406
Example Plant
AUTOMATED
408
Example Plant
AUTOMATED
411
www.powerdb.com
REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE
15

Owner
Plant
Substation
Asset
Example Owner
ROTATING MACHINERY
98005 - PF ROTATING MACHINERY TIP UP
Example Owner
ROTATING MACHINERY
97560 - ROTATING MACHINERY PI TEST
Example Owner
ROTATING MACHINERY
32200 - MOTOR HIGH POTENTIAL TEST
Example Owner
ROTATING MACHINERY
32500 - SYNCH MOTOR DISSIPATION FACTOR
Example Owner
ROTATING MACHINERY
32700 - SYNCH MOTOR WINDING RESISTANCE
Example Owner
ROTATING MACHINERY
32800 - SYNCH MOTOR ROTOR WINDING
Example Owner
ROTATING MACHINERY
32100 - MOTOR DISSIPATION FACTOR TEST
Example Owner
ROTATING MACHINERY
32300 - MOTOR STATOR RESISTANCE TEST
Example Owner
ROTATING MACHINERY
32600 - SYNCH MOTOR HIGH POTENTIAL
Example Owner
SWITCHBOARDS
50001 - MV SWITCHBOARD INSULATION
Example Owner
SWITCHBOARDS
50400 - SWITCHBOARD BUS CONNECTION TEST
Example Owner
SWITCHBOARDS
50100 - LV SWITCHBOARD INSULATION
Example Owner
SWITCHBOARDS
50050 - MV SWITCHBOARD HIPOT
Example Owner
SWITCHBOARDS
50000 - MV SWITCHBOARD INSULATION
Example Owner
SWITCHBOARDS
50900 - SWITCHGEAR INSPECTION
Example Owner
SWITCHBOARDS
50300 - POWER PANEL INSULATION TEST
Example Owner
TRANSFER SWITCHES
54300 - ASCO NEW GROUP 7 CONTROL PANEL
Position
PAGE
NO.
Example Plant
AUTOMATED
413
Example Plant
AUTOMATED
417
Example Plant
GENERAL
419
Example Plant
GENERAL
421
Example Plant
GENERAL
423
Example Plant
GENERAL
425
Example Plant
GENERAL
427
Example Plant
GENERAL
429
Example Plant
GENERAL
431
Example Plant
GENERAL
433
Example Plant
GENERAL
434
Example Plant
GENERAL
436
Example Plant
GENERAL
438
Example Plant
GENERAL
440
Example Plant
GENERAL
442
Example Plant
GENERAL
444
Example Plant
GENERAL
446
www.powerdb.com
REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE
16

Owner
Plant
Substation
Position
Asset
Example Owner
Example Plant
TRANSFER SWITCHES
GENERAL
54100 - AUTOMATIC TRANSFER SWITCH TEST
Example Owner
Example Plant
TRANSFER SWITCHES
GENERAL
54500 - OLD GROUP 8 0R 9
Example Owner
Example Plant
TRANSFER SWITCHES
GENERAL
54000 - AUTOMATIC TRANSFER SWITCH TEST
Example Owner
Example Plant
TRANSFER SWITCHES
GENERAL
54200 - ATS CONTROLS
Example Owner
Example Plant
TRANSFER SWITCHES
GENERAL
54400 - NEW GROUP 8 0R 9
Example Owner
Example Plant
TRANSFER SWITCHES
GENERAL
54550 - ASCO TRANSFER SWITCH OLD GROUP 8
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
56301 - MTO QUICK TEST
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
93510 - MAGNETIC BALANCE
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
56001 - TTR QUICK TEST
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
56370 - TTR VOLTAGE REGULATOR
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
56003 - TTR SINGLE PHASE QUICK TESTS - MULTIPLE RESULTS
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
94500 - PF THREE-WINDING TRANSFORMERS
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
93001 - POWER FACTOR QUICK TEST
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
56006 - TTR IEC 61378-1
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
56353 - MTO WINDING RESISTANCE
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
56365 - 3PH TTR WITH TAP CHANGER
Example Owner
Example Plant
TRANSFORMERS
AUTOMATED
57954 - PDC LAB FLUID TESTING
www.powerdb.com
PAGE
NO.
448
450
452
454
456
458
460
461
462
463
464
465
467
468
469
470
471
REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE
17

Owner
Plant
Substation
Asset
Example Owner
TRANSFORMERS
93507 - MLR10 LEAKAGE REACT. & CAP.
Example Owner
TRANSFORMERS
95500 - PF AUTO TRANSFORMER WITH TERTIARY
Example Owner
TRANSFORMERS
56352 - MTO210 WINDING RESISTANCE
Example Owner
TRANSFORMERS
56004 - TTR TESTING via NAMEPLATE INPUT
Example Owner
TRANSFORMERS
56002 - TTR QUICK TESTS - MULTIPLE RESULTS
Example Owner
TRANSFORMERS
56600 - TRANSFORMER PI TEST
Example Owner
TRANSFORMERS
95501 - PF AUTO TRANSFORMER WITHOUT TERTIARY
Example Owner
TRANSFORMERS
56011 - TTR QUICK TEST 320
Example Owner
TRANSFORMERS
56356 - MTO TRANSFORMER HEAT RUN TEST
Example Owner
TRANSFORMERS
56355 - WINDING RESISTANCE (ADWEL DWR)
Example Owner
TRANSFORMERS
93002 - MULTIPLE POWER FACTOR QUICK TESTS
Example Owner
TRANSFORMERS
56502 - TRANSFORMER TTR (VANGUARD)
Example Owner
TRANSFORMERS
90000 - TRANSFORMER
Example Owner
TRANSFORMERS
93500 - PF TWO-WINDING TRANSFORMERS
Example Owner
TRANSFORMERS
56100 - TRANS. EXCITATION
Example Owner
TRANSFORMERS
56005 - TRANSFORMER INFO HISTORY
Example Owner
TRANSFORMERS
56200 - TRANSFORMER INSPECTION
Position
PAGE
NO.
Example Plant
AUTOMATED
475
Example Plant
AUTOMATED
476
Example Plant
AUTOMATED
479
Example Plant
AUTOMATED
480
Example Plant
AUTOMATED
481
Example Plant
AUTOMATED
482
Example Plant
AUTOMATED
484
Example Plant
AUTOMATED
487
Example Plant
AUTOMATED
488
Example Plant
AUTOMATED
490
Example Plant
AUTOMATED
491
Example Plant
AUTOMATED
492
Example Plant
AUTOMATED
493
Example Plant
AUTOMATED
494
Example Plant
GENERAL
496
Example Plant
GENERAL
498
Example Plant
GENERAL
499
www.powerdb.com
REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE
18

Owner
Plant
Substation
Asset
Example Owner
TRANSFORMERS
5711T - TRANS. LIQUID COOLANT TRENDING
Example Owner
TRANSFORMERS
56300 - TRANSFORMER TURNS RATIO
Example Owner
TRANSFORMERS
56351 - TRANSFORMER WINDING RESISTANCE
Example Owner
TRANSFORMERS
56450 - TRANSFORMER SECONDARY WINDING
Example Owner
TRANSFORMERS
56400 - TRANS. LOAD TAP CHANGER TTR
Example Owner
TRANSFORMERS
56501 - TRANS SINGLE PHASE PRIMARY WINDING
Example Owner
TRANSFORMERS
56900 - TWO-WINDING TRANSFORMER
Example Owner
TRANSFORMERS
56990 - REGULATOR MAINTENANCE REPORT
Example Owner
TRANSFORMERS
56050 - TRANS. DISSIPATION FACTOR
Example Owner
TRANSFORMERS
56150 - TRANSFORMER HIGH POTENTIAL TEST
Example Owner
TRANSFORMERS
56410 - TRANSFORMER LOAD - SINGLE PHASE
Example Owner
TRANSFORMERS
56250 - TRANSFORMER POLARITY TEST
Example Owner
TRANSFORMERS
56500 - TRANSFORMER PRIMARY WINDING
Example Owner
TRANSFORMERS
Example Owner
TRANSFORMERS
Example Owner
TRANSFORMERS
56700 - TRANSFORMER MAINTENANCE TEST
Example Owner
TRANSFORMERS
56910 - TWO-WINDING TRANSFORMER
Position
PAGE
NO.
Example Plant
GENERAL
501
Example Plant
GENERAL
505
Example Plant
GENERAL
507
Example Plant
GENERAL
508
Example Plant
GENERAL
510
Example Plant
GENERAL
512
Example Plant
GENERAL
514
Example Plant
GENERAL
516
Example Plant
GENERAL
518
Example Plant
GENERAL
520
Example Plant
GENERAL
522
Example Plant
GENERAL
524
Example Plant
GENERAL
526
Example Plant
GENERAL
528
Example Plant
GENERAL
529
Example Plant
GENERAL
531
Example Plant
GENERAL
533
www.powerdb.com
REVISED 5/28/2010
Table of Contents
Job #FORMS - ALL
PAGE
19

Owner
Plant
Substation
Asset
Example Owner
TRANSFORMERS
57110 - TRANS. LIQUID COOLANT ANALYSIS
Example Owner
WATTHOUR METERS, TRANSDUCERS
61100 - WATTHOUR METER TEST
Example Owner
61400 - VAR TRANSDUCER TEST
Example Owner
61600 - MULTIFUNCTION METERING MODULE
Example Owner
61000 - KILOWATT-HOUR METER SERVICE
Example Owner
61101 - WATTHOUR METER TEST
Example Owner
61550 - TRANSDUCER TEST
Position
PAGE
NO.
Example Plant
GENERAL
535
Example Plant
GENERAL
537
Example Plant
GENERAL
539
Example Plant
GENERAL
541
Example Plant
GENERAL
543
Example Plant
GENERAL
545
Example Plant
GENERAL
547
www.powerdb.com
REVISED 5/28/2010
BATTERY TEST
OWNER
1
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
Example Customer Company
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
BATTERIES
SUBSTATION
POSITION
STRING NAME:
BATTERY NAME:
NUMBER OF CELLS:
MODEL NUMBER:
INSTALLATION DATE:
LIMITS: HIGH VOLTAGE LIMIT (V):
HIGH RESISTANCE LIMIT (Ohm)
HIGH TEMPERATURE LIMIT (F)
HIGH SPECIFIC GRAVITY LIMIT
LOW VOLTAGE LIMIT (V):
LOW RESISTANCE LIMIT (Ohm)
LOW TEMPERATURE LIMIT (F)
LOW SPECIFIC GRAVITY LIMIT
INTERCELL RESISTANCE THRESHOLD VALUES (Ohm)
AVG. RESISTANCE:
AVG. VOLTAGE:
MIN. VOLTAGE:
MAX. VOLTAGE:
AVG. SPEC. GR.:
AVG. TEMP.:
CELL DATA
CELL
No.
VOLTAGE
(volts)
RESISTANCE
(micro-ohms)
INTERCELL RESISTANCE (micro-ohms)

1
SPECIFIC
GRAVITY
TEMP.
F
NOTES
COMMENTS:
DEFICIENCIES:
TEST EQUIPMENT USED:

TESTED BY:
www.powerdb.com
Default Administrator
10760, REVISED 7/13/2012
BATTERY DISCHARGE TEST
OWNER
ADDRESS
CUSTOMER
2
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
BATTERIES
SUBSTATION
POSITION
BVM Status
BVM Settings
Data Collection Mode:
Update Interval
Number of BVM Sets:
One Set
First BVM Set
Update Interval (Sec):
30
Second BVM Set
Show Total Volt. Graph:

Number of Cells:
Number of Cells:
First Cell Starts At:
First Cell Starts At:
Show Bar Graph:

Show Data Table:
Cells Outside Limits:
Total Voltage vs. Time
VOLTAGE:MEASURED ___
BVM Data (HH:MM:SS)
Total Volt.
Float
Voltage
0%
(00:00:00)
25%
(00:15:00)
50%
(00:30:00)
60%
(00:36:00)
70%
(00:42:00)
80%
(00:48:00)
90%
(00:54:00)
100%
(01:00:00)
Last
Value
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Cell
Number
Fail Time
Fail %
Cell Data
1
2

TESTED BY:
www.powerdb.com
10757, REVISED 2/7/2014
PAGE
BVM Data (HH:MM:SS)

Float
Voltage
0%
(00:00:00)
25%
(00:15:00)
50%
(00:30:00)
60%
(00:36:00)
70%
(00:42:00)
80%
(00:48:00)
90%
(00:54:00)
100%
(01:00:00)
Last
Value
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Total Volt.
Cell
Number
Fail Time
Fail %
Cell Data
3
4
COMMENTS:
DEFICIENCIES:
www.powerdb.com
10757, REVISED 2/7/2014
BATTERY TEST
OWNER
ADDRESS
CUSTOMER
PAGE
JOB #
FORMS - ALL
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
PLANT
Example Plant
POSITION
AUTOMATED
BATTERIES
SUBSTATION
STRING
STRING NAME:
AUTOMATED
DUTY CYCLE:
for
Minutes
to
VPC
INSTALLATION DATE:
HYDROMETER. START/SKIP CELLS:
VOLTS PER CELL:
NOMINAL:
NUMBER OF CELLS:
Amps
NUMBER OF STRAPS:
NUMBER OF CELLS / JAR:
2.2
CHARGER
MANUFACTURER:
FLOAT CURRENT:
CURRENT:
Amps
RIPPLE CURRENT:
VOLTAGE:
Volts
TOTAL AC CURRENT:
EQUALIZATION VOLTAGE:
Volts
MODEL:
LIMITS: LOW VOLTAGE LIMIT (V):

HIGH VOLTAGE LIMIT (V):
VARIATION WARNING (%): 5.0

VARIATION ALARM (%): 10.0
DEVIATION WARNING (%):
CHANGE WARNING (%):
STRAP WARNING (%):
DEVIATION ALARM (%):
CHANGE ALARM (%):
STRAP ALARM (%):
Display Impedance:
Baseline Impedance:
Avg. Impedance:
Total String Voltage:
Dev. from Charger:
Milli-Ohms
%
Min. Voltage:
CELL DATA
IMPEDANCE (milli-ohms)
#
NOTES
VALUE
% DEVIATION % VARIATION
(Baseline)
(String)
Max. Voltage:
CELL DATA
% CHANGE
(Prev.)
VOLTAGE
(volts)
TIME
MODEL
CELL
No.
SPECIFIC
GRAVITY
TEMP.
C
0.000
Avg. Strap Resistance:
STRAP #
Display resistance in:
Micro-Ohms
RESISTANCE % VARIATION MEASUREMENT

CELL
(micro-ohms)
TIME
CONNECTED TO
(Avg)
TYPE
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
10750, REVISED 12/17/2013
SEND STRINGS TO BITE3
STRING NAME:
SITE:
SEND TO BITE3
1. Enter "STRING NAME" and "SITE" and Click "SEND TO BITE3"
2. Wait till the information is sent to the BITE3 before sending another string.
www.powerdb.com
REVISED 7/7/2010
OWNER
ADDRESS
CUSTOMER
6
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
BATTERIES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
CELL VOLTAGE (V)
MODEL
SPEC. GRAVITY RANGE (g/cm3)
CATALOG NO.
NUMBER OF CELLS
OVERALL BATTERY VOLTAGE (V)
CAPACITY RATING (Ah)
COMMISSION DATE
OTHER
TEST PARAMETERS
Temperature Correction Method: Time
Temperature correction using ambient temperature:
IEEE Std 450-2002
1.000
Initial Battery Status: Charged

TEST MODE
NOMINAL CURRENT (A)
TEST CURRENT (A)
END CELL VOLTAGE (V)
END BATTERY VOLTAGE (V)
TIME (h)
CORRECTED
TIME (h)
0.00
5.00
Constant I
LIMITS
VOLTAGE (volts)
CELL
BATTERY
TIME
(HH:MM)
CAPACITY
(Ah)
Warning Limit
00:00
0.00
0.00
0.0
Stop Limit
00:00
0.00
0.00
0.0
Current Measurement Method:
Internal
TORKEL
Voltage Change to Log: 0.050
Ah Change to Log: 10
Update Interval (Minutes): 0.25
Preferred Tolerance:
Show Strap Table:

Show Test Data:
BVM
Data Collection Mode: Voltage Change

Number Of BVM Cells:

Minimum Cell Voltage:
Voltage Range: 0 - 20 V
Cell Numbering: Positive To Negative
Show Data Tables:
Cells Outside Limits:
HISTORICAL CAPACITY
CAPACITY (amp-hours)

TESTED BY:
www.powerdb.com
10756, REVISED 1/10/2014
PAGE
VOLTAGE/CAPACITY VS. TIME
CAPACITY:MEASURED____ CAPACITY: WARNING _ _ _ CAPACITY: STOP ____
Measured Battery Capacity (Ah):

Percent Capacity (%): 0.0
VOLTAGE:MEASURED ___ VOLTAGE:WARNING _ _ _ VOLTAGE:STOP ___
Temp. Corrected Battery Capacity: 0.0

Actual Discharge Time: 0:00:00
@ 25 C
Format Graph Axis
Show Cell Data:

Float (charging)
CELL #
SPECIFIC
GRAVITY
(g/cm3)
Temp.
F
Idle
VOLTAGE
(volts)
VOLTAGE
(volts)
Remark
Total
Avg.
Min.
Max
www.powerdb.com
10756, REVISED 1/10/2014
PAGE
Bar Graph
Initial Voltage: ___
Graphing cells from: 1
Voltage: ____
to:
Warning Voltage: _ _ _
Stop Voltage: ___
COMMENTS:
DEFICIENCIES:
www.powerdb.com
10756, REVISED 1/10/2014
OWNER
ADDRESS
CUSTOMER
9
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
HUMIDITY
Number of Cells:
POSITION
Current Measurement Method:
VOLTAGE (volts)
CELL
BATTERY
TIME
(HH:MM)
Example Plant
AUTOMATED
PLANT
BATTERIES
TEST PARAMETERS
LIMITS
AMBIENT TEMPERATURE
SUBSTATION
Internal
CAPACITY
(Ah)
Warning Limit
00:00
0.000
0.000
0.0
Stop Limit
00:00
0.000
0.000
0.0
TEST MODE
Test Current (A)
Constant I
0.00
VOLTAGE/CAPACITY VS. TIME
CAPACITY:MEASURED____ CAPACITY: WARNING _ _ _ CAPACITY: STOP ____
VOLTAGE:MEASURED ___ VOLTAGE:WARNING _ _ _ VOLTAGE:STOP ___
TORKEL

Update Interval (Minutes): 0.25
Ah Change to Log: 10
Preferred Tolerance:
Show Test Data:
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
10754, REVISED 3/19/2012
UPS BATTERY DISCHARGE
OWNER
ADDRESS
CUSTOMER
10
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
BATTERIES
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
UPS NAMEPLATE DATA

MANUFACTURER
MODEL
SERIAL NO.
CATALOG NO.
kVA RATING
POWER FACTOR
INPUT VOLTAGE
INPUT CURRENT
INPUT FREQUENCY
TYPE
INPUT PHASE
STATIC
DC VOLTAGE INPUT
DC INPUT CURRENT
VOLTAGE OUTPUT
CURRENT OUTPUT
OUTPUT FREQUENCY
OUTPUT PHASE
ROTARY
OTHER
BATTERY NAMEPLATE DATA

MANUFACTURER
CELL TYPE
CELL VOLTAGE
CATALOG NO.
SPECIFIC GRAVITY RANGE
AMP HOUR RTG
NUMBER OF CELLS
BATTERY TEMP
OVERALL BATTERY VOLTAGE
VDC
OTHER
TEST PARAMETERS
TEMPERATURE CORRECTED CURRENT
CELL VOLTAGE ALARM
CELL VOLTAGE DEVIATION ALARM
CELL VOLTAGE SHUTDOWN LEVEL
BATTERY VOLTAGE ALARM
BATTERY VOLTAGE SHUTDOWN LEVEL
MFR.'S RATED CAPACITY - MINUTES
ACTUAL DISCHARGE - MINUTES
PERCENTAGE BATTERY CAPACITY

TESTED BY:
www.powerdb.com
10500, REVISED 5/26/2010
UPS BATTERY DISCHARGE
PAGE
11
COMMENTS:
DEFICIENCIES:
www.powerdb.com
10500, REVISED 5/26/2010
BATTERY INSPECTION REPORT
OWNER
12
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
BATTERIES
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
BATTERY DATA
MANUFACTURER
SPEC. GRAVITY RANGE (g/cm3)
CATALOG NO.
NUMBER OF CELLS
CELL VOLTAGE (V)
MODEL
# OF RACKS 1
CAPACITY RATING (Ah)
OVERALL BATTERY VOLTAGE (V)
COMMISSION DATE
OTHER
CHARGER DATA
MANUFACTURER
CURRENT
MODEL
Amps
EQUALIZATION VOLTAGE
VOLTAGE
Volts
Volts
OTHER
BATTERY INSPECTION
CHARGER INSPECTION
DESCRIPTION
INSPECTED
CONDITION
DESCRIPTION
INSPECTED
VENTILATION OF ROOM OR ENCLOSURE
PHYSICAL AND MECHANICAL CONDITION
EYEWASH EQUIPMENT
ANCHORAGE, ALIGNMENT AND GROUNDING
PHYSICAL AND MECHANICAL CONDITION
CLEAN AND REMOVE DEBRIS
ANCHORAGE, ALIGNMENT AND GROUNDING
FILTER AND TANK CAPACITORS
ELECTROLYTE LEVEL
COOLING FANS, VERIFY OPERATION
FLAME ARRESTERS
CLEAN OR REPLACE FILTERS
SUPPORT RACKS, MOUNTING, CLEARANCES
BOLTED ELECTRICAL CONNECTIONS
NEUTRALIZE ACID ON EXTERIOR SURFACES
FUNCTIONS AND ALARMS
CONDITION
CLEAN CORRODED/OXIDIZED TERMINALS

BATTERY CASE/ENCLOSURE
STRING MEASUREMENTS
Overall Voltage
GROUND TEST
VDC
Float Current
Positive Terminal to Gnd.
ADC
VDC
AC Ripple Current
NegativeTerminal to Gnd.
Total AC Current
VDC
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
10050, REVISED 9/6/2012
BATTERY INSPECTION
RESISTANCE
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
13
FORMS - ALL
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
PLANT
BATTERIES
SUBSTATION
POSITION
Example Plant
GENERAL
NAMEPLATE DATA
MANUFACTURER
CATALOG NO.
BATTERY TEMP.
VDC
CELL TYPE
CELL VOLTAGE
AMP HOUR RATING
NUMBER OF CELLS
OTHER
BATTERY CHARGE STATUS
CELL
CHARGED
DISCHARGED
RESISTANCE ( ) VOLTAGE DROP (mV)
EQUALIZED
CURRENT (A)
TEMPERATURE CORRECTED READINGS
CELL
41
42
43
44
45
46
47
48
49
10
50
11
51
12
52
13
53
14
54
15
55
16
56
17
57
18
58
19
59
20
60
21
61
22
62
23
63
24
64
25
65
26
66
27
67
28
68
29
69
30
70
31
71
32
72
33
73
34
74
35
75
36
76
37
77
38
78
39
79
40
80
www.powerdb.com
RESISTANCE ( ) VOLTAGE DROP (mV)
YES
NO
CURRENT (A)
10200, REVISED 5/26/2010
BATTERY INSPECTION
RESISTANCE
PAGE
CELL RESISTANCE ( ) VOLTAGE DROP (mV)
CURRENT (A)
81
131
82
132
83
133
84
134
85
135
86
136
87
137
88
138
89
139
90
140
91
141
92
142
93
143
94
144
95
145
96
146
97
147
98
148
99
149
100
150
101
151
102
152
103
153
104
154
105
155
106
156
107
157
108
158
109
159
110
160
111
161
112
162
113
163
114
164
115
165
116
166
117
167
118
168
119
169
120
170
121
171
122
172
123
173
124
174
125
175
126
176
127
177
128
178
129
179
130
180
www.powerdb.com
14
CURRENT (A)
10200, REVISED 5/26/2010
BATTERY INSPECTION
RESISTANCE
PAGE
CURRENT (A)
181
226
182
227
183
228
184
229
185
230
186
231
187
232
188
233
189
234
190
235
191
236
192
237
193
238
194
239
195
240
196
241
197
242
198
243
199
244
200
245
201
246
202
247
203
248
204
249
205
250
206
251
207
252
208
253
209
254
210
255
211
256
212
257
213
258
214
259
215
260
216
261
217
262
218
263
219
264
220
265
221
266
222
267
223
268
224
269
225
270
PILOT CELLS
CELL NO.
TEMP. C
CELL NO.
TEMP. C
CELL NO.
15
CURRENT (A)
TEMP. C
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
10200, REVISED 5/26/2010
OWNER
ADDRESS
CUSTOMER
16
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
BATTERIES
SUBSTATION
PLANT
POSITION
Example Plant
GENERAL
NAMEPLATE DATA
MANUFACTURER
CELL TYPE
CELL VOLTAGE
CATALOG NO.
AMP HOUR RATING
NUMBER OF CELLS
BATTERY TEMP.
VDC
OTHER
BATTERY CHARGE STATUS:
CHARGED
MANUFACTURER'S
DISCHARGE RATE
EQUALIZED
TEST CURRENT
END CELL VOLTAGE
OVERALL END BATTERY VOLTAGE
TIME
M
TEST PARAMETERS
TEMPERATURE CORRECTED CURRENT
CELL VOLTAGE ALARM
CELL VOLTAGE DEVIATION ALARM
CELL VOLTAGE SHUTDOWN LEVEL
BATTERY VOLTAGE ALARM
BATTERY VOLTAGE SHUTDOWN LEVEL
MFR'S RATED CAPACITY TIME - MINUTES
ACTUAL DISCHARGE TIME - MINUTES
BATTERY CAPACITY - PERCENT

TESTED BY:
www.powerdb.com
10000, REVISED 6/22/2010
PAGE
17
COMMENTS:
DEFICIENCIES:
www.powerdb.com
10000, REVISED 6/22/2010
BATTERY INSPECTION
SPECIFIC GRAVITY
OWNER
ADDRESS
CUSTOMER
18
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
BATTERIES
SUBSTATION
PLANT
POSITION
Example Plant
GENERAL
NAMEPLATE DATA
MANUFACTURER
CATALOG NO.
BATTERY TEMP.
VDC
CELL TYPE
CELL VOLTAGE
AMP HOUR RATING
NUMBER OF CELLS
OTHER
BATTERY CHARGE STATUS
CELL
CHARGED
SPEC. GRAVITY
DISCHARGED
EQUALIZED
VOLTAGE
TEMPERATURE CORRECTED READINGS
CELL
41
42
43
44
45
46
47
48
49
10
50
11
51
12
52
13
53
14
54
15
55
16
56
17
57
18
58
19
59
20
60
21
61
22
62
23
63
24
64
25
65
26
66
27
67
28
68
29
69
30
70
31
71
32
72
33
73
34
74
35
75
36
76
37
77
38
78
39
79
40
80
www.powerdb.com
SPEC. GRAVITY
YES
NO
VOLTAGE
REVISED 5/26/2010
BATTERY INSPECTION
SPECIFIC GRAVITY
PAGE
CELL
SPEC. GRAVITY
VOLTAGE
CELL
81
131
82
132
83
133
84
134
85
135
86
136
87
137
88
138
89
139
90
140
91
141
92
142
93
143
94
144
95
145
96
146
97
147
98
148
99
149
100
150
101
151
102
152
103
153
104
154
105
155
106
156
107
157
108
158
109
159
110
160
111
161
112
162
113
163
114
164
115
165
116
166
117
167
118
168
119
169
120
170
121
171
122
172
123
173
124
174
125
175
126
176
127
177
128
178
129
179
130
180
www.powerdb.com
SPEC. GRAVITY
19
VOLTAGE
REVISED 5/26/2010
BATTERY INSPECTION
SPECIFIC GRAVITY
PAGE
CELL
SPEC. GRAVITY
VOLTAGE
CELL
181
226
182
227
183
228
184
229
185
230
186
231
187
232
188
233
189
234
190
235
191
236
192
237
193
238
194
239
195
240
196
241
197
242
198
243
199
244
200
245
201
246
202
247
203
248
204
249
205
250
206
251
207
252
208
253
209
254
210
255
211
256
212
257
213
258
214
259
215
260
216
261
217
262
218
263
219
264
220
265
221
266
222
267
223
268
224
269
225
270
PILOT CELLS
CELL NO.
TEMP. C
CELL NO.
TEMP. C
SPEC. GRAVITY
CELL NO.
20
VOLTAGE
TEMP. C
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 5/26/2010
TIME DOMAIN REFLECTOMETER
OWNER
ADDRESS
CUSTOMER
21
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
CABLES
SUBSTATION
POSITION
Select the Memory Locations to Download

1
MEMORY
LOCATION
WAVE TYPE
METER RANGE
PULSE WIDTH (ns)
10
GAIN (dB)
11
12
13
VELOCITY FACTOR
14
15
TRACE STYLE
DATE
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
13300, REVISED 2/7/2014
CABLE POLARIZATION
INDEX (PI)TEST
OWNER
ADDRESS
CUSTOMER
22
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
CABLE SOURCE
CABLE TERMINATION POINT
OPERATING VOLTAGE
kV
MANUFACTURER
Example Plant
AUTOMATED
PLANT
CABLES
SUBSTATION
INSTALLED IN
LENGTH
INSULATION TYPE
SIZE
KCMIL
RATED VOLTAGE
kV
PHASE IDENTIFICATION:
INSULATION THICKNESS
NO. OF CONDUCTORS
GROUNDED
PHASE A
UNGROUNDED
PHASE B
BELTED
SHIELDED
AGE
PHASE C
CABLE TEMPERATURE
TEST VOLTAGE
kVDC
Enter TCF Manually:
K = INSULATION RESISTANCE CONSTANT IN MEGOHMS
20,000
TEST CONDUCTED
TEMP. CORR.
FACTOR
BEFORE
d = INSIDE DIAMETER OF INSULATION

D
1000
R = [ K Log 10 (
)] (
)
d
L (ft)
PHASE A MEGOHMS
20C READING
(megohms)
PHASE B MEGOHMS
READING
(megohms)
TEMPERATURE CORRECTION FACTOR TO 20C, TCF
D = OUTSIDE DIAMETER OF INSULATION
READING
(megohms)
MILS
CONDUCTOR MATERIAL
CONNECTED EQUIPMENT
MINUTES
FT
TEMP. CORR.
FACTOR
AFTER HIGH POTENTIAL TEST
Use Instrument PI Value:
PHASE C MEGOHMS
20C READING
(megohms)
READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)
0.25
0.50
0.75
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
P.I.
POLARIZATION INDEX = 10 MINUTE READING / 1 MINUTE READING
* MINIMUM DESIGN INSULATION RESISTANCE, R =
MEGOHMS
Press F1 for form help

TESTED BY:
www.powerdb.com
13000, REVISED 2/7/2014
CABLE POLARIZATION
INDEX (PI)TEST
PAGE
23
POLARIZATION CURVE
Phase A: Red Square

Phase B: Blue Circle
Phase C: Green Triangle
COMMENTS:
DEFICIENCIES:
www.powerdb.com
13000, REVISED 2/7/2014
CABLE INSULATION
POWER FACTOR TESTS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
24
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
CABLES
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
CABLE NAMEPLATE
MFR. AND TYPE
LOCATION
RATED kV
OPERATING kV
AGE
TYPE
LENGTH - OUTDOOR
LENGTH - INDOOR
NUMBER OF CONDUCTORS
INSULATION MATERIAL
SIZE
JACKET
DUCT TRAY
EARTH TEMP.
IDENTIFICATION
AMPS (LOAD)
INSULATION TYPE
CIRCUIT
DUCT TEMP.
WEATHER
DEPTH
TEST FREQUENCY: 60
MULTIPLE QUICK TESTS
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
INSULATION RATING KEY (IR)

G = GOOD
D = DETERIORATED
I
= INVESTIGATE
B = BAD
Q = QUESTIONABLE
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
Firmware Information:
www.powerdb.com
Calibration Date:
96005, REVISED 12/11/2013
LOW VOLTAGE CABLE INSULATION TEST
OWNER
ADDRESS
CUSTOMER
25
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CABLES
SUBSTATION
POSITION
MANUFACTURER
DATE MANUFACTURED
INSULATION TYPE 1:
TW
THW
INSULATION TYPE 2:
RH
RHW
THHW
XHHW
THHN
EQUIPMENT TEMPERATURE
OTHER
TEST VOLTAGE
IDENTIFICATION
kVDC
NO. &
COND.
SIZE
FROM
INS. TYPE 1
INS. TYPE 2
PHASE
TO
A - GND
B - GND
C - GND
N - GND
A-B
B-C
C-A
A-N
B-N
C-N
RDG
20C
RDG
20C
RDG
20C
RDG
20C
RDG
20C
RDG
20C
RDG
20C
RDG
20C
RDG
20C
RDG
20C
ALL INSULATION VALUES ARE IN MEGOHMS

TESTED BY:
www.powerdb.com
12000, REVISED 5/26/2010
LOW VOLTAGE CABLE INSULATION TEST
PAGE
26
COMMENTS:
DEFICIENCIES:
www.powerdb.com
12000, REVISED 5/26/2010
TAN DELTA CABLE TEST
OWNER
27
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
OPERATING VOLTAGE
kV
POSITION
INSTALLED IN
MANUFACTURER
Example Plant
GENERAL
PLANT
CABLES
SUBSTATION
CONDUIT
TRAY
LENGTH
INSULATION TYPE
FT
CABLE TEMPERATURE
SIZE
MCM
NO. OF CONDUCTORS
RATED VOLTAGE
kV
GROUNDED
SHIELDED
UNGROUNDED
UNSHIELDED
MILS
CONDUCTOR MATERIAL
RESISTANCE GROUND
CU
BELTED
(PILC)
AL
AGE
CONCENTRIC NEUTRAL
CABLE SOURCE
CONNECTED EQUIPMENT
ISOLATE CABLE
NUMBER OF MANHOLES
HAND TAPED
3-M TERM. KIT
SYSTEM VOLTAGE
BREAKDOWN
TEST FREQUENCY
TIME TO FAILURE
SINE
TEST TYPE
COSINE / RECTANGULAR
WITHSTAND
PHASE A OR
TEST VOLTAGE
kV
5kV
CABLE
15 kV
CABLE
1.0
1.5
3.5
2.0
2.4
ARRESTERS
NUMBER OF TERMINATIONS
TERMINATION / SPLICES
WAVE SHAPE
TAN DELTA
PASS / FAIL
NUMBER OF SPLICES
RAYCHEM KIT
YES
NO
PLANNED TEST DURATION PER STEP

1 MIN
5 MIN
END TIME
DIAGNOSTIC
PHASE B
MICRO
AMPS
START TIME
10 MIN
OTHER
TAN DELTA
NANO
FARADS

OTHER
MIN
PHASE A, B, C
NANO
FARADS
POT FUSES
PHASE C
MICRO
AMPS
TESTED BY:
www.powerdb.com
TAN DELTA
NANO
FARADS
MICRO
AMPS
13090, REVISED 5/26/2010
TAN DELTA CABLE TEST
PAGE
28
COMMENTS:
DEFICIENCIES:
www.powerdb.com
13090, REVISED 5/26/2010
CABLE HIGH POTENTIAL TEST
OWNER
ADDRESS
CUSTOMER
29
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CABLES
SUBSTATION
POSITION
CABLE SOURCE
OPERATING VOLTAGE
kV
MANUFACTURER
INSTALLED IN
LENGTH
INSULATION TYPE
SIZE
KCMIL
RATED VOLTAGE
kV
NO. OF CONDUCTORS
GROUNDED
FT
MILS
CONDUCTOR MATERIAL
UNGROUNDED
BELTED
SHIELDED
AGE
CONNECTED EQUIPMENT
TEST
VOLTAGE
TIME
(min.)
PHASE A
TIME
(min.)
PHASE B
TIME
(min.)
PHASE IDENTIFICATION
PHASE C
PHASE A:
RED
PHASE B:
WHITE
PHASE C:
BLUE
4
8
12
16
20
24
26
26
26
26
26
26
26
0
DECAY TO 5kV; SECS
0.00
0.00
0.00
TOTAL TIME for the TEST

TESTED BY:
www.powerdb.com
13101, REVISED 12/12/2013
PAGE
30
COMMENTS:
DEFICIENCIES:
www.powerdb.com
13101, REVISED 12/12/2013
BUS DUCT INSULATION TEST
OWNER
ADDRESS
CUSTOMER
31
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
MANUFACTURER
TYPE
VERTICAL RATING
CONFIGURATION
Example Plant
GENERAL
PLANT
CABLES
SUBSTATION
A
3 WIRE
HORIZONTAL RATING
4 WIRE
5 WIRE
CATALOG NO.
TEST VOLTAGE
A
CONDUCTOR
VOLTAGE CLASS
NEUTRAL RATING
COPPER
ALUMINUM
SERIAL NO.
kVDC
GROUND RATING
DATE MANUFACTURED
CURRENT WITHSTAND RATING
kA
FROM
PHASE
IDENTIFICATION
TO
A - GND
B - GND
C - GND
N - GND
A-B
ACTUAL READING / SHADING INDICATES TEMPERATURE CORRECTED VALUES

B-C
A-N
B-N
C-N
ALL INSULATION VALUES ARE IN MEGOHMS
TESTED BY:
www.powerdb.com
A-C
14000, REVISED 5/26/2010
BUS DUCT INSULATION TEST
PAGE
32
COMMENTS:
DEFICIENCIES:
www.powerdb.com
14000, REVISED 5/26/2010
VLF CABLE TEST
OWNER
33
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
OPERATING VOLTAGE
kV
POSITION
INSTALLED IN
CONDUIT
MANUFACTURER
TRAY
LENGTH
FT
CONDUCTOR MATERIAL
MCM
NO. OF CONDUCTORS
RATED VOLTAGE
kV
GROUNDED
SHIELDED
UNGROUNDED
UNSHIELDED
RESISTANCE GROUND
BELTED
(PILC)
C
MILS
CU
AL
AGE
CONCENTRIC NEUTRAL
CABLE SOURCE
CONNECTED EQUIPMENT
ISOLATE CABLE
NUMBER OF MANHOLES
ARRESTERS
NUMBER OF TERMINATIONS
TERMINATION / SPLICES
HAND TAPED
3-M TERM. KIT
RMS TEST VOLTAGE
kV
BREAKDOWN
TEST FREQUENCY
Hz
TIME TO FAILURE
A-B
OHMS
WAVE SHAPE
SINE
TEST TYPE
WITHSTAND
MEGOHMS
PASS / FAIL
YES
MICRO
AMPS
OTHER
NO
PLANNED TEST DURATION
MIN
1 MIN
OHMS
C-A
15 MIN
30 MIN
START TIME
60 MIN
OHMS
END TIME
OTHER
DIAGNOSTIC
PHASE A, B, C
NANO
FARADS
POT FUSES
NUMBER OF SPLICES
RAYCHEM KIT
B-C
COSINE / RECTANGULAR
PHASE A OR
TESTS
(MINUTES)
CABLE TEMPERATURE
INSULATION TYPE
SIZE
SHIELD RESISTANCE
Example Plant
GENERAL
PLANT
CABLES
SUBSTATION
SEE COMMENT BELOW
PHASE B
MEGOHMS
NANO
FARADS
PHASE C
MICRO
AMPS
MEGOHMS
NANO
FARADS
MICRO
AMPS
10
15
20
25
30
45
60

TESTED BY:
www.powerdb.com
REVISED 5/26/2010
VLF CABLE TEST
PAGE
34
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 5/26/2010
OWNER
ADDRESS
CUSTOMER
35
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
CABLES
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
CABLE SOURCE
OPERATING VOLTAGE
kV
MANUFACTURER
INSTALLED IN
LENGTH
INSULATION TYPE
SIZE
KCMIL
RATED VOLTAGE
kV
NO. OF CONDUCTORS
GROUNDED
FT
MILS
CONDUCTOR MATERIAL
UNGROUNDED
BELTED
SHIELDED
AGE
CONNECTED EQUIPMENT
TIME
MINUTES
TEST
VOLTAGE
PHASE A
PHASE B
PHASE C
PHASE A:
BROWN
PHASE B:
ORANGE
PHASE C:
YELLOW
0.25
0.50
0.75
1.00
1.25
1.50
1.75
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
11.00
12.00
13.00
14.00
15.00
16.00
17.00
18.00
19.00
20.00
21.00
22.00
23.00
24.00
25.00
DECAY TO 5kV; SECS
SHIELD RESIST.- OHMS

TESTED BY:
www.powerdb.com
13100, REVISED 5/26/2010
PAGE
36
COMMENTS:
DEFICIENCIES:
www.powerdb.com
13100, REVISED 5/26/2010

AND INSULATION RESISTANCE
OWNER
ADDRESS
CUSTOMER
37
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
CABLES
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
CABLE SOURCE
OPERATING VOLTAGE
kV
MANUFACTURER
INSTALLED IN
LENGTH
INSULATION TYPE
SIZE
KCMIL
RATED VOLTAGE
kV
NO. OF CONDUCTORS
GROUNDED
FT
MILS
CONDUCTOR MATERIAL
UNGROUNDED
BELTED
SHIELDED
AGE
CONNECTED EQUIPMENT
TIME
MINUTES
TEST
kV
PHASE A
PHASE B
PHASE C
PHASE A:
BROWN
PHASE B:
ORANGE
PHASE C:
YELLOW
0.25
0.50
0.75
1.00
1.25
1.50
1.75
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
11.00
12.00
13.00
14.00
15.00
16.00
17.00
18.00
19.00
20.00
21.00
22.00
23.00
24.00
25.00
DECAY TO 5kV; SECS
SHIELD RESIST.- OHMS
INSULATION
RESISTANCE
GIGA-OHMS @
0.000
0.000
kV
0.000

TESTED BY:
www.powerdb.com
13200, REVISED 5/26/2010

AND INSULATION RESISTANCE
PAGE
38
COMMENTS:
DEFICIENCIES:
www.powerdb.com
13200, REVISED 5/26/2010
SWITCHBOARD BUS
CONNECTION TEST
OWNER
39
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CABLES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
DRAWING NO.
PHASE AMPACITY
TYPE
VOLTAGE CLASS
WITHSTAND RATING
kA
FROM
CONDUCTOR
CU
AL
RESISTANCE IN MICRO-OHMS
IDENTIFICATION
TO

TESTED BY:
www.powerdb.com
14100, REVISED 5/26/2010
SWITCHBOARD BUS
CONNECTION TEST
PAGE
40
COMMENTS:
DEFICIENCIES:
www.powerdb.com
14100, REVISED 5/26/2010
SF6 LIVE TANK CIRCUIT BREAKERS

CAPACITANCE AND POWER FACTOR TESTS
OWNER
PAGE
41
ADDRESS
JOB #
FORMS - ALL
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
HUMIDITY
SPECIAL ID
A
kV
BIL
INT. RATING
INT. MEDIUM
WEIGHT
WEATHER
TANK TEMP
COUNTERS
COOLANT
LOC.
CONTROL VOLTS
TEST FREQUENCY
60
CT NAMEPLATE:
MFR
MFR YEAR
kV
AMPS
PLANT
Example Plant
POSITION
AUTOMATED
CIRCUIT BREAKER
SUBSTATION
SERIAL NO.
CIRCUIT
MFR
MFR YEAR
TYPE
MEC. TYPE
MEC. DESIGN
REASON
TANKS
AMBIENT TEMPERATURE
lb
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
H2
H3
X1
X2
X3
kV
AMPS
YEAR
C
PHASE NAMES
CLASS
OIL
TYPE
CLASS
CATALOG/STYLE
INSULATION TYPE
SF6 VOLUME
LAYOUT
C1 POWER FACTOR %
C1 CAPACITANCE
C2 POWER FACTOR %
C2 CAPACITANCE
CIRCUIT BREAKER OVERALL TESTS

TEST
NO
CAP.
Ph.
TEST
kV
CAP.
C (pF)
POWER FACTOR %
MEAS.
20 C
CORR.
DIRECT
mA
WATTS
IR
1
2
2G
3
4
5
6
7
8
9
10
11
12
2G
13
14
15

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
92525, REVISED 10/31/2013

42
PAGE
CIRCUIT BREAKER CT TESTS
TEST
NO
TEST MODE
16
GSTg-R
17
GSTg-R
18
GSTg-R
19
GSTg-R
20
GSTg-R
21
GSTg-R
22
GSTg-R
23
GSTg-R
24
GSTg-R
25
GSTg-R
26
GSTg-R
27
GSTg-R
TEST
kV
ENG
POWER FACTOR %
CAP.
C (pF)
MEAS.
20 C
EQUIV
CORR.
mA
WATTS
IR
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
92525, REVISED 10/31/2013
OCR COUNTER
OWNER
43
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
CIRCUIT BREAKER
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE INFORMATION
SERIAL NUMBER:
MANUFACTURER:
OF OIL:
WEIGHT:
LB
COIL SIZE:
MAXIMUM kV:
BIL:
kV
MODEL:
LAST MAINTENANCE DATE:

OPERATIONS COUNTER:
DATE
10/13/2014
0
SINCE LAST
MAINTENANCE:
COUNTER
10
AMPS
H
# OF OPERATIONS:
# OF MONTHS:
COMMENTS

COOPER
TESTED BY:
www.powerdb.com
92610, REVISED 11/23/2011
VACUUM RECLOSERS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
44
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
HUMIDITY
CONTROL VOLTS
TEST FREQUENCY
POSITION
SPECIAL ID
A
kV
BIL
INT. RATING
INT. MEDIUM
WEIGHT
WEATHER
TANK TEMP
COUNTERS
COOLANT
LOC.
60
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
SERIAL NO.
CIRCUIT
MFR
MFR YEAR
TYPE
MEC. TYPE
MEC. DESIGN
REASON
TANKS
AMBIENT TEMPERATURE
lb
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
H2
H3
X1
X2
X3
kV
AMPS
YEAR
C
PHASE NAMES
CLASS
OIL
LAYOUT
VACUUM RECLOSER OVERALL TESTS
OPEN
OPEN
TEST
CB
NO
INSULATION
TESTED
Ph.
TEST
MODE
BUSHING CONNECTIONS
ENG
GND
GAR
UST
TEST
kV
Capacitance
C (pF)
POWER FACTOR %
MEAS.
o C
20
DIRECT
IR
CORR.
mA
WATTS
C1G
A GST-GND
1.000
C2G
A GST-GND
1.000
C3G
B GST-GND
1.000
C4G
B GST-GND
1.000
C5G
C GST-GND
1.000
C6G
C GST-GND
C12
UST-R
1.000
C34
UST-R
1.000
C56
UST-R
1.000
1.000
BUSHING & OIL TESTS

TEST
NO.
BUSHING
SERIAL #
TEST
Ph. MODE
BUSHING CONNECTIONS
ENG
GND
GAR
UST
10
UST-R
TAP
11
UST-R
TAP
12
UST-R
TAP
13
UST-R
TAP
14
UST-R
TAP
15
UST-R
TAP
TEST
kV
Capacitance
C (pF)
POWER FACTOR %
MEAS.
o C
20
DIRECT
IR
CORR.
mA
WATTS
INSULATION RATING: G=GOOD; D=DETERIORATED; I=INVESTIGATE; B=BAD; Q=QUESTIONABLE

INSULATION TESTED
1 to 6
=
BUSHING TERMINALS
G
=
GROUND
NOTE: Circuit breaker open: bushing tests

( Test No. 1, 2, 3, 4, 5, 6).
Circuit breaker closed: tank tests
(Test No. 7, 8, and 9).
NOTE: No. in ENG column is bushing energized in

Tests 1 through 6, 10, 11 and 12. All other
bushings must be floating.

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
92550, REVISED 11/17/2013
VACUUM RECLOSERS
PAGE
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
45
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
92550, REVISED 11/17/2013
CIRCUIT BREAKER
TIMING ANALYSIS
OWNER
ADDRESS
CUSTOMER
46
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
CIRCUIT BREAKER
PLANT
POSITION
Example Plant
AUTOMATED
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
15300, REVISED 2/7/2014
CONTACT RESISTANCE
OWNER
ADDRESS
CUSTOMER
47
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
CIRCUIT BREAKER
Example Plant
AUTOMATED
PLANT
POSITION
CONTACT RESISTANCE IN MILLIOHMS

VOLTAGE
CURRENT
RESISTANCE
MINIMUM
MAXIMUM
PASS/FAIL
PHASE A
Ohms
Ohms
PHASE B
Ohms
Ohms
PHASE C
Ohms
Ohms

TESTED BY:
www.powerdb.com
15990, REVISED 3/21/2011
CONTACT RESISTANCE
PAGE
48
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15990, REVISED 3/21/2011
SF6 DEAD TANK CIRCUIT BREAKERS

OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
49
FORMS - ALL
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
SPECIAL ID
A
kV
BIL
INT. RATING
INT. MEDIUM
WEIGHT
WEATHER
TANK TEMP
COUNTERS
COOLANT
LOC.
CONTROL VOLTS
TEST FREQUENCY
CB
HUMIDITY
60
POSITION
SF6 Gas
lb
DSG SERIAL NUM

H1
H2
H3
X1
X2
X3
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
PHASE NAMES
CLASS
OIL

BUSHING CONNECTIONS
TEST
Capacitance
kV
C (pF)
ENG
GND
GAR
UST
C1G
C2G
C3G
GST-GND
1.000
GST-GND
1.000
GST-GND
1.000
C4G
C5G
GST-GND
1.000
GST-GND
1.000
C6G
C12
GST-GND
UST-R
1.000
C34
C56
UST-R
1.000
UST-R
1.000
GST-GND
1&2
1.000
11
C1G + C2G
C3G + C4G
GST-GND
3&4
1.000
12
C5G + C6G
GST-GND
5&6
1.000
OPEN
4
5
6
OPEN
7
8
9
CLOSED
10
BUSHING
SERIAL #
TEST
NO.
TEST
Ph. MODE
YEAR
DIRECT
POWER FACTOR %
1
3
AMPS
SF6 VOLUME
LAYOUT
INSULATION
TESTED
kV
TEST
NO
Ph.
TEST
MODE
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
SERIAL NO.
CIRCUIT
MFR
MFR YEAR
TYPE
MEC. TYPE
MEC. DESIGN
REASON
TANKS
MEAS.
20 C
CORR.
mA
WATTS
IR
1.000
BUSHING CONNECTIONS
ENG
GND
GAR
UST
13
UST-R
TAP
14
UST-R
TAP
15
UST-R
TAP
16
UST-R
TAP
17
UST-R
TAP
18
UST-R
TAP
INSULATION TESTED: 1-6 = BUSHING TERMINALS, G=GROUND

Note: Circuit breaker open: bushing tests
( Test No. 1, 2, 3, 4, 5, 6).
Circuit breaker closed: tank tests
(Test No. 7, 8, and 9).
TEST
kV
Capacitance
C (pF)
EQUIV
POWER FACTOR %
MEAS.
20 C
CORR.
mA
WATTS
IR
INSULATION RATING: G=GOOD, D=DETERIORATED, I=INVESTIGATE,B=BAD, Q=QUESTIONABLE

NOTE: No. in ENG column is bushing energized, in
Tests 1 through 6, 10, 11 and 12. All other
bushings must be floating.

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
92520, REVISED 12/17/2013
SF6 DEAD TANK CIRCUIT BREAKERS

PAGE
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
50
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
92520, REVISED 12/17/2013
LOW VOLTAGE POWER CIRCUIT BREAKER TEST
OWNER
51
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
MANUFACTURER
SN / SO NO.
FRAME SIZE(F)
BREAKER TYPE
SENSOR TAPS
MOUNTING
D.O.
B.I.
FUSE CAT. NO.
CUBICLE CODE
THERMAL MEMORY
ON
OFF
TRIP UNIT TYPE
CATALOG NO.
ZONE INTLK
TARGETS
DESCRIPTION
INSPECTED
CONDITION
CLEAN/LUBE
DESCRIPTION
INSPECTED
CUBICLE AND RACKING DEVICES
ARC CHUTES
CONTACT FINGERS
AUXILIARY DEVICES
LOADING AND ARCING CONTACTS
GROUND CONNECTION
OVERCURRENT DEV. BATTERY
LOAD CONDUCTOR NO.
SETTINGS AS FOUND
FUNCTION
RATING PLUG(R)
PICKUP
LONG
SENSOR TAP
A =
A =
CONDITION
CLEAN/LUBE
SIZE
CU
AL
DELAY
CURVE
DRAWING
DELAY
CURVE
DRAWING
SHORT
INST.
GRD. FLT.
3W
4W
GRD. FLT.
SETTINGS AS LEFT
FUNCTION
RATING PLUG(R)
PICKUP
LONG
SENSOR TAP
SHORT
INST.
GRD. FLT.
3W
4W
GRD. FLT.
PAIR CURRENT AND TIME ON ALL TESTS

TEST
AMPERES
FUNCTION
LONG TIME
CURRENT
MULTIPLE
POLE 1
TIME BAND
MINIMUM
MAXIMUM
AS FOUND
(seconds)
AS LEFT
(seconds)
POLE 2
AS FOUND
(seconds)
POLE 3
AS LEFT
(seconds)
AS FOUND
(seconds)
AS LEFT
(seconds)
LTPU (amps)
VOLTAGE DROP @ LONG TIME TEST CURRENT
SHORT TIME
STPU (amps)
INSTANTANEOUS
IPU (amps)
GROUND FAULT
GFPU (amps)
POLE 1 (P1-P2)
INSULATION
RESISTANCE
READING
20C
POLE 2 (P2-P3)
READING
20C
POLE 3 (P3-P1)
READING
POLE RESISTANCE - MICRO-OHMS
20C
POLE TO POLE
READING
POLE 1
POLE 2
POLE 3
POLE TO FRAME
LINE TO LOAD
CONTROL WIRING
READING
COUNTER READING BEG/END

20C

TESTED BY:
www.powerdb.com
15055, REVISED 9/14/2010
PAGE
52
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15055, REVISED 9/14/2010
VACUUM BREAKERS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
53
FORMS - ALL
ASSET ID
ADDRESS
10/13/2014
DATE
HUMIDITY
CONTROL VOLTS
TEST FREQUENCY
POSITION
SPECIAL ID
A
kV
BIL
INT. RATING
INT. MEDIUM
WEIGHT
WEATHER
TANK TEMP
COUNTERS
COOLANT
LOC.
60
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
SERIAL NO.
CIRCUIT
MFR
MFR YEAR
TYPE
MEC. TYPE
MEC. DESIGN
REASON
TANKS
AMBIENT TEMPERATURE
Vacuum
lb
DSG SERIAL NUM

H1
H2
H3
X1
X2
X3
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
C
PHASE NAMES
CLASS
OIL
LAYOUT
C1G
A GST-GND
1.000
C2G
A GST-GND
1.000
C3G
B GST-GND
1.000
C4G
B GST-GND
1.000
C5G
C GST-GND
1.000
C6G
C GST-GND
1.000
C12
UST-R
1.000
C34
UST-R
1.000
C56
UST-R
1.000
OPEN
ENG
GND
GAR
UST
TEST
kV
Capacitance
C (pF)
DIRECT
Ph.
TEST
MODE
POWER FACTOR %
INSULATION
TESTED
OPEN
CB
BUSHING CONNECTIONS
TEST
NO
IR
MEAS.o
20 C
CORR.
mA
WATTS
BUSHING TESTS
TEST
NO.
BUSHING
SERIAL #
TEST
Ph. MODE
BUSHING CONNECTIONS
ENG
GND
GAR
UST
10
UST-R
TAP
11
UST-R
TAP
12
UST-R
TAP
13
UST-R
TAP
14
UST-R
TAP
15
UST-R
TAP
TEST
kV
Capacitance
C (pF)
POWER FACTOR %
MEAS.
DIRECT
IR
20 C
CORR.
mA
WATTS

INSULATION TESTED
NOTES
1 to 6
=
BUSHING TERMINALS
1) UST test checks grading capacitors across open contacts.
G
=
GROUND
2) No. in ENG column is bushing energized

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
92530, REVISED 12/11/2013
VACUUM BREAKERS
PAGE
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
54
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
92530, REVISED 12/11/2013
OIL CIRCUIT BREAKERS

OWNER
55
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
SERIAL NO.
CIRCUIT
MFR
MFR YEAR
TYPE
MEC. TYPE
MEC. DESIGN
REASON
TANKS
OIL TYPE
AMBIENT TEMPERATURE
HUMIDITY
CONTROL VOLTS
CONVENTIONAL
TEST FREQUENCY
POSITION
SPECIAL ID
A
kV
BIL
INT. RATING
INT. MEDIUM
WEIGHT
WEATHER
OIL TEMP
COUNTERS
COOLANT
LOC.
60
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
Oil
lb
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
H2
H3
X1
X2
X3
kV
AMPS
YEAR
C
PHASE NAMES
CLASS
OIL
LAYOUT

INSULATION
TESTED
CLOSED
OPEN
CB
TEST
NO
ENG
C1G
GST-GND
C2G
GST-GND
C3G
GST-GND
C4G
GST-GND
C5G
GST-GND
C6G
GST-GND
C1G + C2G
GST-GND
1&2
C3G + C4G
GST-GND
3&4
C5G + C6G
GST-GND
5&6
C2 TESTS
C1 TESTS
TEST
NO.
OIL
BUSHINGS CONNECTIONS
TEST
MODE
SERIAL #
Ph.
NAMEPLATE
% PF
MEAS.
BUSHING AND OIL TESTS

Test
TEST
Cap.
Dsg
Mode
kV
(pF)
CAP.
MEAS.
INS #
TLI
TEST
kV
DIRECT
POWER FACTOR %
Cap.
(pF)
BUS FT
20 C
CORR.
POWER FACTOR %
20 C
CORR.
10
UST-R
11
UST-R
12
UST-R
13
UST-R
14
UST-R
15
UST-R
16
GSTg-R
1.000
17
GSTg-R
1.000
18
GSTg-R
1.000
19
GSTg-R
1.000
20
GSTg-R
1.000
21
GSTg-R
1.000
22
TANK 1 OIL
UST-R
23
TANK 2 OIL
UST-R
24
TANK 3 OIL
UST-R

Serial Number:
TESTED BY:
www.powerdb.com
mA
WATTS
mA
WATTS
IR
IR
Calibration Date:
92510, REVISED 12/17/2013
OIL CIRCUIT BREAKERS

PAGE
INSULATION RATING: G=GOOD; D=DETERIORATED; I=INVESTIGATE;
B=BAD; Q=QUESTIONABLE
TANK LOSS INDEX

TANK 1 = W 7 - (W 1 + W2
TANK 2 = W 8 - (W 3 + W4
TANK 3 = W 9 - (W 5 + W6
NOTE: No. in ENG column is bushing energized,

all other bushings must be floating.
)
)
)
56
Note: Subscripts are

test no.s. Index may
be positive or negative.
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
92510, REVISED 12/17/2013
OIL CIRCUIT RECLOSER
OWNER
57
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
NAMEPLATE INFORMATION
TEST SETTINGS
SERIAL NUMBER:
OF OIL:
WEIGHT:
MAXIMUM kV:
BIL:
MANUFACTURER:
kV
COOPER
MODEL:
COIL SIZE:
LB
TCC1:
TCC2:
SHOTS TO LOCKOUT:
TCC3:
NUM. OF TIMING TESTS:
TCC4:
MAXIMUM TOTAL TIME: 20 SECS
H
10
SINGLE SHOT TO LOCKOUT TEST

USE TIME/CURRENT TOLERANCE FOR LIMITS
AMPS
AS FOUND
AS LEFT
COUNTER
SEQUENCE
MINIMUM TRIP TEST
Test Current
Min Current
(amps)
(amps)
Minimum Trip
Current (amps)
Max Current
(amps)
SINGLE SHOT TO LOCKOUT

Single Shot
Current (amps)
to Lockout
OCR TIMING TEST

TEST MULTIPLE:
OPERATION
TOTAL TIME (seconds):
4
CURVE
CURRENT
(amps)
MULTIPLE
TRIP TIME
(seconds)
MIN. TIME
(seconds)
MAX. TIME
(seconds)
RECLOSE
(seconds)
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
92600, REVISED 10/3/2012
OIL CIRCUIT RECLOSER
PAGE
58
TIME (seconds)
TIME Vs CURRENT
CURRENT (multiple of coil size)
OPEN / CLOSE
OPEN / CLOSE TIMES (closed values are high)
TIME (seconds)
www.powerdb.com
92600, REVISED 10/3/2012
MOLDED CASE CIRCUIT BREAKER

INSPECTION REPORT
OWNER
ADDRESS
CUSTOMER
59
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
BREAKER DATA
MANUFACTURER
TYPE
SERIAL NUMBER
VOLTAGE
FRAME SIZE
INT. RATING
THERMAL ELEMENT
NON-ADJUSTABLE
ADJUSTABLE
RANGE
SETTING
MAGNETIC ELEMENT
NON-ADJUSTABLE
ADJUSTABLE
RANGE
SETTING
FRONT IDENTIFICATION - LEFT TO RIGHT:
POLE 1
AS FOUND
POLE 2
AS LEFT
AS FOUND
AS LEFT
POLE 3
AS FOUND
AS LEFT
CONTACT RESISTANCE IN MICROHMS

TIME AT 300% RATED CURRENT IN SECONDS
TRIP
INST. TESTED ON
SETTING
NO TRIP
INSULATION RESISTANCE IN MEGOHMS

AT
kV
ACROSS OPEN POLE

POLE - POLE - GND

TESTED BY:
www.powerdb.com
15800, REVISED 7/7/2010
MOLDED CASE CIRCUIT BREAKER

INSPECTION REPORT
PAGE
60
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15800, REVISED 7/7/2010

OWNER
PAGE
61
ADDRESS
JOB #
FORMS - ALL
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
HUMIDITY
SPECIAL ID
A
kV
BIL
INT. RATING
INT. MEDIUM
WEIGHT
WEATHER
TANK TEMP
COUNTERS
COOLANT
LOC.
CONTROL VOLTS
TEST FREQUENCY
60
CT NAMEPLATE:
MFR
MFR YEAR
kV
AMPS
PLANT
Example Plant
POSITION
AUTOMATED
CIRCUIT BREAKER
SUBSTATION
SERIAL NO.
CIRCUIT
MFR
MFR YEAR
TYPE
MEC. TYPE
MEC. DESIGN
REASON
TANKS
AMBIENT TEMPERATURE
lb
C
PHASE NAMES
CLASS
OIL
SF6 VOLUME
LAYOUT
TYPE
CLASS
CATALOG/STYLE
INSULATION TYPE
C1 POWER FACTOR %
C1 CAPACITANCE
C2 POWER FACTOR %
C2 CAPACITANCE

TEST INSULATION
NO.
TESTED
Ph.
TEST CONNECTIONS
ENG
GND
C1
C2
S1
C1
C2
S1
C1
C2
S1
GAR
UST
TEST
kV
CAP.
C (pF)
DIRECT
POWER FACTOR %
MEAS.
20 C
CORR.
mA
WATTS
IR
R
B
RB
R
B
RB
R
B
RB
TEST
NO
INSULATION
TESTED
10
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
92529, REVISED 11/17/2013
AIR-MAGNETIC CIRCUIT BREAKERS

CAPACITANCE and POWER FACTOR TESTS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
63
FORMS - ALL
ASSET ID
ADDRESS
10/13/2014
DATE
HUMIDITY
CONTROL VOLTS
TEST FREQUENCY
POSITION
SPECIAL ID
A
kV
BIL
INT. RATING
INT. MEDIUM
WEIGHT
WEATHER
TANK TEMP
COUNTERS
COOLANT
LOC.
60
Example Plant
AUTOMATED
PLANT
CIRCUIT BREAKER
SUBSTATION
SERIAL NO.
CIRCUIT
MFR
MFR YEAR
TYPE
MEC. TYPE
MEC. DESIGN
REASON
TANKS
AMBIENT TEMPERATURE
Air
lb
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
H2
H3
X1
X2
X3
kV
AMPS
YEAR
C
PHASE NAMES
CLASS
OIL
LAYOUT

CB
INSULATION
TESTED
C1G
C2G
GSTg-RB
GSTg-RB
C3G
C4G
GSTg-RB
GSTg-RB
C5G
C6G
GSTg-RB
GSTg-RB
UST-R
C12
C34
UST-R
C56
UST-R
OPEN
2
3
4
5
OPEN
6
7
TEST
NO.
BUSHING
SERIAL #
TEST
Ph. MODE
TEST CONNECTIONS BUSHING
TEST
NO.
TEST
Ph. MODE
ENG
GND
UST-R
11
UST-R
12
UST-R
13
UST-R
14
UST-R
15
UST-R
UST
TEST
kV
Capacitance
C (pF)
POWER FACTOR %
DIRECT
IR
MEAS.
20 C
CORR.
mA
WATTS
MEAS.
20 C
CORR.
mA
WATTS
ENG
10
GAR
GND
GAR
BUSHING TESTS
TEST
UST
kV
CAP.
C(pF)
IR

INSULATION TESTED
NOTES
1 to 6
=
BUSHING TERMINALS
1) UST test checks grading capacitors across open contacts.
G
=
GROUND
2) No. in ENG column is bushing energized
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000

Serial Number:
DIRECT
POWER FACTOR %
TESTED BY:
www.powerdb.com
Calibration Date:
92500, REVISED 12/17/2013
AIR-MAGNETIC CIRCUIT BREAKERS

CAPACITANCE and POWER FACTOR TESTS
PAGE
64
COMMENTS:
DEFICIENCIES:
www.powerdb.com
92500, REVISED 12/17/2013
OIL CIRCUIT BREAKER DISSIPATION TEST
OWNER
65
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
MODEL NO.
DATE MANUFACTURED
VOLTAGE
TYPE OPERATING MECHANISM
TOTAL WEIGHT
LBS
NUMBER OF TANKS
TOTAL FLUID CAP.
GAL
AMPERES
INTERRUPTING RATING
kA @
kV
POLE CONFIGURATION
1
MECH POLE 1
TANK LOSS INDEX
POLE 2
POLE 3
kV
TANK TESTS MW - (LINE BUSHINGS MW + LOAD BUSHING MW) = TLI
MECH
DF
TANK TESTS: (4) GST-L GROUNDED

PF =
BUSHING TESTS: (5) GST-L GUARDED
1 + DF

2
INDIVIDUAL BUSHING TESTS - BREAKER OPEN
TANK TESTS - BKR. CLOSED
TEST 1
TEST 2
TEST 3
TEST 4
TEST 5
TEST 6
TANK A:
0.00
TANK B:
0.00
TANK C:
0.00
TANK A
TANK B
TANK C
TEST VOLTAGE - kV
CAPACITANCE
VOLTAGE SW. POSITION

CAPACITANCE - NORMAL
CAPACITANCE - REVERSE
CALCULATED AVERAGE
CAPACITANCE MULTIPLIER
TOTAL CAP. (PICO-FARADS)
DISSIPATION
FACTOR
% D.F. - NORMAL
% D.F. - REVERSE
CALCULATED AVERAGE
VOLTAGE MULTIPLIER
% D.F. - MEASURED
% D.F. @ 20 DEG. C.
MILLIWATTS
CALCULATED % P. F.
M. W. LOSS - NORMAL
M. W. LOSS - REVERSE
CALCULATED AVERAGE
VOLTAGE MULTIPLIER
TOTAL MW LOSS
TANK LOSS INDEX

TESTED BY:
www.powerdb.com
16300, REVISED 5/26/2010
OIL CIRCUIT BREAKER DISSIPATION TEST
PAGE
66
COMMENTS:
DEFICIENCIES:
www.powerdb.com
16300, REVISED 5/26/2010
VACUUM CIRCUIT BREAKER TEST
OWNER
ADDRESS
CUSTOMER
67
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
MANUFACTURER
SERIAL NUMBER
TYPE
MAXIMUM VOLTAGE
kV
INTERRUPTING CAPACITY
kA
DESCRIPTION
INSPECTED
CONDITION
MODEL NO.
DATE MANUFACTURED
AMPACITY
OPERATING VOLTAGE
kV
CLEAN/LUBE
TO
kV =
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
CONTACT FINGERS
INSULATING MEMBERS
VACUUM BOTTLE
MECHANICAL CONNECTIONS
CONTACT EROSION INDICATOR
STRUCTURAL MEMBERS
OPERATING MECHANISM
CUBICLE
CONTACT SEQUENCE
RACKING DEVICES
GROUND CONNECTION
SHUTTER
AUXILIARY DEVICES
INSULATION TEST VOLTAGE
kVDC
MILLIWATT LOSS TEST VOLTAGE
kVAC
READING
mVA
CONDITION
CLEAN/LUBE
HIGH POTENTIAL TEST VOLTAGE
POLE 1 MEGOHMS (P1-P2)

INSULATION RESISTANCE
kV
kVDC
20C
READING
20C
READING
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
0
CONTROL WIRING - MEGOHMS

READING
20C
POLE 1
POLE 2
POLE 3
POLE 1
POLE 2
POLE 3
HIGH POTENTIAL TEST

kVDC
MILLIWATT LOSS kVDC
CONTACT MEASUREMENTS
POLE 1
POLE 2
POLE 3
CONTACT TRAVEL - INCHES

POLE RESISTANCE
MICRO-OHMS
RDG.
CONTACT RESISTANCE
MICRO-OHMS
RDG.
20C
OPENING SPEED (ft/sec)

CLOSING SPEED (ft/sec)
COUNTER READING:
20C
BEG.
END
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
16100, REVISED 8/23/2013
MEDIUM VOLTAGE CIRCUIT BREAKER

INSULATING FLUID TEST
OWNER
ADDRESS
CUSTOMER
68
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
MODEL NO.
DATE MANUFACTURED
VOLTAGE
TOTAL WEIGHT
LBS
NUMBER OF TANKS
TOTAL FLUID CAP.
GAL
AMPERES
INTERRUPTING RATING
kA @
kV
INTERRUPTING RATING
kA @
kV
BIL
kV
VOLTAGE RANGE FACTOR

SHORT CIRCUIT WITHSTAND (SYM)
kV
RATED INTERRUPTING TIME
CYCLES
kV
POLE CONFIGURATION
A=
B=
MECH
POLE 1
POLE 2
POLE 3
INSTRUCTION BOOKLET
MECH
B
TEST RESULTS
POLE 1
POLE 2
POLE 3
POLE 1
VISUAL INSPECTION
PARTICLES
TOP VALVE SIZE
DIELECTRIC STRENGTH - kV
BOTTOM VALVE SIZE
INTERFACIAL TENSION - d/cm
VENTS / PRESSURE RELIEF
ACIDITY - mg KOH/g
VISIBLE LEAKS
ASTM COLOR NO.
HIGH TEMPERATURE READING
PCB CONTENT - PPM
PRESENT TEMPERATURE READING
E. P. A. CLASSIFICATION
PRESSURE READING
POWER FACTOR - %
VACUUM READING
PARTS PER MILLION OF WATER
PAINT CONDITION
POLE 2
POLE 3
GASKETS CONDITION
DISSLOVED GAS ANALYSIS
POLE 1
POLE 2
POLE 3
BUSHING CONDITION
HYDROGEN - ( H2 )
EQUIPMENT GROUNDED
OXYGEN - ( O2 )
COUNTER READING
AF =
AL =
NITROGEN - ( N2 )
*METHANE - ( CH4 )
ANALYSIS OF FLUID TEST RESULTS
*CARBON MONOXIDE - ( CO )
CARBON DIOXIDE - ( CO2 )
CONDITION
*ETHYLENE - ( C2H4 )
EXCELLENT
NO SERVICE REQUIRED
*ETHANE - ( C2H6 )
GOOD
RETEST IN
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
*ACETYLENE - ( C2H2 )
TOTAL GAS CONTENT - ( % )
SERVICE
MONTHS:
COMBUSTIBLE GAS CONTENT

* COMBUSTIBLE GAS

TESTED BY:
www.powerdb.com
16500, REVISED 5/26/2010
MEDIUM VOLTAGE CIRCUIT BREAKER

PAGE
69
COMMENTS:
DEFICIENCIES:
www.powerdb.com
16500, REVISED 5/26/2010
LOW VOLTAGE POWER CIRCUIT BREAKER

INSULATION TEST AND INSPECTION
OWNER
70
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
MANUFACTURER
SN / SO NO.
FRAME SIZE(F)
BREAKER TYPE
SENSOR TAPS
MOUNTING
FUSE CAT. NO.
CUBICLE CODE
TRIP UNIT TYPE
CATALOG NO.
DESCRIPTION
INSPECTED
CONDITION
ZONE INTLK
CLEAN/LUBE
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
CONTACT FINGERS
INSULATING MEMBERS
MAIN CONTACTS
STRUCTURAL MEMBERS
ARCING CONTACTS
CUBICLES
OPERATING MECHANISM
RACKING DEVICES
CONTACT SEQUENCE
SHUTTER
GROUND CONNECTION
AUXILIARY DEVICES
SETTINGS AS FOUND
RATING PLUG(R)
LONG TIME PU
A =
SHORT TIME PU
INST. PU
ON
OFF
GRD. FLT. PU
ON
OFF
LONG TIME PU
A =
SHORT TIME PU
INST. PU
ON
OFF
GRD. FLT. PU
ON
OFF
SENSOR TAP
GRD. FLT.
3W
4W
SETTINGS AS LEFT
RATING PLUG(R)
SENSOR TAP
GRD. FLT.
3W
4W
C
POLE 1 (P1-P2)
READING
20C
B.I.
D.O.
TARGETS
CONDITION
CLEAN/LUBE
DELAY
DELAY
IT
IN
OUT
N/A
DELAY
IT
IN
OUT
N/A
DELAY
IT
IN
OUT
N/A
DELAY
IT
IN
OUT
N/A
DELAY

POLE 1 (P2-P3)
READING
20C
POLE 1 (P1-P3)
READING
POLE RESISTANCE (MICRO-OHMS)
20C
READING
POLE 1
POLE TO POLE
POLE 2
POLE 3
POLE TO FRAME
LINE TO LOAD

READING
20C

TESTED BY:
www.powerdb.com
15100, REVISED 5/26/2010
LOW VOLTAGE POWER CIRCUIT BREAKER

INSULATION TEST AND INSPECTION
PAGE
71
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15100, REVISED 5/26/2010
MOLDED CASE CIRCUIT BREAKER TEST
OWNER
72
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
MANUFACTURER
SN / SO NO.
FRAME SIZE(F)
BREAKER TYPE
SENSOR TAPS
MOUNTING
FUSE CAT. NO.
CUBICLE CODE
THERMAL MEMORY
TRIP UNIT TYPE
CATALOG NO.
ZONE INTLK
DESCRIPTION
INSPECTED
CONDITION
CLEAN/LUBE
DESCRIPTION
ARC CHUTES
CONTACT FINGERS
AUXILIARY DEVICES
GROUND CONNECTION
LOAD CONDUCTOR NO.
SETTINGS
(seconds)
INSPECTED
B.I.
CONDITION
Size
D.O.
ON
OFF
TARGETS
CLEAN/LUBE
CU
AL
TEST
(seconds)
SHORT DELAY PICKUP:

LONG TIME
(seconds)
SHORT DELAY TIME:
INSTANTANEOUS
(seconds)
LONG TIME PHASE A:

LONG TIME PHASE B:
LONG TIME PHASE C:
MEGGER TEST IN MEGAOHMS
A-B
PHASE A:
B-C
PHASE B:
C-A
PHASE C:
A-G
B-G
C-G
OPEN POLES
ABC-

TESTED BY:
www.powerdb.com
15950, REVISED 5/26/2010
PAGE
73
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15950, REVISED 5/26/2010
OIL CIRCUIT BREAKER TEST
OWNER
74
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
MODEL NO.
DATE MANUFACTURED
VOLTAGE
AMPERES
TOTAL WEIGHT
LBS
NUMBER OF TANKS
TOTAL FLUID CAP.
GAL
INTERRUPTING RATING
kA @
kV
kV
OVERCURRENT PROTECTION
DIRECT TRIP COIL OPERATED
POLE CONFIGURATION
RELAY OPERATED
REACTOR TRIP
RANGE
CAPACITOR TRIP
MECH
DC TRIP
OVERCURENT RELAY TESTED:
YES
POLE 2
NO
CURRENT TRANSFORMER RATIO

DESCRIPTION
POLE 1
POLE 3
MECH
:5
INSPECTED
CONDITION
CLEAN/LUBE
DESCRIPTION
INSPECTED
CONDITION
OVERALL CLEANLINESS
OIL GAUGES
INSULATING MEMBERS
TANK LINERS
MAIN CONTACTS
STRUCTURAL MEMBERS
ARCING CONTACTS
TANK RACKING DEVICE
CLOSING SEQUENCE
OPERATING MECHANISM
GROUND CONNECTION
LINKAGE
VISUAL OIL CONDITION
BEARINGS
OIL TESTED
BUSHINGS / GASKETS
DRAINED, CLEANED AND REFILLED WITH NEW OIL:
kVDC
READING
POLE TO POLE
POLE TO FRAME
20C
CLEAN/LUBE
YES
NO

READING
20C
READING
20C
CLOSED
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
OPEN
LIFT RODS
POLE 1
POLE 2
POLE 3
ARCING CONTACT WIPE (inches)
READING
20C
MAIN CONTACT WIPE (inches)
POLE 1
MAIN CONTACT GAP (inches)

MAIN CONTACT TRAVEL (inches)
CONTACT RESISTANCE
MICRO-OHMS
POLE 2
POLE 3
RDG.
20C
COUNTER READING: BEG.
END
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
16200, REVISED 8/23/2013
OWNER
75
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
MANUFACTURER
SN / SO NO.
FRAME SIZE(F)
BREAKER TYPE
SENSOR TAPS
MOUNTING
FUSE CAT. NO.
CUBICLE CODE
THERMAL MEMORY
TRIP UNIT TYPE
CATALOG NO.
ZONE INTLK
DESCRIPTION
INSPECTED
CONDITION
CLEAN/LUBE
DESCRIPTION
INSPECTED
ARC CHUTES
CONTACT FINGERS
AUXILIARY DEVICES
GROUND CONNECTION
LOAD CONDUCTOR NO.
SETTINGS AS FOUND
RATING PLUG(R)
LONG TIME PU
A =
SHORT TIME PU
INST. PU
ON
OFF
GRD. FLT. PU
ON
OFF
SENSOR TAP
GRD. FLT.
3W
4W
SETTINGS AS LEFT
RATING PLUG(R)
3W
LONG TIME PU
A =
SHORT TIME PU
INST. PU
ON
OFF
GRD. FLT. PU
ON
OFF
SENSOR TAP
GRD. FLT.
4W
TCC NO.
POLE 1
TEST
AMPERES
FUNCTION
INSTANTANEOUS
CURRENT
MULTIPLE
TIME BAND
MINIMUM
MAXIMUM
AS FOUND
(seconds)
AS LEFT
(seconds)
B.I.
D.O.
ON
OFF
TARGETS
CONDITION
Size
CLEAN/LUBE
CU
AL
DELAY
DELAY
IT
IN
OUT
N/A
DELAY
IT
IN
OUT
N/A
DELAY
IT
IN
OUT
N/A
DELAY
IT
IN
OUT
N/A
DELAY
POLE 2
AS FOUND
(seconds)
POLE 3
AS LEFT
(seconds)
AS FOUND
(seconds)
AS LEFT
(seconds)
IPU
SHORT TIME
STPU
LONG TIME
LTPU
VOLTAGE DROP @ LONG TIME TEST CURRENT
GROUND FAULT
GFPU
POLE 1 (P1-P2)
INSULATION
RESISTANCE
READING
20C
POLE 2 (P2-P3)
READING
20C
POLE 3 (P3-P4)
READING
POLE RESISTANCE - MICRO-OHMS
20C
POLE TO POLE
READING
POLE 1
POLE 2
POLE 3
POLE TO FRAME
LINE TO LOAD
CONTROL WIRING
READING
COUNTER READING BEG/END

20C

TESTED BY:
www.powerdb.com
15000, REVISED 5/26/2010
PAGE
76
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15000, REVISED 5/26/2010
CIRCUIT BREAKER INSULATING FLUID
OWNER
ADDRESS
CUSTOMER
77
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
MODEL NO.
DATE MANUFACTURED
AMPERES
RATED MAXIMUM VOLTS
kV
VOLTAGE RANGE FACTOR
B.I.L.
SHORT CIRCUIT CURRENT (SYM)
kA
RATED INTERRUPTING TIME
MECHANISM TYPE
TOTAL WEIGHT
INTERRUPTING RATING
LIQUID CAPACITY
kA @
kV
GAL
NUMBER OF TANKS
PLUMBING TABLE
kV
INST. BOOKLET
VOLTAGE
BREAKER INSPECTION
PAINT CONDITION
TOP
GASKETS
BOTTOM
BUSHINGS
VENT
LIQUID LEVEL
ACCESS PORT
TANK GROUNDS
COUNTER READING
TEST RESULTS
POLE 1
POLE 2
POLE 3
POLE CONFIGURATION
PARTICLES
MECH
DIELECTRIC STRENGTH - kV
POLE 1
POLE 2
INTERFACIAL TENSION - d/cm
POLE 3
MECH
ACIDITY - mg KOH/g
ANALYSIS OF TEST RESULTS
ASTM COLOR NO.
CONDITION
PARTS PER MILLION PCB

E. P. A. CLASSIFICATION
POWER FACTOR - %
WATER CONTENT - PPM
SERVICE
EXCELLENT
NO SERVICE REQUIRED
GOOD
RETEST IN
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
MONTHS:
SPECIFIC GRAVITY

TESTED BY:
www.powerdb.com
16400, REVISED 5/26/2010
CIRCUIT BREAKER INSULATING FLUID
PAGE
78
COMMENTS:
DEFICIENCIES:
www.powerdb.com
16400, REVISED 5/26/2010
VACUUM IN OIL RECLOSER TEST
OWNER
79
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
DATE MANUFACTURED
TYPE
VOLTAGE
AMPERES
INTERRUPTING RATING
MECHANISM TYPE
CLOSE COIL VOLTAGE
TRIP COIL VOLTAGE
INST. BOOK
SERIAL NUMBER
NO. TANKS
GALLONS PER TANK

MOTOR VOLTAGE
TEST AND MEASUREMENT DATA

OIL LEVEL
( IF UNIT HAS ONLY ONE TANK INSERT DATA IN ANY ONE PHASE )
PHASE A
OIL DIELECTRIC ( kV )
PHASE B
PHASE C
AS FOUND / AS LEFT
PHASE A
PHASE B
PHASE C
CONTACT RESISTANCE ( MICROHMS )

PHASE A
PHASE B
PHASE C
PHASE B
PHASE C
VACUUM INTEGRITY TEST

PHASE A
OPERATIONS COUNTER
AS FOUND
AS LEFT
RELAY FUNCTION TRIP TEST

PHASE A
PHASE B
PHASE C
RECLOSING RELAY
RECLOSER INTERVALS (SEC)
(1)
GROUND
(2)
(3)
(4)
MECHANICAL INSPECTION
COMPONENT
AS
FOUND
AS
LEFT
AS
FOUND
COMPONENT
AS
LEFT
AS
FOUND
COMPONENT
BUSHINGS / GASKETS
VACUUM BOTTLE
DRAINS / VALVES
ARC BAFFLES
CONDITION
CONTROL BOX CONDITION
BARRIERS
OPERATING LINKS
OVERALL CLEANLINESS
OPERATING MECHANISM
TRIP BAR
TANK LINERS
TANK GASKET
CONNECTIONS
OIL CONDITION

TESTED BY:
www.powerdb.com
AS
LEFT
16600, REVISED 5/26/2010
VACUUM IN OIL RECLOSER TEST
PAGE
80
COMMENTS:
DEFICIENCIES:
www.powerdb.com
16600, REVISED 5/26/2010
MEDIUM VOLTAGE AIR CIRCUIT BREAKER TEST
OWNER
ADDRESS
CUSTOMER
81
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
CIRCUIT BREAKER
SUBSTATION
POSITION
MANUFACTURER
SERIAL NUMBER
TYPE
MAXIMUM VOLTAGE
kV
INTERRUPTING CAPACITY
kA
DESCRIPTION
INSPECTED
CONDITION
MODEL NO.
DATE MANUFACTURED
AMPACITY
OPERATING VOLTAGE
kV
CLEAN/LUBE
TO
kV =
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
MAIN CONTACTS
INSULATING MEMBERS
ARCING CONTACTS
ARC CHUTES
STRUCTURAL MEMBERS
PUFFER OPERATION
CUBICLE
OPERATING MECHANISM
RACKING DEVICES
CONTACT SEQUENCE
SHUTTER
GROUND CONNECTION
CONTACT FINGERS
AUXILIARY DEVICES
TEST VOLTAGE
kVDC

READING
mVA
CONDITION
CLEAN/LUBE
20C
kV
READING
20C
READING
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
POLE 1
POLE 2
ARCING CONTACT GAP (inches)

CONTACT RESISTANCE
RDG.
MICRO-OHMS
20C
POLE 3
D
E
S
I
G
N
READING
20C
POLE 1
POLE 2
POLE 3

COUNTER READING:
BEG.
END
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
16000, REVISED 8/23/2013
OWNER
ADDRESS
CUSTOMER
82
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
CIRCUIT BREAKER
SUBSTATION
PLANT
POSITION
SETTINGS
Example Plant
GENERAL
TEST
SHORT DELAY PICKUP:

SHORT DELAY TIME:
TIME (seconds)
LONG TIME PHASE A:

LONG TIME PHASE B:
LONG TIME PHASE C:

PHASE A:
PHASE B:
PHASE C:
MEGGER TEST IN MEGAOHMS

A-B
B-C
C-A
A-G
B-G
C-G
OPEN POLES
ABC-

TESTED BY:
www.powerdb.com
15900, REVISED 5/26/2010
PAGE
83
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15900, REVISED 5/26/2010
RELAY SETTINGS DATA
OWNER
ADDRESS
CUSTOMER
84
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
BREAKER
POSITION
AMBIENT TEMPERATURE
HUMIDITY
BREAKER DATA
IEEE Text MFR./ Text TAP
ID NO.
TYPE
RANGE
POSITION
POSITION DATA
INST. Text CT
TextPT
RANGE
RATIO
RATIO
TAP
Text
SETTINGS AS FOUND
TIME
INST.
SEALText
DIAL
IN

Example Plant
GENERAL
PLANT
COORDINATION DATA
SUBSTATION
TESTED BY:
www.powerdb.com
TAP
SUGGESTED SETTINGS
INST.
TIME
SEALDIAL
IN
18200, REVISED 7/6/2001
RELAY SETTINGS DATA
PAGE
85
COMMENTS:
DEFICIENCIES:
www.powerdb.com
18200, REVISED 7/6/2001
RELAY SETTINGS DATA
OWNER
ADDRESS
CUSTOMER
86
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
COORDINATION DATA
PLANT
POSITION
Example Plant
GENERAL
DEVICE IDENTIFICATION
RELAY DATA
DEVICE NUMBER
MANUFACTURER
TYPE
RANGE
INST OR DIRECTIONAL RANGE
PICKUP RANGE
DROPOUT OR 2ND PICKUP RANGE
PHASE
% SLOPE OR REACH
SETTINGS AS FOUND
TAP
TIME DIAL
INST OR DIRECTIONAL SETTING
PICKUP SETTING
DROPOUT OR 2ND PU RANGE
3 PHASE PU TIME
3 PHASE DO TIME
MAX. TORQUE ANGLE
% SLOPE OR REACH
TIME
CT RATIO
PT RATIO
SUGGESTED SETTINGS
TAP
TIME DIAL
INST OR DIRECTIONAL SETTING
PICKUP SETTING
DROPOUT OR 2ND PU RANGE
3 PHASE PU TIME
3 PHASE DO TIME
MAX. TORQUE ANGLE
% SLOPE OR REACH
TIME
TARGET SEAL-IN AMPS
CT RATIO
PT RATIO
COMMENTS

TESTED BY:
www.powerdb.com
18300, REVISED 6/28/2007
RELAY SETTINGS DATA
PAGE
87
COMMENTS:
DEFICIENCIES:
www.powerdb.com
18300, REVISED 6/28/2007
CIRCUIT BREAKER DATA
OWNER
ADDRESS
CUSTOMER
88
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
POSITION
BREAKER
POSITION
HUMIDITY
BREAKER DATA
MFR. AND
TYPE
POSITION
CONDUCTOR
TRIP UNIT
TYPE AND
SENSOR
SIZE / NO.
PER PHASE
RECOMMENDED SETTINGS (seconds)

LONG TIME
PICK-UP
DELAY
SHORT TIME
PICK-UP

Example Plant
GENERAL
PLANT
COORDINATION DATA
SUBSTATION
DELAY
TESTED BY:
www.powerdb.com
INSTANT.
I2T
PICK-UP
GROUND FAULT
PICK-UP
DELAY
I2T
18000, REVISED 12/5/2007
CIRCUIT BREAKER DATA
PAGE
89
COMMENTS:
DEFICIENCIES:
www.powerdb.com
18000, REVISED 12/5/2007
DEFICIENCIES LOCATED
OWNER
ADDRESS
CUSTOMER
90
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
COORDINATION DATA
PLANT
POSITION
Example Plant
GENERAL
DEFICIENCIES LOCATED:
EQUIPMENT / SERVICES IMPACTED:
RECOMMENDED REPAIR:
REPAIRS COMPLETED
YES
NO

DATE:
TESTED BY:
www.powerdb.com
18500, REVISED 6/28/2007
DEFICIENCIES LOCATED
PAGE
91
COMMENTS:
DEFICIENCIES:
www.powerdb.com
18500, REVISED 6/28/2007
RELAY SETTINGS DATA
OWNER
ADDRESS
CUSTOMER
92
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
BREAKER
POSITION
AMBIENT TEMPERATURE
HUMIDITY
COORDINATION DATA
SUBSTATION
MFR./
TYPE
RELAY DATA
TAP Text INST.
RANGE RANGE
POSITION DATA
CT
PT
RATIO
RATIO
TIME
CURVE
SETTINGS AS FOUND
TAP
TIME
Text
DIAL

Example Plant
GENERAL
PLANT
POSITION
INST.
TESTED BY:
www.powerdb.com
TIME
CURVE
SUGGESTED SETTINGS
TAP
INST.
TIME
DIAL
SEALIN
18210, REVISED 2/16/2004
RELAY SETTINGS DATA
PAGE
93
COMMENTS:
DEFICIENCIES:
www.powerdb.com
18210, REVISED 2/16/2004
CIRCUIT BREAKER SURVEY
OWNER
ADDRESS
CUSTOMER
94
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MANUFACTURER /
BREAKER TYPE
SHEET
TRIP UNIT
TYPE /
FUNCTIONS
SENSOR
RATINGS
OF
ACTUAL
SETTING

Example Plant
GENERAL
PLANT
POSITION
CUSTOMER ONE LINE DIAGRAM NO.
POSITION
COORDINATION DATA
SUBSTATION
LATEST REVISION DATE
PRINT
SETTING
TESTED BY:
www.powerdb.com
LOAD
CONDUCTORS
LOAD
PANEL
RATING
MEASURED
LOAD
18400, REVISED 2/15/2002
CIRCUIT BREAKER SURVEY
PAGE
95
COMMENTS:
DEFICIENCIES:
www.powerdb.com
18400, REVISED 2/15/2002
FUSE DATA
OWNER
ADDRESS
CUSTOMER
96
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
AS FOUND
FUSE DATA
POSITION
MFR.
kV
TYPE
RECOMMENDED SETTINGS
CONDUCTOR DATA
AMPACITY
Example Plant
GENERAL
PLANT
COORDINATION DATA
SUBSTATION
SIZE
AMPACITY*
FUSE DATA
MFR.
kV
TYPE
AMPACITY
TCC NO.
COMMENT
*CONDUCTOR AMPACITY BASED ON NATIONAL ELECTRICAL CODE, 310-16, OR 310-77, 75 C.

#SIZES INDICATED ARE AWG OR KCM.

TESTED BY:
www.powerdb.com
18100, REVISED 11/29/2007
FUSE DATA
PAGE
97
COMMENTS:
DEFICIENCIES:
www.powerdb.com
18100, REVISED 11/29/2007
LOADBREAK DISCONNECT TEST
OWNER
98
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
DISCONNECTS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
VOLTAGE
TYPE

MOMENTARY FAULT CLOSING AMPS
kA
AMPERES
INTERRUPTING RATING
kA
AGE
B.I.L. RATING
kV
OTHER NAMEPLATE DATA
FUSE DATA
MANUFACTURER
TYPE
HOLDER
MAX. AMPS
REFILL ELEMENT TYPE
SIZE
CAT. NO.
TCC NO.
DESCRIPTION
INSPECTED
CONDITION
CLEANED/LUBED
DESCRIPTION
INSPECTED
NAMEPLATE VS. DRAWING/SPEC.
OVERALL CLEANLINESS
PHYSICAL/MECHANICAL CONDITION
INSULATING MEMBERS
ANCHORAGE & ALIGNMENT
BOLTED CONNECTIONS
GROUNDING & CLEARANCES
VERIFY APPROPRIATE LUBRICATION
BLADE ALIGNMENT/PENETRATION
INDICATION / CONTROL DEVICES
BLADE TRAVEL STOPS
PHASE BARRIER INSTALLATION
MECHANICAL OPERATION
VERIFY INTERLOCKS
FUSE RATINGS VS. DRAWINGS
FUSE MOUNTINGS
kVDC
POLE 1 (P1-P2)
INSULATION TESTS
READING
VOLTAGE
kV
CONDITION
CLEANED/LUBED

POLE 2 (P2-P3)
20C
READING
POLE 3 (P1-P3)
20C
READING
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
POLE 1
CONTACT RESISTANCE
MICRO-OHMS
POLE 2
POLE 3
POLE 1
RDG.
ARCING CONTACT WIPE - INCHES
20C
MAIN CONTACT WIPE - INCHES
FUSE RESISTANCE - MICRO-OHMS
MAIN CONTACT GAP -
MAIN CONTACT TRAVEL INCHES

-
POLE 2
POLE 3
INCHES

COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
29000, REVISED 8/23/2013
LOW VOLTAGE AIR SWITCH
OWNER
ADDRESS
CUSTOMER
99
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
DISCONNECTS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
MODEL NO.
CATALOG NO.
AMPACITY
SERIAL NUMBER
SHUNT TRIP
TYPE
VOLTAGE
YES
CONTROL VOLTAGE
INTERRUPT CAPACITY
OTHER
FUSE DATA
MANUFACTURER
CLASS
AMPACITY
CATALOG NO.
VOLTAGE RATING
INTERRUPT RATING
OTHER
GROUND FAULT RELAY

MANUFACTURER
TYPE
PICKUP RANGE
PICKUP SETTING
CATALOG NO.
TIME DELAY RANGE
TIME DELAY SETTING
OTHER
VISUAL & MECHANICAL INSPECTION

INSPECT PHYSICAL & MECHANICAL CONDITION
INSPECT BOLTED ELECTRICAL CONNECTIONS FOR HIGH RESISTANCE
INSPECT ANCHORAGE, ALIGNMENT & CLEARANCES
WITH ONE OF:
INSPECT GROUNDING
LOW RESISTANCE OHMMETER

CALIBRATED TORQUE WRENCH
PERFORM AS-FOUND TESTS IF REQUIRED
THERMOGRAPHIC SURVEY
CLEAN UNIT
TEST INTERLOCKING SYSTEMS FOR OPERATION & SEQUENCING
VERIFY BLADE ALIGNMENT & PENETRATION
INSPECT INSULATING ASSEMBLIES
VERIFY TRAVEL STOPS & MECHANICAL OPERATION
VERIFY ALL INDICATING & CONTROL DEVICES
VERIFY FUSE SIZES & TYPES
LUBRICATE MOVING CURRENT-CARRYING PARTS
VERIFY FUSE HOLDER SUPPORT
LUBRICATE MOVING & SLIDING SURFACES

VERIFY HEATER OPERATION
ELECTRICAL TESTS
POLE 1
RESISTANCE
MEASUREMENTS
BOLTED
CONNECTIONS
LINE
LOAD
AS FOUND
POLE 2
AS LEFT
FUSE HOLDER
CONTACT
INSULATION RESISTANCE TEST RESULTS

POLE 1 (P1-P2)
POLE TO FRAME
LINE TO LOAD
AS FOUND
AS LEFT
POLE 3
AS LEFT
FUSE
POLE TO POLE
AS FOUND
10 KVDC
POLE 2 (P2-P3)
PICKUP
TIMING
CONTROL WIRING
M

GROUND FAULT
POLE 3 (P1-P3)
TESTED BY:
www.powerdb.com
15510, REVISED 5/26/2010
LOW VOLTAGE AIR SWITCH
PAGE
100
COMMENTS:
DEFICIENCIES:
www.powerdb.com
15510, REVISED 5/26/2010
DISCONNECT SELECTOR SWITCH
OWNER
101
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
DISCONNECTS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
VOLTAGE
TYPE

MOMENTARY FAULT CLOSING AMPS
kA
AMPERES
INTERRUPTING RATING
AGE
B.I.L. RATING
kA
OTHER NAMEPLATE DATA
FUSE DATA
MANUFACTURER
TYPE
HOLDER
MAX. AMPS
REFILL ELEMENT TYPE
SIZE
CAT. NO.
TCC NO.
DESCRIPTION
INSPECTED
CONDITION
CLEANED/LUBED
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
INSULATING MEMBERS
BOLTED CONNECTIONS
BLADE TRAVEL STOPS
VERIFY INTERLOCKS
FUSE MOUNTINGS
kVDC

READING
kV
CONDITION
CLEANED/LUBED
20C
VOLTAGE
READING
20C
READING
20C
INSULATION TESTS
A
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
POLE 1
POLE 2
POLE 3
POLE 1
RES. MICRO-OHMS
RESISTANCE 20C
FUSE RES. MICRO-OHMS
CLOSE/OPEN SPEED (ft/sec)
MAIN CONTACT TRAVEL (inches)
POLE 2
B
POLE 3
A
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
29100, REVISED 8/23/2013
FUSED DISCONNECT INSPECTION & TEST
OWNER
102
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
DISCONNECTS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SIZE
TYPE
CATALOG NO.
SERIES
MAX. VOLTS
DESCRIPTION
INSPECTED
CONDITION
CLEANED/LUBED
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
INSULATING MEMBERS
BOLTED CONNECTIONS
BLADE TRAVEL STOPS
VERIFY INTERLOCKS
FUSE MOUNTINGS
kVDC
CONDITION
CLEANED/LUBED
TEST RESULTS
CONTACT RESISTANCE
MICRO-OHMS
FUSE DATA
POSITION
PHASE PHASE PHASE
A
B
C
ACTUAL READING
TYPE
SIZE
INSULATION RESISTANCE - MEGOHMS
RESISTANCE - MICRO-OHMS
A
PH
A-GND
PH
B-GND
PH
C-GND
PH
A-B
PH
A-C
PH
B-C
SHADING INDICATES TEMPERATURE CORRECTED READING TO 20C
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
15601, REVISED 8/23/2013
BOLTED PRESSURE SWITCH TEST
OWNER
103
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
DISCONNECTS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
MODEL NO.
TYPE
SERIAL NUMBER
CATALOG NO.
AMPACITY
SHUNT TRIP
YES
NO
CONTROL VOLTAGE
FUSE DATA
MANUFACTURER
TYPE
CATALOG NO.
TYPE
CATALOG NO.
AMPACITY
GROUND FAULT RELAY

MANUFACTURER
PICKUP RANGE
TIME DELAY RANGE
PICKUP SETTING
TIME DELAY SETTING
DESCRIPTION
INSPECTED
CONDITION
CLEAN/LUBE
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
ARC CHUTES
INSULATING MEMBERS
OPERATING MECHANISM
CONTACT FINGERS
CONTACT SEQUENCE
MAIN CONTACTS
GROUND CONNECTION
ARCING CONTACTS
AUXILIARY DEVICES
GROUND FAULT RELAY TESTED / CALIBRATED
kVDC
YES
CONDITION
CLEAN/LUBE
NO
INSULATION RESISTANCE TEST RESULTS - MEGOHMS

POLE 1 (P1-P2)
READING
POLE 2 (P2-P3)
20C
READING
POLE 3 (P1-P3)
20C
READING
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
POLE 1
POLE 2
POLE 1
POLE 3
ARCING CONTACT WIPE
CONTACT RESISTANCE - MICRO-OHMS
MAIN CONTACT WIPE
FUSE RESISTANCE - MICRO-OHMS
MAIN CONTACT GAP
POLE 3
MAIN CONTACT TRAVEL

(ALL MEASUREMENTS IN
POLE 2
READING
INCHES
20C
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
15500, REVISED 8/23/2013
GENERATOR POLARIZATION INDEX (PI) TEST
OWNER
ADDRESS
CUSTOMER
104
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
GENERATORS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
GENERATOR NAMEPLATE DATA:

GENERATOR MFR.
MODEL NO.
KVA
KW
VOLTS (KV)
AMPS
S/N
PHASE
FREQUENCY
RPM
GENERATOR CONTROL MFR.
MODEL NO.
GOVERNOR MFR.
YEAR MANUF.
TYPE
VOLTAGE REG. MFR.
FRAME TYPE
OTHER
PHASE TO GROUND TEST VOLTAGE
kVDC
CORE/COIL TEMPERATURE
READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)
INSULATION TYPE
PHASE B TO GROUND
READING
(megohms)
TEMP. CORR.
FACTOR
CHOOSE
TEMPERATURE CORRECTION FACTOR TO 20 C
PHASE A TO GROUND
MINUTES
Enter TCF Manually:
S/N
DRY
PHASE C TO GROUND
20C READING
(megohms)
READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)
0.25
0.50
0.75
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
POLARIZATION
INDEX
POLARIZATION INDEX = 10 MINUTE READING / 1 MINUTE READING

TESTED BY:
www.powerdb.com
REVISED 12/3/2012
PAGE
105
Megohms
Polarization Index
Time (minutes)
PHASE A TO GROUND : Red Square
PHASE B TO GROUND : Blue Circle
PHASE C TO GROUND : Green Triangle
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 12/3/2012
GENERATOR TIP UP TEST
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
106
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
GENERATORS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION

GENERATOR MFR.
MODEL NO.
KVA
KW
VOLTS (KV)
AMPS
S/N
PHASE
FREQUENCY
RPM
MODEL NO.
GOVERNOR MFR.
YEAR MANUF.
TYPE
S/N
VOLTAGE REG. MFR.
FRAME TYPE
OTHER
CHOOSE
TEST FREQUENCY: 60
Use T1, T2, T3
GROUNDED TIP UP TEST

kV
%
TEST
kV
T1 GND T2, T3
25
T1 GND T2, T3
50
T1 GND T2, T3
75
T1 GND T2, T3
100
TERMINAL 2
T2 GND T1, T3
25
T2 GND T1, T3
50
T2 GND T1, T3
75
T2 GND T1, T3
100
TERMINAL 3
P.F. %
CIRCUIT
DESCRIPTION
T3 GND T1, T2
25
10
T3 GND T1, T2
50
11
T3 GND T1, T2
75
12
T3 GND T1, T2
100
CAPACITANCE
C (PF)
MEAS.
DIRECT
mA
PF (%)
TIP UP
WATTS
% POWER FACTOR
TERMINAL 1
TEST ID
Phase A
Phase B
Phase C

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
98000, REVISED 12/11/2013
GENERATOR TIP UP TEST
PAGE
Use T1, T2, T3
UNGROUNDED TIP UP TEST

CIRCUIT
DESCRIPTION
KV
%
TEST
KV
13
T1 MES T2 GND T3
25
14
T1 MES T2 GND T3
50
15
T1 MES T2 GND T3
75
16
T1 MES T2 GND T3
100
TERMINAL 2
17
T2 MES T1 GND T3
25
18
T2 MES T1 GND T3
50
19
T2 MES T1 GND T3
75
20
T2 MES T1 GND T3
100
TERMINAL 3
P.F. %
TEST
ID
21
T3 MES T1 GND T2
25
22
T3 MES T1 GND T2
50
23
T3 MES T1 GND T2
75
24
T3 MES T1 GND T2
100
CAPACITANCE
C (PF)
MEASURED
DIRECT
mA
PF (%)
TIP UP
WATTS
% POWER FACTOR
TERMINAL 1
107
Phase A
Phase B
Phase C
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
Off
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
98000, REVISED 12/11/2013
OWNER
ADDRESS
CUSTOMER
108
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
GENERATORS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION

GENERATOR MFR.
MODEL NO.
KVA
KW
VOLTS (KV)
AMPS
S/N
PHASE
FREQUENCY
RPM
MODEL NO.
GOVERNOR MFR.
YEAR MANUF.
TYPE
VOLTAGE REG. MFR.
FRAME TYPE
OTHER
PHASE TO GROUND TEST VOLTAGE

MINUTES
READING
(megohms)
PHASE A TO B
TEMP. CORR.
FACTOR
20C READING
(megohms)
kVDC
C
Enter TCF Manually:
S/N
READING
(megohms)
CHOOSE
INSULATION TYPE
PHASE B TO C
TEMP. CORR. 20C READING
FACTOR
(megohms)
READING
(megohms)
PHASE C TO A
TEMP. CORR.
FACTOR
DRY
20C READING
(megohms)
0.25
0.50
0.75
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
POLARIZATION
INDEX

TESTED BY:
www.powerdb.com
REVISED 10/15/2012
PAGE
109
Megohms
Polarization Index
Time (minutes)
PHASE A TO GROUND: Red Square
PHASE A TO B: Orange Star
PHASE B TO GROUND: Blue Circle
PHASE B TO C: Purple Down Triangle
PHASE C TO GROUND: Green Triangle
PHASE C TO A: Grey Diamond
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 10/15/2012
GENERATION SYSTEMS
SYSTEM STATUS AND SHUTDOWN TESTS
OWNER
110
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
NAMEPLATE DATA
MANUFACTURER
CATALOG NO.
WIRING NO.
DESCRIPTION
Example Plant
GENERAL
PLANT
GENERATORS
SUBSTATION
SERIAL NO.
SYSTEM VOLTAGE
INSTALLED OPTIONS
INSPECTED
CONDITION
CLEAN/LUBE
TYPE
AMPACITY
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
ENVIRONMENTAL CONDITIONS
INSULATING MEMBERS
OPERATING MECHANISMS
CONDITION
CLEAN/LUBE
STATUS TITLE INDICATIONS
GENERATOR NUMBER
ALARM INITIATED
1
INDICATOR LAMP
ACTIVATED
SIREN ACTIVATED
3
CIRCUIT BREAKER OPEN

CIRCUIT BREAKER CLOSED
CIRCUIT BREAKER TRIP SHUTDOWN
CIRCUIT BREAKER CLOSE FAILURE
OVERCRANK SHUTDOWN*
OVERSPEED SHUTDOWN*
LOW OIL PRESSURE SHUTDOWN*
HIGH OIL TEMPERATURE SHUTDOWN*
HIGH WATER TEMPERATURE SHUTDOWN*
HIGH EXHAUST TEMPERATURE SHUTDOWN*
HIGH CRANKSHAFT PRESSURE*
REVERSE POWER SHUTDOWN
REVERSE VARS SHUTDOWN
EMERGENCY STOP*
HIGH WATER TEMPERATURE PRE-ALARM
LOW WATER LEVEL PRE-ALARM*
LOW WATER TEMPERATURE
LOW OIL PRESSURE PRE-ALARM *
HIGH EXHAUST TEMPERATURE PRE-ALARM *
HIGH INLET AIR TEMPERATURE *
LOW BOILER WATER LEVELS
COMPRESSED AIR SHUTDOWN
HIGH WATER LEVEL
EMERGENCY WATER FEED
FAILURE TO SYNCHRONIZE
CONTROL VOLTAGE FAILURE
CONTROLS NOT IN AUTOMATIC
ENGINE RUNNING *
AUTOMATIC START
BATTERY CHARGER FAILURE
PROGRAMMER LOGIC CONTROLLER STOPPED
HIGH STEAM PRESSURE
HIGH BATTERY VOLTAGE
LOW BATTERY VOLTAGE
* THE ALARM / SHUTDOWN WAS SIMULATED AT THE ENGINE GENERATOR AND VERIFIED AT THE SWITCHGEAR.

TESTED BY:
www.powerdb.com
19200, REVISED 4/22/2009
GENERATION SYSTEMS
PAGE
111
COMMENTS:
DEFICIENCIES:
www.powerdb.com
19200, REVISED 4/22/2009
SWITCHGEAR CHECK LIST
OWNER
ADDRESS
CUSTOMER
112
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
GENERATORS
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
VOLTAGE CLASS
TYPE
CONSISTING OF:
TOTAL BREAKERS
EXTERNAL CONDITION:
GOOD
TOTAL INSTRUMENTS
FAIR
DWGS.
TOTAL RELAYS
MOLDED CASE BREAKERS
POOR
GENERAL INSPECTION OF EXTERIOR

OF EQUIPMENT
INSPECT BREAKER AND CELL CONTACTS
INSPECT FOR DAMGE, BENT OR

TWISTED DOORS
VACUUM AND CLEAN INTERIOR OF CUBICLES
INSPECT DOOR HANDLES, LOCKING BARS

AND MECHANISM
LUBRICATE DRAWOUT ASSEMBLY
CHECK DOOR INTERLOCKS FOR

PROPER OPERATION
CHECK CELL INTERLOCKS AND AUXILIARY

CONTACT ASSEMBLIES
CHECK CONTROL KNOBS AND SWITCHES FOR

FREEDOM OF MOVEMENT AND CONTACT CONDITION
PERFORM BREKER INSPECTION AND TEST
INSPECT FOR BROKEN INSTRUMENTS,

RELAY COVER(S) AND GLASS
INSPECT AND PERFORM INSULATION TEST OF

POWER CABLE / BUS TO GROUND
INSPECT FOR PROPER GROUNDING

OF EQUIPMENT
RESTORE CONTROL POWER TO SWITCHGEAR
INSPECT BUS AND SUPPORT INSULATORS
CHECK RELAYS FOR POSITIVE TRIPPING
CLEAN BUS INSULATORS
TEST ANNUNCIATOR-ALARM FOR TARGET
DIELECTRIC TEST OF BUS WORK AND POTHEADS
CHECK PANEL LIGHTS FOR OPERATION:

BURNED OUT / MISSING BULBS AND LAMP COVERS
INSPECT CONTROL AND METERING TRANSFORMERS
OPERATE CLOSE AND TRIP BREAKER CONTROLS
INSPECT AND CHECK INSTRUMENTS
CHECK AUTOMATIC TRANSFER OPERATION
CHECK CONDITION OF WIRING AND TERMINAL

CONNECTIONS
MAKE FINAL VISUAL INSPECTION:

REMOVE LEADS, TOOLS, ETC.
REMOVE DRAWOUT BREAKERS
NOTE AND REPORT ANY UNMARKED CIRCUITS
CHECK RAILS, GUIDES, ROLLERS AND SHUTTER

MECHANISM
REPORT UNSAFE CONDITIONS

TESTED BY:
www.powerdb.com
19300, REVISED 4/22/2009
SWITCHGEAR CHECK LIST
PAGE
113
COMMENTS:
DEFICIENCIES:
www.powerdb.com
19300, REVISED 4/22/2009
ANNUAL
ENGINE-GENERATOR
PREVENTATIVE MAINTENANCE REPORT
OWNER
PAGE
ADDRESS
CUSTOMER
JOB #
114
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
GENERATORS
SUBSTATION
POSITION

GENERATOR MFR.
kVA
MODEL NO.
kW
VOLTS
AMPS
PHASE
S/N
CYCLES
RPM
MODEL NO.
S/N
GOVERNOR MFR.
MODEL NO.
S/N
VOLTAGE REG. MFR.
MODEL NO.
S/N
ENGINE NAMEPLATE DATA:

MANUFACTURER
SERIAL NUMBER
CHECK RADIATOR CORE FOR PROPER AIR FLOW

CHECK COOLANT FOR ANTI-FREEZE PROTECTION AND INHIBITOR STRENGTH
CHECK COOLANT LEVEL, WITH ENGINE COOL AND WITH ENGINE HOT
CHECK RADIATOR CAP AND SEAL
VERIFY THAT JACKET WATER HEATER IS OPERATING PROPERLY
CHECK FOR COOLANT LEAKS BEFORE, DURING AND AFTER RUNNING ENGINE
CHECK LUBE OIL LEVEL WITH ENGINE OFF AND WITH ENGINE RUNNING
CHECK FAN BELT TENSION
CHECK CONDITION OF HOSES AND HOSE CLAMPS
CHECK CONDITION OF FLEXIBLE FUEL LINES
CHECK FUEL SYSTEM FOR LEAKS, AND CHECK DAY TANK PUMPS AND ALARMS
CHECK BATTERY SPECIFIC GRAVITY AND ELECTROLYTE LEVEL - RECORD
CHECK BATTERY VOLTAGE AND BATTERY CHARGER RATE - RECORD
CHECK BATTERY CABLES AND CONNECTIONS
CHECK EXHAUST SYSTEM, INCLUDING FLEXIBLE COUPLINGS, DRAIN MOISTURE TRAPS
CHECK AIR CLEANER ELEMENTS, SEALS, AND AIR CLEANER INDICATOR
CHECK TERMINAL STRIP CONNECTIONS
CHECK POWER FEEDER CONNECTIONS AT THE GENERATOR
CHECK INSULATION ON GENERATOR LEADS - PERFORM MEGGAR TEST - RECORD
CHECK FOR LOOSE RELAYS IN CONTROL PANEL
CHECK GOVERNOR OIL LEVEL (IF APPLICABLE)
CHECK GOVERNOR AND LINKAGE FOR PROPER OPERATION
www.powerdb.com
REVISED 7/24/2009
ANNUAL
ENGINE-GENERATOR
PREVENTATIVE MAINTENANCE REPORT
PAGE
115
CHECK AIR GAP ON GENERATOR

CHECK COLLECTOR RING AND BRUSHES
CHECK FOR OIL AND DIRT BUILD UP IN GENERATOR
CHECK GENERATOR INSTALLATION FOR LOOSE BOLTS, ETC.
CHECK CRANK TERMINATION TIME AND CRANKING VOLTAGE DROP - RECORD
CHECK ALL ENGINE INSTRUMENTS FOR PROPER OPERATION
CHECK FOR ABNORNAL NOISE OR VIBRATION
CHECK FOR PROPER LOUVER OPERATION, (WHERE APPICABLE)
VERIFY PROPER OPERATION OF ALL PRE-ALARMS AND SHUTDOWN DEVICES
CHECK CRANKSHAFT BLOWBY, AND CLEAN CRANKCASE BREATHER
VERIFY PROPER VOLTAGE AND FREQUENCY - RECORD
DRAIN WATER AND SEDIMENT FROM DAY TANK
LUBRICATE GENERATOR BEARING AND FAN PULLEY
CLEAN PRIMARY FILTER
TAKE OIL SAMPLE FOR DETAILED OIL ANALYSIS
CLEAN THE PRIMARY FUEL FILTER SCREEN AND REPLACE THE FUEL FILTER ELEMENTS
CHANGE LUBE OIL AND FILTERS
PERFORM A FOUR HOUR LOADBANK TEST AT FULL LOAD
CHECK THAT ALL SWITCHES ARE LEFT IN PROPER MODE
CORRECTIVE ACTION TAKEN:
ADDITIONAL SERVICES REQUIRED:
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 7/24/2009
GENERATOR
OWNER
ADDRESS
CUSTOMER
116
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
GENERATORS
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION

MANUFACTURER
SERIAL NUMBER
VOLTAGE RATING
VOLTS
WATTAGE RATING
KILOWATTS
ADDITIONAL INFORMATION:
MANUFACTURER
TYPE
SERIAL NUMBER
DIESEL
WATER
NATURAL
ADDITIONAL INFORMATION:
MEASURED TEST RESULTS

PHASE VOLTAGES
LINE CURRENTS
FRE-
TIME
POWER
A-B
B-C
C-A
QUENCY
(hh:mm:ss)
(KILOWATTS)
(VOLTS)
(VOLTS)
(VOLTS)
(AMPERES)
(AMPERES)
(AMPERES)
(HERTZ)
GENERATOR INSTRUMENT PANEL RESULTS

FRE-
ENGINE
FUEL
WATER
OIL
TIME
POWER
A-B
PHASE VOLTAGES
B-C
C-A
LINE CURRENTS
B
QUENCY
HOURS
PRESS.
TEMP.
PRESS.
(hh:mm:ss)
(KILOWATTS)
(VOLTS)
(VOLTS)
(VOLTS)
(AMPERES)
(AMPERES)
(AMPERES)
(HERTZ)
(LBS.)
( C)
(LBS.)

TESTED BY:
www.powerdb.com
19600, REVISED 4/22/2009
GENERATOR
PAGE
117
COMMENTS:
DEFICIENCIES:
www.powerdb.com
19600, REVISED 4/22/2009
CO-GENERATION SYSTEM
SYSTEM STATUS & SHUTDOWN TESTS
OWNER
118
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
GENERATORS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
SYSTEM VOLTAGE
AMPACITY
WIRING NO.
INSTALLED OPTIONS
DESCRIPTION
INSPECTED
CONDITION
CLEAN/LUBE
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
ARC CHUTES
INSULATING MEMBERS
OPERATING MECHANISM
CONTACT SEQUENCE
INDICATION
ALARM INITIATED
SIREN ACTIVATED
CONDITION
CLEAN/LUBE
INDICATOR LAMP
ACTIVATED
EG-1 RUNNING
EG-1 ON LINE
EG-1 LOCKED OUT
MANUAL PARALLEL AVAILABLE
BUS OVERLOAD
EG-2 RUNNING
EG-2 ON LINE
EG-2 LOCKED OUT
PRI-2 LOAD SHED ACTIVE
PRI-2 LOAD SHED BYPASSED
EG-3 RUNNING
EG-3 ON LINE
EG-3 LOCKED OUT
PRI-3 LOAD SHED ACTIVE
PRI-3 LOAD SHED BYPASSED
LOAD DEMAND OPERATION
PLC STOPPED
PLC BATTERY CHARGER FAILURE
BUS OVER FREQUENCY
BUS UNDER VOLTAGE
BUS OVER VOLTAGE
EMERGENCY OPERATION
CO-GENERATION OPERATION

TESTED BY:
www.powerdb.com
19100, REVISED 4/22/2009
CO-GENERATION SYSTEM
SYSTEM STATUS & SHUTDOWN TESTS
PAGE
119
COMMENTS:
DEFICIENCIES:
www.powerdb.com
19100, REVISED 4/22/2009
GENERATION SYSTEMS
OWNER
120
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
GENERATORS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
SYSTEM VOLTAGE
AMPACITY
WIRING NO.
INSTALLED OPTIONS
DESCRIPTION
INSPECTED
CONDITION
CLEAN/LUBE
DESCRIPTION
INSPECTED
OVERALL CLEANLINESS
ENVIRONMENTAL CONDITIONS
INSULATING MEMBERS
OPERATING MECHANISMS
CONDITION
CLEAN/LUBE
STATUS TITLE INDICATIONS

GENERATION NUMBER
ALARM INITIATED
1
INDICATOR LAMP
ACTIVATED
SIREN ACTIVATED
3
LOW OIL PRESSURE PRE-ALARM *

HIGH EXHAUST TEMPERATURE PRE-ALARM *
HIGH INLET AIR TEMPERATURE *
LOW BOILER WATER LEVELS
COMPRESSED AIR SHUTDOWN
HIGH WATER LEVEL
EMERGENCY WATER FEED
FAILURE TO SYNCHRONIZE
CONTROL VOLTAGE FAILURE
CONTROLS NOT IN AUTOMATIC
ENGINE RUNNING *
AUTOMATIC START
BATTERY CHARGER FAILURE
PROGRAMMER LOGIC CONTROLLER STOPPED
HIGH STEAM PRESSURE
HIGH BATTERY VOLTAGE
LOW BATTERY VOLTAGE
THE ALARM / SHUTDOWN WAS SIMULATED AT THE ENGINE GENERATOR AND VERIFIED AT THE SWITCHGEAR.
FORM 19200 (GENERATION SYSTEMS SYSTEM STATUS AND SHUTDOWN B1 ) MUST BE COMPLETED ALSO.

TESTED BY:
www.powerdb.com
19250, REVISED 4/22/2009
GENERATION SYSTEMS
PAGE
121
COMMENTS:
DEFICIENCIES:
www.powerdb.com
19250, REVISED 4/22/2009
BI-ANNUAL
ENGINE-GENERATOR
PREVENTIVE MAINTENANCE REPORT
OWNER
ADDRESS
CUSTOMER
122
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
GENERATORS
SUBSTATION
POSITION

GENERATOR MFR.
S/N
MODEL NO.
kVA
kW
VOLTS
AMPS
PHASE
CYCLES
RPM
MODEL NO.
S/N
GOVERNOR MFR.
MODEL NO.
S/N
VOLTAGE REG. MFR.
MODEL NO.
S/N

MANUFACTURER
SERIAL NUMBER
AIR CLEANER
LOW
OK
HIGH
COMMENTS
LOW
OK
HIGH
COMMENTS
LOW
OK
HIGH
COMMENTS
AIR CLEANER ELEMENTS

AIR CLEANER SEALS
AIR CLEANER INDICATOR
BATTERY SYSTEM
CABLES AND CONNECTIONS
CHARGER RATE
CRANKING VOLTAGE DROP
ELECTROLYTE LEVEL
OVERALL VOLTAGE
SPECIFIC GRAVITY OF EACH CELL
LUBRICATION SYSTEM
CLEAN CRANKCASE BREATHER VENT
CLEAN PRIMARY FILTER
CRANKCASE BLOWBY
CRANKCASE OIL LEVEL WITH ENGINE OFF
CRANKCASE OIL LEVEL WITH ENGINE RUNNING
GOVERNOR OIL LEVEL
LUBRICATE GENERATOR BEARING & FAN PULLY
SAMPLE CRANKCASE OIL FOR LABORATORY TESTING
www.powerdb.com
REVISED 7/24/2009
BI-ANNUAL
ENGINE-GENERATOR
PAGE
EXHAUST & MECHANICAL SYSTEM
LOW
OK
HIGH
COMMENTS
LOW
OK
HIGH
COMMENTS
LOW
OK
HIGH
COMMENTS
GOVERNOR
LOW
OK
HIGH
COMMENTS
RADIATOR
LOW
OK
HIGH
COMMENTS
123
ABNORMAL NOISE OR VIBRATION

DRAIN MOISTURE TRAPS
EXTERIOR OPENING COVER
FLEXIBLE COUPLINGS
INSULATING MATERIALS
LOOSE BOLTS ON STRUCTURAL MOUNTINGS
SUPPORTS
FUEL SYSTEM
CONDITION OF HOSES & PIPE FITTINGS
DAY TANK ALARMS
DAY TANK LEAKS
DAY TANK PUMP
DRAIN WATER & SEDIMENT
GENERATOR
AIR GAP
COLLECTOR BRUSHES
COLLECTOR RINGS
DIRT / OIL / GREASE ACCUMULATION
POWER FEEDER CONNECTIONS
POWER FEEDER INSULATION TESTS
GOVERNOR OPERATION
LINKAGE OPERATION
OIL LEVEL
AIR FLOW THROUGH CORE

ANTIFREEZE & INHIBITOR STRENGTH
CAP & SEAL
COOLANT LEVEL - ENGINE HOT
COOLANT LEVEL - ENGINE COOL
FAN BELT CONDITION
FAN BELT TENSION
JACKET WATER HEATER OPERATING TEMPERATURE
LEAKS - BEFORE RUNNING
LEAKS - AFTER RUNNING
LOUVER OPERATION
www.powerdb.com
REVISED 7/24/2009
BI-ANNUAL
ENGINE-GENERATOR
PAGE
WIRING - CONTROL
LOW
OK
HIGH
124
COMMENTS
AMMETER OPERATION
AUTOMATIC / MANUAL MODE
CONTROL RELAYS
CRANK TERMINATION RESET
CRANK TERMINATION TIME
FREQUENCY METER OPERATION
OIL PRESSURE
PROPER OPERATION OF ALL PRE-ALARMS
PROPER OPERATION OF ALL SHUTDOWNS
TEMPERATURE GAUGE
TERMINAL STRIP CONNECTIONS
VOLTMETER OPERATION
CORRECTIVE ACTION COMPLETED:
ADDITIONAL SERVICES REQUIRED:
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 7/24/2009
GENERATOR LOAD TEST REPORT
OWNER
ADDRESS
CUSTOMER
125
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
GENERATORS
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
GENERATOR MFR.
MODEL NO.
kVA
kW
VOLTS
AMPS
S/N
PHASE
CYCLES
RPM
MODEL NO.
S/N
GOVERNOR MFR.
MODEL NO.
S/N
VOLTAGE REG. MFR.
MODEL NO.
S/N
TEST RUN
TEST READING INTERVALS
START
REAL TIME
TARGET KILOWATT
LOADING
ENGINE SPEED - R.P.M.
FREQUENCY - HERTZ
ENGINE WATER F
RADIATOR WATER
TEMPERATURE F
ENGINE OIL
TEMPERATURE F
ENGINE OIL PRESSURE - PSI
PANEL METER
VOLTAGE READING
MEASURED VOLTAGE
PANEL METER
AMPERE READING
MEASURED AMPERES
PANEL METER
KILOWATT READING
MEASURED KILOWATT
READING
BATTERY VOLTAGE
FUEL PRESSURE
FUEL MONITORING SYSTEM

VOLUME
GAL.
ULLAGE
GAL.
90% ULLAGE
GAL.
TC VOLUME
HEIGHT
INCHES
WATER
GAL.
WATER
INCHES
TEMPERATURE
GAL.
F
TIME

TESTED BY:
www.powerdb.com
19000, REVISED 4/22/2009
GENERATOR LOAD TEST REPORT
PAGE
126
COMMENTS:
DEFICIENCIES:
www.powerdb.com
19000, REVISED 4/22/2009
GROUND FAULT PROTECTION SYSTEM
OWNER
127
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
GROUND FAULT
SUBSTATION
POSITION
INTERRUPTER DATA
DEVICE
CIRCUIT BREAKER
FUSED SWITCH
SERIAL NUMBER
MANUFACTURER
CURRENT RATING
TYPE
MODEL NUMBER
AMPERES
GROUND FAULT DATA
CATALOG NUMBER
SYSTEM VOLTAGE
VOLTS
DEVICE VOLTAGE RATING
VOLTS
GROUND FAULT RELAY DATA
GROUND FAULT SYSTEM TYPE
NEUTRAL-GROUND
ZERO-SEQUENCE
MANUFACTURER
RESIDUAL
TYPE
MODEL NUMBER
CATALOG NUMBER
PICKUP RANGE
AMPERES
SENSOR/CT RATING
TIME RANGE
CT TYPE
IN-LINE
TOROIDAL
AS FOUND DIAL SETTINGS
AMPERES
TIME
SECONDS
CYCLES
AS LEFT DIAL SETTINGS
AMPERES
TIME
SECONDS
CYCLES
SETTINGS SUPPLIED BY
OF
INSPECTION REPORT
INSPECTION REMARKS
NEUTRAL-GROUND LOCATION
CORRECT
INCORRECT
NEUTRAL DISC LINK
CORRECT
INCORRECT
CONTROL POWER
CORRECT
INCORRECT
MONITOR/TEST PANEL
CORRECT
INCORRECT
SENSOR LOCATION
CORRECT
INCORRECT
ELECTRICAL TESTS
STATIC TESTS: APPLIES TO SINGLE SOURCE SERVICE ONLY - NO EMERGENCY GENERATOR
SYSTEM NEUTRAL ISOLATED: RESISTANCE
SIMULATED CT WRAP TEST
YES
CT POLARITY TEST
NO
VERIFIED
INCORRECT
NOT PERFORMED
TOTAL
FUNCTION
CHECK
CURRENT APPLIED
DYNAMIC TESTS: SIMULATED GROUND FAULT APPLIED AT

LOCATION #1
CURRENT MEASURED
CURRENT AT SENSOR
LOCATION #2
CURRENT MEASURED
CURRENT AT SENSOR
DIAL SETTINGS
AMPERES
SECONDS
ACTUAL
PERCENT
PRIMARY
PICKUP
PICKUP
CURRENT
TIME
TIME
AMPERES
SECONDS
SECONDS
CYCLES
CYCLES
AMPERES
CYCLES
RELAY
TRIP
NO TRIP
TRIP
NO TRIP
TRIP
NO TRIP
TRIP
NO TRIP
TRIP
NO TRIP
TRIP
NO TRIP

TESTED BY:
www.powerdb.com
22900, REVISED 8/25/2006
GROUND FAULT PROTECTION SYSTEM
PAGE
128
COMMENTS:
DEFICIENCIES:
www.powerdb.com
22900, REVISED 8/25/2006
GROUND FAULT RELAY TEST
OWNER
ADDRESS
CUSTOMER
129
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
GROUND FAULT
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
MANUFACTURER
SERIAL NUMBER
TYPE
MODEL NO.
DATE MANUFACTURED
CATALOG NO.
INSTRUCTION BOOK NO.
CURRENT SETTING RANGE
TIME DELAY RANGE
CURRENT TRANSFORMER TYPE:
SENSOR CAT. NO.
BAR TYPE
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
RELAY SETTINGS
SENSOR AMPERE RATING

CONTROL VOLTAGE
AS SPECIFIED
AS FOUND
CURRENT PICKUP
TIME DELAY
SEC
SEC
SEC
AS SPECIFIED
TEST RESULTS
AS LEFT
AS FOUND
AS LEFT
CURRENT PICKUP (AMPS)

TIME DELAY
CONTROL
VOLTAGE
SEC. @
SEC. @
SEC. @
TIME DELAY
CONTROL
VOLTAGE
SEC. @
SEC. @
SEC. @
NEUTRAL TO GROUND INSULATION TEST RESULTS @ 1 kVDC
MEGOHMS

TESTED BY:
www.powerdb.com
22000, REVISED 12/26/2008
GROUND FAULT RELAY TEST
PAGE
130
COMMENTS:
DEFICIENCIES:
www.powerdb.com
22000, REVISED 12/26/2008
EARTH RESISTANCE DET24C
OWNER
ADDRESS
CUSTOMER
131
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
PLANT
POSITION
Example Plant
AUTOMATED
NUMBER OF TESTS: 1
ASSET ID
SERIAL
NO.
RESISTANCE CURRENT
TIME
DATE
FILTER
on/off
INSTRUMENT
SERIAL NO.
TEST NOTES
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 9/4/2013
INTERSECTING CURVES
OWNER
132
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
TYPE OF GROUND ROD
NUMBER OF GROUND RODS
DIAMETER OF GROUND ROD
INCHES
LENGTH OF GROUND RODS

SOIL CONDITION:
SOIL TYPE
CONNECTING CONDUCTOR SIZE
AWG
DIAGONAL MEASUREMENT OF GROUND GRID
FEET
DRY
CONNECTING CONDUCTOR
FEET
DAMP
BARE
WET
INSULATED
GROUND TESTER MAKE/MODEL
GROUND TESTER SERIAL NUMBER
LAST CALIBRATION DATE
PROBE PLACEMENT DIRECTION

DISTANCE FROM C TO O
TEST 1
DISTANCE IN
FEET
(P)
RESISTANCE
(OHMS)
TEST 2
DISTANCE IN
FEET
(P)
RESISTANCE
(OHMS)
TEST 3
DISTANCE IN
FEET
(P)
RESISTANCE
(OHMS)
1
2
3
4
5
6
7
8
9
10
Measurement process is repeated with three different values for D c.

TESTED BY:
www.powerdb.com
24470, PAGE 1 OF 3, REVISED 7/15/2010
INTERSECTING CURVES
PAGE
FEET
FALL OF POTENTIAL CURVE: O TO C =
FEET
FEET
133
RESISTANCE (ohms)
RESISTANCE (ohms)
RESISTANCE (ohms)
www.powerdb.com
24470, PAGE 1 OF 3, REVISED 7/15/2010
INTERSECTING CURVES
PAGE
ARBITRARY
X
DISTANCE
TEST 1
TEST 2
FEET
FEET
Dp
RESISTANCE
Dp
134
TEST 3
FEET
RESISTANCE
Dp
RESISTANCE
1.0
1.0
1.0
100
1.0
1.0
1.0
200
1.0
1.0
1.0
300
1.0
1.0
1.0
400
1.0
1.0
1.0
500
1.0
1.0
1.0
600
1.0
1.0
1.0
700
1.0
1.0
1.0
800
1.0
1.0
1.0
RESISTANCE (ohms)
RESISTANCE VERSUS X DISTANCES (O to C = , and FEET )
RESISTANCE RESULT:
1.0
OHMS
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24470, PAGE 1 OF 3, REVISED 7/15/2010
FULL FALL OF POTENTIAL
OWNER
135
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
TYPE OF GROUND ROD
Example Plant
GENERAL
PLANT
POSITION
INCHES

SOIL CONDITION:
SOIL TYPE
AWG
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED


DISTANCE FROM GROUND ELECTRODE TO C IN FEET
PERCENT OF
OVERALL
DISTANCE
RESISTANCE
READING
(Ohms)
RESISTANCE (OHMS)
DISTANCE IN
FEET
(GROUND ELECTRODE TO P)
EARTH RESISTANCE CURVE
DISTANCE FROM GROUND ELECTRODE TO P (FEET)
RESULT:
OHMS

TESTED BY:
www.powerdb.com
24400, REVISED 1/17/2011
FULL FALL OF POTENTIAL
PAGE
136
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24400, REVISED 1/17/2011
SIMPLIFIED FALL OF POTENTIAL
OWNER
137
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TYPE OF GROUND ROD
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
INCHES

SOIL CONDITION:
SOIL TYPE
AWG
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED


DESIRED ACCURACY
PERCENT
OF OVERALL
DISTANCE
DISTANCE IN
FEET
RESISTANCE
READING
(OHMS)
R avg
0.00
DEVIATION
R1
40.00 %
0.0
0.00
R2
50.00 %
0.0
0.00
R3
60.00 %
0.0
0.00
MAX DEVIATION
0.00
ACCURACY
0.0 %
RESULT (OHMS)

TESTED BY:
www.powerdb.com
RETEST
24420, REVISED 7/7/2010
SIMPLIFIED FALL OF POTENTIAL
PAGE
138
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24420, REVISED 7/7/2010
SOIL RESISTIVITY
OWNER
ADDRESS
CUSTOMER
139
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
TYPE OF GROUND ROD

POSITION
INCHES

SOIL CONDITION:
SOIL TYPE
Example Plant
GENERAL
PLANT
AWG
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED

Soil Resistivity (ohm-cm) = 2 * PI * Distance Between Electrodes (cm) * Resistance (ohms)
DISTANCE
DISTANCE
BETWEEN
BETWEEN
ELECTRODE
SOIL
LOCATION ELECTRODES ELECTRODES
DEPTH
RESISTANCE RESISTIVITY
IDENTIFIER
(feet)
(cm)
(inches)
(ohms)
(ohm-cm)
Measures average
soil resistivity at
this one point.

TESTED BY:
www.powerdb.com
24440, REVISED 7/7/2010
SOIL RESISTIVITY
PAGE
140
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24440, REVISED 7/7/2010
FALL OF POTENTIAL
61.8% RULE
OWNER
141
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
TYPE OF GROUND ROD
Example Plant
GENERAL
PLANT
POSITION
INCHES

SOIL CONDITION:
SOIL TYPE
AWG
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED

DISTANCE IN
FEET
(GROUND ELECTRODE TO C)
PERCENT OF
OVERALL DISTANCE
DISTANCE #1
61.8 %
DISTANCE #2
61.8 %
DISTANCE #3
61.8 %
DISTANCE IN
FEET

TESTED BY:
www.powerdb.com
RESISTANCE
READING
(OHMS)
24460, REVISED 7/7/2010
FALL OF POTENTIAL
61.8% RULE
PAGE
142
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24460, REVISED 7/7/2010
FOUR POTENTIAL METHOD
OWNER
143
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
TYPE OF GROUND ROD
Example Plant
GENERAL
PLANT
POSITION
INCHES

SOIL CONDITION:
SOIL TYPE
AWG
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED


PERCENT OF
OVERALL DISTANCE
R1
DISTANCE IN
FEET
20.00 %
R2
40.00 %
R3
50.00 %
R4
60.00 %
R5
70.00 %
R6
80.00 %
GROUND
RESISTANCE
(OHMS)
EQUATION #1
EQUATION #2
EQUATION #3
EQUATION #4
EQUATION #1 (R ) =
-0.1187R1 - 0.4667R2 + 1.9816R4 - 0.3961R6
EQUATION #2 (R ) =
-2.6108R2 + 4.0508R3 - 0.1626R4 - 0.2774R6
EQUATION #3 (R ) =
-1.8871R2 + 1.1148R3 + 3.6837R4 - 1.9114R5
EQUATION #4 (R ) =
-6.5225R3 + 13.6816R4 - 6.8803R5 + 0.7201R6

TESTED BY:
www.powerdb.com
RESULT
RESULT
RESULT
RESULT
24410, REVISED 7/7/2010
FOUR POTENTIAL METHOD
PAGE
144
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24410, REVISED 7/7/2010
SLOPE METHOD
OWNER
145
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TYPE OF GROUND ROD
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
INCHES

SOIL CONDITION:
SOIL TYPE
AWG
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED


Interpolate Result
Measure Result
"P" PROBE
POSITION
PERCENT OF
OVERALL DISTANCE
DISTANCE IN
FEET
R1
20.00 %C
0.0
R2
40.00 %C
0.0
R3
60.00 %C
0.0
RESISTANCE
READING
(OHMS)
PT / C
PT / (ft)
RESULT (ohms):

SLOPE CHANGE RESISTANCE/DISTANCE CURVE
TESTED BY:
www.powerdb.com
0.0
0.00
24430, REVISED 7/7/2010
SLOPE METHOD
PAGE
146
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24430, REVISED 7/7/2010
STAR DELTA
OWNER
ADDRESS
CUSTOMER
147
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
POSITION
TYPE OF GROUND ROD
INCHES

SOIL CONDITION:
SOIL TYPE
AWG
FEET
DISTANCE IN
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED

RESISTANCE
READING
(OHMS)
R12
R13
R1
RESISTANCE OF THE GROUND ELECTRODE UNDER TEST
R2
RESISTANCE OF PROBE P2
R3
R4
R14
R23
R34
R42
EQUATION
R1 RESULT
OHMS
R2 RESULT
OHMS
R3 RESULT
OHMS
R4 RESULT
OHMS
#1
#2
Resistance
Areas
#3
#4

TESTED BY:
www.powerdb.com
24450, REVISED 7/7/2010
STAR DELTA
PAGE
148
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24450, REVISED 7/7/2010
FALL OF POTENTIAL TEST
OWNER
ADDRESS
CUSTOMER
149
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TYPE OF GROUND ROD
Example Plant
OTHER
PLANT
SUBSTATION
POSITION
INCHES

SOIL CONDITION:
SOIL TYPE
AWG
FEET
FEET
DRY
DAMP
BARE
WET
INSULATED

POINT UNDER TEST

DIRECTION OF ELECTRODES
DISTANCE
C1 TO C2
DISTANCE
P1 TO P2
RA EQUALS AVERAGED RESISTANCE ( R40 R 50 R 60 ) :

R
60
PERCENT
P TO C
MEASURED
RESISTANCE
R 40
OHM(S)
R 50
OHM(S)
R 60
OHM(S)
OHM(S)
OHM(S)
OHM(S)
MINUS RA DIVIDE BY RA EQUALS X PERCENT
X PERCENT TIMES 1.2 EQUALS Y PERCENT

IF Y PERCENT IS LESS THAN YOUR DESIRED TEST ACCURACY, RA CAN BE USED AS THE REST RESULT.

TESTED BY:
www.powerdb.com
24010, REVISED 4/22/2009
FALL OF POTENTIAL TEST
PAGE
150
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24010, REVISED 4/22/2009
GROUND ROD SURVEY
OWNER
ADDRESS
CUSTOMER
151
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
PLANT
ROD
NUMBER
LOCATION OR
IDENTIFICATION
ROD SIZE
DXL
POSITION
COPPER CLAD
STEEL OR
GALVANIZED
* TEST METHOD USED FOR DETERMINING GROUND ROD RESISTANCE:
CONNECTING
CONDUCTOR
SIZE
2 POINT
Example Plant
OTHER
RESISTANCE
OHMS *
SOIL TYPE
REFERENCE GROUND
3 POINT
CLAMP-ON

TESTED BY:
www.powerdb.com
24300, REVISED 4/22/2009
GROUND ROD SURVEY
PAGE
152
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24300, REVISED 4/22/2009
GROUNDED SURFACES TEST

SINGLE ROOM
OWNER
ADDRESS
CUSTOMER
153
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
OTHER
PLANT
POSITION
OTHER
GROUND REFERENCE
ITEM
MILLIVOLT
READING
ITEM
MILLIVOLT
READING
MAXIMUM ALLOWABLE VALUE IS 20 MILLIVOLTS FOR NEW CONSTRUCTION PER THE NATIONAL FIRE PROTECTION ASSOCIATION NFPA-99, 1996, 3-3.3.2.6.

TESTED BY:
www.powerdb.com
25100, REVISED 4/22/2009

SINGLE ROOM
PAGE
154
COMMENTS:
DEFICIENCIES:
www.powerdb.com
25100, REVISED 4/22/2009
GROUND RESISTANCE
TWO TERMINAL METHOD
OWNER
ADDRESS
CUSTOMER
155
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
Example Plant
OTHER
PLANT
POSITION
DRAWING REFERENCE NUMBER

FROM
TEST #
TO
UNCORRECTED

TESTED BY:
www.powerdb.com
CORRECTED
RESISTANCE RESULT
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
MILLI-OHMS
OHMS
24210, REVISED 4/22/2009
GROUND RESISTANCE
TWO TERMINAL METHOD
PAGE
156
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24210, REVISED 4/22/2009
GROUND MAT TEST
OWNER
ADDRESS
CUSTOMER
157
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
OTHER
PLANT
POSITION
TYPE OF GROUND ROD
NUMBER OF RODS
SOIL TYPE
SOIL CONDITION:
DRY
DAMP
BARE
WET
INSULATED
BAR TYPE
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
AUXILIARY POTENTIAL ELECTRODE
DISTANCE IN FEET
RESISTANCE IN OHMS
GROUND RESISTANCE @ 61.8% OF DISTANCE

TEST TYPE:
OHMS
FALL OF POTENTIAL
TWO-POINT
INDUCED FREQUENCY
DISTANCE IN FEET

TESTED BY:
www.powerdb.com
24020, REVISED 4/22/2009
GROUND MAT TEST
PAGE
158
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24020, REVISED 4/22/2009
LINE ISOLATION MONITOR

SYSTEM TEST
OWNER
ADDRESS
CUSTOMER
159
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
Example Plant
OTHER
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
MODEL NO.
CATALOG NO.
TYPE
INPUT VOLTAGE
OUTPUT VOLTAGE
ALARM CURRENT PICKUP
INDICATOR TESTS
DESCRIPTION
INSPECTED
CONDITION
DESCRIPTION
INSPECTED
CONDITION
SAFE LIGHT
SILENCE
HAZARD LIGHT
SELF CALIBRATION
PUSH TO TEST
METER READING - CIRCUITS ON
mA
PUSH TO TEST
METER READING - CIRCUITS OFF
mA
VOLTAGE TESTS
NO LOAD PRIMARY VOLTAGE
NO LOAD SECONDARY VOLTAGE
H1-GROUND
H1-H2
X1-GROUND
X1-X2
H2-GROUND
H2-H3
X2-GROUND
X2-X3
H3-GROUND
H3-H1
X3-GROUND
X3-X1
HAZARD LEAKAGE CURRENT TESTS - BRANCH CIRCUITS

CIRCUIT
NUMBER
VOLTAGE TESTS
PANEL LEAKAGE
L1-GND
( A)
L2-GND
( A)
L3-GND
( A)
LEAKAGE
CURRENT
L1-GND ( A)
LEAKAGE
CURRENT
L2-GND ( A)
LEAKAGE
CURRENT
L3-GND ( A)
1
2
BRANCH CKT. BREAKERS OFF
BRANCH CKT. BREAKERS ON

(LOADS ARE REMOVED OR OFF)
4
5
6
7
8
LIM TRIP LEVEL TEST

L1-GND
(mA)
L2-GND
(mA)
L3-GND
(mA)
9
10
11
LIM METER READING
12
13
EXTERNAL METER READING
14
15
16
SHADED AREAS FOR 3-PHASE SYSTEMS ONLY

TESTED BY:
www.powerdb.com
26000, REVISED 4/22/2009
LINE ISOLATION MONITOR

SYSTEM TEST
PAGE
160
COMMENTS:
DEFICIENCIES:
www.powerdb.com
26000, REVISED 4/22/2009
GROUND MAT TEST
OWNER
ADDRESS
CUSTOMER
161
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
OTHER
PLANT
POSITION
TYPE OF GROUND ROD
NUMBER OF RODS
SOIL TYPE
SOIL CONDITION:
DRY
DAMP
BARE
WET
INSULATED
BAR TYPE
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
AUXILIARY POTENTIAL ELECTRODE
DISTANCE IN FEET
RESISTANCE IN OHMS
GROUND RESISTANCE @ 61.8% OF DISTANCE
TEST TYPE:
OHMS
FALL OF POTENTIAL
TWO-POINT
INDUCED FREQUENCY
DISTANCE IN FEET

TESTED BY:
www.powerdb.com
24000, REVISED 4/22/2009
GROUND MAT TEST
PAGE
162
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24000, REVISED 4/22/2009
GROUND POINT CONTINUITY TEST
OWNER
ADDRESS
CUSTOMER
163
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
PLANT
POSITION
Example Plant
OTHER
General Description:
Maximum Resistance
Test
#
Description
Test
Amps Volts
V
A
Calc.
Resist.
(ohms)
Lead
Resist.
(ohms)
Ground
Resist.
(ohms)
Com.
Test
#
Description
Test
Amps Volts
V
A
Calc.
Resist.
(ohms)
Lead
Resist.
(ohms)
Ground
Resist.
(ohms)
Com.
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
24220, REVISED 11/21/2013

MULTI-ROOM
OWNER
ADDRESS
CUSTOMER
164
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
OTHER
PLANT
POSITION
GROUND REFERENCE
OTHER
ITEM
MILLIVOLT READING
RM
RM
RM
RM
RM
MAXIMUM ALLOWABLE VALUE IS 20 MILLIVOLTS FOR NEW CONSTRUCTION CRITICAL CARE AREAS, AND 500 MILLIVOLTS FOR GENERAL CARE AREAS PER
NFPA-99, 1996, 3-3.3.2.6, CRITERIA FOR ACCEPTABILITY.

TESTED BY:
www.powerdb.com
25000, REVISED 4/22/2009

MULTI-ROOM
PAGE
165
COMMENTS:
DEFICIENCIES:
www.powerdb.com
25000, REVISED 4/22/2009
GROUND RESISTIVITY TEST
OWNER
ADDRESS
CUSTOMER
166
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
SOIL TYPE
POSITION
DRY
SOIL CONDITION:
TEST ELECTRODE DEPTH
TEST PLOT
ID
Example Plant
OTHER
PLANT
METER
READING
(OHMS)
INCHES
CALCULATED
RESISTIVITY
(OHMS - CM)
- SOIL RESISTIVITY IN OHM CENTIMETERS
- DISTANCE BETWEEN TEST ELECTRODES IN FEET

FEET
- RESISTANCE IN OHMS
TEST PLOT
ID
DAMP
TEST ELECTRODE SPACING
METER
READING
(OHMS)
CALCULATED
RESISTIVITY
(OHMS - CM)
RESISTIVITY CALCULATION N:
FEET
TEST PLOT
ID
WET
METER
READING
(OHMS)
CALCULATED
RESISTIVITY
(OHMS - CM)
CENTIMETERS = (INCHES) ( 2.54 )

CENTIMETERS = (FEET) ( 12 ) ( 2.54 )

TESTED BY:
www.powerdb.com
24200, REVISED 4/22/2009
GROUND RESISTIVITY TEST
PAGE
167
COMMENTS:
DEFICIENCIES:
www.powerdb.com
24200, REVISED 4/22/2009
INFRARED INSPECTION
OWNER
168
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
INFRARED
SUBSTATION
POSITION
EQUIPMENT TESTED
SEVERITY CRITERIA FOR SIMILAR COMPARISONS
NORMAL
ALERT
SEVERE
CRITICAL
LESS THAN 4.1C
4.1C TO 8.0C
8.1C TO 15.0C
GREATER THAN 15.0C
REFERENCE TEMPERATURE
PROBLEM TEMPERATURE
LOAD CORRECTION PHASE:

VARIABLES
PHASE A
DIFFERENCE TEMPERATURE
LOAD CORRECTION FACTOR
PROBLEM POLE LOCATION CURRENT DRAW (AMPS)
CALCULATED MAX TEMPERATURE
1.6
CURRENT RATING (AMPS) THDC (%THD-F)
VOLTAGE DROP (VOLTS)
PHASE A
PHASE B
PHASE C
PROBLEM CORRECTED
TIGHTENED/TORQUED CONNECTION
CORRODED/DISCOLORED
OVERLOADED CIRCUIT
EXCESSIVE CURRENT HARMONICS
STRIPPED/CROSS-THREADED HARDWARE
Consequences if Not Corrected

Equipment Failure
Fire Hazard
Safety Hazard
Power/Business Interruption
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
45444, REVISED 2/3/2014
INFRARED INSPECTION REPORT SHEET
OWNER
169
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
INFRARED
SUBSTATION
POSITION
EQUIPMENT TESTED
SEVERITY CRITERIA FOR SIMILAR COMPARISONS
NORMAL
ALERT
SEVERE
CRITICAL
LESS THAN 4.1C
4.1C TO 8.0C
8.0C TO 15.0C
GREATER THAN 15.0C
REFERENCE TEMPERATURE
VARIABLES
PROBLEM TEMPERATURE
DIFFERENCE TEMPERATURE
PROBLEM POLE LOCATION CURRENT RATING (AMPS) CURRENT DRAW (AMPS)
THDC (%THD-F)
VOLTAGE DROP (VOLTS)
PHASE A
PHASE B
PHASE C
Immediate Hazard
Problem Description -
Customer Notified Immediately
PROBLEM CORRECTED
TIGHTENED/TORQUED CONNECTION
CORRODED/DISCOLORED
OVERLOADED CIRCUIT
EXCESSIVE CURRENT HARMONICS
STRIPPED/CROSS-THREADED HARDWARE
Consequences if Not Corrected

Equipment Failure
Fire Hazard
Safety Hazard
Power/Business Interruption
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
45455, REVISED 8/13/2013
INFRARED IMAGE CAPTURE
OWNER
ADDRESS
CUSTOMER
170
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
INFRARED
SUBSTATION
PLANT
POSITION
Example Plant
GENERAL
ASSET DESCRIPTION:
TEST POINT:
NOTES:

TESTED BY:
www.powerdb.com
REVISED 6/23/2010
INFRARED IMAGE CAPTURE
PAGE
171
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 6/23/2010
THERMOGRAPHIC INSPECTION
OWNER
172
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
LOCATION
AMBIENT TEMPERATURE
HUMIDITY
INFRARED
SUBSTATION
PANEL
NUMBER
POSITION
Example Plant
GENERAL
THERMOGRAPHIC
IMAGE FILE ID
NOTES

PLANT
POSITION
TESTED BY:
www.powerdb.com
52000, REVISED 7/7/2010
THERMOGRAPHIC INSPECTION
PAGE
173
COMMENTS:
DEFICIENCIES:
www.powerdb.com
52000, REVISED 7/7/2010
PM 013 Infrared Inspection
OWNER
PAGE
ADDRESS
CUSTOMER
JOB #
174
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
INFRARED
SUBSTATION
PLANT
POSITION
Example Plant
GENERAL
INFRARED IMAGES:
ASSET DESCRIPTION:
TEST POINT:
NOTES:
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 11/2/2012
INFRARED INSPECTION SUMMARY
OWNER
ADDRESS
CUSTOMER
175
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
PLANT
INFRARED
SUBSTATION
POSITION
Example Plant
GENERAL
EQUIPMENT INSPECTED
LOCATION / DESIGNATION
CONDITION
REMARKS
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
52005, REVISED 9/14/2011
CURRENT TRANSFORMER
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
176
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
MFR
CATALOG/STYLE
IMPEDANCE
INSULATION TYPE
SERIAL NO.
YEAR
WEATHER
OIL VOL.
BIL
SPECIAL ID
POSITION
GAL
kV
C1 POWER FACTOR %
C1 Capacitance
Example Plant
AUTOMATED
PLANT
REASON
TANK TEMP.
WEIGHT
TYPE
C
LB
CLASS
kV
Amps
Secondary Ohms
C2 POWER FACTOR %
C2 Capacitance
CURRENT RATIOS
TEST FREQUENCY: 60
TRANSFORMER OVERALL TESTS
Capacitance
TEST
C (pF)
kV
ENG
GND
GAR
UST
DIRECT
POWER FACTOR %
TEST
NO.
INSULATION
TESTED
TEST
MODE
Overall
GST-GND
H1,H2
C1
UST-R
H1,H2
C2
GSTg-R
TAP
H1,H2
1.000
H1,H2
@ 2 kV
1.000
MEAS.
20 C
CORR.
IR
mA
WATTS
1.000
TAP
1.000
Overall at 2 kV GST-GND
GST-GND
1.000
GST-GND
1.000
HOT COLLAR TESTS
Term ID
ID
SKIRT #
TEST MODE
GST-GND
GST-GND
GST-GND
10
GST-GND
11
GST-GND
12
GST-GND
13
GST-GND
14
GST-GND
15
GST-GND
16
GST-GND
17
GST-GND
18
GST-GND
Test kV
mA
WATTS
IR

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
27610, REVISED 11/18/2013
CURRENT TRANSFORMER
PAGE
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
Off
TEST
kV
Test
Freq
L(H)
CAP.(pF)
177
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27610, REVISED 11/18/2013
CURRENT TRANSFORMER TEST
OWNER
ADDRESS
CUSTOMER
178
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
CT INFORMATION
COMPANY
STATION
DESIGNATION
MANUFACTURER
SERIAL NO.
PHASE
POSITION
CLASS
RATIO
VOLTAGE RATING
TIME
TEMPERATURE
INSTRUMENT S/N
TAP
EXPECTED
RATIO
BURDEN IMPEDANCE:
ACTUAL
RATIO
RATIO
% ERROR
: 5
PHASE DEV.
(deg.)
POLARITY
SATURATION
VOLTAGE
(volts)
WINDING
RESISTANCE
(Ohms)
INSULATION
RESISTANCE
(Ohms)
:
:
:
:
:
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
27655, REVISED 7/7/2010
PAGE
179
EXCITATION DATA
SERIAL NO.
COMPANY
STATION
DESIGNATION
PHASE
POSITION
VOLTAGE/CURRENT
VOLTAGE (volts)
CURRENT (mA)
www.powerdb.com
27655, REVISED 7/7/2010
MTO CT RESISTANCE TESTS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
180
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
MFR
CATALOG/STYLE
INSULATION TYPE
SERIAL NO.
HUMIDITY
PLANT
YEAR
WEATHER
BIL
POSITION
REASON
SPECIAL ID
kV
kV
Example Plant
AUTOMATED
RATED FREQUENCY
PRIMARY AMPS
SECONDARY AMPS
ACCURACY RATING
Hz
Asset ID:
Resistance Units:
CT Description:
#
Winding Tested
DC Test Current
Measured Resistance
Reading Stability
Ohms
Note
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
27800, REVISED 11/18/2013
POTENTIAL TRANSFORMER
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
181
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
MFR
CATALOG/STYLE
IMPEDANCE
INSULATION TYPE
SERIAL NO.
YEAR
WEATHER
OIL VOL.
BIL
SPECIAL ID
Example Plant
AUTOMATED
PLANT
POSITION
GAL
kV
REASON
WEIGHT
TYPE
CLASS
kV
LB
VA RATING
TEST FREQUENCY: 60
TEST
NO.
INSULATION
TESTED
TEST
MODE

ENG
GND
GAR
GST-GND
H1,H2
X1,Y1
GSTg-R
H1
X1,Y1
H2
GSTg-R
H2
X1,Y1
H1
UST-R
H1
X1,Y1
UST-R
H2
X1,Y1
GST-GND
H1,H2
X1,Y1
UST
TEST
kV
POWER FACTOR %
Cap.
(pF)
MEAS.
H2
20 C
DIRECT
CORR.
mA
IR
WATTS
H1
@2kV
SUPPLEMENTAL TESTS
TEST
NO.
INSULATION
TESTED
TEST
MODE
TEST CONNECTIONS (WINDINGS)

ENG
GND
UST-R
H1,H2
Y1
UST-B
H1,H2
X1
GSTg-R
H1
H2,X1,Y1
10
GSTg-R
H2
H1,X1,Y1
GAR
UST
TEST
kV
POWER FACTOR %
Cap.
(pF)
MEAS.
20 C
DIRECT
CORR.
mA
IR
WATTS
X1
Y1
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
Off
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
27600, REVISED 12/11/2013
OWNER
182
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SECONDARY CURRENT
ASSET ID
TYPE
STYLE
ACCURACY CLASS
VOLTAGE RATING
NUMBER OF TESTS
NAMEPLATE
RATIO
SECURITY LIMITING FACTOR
: 5
ACTUAL
RATIO
:
RATIO
% ERROR
FREQUENCY
RATED OUTPUT (VA)

5
INSULATION RATING
SEC. BURDEN TEST AMPS
SATURATION STANDARD ANSI 45
CT RATIOS
Tap
PHASE
PHASE DEV.
(deg.)
KNEE POINT
POLARITY
X VOLTAGE X CURRENT
(volts)
(amps)
VOLTAGE
(volts)
RESISTANCE
CURRENT
(amps)
(ohms)
:5
ANSI 45
BURDEN
VA
POWER FACTOR PHASE (Degree)
INSULATION
RESISTANCE
Primary To Secondary
Primary To Ground
Secondary To Ground
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
27650, REVISED 3/25/2013
MTO PT RESISTANCE TESTS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
183
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
MFR
CATALOG/STYLE
INSULATION TYPE
FREQUENCY
HUMIDITY
YEAR
WEATHER
SERIAL NO.
BIL
Hz
PLANT
POSITION
kV
SPECIAL ID
REASON
kV
RATIO
Example Plant
AUTOMATED
PRIMARY VOLTAGE
SECONDARY VOLTAGE
ACCURACY RATING
VA RATING
Asset ID:
Resistance Units:
PT Description:
#
Winding Tested
DC Test Current
Measured Resistance
Reading Stability
Ohms
Note
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
27850, REVISED 11/6/2013
PT RATIO TESTS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
184
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
MFR
CATALOG/STYLE
INSULATION TYPE
FREQUENCY
Allowed % Error:
Hz
YEAR
WEATHER
SERIAL NO.
BIL
Example Plant
AUTOMATED
PLANT
POSITION
kV
0.1
SPECIAL ID
REASON
kV
RATIO
PRIMARY VOLTAGE
SECONDARY VOLTAGE
ACCURACY RATING
VA RATING
Phase Display
Degrees
PT Description:
Test Info
Primary Volts
Sec Volts
Set Volts
Calc Ratio
Test Volts
Ratio
%
error
Exc I (mA)
Phase (Deg)
1
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
27750, REVISED 2/7/2014
CT RATIO TESTS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
185
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
MFR
CATALOG/STYLE
INSULATION TYPE
SERIAL NO.
C1
C1
YEAR
WEATHER
BIL
kV
% PF
Capacitance
pF
POSITION
REASON
SPECIAL ID
kV
C2
C2
Phase Display
Allowed % Error:
Example Plant
AUTOMATED
PLANT
% PF
Capacitance
RATED FREQUENCY
PRIMARY AMPS
SECONDARY AMPS
ACCURACY RATING
RF
Hz
pF
Degrees
0.1
CT Description:
Description
Secondary
Tap
Primary
Amps
Secondary
Set
Amps
Voltage
Calc
Ratio
Test
Voltage
Ratio
% Exc Cur Phase (Deg)

error
(mA)
1
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
27700, REVISED 12/10/2013
MULTI-WINDING CT SUMMARY REPORT
OWNER
186
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MANUFACTURER
POSITION
SERIAL NO.
STYLE
ASSET ID
TYPE
NUMBER OF WINDINGS
WINDING NUMBER
BURDEN
SHOW GRAPH AND DATA
FILE NAME
RATED OUTPUT (VA)
ACTUAL
RATIO
VA
FREQUENCY
SATURATION STANDARD
SEC. BURDEN TEST AMPS
CT RATIOS
NAMEPLATE
RATIO
PHASE
VOLTAGE RATING
INSULATION RATING
SECURITY LIMITING FACTOR
Tap
Example Plant
AUTOMATED
PLANT
SUBSTATION
POWER FACTOR
RATIO
% ERROR
KNEE POINT
PHASE DEV.
(deg.)
PHASE (Degree)
ACCURACY CLASS
POLARITY
INSULATION
RESISTANCE
X VOLTAGE
(volts)
X CURRENT
(amps)
VOLTAGE
(volts)
PRI. TO SECONDARY
CURRENT
(amps)
SATURATION
VOLTAGE
(volts)
CURRENT
(amps)
PRIMARY TO GROUND
RESISTANCE
(ohms)
SECONDARY TO GROUND
COMMENTS:
DEFICIENCIES:
VOLTAGE/CURRENT
VOLTAGE (volts)
CURRENT (amps)
Winding 1
Winding 2
Winding 3

Winding 4
TESTED BY:
www.powerdb.com
ct1
ct1
ct2
ct2
ct3
ct3
ct4
ct4
ct5
ct5
Winding 5
27660, REVISED 2/7/2014
CURRENT TRANSFORMER
PRIMARY INJECTION RATIO TEST
OWNER
ADDRESS
CUSTOMER
187
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
VOLTAGE CLASS
STYLE/MODEL NO.
FREQUENCY
CURRENT RATING
:5A
HERTZ
PRIMARY CURRENT RATING
BURDEN RATING
ACCURACY CLASS
BASIC IMPULSE LEVEL
kV
CT IDENTIFICATION:
SECONDARY CURRENT RATING
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
SERIAL NUMBER:
NAMEPLATE RATIO:
INSULATION TEST
POINT 1
PRIMARY CURRENT APPLIED
POINT 2
RDG.
A
TURN MULTIPLIER
SECONDARY CURRENT INDUCED
PANEL AMMETER READINGS
CT IDENTIFICATION:
PRIMARY - GROUND
SECONDARY - GROUND
SECONDARY WIRING - GROUND
SERIAL NUMBER:
PRIMARY INJECTION TEST
CT IDENTIFICATION:
kVDC
MEGOHMS
kVDC
MEGOHMS
NAMEPLATE RATIO:
PRIMARY - GROUND
SECONDARY - GROUND
SECONDARY WIRING - GROUND @
SERIAL NUMBER:
20C
kVDC
MEGOHMS
kVDC
MEGOHMS
kVDC
MEGOHMS
NAMEPLATE RATIO:
INSULATION TEST
POINT 1
POINT 2
A
RDG.
A
TURN MULTIPLIER
KWHR
PRIMARY - GROUND
SECONDARY - GROUND
SECONDARY WIRING - GROUND
PANEL METERS

RDG.
A
TURN MULTIPLIER
RELAYS
MEGOHMS
POINT 2
A
20C
kVDC
INSULATION TEST
POINT 1
BAR TYPE
DEVICES:
PART NO.
MEGOHMS
kVDC
MEGOHMS
kVDC
MEGOHMS
TRANSDUCERS
TESTED BY:
www.powerdb.com
20C
kVDC
OTHER
27000, REVISED 4/22/2009
CURRENT TRANSFORMER
PRIMARY INJECTION RATIO TEST
PAGE
188
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27000, REVISED 4/22/2009
CURRENT TRANSFORMER
SECONDARY VOLTAGE INJECTION RATIO TEST
OWNER
ADDRESS
CUSTOMER
189
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
STYLE / MODEL NO.
VOLTAGE CLASS
FREQUENCY
HERTZ
PART NO.
BURDEN RATING
BAR TYPE
ACCURACY CLASS
BASIC IMPULSE LEVEL
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
kV
OTHER
TEST RESULTS
POSITION
PHASE
PART NO.
OR
SERIAL NO.
NAMEPLATE
RATIO
APPLIED
SECONDARY
VOLTAGE
INDUCED
PRIMARY
VOLTAGE
MEASURED
RATIO
%
ERROR
COMMENTS
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:

TESTED BY:
www.powerdb.com
27100, REVISED 4/22/2009
CURRENT TRANSFORMER
SECONDARY VOLTAGE INJECTION RATIO TEST
PAGE
190
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27100, REVISED 4/22/2009

SATURATION TEST
OWNER
191
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
VOLTAGE CLASS
FREQUENCY
BURDEN RATING
NAMEPLATE RATIO
ACCURACY CLASS
STYLE / MODEL NO.

HERTZ
: 5
BASIC IMPULSE LEVEL
kV
OTHER
POSITION
GENERAL
PART NO.
SERIAL NO.
BAR TYPE
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
CT DATA
CURRENT IN
VOLTAGE IN
IMPEDANCE IN
POINT
AMPERES
VOLTS
OHMS
1
PHASE
N
2
LINE SIDE
LOAD SIDE
3
4
CT SET ID
5
6
7
8
NAMEPLATE RATIO
: 5
MEASURED RATIO
: 5
ERROR
10
11
12
POLARITY
IN PHASE
OUT OF PHASE
13
14
PHASE ANGLE
15
EXCITATION VOLTAGE
16
EXCITATION CURRENT
KNEE VOLTAGE
17
18
19
KNEE POINT TYPE

FILE NAME
20
21
22
TEST NUMBER
23
24
25
26
27
28
29
30

TESTED BY:
www.powerdb.com
27111, PAGE 1 OF 2, REVISED 7/15/2010

SATURATION TEST
192
PAGE
SUBSTATION
PHASE
X
CT SET ID
POSITION
GENERAL
JOB # FORMS - ALL
SERIAL NO.
LINE SIDE
LOAD SIDE
NAMEPLATE RATIO
: 5
MEASURED RATIO
: 5
ERROR
VOLTAGE
CURRENT
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27111, PAGE 2 OF 2, REVISED 7/15/2010
VOLTAGE TRANSFORMER TEST
OWNER
ADDRESS
CUSTOMER
193
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
CATALOG NO.
TYPE
PRIMARY VOLTAGE
SECONDARY VOLTAGE
NAMEPLATE RATIO
kVA
CLASS
OTHER
PRIMARY FUSE:
MANUFACTURER
TYPE
SIZE
NO.
SECONDARY FUSE:
MANUFACTURER
TYPE
SIZE
NO.
VT IDENTIFICATION:
SERIAL NUMBER:
TURNS RATIO TEST
INSULATION TEST
RDG.
CALCULATED TURNS RATIO

MEASURED TURNS RATIO
CONNECTIONS
POLARITY
ERROR
20C
PRI - SEC
kVDC
MEGOHMS
PRI - GRD
kVDC
MEGOHMS
SEC - GRD @
kVDC
MEGOHMS
VT IDENTIFICATION:
SERIAL NUMBER:
INSULATION TEST
TURNS RATIO TEST
20C
RDG.
PRI - SEC
kVDC
MEGOHMS
PRI - GRD
kVDC
MEGOHMS
SEC - GRD @
kVDC
MEGOHMS
CONNECTIONS
ERROR
POLARITY
VT IDENTIFICATION:
SERIAL NUMBER:
TURNS RATIO TEST
INSULATION TEST
RDG.
20C
PRI - SEC
kVDC
MEGOHMS
PRI - GRD
kVDC
MEGOHMS
SEC - GRD @
kVDC
MEGOHMS
CONNECTIONS
ERROR
POLARITY
VT CONNECTION:
1 PHASE
3 PHASE
PRIMARY:
WYE

DELTA
TESTED BY:
www.powerdb.com
SECONDARY:
WYE
DELTA
27200, REVISED 4/22/2009
VOLTAGE TRANSFORMER TEST
PAGE
194
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27200, REVISED 4/22/2009
CONTROL POWER TRANSFORMER TEST
OWNER
195
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
CATALOG NO.
TYPE
PRIMARY VOLTAGE
SECONDARY VOLTAGE
NAMEPLATE RATIO
kVA
1.000
CLASS
OTHER
PRIMARY FUSE:
MANUFACTURER
TYPE
SIZE
NO.
SECONDARY FUSE:
MANUFACTURER
TYPE
SIZE
NO.
IDENTIFICATION:
SERIAL NUMBER:
TURNS RATIO TEST
CALCULATED
RATIO
TEST CONNECTIONS
INSULATION TESTS
MEASURED
RATIO
%
ERROR
RDG.
X
H
PRI - SEC @
kVDC
MEGOHMS
PRI - GRD @
kVDC
MEGOHMS
kVDC
MEGOHMS
SEC - GRD @
20C
1.0
POLARITY
IDENTIFICATION:
SERIAL NUMBER:
INSULATION TESTS
TURNS RATIO TEST
CALCULATED
RATIO
TEST CONNECTIONS
MEASURED
RATIO
%
ERROR
RDG.
X
H
X
X
1
2
1
X
X
X
3
4
PRI - SEC
PRI - GRD
SEC - GRD @
1.0
20C
kVDC
MEGOHMS
kVDC
MEGOHMS
kVDC
MEGOHMS
POLARITY

TESTED BY:
www.powerdb.com
27400, REVISED 8/8/2012
PAGE
196
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27400, REVISED 8/8/2012
CURRENT TRANSFORMER
RATIO AND EXCITATION TEST
SECONDARY INJECTION - VOLTAGE
OWNER
ADDRESS
CUSTOMER
197
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
CATALOG NO.
MODEL NO.
PART/STYLE NO.
VOLTAGE RATING
BASIC IMPULSE LVL
FREQUENCY
MAX RATIO
AVAILABLE RATIOS
RELAY ACC. CLASS

METER ACC. CLASS
BURDEN RATING
CURVE SHEET NO.
TRANSFORMER IDENTIFICATION AND CONNECTIONS

PHASE 1
SERIAL #
TAP
PHASE 2
SERIAL #
RATIO
PHASE 3
SERIAL #
CONFIGURATION
WYE
DELTA
LINE SIDE
LOAD SIDE
CONSTRUCTION TYPE
CONNECTED BURDEN
VISUAL AND MECHANICAL INSPECTION

DESCRIPTION
EQUIPMENT NAMEPLATE DATA
PHYSICAL CONDITION
CORRECT CONNECTION
ADEQUATE CLEARANCES
INSPECTED
CONDITION
DESCRIPTION
OVERALL CLEANLINESS
BOLTED ELECTRICAL CONNECTIONS
GROUNDING AND SHORTING CONNECTIONS
CKTS GROUNDED AND ONE GROUNDING POINT
INSPECTED
CONDITION
ELECTRICAL TESTS
PHASE 1
Insulation Resistance
TEST VOLTAGE 1,000 VDC
READING
PHASE 2
20C
READING
PHASE 3
READING
20C
20C
WDG-TO-WDG
'H' WDG-TO-GND
'X' WDG-TO-GND
PHASE 1
Ratio Verification
SECONDARY
TAPS
TURN
RATIO
APPLIED
SEC VOLTAGE
INDUCED
PRI VOLTAGE
MEASURED
RATIO
PHASE 2
X1 - X2
X1 - X3
X1 - X4
X1 - X5
Polarity
APPLIED
SEC VOLTAGE
% ERROR
INDUCED
PRI VOLTAGE
MEASURED
RATIO
PHASE 3
%
%
%
%
%
H1 - X1
AGREE
DISAGREE
N/T
APPLIED
SEC VOLTAGE
% ERROR
INDUCED
PRI VOLTAGE
MEASURED
RATIO
% ERROR
%
%
%
%
%
AGREE
DISAGREE
N/T
%
%
%
%
%
AGREE
DISAGREE
N/T
VOLTS
TAP X1 - X5
Excitation
VOLTS
AMPERES MEASURED
INJECTED PHASE 1
PHASE 2 PHASE 3
PHASE 1
PHASE 2
PHASE 3

TESTED BY:
www.powerdb.com
27500, REVISED 8/8/2012
CURRENT TRANSFORMER
RATIO AND EXCITATION TEST
PAGE
198
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27500, REVISED 8/8/2012
CURRENT TRANSFORMER
OWNER
ADDRESS
CUSTOMER
199
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
VOLTAGE RATING
PHASE TYPE
STYLE
CT IDENTIFICATIONS
PHASE A:
VOLTS
RATIO
PHASE B:
PHASE C:
SATURATION
CORE SATURATION
VOLTAGE (VOLTS)
VOLTAGES
PHASE A
(AMPERES)
PHASE B
(AMPERES)
PHASE C
(AMPERES)
BURDEN
LOAD
VOLTAGE @
1 AMPERE
(VOLTS)
CALCULATED
IMPEDANCE
(OHMS)
RELAY
MAXIMUM
SETTING
(AMPERES)
MINIMUM CT VOLTAGE
RATIO TEST
(IN VOLTS)
MAXIMUM
RANGE
(AMPERES)
CALCULATED
RATIO
IMPEDANCE X SETTING
(VOLTS)
PRIMARY
PHASE A
SECONDARY
PRIMARY
PHASE B
SECONDARY
PRIMARY
PHASE C
SECONDARY
CT LOAD
PHASE A
PHASE B
PHASE C
TEST AT
VOLTS DC
ADDITIVE
MEGOHMS
GROUND REPLACED

SUBTRACTIVE
POLARITY
TESTED BY:
www.powerdb.com
27010, REVISED 4/22/2009
CURRENT TRANSFORMER
PAGE
200
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27010, REVISED 4/22/2009

SATURATION TEST
OWNER
201
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
VOLTAGE CLASS
FREQUENCY
BURDEN RATING
NAMEPLATE RATIO
ACCURACY CLASS
STYLE / MODEL NO.

HERTZ
: 5
BASIC IMPULSE LEVEL
kV
OTHER
POSITION
GENERAL
PART NO.
SERIAL NO.
BAR TYPE
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
CT DATA
CURRENT IN
VOLTAGE IN
IMPEDANCE IN
POINT
AMPERES
VOLTS
OHMS
1
PHASE
N
2
LINE SIDE
LOAD SIDE
3
4
CT SET ID
5
6
7
8
NAMEPLATE RATIO
: 5
MEASURED RATIO
: 5
ERROR
10
11
12
POLARITY
IN PHASE
OUT OF PHASE
13
14
PHASE ANGLE
15
EXCITATION VOLTAGE
16
EXCITATION CURRENT
KNEE VOLTAGE
17
18
19
KNEE POINT TYPE

FILE NAME
20
21
22
TEST NUMBER
23
24
25
26
27
28
29
30

TESTED BY:
www.powerdb.com
27110, PAGE 1 OF 2, REVISED 7/15/2010

SATURATION TEST
202
PAGE
SUBSTATION
PHASE
X
CT SET ID
POSITION
GENERAL
JOB # FORMS - ALL
SERIAL NO.
LINE SIDE
LOAD SIDE
NAMEPLATE RATIO
: 5
MEASURED RATIO
: 5
ERROR
VOLTAGE
CURRENT
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27110, PAGE 2 OF 2, REVISED 7/15/2010
CURRENT TRANSFORMER
PRIMARY CURRENT INJECTION RATIO TEST
OWNER
203
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
STYLE/MODEL NO.
VOLTAGE CLASS
FREQUENCY
HERTZ
PART NO.
BURDEN RATING
BAR TYPE
ACCURACY CLASS
BASIC IMPULSE LEVEL
WINDOW:
SOLID
SPLIT CORE
STYLE:
ROUND
RECTANGULAR
kV
OTHER
TEST RESULTS
POSITION
PHASE
PART NO.
OR
SERIAL NO.
NAMEPLATE
RATIO
APPLIED
PRIMARY
CURRENT
INDUCED
SECONDARY
CURRENT
MEASURED
RATIO
%
ERROR
COMMENTS
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:

TESTED BY:
www.powerdb.com
27150, REVISED 4/22/2009
CURRENT TRANSFORMER
PRIMARY CURRENT INJECTION RATIO TEST
PAGE
204
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27150, REVISED 4/22/2009
VOLTAGE TRANSFORMER
APPLIED VOLTAGE RATIO TEST
OWNER
205
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
STYLE / MODEL NO.
VOLTAGE CLASS
FREQUENCY
HERTZ
PART NO.
BURDEN RATING
ACCURACY CLASS
BASIC IMPULSE LEVEL
kV
OTHER
TEST RESULTS
POSITION
PHASE
PART NO.
OR
SERIAL NO.
NAMEPLATE
RATIO
APPLIED
PRIMARY
VOLTAGE
MEASURED
SECONDARY
VOLTAGE
MEASURED
RATIO
%
ERROR
COMMENTS
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:

TESTED BY:
www.powerdb.com
27300, REVISED 4/22/2009
VOLTAGE TRANSFORMER
APPLIED VOLTAGE RATIO TEST
PAGE
206
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27300, REVISED 4/22/2009
OWNER
207
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
CATALOG NO.
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
NAMEPLATE RATIO
kVA
CLASS
: 1.000
OTHER
PRIMARY FUSE:
MANUFACTURER
TYPE
SIZE
NO.
SECONDARY FUSE:
MANUFACTURER
TYPE
SIZE
NO.
IDENTIFICATION:
SERIAL NUMBER:
TURNS RATIO TEST
CALCULATED
RATIO
TEST CONNECTIONS
INSULATION TEST
MEASURED
RATIO
%
ERROR
RDG.
H
H
H
1
2
1
H
H
3
4
20C
PRIMARY - SECONDARY
kVDC
MEGOHMS
PRIMARY - GROUND
kVDC
MEGOHMS
SECONDARY - GROUND
kVDC
MEGOHMS
1.0
POLARITY
SERIAL NUMBER:
IDENTIFICATION:
TURNS RATIO TEST
CALCULATED
RATIO
TEST CONNECTIONS
INSULATION TEST
MEASURED
RATIO
%
ERROR
RDG.
H
H
H
1
2
1
H
H
H
3
4
20C
PRIMARY - SECONDARY
kVDC
MEGOHMS
PRIMARY - GROUND
kVDC
MEGOHMS
SECONDARY - GROUND
kVDC
MEGOHMS
1.0
POLARITY

TESTED BY:
www.powerdb.com
27450, REVISED 8/8/2012
PAGE
208
COMMENTS:
DEFICIENCIES:
www.powerdb.com
27450, REVISED 8/8/2012
ELECTRICAL EQUIPMENT FLUID TESTING RESULTS
TC#
(testing provided by SD Myers, Inc.)

Owner
Example Owner
Example Plant
Plant
Unit No.
Other
City
Location
Substation
209
Job #
FORMS - ALL
10/13/2014
Date
INSULATION FLUID
Position
AUTOMATED
NAMEPLATE DATA
Manufacturer
Manufacture Date
Serial No.
KVA Rating
High Voltage
Low Voltage
Weight (lbs)
Page
ADDITIONAL EQUIPMENT
Equipment Type
Transformer Class
Impedance %
Phase/Cycle
Liquid Type
Gallons
Other Access
Radiators
Fans
Water Cooled
Oil Pumps
Top FPV (inch)
Bottom FPV (inch)
Insulation Type
Conservator Tank
LTC Compartment
Bushing Location
Breather
Hose Length (feet)
Service Online
Power Available
VISUAL INSPECTION
DATE
LEVEL
SAMPLE
TEMP
TOP
TEMP
FIELD SERVICE
P/V
PAINT
LEAKS
DATE
SERVICE
Additional Information
Reason Not Tested
LIQUID SCREEN TEST DATA

DATE
SERVICE
ACID
IFT
DIEL 877
DIEL 1816
INHIBITOR CONTENT
DATE
PCT. BY WEIGHT
This test was not run on this transformer.
GAP
COLOR
SP. GRAV.
VISUAL
SEDIMENT
LIQUID POWER FACTOR

DATE
25 C
100 C
KEY TO ABBREVIATIONS: AC -- ACCEPTABLE QU -- QUESTIONABLE UN -- UNACCEPTABLE RS -- RESAMPLE

NOTE: * AFTER A TEST RESULT INDICATES THAT THIS TEST WAS PERFORMED OTHER THAN SD MYERS INC.
DISCLAIMER: All testing was provided by SD Myers, Inc. analytical lab with all data being provided to PowerDB for the convenience of S. D. Myers, Inc. customers using
PowerDB. SD Myers, Inc. shall not be liable for any errors in data or format of data after provided to PowerDB. For comprehensive test data, SD Myers, Inc. Rainbow
Report, or to verify any information provided through this report, please visit http://transformerdashboard.com or call SD Myers, Inc. at 330.630.7000.
TC#
Owner
Example Owner
Page
S/N
Substation
Mfg.
Gal Liq.
High V.
Location
Unit No.
KVA
Low V.
K.F. TEST MOISTURE CONTENT EXPRESSED IN PPM

DATE
AVG
TEMP
PPM
PCT.
SATURATION
MOIST./DRY WGT.
PCT.
210
FURAN ANALYSIS EXPRESSED IN PPB

DATE
5H2F
2FOL
2FAL
2ACF
5M2F
TOTAL

GAS-IN-OIL ANALYSIS GAS CHROMATOGRAPHY EXPRESSED IN PPM

DATE
HYDROGEN OXYGEN NITROGEN
METHANE
CARBON
MONOXIDE
CARBON
DIOXIDE
ETHANE
ETHYLENE
TOTAL
ACETYLENE COMBUST.
TOTAL
GAS
ICP METALS-IN-OIL EXPRESSED IN PPM

DATE
ALUMINUM
IRON
COPPER
PCB CONTENT EXPRESSED IN PPM

DATE
1242
1254
1260
OTHER
TOTAL
KEY TO ABBREVIATIONS: AC -- ACCEPTABLE QU -- QUESTIONABLE UN -- UNACCEPTABLE

NOTE: * AFTER A TEST RESULT INDICATES THAT THIS TEST WAS PERFORMED BY AN OUTSIDE LAB.
DISCLAIMER: All testing was provided by S. D. Myers, Inc. analytical lab with all data being provided to PowerDB for the convenience of S. D. Myers, Inc. customers using
PowerDB. S. D. Myers, Inc. shall not be liable for any errors in data or format of data after provided to PowerDB. For comprehensive test data, S. D. Myers, Inc. Rainbow
Report, or to verify any information provided through this report, please visit http://lab.sdmyers.net or call S. D. Myers, Inc. at 330.630.7000.
TC#
Owner
Example Owner
Page
S/N
Substation
Mfg.
Gal Liq.
High V.
Location
Unit No.
KVA
Low V.
211
RECAP RECOMMENDATIONS
COMMENTS:
DEFICIENCIES:
KEY TO ABBREVIATIONS: AC -- ACCEPTABLE QU -- QUESTIONABLE UN -- UNACCEPTABLE

NOTE: * AFTER A TEST RESULT INDICATES THAT THIS TEST WAS PERFORMED BY AN OUTSIDE LAB.
DISCLAIMER: All testing was provided by S. D. Myers, Inc. analytical lab with all data being provided to PowerDB for the convenience of S. D. Myers, Inc. customers using
PowerDB. S. D. Myers, Inc. shall not be liable for any errors in data or format of data after provided to PowerDB. For comprehensive test data, S. D. Myers, Inc. Rainbow
Report, or to verify any information provided through this report, please visit http://lab.sdmyers.net or call S. D. Myers, Inc. at 330.630.7000.
INSULATING FLUID ANALYSIS
Report Date
Equipment ID
Manufacturer
Owner
Apparatus Type
Serial No
Location
Fluid Type
Year Mfg
Designation
Fluid Cap.
Model/Type
Description
Analysis Rules
kV Rating
Preservation
MVA Rating
Cooling
SUBSTATION
INSULATION FLUID
POSITION
AUTOMATED
PAGE
Gas Analysis
212
ppm/day
Limits
Hydrogen (H2)
0.00
< 100
Methane (CH4)
0.00
< 120
Ethane (C2H6)
0.00
< 65
Ethylene (C2H4)
0.00
< 50
Acetylene (C2H2)
0.00
< 35
Carbon Monoxide (CO)
0.00
< 350
Carbon Dioxide (CO2)
0.06
< 2500
0.00
< 720
Sample No
Fluid Temp (C)
Oxygen (O2)
Nitrogen (N2)
TDCG (ppm)
Equivalent TCG (%)
Total Gas (%)
CO2/CO
O2/N2
Water
< 35
Water Saturation
Equipment Condition
Result
Port or Tank
Test Lab
Interval (days)
Sampled by
Test Date
Gas Std
Reason
Lab Ref No
Gas Analysis Remarks
Fluid Quality
Limits
Sample No
Fluid Temp (C)
Acid Number
mg KOH/g
Interfacial Tension
mN/m
< .15
> 30
Diel Str (D1816)
kV
> 47
Diel Str (D877)
kV
PF at 25 C
< .5
Water
ppm
< 20
Water Saturation
< 15
Color
<3
Specific Gravity
Fluid / PCB Cond
Result
Port or Tank
Test Lab
Interval (days)
Sampled by
Test Date
Fluid Std
Reason
Lab Ref No
Fluid Quality Analysis Remarks
OIL TEST
OWNER
ADDRESS
CUSTOMER
213
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
OTS60PB EDITION
Example Plant
AUTOMATED
PLANT
INSULATION FLUID
SUBSTATION
POSITION
OTS SER. NO.
PASS/FAIL LIMIT
SAMPLE DESCRIPTION
TEST STANDARD
PASS LIMIT
AVG BREAKDOWN VOLTAGE
kV
STANDARD DEVIATION
kV
s=
TEST FREQUENCY
s/x=
Hz
TEMPERATURE
NO. OF TESTS
F
5
GAP
mm
OIL TYPE
RESULT
TEST NO.
BREAKDOWN VOLTAGE (kV)

NOTES
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
57400, REVISED 7/7/2010
DISSOLVED GAS ANALYSIS

WEIDMANN DIAGNOSTIC SOLUTIONS
5305 Commerce Square Drive Indianapolis, IN 46237 USA
Phone 317 888 7288 Fax 317 888 2577
WWW.WEIDMANN-DIAGNOSTICS.COM
SERIAL #
NA3118001
BANK/PH
TANK
BREATHING
FLUID
GALLONS
SUBSTATION INSULATION FLUID
ATTN
P. O. #
LOCATION
ASTM D-3612
LAB CONTROL NUMBER
REPORT UNITS: PPM
DATE SAMPLED
ORDER NUMBER
OIL TEMP (C)

HYDROGEN (H2)
METHANE (CH4)
ETHANE (C2H6)
ETHYLENE (C2H4)
ACETYLENE (C2H2)
CARBON MONOXIDE (CO)
CARBON DIOXIDE (CO2)
NITROGEN (N2)
OXYGEN (O2)
TOTAL DISSOLVED GAS
TOTAL DISSOLVED COMBUSTIBLE GAS
EQUIVALENT TCG PERCENT
D-1533B
OIL SCREEN
D-971
MOISTURE IN OIL
(ppm)
INTERFACIAL TENSION
(dynes/cm)
D-974
ACID NUMBER
(mg KOH/g)
D-1500
COLOR NUMBER
(RELATIVE)
D-1524
VISUAL EXAM
(RELATIVE)
D-1524
SEDIMENT EXAM
(RELATIVE)
D-877
DIELECTRIC BREAKDOWN
D-1816
DIELECTRIC BREAKDOWN 1 mm
(kV mm-C)
D-1816
DIELECTRIC BREAKDOWN 2 mm
(kV mm-C)
D-924
POWER FACTOR-25
D-924
POWER FACTOR-100C
D-1298
SPECIFIC GRAVITY
WDS
D-1298
(kV)
(%)
(%)
(RELATIVE)
PASSIVATOR
(ppm)
OXIDATION INHIBITOR
(wt. %):
DGA KEY GAS / INTERPRETIVE METHOD

IEEE (C57.104)
DIAGNOSTICS
(Most Recent Sample)
DGA TDCG RATE INTERPERATIVE METHOD

DGA IEEE/ANSI (C57.104-2008)
(Two most recent samples)
DGA CELLULOSE (PAPER) INSULATION
WDS DGA CONDITION CODE
WDS RECOMMENDED ACTION
MOISTURE IN OIL
INTERFACIAL TENSION
ACID NUMBER
COLOR NUMBER AND VISUAL
DIELECTRIC BREAKDOWN D-877
DIELECTRIC BREAKDOWN D-1816
POWER FACTOR @ 25C
POWER FACTOR @ 100C
OXIDATION INHIBITOR
JOB #
FORMS - ALL
PAGE
MFR.
ACCOUNT
KV
ORDER #
KVA
CONTROL #
% IMP. (% Z)
RECEIVED
CONTAINER
REPORTED
PROJECT ID
CUSTOMER ID
POSITION AUTOMATED
214
USER
SUBSTATION
SERIAL NO.
INSULATION FLUID
POSITION
AUTOMATED
PAGE
215
JOB #
FORMS - ALL
NA3118001
* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
(C0)
CARBON DIOXIDE
(C02)
NITROGEN
(N2)
OXYGEN
(O2)
TOTAL
COMBUSTIBLE GAS
* COMBUSTIBLE GAS
HISTORICAL DATA WITH

AVERAGE (SOLID LINES) AND
2-SIGMA (DOTTED LINES)
www.powerdb.com
57952, PAGE 2 OF 3, REVISED 2/7/2014
USER
SUBSTATION
SERIAL NO.
INSULATION FLUID
POSITION
AUTOMATED
PAGE
216
JOB #
FORMS - ALL
NA3118001
COMMENTS:
DEFICIENCIES:
www.powerdb.com
57952, PAGE 3 OF 3, REVISED 2/7/2014

Page:
Report Date:
Job Number:
Report Number:
PO Number:
Location:
FORMS - ALL
Year of Mfg.:
Bank & Phase:
kV Rating:
Serial Number:
Breathing:
Manufacturer:
Cooling:
Equipment Type:
Fluid Type:
Model:
Substation:
217
Fluid Volume:
INSULATION FLUID
Position:
AUTOMATED
Sample Date:
Laboratory No.:
Container No.:
Temperature:
Hydrogen (ppm):
Methane (ppm):
Ethane (ppm):
Ethylene (ppm):
Acetylene (ppm):
Carbon Monoxide (ppm):
Carbon Dioxide (ppm):
Nitrogen (ppm):
Oxygen (ppm):
Total (ppm):
TDCG (ppm):
TDCG Rate (ppm/day):
TDCG (gallons):
TDHHG (ppm):
ETCG (% in blanket):
CH4 / H2:
C2H2 / C2H4:
C2H2 / CH4:
C2H6 / C2H2:
C2H4 / C2H6:
CO2 / CO:
Dissolved Gas Diagnostics

Key Gas Method:
Doernenburg Ratios:
Rodgers Ratios (3):
Rodgers Ratios (4):
CO2 / CO:
Heat Index:
IEEE Std. C57.104 - 1991 Condition:
TDCG Level (ppm):
TDCG Rate (ppm/day):
Sampling Interval:
Operating Procedure:
Comments:
3123 Fite Circle

Sacrmento, CA 95827
(916) 361-7177
1000 Riverbend Blvd: Suite O

St. Rose, LA 70087
(604) 468-8837
3098 Happy Valley Road

Sun Prairie, WI 53590
(608) 825-2022
204 Gale Lane

Kennett Square, PA 19348
(610) 925-0688
REVISED 9/23/2010

Page:
218
* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
(C0)
CARBON DIOXIDE
(C02)
NITROGEN
(N2)
OXYGEN
(O2)
TOTAL
COMBUSTIBLE GAS
* COMBUSTIBLE GAS
HISTORICAL
HISTORICALDATA
DATAWITH
WITH
AVERAGE
AVERAGE(SOLID
(SOLIDLINES)
LINES)AND
AND
2-SIGMA
2-SIGMA(DOTTED
(DOTTEDLINES)
LINES)
3123 Fite Circle

Sacrmento, CA 95827
(916) 361-7177

St. Rose, LA 70087
(604) 468-8837

(608) 825-2022
204 Gale Lane

(610) 925-0688
REVISED 9/23/2010
OIL TEST - COMPACT
OWNER
ADDRESS
CUSTOMER
PAGE
219
JOB #
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
INSULATION FLUID
OTS60PB EDITION
OTS SER. NO.
No.
TEST
STANDARD
SAMPLE
HUMIDITY
PLANT
Example Plant
POSITION
AUTOMATED
PASS/FAIL LIMIT
GAP PASS TEMP NO. FREQ
F TESTS Hz
mm LIMIT
OIL TYPE
STD DEV
AVG
s/x
RESULT
SAMPLE NOTES
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
57450, REVISED 7/7/2010
INSULATING FLUID EVALUATION

Page:
Report Date:
Job Number:
Report Number:
PO Number:
Location:
FORMS - ALL
Year of Mfg.:
Bank & Phase:
kV Rating:
Serial Number:
Breathing:
Manufacturer:
Cooling:
Equipment Type:
Fluid Type:
Model:
Substation:
220
Fluid Volume:
INSULATION FLUID
Position:
AUTOMATED
Sample Date:
Laboratory No.:
Container No.:
Temperature:
D1533
Moisture
D971
Interfacial Tension
D974
Acid Number
D1500
Color Number
D1524
Visual Examination
D877
Dielectric BV
(ppm):
(dynes/cm)
(mg/KOH/g):
:
:
(kV):
D1816
Dielectric BV
(kV):
D924
Power Factor
(% at 25 C):
D924
Power Factor
(% at 100 C):
D2668
Oxidation Inhibitor
D129
Specific Gravity
D88
Viscosity
(%):
:
(SUS):
D97
Pour Point
D92
Flash Point
( C):
( C):
D92
Fire Point
( C):
D1807
Refractive Index
D1275
Corrosive Sulfur
:
Insulating Fluid Daignostics
ASTM D3487
IEEE Group I
<69
>69<288
>345
Moisture:
35 max
35 max
25 max
20 max
Interfacial Tension:
26 min
IEEE Group II
IEEE Group III
40 min
24 min
30 min
24 min
16 min
Acid Number:
0.03 max
0.2 max 0.2 max
0.1 max
0.2 max
0.5 max
Color Number:
0.5 max
Visual Examination:
clear & bright
Dielectric BV D877:
30 min
26 min
26 min
26 min
Dielectric BV D1816:
28 min
23 min
26 min
26 min
Power Factor @ 25 C:
0.05 max
Power Factor @ 100 C:
0.30 max
Oxidation Inhibitor:
Specific Gravity:
Viscosity @ 40 C:
0.3 max
0.91 max
66 max
Pour Point:
-40 max
Flash Point:
145 min
Fire Point:
Refractive Index:
Corrosive Sulfur:
noncorrosive
Comments:
3123 Fite Circle

Sacrmento, CA 95827
(916) 361-7177

St. Rose, LA 70087
(604) 468-8837

(608) 825-2022
204 Gale Lane

(610) 925-0688
REVISED 9/23/2010
OTS OIL TEST
OWNER
221
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
INSULATION FLUID
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
INSTRUMENT TYPE:
RESULT ID:
1
TEST ID:
TEST NAME:
DATE:
MACHINE SERIAL NO:
SOFTWARE:
STD LIB:
ELECTRODE TYPE:
OIL TEMPERATURE:
MEAN BREAKDOWN:
kV
OIL TYPE:
STD DEVIATION:
kV
STIRRER TYPE:
DISPERSION:
MAX VOLTAGE:
kV
VOLTAGE RISE:
V/s
TEST FREQUENCY:
61.8
Hz
ELECTRODE GAP:
mm
VALIDATION %:
RANGE:
kV
VALIDATION VALUE:
kV
TRIP SETTING:
TEST NO.
TIME:
RESULT:
1
NO. OF RESULTS:

NOTES:
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
57390, REVISED 7/31/2012
OIL CIRCUIT BREAKER FLUID TEST
OWNER
ADDRESS
CUSTOMER
222
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
INSULATION FLUID
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
MODEL NO.
TEMPERATURE RISE
DATE MANUFACTURED
IMPEDANCE
B.I.L. RATING
kV PRI.
PRIMARY VOLTAGES
K FACTOR
SECONDARY VOLTAGES
TOTAL WEIGHT
kV SEC.
LIQUID CAPACITY
TRANSFORMER INSPECTION
TEST RESULTS
PARTICLES
TEMPERATURE GUAGE PRESENT READING
DIELECTRIC STRENGTH
kV
TEMPERATURE GUAGE HIGH READING
INTERFACIAL TENSION
D/CM
PRESSURE/VACUUM GUAGE READING
ACIDITY
MG KOH/G
PAINT CONDITION
ASTM COLOR NO.
GASKETS
PARTS PER MILLION OF PCB
BUSHINGS
E.P.A. CLASSIFICATION
LIQUID LEVEL
POWER FACTOR
PARTS PER MILLION OF WATER

PLUMBING TABLE
P
OTHER
TOP
BOTTOM
VENT
* HYDROGEN
(H2)
PPM
OXYGEN
(O2)
PPM
NITROGEN
(N2)
PPM
* METHANE
(CH4)
PPM
* CARBON MONOXIDE
(CO)
PPM
CARBON DIOXIDE
(CO2)
PPM
* ETHYLENE
(C2H4)
PPM
* ETHANE
(C2H6)
PPM
* ACETYLENE
(C2H2)
PPM
TOTAL GAS CONTENT
%
PPM
COMBUSTIBLE GAS CONTENT

* COMBUSTIBLE GAS
ACCESS PORT
** NONE DETECTED

CONDITION
NO SERVICE REQUIRED
GOOD
RETEST IN
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
TESTED BY:
www.powerdb.com
SERVICE
EXCELLENT
MONTHS:
57150, REVISED 4/22/2009
OIL CIRCUIT BREAKER FLUID TEST
PAGE
223
COMMENTS:
DEFICIENCIES:
www.powerdb.com
57150, REVISED 4/22/2009
ELECTRICAL EQUIPMENT
OWNER
ADDRESS
CUSTOMER
224
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
Example Plant
GENERAL
PLANT
INSULATION FLUID
POSITION
SAMPLE DATA
CUSTOMER SAMPLE I.D.
TESTING COMPANY SAMPLE I.D.
DATE SAMPLES RECEIVED

DEVICE IDENTIFICATION
DEVICE LOCATION
DEVICE MANUFACTURER
FLUID TYPE
EQUIP. CAP.
GAL.
TEST RESULTS
PARTICLES
DIELECTRIC STRENGTH
kV
INTERFACIAL TENSION
d/cm
ACIDITY
mg KOH/g
ASTM COLOR NO.
CONDITION
SERVICE
EXCELLENT
NO SERVICE REQUIRED
GOOD
RETEST IN
PARTS PER MILLION OF PCB
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
POWER FACTOR
MOISTURE
PPM
MONTHS:
SPECIFIC GRAVITY
VISCOSITY
SUS
POUR POINT
FLASH POINT

TESTED BY:
www.powerdb.com
57300, REVISED 4/22/2009
ELECTRICAL EQUIPMENT
PAGE
225
COMMENTS:
DEFICIENCIES:
www.powerdb.com
57300, REVISED 4/22/2009
TRANSFORMER LIQUID COOLANT TEST
OWNER
226
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
INSULATION FLUID
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
TEST RESULTS
INTERNAL
EXTERNAL
DRY TYPE
ASTM
PARTICLES
D-1524
DIELECTRIC STRENGTH
kV
D-877
INTERFACIAL TENSION
D/CM
D-971
ACIDITY
MG KOH/G D-974
ASTM COLOR NO.

PCB CONTENT
PPM
PAINT CONDITION
D-1500
GASKETS
D-4059
BUSHINGS
LIQUID LEVEL
POWER FACTOR
D-924
WATER CONTENT
PPM
D-1533B
SPECIFIC GRAVITY
D-287
PLUMBING TABLE
CONDITION
P
SERVICE
OTHER
TOP
EXCELLENT
NO SERVICE REQUIRED
GOOD
RETEST IN
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
MONTHS:
BOTTOM
VENT
ACCESS PORT
SAMPLE VALVE

TESTED BY:
www.powerdb.com
57000, REVISED 4/22/2009
TRANSFORMER LIQUID COOLANT TEST
PAGE
227
COMMENTS:
DEFICIENCIES:
www.powerdb.com
57000, REVISED 4/22/2009
TRANSFORMER LIQUID COOLANT TRENDING
OWNER
228
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
INSULATION FLUID
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
FLUID QUALITY
10/13/2014
10/13/2014
10/13/2014
10/13/2014
TOTAL GAS
TOTAL COMBUSTIBLE GAS
# FANS
TAP CHANGER:
INTERNAL
EXTERNAL
DRY TYPE
PARTICLES
DIELECTRIC STRENGTH
INTERFACIAL TENSION
ACIDITY
(kV)
(D/CM)
(MG KOH/G)
ASTM COLOR NO.

PCB CONTENT
(PPM)
POWER FACTOR
(%)
WATER CONTENT
(PPM)
SPECIFIC GRAVITY

* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
(CO)
CARBON DIOXIDE
(CO2)
NITROGEN
(N2)
OXYGEN
(O2)
* COMBUSTIBLE GAS
SAMPLED BY:
TESTED BY: WEIDMANN - ACTI

www.powerdb.com
REVISED 9/23/2010

USER
SUBSTATION
INSULATION FLUID
POSITION
GENERAL
PAGE
229
JOB #
FORMS - ALL
SERIAL NO.
10/13/2014
10/13/2014
10/13/2014
10/13/2014
* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
(C0)
CARBON DIOXIDE
(C02)
NITROGEN
(N2)
OXYGEN
(O2)
TOTAL
COMBUSTIBLE GAS
* COMBUSTIBLE GAS

www.powerdb.com
REVISED 9/23/2010

FLUID QUALITY
USER
SUBSTATION
INSULATION FLUID
POSITION
GENERAL
PAGE
230
JOB #
FORMS - ALL
SERIAL NO.
10/13/2014
10/13/2014
10/13/2014
10/13/2014
DIELECTRIC STRENGTH
(KV)
INTERFACIAL TENSION
(D/CM)
ACIDITY
(MG KOH/G)
PCB CONTENT
(PPM)
POWER FACTOR
(%)
WATER CONTENT
(PPM)
SPECIFIC GRAVITY

www.powerdb.com
REVISED 9/23/2010

FLUID QUALITY
USER
SUBSTATION
INSULATION FLUID
POSITION
GENERAL
PAGE
231
JOB #
FORMS - ALL
SERIAL NO.
COMMENTS:
DEFICIENCIES:
TEST EQUIPMENT USED: Default Administrator

TESTED BY:
www.powerdb.com
WEIDMANN - ACTI
REVISED 9/23/2010

ELECTRICAL INSULATING FLUID
OWNER
232
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
INSULATION FLUID
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
ASTM D-3612
INTERNAL
EXTERNAL
DRY TYPE
HISTORICAL DATA - PPM
GAS
* HYDROGEN
(H2)
PPM
* METHANE
(CH4)
PPM
* ETHANE
(C2H6)
PPM
* ETHYLENE
(C2H4)
PPM
* ACETYLENE
(C2H2)
PPM
* CARBON MONOXIDE
(CO)
PPM
CARBON DIOXIDE
(CO2)
PPM
NITROGEN
(N2)
PPM
OXYGEN
(O2)
PPM
TOTAL GAS
PPM
PPM
EQUIVALENT TCG READING
* COMBUSTIBLE GAS
ANALYSIS OF CURRENT TEST RESULTS

CONDITION
LOW VOLUME OF COMBUSTIBLE GAS PRESENT
SERVICE
EXCELLENT
NO SERVICE REQUIRED
OVERHEATING OF:
OIL
CELLULOSE
GOOD
RETEST IN
CORONA IN:
OIL
CELLULOSE
INVESTIGATE
SERVICE REQUIRED
ARCING IN:
OIL
CELLULOSE
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
UNUSUAL CONDITION (SEE COMMENTS)

TESTED BY:
www.powerdb.com
MONTHS:
57200, REVISED 3/1/2010

ELECTRICAL INSULATING FLUID
PAGE
233
COMMENTS:
DEFICIENCIES:
www.powerdb.com
57200, REVISED 3/1/2010
TRANSFORMER FURFURAN ANALYSIS
OWNER
234
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
INSULATION FLUID
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
INTERNAL
EXTERNAL
DRY TYPE
FURFURYL ANALYSIS
1 - FUROIC ACID
PPM
2 - FURYL ALCOHOL
PPM
5 - HYDRO-METHYL FURALDEHYDE
PPM
2 - FURALDEHYDE
PPM
2 - ACETYLFURAN
PPM
5 - METHYL - 2 - FURALDEHYDE
PPM
* NONE DETECTED
TESTED BY
SAMPLED BY
ANALYSIS OF CURRENT TEST RESULTS

CONDITION
DEGREE OF POLYMERIZATION
EQUIVALENT OPERATING AGE
DEGREE OF POLYMERIZATION = (LOG [FUR] - 1.51) / -0.0035
SERVICE
EXCELLENT
NO SERVICE REQUIRED
GOOD
RETEST IN
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
MONTHS
EQUIVALENT OPERATING AGE = (LOG [FUR] + 1.83) / 0.058

(2 - FURALDEHYDE USED IN CALCULATIONS)

TESTED BY:
www.powerdb.com
57500, REVISED 10/28/2013
TRANSFORMER FURFURAN ANALYSIS
PAGE
235
COMMENTS:
DEFICIENCIES:
www.powerdb.com
57500, REVISED 10/28/2013
TRANSFORMER LIQUID COOLANT ANALYSIS
OWNER
236
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
INSULATION FLUID
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
IMPEDANCE
COOLANT
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
TEST RESULTS
ASTM
PARTICLES
INTERNAL
EXTERNAL
DRY TYPE
D-1524
DIELECTRIC STRENGTH
kV
D-877
INTERFACIAL TENSION
D/CM
D-971
ACIDITY
MG KOH/G
D-974
PAINT CONDITION
D-1500
GASKETS
PPM
D-4059
BUSHINGS
POWER FACTOR
D-924
WATER CONTENT
PPM
D-1533B
ASTM COLOR NO.

PCB CONTENT
LIQUID LEVEL
SPECIFIC GRAVITY
D-287
PLUMBING TABLE
P
OTHER
TOP
ASTM D-3612C
* HYDROGEN
(H2)
PPM
* METHANE
(CH4)
PPM
* ETHANE
(C2H6)
PPM
* ETHYLENE
(C2H4)
PPM
* ACETYLENE
(C2H2)
PPM
* CARBON MONOXIDE
(CO)
PPM
CARBON DIOXIDE
(CO2)
PPM
NITROGEN
(N2)
PPM
OXYGEN
(O2)
PPM
TOTAL GAS
PPM
PPM
BOTTOM
VENT
ACCESS PORT
SAMPLE VALVE
* COMBUSTIBLE GAS
CONDITION
SERVICE
EXCELLENT
NO SERVICE REQUIRED
GOOD
RETEST IN
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
MONTHS:
COMMENTS:
DEFICIENCIES:
SAMPLED BY:

www.powerdb.com
57100, REVISED 7/7/2010
DIELECTRIC DISCHARGE TEST
OWNER
ADDRESS
CUSTOMER
237
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
INSULATION RESISTANCE CURVE
A : Red Square
B : Blue Circle
C : Green Triangle
...CLICK HERE TO SELECT DEVICE

A
TIME
(minutes)
READING
(megohms)
CURRENT
uA
TIME
(minutes)
READING
(megohms)
C
CURRENT
uA
TIME
(minutes)
READING
(megohms)
CURRENT
uA
CAPACITANCE
TIME CONSTANT
PI VALUE
DAR VALUE
DD VALUE
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
60050, REVISED 12/3/2012
MICROHMMETER COOLING CURVE
OWNER
238
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
OTHER INFORMATION
CONNECTED EQUIPMENT
WEATHER
VOLTAGE RATING
All fields in this form with background color are calculated

METAL TYPE:
LOAD APPLIED:
FOR TIME:
Min
Settings Table
TIME INTERVAL dT:
Min
TEMPERATURE AMBIENT:
TEMPERATURE COEFFICIENT:
TC
RESISTANCE AMBIENT:
ohms
Readings Table
Extrapolated Cooling Curve
(enter data in table starting at T1)
TIME INTERVAL t
T0
READING
T1 - 75%
T1 - 50%
T1 - 25%
T1
Calculations Table
Calculated Maximum Resistance (ohms):
Calculated Temperature Rise (C):
Calculated Max. Winding Temp. (C):
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
76000, REVISED 2/7/2014
POLARIZATION INDEX (PI) TEST
OWNER
ADDRESS
CUSTOMER
239
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
OTHER INFORMATION
CONNECTED EQUIPMENT
WEATHER
TEST VOLTAGE
kVDC
TEMPERATURE
VOLTAGE RATING
TEMPERATURE CORRECTION FACTOR TO 20 C, TCF
1.00
Use Instrument PI / DAR Value:

A
MINUTES
READING
(megohms)
B
CORR. VALUE
(megohms)
READING
(megohms)
C
CORR. VALUE
(megohms)
READING
(megohms)
CORR. VALUE
(megohms)
0.25
0.50
0.75
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
P. I.
D. A. R.
POLARIZATION CURVE
A : Red Square
B : Blue Circle
C : Green Triangle
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
60000, REVISED 2/10/2014
CUSTOM STEP VOLTAGE TEST
OWNER
241
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
OTHER INFORMATION
CONNECTED EQUIPMENT
WEATHER
VOLTAGE RATING

TEMPERATURE
20
TEMP. CORR. FACTOR (TCF) TO 20C

A
TIME
(seconds)
IR
(megohms)
STEP VOLT (kVDC)

NOMINAL
ACTUAL
1.00
IR 20C
(megohms)
CURRENT
(microamps)
MAX. TEST VOLTAGE
KVDC
STEP VOLT.
TEST 1
IR
Current
1.00
KVDC
B
TIME
(seconds)
NOMINAL
ACTUAL
1.00
1.00
IR
(megohms)
STEP VOLT (kVDC)
IR 20C
(megohms)
CURRENT
(microamps)
STEP VOLT.
TEST 2
IR
Current
KVDC
C
TIME
(seconds)
STEP VOLT (kVDC)

NOMINAL
ACTUAL
1.00
IR
(megohms)
IR 20C
(megohms)
CURRENT
(microamps)
STEP VOLT.
TEST 3
IR
Current
1.00
KVDC
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
60080, REVISED 10/9/2013
BUSHING POWER FACTOR TESTS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
242
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
MISCELLANEOUS
POSITION
MANUFACTURER:
TYPE/CLASS:
MFR. LOCATION:
MFR. DATE:
SERIAL NO.:
S.O. NUMBER:
CLASS/STYLE:
DRAWING:
kV RATING:
kV BIL:
AMP RATING:
CATALOG NO.:
C1 % P.F.:
C1 Cap. (pF):
TAP:
C2 % P.F.:
C2 Cap. (pF):
REASON:
Yes
OTHER:
OTHER:
TEST FREQUENCY: 60
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
91515, REVISED 2/10/2014
MICROHMMETER MEASUREMENTS
OWNER
243
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
...SELECT DEVICE
Device Type:
Use Temperature Correction:
START DATA CAPTURE
DOWNLOAD READINGS
TEST RESULTS
TEST #
TEST TYPE
DATE
TIME
SET CURRENT
RESISTANCE
MEAS. CURR.
VOLT DROP
UPPER LIM.
LOWER LIM.
PASS/FAIL
COMMENTS
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 6/6/2011
MICROHMMETER MEASUREMENTS
OWNER
244
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
...SELECT DEVICE
Device Type:
Use Temperature Correction:
START DATA CAPTURE
DOWNLOAD READINGS
TEST RESULTS
TEST #
TEST TYPE
DATE
TIME
SET CURRENT
FWD RESISTANCE REV RESISTANCE AVG RESISTANCE
UPPER LIM.
LOWER LIM.
PASS/FAIL
COMMENTS
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 6/6/2011
POWER MULTIMETER TEST
OWNER
ADDRESS
CUSTOMER
245
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
SETTINGS
SCAN MODE
360Lag
SCAN RATE
Min
Sec
USE CT/VT RATIOS TO DISPLAY PRIMARY VALUES
NO
SINGLE PHASE REPORT

CIRCUIT
DATE
PHASE REF
TIME
ITEM NO.
CHANNEL 1
CHANNEL 2
WATTS
VARS
PHASE
ANGLE (deg)
POWER
FACTOR
FREQUENCY
Scale 1: 1
Scale 2: 1
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 2/7/2013
OWNER
ADDRESS
CUSTOMER
246
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
INSULATION RESISTANCE CURVE
A : Red Square
B : Blue Circle
C : Green Triangle
COMMENTS:
DEFICIENCIES:
TEMPERATURE
20
TEMPERATURE CORRECTION FACTOR TO 20 C, TCF
1.00

A
TIME
Volts READING TEMP CORR. CURRENT
(minutes) (kV) (megohms) (megohms)
uA
TIME
Volts READING TEMP CORR. CURRENT
(minutes) (kV) (megohms) (megohms)
uA

TESTED BY:
www.powerdb.com
TIME
Volts
(minutes) (kV)
READING TEMP CORR. CURRENT

(megohms) (megohms)
uA
60010, REVISED 12/3/2012
STEP VOLTAGE TEST
OWNER
247
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
OTHER INFORMATION
CONNECTED EQUIPMENT
WEATHER
VOLTAGE RATING

TEMPERATURE
20
MAX. TEST VOLTAGE

KVDC
TIME
(minutes)
STEP VOLT.
(kVDC)
1.0
1.00
2.0
2.00
3.0
3.00
4.0
4.00
5.0
5.00
TIME
(minutes)
STEP VOLT.
(kVDC)
1.0
1.00
2.0
2.00
3.0
3.00
4.0
4.00
5.0
5.00
TIME
(minutes)
STEP VOLT.
(kVDC)
1.0
1.00
2.0
2.00
3.0
3.00
4.0
4.00
5.0
5.00
TEST TIME
IR
(megohms)
IR 20C
(megohms)
minutes
CURRENT
(microamps)
STEP VOLT.
TEST 1
IR
Current
KVDC
IR
(megohms)
IR 20C
(megohms)
CURRENT
(microamps)
STEP VOLT.
TEST 2
IR
Current
KVDC
IR
(megohms)
IR 20C
(megohms)
CURRENT
(microamps)
STEP VOLT.
TEST 3
IR
Current
KVDC

TESTED BY:
www.powerdb.com
60070, REVISED 10/25/2013
STEP VOLTAGE TEST
PAGE
248
COMMENTS:
DEFICIENCIES:
www.powerdb.com
60070, REVISED 10/25/2013
RAMP TEST
OWNER
ADDRESS
CUSTOMER
249
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
CURRENT VS VOLTAGE CURVE
A : Red Square
B : Blue Circle
C : Green Triangle
COMMENTS:
DEFICIENCIES:
A
A
TIME
(minutes)
Volts
(kV)
CURRENT
uA
B
RESISTANCE
(megohms)
TIME
(minutes)
Volts
(kV)
CURRENT
uA
TIME
(minutes)
Volts
(kV)
CURRENT
uA
RESISTANCE
(megohms)

C
RESISTANCE
(megohms)
TESTED BY:
www.powerdb.com
60100, REVISED 2/10/2014
MISCELLANEOUS EQUIPMENT
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
250
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
POSITION
MANUFACTURER
MFR. LOCATION
SERIAL
MVA/kVA
kVA
Example Plant
AUTOMATED
PLANT
# OF PHASES
YEAR OF MFR.
kV
CLASS
BIL
WEIGHT
AMPS
kg
CATALOG/STYLE #
NOTES
TEST FREQUENCY: 60
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
91510, REVISED 12/11/2013
DLRO-H200/MOM2 MICRO-OHMETER
OWNER
ADDRESS
CUSTOMER
251
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
HUMIDITY
MISCELLANEOUS
Retrieve Data
Record
AMBIENT TEMPERATURE
SUBSTATION
Label
Date
Delete Data
Time
Example Plant
AUTOMATED
PLANT
POSITION
User Configurations
Max Current
(A)
Min Current
(A)
Synchronize Clock
Min Current Limit

(A)
Resistance
(mOhm)
Pass/Fail Upper Limit

(mOhm)
Measurement Time
(ms)
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
90513, REVISED 8/30/2012
PANEL CURRENT
VOLTAGE MEASUREMENT TEST
OWNER
ADDRESS
CUSTOMER
252
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
CURRENT
(amps)
IDENTIFICATION
A
VOLTAGE
(volts)
N
A-GRD
B-GRD
C-GRD

Example Plant
GENERAL
PLANT
MISCELLANEOUS
SUBSTATION
N-GRD
TESTED BY:
www.powerdb.com
A-B
B-C
C-A
A-N
B-N
C-N
28510, REVISED 4/22/2009
PANEL CURRENT
VOLTAGE MEASUREMENT TEST
PAGE
253
COMMENTS:
DEFICIENCIES:
www.powerdb.com
28510, REVISED 4/22/2009
MANHOLE INSPECTION REPORT
OWNER
ADDRESS
CUSTOMER
254
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
Example Plant
GENERAL
PLANT
MISCELLANEOUS
POSITION
N
W
E
S
DUCT IDENTIFICATION
DUCT
LOC'N.
CONDR.
NO.
NO.
SIZE
CABLE
I.D.
REMARKS
DUCT IDENTIFICATION
DUCT
LOC'N.
CONDR.
NO.
NO.
SIZE

TESTED BY:
www.powerdb.com
CABLE
I.D.
REMARKS
65100, REVISED 4/22/2009
MANHOLE INSPECTION REPORT
PAGE
255
COMMENTS:
DEFICIENCIES:
www.powerdb.com
65100, REVISED 4/22/2009
TRENDING
OWNER
ADDRESS
CUSTOMER
256
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
PLANT
POSITION
Example Plant
GENERAL
ASSET DESCRIPTION:
TEST POINT:
NOTES:

TESTED BY:
www.powerdb.com
55555, REVISED 4/22/2009
TRENDING
PAGE
257
COMMENTS:
DEFICIENCIES:
www.powerdb.com
55555, REVISED 4/22/2009
LOAD RECORDINGS
OWNER
ADDRESS
CUSTOMER
258
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
PLANT
POSITION
Example Plant
GENERAL
PANEL DESIGNATION:
MINIMUM kVA
DATE
DAY OF WEEK
TIME
VOLTAGE
A
B
C
AMPERES
A
B
C
MINIMUM kVA
A
B
C
T
kW
A
B
C
T
kVAR
A
B
C
T
POWER FACTOR
A
B
C
T

TESTED BY:
www.powerdb.com
28100, REVISED 7/15/2010
LOAD RECORDINGS
259
MAXIMUM kVA
AMPERES
VOLTAGE
PAGE
www.powerdb.com
28100, REVISED 7/15/2010
LOAD RECORDINGS
260
POWER FACTOR
kVAR
kW
PAGE
COMMENTS:
DEFICIENCIES:
www.powerdb.com
28100, REVISED 7/15/2010
CALIBRATION DATA LOG
OWNER
ADDRESS
CUSTOMER
261
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE
ITEM TESTED
MANUFACTURER
MODEL NUMBER
SERIAL NUMBER
TAG NUMBER
OPERATING RANGE
INPUT
OUTPUT IN
FUNCTION
TEST
RANGE %
OUTPUT
AS FOUND
INPUT IN
AS LEFT

TESTED BY:
www.powerdb.com
81000, REVISED 4/22/2009
CALIBRATION DATA LOG
PAGE
262
COMMENTS:
DEFICIENCIES:
www.powerdb.com
81000, REVISED 4/22/2009
INSPECTION SHEET
OWNER
ADDRESS
CUSTOMER
263
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
PLANT
POSITION
Example Plant
GENERAL
DESCRIPTION:
COMMENTS:
10/13/2014
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
66500, REVISED 10/10/2014
METER SETTINGS TEST
OWNER
264
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
CIRCUIT & RELAY INFORMATION

CIRCUIT NAME
CIRCUIT NAME
VOLTAGE
AMP
CT RATIO
PT RATIO
CALIBRATION
EXTERNAL DEVICES
METER DESCRIPTION
TYPE
RANGE
SERIAL NUMBER
FUNCTION
SETTINGS
% OF FULL
SCALE
TEST
VOLTS
TEST
AMPS
CALIB.
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
100%
75%
50%
25%
0%

TESTED BY:
www.powerdb.com
80000, REVISED 4/22/2009
METER SETTINGS TEST
PAGE
265
COMMENTS:
DEFICIENCIES:
www.powerdb.com
80000, REVISED 4/22/2009
CAPACITOR BANK TEST
OWNER
266
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
MANUFACTURER
CATALOG NUMBER
SERIAL NUMBER
DATE OF MANUF.
VOLTAGE (kV)
KVAR
DESCRIPTION
INSPECTED
Example Plant
GENERAL
PLANT
MISCELLANEOUS
SUBSTATION
TYPE
# OF PHASES
BIL (kV)
CONDITION
FREQUENCY
NOTES
DESCRIPTION
OVERALL CLEANLINESS
CAPACITOR CONDITION
INSULATOR CONDITION
CONNECTED BUS
STRUCTURAL MEMBERS
CT RATIO
CUBICLE
CT LOOPS
CONTROL CABLES
SHORT/GND SPARE CT'S
WIRE CONNECTIONS
GROUNDING
HEATERS
PRIMARY CONNECTIONS
LIGHTS AND RECEPTACLES
WEATHERSTRIPPING
60
INSPECTED
CONDITION
NOTES
INSULATION RESISTANCE (IR)

LOCATION
enter location/phase
H - GND
H - GND
H - GND
CONNECTION
TEST VOLTAGE (kV)
TEST TIME (1 min)
TEST RESULT
UNIT
TEST RESULT
UNIT
Meg-ohms
UNIT
Meg-ohms
Meg-ohms
Number of cans/phase:
Capacitance tests
SERIAL #
TEST RESULT
Cact uF
Cmeas uF
DEV %
SERIAL #
Cact uF
Cmeas uF
DEV %
SERIAL #
Cact uF
Cmeas uF
DEV %
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
65150, REVISED 9/6/2011
PANEL CURRENT/VOLTAGE MEASUREMENT TEST
OWNER
ADDRESS
CUSTOMER
267
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
CURRENT
(amps)
IDENTIFICATION
A
Example Plant
GENERAL
PLANT
MISCELLANEOUS
SUBSTATION
VOLTAGE
(volts)
N
A-GRD
B-GRD
C-GRD
N-GRD
A-B
B-C
C-A
A-N
B-N
C-N
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
28500, REVISED 6/22/2010
DISSIPATION FACTOR TEST

Miscellaneous Equipment
OWNER
ADDRESS
CUSTOMER
268
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
TEST
HUMIDITY
POSITION
EQPT.
TEMP.
EQUIPMENT TESTED
Example Plant
GENERAL
PLANT
MISCELLANEOUS
SUBSTATION
EQUIPMENT LOCATION
DESCRIPTION OF TEST
CAPACITANCE
TEST
TEST
kV
TYPE OF TEST
TRANSFORMER TEMPERATURE
EQUIPMENT TYPE TESTED:
SW.
% DISSIPATION FACTOR
DIAL READING CALC. MULTIAVG. PLIER

NORM. REV.
CAP.
P.F.
DIAL READING CALC. MULTI- MEAS.

AVG. PLIER
%
NORM. REV.
CALC.
%
P.F.
OIL-FILLED BUSHINGS
COMPOUND-FILLED BUSHINGS
LIGHTNING ARRESTORS
LOW VOLTAGE CABLE; INS. TYPE TW,

THW, THHW, XHHW, THHN
LOW VOLTAGE CABLE: INS.

TYPE RH, RHW
MEDIUM VOLTAGE CABLE

20
%
TESTED BY:
www.powerdb.com
DF
PF =
1 + DF
65000, REVISED 4/22/2009

Miscellaneous Equipment
PAGE
269
COMMENTS:
DEFICIENCIES:
www.powerdb.com
65000, REVISED 4/22/2009
PANEL METER TEST
OWNER
ADDRESS
CUSTOMER
270
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
PANEL VOLTMETER
MANUFACTURER
TYPE
CATALOG NO.
RATING
FREQUENCY
OTHER
PANEL AMMETER
MANUFACTURER
TYPE
CATALOG NO.
RATING
FREQUENCY
OTHER
TEST RESULTS
POSITION
MOVEMENT
RANGE
TEST VALUE
AS FOUND

TESTED BY:
www.powerdb.com
AS SPECIFIED
AS LEFT
34000, REVISED 4/22/2009
PANEL METER TEST
PAGE
271
COMMENTS:
DEFICIENCIES:
www.powerdb.com
34000, REVISED 4/22/2009
LOAD RECORDINGS
OWNER
ADDRESS
CUSTOMER
272
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MISCELLANEOUS
SUBSTATION
PLANT
POSITION
Example Plant
GENERAL
PANEL DESIGNATION:
MAXIMUM kVA
DATE
10/13/2014
10/13/2014
DAY OF WEEK
TIME
VOLTAGE
A
B
C
AMPERES
A
B
C
MAXIMUM kVA
A
B
C
T
kW
A
B
C
T
kVAR
A
B
C
T
POWER FACTOR
A
B
C
T

TESTED BY:
www.powerdb.com
28000, REVISED 7/15/2010
LOAD RECORDINGS
273
MAXIMUM kVA
AMPERES
VOLTAGE
PAGE
www.powerdb.com
28000, REVISED 7/15/2010
LOAD RECORDINGS
274
POWER FACTOR
kVAR
kW
PAGE
COMMENTS:
DEFICIENCIES:
www.powerdb.com
28000, REVISED 7/15/2010
AERIAL BUCKET UNIT
OWNER
276
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
Example Plant
GENERAL
PLANT
MISCELLANEOUS
POSITION
ELECTRICAL TEST RECORD OF INSULATED AERIAL BUCKET UNIT UPPER BOOM, LOWER BOOM INSERT,
DERRICK FIBERGLASS EXTENSION, BUCKET LINER
TYPE OR MODEL NO. OF UNIT
COMPANY TRUCK NUMBER
LIFT MAKE
TEST VOLTAGE DC UPPER BOOM
MODEL
kV
SERIAL NUMBER
LOWER BOOM INSERT
kV
BUCKET LINER
kV
BUCKET LINER NO.
ELECTRICAL TEST-RECORD LEAKAGE IN MICROAMPERES

CHECK TYPE OR TYPES OF EQUIPMENT BEING TESTED
1
2
FIBERGLASS
FIBERGLASSOUTER
OUTERBOOM
BOOM
AND
ANDBUCKET
BUCKET
DERRICK WITH
FIBERGLASS EXTENSION
FIBERGLASS OUTER BOOM AND

BUCKET & LOWER BOOM INSERT
MAX
VOLTAGE
DURING
TEST (kV)
VOLTAGE
(kV)
INSULATED BUCKET LINER
LEAKAGE
CURRENT
IN MICROAMPERES
LOWER BOOM
INSERT
UPPER
BOOM
INSULATED BUCKET LINER
NUMBER
VOLTAGE
(kV)
LEAKAGE
CURRENT
IN MICROAMPERES
TESTED PER ANSI A92.0 - 2001

THIS IS A TEST ONLY - NOT A GUARANTEE

TESTED BY:
www.powerdb.com
77777, REVISED 4/22/2009
AERIAL BUCKET UNIT
PAGE
277
COMMENTS:
DEFICIENCIES:
www.powerdb.com
77777, REVISED 4/22/2009
MULTI-METER SETTINGS TEST
OWNER
ADDRESS
CUSTOMER
278
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
Example Plant
GENERAL
CIRCUIT & RELAY INFORMATION

CIRCUIT NAME
EXTERNAL DEVICES
VOLTAGE
AMP
CT RATIO
PT RATIO
CALIBRATION
METER DESCRIPTION
TYPE
SERIAL NUMBER
RANGE
FUNCTION
SETTINGS
A PHASE VOLTS
% OF FULL
SCALE
A-N PHASE VOLTS

TEST
VOLTS
ACTUAL METER
READING
CAL. METER
READING
A PHASE AMPS
% OF
ERROR
100%
75%
50%
25%
0%
B-N PHASE VOLTS
TEST
VOLTS
ACTUAL METER
READING
CAL. METER
READING
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
TEST
AMPS
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
TEST
AMPS
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
B PHASE AMPS
% OF
ERROR
100%
75%
50%
25%
0%
% OF FULL
SCALE
100%
75%
50%
25%
0%
C PHASE VOLTS
% OF FULL
SCALE
TEST
AMPS
100%
75%
50%
25%
0%
B PHASE VOLTS
% OF FULL
SCALE
% OF FULL
SCALE
C-N PHASE VOLTS

TEST
VOLTS
ACTUAL METER
READING
CAL. METER
READING
C PHASE AMPS
% OF
ERROR
100%
75%
50%
25%
0%
% OF FULL
SCALE
100%
75%
50%
25%
0%
A-B PHASE VOLTS

% OF FULL
SCALE
TEST
VOLTS
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
100%
75%
50%
25%
0%
% OF FULL
SCALE
100%
75%
50%
25%
0%
B-C PHASE VOLTS

% OF FULL
SCALE
TEST
VOLTS
ACTUAL METER
READING
CAL. METER
READING
% OF
ERROR
100%
75%
50%
25%
0%
% OF FULL
SCALE
100%
75%
50%
25%
0%
A-C PHASE VOLTS

% OF FULL
SCALE
TEST
VOLTS
ACTUAL METER
READING
100%
75%
50%
25%
0%
CAL. METER
READING
% OF
ERROR
% OF FULL
SCALE
100%
75%
50%
25%
0%

TESTED BY:
www.powerdb.com
80001, REVISED 4/22/2009
MULTI-METER SETTINGS TEST
PAGE
279
COMMENTS:
DEFICIENCIES:
www.powerdb.com
80001, REVISED 4/22/2009
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
280
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
MISCELLANEOUS
HUMIDITY
PLANT
POSITION
Example Plant
GENERAL
LIGHTNING ARRESTER TEST
OWNER
281
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MISCELLANEOUS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL
CATALOG NO.
SERIAL NO.
RELIEF
RATED RMS VOLTAGE
kV
SYSTEM VOLTAGE
kV
RATED MCOV
ARRESTER TYPE
kV DC
RANGE MULTIPLIER
kV
STATION
RMS CURRENT RATING
INTERMEDIATE
kA
DISTRIBUTION
RATED CREST
MATERIAL TYPE
PORCELAIN
kA
POLYMER
TEST VOLTAGE MULTIPLIER

INSULATION TEST
POSITION
TOTAL
CORRECTION
MULTIPLIER
A PHASE TO GROUND
ACTUAL
MEGOHMS
WATT LOSS TEST

TEST kV SWITCH SETTING
CORRECTED
MEGOHMS
B PHASE TO GROUND
ACTUAL
MEGOHMS
C PHASE TO GROUND
CORRECTED
MEGOHMS
ACTUAL
MEGOHMS
CORRECTED
MEGOHMS
A PHASE
B PHASE
C PHASE
MILLI-WATT LOSS
POSITION
OUTPUT TEST VOLTAGE

READING CORRECTION FACTOR
GROUNDED SPECIMEN TEST

UNGROUNDED SPECIMEN TEST

TESTED BY:
www.powerdb.com
65500, REVISED 7/13/2012
LIGHTNING ARRESTER TEST
PAGE
282
COMMENTS:
DEFICIENCIES:
www.powerdb.com
65500, REVISED 7/13/2012
VARIABLE FREQUENCY DRIVE
OWNER
ADDRESS
CUSTOMER
283
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
MOTOR CONTROL
SUBSTATION
POSITION
VFD
MOTOR
MFG:
EQUIPMENT ID:
I/D:
P/N:
MODEL/HP:
ENG:
SYSTEM S/N:
INPUT:
OUTPUT:0-460VAC
ORDER:
WIRING DIAGRAM:
COOLING
FANS:
TEST
LOCATION:
MFG:
EQUIPMENT ID:
I/D:
M/D:
HP:
FRAME:
VOLTS:
AMPS:
RPM:
Fan Manufacturer
Fan Model Number
Number of Fans
Number of Fans Not Operating
Number of Fans Replaced
L1 Channel 1
L2 Channel 2
Reference to Ground
DLRO
READINGS
Red Probe
Black Probe
Ground lead of scope
(micro-ohms)
LABEL:
L1
L2
L3
T1
T2
T3
AS FOUND:
AS LEFT:
LABEL:
AS FOUND:
AS LEFT:
Input Voltage (Line-Line)
RMS Measurements In Volts AC:
L1-L2:
L1-L3:

L2-L1:
TESTED BY:
www.powerdb.com
L2-L3:
L3-L1:
L3-L2:
REVISED 7/15/2010
Input Voltage (Line-Ground)
L1-G:
L2-G:
L3-G:
Inputs To Negative DC Bus
RMS AC Measurements:
VL1-BUS:
IL1:
VL2-BUS:
IL2:
L3-BUS:
IL3:
DC BUS VOLTAGE AND AC RIPPLE
DC BUS VOLTAGE (in volts):

DC BUS AC RIPPLE (in volts):

www.powerdb.com
REVISED 7/15/2010
Output To Load
T1-T2:
T1-T3:
T2-T1:
T2-T3:
T3-T1:
T3-T2:
T3V-L:
T3I:
Output To Load (Voltage And Current)
T1V-L:
T1I:
T2VL:
T2I:
CONTROL BOARD DC VOLTAGE
CONTROL BOARD DC VOLTAGE (in volts):

www.powerdb.com
REVISED 7/15/2010
VARIABLE FREQUENCY DRIVE
PAGE
286
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 7/15/2010
MOTOR STARTER TEST
OWNER
ADDRESS
CUSTOMER
287
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MOTOR CONTROL
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
STARTER SIZE
FORM
SERIES
MAXIMUM VOLTAGE
INT. RATING
OPERATING VOLTAGE
CONTROL VOLTAGE
OTHER
MOTOR CONTROL CENTER SYSTEM VOLTAGE
kA @
kV
STARTER IDENTIFICATION
OVERCURRENT PROTECTION DEVICES

CONTROL POWER FUSE:
MFR.
TYPE
SIZE
MAIN POWER FUSE:
MFR.
TYPE
SIZE
OVERLOAD PROTECTION: MFR.
TYPE
TESTED
YES
NO
INSTRUMENT TRANSFORMER DATA

CONTROL POWER TRANSFORMER: MFR.
kVA
CURRENT TRANSFORMER:
RATIO
MFR.
DESCRIPTION
OVERALL CLEANLINESS
INSULATING MEMBERS
STRUCTURAL MEMBERS
CUBICLE
RACKING DEVICES
SHUTTER
CONTACT FINGERS
INSPECTED
CONDITION
CLEAN/LUBE
:5
TYPE
VOLTAGE
TYPE
CAT. NO.
DESCRIPTION
MAIN CONTACTS
ARCING CONTACTS
ARC CHUTES
OPERATING MECHANISM
CONTACT SEQUENCE
GROUND CONNECTIONS
AUXILIARY DEVICES
INSPECTED
CONDITION
kVDC
TEST VOLTAGE MULTIPLIER, K1 =
CLEAN/LUBE
K2 = (K1) (TCF)

RANGE
MULTIPLIER
K2
POLE 1 (P1-P2)
READING
POLE 2 (P2-P3)
20C
READING
20C
POLE 3 (P1-P3)
READING
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
CONTACT RESISTANCE
MICRO-OHMS
POLE 1
POLE 2
POLE 3

READING

TESTED BY:
www.powerdb.com
20C
31000, REVISED 4/30/2009
MOTOR STARTER TEST
PAGE
288
COMMENTS:
DEFICIENCIES:
www.powerdb.com
31000, REVISED 4/30/2009
MOTOR CONTROL CENTER INSPECTION
OWNER
289
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MOTOR CONTROL
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
DRAWING NO.
VOLTAGE CLASS
MAIN BUS RATING
MAIN BUS NEUTRAL RATING
NUMBER OF SECTIONS
CONDUCTOR
LISTING
CU
UL
AL
CSA
OTHER
INSTALLED DEVICES
MAIN BREAKER
TYPE
AMPACITY
TOTAL POSITIONS EQUIPPED
MAIN DISCONNECT
FUSE TYPE
NO. OF SPARE SPACES
DESCRIPTION
SIZE
MLO
TOTAL POSITIONS USED
INSPECTED
CONDITION
CLEANED/LUBED
OVERALL CLEANLINESS
INSULATING MEMBERS
CUBICLES
GROUND CONNECTIONS
AUXILIARY DEVICES
POSITION
LOAD
LOAD
NO.
M. S.
OVER-
OVER-
OVER-
STARTER
COND.
COND./
DISC.
CURRENT
CURRENT
LOAD
NEMA
SIZE
PHASE
TYPE
TYPE
SIZE
SIZE
SIZE

TESTED BY:
www.powerdb.com
COMMENTS
30000, REVISED 4/30/2009
MOTOR CONTROL CENTER INSPECTION
PAGE
290
COMMENTS:
DEFICIENCIES:
www.powerdb.com
30000, REVISED 4/30/2009
480 VOLT MOTOR CONTROL CENTER

PREVENTATIVE MAINTENANCE
OWNER
291
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MOTOR CONTROL
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
TEST HISTORY
PHASE A: BROWN CIRCLE
TEST DATE
10/13/2014
10/13/2014
0
PHASE B: ORANGE SQUARE
TESTED BY
PHASE C: GRAY TRIANGLE
OVERLOAD RELAY
/
HEATERS
DELAY
@
300% MFLA
AMPS:
@ 3 X AMPS
A (seconds)
B (seconds)
0
C (seconds)
STARTER CONTACT CONDITION

STARTER IR
@
1000 VDC
(w/starter open)
AA (megohms)
BB (megohms)
0
CC (megohms)
AB (ohms)
PHASE-TO-PHASE
OHMS
BC (ohms)
CA (ohms)
FEEDER & MOTOR IR @ 1000VDC

BREAKER
A (volts)
0
B (volts)
C (volts)
VOLTAGE
DROP
TEST SET
A (volts)
0
B (volts)
C (volts)
A (amps)
INSTANTANEOUS
PICKUP
0
B (amps)
C (amps)
MCP IR
@
1000VDC
(w/open breaker)
AA (megohms)
BB (megohms)
CC (megohms)
TESTED BY:
www.powerdb.com
10/13/2014
10/13/2014
32950, REVISED 8/5/2010
480 VOLT MOTOR CONTROL CENTER

PREVENTATIVE MAINTENANCE
PAGE
292
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32950, REVISED 8/5/2010
MEDIUM VOLTAGE VACUUM

MOTOR STARTER TEST
OWNER
ADDRESS
CUSTOMER
293
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MOTOR CONTROL
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
STARTER SIZE
FORM
SERIES
MAXIMUM VOLTAGE
INT. RATING
OPERATING VOLTAGE
CONTROL VOLTAGE
kA @
kV
OTHER

CONTROL POWER FUSE: MFR.
TYPE
SIZE
MAIN POWER FUSE:
MFR.
TYPE
SIZE
TYPE
TESTED
YES
NO

DESCRIPTION
OVERALL CLEANLINESS
INSULATING MEMBERS
STRUCTURAL MEMBERS
CUBICLE
RACKING DEVICES
SHUTTER
VA RATING
MFR.
INSPECTED
:5
RATIO
CONDITION
CLEAN/LUBE
TYPE
VOLTAGE
TYPE
CAT. NO.
DESCRIPTION
OPERATING MECHANISM
CONTACT FINGERS
VACUUM INTERRUPTER
CONTACT SEQUENCE
GROUND CONNECTIONS
AUXILIARY DEVICES
INSPECTED
CONDITION
kVDC
TEST VOLTAGE MULTIPLIER, K1 =
kVDC
INSULATION
TESTS
RANGE
MULTIPLIER
CLEAN/LUBE
K2 = (K1) (TCF)
kVDC
kVAC
POLE 1 MEGOHMS (P1 - P2)
READING
READING
READING
K2
20C
20C
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
POLE 1
POLE 2
POLE 3

POLE RESISTANCE

READING
20C
RDG.
MICRO - OHMS
20C
INTERRUPTER RESISTANCE
RDG.
HIGH POTENTIAL TEST DC
POLE 1
MICRO - OHMS
20C
MILLIWATT LOSS TEST DC

TESTED BY:
www.powerdb.com
POLE 2
POLE 3
31300, REVISED 8/5/2010

MOTOR STARTER TEST
PAGE
294
COMMENTS:
DEFICIENCIES:
www.powerdb.com
31300, REVISED 8/5/2010
MOTOR STARTER TEST
OWNER
ADDRESS
CUSTOMER
295
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MOTOR CONTROL
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
STARTER SIZE
FORM
SERIES
MAXIMUM VOLTAGE
INT. RATING
OPERATING VOLTAGE
CONTROL VOLTAGE
OTHER
kA @
kV

CONTROL POWER FUSE:
MFR.
TYPE
SIZE
MAIN POWER FUSE:
MFR.
TYPE
SIZE
TYPE
TESTED
YES
NO

kVA
RATIO
DESCRIPTION
OVERALL CLEANLINESS
INSULATING MEMBERS
STRUCTURAL MEMBERS
CUBICLE
RACKING DEVICES
SHUTTER
CONTACT FINGERS
MFR.
INSPECTED
kVDC
CONDITION
CLEAN/LUBE
:5
DESCRIPTION
MAIN CONTACTS
ARCING CONTACTS
ARC CHUTES
OPERATING MECHANISM
CONTACT SEQUENCE
GROUND CONNECTIONS
AUXILIARY DEVICES
TYPE
VOLTAGE
TYPE
CAT. NO.
INSPECTED
CONDITION
CLEAN/LUBE

POLE 1 (P1-P2)
READING
POLE 2 (P2-P3)
20C
READING
POLE 3 (P1-P3)
20C
READING
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
CONTACT RESISTANCE
MICRO-OHMS
POLE 1
POLE 2
POLE 3

READING
20C
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
31000, REVISED 8/23/2013
MOTOR CONTROL CENTER

INSULATION TEST
OWNER
ADDRESS
CUSTOMER
296
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MOTOR CONTROL
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
DRAWING NO.
VOLTAGE CLASS
MAIN BUS RATING
MAIN BUS NEUTRAL RATING
CONDUCTOR
NUMBER OF SECTIONS
LISTING
CU
UL
CSA
AL
OTHER
INSTALLED DEVICES
MAIN BREAKER
MLO
TYPE
TOTAL POSITIONS EQUIPPED
AMPACITY
MAIN DISCONNECT
NO. OF SPARE SPACES
DESCRIPTION
FUSE TYPE
SIZE
TOTAL POSITIONS USED
INSPECTED
CONDITION
CLEANED/LUBED
OVERALL CLEANLINESS
INSULATING MEMBERS
CUBICLES
GROUND CONNECTIONS
AUXILIARY DEVICES
TEST VOLTAGE
kVDC

BUS SECTION TESTED
PHASE
A-GND
B-GND
C-GND
N-GND
A-B
A-C
B-C
A-N
B-N
C-N
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C

TESTED BY:
www.powerdb.com
30100, REVISED 4/30/2009
MOTOR CONTROL CENTER

INSULATION TEST
PAGE
297
COMMENTS:
DEFICIENCIES:
www.powerdb.com
30100, REVISED 4/30/2009

MOTOR STARTER TEST
OWNER
ADDRESS
CUSTOMER
298
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
MOTOR CONTROL
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
STARTER SIZE
FORM
SERIES
MAXIMUM VOLTAGE
INT. RATING
OPERATING VOLTAGE
CONTROL VOLTAGE
kA @
kV
OTHER

CONTROL POWER FUSE: MFR.
TYPE
SIZE
MAIN POWER FUSE:
MFR.
TYPE
SIZE
TYPE
TESTED
YES
NO

DESCRIPTION
OVERALL CLEANLINESS
INSULATING MEMBERS
STRUCTURAL MEMBERS
CUBICLE
RACKING DEVICES
SHUTTER
VA RATING
MFR.
INSPECTED
kVDC
RATIO
CONDITION
CLEAN/LUBE
kVDC
READING
20C
TYPE
VOLTAGE
TYPE
CAT. NO.
DESCRIPTION
OPERATING MECHANISM
CONTACT FINGERS
VACUUM INTERRUPTER
CONTACT SEQUENCE
GROUND CONNECTIONS
AUXILIARY DEVICES
INSULATION TESTS
:5
INSPECTED
CLEAN/LUBE

READING
CONDITION
kVDC
kVAC
20C
READING
20C
POLE TO POLE
POLE TO FRAME
LINE TO FRAME
LOAD TO FRAME
LINE TO LOAD
POLE 1
POLE 2
POLE 3

POLE RESISTANCE

READING
20C
RDG.
MICRO - OHMS
20C
INTERRUPTER RESISTANCE
RDG.
HIGH POTENTIAL TEST DC
POLE 1
MICRO - OHMS
20C
MILLIWATT LOSS TEST DC
POLE 2
POLE 3
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
31300, REVISED 8/26/2013
MOTOR CONTROL MCC TEST REPORT
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
299
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
Example Plant
GENERAL
PLANT
POSITION
MCC ID
MODEL #
# OF BUCKETS
MANUFACTURER
SERIAL #
VOLTAGE
Contact
Resistance
A
Bucket ID
HUMIDITY
MOTOR CONTROL
SUBSTATION
MCC DATA
AMBIENT TEMPERATURE
Size
Rating
(Micro Ohms)
@ 1000V
A
(Meg Ohms)
@ 1000V (Control)
A
(Meg Ohms)
O/L Data
Type
Md #/Cat # (SS or HTR)
O/L Test
A
(Sec)
Breaker Test
C
(Sec)
Visual
Inspect
Operation
Test
0 COMMENTS:
3
DEFICIENCIES:
TEST EQUIPMENT USED

TESTED BY: Default Administrator

www.powerdb.com
31200, REVISED 6/22/2010
Comments
INSULATION TESTS
OWNER
ADDRESS
CUSTOMER
300
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
DOBLE
PLANT
POWER FACTOR TESTS
SUBSTATION
POSITION
EQUIPMENT TESTED
DATE LAST TEST
COPIES TO
WEATHER
LAST TEST SHEET NO.
OIL TEMP.
EQPT. TEMP.
EQUIVALENT 2.5 kV READINGS

% POWER FACTOR
MILLIVOLTAMPERES
LINE
NO.
SERIAL NO.
TEST
klV
METER
READING
MULTIPLIER
MILLIWATTS
mVA
METER
READING
MULTIPLIER
mW
MEASURED
INSULATION
RATING
COR. 20C
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
KEY TO INSULATION RATING
BUSHINGS - INSULATORS - ETC.
WOOD MEMBERS - OIL - ETC.
WINDINGS
G = GOOD
XG = GOOD
WG = GOOD
D = DETERIORATED
XD = DETERIORATED
WD = DETERIORATED
I = INVESTIGATE
XI = INVESTIGATE
WI = INVESTIGATE
B = BAD (REMOVE OR RECONDITION)
XB = BAD (REMOVE OR RECONDITION)
WB = BAD (REMOVE OR RECONDITION)

TESTED BY:
www.powerdb.com
91000, REVISED 11/30/2007
INSULATION TESTS
PAGE
301
COMMENTS:
DEFICIENCIES:
www.powerdb.com
91000, REVISED 11/30/2007
INSULATION TEST
AUTO TRANSFORMERS
OWNER
302
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
MFR.
FORM
HIGH SIDE kV
WYE
DELTA
LOW SIDE kV
WYE
DELTA
TERT. SIDE kV
WYE
DELTA
BUSHINGS
TRANSFORMER
AGE
TYPE
COPIES TO
POSITION
SERIAL NO.
CLASS
MFR.
TYPE
Example Plant
DOBLE
PLANT
POWER FACTOR TESTS
SUBSTATION
FORM
WEATHER
DATE LAST TEST
DRY TYPE
CLASS
DWG. NO.
TOP OIL TEMP.

LAST SHEET NO.
EQUIPMENT TEMP.
CAT. NO.
kV
AMP
YEAR
OVER-ALL TESTS

TEST CONNECTIONS
% POWER FACTOR
MILLIVOLTAMPERES
WINDING
ENERGIZED
WINDING
GROUNDED
HIGH
LOW
TERT.
HIGH
LOW
TERT.
TERT.
TEST
WINDING
GUARDED
TEST
kV
METER
READING
MULTIPLIER
MILLIWATTS
mVA
METER
READING
MULTIPLIER
G = GOOD
D = DETERIORATED
I = INVESTIGATE
mW
MEASURED
COR. 20C
TERT.
HIGH AND
TERT.
HT
INSULATION
RATING
HIGH
LOW
(TEST 1 MINUS TEST 2)
CALCULATED RESULTS
X
mVA AND mW SHOULD

COMPARE WITH THOSE FOR C
HT
BUSHING TESTS
LINE
NO.
BUSH
NO.
P
H
A
S
E
COLLAR TESTS
(mW/mVA)
% POWER FACTOR
MILLIVOLTAMPERES
BUSHING
SERIAL NO.
TEST
kV
METER
READING
MULTIPLIER
MILLIWATTS
mVA
METER
READING
MULTIPLIER
mW
MEASURED
COR. 20C
INSULATION
RATING
TOP
HIGH
1
2
3
LOW
4
5
6
7
TERTIARY
8
9
10
11
12
13
14
OIL TEMP.
OIL SAMPLE
N = NEUTRAL

TESTED BY:
www.powerdb.com
95000, REVISED 5/8/2008
INSULATION TEST
AUTO TRANSFORMERS
PAGE
303
COMMENTS:
DEFICIENCIES:
www.powerdb.com
95000, REVISED 5/8/2008
INSULATION TESTS
TWO-WINDING TRANSFORMERS
OWNER
304
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMER
AGE
TYPE/CLASS
OIL
ASKAREL
AIR
MFR
kVA
GAS
WYE
DELTA
LOW SIDE kV
WYE
DELTA
BUSHINGS
HIGH SIDE kV
POSITION
SERIAL NO.
GALLONS OF OIL
FREE BREATHING
COPIES TO
NEUTRAL
Example Plant
DOBLE
PLANT
POWER FACTOR TESTS
SUBSTATION
MFR.
WEATHER
DATE LAST TEST
SEALED
GAS BLANKETED
TYPE
CLASS
DWG. NO.
TOP OIL TEMP.

LAST SHEET NO.
CONSERVATOR
CAT. NO.
kV
YEAR
OVER-ALL TESTS
TEST CONNECTIONS
MILLIWATTS
MILLIVOLTAMPERES
WINDING
ENERGIZED
WINDING
GROUNDED
HIGH
LOW
HIGH
LOW
LOW
TEST
WINDING
GUARDED
TEST
kV
METER
READING
MULTIPLIER
mVA
METER
READING
MULTIPLIER
% POWER FACTOR
mW
MEASURED
COR. 20C
G = GOOD
D = DETERIORATED
I = INVESTIGATE
INSULATION
RATING
LOW
HIGH
HIGH
CALCULATED RESULTS
BUSHING TESTS
LINE
NO.
BUSH
NO.
P
H
A
S
E
COLLAR TESTS
(mW/mVA)
% POWER FACTOR
MILLIVOLTAMPERES
BUSHING
SERIAL NO.
TEST
kV
METER
READING
MULTIPLIER
MILLIWATTS
mVA
METER
READING
MULTIPLIER
mW
MEASURED
COR. 20C
INSULATION
RATING
TOP
HIGH SIDE
1
2
3
4
LOW SIDE
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
OIL TEMP.
OIL SAMPLE

TESTED BY:
www.powerdb.com
93000, REVISED 12/3/2007
INSULATION TESTS
PAGE
305
COMMENTS:
DEFICIENCIES:
www.powerdb.com
93000, REVISED 12/3/2007
INSULATION TESTS
CABLES AND POTHEADS
OWNER
306
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
CIRCUIT
COPIES TO
Example Plant
DOBLE
PLANT
POWER FACTOR TESTS
SUBSTATION
POSITION
WEATHER
EARTH TEMP.
DUCT TEMP.
DATE LAST TEST
CABLE
DEPTH
LAST TEST SHEET NO.
POTHEAD
MFR. AND TYPE
MFR. AND TYPE
LOCATION
LOCATION
IDENTIFICATION
IDENTIFICATION
RATED kV
RATED kV
OPER kV
OPER kV
AMPS. (LOAD)
AMPS. (RATED)
LENGTH - OUTDOOR
OUTDOOR - INDOOR
LENGTH - INDOOR
AGE
AGE
TYPE: DRY, CPD-FILLED,

OIL-FILLED
TYPE: DRY, OIL-FILLED, OIL

RESERVOIR, GAS RESERVOIR
NO. COND.
NO. COND.
SIZE
SIZE
PORCELAIN SINGLE
MULTIPIECE
AWG, MCW
AWG, MCM
INSULATION MATERIAL
TERM. TYPE CAP NUT,

SOLDER SEALED
AERIAL CONN.
RIGID, FLEXIBLE
INSULATION TYPE
BELTED, SHIELDED
JOINTS INSULATED,
WIPED, COMPRESSED
JACKET
LEAD, ARMOR, BRAID
DUCT TRAY
METALLIC, NONMETALIC
LINE
NO.
IDENTIFICATION
P
H
A
S
E
MILLIVOLTAMPERES
TEST
kV
METER
READING
MULTIPLIER
MILLIWATTS
mVA
METER
READING
MULTIPLIER
%
POWER
FACTOR
D. C.
MEGOHMS
mW
INSULATION
RATING
CABLE
POTHEAD HOT-COLLAR TESTS

mW / mVA
LOCATION
TOP
INSULATION
RATING
POTHEAD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
KEY TO INSULATIN RATING
G = GOOD
D = DETERIORATED
I = INVESTIGATE

TESTED BY:
www.powerdb.com
96000, REVISED 11/30/2007
INSULATION TESTS
CABLES AND POTHEADS
PAGE
307
COMMENTS:
DEFICIENCIES:
www.powerdb.com
96000, REVISED 11/30/2007
EXCITATION - CURRENT TEST
OWNER
ADDRESS
CUSTOMER
308
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
THREE - PHASE WYE (1)
SINGLE PHASE
ENERGIZE
H
H
UST
H
( or H
2
( or H
2
ENERGIZE
0
H 1
H 1
H 2
GROUND
PHASE
2
3
B
0
C
0
UST
H 1
H 2
H 3
PHASE
X
0
A
0
X
0
B
0
X
0
C
0
B
1
H
1
C
2
SERIAL NO.
1(A)
2(B)
3(C)
4(D)
5(E)
TEST VOLTAGE :
kV
(2)
MILLIVOLTAMPERES
(3)
ULTC
POSITION
A
0
TAP CHANGER FOUND / LEFT ON POSITION :
LINE
NO.
ENERGIZE
3
H
MANUFACTURER
NLTC POSITION (CHECK) :
THREE - PHASE WYE
PHASE
H 3
THREE - PHASE DELTA

UST
UST
H 2
(1)
ENERGIZE
Example Plant
DOBLE
PLANT
POWER FACTOR TESTS
SUBSTATION
PHASE A
METER
READING
MULTIPLIER
PHASE B
mVA
METER
READING
MULTIPLIER
PHASE C
mVA
METER
READING
MULTIPLIER
mVA
REMARKS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
NOTES:
1. IF THE LOW-VOLTAGE WINDING IS WYE CONNECTED, THEN Xo IS CONNECTED AS IN SERVICE (USUALLY, THIS WOULD MEAN GROUNDING Xo).
2. ALL TESTS SHOULD BE PERORMED ROUTINELY AT THE SAME VOLTAGE.
3. INDICATE TAP POSITION: RAISED, LOWERED OR NEUTRAL.

TESTED BY:
www.powerdb.com
90000, REVISED 2/15/2006
EXCITATION - CURRENT TEST
PAGE
309
COMMENTS:
DEFICIENCIES:
www.powerdb.com
90000, REVISED 2/15/2006
INSULATION TESTS
CIRCUIT BREAKERS
OWNER
310
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
CIRCUIT BREAKER
BREAKER MFR.
BREAKER SERIAL NO.
DATE LAST INSP.
COPIES TO
Example Plant
DOBLE
PLANT
POWER FACTOR TESTS
SUBSTATION
POSITION
WEATHER
OIL TEMP.
AGE
A
EQUIP. TEMP.
TYPE
kV
DATE LAST TEST
BUSHING MFR.
LAST TEST SHEET NO.

BUSHING
(TYPE - FORM - DWG. NO.)

MILLIWATTS
MILLIVOLTAMPERES
BUSH
NO.
BUSHING
SERIAL NO.
SIDE
PHASE
FEET
OF BUS
INS. IN
PAR'LL
METER
READING
MULTIPLIER
METER
READING
% POWER FACTOR
COLLAR TESTS
mW / mVA
MULTIPLIER
mVA
mW
MEASURED
COR. 20C
INSULATION
RATING
CIRCUIT BREAKER OPEN
1
2
3
4
5
C.B. CLOSED
6
TANK
1
TANK
2
TANK
3
LINE
NO.
OTHER TESTS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
BUSHINGS - INSULATORS - ETC.
G = GOOD
D = DETERIORATED
I = INVESTIGATE
WOOD MEMBERS - OIL - ETC.

XG = GOOD
XD = DETERIORATED
XI = INVESTIGATE
WINDINGS
WG = GOOD
WD = DETERIORATED
WI = INVESTIGATE
XB = BAD (REMOVE OR RECONDITION)
WB = BAD (REMOVE OR RECONDITION)

TESTED BY:
www.powerdb.com
92000, REVISED 11/30/2007
INSULATION TESTS
CIRCUIT BREAKERS
PAGE
311
COMMENTS:
DEFICIENCIES:
www.powerdb.com
92000, REVISED 11/30/2007
INSULATION TEST
THREE-WINDING TRANSFORMER
OWNER
312
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMER
AGE
TYPE/CLASS
OIL
ASKAREL
AIR
MFR.
kVA
GAS
WYE
DELTA
LOW SIDE kV
WYE
DELTA
BUSHINGS
HIGH SIDE kV
POSITION
SERIAL NO.
GALLONS OF OIL
FREE BREATHING
COPIES TO
NEUTRAL
Example Plant
DOBLE
PLANT
POWER FACTOR TESTS
SUBSTATION
MFR.
WEATHER
DATE LAST TEST
SEALED
GAS BLANKETED
TYPE
CLASS
DWG. NO.
TOP OIL TEMP.

LAST SHEET NO.
CONSERVATOR
CAT. NO.
kV
YEAR
OVER-ALL TESTS

TEST CONNECTIONS
% POWER FACTOR
MILLIVOLTAMPERES
TEST
WINDING
ENERGIZED
WINDING
GROUNDED
HIGH
LOW
HIGH
LOW
LOW
TERT.
TERT.
ALL
WINDING
GUARDED
TEST
kV
METER
READING
MULTIPLIER
MILLIWATTS
mVA
METER
READING
MULTIPLIER
G = GOOD
D = DETERIORATED
I = INVESTIGATE
mW
MEASURED
COR. 20C
INSULATION
RATING
TERT.
LOW AND
TERT.
TERT.
HIGH
HIGH AND
TERT.
HIGH
LOW
HIGH AND
LOW
CHECK TEST
CALCULATED RESULTS
SHOULD EQUAL
CH = CL = CT
HL
LT
HT
BUSHING TESTS
LINE
NO.
BUSH
NO.
P
H
A
S
E
COLLAR TESTS
(mW/mVA)
% POWER FACTOR
MILLIVOLTAMPERES
BUSHING
SERIAL NO.
TEST
kV
METER
READING
MULTIPLIER
MILLIWATTS
mVA
METER
READING
MULTIPLIER
mW
MEASURED
COR. 20C
INSULATION
RATING
TOP
HIGH SIDE
1
2
3
4
LOW SIDE
5
6
7
8
TERTIARY
9
10
11
12
13
14
OIL TEMP.
OIL SAMPLE
N = NEUTRAL

TESTED BY:
www.powerdb.com
94000, REVISED 5/8/2008
INSULATION TEST
THREE-WINDING TRANSFORMER
PAGE
313
COMMENTS:
DEFICIENCIES:
www.powerdb.com
94000, REVISED 5/8/2008
CO-2 OVERCURRENT
OWNER
314
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
LONG TIME RANGE
CO-2
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
CONNECTION TIGHTENED
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
BEARING CONDITION OK
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
CT SHORTING BAR REMOVED
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)
TIME OVERCURRENT PICKUP

INSTANTANEOUS PICKUP
3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
20.24
12.11
8.12
As Found (seconds)
As Left (seconds)
22.43
13.44
9.03
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 8/25/2011
IAC-53A OVERCURRENT
OWNER
315
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-53A
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
TAP
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
NO FOREIGN MATERIAL
RELAY CLEANED
SEAL IN
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)
3.50
4.90

AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.54
1.00
0.47
As Found (seconds)
As Left (seconds)
2.86
1.16
0.57
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
IAC-54A OVERCURRENT
OWNER
316
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-54A
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
TAP
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
NO FOREIGN MATERIAL
RELAY CLEANED
SEAL IN
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)
3.50
4.90

AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.50
1.02
0.46
As Found (seconds)
As Left (seconds)
2.81
1.17
0.56
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
CO-6 OVERCURRENT
OWNER
317
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
LONG TIME RANGE
CO-6
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
0.91
0.61
0.49
As Found (seconds)
As Left (seconds)
1.06
0.72
0.59
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
IAC-60 OVERCURRENT
OWNER
318
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-60
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
1.42
0.96
0.68
As Found (seconds)
As Left (seconds)
1.62
1.11
0.80
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
CO-8 OVERCURRENT
OWNER
319
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
LONG TIME RANGE
CO-8
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
3.79
1.54
0.71
As Found (seconds)
As Left (seconds)
4.24
1.75
0.84
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
Automate Output Contact Setting
SEL 351
DIRECTIONAL OVERCURRENT RELAY
OWNER
320
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
Identifier Labels
Instantaneous Overcurrent Elements
Current And Potential Transformer Ratios
Unit
PkUp(50x1P) PkUp(50x2P) PkUp(50x3P) PkUp(50x4P) PkUp(50x5P) PkUp(50x6P) Enable(E50x)
Ph-Ph(PP)
5
5
5
5
Phase(P)
5
5
5
5
5
5
N
Neutral(N)
5
5
5
5
5
5
N
Res. Gnd.(G)
5
5
5
5
5
5
N
Neg. Seq.(Q)
5
5
5
5
5
5
N
RID =
TID =
CTR = 240
CTRN =
VNOM = 69
PTR = 100
PTRS =
Line Settings
Z1ANG =
Z1MAG =
Z0MAG =
Z0SMAG =
LL =
Definite Time Overcurrent Elements

Unit
Phase(P)
Neutral(N)
Res. Gnd.(G)
Neg. Seq.(Q)
Z0ANG =
Z0SANG =
Time Delay (67x1D)
Time Delay (67x2D)
Other Enable
E32
E79
E81
EPWR
ESV
EDEM
ELOP
ZLF =
PLAF =
PLAR =
DIR1
DIR3
ORDER
Z2F
50QFP
a2
50GFP
a0
Z0R
50NRP
=
=
=
=
=
=
=
=
=
=
ESOTF
E25
EFLOC
ECOMM
NLAF =
NLAR =
Directional Elements
DIR2 =
DIR4 =
50P32P =
Z2R =
50QRP =
k2 =
50GRP =
Z0F =
50NFP =
a0N =
Reclosing Relay
79OI1 =
79OI2 =
79OI3 =
79OI4 =
79RSD =
79RSLD =
79CLSD =
Additional DCUB Trip Scheme Settings
UBDURD =
Other Settings
TDURD =
3POD =
59RES =
32WRP =
CFD =
50LP =
Wattmetric Element Settings
32WFP =
32WD =
Synchronism Check Elements
25VLO =
25SF =
25ANG2 =
TCLOSD =
Time Delay (67x4D)
Time Overcurrent Elements

EVOLT
ELOAD
ESSI
Load-Encroachment Elements
ZLR =
GARD1D =
UBEND =
Time Delay (67x3D)
25VHI =
25ANG1 =
SYNCP =
Power System Config & Date Format

NFREQ = 60 Hz
PHROT =
DATE_F =
Unit
Pickup (51xP)
Curve (51xC)
A Phase(A)
B Phase(B)
C Phase(C)
Ph-Ph(P)
Neutral(N)
Res. Gnd.(G)
Neg. Seq.(Q)
5
5
5
5
5
5
5
U1
U1
U1
U1
U1
U1
U1
Enable(E51x)
1
1
1
1
1
1
1
Power Elements
PhPkUp (PWRxP)
3PhPkUp (3PWRxP)
Type (PWRxT)
Time Delay (PWRxD)
1
2
3
4
Voltage Elements
UNIT
PkUp (xxxxP)
Phase Over V (59P1)
VS Over V (59S)
ZeroSeq Over V (59N)
NegSeq Over V (59Q)
PosSeq Over V (59V1)
Ph-Ph Over V (59P)
Ph-Ph Under V (27P)
VS Under V (27S)
Phase Under V (27P1)
5
Ph UV Block (27B81)
#
1
2
3
4
5
6
PkUp (xxx2P)
DCLOP =
Demand Metering Settings

PDEMP =
GDEMP =
Reclosing Relay Equations
Station DC Battery Monitor

DCHIP =
TESTED BY:
www.powerdb.com
Switch-Onto-Fault
52AEND =
CLOEND =
SOTFD =
DMTC =
NDEMP =
QDEMP =
Frequency Elements
Pickup (81DxP)
Time Delay (81DxD)
OFF
OFF
OFF
OFF
OFF
OFF

Time Dial (51xTD) EM Reset (51xRS)
79RI
79RIS
79DTL
79DLS
79SKP
79STL
79BRS
79SEQ
79CLS
=
=
=
=
=
=
=
=
=
Trip Logic Equations
TR =
TRCOMM =
TRSOTF =
DTT =
ULTR =
43351, REVISED 12/15/2010
SEL 351
PAGE
Voltage Sag / Swell / Interrupt
VINT =
VSWELL =
VSAG =
DCB Trip Scheme Settings
Z3XPU =
BTXD =
67N2SD =
67Q2SD =
Z3XD =
67P2SD =
67G2SD =
POTT Trip Scheme Settings
Z3RBD =
ETDPU =
EWFC
EBLKD =
EDURD =
Torque Control Equations for Time Overcurrent

51ATC
51BTC
51CTC
51PTC
51NTC
51GTC
51QTC
=
=
=
=
=
=
=
#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
SELogic Control Equation Variable Timers

Pickup (SVxPU)
Dropout (SVxDO)
PT1
LOG1
PT2
LOG2
BT
Setting Group Selection Equations

SS1
SS2
SS3
SS4
SS5
SS6
=
=
=
=
=
=
OUT101
OUT102
OUT103
OUT104
OUT105
OUT106
OUT107
OUT201
OUT202
OUT203
OUT204
OUT205
OUT206
OUT207
OUT208
OUT209
OUT210
OUT211
OUT212
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
Latch Bits Set / Reset Equations

#
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
52A =
CL =
ULCL =
Communications-Assisted Trip Scheme Input Equations
Torque Control Equations for Inst./Def. Time Overcur

67P1TC
67P2TC
67P3TC
67P4TC
67N1TC
67N2TC
67N3TC
67N4TC
67G1TC
67G2TC
67G3TC
67G4TC
67Q1TC
67Q2TC
67Q3TC
67Q4TC
321
Close Logic Equations
Set Latch Bit (SETx)
Reset Latch Bit (RSTx)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Mirrored Bits Transmit Equations
Output Contact Equations
#
1
2
3
4
5
6
7
8
Channel A (TMBxA)
Channel B (TMBxB)
Display Points
#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Equation (DPx)
On Label (DPx_1)
Off Label (DPx_0)
Load Profile Settings

LDLIST =
LDAR =
www.powerdb.com
43351, REVISED 12/15/2010
SEL 351
PAGE
SELogic Control Equation Variable Timer Input
SV1
SV2
SV3
SV4
SV5
SV6
SV7
SV8
SV9
SV10
SV11
SV12
SV13
SV14
SV15
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
FP_TO =
FPNGD =
Settings Group Change Delay

LER =
TGR =
IN101D
IN103D
IN105D
IN201D
IN203D
IN205D
IN207D
Optoisolated Input Timers

IN102D =
IN104D =
IN106D =
IN202D =
IN204D =
IN206D =
IN208D =
=
=
=
=
=
=
=
Other Equations
Front-Panel Display Operation

SCROLD =
ER
FAULT
BSYNCH
CLMON
BKMON
E32IV
=
=
=
=
=
=
79SL =
Protocol Settings
PROTO =
ADDR =
PREFIX =
SETTLE =
Communication Settings
SPEED =
PARITY =
BITS =
STOP =
Other Port Settings

T_OUT =
RTSCTS =
AUTO =
FASTOP =
=
=
=
=
Breaker Monitor Settings

COSP2 =
KASP1 =
KASP3 =
Sequential Events Recorder Triggers

SER1 =
SER2 =
SER3 =
Voltage Input Configuration
PTCONN =
Reclosing Relay Labels

79LL =
COSP1
COSP3
KASP2
EBMON
322
Event Parameters
PRE =
VSCONN =
Local Bit Labels

#
Local Bit (NLBx)
Clear Local Bit (CLBx)
Set Local Bit (SLBx)
Pulse Local Bit (PLBx)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
www.powerdb.com
43351, REVISED 12/15/2010
SEL 351
PAGE
METER TEST
Measured
A-N
Expected
% Error
Measured
B-N
Expected
% Error
C-N
Expected
Measured
323
% Error
Voltage Amplitude (primary volts)

Voltage Phase (degrees lagging)
Current Amplitude (primary amps)
Current Phase (degrees lagging)
Pickup (amps)
Unit
51A
51B
51C
Maximum Torque Angle (degrees)
Expected Minimum Maximum Pickup

Current
Current
Current Current
5.00
5.00
5.00
4.75
4.75
4.75
Minimum Maximum
Angle
Angle
CW
Angle
CCW
Angle
Timing
Actual
Angle
5.25
5.25
5.25
Multiple
Test
Current
Minimum
Seconds
Maximum
Seconds
1.5
7.50
1.210
1.390
3.0
15.00
0.441
0.540
6.0
30.00
0.267
0.348
1.5
7.50
1.210
1.390
3.0
15.00
0.441
0.540
6.0
30.00
0.267
0.348
1.5
7.50
1.210
1.390
3.0
15.00
0.441
0.540
6.0
30.00
0.267
0.348
Actual
Seconds
51A, 51B, 51C, 51P
Unit
Phase To Phase Pickup (amps)

Expected
Minimum
Maximum
A-B
50PP1
5.00
4.75
5.25
50PP2
5.00
4.75
5.25
50PP3
5.00
4.75
5.25
50PP4
5.00
4.75
5.25
Unit
Under Voltage 27P1
COMMENTS:
DEFICIENCIES:
B-C
C-A
B-N
C-C
Phase To Ground Voltage Pickup (volts)

Expected
Minimum
5.00
Maximum
4.75
A-N
5.25
CV-2 UNDER VOLTAGE
OWNER
324
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
INSTRUCTION BOOKLET
CV-2
SEAL-IN RANGE
RELAY SETTINGS
Nominal Voltage (volts)
Pickup Voltage (volts)
Time Dial
Seal In (DC amps)
PT RATIO
DEVICES OPERATED
VISUAL INSPECTION
ROUTINE MAINTENANCE
120
COVER GASKET OK
GLASS CLEANED
110
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
0.2
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
Pickup
Unit
Expected
Voltage
Minimum
Voltage
Maximum
Voltage
Under Voltage
110.00
104.50
115.50
Timing
As Found
Voltage
As Left
Voltage
0.9
0.6
Test
Voltage
99.00
66.00
Minimum
Seconds
-0.025
3.343
Maximum
Seconds
0.025
3.748
0.5
55.00
2.939
3.301
Multiple
As Found
Seconds
As Left
Seconds
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
CO-11 OVERCURRENT
OWNER
325
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
LONG TIME RANGE
CO-11
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
3.47
1.27
0.45
As Found (seconds)
As Left (seconds)
3.89
1.46
0.55
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
CV-1 UNDER VOLTAGE
OWNER
326
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
INSTRUCTION BOOKLET
CV-1
SEAL-IN RANGE
RELAY SETTINGS
Time Dial
Seal In (DC amps)
PT RATIO
DEVICES OPERATED
VISUAL INSPECTION
ROUTINE MAINTENANCE
120
COVER GASKET OK
GLASS CLEANED
110
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
0.2
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
Pickup
Unit
Expected
Voltage
Minimum
Voltage
Maximum
Voltage
Under Voltage
110.00
104.50
115.50
Timing
As Found
Voltage
As Left
Voltage
0.9
0.6
Test
Voltage
99.00
66.00
Minimum
Seconds
67.773
26.463
Maximum
Seconds
74.960
29.301
0.5
55.00
22.430
24.844
Multiple
As Found
Seconds
As Left
Seconds
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
CV-5 OVER VOLTAGE
OWNER
327
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
INSTRUCTION BOOKLET
CV-5
SEAL-IN RANGE
RELAY SETTINGS
Time Dial
Seal In (DC amps)
PT RATIO
DEVICES OPERATED
VISUAL INSPECTION
ROUTINE MAINTENANCE
120
COVER GASKET OK
GLASS CLEANED
130
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
0.2
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
Pickup
Unit
Expected
Voltage
Minimum
Voltage
Maximum
Voltage
Over Voltage
130.00
123.50
136.50
Timing
As Found
Voltage
As Left
Voltage
1.1
1.5
Test
Voltage
143.00
195.00
Minimum
Seconds
-0.025
1.534
Maximum
Seconds
0.025
1.748
1.7
221.00
1.056
1.220
Multiple
As Found
Seconds
As Left
Seconds
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
IAC-80 OVERCURRENT
OWNER
328
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-80
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.50
1.02
0.46
As Found (seconds)
As Left (seconds)
2.81
1.17
0.56
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
CV-7 UNDER/OVER VOLTAGE
OWNER
329
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
INSTRUCTION BOOKLET
CV-7
SEAL-IN RANGE
RELAY SETTINGS
Time Dial
Seal In (DC amps)
Time Dial
Seal In (DC amps)
PT RATIO
DEVICES OPERATED
VISUAL INSPECTION
COVER GASKET OK
GLASS CLEANED
110
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
0.2
NO MOISTURE PRESENT
130
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
2
0.2
Pickup
Unit
Expected
Voltage
Minimum
Voltage
Maximum
Voltage
Under Voltage
110.00
104.50
115.50
Over Voltage
130.00
ROUTINE MAINTENANCE
120
123.50
Timing
As Found
Voltage
As Left
Voltage
Multiple
0.9
0.6
136.50
Test
Voltage
99.00
66.00
Minimum
Seconds
7.643
2.443
Maximum
Seconds
8.500
2.753
0.5
55.00
2.127
2.404
1.1
1.5
143.00
195.00
-0.025
-0.025
0.025
0.025
1.7
221.00
-0.025
0.025
As Found
Seconds
As Left
Seconds
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
CEY51A RELAY
OWNER
330
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
RELAY SETTINGS
MANUFACTURER
General Electric
TYPE
CT RATIO
CEY
MODEL
PT RATIO
SEC. OHMIC REACH
MAX TORQUE ANG.
60
ohms
BMR
degrees
SEAL IN
VOLTAGE CLASS
3
ohms
MTA ALLOWED ERROR
Impedance In Ohms
Calc.
Min.
Max
6.00
5.82
6.30
A-B
Volts
10.00
Amps
Ohms
50
amps ALLOWED ERROR
REACH TESTS
Angle
(degrees)
60
PERCENT TAP
Pass / Fail
Volts
10.00
Amps
B-C
Ohms
Pass / Fail
Volts
10.00
3.00
2.00
Amps
C-A
Ohms
%
degrees
Pass / Fail
MAX TORQUE ANGLE TEST

Min.
Max.
Angle
Angle
(degrees) (degrees)
58.00
62.00
Test
Ohms
Test
Amps
4.80
1.04
A-B
CW Ang. CCW Ang.
MTA
(degrees) (degrees) (degrees)
Pass /
Fail
B-C
CW Ang. CCW Ang.
MTA
Pass /
Fail
C-A
CW Angle CCW Ang.
MTA
Pass /
Fail
CHARACTERISTIC TESTS
Angle
(degrees)
30
60
90
Impedance In Ohms
Calc.
Min.
Max
5.20
0.00
0.00
6.00
0.00
0.00
5.20
0.00
0.00
A-B
Volts
10.00
10.00
10.00
Amps
Ohms
Pass / Fail
Volts
10.00
10.00
10.00
Amps
B-C
Ohms
Pass / Fail
Volts
10.00
10.00
10.00
Amps
C-A
Ohms
Pass / Fail
Phase A-B: Red Squares

Phase B-C: Green Circles
Phase C-A: Blue Triangles

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
CEY51A RELAY
PAGE
331
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 12/15/2010
IAC-51A OVERCURRENT
OWNER
332
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-51A
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
TAP
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
NO FOREIGN MATERIAL
RELAY CLEANED
SEAL IN
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)
3.50
4.90

AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
1.36
0.94
0.66
As Found (seconds)
As Left (seconds)
1.56
1.09
0.78
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
IAC-52 OVERCURRENT
OWNER
333
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-52
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
1.42
0.96
0.68
As Found (seconds)
As Left (seconds)
1.62
1.11
0.80
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
IAC-66B OVERCURRENT
OWNER
334
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-66B
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
15.78
9.82
6.38
As Found (seconds)
As Left (seconds)
17.50
10.91
7.10
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
IAC-53B OVERCURRENT
OWNER
335
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-53B
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.54
1.00
0.47
As Found (seconds)
As Left (seconds)
2.86
1.16
0.57
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
CO-5 OVERCURRENT
OWNER
336
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
LONG TIME RANGE
CO-5
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
11.17
6.84
5.20
As Found (seconds)
As Left (seconds)
12.40
7.61
5.79
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
IAC-54B OVERCURRENT
OWNER
337
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-54B
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.50
1.02
0.46
As Found (seconds)
As Left (seconds)
2.81
1.17
0.56
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
CO-7 OVERCURRENT
OWNER
338
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
LONG TIME RANGE
CO-7
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
1.33
0.85
0.59
As Found (seconds)
As Left (seconds)
1.52
0.99
0.71
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
CO-9 OVERCURRENT
OWNER
339
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
LONG TIME RANGE
CO-9
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.64
1.01
0.43
As Found (seconds)
As Left (seconds)
2.97
1.17
0.53
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
IJS-51A SYNCHRONIZATION
OWNER
340
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
PLANT
RELAYS
SUBSTATION
POSITION
Example Plant
AUTOMATED
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IJS-51A
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
ANGLE
TIME DIAL
SEAL IN
CT RATIO
VISUAL INSPECTION
20
2
0.2
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CONDITION OK
GLASS CLEANED
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
TRIP CIRCUIT TESTED
NO RUST PRESENT
ANGLE TESTS
Min. Angle
(degrees)
UNIT
Expected. Angle
(degrees)
Max. Angle
(degrees)
Leading Angle
16
20
24
Lagging Angle
336
340
344
Actual Angle
(degrees)
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
CV-4 OVER VOLTAGE
OWNER
341
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
INSTRUCTION BOOKLET
CV-4
SEAL-IN RANGE
RELAY SETTINGS
Time Dial
Seal In (DC amps)
PT RATIO
DEVICES OPERATED
VISUAL INSPECTION
ROUTINE MAINTENANCE
120
COVER GASKET OK
GLASS CLEANED
130
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
0.2
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
Pickup
Unit
Expected
Voltage
Minimum
Voltage
Maximum
Voltage
Over Voltage
130.00
123.50
136.50
Timing
As Found
Voltage
As Left
Voltage
1.1
1.5
Test
Voltage
143.00
195.00
Minimum
Seconds
-0.025
8.469
Maximum
Seconds
0.025
9.413
1.7
221.00
5.797
6.460
Multiple
As Found
Seconds
As Left
Seconds
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
OVERCURRENT RELAY
OWNER
342
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
LONG TIME RANGE
INSTRUCTION BOOKLET
MODEL / STYLE NO.
SEAL-IN RANGE
/
TCC. NO.
DEVICES OPERATED
INSTANTANEOUS RANGE
/
(PHASE RELAYS / NEUTRAL RELAY)
CT RATIO
:5
VISUAL INSPECTION
ROUTINE MAINTENANCE
A
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
TAP / TIME DIAL
RELAY SETTINGS
SEAL - IN
SPECIFIED
INSTANTANEOUS
SPECIFIED
AS FOUND
AS LEFT
AS FOUND
AS LEFT
SPECIFIED
PHASE RELAYS
A/
A/
A/
ADC
ADC
ADC
AS FOUND
A
AS LEFT
A
NEUTRAL RELAYS
A/
A/
A/
ADC
ADC
ADC
PICKUP TESTS
TIMING UNIT
PHASE
AS FOUND
SEAL - IN UNIT
AS LEFT
AS FOUND
INSTANTANEOUS UNIT
AS LEFT
AS FOUND
AS LEFT
ADC
ADC
ADC
ADC
ADC
ADC
ADC
ADC
TIMING TESTS
PHASE
SPECIFIED
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SEC.
SPECIFIED
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SPECIFIED
SEC.
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SEC.
A
B
C
N

TESTED BY:
www.powerdb.com
45000, REVISED 11/21/2011
OVERCURRENT RELAY
PAGE
343
COMMENTS:
DEFICIENCIES:
www.powerdb.com
45000, REVISED 11/21/2011
IAC-77 OVERCURRENT
OWNER
344
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-77
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.55
1.02
0.39
As Found (seconds)
As Left (seconds)
2.87
1.18
0.48
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
CV-8 OVER VOLTAGE
OWNER
345
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
INSTRUCTION BOOKLET
CV-8
SEAL-IN RANGE
RELAY SETTINGS
Time Dial
Seal In (DC amps)
PT RATIO
DEVICES OPERATED
VISUAL INSPECTION
0
110
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
0.2
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
Pickup
Unit
Expected
Voltage
Minimum
Voltage
Maximum
Voltage
Over Voltage
110.00
104.50
115.50
Timing
As Found
Voltage
As Left
Voltage
1.1
1.5
Test
Voltage
121.00
165.00
1.7
187.00
Multiple
Minimum
Seconds
Maximum
Seconds
As Found
Seconds
As Left
Seconds
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
IAC-90 OVERCURRENT
OWNER
346
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-90
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
2.67
1.07
0.39
As Found (seconds)
As Left (seconds)
3.00
1.23
0.48
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
CV-6 UNDER/OVER VOLTAGE
OWNER
347
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
ABB / Westinghouse
MODEL
INSTRUCTION BOOKLET
CV-6
SEAL-IN RANGE
RELAY SETTINGS
Time Dial
Seal In (DC amps)
Time Dial
Seal In (DC amps)
PT RATIO
DEVICES OPERATED
VISUAL INSPECTION
COVER GASKET OK
GLASS CLEANED
110
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
0.2
NO MOISTURE PRESENT
130
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
2
0.2
Pickup
Unit
Expected
Voltage
Minimum
Voltage
Maximum
Voltage
Under Voltage
110.00
104.50
115.50
Over Voltage
130.00
ROUTINE MAINTENANCE
120
123.50
Timing
As Found
Voltage
As Left
Voltage
Test
Voltage
99.00
66.00
Minimum
Seconds
47.629
13.767
Maximum
Seconds
52.696
15.269
0.5
55.00
11.615
12.891
1.1
1.5
143.00
195.00
-0.025
-0.025
0.025
0.025
1.7
221.00
-0.025
0.025
Multiple
0.9
0.6
136.50
As Found
Seconds
As Left
Seconds
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/7/2011
GENERIC OVERCURRENT RELAY
OWNER
348
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
RELAYS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
MODEL
LONG TIME RANGE
CURVE
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
Minimum (seconds)
Maximum (seconds)
As Found (seconds)
As Left (seconds)
10.00
15.00
25.00
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 12/15/2010
IAC-51B OVERCURRENT
OWNER
349
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
MODEL
LONG TIME RANGE
IAC-51B
SEAL-IN RANGE
INSTRUCTION BOOKLET
INSTANTANEOUS RANGE
DEVICES OPERATED
RELAY SETTINGS
TAP
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
TIME DIAL
GLASS CONDITION OK
CASE CLEANED
INSTANTANEOUS
10
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
SEAL IN
MONITOR
Normally Open
RESET TIME
BEARING ENDPLAY OK
CONTACTS CLEANED
MAX TIME TO OPERATE
40
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
PICKUP TESTS
UNIT
Minimum
(amps)
Maximum
(amps)

3.50
9.50
4.90
10.50
AS FOUND
(amps)
AS LEFT
(amps)
TIMING TESTS
Multiple
Current (amps)
2.0
3.0
5.0
10.00
15.00
25.00
Minimum (seconds)
Maximum (seconds)
1.36
0.94
0.66
As Found (seconds)
As Left (seconds)
1.56
1.09
0.78
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 11/11/2011
MAGNETIC OVERLOAD RELAY
OWNER
350
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
TYPE
MODEL / STYLE NO.
CATALOG NO.
SYSTEM VOLTAGE
AMPACITY
CURRENT PICKUP RANGE
TIME DELAY ADJUSTMENT
DEVICE NUMBER
DASHPOT SERIES
DASHPOT FLUID SERIES
DASHPOT FLUID COLOR
INSTRUCTION BOOKLET
TCC NO.
DASHPOT FLUID REPLACED
YES
NO
OTHER
TRIP CURRENT PICKUP IN AMPERES
TIME DELAY AT
WITHOUT DASHPOT FLUID
TIMES RATED LOAD
DASHPOT FLUID INSTALLED
POLE
SPECIFIED
SPECIFIED
AS FOUND
AMPS

AS FOUND
AS LEFT
AS LEFT
TESTED BY:
www.powerdb.com
SECS
AMPS
SECS
AMPS
SECS
44000, REVISED 12/26/2008
MAGNETIC OVERLOAD RELAY
PAGE
351
COMMENTS:
DEFICIENCIES:
www.powerdb.com
44000, REVISED 12/26/2008
FREQUENCY RELAY TEST
OWNER
ADDRESS
CUSTOMER
352
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
NOMINAL FREQUENCY
OVERFREQUENCY RANGE
TYPE
MODEL / STYLE NO.
VOLTAGE
CONTROL VOLTAGE
UNDERFREQUENCY RANGE
INSTRUCTION BOOKLET
CURVE
SEAL-IN RANGE
VT RATIO
VISUAL INSPECTION
:120
DEVICE NUMBER
ROUTINE MAINTENANCE
YES
NO
N/A
COVER GASKET OK
YES
GLASS CONDITION OK
GLASS CLEANED
FOREIGN MATERIAL
CASE CLEANED
MOISTURE
RELAY CLEANED
SPIRAL SPRING OK
CONNECTIONS TIGHTENED
BEARING ENDPLAY OK
TAPS TIGHTENED
CONTACTS CLEANED
DISC CLEARANCE OK
TRIP CIRCUIT TESTED
RUST PRESENT
INSULATION RES. MEGOHMS
RELAY SETTINGS
OVERFREQUENCY (Hz)
SPECIFIED
AS FOUND
NO
N/A
UNDERFREQUENCY (Hz)
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
PICKUP
TIME DELAY
TARGET SEAL-IN
PICKUP TESTS
FREQUENCY UNIT (Hz)

AS FOUND
SEAL-IN UNIT (Hz)

AS LEFT
AS FOUND
AS LEFT
OVERFREQUENCY
ADC
ADC
UNDERFREQUENCY
ADC
ADC
TIMING TESTS
SPECIFIED
AS FOUND
AS LEFT
OVERFREQUENCY 60 HERTZ TO
HERTZ
CY
CY
CY
OVERFREQUENCY 60 HERTZ TO
HERTZ
CY
CY
CY
UNDERFREQUENCY 60 HERTZ TO
HERTZ
CY
CY
CY
UNDERFREQUENCY 60 HERTZ TO
HERTZ
CY
CY
CY

TESTED BY:
www.powerdb.com
41500, REVISED 12/26/2008
FREQUENCY RELAY TEST
PAGE
353
COMMENTS:
DEFICIENCIES:
www.powerdb.com
41500, REVISED 12/26/2008
TRANSFORMER DIFFERENTIAL RELAY

TYPE BDD
OWNER
ADDRESS
CUSTOMER
354
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
CURRENT RATING
PICKUP
MODEL NO.
CURRENT TRANSFORMER RATIO MATCHING TAPS

DC CONTROL VOLTAGES
INSTRUCTION BOOKLET
VISUAL INSPECTION
ROUTINE MAINTENANCE
YES
NO
N/A
YES
COVER GASKET OK
GLASS CLEANED
GLASS OK
CASE CLEANED
FOREIGN MATERIAL
RELAY CLEANED
MOISTURE
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
RUST PRESENT
RELAY SETTINGS
PERCENT HARMONIC
NO
N/A
INSTANTANEOUS
PERCENT SLOPE
SPECIFIED
AS FOUND
DC VOLTAGE TAP
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
CT RATIO MATCHING TAPS

WINDING 1
SPECIFIED
AS FOUND
WINDING 2
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
RELAY TESTS
MINIMUM
MAXIMUM
RESULT
WINDING 1 PICKUP TEST
To
WINDING 2 PICKUP TEST
To
HARMONIC RESTRAINT TEST
To
SLOPE TEST (W1-W2)
To
INSTANTANEOUS UNIT TEST
To
AUX UNIT PICKUP TEST
To
% ERROR
PASS/FAIL
NA
VERIFY POLAR UNIT DROPOUT

TESTED BY:
www.powerdb.com
48500, REVISED 12/26/2008

TYPE BDD
PAGE
355
COMMENTS:
DEFICIENCIES:
www.powerdb.com
48500, REVISED 12/26/2008
PERCENTAGE DIFFERENTIAL RELAY

PICKUP TESTS
OWNER
356
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL / STYLE NO.
RATED CURRENT
% SLOPE
MINIMUM PICKUP
LONG TIME RANGE
SEAL-IN RANGE
INSTANTANEOUS RANGE
INSTRUCTION BOOKLET
TCC NO.
DEVICES OPERATED
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
TAP/TIME DIAL
SEAL-IN
SPECIFIED
AS FOUND
AS LEFT
A/
A/
A/
PHASE RELAYS
SPECIFIED
AS FOUND
ADC
AS LEFT
ADC
ADC
PICKUP TESTS
TIMING UNIT
MINIMUM DIFFERENTIAL PICKUP
% DIFFERENTIAL (FORWARD / REV)
SEAL-IN
PHASE
SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
AS FOUND
AS LEFT
A/
A/
A/
ADC
ADC
A/
A/
A/
ADC
ADC
A/
A/
A/
ADC
ADC
TIMING TESTS
LEFT
PHASE
SPECIFIED
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SPECIFIED
SEC.
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SPECIFIED
SEC.
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SEC.
A
B
C
RIGHT
A THROUGH RIGHT & OPERATE
A THROUGH LEFT COIL
A
B
C
A THROUGH LEFT & RIGHT,
A THROUGH OPERATE COIL

TESTED BY:
www.powerdb.com
46000, REVISED 12/26/2008
PERCENTAGE DIFFERENTIAL RELAY

PICKUP TESTS
PAGE
357
COMMENTS:
DEFICIENCIES:
www.powerdb.com
46000, REVISED 12/26/2008
MOTOR PROTECTION CONTROLLER

(IQ-2000)
OWNER
ADDRESS
CUSTOMER
358
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
RELAYS
SUBSTATION
SETPOINT FUNCTION
SETPOINT VALUE RANGE
WINDING TEMP.
TRIP & ALARM: 0 TO 199 DEG. C (1C STEP)
MOTOR BRG. TEMP.
LOAD BRG. TEMP.
GROUND FAULT
TRIP: 4-12 PRIMARY CIRCUIT (1 AMP STEP)

ALARM: 0-12A PRIMARY CIRCUIT (1 AMP STEP)
TIME: 0-5 SEC. (1 SEC. STEP)
INSTANTANEOUS
OVERCURRENT
TRIP: 300-1500% OF FULL LOAD AMPERES

(IN 100% STEP) USE NUMBERS 3-15 ONLY
LOCKED ROTOR
CURRENT
TRIP: 300-1200% (IN 10% STEP) USE NUMBERS 30-120

ONLY. THE DECIMAL POINT HERE SHOWN AS: 3.0, 12.0
TIME: 0-60 SEC. ( IN 1 SEC. STEP)
LOAD ACCELERAT.
JAM
TRIP: 70-1200% OF FULL-LOAD AMPS ( IN 1% STEP)

USE NUMBERS 70-1200
UNDERLOAD START
10 UNDERLOAD RUN
TRIP: 0-90% OF FULL-LOAD AMPS ( IN 1% STEP)

11 ULTIMATE TRIP
AMP: 85-125% OF FULL-LOAD AMPS ( IN 1% STEP)

USE NUMBERS 85-125
12 OVERVOLTAGE
TRIP: 0-9999 VAC ( IN 1 VOLT STEP)

13 UNDERVOLTAGE
TRIP: 0-9999 VAC ( IN 1 VOLT STEP)

14 PRE-START TIMER
15 PRE-RUN TIMER
16 PRE-STOP TIMER
17 INCOMPLETE SEQ.
18 ANTI-BACKSPIN
19 ANTI-RECYCLE, MIN.
TIME: 0-60 MIN. ( IN 1 MIN. STEP)
20 TIME UNDERVOLT.
21 POST-START TIMER
22 POST-STOP TIMER
23 START COUNTS/HRS.
COUNTS: 1-10 COUNTS ( IN 1 COUNT STEP)

TIME: 0-24 HR. ( IN 1 HR. STEP)
OPEN/UNBALANCE
24 PHASE
ALARM: 5-30% OF FULL-LOAD AMPERES ( IN 1% STEP)

25 FULL LOAD CURRENT
AMP: 1-1000 ( IN 1 AMP STEP)
26 C.T. RATIO
RATIO: 2,4,5,8,10,15,20,30,40,50,60,80,
100,120,160,200 (WHERE: 2 = 2:1, ETC.)
27 V.T. RATIO
RATIO: 0,2,4,5,20,30,35,40,55,60,70 (WHERE: 4 = 4:1, ETC.)
28 STARTER CLASS
PREFIX IN ALARM WINDOW: 11, 13, 14

SUFFIX IN TIME WINDOW: 202, 212, 502, 512, ETC.

Example Plant
GENERAL
PLANT
POSITION
TRIP
TESTED BY:
www.powerdb.com
ALARM
TIME
COMMENTS
44200, REVISED 6/14/2001
MOTOR PROTECTION CONTROLLER

(IQ-2000)
PAGE
359
COMMENTS:
DEFICIENCIES:
www.powerdb.com
44200, REVISED 6/14/2001
OVERCURRENT RELAY
WITH
VOLTAGE RESTRAINT
OWNER
ADDRESS
CUSTOMER
360
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL / STYLE NO.
RATED VOLTAGE
MINIMUM PICKUP
VT RATIO
:120
LONG TIME RANGE
SEAL-IN RANGE
CT RATIO
:5
INSTRUCTION BOOKLET
DEVICE NUMBER
TCC NO.
DEVICES OPERATED
VISUAL INSPECTION
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
CT SHORTING BAR REM.
RELAY SETTINGS
TAP/TIME DIAL
SEAL-IN
SPECIFIED
AS FOUND
AS LEFT
A/
A/
A/
PHASE RELAYS
SPECIFIED
AS FOUND
ADC
AS LEFT
ADC
ADC
PICKUP TESTS
ZERO RESTRAINT
RATED RESTRAINT UNITY P.F.
RATED RESTRAINT
SEAL-IN
PHASE
SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
AS FOUND
AS LEFT
ADC
ADC
ADC
ADC
ADC
ADC
TIMING TESTS @ RATED RESTRAINT & UNITY POWER FACTOR

SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
PHASE
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
A
B
C

TESTED BY:
www.powerdb.com
49500, REVISED 12/26/2008
OVERCURRENT RELAY
WITH
VOLTAGE RESTRAINT
PAGE
361
COMMENTS:
DEFICIENCIES:
www.powerdb.com
49500, REVISED 12/26/2008
POLYPHASE POWER DIRECTIONAL RELAY

TYPE GGP
OWNER
362
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
RELAYS
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL / STYLE NO.
RATED VOLTS
AMPS
DIRECTIONAL UNIT PICKUP
SEAL-IN RANGE
INSTRUCTION BOOKLET
CURVE
DEVICES OPERATED
CT RATIO
:5
VISUAL INSPECTION
VT RATIO
:120
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
TIME DIAL
AS FOUND
SPECIFIED
VOLTAGE UNIT
AS LEFT
AS FOUND
SPECIFIED
SEAL-IN
AS LEFT
AS FOUND
SPECIFIED
AS LEFT
PICKUP TESTS
CLOSING ZONE @ RATED E & 1A
AS FOUND
SPECIFIED
MINIMUM PICKUP @ MAX Q
AS LEFT
AS FOUND
SPECIFIED
mA
mA
SEAL-IN
AS LEFT
AS FOUND
mA
AS LEFT
ADC
ADC
TIMING TESTS
AS FOUND
SPECIFIED
AS LEFT
TIME @ TD
SEC
SEC
SEC
TIME @ TD
SEC
SEC
SEC
TIME @ TD
SEC
SEC
SEC

TESTED BY:
www.powerdb.com
46200, REVISED 12/4/2007
POLYPHASE POWER DIRECTIONAL RELAY

TYPE GGP
PAGE
363
COMMENTS:
DEFICIENCIES:
www.powerdb.com
46200, REVISED 12/4/2007
REVERSE CURRENT RELAY
OWNER
ADDRESS
CUSTOMER
364
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL / STYLE NO.
RATED VOLTAGE
MAXIMUM TORQUE SETTING
LONG TIME RANGE
INSTRUCTION BOOKLET
SEAL-IN RANGE
/
TCC. NO.
DEVICES OPERATED
INSTANTANEOUS RANGE
/
CT RATIO
VISUAL INSPECTION
DEVICE NUMBER
:5
(PHASE RELAYS : NEUTRAL RELAY / GROUND RELAY)
ROUTINE MAINTENANCE
COVER GASKET / GLASS OK
GLASS / CASE CLEANED
NO FOREIGN MATERIAL / MOISTURE
RELAY / CONNECTIONS TIGHTENED
SPIRAL SPRING / BEARING ENDPLAY
TAPS TIGHTENED / CONTACTS CLEANED
BEARING / DISC CLEARANCE OK
TRIP CIRCUIT / INSULATION RESISTANCE
NO RUST PRESENT
TAP / TIME DIAL
RELAY SETTINGS
TOC SEAL-IN
SPECIFIED
INSTANTANEOUS
AS SPECIFIED
AS FOUND
AS LEFT
AS FOUND
AS LEFT
SPECIFIED
PHASE RELAYS
A/
A/
A/
ADC
ADC
ADC
NEUTRAL RELAY
A/
A/
A/
ADC
ADC
ADC
INSTANTANEOUS SEAL-IN
AS FOUND
AS LEFT
DIRECTIONAL UNIT LINK
PHASE RELAYS
ADC
ADC
ADC
NEUTRAL RELAY
ADC
ADC
ADC
PICKUP TESTS
TIMING UNIT
PHASE
AS FOUND
NO OPERATION VERIFIED
0 VAC; RATED AMPS APPLIED
(TERMINALS 7-8 SHORTED)
TOC SEAL-IN UNIT

AS LEFT
AS FOUND
AS LEFT
VOLTAGE @ P. U.
MAXIMUM Q
ADC
ADC
ADC
ADC
ADC
ADC
ADC
ADC
INSTANTANEOUS UNIT
INSTANTANEOUS SEAL-IN UNIT
CLOSING ZONE
MAXIMUM Q
TIMING TESTS
PHASE
SPECIFIED
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SEC.
SPECIFIED
AMPS
SEC.
AS FOUND
AMPS
AS LEFT
SEC.
AMPS
SEC.
SPECIFIED
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SEC.
A
B
C
N

TESTED BY:
www.powerdb.com
47000, REVISED 12/26/2008
REVERSE CURRENT RELAY
PAGE
365
COMMENTS:
DEFICIENCIES:
www.powerdb.com
47000, REVISED 12/26/2008
REVERSE POWER RELAY
OWNER
366
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL / STYLE NO.
RATED VOLTS
AMPS
PICKUP RANGE
PHASE WATTS
SEAL-IN RANGE
DEVICE NO.
INSTRUCTION BOOKLET
CURVE
DEVICES OPERATED
CT RATIO
:5
VISUAL INSPECTION
VT RATIO
:120
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
CALCULATED MINIMUM PICKUP CURRENT
RELAY SETTINGS
@ RATED VOLTAGE & MAXIMUM TORQUE ANGLE

SEAL-IN UNIT
AS FOUND
AS SPECIFIED
I MIN. =
AS LEFT
WATT TAP SETTING

(1.732) (RATED VOLTS) (1)
(1.732) (
) (1)
PICKUP TESTS
ICW52
AS FOUND
AS SPECIFIED
AS LEFT
AS SPECIFIED
AS LEFT
ACTUAL MINIMUM PICKUP - AMPS

CLOSING ZONE @ RATED E & 5A - DEG
ICW52A
AS FOUND
CURRENT TO CLOSE RIGHT CONTACT
I MIN. (
) * .80 =
A, OR SPECIFIED DROPOUT
ACTUAL CURENT
TIMING POINTS AT RATED VOLTAGE & MAXIMUM TORQUE ANGLE

AS FOUND
AMPS
SECONDS
AS SPECIFIED
AMPS
SECONDS
AS LEFT
AMPS
AS FOUND
SECONDS
AMPS

SECONDS
TESTED BY:
www.powerdb.com
AS SPECIFIED
AMPS
AS LEFT
SECONDS
AMPS
SECONDS
47200, REVISED 2/18/2002
REVERSE POWER RELAY
PAGE
367
COMMENTS:
DEFICIENCIES:
www.powerdb.com
47200, REVISED 2/18/2002

TYPE BDD
OWNER
ADDRESS
CUSTOMER
368
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
CURRENT RATING
PICKUP
MODEL NO.
CURRENT TRANSFORMER RATIO MATCHING TAPS

SLOPE
DC CONTROL VOLTAGES
INSTANTANEOUS
INSTRUCTION BOOKLET
VISUAL INSPECTION
YES
NO
ROUTINE MAINTENANCE
N/A
YES
COVER GASKET OK
GLASS CLEANED
GLASS OK
CASE CLEANED
FOREIGN MATERIAL
RELAY CLEANED
MOISTURE
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
RUST PRESENT
RELAY SETTINGS
PERCENT SLOPE
SPECIFIED
AS FOUND
NO
N/A
DC VOLTAGE TAP
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
CT RATIO MATCHING TAPS

WINDING 1
SPECIFIED
RELAY TESTS
WINDING 2
AS FOUND
AS LEFT
SPECIFIED
5A TAP; 25% SLOPE

SPECIFIED
AS FOUND
4.6A TAP; 15% SLOPE
AS FOUND
SPECIFIED
MINIMUM PICKUP OPERATING VALUE
1.35 - 1.65 A
APPROX. 1.47
HARMONIC RESTRAINT OPERATING VALUE
9.0 - 10.3 A
NOT SPECIFIED
SLOPE TEST
7.0 - 8.3 A
INSTANTANEOUS
36 - 44 A

AS FOUND
4.0 - 5.0 A
VERIFY POLAR UNIT DROPOUT
TESTED BY:
www.powerdb.com
AS LEFT
48500, REVISED 12/26/2008

TYPE BDD
PAGE
369
COMMENTS:
DEFICIENCIES:
www.powerdb.com
48500, REVISED 12/26/2008
SYNCHRONISM CHECK RELAY
OWNER
ADDRESS
CUSTOMER
370
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
AC VOLTS
DC VOLTS
MODEL / STYLE NO.
CLOSING ANGLE
INSTRUCTION BOOKLET
VISUAL INSPECTION
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
TRIP CIRCUIT TESTED
NO RUST PRESENT
RELAY SETTINGS
AS FOUND
AS SPECIFIED
AS LEFT
EXTERNAL SUPERVISION (UV)

SYNCH CHECK LL-LB
SYNCH CHECK DL-DB
SYNCH CHECK LL-DB
SYNCH CHECK DL-LB
TIMER TL-2
2.0-20
TIMER TL-2
0.2-2.0
TIMER TL-2
0.02-0.2
TESTS
UNDERVOLTAGE - LINE
UNDERVOLTAGE - BUS
SUPERVISION INPUT
PHASE ANGLE
TIMING
SEC
SEC
SEC
SEAL-IN
Adc
Adc
Adc

TESTED BY:
www.powerdb.com
47900, REVISED 12/4/2007
SYNCHRONISM CHECK RELAY
PAGE
371
COMMENTS:
DEFICIENCIES:
www.powerdb.com
47900, REVISED 12/4/2007
DIFFERENTIAL VOLTAGE RELAY

TYPE KAB
OWNER
372
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
VOLTAGE
TYPE
PICKUP RANGE
INSTRUCTION BOOKLET
CEY
MODEL / STYLE NO.
DROPOUT RANGE
SEAL-IN RANGE
CURVE
VT RATIO
A
:120
DEVICE NO.
VISUAL INSPECTION
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
NO RUST PRESENT
TAPS TIGHTENED
TRIP CIRCUIT TESTED

RELAY SETTINGS
INSTANTANEOUS OVERCURRENT
SPECIFIED
AS FOUND
SEAL-IN
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
PICKUP TESTS
PHASE
INSTANTANEOUS OVERCURRENT
AS FOUND
AS LEFT
VOLTAGE UNIT
SPECIFIED
SEAL-IN UNIT
AS FOUND
AS LEFT
AS FOUND
AS LEFT
ADC
ADC
ADC
ADC
ADC
ADC
TIMING TESTS
SPECIFIED
AS FOUND
AS LEFT
PHASE A PICKUP TIME @
SEC
SEC
SEC
PHASE B PICKUP TIME @
SEC
SEC
SEC
PHASE C PICKUP TIME @
SEC
SEC
SEC

TESTED BY:
www.powerdb.com
40950, REVISED 12/26/2008

TYPE KAB
PAGE
373
COMMENTS:
DEFICIENCIES:
www.powerdb.com
40950, REVISED 12/26/2008
GROUND DIRECTIONAL OVERCURRENT RELAY
OWNER
ADDRESS
CUSTOMER
374
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
TYPE
MODEL / STYLE NO.
AC VOLTS
AMPS
INSTRUCTION BOOKLET
TIME OVERCURRENT CURVE TYPE
INSTANTANEOUS OVERCURRENT RANGE
DIRECTIONAL UNIT PICKUP:
POTENTIAL POLARIZED
CURRENT POLARIZED
DEVICES OPERATED
CT RATIO
:5
VISUAL INSPECTION
VT RATIO
:120
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
OVERCURRENT TAP
TIME DIAL
MINIMUM TORQUE ANGLE

TORQUE
TORQUE LINK
LINK
IN
20 LAG
INSTANTANEOUS TAP
MAXIMUM TORQUE ANGLE

OUT
45 LAG
PICKUP & TIMING TESTS

SPECIFIED
NEUTRAL PICKUP
AS FOUND
AS LEFT
NEUTRAL TIMING TESTS

2X =
SEC
SEC
SEC
5X =
SEC
SEC
SEC
SEC
SEC
SEC
EFFECTIVE TORQUE ANGLE

DIRECTIONAL UNIT CHECK
CURRENT POLARIZATION
POTENTIAL POLARIZATION @ 5 Vac
INSTANTANEOUS UNIT
SEAL IN:
TIME ELEMENT
Adc
INSTANTANEOUS

TESTED BY:
www.powerdb.com
Adc
42500, REVISED 12/26/2008
GROUND DIRECTIONAL OVERCURRENT RELAY
PAGE
375
COMMENTS:
DEFICIENCIES:
www.powerdb.com
42500, REVISED 12/26/2008
DIGITRIP OVERCURRENT RELAY
OWNER
ADDRESS
CUSTOMER
376
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
TYPE
MODEL / STYLE NO.
SERIAL NO.
PHASE CT RATIO
DEVICES OPERATED
INSTRUCTION BOOKLET
VISUAL INSPECTION
:5
BOLT-IN:
GLASS CLEANED
ROUTINE MAINTENANCE
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
TRIP CIRCUIT TESTED
NO MOISTURE PRESENT
ON
LONG TIME PU
A =
SHORT TIME PU
ON
OFF
INST. PU
ON
OFF
OFF
PHASE SETTINGS AS LEFT
DISCRIMINATOR
GROUND CT RATIO
DRAWOUT:
PHASE SETTINGS AS FOUND

DISCRIMINATOR
:5
ON
LONG TIME PU
A =
SHORT TIME PU
ON
OFF
INST. PU
ON
OFF
LONG TIME PU
A =
SHORT TIME PU
ON
OFF
INST. PU
ON
OFF
LONG TIME PU
A =
SHORT TIME PU
ON
OFF
INST. PU
ON
OFF
OFF
DELAY
DIP SWITCH SETTINGS
DELAY
AF
AL
1
DELAY
DELAY
3
4
5
GROUND SETTINGS AS FOUND
DISCRIMINATOR
ON
OFF
GROUND SETTINGS AS LEFT
DISCRIMINATOR
ON
OFF
PHASE TEST RESULTS

FUNCTION
LONG TIME
SHORT TIME
INSTANTANEOUS
GROUND FAULT
SHORT TIME
INSTANTANEOUS
GROUND FAULT
POLE 1 (sec)
TEST
AMPERES
CURRENT
MULTIPLE
TIME BAND (sec)

MINIMUM
MAXIMUM
AS
FOUND
AS
LEFT
AS FOUND
(sec)
AS LEFT
(sec)
DELAY
DELAY
7
8
9
DELAY
10
DELAY
POLE 2 (sec)
AS
FOUND
AS
LEFT
POLE 3 (sec)
AS
FOUND
AS
LEFT
LTPU
STPU
IPU
LTPU
GROUND TEST RESULTS

LONG TIME
LTPU
STPU
PHASE TCC TYPE
IPU
GROUND TCC TYPE
LTPU

TESTED BY:
www.powerdb.com
41200, REVISED 1/30/2009
DIGITRIP OVERCURRENT RELAY
PAGE
377
COMMENTS:
DEFICIENCIES:
www.powerdb.com
41200, REVISED 1/30/2009
VOLTAGE RELAY
OWNER
ADDRESS
CUSTOMER
378
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
VOLTAGE
PICKUP RANGE
INSTRUCTION BOOKLET
TYPE
MODEL / STYLE NO.
DROPOUT RANGE
SEAL-IN RANGE
CURVE
VT RATIO
:120
DEVICE NO.
VISUAL INSPECTION
YES
NO
ROUTINE MAINTENANCE
N/A
COVER GASKET OK
YES
GLASS CONDITION OK
GLASS CLEANED
FOREIGN MATERIAL
CASE CLEANED
MOISTURE
RELAY CLEANED
SPIRAL SPRING OK
BEARING ENDPLAY OK
TAPS TIGHTENED
CONTACTS CLEANED
DISC CLEARANCE OK
TRIP CIRCUIT TESTED
RUST PRESENT
NO
N/A
RELAY SETTINGS
AS SPECIFIED
AS FOUND
AS LEFT
VOLTAGE PICKUP
VOLTAGE DROPOUT
ADC
ADC
ADC
TIME DELAY
TARGET SEAL-IN
PICKUP TESTS
AS SPECIFIED
AS FOUND
AS LEFT
PICKUP
DROPOUT
ADC
ADC
ADC
TARGET SEAL-IN
TIMING TESTS
AS SPECIFIED
AS FOUND
AS LEFT
3 PH. DROP-OUT TIME TO
CY
CY
CY
1 PH. DROP-OUT TIME TO
CY
CY
CY
CY
CY
CY
PICKUP TIME 0.0 V TO RATED

TESTED BY:
www.powerdb.com
49000, REVISED 12/26/2008
VOLTAGE RELAY
PAGE
379
COMMENTS:
DEFICIENCIES:
www.powerdb.com
49000, REVISED 12/26/2008
METERING MODULE TEST
OWNER
380
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
RELAYS
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
SERIAL NO.
STYLE/SERIES NO.
MODEL NO.
CONTROL VOLTAGE
TYPE
INSTRUCTION MANUAL
CLASS
OTHER
PHASE
INPUT VOLTAGE
(volts)
VOLTAGE
TURNS RATIO
A-N
B-N
C-N
A-B
A-C
B-C
PHASE
INPUT CURRENT
(amps)
CURRENT
TURNS RATIO
MEASURED
SYSTEM VOLTAGE
(volts)
MULTI-FUNCTION
METER READING
PERCENT
ERROR
MEASURED
SYSTEM CURRENT
(amps)
MULTI-FUNCTION
METER READING
PERCENT
ERROR
kWHRS: AS LEFT
3 PH. kW DEMAND
3 PH. kVA DEMAND

TESTED BY:
www.powerdb.com
44100, REVISED 12/5/2007
METERING MODULE TEST
PAGE
381
COMMENTS:
DEFICIENCIES:
www.powerdb.com
44100, REVISED 12/5/2007
NEGATIVE SEQUENCE
OVERCURRENT RELAY TEST
OWNER
382
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
INSTRUCTION BOOKLET
TCC NO.
MODEL / STYLE NO.
DEVICES OPERATED
CT RATIO
DEVICE NO.
:5
VT RATIO
:120
VISUAL INSPECTION
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
SPECIFIED
AS FOUND
AS LEFT
SEAL-IN
UNIT
TAP
TIME DIAL
TAP
TIME DIAL
TAP
TIME DIAL
SPECIFIED
AS FOUND
AS LEFT
INDUCTION
ALARM
PICKUP TESTS
INDUCTION COIL P.U. CURRENT
AS FOUND
ALARM COIL P.U. CURRENT
AS LEFT
ADC
AS FOUND
ADC
ALARM COIL VOLTAGE
AS LEFT
SPECIFIED
SPECIFIED
SEC.
AS FOUND
SEC.
AS LEFT
ADC
AS FOUND
AMPS
INDUCTION UNIT SEAL-IN

AS LEFT
ADC
AMPS
AS LEFT
ALARM UNIT SEAL-IN

AS FOUND
TIMING TEST
AS FOUND
AS LEFT
AMPS
SEC.
SPECIFIED
AMPS
SEC.
ADC
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SEC.
ADC
SPECIFIED
AMPS
SEC.
AS FOUND
AMPS
SEC.
AS LEFT
AMPS
SEC.
INDUCTION
ALARM

TESTED BY:
www.powerdb.com
44500, REVISED 12/26/2008
NEGATIVE SEQUENCE
OVERCURRENT RELAY TEST
PAGE
383
COMMENTS:
DEFICIENCIES:
www.powerdb.com
44500, REVISED 12/26/2008
PHASE DIRECTIONAL OVERCURRENT RELAY
OWNER
ADDRESS
CUSTOMER
384
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL / STYLE NO.
AC VOLTS
AMPS
INSTRUCTION BOOKLET
TIME OVERCURRENT CURVE TYPE
INSTANTANEOUS OVERCURRENT RANGE
DIRECTIONAL UNIT PICKUP:
POTENTIAL POLARIZED
CURRENT POLARIZED
DEVICES OPERATED
CT RATIO
:5
VISUAL INSPECTION
VT RATIO
:120
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
OVERCURRENT TAP
TIME DIAL
INSTANTANEOUS TAP
PICKUP & TIMING TESTS

AS FOUND
SPECIFIED
AS LEFT
PHASE A PICKUP
PHASE B PICKUP
PHASE C PICKUP
PHASE A TIMING
PHASE B TIMING
PHASE C TIMING
X=
SEC
SEC
SEC
X=
SEC
SEC
SEC
X=
SEC
SEC
SEC
X=
SEC
SEC
SEC
X=
SEC
SEC
SEC
X=
SEC
SEC
SEC
DIRECTIONAL UNIT CHECK

REVERSE CURRENT POLARITY
CLOSED BOTTOM CONTACTS
INSTANTANEOUS UNIT
SEAL-INS
CONTACTS OPEN
AS FOUND
AS LEFT
TIME
INSTANTANEOUS
PHASE A UNIT
YES
NO
YES
NO
Adc
Adc
PHASE B UNIT
YES
NO
YES
NO
Adc
Adc
PHASE C UNIT
YES
NO
YES
NO
Adc
Adc

TESTED BY:
www.powerdb.com
46100, REVISED 2/21/2003
PHASE DIRECTIONAL OVERCURRENT RELAY
PAGE
385
COMMENTS:
DEFICIENCIES:
www.powerdb.com
46100, REVISED 2/21/2003
PROTECTION RELAY
CUSTOMER
PAGE
PLANT
TEST DATE
RELAYS
SUBSTATION
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
MANUFACTURER:
MODEL:
TYPE:
SOFTWARE VER.:
EQUIPMENT PROTECTED:
SERIAL NO.:
POSITION
JOB #
386
GENERAL
FORMS - ALL
TEST RESULTS
<enter function description>

<enter test description>
<enter text>
<enter text>
<enter text>
<enter text>
<enter result>
<enter result>
<enter result>
<enter result>
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
49900, REVISED 2/1/2012
POWER DIRECTIONAL
CAP RELAY TEST
OWNER
387
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL/STYLE NO.
RATED VOLTS
AMPS
DIRECTIONAL UNIT PICKUP
INSTRUCTION BOOKLET
CURVE
DEVICES OPERATED
DEVICE NUMBER
CT RATIO
:5
VISUAL INSPECTION
VT RATIO
:120
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
SINGLE PHASE TEST

CALCULATED MINIMUM PICKUP @ RATED VOLTAGE & MAX. Q
SEAL-IN UNIT
AS FOUND
WATT TAP SETTING

AS LEFT
ADC
I MIN. =
=
(1.732) (RATED VOLTS)
ADC
=
(1.732)
PICKUP TESTS
PHASE ANGLE TESTS
AS FOUND
AS SPECIFIED
AS LEFT
ANGLE 1 (ANGLE @ PICKUP)

ANGLE 2 (ANGLE @ PICKUP)
MAXIMUM ANGLE OF TORQUE (MAX. Q)
PICKUP @ MAXIMUM Q
TIMING POINTS AT RATED VOLTAGE & MAXIMUM TORQUE ANGLE

AS FOUND
AMPS
SECONDS
AS SPECIFIED
AMPS
SECONDS
AS LEFT
AMPS
AS FOUND
SECONDS
AMPS

SECONDS
TESTED BY:
www.powerdb.com
AS SPECIFIED
AMPS
AS LEFT
SECONDS
AMPS
SECONDS
46400, REVISED 2/18/2002
POWER DIRECTIONAL
CAP RELAY TEST
PAGE
388
COMMENTS:
DEFICIENCIES:
www.powerdb.com
46400, REVISED 2/18/2002
STATIC TIMING RELAY
OWNER
389
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
DC VOLTS
MODEL/STYLE NO.
AC VOLTS
TIME RANGE #1
PARTS BULLETIN
TIME RANGE #2
INSTRUCTION BOOKLET
SEAL-IN RANGE
OPERATING DEVICE
DEVICES OPERATED
VISUAL INSPECTION
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
TIME DIAL
AS FOUND
SEAL-IN
AS SPECIFIED
AS LEFT
AS FOUND
AS SPECIFIED
AS LEFT
UNIT 1
ADC
ADC
ADC
UNIT 2
ADC
ADC
ADC
TEST RESULTS
TIME UNIT
AS FOUND
SEAL-IN UNIT
AS SPECIFIED
AS LEFT
AS FOUND
AS LEFT
UNIT 1
SEC
SEC
SEC
ADC
ADC
UNIT 2
SEC
SEC
SEC
ADC
ADC

TESTED BY:
www.powerdb.com
47800, REVISED 12/4/2007
STATIC TIMING RELAY
PAGE
390
COMMENTS:
DEFICIENCIES:
www.powerdb.com
47800, REVISED 12/4/2007
BALANCED CURRENT RELAY
OWNER
391
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
General Electric
MODEL/STYLE NO.
CEY
RATED CURRENT
% SLOPE
MINIMUM PICKUP
SEAL-IN RANGE
TCC NO.
INSTRUCTION BOOKLET
DEVICES OPERATED
CT RATIO
VISUAL INSPECTION
:5
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
TAP / TIME DIAL

AS FOUND
A/
SPECIFIED
A/
AS LEFT
A/
SPECIFIED
%
% SLOPE
AS FOUND
%
AS LEFT
%
SPECIFIED
ADC
SEAL-IN UNIT
AS FOUND
ADC
AS LEFT
ADC
PICKUP TESTS
TIMING UNIT
MINIMUM PICKUP
SEAL-IN UNIT
PHASE
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
AS FOUND
AS LEFT
ADC
ADC
ADC
ADC
ADC
ADC
TIMING POINTS @ ZERO RESTRAINT

SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
SPECIFIED
AS FOUND
AS LEFT
PHASE
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
AMPS
SEC.
A
B
C
SLOPE TESTS
* REFER TO THE SLOPE CURVE TO VERIFY OPERATING CURRENT LIMITS

OPERATING CURRENT
OPERATING CURRENT LIMITS *
RESTRAINT CURRENT
PHASE A - TOP
PHASE B - MIDDLE
PHASE C - BOTTOM
MINIMUM
MAXIMUM

TESTED BY:
www.powerdb.com
40500, REVISED 12/26/2008
BALANCED CURRENT RELAY
PAGE
392
COMMENTS:
DEFICIENCIES:
www.powerdb.com
40500, REVISED 12/26/2008
TIMING RELAY
OWNER
393
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TYPE
MODEL/STYLE NO.
RATED VOLTS
AMPS
PICKUP RANGE
TIME RANGE #2
SEAL-IN RANGE
TIME RANGE #1
INSTRUCTION BOOKLET
OPERATING DEVICE
DEVICES OPERATED
VISUAL INSPECTION
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
SPIRAL SPRING OK
TAPS TIGHTENED
BEARING ENDPLAY OK
CONTACTS CLEANED
TRIP CIRCUIT TESTED
DISC CLEARANCE OK
NO RUST PRESENT
RELAY SETTINGS
TIME DIAL
AS FOUND
SEAL-IN
AS SPECIFIED
AS LEFT
AS FOUND
AS SPECIFIED
AS LEFT
UNIT 1
ADC
ADC
ADC
UNIT 2
ADC
ADC
ADC
TEST RESULTS
TIME UNIT
AS FOUND
SEAL-IN UNIT
AS SPECIFIED
AS LEFT
AS FOUND
AS LEFT
UNIT 1
SEC
SEC
SEC
ADC
ADC
UNIT 2
SEC
SEC
SEC
ADC
ADC

TESTED BY:
www.powerdb.com
48000, REVISED 12/4/2007
TIMING RELAY
PAGE
394
COMMENTS:
DEFICIENCIES:
www.powerdb.com
48000, REVISED 12/4/2007

TYPE PVD
OWNER
ADDRESS
CUSTOMER
395
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
RELAYS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
General Electric
TYPE
VOLTAGE CONTINUOUS
CEY
VAC
MODEL / STYLE NO.
FREQUENCY
HZ
87L CALIBRATION CLOCKWISE HIGH
87L CALIBRATION CLOCKWISE LOW
87L VOLTAGE RANGE HIGH
87L VOLTAGE RANGE LOW
87L CURRENT RANGE HIGH
AMPS
87L CURRENT RANGE LOW
AMPS
SEAL-IN RANGE
DEVICE NO.
INSTRUCTION BOOKLET
CURVE
DEVICES OPERATED
CT RATIO
VISUAL INSPECTION
:5
VT RATIO
:120
ROUTINE MAINTENANCE
COVER GASKET OK
GLASS CLEANED
GLASS CONDITION OK
CASE CLEANED
NO FOREIGN MATERIAL
RELAY CLEANED
NO MOISTURE PRESENT
NO RUST PRESENT
TAPS TIGHTENED
TRIP CIRCUIT TESTED

RELAY SETTINGS
87L
SPECIFIED
87H
AS FOUND
V
AS LEFT
V
SPECIFIED
V
SEAL-IN
AS FOUND
A
AS LEFT
A
SPECIFIED
A
AS FOUND
ADC
ADC
AS LEFT
ADC
PICKUP TESTS
87L
87H
PHASE
AS FOUND
AS LEFT
AS FOUND
AS LEFT
THYRITE STACK - 120VDC APPLIED
SEAL-IN
PHASE
SPECIFIED
AS FOUND
AS LEFT
AS FOUND
AS LEFT
mA
mA
mA
ADC
ADC
mA
mA
mA
ADC
ADC
mA
mA
mA
ADC
ADC

TESTED BY:
www.powerdb.com
41000, REVISED 4/23/2013

TYPE PVD
PAGE
396
COMMENTS:
DEFICIENCIES:
www.powerdb.com
41000, REVISED 4/23/2013
SEL 351
OWNER
397
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
SEL
PLANT
RELAYS
SUBSTATION
POSITION
Pickup (amps)
Unit
Timing
Theo
Min
Max
As Found
As Left
Current
Current
Current
Current
Current
51P
Phase A-N
51P
Phase B-N
51P
Phase C-N
4.75
5.25
4.75
5.25
4.75
5.25
Value
Theo
As Found
As Found
As Left
As Left
Multiple
Current
Seconds
Sec
Error
Sec
Error
3
5
15
25
35
3
5
15
25
35
15
5
7
25
35
3
51A
5
7
3
51B
5
7
3
51C
5
7
3
51G
5
7
3
51Q
5
7
3
51N
5
7
Pickup (amps)
Unit
Theo
Min
Max
Current
Current
Current
A-N
As Found
B-N
As Left
As Found
C-N
As Left
As Found
As Left
50P1
50P2
50P3
50P4
50P5
50P6
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
43351, REVISED 2/10/2014
SEL 351
398
PAGE
Under - Over Voltage Phase Pickups (volts)
Theo
Min
Max
Unit
Volts
Volts
Volts
27P1P UV
3.75
6.25
A Phase Volts
As Found
B Phase Volts
As Left
As Found
C Phase Volts
As Left
As Found
As Left
27P2P UV
59P1P OV
59P2P OV
Under - Over Voltage Phase To Phase Pickups
Theo
Min
Max
Volts
Volts
Volts
Theo
Min
Max
Current
Current
Current
Unit
Phase A-B Volts

As Found
Phase B-C Volts
As Left
As Found
Phase C-A Volts
As Left
As Found
As Left
27PP UV
59PP OV
Phase To Phase Instantaneous Pickups (amps)
Unit
Phase A-B Current

As Found
Phase B-C Current
As Left
As Found
Phase C-A Current
As Left
As Found
As Left
50PP1
50PP2
50PP3
50PP4
Voltage Pickups
Theo
Min
Max
Unit
Volts
Volts
Volts
27P1P 3PH
3.75
6.25
Current Pickups (amps)

Volts
As Found
As Left
Unit
Theo
Min
Max
Current
Current
Current
Current
As Found
As Left
50PP1
59P1P 3PH
50PP2
59N1P OV
50PP3
59N2P OV
50PP4
59QP OV
50G1
59V1P OV
50G2
27B81P
50G3
27SP
50G4
59S1P
50G5
59S2P
50G6
25VLO
50Q1
25VHI
50Q2
50Q3
50Q4
UNIT
25ANG1
25ANG2
Sync Angle (degrees)

Min
Max
Angle
LEADING:
50Q5
As Found
As Left
LAGGING:
50QF
LEADING:
50N1
LAGGING:
50N2
50N3
Slip Frequency
Unit
50Q6
50QR
Min
Max
Hz
Hz
Pickup Hz
As Found
25
As Left
Drop Out Hz
As Found
As Left
50N4
50N5
50N6
0 COMMENTS:
3
DEFICIENCIES:
www.powerdb.com
43351, REVISED 2/10/2014
SEL 351
PAGE
Frequency Pickup
Unit
399
Frequency Time
Theo
Min
Max
Hz
Hz
Hz
Hz
As Found
Applied
As Left
Hz.
Seconds
Min
Seconds
Max
As Found
As Left
81D1
81D2
81D3
81D4
81D5
81D6
Reach
Current (amps)
Unit
Angle
Voltage
As Found
As Left
Impedance (ohms)
As Found
As Left
Error
As Found
As Left
Z2R
Z2F
Timer
Unit
Multiple
Value
Min
Max
Seconds
Seconds
Seconds
As Found
As Left
67P1
67P2
67P3
67P4
67G1
67G2
67G3
67G4
67Q1
67Q2
67Q3
67Q4
67N1
67N2
67N3
67N4
www.powerdb.com
43351, REVISED 2/10/2014
SEL 351
400
PAGE
Identifier Labels
Instantaneous Overcurrent Elements

Unit
RID =
TID =
Current And Potential Transformer Ratios
CTR =
CTRN =
VNOM =
PTR =
PTRS =
Ph-Ph(PP)
Phase(P)
Neutral(N)
Res. Gnd.(G)
Neg. Seq.(Q)
Line Settings
Z1ANG =
Z1MAG =
Z0MAG =
Z0SMAG =
LL =
PkUp(50x1P) PkUp(50x2P) PkUp(50x3P) PkUp(50x4P) PkUp(50x5P) PkUp(50x6P) Enable(E50x)
Definite Time Overcurrent Elements

Unit
Z0ANG =
Z0SANG =
Time Delay (67x1D)
Time Delay (67x2D)
Other Enable
E32
E79
E81
EPWR
ESV
EDEM
ELOP
ZLF =
PLAF =
PLAR =
DIR1
DIR3
ORDER
Z2F
50QFP
a2
50GFP
a0
Z0R
50NRP
=
=
=
=
=
=
=
=
=
=
ESOTF
E25
EFLOC
ECOMM
Load-Encroachment Elements
ZLR =
NLAF =
NLAR =
Directional Elements
DIR2 =
DIR4 =
50P32P =
Z2R =
50QRP =
k2 =
50GRP =
Z0F =
50NFP =
a0N =
79OI2 =
79OI4 =
79RSLD =
Additional DCUB Trip Scheme Settings

GARD1D =
UBEND =
UBDURD =
Other Settings
TDURD =
3POD =
59RES =
32WRP =
CFD =
50LP =
Wattmetric Element Settings
32WFP =
32WD =
Synchronism Check Elements
25VLO =
25SF =
25ANG2 =
TCLOSD =
25VHI =
25ANG1 =
SYNCP =
Voltage Sag / Swell / Interrupt
VINT =
VSWELL =
VSAG =
DCB Trip Scheme Settings
Z3XPU =
BTXD =
67N2SD =
67Q2SD =
Z3XD =
67P2SD =
67G2SD =
POTT Trip Scheme Settings
Z3RBD =
ETDPU =
EWFC
Time Delay (67x4D)
Time Overcurrent Elements

EVOLT
ELOAD
ESSI
Reclosing Relay
79OI1 =
79OI3 =
79RSD =
79CLSD =
Time Delay (67x3D)
Phase(P)
Neutral(N)
Res. Gnd.(G)
Neg. Seq.(Q)
EBLKD =
EDURD =
Unit
Pickup (51xP)
A Phase(A)
B Phase(B)
C Phase(C)
Ph-Ph(P)
Neutral(N)
Res. Gnd.(G)
Neg. Seq.(Q)
PhPkUp (PWRxP)
Curve (51xC)
Time Dial (51xTD) EM Reset (51xRS)
Power Elements
3PhPkUp (3PWRxP)
Type (PWRxT)
Enable(E51x)
Time Delay (PWRxD)
1
2
3
4
#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
#
1
2
3
4
5
6
SELogic Control Equation Variable Timers

Pickup (SVxPU)
Dropout (SVxDO)
Switch-Onto-Fault
52AEND =
CLOEND =
SOTFD =
Demand Metering Settings

DMTC =
NDEMP =
QDEMP =
PDEMP =
GDEMP =
Reclosing Relay Equations
79RI
79RIS
79DTL
79DLS
79SKP
79STL
79BRS
79SEQ
79CLS
Frequency Elements
Pickup (81DxP)
Dropout (81DxD)
Voltage Elements
UNIT
PkUp (xxxxP)
Phase Over V (59P1)
VS Over V (59S)
NegSeq Over V (59Q)
ZeroSeq Over V (59N)
PosSeq Over V (59V1)
Ph-Ph Over V (59P)
Ph-Ph Under V (27P)
VS Under V (27S)
Phase Under V (27P1)
5
Ph UV Block (27B81)
www.powerdb.com
=
=
=
=
=
=
=
=
=
Trip Logic Equations
TR =
TRCOMM =
TRSOTF =
DTT =
ULTR =
Close Logic Equations

PkUp (xxx2P)
52A =
CL =
ULCL =
Communications-Assisted Trip Scheme Input Equations

PT1
LOG1
PT2
LOG2
BT
=
=
=
=
=
43351, REVISED 2/10/2014
SEL 351
PAGE
Torque Control Equations for Time Overcurrent
51ATC
51BTC
51CTC
51PTC
51NTC
51GTC
51QTC
=
=
=
=
=
=
=
Torque Control Equations for Inst./Def. Time Overcur

67P1TC
67P2TC
67P3TC
67P4TC
67N1TC
67N2TC
67N3TC
67N4TC
67G1TC
67G2TC
67G3TC
67G4TC
67Q1TC
67Q2TC
67Q3TC
67Q4TC
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
OUT101
OUT102
OUT103
OUT104
OUT105
OUT106
OUT107
OUT201
OUT202
OUT203
OUT204
OUT205
OUT206
OUT207
OUT208
OUT209
OUT210
OUT211
OUT212
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
Set Latch Bit (SETx)
Mirrored Bits Transmit Equations

Channel A (TMBxA)
Front-Panel Display Operation

FP_TO =
SCROLD =
FPNGD =
Display Points
On Label (DPx_1)
Equation (DPx)
Off Label (DPx_0)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Load Profile Settings
LDLIST =
LDAR =
Power System Config & Date Format

NFREQ =
PHROT =
DATE_F =
SELogic Control Equation Variable Timer Input

=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
Channel B (TMBxB)
1
2
3
4
5
6
7
8
#
Output Contact Equations
SV1
SV2
SV3
SV4
SV5
SV6
SV7
SV8
SV9
SV10
SV11
SV12
SV13
SV14
SV15
Reset Latch Bit (RSTx)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
#
Setting Group Selection Equations

SS1
SS2
SS3
SS4
SS5
SS6
401
Latch Bits Set / Reset Equations
DCLOP =
Settings Group Change Delay

LER =
TGR =
IN101D
IN103D
IN105D
IN201D
IN203D
IN205D
IN207D
Optoisolated Input Timers

IN102D =
IN104D =
IN106D =
IN202D =
IN204D =
IN206D =
IN208D =
=
=
=
=
=
=
=
Other Equations
ER
FAULT
BSYNCH
CLMON
BKMON
E32IV
=
=
=
=
=
=
COSP1
COSP3
KASP2
EBMON
=
=
=
=
Station DC Battery Monitor

DCHIP =
Event Parameters
PRE =
Breaker Monitor Settings
COSP2 =
KASP1 =
KASP3 =
Sequential Events Recorder Triggers

SER1 =
SER2 =
SER3 =
Voltage Input Configuration
PTCONN =
www.powerdb.com
VSCONN =
43351, REVISED 2/10/2014
SEL 351
PAGE
Reclosing Relay Labels
79LL =
79SL =
Protocol Settings
PROTO =
ADDR =
PREFIX =
SETTLE =
Communication Settings
SPEED =
PARITY =
BITS =
STOP =
Other Port Settings

T_OUT =
RTSCTS =
AUTO =
FASTOP =
402
Local Bit Labels

#
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Local Bit (NLBx)
www.powerdb.com
Clear Local Bit (CLBx)
Set Local Bit (SLBx)
Pulse Local Bit (PLBx)
43351, REVISED 2/10/2014
ROTATING MACHINERY INSULATION TEST

STEP VOLTAGE TEST
OWNER
403
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
ROTATING MACHINERY
SUBSTATION
SERIAL NO.
SPECIAL ID
CIRCUIT
MFR
MFR YEAR
REASON
WEATHER
TANK TEMP
YR RWND
YR SERVICE
STATOR kV
FREQ Hz
TYPE
VOLTS
AMPS
CONFIGURATION
TEMPERATURE
MACHINE
TYPE
INS TYPE
COOLING
INS NAME
kVA 1
kVA 2
hp/kw
SPEED/rpm
PWR FACTOR
CREW SIZE
STA AMP 1
STA AMP 2
POLES
Enter TCF Manually:
Example Plant
AUTOMATED
PLANT
POSITION
EXCITER MFR
EXCITER S/N
EXCITER DESIGN
EXCITER VOLTS
EXCITER AMPS
EXCITER kW
EXCITER DRWG
EXCITER rpm
EXCITER TYPE
RES S/N
SEMI-CON COAT
VOLT GRADING APPLIED
GLOBAL VPI
H2 PRESS
H2 PRESS
MAX. TEST VOLTAGE
WINDING 3 TO FRAME
WINDING 2 TO FRAME
WINDING 1 TO FRAME
TEST TIME
TIME
(minutes)
STEP VOLT.
(kVDC)
1.0
1.00
2.0
2.00
3.0
3.00
4.0
4.00
5.0
5.00
TIME
(minutes)
STEP VOLT.
(kVDC)
1.0
1.00
2.0
2.00
3.0
3.00
4.0
4.00
5.0
5.00
TIME
(minutes)
STEP VOLT.
(kVDC)
1.0
1.00
2.0
2.00
3.0
3.00
4.0
4.00
5.0
5.00
IR
(megohms)
IR 20C
(megohms)
CURRENT
(microamps)
KVDC
minutes
STEP VOLT.
TEST
WINDING 1
TO FRAME
IR
Current
KVDC
IR
(megohms)
IR 20C
(megohms)
CURRENT
(microamps)
STEP VOLT.
TEST
WINDING 2
IR
Current
KVDC
IR
(megohms)
IR 20C
(megohms)
CURRENT
(microamps)
STEP VOLT.
TEST
WINDING 3
TO FRAME
IR
Current
KVDC
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
98500, REVISED 10/17/2013
MOTOR POLARIZATION INDEX (PI) TEST
OWNER
404
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
ROTATING MACHINERY
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
LOCKED ROTOR CURRENT
AMPS
HZ
RPM
FULL LOAD CURRENT
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
CONNECTED EQUIPMENT
MOTOR TEMPERATURE
TEST VOLTAGE
kVDC
Enter TCF Manually:

WINDING 1 TO FRAME - MEGOHMS
MINUTES
READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)

READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)
READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)
0.25
0.50
0.75
1.00
1.25
1.50
1.75
2.00
2.50
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
P.I. NO.*
* POLARIZATION INDEX = 10 MINUTE READING / 1 MINUTE READING

TESTED BY:
www.powerdb.com
32000, REVISED 1/8/2013
MOTOR POLARIZATION INDEX (PI) TEST
PAGE
405
POLARIZATION CURVE
Winding 1: Red Square

Winding 2: Blue Circle
Winding 3: Green Triangle
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32000, REVISED 1/8/2013
SYNCHRONOUS MOTOR
POLARIZATION INDEX (PI) TEST - ARMATURE
OWNER
ADDRESS
CUSTOMER
406
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
ROTATING MACHINERY
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
FULL LOAD CURRENT
RPM
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
FIELD INFORMATION
TYPE
CURRENT RATING
SERIAL NO.
AMPS
VOLTAGE
TEMPERATURE RISE
VDC
POWER FACTOR
OTHER
CONNECTED EQUIPMENT
TEST VOLTAGE:
MOTOR TEMPERATURE
kVDC
Enter TCF Manually:
TEMPERATURE CORRECTION FACTOR T0 20C, TCF
ARMATURE WINDING TO GROUND

MINUTES
READING
(megohms)
TEMP. CORR.
FACTOR
20C
0.25
0.50
0.75
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
P. I.

TESTED BY:
www.powerdb.com
32450, REVISED 5/1/2013
SYNCHRONOUS MOTOR
POLARIZATION INDEX (PI) TEST - ARMATURE
PAGE
407
POLARIZATION CURVE
Armature: Red Square
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32450, REVISED 5/1/2013
STATOR COIL
TIP UP TEST
OWNER
ADDRESS
CUSTOMER
PAGE
408
JOB #
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
ROTATING MACHINERY
SUBSTATION
SERIAL NO.
SPECIAL ID
CIRCUIT
MFR
MFR YEAR
REASON
WEATHER
TANK TEMP
YR RWND
YR SERVICE
STATOR kV
FREQ Hz
TYPE
VOLTS
AMPS
CONFIGURATION
MACHINE
TYPE
INS TYPE
COOLING
INS NAME
kVA 1
kVA 2
hp/kw
SPEED/rpm
PWR FACTOR
CREW SIZE
STA AMP 1
STA AMP 2
POLES
PLANT
Example Plant
POSITION
AUTOMATED
EXCITER MFR
EXCITER S/N
EXCITER DESIGN
EXCITER VOLTS
EXCITER AMPS
EXCITER kW
EXCITER DRWG
EXCITER rpm
EXCITER TYPE
RES S/N
SEMI-CON COAT
GLOBAL VPI
H2 PRESS
H2 PRESS
TEST FREQUENCY: 60
COIL ID
STEP
NUMBER
TEST TYPE
kV
%
TEST
kV
1
2
UST-B
25
UST-B
50
3
4
UST-B
75
UST-B
100
Capacitance
C (pF)

Serial Number:
P.F. %
MEAS.
TESTED BY:
www.powerdb.com
DIRECT
mA
WATTS
%
TIP UP
Calibration Date:
98006, REVISED 1/6/2014
STATOR COIL
TIP UP TEST
409
POWER FACTOR %
PAGE
1-Blue Circle
www.powerdb.com
98006, REVISED 1/6/2014
STATOR COIL
TIP UP TEST
PAGE
410
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
Off
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
98006, REVISED 1/6/2014
SYNCHRONOUS MOTOR
OWNER
411
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
ROTATING MACHINERY
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
FULL LOAD CURRENT
RPM
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
FIELD INFORMATION
TYPE
SERIAL NO.
CURRENT RATING
AMPS
VOLTAGE
TEMPERATURE RISE
VDC
POWER FACTOR
OTHER
CONNECTED EQUIPMENT
TEST VOLTAGE:
MOTOR TEMPERATURE
STATOR
kVDC
Enter TCF Manually:
ROTOR
kVDC
STATOR TO FRAME - ROTOR GUARDED

MINUTES
READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)
ROTOR TO FRAME - STATOR GUARDED

READING
(megohms)
TEMP. CORR.
FACTOR
20C READING
(megohms)
0.25
0.50
0.75
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
P. I.

TESTED BY:
www.powerdb.com
32400, REVISED 1/8/2013
SYNCHRONOUS MOTOR
PAGE
412
POLARIZATION CURVE
Stator: Red Square

Rotor: Blue Circle
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32400, REVISED 1/8/2013
ROTATING MACHINES
TIP UP TEST
OWNER
ADDRESS
CUSTOMER
PAGE
413
JOB #
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
SERIAL NO.
SPECIAL ID
CIRCUIT
MFR
MFR YEAR
REASON
WEATHER
TANK TEMP
YR RWND
YR SERVICE
STATOR kV
FREQ Hz
TYPE
VOLTS
AMPS
CONFIGURATION
PLANT
Example Plant
POSITION
AUTOMATED
ROTATING MACHINERY
SUBSTATION
MACHINE
TYPE
INS TYPE
COOLING
INS NAME
kVA 1
kVA 2
hp/kw
SPEED/rpm
PWR FACTOR
CREW SIZE
STA AMP 1
STA AMP 2
POLES
EXCITER MFR
EXCITER S/N
EXCITER DESIGN
EXCITER VOLTS
EXCITER AMPS
EXCITER kW
EXCITER DRWG
EXCITER rpm
EXCITER TYPE
RES S/N
SEMI-CON COAT
GLOBAL VPI
H2 PRESS
H2 PRESS
TEST FREQUENCY: 60
GROUNDED TIP UP TEST
PHASE
CIRCUIT
DESCRIPTION
kV
%
TEST
kV
T1 GND T2, T3
25
T1 GND T2, T3
50
T1 GND T2, T3
75
T1 GND T2, T3
100
T2 GND T3, T1
25
T2 GND T3, T1
50
T2 GND T3, T1
75
T2 GND T3, T1
100
T3 GND T1, T2
25
10
T3 GND T1, T2
50
11
T3 GND T1, T2
75
12
T3 GND T1, T2
100
TEST ID
Capacitance
C (pF)

Serial Number:
P.F. %
MEAS.
TESTED BY:
www.powerdb.com
DIRECT
mA
WATTS
%
TIP UP
Calibration Date:
98005, REVISED 2/12/2014
ROTATING MACHINES
TIP UP TEST
414
POWER FACTOR %
PAGE
Phase A - Blue Circle
Phase B - Red Triangle

GND - Purple Square
Phase C - Green Triangle
UNGROUNDED TIP UP TEST
PHASE
CIRCUIT
DESCRIPTION
kV
%
TEST
kV
T1 MES T2 GND T3
25
T1 MES T2 GND T3
50
T1 MES T2 GND T3
75
T1 MES T2 GND T3
100
T2 MES T3 GND T1
25
T2 MES T3 GND T1
50
T2 MES T3 GND T1
75
T2 MES T3 GND T1
100
T3 MES T1 GND T2
25
10
T3 MES T1 GND T2
50
11
T3 MES T1 GND T2
75
12
T3 MES T1 GND T2
100
TEST ID
Capacitance
C (pF)
www.powerdb.com
P.F. %
MEAS.
DIRECT
mA
WATTS
%
TIP UP
98005, REVISED 2/12/2014
ROTATING MACHINES
TIP UP TEST
415
POWER FACTOR %
PAGE
Phase A - Blue Circle
Phase B - Red Triangle
Phase C - Green Triangle
www.powerdb.com
98005, REVISED 2/12/2014
ROTATING MACHINES
TIP UP TEST
PAGE
416
TEST
NO
INSULATION
TESTED
TEST
MODE
SUPPRESS.
UST-R
Off
TEST
kV
Test
Freq
L(H)
CAP.(pF)
DIRECT
POWER FACTOR %
%VDF
MEAS.
@ 20C
CORR.
mA
IR
WATTS
1.000
COMMENTS:
DEFICIENCIES:
www.powerdb.com
98005, REVISED 2/12/2014
ROTATING MACHINERY
OWNER
417
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
ROTATING MACHINERY
SUBSTATION
SERIAL NO.
SPECIAL ID
CIRCUIT
MFR
MFR YEAR
REASON
WEATHER
TANK TEMP
YR RWND
YR SERVICE
STATOR kV
FREQ Hz
TYPE
VOLTS
AMPS
CONFIGURATION
Example Plant
AUTOMATED
PLANT
POSITION
MACHINE
TYPE
INS TYPE
COOLING
INS NAME
kVA 1
kVA 2
hp/kw
SPEED/rpm
PWR FACTOR
CREW SIZE
STA AMP 1
STA AMP 2
POLES
EXCITER MFR
EXCITER S/N
EXCITER DESIGN
EXCITER VOLTS
EXCITER AMPS
EXCITER kW
EXCITER DRWG
EXCITER rpm
EXCITER TYPE
RES S/N
SEMI-CON COAT
GLOBAL VPI
H2 PRESS
H2 PRESS
CONNECTED EQUIPMENT
TEST VOLTAGE
MOTOR TEMPERATURE
Enter TCF Manually:
kVDC

A
MINUTES
READING
(megohms)
B
CORR. VALUE
(megohms)
READING
(megohms)
C
CORR. VALUE
(megohms)
READING
(megohms)
CORR. VALUE
(megohms)
0.25
0.50
0.75
1.00
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
P. I.
D. A. R.
INSULATION
CONDITION
DAR
60/30 SEC
POLARIZATION
INDEX (PI)
POOR
QUESTIONABLE
GOOD
EXCELLENT
<1
1.0 - 1.25
1.4 - 1.6
> 1.6
<1
1.0 - 2
2-4
>4

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
97560, REVISED 10/10/2013
ROTATING MACHINERY
PAGE
DATE
10/13/2014
SUBSTATION
TEMPERATURE
HUMIDITY
EQPT. LOCATION
Example Plant
POSITION
AUTOMATED
ROTATING MACHINERY
418
POLARIZATION CURVE
A : Red Square
B : Blue Circle
C : Green Triangle
COMMENTS:
DEFICIENCIES:
www.powerdb.com
97560, REVISED 10/10/2013
MOTOR HIGH POTENTIAL TEST
OWNER
ADDRESS
CUSTOMER
419
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
ROTATING MACHINERY
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
RPM
FULL LOAD CURRENT
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
CONNECTED EQUIPMENT
MOTOR TEMPERATURE
TEST VOLTAGE UTILIZED:
DC
AC, 60HZ
AC, 180HZ
Winding 1
TIME
MINUTES
TEST
VOLTAGE
(volts)
WINDING
1
WINDING
2
Winding 2
Winding 3
WINDING
3
0.25
0.50
0.75
1.00
1.25
1.50
1.75
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00
11.00
12.00
13.00
14.00
15.00
16.00
17.00
18.00
19.00
20.00

TESTED BY:
www.powerdb.com
32200, REVISED 4/22/2009
MOTOR HIGH POTENTIAL TEST
PAGE
420
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32200, REVISED 4/22/2009
SYNCHRONOUS MOTOR
OWNER
421
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
ROTATING MACHINERY
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
FULL LOAD CURRENT
RPM
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
FIELD INFORMATION
TYPE
SERIAL NO.
CURRENT RATING
AMPS
VOLTAGE
TEMPERATURE RISE
VDC
POWER FACTOR
OTHER
CONNECTED EQUIPMENT
MOTOR TEMPERATURE

STATOR WINDING TEST
CAPACITANCE
TYPE OF TEST
TEST
kV
SW.
POS.
DIAL READING
NORM.
REV.
CALC.
AVG.
MULTIPLIER
PICO
FARADS
DIAL READING
NORM.
REV.
CALC.
AVG.
MULTIPLIER
MEAS.
%
20C
%
CALC.
%
P.F.
25% GST=STATOR-GND; RTR GND

25% UST=STATOR-ROTOR
100% UST=STATOR-ROTOR
ROTOR WINDING TEST
25% GST=RTR-GND; STATOR GND
25% UST=ROTOR-STATOR
100% UST=ROTOR-STATOR
DF
PF =
1 + DF

TESTED BY:
www.powerdb.com
32500, REVISED 4/22/2009
SYNCHRONOUS MOTOR
PAGE
422
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32500, REVISED 4/22/2009
SYNCHRONOUS MOTOR
WINDING RESISTANCE
OWNER
423
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
ROTATING MACHINERY
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
FULL LOAD CURRENT
RPM
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
FIELD INFORMATION
TYPE
SERIAL NO.
CURRENT RATING
AMPS
VOLTAGE
TEMPERATURE RISE
VDC
POWER FACTOR
OTHER
STATOR WINDING
R
WINDING MATERIAL:
COPPER
R
MEASURED
RESISTANCE
OHMS
RESISTANCE
CORRECTED TO
85 C, OHMS
T
T
T = TOTAL WINDING RESISTANCE AT 85C

M = TOTAL WINDING RESISTANCE AT TEST TEMPERATURE
S = TEMPERATURE FOR DESIRED RESISTANCE (85C)
M = AMBIENT TEMPERATURE
K = TEMPERATURE RESISTANCE CONSTANT (C)
PHASE A -
COPPER = 234.5C
PHASE B -
DELTA WINDING MULTIPLIER = 3/2X
PHASE C -
WYE WINDING MULTIPLIER = 3X
TOTAL WINDING RESISTANCE

ROTOR WINDING
WINDING MATERIAL:
COPPER
CONNECTED CONFIGURATION:
CALCULATED RESITANCE
CORRECTED TO 85C
MEASURED RESISTANCE
OHMS
DELTA
MOTOR TEMPERATURE
WYE
C
OHMS
FIELD RESISTOR
NAMEPLATE VALUE
MEASURED RESISTANCE
OHMS
CALCULATED RESISTANCE
CORRECTED TO 85C
OHMS
OHMS

T S + TK
R T = RM T M + TK
TESTED BY:
www.powerdb.com
32700, REVISED 4/22/2009
SYNCHRONOUS MOTOR
WINDING RESISTANCE
PAGE
424
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32700, REVISED 4/22/2009
SYNCHRONOUS MOTOR
ROTOR WINDING VOLTAGE DROP TEST
OWNER
425
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
ROTATING MACHINERY
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
FULL LOAD CURRENT
RPM
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
FIELD INFORMATION
TYPE
SERIAL NO.
CURRENT RATING
AMPS
VOLTAGE
TEMPERATURE RISE
VDC
POWER FACTOR
OTHER
COIL NO.
VOLTAGE READING (volts)
COIL NO.
VOLTAGE READING
COIL NO.
21
41
22
42
23
43
24
44
25
45
26
46
27
47
28
48
29
49
10
30
50
11
31
51
12
32
52
13
33
53
14
34
54
15
35
55
16
36
56
17
37
57
18
38
58
19
39
59
20
40
60
APPLIED TEST VOLTAGE
VAC

VOLTAGE READING
TESTED BY:
www.powerdb.com
32800, REVISED 4/22/2009
SYNCHRONOUS MOTOR
ROTOR WINDING VOLTAGE DROP TEST
PAGE
426
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32800, REVISED 4/22/2009
MOTOR DISSIPATION FACTOR TEST
OWNER
427
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
ROTATING MACHINERY
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
RPM
FULL LOAD CURRENT
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
CONNECTED EQUIPMENT
MOTOR TEMPERATURE
CAPACITANCE
TEST
TYPE OF TEST
TEST
kV
SW.
POS.
DIAL READING
NORM.
REV.
CALC.
AVG.
MULTIPLIER
CAP.
pF
DIAL READING
NORM.
REV.
CALC.
AVG.
MULTIPLIER
MEAS.
%
20
%
CALC.
%
P.F.
20C
1
2
3
4
5
6
WINDING TIP UP TESTS

1. GST - WINDING 1 - GROUND @ 25% TEST VOLTAGE
DF
2. GST - WINDING 1 - GROUND @100% TEST VOLTAGE
PF =
1 + DF


TESTED BY:
www.powerdb.com
32100, REVISED 4/22/2009
MOTOR DISSIPATION FACTOR TEST
PAGE
428
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32100, REVISED 4/22/2009
MOTOR STATOR
WINDING RESISTANCE TEST
OWNER
ADDRESS
CUSTOMER
429
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
ROTATING MACHINERY
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
FULL LOAD CURRENT
RPM
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
R
R
T
T
T
CONNECTED CONFIGURATION
DELTA
WYE
T = TOTAL WINDING RESISTANCE AT 85C

M = TOTAL WINDING RESISTANCE AT TEST TEMPERATURE
MOTOR TEMPERATURE

K = TEMPERATURE RESISTANCE CONSTANT (C)
COPPER = 234.5C

MEASURED
RESISTANCE
OHMS
RESISTANCE
CORRECTED TO
85 C, OHMS
PHASE A - T1 - T2
PHASE B - T3 - T4
T S + TK
R T = RM T M + TK
PHASE C - T5 - T6
TOTAL RESISTANCE

TESTED BY:
www.powerdb.com
32300, REVISED 4/22/2009
MOTOR STATOR
WINDING RESISTANCE TEST
PAGE
430
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32300, REVISED 4/22/2009
SYNCHRONOUS MOTOR
HIGH POTENTIAL TEST
OWNER
ADDRESS
CUSTOMER
431
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
ROTATING MACHINERY
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
FRAME
HORSEPOWER
VOLTAGE
PHASE
FREQUENCY
AMPS
HZ
FULL LOAD CURRENT
RPM
AMPS
POWER FACTOR
SERVICE FACTOR
TEMPERATURE RISE
DATE MANUFACTURED
NEMA DESIGN
SHAFT DIAMETER
LISTING
INSULATION CLASS
WEIGHT
UL
CSA
OTHER
THERMALLY PROTECTED
OTHER INFORMATION
FIELD INFORMATION
TYPE
SERIAL NO.
CURRENT RATING
AMPS
VOLTAGE
TEMPERATURE RISE
VDC
POWER FACTOR
OTHER
CONNECTED EQUIPMENT
MOTOR TEMPERATURE
TEST VOLTAGE
C
kV
DC
AC
STATOR HIGH POTENTIAL TEST

TIME
MINUTES
TEST
VOLTAGE (kV)
0.25
0.50
0.75
1.00
1.25
1.50
1.75
2.00
3.00
4.00
5.00
6.00
7.00
8.00
9.00
10.00

TESTED BY:
www.powerdb.com
32600, REVISED 4/22/2009
SYNCHRONOUS MOTOR
HIGH POTENTIAL TEST
PAGE
432
COMMENTS:
DEFICIENCIES:
www.powerdb.com
32600, REVISED 4/22/2009
MEDIUM VOLTAGE
SWITCHBOARD INSULATION TEST
OWNER
433
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SWITCHBOARDS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
TYPE
DRAWING NO.
PHASE AMPACITY
VOLTAGE CLASS
WITHSTAND RATING
kA
CONDUCTOR
CU
AL
INSTALLED DEVICES
VACUUM BREAKERS
AIR BREAKERS
LOADBREAK DISCONNECTS
VOLTAGE RELAYS
NUMBER OF BAYS
OVERCURRENT RELAYS
OTHER PROTECTIVE RELAYS
AUXILIARY RELAY
PANEL METERS
kWHR METERS
VT's
CPT's
CT's
OTHER
DESCRIPTION
INSPECTED
CONDITION
CLEANED/LUBED
OVERALL CLEANLINESS
INSULATING MEMBERS
CUBICLES
GROUND CONNECTIONS
AUXILIARY DEVICES
kVDC
TEMPERATURE CORRECTION FACTOR TO 20C, TCF =

PHASE
BUS SECTION TESTED
A-GND
B-GND
C-GND
N-GND
A-B
A-C
B-C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
ACTUAL READING
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
50000, REVISED 8/26/2013
SWITCHBOARD BUS
CONNECTION TEST
OWNER
ADDRESS
CUSTOMER
434
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SWITCHBOARDS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
DRAWING NO.
PHASE AMPACITY
BUS SECTION TESTED

FROM
TO
VOLTAGE CLASS
WITHSTAND RATING
A
TYPE
BUS SECTION TESTED

G
FROM

kA
TO
TESTED BY:
www.powerdb.com
CONDUCTOR
CU
AL
A
50400, REVISED 4/22/2009
SWITCHBOARD BUS
CONNECTION TEST
PAGE
435
COMMENTS:
DEFICIENCIES:
www.powerdb.com
50400, REVISED 4/22/2009
LOW VOLTAGE
OWNER
ADDRESS
CUSTOMER
436
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SWITCHBOARDS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
TYPE
DRAWING NO.
PHASE AMPACITY
VOLTAGE CLASS
WITHSTAND RATING
kA
CONDUCTOR
CU
AL
INSTALLED DEVICES
DRAWOUT LVACB
BOLT-IN LVACB
DRAWOUT MCCB
BOLT-IN MCCB
BOLTED PRESSURE SWITCHES
FUSED DISCONNECTS
PROTECTIVE RELAYS
PANEL METERS
kWHR METERS
VT's
CT's
CPT's
OTHER
DESCRIPTION
INSPECTED
CONDITION
CLEANED/LUBED
OVERALL CLEANLINESS
INSULATING MEMBERS
CUBICLES
GROUND CONNECTION
AUXILIARY DEVICES
TEST VOLTAGE
kVDC
BUS SECTION TESTED
A-GND
B-GND
C-GND
N-GND
A-B
A-C
B-C
A-N
B-N
C-N
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C

TESTED BY:
www.powerdb.com
50100, REVISED 4/22/2009
LOW VOLTAGE
PAGE
437
COMMENTS:
DEFICIENCIES:
www.powerdb.com
50100, REVISED 4/22/2009
MEDIUM VOLTAGE
SWITCHBOARD HIGH POTENTIAL TEST
OWNER
ADDRESS
CUSTOMER
438
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SWITCHBOARDS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
DRAWING NO.
PHASE AMPACITY
TYPE
VOLTAGE CLASS
WITHSTAND RATING
kA
CONDUCTOR
CU
AL
INSTALLED DEVICES
VACUUM BREAKERS
AIR BREAKERS
NUMBER OF BAYS
VOLTAGE RELAYS
OVERCURRENT RELAYS
AUXILIARY RELAYS
PANEL METERS
kWHR METERS
VT's
CPT's
CT's
OTHER
DESCRIPTION
INSPECTED
CONDITION
CLEANED/LUBED
OVERALL CLEANLINESS
INSULATING MEMBERS
CUBICLES
GROUND CONNECTIONS
AUXILIARY DEVICES
kVDC
TEST VOLTAGE MULTIPLIER
K1 = RANGE MULTIPLIER
HIGHPOTENTIAL TESTS
LEAKAGE - MICROAMPS
BUS SECTION TESTED
K1
A-GND
B-GND
C-GND
N-GND
BUS HIGH POTENTIAL TESTS
CONDUCTED PHASE TO GROUND,
WITH OTHER CONDUCTORS
GROUNDED. LEAKAGE RECORDED
AFTER TEST VOLTAGE APPLIED
FOR ONE MINUTE.
RDG.
TOTAL LEAKAGE
RDG.
TOTAL LEAKAGE
RDG.
TOTAL LEAKAGE
TOTAL LEAKAGE = ( K1 ) ( ACTUAL READING )
RDG.
TOTAL LEAKAGE
RDG.
TOTAL LEAKAGE

TESTED BY:
www.powerdb.com
50050, REVISED 4/22/2009
MEDIUM VOLTAGE
SWITCHBOARD HIGH POTENTIAL TEST
PAGE
439
COMMENTS:
DEFICIENCIES:
www.powerdb.com
50050, REVISED 4/22/2009
MEDIUM VOLTAGE
OWNER
ADDRESS
CUSTOMER
440
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
SWITCHBOARDS
SUBSTATION
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
TYPE
DRAWING NO.
PHASE AMPACITY
VOLTAGE CLASS
WITHSTAND RATING
kA
CONDUCTOR
CU
AL
INSTALLED DEVICES
VACUUM BREAKERS
AIR BREAKERS
VOLTAGE RELAYS
NUMBER OF BAYS
OVERCURRENT RELAYS
AUXILIARY RELAY
PANEL METERS
kWHR METERS
VT's
CPT's
CT's
OTHER
DESCRIPTION
INSPECTED
CONDITION
CLEANED/LUBED
OVERALL CLEANLINESS
INSULATING MEMBERS
CUBICLES
GROUND CONNECTIONS
AUXILIARY DEVICES
kVDC
TEST VOLTAGE MULTIPLIER, K1
K2 = (K1) (TCF)
TEMPERATURE CORRECTION FACTOR TO 20C, TCF =

BUS SECTION TESTED
RANGE
MULT.
PHASE
K2
A-GND
B-GND
C-GND
N-GND
A-B
A-C
B-C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
RDG.
20C
ACTUAL READING

TESTED BY:
www.powerdb.com
50000, REVISED 9/10/2012
MEDIUM VOLTAGE
PAGE
441
COMMENTS:
DEFICIENCIES:
www.powerdb.com
50000, REVISED 9/10/2012
SWITCHGEAR INSPECTION
OWNER
442
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SWITCHBOARDS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
TYPE
CURRENT RATING
VOLTAGE CLASS
VOLTS
CONDITION
REMARK NUMBER
AMPERES
ADDITIONAL INFORMATION
INSPECTIONS
EXTERIOR OF EQUIPMENT
ALL INTERIOR OF CUBICLES
ALL INTERIOR BUS
DOORS
DOOR HANDLES
LOCKING BARS / MECHANISMS
INSTRUMENTS
RELAY COVERS
BREAKER
CELL CONTACTS
CONTROL TRANSFORMERS
GROUNDING
RAILS
GUIDES
WIRING
TERMINAL CONNECTIONS
GRID ASSEMBLIES
SPACE HEATERS
CELL INTERLOCKS
AUXILIARY CONTACT ASSEMBLIES
FILTERS IN PLACE
VENTS ARE CLEAR
CONDITION
CABLE SYSTEMS
BUS SUPPORT INSULATORS AND SPACING
REMARK NUMBER
PANELS
BRACKETS
METERING TRANSFORMERS
ROLLERS
INSTRUMENTS
SHUTTER MECHANISMS
SYSTEM MAINTENANCE AND CHECKS
TORQUE-TEST BOLTED BUS (READILY ACCESSIBLE CONNECTIONS ONLY)
LUBRICATE DRAW-OUT ASSEMBLY PARTS
VACUUM AND CLEAN INTERIOR OF CUBICLES
OPERATE CONTROLS AND CHECK CORRECTNESS OF FUNCTIONS
CHECK AUTOMATIC TRANSFER RELAY OPERATION (IF USED)
ANNUNCIATOR
= ITEMS FOUND IN SATISFACTORY CONDITION
= ITEMS FOUND IN POOR CONDITION AND REQUIRING FUTURE CORRECTIVE ACTION
= ITEMS REPAIRED OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
= ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONS

ALARM / TARGET OPERATION
TESTED BY:
www.powerdb.com
REVISED 6/22/2010
SWITCHGEAR INSPECTION
443
PAGE
DESCRIBE WHAT WAS TESTED
REFERENCE STANDARD:
NETA
ACCEPTABLE
TEST VOLTAGE:
VOLTS DC
DURATION:
MINUTE(S)
MEASURED
RECOMMENDED
RESULT
RESULT
MINIMUM
ACCEPTABLE
(MEGOHMS)
(MEGOHMS)
(YES / N0)
PHASE - TO - PHASE - AND - GROUND

PHASE A TO PHASE B, PHASE C AND GROUND
PHASE B TO PHASE C, PHASE A AND GROUND
PHASE C TO PHASE A, PHASE B AND GROUND
OVERPOTENTIAL
DESCRIBE WHAT WAS TESTED
REFERENCE STANDARD:
NETA
ACCEPTABLE
TEST VOLTAGE:
VOLTS DC
DURATION:
MINUTE(S)
MEASURED
RESULT
RESULT
RESULT
ACCEPTABLE
(MEGOHMS)
(PASS / FAIL)
(YES / N0)
PHASE - TO - PHASE - AND - GROUND

PHASE A TO PHASE B, PHASE C AND GROUND
PHASE B TO PHASE C, PHASE A AND GROUND
PHASE C TO PHASE A, PHASE B AND GROUND
CONNECTION RESISTANCE
CONNECTION FROM
CONNECTION TO
MEASURED RESULT
(
OHMS)
ACCEPTABLE
(YES / NO)
CONNECTION FROM
CONNECTION TO
PHASE
PHASE
PHASE
PHASE
PHASE
PHASE
CONNECTION FROM
CONNECTION FROM
CONNECTION TO
CONNECTION TO
PHASE
PHASE
PHASE
PHASE
PHASE
PHASE
NETA
ARE RESULTS SATISFACTORY
MEASURED RESULT
(
OHMS)
ACCEPTABLE
(YES / N0)
CONNECTION RESISTANCE REQUIREMENT: COMPARE RESULTS TO RESULTS OF SIMILAR CONNECTIONS.

YES
NO
( IF NO, SEE COMMENTS FOR AN EXPLANATION )
COMMENTS:
DEFICIENCIES:
www.powerdb.com
REVISED 6/22/2010
POWER PANEL INSULATION TEST
OWNER
ADDRESS
CUSTOMER
444
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SWITCHBOARDS
SUBSTATION
POSITION
MANUFACTURER
CATALOG NO.
SERIAL NO.
VOLTAGE
TYPE
AMPACITY
PANEL WITHSTAND RATING
MAIN
NO. FEEDER DISCONNECTS
OTHER
FED FROM
TYPE OF LOADS
MLO
NO. FEEDER BREAKERS
PANEL DESIGNATION:
TEST VOLTAGE
kVDC
PANEL LOCATION:
TEST RESULTS - MEGOHMS

RDG.
20C
RDG.
20C
RDG.
A - GRD
A-B
A-N
B - GRD
A-C
B-N
C - GRD
B-C
C-N
20C
N - GRD
CONNECTED EQUIPMENT
MANUFACTURER
CATALOG NO.
SERIAL NO.
VOLTAGE
TYPE
AMPACITY
PANEL WITHSTAND RATING
MAIN
NO. FEEDER DISCONNECTS
OTHER
FED FROM
TYPE OF LOADS
MLO
NO. FEEDER BREAKERS
PANEL DESIGNATION:
TEST VOLTAGE
kVDC
PANEL LOCATION:
TEST RESULTS - MEGOHMS

RDG.
20C
RDG.
20C
RDG.
A - GRD
A-B
B - GRD
A-C
B-N
C - GRD
B-C
C-N
20C
A-N
N - GRD
CONNECTED EQUIPMENT

TESTED BY:
www.powerdb.com
50300, REVISED 6/22/2010
POWER PANEL INSULATION TEST
PAGE
445
COMMENTS:
DEFICIENCIES:
www.powerdb.com
50300, REVISED 6/22/2010
ASCO TRANSFER SWITCH CALIBRATION REPORT

NEW GROUP 7 CONTROL PANEL
OWNER
ADDRESS
CUSTOMER
446
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFER SWITCHES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
SYSTEM VOLTAGE
WIRING NO.
CONTROLS TYPE:
TYPE
AMPACITY
ELECTROMECHANICAL
SOLID STATE
MICROPROCESSOR
INSTALLED OPTIONS
TIME DELAYS
AS FOUND
OVERRIDE MOMENTARY OUTAGES

ADJUSTMENT RANGE 0 TO 6 SEC. OFF OFF ON OFF
FACTORY SET @ 1 SEC.
5
6
7 8
TIMING TEST RESULTS
RETRANSFER TO NORMAL
ADJUSTMENT RANGE 0 TO 30 MIN. OFF OFF ON OFF
FACTORY SET @ 30 MIN.
1
2
3 4
TIMING TEST RESULTS
NO LOAD ENGINE COOL DOWN
ADJUSTMENT RANGE 0 TO 60 MIN. OFF OFF ON OFF
FACTORY SET @ 5 MIN.
5
6
7 8
TIMING TEST RESULTS
TRANSFER TO EMERGENCY
ADJUSTMENT RANGE 0 TO 5 MIN. OFF OFF OFF OFF
1
2
3
4
TIMING TEST RESULTS
SENSOR SETTINGS
NORMAL SOURCE PICKUP VOLTAGE
PHASE A
ADJUSTMENT RANGE 85 TO 100%
PHASE B
FACTORY SET @ 90%
PHASE C
DIP SWITCH
OFF ON OFF ON
SETTINGS
OFF
FACTORY SET @ 60 HERTZ
OFF = 3 PHASE ON = 1 PHASE

IN-PHASE MONITOR
ON = ACTIVE,
OFF = OFF
SEC
5
MIN
MIN
MIN
SEC
%
MIN
MIN
VOLTS
SEC
5
MIN
SEC
VOLTS
SEC
VOLTS
DROPOUT
EMERGENCY FREQUENCY
PHASE SELECTION
PICKUP
OFF ON OFF ON
SETTINGS
SEC
5
AS LEFT
EMERGENCY SOURCE VOLTAGE PICKUP

FACTORY SET @ 90%
DIP SWITCH
SPECIFIED
OFF
7
OFF
NORMAL SOURCE DROP-OUT VOLTAGE

ADUSTMENT RANGE 75 TO 98%
FACTORY SET @ 94%
EMERGENCY FREQUENCY PICKUP
PHASE A
PHASE B
PHASE C
1
ADJ. RANGE 90-100% FACTORY SET @ 95%

TESTED BY:
www.powerdb.com
54300, REVISED 4/22/2009
ASCO TRANSFER SWITCH CALIBRATION REPORT

NEW GROUP 7 CONTROL PANEL
PAGE
447
COMMENTS:
DEFICIENCIES:
www.powerdb.com
54300, REVISED 4/22/2009
AUTOMATIC TRANSFER SWITCH TEST

TS UNIT
OWNER
448
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFER SWITCHES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
SYSTEM VOLTAGE
TYPE
WIRING NO.
CONTROLS TYPE:
AMPACITY
ELECTROMECHANICAL
SOLID STATE
MICROPROCESSOR
INSTALLED OPTIONS
DESCRIPTION
INSPECTED
CONDITION
CLEAN/LUBE
OVERALL CLEANLINESS
INSULATING MEMBERS
STRUCTURAL MEMBERS
CUBICLE
RACKING DEVICES
CONTACT FINGERS
MAIN CONTACTS
ARCING CONTACTS
ARC CHUTES
OPERATING MECHANISM
CONTACT SEQUENCE
GROUND CONNECTION
AUXILIARY DEVICES
LOAD CONDUCTOR NO./ PHASE:
SIZE:
KCM:
CU
AL
POLE RESISTANCE
R
R
T
T
T
TEMPERATURE CORRECTION FACTOR 20C, TCF
T = TOTAL POLE RESISTANCE AT 85C

M = TOTAL POLE RESISTANCE AT TEST TEMPERATURE
T S + TK
R T = RM T M + TK

K = TEMP. RESISTANCE CONSTANT (C)
COPPER = 234.5C
NORMAL
POLE
AS FOUND
20C
EMERGENCY
AS LEFT
20C
POLE
AS FOUND
20C
AS LEFT
20C
N
MICRO-OHMS LINE TO LOAD
MICRO-OHMS LINE TO LOAD

TESTED BY:
www.powerdb.com
54100, REVISED 4/22/2009

TS UNIT
PAGE
449
COMMENTS:
DEFICIENCIES:
www.powerdb.com
54100, REVISED 4/22/2009

OLD GROUP 8 OR GROUP 9 CONTROL PANEL
OWNER
450
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFER SWITCHES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
SYSTEM VOLTAGE
TYPE
WIRING NO.
CONTROLS TYPE:
AMPACITY
ELECTROMECHANICAL
SOLID STATE
MICROPROCESSOR
INSTALLED OPTIONS
115 - 125
28.5 - 31.5
10.4 - 11.9
6
7
8
TEST KIT
CKT BOARD
TEST KIT
CKT BOARD
SWITCH NO. TEST VLTG SWITCH NO. TEST VLTG
VALUES
TEST KIT
CKT BOARD
SWITCH NO. TEST VLTG
SPECIFIED
TEST KIT
CKT BOARD
SWITCH NO. TEST VLTG
AS FOUND
VALUES
A2 BOARD
SWITCH S18 TESTS
SPECIFIED
VALUES
A1 BOARD
SWITCH S18 TESTS
111 - 121
28 - 31
9.3 - 10.3
10.4 - 11.9
S14 ON
S15 OFF
TEST KIT
CKT BOARD
TEST KIT
CKT BOARD
SWITCH NO. TEST VLTG SWITCH NO. TEST VLTG
S14 ON
S14 ON
S15 OFF
S15 OFF
4
S16 OFF
4
S16 OFF
4
S16 OFF
TIME DELAY CALIBRATION

AS FOUND
SPECIFIED
AS LEFT

ACC
NO. 1
ADJUSTMENT RANGE 0.5 TO 6 SEC.

ACC
NO. 2B
ADJUST RANGE UP: 0-60 SEC DOWN 0-8 MIN

NO-LOAD ENGINE COOL DOWN
ACC
NO. 2E
ADJUST RANGE UP: 0-8 SEC DOWN 0.5-30 MIN

FACTORY SET @ 5 MINS
RE-TRANSFER TO NORMAL
ACC
NO. 3
ADJUST RANGE UP: 0 SEC DOWN: 0.5-30 MIN

SENSOR SETTINGS (120V BASE)

FACTORY SET @ 90%
NORMAL SOURCE DROPOUT VOLTAGE
FACTORY SET @ 85%
EMERGENCY SOURCE VOLTAGE
FACTORY SET @ 90%
EMERGENCY SOURCE FREQUENCY
FACTORY SET @ 95%
READING
READING
READING
PHASE B
PHASE C
PHASE A
PHASE B
PHASE C
PICKUP
15%
FIXED
DROPOUT
PICKUP
12%
FIXED
DROPOUT

PHASE A
TESTED BY:
www.powerdb.com
54500, REVISED 4/22/2009

OLD GROUP 8 OR GROUP 9 CONTROL PANEL
PAGE
451
COMMENTS:
DEFICIENCIES:
www.powerdb.com
54500, REVISED 4/22/2009
OWNER
452
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFER SWITCHES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
SYSTEM VOLTAGE
TYPE
WIRING NO.
CONTROLS TYPE:
AMPACITY
ELECTROMECHANICAL
SOLID STATE
MICROPROCESSOR
INSTALLED OPTIONS
DESCRIPTION
OVERALL CLEANLINESS
INSULATING MEMBERS
STRUCTURAL MEMBERS
MAIN CONTACTS
ARCING CONTACTS
INSPECTED
CONDITION
CLEAN/LUBE
TIME DELAYS
DESCRIPTION
ARCING CHUTES
OPERATING MECHANISM
CONTACT SEQUENCE
GROUND CONNECTION
AUXILIARY DEVICES
LOAD CONDUCTOR NO.
SPECIFIED
INSPECTED
CONDITION
SIZE
CLEAN/LUBE
CU
AS FOUND
AL
AS LEFT

ADJUSTMENT RANGE:
FACTORY SET @
SEC
ADJUSTMENT RANGE:
FACTORY SET @
SEC
NO LOAD ENGINE COOL DOWN

ADJUSTMENT RANGE:
FACTORY SET @
MIN
ADJUSTMENT RANGE:
FACTORY SET @
SENSOR SETTINGS
MIN
NOMINAL VOLTAGE:

ADJUSTMENT RANGE:
FACTORY SET @
TCF TO 20C
PHASE B
PHASE A
PHASE B
PICKUP
NORMAL
AS FOUND
20C
EMERGENCY
AS LEFT
20C
A
C
POLE
AS FOUND
20C
AS LEFT
20C

DROPOUT
POLE RESISTANCE
TESTED FROM LINE TO
LOAD TERMINALS
VOLTS & HZ
DROPOUT
POLE
PICKUP

ADJUSTMENT RANGE:
EQPT. TEMP
VOLTZ & HZ
PHASE C

ADJUSTMENT RANGE:
%
FACTORY SET @
FACTORY SET @
PHASE C

ADJUSTMENT RANGE:
FACTORY SET @
VOLTS & HZ
PHASE A
TESTED BY:
www.powerdb.com
54000, REVISED 4/22/2009
PAGE
453
COMMENTS:
DEFICIENCIES:
www.powerdb.com
54000, REVISED 4/22/2009
AUTOMATIC TRANSFER SWITCH

CONTROLS TEST
OWNER
454
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFER SWITCHES
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
SYSTEM VOLTAGE
TYPE
WIRING NO.
CONTROLS TYPE:
AMPACITY
ELECTROMECHANICAL
SOLID STATE
MICROPROCESSOR
INSTALLED OPTIONS
TIME DELAYS
AS FOUND
SPECIFIED
AS LEFT

ADJUSTMENT RANGE:
FACTORY SET @
SEC
ADJUSTMENT RANGE:
FACTORY SET @
SEC

ADJUSTMENT RANGE:
FACTORY SET @
MIN
ADJUSTMENT RANGE:
FACTORY SET @
MIN
NOMINAL VOLTAGE:
AS FOUND
SENSOR SETTINGS

ADJUSTMENT RANGE:
FACTORY SET @
VOLTS
ADJUSTMENT RANGE:
FACTORY SET @
VOLTS
ADJUSTMENT RANGE:
FACTORY SET @
VOLTS
ADJUSTMENT RANGE:
FACTORY SET @
HERTZ
VOLTS & HZ
VOLTZ & HZ
AS LEFT
%
VOLTS & HZ
PHASE A
PHASE B
PHASE C
PHASE A
PHASE B
PHASE C
PICKUP
DROPOUT
PICKUP
DROPOUT

SPECIFIED
%
TESTED BY:
www.powerdb.com
54200, REVISED 4/22/2009

CONTROLS TEST
PAGE
455
COMMENTS:
DEFICIENCIES:
www.powerdb.com
54200, REVISED 4/22/2009

NEW GROUP 8 OR 9 CONTROL PANEL
OWNER
456
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFER SWITCHES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
SYSTEM VOLTAGE
TYPE
WIRING NO.
CONTROLS TYPE:
AMPACITY
ELECTROMECHANICAL
SOLID STATE
MICROPROCESSOR
INSTALLED OPTIONS
SWITCH S18 TEST - NORMAL

CONTROL PANEL
TEST KIT
SWITCH NO.
CKT BOARD
TEST VLTG
SWITCH S18 TESTS - EMERGENCY
TEST KIT
SWITCH NO.
CKT BOARD
TEST VLTG
TEST KIT
SWITCH NO.
CKT BOARD
TEST VLTG
TEST KIT
SWITCH NO.
CKT BOARD
TEST VLTG
10.6 - 12.2
TIME DELAY CALIBRATION
4
5
POTENTIOMETER/
ACTUATOR
25.8 - 28.8
10.6 - 12.2
TIMING
ACTUATOR
UP/DOWN
AS FOUND
ACTUATOR
UP/DOWN
EMERGENCY
10 - 11.6
AS LEFT
EMERGENCY
28 - 31
SPECIFIED
111 - 121
NORMAL
AS LEFT
NORMAL
SPECIFIED
TEST
SPECIFIED
AS LEFT
TIMING
ACTUATOR
UP/DOWN
TIMING

ACC
NO. 1
ADJUSTMENT RANGE 0.5 TO 6 SEC.
P4 / NA

ACC
NO. 2B
ADJUST RANGE UP: 0-60 SEC DOWN 0-8 MIN
P2 / 2

ACC
NO. 2E
ADJUST RANGE UP: 0-8 SEC DOWN 0.5-30 MIN
P3 / 3

ACC
NO. 3
ADJUST RANGE UP: 0 SEC DOWN: 0.5-30 MIN
P1 / 1

SENSOR SETTINGS (120V BASE)
FACTORY SET @ 90%
FACTORY SET @ 85%
FACTORY SET @ 90%
FACTORY SET @ 95%
READING
READING
READING
PHASE B
PHASE C
PHASE A
PHASE B
PHASE C
PICKUP
15%
FIXED
DROPOUT
PICKUP
12%
FIXED
DROPOUT

PHASE A
TESTED BY:
www.powerdb.com
54400, REVISED 4/22/2009

NEW GROUP 8 OR 9 CONTROL PANEL
PAGE
457
COMMENTS:
DEFICIENCIES:
www.powerdb.com
54400, REVISED 4/22/2009

OLD GROUP 8 / GROUP 9 CONTROL PANEL
OWNER
458
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFER SWITCHES
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
CATALOG NO.
SYSTEM VOLTAGE
TYPE
WIRING NO.
CONTROLS TYPE:
AMPACITY
ELECTROMECHANICAL
SOLID STATE
MICROPROCESSOR
INSTALLED OPTIONS
MOTHER BOARD CHECK OUT
TEST POINT
NORMAL
1 - 15
82.6 - 91.4 VAC
2 - 15
82.6 - 91.4 VAC
3 - 15
82.6 - 91.4 VAC
4 - 15
21.8 - 24.1 VAC
5 - 15
21.8 - 24.1 VAC
6 - 15
21.8 - 24.1 VAC
7 - 15
21.8 - 24.1 VAC
8 - 15
21.8 - 24.1 VAC
9 - 15
21.8 - 24.1 VAC
10 - 15
28.5 - 31.5 VDC
11 - 15
115.9 - 128.1 VDC
82.6 - 91.4 VAC
13 - 15
21.8 - 24.1 VAC
14 - 15
21.8 - 24.1 VAC
A1 BOARD
A2 BOARD
SWITCH S18 TESTS
SWITCH S18 TESTS
CKT BOARD
TEST KIT
CKT BOARD
TEST KIT
CKT BOARD
TEST VLTG SWITCH NO. TEST VLTG SWITCH NO. TEST VLTG
28.5 - 31.5
10.4 - 11.9
7
8
VALUES
6
SPECIFIED
115 - 125
VALUES
VALUES
SPECIFIED
26.1 - 28.9 VDC
12 - 15
(CP30 DISCONNECTED)
10 - 15
AS FOUND
TEST KIT
111 - 121
28 - 31
TEST KIT
CKT BOARD TEST KIT CKT BOARD TEST KIT CKT BOARD
SWITCH NO. TEST VLTG SWITCH NO. TEST VLTG SWITCH NO. TEST VLTG
S14 ON
S14 OFF 2
9.3 - 10.3
10.4 - 11.9
S16 OFF
S15 ON
2
3
S15 OFF
S16 OFF 5
TESTED BY:
www.powerdb.com
S14 OFF
S15 OFF

AS LEFT
(VAC)
(CP14 DISCONNECTED)
EMERGENCY
SWITCH NO.
AS FOUND
(VAC)
REFERENCE
4
S16 ON
54550, REVISED 4/22/2009

OLD GROUP 8 / GROUP 9 CONTROL PANEL
PAGE
459
COMMENTS:
DEFICIENCIES:
www.powerdb.com
54550, REVISED 4/22/2009
TRANSFORMER WINDING RESISTANCE QUICK TEST
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
460
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
TRANSFORMERS
POSITION
Asset ID:
MANUAL WINDING RESISTANCE

First Winding Units:
Second Winding Units:
Ohms
Ohms
Winding Material:
Cu
Please select the First (and Second) Winding to test

Test #
Description
Current
(amp)
First
Winding
First Winding
Reading
None

Serial Number:
www.powerdb.com
Second Winding
Reading
Reading Stability %
First
Second
None
TESTED BY:
Second
Winding
Calibration Date:
56301, REVISED 1/10/2014
MAGNETIC BALANCE
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
461
FORMS - ALL
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
Nameplate Data
Serial Number
Manufacturer
Winding Material
Allowed Error
Year
Phases
Reason
Weight
Cu
%
Class
Coolant
Oil Volume
Oil Temp
3
lb
YNyn0
Voltage (kV)
Diagram # 7
kVA
Rated I
BIL
Impedance
Weather
Tank Type
OIL
GAL
C
#
Taps
Nominal
Changer
Primary
Off Load
Secondary
On Load
kV
%
SEALED
Tap Setting
(ANSI)
Transformer Turns Ratio
Tap
H/L
Voltage
H/L
Test
V
TTR
Actual
TTR
H1 - H0 / X1 - X0
%
I exc
error
mA
Phase
(Deg)
Actual
TTR
H2 - H0 / X2 - X0
%
I exc
error
mA
Phase
(Deg)
Actual
TTR
H3 - H0 / X3 - X0
%
I exc
error
mA
Phase
(Deg)
1 NominalNominal
2
H1
H0
H2
H0
H3
H0
Magnetic Balance Test
Applied Voltage to
High Voltage Side B/W
Measured Percentage (%)

H1-H0
H2-H0
H3-H0
H1-H0
0.0000
0.0000
0.0000
H2-H0
0.0000
0.0000
0.0000
H3-H0
0.0000
0.0000
0.0000
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
93510, REVISED 2/19/2014
Dd0
Diagram # 3
Detect Transformer Type
ASSET ID:
Windings
(ANSI)
Test
Voltage
(V)
Actual
TTR
TEST DATE:
Excitation
Current
(mA)
10/13/2014
Phase
Deviation
(degrees)
H1 - H3 / X1 - X3
H2 - H1 / X2 - X1
H3 - H2 / X3 - X2
Test 1 of 1

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56001, REVISED 11/26/2013
VOLTAGE REGULATOR
TURNS RATIO TEST
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
463
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
1
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
ALLOWED ERROR 1
CLASS
COOLANT OIL
BIL
VREG
Diagram # 43 (ANSI)
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
#
TAPS
5
1
NOMINAL CHANGER
3
3
Example Plant
AUTOMATED
PLANT
lb
DSG SERIAL NUM

S
L
SL
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
GAL
C
%
TAP
SETTING
DETC
DETC
COMMENTS:
High Side
Tap #
Voltage
Low Side
Tap #
Voltage
H1 - H2 / X2 - X1
Test
Volt
Calculated
Ratio
Actual
Ratio
Percent
Error
Excitation
Current (mA)
Phase
(Degrees)
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56370, REVISED 12/11/2013
Dd0
Diagram # 1
ASSET ID:
High Side
(ANSI)
Tap #
Voltage
TEST DATE:
Low Side
Tap #
Voltage
10/13/2014
H-H/X-X
Test
Volt
Calculated
Ratio
Actual
Ratio
Percent
Error
Excitation
Current (mA)
Phase
(Degrees)
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56003, REVISED 11/21/2013
THREE-WINDING TRANSFORMERS
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
465
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
YNyn0yn0
Diagram # 7
(ANSI)
VOLTAGE (kV) kVA

PRIMARY:
SECOND:
TERTIARY:
#
TAPS
RATED I
/
/
/
NOMINAL CHANGER
5
1
1
3
3
C HG + CHL
CHG
CHL
UST-R
3
4
5
6
7
8
9
10
11
12
13
14
15
11
12
CHL
CLG + CLT
CLG
CLT
CLT
CTG + CHT
CTG
CHT
Test
Mode
AMPS
YEAR
TAP
SETTING
DETC
LTC
LTC
TRANSFORMER OVERALL TEST SET UP
INSULATION
TESTED
kV
COMMENTS:
TEST FREQUENCY: 60
Test
No.
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
lb
H2
H3
GAL H0
C X1
% X2
X3
X0
Y1
Y2
Y3
Y0
Test Lead Connections

HV
Red
Blue Gnd
GSTg-B
GSTg-RB
TRANSFORMER OVERALL TEST RESULTS
TEST
kV
Freq
Sweep
Capacitance
C (pF)
DIRECT
POWER FACTOR %
%VDF
Measured
@ 20C
Corr Factor
mA
Watts
IR
Test 1 Minus Test 2

GSTg-R
GSTg-RB
UST-B
Test 5 Minus Test 6

GSTg-B
GSTg-RB
UST-R
CHT
CHG'
CLG'
CTG'
CH + CL + CT GSTg-RB
CH + CL + CT
Test 9 Minus Test 10

CHG Minus H Bushings
CLG Minus L Bushings
CTG Minus T Bushings
H
Test 2 + 6 + 10

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
94500, REVISED 12/17/2013
THREE-WINDING TRANSFORMERS
PAGE
466
EQUIVALENT CIRCUIT
INSULATION RATING KEY

G=GOOD
D=DETERIORATED
I=INVESTIGATE
B=BAD
NOTE:
SHORT EACH WINDING
ON ITSELF
Transformer - Bushing C1 Tests

Test
No.
Bushing Nameplate
Dsg.
SERIAL #
CAT. #
PF
Test
Cap. (pF) Mode
16 H1
UST-R
HI 17 H2
kV 18 H3
UST-R
19 H0
UST-R
20
X1
UST-R
LOW 21
kV
X2
UST-R
22
X3
UST-R
23
X0
UST-R
24
Y1
UST-R
T 25
kV 26
Y2
UST-R
Y3
UST-R
27
Y0
28
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
Measured
@ 20C Corr Factor
DIRECT
mA
WATTS
%VDF
IR
UST-R
UST-R
OIL TEST
UST-R

Test
No.
Bushing Nameplate
Dsg.
29
30
31
32
33
LOW 34
kV 35
36
37
LOW 38
kV 39
40
HI
kV
SERIAL #
CAT. #
H1
H2
H3
H0
X1
X2
X3
X0
Y1
Y2
Y3
Y0
PF
Cap. (pF)
Test
Mode
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
Measured
@ 20C Corr Factor
DIRECT
mA
WATTS
%VDF
IR
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
COMMENTS:
DEFICIENCIES:
www.powerdb.com
94500, REVISED 12/17/2013
ASSET ID:
DESCRIPTION:
MODE: UST:MEAS RED, GND BLUE
TEST
VOLTAGE
% POWER
FACTOR
DIRECT
MILLIAMPS
CAPACITANCE: 0.00 pF
WATTS
TRANSFORMER
IEC 61378-1
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
468
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
ALLOWED ERROR 0.05
Winding Type
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
#
TAPS
5
1
NOMINAL CHANGER
3
3
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
Example Plant
AUTOMATED
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
TAP
SETTING
DETC
LTC
COMMENTS:
TAP
H/L
Voltage
H/L
Test
V
TTR
Actual
TTR
%
error
Phase Angle (deg)
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56006, REVISED 12/2/2013
TRANSFORMER WINDING RESISTANCE TEST
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
469
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
MFR
SER NO
YEAR
TYPE
CLASS
PHASES
WEIGHT
WEATHER
BIL
IMPEDANCE
REASON
Max Wdg Diff (%):
SEALED
3
Example Plant
AUTOMATED
PLANT
POSITION
lb
kV
%
OIL VOLUME
OIL TEMP
WINDING TEMP
CORRECT TO
COOLANT
85
OIL
GAL
C
C
C
Dd0
Diagram # 3
kVA
VOLTAGE (kV)
RATED I
PRIMARY:
SECOND:
# TAPS
5
1
NOMINAL
3
1
CHANGER
TAP SETTING
DETC
DETC
(ANSI)
WINDING MATERIAL
Cu
Cu
HIGH VOLTAGE WINDING RESISTANCE
Show Graph
Units: Ohms
Measured Resistance
Current
(amp)
TAP
1
2
3
4
5
1
2
Nominal
4
5
Nameplate
Voltage
H1 - H3
H2 - H1
H3 - H2
Reading
Stability %
Winding
Difference %
0
0
0
0
0
LOW VOLTAGE WINDING RESISTANCE
Show Graph
Units: Ohms
Measured Resistance
Current
(amp)
TAP
Nominal
SHOW RESULTS
Nameplate
Voltage
X1 - X 3
X2 - X 1
X3 - X 2
Reading
Stability %
Winding
Difference %
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56353, REVISED 12/12/2013
THREE PHASE TTR TEST

WITH TAP CHANGER
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
470
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
ALLOWED ERROR 1
Dd0
Diagram # 3
(ANSI)
Example Plant
AUTOMATED
PLANT
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
HAS TERTIARY

VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
#
TAPS
5
1
NOMINAL CHANGER
3
3
TAP
SETTING
DETC
DETC
COMMENTS:
HIGH SIDE TAPS TO LOW SIDE NOMINAL TURNS RATIO TESTS
TAP
H/L
Voltage
H/L
Test
V
TTR
Actual
TTR
H1 - H3 / X1 - X3
%
I exc
Phase
error
mA
(Deg)
Actual
TTR
H2 - H1 / X2 - X1
%
I exc
Phase
error
mA
(Deg)
Actual
TTR
H3 - H2 / X3 - X2
%
I exc
Phase
error
mA
(Deg)
1
2
3
4
5
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56365, REVISED 12/19/2013
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
471
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
VREG
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
#
TAPS
5
1
NOMINAL CHANGER
3
3
lb
DSG SERIAL NUM

S
L
SL
Example Plant
AUTOMATED
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
GAL
C
%
TAP
SETTING
DETC
LTC
COMMENTS:
TEST FREQUENCY: 60
FLUID QUALITY
WATER CONTENT
(PPM)
INTERFACIAL TENSION
ACIDITY
(D/CM)
(MG KOH/G)
DIELECTRIC STRENGTH
(kV)
VISUAL EXAM
ASTM COLOR NO.
OIL TEMP (C)
SPECIFIC GRAVITY

* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
(CO)
CARBON DIOXIDE
(CO2)
NITROGEN
(N2)
OXYGEN
(O2)
TOTAL GAS
* COMBUSTIBLE GAS
www.powerdb.com
57954, PAGE 1 OF 4, REVISED 7/31/2013
USER
SUBSTATION
TRANSFORMERS
POSITION
AUTOMATED
PAGE
472
JOB #
FORMS - ALL
SERIAL NO.
* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
(C0)
CARBON DIOXIDE
(C02)
NITROGEN
(N2)
OXYGEN
(O2)
TOTAL
COMBUSTIBLE GAS
* COMBUSTIBLE GAS

www.powerdb.com
57952, PAGE 2 OF 4, REVISED 7/31/2013
USER
SUBSTATION
TRANSFORMERS
POSITION
AUTOMATED
PAGE
473
JOB #
FORMS - ALL
SERIAL NO.
DIELECTRIC STRENGTH
(KV)
INTERFACIAL TENSION
(D/CM)
ACIDITY
(MG KOH/G)
WATER CONTENT
(PPM)
SPECIFIC GRAVITY

www.powerdb.com
57954, PAGE 3 OF 4, REVISED 7/31/2013
USER
SUBSTATION
TRANSFORMERS
POSITION
AUTOMATED
PAGE
474
JOB #
FORMS - ALL
SERIAL NO.
COMMENTS:
DEFICIENCIES:
www.powerdb.com
57954, PAGE 4 OF 4, REVISED 7/31/2013
LEAKAGE REACTANCE AND

CAPACITANCE TEST
OWNER
475
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
Test
Delete All Data

Base KVA
LEAKAGE REACTANCE TEST

#
Type
HUMIDITY
Voltage
(volts)
Example Plant
AUTOMATED
PLANT
TRANSFORMERS
SUBSTATION
POSITION
Delete All (Leakage)
Delete All (Capacitance)
Base Voltage
% Impedance
Show (Leak)
% Reactance
Current
(amps)
Power
Power
Impedance Resistance Reactance
(watts) Factor (%)
(ohms)
(ohms)
(ohms)
Inductance Impedance
(mH)
(%)
Current
(amps)
Power
Power
Impedance Resistance Reactance Capacitance Impedance
(watts) Factor (%)
(ohms)
(ohms)
(ohms)
(uF)
(%)
Show (Cap)
T.O.C.
Delta %
Reactance
Impedance
(%)
Delta %
Reactance
Base KVA
CAPACITANCE TEST
#
Type
Voltage
(volts)
Base Voltage
% Impedance
% Reactance
T.O.C.
Delta %
Reactance
Impedance
(%)
Delta %
Reactance
1
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 2/21/2013
INSULATION TESTS
AUTO TRANSFORMERS WITH TERTIARY
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
476
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
3
PHASES
CONFIGURATION
SEALED
TYPE
Example Plant
AUTOMATED
PLANT
POSITION
REASON
WEIGHT
WINDING MATERIAL
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
lb
DSG SERIAL NUM

Cu
H1
GAL H2
C
H3
kV
%
X1
X2
X3
Y1
VOLTAGE (kV) kVA
RATED I # TAPS NOMINAL CHANGER TAP SETTING Y2
Y3
PRIMARY:
/
5
3
Off Load
SECOND:
/
1
3
On Load
TERTIARY:
1
On Load
AMPS
YEAR
COMMENTS:
TEST FREQUENCY: 60

Test
No.
INSULATION
TESTED
CH + CHT
GST-GND H+L
CH
GSTg-RB H+L
CHT (UST)
CHT'
Test
Mode
kV
HV
Red
Blue Gnd
UST-R
H+L
CT + CHT
GST-GND
H+L
CT
GSTg-RB
H+L
CHT (UST)
CHT'
UST-R
H+L
8
9
CH'
10
CT'
TEST
kV
Freq
Sweep
Capacitance
C (pF)
DIRECT
POWER FACTOR %
%VDF
Measured
@ 20C
Corr Factor
mA
IR
Watts
Test 1 Minus Test 2
Test 5 Minus Test 6

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
95500, REVISED 12/16/2013
INSULATION TESTS
PAGE
477

Test
No.
Bushing Nameplate
Dsg.
SERIAL #
CAT. #
PF
Test
Cap. (pF) Mode
16 H1
UST-R
HI 17 H2
kV 18 H3
UST-R
19 N/A
UST-R
20
X1
UST-R
LOW 21
kV
X2
UST-R
22
X3
UST-R
23
Y1
UST-R
24
Y2
UST-R
T 25
kV 26
Y3
UST-R
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
Measured
@ 20C Corr Factor
DIRECT
mA
WATTS
%VDF
IR
UST-R
UST-R
27
UST-R
28
OIL TEST
UST-R
Test
No.
Bushing Nameplate
Dsg.
SERIAL #
CAT. #
PF
Cap. (pF)
29 H1
30 H2
31 H3
32 N/A
33 X1
LOW 34 X2
kV 35 X3
36 Y1
37 Y2
LOW 38 Y3
kV 39
40
Test
Mode
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
Measured
@ 20C Corr Factor
DIRECT
mA
WATTS
%VDF
IR
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
GSTg-R
HI
kV
HOT COLLAR TESTS

Test
No.
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
Dsg
Serial #
H1
H2
H3
X1
X2
X3
Y1
Y2
Y3
Designation
Test Mode
Test kV
Freq
Sweep
DIRECT
mA
Watts
IR
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
GST-GND
www.powerdb.com
95500, REVISED 12/16/2013
INSULATION TESTS
478
PAGE
SURGE ARRESTERS
Location
Serial #
Overall
Catalog
Mfr
Unit
Catalog
Rated
kV
Type
Order
61
Test Mode
Test
kV
Freq
Sweep
DIRECT
mA
Watts
IR
GST-GND
EXCITING CURRENT TESTS

CONNECTIONS:
DETC
LTC
TURNS RATIO TEST

47
kV
TEST
kV
PHASE A: Enter connection

PHASE B: Enter connection
EQUIV. 10 kV
EQUIV. 10 kV
L(H) /
TEST
L(H) /
mA
mA
C (pF)
kV
C (pF)
mA
WATTS
mA
WATTS
PHASE C: Enter connection

EQUIV. 10 kV
L(H) /
mA
C (pF)
mA
WATTS
IR
REF [TTR] CAP (pF)

PHASE A
DETC
TEST
kV
LTC
H
L
Voltage Voltage
Calc.
ratio
kV
48
Cap.
(pF)
PHASE B
Turns
Ratio
%
Error
kV
49
Cap.
(pF)
Turns
Ratio
PHASE C
%
Error
kV
Cap.
(pF)
Turns
Ratio
%
Error
49
COMMENTS:
DEFICIENCIES:
www.powerdb.com
95500, REVISED 12/16/2013
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
479
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
MFR
SER NO
YEAR
TYPE
CLASS
PHASES
POSITION
WEIGHT
WEATHER
BIL
IMPEDANCE
REASON
Max Wdg Diff (%):
SEALED
3
Example Plant
AUTOMATED
PLANT
lb
kV
%
OIL VOLUME
OIL TEMP
WINDING TEMP
CORRECT TO
COOLANT
20
85
OIL
GAL
C
C
C
Dd0
Diagram # 3
VOLTAGE (kV)
kVA
RATED I
PRIMARY:
SECOND:
# TAPS
5
1
Winding Temperature
R1 Units:
R1 Winding Material: Cu
20
NOMINAL
3
1
TAP SETTING
CHANGER
DETC
DETC
Correct to
85
(ANSI)
WINDING MATERIAL
Cu
Cu
SHOW RESULTS
R1 Winding Material: Cu
R2 Units:
TEST RESULTS
TEST#
DESCRIPTION
DATE
TIME
R1
R2
CURRENT(A)
BBM
WINDING RESISTANCE GRAPH
R1 - Red Square
R2 - Blue Circle
Units: mOhms
Units: mOhms
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56352, REVISED 10/18/2013
TRANSFORMER
TURNS RATIO TEST
OWNER
PAGE
480
ADDRESS
JOB #
FORMS - ALL
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
Dd0
Diagram # 3
HUMIDITY
TRANSFORMERS
VOLTAGE ( kV )
KVA
RATED I
# TAPS
NOMINAL
CHANGER
(ANSI)
PRIMARY
SECONDARY
5
3
Off Load
1
3
PLANT
Example Plant
POSITION
AUTOMATED
ALLOWED ERROR: 0.05 %
HIGH SIDE TAPS TO LOW SIDE NOMINAL TURNS RATIO TESTS
TAP
H/L
Voltage
H/L
Test
V
TTR
Actual
TTR
H1 - H3 / X1 - X3
%
I exc
Phase
error
mA
(Deg)
Actual
TTR
H2 - H1 / X2 - X1
%
I exc
Phase
error
mA
(Deg)
Actual
TTR
H3 - H2 / X3 - X2
%
I exc
Phase
error
mA
(Deg)
1
2
3
4
5
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56004, REVISED 10/15/2013
Dd0
Diagram # 3
ASSET ID:
TAP
H/L
(ANSI)
Voltage
H/L
Test
V
TTR
Actual
TTR
H1 - H3 / X1 - X3
%
I exc
Phase
error
mA
(Deg)
TEST DATE:
Actual
TTR
H2 - H1 / X2 - X1
%
I exc
Phase
error
mA
(Deg)
Actual
TTR
10/13/2014
H3 - H2 / X3 - X2
%
I exc
Phase
error
mA
(Deg)
COMMENTS:
DEFICIENCIES:

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
56002, REVISED 11/20/2013
TRANSFORMER
OWNER
ADDRESS
CUSTOMER
482
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
VREG
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
5
1
NOMINAL CHANGER
3
3
lb
kV
AMPS
YEAR
GAL
C
%
TAP
SETTING
DETC
LTC
COMMENTS:
TEST FREQUENCY: 60
TEST VOLTAGE:
#
TAPS
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

S
L
SL
HIGH TO LOW+GND
KVDC
C
LOW TO HIGH+GND
Enter TCF Manually:
KVDC
HIGH+LOW TO GND
TEMP. CORR. FACTOR TO 20C, TCF DRY
KVDC
LIQUID

TRANSFORMER
High to Low (Low Grounded)
MINUTES
READING
(megohms)
CORR. VALUE
(megohms)
Low to High (High Grounded)

READING
(megohms)
CORR. VALUE
(megohms)
High + Low to Ground

READING
(megohms)
CORR. VALUE
(megohms)
0.25
0.50
1
10
0.75
1.00
2.00
1.25
3.00
1.50
4.00
1.75
5.00
6.00
7.00
8.00
9.00
10.00
P. I.
D. A. R.
INSULATION
CONDITION
POLARIZATION
INDEX (PI)
DANGEROUS
POOR
QUESTIONABLE
FAIR
GOOD
< 1.0
1.0 to 1.1
1.1 to 1.25
1.25 TO 2.0
> 2.0
NOTES:
PI ranges from IEEE C57.152-2013
Polarization Index should not be used to assess insulation
in new power transformers (IEEE C57.152-2013)
The polarization index for insulation liquid is always close to 1. Therefore,
the polarization index for transformers with low conductivity liquids
(e.g. new mineral oil) may be low in spite of good insulation condition.
(IEEE C57.152-2013)

INSULATION
CONDITION
DAR
60/30 SEC
QUESTIONABLE
GOOD
EXCELLENT
1.0 - 1.25
1.4 to 1.6
> 1.6
TESTED BY:
www.powerdb.com
NOTES:
DAR ranges from
A Stitch In Time (Megger, 2006)
These values must be considered
tentative and relative - subject
to experience, over time
56600, REVISED 8/26/2013
TRANSFORMER
PAGE
DATE
10/13/2014
SUBSTATION
TEMPERATURE
HUMIDITY
EQPT. LOCATION
Example Plant
POSITION
AUTOMATED
TRANSFORMERS
POLARIZATION CURVE
High to Low (Low Grounded) : Red Square
POLARIZATION CURVE
Low to High (High Grounded) : Blue Circle
POLARIZATION CURVE
483
High + Low to Ground : Green Triangle
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56600, REVISED 8/26/2013
INSULATION TESTS
AUTO TRANSFORMER WITHOUT TERTIARY
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
484
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
HUMIDITY
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
3
PHASES
CONFIGURATION
SEALED
TYPE
VOLTAGE (kV) kVA
/
/
POSITION
REASON
WEIGHT
WINDING MATERIAL
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
kV
Example Plant
AUTOMATED
PLANT
TRANSFORMERS
SUBSTATION
PRIMARY:
SECOND:
AMBIENT TEMPERATURE
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
lb
Cu
DSG SERIAL NUM

H1
GAL H2
C
H3
%
X1
X2
X3
kV
AMPS
YEAR
RATED I # TAPS NOMINAL CHANGER TAP SETTING

5
3
Off Load
1
3
On Load
COMMENTS:
TEST FREQUENCY: 60

TEST
NO
INSULATION
TESTED
TEST
MODE
CH
TEST LEAD
CONNECTIONS
GST-GND
HV
RED
H+L
BLUE
TEST
kV
FREQ
SWEEP
POWER FACTOR %
CAPACITANCE
C (pF)
GND
MEASURED
@ 20C
CORR
FACTOR
DIRECT
%VDF
mA
IR
WATTS

Test
No. Dsg.
Bushing Nameplate
SERIAL #
CAT. #
PF
Cap. (pF)
Test
Mode
11
H1
UST-R
12
H2
UST-R
13
H3
UST-R
14
N/A
UST-R
15
X1
UST-R
16
X2
UST-R
17
X3
UST-R
18
19
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
Measured @ 20C Corr Factor
DIRECT
mA
WATTS
%VDF
IR
UST-R
OIL TEST
UST-R

Serial Number:
TESTED BY:
www.powerdb.com
Calibration Date:
95501, REVISED 12/16/2013
INSULATION TESTS
485
PAGE

Test
No. Dsg.
Bushing Nameplate
SERIAL #
CAT. #
PF
Cap. (pF)
Test
Mode
20
H1
GSTg-R
21
H2
GSTg-R
22
H3
GSTg-R
23
N/A
GSTg-R
24
X1
GSTg-R
25
X2
GSTg-R
26
X3
GSTg-R
27
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
DIRECT
mA
WATTS
%VDF
IR
GSTg-R
Transformer - Surge Arresters Tests

Location
Serial #
Overall
Catalog
Mfr
Unit
Catalog
Rated
kV
Type
Order
Test Mode
19
28
GST-GND
20
29
GST-GND
21
30
GST-GND
22
31
GST-GND
23
32
GST-GND
24
33
GST-GND
25
34
GST-GND
26
35
GST-GND
27
36
GST-GND
Test
kV
Freq
Sweep
DIRECT
mA
Watts
IR
Transformer - Hot Collar Tests

Test
No.
Dsg
37
H1
GST-GND
38
H2
GST-GND
39
H3
GST-GND
40
X1
GST-GND
41
X2
GST-GND
42
X3
GST-GND
Serial #
Designation
Test Mode
43
GST-GND
44
GST-GND
45
GST-GND
46
GST-GND
Test kV
Freq
Sweep
DIRECT
mA
IR
Watts
EXCITING CURRENT TESTS

CONNECTIONS:
TEST
DETC LTC
TURNS RATIO TEST kV
47
kV
PHASE A: Enter connection

PHASE B: Enter connection
EQUIV. 10 kV
EQUIV. 10 kV
L(H) /
TEST
L(H) /
mA
mA
C (pF)
kV
C (pF)
mA
WATTS
mA
WATTS
PHASE C: Enter connection

EQUIV. 10 kV
L(H) /
mA
C (pF)
mA
WATTS
IR
REF [TTR] CAP (pF)

PHASE A
DETC
TEST
kV
LTC
H
L
Voltage Voltage
Calc.
ratio
kV
48
Cap.
(pF)
PHASE B
Turns
Ratio
%
Error
kV
49
www.powerdb.com
Cap.
(pF)
Turns
Ratio
PHASE C
%
Error
kV
Cap.
(pF)
Turns
Ratio
%
Error
49
95501, REVISED 12/16/2013
INSULATION TESTS
PAGE
486
COMMENTS:
DEFICIENCIES:
www.powerdb.com
95501, REVISED 12/16/2013
Press i for help, tab or

shift-tab to change tests
Test 1 of 1
ASSET ID:
HIGH: LOW:
TAP:
VOLTAGE (V):
Diagram # 3
(ANSI)
CALCULATED RATIO:
Windings
Ha - Hb / Xa - Yb
H2 - H1 / X2 - X1
H3 - H2 / X3 - X2
Comment:
10/13/2014
Actual
Ratio
TEST VOLTAGE (V): Auto

%
ERROR
EXCITATION
CURRENT
(mA)
Phase
Deviation
(deg)
TRANSFORMER HEAT RUN TEST
OWNER
ADDRESS
CUSTOMER
PAGE
488
JOB #
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
HUMIDITY
TRANSFORMERS
SUBSTATION
MFR
SER NO
YEAR
TYPE
CLASS
PHASES
AMBIENT TEMPERATURE
lb
WEIGHT
WEATHER
BIL
IMPEDANCE
REASON
SEALED
PLANT
Example Plant
POSITION
AUTOMATED
GAL
OIL VOLUME
COOLANT
Dd0
OIL
kV
%
Diagram # 3
kVA
VOLTAGE (kV)
RATED I
# TAPS
5
1
PRIMARY:
SECOND:
NOMINAL
3
1
CHANGER
TAP TO BE TESTED
DETC
DETC
WINDING MATERIAL
Cu
Cu
(ANSI)
SHOW RESULTS
HIGH VOLTAGE WINDING RESISTANCE

Ambient Resistance Data for Tap
Ambient
Temperature
H1 - H3
H2 - H1
H3 - H2
Ohms
Winding Res: H1 - H3
H2 - H1
H3 - H2
Units: Ohms
Maximum Number of Points on Graph:
40
Measured Resistance Data for Tap

Time
Current
H1 - H3
H2 - H1

Serial Number:
H3 - H2
TESTED BY:
www.powerdb.com
Reading
Stability %
Calculated Winding
Temperature (C)
Calibration Date:
56356, REVISED 1/15/2014
TRANSFORMER HEAT RUN TEST
489
PAGE
LOW VOLTAGE WINDING RESISTANCE

Ambient Resistance Data for Tap
Ambient
Temperature
X1 - X 3
X2 - X 1
X3 - X 2
Ohms
Winding Res: X1 - X3
X2 - X 1
X3 - X 2
Units: Ohms
Maximum Number of Points on Graph:
40
Measured Resistance Data for Tap

Time
Current
X1 - X 3
X2 - X 1
X3 - X 2
Reading
Stability %
Calculated Winding
Temperature (C)
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56356, REVISED 1/15/2014
WINDING RESISTANCE REPORT
OWNER
ADDRESS
CUSTOMER
490
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
AUTOMATED
PLANT
TRANSFORMERS
SUBSTATION
POSITION
TRANSFORMER INFORMATION
COMPANY
STATION
DESIGNATION
MANUFACTURER
SERIAL NO.
TIME
TEMPERATURE
INSTRUMENT S/N
CHANNEL A
Tap
Winding
CHANNEL B
Resistance
Tap
Winding
Resistance
Current
Interval
Total Time
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
56355, REVISED 5/7/2012
MULTIPLE POWER FACTOR

QUICK TESTS
ASSET ID:
TEST FREQUENCY: 60
TEST
NO
INSULATION
TESTED
COMMENTS:
TEST
MODE
SUPPRESS.
UST-R
On
TEST
kV
Test
Freq
L(H)
CAP.(pF)

Serial Number:
%VDF
MEAS.
@ 20C
TESTED BY:
www.powerdb.com
DIRECT
POWER FACTOR %
CORR.
mA
IR
WATTS
Calibration Date:
93002, REVISED 11/18/2013
TRANSFORMER
TURNS RATIO TEST
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
492
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
HUMIDITY
Company:
Location:
Circuit:
Operator:
Comment:
POSITION
Step:
MFR:
Device:
Type:
Model:
# Tap # Voltage Tap # Voltage
Rating:
Serial #:
Max Deviation %:
Test Voltage:
Asset ID:
H1 - H3 / X2 - X1
Low Side
Test
Volt
Calc
Ratio
Actual
Ratio
%
error
Example Plant
AUTOMATED
PLANT
TRANSFORMERS
SUBSTATION
High Side
AMBIENT TEMPERATURE
P/F
I exc
mA
Phase
(degrees)
Actual
Ratio
H2 - H1 / X3 - X2
%
I exc
Phase
error P/F
mA
(degrees)
Actual
Ratio
H3 - H2 / X1 - X3
%
I exc
Phase
error P/F
mA
(degrees)
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
56502, REVISED 8/23/2013
POWER TRANSFORMER TESTS
OWNER
493
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
CIRCUIT ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
Nameplate Data
UpdatePaging
Serial Number
Manufacturer
Winding Material
Edit Highside
Year
Phases
Reason
Weight
lb
Class
Coolant
Oil Volume
TEMP
GAL
C
BIL
Impedance
Weather
Tank Type
kV
%
Edit Lowside
VREG
Rated I
#
Taps
Nominal
Changer
Tap Setting
Primary
Secondary
Diagram # 43 (ANSI)
Test Frequency 60
Comments:

TESTED BY:
www.powerdb.com
90000, REVISED 1/29/2014
INSULATION TESTS
USER
PAGE
ADDRESS
JOB #
CUSTOMER
494
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMERS
SUBSTATION
Example Plant
AUTOMATED
PLANT
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
Dd0
Diagram # 3
RATED I
PRIMARY:
SECOND:
#
TAPS
NOMINAL CHANGER
5
1
AMPS
YEAR
3
3
TAP
SETTING
DETC
LTC
COMMENTS:
TEST FREQUENCY: 60
kV
(ANSI)
VOLTAGE (kV) kVA
Test
No.
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
INSULATION
TESTED
Test
Mode
CHG + CHL GST-GND

HV
Red
Blue Gnd
CHG
GSTg-RB
CHL
UST-R
CHL'
CLG + CHL
GST-GND
CLG
GSTg-RB
UST-R
CHL
CHL'
CHG'
10
CLG'
TEST
kV
Freq
Sweep
Capacitance
C (pF)
DIRECT
POWER FACTOR %
%VDF
Measured
@ 20C
Corr Factor
mA
IR
Watts
Test 1 Minus Test 2
Test 5 Minus Test 6
NOTE: SHORT EACH WINDING ON ITSELF

G = GOOD
D = DETERIORATED
I
= INVESTIGATE
B = BAD
H
L
G
N
=
=
=
=
HIGH VOLTAGE WINDING

LOW VOLTAGE WINDING
GROUND
NEUTRAL BUSHING

Serial Number:
EQUIVALENT
CIRCUIT
TESTED BY:
www.powerdb.com
Calibration Date:
93500, REVISED 12/16/2013
INSULATION TESTS
PAGE
495

Test
No. Dsg.
Bushing Nameplate
SERIAL #
CAT. #
PF
Cap. (pF)
Test
Mode
11
H1
UST-R
12
H2
UST-R
13
H3
UST-R
14
X1
UST-R
15
X2
UST-R
16
X3
UST-R
17
UST-R
18
UST-R
19
OIL TEST
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
DIRECT
mA
WATTS
%VDF
IR
%VDF
IR
UST-R
Test
No. Dsg.
Bushing Nameplate
SERIAL #
CAT. #
PF
Cap. (pF)
Test
Mode
20
H1
GSTg-R
21
H2
GSTg-R
22
H3
GSTg-R
23
X1
GSTg-R
24
X2
GSTg-R
25
X3
GSTg-R
26
GSTg-R
27
GSTg-R
TEST
kV
POWER FACTOR %
Freq Capacitance
Sweep
C (pF)
DIRECT
mA
WATTS
COMMENTS:
DEFICIENCIES:
www.powerdb.com
93500, REVISED 12/16/2013
TRANSFORMER EXCITATION CURRENT TEST
OWNER
496
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
TEST
VOLTS
TAP CHANGER
POSITION
TEST kV
SEE NOTE 2
# FANS
TAP CHANGER:
INTERNAL
EXTERNAL
DRY TYPE
MILLIAMPERES
REMARKS
PHASE A
PHASE B
PHASE C
TEST LEAD CONNECTION

SINGLE PHASE
THREE-PHASE WYE (1)
TEST NOTES:
ENERGIZE
RETURN (RED)
ENERGIZE
RETURN
PHASE
H1
H2 (OR HO)
H2 (OR HO)
H1
H1
H2
H3
HO
HO
HO
A
B
C
THREE-PHASE DELTA (1)
THREE-PHASE AUTO
ENERGIZE
RETURN
GRD
PHASE
ENERGIZE
RETURN
PHASE
H3
H1
H1
H2
H2
H3
A
B
H1
HOXO
H2
HOXO
H2
H3
H1
H3
HOXO

1. IF THE LOW VOLTAGE WINDING IS WYE CONNECTED, THEN

XO IS CONNECTED AS IN SERVICE (USUALLY, THIS WOULD
MEAN GROUNDING XO).
2. ALL TESTS SHOULD BE PERFORMED ROUTINELY AT THE
SAME VOLTAGES.
3. INDICATE STEP POSITION FOR LOAD TAP CHANGERS:
RAISED, LOWERED OR NEUTRAL. SEE FORM 5640C.
4. ON SINGLE PHASE TRANSFORMERS THE WINDING IS
NORMALLY ENERGIZED ALTERNATELY FROM OPPOSITE
ENDS. THIS SHOULD BE DONE ON THREE PHASE TRANSFORMERS IF THE EXCITATION CURRENT IS ABNORMAL.
TESTED BY:
www.powerdb.com
56100, REVISED 4/22/2009
TRANSFORMER EXCITATION CURRENT TEST
PAGE
497
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56100, REVISED 4/22/2009
TRANSFORMER INFORMATION & HISTORY
OWNER
PAGE
ADDRESS
JOB #
CUSTOMER
498
FORMS - ALL
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
Yyn0
VOLTAGE (kV) kVA

PRIMARY:
SECOND:
RATED I
/
/
TEST FREQUENCY: 60
#
TAPS
5
1
NOMINAL CHANGER
3
3
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
X0
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
TAP
SETTING
DETC
LTC
COMMENTS:
Transformer Photo
Nameplate Photo
ASSET HISTORY
Location:
Date Installed:
Date Removed:
www.powerdb.com
NOTES
REVISED 9/28/2012
OWNER
499
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
INTERNAL
EXTERNAL
DRY TYPE
GAUGES:
WINDING TEMPERATURE
MAXIMUM WINDING TEMPERATURE
COOLANT TEMPERATURE
MAXIMUM COOLANT TEMPERATURE
COOLANT LEVEL
PRESSURE VACUUM
RESET TEMPERATURE GAUGES
LCR COUNTER
OTHER GAUGES
VISUAL INSPECTION:
BUSHINGS
SUPPORT INSULATORS
CONNECTIONS
PAINT
RADIATORS
FANS
NO-LOAD TAP CHANGER
LEAKS
FAN PUMP CONTROLS

ADDITIONAL EQUIPMENT
GROUND CONDUCTOR SIZE
AWG/KCM
NO. OF GROUND CONDUCTORS
GROUND CONDUCTOR CONDITION
VECTOR DIAGRAM
POST TEST VOLTAGES
NO LOAD SECONDARY VOLTAGE

PRI. VECTOR:
SEC. VECTOR:

TESTED BY:
www.powerdb.com
X1 - X2
X0 - G
X1 - X3
X0 - X1
X2 - X3
X0 - X2
X0 - X3
56200, REVISED 4/22/2009
PAGE
500
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56200, REVISED 4/22/2009
OWNER
501
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
Dd0
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
#
TAPS
NOMINAL CHANGER
5
1
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
TAP
SETTING
DETC
LTC
COMMENTS:
TEST FREQUENCY: 60
FLUID QUALITY
3
3
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
Example Plant
GENERAL
10/13/2014
10/13/2014
10/13/2014
10/13/2014
TOTAL GAS
PARTICLES
DIELECTRIC STRENGTH
INTERFACIAL TENSION
ACIDITY
(kV)
(D/CM)
(MG KOH/G)
ASTM COLOR NO.

PCB CONTENT
(PPM)
POWER FACTOR
(%)
WATER CONTENT
(PPM)
SPECIFIC GRAVITY

* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
CARBON DIOXIDE
(CO)
(CO2)
NITROGEN
(N2)
OXYGEN
(O2)
* COMBUSTIBLE GAS
SAMPLED BY:

www.powerdb.com
REVISED 9/28/2012

USER
SUBSTATION
TRANSFORMERS
POSITION
GENERAL
PAGE
502
JOB #
FORMS - ALL
SERIAL NO.
10/13/2014
10/13/2014
10/13/2014
10/13/2014
* HYDROGEN
(H2)
* METHANE
(CH4)
* ETHANE
(C2H6)
* ETHYLENE
(C2H4)
* ACETYLENE
(C2H2)
* CARBON MONOXIDE
(C0)
CARBON DIOXIDE
(C02)
NITROGEN
(N2)
OXYGEN
(O2)
TOTAL
COMBUSTIBLE GAS
* COMBUSTIBLE GAS

www.powerdb.com
REVISED 9/28/2012

FLUID QUALITY
USER
SUBSTATION
TRANSFORMERS
POSITION
GENERAL
PAGE
503
JOB #
FORMS - ALL
SERIAL NO.
10/13/2014
10/13/2014
10/13/2014
10/13/2014
DIELECTRIC STRENGTH
(KV)
INTERFACIAL TENSION
(D/CM)
ACIDITY
(MG KOH/G)
PCB CONTENT
(PPM)
POWER FACTOR
(%)
WATER CONTENT
(PPM)
SPECIFIC GRAVITY

www.powerdb.com
REVISED 9/28/2012

FLUID QUALITY
USER
SUBSTATION
TRANSFORMERS
POSITION
GENERAL
PAGE
504
JOB #
FORMS - ALL
SERIAL NO.
COMMENTS:
DEFICIENCIES:
TEST EQUIPMENT USED: Default Administrator

TESTED BY:
www.powerdb.com
WEIDMANN - ACTI
REVISED 9/28/2012
TRANSFORMER TURNS RATIO TEST
OWNER
505
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
INTERNAL
EXTERNAL
DRY TYPE
TRANSFORMER TURNS RATIO TESTS
TAP NUMBER
WINDING
VOLTAGES
(volts)
CALCULATED
RATIO
MEASURED RATIO
H
/ X
/ X
/ X
VECTOR DIAGRAM
CORRECTION FACTOR FOR UNACCESSIBLE NEUTRAL
PRI. VECTOR:
SEC. VECTOR:
PHASE TESTED BLACK RED

DELTA-WYE
A
B
C

H1
H2
H3
H3
H1
H2
TESTED BY:
www.powerdb.com
BLACK
X1
X2
X3
READING
TEST SHEET
RED JUMPER MULTIPLIER DESIGNATION
X2
X3
X1
H2H3
H1H3
H1H2
1.1547
1.1547
1.1547
H1-H3 X1-X2
H2-H3 X2-X3
H3-H2 X3-X1
56300, REVISED 4/22/2009
TRANSFORMER TURNS RATIO TEST
PAGE
506
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56300, REVISED 4/22/2009
OWNER
ADDRESS
CUSTOMER
507
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
Dd0
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
#
TAPS
NOMINAL CHANGER
5
1
3
3
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
kV
AMPS
TAP
SETTING
DETC
LTC
COMMENTS:
TEST FREQUENCY: 60
WINDING TEMPERATURE:
PRIMARY WINDING:
SECONDARY WINDING:
MEASURED RESISTANCE
MEASURED RESISTANCE
-H
OHMS
-X
OHMS
-H
OHMS
-X
OHMS
-H
OHMS
-X
OHMS
% Variance
PRIMARY WINDING MATERIAL
COPPER
SECONDARY WINDING MATERIAL
CALCULATED TOTAL RESISTANCE CORRECTED TO 85C

PRIMARY R
YEAR
SECONDARY R T
COPPER
R T = TOTAL WINDING RESISTANCE AT 85C
OHMS
% Variance
OHMS
R M = TOTAL WINDING RESISTANCE AT TEST TEMPERATURE

T S = TEMPERATURE FOR DESIRED RESISTANCE (85C)
T M = WINDING TEMPERATURE
T K = TEMP. RESISTANCE CONSTANT (C)
T S + TK
R T = RM T M + TK
COPPER + 234.5C
ALUMINUM = 226.0C
(IEEE C57.12.91)
DELTA WINDING MULTIPLIER = 1.5X

COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
56351, REVISED 9/28/2012
TRANSFORMER
SECONDARY WINDING RESISTANCE TESTS
OWNER
ADDRESS
CUSTOMER
508
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SECONDARY CONFIGURATION
WYE
TAP
POSITION
WINDING MATERIAL
COPPER
RESISTANCE IN MILLIOHMS
X
-X
-X
-X
WINDING TEMPERATURE
CORRECTED TO 85C
16L
15L
14L
13L
12L
11L
10L
9L
8L
7L
6L
5L
4L
3L
2L
1L
N
1R
2R
3R
4R
5R
6R
7R
8R
9R
10R
11R
12R
13R
14R
15R
16R

TESTED BY:
www.powerdb.com
56450, REVISED 4/22/2009
TRANSFORMER
SECONDARY WINDING RESISTANCE TESTS
PAGE
509
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56450, REVISED 4/22/2009
TRANSFORMER LOAD TAP CHANGER

TURNS RATIO TEST
3 Phase Test Method
OWNER
ADDRESS
CUSTOMER
510
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TAP
NO.
SERIAL NUMBER
SECONDARY
TAP VOLTAGE
(volts)
16L
15L
14L
13L
12L
11L
10L
9L
8L
7L
6L
5L
4L
3L
2L
1L
1R
2R
3R
4R
5R
6R
7R
8R
9R
10R
11R
12R
13R
14R
15R
16R
PRIMARY
VOLTAGE
(volts)
CALCULATED
RATIO
MEASURED RATIO
H

/X
TESTED BY:
www.powerdb.com
/X
/X
56400, REVISED 7/15/2013

TURNS RATIO TEST
3 Phase Test Method
PAGE
511
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56400, REVISED 7/15/2013
TRANSFORMER SINGLE PHASE

PRIMARY WINDING RESISTANCE TESTS
OWNER
ADDRESS
CUSTOMER
512
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
SUBSTATION
HUMIDITY
TRANSFORMERS
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
WYE
WINDING MATERIAL
TAP
POSITION
RESISTANCE IN OHMS
COPPER
WINDING TEMPERATURE
CORRECTED TO 85C
-H
10

TESTED BY:
www.powerdb.com
56501, REVISED 4/22/2009
TRANSFORMER SINGLE PHASE

PAGE
513
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56501, REVISED 4/22/2009
TWO-WINDING TRANSFORMER
OWNER
514
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
YR MFR
IMPEDANCE
CAPACITY
kVA
GALLONS
CLASS
OA
FA
VOLTS
PRIMARY
SECONDARY
SERIAL NO.
TYPE
CATALOG NUMBER
FOA
FOW
OW
FOW
CONNECTIONS
WINDING MATERIAL
DELTA
WYE
SINGLE PHASE
ALUMINUM
COPPER
DELTA
WYE
SINGLE PHASE
ALUMINUM
COPPER
TAP VOLTAGES
TAP POSITION
TAP POSITION LEFT
VOLTS
MEDIUM TYPE
SILICONE
OIL
AIR
INSULATING MEDIUM
LIQUID-FILLED
GAS-FILLED
AIR
PRESSURE
PERCENT )
PCB
RTEMP
FIELD SAMPLE
PSI
WESCOL
YES
GAS
NO
MEDIUM LEVEL
CAPACITY
GALLONS
TEMPERATURE RISE
MAXIMUM TEMPERATURE INDICATOR
TEMPERATURE GAUGE
MAXIMUM TEMPERATURE INDICATOR RESET TO
WINDING TEMPERATURE
FAN SET TO
ENVIRONMENTAL DATA
WEATHER CONDITIONS
LOCATED ON
AMBIENT TEMPERATURE
POLE
PAD
INDOOR
HUMIDITY
OUTDOOR
VISUAL INSPECTION
FANS
GOOD
FAIR
POOR
EXPLAIN:
CONTROLS
GOOD
FAIR
POOR
EXPLAIN:
VOLTS
CONTROL VOLTAGE
PAINT
GOOD
FAIR
POOR
EXPLAIN:
CONNECTIONS
GOOD
FAIR
POOR
EXPLAIN:
GROUNDS
GOOD
FAIR
POOR
EXPLAIN:
LEAKS
LIQUID
GAS
AIR
NONE DETECTED
YES
DESCRIBE:
DESCRIBE OPERATING ENVIRONMENT
www.powerdb.com
REVISED 7/15/2010
TWO-WINDING TRANSFORMER
515
PAGE
WINDING RESISTANCE TESTS
PRIMARY
SECONDARY
WINDING
TESTED
TAP POSITION
H1-H2
H2-H3
H3-H1
X0-X1
X0-X2
X0-X3
ARE WINDING POLARITIES AS PER NAMEPLATE?
YES
NO
IF NO, DESCRIBE:
INSULATION RESISTANCE TEST
WINDINGS
TESTED
TEST
VOLTAGE
RESISTANCE
(MEGOHMS)
(VOLTS DC)
0.5 MINUTE
RECOMMENDED
MINIMUM
1.0 MINUTE
10 MINUTES
(MEGOHMS)
ACCEPTABLE
PRIMARY TO
SECONDARY AND GROUND
YES
NO
SECONDARY TO
PRIMARY AND GROUND
YES
NO
TEMPERATURE CORRECTION FACTOR:
AIR
MEDIUM TEMPERATURE WAS
MULTIPLY RESULT BY CORRECTION FACTOR

PRIMARY
SECONDARY
WINDING
WINDING
ACCEPTABLE
DIELECTRIC ABSORPTION: (RATIO OF 1 MINUTE TO 0.5 MINUTE RESULT)
YES
NO
POLARIZATION INDEX: (RATIO OF 10 MINUTE RESULT TO 1 MINUTE RESULT)
YES
NO
TRANSFORMER TURNS RATIO TESTS

TAP
NAMEPLATE
CALCULATED
MEASURED
VOLTAGE
RATIO
H1-H2
% DEVIATION
MEASURED
% DEVIATION
H2-H3
TO
CALCULATED
PASS/FAIL
MEASURED
H3-H1
TO
CALCULATED
TURNS RATIO RESULTS: ARE THEY WITHIN +/- 0.5% OF ADJACENT PHASES AND/OR CALCULATED RATIO.
PASS/FAIL
YES
% DEVIATION
TO
CALCULATED
PASS/FAIL
NO
ASTERICK (*) DENOTES RESULTS NOT WITHIN TOLERANCE

AC OVERPOTENTIAL TEST
WINDINGS
TEST
TEST
TESTED
VOLTAGE
DURATION
RESULTS
LEAKAGE
(VOLTS AC)
(MINUTES)
(PASS / FAIL)
CURRENT
(AMPERES AC)
ACCEPTABLE
PRIMARY TO GROUND WITH SECONDARY GROUNDED
PASS
FAIL
YES
NO
SECONDARY TO GROUND WITH PRIMARY GROUNDED
PASS
FAIL
YES
NO
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
REVISED 7/15/2010
REGULATOR MAINTENANCE REPORT
OWNER
516
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
CAT #
MANUFACTURER
YR. MFR.
SERIAL NO.
TYPE
PRIMARY kV
SECONDARY kV
GALLONS OF OIL
WEIGHT
CLASS
AMPS
CT RATIO
LAST TEST DATE
NEXT TEST DATE
COUNTER READING BEFORE
AFTER
TCUL TURNS RATIO TEST

TAP
LOWER
RATIO
TAP
RATIO
TAP
16
16
16
15
15
15
14
14
14
13
13
13
12
12
12
11
11
11
10
10
10
10
10
10
11
11
11
12
12
12
13
13
13
14
14
14
15
15
15
16
16
16
NEUTRAL
17
17
17
RAISE
18
18
18
MEGGER TEST VOLTAGE
MINUTES
Volts
RESISTANCE (megohms)
1 MIN
3 MIN
OIL TEMPERATURE
5 MIN
RATIO
10 MIN
PRIMARY TO GROUND
PRIMARY TO SECONDARY
SECONDARY TO GROUND

TESTED BY:
www.powerdb.com
56990, REVISED 4/22/2009
REGULATOR MAINTENANCE REPORT
PAGE
517
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56990, REVISED 4/22/2009
TRANSFORMER DISSIPATION FACTOR TEST
OWNER
518
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
INTERNAL
CAPACITANCE
TEST
TYPE OF TEST
(5)GST-L GUARDED
(4)GST-L GROUNDED
(3)UST
(5)GST-H GUARDED
(4)GST-H GROUNDED
(3)UST
TRANSFORMER TEMPERATURE
TEST
kV
SW.
POS.
EXTERNAL
DRY TYPE
DIAL READING CALC. MULTIAVG. PLIER

NORM. REV.
CAP.
pF
DIAL READING CALC. MULTI- MEAS.

AVG. PLIER
%
NORM. REV.
DRY
20
%
CALC.
% P.F.
20C
LIQUID
CONVERSION
VECTOR DIAGRAM
DF
PRI. VECTOR:
SEC. VECTOR:

PF =
1 + DF
TESTED BY:
www.powerdb.com
56050, REVISED 4/22/2009
TRANSFORMER DISSIPATION FACTOR TEST
PAGE
519
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56050, REVISED 4/22/2009
TRANSFORMER HIGH POTENTIAL TEST
OWNER
520
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
INTERNAL
EXTERNAL
DRY TYPE
TEST VOLTAGE:
PRIMARY TO GROUND
kV
AC
DC
CORE / COIL TEMPERATURE
SECONDARY TO GROUND
kV
AC
DC
TEST VOLTAGE FREQUENCY
HZ
ALL PRIMARY WINDINGS AND ALL SECONDARY WINDINGS MUST BE EXTERNALLY JUMPERED PRIOR TO
PERFORMING HIGH POTENTIAL TEST.
PRIMARY TO GROUND
SECONDARY GUARDED
MICRO/MILLIAMPERES
MINUTES
SECONDARY TO GROUND
PRIMARY GUARDED
MICRO/MILLIAMPERES
0.25
mA
mA
0.50
mA
mA
0.75
mA
mA
1.00
mA
mA
= MICROAMPERES
mA = MILLIAMPERES

TESTED BY:
www.powerdb.com
56150, REVISED 4/22/2009
TRANSFORMER HIGH POTENTIAL TEST
PAGE
521
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56150, REVISED 4/22/2009

TURNS RATIO TEST
(1 Phase Test Method)
OWNER
ADDRESS
CUSTOMER
522
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
TAP
NO.
SERIAL NUMBER
SECONDARY
TAP VOLTAGE
(volts)
16L
15L
14L
13L
12L
11L
10L
9L
8L
7L
6L
5L
4L
3L
2L
1L
1R
2R
3R
4R
5R
6R
7R
8R
9R
10R
11R
12R
13R
14R
15R
16R
PRIMARY
VOLTAGE
(volts)
CALCULATED
RATIO

MEASURED RATIO
H
/X
TESTED BY:
www.powerdb.com
/X
/X
56410, REVISED 7/15/2013

TURNS RATIO TEST
(1 Phase Test Method)
PAGE
523
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56410, REVISED 7/15/2013
TRANSFORMER POLARITY TEST
OWNER
524
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
COOLANT
IMPEDANCE
CAPACITY
WINDING POLARITY
SUBTRACTIVE
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
H 1
VOLTS
TIED TO X 1
# FANS
TAP CHANGER:
INPUT VOLTAGE
-H 2
HH
INTERNAL
EXTERNAL
-H 3
H 1
-X 1
-X 1
H 3
-X 1
H 1
-X 2
-X 2
H 3
-X 2
-X 3
H 3
-X 3
DRY TYPE
-H 3
-X 3
VECTOR DIAGRAM
PRI. VECTOR:
SEC. VECTOR:

TEST RESULTS INDICATE
TESTED BY:
www.powerdb.com
SUBTRACTIVE
POLARITY
56250, REVISED 4/22/2009
TRANSFORMER POLARITY TEST
PAGE
525
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56250, REVISED 4/22/2009
TRANSFORMER
OWNER
ADDRESS
CUSTOMER
526
FORMS - ALL
PAGE
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
WYE
WINDING MATERIAL
COPPER
RESISTANCE IN OHMS
TAP
POSITION
H
-H
-H
WINDING TEMPERATURE
CORRECTED TO 85C
H
-H
10

TESTED BY:
www.powerdb.com
56500, REVISED 4/22/2009
TRANSFORMER
PAGE
527
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56500, REVISED 4/22/2009
OWNER
528
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
Dd0
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
TEST FREQUENCY: 60
5
1
TAP
POSITION
NOMINAL CHANGER
3
3
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
kV
AMPS
YEAR
TAP
SETTING
DETC
LTC
COMMENTS:
PRIMARY WINDING
TEST
#
#
TAPS
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
TEST CURRENT
mA
milli-Ohms
WINDING TESTED
H1 - H2
H3 - H1
H1 - H2
% Variance
SECONDARY WINDING
TEST
#
TAP
POSITION
TEST CURRENT
mA
milli-Ohms
WINDING TESTED
X1 - X2
X1 - X2
X1 - X2
% Variance
TERTIARY WINDING
TEST
#
TAP
POSITION
TEST CURRENT
mA
WINDING TESTED
Y1 - Y2
Y1 - Y2
Res. Unit: milli-Ohms

Y1 - Y2
% Variance
COMMENTS:
DEFICIENCIES:

TESTED BY:
www.powerdb.com
56357, REVISED 1/24/2013
OWNER
529
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
SPECIFICATION NO.
PHASE
KVA
TEMPERATURE RISE
IMPEDANCE
COOLANT
CAPACITY
WINDING POLARITY
SUBTRACTIVE
/
CLASS
B.I.L. RATING
kV PRI.
GALLONS
kV SEC.
TOTAL WEIGHT
WINDING MATERIAL
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TYPE
K FACTOR
NA
DELTA
WYE
RATED CURRENT
AMPERES
DELTA
WYE
RATED CURRENT
AMPERES
TAP VOLTAGES
TAP CONNECTIONS
TAP SETTING
VOLTS
# FANS
TAP CHANGER:
INTERNAL
EXTERNAL
DRY TYPE
PRIMARY WINDING:
VECTOR DIAGRAM
MEASURED RESISTANCE
H
-H
OHMS
PRI. VECTOR:
-H
OHMS
SEC. VECTOR:
-H
OHMS
PRIMARY WINDING MATERIAL

R T = TOTAL WINDING RESISTANCE AT 85C
SECONDARY WINDING:
R M = TOTAL WINDING RESISTANCE AT TEST TEMPERATURE

T S = TEMPERATURE FOR DESIRED RESISTANCE (85C)
MEASURED RESISTANCE
T M = WINDING TEMPERATURE
X
-X
OHMS
-X
OHMS
-X
OHMS
T K = TEMP. RESISTANCE CONSTANT (C)

COPPER + 234.5C
ALUMINUM = 226.0C
SECONDARY WINDING MATERIAL

WINDING TEMPERATURE
(STD. C57.12.91)

CALCULATED RESISTANCE CORRECTED TO 85C

PRIMARY R
SECONDARY R T
T S + TK
R T = RM T M + TK
OHMS
OHMS

TESTED BY:
www.powerdb.com
56350, REVISED 4/22/2009
PAGE
530
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56350, REVISED 4/22/2009
TRANSFORMER MAINTENANCE TEST
OWNER
531
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
YR MFR
IMPEDANCE
KVA
GALLONS
CAPACITY
/
SERIAL NO.
TYPE
CLASS
TEMPERATURE RISE
WINDING MATERIAL
PRIMARY KV
B.I.L. RATING
DELTA
SECONDARY KV
WYE
TAP VOLTAGES
INSULATING MEDIUM
TAP POSITION
TANK TYPE
TAP SETTING
VOLTS
Free Breathing
DRY TYPE
CONSERVATOR
VISUAL AND MECHANICAL INSPECTION

INSPECTION REPORT
INSPECTION REMARKS
INSPECT PHYSICAL AND MECHANICAL CONDITION
PASS
FAIL
VERIFY FANS OPERATE
PASS
FAIL
INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING
PASS
FAIL
ELECTRICAL TESTS
(OPTIONAL FOR L.V. TRANSFORMERS OR BELOW 500 kVA)
MAINTENANCE
ACCEPTANCE
INSULATION RESISTANCE IN MEGOHMS
MINUTES
PRIMARY TO
GROUND
SECONDARY TO
GROUND
WINDING RESISTANCE TEST IN OHMS

PRIMARY TO
SECONDARY
H1-H2
X0-X2
Test kV
H2-H3
X0-X3
0.50
H3-H1
X0-X1
1.00
TRANSFORMER TURN RATIO TEST
10.00
TAP
CALC
PHASE A
PHASE B
PHASE C
P. I.
WORKING TAP
P.I. = 10 min/1 min

TESTED BY:
www.powerdb.com
AF
AL
56700, REVISED 6/18/2009
TRANSFORMER MAINTENANCE TEST
PAGE
532
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56700, REVISED 6/18/2009
INSULATION TESTS
OWNER
533
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
10/13/2014
DATE
AMBIENT TEMPERATURE
HUMIDITY
TRANSFORMER
MFR YEAR
OIL
ASKAREL
POSITION
MFR
TYPE/CLASS
AIR
GAS
kVA
SILICONE
500
12
LOW SIDE: kV
WYE
DELTA
WYE
DELTA
SERIAL NO.
GALLONS OF OIL
FREE BREATHING
MFR.
BUSHINGS
COPIES TO
HIGH SIDE: kV
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
NEUTRAL
WEATHER
DATE LAST TEST
SEALED
GAS BLANKETED
TYPE / CLASS
DWG. NO.
TEMP
LAST SHEET NO.
CONSERVATOR
CAT. NO.
kV
YEAR

TEST
NO
INSULATION
TESTED
C HG
TEST CONNECTIONS
(WINDINGS)
TEST
MODE
C HL
ENG
GND
GST
GND
CHG
HG
GST
C HL
UST
C HL
C LG
GAR
% POWER FACTOR
TEST
kV
CAPACITANCE
C (PF)
UST
MEASURED
o20 C
EQUIV
CORR
FACTOR
mA
WATTS
INSULATION
RATING
L
L
TEST 1 MINUS TEST 2
C HL
GST
GND
CLG
GST
C HL
UST
C HL
C HG'
10
C HG'
C LG
H
H
TEST 5 MINUS TEST 6
HG
MINUS HIGH BUSH.

MINUS HIGH BUSH.
BUSHING TESTS
TEST
NO.
HI
kV
LOW
kV
NO.
BUSHING
SERIAL #
Ph.
11
UST
12
UST
13
UST
14
UST
15
UST
16
UST
17
UST
18
19
UST
OIL TEST

G = GOOD
D = DETERIORATED
I
= INVESTIGATE
B = BAD
EQUIVALENT CIRCUIT
NOTE: SHORT EACH WINDING ON ITSELF

H
L
G
N
=
=
=
=
HIGH VOLTAGE WINDING

LOW VOLTAGE WINDING
GROUND
NEUTRAL BUSHING

TESTED BY:
www.powerdb.com
56910, REVISED 4/22/2009
INSULATION TESTS
PAGE
534
COMMENTS:
DEFICIENCIES:
www.powerdb.com
56910, REVISED 4/22/2009
TRANSFORMER LIQUID COOLANT ANALYSIS
OWNER
535
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
TRANSFORMERS
SUBSTATION
POSITION
NAMEPLATE DATA
MFR
SER NO
YEAR
CLASS
COOLANT OIL
BIL
PHASES
REASON
kV
WEIGHT
WINDING MATERIAL Cu
OIL VOLUME
OIL TEMP
IMPEDANCE
WEATHER
TANK TYPE SEALED
Dd0
VOLTAGE (kV) kVA
RATED I
PRIMARY:
SECOND:
#
TAPS
NOMINAL CHANGER
5
1
3
3
BUSHING NAMEPLATE
MFR.
TYPE/CLASS
DSG SERIAL NUM

H1
lb
H2
H3
GAL X1
C X2
% X3
kV
AMPS
YEAR
TAP
SETTING
DETC
LTC
COMMENTS:
TEST FREQUENCY: 60
TEST RESULTS
ASTM
PARTICLES
D-1524
DIELECTRIC STRENGTH
kV
D-877
INTERFACIAL TENSION
D/CM
D-971
ACIDITY
MG KOH/G
D-974
PAINT CONDITION
D-1500
GASKETS
PPM
D-4059
BUSHINGS
POWER FACTOR
D-924
WATER CONTENT
PPM
D-1533B
ASTM COLOR NO.

PCB CONTENT
LIQUID LEVEL
SPECIFIC GRAVITY
PLUMBING TABLE
D-287
OTHER
TOP
ASTM D-3612C
BOTTOM
(H2)
PPM
VENT
* METHANE
(CH4)
PPM
ACCESS PORT
* ETHANE
(C2H6)
PPM
SAMPLE VALVE
* ETHYLENE
(C2H4)
PPM
* ACETYLENE
* HYDROGEN
(C2H2)
PPM
* CARBON MONOXIDE
(CO)
PPM
CARBON DIOXIDE
(CO2)
PPM
NITROGEN
(N2)
PPM
OXYGEN
(O2)
PPM
TOTAL GAS
PPM
PPM
CONDITION
SERVICE
EXCELLENT
NO SERVICE REQUIRED
GOOD
RETEST IN
INVESTIGATE
SERVICE REQUIRED
POOR
SERVICE IMMEDIATELY
FAILED UNIT
REFER TO COMMENTS
MONTHS:
* COMBUSTIBLE GAS
COMMENTS:
DEFICIENCIES:
SAMPLED BY:

www.powerdb.com
57110, REVISED 9/28/2012
WATTHOUR METER TEST
OWNER
537
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
POSITION
kWHR METER DATA

MANUFACTURER
SERIAL NO.
TYPE
CLASS
PKh
Kh
TA
WIRE
VOLTAGE
STATORS
CAT. NO./STYLE NO.
INSTRUCTION BOOKLET
PHASE
OTHER
kWHR REGISTER DATA

MANUFACTURER
SERIAL NO.
TYPE
FULL SCALE kW
VOLTAGE
REGISTER RATIO
CLASS
DEMAND INTERVAL
MIN.
DIRECT RDG. FOR Kh
CURRENT TRANSFORMER DATA

MANUFACTURER
SERIAL NO.
RATIO
:5
STYLE
TYPE
VOLTAGE CLASS
kV
CATALOG NO.
ACCURACY CLASS
BURDEN
VOLTAGE TRANSFORMER DATA

MANUFACTURER
SERIAL NO.
RATIO
:1
VOLTAMPERE RATING
AS FOUND READINGS
VA
kWHR
AS FOUND TESTS
LOAD
TYPE
VOLTAGE CLASS
kV
CATALOG NO.
POLARITY
DEMAND
ELEMENT BALANCE:
STANDARD
CONSTANT
OK
CORRECTION
OF INST. TRANS.
ACCURACY CLASS
MULTIPLY BY
CORRECTED
DEFECTIVE
CREEP TEST:
REV / 3MIN
REVOLUTIONS
STANDARD
STAND. CORR.
ACTUAL %
REGISTRATION
METER
LIGHT
FULL
50% FP, FULL LOAD
AS LEFT TESTS
LOAD
OK
ELEMENT BALANCE:
STANDARD
CONSTANT
CORRECTION
OF INST. TRANS.
CORRECTED
DEFECTIVE
CREEP TEST:
REV / 3MIN
REVOLUTIONS
STANDARD
STAND. CORR.
ACTUAL %
REGISTRATION
METER
LIGHT
FULL
50% FP, FULL LOAD
AMPS @
DEMAND INDICATOR TEST

PULSE INITIATOR TEST
SPECIFIED
AS LEFT READINGS
kWHR
VOLTS & 100% P.F. FOR

REV./
PULSES
MINUTES =
TEST RESULTS:
DEMAND
OPERATING VOLTAGE
kWHR STANDARD S/N
STANDARD CALIBRATION DATE
TESTED BY:
www.powerdb.com
PULSES
MULTIPLY BY
WIRING CORRECT PER MFR. DIAGRAM NO.
kW
REV./
3 PH 3W
3 PH 4W
1 PH
61100, REVISED 4/22/2009
WATTHOUR METER TEST
PAGE
538
COMMENTS:
DEFICIENCIES:
www.powerdb.com
61100, REVISED 4/22/2009
VAR TRANSDUCER TEST
OWNER
539
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
VOLTAGE
CURRENT
FREQUENCY
PHASE
CALIBRATION ADJUSTMENT
WIRE
ELEMENTS
ACCURACY
OUTPUT
OTHER
TEST RESULTS
MILLIAMP OUTPUT
INPUT
PHASE ANGLE
VAR INPUT
AS FOUND
AS SPECIFIED
AS LEFT
PHASE ANGLE MULTIPLIER (TANGENT)

ANGLE
MULTIPLIER
ANGLE
MULTIPLIER
ANGLE
MULTIPLIER
0 DEG
45 DEG
1.0000
90 DEG
30 DEG
0.57735
-30 DEG
-0.57735
-90 DEG
-45 DEG
-1.0000

TESTED BY:
www.powerdb.com
61400, REVISED 4/22/2009
VAR TRANSDUCER TEST
PAGE
540
COMMENTS:
DEFICIENCIES:
www.powerdb.com
61400, REVISED 4/22/2009
MULTIFUNCTION METERING MODULE
OWNER
541
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
MODEL
CONTROL VOLTAGE
STYLE / SERIES NO.
INSTRUCTION MANUAL NO.
CLASS
TYPE

VOLTAGE TRANSFORMER:
PRIMARY VOLTAGE
SECONDARY VOLTAGE
VTR =
PRIMARY CURRENT
SECONDARY CURRENT
CTR =
VOLTAGE READINGS
MEASURED PT
SECONDARY VOLTAGE
(volts)
VTR
MEASURED
SYSTEM VOLTAGE
(volts)
MULTIFUNCTION
METER READING
PERCENT
ERROR
MEASURED CT
SECONDARY CURRENT
(amps)
CTR
MEASURED
SYSTEM CURRENT
(amps)
MULTIFUNCTION
METER READING
PERCENT
ERROR
A-N
B-N
C-N
A-B
A-C
B-C
CURRENT READINGS
PHASE A
PHASE B
PHASE C

TESTED BY:
www.powerdb.com
61600, REVISED 4/22/2009
MULTIFUNCTION METERING MODULE
PAGE
542
COMMENTS:
DEFICIENCIES:
www.powerdb.com
61600, REVISED 4/22/2009
KILOWATT-HOUR METER SERVICE RECORD
OWNER
543
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
DATE
REMOVED
AMBIENT TEMPERATURE
HUMIDITY
SERIAL
NUMBER
SUBSTATION/
POSITION
READING
ON DATE
REMOVED

PLANT
POSITION
DEMAND
ON DATE
REMOVED
TESTED BY:
www.powerdb.com
Example Plant
GENERAL
DATE
REINSTALLED
READING
ON DATE
REINSTALLED
61000, REVISED 4/22/2009
KILOWATT-HOUR METER SERVICE RECORD
PAGE
544
COMMENTS:
DEFICIENCIES:
www.powerdb.com
61000, REVISED 4/22/2009
WATTHOUR METER TEST
OWNER
545
FORMS - ALL
PAGE
ADDRESS
JOB #
CUSTOMER
ASSET ID
ADDRESS
DATE
10/13/2014
SUBSTATION
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
POSITION
kWHR METER DATA

MANUFACTURER
SERIAL NO.
TYPE
CLASS
PKh
Kh
TA
WIRE
VOLTAGE
STATORS
CAT. NO./STYLE NO.
INSTRUCTION BOOKLET
PHASE
OTHER
kWHR REGISTER DATA

MANUFACTURER
SERIAL NO.
TYPE
FULL SCALE kW
VOLTAGE
REGISTER RATIO
CLASS
DEMAND INTERVAL
MIN.
DIRECT RDG. FOR Kh
CURRENT TRANSFORMER DATA

MANUFACTURER
SERIAL NO.
RATIO
:5
STYLE
TYPE
VOLTAGE CLASS
kV
CATALOG NO.
ACCURACY CLASS
BURDEN
VOLTAGE TRANSFORMER DATA

MANUFACTURER
SERIAL NO.
RATIO
:1
VOLTAMPERE RATING
AS FOUND READINGS
VA
kWHR
AS FOUND TESTS
LOAD
TYPE
VOLTAGE CLASS
kV
CATALOG NO.
POLARITY
DEMAND
ELEMENT BALANCE:
STANDARD
CONSTANT
OK
CORRECTION
OF INST. TRANS.
ACCURACY CLASS
MULTIPLY BY
CORRECTED
DEFECTIVE
CREEP TEST:
REV / 3MIN
REVOLUTIONS
MEASURED
CALCULATED
STAND. CORR.
ACTUAL %
REGISTRATION
METER
LIGHT
FULL
50% FP, FULL LOAD
AS LEFT TESTS
LOAD
OK
ELEMENT BALANCE:
STANDARD
CONSTANT
CORRECTION
OF INST. TRANS.
CORRECTED
DEFECTIVE
CREEP TEST:
REV / 3MIN
REVOLUTIONS
MEASURED
CALCULATED
STAND. CORR.
ACTUAL %
REGISTRATION
METER
LIGHT
FULL
50% FP, FULL LOAD
AMPS @
DEMAND INDICATOR TEST

PULSE INITIATOR TEST
SPECIFIED
AS LEFT READINGS
kWHR
VOLTS & 100% P.F. FOR

REV./
PULSES
MINUTES =
TEST RESULTS:
DEMAND
OPERATING VOLTAGE
kWHR STANDARD S/N
STANDARD CALIBRATION DATE
TESTED BY:
www.powerdb.com
PULSES
MULTIPLY BY
WIRING CORRECT PER MFR. DIAGRAM NO.
kW
REV./
3 PH 3W
3 PH 4W
1 PH
61101, REVISED 4/22/2009
WATTHOUR METER TEST
PAGE
546
COMMENTS:
DEFICIENCIES:
www.powerdb.com
61101, REVISED 4/22/2009
TRANSDUCER TEST
OWNER
547
FORMS - ALL
PAGE
ADDRESS
CUSTOMER
JOB #
ASSET ID
ADDRESS
DATE
10/13/2014
AMBIENT TEMPERATURE
HUMIDITY
Example Plant
GENERAL
PLANT
SUBSTATION
POSITION
NAMEPLATE DATA
MANUFACTURER
SERIAL NO.
TYPE
CATALOG NO.
VOLTAGE
CURRENT
FREQUENCY
CALIBRATION ADJUSTMENT
PHASE
WIRE
ACCURACY
ELEMENTS
OUTPUT
OTHER
TEST RESULTS
MILLIAMP OUTPUT
INPUT
PHASE ANGLE
DEGREES
AS FOUND

AS SPECIFIED
TESTED BY:
www.powerdb.com
AS LEFT
61550, REVISED 4/22/2009
TRANSDUCER TEST
PAGE
548
COMMENTS:
DEFICIENCIES:
www.powerdb.com
61550, REVISED 4/22/2009

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Table of Contents

Job #FORMS - ALL

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Customer Example Customer Company

COPYRIGHT 2002-2014 POWERDB, INC.

Example Customer Company

LIMITS: HIGH VOLTAGE LIMIT (V):

HIGH RESISTANCE LIMIT (Ohm)

HIGH TEMPERATURE LIMIT (F)

HIGH SPECIFIC GRAVITY LIMIT

LOW VOLTAGE LIMIT (V):

LOW RESISTANCE LIMIT (Ohm)

LOW TEMPERATURE LIMIT (F)

LOW SPECIFIC GRAVITY LIMIT

INTERCELL RESISTANCE THRESHOLD VALUES (Ohm)

AVG. SPEC. GR.:

INTERCELL RESISTANCE (micro-ohms)

TEST EQUIPMENT USED:

BATTERY DISCHARGE TEST

Example Customer Company

Data Collection Mode:

Number of BVM Sets:

First BVM Set

Update Interval (Sec):

Second BVM Set

Show Total Volt. Graph:

First Cell Starts At:

First Cell Starts At:

Show Bar Graph:

Cells Outside Limits: