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Form : E0D

DC UNDER VOLTAGE RELAY TEST RECORD Rev. 0


Date : ___________

TESTING / EQUIPMENT IDENTIFICATION


Project Application

System Unit No. Circuit Breaker Dwg No (S/L) Dwg No (CWD)

EQUIPMENT NAMEPLATE DATA


Manufacturer Type

STARTUP AND TEST DATA

1 Pickup / Dropout Test; Under Voltage settings _________


Rated Voltage : _ _ _ _ _ _ _ Volts
Pickup Voltage : _ _ _ _ _ _ _ Volts
Dropout Voltage : _ _ _ _ _ _ Volts

Remarks

Test Equipment used Model Cal. Due Test Equipment used Model Cal. Due

Signature Name Company Date


Testing Performed By :
Witnessed by : SBG
Witnessed by : SAMGE
Witnessed by : EWI
Witnessed by : SCECO