Respon SITE TEST REPORT DATE :

sibilities LOGO CONTRACTOR’S NAME: CUSTOMER:

Legend
CSDName of substation:
NG-SA CONTRACT NO. :

AC Distribution Panels
PAGE 1 OF 2
PANEL/ BAY NO: EQUIP. NO.: DWG. REF.: RECORD NO.:

1. GENERAL DATA AND INFORMATION.

S.No: Circuit Reference

Panel No: Rated Voltage

Make Rated Current

Type Rated Frequency

DATE:
TESTING ENGINEER APPROVAL ENGINEER

Signature: ________________ Signature: ________________

Name : ________________ Name : ________________
 SITE TEST REPORT DATE :

LOGO CONTRACTOR’S NAME: CUSTOMER:

Name of substation:
NG-SA CONTRACT NO. :

AC Distribution Panels
PAGE 2 OF 2
PANEL/ BAY NO: EQUIP. NO.: DWG. REF.: RECORD NO.:

DATE:
TESTING ENGINEER APPROVAL ENGINEER

Signature: ________________ Signature: ________________

Name : ________________ Name : ________________