• Breaker Oil Analysis

BOA• SPECIAL PROJECT #:

Oil Circuit Breaker
Sample Data

SEND REPORT TO: RETURN CONTAINERS TO: SEND INVOICE TO:

Company: Company: Company:
Attention: Attention: Attention:
Address: Address: Address:
City: State: Zip: City: State: Zip: City: State: Zip:
Phone: Phone: Phone:
Fax: Fax: Fax:
Email: Email: Email:

P.O. # Sampled By:

Sample Location (Substation/PH/PP) Notes:
Equipment / Company Number
Serial Number (Nameplate)
Manufacturer (Nameplate)
Date of Manufacture (Nameplate)
Model Number /Type (Nameplate)
Voltage Rating (Nameplate)
Fluid Volume (Nameplate)
Tank No. 1 Tank No. 2 Tank No. 3
Pole (Tank)
Phase A B C A B C A B C
Interrupting Rating (KA) (KVA) (MVA)
Amp Rating
Present Counter Reading
Oil Temperature
No. of switching operations since last internal
inspection
Number of fault operations since last internal
inspection
Present Accumulated Fault Count (ACC) % % %
Date of last internal inspection
Date oil was last filtered
Date oil was last replaced
Sample Date
DGA Syringe #
Oil Quality Bottle #
Status: Routine Rush Routine Rush Routine Rush
Lab Use Only
All Tests below are Required for BOA Diagnostics Optional Tests
Dissolved Gas Analysis (D-3612) Acid Number (D-974)
Particle Counts Color (D-1500)
Moisture in Oil (D-1533B) PCB (EPA-8080)
Dielectric Breakdown (D-1816) Metals (D-3635 ICP)
Interfacial Tension (D-971) Microscopy
Other
Instructions: All DGA samples are taken using a glass syringe or stainless steel cylinder. All oil quality tests samples are taken using a 1 qt plastic
bottle. OCBs containing more than 350 gallons of oil require one gallon of oil to be flushed through the fill/drain valve prior to collecting samples.
OCBs containing less than 350 gallons of oil require one quart of oil to be flushed through the fill/drain valve prior to collecting samples.
Routine Test Retest This is a Return to Service Test

TJH2b Analytical Services Inc.
3123 Fite Circle
Sacramento, CA 95827
Phone (916) 361-7177
Fax (916) 361-7178
TJH2b Analytical Services Inc. TJH2b Analytical Services Inc. TJH2b Analytical Services Inc
1000 Riverbend Blvd, Suite O 800 Wilburn Road, Suite K 204 Gale Lane
St. Rose, LA 70087 Sun Prairie, WI 53590 Kennett Square, PA 19348
Phone (504) 468-8837 Phone (608) 825-2022 Phone (610) 925-0688
Fax (504) 468-8838 Fax (608) 825-2023 Fax (610) 925-0689
Revised 07/12