Date Conducted :

Control No. :

MOTORS / PUMP TESTING FORM

PROJECT :

LOCATION :
Trade:

Mechanical ✘ Fire Protection Electrical Plumbing / Sanitary

Attachment:
Plan Diagram Product Data Methodology Calibration Certificate Mill Certificate

Bldg. # / Loc. : Brand / Contractor :

Equipment No. : Model/Serial No. :
Type/ Rating :

DATA DESIGN / SPECS ACTUAL PASS FAIL REMARKS

1. Model number/brand see Product Data same

2. Serial number see Product Data same
3. Capacity (lps) see Product Data same
4. TDH (mm h20) see Product Data same
5. Motor drive
5.1 Power (kw) see Product Data to be tested Note: if Failed - Testing must be Retested
5.2 Volts see Product Data to be tested
L1 - L2 see Product Data to be tested Subcontractor / Supplier must conduct initial or
L2 - L3 see Product Data to be tested internal testing first before notice for final test
L3 - L1 see Product Data to be tested
5.3 Ampere (FLA/Starting/Running)
L1 see Product Data to be tested
L2 see Product Data to be tested
L3 see Product Data to be tested
5.4 Phase see Product Data same
6.5 Cycle see Product Data same
6. Pump RPM see Product Data same
7. Operational set points
7.1 Suction pressure (psi) see Product Data to be tested
7.2 Discharge pressure (psi) see Product Data to be tested
7.3 Diff pressure (psi) see Product Data to be tested
8. Pump type see Product Data same
9. Impeller diameter (mm) see Product Data same
10. Overload rating see Product Data same
11. Functional Test of Motor see Product Data to be tested

CONDUCTED BY: WITNESSED BY: APPROVED BY: NOTED BY:

(Supplier & Contractor Representative) ( MEPF / Client) (QA / QC) ( PIC / PM / MEPF HEAD)

DISTRIBUTION : Subcon Document Control Client