FTW Testing.pdf
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- Solicitation number
- 36C25026Q0067
About this file
This document is a comprehensive electrical maintenance and testing report by Premier Power Maintenance for the VA Medical Center in Fort Wayne, Indiana, covering job number 220919 performed between February 21 and March 23, 2023. The report includes detailed inspections, tests, and recommendations for various electrical systems and equipment across multiple buildings and substations, including transformers, circuit breakers, switchboards, and electrical panels.
Key findings include multiple equipment deficiencies requiring attention, such as breakers with loose connections, temperature anomalies, corrosion signs, and trip unit performance issues. Specific recommendations include rechecking torque on load wires, replacing breakers with signs of wear or poor performance, investigating temperature increases in certain electrical components, and verifying proper load wire sizing. The testing was conducted using standards from organizations like NETA, NEC, and IEEE, and involved thermographic inspections, ground resistance testing, and low voltage power circuit breaker tests across different buildings and electrical systems.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25026Q0067 0004.pdf | ||
| Marion testing.pdf | ||
| Marion testing 2.pdf | ||
| FTW Testing 2.pdf | ||
| 36C25026Q0067 0003.pdf | ||
| 36C25026Q0067 0002.pdf | ||
| Sign-in-Marion.pdf | ||
| 36C25026Q0067 0001.pdf | ||
| Sign-in-Ft.-Wayne.pdf | ||
| Attachment VII - marion dry type transformers.docx | DOCX document | |
| Attachment I - SOW Attachments.pdf | ||
| Attachment VIII - Marion MCC.docx | DOCX document | |
| 36C25026Q0067.docx | DOCX document | |
| Attachment III - Wage Determination - Allen Co.pdf | ||
| Attachment II - Wage Determination - Grant Co.pdf | ||
| Attachment IX - Important Information.docx | DOCX document | |
| Attachment VI - Marion panel boards.docx | DOCX document | |
| Attachment V - Fort Wayne Electrical test equipment list 08-05-25.xlsx | XLSX spreadsheet | |
| Attachment IV - Fort Wayne Electrical Panel 08-05-25.xlsx | XLSX spreadsheet |
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Text version
“Integrity, Skill, Teamwork”
W W W . P R E M I E R P O W E R M A I N T E N A N C E . C O M
Engineering Report VA Medical Center-Ft. Wayne
John Hendricks Maintenance Testing Job Number: 220919
April 10, 2023
Premier Power Maintenance
4035 Championship Drive Indianapolis, IN 46268
T (317) 879-0660 www.premierpowermaintenance.com
April 10, 2023
VA Medical Center –Ft. Wayne 2121 Lake Ave.
Ft. Wayne, IN 46805
Attention: John Hendricks
Subject: Maintenance Testing Project No. 220919
Dear Mr. Hendricks, Thank you for the opportunity to provide services for you during this project. Our comprehensive report and recommendations are attached. They detail the work we performed, results obtained and provide recommendations for any corrective actions. Please let us know if you have any questions or need additional information.
As an independent third party electrical testing, maintenance and engineering services firm and full member of the InterNational Electrical Testing Association (NETA), Premier Power Maintenance prides itself in the quality of our services and skills of our people. Thanks again for the opportunity to provide you with electrical testing services. If there is anything more we can do for you, please don’t hesitate to contact us.
Sincerely, Premier Power Maintenance
Melvin Williams Field Service Supervisor
1. Summary
• Maintenance tests and inspections of electrical equipment help assure proper and safe operation.
• This project involved air switches, oil-filled and dry type transformers, low and medium voltage breakers, switchboards, panel inspections and ground resistance.
• Please refer to Section 5 for complete details regarding comments, deficiencies and recommendations.
2. Objectives
Maintenance Testing
• The equipment and components listed in Section 3.0 of this report have been inspected and tested to help assure their proper and safe operation. Defective or marginal equipment can be identified, repaired, replaced or scheduled for future repairs without costly or unexpected interruptions during normal operating periods.
• The test results are particularly valuable when kept for comparison with past and future maintenance test results. This historic database enables one to predict the probability of equipment failure and thus schedule facility production and financial budgets to accommodate preventive maintenance or repair rather than breakdown maintenance.
Oil Testing
• The oil in an oil filled transformer is intended to:
o Provide dielectric strength of the transformer insulation system o Provide efficient cooling o Protect the transformer core and coil assembly from chemical attack
• The oil quality screen (moisture, dielectric, interfacial tension, neutralization number, specific gravity, color and visual) is the standard testing means to determine if the oil is still capable of performing its intended function. While the degradation of oil is a natural process, early detection and remediation will extend the life of the transformer.
Another valuable oil testing method for transformers is the dissolved gas analysis (DGA). This battery of tests, often called fault gas analysis, is the easiest method to determine the operating condition of the transformer itself. Some gases indicate overheating of the unit possibly due to overloading, while other gases indicate a fault type condition within the transformer. The proper monitoring of dissolved gas within the transformer with remediation can prolong the life of the unit. It can also be used as a warning for the need to replace the transformer prior to failure.
Thermographic Survey
• The purpose of infrared inspections is to provide information relative to the physical condition of the electrical distribution system. Loose and poor connections, unbalanced loads, and loose bus joints can be located. These conditions are characterized by increased resistance and accompanied by a temperature rise, which is detected by infrared scanning. The survey was performed while the system was loaded, representative of a “normal” workday.
3. Service Description
• This project was initiated by John Hendricks with VA Medical Center-Marion. All testing was performed by Premier Power Maintenance field technicians Melvin Williams, Tracy Stafford, Brandon Andrus, Austin Knight, Larry Jones and Austin Hudson from February 21, 2023 to March 23, 2023.
• For a list of equipment tested in this project, please see test sheets located in the Appendix.
4. Procedure
• All testing is performed in accordance with PPM’s standard procedures including, but not limited to, selected specifications from the following: InterNational Electrical Testing Association (NETA), National Electrical Code (NEC), National Fire Protection Association 70B-Electrical Equipment Maintenance (NFPA 70B), Institute of Electrical and Electronic Engineers (IEEE), American Society for Testing and Materials (ASTM), National Electrical Manufacturer’s Association (NEMA), manufacturer’s instruction manuals and/or project specifications, unless otherwise noted.
5. Results: Comments, Deficiencies and Recommendations
• The following is a list of problems discovered during this testing project along with any corrective action that was made by Premier Power Maintenance. Those corrections beyond the scope of the project that require your additional corrective action are in bolded text.
Based on the results of the inspections and tests performed, the equipment included in this project (see detailed test data in Appendix) is considered serviceable.
o BLDG 1 (399): PP-10- FOUND 1-3 PHASE BREAKER (POLE 2,4,6) TURNED ON. NO LOAD
WIRES. OPENED BREAKER. RECOMMEND INVESTIGATION.
o BLDG 1 MRI ENTRANCE WESTINGHOUSE: SPARE BREAKER 29 AND 30 STRUGGLED TO
CLOSE. RECOMMEND INVESTIGATION.
o BLDG 1-LP1M: UPPER RIGHT PLASTIC BACKING FOR THE CENTER COVER HAS BROKEN
OFF. WILL NEED TO BE REPLACED.
o BLDG1-TRAYLINE PNL: BREAKER #2 CONTINUITY TEST WAS INTERMITTING IN THE
CLOSED POSITION.
o BLDG1-EQ-KP-8: NEUTRAL BRACKET FOUND BROKEN. RECOMMEND REPAIR/REPLACE.
o BLDG1-PP-B: MARKED ONE OF THE SPARE BREAKERS AS BAD. DID NOT REMOVE FROM
PANEL.
o BLDG1-CR-1: TURNED OFF UNUSED BREAKERS. BREAKER #9 LOAD SIDE SCREW WAS
STRIPPED OUT. REPLACED WITH BREAKER #11.
o BLDG1-LP-1E: #19 BREAKER MANUAL TRIP FUNCTION DOES NOT WORK. RECOMMEND
INVESTIGATION.
o BLDG1-LP-B12: FOUND A FEW BREAKERS TO BE SLUGGISH. DID NOT REPLACE THEM AT
THIS TIME. PASSED CONTINUITY TESTS. RECOMMEND REPLACING IN THE FUTURE.
o BLDG1-CR-1: TURNED OFF UNUSED BREAKERS. BREAKER #9 LOAD SIDE SCREW WAS
STRIPPED OUT. REPLACED WITH BREAKER #11.
o BLDG1-LP-3D: FOUND BREAKER BAD. REPLACED BREAKER.
o BLDG1-LP-3E: PANEL COVER BOLT FOUND BROKEN . INSTALLED NEW BOLT.
o BLDG1-DP-1E: BREAKER #22 (REMOVED LOTO FROM OTHER CONTRACTOR PER
CUSTOMER).
o BLDG1-CR-OIT-2: BREAKERS #1 WIRE WAS FOUND LOOSE. TIGHTENED.
o BLDG1-CR-OIT-1: BREAKER #1 WAS FOUND LOOSE. TIGHTENED.
o BLDG1-EMP: 5/16 BOLT ON PRIMARY INCOMING BUS (BLACK PHASE) WAS FOUND
STRIPPED. HARDWARE HAS BEEN REPLACED.
o BLDG 17 PNL A (MRI): BREAKER #7 RUNG OUT WITH BREAKER IN THE OPEN POSITION.
REPLACED WITH NEW BREAKER.
o BLDG2-B-EQ-DP-1: B PHASE CABLE ON EQ-HPP-4 FOUND LOOSE. IT WAS TIGHTENED.
o BLDG2-PNL LVA: REPLACED 1-20A BREAKER. ALSO, REPLACED 2 BLANKS.
o BLDG3-B3A2: FOUND 3 SPARES WHICH TESTED BAD. BREAKER #2 SHOWED SIGNS OF
CORROSION. RECOMMEND REPLACE.
o BLDG6-PPE-3: FOUND EACH PRIMARY LUG TO BUS LOOSE. RETIGHTENED.
o BLDG6-PP1: BREAKER 21/23 SHOWING SIGNS OF CORROSION. BREAKER 25 SHOWING
SIGNS OF OVERHEATING. RECOMMEND REPLACE.
o BLDG6-B6-208V SW: FOUND A PHASE LOOSE. RETIGHTENED. (FUSETRON FUS-FRN-R-
350).
o BLDG7-PP-7A: SPARE BREAKER #1 AND 3 FOUND BAD. RECOMMEND REPLACE.
o BLDG7-B7-A: FOUND BREAKER #13 OF DOUBLE-POLE TO BE BAD. UNABLE TO
ESTABLISH CONTINUITY.
o MAIN SUBSTATION 1500kVA EAST PADMOUNT TRANSFORMER: UNABLE TO REMOVE
H3A LOADBREAK CONNECTION FROM TRANSFORMER. PERFORMED ALL TESTING WITH
CABLE INCLUDED IN RESULTS. RECOMMEND REMOVAL OF LOADBREAK AND INSERT.
REPLACE BOTH WITH NEW ONES. PICTURE(S) INCLUDED OF CONNECTION AND CABLE
INFO.
o MAIN SUBSTATION 1500kVA WEST PADMOUNT TRANSFORMER: UNABLE TO REMOVE
ARRESTERS ON HIGH SIDE. RECOMMEND OUTAGE TO CUT BACK/REMOVE ALL 3
ARRESTERS FROM BUSHING AND REPLACE THEM WITH COOPER RTE LPC215 8.3 /
14.4kV LOADBREAK ARRESTERS. PICTURES INCLUDED WITH TEST SHEET.
o MAIN SUBSTATION 500 kVA EAST PADMOUNT TRANSFORMER: UNABLE TO REMOVE
ARRESTERS ON HIGH SIDE. RECOMMEND OUTAGE TO CUT BACK/REMOVE ALL 3
ARRESTERS FROM BUSHING AND REPLACE THEM WITH COOPER RTE LPC215 8.3 /
14.4kV LOADBREAK ARRESTERS. PICTURES INCLUDED WITH TEST SHEET.
o HAZMAT PANEL: FOUND LOOSE LOAD WIRES ON BREAKER 28/30. TIGHTENED WIRES.
o T6-3: TIGHTENED MAIN LUGS.
o T4-2: BREAKER #13 HOLD CONTINUITY WHILE IN THE OPEN POSITION.
o T5-3: LOOSE NEUTRAL WIRE TIGHTENED.
o RM 42 BREAKERS BOILER PLANT: SHORT TIME DELAY OUT OF TOLERANCE ON TIME.
RECOMMEND INVESTIGATION.
o RM 42 BREAKERS SOUTH MAIN: SHORT TIME AND GROUND FAULT DELAYS FOUND TO
BE OUT OF TOLERANCE. RECOMMEND REPLACING TRIP UNIT.
APPENDIX
FT WAYNE VA MEDICAL CENTER
FT WAYNE VA MEDICAL CENTERCustomer
Plant
Table of Contents Job #220919
4035 Championship Drive Indianapolis, IN 46268
317-879-0660 www.premierpowermaintenance.com24 Hour Emergency Service REVISED 2/18/2008
PANEL INSPECTIONSBUILDING # 1
User
PagePositionSubstation Equipment
50955 - PANEL INSPECTION RESULTS_R01-23
PANEL INSPECTIONS-2BUILDING # 1 50955 - PANEL INSPECTION RESULTS_R01-23 (2)
PANEL INSPECTIONS-3BUILDING # 1 50955 - PANEL INSPECTION RESULTS_R01-23 (3)
PANEL INSPECTIONS-4BUILDING # 1 50955 - PANEL INSPECTION RESULTS_R01-23 (4)
PANEL INSPECTIONS-5BUILDING # 1 50955 - PANEL INSPECTION RESULTS_R01-23 (5)
PANEL INSPECTIONS-6BUILDING # 1 50955 - PANEL INSPECTION RESULTS_R01-23 (6)
PANEL INSPECTIONS-7BUILDING # 1 50955 - PANEL INSPECTION RESULTS_R01-23 (7)
PANEL INSPECTIONSBUILDING # 16 50955 - PANEL INSPECTION RESULTS_R01-23 (3)
PANEL INSPECTIONSBUILDING # 17 50955 - PANEL INSPECTION RESULTS_R01-23
CB/201BUILDING # 2 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
PANEL INSPECTIONSBUILDING # 2 50955 - PANEL INSPECTION RESULTS_R01-23 (2)
PANEL INSPECTIONSBUILDING # 3 50955 - PANEL INSPECTION RESULTS_R01-23 (2)
PANEL INSPECTIONSBUILDING # 4 50955 - PANEL INSPECTION RESULTS_R01-23 (2)
PANEL INSPECTIONSBUILDING # 5 50955 - PANEL INSPECTION RESULTS_R01-23 (2)
PANEL INSPECTIONSBUILDING # 6 50955 - PANEL INSPECTION RESULTS_R01-23 (2)
PANEL INSPECTIONSBUILDING # 7 50955 - PANEL INSPECTION RESULTS_R01-23 (2)
1500kVA EAST PADMOUNT XFMRMAIN SUBSTATION 56750 - XFMR MAINTENANCE AND INSP_R05-23 (2)
1500KVA EAST PADMOUNT XFMRMAIN SUBSTATION 57130 - TRANSFORMER LIQUID COOLANT TRENDING
1500KVA WEST PADMOUNT XFMRMAIN SUBSTATION 56750 - XFMR MAINTENANCE AND INSP_R05-23
1500KVA WEST PADMOUNT XFMRMAIN SUBSTATION 57130 - TRANSFORMER LIQUID COOLANT TRENDING
1500KVA XFMR (EAST) SWITCHMAIN SUBSTATION 29000 - LOADBREAK DISCONNECT_R02-23 (4)
500KVA EAST PADMOUNT XFMRMAIN SUBSTATION 56750 - XFMR MAINTENANCE AND INSP_R04-23 (2)
500KVA EAST PADMOUNT XFMRMAIN SUBSTATION 57130 - TRANSFORMER LIQUID COOLANT TRENDING
500KVA WEST PADMOUNT XFMRMAIN SUBSTATION 56750 - XFMR MAINTENANCE AND INSP_R04-23
500KVA WEST PADMOUNT XFMRMAIN SUBSTATION 57130 - TRANSFORMER LIQUID COOLANT TRENDING
500KVA XFMR (WEST) SWITCHMAIN SUBSTATION 29000 - LOADBREAK DISCONNECT_R02-23 (3)
ANTHONY-WABASH SWITCHMAIN SUBSTATION 27200 - VOLTAGE TRANSFORMER TEST (2)
ANTHONY-WABASH SWITCHMAIN SUBSTATION 29000 - LOADBREAK DISCONNECT_R02-23 (2)
METERING PTsMAIN SUBSTATION 27200 - VOLTAGE TRANSFORMER TEST
SPYRUN DISCONNECT SWITCHMAIN SUBSTATION 27200 - VOLTAGE TRANSFORMER TEST
SPYRUN DISCONNECT SWITCHMAIN SUBSTATION 29000 - LOADBREAK DISCONNECT_R02-23
PANEL INSPECTIONSMDP-TRAILERS 50955 - PANEL INSPECTION RESULTS_R01-23
208-120 TIERM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
AMBULATORY CARERM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
ATS-1 #1RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
ATS-10 #8RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
ATS-2 #15RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
ATS-3 #14RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
Table of Contents Job #220919
4035 Championship Drive Indianapolis, IN 46268
317-879-0660 www.premierpowermaintenance.com24 Hour Emergency Service REVISED 2/18/2008
PagePositionSubstation Equipment
ATS-4 #6RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
ATS-8 #7RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
ATS-9 #11RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
BEQH2RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
BOILER PLANT (4)RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
DP-1 #2RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
DP-10 #13RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
DP-2 #5RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
DP-3 #12RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
DP-4 #10RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
DP-5 #4RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
DP9 #16RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
FIRE PUMP #17RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
GENERATOR 1RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
GENERATOR 2 SPARERM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
GENERATOR 3RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
MDP-OR #9RM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
NORTH MAINRM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
NORTH MAIN 208 GEARRM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
SOUTH MAINRM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
SOUTH MAIN 208 GEARRM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
TIERM 42 BREAKERS 15200 - LOW VOLTAGE POWER CIRCUIT BREAKER TEST_R01-23
FALL OF POTENTIAL TESTINGVARIOUS AREAS 34567 - MEMO
GROUND RESISTANCE TESTINGVARIOUS AREAS 24210 - GROUND RESISTANCE TWO TERMINAL
GROUND RESISTANCE TESTING (2)VARIOUS AREAS 24210 - GROUND RESISTANCE TWO TERMINAL
INFRARED SURVEYVARIOUS AREAS 52000 - THERMOGRAPHIC INSPECTION
EQPT. LOCATION
PAGE
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 1 PANEL INSPECTIONSPOSITION
2/27/2023 AMBIENT TEMPERATURE 20 °C HUMIDITY 45 %
B. ANDRUS / A. KNIGHT / L. JONES / T. STAFFORDTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
PRL3A250A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
EATON
CATALOG #
EZB2090R
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
DT-375KVABLDG 1: S. BRKR XFM EATON V48M28T756CULS47
DRY TYPE TRANSFORMER
NAB400ABLDG 1 (399): PP-10 GE NA
FOUND 1 - 3PHASE BREAKER (POLE 2,4,6) TURNED ON. NO
LOAD WIRES. OPENED BREAKER.
NQB100ABLDG 1(399): PP-10A WESTINGHOUSE FY-37632
FOUND BREAKER 1 LOAD WIRE LOOSE. TIGHTENED
MODEL 36B150KVABLDG1(XFMR 105) FPI T204H150E
QL150KVABLDG1 (XFMR 104) GE 9T23Q9876
NA600ABLDG1(DISC.104XF) GE NA
FUSED DISCONNECT 240VAC; EQUIPPED WITH FLNR 600A ID
FUSES CHECKED GOOD.
NA400ABLDG1(DISC SWB 19) GE NA
NO FUSES
NA600ABLDG1 (DISC DS 103) GE NA
EQUIPPED WITH FLNR 400 ID FUSES. CHECKED OK.
QL150KVABLDG1 (XFMR T-103) GE 9T23Q9876
GCB600ABLDG 1 (DP-5) GE BJ10141
4 SPARES FOUND WITHIN PANEL. MISSING HARDWARE ON
TOP CENTER PLATE.
WEB31CIR100ABLDG 1 (LP-BF) WESTINGHOUSE TE-40910
NQOD100ABLDG 1 (LP IH) SQUARE D NQOD430M100
NANABLDG 1 (DIMMING) LITHONIA CNTRL SYS NA
LITHONIA LIGHTING CONTROL PANEL. 6 BREAKERS.
HDP400ABLDG 1 (EQ HDP-B) GE EQ-HDP-B
BLDG 1 RM 250. REPLACED BREAKER HDP-2 WITH USED
BREAKER. (ORIGINAL BREAKER WOULD NOT CLOSE) 225A PL
PRL1C125ABLDG1 CR4B-SEC 1 EATON EZB2048R
PRL1A225ABLDG1 CR4B-SEC 2 EATON EZB2036R
PRL1A125ABLDG1 CR4C EATON EZB2036R
PRL1A225ABLDG1 CR4A-SEC2 EATON E2B2042R
BREAKERS TO BUS FOUND LOOSE. TIGHTENED.
PRL1C125ABLDG1 CR4A-SEC1 EATON E2B1048R
UNUSED BREAKERS TURNED OFF (4 TOTAL)
TYPE 1100ABLDG 1- DP-6 WESTINGHOUSE YS2042
WLA42CIR225ABLDG 1 MRI ENTRANC WESTINGHOUSE TE-4091D
SPARE BREAKER 29 AND 30 STRUGGLED TO CLOSE
NANABLDG1 EQ-HDP-B SQUARE D NA
CT SCANNER DISCONNECT
NF225ABLDG1 EQ-HDP-2 SQUARE D 1228435189
NF125ABLDG1 1HE1 CRITICA SQUARE D 123381495300
NQ100ABLDG1 EQ-USP SQUARE D N218L2C
AXB7150ABLDG1 EQ-PP-B GE AQF3242CBX
QL45KVABLDG1-T-102 XFMR GE 9T23Q9873
OOB400ABLDG 1 EQ-PP-11 GE NA
NA225ABLDG 1 LP-OR 3217 GE AQF3302MGX
TABS FOR BREAKER(S) 3,27, AND 27 FOUND BROKEN.
REPLACED BREAKERS.
NA225ABLDG 1 MDP-OR GE AQF3362CBX
CTL225ABLDG1 RM 536 LP-5A WESTINGHOUSE B2SS140
1225ABLDG1 LP-3-A EATON EZB2060R
1225ABLDG1 LP-3-B EATON EZB2060R
BLDG 1: CRDP1
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 1 PANEL INSPECTIONS-2POSITION
2/28/2023 AMBIENT TEMPERATURE 15 °C HUMIDITY 45 %
B. ANDRUS / T. STAFFORDTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
NA100A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
WESTINGHOUSE
CATALOG #
NA
COMMENTS
UNUSED BREAKERS WERE OPENED.
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
WCA42CIR225ABLDG1 LP-2A WESTINGHOUSE TE-40910
CTL225ABLDG1 LP-2BA WESTINGHOUSE TE-40910
UNUSED BREAKERS WERE OPENED.
CTL225ABLDG1 LP-2B WESTINGHOUSE TE-40910
UNUSED BREAKERS WERE OPENED.
B10R18CIR100ABLDG1 PP-CA WESTINGHOUSE TE-43220
UNUSED BREAKERS WERE OPENED.
NA250A BLDG1 2H12 EAST HL SQUARE D LE36225LSG
NA250ABLDG1 CHILLER CH-1 SQUARE D LE36225LSG
NA400ABLDG1 SPARE SQUARE D LE36400LSG
NA400ABLDG1 PP-A SQUARE D LE36400LSG
NA400ABLDG1 WEST POWER SQUARE D LE36400LSG
NA150ABLDG1 ATS-11 SQUARE D AL150HD
PRL4B400ABLDG1 PP-A CUTLER HAMMER PRL4
NANABLDG1 PP-AA GE NA
NA400ABLDG1 N-H3 RISER SQUARE D LE36400LSG
NA400ABLDG1N-ATS-6 SQUARE D LE36400LSG
NA400ABLDG 1 N-BLDG 5,6,7 SQUARE D LE36300LSG
NA250ABLDG 1 N-PP-B SQUARE D LE36250LSG
NA400ABLDG1 N- H2-RISER SQUARE D LE36400LSG
NA400ABLDG1 N-3H1,4H1,5H1 SQUARE D LE36400LSG
NA400ABLDG1 N- ATS 13 SQUARE D LJA36400CU44Y
NA400ABLDG1 N-BEQHI RM49 SQUARE D LJA36400CU44Y
NANABLDG1 N -ESS-P NA NA
NA400ABLDG1 N--ATS-7 SQUARE D LE36400LSG
NA250ABLDG1 N-SPARE SQUARE D LE36100LSG
NA250ABLDG1 N-NEW CHLR SQUARE D AL250JD
NQ100ABLDG1 LP1B (NORM) SQUARE D 12338149530010001
NQ100ABLDG1 LP-1A(NORM) SQUARE D 12338149530010001
HCA-42-CIR225ABLDG1-LP-BA WESTINGHOUSE TE-40910
NQ100ABLDG1-LP-BA-A SQUARE D NQ430L
NANABLDG1-DP-4 WESTINGHOUSE NA
HCA-42-CIR100ABLDG1-EM-2 WESTINGHOUSE TE-40910
NQOD100ABLDG1-PNL BASE A1 SQUARE D NQOD12L100CU
S25KVABLDG1 XFMR 269 SQUARE D 25S3HF
NANABLDG1-A1 (RM 305) SQUARE D NA
NA400ABLDG1- EQ-DP-B GE AQF3124MTX
RM 42.
BLDG1 PP 2BA
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 1 PANEL INSPECTIONS-3POSITION
3/8/2023 AMBIENT TEMPERATURE 20 °C HUMIDITY 45 %
M Williams / A. Hudson / T. Stafford / B. AndrusTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
NA600A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
SQUARE D
CATALOG #
MODEL 6
COMMENTS
ALL FUSES CHECKED GOOD.
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
QL30KVABLDG1- TS-202 XFMR GE 9T23Q9872
EQ-1A225ABLDG1-EQ-1A GE AF495
CDP-7225ABLDG1-PP-REF ITE SERIES 8
FUSED600ABLDG1-AMB CARE DIS SQUARE D H326NR
TR500R FUSES. ALL CHECKED GOOD
NANABLDG1-AMB XFMR FPI NA
NAMEPLATE HAS BEEN REMOVED
NA150KVABLDG1 XFMR DP SQUARE D 150T3H
1250ABLDG 1-MDP SQUARE D HC4250DB
RM A155
E1400ABLDG 1-DP SQUARE D 12107016971
NQOD225ABLDG 1-LP1N SQUARE D NQOD442L225CU
NQOD225ABLDG 1-LP1M SQUARE D NQOD442L225CU
UPPER RIGHT PLASTIC BACKING FOR THE CENTER COVER
HAS BROKEN OFF. WILL NEED REPAIRED
PRLA225ABLDG 1-LP4C1-SEC2 EATON 1C96649G06
PRL1A100ABLDG1-LP4E EATON EZB2036R
SEVERAL SPARES WITHIN PANEL.
NA225ABLDG1-LP4C1-SEC1 EATON 1C96649G06
PRLA225ABLDG1-LP4C2 EATON EZB2060R
WCA-42-CIR225ABLDG1-LP-5B WESTINGHOUSE TE-40910
WCA-42-CIR225ABLDG1-LP-3C WESTINGHOUSE TE-40910
GCB600ABLDG1-DP-2 GE NA
1 SPARE BREAKER (11,13,15) WOULD NOT RESET.
NA225ABLDG1-LP-BE WESTINGHOUSE TE-40910
KITCHEN AREA-ROOM 2
NA400ABLDG1-CR-DP-B GE AQF3184MBX
ROOM 42 (LOCATED BEHIND 208 SWITCHGEAR/ LV
BREAKERS.
PRL1A200ABLDG1-CR-OIT-5 EATON 1C96649G06
5TH FLOOR
1100ABLDG1-CR-OIT-4 SIEMENS P122481100CU
PRL1A200ABLDG1-CR-OIT-3 EATON 1C96649G02
NA225ABLDG1-LP-BC WESTINGHOUSE BZ56344
CUSTOMER REMOVED 4 LOTO FROM OTHER CONTRACTOR
FOR PANEL. PPM REMOVED LOAD WIRES AND TAPED OFF.
WEB15-CIR100ABLDG1-EM-1 WESTINGHOUSE TE-40910
1ST FLOOR/ RM 176
SERIES E2100ABLDG1-EM1A SQUARE D DQDD12LI
1ST FLOOR / RM A155 MECH ROOM
CTL100ABLDG1-EM-5 WESTINGHOUSE BV220216
5TH FLOOR
WEB15-CIR100ABLDG1-EM-13 WESTINGHOUSE TE-40910
FOIUND BREAKER # 18 LOOSE. TIGHTENED.
NQ100ABLDG1-BLSL2 SQUARE D 4536773271
WEB15-CIR100A BLDG1-LP-E2 WESTINGHOUSE TE-40910
1100ABLDG1-BLRL2 SQUARE D 453677327100S0001
NQOD100ABLDG1-CR1A SQUARE D NQOD431
NQOD100ABLDG1-CR1B SQUARE D NQOD431
BLDG1-MCC1
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 1 PANEL INSPECTIONS-4POSITION
3/9/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
WEB15-CIR100A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
WESTINGHOUSE
CATALOG #
TE-40910
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
PRL1A225ABLDG1-CRP CUTLER-HAMMER FJ727559
BIOB24-CIR100ABLDG1-DP-3A WESTINGHOUSE 5217-969
A100ABLDG1-CR-OIT-AMB EATON EZB2042R
PRL1A100ABLDG1-CR-OIT-2 EATON EZB2042R
BREAKER # 1 WIRE FOUND LOOSE. TIGHTENED.
PRL1A100ABLDG1-CR-OIT-B EATON EZB2042R
1100ABLDG1-CR-OIT-1 EATON EZB2042R
BREAKER # 1 FOUND LOOSE. TIGHTENED.
1NABLDG1-CR-2C SQUARE D NC385HR
USUSED BREAKERS TURNED OFF
1NABLDG1-CR-2D SQUARE D NC38SHR
PRL1A100ABLDG1-LPE1 CUTLER HAMMER YS204B
UNUSED BREAKERS TURNED OFF.
PRL1A225ABLDG1-EMP CUTLER HAMMER NA
5/16 BOLT ON PRIMARY INCOMING BUS (BLACK PHASE) WAS
FOUND STRIPPED. HARDWARE HAS BEEN REPLACED.
QL112.5KVABLDG1-T-101 XFMR GE 9T23Q9875
10200ABLDG1-DS-101 GE THN3364
NA100ABLDG1-TRAYLINE PNL SQUARE D QOC24US
BREAKER # 2 CONTINUITY TEST WAS INTERMITTING IN THE
CLOSED POSITION.
175KVABLDG1-CR1DA XFMR SQUARE D 12338149S300S0001
PRL1A225ABLDG1-PP-1 CUTLER HAMMER 1C96649G01
WEB15-CIR100ABLDG1-EQ-B WESTINGHOUSE TE-40910
BIOB23-CIR100ABLDG1-DP-3A WESTINGHOUSE 5217-969
1NABLDG1-TELE-C XFMR SQUARE D NCSOSHR
A100ABLDG1-CR1D SQUARE D 12338149530020001
NANABLDG1-CR-3 WESTINGHOUSE TE-40910
NA100ABLDG1-CR3-B EATON EZB2060R
NA125ABLDG1-CR-3A GE AQF3241CBX
NA15KVABLDG1-TELE-A XFMR GE 9T22B3091G03
NA225ABLDG1-2H1 SQUARE D 1210377300005
NA125ABLDG1-CR-5 GE AQF3301AT
NA100ABLDG1-CR-2 WESTINGHOUSE TE-40910
NA60ABLDG1-PP-DISHMAC WESTINGHOUSE IN74370
NA225ABLDG1-PP-4 CUTLER HAMMER YSZ049
NA100ABLDG1-EQ-5 WESTINGHOUSE TE-60910
NA100ABLDG1-EQ-4 EATON EZB2036R
NA100ABLDG1-EQ-3 WESTINGHOUSE TE-40910
NA225ABLDG1-LP-2CA WESTINGHOUSE TE-40310
FOUND A BAD SPARE BREAKER WITHIN PANEL.
NA225ABLDG1-LP-2C WESTINGHOUSE TE-40310
BLDG1-CR-B
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 1 PANEL INSPECTIONS-5POSITION
3/10/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
A. HUDSON / A. KNIGHT / L. JONES / B. ANDRUSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
NA225A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
CUTLER HAMMER
CATALOG #
YS204B
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
NA225ABLDG1-LP-1C WESTINGHOUSE TE-40910
NA225ABLDG1-LP-1F WESTINGHOUSE TE-40910
NA400ABLDG1-BEQH-1 SQUARE D 44367732710020031
NA400ABLDG1-BEHQ-3 SQUARE D 29436891020040001
NA225ABLDG1-DP-TELE-A GE AQF3242CTX
NA225ABLDG1-DP-TELE-B GE NA
NA125ABLDG1-DP-TELE GE A331
NA125ABLDG1-CR-2B GE AQF3241MBX
NA225ABLDG1-CR-2A GE AQF3422MBX
NA125ABLDG1-CR-1C GE AQF3241MBX
NA400ABLDG1-LP1K SQUARE D NQOD442L400CU
NA225ABLDG1-LP1L SQUARE D NQOD442L225CU
PANEL FOUND BROKEN IN A FEW AREAS.
NA100ABLDG1-EM2 WESTINGHOUSE TY40910
NA100ABLDG1-EM-4 EATON 1C96646001
NA225ABLDG1-EQ-KP-8 GE AQF3242MBX
NEUTRAL BRACKET FOUND BROKEN
NA100ABLDG1-4H2 SQUARE D 121037730012
NA100ABLDG1-3H2 SQUARE D 1210377300009
NA100ABLDG1-2H2 SQUARE D 1210377300006
NA225ABLDG1-EQ-2A GE AQF3362CBX
NA200ABLDG1-10S POWER SQUARE D 5H1S2100-FA
NA100ABLDG1-5H2 SQUARE D 1210377300015
NA100ABLDG1-1H2 SQUARE D 12103773000003
WCA42-CIR225ABLDG1-LP-ID WESTINGHOUSE TE-40910
NA125ABLDG1-PP-OR GE AQF3301MBX
NQO100ABLDG1-RM 311 SQUARE D 5H152100-FA
2A225ABLDG1-PP-B GE AR-243606
MARKED ONE OF THE SPARE BREAKERS AS BAD. DID NOT
REMOVE FROM PANEL.
I-LINE100ABLDG1-5H1 SQUARE D 1210377300014
I-LINE150ABLDG1-4H1 SQUARE D 1210377300011
E1125ABLDG1-2H3 SQUARE D 121377300007
NH1B225ABLDG1-5H3 SQUARE D 46612-2A
OPENED UNUSED SPARE BREAKERS.
PRL2A200ABLDG1-3H1 EATON EZB2048R
NA200ABLDG1-OR ROOM 313 SQUARE D 5H152100-FE
MISSING DEAD FRONT BOLT
E1100ABLDG1-1H3 SQUARE D 1210377300-004
E1125ABLDG1-3H3 SQUARE D 1210377300010
BLDG1-PP-XRAY
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 1 PANEL INSPECTIONS-6POSITION
3/9/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
WEB15-CIR100A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
WESTINGHOUSE
CATALOG #
TE-40910
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
NQO100ABLDG1-OR PANEL SQUARE D Q020-40504
NANABLDG1-OR RM 303 NA NA
PRL4B400ABLDG1-EQP CUTLER HAMMER BX3673
WEB15-CIR100ABLDG1-EQ-1 WESTINGHOUSE TE-40910
NLAB225ABLDG1-LP-IJ GE BR23910B
TURNED OFF UNUSED BREAKERS
WEB15-CIR100ABLDG1-CR-1 WESTINGHOUSE TE-40910
TURNED OFF UNUSED BREAKERS. BKR # 9 LOAD SIDE
SCREW WAS STRIPPED OUT. REPLACED WITH BRK # 11
PRL1A225ABLDG1-PP-9 CUTLER HAMMER YS2060
BREAKER FOR 208 CHARGING RECEPTACLE FOUND
TRIPPED. RESET BREAKER.
N/P30KVABLDG1-DOC XFMR FPI T20LH42-3
WCE 42 CIR225ABLDG1-LP2E WESTINGHOUSE TE-40910
WEB 24 CIR100ABLDG1-LP-3DA WESTINGHOUSE TE-40910
WCA 42 CIR225ABLDG1-LP-3D WESTINGHOUSE TE-40910
FOUND BREAKER BAD. REPLACED BREAKER
WCA 42 CIR225ABLDG1-LP-3E WESTINGHOUSE TE-40910
PANEL COVER BOLT FOUND BROKEN. INSTALLED NEW
BOLT.
PRL1A225ABLDG1-LP-4D SEC1 EATON NA
PRL1A225ABLDG1-LP4D1-SEC2 EATON NA
PRL1A225ABLDG1-LP4D1-SEC1 EATON NA
WCA 42 CIR225ABLDG1-LP-5C WESTINGHOUSE TE-40910
NQOB225ABLDG1-LP-5D SQUARE D 46612-3P
PRL1A225ABLDG1-LP4D2-SEC2 EATON NA
NQBNABLDG1-PP-6B WESTINGHOUSE FY35005
PRL1A225ABLDG1-PP-6 CUTLER-HAMMER YS2048
1400ABLDG1-DP-9 SQUARE D HC42S9TSHR
NQOD225ABLDG1-LP-2H SQUARE D NA
UNUSED BREAKERS OPENED.
PRL1A225ABLDG1-LP-2G CUTLER HAMMER YS2048
PRL1A225ABLDG1-PP-3 CUTLER HAMMER YS2060
WCA 42 CIR225ABLDG1-LP-1E WESTINGHOUSE TE-40910
#19 BREAKER MANUAL TRIP FUNCTION DOES NOT WORK.
WCA 42 CIR225ABLDG1-LP-1EA WESTINGHOUSE TE-40910
WCA 42 CIR225ABLDG1-LP-2D WESTINGHOUSE TE-40910
CGB600ABLDG1-DP-1 GE NA
THIS SWITCHBOARD IS EQUIPPED WITH 1-50A BREAKER
WCA 42 CIR225ABLDG1-LP-B12 WESTINGHOUSE TE-40910
FOUND A FEW BREAKERS TO BE SLUGGISH. DID NOT
REPLACE THEM AT THIS TIME. PASSED CONTINUITY TESTS
NLAB200ABLDG1-DP-1E GE NA
BREAKER # 22 (REMOVED LOTO FROM OTHER CONTRACTOR
PER CUSTOMER)
NQ225ABLDG1-BNL2-1 SQUARE D NC38SHR
NQ225ABLDG1-BNL2-2 SQUARE D NC38SHR
NQ225ABLDG-BEQL2 SQUARE D NC38SHR
BLDG1-EQ-2
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 1 PANEL INSPECTIONS-7POSITION
3/9/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
NLAB225A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
GE
CATALOG #
NA
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
PRL4B800ABLDG1-DP-3 CUTLER HAMMER NA
NQOB100ABLDG1-MED-REC SQUARE D NQOB-204
PRL1A225ABLDG1-LPL CUTLER HAMMER NA
NA400ABLDG1-ATS#14 SQUARE D LJA36400CU44X
NA250ABLDG1-ACC3 KIT CON SQUARE D LX36200
NA250ABLDG1-ACC2 LAB CO SQUARE D LX38175
BLDG1-PP-2
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 16 PANEL INSPECTIONSPOSITION
3/9/2023 AMBIENT TEMPERATURE 16 °C HUMIDITY 45 %
Melvin WilliamsTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
PRL3A400A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
CUTLER HAMMER
CATALOG #
YS2072
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
NANABLDG 16-B16-A WESTINGHOUSE NA
#8 BREAKER RINGS THROUGH IN THE OPEN POSITION.
REMOVED BREAKER. LOAD CABLE RINGS THROUGH BUS
NA15KVABLDG 16-XFMR 16-A SQUARE D 15T3H
BLDG 16-PP-16
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 17 PANEL INSPECTIONSPOSITION
3/7/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 35 %
Melvin WilliamsTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
NQ225A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
SQUARE D
CATALOG #
NQ442L2C
COMMENTS
BREAKER # 7 RUNG OUT WITH BREAKER IN THE OPEN
POSITION. REPLACED WITH NEW BREAKER.
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
HCM400ABLDG 17: MDP (MRI) SQUARE D HCM91TSD
THIS PANEL WAS EQUIPPED WITH A MAIN 400A BREAKER.
REMOVED LUG SHIELD. SCREWS WERE STRIPPED OUT.
330KVABLDG 17: XFMR (MRI) SQUARE D EE30T3H
BLDG 17: PNL A (MRI)
D.O.
ELECTRICALLY OPERATED
BREAKER TYPE
TRIP UNIT TYPE
SGHA36AT0600
CUBICLE CODE
SN / SO NO.
MOUNTING
GE
NA
NA
600SPECTRA RMS
FUSE CAT. NO.
TCLK265
SENSOR TAPS
CB/201
TRIP UNIT CAT #
MANUFACTURER
INSPECTED CONDITION CLEAN/LUBE INSPECTED CONDITION CLEAN/LUBE
C
NA
C
C
NA
C
Description
ARC CHUTES
AUXILIARY DEVICES
GROUND CONNECTION
Description
CUBICLE AND RACKING DEVICES
CONTACT FINGERS
LOADING AND ARCING CONTACTS
OVERCURRENT DEV. BATTERY CTRIP UNIT
COUNTER BEGINNING
PAGE
ADDRESS
CUSTOMER
LOW VOLTAGE POWER CIRCUIT BREAKER TEST 4035 Championship Drive Indianapolis, IN 46268
317-879-0660
(765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
JOHN HENDRICKSOWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 2
3/7/2023 AMBIENT TEMPERATURE 19 30 %
POSITION
ASSET #:
CB/201
HUMIDITY°C
AUSTIN KNIGHTTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service 15200, REVISED 3/23/2023
NA
B.I.
NA
NOYES
GOOD
NA
GOOD
GOOD C
GOOD
GOOD
NA
GOOD
FRAME SIZE AMPS V600600
COUNTER END
= AA
600X 600
SENSOR TAP
DELAY
RATING PLUG
I2T
NA
NA
ADDI INFO
GRD. FLT.
INST.
SHORT
LONG
FUNCTION
SettingSETTINGS AS FOUND
A
X
X
X
5,400 A
A
A
9 -
X
A
A = A
5,400
600 600RATING PLUG
SENSOR TAP
NA
NA
SHORT
LONG 1
INST.
GRD. FLT.
SETTINGS AS LEFT FUNCTION Setting DELAY I2T ADDI INFO
Test Amps
% of Setting
Performance Tolerance
Pole 1 Pole 2 Pole 3 Targets
Found/Left Found/Left
Trip Unit SettingTest Criteria
Found/Left
Primary/Secondary Current Performance Tests
Long Time Delay
1 600 100 NA NA
1800 300 NA NA
NANA
34.334.3 /
36.2
NA
36.2
NA
34.9
NA
34.9
NA
/LongTime PU
Instant Delay
NA NA
8100 150 0/0.07 NA
9 5400 100 5419
0.01
0.01 /
0.010.01
5450 5450/
/0.030.03
5270 5270/
Instant PU
Insulation Resistance
POLE TO FRAME
2,680,000
3,000,000
2,578,160
2,886,000
2,886,000
3,000,000
3,000,000
3,000,000
2,886,000
2,886,000
2,700,000
3,000,000
3,000,000
2,597,400
2,886,000
2,886,000
2,886,000
LINE TO LOAD 3,000,000
EQUIPMENT TEMPERATURE TEMPERATURE CORRECTION FACTOR TO 20 °C
0.962°CV °C1,000
POLE 1 (M©) (P1-P2) POLE 2 (M©) (P2-P3)
TEST VOLTAGE
POLE 3 (M©) (P3-P1)
POLE TO POLE
READINGREADING 20°C20°CREADING 20°C
POLE RESISTANCE (µ©)
POLE 3
110.7106.7 100.6
POLE 2POLE 1
COMMENTS: UNABLE TO PERFORM LONGTIME PICKUP FOR THIS MODEL UNIT
DEFICIENCIES:
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 2 PANEL INSPECTIONSPOSITION
3/9/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
NQ225A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
SQUARE D
CATALOG #
NQ442L2C
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
NF250ABLDG2-EQ-HPP-4 SQUARE D NF430L2C
SO75KVABLDG2-TS-203 XFMR SQUARE D EXN76T3H
SERIES E2225ABLDG2-A SQUARE D NQODQ2
NQOD100ABLDG2-A1 SQUARE D NQOD424
CTLNABLDG2-B2-A2 WESTINGHOUSE NA
NQ100ABLDG2-A3 SQUARE D NQ430L1U
NA225ABLDG2-EQ-HPP-3 GE AEF3362MBX
APNBNABLDG2-B-EQ-DP-1 GE NA
B PHASE CABLE ON EQ--HPP-4 FOUND LOOSE. TIGHTENED.
QL112.5KVABLDG2-TS 201 XFMR GE 9T23Q9875
MCC600ABLDG2-MAIN MCC GE 481X0476L01
NLAB225ABLDG2-LP PNL LVA GE NA
NLAB225ABLDG2-PNL LVA GE NA
REPLACED 1-20A BREAKER. ALSO, REPLACED 2 BLANKS.
BLDG2-EQ-LLP-4
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 3 PANEL INSPECTIONSPOSITION
3/9/2023 AMBIENT TEMPERATURE 189 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
DT-375KVA
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
NA
CATALOG #
V48M28T7516CU
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
NANABLDG3-DISC TS-BLD3 EATON NA
PRL1A225ABLDG3-B3A1 CUTLER-HAMMER Y32048
NANABLDG3-B3A2 EATON NA
FOUND 3 SPARES WHICH TESTED BAD. BREAKER #2
SHOWED SIGNS OF CORROSION. RECOMMEND REPLACING
PRL1A225ABLDG3-B3A EATON YS2048
BLDG3-TS-BLD3 XFM
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 4 PANEL INSPECTIONSPOSITION
2/21/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
NA100A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
WESTINGHOUSE
CATALOG #
TY43727
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
BLDG4-B4-A
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 5 PANEL INSPECTIONSPOSITION
3/9/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
1NA
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
SQUARE D
CATALOG #
QOL24U
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
WEHB-15-CIR150ABLDG5- B5-A WESTINGHOUSE FY-43313
B1OB-18-CIR150ABLDG5-PP-5 WESTINGHOUSE FY-43313
S25KVABLDG5-T-B5A XFMR SQUARE D EE2553H
MP-230KVABLDG5-B5B XFMR SQUARE D PMP2-CTYPE 3R
THIS IS A PANEL/XFMR COMBINATION. UNABLE TO ACCESS
TRANSFORMER PICTURE.
BLDG5- 5-LP
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 6 PANEL INSPECTIONSPOSITION
3/9/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
MELVIN WILLIAMSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
PRL2A225A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
EATON
CATALOG #
EZB2042R
COMMENTS
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
NQ225ABLDG6-PPE-3 SQUARE D NQ442L2C
FOUND EACH PRMARY LUG TO BUSS LOOSE. RETIGHTENED.
PRL1A400ABLDG6-PP1 EATON EZB2060R
BREAKER 21/23 SHOING SIGNS OF CORROSION. BREAKER 25
SHOWING SIGNS OF OVERHEATING.
1225ABLDG6-PP1A EATON EZB2042R
AA112.5KVABLDG6-TS-6 XFMR EATON V48M28T12CU
3R400ABLDG6-B6-208V SW EATON DG325NRK
FOUND A PHASE LOOSE. RETIGHTENED. (FUSETRON FUS
FRN-R-350).
3R100ABLDG6-PP3 DISC. SQUARE D H323NRB
BUSSMAN- FUSE NON-100
N200ABLDG6-480V SWITCH EATON NA
LITTLE FUSE-FLSR 200ID
BLDG6-PP2
ADDRESS
CUSTOMER
4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION BUILDING # 7 PANEL INSPECTIONSPOSITION
3/9/2023 AMBIENT TEMPERATURE 18 °C HUMIDITY 45 %
Melvin WilliamsTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service REVISED 3/16/2023
G =
P =
C =
ITEMS REQUIRING IMMEDIATE CORRECTIVE ACTIONSITEMS FOUND IN POOR CONDITION AND REQUIRE FUTURE CORRECTIVE ACTION
ITEMS FOUND IN SATISFACTORY CONDITION ITEMS FOUND OR CORRECTED AND LEFT IN SATISFACTORY CONDITION
G P C I
WEHB15-CIR100A
CURRENT
RATING TYPE
RESULTS
LOCATION / PANEL ID MANUFACTURE
WESTINGHOUSE
CATALOG #
FY43313
COMMENTS
SPARE BREAKER # 1 AND 3 FOUND BAD.
PANEL INSPECTION
I =
CONDITIONS - (OVERALL , TORQUE CHECK, CLEANLINESS, CONTINUITY CHECKS)
WEHB15-CIR100ABLDG7-PP-7B WESTINGHOUSE FY43313
B10B18-CIR150ABLDG7-B7-B WESTINGHOUSE FY43313
QO50ABLDG7-A1 SQUARE D QOC16W
QO50ABLDG7-B7-B1 SQUARE D QOC16W
B10818-CIR150ABLDG7-B7-A WESTINGHOUSE FY43313
FOUND BREAKER #13 OF DOUBLE-POLE TO BE BAD. UNABLE
TO ESTABLISH CONTINUITY.
BLDG7-PP-7A
ADDRESS
CUSTOMER
TRANSFORMER MAINTENANCE AND INSPECTION 4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION MAIN SUBSTATION 1500kVA EAST PADMOUNT XFMRPOSITION
3/1/2023 AMBIENT TEMPERATURE 15 °C HUMIDITY 45 %
TANK TYPE
5.9
NAMEPLATE DATA
976000796SERIAL NO.
D E
12,780
COOPER YR MFR 1997
KVA
IMPEDANCE //OA
WINDING MATERIAL °CALUMINUM
B
CLASS
B.I.L. RATING
PRIMARY V
TAP SETTING
/ 65
DISTRIB
MANUFACTURER
DELTA
/ 3095
WYE EXPOSED NEUTRAL - X0
11807627CAPACITY
TEMPERATURE RISE
LBSGAL WEIGHT TYPE
MFR LOCATION
INSULATING MEDIUM
0.277
12.470
12,470
277.12
13,090 12,780 12,470 12,160 11,850
A
V
WAUKESHA WI
SEALED
TAP VOLTAGES
TAP POSITION B
MINERAL OIL
CONSERVATOR
/1,500
SECONDARY V
C0.480
HIGH SIDE TAP LOW SIDE TAP
T. STAFFORD / B. ANDRUSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service 56750, REVISED 4/10/2023
NA YES 25'C NA YES
OIL C/ MAX WIND C/ MAX
POWER FACTOR
RESET LEVEL PRESSUREDATE OIL/DGA SAMPLE TAKEN
3/1/2023 30/50
EXTERNAL DOCUMENTS
ATTACHED TO REPORT
INSPECT PHYSICAL AND MECHANICAL CONDITION VERIFY FANS OPERATEPASS
NOTES
ROUTINEREASON FOR INSPECTION
Description NOTES
PASS
NA
Description
INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING
VISUAL AND MECHANICAL INSPECTION
SECONDARY TO
GROUND
1.95
10,410
5,350
4,650
PRIMARY TO
SECONDARY
1.72
20,200
11,730
9,993
PRIMARY TO
GROUND
P. I. (10min/1min)
Test kV
0.50
1.00
10.00
MINUTES
10,640
6,710
1.59
INSULATION RESISTANCE (M©)
6,050
ELECTRICAL TESTS
20TEST AMPS20
WINDING RESISTANCE TEST (m©)
APPARATUS TEMP. (°C)
CORRECTED CORRECTEDMeasured CORRECTEDMeasured
CORRECTED CORRECTEDMeasured CORRECTEDMeasured
784.80 800.82 781.00 796.94 807.45 823.93
0.482 0.468 0.4670.472 0.458 0.458
H3-H1 H1-H2 H2-H3
X0-X1 X0-X2 X0-X3
Measured
Measured
TRANSFORMER TURN RATIO TEST
PHASE B PHASE CTAP CALC PHASE A
46.129 46.130B
ERROR 0.032% 0.026% 0.028%
46.117 46.132
COMMENTS:
DEFICIENCIES: UNABLE TO REMOVE H3A LOADBREAK CONNECTION FROM TRANSFORMER. PERFORMED ALL TESTING WITH CABLE INCLUDED IN RESULTS.
RECOMMEND REMOVAL OF LOADBREAK AND INSERT; REPLACE BOTH WITH NEW ONES. PICTURE(S) INCLUDED OF CONNECTION AND CABLE INFO.
IM
G
_7938 (H 3A
-1500K V
A ).jpg
IMG_7939 (H3A-1500KVA).jpg
976000796_X2 (1500KVA EAST)
TwoWindingTransformerReport Source
3/1/2023 8:01:08 PMSession Test Date
Nameplate - Two-winding Transformer Company PREMIER POWER MAINTENANCE Serial Number 976000796
Location VA-FORT WAYNE IN Special ID 1500KVA EAST XFMR
Division INDIANAPOLIS Circuit Designation
Manufacturer Cooper Power Systems Configuration D_Y
Year Manufactured 1997 Tank Type Sealed
Mfr Location WAUKESHA WI Coolant Oil
Phases Three Class OA
Oil Volume 627 UG BIL 95 kV
Weight 11807 LB kV 12.47, 0.48 VA Rating 1500, *, *, *, kVA
Administration Test Date 3/1/2023 Test Time: 8:01 PM Weather Night
Air Temperature 13.6°C Apparatus Temperature
30°C Humidity 53.748 %
Tester TRACY STAFFORD Work Order 220919 Date Last Tested
Verified BRANDON ANDRUS Test Set Type M4100 Date Retested
Verification Date 3/2/2023 Set Top Serial # 69400229 Reason Routine
Last Sheet # Test Set Model M4100 Travel Time
Purchase Order Ins. Book # Duration
Copies Sheet # Crew Size 3
Excitation Current & Losses Tests Manufacturer Type Steps Boost % Buck % Position Found Position Left Oil Volume
DETC 5 * * 2 2 *
H1 H3 H2 H1 H2 H3
Winding :
Tap Position
(s)
Test kV mA Watts X mA Watts X mA Watts X FRANK™ Manual
HV: 2 10 75.730 575.601 L 29.485 227.850 L 78.636 577.315 L Good
Report generated on 3/2/2023 12:45:32 AM 1 - 1
TOP / BOTTOM VALVES
BUSHING OIL LEVEL PRI / SEC
GROUNDS
RESET GAUGES
OXYGEN CONTENT %
PRESSURE PSI
OIL LEVEL
#2 WINDING C / MAX
#1 WINDING C / MAX
EQPT. LOCATION
PAGE
ADDRESS
CUSTOMER
TRANSFORMER LIQUID COOLANT TRENDING 4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION MAIN SUBSTATION 1500KVA EAST PADMOUNT XFMRPOSITION
3/1/2023 AMBIENT TEMPERATURE 15 °C HUMIDITY 45 %
DELTA
DELTA
WYE
NA 1,500 DISTRIB OA
°C 5.9
NA
1,804
CAPACITY
WINDING MATERIAL ALUMINUM
LBS627
NAMEPLATE DATA
MANUFACTURER 976000796SERIAL NO.
SPECIFICATION NO. TYPE CLASS
PHASE IMPEDANCE %
TOTAL WEIGHT 11807 LBS
K FACTOR NA
RATED CURRENT
RATED CURRENT
AMPERES
AMPERES/
TAP VOLTAGES 13,090 12,780 12,470 12,160 11,850
A B C D E
TAP SETTING B 12,780 Volts INTERNAL EXTERNAL DRY TYPE
12,470
TAP CHANGER:# FANS 0
COOPER
3 65TEMPERATURE RISE KV SEC.30B.I.L. RATING 95 KV PRI.
COOLANT MINERAL OIL
WINDING POLARITY
PRIMARY VOLTAGE
SECONDARY VOLTAGE
TAP CONNECTIONS
277 WYE
KVA
3/1/2023
OIL C / MAX
RADIATORS AND FANS
CONSERVATOR
AUTO GAS CYLINDER
RAPID RISE RELAY
SUDDEN PRESSURE RELIEF
PRI / SEC BUSHING VISUAL
30/50
NA
NA
25'C
NA
NT
YES
OK
NA
OK
NA
OK
OK/NA
NA
NA
NA
OK
TEST DATE
VISUAL INSPECTION
DOBLE ENGINEERINGSAMPLED BY: TESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service 57130, REVISED 1/31/2023
MELVIN WILLIAMS
PV SYSTEM
COMMENTS:
ADDRESS
CUSTOMER
TRANSFORMER MAINTENANCE AND INSPECTION 4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121 LAKE AVE; FORT WAYNE IN USA 46805
FT WAYNE VA MEDICAL CENTER
JOB # 220919
OWNER REPRESENTATIVE TELEPHONE
DATE
SUBSTATION MAIN SUBSTATION 1500KVA WEST PADMOUNT XFMRPOSITION
3/1/2023 AMBIENT TEMPERATURE 15 °C HUMIDITY 45 %
TANK TYPE
5.9
NAMEPLATE DATA
976000795SERIAL NO.
D E
12,780
COOPER YR MFR 1997
KVA
IMPEDANCE //OA
WINDING MATERIAL °CALUMINUM
B
CLASS
B.I.L. RATING
PRIMARY V
TAP SETTING
/ 65
DISTRIB
MANUFACTURER
DELTA
/ 3095
WYE EXPOSED NEUTRAL - X0
11807627CAPACITY
TEMPERATURE RISE
LBSGAL WEIGHT TYPE
MFR LOCATION
INSULATING MEDIUM
0.277
12.470
12,470
277.12
13,090 12,780 12,470 12,160 11,850
A
V
WAUKESHA WI
SEALED
TAP VOLTAGES
TAP POSITION B
MINERAL OIL
CONSERVATOR
/1,500
SECONDARY V
C0.480
HIGH SIDE TAP LOW SIDE TAP
T. STAFFORD / B. ANDRUSTESTED BY:
www.premierpowermaintenance.com24 Hour Emergency Service 56750, REVISED 4/10/2023
NA YES 25'C NA YES
OIL C/ MAX WIND C/ MAX
POWER FACTOR
RESET LEVEL PRESSUREDATE OIL/DGA SAMPLE TAKEN
3/1/2023 30/50
EXTERNAL DOCUMENTS
ATTACHED TO REPORT
INSPECT PHYSICAL AND MECHANICAL CONDITION VERIFY FANS OPERATEPASS
NOTES
ROUTINEREASON FOR INSPECTION
Description NOTES
PASS
NA
Description
INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING
VISUAL AND MECHANICAL INSPECTION
SECONDARY TO
GROUND
1.78
9,190
5,150
4,500
PRIMARY TO
SECONDARY
1.79
27,900
15,590
13,350
PRIMARY TO
GROUND
P. I. (10min/1min)
Test kV
0.50
1.00
10.00
MINUTES
22,300
13,340
1.67
INSULATION RESISTANCE (M©)
11,150
ELECTRICAL TESTS
20TEST AMPS20
WINDING RESISTANCE TEST (m©)
APPARATUS TEMP. (°C)
CORRECTED CORRECTEDMeasured CORRECTEDMeasured
CORRECTED CORRECTEDMeasured CORRECTEDMeasured
789.45 805.56 787.60 803.67 778.20 794.08
0.478 0.467 0.4670.469 0.458 0.457
H3-H1 H1-H2 H2-H3
X0-X1 X0-X2 X0-X3
Measured
Measured
TRANSFORMER TURN RATIO TEST
PHASE B PHASE CTAP CALC PHASE A
46.129 46.134B
ERROR 0.034% 0.026% 0.037%
46.117 46.133
COMMENTS:
DEFICIENCIES: UNABLE TO REMOVE ARRESTERS ON HIGH SIDE. RECOMMEND OUTAGE TO CUT BACK/REMOVE ALL 3 ARRESTERS FROM BUSHING AND REPLACE THEM WITH
COOPER RTE LPC215 8.3 / 14.4KV LOADBREAK ARRESTERS. PICTURES INCLUDED WITH TEST SHEET.
IMG_7944 (1500KVA W-ARRESTERS).jpg
IMG_7943 (1500KVA W-ARRESTERS).jpg
976000795_X2 (1500KVA WEST)
3/1/2023 7:56:08 PMSession Test Date
Nameplate - Two-winding Transformer Company PREMIER POWER MAINTENANCE Serial Number 976000795
Location VA-FORT WAYNE IN Special ID 1500KVA XFMR (WEST)
Division INDIANAPOLIS Circuit Designation
Manufacturer Cooper Power Systems Configuration D_Y
Year Manufactured 1997 Tank Type Sealed
Mfr Location WAUKESHA WI Coolant Oil
Phases Three Class OA
Oil Volume 627 UG BIL 95 kV
Weight 11807 LB kV 12.47, 0.48 VA Rating 1500, *, *, *, kVA
Administration Test Date 3/1/2023 Test Time: 7:56 PM Weather Night
Air Temperature 13.6°C Apparatus Temperature
30°C Humidity 53.138 %
Tester TRACY STAFFORD Work Order 220919 Date Last Tested
Verified BRANDON ANDRUS Test Set Type M4100 Date Retested
Verification Date 3/2/2023 Set Top Serial # 69400229 Reason Routine
Last Sheet # Test Set Model M4100 Travel Time
Purchase Order Ins. Book # Duration
Copies Sheet # Crew Size 3
Excitation Current & Losses Tests Manufacturer Type Steps Boost % Buck % Position Found Position Left Oil Volume
DETC 5 * * 2 2 *
H1 H3 H2 H1 H2 H3
Winding :
Tap Position
(s)
Test kV mA Watts X mA Watts X mA Watts X FRANK™ Manual
HV: 2 10 76.703 578.358 L 30.238 221.700 L 78.789 575.115 L Good
Report generated on 3/2/2023 12:44:37 AM 1 - 1
GROUNDS
RESET GAUGES
OXYGEN CONTENT %
PRESSURE PSI
OIL LEVEL
#2 WINDING C / MAX
#1 WINDING C / MAX
EQPT. LOCATION
PAGE
ADDRESS
CUSTOMER
TRANSFORMER LIQUID COOLANT TRENDING 4035 Championship Drive Indianapolis, IN 46268
317-879-0660
JOHN HENDRICKS (765) 674-3321 x74390
2121…
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