Exhibit A - Bldg. 104A Test Report.pdf

Prepared By:

Chris Espartero Sr Field Service Representative

North America Service Operations

Houston, TX

Bldg. 104A

May 13, 2021

Work Order: 08391081

2 | P a g e

EXECUTIVE SUMMARY

Schneider Electric Services perform Transformer and Switchboard PM in accordance with project specification and applicable industry standard on Bldg. 104A Substation located at VA Cooling

Tower 2002 Holcombe Blvd Houston, Texas 77030. The site contact for this project was Joe

Ceasar of VA Medical Center Electrical Power Distribution Department (713)806-7506.

Chiller 8 Starting Contactor

Chiller 8 Starting contactor umbilical cord male plug connector was frozen and secondary control wiring needed to be disconnected at the terminal block to be able to pull the contactor out of the cubicle. Medium Voltage contactor umbilical cord male plug is also missing a protective covering and needed to be replaced.

3 | P a g e

MCC 6

We are not able to test 480V MCC 6 main bus due to a potential back feed from the ATS to the last section of MCC 6 gear.

If there are any questions or concerns, please contact:

Chris Espartero

832-205-1547

Christopher.Espartero@se.com

PT-14_010584-VA1_X2

TwoWindingTransformerReport Source

5/13/2021 1:46:08 PMSession Test Date

Nameplate - Two-winding Transformer Company VA Medical Center Serial Number 010584-VA1

Location 2002 Holcombe Blvd Houston, Texas 77030

Special ID PT-14 XFMR

Division Houston Circuit Designation BLDG 104-A PT-14

Manufacturer Square D Electric Configuration Δ-Y Year Manufactured 1988 Tank Type Sealed

Mfr Location USA Coolant Oil

Phases Three Class ONAN

Oil Volume 309 UG BIL 95 kV

Weight 7078 LB kV 4.16, 0.48 VA Rating 750, *, *, *, KVA

Administration Test Date 5/13/2021 Test Time: 1:46 PM Weather Partly Cloudy

Air Temperature 27.8°C Apparatus Temperature

35°C Humidity 56 %

Tester C.Espartero Work Order Date Last Tested

Verified Test Set Type M4000 Date Retested

Verification Date 5/13/2021 Set Top Serial # Reason ROUTINE

Last Sheet # Set Bottom Serial # Travel Time

Purchase Order Ins. Book # Duration

Copies Sheet # Crew Size 1

Bushing Nameplate Designation Serial # Manufacturer Type C1 %PF C1 Cap C2 %PF C2 Cap Rated kV Amps

H1 H1 * * * * * *

H2 H2 * * * * * *

H3 H3 * * * * * *

1 - 4010584-VA1

Overall Tests Insulation Test kV mA Watts % PF

Corr.

Corr Fctr Cap (pF) FRANK™ Manual

1 CH+CHL 1.999 40.492 2.146 0.489 0.923 10740.30

2 CH 2.000 5.150 0.142 0.255 0.923 1366.078 Good

3 CHL(UST) 2.000 35.318 2.009 0.525 0.923 9368.289 Good

4 CHL 0 35.342 2.004 0.523 0.923 9374.227

5 CL+CHL 1.000 53.810 2.588 0.444 0.923 14273.20

6 CL 1.000 18.494 0.601 0.300 0.923 4905.680 Good

7 CHL(UST) 1.000 35.321 2.026 0.529 0.923 9368.875

8 CHL 0 35.316 1.987 0.519 0.923 9367.524 Good

LSR mA: 40.492/40.492, 1/1 Watts: 2.146/2.146, 1/1 Cap (pF): 10740.305/10740.305, 1/1

LSR mA: 5.150/5.150, 1/1 Watts: 0.142/0.142, 1/1 Cap (pF): 1366.078/1366.078, 1/1

LSR mA: 35.318/35.318, 1/1 Watts: 2.009/2.009, 1/1 Cap (pF): 9368.289/9368.289, 1/1

LSR mA: 35.342/35.342, 1/1 Watts: 2.004/2.004, 1/1 Cap (pF): 9374.227/9374.227, 1/1

LSR mA: 53.810/53.810, 1/1 Watts: 2.588/2.588, 1/1 Cap (pF): 14273.204/14273.204, 1/1

LSR mA: 18.494/18.494, 1/1 Watts: 0.601/0.601, 1/1 Cap (pF): 4905.680/4905.680, 1/1

LSR mA: 35.321/35.321, 1/1 Watts: 2.026/2.026, 1/1 Cap (pF): 9368.875/9368.875, 1/1

LSR mA: 35.316/35.316, 1/1 Watts: 1.987/1.987, 1/1 Cap (pF): 9367.524/9367.524, 1/1

FRANK™ Message 2 (Good) - For this transformer, the upper % power factor limit for a "G" rating is 1.0 and the upper % power factor limit before an "I" rating is 1.5

The relative humidity is between 45 and 70 percent, a medium amount, which may cause some increases in watts and power factor ratings. Clean and dry the surfaces of bushings arresters, and other apparatus with insulators onto which may condense moisture from the air, before testing, using heat if necessary.

3 (Good) - All values are acceptable.

6 (Good) - All values are acceptable.

8 (Good) - All values are acceptable.

2 - 4010584-VA1

Winding Resistance

DETC LTC Phase Resistance Units Calculated Resistance

Correction Factor

Corrected Resistance

Percentage Deviation

1 A 230 milli Ohms * * * *

1 B 230 milli Ohms * * * *

1 C 230 milli Ohms * * * *

High Voltage

DETC LTC Phase Resistance Units Calculated Resistance

Correction Factor

Corrected Resistance

Percentage Deviation

1 A 1.01 milli Ohms * * * *

1 B 1.18 milli Ohms * * * *

1 C 1.18 milli Ohms * * * *

Low Voltage

Winding

Manufacturer Serial Number Configuration Winding Temperature

Temperature Rise

Factory Resistance

(Ohms)

Factory Temperature

Square D 010584-VA1 Δ-Y 0°C 18.3°C * *

Exciting Current Tests Manufacturer Type Steps Boost % Buck % Position Found Position Left Oil Volume

DETC 3 3 *

H3 H1 H1 H2 H2 H3

DETC LTC Test kV mA Watts X mA Watts X mA Watts X FRANK™ Manual

3 2 278.256 2367.550 L 195.095 1676.755 L 269.054 2296.742 L Good Good

LSR mA: 278.256/278.256, 1/1 Watts: 2367.550/2367.550, 1/1 Cap (pF): */*, 1/1

LSR mA: 195.095/195.095, 1/1 Watts: 1676.755/1676.755, 1/1 Cap (pF): */*, 1/1

LSR mA: 269.054/269.054, 1/1 Watts: 2296.742/2296.742, 1/1 Cap (pF): */*, 1/1

3 - 4010584-VA1

Turns Ratio Tests Serial Number HV Winding LV Winding

Delta Wye

Connections H3 - H1 H1 - H2 H2 - H3

Tap NP Volt Tap NP Volt Cal Ratio 1 Ratio 2 Ratio 3 Min. Lim Max. Lim FRANK™ Manual

3 4160 3 480 15.011 15.004 15.014 15.011 14.936 15.086 Good Good

FRANK™ Message 1 (Good) - Ratio is within expected values.

TTR results are considered acceptable if the measured value is within 0.5% of the calculated value. Anything outside this range is cause for further investigation.

Exciting Current Plot

4 - 4010584-VA1

SE Medium Voltage Vacuum Contactor

TEMPERATURE 75 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-4DESIGNATION

SUBSTATION BUILDING 104-A

5/14/2021 60

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CHILLER 8 MAIN CONTACTOR

Javier Rojas

VA Hospital WO-08391081

CONTACTOR NAMEPLATE DATA

MANUFACTURER

TYPE or STYLE

CATALOG NUMBER

SL50W430

NA

RCY67977-1

BIL kV RATING

NADATE MANUFACTURED RATED CURRENT

RATED SHORT CIRC. 8500 A

SERIAL NUMBER

RATED VOLTAGE

CUTLER-HAMMERFUSE MFG. 5SCL-12RFUSE CAT. NO. 230FUSE AMPS

NANA COUNTER READING ALCOUNTER READING AF

Cutler-Hammer

INSPECTION

Description CONDITION CLEAN/LUBE

N/A N/A

PHY. & MECH. CONDITION Acceptable

Acceptable N/A

N/A N/A

Acceptable C & L

Acceptable N/A

CONDITIONDescription CLEAN/LUBE

OPERATING MECHANISM Acceptable N/A

FUSE HOLDERS ADEQ. SUPP. Acceptable N/A

EXT. & INT. CUBICLE CONDITION Acceptable C & L

IND. & CTRL. DEVICE OPER. N/A N/A

OPER. COIL CONDITION Acceptable N/A

C & LAcceptableDISCONN. FINGER CONDITION

MATCHES DWG OR SPEC

C & L

TIGHTNESS OF BOLTED CONN.

ANCH. & REQ. CLEARANCES

LUBRICATION

FUSES SIZED PROPERLY

CONDITION CLEAN/LUBEDescription

PHASE BARRIERS Acceptable Cleaned

TEST RESULTS

1245 1240 1235

POLE 3POLE 2

68160

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@1000VGIG-OHMS 20°C

68.0 81.3

122.0 145.8

TEST 1

TEST 3

1.195TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

444.5372.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

418.0

489.0

113.0

169.0

187.0

267.0135.0

499.5

319.1

584.4 202.0

223.5

XX

POLE 1

TEST KV

VACUUM INTEGRITY (as per Manufacturer)

POLE 3 POLE 2

A.C. D.C.

INSULATION RESISTANCE IN:

N/AN/A

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

ADDITIONAL INFORMATIONCONTACTOR OPERATING VOLTAGE

120 VOLT RANGE

CLOSE COIL INFORMATION

N/AVolts

ADDITIONAL INFO

PICKUP VOLTS

CONTROL WIRING

MEG-OHMS @500V 20°C

TECH NOTE(S):

COMMENTS: All tests proved satisfactory.

DEFICIENCIES:

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-4DESIGNATION

SUBSTATION BUILDING 104-A

5/14/2021 60

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CHILLER 8 STARTING CONTACTOR

Javier Rojas

VA Hospital WO-08391081

CONTACTOR NAMEPLATE DATA

MANUFACTURER

TYPE or STYLE

CATALOG NUMBER

SL50W230

NA

NA

BIL kV RATING

NADATE MANUFACTURED RATED CURRENT

RATED SHORT CIRC. 8500

SERIAL NUMBER

RATED VOLTAGE

NAFUSE MFG. NAFUSE CAT. NO. NAFUSE AMPS

NANA COUNTER READING ALCOUNTER READING AF

Cutler-Hammer

INSPECTION

Description CONDITION CLEAN/LUBE

N/A N/A

PHY. & MECH. CONDITION Acceptable

Acceptable N/A

N/A N/A

Acceptable C & L

N/A N/A

CONDITIONDescription CLEAN/LUBE

OPERATING MECHANISM Acceptable N/A

FUSE HOLDERS ADEQ. SUPP. N/A N/A

EXT. & INT. CUBICLE CONDITION Acceptable C & L

IND. & CTRL. DEVICE OPER. N/A N/A

OPER. COIL CONDITION Acceptable N/A

C & LAcceptableDISCONN. FINGER CONDITION

MATCHES DWG OR SPEC

C & L

TIGHTNESS OF BOLTED CONN.

ANCH. & REQ. CLEARANCES

LUBRICATION

FUSES SIZED PROPERLY

CONDITION CLEAN/LUBEDescription

PHASE BARRIERS Acceptable Cleaned

TEST RESULTS

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@1000VGIG-OHMS 20°C

287.0 343.0

329.0 393.2

TEST 1

TEST 3

1.195TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

811.4679.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

424.0

763.0

324.0

275.0

309.0

288.0387.2

506.7

344.2

911.8 328.6

369.3

XX

POLE 1

TEST KV

VACUUM INTEGRITY (as per Manufacturer)

POLE 3 POLE 2

A.C. D.C.

INSULATION RESISTANCE IN:

N/A120 VAC

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

ADDITIONAL INFORMATIONCONTACTOR OPERATING VOLTAGE

VOLT RANGE

CLOSE COIL INFORMATION

120 VACVolts

ADDITIONAL INFO

PICKUP VOLTS

CONTROL WIRING

MEG-OHMS @500V 20°C

TECH NOTE(S):

DEFICIENCIES: Controls 120 abilical cord male plug is frozen together with female plug and the male plug covering is broken.

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-4DESIGNATION

SUBSTATION BUILDING 104-A

5/14/2021 60

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CHILLER 8 RUN CONTACTOR

Javier Rojas

VA Hospital WO-08391081

CONTACTOR NAMEPLATE DATA

MANUFACTURER

TYPE or STYLE

CATALOG NUMBER

SL50W430

NA

NA

BIL kV RATING

NADATE MANUFACTURED RATED CURRENT

RATED SHORT CIRC. 8500 A

SERIAL NUMBER

RATED VOLTAGE

NAFUSE MFG. NAFUSE CAT. NO. NAFUSE AMPS

NANA COUNTER READING ALCOUNTER READING AF

Cutler-Hammer

INSPECTION

Description CONDITION CLEAN/LUBE

N/A N/A

PHY. & MECH. CONDITION Acceptable

Acceptable N/A

N/A N/A

Acceptable C & L

N/A N/A

CONDITIONDescription CLEAN/LUBE

OPERATING MECHANISM Acceptable N/A

FUSE HOLDERS ADEQ. SUPP. N/A N/A

EXT. & INT. CUBICLE CONDITION Acceptable C & L

IND. & CTRL. DEVICE OPER. N/A N/A

OPER. COIL CONDITION Acceptable N/A

C & LAcceptableDISCONN. FINGER CONDITION

MATCHES DWG OR SPEC

C & L

TIGHTNESS OF BOLTED CONN.

ANCH. & REQ. CLEARANCES

LUBRICATION

FUSES SIZED PROPERLY

CONDITION CLEAN/LUBEDescription

PHASE BARRIERS Acceptable Cleaned

TEST RESULTS

N/A N/A N/A

POLE 3POLE 2

130133

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@1000VGIG-OHMS 20°C

135.0 161.3

249.0 297.6

TEST 1

TEST 3

1.195TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

527.0441.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

564.0

572.0

248.0

336.0

369.0

300.0296.4

674.0

358.5

683.5 401.5

441.0

XX

POLE 1

TEST KV

VACUUM INTEGRITY (as per Manufacturer)

POLE 3 POLE 2

A.C. D.C.

INSULATION RESISTANCE IN:

N/A120 VAC

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

ADDITIONAL INFORMATIONCONTACTOR OPERATING VOLTAGE

VOLT RANGE

CLOSE COIL INFORMATION

120 VACVolts

ADDITIONAL INFO

PICKUP VOLTS

CONTROL WIRING

MEG-OHMS @500V 20°C

TECH NOTE(S):

20°C

MEDIUM VOLTAGE AIR SWITCH

TEMPERATURE 86 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-4DESIGNATION

SUBSTATION BUILDING 104-A

05/13/2021 80

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH MCC-4

Mike Danford

1509,0115

N/A

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

NA NA

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

Acceptable

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

Cleaned

Cleaned

N/AOPERATING MECHANISM C & L

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

ARC CHUTES Acceptable Cleaned N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

Acceptable

Acceptable

Acceptable

Acceptable

SWITCH NAMEPLATE

INSPECTION

CONTROL WIRING

MEG-OHMS

06060, REVISED 10/19/2020(888) 778-2733 www.schneider-electric.us

@500V

INSULATION RESISTANCE IN:

N/A

MANUFACTURER

RATED CURRENT INT. RATING

17-15229802-001

44036-325-50

15 kv

NA

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE HVL

95 kv

N/A

ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE VOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

N/A

CLOSE COIL INFORMATION

24 VDC N/A VoltsVolts

PICKUP VOLTS

Volts

TRIP COIL INFORMATION

Volts

ADDITIONAL INFO

VOLT RANGE

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPS55GFMSJD200EFUSE MFG. Square D FUSE CAT. NO. 200

@5000VGIG-OHMS 20°C

220.0 347.6

143.0 225.9

TEST 1

TEST 3

1.58TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

301.8191.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

251.0

267.0

139.0

145.0

208.0

255.0219.6

396.6

402.9

421.9 229.1

328.6

15 kv

Square D

61 ka

RANGE

(µ-ohms) 36

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

35 38

10 A 2,111 2,1102,119FUSE RESISTANCE at (m-ohms)

TECH NOTE(S):

COMMENTS: All results are satisfactory at this time.

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-5DESIGNATION

SUBSTATION BUILDING 104-A

5/14/2021 60

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CHILLER 9 MAIN CONTACTOR

Javier Rojas

VA Hospital WO-08391081

CONTACTOR NAMEPLATE DATA

MANUFACTURER

TYPE or STYLE

CATALOG NUMBER

SL50W430

NA

NA

BIL kV RATING

NADATE MANUFACTURED RATED CURRENT

RATED SHORT CIRC. 8500

SERIAL NUMBER

RATED VOLTAGE

CUTLER-HAMMERFUSE MFG. 5ACLS-12RFUSE CAT. NO. 230FUSE AMPS

NANA COUNTER READING ALCOUNTER READING AF

Cutler-Hammer

INSPECTION

Description CONDITION CLEAN/LUBE

N/A N/A

PHY. & MECH. CONDITION Acceptable

Acceptable Cleaned

N/A N/A

Acceptable C & L

Acceptable Cleaned

CONDITIONDescription CLEAN/LUBE

OPERATING MECHANISM Acceptable N/A

FUSE HOLDERS ADEQ. SUPP. Acceptable N/A

EXT. & INT. CUBICLE CONDITION Acceptable C & L

IND. & CTRL. DEVICE OPER. N/A N/A

OPER. COIL CONDITION Acceptable N/A

C & LAcceptableDISCONN. FINGER CONDITION

MATCHES DWG OR SPEC

C & L

TIGHTNESS OF BOLTED CONN.

ANCH. & REQ. CLEARANCES

LUBRICATION

FUSES SIZED PROPERLY

CONDITION CLEAN/LUBEDescription

PHASE BARRIERS Acceptable Cleaned

TEST RESULTS

1220 1234 1235

POLE 3POLE 2

167183

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@1000VGIG-OHMS 20°C

120.0 143.4

173.0 206.7

TEST 1

TEST 3

1.195TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

490.0410.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

324.0

410.0

163.0

141.0

74.0

211.0194.8

387.2

252.1

490.0 168.5

88.4

XX

POLE 1

TEST KV

VACUUM INTEGRITY (as per Manufacturer)

POLE 3 POLE 2

A.C. D.C.

INSULATION RESISTANCE IN:

N/A120 VAC

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

ADDITIONAL INFORMATIONCONTACTOR OPERATING VOLTAGE

VOLT RANGE

CLOSE COIL INFORMATION

120 VACVolts

ADDITIONAL INFO

PICKUP VOLTS

CONTROL WIRING

MEG-OHMS @500V 20°C

TECH NOTE(S):

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-5DESIGNATION

SUBSTATION BUILDING 104-A

5/14/2021 60

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CHILLER 9 RUNNING CONTACTOR

Javier Rojas

VA Hospital WO-08391081

CONTACTOR NAMEPLATE DATA

MANUFACTURER

TYPE or STYLE

CATALOG NUMBER

SL50W430

NA

NA

BIL kV RATING

NADATE MANUFACTURED RATED CURRENT

RATED SHORT CIRC. 8500

SERIAL NUMBER

RATED VOLTAGE

NAFUSE MFG. NAFUSE CAT. NO. NAFUSE AMPS

NANA COUNTER READING ALCOUNTER READING AF

Cutler-Hammer

INSPECTION

Description CONDITION CLEAN/LUBE

N/A N/A

PHY. & MECH. CONDITION Acceptable

Acceptable N/A

N/A N/A

Acceptable C & L

N/A N/A

CONDITIONDescription CLEAN/LUBE

OPERATING MECHANISM Acceptable N/A

FUSE HOLDERS ADEQ. SUPP. N/A N/A

EXT. & INT. CUBICLE CONDITION Acceptable C & L

IND. & CTRL. DEVICE OPER. N/A N/A

OPER. COIL CONDITION Acceptable N/A

C & LAcceptableDISCONN. FINGER CONDITION

MATCHES DWG OR SPEC

C & L

TIGHTNESS OF BOLTED CONN.

ANCH. & REQ. CLEARANCES

LUBRICATION

FUSES SIZED PROPERLY

CONDITION CLEAN/LUBEDescription

PHASE BARRIERS Acceptable Cleaned

TEST RESULTS

N/A N/A N/A

POLE 3POLE 2

155150

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@1000VGIG-OHMS 20°C

160.0 191.2

42.0 50.2

TEST 1

TEST 3

1.195TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

148.2124.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

119.0

152.0

32.0

71.0

400.0

226.038.2

142.2

270.1

181.6 84.8

478.0

XX

POLE 1

TEST KV

VACUUM INTEGRITY (as per Manufacturer)

POLE 3 POLE 2

A.C. D.C.

INSULATION RESISTANCE IN:

N/A120 VAC

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

ADDITIONAL INFORMATIONCONTACTOR OPERATING VOLTAGE

VOLT RANGE

CLOSE COIL INFORMATION

120 VACVolts

ADDITIONAL INFO

PICKUP VOLTS

CONTROL WIRING

MEG-OHMS @500V 20°C

TECH NOTE(S):

TEMPERATURE 86 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-5DESIGNATION

SUBSTATION BUILDING 104-A

05/13/2021 80

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH MCC-5

Mike Danford

1509, 0115

N/A

N/A

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

NA NA

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

Acceptable

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

Cleaned

Cleaned

N/AOPERATING MECHANISM C & L

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

ARC CHUTES Acceptable Cleaned N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

Acceptable

Acceptable

Acceptable

Acceptable

SWITCH NAMEPLATE

INSPECTION

CONTROL WIRING

MEG-OHMS

06060, REVISED 10/19/2020(888) 778-2733 www.schneider-electric.us

@500V

INSULATION RESISTANCE IN:

N/A

MANUFACTURER

RATED CURRENT INT. RATING

17-15229802-001

44036-325-50

15 kv

NA

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE HVL

95 kv

N/A

ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE VOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

N/A

CLOSE COIL INFORMATION

N/A N/A VoltsVolts

PICKUP VOLTS

Volts

TRIP COIL INFORMATION

Volts

ADDITIONAL INFO

VOLT RANGE

48 VDC

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPS55GFMSJD200EFUSE MFG. Square D FUSE CAT. NO. 200

@5000VGIG-OHMS 20°C

524.0 827.9

44.1 69.7

TEST 1

TEST 3

1.58TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

270.2171.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

208.0

170.0

34.7

54.1

573.0

516.054.8

328.6

815.3

268.6 85.5

905.3

15 kv

Square D

61 ka

RANGE

(µ-ohms) 42

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

34 58

10 A 2,159 2,1702,116FUSE RESISTANCE at (m-ohms)

TECH NOTE(S):

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-5DESIGNATION

SUBSTATION BUILDING 104-A

5/14/2021 60

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CHILLER 9 STARTING CONTACTOR

Javier Rojas

VA Hospital WO-08391081

CONTACTOR NAMEPLATE DATA

MANUFACTURER

TYPE or STYLE

CATALOG NUMBER

SL50W230

NA

NA

BIL kV RATING

NADATE MANUFACTURED RATED CURRENT

RATED SHORT CIRC. 8500

SERIAL NUMBER

RATED VOLTAGE

NAFUSE MFG. NAFUSE CAT. NO. NAFUSE AMPS

NANA COUNTER READING ALCOUNTER READING AF

Cutler-Hammer

INSPECTION

Description CONDITION CLEAN/LUBE

N/A N/A

PHY. & MECH. CONDITION Acceptable

Acceptable N/A

N/A N/A

Acceptable C & L

N/A N/A

CONDITIONDescription CLEAN/LUBE

OPERATING MECHANISM Acceptable N/A

FUSE HOLDERS ADEQ. SUPP. N/A N/A

EXT. & INT. CUBICLE CONDITION Acceptable C & L

IND. & CTRL. DEVICE OPER. N/A N/A

OPER. COIL CONDITION Acceptable N/A

C & LAcceptableDISCONN. FINGER CONDITION

MATCHES DWG OR SPEC

C & L

TIGHTNESS OF BOLTED CONN.

ANCH. & REQ. CLEARANCES

LUBRICATION

FUSES SIZED PROPERLY

CONDITION CLEAN/LUBEDescription

PHASE BARRIERS Acceptable Cleaned

TEST RESULTS

N/A N/A N/A

POLE 3POLE 2

108116

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@1000VGIG-OHMS 20°C

90.0 107.6

15.0 17.9

TEST 1

TEST 3

1.195TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

33.528.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

32.0

40.0

9.0

25.0

50.0

114.010.8

38.2

136.2

47.8 29.9

59.8

XX

POLE 1

TEST KV

VACUUM INTEGRITY (as per Manufacturer)

POLE 3 POLE 2

A.C. D.C.

INSULATION RESISTANCE IN:

N/AN/A

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

MAX CLOSING VOLTAGE

MIN CLOSING VOLTAGE

VOLT RANGE

Volts

ADDITIONAL INFORMATIONCONTACTOR OPERATING VOLTAGE

VOLT RANGE

CLOSE COIL INFORMATION

N/AVolts

ADDITIONAL INFO

PICKUP VOLTS

CONTROL WIRING

MEG-OHMS @500V 20°C

TECH NOTE(S):

TEMPERATURE 86 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-6DESIGNATION

SUBSTATION BUILDING 104-A

05/13/2021 80

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH MCC-6

Mike Danford

1509, 0115

N/A

N/A

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

NA NA

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

Acceptable

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

Cleaned

Cleaned

N/AOPERATING MECHANISM C & L

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

ARC CHUTES Acceptable Cleaned N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

Acceptable

Acceptable

Acceptable

Acceptable

SWITCH NAMEPLATE

INSPECTION

CONTROL WIRING

MEG-OHMS

06060, REVISED 10/19/2020(888) 778-2733 www.schneider-electric.us

@500V

INSULATION RESISTANCE IN:

N/A

MANUFACTURER

RATED CURRENT INT. RATING

17-15229802-001

44036-325-50

15 kv

NA

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE HVL

95 kv

N/A

ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE VOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

N/A

CLOSE COIL INFORMATION

N/A N/A VoltsVolts

PICKUP VOLTS

Volts

TRIP COIL INFORMATION

Volts

ADDITIONAL INFO

VOLT RANGE

48 VDC

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPS55GFMSJD200EFUSE MFG. Square D FUSE CAT. NO. 200

@5000VGIG-OHMS 20°C

471.0 744.2

251.0 396.6

TEST 1

TEST 3

1.58TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

301.8191.0

20°C ACTUAL

PH A

ACTUALACTUAL

A - B A-GND

CLOSED: POLE-GROUND OPEN: LINE-LOAD

20°C

PH B

PH C

B-GND

C-GND

B - C

C - A

251.0

267.0

139.0

267.0

406.0

503.0219.6

396.6

794.7

421.9 421.9

641.5

15 kv

Square D

61 ka

RANGE

(µ-ohms) 41

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

39 38

10 A 2,117 2,2212,118FUSE RESISTANCE at (m-ohms)

TECH NOTE(S):

ZONE INTLK

BREAKER TYPE

TRIP UNIT TYPE

N/A

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 80 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MCC-6DESIGNATION

SUBSTATION BUILDING 104-A

05/13/2021 85

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MAIN BREAKER

Mike Danford

0030, 1509

N/A

N/A

VA Hospital WO-08391081

N/A

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTION

ONPXL

100KA

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. PXF361000G

N/AFUSE CAT. NO.

1200 Off

B.I.

THERMAL MEMORY

SENSOR TAPS

FRAME SIZE

MAIN / ARCING CONTACTS

BATTERY STATUS

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

N/A

N/A

Acceptable

N/A

N/A

ARC CHUTES

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

Cleaned

N/A

N/AOPERATING MECHANISM N/A

PHASE BARRIERS Acceptable N/A

N/AAUXILIARY DEVICES

BLOWN FUSE INDICATOR N/A N/A N/AINTERLOCKS

OVERALL CONDITION Acceptable

CONDITION

N/A

N/A

N/A

Acceptable

N/A

BREAKER NAMEPLATE

INSPECTION

TARGETS

03001, REVISED 10/19/2020(888) 778-2733 www.schneider-electric.us

D.O.

N/A

N/A

N/A

N/AMFR. DATE / CODE N/A

SN / SO NO.Square D

Micrologic N/A

COUNTER READING AL N/A

FUSE AMPS N/A

COUNTER READING AF

RANGE

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

N/A N/A N/A

POLE 3POLE 2

1.0

.1 OUT

2.5 5 2.5

.2

.1 ON

1.0

.2 OUT

1.0

.1 OUT

LONG TIME DELAY

SHORT TIME PICKUP

SHORT TIME DELAY

INSTANTANEOUS PICKUP

GROUND FAULT PICKUP

GROUND FAULT DELAY

LONG TIME PICKUP

AS FOUND

SETTING

AS TESTED

SETTING

AS LEFT

SETTING I2T ON

AS TESTED

SETTING

AS LEFT

SETTING I*2 T ON

AS FOUND

SETTING

CT / SENSOR TAP: 1000RATING PLUG:1200 1200

Overcurrent Settings

CT / SENSOR RATINGS:

.1 ON .2 ON

.35.2

AS FOUND

RANGE

MINIMUM MAXIMUM

5,016

1.047

0.160

5,000 0.75 1.25

1,000 0.14 0.2

POLE 3

AS FOUNDAS FOUND AS LEFT AS LEFT

2.5

NT NT NT

CURRENT

MULTIPLE

TEST

AMPERES

sec 8 sec

LONG TIME PICKUP

LONG TIME DELAY

MILLIVOLT DROP

5,000

1,092

7.379

SHORT TIME PICKUP

SHORT TIME DELAY 5

INSTANTANEOUS PICKUP

INSTANTANEOUS DELAY

GROUND FAULT PICKUP

GROUND FAULT DELAY 2.5

sec sec sec sec sec sec

AS LEFT

900 A A1,100

A A

AA

A A

3,600 4,400

5,5004,500

360 440

POLE 1

FUNCTION

POLE 2TEST RESULTS BY SECONDARY INJECTION

5.5

TECH NOTE(S): Did not perform insulation resistance test due to other electrical equipment, cables or bus duct connected to breaker.

All tested functions passed at this time.

COMMENTS:

0 104

NAMEPLATE DATA

RATED CURRENT

RATED CURRENT

AMPERES

AMPERES/

3,950

3 4 5 kV PRI.

PRIMARY VOLTAGE

SECONDARY VOLTAGE 277 WYE

4,370

TAP POSITION/CONNECTION

4,260 4,060

CLASS

4,160

Phase 3010584-VA1SERIAL NO.

kVA/

THERMAL RATINGS

DELTA

kV SEC.

IMPEDANCE

COOLANT TYPE 7078

YEAR OF MANUF.N/A N/A

MANUFACTURER

SEALED

SPECIFICATION NO. MANUF. LOCATION

TYPE ONAN K FACTOR N/A °CTEMPERATURE RISE

U.S.A

655.5

B.I.L. RATING

MAIN TANK VOLUME

WINDING MATERIAL Cu

OIL UG LBTOTAL WEIGHTOLTC VOLUME GAL

DELTA480

TAP VOLTAGES

DETC OLTC

WINDING POLARITY SUBTRACTIVE

WYE

/TAP CHANGER:

4,160

Square D

RANGE

LIQUID FILLED TRANSFORMER

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

PT-14DESIGNATION

SUBSTATION BUILDING 104-A

5/13/2021 63

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

PT-14 XFMR

Chris Espartero

M4K, 2988, 1388, 3115

N/A

N/A

VA Hospital WO-08391081

N/A

CONDITIONDescription CLEAN/LUBEDescription

Cleaned

Acceptable N/A

N/A N/A

FANS

Acceptable

N/A

INSPECTION

N/A

N/A

N/A

N/A

PAINT Acceptable

CLOUDY

Cleaned

MATCHES DWG OR SPEC

WEATHER

N/A

ENVIRONMENT

N/A

N/A

GAUGES

SUPPORT INSULATORS

N/A

Torqued

N/A

Acceptable

N/A CABINET HEATERS

AUXILIARY DEVICES N/ATorqued

PRIMARY CONNECTIONS

TANK / FRAME GROUND

NEUTRAL GROUND

Description CONDITION

SEC. CONNECTIONS Acceptable

N/A

N/A

N/A

Torqued

ARRESTERSCORE GROUND

ALARMS / ANNUNCIATOR

CONTROLS

BUSHINGS

CLEAN/LUBE CLEAN/LUBECONDITION

TEMPERATURE GAUGES WERE RESETunavailable °CMAXIMUM WINDING TEMPERATURE (1)°CunavailableWINDING TEMPERATURE (1)

Acceptable

OUTSIDE

23230, REVISED 10/20/2020(888) 778-2733 www.schneider-electric.us

N/A

N/A

N/A

N/A

GAUGES

OIL TEMPERATURE 35

Calculated PASS/FAIL Calculated

PASS/FAIL

TO

% DEVIATIONMeasured

TRANSFORMER TURNS RATIO TESTS

Calculated PASS/FAIL

CALC.

RATIO

Secondary

VOLTAGE

ENTER Primary

VOLTAGE

X1 - X0 X2 - X0

H1 - H3 H2 - H1 H3 - H2

X3 - X0

TAP TO

TEST

3 15.004 15.014 15.0110.02 % PASS 0.00 % PASSPASS15.011 0.04 %4,160 277

H3-H1 X0-X3X0-X1

WINDING RESISTANCE

H2-H3

Meas. Corr.

TAP

POSITION

TEST

# (milliohms)H1-H2 (milliohms) (milliohms)

Corr.Meas. Corr.Meas.

(milliohms)

Corr. Corr.Meas. Corr.Meas.Meas.

X0-X2 (milliohms) (milliohms)

WINDING TESTED

(t = Equipment Temperature)

Values Corrected to: °C75

Aluminum windings

R(Corr) = R(Meas) * (234.5 + c) / (234.5 + t)Copper windings

R(Corr) = R(Meas) * (226 + c) / (226 + t)

(c = Corrected Temperature)

3 230.000 271.388 230.000 271.388 230.000 271.388 1.010 1.192 1.000 1.180 1.000 1.1801

Primary Secondary

TECH NOTE(S):

LIQUID FILLED TRANSFORMER

PAGEPT-14 XFMRDEVICE N/ADBID

23230, REVISED 10/20/2020(888) 778-2733 www.schneider-electric.us

COMMENTS: