Exhibit L - MSG Test Report.pdf

PDF 2 MB Posted Nov 17, 2022

Attached to: J061--AUTOMATICE TRANSFER SWITCHES AND PARALLELING SWITCHGEAR PREVENITIVE MAINTENANCE, TESTING, AND INSPECTION SERVICES
Solicitation number: 36C25623Q0012
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

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Prepared By:

Chris Espartero Sr Field Service Representative

North America Service Operations

Houston, TX

Bldg. 104 MSG

May 26, 2021

Work Order: 08391081

2 | P a g e

EXECUTIVE SUMMARY

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

RA Breaker

Breaker racking mechanism shaft is broken and needs to be replaced. Breaker needs to be sent to the shop for repair. RA Breaker was replaced by the MSG tie breaker.

3 | P a g e

RA C-Phase 50/51 Relay

RA C-Phase 50/51 Electromechanical relay failed to operate during testing. The induction relay restraining spring failed to release the disk during relay testing and the relay may not operate under fault condition. The relay was replaced by a refurbished 50/51 electromechanical relay.

Breaker B2

Breaker B2 Insulation resistance test was lower than the acceptable value which may be due to the high humidity in the area during the time of testing. Breaker B2 Operation counter was not working and needs to be repaired or replaced.

Circuit Breaker Main B, and B3

Circuit Breaker Main B, and B3 operation counter was not working and needs repair or replacement.

4 | P a g e

Medium Voltage HVL Switch A2 and B3

Fused Air Switches A 1-5 and B 6-11, non-fuse Air switches A2 and B3 insulation resistance test results were abnormally low which may be due to a failing switch support insulation and high humidity in the area during the time of testing.

CAP Bank RA, RB, A, B were missing line fuses.

If there are any questions or concerns, please contact:

Chris Espartero

832-205-1547

Christopher.Espartero@se.com

MEDIUM VOLTAGE VACUUM CIRCUIT BREAKER

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG A-1DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER A1

Cuong Ho, Alex Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 113

COUNTER READING AF 111

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

125.0 179.4

30.0 43.0

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

109.076.0

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

68.0

84.0

42.0

28.0

120.0

192.060.3

97.6

275.5

120.5 40.2

172.2

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

1233.3330

1088.24

1233.33

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

COMMENTS: All results are satisfactory at this time.

DEFICIENCIES:

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG A-2DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER A2

Cuong Ho, Alex Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 150

COUNTER READING AF 149

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VGIG-OHMS 20°C

336.0 482.1

76.0 109.0

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

205.2143.0

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

176.0

154.0

54.0

83.0

310.0

209.077.5

252.5

299.9

221.0 119.1

444.8

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

1321.4328

1233.33

1321.43

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

COMMENTS: All result are satisfactory at this time.

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG A-3DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER A3

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 144

COUNTER READING AF 143

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Cleaned

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A CleanedINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VGIG-OHMS 20°C

373.0 535.2

81.0 116.2

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

206.6144.0

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

182.0

152.0

52.7

79.0

364.0

234.075.6

261.1

335.7

218.1 113.3

522.3

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

1233.3330

1156.25

1233.33

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

COMMENTS: All result are satisfactory at this time.

MEASURED CAPACITANCE

Values in

Discharges within alloted time

INSULATION RESISTANCE

Values in

TYPE or STYLE

MANUFACTURER

253424

CATALOG NUMBER

SERIAL NUMBER

274-042-507

VERSA RAPTOR

ABB

NAMEPLATE DATA

Capacitor

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG A-3DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CAPACITOR A

Tony Summerville, Shawn Vail

0133,1230

VA Hospital WO-08391081

N/A

KVAR 300

0133,1230 Tony Summerville, Shawn VailTESTED BY:

25013, REVISED 2/23/2012(888) 778-2733 www.schneider-electric.us

TEST EQUIPMENT USED:

TEST DATA

MATCHES DWGS. OR SPECS.

Acceptable NoYes

Acceptable Yes No

VISUAL AND MECHANICAL INSPECTIONS

CONNECTED AS SPECIFIED

{Not Applicable unless otherwise marked}

PHYSICAL & MECHANICAL CONDITION EXT. & INT. CUBICLE CONDITION

TIGHTNESS OF BOLTED CONN. ANCHORAGE & REQ. CLEARANCES

MICRO FARADS

KV RATING 3/9417 DATE MANUFACTURED

BIL RATING

Yes No

OVERALL CLEANLINESS

Acceptable

Meg-ohms

1 Minute Test Duration

A Phase to Case

B Phase to Case

C Phase to Case

TEST VOLTAGE

B Phase

C Phase

N/A

DISCHARGE RESISTOR

Values in

A phase

Ohms NoYes

<=600 Volts in 1 Minute or > 600 Volts in 5 Minutes

A phase

B Phase

C Phase

7.91

7.90

7.91

Micro-Farads

TECH NOTE(S):

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG B-1DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER B1

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 153

COUNTER READING AF 152

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

3,100.0 4,447.9

1,000.0 1,434.8

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

1,879.61,310.0

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

2,500.0

3,400.0

1,400.0

901.0

3,760.0

3,380.02,008.7

3,587.0

4,849.6

4,878.3 1,292.8

5,394.8

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

2312.516

2312.5

2055.56

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG B-2DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER B2

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 101

COUNTER READING AF 101

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

611.0 876.7

168.0 241.0

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

322.8225.0

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

283.0

235.0

185.0

168.0

384.0

548.0265.4

406.0

786.3

337.2 241.0

551.0

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

1583.3324

1357.14

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S): Breaker insulation resistance results are lower than the acceptable value which could be due by high humidity during the time of the test. Breaker pass the di-electric withstand test

COMMENTS:

DEFICIENCIES: Counter is not working

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG B-3DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER B3

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 98

COUNTER READING AF 98

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

762.0 1,093.3

131.0 188.0

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

470.6328.0

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

433.0

583.0

250.0

227.0

788.0

851.0358.7

621.3

1,221.0

836.5 325.7

1,130.6

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

1541.6724

1321.43

1681.82

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

DEFICIENCIES: Breaker counter is not working

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG B-4DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER B4

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 116

COUNTER READING AF 113

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

New

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

5,560.0 7,977.5

907.0 1,301.4

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

3,429.22,390.0

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

2,010.0

1,280.0

875.0

556.0

4,610.0

3,150.01,255.5

2,883.9

4,519.6

1,836.5 797.7

6,614.4

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

3083.3312

2846.15

2466.67

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

Discharges within alloted time

INSULATION RESISTANCE

Values in

TYPE or STYLE

MANUFACTURER

253426

CATALOG NUMBER

SERIAL NUMBER

274-042-507

VERSA RAPTER

ABB

NAMEPLATE DATA

Capacitor

TEMPERATURE 82 °C

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG B-4DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CAPACITOR B

Tony Summerville, Shawn Vail

0133,1230

VA Hospital WO-08391081

N/A

KVAR N/A

0133,1230 Tony Summerville, Shawn VailTESTED BY:

25013, REVISED 2/23/2012(888) 778-2733 www.schneider-electric.us

TEST EQUIPMENT USED:

TEST DATA

MATCHES DWGS. OR SPECS.

Acceptable NoYes

Acceptable Yes No

VISUAL AND MECHANICAL INSPECTIONS

CONNECTED AS SPECIFIED

{Not Applicable unless otherwise marked}

PHYSICAL & MECHANICAL CONDITION EXT. & INT. CUBICLE CONDITION

TIGHTNESS OF BOLTED CONN. ANCHORAGE & REQ. CLEARANCES

40000MICRO FARADS

KV RATING N/A17 DATE MANUFACTURED

BIL RATING

Yes No

OVERALL CLEANLINESS

Acceptable

70.6

Meg-ohms

1 Minute Test Duration

A Phase to Case

B Phase to Case

C Phase to Case

TEST VOLTAGE

B Phase

C Phase

N/A

DISCHARGE RESISTOR

Values in

A phase

Ohms NoYes

<=600 Volts in 1 Minute or > 600 Volts in 5 Minutes

A phase

B Phase

C Phase

11.79

11.8

Micro-Farads

TECH NOTE(S):

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG MAIN-ADESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MAIN BREAKER A

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 102

COUNTER READING AF 100

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Allen Bradley

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

4,600.0 6,600.1

778.0 1,116.3

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

1,721.81,200.0

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

1,500.0

1,900.0

621.0

452.0

2,500.0

2,300.0891.0

2,152.2

3,300.0

2,726.1 648.5

3,587.0

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

185020

2055.56

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

COMMENTS: All results are satisfactory at this time

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG MAIN-BDESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MAIN BREAKER B

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 106

COUNTER READING AF 106

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

583.0 836.5

457.0 655.7

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

1,721.81,200.0

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

1,100.0

503.0

205.0

848.0

545.0721.7

1,578.3

782.0

1,578.3 294.1

1,216.7

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

1681.8222

2055.56

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

DEFICIENCIES: Counter is not working

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG RADESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER RA

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 104

COUNTER READING AF 102

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Deficiency

CONDITION

Acceptable

Deficiency

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

125 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VGIG-OHMS 20°C

1,810.0 2,597.0

481.0 690.1

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

2,023.11,410.0

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

1,150.0

1,230.0

648.0

398.0

1,800.0

1,150.0929.8

1,650.0

1,764.8 571.1

2,582.6

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

200019

1727.27

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

DEFICIENCIES: Breaker Racking mechanism shaft is broken. Breaker will be sent to schneider electric shop to get evaluated for repair or direct replacement.

Discharges within alloted time

INSULATION RESISTANCE

Values in

TYPE or STYLE

MANUFACTURER

253428

CATALOG NUMBER

SERIAL NUMBER

274-042-507

VERSA RAPTER

ABB

NAMEPLATE DATA

Capacitor

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG RADESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CAPACITOR RA

Tony Summerville, Shawn Vail

0133,1230

VA Hospital WO-08391081

N/A

KVAR N/A

0133,1230 Tony Summerville, Shawn VailTESTED BY:

25013, REVISED 2/23/2012(888) 778-2733 www.schneider-electric.us

TEST EQUIPMENT USED:

TEST DATA

MATCHES DWGS. OR SPECS.

Acceptable NoYes

Acceptable Yes No

VISUAL AND MECHANICAL INSPECTIONS

CONNECTED AS SPECIFIED

{Not Applicable unless otherwise marked}

PHYSICAL & MECHANICAL CONDITION EXT. & INT. CUBICLE CONDITION

TIGHTNESS OF BOLTED CONN. ANCHORAGE & REQ. CLEARANCES

40000MICRO FARADS

KV RATING N/A17 DATE MANUFACTURED

BIL RATING

Yes No

OVERALL CLEANLINESS

Acceptable

Meg-ohms

1 Minute Test Duration

A Phase to Case

B Phase to Case

C Phase to Case

TEST VOLTAGE

B Phase

C Phase

N/A

DISCHARGE RESISTOR

Values in

A phase

Ohms NoYes

<=600 Volts in 1 Minute or > 600 Volts in 5 Minutes

A phase

B Phase

C Phase

3.98

3.96

3.95

Micro-Farads

TECH NOTE(S):

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG RBDESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BREAKER RB

Cuong Ho, Alexander Ramos

3201, 2319

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 135

COUNTER READING AF 133

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

1,740.0 2,496.6

681.0 977.1

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

2,439.21,700.0

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

1,400.0

1,800.0

334.0

491.0

2,310.0

2,770.0479.2

2,008.7

3,974.4

2,582.6 704.5

3,314.4

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

2312.516

2055.56

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S):

Discharges within alloted time

INSULATION RESISTANCE

Values in

TYPE or STYLE

MANUFACTURER

253425

CATALOG NUMBER

SERIAL NUMBER

274-042-507

VERSA RAPTER

ABB

NAMEPLATE DATA

Capacitor

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG RBDESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

CAPACITOR RB

Tony Summerville, Shawn Vail

0133, 1230

VA Hospital WO-08391081

N/A

KVAR N/A

0133, 1230 Tony Summerville, Shawn VailTESTED BY:

25013, REVISED 2/23/2012(888) 778-2733 www.schneider-electric.us

TEST EQUIPMENT USED:

TEST DATA

MATCHES DWGS. OR SPECS.

Acceptable NoYes

Acceptable Yes No

VISUAL AND MECHANICAL INSPECTIONS

CONNECTED AS SPECIFIED

{Not Applicable unless otherwise marked}

PHYSICAL & MECHANICAL CONDITION EXT. & INT. CUBICLE CONDITION

TIGHTNESS OF BOLTED CONN. ANCHORAGE & REQ. CLEARANCES

40000MICRO FARADS

KV RATING N/A17 DATE MANUFACTURED

BIL RATING

Yes No

OVERALL CLEANLINESS

Acceptable

9.7

12.97

18.18

Gig-ohms

1 Minute Test Duration

A Phase to Case

B Phase to Case

C Phase to Case

TEST VOLTAGE

B Phase

C Phase

N/A

DISCHARGE RESISTOR

Values in

A phase

Ohms NoYes

<=600 Volts in 1 Minute or > 600 Volts in 5 Minutes

A phase

B Phase

C Phase

3.96

3.94

3.98

Micro-Farads

TECH NOTE(S):

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

MSG TIEDESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

TIE BREAKER

Cuong Ho, Alexander Ramos

VA Hospital WO-08391081

23 KA. RMS

BREAKER NAMEPLATE

N/A

MANUFACTURER

INT. RATING

FG-2-15050-12

N/A

SN / SO NO.

RATED VOLTAGE MAX. VOLTAGE 15 KV

FLUARC

95 KV

RATED INT. TIME 5 cyc

K FACTOR

17-16920A

60 HZ

12.47 KV

1200 ARATED CURRENT

TYPE / STYLE

BIL RATING

D.O.

FREQUENCY

MOUNTING

FACTORY ORDER #

MANUF. DATE

CATALOG NO.

COUNTER READING AL 150

COUNTER READING AF 148

N/A

B.I.

03058, REVISED 9/17/2020(888) 778-2733 www.schneider-electric.us

C & L

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTIONCONTACT EROSION

CONTACT WIPE

PRIMARY DISCONNECTS

CELL AND RACKING DEV.

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

ANTI-PUMP

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

Cleaned

AcceptableOPERATING MECHANISM Lubed

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

PUSH / PULL ROD ADJ. Acceptable N/A N/AINTERLOCKS Acceptable CleanedINS. LINKAGES / BRACES

OVERALL CONDITION Acceptable

CONDITION

Acceptable

INSPECTION

N/A

Square D

RANGE

INSULATION RESISTANCE IN:

MEG-OHMS @1000V

ADDITIONAL INFO ADDITIONAL INFO

PICKUP VOLTS PICKUP VOLTS

ADDITIONAL INFO

VOLT RANGE N/AVOLT RANGE

PICKUP VOLTS

VOLT RANGE

ADDITIONAL INFO

DROP-OUT VOLTS

CHARGING MOTOR INFORMATION

48 VDC

N/A

CLOSE COIL INFORMATION

N/A

48 VDC

N/A

48 VDC VoltsVolts

PICKUP VOLTS

Volts Volts

CONTROL WIRING

20°C

OPTIONAL

VOLT RANGE

INFORMATIONTRIP COIL INFORMATION

N/A N/A N/A

POLE 3POLE 2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

@5000VMEG-OHMS 20°C

1,400.0 2,008.7

304.0 436.2

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

1,236.8862.0

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

386.0

625.0

342.0

343.0

1,180.0

1,250.0490.7

553.8

1,793.5

896.8 492.1

1,693.1

DIELECTRIC WITHSTAND TEST

A / C

N/AMEG-OHMSMICRO-AMPSCLOSED

1681.8222

1541.67

B to C, A & GND

C to A, B & GND

A to B, C & GND

D / C

DIELECTRIC WITHSTAND TEST

(Note: All specimens not under test are grounded)

VOLTAGE (kV)

TECH NOTE(S): Tie breaker was used to replace Breaker RA. Breaker could not be rack in to the gear due to broken shaft.

20°C

MEDIUM VOLTAGE AIR SWITCH

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

SWITCHGEAR A2DESIGNATION

SUBSTATION BUILDING 104

5/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH PT-4

Scott Snyder, Mike Danford

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

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 Comment

CONDITION

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

44035-234-57

15 kv

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE Power-Zone

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

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPSA1550X100E-1DFUSE MFG. Shawmut/Gould FUSE CAT. NO. 100

@5000VMEG-OHMS 20°C

16,000.0 22,956.8

282.0 404.6

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

622.7434.0

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

390.0

103.0

28.0

82.0

11,500.0

9,800.040.2

559.6

14,061.0

147.8 117.7

16,500.2

15 kv

Square D

61 ka

RANGE

(µ-ohms) 29

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

53 35

10 A 10.7 10.3711.41FUSE RESISTANCE at (m-ohms)

TECH NOTE(S):

COMMENTS: Close insulation resistance test result is lower than the acceptable value due to high humidity during the time of the test.

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

SWITCHGEAR A2DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MAIN MV AIR SWITCH

Scott Snyder, Mike Danford

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

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 Comment

CONDITION

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

44035-241-53

15 kv

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE Power-Zone

95kv

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

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPSNAFUSE MFG. NA FUSE CAT. NO. NA

@5000VMEG-OHMS 20°C

124.0 177.9

0.0 0.0

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

0.00.0

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

0.0

477.0

184.00.0

0.0

264.0

0.0 0.0

684.4

15 kv

Square D

65 ka

RANGE

(µ-ohms)

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

10 A 26 3339POLE CONTACT RESISTANCE at (µ-ohms)

TECH NOTE(S): Close insulation resistance test was not perform due to cable connected on the primary side of the switch.

No Fuse. Overcurrent protection is upstream throuh the A2 Breaker 50/51 relay.

COMMENTS: Insulation resistance test results is lower than the acceptable value which may due by the high humidity in the area during testing.

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

SWITCHGEAR A2DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH PT-7

Scott Snyder, Mike Danford

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

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

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

44035-234-57

15 kv

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE Power-Zone

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

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPSA1550X100E-1DFUSE MFG. Shawmut/Gould FUSE CAT. NO. 100

@5000VMEG-OHMS 20°C

12,400.0 17,791.5

282.0 404.6

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

622.7434.0

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

390.0

103.0

28.0

82.0

6,030.0

189.040.2

559.6

271.2

147.8 117.7

8,651.8

15 kv

Square D

61 ka

RANGE

(µ-ohms) 50

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

48 54

10 A 10.27 10.8810.55FUSE RESISTANCE at (m-ohms)

TECH NOTE(S):

COMMENTS: Close insulation resistance test result is lower than the acceptable value due to high humidity during the time of the test.

TEMPERATURE 20 °C

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

SWITCHGEAR A2DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 30

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH PT-5

Scott Snyder, Mike Danford

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

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 Comment

CONDITION

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

44035-234-57

15 kv

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE Power-Zone

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

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPSA1550X100E-1DFUSE MFG. Shawmut/Gould FUSE CAT. NO. 100

@5000VMEG-OHMS 20°C

10,200.0 10,200.0

281.0 281.0

TEST 1

TEST 3

1TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

343.0343.0

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

390.0

103.0

28.0

82.0

16,080.0

6,470.028.0

390.0

6,470.0

103.0 82.0

16,080.0

15 kv

Square D

61 ka

RANGE

(µ-ohms) 50

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

37 39

10 A 10.95 11.3810.91FUSE RESISTANCE at (m-ohms)

TECH NOTE(S):

COMMENTS: Close insulation resistance test result is lower than the acceptable value due to high humidity during the time of the test.

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

SWITCHGEAR A2DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH PT-SPARE

Scott Snyder, Mike Danford

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

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 Comment

CONDITION

Acceptable

Comment

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

44035-234-57

15 kv

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE Power-Zone

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

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPSA1550X100E-1DFUSE MFG. Shawmut/Gould FUSE CAT. NO. 100

@5000VMEG-OHMS 20°C

2,100.0 3,013.1

281.0 403.2

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

622.7434.0

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

390.0

103.0

28.0

82.0

4,500.0

1,800.040.2

559.6

2,582.6

147.8 117.7

6,456.6

15 kv

Square D

61 ka

RANGE

(µ-ohms) 30.2

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

33.1 31.7

10 AFUSE RESISTANCE at (m-ohms)

TECH NOTE(S): No fuses installed at this time. Switch has Missing handle

COMMENTS: Close insulation resistance test result is lower than the acceptable value due to high humidity during the time of the test.

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

SWITCHGEAR A2DESIGNATION

SUBSTATION BUILDING 104

5/122/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH PT-6

Mike Danford, Scott Snyder

VA Hospital WO-08391081

C & L

Cleaned Torqued

MATCHES DWG OR SPEC

GROUND CONNECTION

COUNTER READING AF/AL

ARCING CONTACTS

HEATER CIRCUIT

MAIN CONTACTS

CUBICLE

CLEAN/LUBE Description CLEAN/LUBECONDITION

Acceptable

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

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

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

44035-234-57

15 kv

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE Power-Zone

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

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPSA1550X100E-1DFUSE MFG. Shawmut/Gould FUSE CAT. NO. 100

@5000VMEG-OHMS 20°C

11,300.0 16,213.2

282.0 404.6

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

622.7434.0

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

390.0

103.0

28.0

82.0

24,200.0

4,560.040.2

559.6

6,542.7

147.8 117.7

34,722.2

15 kv

Square D

61 ka

RANGE

(µ-ohms) 46

POLE 2 POLE 3CONTACT RESISTANCE MEASUREMENTS

BYPASS CONTACT RESISTANCE at 10 A

POLE 1

58 47

10 A 11.14 10.8811FUSE RESISTANCE at (m-ohms)

TECH NOTE(S):

COMMENTS: Close insulation resistance test result is lower than the acceptable value due to high humidity during the time of the test.

TEMPERATURE 82 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

SWITCHGEAR A2DESIGNATION

SUBSTATION BUILDING 104

05/22/2021 96

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MV AIR SWITCH PT-13

Scott Snyder, Mike Danford

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

N/A

Cleaned

CONTROL CIRCUIT

FUSE HOLDERS

CONDITIONDescription CLEAN/LUBE

N/AN/A

Description

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

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

44035-234-57

15 kv

SN / SO NO.

RATED VOLTAGE

CATALOG NO.

MAX. VOLTAGE BIL RATING

TYPE / STYLE Power-Zone

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 48 VDC VoltsVolts

PICKUP VOLTS

Volts

TRIP COIL INFORMATION

Volts

ADDITIONAL INFO

VOLT RANGE

N/A

OPTIONAL INFORMATION

TEST RESULTS

MANUF. DATE

FUSE AMPSA155F1DORO-50EFUSE MFG. Shawmut/Gould FUSE CAT. NO. 50

@5000VMEG-OHMS 20°C

256.0 367.3

281.0 403.2

TEST 1

TEST 3

1.4348TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

622.7434.0

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 -…

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File details come from the government source that posted it. Updated Nov 17, 2022.