Exhibit S - USS-2 Test Report.pdf

Prepared By:

Chris Espartero Sr Field Service Representative

North America Service Operations

Houston, TX

USS-2 Substation PM

April 23, 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 USS-2 Substation located at VA loading duct tunnel 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.

USS-2 Main Breaker

USS-2 Switchboard main breaker actuator would not engage the trip bar 100% of the time. The circuit breaker trip bar spring has gotten weak and will cause it to not reset automatically when the breaker is tripped. With the trip bar not resetting properly the circuit breaker will not closed manually unless the trip bar is re-adjusted. The circuit breaker was replaced by one of the circuit breakers that was repair on site.

USS-2 Dry Type Transformer

USS-2 Transformer excitation test did not match the exciting current known pattern for a Delta

Wye transformer. This may indicate a short on the transformer winding. It is also evident on the transformer TTR test. USS-2 Transformer also failed on TTR calculated ratio.

Transformer temperature control is unserviceable. The circuit breaker inside the control cabinet was found to be on off position and ice cube relays has been pulled previously to isolate the circuit.

Temperature controller and components need to be replaced to keep transformer from overheating.

If there are any questions or concerns, please contact:

Chris Espartero

832-205-1547

Christopher.Espartero@se.com

USS-2_876101-E1_XD

DryTypeTransformerReport Source

4/22/2021 7:06:15 PMSession Test Date

Nameplate Company VA Medical Center Serial Number 876101-E1

Location 2002 Holcombe Blvd Houston, Texas 77030

Special ID USS-2 XFMR

Division Houston Circuit Designation USS-2 SUBSTATION

Manufacturer Square D Electric Class

Year Manufactured Type DryTypeTransformer

Mfr Location USA Winding Insulation Encapsulated

Coolant Select Coolant Weight 7710

Tank Type Select Tank Type BIL 110 kV

Dry Tank Type Ventilated VA Rating 1500 kV 12.47,0.48,* Insulation Material Epoxy Mica

Administration Test Date 4/22/2021 Test Time: 7:06 PM Weather Indoors

Air Temperature 25°C Apparatus Temperature

* Humidity 61 %

Tester C.Espartero Work Order Date Last Tested

Verified Test Set Type M4000 Date Retested

Verification Date 4/22/2021 Set Top Serial # Reason ROUTINE

Last Sheet # Set Bottom Serial # Travel Time

Purchase Order Ins. Book # Duration

Copies Sheet # Crew Size 1

1 - 6876101-E1

Session Notes

2 - 6876101-E1

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

H1 H1 * * * * * *

H2 H2 * * * * * *

H3 H3 * * * * * *

LSR mA: 4.552/4.552, 1/1 Watts: 0.066/0.066, 1/1 Cap (pF): 1207.369/1207.369, 1/1

LSR mA: 0.946/0.946, 1/1 Watts: 0.039/0.039, 1/1 Cap (pF): 250.965/250.965, 1/1

LSR mA: 3.606/3.606, 1/1 Watts: 0.024/0.024, 1/1 Cap (pF): 956.510/956.510, 1/1

LSR mA: 3.606/3.606, 1/1 Watts: 0.027/0.027, 1/1 Cap (pF): 956.404/956.404, 1/1

LSR mA: 8.806/8.806, 1/1 Watts: 0.123/0.123, 1/1 Cap (pF): 2335.785/2335.785, 1/1

LSR mA: 5.200/5.200, 1/1 Watts: 0.097/0.097, 1/1 Cap (pF): 1379.210/1379.210, 1/1

LSR mA: 3.608/3.608, 1/1 Watts: 0.016/0.016, 1/1 Cap (pF): 957.009/957.009, 1/1

LSR mA: 3.606/3.606, 1/1 Watts: 0.026/0.026, 1/1 Cap (pF): 956.575/956.575, 1/1

Overall Tests - 2K # Insulation Test kV mA Watts % PF Meas. Cap (pF) IR Man.

1 CH+CHL 2.000 4.552 0.066 0.145 1207.369 Good

2 CH 2.000 0.946 0.039 0.408 250.965 Good

3 CHL(UST) 2.000 3.606 0.024 0.065 956.510 Good

4 CHL 0 3.606 0.027 0.076 956.404 Good

5 CL+CHL 1.000 8.806 0.123 0.139 2335.785 Good

6 CL 1.000 5.200 0.097 0.186 1379.210 Good

7 CHL(UST) 1.000 3.608 0.016 0.044 957.009 Good

8 CHL 0 3.606 0.026 0.071 956.575 Good

3 - 6876101-E1

LSR mA: 4.552/4.552, 1/1 Watts: 0.069/0.069, 1/1 Cap (pF): 1207.415/1207.415, 1/1

LSR mA: 0.946/0.946, 1/1 Watts: 0.042/0.042, 1/1 Cap (pF): 251.059/251.059, 1/1

LSR mA: 3.606/3.606, 1/1 Watts: 0.030/0.030, 1/1 Cap (pF): 956.384/956.384, 1/1

LSR mA: 3.605/3.605, 1/1 Watts: 0.028/0.028, 1/1 Cap (pF): 956.356/956.356, 1/1

LSR mA: 8.806/8.806, 1/1 Watts: 0.122/0.122, 1/1 Cap (pF): 2335.837/2335.837, 1/1

LSR mA: 5.200/5.200, 1/1 Watts: 0.097/0.097, 1/1 Cap (pF): 1379.224/1379.224, 1/1

LSR mA: 3.608/3.608, 1/1 Watts: 0.016/0.016, 1/1 Cap (pF): 957.037/957.037, 1/1

LSR mA: 3.606/3.606, 1/1 Watts: 0.025/0.025, 1/1 Cap (pF): 956.614/956.614, 1/1

Overall Tests - LG # Insulation Test kV mA Watts % PF Meas. Cap (pF) Tip UP FRANK™ IR Man.

1 CH+CHL 10.004 4.552 0.069 0.152 1207.415 *

2 CH 10.003 0.946 0.042 0.443 251.059 0.035 Good

3 CHL(UST) 10.003 3.606 0.030 0.082 956.384 0.017 Investigate

4 CHL 0 3.605 0.028 0.076 956.356 *

5 CL+CHL 0.999 8.806 0.122 0.139 2335.837 *

6 CL 1.000 5.200 0.097 0.186 1379.224 0.000 Good

7 CHL(UST) 1.000 3.608 0.016 0.044 957.037 -0.001

8 CHL 0 3.606 0.025 0.071 956.614 * Investigate

Winding Resistance

DETC LTC Phase Resistance Units Calculated Resistance

Correction Factor

Corrected Resistance

Percentage Deviation

1 A 288.7 milli Ohms * * * *

1 B 284.7 milli Ohms * * * *

1 C 286.5 milli Ohms * * * *

High Voltage

DETC LTC Phase Resistance Units Calculated Resistance

Correction Factor

Corrected Resistance

Percentage Deviation

1 A 468.5 micro Ohms * * * *

1 B 445 micro Ohms * * * *

1 C 420.2 micro Ohms * * * *

Low Voltage

Winding

Manufacturer Serial Number Configuration Winding Temperature

Temperature Rise

Factory Resistance

(Ohms)

Factory Temperature

Δ-Y * * * *

4 - 6876101-E1

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 5 95.953 773.852 L 126.608 888.560 L 49.621 408.240 L Investigate

LSR mA: 95.953/95.953, 1/1 Watts: 773.852/773.852, 1/1 Cap (pF): */*, 1/1

LSR mA: 126.608/126.608, 1/1 Watts: 888.560/888.560, 1/1 Cap (pF): */*, 1/1

LSR mA: 49.621/49.621, 1/1 Watts: 408.240/408.240, 1/1 Cap (pF): */*, 1/1

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 12470 3 480 44.997 42.864 45.147 45.099 44.772 45.222 Investigate Investigate

5 - 6876101-E1

Exciting Current Plot

6 - 6876101-E1

TWO-WINDING DRY-TYPE TRANSFORMER

TEMPERATURE 77 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

4/22/2021 61

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

DRY TYPE TRANSFORMER

Chris Espartero

N/A

N/A

VA Hospital WO-08391081

Acceptable

CONDITIONDescription CLEAN/LUBEDescription

N/A

Torqued

N/A N/A

N/A

N/A N/A

FANS

N/AAcceptable

Acceptable

N/A N/A N/A

N/A

N/AVENTILATION / FILTERS

N/A

PAINT Acceptable

INDOOR

CleanedAcceptable

N/A

MATCHES DWG OR SPEC

WEATHER

Cleaned

ENVIRONMENT

N/A

N/A

GAUGES

SUPPORT INSULATORS

N/ATorqued

Deficiency

Windings

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

Acceptable

N/A Torqued

ARRESTERS

CORE GROUND

ALARMS / ANNUNCIATOR

CONTROLS

BUSHINGS

CLEAN/LUBE CLEAN/LUBECONDITION

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

GAUGES

N/A

CONTROLLED

23210, REVISED 10/20/2020(888) 778-2733 www.schneider-electric.us

69 69

1,8041,8041,804

NAMEPLATE DATA

RATED CURRENT

RATED CURRENT

AMPERES

AMPERES/

11,846

3 4 5 kV PRI.

PRIMARY VOLTAGE

SECONDARY VOLTAGE 277 WYE

13,094

TAP POSITION/CONNECTION

12,782 12,158

1,500

CLASS

12,470

Phase 3876101-E1SERIAL NO.

kVA/

THERMAL RATINGS

DELTA

kV SEC.

IMPEDANCE

YEAR OF MANUF.N/A 1988

MANUFACTURER

SPECIFICATION NO. MANUF. LOCATION

TYPE AA/FA K FACTOR N/A °CTEMPERATURE RISE

U.S.A

805.7

B.I.L. RATINGWINDING MATERIAL Cu

LB

DELTA480

TAP VOLTAGES

WINDING POLARITY SUBTRACTIVE

WYE

1,500 / 1,500

12,470

TOTAL WEIGHT

Dry

Square D

RANGE

INSPECTION

INSULATION RESISTANCE TEST

TESTED

PRIMARY TO

SECONDARY AND GROUND

SECONDARY TO

PRIMARY AND GROUND

VOLTAGE

(VOLTS DC)

(MEGOHMS)

Windings TEST RESISTANCE

PRIMARY TO

SECONDARY

1.0 MINUTE0.5 MINUTE 0.5 MIN. 20C 1.0 MIN. 20C

Acceptable

Acceptable

Acceptable

DIELECTRIC

ABSORPTION

RATIO

TEMPERATURE CORRECTION FACTOR TO 20°C, TCF 1.25

5,000

1,000

5,000

171,000.0 213,750.0 190,900.0 238,625.0

1,762,5001,410,0001,470,0001,176,000

305,000.0 381,250.0 383,000.0 478,750.0

1.12

1.20

1.26

Calculated PASS/FAIL Calculated

PASS/FAIL

TO

% DEVIATIONMeasured

TRANSFORMER TURNS RATIO TESTS

Calculated PASS/FAIL

CALC.

RATIO

Secondary

VOLTAGE

ENTER Primary

VOLTAGE

X1 - X0 X3 - X1

H1 - H3 H2 - H1 H3 - H2

X0 - X1

TAP TO

TEST

3 42.864 45.147 45.0990.34 % PASS 0.23 % PASSFAIL44.996 4.74 %12,470 277

TWO-WINDING DRY-TYPE TRANSFORMER

PAGEDRY TYPE TRANSFORMERDEVICE N/ADBID

23210, REVISED 10/20/2020(888) 778-2733 www.schneider-electric.us

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)

3 288.700 344.326 284.700 339.555 286.500 341.702 468.500 558.770 445.000 530.742 420.200 501.1631

Primary Secondary

TECH NOTE(S):

COMMENTS: Caculated ratio on H1-H3 to X0-X1 failed.

DEFICIENCIES: Temperature controler is not working fuse and relay have been found to be pulled out from previous troubleshooting.

SE SWITCHBOARD / SWITCHGEAR INSPECTION

TEMPERATURE 73 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

04/22/2021 40

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

480 VOLT SWITCHGEAR

Chris Espartero

VA Hospital WO-08391081

480/277

N/A

MANUFACTURER

1600 AMP

BUS CONNECTIONS

EXTERIOR CONDITION

CLEAN/LUBE CLEAN/LUBECONDITION

Acceptable

Acceptable

Acceptable

Acceptable

N/A

CONDITION

N/A

Description

Cleaned

N/A

INDICATORS / LAMPS

N/A

MATCHES DWG OR SPEC N/A

FUNCTIONAL CHECKS

BUS INSULATION N/A N/A

KEY / MECH. INTERLOCKS

N/A

PLC's / HMI's N/A

CONDITION

N/A

N/A

N/A

N/A

N/A

NAMEPLATE

21001, REVISED 10/20/2020(888) 778-2733 www.schneider-electric.us

WITHSTAND RATING

TYPE / STYLECURRENT RATING QED

SN / SO NO. SYSTEM VOLTAGE

MODEL / CATALOG

N/A

45-08000-62S

INSPECTION

Acceptable

PT'S AND CT'S

N/A N/A AcceptablePOWER CABLES

N/A N/A N/A INTERCONNECT WIRING N/ARACKING / LIFTING MECHANISMS

AcceptableDOORS / COVERS / GASKETS

CPT AND CPT XFER CKT. ANCHORAGE

GROUNDING

PHASING CHECK

CONTROL WIRING

SPACE HEATERS

Description

N/A

CleanedINTERIOR SECTIONS / CUBICLES

Cleaned

PHASE BARRIERS

SEQUENCE OF OPERATION

Description

N/A

N/A

N/A

N/A

N/A

Square D

RANGE

BARRIERS / SHUTTERS

@1000Vohms 20°C

115.0 131.1

TEST 1

TEST 2

INSULATION RESISTANCE IN: PHASE-PHASE

19.417.0

20°CACTUALACTUAL

A - B A-GND

PHASE-GROUND

B-GND

C-GND

B - C

C - A

10.0

15.0

13.0

10.0

14.8

11.4

17.1 11.4TEST 3

N-GNDTEST 4

1.14TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

INSULATION RESISTANCE TEST

SECTION 1 SECTION 2 45 61 66 19

NBAFROM TO

BUS SECTION TESTED RESISTANCE IN MICRO-OHMS

C

RESISTANCE IN MICRO-OHMS

G

N

BUSWORK CONNECTION RESISTANCE

CBAFROM TO

BUS SECTION TESTED

G

TECH NOTE(S):

COMMENTS: All results are satisfactory at this time.

DEFICIENCIES:

ZONE INTLK

BREAKER TYPE

TRIP UNIT TYPE

8IY8028

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 75 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

4/22/21 40

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MAIN BREAKER

Javier Rojas

01025, 1797, 3115

VA Hospital WO-08391081

1600 AMP

Cleaned

C & L Cleaned

MATCHES DWG OR SPEC

GROUND CONNECTION

ONDS-416

50 KA

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. N/A

N/AFUSE CAT. NO.

1600 AMP 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

Acceptable

Acceptable

Acceptable

N/A

Cleaned

ARC CHUTES

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

CleanedAcceptable

Description

Cleaned

C & L

N/AOPERATING MECHANISM C & L

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

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

OVERALL CONDITION Acceptable

CONDITION

N/A

Acceptable

Acceptable

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

AC PRO N/A

COUNTER READING AL N/A

FUSE AMPS N/A

COUNTER READING AF

RANGE

@1000VGIG-OHMS 20°C

1,770.0 2,115.2

703.0 840.1

TEST 1

TEST 3

1.195TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

1,167.5977.0

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

919.0

961.0

631.0

686.0

1,747.0

1,739.0754.0

1,098.2

2,078.1

1,148.4 819.8

2,087.7

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

N/A N/A N/A

POLE 3POLE 2

.1

19200 3200 19200

.4

.4

.1

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: 1600 AMPRATING PLUG:1600 AMP 1600 AMP

Overcurrent Settings

CT / SENSOR RATINGS:

.4 .4

480640

AS FOUND

RANGE

MINIMUM MAXIMUM

3,205

0.48

0.46

3,205

0.48

6,330

0.46

3,122

0.45

6,520

0.46

3,122

0.45

6,520

0.46

3,020

0.45

6,510

0.46

3,020

0.45

6,510

0.46

9,600 0.4 0.5

960 0.38 0.5

POLE 3

AS FOUNDAS FOUND AS LEFT AS LEFT

3 7.8 7.4 7.4 7.31 7.31

1,651 1,647 1,647 1,680 1,680

NT NT NT

CURRENT

MULTIPLE

TEST

AMPERES

sec 10 sec

LONG TIME PICKUP

LONG TIME DELAY

MILLIVOLT DROP

4,800 6

1,651

7.8

SHORT TIME PICKUP

SHORT TIME DELAY 1.5

INSTANTANEOUS PICKUP

INSTANTANEOUS DELAY

GROUND FAULT PICKUP

GROUND FAULT DELAY 2

sec sec sec sec sec sec

AS LEFT

1,440 A A1,760

A A

AA

A A

5,760 7,040

3,5202,880

452 528

POLE 1

FUNCTION

POLE 2TEST RESULTS BY PRIMARY INJECTION

TECH NOTE(S):

COMMENTS: All tests proved satisfactory.

DEFICIENCIES: Acuator is not engaging the tripper bar 100% of the time. Replacing actuator is recommended.

TRIP UNIT TYPE

CNTJ99430

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 74 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

4/27/21 55

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

MAIN BREAKER Replacement

Cuong Ho

3230,3115,01025

VA Hospital WO-08391081

1600 AMP

Cleaned

C & L Cleaned

MATCHES DWG OR SPEC

GROUND CONNECTION

ONDS 416H

65 KVA

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. N/A

N/AFUSE CAT. NO.

1600 AMP 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

Not Checked

N/A

Acceptable

N/A

Cleaned

ARC CHUTES

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

CleanedAcceptable

Description

Cleaned

C & L

N/AOPERATING MECHANISM C & L

PHASE BARRIERS Acceptable Cleaned

N/AAUXILIARY DEVICES

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

OVERALL CONDITION Acceptable

CONDITION

N/A

Acceptable

Acceptable

Deficiency

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

AC Pro N/A

COUNTER READING AL N/A

FUSE AMPS N/A

COUNTER READING AF

RANGE

@1000VGIG-OHMS 20°C

357.7

323.9

TEST 1

TEST 3

1.165TEMPERATURE CORRECTION FACTOR TO 20°C, TCF

TEST 2

INSULATION RESISTANCE IN: CLOSED: POLE-POLE

357.7

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

351.8

312.2

308.7

362.3 381.0

206.2

CONTACT RESISTANCE - MICRO-OHMS

POLE 1

FUSE 2FUSE 1 FUSE 3

N/A N/A N/A

POLE 3POLE 2

.70

2.5

3.0

.15

4 OFF 2 4 OFF

.3

.2

1.0

2.5

2.5

.15

.70

2.5

3.0

.15

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: 1600 AMPRATING PLUG:1600 AMP 1600 AMP

Overcurrent Settings

CT / SENSOR RATINGS:

.2 .4

.4.3

AS FOUND

RANGE

MINIMUM MAXIMUM

0.12

0.45

0.12

5,082

0.45

0.14

4,960

0.47

0.14

4,960

0.47

3,001

0.14

5,060

0.47

3,001

0.14

5,060

0.47

7,200 0.08 0.18

960 0.38 0.5

POLE 3

AS FOUNDAS FOUND AS LEFT AS LEFT

3 10.45 10.11 10.11 11.01 11.01

1,636 1,624 1,624 1,641 1,641

NT NT NT

CURRENT

MULTIPLE

TEST

AMPERES

sec 12 sec

LONG TIME PICKUP

LONG TIME DELAY

MILLIVOLT DROP

4,800 7

1,636

10.45

SHORT TIME PICKUP

SHORT TIME DELAY 3

INSTANTANEOUS PICKUP

INSTANTANEOUS DELAY

GROUND FAULT PICKUP

GROUND FAULT DELAY 1.5

sec sec sec sec sec sec

AS LEFT

1,440 A A1,760

A A

AA

A A

4,320 5,220

3,5202,880

288 352

POLE 1

FUNCTION

POLE 2TEST RESULTS BY PRIMARY INJECTION

TECH NOTE(S):

COMMENTS: All results are satisfactory at this time.

TRIP UNIT TYPE

N/A

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 74 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

04/22/21 40

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

ATS-38

David Gordon

3285,3208

VA Hospital WO-08391081

N/A

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTION

ONME

65K

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. MEF436LSIG

N/AFUSE CAT. NO.

400 AMP 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/AAcceptable

Description

N/A

C & L

N/AOPERATING MECHANISM Cleaned

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 IN

10 7 10

.2

1 IN

.9

4 IN

1 IN

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: 400RATING PLUG:400 400

Overcurrent Settings

CT / SENSOR RATINGS:

1 IN 4 IN

.4.2

AS FOUND

RANGE

MINIMUM MAXIMUM

NT

2,804

2.022

0.547

NT

2.022

0.547

NT

2.022

0.547

NT

2.022

0.547

NT

2.022

0.547

NT

2.022

0.547

2,808

1,992 1.6 2.6

168 0.5 0.6

POLE 3

AS FOUNDAS FOUND AS LEFT AS LEFT

1.02 9.05 9.05 9.05 9.05 9.05

NT NT NT

CURRENT

MULTIPLE

TEST

AMPERES

sec 15 sec

LONG TIME PICKUP

LONG TIME DELAY

MILLIVOLT DROP

9.05

SHORT TIME PICKUP

SHORT TIME DELAY 4.98

INSTANTANEOUS PICKUP

INSTANTANEOUS DELAY 7.02

GROUND FAULT PICKUP

GROUND FAULT DELAY 0.42

sec sec sec sec sec sec

AS LEFT

360 A A440

A A

AA

A A

1,800 2,200

3,0802,520

144 176

POLE 1

FUNCTION

POLE 2TEST RESULTS BY SECONDARY INJECTION

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:

TRIP UNIT TYPE

N/A

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 74 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

04/22/2021 48

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

B04 NHC

David Gordon

VA Hospital WO-08391081

N/A

N/A

N/A Cleaned

MATCHES DWG OR SPEC

GROUND CONNECTION

ONILL

200KA

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. ILL342501021

N/AFUSE CAT. NO.

250 AMP 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

Acceptable

N/A

Acceptable

N/A

N/A

ARC CHUTES

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

N/A

N/A

N/AOPERATING MECHANISM Cleaned

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

GROUND SENSOR 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

412403

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.

TRIP UNIT TYPE

N/A

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 77 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

04/22/2021 48

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BUS DUCT A

David Gordon

3284,3230

VA Hospital WO-08391081

800 AMP

N/A

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTION

ONME

65K

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. MEF836LSIG

N/AFUSE CAT. NO.

800 AMP 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/AAcceptable

Description

N/A

C & L

N/AOPERATING MECHANISM Cleaned

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 IN

10 7 10

.2

1 OUT

.9

4 IN

1 IN

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: 600RATING PLUG:800 800

Overcurrent Settings

CT / SENSOR RATINGS:

1 OUT 4 IN

.4.2

AS FOUND

RANGE

MINIMUM MAXIMUM

NT

4,188

1.982

0.542

NT

1.982

0.542

NT

1.982

0.542

NT

1.982

0.542

NT

1.982

0.542

NT

1.982

0.542

4,182

2,988 1.6 2.6

328 0.5 0.6

POLE 3

AS FOUNDAS FOUND AS LEFT AS LEFT

1.03 8.935 8.935 8.935 8.935 8.935

NT NT NT

CURRENT

MULTIPLE

TEST

AMPERES

sec 15 sec

LONG TIME PICKUP

LONG TIME DELAY

MILLIVOLT DROP

8.935

SHORT TIME PICKUP

SHORT TIME DELAY 4.98

INSTANTANEOUS PICKUP

INSTANTANEOUS DELAY 6.97

GROUND FAULT PICKUP

GROUND FAULT DELAY 0.41

sec sec sec sec sec sec

AS LEFT

540 A A660

A A

AA

A A

2,700 3,300

4,6203,780

288 352

POLE 1

FUNCTION

POLE 2TEST RESULTS BY SECONDARY INJECTION

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: is ground fault delay setting 1 OUT or 2 OUT . The breaker was set to 2 OUT but the test report said 1 OUT.

TRIP UNIT TYPE

N/A

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 77 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

04/22/2021 48

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BUS DUCT B

David Gordon

3285,3208

VA Hospital WO-08391081

N/A

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTION

ONME

65K

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. MEF436LSIG

N/AFUSE CAT. NO.

400 AMP 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/AAcceptable

Description

N/A

C & L

N/AOPERATING MECHANISM Cleaned

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

2 IN

8 7 8

.2

1 IN

.9

4 IN

2 IN

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: 400RATING PLUG:400 400

Overcurrent Settings

CT / SENSOR RATINGS:

1 IN 4 IN

.4.2

AS FOUND

RANGE

MINIMUM MAXIMUM

NT

2,788

1.982

0.54

NT

1.982

0.54

NT

1.982

0.54

NT

1.982

0.54

NT

1.982

0.54

NT

1.982

0.54

2,792

1,984 1.6 2.6

164 0.5 0.6

POLE 3

AS FOUNDAS FOUND AS LEFT AS LEFT

1.03 8.945 8.945 8.945 8.945 8.945

NT NT NT

CURRENT

MULTIPLE

TEST

AMPERES

sec 15 sec

LONG TIME PICKUP

LONG TIME DELAY

MILLIVOLT DROP

8.945

SHORT TIME PICKUP

SHORT TIME DELAY 4.96

INSTANTANEOUS PICKUP

INSTANTANEOUS DELAY 6.98

GROUND FAULT PICKUP

GROUND FAULT DELAY 0.41

sec sec sec sec sec sec

AS LEFT

360 A A440

A A

AA

A A

1,600 2,400

3,0802,520

144 176

POLE 1

FUNCTION

POLE 2TEST RESULTS BY SECONDARY INJECTION

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.

TRIP UNIT TYPE

N/A

BKR INT. RATING

MOUNTING

LOW VOLTAGE POWER CIRCUIT BREAKER

TEMPERATURE 171 °F

PAGE

END USER

CUSTOMER

2002 HOLCOMBE BLVD.

DEPARTMENT OF VETERAN AFFAIRS

SITE LOCATION

USS-2DESIGNATION

SUBSTATION BUILDING 100

04/22/21 40

JOB #

DBID

END USER ASSET/ID

HUMIDITYDATE

TESTED BYELEMENT

SUB-ELEMENT

DEVICE

EQUIPMENT USED

BUS DUCT C

David Gordon

3285,3208

VA Hospital WO-08391081

1200 AMP

N/A

N/A N/A

MATCHES DWG OR SPEC

GROUND CONNECTION

ONNE

100KA

MANUFACTURER

FUSE MFR.

BKR CATALOG NO. NEF1236LSIG

N/AFUSE CAT. NO.

1200 AMP 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

Acceptable

N/A

N/A

N/A

N/A

ARC CHUTES

SECONDARY DISCONNECT

CONDITIONDescription CLEAN/LUBE

N/AAcceptable

Description

N/A

Cleaned

N/AOPERATING MECHANISM Cleaned

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 IN

6 7 6

.2

1 IN

.9

4 IN

1 IN

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 IN 1 IN

.4.2

AS FOUND

RANGE

MINIMUM MAXIMUM

NT

6,950

1.984

0.544

NT

1.984

0.544

NT

1.984

0.544

NT

1.984

0.544

NT

1.984

0.544

NT

1.984

0.544

6,950

4,950 1.6 2.8

512 0.5 0.6

POLE 3

AS FOUNDAS FOUND AS LEFT AS LEFT

1.01 8.93 8.93 8.93 8.93 8.93

NT NT NT

CURRENT

MULTIPLE

TEST

AMPERES

sec 12.5 sec

LONG TIME PICKUP

LONG TIME DELAY

MILLIVOLT DROP

1,010

1,020

8.93

SHORT TIME PICKUP

SHORT TIME DELAY 4.95

INSTANTANEOUS PICKUP

INSTANTANEOUS DELAY 6.95

GROUND FAULT PICKUP

GROUND FAULT DELAY 0.41

sec sec sec sec sec sec

AS LEFT

990 A A1,100

A A

AA

A A

4,500 5,500

7,7006,300

432 528

POLE 1

FUNCTION

POLE 2TEST RESULTS BY SECONDARY INJECTION

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.