Amendment 0002 - Attachment 2 - VA Fresno Completed Final Report.pdf

SHUTDOWN REPORT

Prepared For:

VA Central California Health Care System

2615 E Clinton Ave Fresno, CA 93703

Prepared By:

Veteran Electrical Power Systems

8837 Lankershim Blvd Los Angeles, CA 91352

Office: (818) 861-7610

VETERAN ELECTRICAL POWER SYSTEMS 8837 LANKERSHIM BLVD LOS ANGELES, CA 91352 (818) 861-7610

Table of Content

Work Summary…………………………………………….. Page 2-12

ATS Test………………………………………………………..Page 13-17

Transformer Test…..……….…………………………... Page 18-39

Circuit Breaker Test.…………………………………….. Page 40

Job#: 22575 September 26, 2023

Summary Report ATTN: VA Central California Health Care System

At the request of the VA Central California Health Care System, Veteran Electrical Power Systems performed electrical maintenance, testing and inspection at 2615 E Clinton Ave.

1.0 Purpose

1.1 The purpose of maintenance testing is to ensure that electrical equipment and components are safe and operational within their original design and manufacturers specifications.

Comprehensive testing allows your company to safely identify defective or severely aged equipment prior to electrical failure. When necessary, repairs may be scheduled, thus avoiding costly and unexpected interruptions to normal production

2.0 Equipment Listed:

Automatic Transfer Switches

Equipment Identification Location Make _ ATS-1 1B09/Bldg. 27 Cummins ATS-A Main Elec. Rm/ Bldg. OPC Square D ATS-B Main Elec. Rm/ Bldg. OPC Square D ATS-C Main Elec. Rm/ Bldg. OPC Square D ATS-D Main Elec. Rm/ Bldg. OPC Square D

Transformer List

T-6 Chiller Yard/ Bldg. 2 Standard T-11 Outside/Bldg. CLC Square D T-1 Main Elec. Rm/Bldg. 34 GE T-8 Bldg. 25 Standard NX Main Central Plant/ Bldg. 24 GE T-9 Outside/Bldg. 24 Standard XFMR 75KVA 3A19 Elec. Rm/Bldg. 24 Square D XFMR 112.5KVA 3A19 Elec. Rm/Bldg. 24 Square D T-1 2A21 Elec. Rm/Bldg. 24 Square D T-1 Basement/Elev. Rm/Bldg. 24 Square D XFMR 300KVA Bldg. 22 GE

Circuit Breakers

Equipment Identification Location Make _

N-E-1E 1st FL Hallway/Bldg. 1 GE N-E-1F 1st FL Hallway/Bldg. 1 GE N-E-1C 1st FL Pharmacy/Bldg. 1 GE N-W-1D 1st FL Pharmacy/Bldg. 1 Square D NUC-MED 2nd FL/Bldg. 1 Square D P3 P6 2nd FL/Bldg. 1 Square D PNL BA 2nd FL/Bldg. 1 Square D PNL BCP 2nd FL/Bldg. 1 GE PNL LP 2nd FL/Bldg. 1 GE PNL D Feeder 2nd FL/Bldg. 1 GE PNL PLI 2nd FL/Bldg. 1 GE PNL Z Feeder 2nd FL/Bldg. 1 GE PNL Z Main 2nd FL/Bldg. 1 Square D PNL Z MRI 2nd FL/Bldg. 1 Square D Cannon CT 2A18 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D MRI Water Chiller 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D PNL P Main 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D PNL P Spare 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D PNL Z Spare 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D Radiology 1 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D Radiology 2 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D Radiology 3 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D Radiology 4 (Spare) 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D Special Procedure Toshiba E212 2nd FL 2A07A Elec. Rm. /Bldg. 1 Square D N-E-4E 4th FL 4A27 Hallway /Bldg. 1 GE N-EQ-4C Main 4th FL 4B08 Mech. Rm. /Bldg. 1 Siemens N-W-4B Main 4th FL 4B31/Bldg. 1 GE N-E-4F 4th FL Stair 1/Bldg. 1 GE N-C-4C 4th FL Stair 2/Bldg. 1 GE N-E-5E 5th FL Nurse St. Hallway/Bldg. 1 GE N-E-5F 5th FL Stair 1/Bldg. 1 GE ATS-1 (EDP) Basement/Bldg. 1 GE ATS-2 (EDP) Basement/Bldg. 1 GE ATS-3 (EDP) Basement/Bldg. 1 GE ATS-4 (EDP) Basement/Bldg. 1 GE EDP Main Basement/Bldg. 1 GE Riser C Basement/Bldg. 1 GE XRDP Basement/Bldg. 1 GE 1A/2A Basement 1B1B6A Hlwy/Bldg. 1 GE 1B/2B/3B Basement 1B1B6A Hlwy/Bldg. 1 GE 3A/4A Basement 1B1B6A Hlwy/Bldg. 1 GE 4B/5B Basement 1B1B6A Hlwy/Bldg. 1 GE BB Basement 1B1B6A Hlwy/Bldg. 1 GE LL Basement 1B1B6A Hlwy/Bldg. 1 GE PNL Riser A+B Spare Basement 1B1B6A Hlwy/Bldg. 1 GE

1D/2D Basement Kit-A/Bldg. 1 GE 2DA Basement Kit-A/Bldg. 1 GE 3B/4D/5D Basement Kit-A/Bldg. 1 GE 6B/7B Basement Kit-A/Bldg. 1 GE BD1 Basement Kit-A/Bldg. 1 GE N-C-BD1 Main Basement Kit-A/Bldg. 1 Square D PNL BD Basement Kit-A/Bldg. 1 GE 1E/2E Basement Kitchen/Bldg. 1 GE 1F/2F/3F Basement Kitchen/Bldg. 1 GE 3E/4E Basement Kitchen/Bldg. 1 GE 4F/5F/6D/7D Basement Kitchen/Bldg. 1 GE 5E/6C/7C Basement Kitchen/Bldg. 1 GE N-E-BE1 Main Basement Kitchen/Bldg. 1 GE N-E-K Basement Kitchen/Bldg. 1 Westinghouse PNL BE Basement Kitchen/Bldg. 1 GE PNL BR Basement Kitchen/Bldg. 1 GE PNL FC Basement Kitchen/Bldg. 1 GE PNL N-E-FC Main Basement Kitchen/Bldg. 1 Westinghouse Riser E+F-R Spare Basement Kitchen/Bldg. 1 GE N-W-LP (Washer Disc. BKR) Basement Laundry Rm. /Bldg. 1 GE 1C/2C/3C/4C Basement Stair 2/Bldg. 1 GE 5C/6A/7A Basement Stair 2/Bldg. 1 GE B-C Basement Stair 2/Bldg. 1 GE NCCS Basement Stair 2/Bldg. 1 GE WHB-B Basement Stair 2/Bldg. 1 Westinghouse N-W-1A Cafeteria/Bldg. 1 GE EBAC-ATS EDP1/Bldg. 1 GE EDPA EDP1/Bldg. 1 GE PNL 1X EDP1/Bldg. 1 GE PNL 1Y EDP1/Bldg. 1 GE PNL 1YY EDP1/Bldg. 1 GE PNL 2YY EDP1/Bldg. 1 GE PNL 4X EDP1/Bldg. 1 GE PNL 5Y EDP1/Bldg. 1 GE PNL 5Z EDP1/Bldg. 1 GE PNL 6Y EDP1/Bldg. 1 GE PNL DL EDP1/Bldg. 1 GE PNL SP EDP1/Bldg. 1 GE PNL E1 EDP2/Bldg. 1 GE PNL LSBE/LSIE EDP2/Bldg. 1 GE PNL LSBW/LSIW EDP2/Bldg. 1 GE PNL PX EDP2/Bldg. 1 GE PNL TE EDP2/Bldg. 1 GE PNL TR EDP2/Bldg. 1 GE UPS EDP2/Bldg. 1 GE E-E-3W EDP3/Bldg. 1 GE Gen Compound EDP3/Bldg. 1 GE PNL EBAC EDP3/Bldg. 1 GE

PNL RF EDP3/Bldg. 1 GE PNL Vault EDP3/Bldg. 1 GE SURG MCC EDP3/Bldg. 1 GE BE1 MSS-A/Bldg. 1 GE EDP3 MSS-A/Bldg. 1 GE Elevator MSS-A/Bldg. 1 GE Elevator S3 MSS-A/Bldg. 1 Square D Riser E+F MSS-A/Bldg. 1 GE ATS-1 MSS-B/Bldg. 1 GE ATS-2 MSS-B/Bldg. 1 GE Chiller Panel MSS-B/Bldg. 1 GE N-EQ-4C MSS-B/Bldg. 1 Eaton NDP1 MSS-B/Bldg. 1 GE NDP3 MSS-B/Bldg. 1 GE PNL DHA MSS-B/Bldg. 1 GE PNL K1 K2 MSS-B/Bldg. 1 GE PNL KH MSS-B/Bldg. 1 GE PNL NPA MSS-B/Bldg. 1 GE Riser A+B MSS-B/Bldg. 1 GE Riser D MSS-B/Bldg. 1 GE Solar Output MSS-B/Bldg. 1 Eaton Temp Dehumidifier MSS-B/Bldg. 1 Cutler Hammer Elevator P1 Roof/Elevator Rm/Bldg. 1 Square D Elevator P2 Roof/Elevator Rm/Bldg. 1 Square D Elevator S3 Roof/Elevator Rm/Bldg. 1 Square D Elevator S4 Roof/Elevator Rm/Bldg. 1 Square D PNL 1EM Roof/Elevator Rm/Bldg. 1 Square D ATS-2B 250A Boiler Plant/Bldg. 2 ITE ATS-2B 600A Boiler Plant/Bldg. 2 ITE Deep Well Boiler Plant/Bldg. 2 ITE Emergency Main Boiler Plant/Bldg. 2 ITE Fire Pump Disc Boiler Plant/Bldg. 2 ITE LVDP Boiler Plant/Bldg. 2 ITE LVDP Main Boiler Plant/Bldg. 2 Eaton LVDP Spare Boiler Plant/Bldg. 2 Eaton MCC 1-2A Boiler Plant/Bldg. 2 ITE MCC 2 Boiler Plant/Bldg. 2 ITE SWBD 1-2 Main Boiler Plant/Bldg. 2 ITE

SWBD EDP2 Main Boiler Plant/Bldg. 2 Eaton XFMR T6 Main Disc Chiller Yard/Bldg. 2 ITE EDP4 ATS-22 Street side/Bldg. 2 Eaton EDP4 Main Street side/Bldg. 2 Eaton EDP4 ATS-31 Street side/Bldg. 2 Eaton L1 Main Breaker 1A-7 Workshop/Bldg. 24 Square D

L1 PNL P1 100A 1A-7 Workshop/Bldg. 24 Square D P1 Main Breaker 1A-7 Workshop/Bldg. 24 Square D DP Main Dist. SW 1st FL Elec. Rm/Bldg. 24 Square D MDP Main Breaker 1st FL Elec. Rm/Bldg. 24 Square D

DP Panel Main Breaker 2nd FL Elec. Rm/Bldg. 24 Square D ISO XFMR Main 3A19 Elec. Rm/Bldg. 24 Square D Panel L3 Main 3A19 Elec. Rm/Bldg. 24 Square D Panel P3 Main 3A19 Elec. Rm/Bldg. 24 Square D S. Penthouse Main 3A19 Elec. Rm/Bldg. 24 Square D T-3 Main 3A19 Elec. Rm/Bldg. 24 Square D Panel P3B-3 Main 3A19 Elec. Rm/Bldg. 24 Square D LB Main Breaker Bsmnt/Elev. Machine Rm/Bldg. 24 Square D LE1 Main Breaker 1X01 Main Elec. Rm/Bldg. 25 Eaton MSB Elev. Control 1X01 Main Elec. Rm/Bldg. 25 Eaton MSB Main Breaker 1X01 Main Elec. Rm/Bldg. 25 Eaton CB-EDP-02 Main Grounds/Bldg. 25 Eaton EDP-02 Main Grounds/Bldg. 25 Eaton T-BEMD Grounds/Bldg. 25 Eaton T-BSB Grounds/Bldg. 25 Eaton T-EDP4 Grounds/Bldg. 25 Eaton A1 AHU1 1st FL Elec. Rm/Bldg. 34 GE A1 Main Breaker 1st FL Elec. Rm/Bldg. 34 GE B1 Main Breaker 1st FL Elec. Rm/Bldg. 34 GE B1 Panel B1-1 1st FL Elec. Rm/Bldg. 34 GE B1-1 Main Breaker 1st FL Elec. Rm/Bldg. 34 GE MSB Elevator 1st FL Elec. Rm/Bldg. 34 GE MSB Main 1st FL Elec. Rm/Bldg. 34 GE MSB Panel A1 Breaker 1st FL Elec. Rm/Bldg. 34 GE MSB Panel A2 Breaker 1st FL Elec. Rm/Bldg. 34 GE MSB Spare 1st FL Elec. Rm/Bldg. 34 GE MSB XFMR T1 1st FL Elec. Rm/Bldg. 34 GE A2 Main Breaker 2nd FL Elec. Rm/Bldg. 34 GE A2 XFMR T2 2nd FL Elec. Rm/Bldg. 34 GE B2 Main Breaker 2nd FL Elec. Rm/Bldg. 34 GE B2 Panel B2-1 2nd FL Elec. Rm/Bldg. 34 GE B2 Main Breaker 2nd FL Elec. Rm/Bldg. 34 GE B2-1 Main Breaker 2nd FL Elec. Rm/Bldg. 34 GE JC-1 Panel E Elec. Rm/Bldg. LC2 Square D JC-1 Panel G Elec. Rm/Bldg. LC2 Square D JC-1 Panel H Elec. Rm/Bldg. LC2 Square D JC-1 Panel I Elec. Rm/Bldg. LC2 Square D TB2 Panel A Elec. Rm/Bldg. LC2 Square D TB2 Panel B Elec. Rm/Bldg. LC2 Square D TB2 Panel C Elec. Rm/Bldg. LC2 Square D TB2 Panel D Elec. Rm/Bldg. LC2 Square D Panel A Main Outside/Bldg. LC2 Siemens Panel B Main Outside/Bldg. LC2 Siemens Panel C Main Outside/Bldg. LC2 Siemens Panel D Main Outside/Bldg. LC2 Siemens Panel E Main Outside/Bldg. LC2 Siemens Panel F Main Outside/Bldg. LC2 Siemens Panel G Main Outside/Bldg. LC2 Siemens

Equipment Identification Location Make Panel H Main Outside/Bldg. LC2 Siemens JC1 Main Disc Trailer/Bldg. LC2 Square D TB2 Main Disc Trailer/Bldg. LC2 Square D 2NLDP 2NLB 2C15E/Bldg. OPC Square D 2NLDP 2NLC 2C15E/Bldg. OPC Square D 2NLDP 2NLD 2C15E/Bldg. OPC Square D 2NLDP 2SL 2C15E/Bldg. OPC Square D 2NLDP 3NLA 2C15E/Bldg. OPC Square D 2NLDP 3NLB 2C15E/Bldg. OPC Square D 2NLDP Main Breaker 2C15E/Bldg. OPC Square D 1-BPH Main Basement/Bldg. OPC Square D 1-BPH MCC2 Basement/Bldg. OPC Square D BECD Main Disc Basement/Bldg. OPC Square D BECD PNL 2ECLA+3E Basement/Bldg. OPC Square D BECD PNL 3ECLA Basement/Bldg. OPC Square D BECD PNL BE-2 Basement/Bldg. OPC Square D BECD PNL BE-3 Basement/Bldg. OPC Square D BECD Unknown Basement/Bldg. OPC Square D MSB Main Basement/Bldg. OPC Westinghouse MSB Panel 2NLP Basement/Bldg. OPC Westinghouse T-BEMD ATS A Basement/Bldg. OPC Square D T-BEMD ATS B Basement/Bldg. OPC Square D T-BEMD ATS C Basement/Bldg. OPC Square D T-BEMD Main Basement/Bldg. OPC Square D T-BEMD Spare Basement/Bldg. OPC Square D ECBB MCC-3 SO-G14A Mech. Rm/Bldg. OPC Square D

Location (OPC) SWBD ID V A Make

B1C17A 1BPH PNL BESD 480 225 SQUARE D

B1C17A 1BPH 2NHA/3NHA 480 125 SQUARE D

B1C17A 1BPH MCCB-N 480 100 SQUARE D

B1C17A 1BPH ATS-D 480 150 SQUARE D

B1C17A 1BPH ATS-B 480 150 SQUARE D

B1C17A 1BPH ATS-A 480 225 SQUARE D

B1C17A 1BPH MCC-2 480 400 SQUARE D

B1C17A 1BPH ATS-C 480 225 SQUARE D

B1C17A 1BPH SOLAR OUTPUT 480 150 SQUARE D

B1C17A MS-B DA 480 225 WESTING

B1C17A MS-B 1-B 480 150 WESTING

B1C17A MS-B 1A 480 100 WESTING

B1C17A MS-B SPARE 480 200 WESTING

B1C17A MS-B MCC1 480 150 WESTING

B1C17A BEMD ATS A 480 225 SQUARE D

B1C17A BEMD ATS C 480 175 SQUARE D

B1C17A BEMD ATS B 480 150 SQUARE D

ED RAMP CHILLER PNL CH1 208 175 SQUARE D

ED RAMP CHILLER PNL CH2 208 175 SQUARE D

ED RAMP CHILLER PNL CH3 208 175 SQUARE D

ED RAMP CHILLER PNL SPARE 208 200 SQUARE D

ED RAMP CHILLER PNL SHELTER 208 100 SQUARE D

B1C17A MRI TRAILER 480 200 SQUARE D

2C15E 2NLDP 3NLB 208 150 SQUARE D

2C15E 2NLDP 3NLA 208 150 SQUARE D

2C15E 2NLDP 2NLA 208 100 SQUARE D

2C15E 2NLDP 2NLC 208 150 SQUARE D

2C15E 2NLDP 2NLD 208 100 SQUARE D

2C15E 2NLDP 2SL 208 200 SQUARE D

2C15E 2NLDP 2NLB 208 150 SQUARE D

B1C17A 1BPH MAIN 480 1200 SQUARE D

B1C17A MS-B MAIN 480 1600 WESTING

B1C17A MS-B NLDP-2NLDP 480 600 WESTING

B1C17A MS-B XMAS TREE PNL 480 400 WESTING

B1C17A BEMD MAINS 480 450 SQUARE D

B1C17A BECD MAINS 480 400 SQUARE D

2C15E 2NLDP MAIN 208

ED RAM CH PNL MAIN 208 800 SQUARE D

3.0 Inspection and Test Procedures

The contractor performed the following visual and mechanical inspections on the Circuit Breaker:

• Compare equipment nameplate data with drawings and specifications.

• Inspect physical and mechanical condition.

• Inspect anchorage and alignment.

• Verify the unit is clean.

• Operate the circuit breaker to insure smooth operation.

• Inspect bolted electrical connections for high resistance using one or more of the following methods:

o Verify tightness of accessible bolted electrical connections by calibrated torque-wrench method in accordance with manufacturer’s published data.

• Inspect operating mechanism, contacts, and arc chutes in unsealed units.

• Perform adjustments for final protective device settings in accordance with the coordination study.

The contractor performed the following electrical tests on Circuit Breaker:

• Measure the system neutral-to-ground insulation resistance with the neutral disconnect link temporarily removed. Replace neutral disconnect link after testing.

• Perform ground fault protective device pickup tests using primary current injection.

• For summation type systems utilizing phase and neutral current transformers, verify correct polarities by applying current to each phase-neutral current transformer pair.

This test also applies to molded-case breakers utilizing an external neutral current transformer.

• Measure time delay of the ground fault protective device at a value equal to or greater than 150 percent of the pickup value.

• Verify that reduced control voltage tripping capability is 55 percent for ac systems and 80 percent for dc systems.

The contractor performed the following visual and mechanical inspections on the Automatic Transfer Switches

• Inspect physical and mechanical condition.

• Inspect anchorage, alignment, grounding, and required clearances.

• Prior to cleaning the unit, perform as-found tests.

• Clean the unit.

• Use appropriate lubrication on moving current-carrying parts and on moving and sliding surfaces.

• Verify that manual transfer warnings are attached and visible.

• Verify tightness of all control connections.

The contractor performed the following electrical tests on the Automatic Transfer Switches

• Perform resistance measurements through bolted connections with a low-resistance ohmmeter, if applicable, in accordance with Section 7.22.3.1.

• Perform insulation resistance tests on all control wiring with respect to ground. The applied potential shall be 500 volts dc for 300-volt rated cable and 1000 volts dc for 600-volt rated cable. Test duration shall be one minute. For units with solid-state components or for control devices that cannot tolerate the applied voltage, follow manufacturer’s recommendation.

• Perform a contact/pole-resistance test.

• Verify settings and operation of control devices.

• Calibrate and set all relays and timers in accordance with Section 7.9.

• Perform automatic transfer tests:

o Simulate loss of normal power.

o Return to normal power.

o Simulate loss of emergency power.

o Simulate all forms of single-phase conditions.

• Verify correct operation and timing of the following functions:

o Normal source voltage-sensing relays.

o Engine start sequence.

o Time delay upon transfer.

o Alternate source voltage-sensing relays.

o Automatic transfer operation.

o Interlocks and limit switch function.

o Time delay and retransfer upon normal power restoration.

o Engine cool down and shutdown feature

Transformers, Dry Type, Air-Cooled, Large

NOTE: This category consists of power transformers with windings rated higher than 600 volts and low-voltage transformers larger than 167 kVA single-phase or 500 kVA three-phase.

Visual and Mechanical Inspection

Inspect physical and mechanical condition including evidence of moisture and corona.

Inspect anchorage, alignment, and grounding.

Prior to cleaning the unit, perform as-found tests, if required.

Clean the unit.

Verify that cooling fans operate correctly.

Inspect bolted electrical connections for high resistance using one or more of the following methods:

o Verify tightness of accessible bolted electrical connections by calibrated torque-wrench method in accordance with manufacturer’s published data.

Perform specific inspections and mechanical tests as recommended by the manufacturer.

Perform as-left tests.

Verify that as-left tap connections are as specified.

Verify the presence of surge arresters.

Electrical Tests

Perform insulation-resistance tests winding-to-winding and each winding-to-ground. Apply voltage in accordance with manufacturer’s published data.

Perform insulation power-factor or dissipation-factor tests on all windings in accordance with the test equipment manufacturer’s published data.

Perform turns-ratio tests at the designated tap position.

Perform an excitation-current test on each phase.

Measure core insulation resistance at 500 volts dc if the core is insulated and if the core ground strap is removable.

Verify correct secondary voltage phase-to-phase and phase-to-neutral after energization and prior to loading.

Transformers, Liquid-Filled

Visual and Mechanical Inspection

Inspect physical and mechanical condition.

Inspect anchorage, alignment, and grounding.

Verify the presence of PCB labeling.

Prior to cleaning the unit, perform as-found tests, if required.

Clean bushings and control cabinets.

Verify that cooling fans and/or pumps operate correctly.

Inspect bolted electrical connections for high resistance using one or more of the following methods:

o Verify tightness of accessible bolted electrical connections by calibrated torque-wrench method in accordance with manufacturer’s published data.

Verify correct liquid level in tanks and bushings.

Verify that positive pressure is maintained on gas-blanketed transformers.

Perform inspections and mechanical tests as recommended by the manufacturer.

Verify the presence of transformer surge arresters.

Perform as-left tests.

Verify de-energized tap-changer position is left as specified.

B. Electrical Tests

Perform insulation-resistance tests, winding-to-winding and each winding-to-ground. Apply voltage in accordance with manufacturer’s published data. In the absence of manufacturer’s published data, use Table 100.5. Calculate polarization index.

Perform turns-ratio tests at the designated tap position.

Perform insulation power-factor or dissipation-factor tests on all windings in accordance with test equipment manufacturer’s published data.

Perform power-factor or dissipation-factor tests on each bushing equipped with a power-factor/ capacitance tap. In the absence of a power-factor/ capacitance tap, perform hot-collar tests.

These tests shall be in accordance with the test equipment manufacturer’s published data.

Perform excitation-current tests in accordance with the test equipment manufacturer’s published data.

Measure the resistance of each winding at the designated tap position.

Remove a sample of insulating liquid in accordance with ASTM D 923. The sample shall be tested for the following.

o Dielectric breakdown voltage: ASTM D 877 and/or ASTM D 1816 o Acid neutralization number: ANSI/ASTM D 974 o Specific gravity: ANSI/ASTM D 1298 o Interfacial tension: ANSI/ASTM D 971 or ANSI/ASTM D 2285 o Color: ANSI/ASTM D 1500 o Visual Condition: ASTM D 1524

Test the instrument transformers in accordance with Section 7.10.

Test the surge arresters in accordance with Section 7.19.

4.0 Findings and Recommendations

Automatic Transfer Switches are suitable for continued use.

Transformers are suitable for continued use.

Circuit breaker is suitable for continued use.

o It is recommended that breakers be tested every three years.

2nd floor circuit breaker NUC-MED is not suitable for continued use, contact resistance test failed to meet requirements.

o Recommend observing circuit breaker for any further anomalies.

2nd floor circuit breaker PNL Z Main is not suitable for continued use, contact resistance test failed to meet requirements.

o Recommend observing circuit breaker for any further anomalies.

2nd floor 2A07A Electrical Room circuit breaker Radiology 4 (Spare) B phase is missing lug bolt.

o Recommend installing lug bolt for B phase for future use of circuit breaker.

Basement circuit breaker EDP Main is not suitable for continued use, contact resistance test failed to meet requirements.

o Recommend observing circuit breaker for any further anomalies.

EDP1 circuit breaker EBAC-ATS rating plug read as 125A but LO indications the plug should read

225A.

o Recommend checking and labeling rating plug accordingly.

EDP2 circuit breaker UPS is not suitable for continued use, contact resistance failed to meet requirements.

o Recommend observing circuit breaker for any further anomalies.

MSS-B circuit breaker NDP3 is not suitable for continued use, short time pick up failed to meet requirements.

o Recommend replacing unit.

MSS-B circuit breaker Riser A+B is not suitable for continued use, short time pick up failed to meet requirements o Recommend replacing unit.

Roof/Elevator Room circuit breaker Elevator S3 A0 Lug is bad. Wire burnt due to loose connection. Our technicians replaced the lug and fixed the wire.

Thank you for the opportunity to service to your electrical needs.

Respectfully, Sergio Rangel President Veteran Electrical Power Systems, Inc.

Default AdministratorTESTED BY:

Form Schema 0, REVISED 4/18/2023COPYRIGHT © 2002-2023 POWERDB, INC. www.powerdb.com

Catalog #

Manufacturing

Wire Diag:

Amps:

Inst. Bk:

Serial #

Parts Bk.

Voltage:

Op. Coil:

Bul #

Time Range "Transfer to Emergency" ToFrom

Time Range "Retransfer to Normal" From To

Transfer Time to Emergency

TEST OPERATIONS

As Found As Left

Type:

Phase: 3

Power Generation

Retransfer Time to Normal As Found As Left

NORMAL EMERGENCY

A B CVoltage Drop in Millivolts:

B-N A-NC-NVoltage Readings: A-N

B-C A-BC-A B-CA-B

A B CAC BAmperage Readings:

Contacts:

Megger:

Cleaned:

Lubrication:

OK

N/A

Circuit Properly Tagged:

Bolted Connections:

Mechanical Operation:

Unusual Conditions:OK

OK

276.6

478.8

276.4

479.1

0 sec

0 sec

1800 sec

1800 sec

478.4

276.5

B C

-C

A

B

C-N

A

B-N

C-A

A BContact Resistance in Microhms: C- --

OK

OK

N/A

OKOK

Cummins

BTPCB-AU52U347

G15M850139

8837 Lankershim Blvd Los Angeles CA 91352 Office: (818) 861-7610 C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSAUTOMATIC TRANSFER SWITCH

PAGE

22575JOB #

DATE 2/28/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

84 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 27

1B09

ATS-1

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 41

Arc Chutes:

COMMENTS: ATS is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:1 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

Fluke1 1/1/2023 1/1/2023117 Other1

Catalog #

Manufacturing

Wire Diag:

Amps:

Inst. Bk:

Serial #

Parts Bk.

Voltage:

Op. Coil:

Bul #

Time Range "Transfer to Emergency" ToFrom

Time Range "Retransfer to Normal" From To

Transfer Time to Emergency

TEST OPERATIONS

As Found As Left

Type:

Phase: 3

Class 8902

Retransfer Time to Normal As Found As Left

NORMAL EMERGENCY

A B CVoltage Drop in Millivolts:

B-N A-NC-NVoltage Readings: A-N

B-C A-BC-A B-CA-B

A B CAC BAmperage Readings:

Contacts:

Megger:

Cleaned:

Lubrication:

OK

N/A

Circuit Properly Tagged:

Bolted Connections:

Mechanical Operation:

Unusual Conditions:OK

OK

271.5

471.1

0 sec

0 sec

1800 sec

1800 sec

247.4

478.6

276.2

474.2

B C

-C

A

B

C-N

A

B-N

C-A

A BContact Resistance in Microhms: C1808 16191501

OK

OK

N/A

OKOK

Square D

8902IG260-3-48

8837 Lankershim Blvd Los Angeles CA 91352 Office: (818) 861-7610 C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSAUTOMATIC TRANSFER SWITCH

PAGE

22575JOB #

DATE 3/21/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

84 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building OPC

Main Electrical Room

ATS-A

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 41

Arc Chutes:

COMMENTS: ATS is suitable for continued use.

DEFICIENCIES:

Catalog #

Manufacturing

Wire Diag:

Amps:

Inst. Bk:

Serial #

Parts Bk.

Voltage:

Op. Coil:

Bul #

Time Range "Transfer to Emergency" ToFrom

Time Range "Retransfer to Normal" From To

Transfer Time to Emergency

TEST OPERATIONS

As Found As Left

Type:

Phase: 3

Class 8902

Retransfer Time to Normal As Found As Left

NORMAL EMERGENCY

A B CVoltage Drop in Millivolts:

B-N A-NC-NVoltage Readings: A-N

B-C A-BC-A B-CA-B

A B CAC BAmperage Readings:

Contacts:

Megger:

Cleaned:

Lubrication:

OK

N/A

Circuit Properly Tagged:

Bolted Connections:

Mechanical Operation:

Unusual Conditions:OK

OK

271.9

471.7

0 sec

0 sec

1800 sec

1800 sec

274.6

479.1

276.1

474.2

B C

-C

A

B

C-N

A

B-N

C-A

A BContact Resistance in Microhms: C- --

OK

OK

N/A

OKOK

Square D

8902IG150

8837 Lankershim Blvd Los Angeles CA 91352 Office: (818) 861-7610 C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSAUTOMATIC TRANSFER SWITCH

PAGE

22575JOB #

DATE 3/21/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

84 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building OPC

Main Electrical Room

ATS-B

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 41

Arc Chutes:

COMMENTS: ATS is suitable for continued use.

DEFICIENCIES:

Catalog #

Manufacturing

Wire Diag:

Amps:

Inst. Bk:

Serial #

Parts Bk.

Voltage:

Op. Coil:

Bul #

Time Range "Transfer to Emergency" ToFrom

Time Range "Retransfer to Normal" From To

Transfer Time to Emergency

TEST OPERATIONS

As Found As Left

Type:

Phase: 3

Class 8902

Retransfer Time to Normal As Found As Left

NORMAL EMERGENCY

A B CVoltage Drop in Millivolts:

B-N A-NC-NVoltage Readings: A-N

B-C A-BC-A B-CA-B

A B CAC BAmperage Readings:

Contacts:

Megger:

Cleaned:

Lubrication:

OK

N/A

Circuit Properly Tagged:

Bolted Connections:

Mechanical Operation:

Unusual Conditions:OK

OK

276.5

471.6

0 sec

0 sec

1800 sec

1800 sec

274.6

479.2

276.3

474.3

B C

-C

A

B

C-N

A

B-N

C-A

A BContact Resistance in Microhms: C- --

OK

OK

N/A

OKOK

Square D

8902IG260

8837 Lankershim Blvd Los Angeles CA 91352 Office: (818) 861-7610 C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSAUTOMATIC TRANSFER SWITCH

PAGE

22575JOB #

DATE 3/21/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

84 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building OPC

Main Electrical Room

ATS-C

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 41

Arc Chutes:

COMMENTS: ATS is suitable for continued use.

DEFICIENCIES:

Catalog #

Manufacturing

Wire Diag:

Amps:

Inst. Bk:

Serial #

Parts Bk.

Voltage:

Op. Coil:

Bul #

Time Range "Transfer to Emergency" ToFrom

Time Range "Retransfer to Normal" From To

Transfer Time to Emergency

TEST OPERATIONS

As Found As Left

Type:

Phase: 3

Class 8902

Retransfer Time to Normal As Found As Left

NORMAL EMERGENCY

A B CVoltage Drop in Millivolts:

B-N A-NC-NVoltage Readings: A-N

B-C A-BC-A B-CA-B

A B CAC BAmperage Readings:

Contacts:

Megger:

Cleaned:

Lubrication:

OK

N/A

Circuit Properly Tagged:

Bolted Connections:

Mechanical Operation:

Unusual Conditions:OK

OK

272.3

472.2

0 sec

0 sec

1800 sec

1800 sec

279.2

479.5

276.1

475.4

B C

-C

A

B

C-N

A

B-N

C-A

A BContact Resistance in Microhms: C- --

OK

OK

N/A

OKOK

Square D

8901AG150-3-480

8837 Lankershim Blvd Los Angeles CA 91352 Office: (818) 861-7610 C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSAUTOMATIC TRANSFER SWITCH

PAGE

22575JOB #

DATE 3/21/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

84 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building OPC

Main Electrical Room

ATS-D

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 41

Arc Chutes:

COMMENTS: ATS is suitable for continued use.

DEFICIENCIES:

8837 Lankershim Blvd Los Angeles CA 91352

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

67 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

2A21 Electrical Room

T-1

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 34

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

4.0014

PHASE B

4.0001

PHASE C

4.0014

CALC

3.997

TRANSFORMER TURN RATIO TEST

TAP

3 3AL

Fixed

WINDING RESISTANCE TEST IN OHMS

/150 -

4.8 -

NAMEPLATE DATA

150T3HSERIAL NO.

Volts

Square D YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

SO

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.48

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X11.32T 813G 845G

ELECTRICAL TESTS

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

MEGGER2 12/7/2022 12/7/2023MIT515 Other101473840

MEGGER3 5/12/2023 5/12/2024MTO210 OtherMN6156

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

67 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

3A19 Electrical Room

XFMR 112.5KVA

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 34

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

4.0026

PHASE B

4.0028

PHASE C

4.0028

CALC

3.997

TRANSFORMER TURN RATIO TEST

TAP

3 3AL

WINDING RESISTANCE TEST IN OHMS

/113 95

5.5 -

NAMEPLATE DATA

112T3HEESERIAL NO.

Volts

Square D YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

SO

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.48

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X168.7G 54.6G 50.4G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

67 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

3A19 Electrical Room

XFMR 75KVA

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 34

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

4.0042

PHASE B

4.0042

PHASE C

4.0045

CALC

3.997

TRANSFORMER TURN RATIO TEST

TAP

3 3AL

WINDING RESISTANCE TEST IN OHMS

/75 95

5.5 -

NAMEPLATE DATA

75T3HEESERIAL NO.

Volts

Square D YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

SO

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.48

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X146.9G 39.8G 44.2G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

67 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

Basement/Elevator Machine Room

T-1

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 34

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

4.0

PHASE B

4.0

PHASE C

3.99

CALC

3.997

TRANSFORMER TURN RATIO TEST

TAP

3 3AL

WINDING RESISTANCE TEST IN OHMS

/45 -

4.6 -

NAMEPLATE DATA

SG3A0045KBSERIAL NO.

Volts

Hammond Power YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

SO

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.48

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X152.2G 48.0G 61.4G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

65 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 25

Building 25

XFMR T-8

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 33

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

100.03

PHASE B

100.04

PHASE C

100.04

CALC

TRANSFORMER TURN RATIO TEST

TAP

- -AL

3.183

3.197

3.182

.000512

.000521

.000521

C

WINDING RESISTANCE TEST IN OHMS

/300 95

5.7 263

NAMEPLATE DATA

3359284811SERIAL NO.

Volts

Howard Ind. YR MFR N/A

KVA

IMPEDANCE //OA

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Sealed

TAP SETTING

TAP VOLTAGES

Oil Filled

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

Mineral Oil

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X127.4G 18.8G 23.2G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

76 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 22

Buildng 22

XFMR 300KVA

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 29

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

45.044

PHASE B

45.030

PHASE C

45.036

CALC

44.997

TRANSFORMER TURN RATIO TEST

TAP

E-G E-GAL

0.2402

0.2409

0.2386

0.1819

0.1693

0.1593

E-G

WINDING RESISTANCE TEST IN OHMS

/300 -

5.93 -

NAMEPLATE DATA

SG3A0045KBSERIAL NO.

Volts

GE YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

VPI

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.48

DRY TYPE CONSERVATOR

WYE

12.47

0.277/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X1311G 302G 313G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

72 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 2

Chiller Yard

T-6

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 30

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

44.382

PHASE B

44.394

PHASE C

44.386

CALC

43.301

TRANSFORMER TURN RATIO TEST

TAP

- -AL

C

WINDING RESISTANCE TEST IN OHMS

/750 95

5.44 -

NAMEPLATE DATA

PJG-3002SERIAL NO.

Volts

Standard Transformer YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

S

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.48

DRY TYPE CONSERVATOR

WYE

0.277/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X14.26G 3.46G 3.91G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

72 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

Main Central Plant

NX

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 30

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

4.0016

PHASE B

4.0018

PHASE C

4.0018

CALC

3.997

TRANSFORMER TURN RATIO TEST

TAP

- -AL

WINDING RESISTANCE TEST IN OHMS

/45 -

4.5 -

NAMEPLATE DATA

9T83C9873SERIAL NO.

Volts

GE YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

QL

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.48

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X111G 10.6G 13.2G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

72 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 34

Main Electrical Room

T-1

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 30

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

4.0012

PHASE B

4.0012

PHASE C

4.0016

CALC

3.997

TRANSFORMER TURN RATIO TEST

TAP

- -AL

WINDING RESISTANCE TEST IN OHMS

/75 -

4.5 -

NAMEPLATE DATA

9T83C9874615SERIAL NO.

Volts

GE YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

QL

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.48

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X140.56G 36.46G 3

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

72 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building CLC

Outside

T-11

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 30

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

100.05

PHASE B

100.06

PHASE C

100.06

CALC

99.926

TRANSFORMER TURN RATIO TEST

TAP

- -AL

Fixed

WINDING RESISTANCE TEST IN OHMS

/75 -

5 -

NAMEPLATE DATA

N/ASERIAL NO.

Volts

Square D YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

N/A

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV 0.208

DRY TYPE CONSERVATOR

WYE

0.12/

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X15.37G 3.87G 5.37G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

22575JOB #

DATE 9/26/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

67 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

Outside

T-9

Incomplete

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 34

VISUAL AND MECHANICAL INSPECTION

INSPECT PHYSICAL AND MECHANICAL CONDITION

VERIFY FANS OPERATE

INSPECT ANCHORAGE, ALIGNMENT AND GROUNDING

INSPECTION REPORT

FAIL

FAIL

FAIL

PASS

PASS

PASS

INSPECTION REMARKS

Dusty/Cleaned

2,500 1,000 2,500

MINUTES

PRIMARY TO

GROUND

SECONDARY TO

GROUND

PRIMARY TO

SECONDARY

INSULATION RESISTANCE IN MEGOHMS

Test kV

1.00

PHASE A

44.998

PHASE B

44.990

PHASE C

44.988

CALC

44.997

TRANSFORMER TURN RATIO TEST

TAP

- -AL

1.155

1.157

1.152

950.5

1.910

1041.7

Fixed

WINDING RESISTANCE TEST IN OHMS

/0 -

0 -

NAMEPLATE DATA

-SERIAL NO.

Volts

Standard YR MFR N/A

KVA

IMPEDANCE //-

WINDING MATERIAL °CCOPPER

CLASSTYPECAPACITY

B.I.L. RATINGTEMPERATURE RISE

PRIMARY KV

TAP POSITION Free Breathing

TAP SETTING

TAP VOLTAGES

MANUFACTURER

INSULATING MEDIUM

TANK TYPE

SECONDARY KV

DRY TYPE CONSERVATOR

WYE

DELTA

GALLONS

WORKING TAP AF

H1-H2

H2-H3

H3-H1

X0-X2

X0-X3

X0-X17.48G 2.61G 6.69G

ELECTRICAL TESTS

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMS TRANSFORMER MAINTENANCE TEST

PAGE

56700, Form Schema 0, REVISED 10/6/2022COPYRIGHT © 2002-2022 POWERDB, INC. www.powerdb.com

COMMENTS: Transformer is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

RAYTECH1 5/12/2023 5/12/2024TR-MARK III Other321-165

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSBREAKER INSPECTION & TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

82 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

1A-7 Workshop

L1 Main Breaker

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 32

Default AdministratorTESTED BY:

16107, Form Schema 0, REVISED 8/1/2023COPYRIGHT © 2002-2023 POWERDB, INC. www.powerdb.com

AMPACITY0.600

BIL kV

LL LL-1565

kV kA

N/A

0.480

N/ASquare D SERIAL NUMBER

MANUFACTURER

TYPE

MAXIMUM VOLTAGE

INTERRUPTING CAPACITY

MODEL NO. DATE MANUFACTURED

kV

OPERATING VOLTAGE

SETTINGS

LONG TIME (PICK UP)

LONG TIME (DELAY)

SHORT TIME (PICK UP)

SHORT TIME (DELAY)

SHORT TIME I2T (ST I SQ T)

GROUND FAULT (DELAY)

GROUND FAULT I2T (GF I SQ T)

PHASE UNBALANCE (U/B) (PICK UP)

PHASE UNBALANCE (U/B) (DELAY)

GF QT (PICK UP)

I QT (PICK UP)

Fixed

100 100

Fixed

RATING PLUG

AS LEFTAS FOUND AS FOUND AS LEFT

GROUND FAULT (PICK UP)

THERMAL MEMORY- - - -INSTANTANEOUS PICK UP

THERMAL MAGNETIC (O/L)

VISUAL AND MECHANICAL INSPECTION

OK N/ACHECKLIST NOTES

OK

OK

OK

GENERAL PHYSICAL CONDITION OK

ARC CHUTES

TRIP MECHANISM

MECHANICAL OPERATION

CONTACT RESISTANCE (MICRO-OHMS)

811 AF / AL 811 AF / AL 827827 821 821AF / AL

PASSC PHASEA PHASE FAILB PHASE

CURRENT INJECTION

FAILPASS

TIME DELAY / CURRENTCURRENT

Secondary

CURRENT

Primary

TIME DELAY / CURRENT

FUNCTION

TEST

SETTINGS

1.0 PASS63s300LONG TIME

SHORT TIME -

INSTANTANEOUS -

GROUND FAULT -

>2200

>2200 >2200

>2200VDC

Closed ( Ph. - Ph. )

INSULATION RESISTANCE

Open ( Line - Load )

Gigaohms B-G

C-G

>2200

>2200

>2200

C-A

Closed ( Ph. - Gnd. )

A-BA-G

B-B'B-C

C-C'

>2200 A-A' >2200 1000@

PASS PASS

COMMENTS: Breaker is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

AVO1 9/5/2023 9/5/2024DDA-6000 Other121086-001

MEGGER2 4/10/2023 4/10/2024DLRO Other101433317

MEGGER3 5/12/2023 5/12/2024MIT515 Other101720062

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSBREAKER INSPECTION & TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

82 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

1A-7 Workshop

L1 Panel P1 100A

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 32

Default AdministratorTESTED BY:

16107, Form Schema 0, REVISED 8/1/2023COPYRIGHT © 2002-2023 POWERDB, INC. www.powerdb.com

AMPACITY0.600

BIL kV

FA FA26100AC

kV kA

N/A

0.480

N/ASquare D SERIAL NUMBER

MANUFACTURER

TYPE

MAXIMUM VOLTAGE

INTERRUPTING CAPACITY

MODEL NO. DATE MANUFACTURED

kV

OPERATING VOLTAGE

SETTINGS

LONG TIME (PICK UP)

LONG TIME (DELAY)

SHORT TIME (PICK UP)

SHORT TIME (DELAY)

SHORT TIME I2T (ST I SQ T)

GROUND FAULT (DELAY)

GROUND FAULT I2T (GF I SQ T)

PHASE UNBALANCE (U/B) (PICK UP)

PHASE UNBALANCE (U/B) (DELAY)

GF QT (PICK UP)

I QT (PICK UP)

Fixed

100 100

Fixed

RATING PLUG

AS LEFTAS FOUND AS FOUND AS LEFT

GROUND FAULT (PICK UP)

THERMAL MEMORY- - - -INSTANTANEOUS PICK UP

THERMAL MAGNETIC (O/L)

VISUAL AND MECHANICAL INSPECTION

OK N/ACHECKLIST NOTES

OK

OK

OK

GENERAL PHYSICAL CONDITION OK

ARC CHUTES

TRIP MECHANISM

MECHANICAL OPERATION

CONTACT RESISTANCE (MICRO-OHMS)

804 AF / AL 804 AF / AL 923923 874 874AF / AL

PASSC PHASEA PHASE FAILB PHASE

CURRENT INJECTION

FAILPASS

TIME DELAY / CURRENTCURRENT

Secondary

CURRENT

Primary

TIME DELAY / CURRENT

FUNCTION

TEST

SETTINGS

1.0 PASS45.6s300LONG TIME

SHORT TIME -

INSTANTANEOUS -

GROUND FAULT -

>2200

>2200 >2200

>2200VDC

Closed ( Ph. - Ph. )

INSULATION RESISTANCE

Open ( Line - Load )

Gigaohms B-G

C-G

>2200

>2200

>2200

C-A

Closed ( Ph. - Gnd. )

A-BA-G

B-B'B-C

C-C'

>2200 A-A' >2200 1000@

PASS PASS

COMMENTS: Breaker is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

AVO1 9/5/2023 9/5/2024DDA-6000 Other121086-001

C10 Lincense #987407

VETERAN ELECTRICAL POWER SYSTEMSBREAKER INSPECTION & TEST

PAGE

22575JOB #

DATE 3/1/2022

VA Central California Health Care System

2615 E Clinton Ave; Fresno CA USA 93703

VA Central California Health Care SystemOWNER

ADDRESS

CUSTOMER

82 °F

TEST STATUSSITE

SUBSTATION

EQUIPMENT %

Building 24

1A-7 Workshop

P1 Main Breaker

Pass

ASSET ID N/A

HUMIDITYAMBIENT TEMPERATURE 32

Default AdministratorTESTED BY:

16107, Form Schema 0, REVISED 8/1/2023COPYRIGHT © 2002-2023 POWERDB, INC. www.powerdb.com

AMPACITY0.600

BIL kV

LK LK-3023

kV kA

N/A

0.480

N/ASquare D SERIAL NUMBER

MANUFACTURER

TYPE

MAXIMUM VOLTAGE

INTERRUPTING CAPACITY

MODEL NO. DATE MANUFACTURED

kV

OPERATING VOLTAGE

SETTINGS

LONG TIME (PICK UP)

LONG TIME (DELAY)

SHORT TIME (PICK UP)

SHORT TIME (DELAY)

SHORT TIME I2T (ST I SQ T)

GROUND FAULT (DELAY)

GROUND FAULT I2T (GF I SQ T)

PHASE UNBALANCE (U/B) (PICK UP)

PHASE UNBALANCE (U/B) (DELAY)

GF QT (PICK UP)

I QT (PICK UP)

Fixed

150 150

Fixed

RATING PLUG

AS LEFTAS FOUND AS FOUND AS LEFT

GROUND FAULT (PICK UP)

THERMAL MEMORY- - - -INSTANTANEOUS PICK UP

THERMAL MAGNETIC (O/L)

VISUAL AND MECHANICAL INSPECTION

OK N/ACHECKLIST NOTES

OK

OK

OK

GENERAL PHYSICAL CONDITION OK

ARC CHUTES

TRIP MECHANISM

MECHANICAL OPERATION

CONTACT RESISTANCE (MICRO-OHMS)

517 AF / AL 517 AF / AL 478478 519 519AF / AL

PASSC PHASEA PHASE FAILB PHASE

CURRENT INJECTION

FAILPASS

TIME DELAY / CURRENTCURRENT

Secondary

CURRENT

Primary

TIME DELAY / CURRENT

FUNCTION

TEST

SETTINGS

1.0 PASS43.8s450LONG TIME

SHORT TIME -

INSTANTANEOUS -

GROUND FAULT -

>2200

>2200 >2200

>2200VDC

Closed ( Ph. - Ph. )

INSULATION RESISTANCE

Open ( Line - Load )

Gigaohms B-G

C-G

>2200

>2200

>2200

C-A

Closed ( Ph. - Gnd. )

A-BA-G

B-B'B-C

C-C'

>2200 A-A' >2200 1000@

PASS PASS

COMMENTS: Breaker is suitable for continued use.

DEFICIENCIES:

EQUIPMENT USED:3 Manufacturer# Calibration Date Calibration DueModel TypeSerial / ID Number

AVO1 9/5/2023…