Title Page
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Client / Site
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Conducted on
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Location
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Personnel
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The customer MCC Number
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What is the current rating of the breaker?
- 800
- 1200
- 1600
- 2000
- 2500
- 3200
- 4000
- 5000
- 6000
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How many poles is the breaker?
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Breaker Serial number.
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Existing OCR serial Number
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Pictures of the breaker as received.
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Does the breaker needs contacts cleaning or replacement?
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Value before cleaning.
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Value after cleaning.
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Motor to be fitted?
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LRC Voltage?
- 24VDC
- 48VDC
- 110VDC
- 240VDC
- 415VDC
- 24VAC
- 48VAC
- 110VAC
- 240VAC
- 415VAC
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Motor Voltage
- 24VDC
- 48VDC
- 110VDC
- 240VDC
- 415VDC
- 24VAC
- 48VAC
- 110VAC
- 240VAC
- 415VAC
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Shunt to be fitted?
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Shunt voltage?
- 24VDC
- 48VDC
- 110VDC
- 240VDC
- 415VDC
- 24VAC
- 48VAC
- 110VAC
- 240VAC
- 415VAC
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OCR to be fitted?
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New OCR serial number.
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Type of OCR
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OCR Voltage
- 24VDC
- 48VDC
- 110VDC
- 240VDC
- 415VDC
- 24VAC
- 48VAC
- 110VAC
- 240VAC
- 415VAC
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Supply Carriage parts?
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Take a picture of the supplied ARR
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Pictures of the complete breaker from all sides.
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General observations.
