A. General Site Information

General Site Information

  • How many Plant Rooms on Site

  • This Plan Room Name/Building No

  • 3. Does Motivair currently maintain the equipment - (if No - add detail)

  • 4. Who currenly maintains the compressed air

  • 5. Does the Customer have other sites - if "Yes" add detail below

  • 5.a. List Other Site Locations

  • 6. Is the customer interested in saving money on Energy and Service Costs

  • 7. Does the customer have a Written Scheme of Examination

B. Compressor 1 - Information

Compressor 1 Information

  • Compressor Type

  • Take a picture of the compressor

  • Location: Building No/Building Name

  • Manufacturer

  • Take a picture of the data plate

  • Model No

  • Serial No

  • Kw Rating

  • Pressure Rating

  • If High Pressure State Operating Pressure

  • Capcity (CFM etc)

  • Year of Manufacture

  • Running Hours

  • Next Service due

  • Are there any Faults with this compressor

  • What Oil is Used in this Compressor

  • Is there anything more Specific to this Compressor

  • List the Specific Detail here:

  • Take Picture of Compressor

C. Compressor 2 - Information

Compressor 2 Information

  • Compressor Type

  • Take a picture of the compressor

  • Location: Building No/Building Name

  • Manufacturer:

  • Take a picture of the data plate

  • Model No

  • Serial No

  • Kw Rating

  • Pressure Rating

  • Capacity (CFM)

  • Year of Manufacture

  • Running Hours

  • Next Service Due

  • Are there any Faults with this Compressor

  • What Oil is used in this Compressor

  • Is there anything more Specific to this Compressor

  • List the Specific Detail here:

  • Take Picture of Compressor

D. Compressor 3 - Information

Compressor 3 Information

  • Compressor Type

  • Take a picture of the compressor

  • Location: Building No/Building Name

  • Manufacturer

  • Take a picture of the data plate

  • Model

  • Serial No

  • Kw Rating

  • Pressure Rating

  • Capacity (CFM)

  • Year of Manufacturer

  • Running Hours

  • Next Service Due

  • Are there any FAULTS with this compressor

  • What Oil is used in this Compressor

  • Is there anything more specific to this Compressor

  • Add Specific Detail Here:

  • Take Picture of Compressor

E. Dryer 1 - Information

Dryer 1 Information

  • Dryer Type

  • Which compressor is this Dryer connected to

  • Manufacturer

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which Type of Refrigerant

  • Quantiy of Refrigerant

  • Port Size (inches)

F. Dryer 2 - Information

Dryer 2 - Information

  • Dryer Type

  • Which Compressor is the Dryer connected to

  • Manufacturer

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which type of Refrigerant

  • Quantity of Refrigerant

  • Port Size (inches)

G. Receivers

Receivers

  • How many receivers ar fitted

  • 1.0 Receiver

  • 1.1 Manufacturer

  • 1.11 Other Manufacturer

  • 1.2 Volume (Lt)

  • 1.3 Serial No

  • 1.4 Safe Working Pressure

  • 1.5 Wet or Dry Receiver

H. Filtration

Filtration

  • 1.0 MANUFACTURER

  • 1.1 Model No

  • 1.11 Element No

  • 1.12 Port Size (inches)

  • 1.13 Automatic Drain Fitted

  • 1.13.1 Autodrain Detail

  • 2.0 MANUFACTURER

  • 2.1 Model No

  • 2.11 Element No

  • 2.12 Port Size (inches)

  • 2.13 Automatic Drain Fitted

  • 2.13.1 Autodrain Detail

  • 3.0 MANUFACTURER

  • 3.1 Model No

  • 3.11 Element No

  • 3.12 Port Size (inches)

  • 3.13 Automatice Drain Fitted

  • 3.13.1 Autodrain Detail

  • 4.0 MANUFACTURER

  • 4.1 Model No

  • 4.11 Element No

  • 4.12 Port Size (inches)

  • 4.13 Automatic Drain Fitted

  • 4.13.1 Autodrain Detail

  • 5.0 MANUFACTURER

  • 5.1 Model No

  • 5.11 Element No

  • 5.12 Port Size (inches)

  • 5.13 Automatic Drain Fitted

  • 5.13.1 Autodrain Detail

  • 6.0 MANUFACTURER

  • 6.1 Model No

  • 6.11 Element No

  • 6.12 Pot Size (inches)

  • 6.13 Automatic Drain Fitted

  • 6.13.1 Autodrain Detail

I. Condensate Management

Condensate Management

  • Is there a Condensate Management System Fitted

  • 1.0 Oil Water Separator

  • 1.1 Manufacturer

  • 1.2 Model No

  • 1.3 Serial No

  • Take Picture of OWS

  • 2.0 Oil Water Separator

  • 2.1 Manufacturer

  • 2.2 Model No

  • 2.3 Serial No

  • Take Picture of OWS

J. Additional Technical Information

Additional Technical Information

  • Add Free Text

K. Additional Site Information

Additional Site Information

  • Add Free Text

L. Verification and Sgnature

  • Name

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