NREL Equipment Inspection Report

• Room/Space

  Select

• Enter here:

• Inspected by:

• Inspection date

  Date

• Requested By:

  Select

• Is this a Non-Reputable Manufacturer (NRM) or a Reputable Manufacturer (RM)?

  RM

  NRM

• Manufacturer

• Select manufacture

  Select

• Model #

• Report Number:

• Bar code

Part 1 - Information

• Phase

  Final

  Re-inspection

• Type of inspection:

  Reputable Manufacturer

  Non- reputable manufacturer

  Field evaluated

• Equipment Name and Description of Function:

• Serial Number (N/A if there is not one):

• Listing Status:

  Unlisted

  NRTL Modified

  Used Outside of Listing

• Equipment Status:

  New

  Modified

  In Use

  Not Previously Approved

  Removed From Service

Part 2 - External Inspection

• Enclosure

• Operator not exposed to any hazard:

  Approved

  Disapproved

  N/A

• System Voltage and Number of Phases:

• Not damaged:

  Approved

  Disapproved

  N/A

• Appropriate material:

  Approved

  Disapproved

  N/A

• Protects contents from operating environment and an internal fault:

  Approved

  Disapproved

  N/A

• Panel interlocks and/or guarding is adequate:

  Approved

  Disapproved

  N/A

• Proper voltage, frequency, phasing, and ampacity rating for the plug and cord. Cord cap matches voltage and load. If the cord cap is not of the molded type then verify that the cord is properly terminated in the cord cap:

  Approved

  Disapproved

  N/A

• Cord is not frayed or damaged:

  Approved

  Disapproved

  N/A

• Listed strain relief on cord:

  Approved

  Disapproved

  N/A

Part 3 - Power Source

• Direct Wired into Facility

  Yes

  No

• Verify proper voltage and ampacity for the wiring method:

  Approved

  Disapproved

  N/A

• Circuit number and panelboard that feeds equipment is identified:

  Approved

  Disapproved

  N/A

• Verify proper over current protection for the equipment branch circuit:

  Approved

  Disapproved

  N/A

• Panel schedule updated:

  Approved

  Disapproved

  N/A

Part 4- External Inspection: Grounding

• External auxiliary ground terminated if required:

  Approved

  Disapproved

  N/A

• Equipment ground is run with circuit conductors:

  Approved

  Disapproved

  N/A

Part 5- Marking and Documentation:

• Hazards marked:<br>(i.e. shock, arc flash, stored energy, multiple sources, back-feed potential, or as required by NEC)

  Approved

  Disapproved

  N/A

• Power requirements marked (voltage, current, frequency):

  Approved

  Disapproved

  N/A

• Restriction or limitation of use based on manual, instructions, or identified operating hazards?

  No

  Yes

• Specify in part 12 of report. Equipment marked with reference to restriction or limitation of use:

  Approved

  Disapproved

• Make/Model/Drawing number (if applicable) marked:

  Approved

  Disapproved

  N/A

• Documentation adequate:

  Approved

  Disapproved

  N/A

Part 6 - Internal Inspection

• Internal electrical parts are listed by a NRTL or UL Recognized:

  Approved

  Disapproved

  N/A

• Non-listed parts are acceptable for their purpose, well built, a failure will be contained and not cause harm to others or <50 volts:

  Approved

  Disapproved

  N/A

• Polarity: the neutral and line are properly terminated and the neutral is not fused. Exception: cord connected equipment applicable to UL61010-1 (9.6.1ADV.4a).

  Approved

  Disapproved

  N/A

• All non-current carrying internal conductive subsystems are bonded if likely to become energized:

  Approved

  Disapproved

  N/A

• Grounding and bonding conductors are properly terminated:

  Approved

  Disapproved

  N/A

• Wiring terminal and leads are acceptable:

  Approved

  Disapproved

  N/A

• Wire sizes adequate:

  Approved

  Disapproved

  N/A

• Overcurrent protection adequate for conductors and loads:

  Approved

  Disapproved

  N/A

• Listed conductors, if applicable:

  Approved

  Disapproved

  N/A

Part 7 - Other Internal Issues:

• Neat workmanship:

  Approved

  Disapproved

  N/A

• All non-electrical components are acceptable for their purpose:

  Approved

  Disapproved

  N/A

• Free of sharp edges:

  Approved

  Disapproved

  N/A

• Adequate cooling:

  Approved

  Disapproved

  N/A

• Automatic discharge of high voltage capacitors:

  Approved

  Disapproved

  N/A

Part 8 - Other Considerations: Secondary Hazards Created by this equipment

• Are There Secondary Hazards Created By This Equipment? (RF, IR, UV, X-ray, magnetic fields)

  No

  Yes

• Rf Hazards:

  No

  Yes

  N/A

• Sub rf hazards:

  No

  Yes

  N/A

• DC electric or magnetic fields:

  No

  Yes

  N/A

• Light Exposure- IR, visible, or UV:

  No

  Yes

  N/A

• X-rays:

  No

  Yes

  N/A

• Fire, electrical explosion:

  No

  Yes

  N/A

• Are workers protected from these hazards? May require SME evaluation or SOP/SWP to operate. Address as condition of use.

  Approved

  Disapproved

  N/A

• Are there resistance heating loads (or similar) capable of attaining hazardous temperatures? (NFPA 79 7.4)

  Yes

  No

• Is there a suitably installed means of temperature detection that would initiate a controlled shutdown? (e.g. limit controller, PLC logic, thermal fuse, thermostat)

  Approved

  Disapproved

  N/A

Part 9 - Other considerations: Failure analysis & Control

• Adequate to protect the equipment and personnel in the event of a ground-fault or short-circuit, such as AIC ratings or SCCR:<br>(Note: As applicable to equipment where there is a likelihood of high fault currents and/or arc flash potential, verify fault current at existing power source. Use "Eaton Bussmann Fault Current Calculator" app as needed)

  Approved

  Disapproved

  N/A

• Is an EPO button present or any other additional EMO controls? (i.e. safety interlocks or controllers for monitoring hazardous processes)

  Yes

  No

• Does EPO/EMO control all critical safety concerns such as uncontrolled energy or exposed hazards that could be present during normal operation? Consult with ESH POC, operator, or ESA for risk assessment per NFPA 79 9.2 if there are concerns. Critical safety controls must comply with NFPA 79 chapter 9.

  Approved

  Disapproved

  N/A

• Are there potential safety concerns such as uncontrolled energy or exposed hazards that could be present during normal operation? Could an EPO/EMO be needed for critical safety controls? Consult with ESH POC, operator, or ESA for risk assessment per NFPA 79 9.2 if there are concerns. Critical safety controls must comply with NFPA 79 chapter 9.

  Approved

  Disapproved

  N/A

Part 10 - Other Considerations Maintenance

• Necessary working clearances:

  Approved

  Disapproved

  N/A

Part 11 - Test to Perform

• All non-current carrying exposed metal required to be bonded tests less than 1 ohm to ground pin/conductor:

  Approved

  Disapproved

  N/A

• Perform functional test of GFCI's, GFED, interlocks and EMO/EPO:

  Approved

  Disapproved

  N/A

Part 12 - Approval

• Equipment complies with the NFPA 70E, 70, 79 and the NREL LLP for Electrical Safety:

  Approved

  Disapproved

  N/A

• Is there a condition of use? (Include all designer/builder instructions, drawings, or information that is relevant to the safe installation and use of this equipment. Attach additional sheets as necessary.) This needs to be communicated in writing to both the requestor and the ESH POC.

  No

  Yes

• Equipment Name and Description of Function

• Serial Number

  Yes

  No

• Enter serial number

• Listing Status

  Unlisted

  NRTL Modified

  Used Outside of Listing

• Equipment Status

  New

  Modified

  In Use

  Not Previously Approved

  Removed From Service

Part 2 - External Inspection

• Enclosure

• Operator not exposed to any hazard:

  Approved

  Disapproved

  N/A

• System Voltage and Number of Phases

• Not damaged:

  Approved

  Disapproved

  N/A

• Appropriate material:

  Approved

  Disapproved

  N/A

• Protects contents from operating environment and an internal fault

  Approved

  Disapproved

  N/A

• Panel interlocks and/or guarding is adequate

  Approved

  Disapproved

  N/A

• Proper voltage, frequency, phasing, and ampacity rating for the plug and cord. Cord cap matches voltage and load. If the cord cap is not of the molded type then verify that the cord is properly terminated in the cord cap:

  Approved

  Disapproved

  N/A

• Not frayed or damaged:

  Approved

  Disapproved

  N/A

• Listed strain relief on cord

  Approved

  Disapproved

  N/A

Part 3 - Power Source

• Direct Wired into Facility

  Yes

  No

• Verify proper voltage and ampacity for the wiring method

  Approved

  Disapproved

  N/A

• Circuit number and panelboard that feeds equipment is identified.

  Approved

  Disapproved

  N/A

• Verify proper over current protection for the equipment branch circuit

  Approved

  Disapproved

  N/A

• Panel schedule updated

  Approved

  Disapproved

  N/A

Part 4- External Inspection: Grounding

• External auxiliary ground terminated if required:

  Approved

  Disapproved

  N/A

• Equipment ground is run with circuit conductors:

  Approved

  Disapproved

  N/A

Part 5- Marking and Documentation:

• Hazards marked:<br>(i.e. shock, arc flash, stored energy, multiple sources, back-feed potential, or as required by NEC)

  Approved

  Disapproved

  N/A

• Power requirements marked (voltage, current, frequency):

  Approved

  Disapproved

  N/A

• Restriction and limitation of use:

  Approved

  Disapproved

  N/A

• Restriction or limitation of use based on manual, instructions, or identified operating hazards?

  No

  Yes

• Specify in part 12 of report. Equipment marked with reference to restriction or limitation of use:

  Approved

  Disapproved

  N/A

• Make/Model/Drawing number marked:

  Approved

  Disapproved

  N/A

• Documentation adequate:

  Approved

  Disapproved

  N/A

Part 8 - Other Considerations: Secondary Hazards Created by this equipment

• Are There Secondary Hazards Created By This Equipment? (RF, IR, UV, X-ray, magnetic fields)

  No

  Yes

• Rf Hazards

  No

  Yes

  N/A

• Sub rf hazards:

  No

  Yes

  N/A

• DC electric or magnetic fields:

  No

  Yes

  N/A

• Light Exposure- IR, visible, or UV:

  No

  Yes

  N/A

• X-rays:

  No

  Yes

  N/A

• Fire, electrical explosion:

  No

  Yes

  N/A

• Are workers protected from these hazards? May require SME evaluation or SOP/SWP to operate. Address as condition of use.

  Approved

  Disapproved

  N/A

• Are there resistance heating loads (or similar) capable of attaining hazardous temperatures? (NFPA 79 7.4)

  Yes

  No

• Is there a suitably installed means of temperature detection that would initiate a controlled shutdown? (e.g. limit controller, PLC logic, thermal fuse, thermostat)

  Approved

  Disapproved

  N/A

Part 9 - Other considerations: Failure analysis & Control

• Adequate to protect the equipment and personnel in the event of a ground-fault or short-circuit, such as AIC ratings or SCCR:<br>(Note: Verify fault current at existing power source. Use Eaton Bussmann Fault Current Calculator app as needed)

  Approved

  Disapproved

  N/A

• Is an EPO button present or any other additional EMO controls? (i.e. safety interlocks or controllers for monitoring hazardous processes)

  Yes

  No

• Does EPO/EMO control all critical safety concerns such as uncontrolled energy or exposed hazards that could be present during normal operation? Consult with ESH POC, operator, or ESA for risk assessment per NFPA 79 9.2 if there are concerns. Critical safety controls must comply with NFPA 79 chapter 9.

  Approved

  Disapproved

  N/A

• Are there potential safety concerns such as uncontrolled energy or exposed hazards that could be present during normal operation? Could an EPO/EMO be needed for critical safety controls? Consult with ESH POC, operator, or ESA for risk assessment per NFPA 79 9.2 if there are concerns. Critical safety controls must comply with NFPA 79 chapter 9.

  Approved

  Disapproved

  N/A

Part 10 - Other Considerations Maintenance

• Necessary working clearances:

  Approved

  Disapproved

  N/A

Part 11 - Test to Perform

• All non-current carrying exposed metal required to be bonded tests less than 1 ohm to ground pin/conductor:

  Approved

  Disapproved

  N/A

• Perform functional test of GFCI's, GFED, EMO and EPO

  Approved

  Disapproved

  N/A

Part 12 - Approval

• Equipment complies with the NFPA 70E, 70, 79 and the NREL LLP for Electrical Safety.

  Approved

  Disapproved

  N/A

• Is there a condition of use? (Include all designer/builder instructions, drawings, or information that is relevant to the safe installation and use of this equipment. Attach additional sheets as necessary.) This needs to be communicated in writing to both the requestor and the ESH POC.

  No

  Yes

• Attach Field Evaluation

  Media
Attachments

• Place additional attachments here. (Mark disapproved if this attachment is a fail that couldn't be captured above)

  Approved

  Disapproved

  N/A

• Result

  PASS

  FAIL

• PLEASE SET UP A RE-INSPECTION WHEN CORRECTIONS HAVE BEEN COMPLETED. APPROVAL IS REQUIRED BEFORE USE. Electrical Inspection Request @ https://forms.nintex.com/FormHost.aspx?id=sF-RSbROQ1b5IhoTx-rRHidHoAk_4H2YXHUYYFgJVxdtOsdRQeWMQ61tw_pAXoUsLkBVjU5hPu8VzB24wpSJC4XNT9aC0htzSvA6m8HVGnSIrYgnO6X_nBPnQAYK060T

• IF THIS EQUIPMENT IS MODIFIED, DAMAGED, OR UTILIZED FOR OTHER THAN THE INTENDED USE STATED ABOVE, THIS APPROVAL IS VOID, PENDING RE-EXAMINATION.

• Inspector

  Sign