PARTIAL TEST REPORT

CONTINUITY
Project _______________________
No. Dok. FORM-SPN-ENG-TC-051 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _________________________ Installation No. : _________________________

Level : _________________________ Service : _________________________
Test Date : _________________________ Drawing Ref. : _________________________
Report Date : _________________________

Description Cable Size Cable Marker Result Remarks

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

_________________________ ________________________ _____________________

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 PARTIAL TEST REPORT
INSULATION
Project _______________________
No. Dok. FORM-SPN-ENG-TC-052 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _________________________ Installation No. : _________________________

Level : _________________________ Service : _________________________
Test Date : _________________________ Drawing Ref. : _________________________
Report Date : _________________________

Cable
Description R-S S-T T-R R-N S-N T-N R-G S-G T-G U-V V-W W-U U-G V-G W-G
Size

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

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 PARTIAL TEST REPORT
GRAVITY
Project _______________________
No. Dok. FORM-SPN-ENG-TC-053 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _____________________________ Installation No. : _____________________________

Level : _____________________________ Service : _____________________________
Test Date : _____________________________ Drawing Ref. : _____________________________
Report Date]: _____________________________

Media Test Gravity :

Water nitrogent

Air __________________

Duration Time Test :

5 minutes 15 minutes

10 minutes ________ minutes

Test Result :

Good

Blocked

Drawing Reference

Attached

Not Attached

_________________

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

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 PARTIAL TEST REPORT
EARTH RESIST
Project _______________________
No. Dok. FORM-SPN-ENG-TC-054 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _____________________________ Installation No. : _____________________________

Level : _____________________________ Service : _____________________________
Test Date : _____________________________ Drawing Ref. : _____________________________
Report Date : _____________________________

Earth System : ___________________________________________________________

Earth Media : ___________________________________________________________

Earth Resistance Test Result

No Grid References Earth Resistance Value (Ohm)

Maximum Earth Resistance Value : _______________________________

Test Result : Good

No Good

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

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 PARTIAL TEST REPORT
VACUUM
Project _______________________
No. Dok. FORM-SPN-ENG-TC-055 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _____________________________ Installation No. : _____________________________

Level : _____________________________ Service : _____________________________
Test Date : _____________________________ Drawing Ref. : _____________________________
Report Date : _____________________________

Test Vacuum Spesifikasi : Psi

Duration Vacuum Test

2 hours 8 hours 24 hours

4 hours 12 hours ________ hours

Time Date Result

Start Psi

Finished Psi

Pressure Losses Psi

Drawing Reference

Attached

Not Attached

_________________

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

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 PARTIAL TEST REPORT
STAGNANT
Project _______________________
No. Dok. FORM-SPN-ENG-TC-056 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _____________________________ Installation No. : _____________________________

Level : _____________________________ Service : _____________________________
Test Date : _____________________________ Drawing Ref. : _____________________________
Report Date : _____________________________

Stagnant Test Media

Water nitrogent

Air __________________

Duration Time Test

2 hours 8 hours 24 hours

4 hours 12 hours ________ hours

Time Date Result

Start cm

Finished cm

Pressure Losses cm

Drawing Reference

Attached

Not Attached

_________________

Test Result Equipment Test Comments

Approved

Not Approved

Re -Tested

Approved by, Checked by, Tested by,

_________________________ _________________________ _________________________

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 PARTIAL TEST REPORT
HYDROSTATIC
Project _______________________
No. Dok. FORM-SPN-ENG-TC-057 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _____________________________ Installation No. : _____________________________

Level : _____________________________ Service : _____________________________
Test Date : _____________________________ Drawing Ref. : _____________________________

Hydrostatic Test Media

Water nitrogent

Air __________________

Test Hydrostatic Spesifikasi : kg/cm3

Duration Hydrostatic Test

2 hours 8 hours 24 hours

4 hours 12 hours ________ hours

Time Date Result

Start kg/cm3

Finished kg/cm3

Pressure Losses kg/cm3

Drawing Reference

Attached

Not Attached

_________________

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

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 PARTIAL TEST REPORT
PNEUMATIC
Project _______________________
No. Dok. FORM-SPN-ENG-TC-058 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _____________________________ Installation No. : _____________________________

Level : _____________________________ Service : _____________________________
Test Date : _____________________________ Drawing Ref. : _____________________________
Report Date : _____________________________

Pneumatic Test Media

Water nitrogent

Air __________________

Test Pneumatic Spesifikasi : Psi

Duration Pneumatic Test

2 hours 8 hours 24 hours

4 hours 12 hours ________ hours

Time Date Result

Start Psi

Finished Psi

Pressure Losses Psi

Drawing Reference

Attached

Not Attached

_________________

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

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 PARTIAL TEST REPORT
DUCT LEAKAGE
Project _______________________
No. Dok. FORM-SPN-ENG-TC-059 Revisi 0 ( 1 Juli 2003 ) Halaman 1 dari 1

Location : _____________________________ Installation No. : _____________________________

Level : _____________________________ Service : _____________________________
Test Date : _____________________________ Drawing Ref. : _____________________________
Report Date : _____________________________

Duct Installation

Rectangular / Round Duct (m2) :

Seal Class :

Static Pressure (Pa) :

Leaked Class ( CFM/100 ft2 ) :

Duct Leakage Recomanded (CFM) :

Equipment Leakage Test Duct Power of Blower / Motor Air Flow Meter

Static Pressure (Pa) : Power Input (kW) :

Digital Anemometer
Capacity (CFM) : Current Rating (A) :

Test Result Convertion Reading air flow

Static Pressure (Pa) :

Time (menit) :

Avg. Leakage Flow at VD (m/s) :

Volume Damper (VD) Sq (m2) :

Duct Leaked Test Result (FCM) :

Test Result Equipment Test Comments

Approved Duct Leaked Test Fan

Tang Ampere Digital
Not Approved Anemometer Digital
Stop Watch
Re - Tested

Approved by, Checked by, Tested by,

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