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TESTING & COMMISSIONING VENTILATION FAN

(KIM TRA & NGHIM THU QUT THNG GI)
Project:
Tn d n:
Contractor:
Nh Thu:
Client :
Ch u t

Ref No.:
S tham chiu:
Contract package:
Gi thu:
Project Management:
T vn QLDA:

QA-F-VN-PCMT&C_For_Ventilation_Fan-Rev A

ARCHETYPE

Description of item(s):
(M t hng mc)
According to Drawing No.:
(Da theo bng v s):
Owners Inspection Report
(Bin bn kim tra ca Ch u t)

Date:
(Ngy)

Time:
(Gi)
Specified
Ch nh

Actual
Thc t

1. Make (Ch to)

2. Manufacturer (Thng hiu)
3. Model (M s)
4. Fan enclosure (V qut)
5. Fan type (Loi qut)
6. Abnormal noise ( n bt thng)
7. Abnormal vibration ( rung bt thng)
8. Motor KW / RPM (Cng sut v tc quay mt)
9. Voltage (V) (in p)
10. Starting current (Amp) (Dng khi ng)
11. Running current (Amp) (Dng hot ng)
12. Thermal overload setting (Amp) (Ci t ngng qu nhit)
13. Fan (RPM) (Tc quay ca qut)
14. Fan quantity (CMH) (Lu lng gi ca qut)
15. Static pressure (Pa) (p sut tnh)

Note (Ghi ch):

QA-F-VN-PCM-T&C_For_Ventilation_Fan-Rev A

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Your submission for approval is subject to following conditions: (n trnh ph duyt c kt

qu nh sau):
Approved
(Chp thun)
Not approved as noted
(Khng chp thun vi ghi ch sau)

Approved on condition as noted

(Chp thun vi iu kin ghi ch sau)
Amend and resubmit
(Sa v trnh li)

Note (Ghi ch): Accepting the T & C works in this inspection SHALL not relieve the contractors responsibilities from his
contract agreements. /Vic chp nhn kit qu kim tra vn hnh v th nghim trong bin bn nghim thu ny s
khng lm gim trch nhim ca nh thu theo nhng iu khon rng buc trong hp ng.

Contractor
(Nh thu):

Project Management
Consultant
(T vn Qun L D n):

Client's Representatives
(i din Ch u t):

Signature (Ch k):

Signature (Ch k):

Signature (Ch k):

Name (Tn):_______________

Name (Tn):_______________

Name (Tn):_______________

Position (Chc v):__________

Position (Chc v):__________

Position (Chc v):__________

Date (Ngy):_______________

Date (Ngy):_______________

Date (Ngy):_______________

QA-F-VN-PCM-T&C_For_Ventilation_Fan-Rev A

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