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INGRESS PROTECTION TEST REPORT

CERTIFICATE NO. : DATE ISSUE :


CUSTOMER : SPK :
OWNER : PAGE : of
CUSTOMER WO. :
JOB LOCATION :

DESCRIPTION : SCOPE OF WORKS :


MANUFAKTURER : 1ST CHAR NUMERAL
SERIAL NUMBER : 2ND CHAR NUMERAL
TESTING DATE : ADDITIONAL LETTER
TESTING AREA : FULL BODY FULL BODY EXCLUDE MOUNTING CUST REQUIREMENT SUPPLEMENTARY LETTER
ACCEPTANCE CRITERIA : IEC / EN 60529 - 2013 CUSTOMER REQUIREMENT CUSTOMER REQUIREMENT

:
:

Inspector Notes / Comments : Inspected by : Reviewed and Approved, Approved by


Customer Representative :
INGRESS PROTECTION INSPECTION REPORT FOR
S/N :
CERTIFICATE NO. : DATE ISSUED:
CUSTOMER : SPK :
OWNER : PAGE : of
CUSTOMER WO. :
JOB LOCATION :

DESCRIPTION : SCOPE OF WORKS :


MANUFAKTURER : 1ST CHAR NUMERAL
SERIAL NUMBER : 2ND CHAR NUMERAL
TESTING DATE : ADDITIONAL LETTER
TESTING AREA : FULL BODY FULL BODY EXCLUDE MOUNTING CUST REQUIREMENT SUPPLEMENTARY LETTER
ACCEPTANCE CRITERIA : IEC / EN 60529 - 2013 CUSTOMER REQUIREMENT CUSTOMER REQUIREMENT

FIRST CHARACTERISTIC NUMERAL TEST

AGAINST ACCESS TO HAZARDOUS PART AGAINST INGRESS OF SOLID FOREIGN OBJECT


0 NON PROTECTED 0 NON PROTECTED
1 BACK OF HAND 1 DIA 50 MM GREATER
2 FINGER 2 DIA 12.5 MM GREATER
3 TOOLS 3 DIA 2.5 MM GREATER
4 WIRE 4 DIA 1.0 MM GREATER
5 WIRE 5 DUST PROTECTED
6 WIRE 6 DUST TIGHT

LABORATORY / FIELD AMBIENCE CONDITION LABORATORY / FIELD AMBIENCE CONDITION

1 TEMPERATURE : 1 TEMPERATURE :
2 RELATIVE HUMUDITY : 2 RELATIVE HUMUDITY :
3 AIR PRESSURE : 3 AIR PRESSURE :

SAMPLE CONDITION SAMPLE CONDITION

1 SAMPLE QUANTITY : 1 SAMPLE QUANTITY :


2 MOUNTING CONDITION : 2 MOUNTING CONDITION :
3 PRECONDITIONING : 3 PRECONDITIONING :
4 ENERGIZED DURING TESTING : YES NO 4 ENERGIZED DURING TESTING : YES NO
5 PART MOVING DURING TESTING : YES NO 5 PART MOVING DURING TESTING : YES NO

ACCESS PROBE SKETCH AND PARAMETERS DUST CHAMBER SKETCH AND PARAMETERS

SKETCH / PICTURES SKETCH / PICTURES

PARAMETER PARAMETER
1 TESTING FORCE : 1 TESTING FORCE :
2 EQUIPMENT VOLTAGE : 2 DUST MATERIAL :
3 VOLTAGE CATEGORY HIGH LOW 3 PARTICLE SIZE :
4 OTHER : 4 DUST DENSITY :
5 AMOUNT OF TALCUM POWDER :
6 AIR DIRECTION :
7 DURATION OF EXPOSURE :
TESTING SUMMARY TESTING SUMMARY

DISTANCE DISTACE
NO TYPE OF INDICATION FROM ACCEPT / REPAIR REMARK NO TYPE OF INDICATION FROM ACCEPT / REPAIR REMARK
DATUM DATUM

Inspector Name :
Inspector Certificate :

Inspector Notes / Comments : Inspected by : Reviewed and Approved, Approved by


Customer Representative :
INGRESS PROTECTION INSPECTION REPORT FOR
S/N :
CERTIFICATE NO. : DATE ISSUED:
CUSTOMER : SPK :
OWNER : PAGE : of
CUSTOMER WO. :
JOB LOCATION :

DESCRIPTION : SCOPE OF WORKS :


MANUFAKTURER : 1ST CHAR NUMERAL
SERIAL NUMBER : 2ND CHAR NUMERAL
TESTING DATE : ADDITIONAL LETTER
TESTING AREA : FULL BODY FULL BODY EXCLUDE MOUNTING CUST REQUIREMENT SUPPLEMENTARY LETTER
ACCEPTANCE CRITERIA : IEC / EN 60529 - 2013 CUSTOMER REQUIREMENT CUSTOMER REQUIREMENT

FIRST CHARACTERISTIC NUMERAL TEST

AGAINST ACCESS TO HAZARDOUS PART AGAINST INGRESS OF SOLID FOREIGN OBJECT

PHOTO BEFORE TEST PHOTO BEFORE TEST

PHOTO DURING TEST PHOTO DURING TEST

PHOTO AFTER AND FUNCTION TEST PHOTO AFTER AND FUNCTION TEST

Inspector Name :
Inspector Certificate :

Inspector Notes / Comments : Inspected by : Reviewed and Approved, Approved by


Customer Representative :
INGRESS PROTECTION INSPECTION REPORT FOR
S/N :
CERTIFICATE NO. : DATE ISSUED :
CUSTOMER : SPK :
OWNER : PAGE : of
CUSTOMER WO. :
JOB LOCATION :

DESCRIPTION : SCOPE OF WORKS :


MANUFAKTURER : 1ST CHAR NUMERAL
SERIAL NUMBER : 2ND CHAR NUMERAL
TESTING DATE : ADDITIONAL LETTER
TESTING AREA : FULL BODY FULL BODY EXCLUDE MOUNTING CUST REQUIREMENT SUPPLEMENTARY LETTER
ACCEPTANCE CRITERIA : IEC / EN 60529 - 2013 CUSTOMER REQUIREMENT CUSTOMER REQUIREMENT

SECOND CHARACTERISTIC NUMERAL TEST

AGAINST INGRESS OF WATER WITH HARMFULL EFFECT LABORATORY / FIELD AMBIENCE CONDITION
0 NON PROTECTED 1 TEMPERATURE :
1 VERTICAL DRIPPNG 2 RELATIVE HUMUDITY :
2 DRIPPING 15O TILTED 3 AIR PRESSURE :
3 SPRAYING
SAMPLE CONDITION
4 SPLASHING
5 JETTING 1 SAMPLE QUANTITY :
6 PEWERFULL JETTING 2 MOUNTING CONDITION :
7 TEMPORARY IMMERSION 3 PRECONDITIONING :
8 CONTINUOUS IMMERSION 4 ENERGIZED DURING TESTING : YES NO
5 PART MOVING DURING TESTING : YES NO

WATER INGRESS TESTING SKETCH / PHOTO BEFORE TESTING

SKETCH / PICTURES SKETCH / PICTURES

DURING TESTING AFTER AND FUNCTION TESTING

SKETCH / PICTURES SKETCH / PICTURES

PARAMETER PARAMETER
1 TESTING EQUIPMENT TYPE : 8 NUMBER OF OPEN HOLES :
2 TESTING EQUIPMENT SN : 9 TOTAL WATER FLOW :
3 WATER FLOW RATE : 10 COUNTER BALANCE :
4 TESTING DURATION : 11 ID NOZZLE :
5 TESTING ANGLE : 12 DELIVERY RATE :
6 OSCILLATING TUBE ANGLE : 13 ENCLOSURE LOWEST POINT :
7 TUBE RADIUS : 14 ENCLOSURE HIGHEST POINT :

TESTING SUMMARY TESTING SUMMARY

DISTANCE DISTACE
NO TYPE OF INDICATION FROM ACCEPT / REPAIR REMARK NO TYPE OF INDICATION FROM ACCEPT / REPAIR REMARK
DATUM DATUM

Inspector Name :
Inspector Certificate :

Inspector Notes / Comments : Inspected by : Reviewed and Approved, Approved by


Customer Representative :
INGRESS PROTECTION INSPECTION REPORT FOR
S/N :
CERTIFICATE NO. : DATE ISSUED :
CUSTOMER : SPK :
OWNER : PAGE : of
CUSTOMER WO. :
JOB LOCATION :

DESCRIPTION : SCOPE OF WORKS :


MANUFAKTURER : 1ST CHAR NUMERAL
SERIAL NUMBER : 2ND CHAR NUMERAL
TESTING DATE : ADDITIONAL LETTER
TESTING AREA : FULL BODY FULL BODY EXCLUDE MOUNTING CUST REQUIREMENT SUPPLEMENTARY LETTER
ACCEPTANCE CRITERIA : IEC / EN 60529 - 2013 CUSTOMER REQUIREMENT CUSTOMER REQUIREMENT

SECOND CHARACTERISTIC NUMERAL TEST

PHOTO BEFORE TEST

PHOTO DURING TEST

PHOTO AFTER AND FUNCTION TEST

Inspector Name :
Inspector Certificate :

Inspector Notes / Comments : Inspected by : Reviewed and Approved, Approved by


Customer Representative :
INGRESS PROTECTION INSPECTION REPORT FOR
S/N :
CERTIFICATE NO. : DATE ISSUED:
CUSTOMER : SPK :
OWNER : PAGE : of
CUSTOMER WO. :
JOB LOCATION :

DESCRIPTION : SCOPE OF WORKS :


MANUFAKTURER : 1ST CHAR NUMERAL
SERIAL NUMBER : 2ND CHAR NUMERAL
TESTING DATE : ADDITIONAL LETTER
TESTING AREA : FULL BODY FULL BODY EXCLUDE MOUNTING CUST REQUIREMENT SUPPLEMENTARY LETTER
ACCEPTANCE CRITERIA : IEC / EN 60529 - 2013 CUSTOMER REQUIREMENT CUSTOMER REQUIREMENT

ADDITIONAL LETTER SUPPLEMENTARY LETTER

AGAIN ACCESS TO HAZARDOUS PART WITH SUPLEMENTARY INFORMATION SPECIFIC TO

A BACK OF HAND H HIGH VOLTAGE APPARATUS


B FINGER M MOTION DURING WATER TEST
C TOOL S STATIONARY DURING WATER TEST
D WIRE W WEATHER CONDITION

LABORATORY / FIELD AMBIENCE CONDITION LABORATORY / FIELD AMBIENCE CONDITION

1 TEMPERATURE : 1 TEMPERATURE :
2 RELATIVE HUMUDITY : 2 RELATIVE HUMUDITY :
3 AIR PRESSURE : 3 AIR PRESSURE :

SAMPLE CONDITION SAMPLE CONDITION

1 SAMPLE QUANTITY : 1 SAMPLE QUANTITY :


2 MOUNTING CONDITION : 2 MOUNTING CONDITION :
3 PRECONDITIONING : 3 PRECONDITIONING :
4 ENERGIZED DURING TESTING : YES NO 4 ENERGIZED DURING TESTING : YES NO
5 PART MOVING DURING TESTING : YES NO 5 PART MOVING DURING TESTING : YES NO

ACCESS PROBE SKETCH AND PARAMETERS ACCESS PROBE SKETCH AND PARAMETERS

SKETCH / PICTURES SKETCH / PICTURES

PARAMETER PARAMETER
1 TESTING FORCE : 1 TESTING FORCE :
2 EQUIPMENT VOLTAGE : 2 EQUIPMENT VOLTAGE :
3 VOLTAGE CATEGORY HIGH LOW 3 VOLTAGE CATEGORY HIGH LOW
4 OTHER : 4 OTHER :

TESTING SUMMARY TESTING SUMMARY

DISTANCE DISTACE
NO TYPE OF INDICATION FROM ACCEPT / REPAIR REMARK NO TYPE OF INDICATION FROM ACCEPT / REPAIR REMARK
DATUM DATUM

Inspector Name :
Inspector Certificate :

Inspector Notes / Comments : Inspected by : Reviewed and Approved, Approved by


Customer Representative :
INGRESS PROTECTION INSPECTION REPORT FOR
S/N :
CERTIFICATE NO. : DATE ISSUED:
CUSTOMER : SPK :
OWNER : PAGE : of
CUSTOMER WO. :
JOB LOCATION :

DESCRIPTION : SCOPE OF WORKS :


MANUFAKTURER : 1ST CHAR NUMERAL
SERIAL NUMBER : 2ND CHAR NUMERAL
TESTING DATE : ADDITIONAL LETTER
TESTING AREA : FULL BODY FULL BODY EXCLUDE MOUNTING CUST REQUIREMENT SUPPLEMENTARY LETTER
ACCEPTANCE CRITERIA : IEC / EN 60529 - 2013 CUSTOMER REQUIREMENT CUSTOMER REQUIREMENT

ADDITIONAL LETTER SUPPLEMENTARY LETTER

AGAIN ACCESS TO HAZARDOUS PART WITH SUPLEMENTARY INFORMATION SPECIFIC TO

PHOTO BEFORE TEST PHOTO BEFORE TEST

PHOTO DURING TEST PHOTO DURING TEST

PHOTO AFTER AND FUNCTION TEST PHOTO AFTER AND FUNCTION TEST

Inspector Name :
Inspector Certificate :

Inspector Notes / Comments : Inspected by : Reviewed and Approved, Approved by


Customer Representative :

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