FORM 2A - MOLDED CASE CIRCUIT BREAKER (MCCB) TEST REPORT

TEST REPORT No.: SR2A- Date: Page: 1 of 6

JOB No.: Item No.: Quantity:
Customer: Customer Ref. No.:

Unit of Item
Details Measure
1 2 3 4 5 6 7 8
A. MCCB
Manufacturer -
Type/Model/Catalog No. -
AT/AF A
Voltage V
Serial No. -
Manufacturer's Curve No. -
Accessories -

B. TEST DATA
1. Mechanical Operation -
1.1 As found: Pass (P) or Fail (F) -
1.2 As left: P or F -
2. Insulation Resistance Test
2.1 DC volts used V
2.2 Ambient Temperature C
o

2.3 Breaker open: -

A-A MΩ/GΩ
B-B MΩ/GΩ
C-C MΩ/GΩ
Remarks: Pass or Fail -
FORM 2A - MOLDED CASE CIRCUIT BREAKER (MCCB) TEST REPORT
TEST REPORT No.: SR2A- Date: Page: 2 of 6
JOB No.: Item No.: Quantity:
Customer: Customer Ref. No.:

Unit of Item
Details Measure
1 2 3 4 5 6 7 8
2.4 Breaker closed: -
A-B MΩ/GΩ
B-C MΩ/GΩ
C-A MΩ/GΩ
A-G MΩ/GΩ
B-G MΩ/GΩ
C-G MΩ/GΩ
Remarks: Pass or Fail -
3. Individual Pole Resistance -
3.1 As found: -
A mΩ/µΩ
B mΩ/µΩ
C mΩ/µΩ
Remarks: Pass or Fail -
3.2 As left: -
A mΩ/µΩ
B mΩ/µΩ
C mΩ/µΩ
Remarks: Pass or Fail -
4. Overcurrent Test -
Trip Unit Model -
Rating Plug Ampere, In A
FORM 2A - MOLDED CASE CIRCUIT BREAKER (MCCB) TEST REPORT
TEST REPORT No.: SR2A- Date: Page: 3 of 6
JOB No.: Item No.: Quantity:
Customer: Customer Ref. No.:

Unit of Item
Details Measure
1 2 3 4 5 6 7 8
Sensor Ampere Rating A
Continuous Ampere Rating, Ir A
4.1 Breaker Settings -
Ranges: -
Long time delay -
Short time delay -
Instantaneous -
Ground fault -
E/L
Settings: -
Long time delay -
Short time delay -
Instantaneous -
Ground fault -
E/L
4.2 Characteristics -
Long Time Delay:
% setting %
Time, minimum sec
maximum sec
maximum @ 25 C o
sec

FORM 2A - MOLDED CASE CIRCUIT BREAKER (MCCB) TEST REPORT

TEST REPORT No.: SR2A- Date: Page: 4 of 6
JOB No.: Item No.: Quantity:
Customer: Customer Ref. No.:

Unit of Item
Details Measure
1 2 3 4 5 6 7 8
Short Time Delay:
% setting %
Time, minimum sec
maximum sec
maximum @ 25oC sec
Instantaneous:
% setting %
Time, minimum sec
maximum sec
maximum @ 25oC sec
Ground Fault:
% setting %
Time, minimum sec
maximum sec
maximum @ 25oC sec
Earth Leakage:
% setting %
Time, minimum sec
maximum sec
maximum @ 25 C
o
sec

FORM 2A - MOLDED CASE CIRCUIT BREAKER (MCCB) TEST REPORT

TEST REPORT No.: SR2A- Date: Page: 5 of 6
JOB No.: Item No.: Quantity:
Customer: Customer Ref. No.:

Unit of Item
Details Measure
1 2 3 4 5 6 7 8
4.3 TEST RESULTS: -
Ambient Temperature o
C
Long Time Delay:
% setting %
Test ampere A
As found: Phase A sec
Phase B sec
Phase C sec
Short Time Delay:
% setting %
Test ampere A
As found: Phase A sec
Phase B sec
Phase C sec
Ground Fault:
% setting %
Test ampere A
As found: Phase A sec
Phase B sec
Phase C sec
Push to Trip -

FORM 2A - MOLDED CASE CIRCUIT BREAKER (MCCB) TEST REPORT

TEST REPORT No.: SR2A- Date: Page: 6 of 6
JOB No.: Item No.: Quantity:
Customer: Customer Ref. No.:

Unit of Item
Details Measure
1 2 3 4 5 6 7 8
Earth Leakage:
% setting %
Test ampere A
As found: Phase A sec
Phase B sec
Phase C sec
Push to Trip -
Remark: Pass or Fail -

Test Instrument Used Manufacturer Serial/ID No. Date of Calibration Due of Calibration
CURRENT INJECTOR

Test Location

Record Acceptance
Name: RISAS
Signature:
Date: