GE Industrial Solutions PowerVac 5kV VL PV VL 4.16-250-0 User Manual
Page 66
66
USER
REPORT NO.
FAILURE REPORTING FORM
Check all appropriate blocks and provide information indicated. For major trouble provide additional information
requested on back of page supplemented with additional pages if necessary.
User Ident
EQUIPMENT:
Station__________________________ of Recloser
______________
Equipment Nameplate
Mfgr._______________________________Type_______________ Serial
#________________
Information
KV_________ Inter Amps/MVA___________________ Continuous
Amps_______BIL_________
Trouble
Recl Background:
Shipped______, Installed______, Maintained______, Modernized____________,
Date__________
(Mo/Yr) (Mo/Yr) (Mo/Yr) (Mo/Yr)
(Mo/Day/Yr)
Operational Counter Reading
__________________________________________________________________________
Location:
! Indoor
! Outdoor
Enclosure:
! Non-metal Clad, ! Metalclad, ! GIS
Interrupter:
! Air Blast, ! Air Magnetic, ! Oil, ! SF
6, ! Vacuum,
Other_________________________________
ENVIRONMENT:
General:
! Industrial, ! Urban,
o Suburban, o Rural, o Sea Coast, o Above 3300', o High
Contamination,
Other_________________________________________________________________________________
W eather Conditions:
o Dry,
o Rain, o Lightning in Area, o Snow,
o Fog, o Freezing Rain, o Frost, o
Condensation,
Temp. Trend —
o Rising, o Falling, o Steady,
o Extreme Cold, Temperature_____° F,
Wind —
o Calm, o Light, o Strong-Steady,
o Strong-Gusty
External Mechanical Stresses Involved:
o Normal, o Earthquake, o Wind, o Abnormal Terminal Loading,
Other_____________________________________________________________________________________________
Nominal System voltage__________________________
TROUBLE:
When Discovered:
o Installation, o In Service, o Maintenance, o Test,
Other__________________________________
Recloser Mode at Time of Trouble:
o De-energized, o Closed, o Open, o Tripping, o Closing, o
Reclosing,
o Fault Interruption, o Load Switching, o Line Switching
Recloser Response at Time of Trouble: o Not Called to Operate, o Performed as Intended, o Unsatisfactory
Operation,
o Failed to Operate
Subsystem in Trouble: o External Insulation to Grnd, o Internal Insulation to Grnd, o Insulating Medium,
o Isolating Contact, o Bushing, o Interrupter,
o Seals-Gaskets, o Air System, o S F
6
System, o C.T.
,
o Resistor Sw or Aux. Int., o Voltage Grading Dev,
o Line Terminals, o Compressor,
o Heater,
o Electri-
cal Controls,
o Wiring, o Operating Mechanism, o Mechanical Linkage, o
Other__________________________________________
______________________________________________________________________________________________________
State Specifically What Failed (With Instr. Book
Ref.):________________________________________________________
_______________________________________________________________________________________________________
Has it occurred before on this type of recloser? o No, o Yes, How many
times__________________________________
State How Problem was Cor-
rected:_____________________________________________________________________
________________________________________________________________________________________________________
POSSIBLE CAUSE:
o Design/Manufacture, o Shipping, o Storage, o Installation, o Instructions, o Mainte-
nance,
o Wear/Aging, o Animal/Birds, o Other,
o Not Obvious
Comments and Suggestions: