1. CUSTOMER / USER
Company:
Talked To:
2. MOTOR
Model-Nb.:
Date Code:
Built in:
o
Worked for:
Month:
3. INSTALLATION
o Vertical
o Horizontal
Well depth [m]:
Cable lenght [m]:
Water:
4. EXTERNAL MEASUREMENTS
Shaft high:
Stator Shell:
Splines:
Nameplate:
Lead Sealing:
5. ELECTRICAL MEASUREMENTS
Phase 1 [Ω]:
Mainphase [Ω]:
6. TEARDOWN
Prong:
Filling Liquid:
Thrust Bearing:
Sleeve Lower Shaft End :
Shaft Seal :
Stator Endring :
Pressure Test Stator PU :
7. CONTROL BOX
Control Box Type:
8. REMARKS
Tech. Warranty :
Signature:
Motor Test Report
Aditional comments under "Remarks"
Country:
Tel.:
Rating [kW]:
Sequenz-Nb.:
Equipped for:
o
Days:
Pump Make:
Well diameter [cm]:
Cable square[m]:
Temperature:
Upper End Bell:
Lower End Bell:
Diaphragm Pos.:
Leakage:
Plug Resin:
Phase 2 [Ω]:
Startphase [Ω]:
Windings:
Diaphragm:
Lower Radial Bearing:
Sleeve Upper Shaft End :
Liner :
Cage Thrust Bearing :
Com. Warranty:
Date:
FEE - NO.:
VISIT DATE:
Voltage [V]:
Stator- Nb.:
Worked with:
o
Hours:
Pump at [m]:
Protection make:
PH-Value:
Shaft Rotation:
Deposits:
Lead Insul.:
Lead Clamp:
Phase 3 [Ω]:
Insulation Resist. [MΩ]:
Winding Splicing:
Segments:
Upper Radial Bearing:
Up-Thrust Bearing:
Rotor Core PM:
Pressure Test Line :
Defective:
o
o
Repair
Scrap
Entered into EDP:
C
Town:
Assembler:
Hz:
Material:
o
Date failed:
Type:
Water inlet at [m]:
Type:
Setting [A]:
Slinger:
Valve:
Connector:
Hi-Pot:
Defect:
Cause:
Date: