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Verification 19

Table 2-4. Performance Test Record Form

Test Facility:

__________________________________________ Report No.__________________________________________

__________________________________________ Date______________________________________________

__________________________________________ Customer___________________________________________

__________________________________________ Tested By___________________________________________

Model_____________________________________ Ambient Temperature__________________________________

Serial No.__________________________________ Relative Humidity_____________________________________

Options ___________________________________ Nominal Line Frequency (Hz)___________________________

Firmware Revision___________________________

Special Notes:

____________________________________________________________________________________________

Test Equipment Used:

Description Model No. Trace No. Cal. Due Date

1. AC Source ________ ___________ ___________

2. DC Voltmeter ________ ___________ ___________

3. RMS Voltmeter ________ ___________ ___________

4. Oscilloscope ________ ___________ ___________

5. Electronic Load ________ ___________ ___________

6. Current Monitoring ________ ___________ ___________

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