Version 1
29
Type of Test:
Mechanical: (describe)_______________________
Equipment Name:
Electrial: (describe)__________________________
________________________________
Leak: (describe)_____________________________
________________________________
Diagram of Equipment (if needed)
Location:
________________________________
________________________________
________________________________
Test Point I.D. (E.G.; Bearing Number, Insulator Tag, Trap Tag, Etc.)
M
od
ul
e
Use
d
(c
on
ta
c
t
Sc
a
nn
in
g)
Acc
e
s
s
or
y
Use
d
Fre
qu
e
nc
y
Se
ttin
g
Se
ns
iti
v
ity
Se
ttin
g
Ba
s
e
li
n
e
dB Ga
in
Date
M
e
te
r
(L
in
M
od
e
)
Acti
on
To
T
a
k
e
Acti
on
T
a
k
e
n
By:
Wo
rk
