A.C. Cortes Ave., Cambaro, Mandaue City 6014, Cebu Philippines; Contact No.
: 092 2953 9333 or 0928 613 6306; LL : 032 340 0805
Email add:
[email protected] INSULATION RESISTANCE TEST DATA FORM
GENERAL INFORMATION:
Date:_____________ Test No.:________________
Client: ______________________________________ Ref. PO No.: __________________________________
Technician:______________________ Company:______________________ Circuit ID/Name:_____________
Circuit Information: __________________________________________________________________________
Phase Conductor Size:_____________________ Circuit Install Date/Age:_________________________
Neutral Conductor Size:_____________________ Conductor Rated Voltage:_______________________
Ground Conductor Size:_____________________ Circuit Length:________________________________
Wire/Cable : Conduit/Duct Size
Manufacturer:_____________________________ and Type:_____________________________
Wire/Cable Type:_________________________ Installation: ☐ Indoor ☐ Outdoor
Buried: ☐ Yes ☐ No
Wire Insulation Type:________________________ Concrete-Encased: ☐ Yes ☐ No
Wire Insulation Number and
Thickness:_____________________________ Type of Splices: ______________________________
Shielded: ☐ Yes ☐ No
Testing Conditions:
Ambient
Temperature:________________________ Meter Manufacturer:___________________________
Relative Humidity:_______________________ Meter Model:__________________________
Test Voltage (DC):_______________________ Meter Serial:__________________________
Wire Grounding
Time Prior to Test:_______________________
Were adjacent conductors (within same conduit/cable) grounded during test? ☐ Yes ☐ No
1SALES MAINTENANCE SERVICES AUTOMATION AUDIO/VISUAL INSTRUMENTATION&CONTROL SAFETY&SECURITY MEP WORKS
A.C. Cortes Ave., Cambaro, Mandaue City 6014, Cebu Philippines; Contact No.: 092 2953 9333 or 0928 613 6306; LL : 032 340 0805
Email add:
[email protected] Circuit
Date:_____________ ID/Name:______________________ Test No.:_______________
Test Results: Where a circuit does not contain a neutral conductor_______________________________
Resistance in ☐ MΩ ☐ GΩ
Test Connection
Test time
A-GND B-GND C-GND A-B B-C C-A
30 Seconds
1 Minute
2 Minutes
3 Minutes
4 Minutes
5 Minutes
6 Minutes
7 Minutes
8 Minutes
9 Minutes
10 Minutes
R (Ω*1000ft)
60/30-Sec
Absorption Ratio
10/1-Min
Polarization Index
Test Results: Where a circuit contain a neutral conductor_________________________________________
Resistance in ☐ MΩ ☐ GΩ
Test Connection
Test time
A-Neutral B-Neutral C-Neutral Neutral-GND
30 Seconds
1 Minute
2 Minutes
3 Minutes
4 Minutes
5 Minutes
6 Minutes
7 Minutes
8 Minutes
9 Minutes
10 Minutes
R (Ω*1000ft)
60/30-Sec
Absorption Ratio
10/1-Min
Polarization Index
Notes and Remarks (note any circumstances which may affect test results):
Prepared by: Noted by: Client:
DCNC Sales & Service DCNC Sales & Service Corp Client representative
Corp. Technician Supervisor
2SALES MAINTENANCE SERVICES AUTOMATION AUDIO/VISUAL INSTRUMENTATION&CONTROL SAFETY&SECURITY MEP WORKS
