IR SCAN (Either Winter,Summer,Quarterly Etc.)

Thermography Inspection at

(Site)

(Site address)(date)By

(Name)Thermography Inspection

at

(Site)Date:

(date)

Inspection Site Information

Customer(Site)

Address(Site address)

Contact personTJ Williams Electric

Phone number(513) 617-4262

E-mail addressmarkw@tjwelectric.com

ThermographerMark Westrich

INFORMATION

Thermography Inspection

at

(Site)Date:

(date)

Summary of Inspection

Location Equipment Fault Recommendation Page Number

(Where) (What) 3 Repair 4

(Where) (What) 3 Repair 5

(Where) (What) 1 Repair 6

(Where) (What) 1 Repair 7

Thermography Inspection

at

(Site)Date:

(date)

Photo and Identification

Location (Where) Equipment (What) Type (Part #) Actual load amps Fault 3Recommendation Repair

Thermogram 11/14/2009

Ar1 Max. Temperature 70.0 C Sp1 Temperature 35.2 C Delta T Value 34.8

Analysis & Recommended action:

Inspected by : (Name) Signature:...date: (date)

Repaired by: date:

Comment:..

Thermography Inspection

at

(Site)Date:

(date)

Photo and Identification

Location (Where) Equipment (What) Type (Part #) Actual load amps Fault 3 Recommendation Repair

Thermogram 8/14/2009

Ar1 Max. Temperature 43.9 C Sp1 Temperature 27.2 C Delta T Value 16.8

Analysis & Recommended action:

Inspected by : (Name) Signature:...date: (date)

Repaired by: date:

Comment:..

Thermography Inspection

at

(Site)Date:

(date)

Photo and Identification

Location (Where) Equipment (What) Type (Part #) Actual load amps Fault 1 Recommendation Repair

Thermogram 2/19/2009

Ar1 Max. Temperature 30.5 C Sp1 Temperature 27.1 C Delta T Value 3.4

Analysis & Recommended action:

Inspected by : (Name) Signature:...date: (date)

Repaired by: date:

Comment:..

Thermography Inspection

at

(Site)Date:

(date)

Photo and Identification

Location (Where) Equipment (What) Type (Part #) Actual load amps Fault 1 Recommendation Repair

Thermogram 2/19/2009

Ar1 Max. Temperature 31.5 C Sp1 Temperature 27.3 C Delta T Value 4.2

Analysis & Recommended action:

Inspected by : (Name) Signature:...date: (date)

Repaired by: date:

Comment:..

Overview of Fault Rating:

0: Normal Temp rise 0-5 C No action

1: Low gradeTemp rise 5-10 C To be monitored Plan new inspection

2: Medium gradeTemp rise 10-35 C Repair at scheduled shut down

3: SevereTemp rise >35 C Repair immediately

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Document15 (8)2010-03-14

ThermaCAM Reporter 8.2

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