COMMISSIONING CLEARANCE TEST RECORD #Sr_No

Equipment
MOTORIZED VAVLE
Feeder Name

Area

Group

KKS

Description

Logic_Sheet

Graphics_No

Faceplate_No

O O
O
O

LOCAL

FIELD

REMOTE

VALVE
POSITION:

CLOSE
OPEN

TOURQE LS:

10

11

12

13

14

15

O O

O
O
O

O
O

FIELD

O
O
O

O O

O O

SEL SW:

O O

MANUAL

O
B

EMR'Y PUSH BUTTON

MANUAL:

DCS
FIELD

OPEN CMD: (Term: 3,4)

VALVE POS:

OPEN CMD: (Term: 3,4)

CLOSE
OPEN

VALVE:

Remarks:

CLOSE (Term: 5, 6)
OPEN (Term: 5, 7)
ALARM (FOP, FOC, TQ)
VALVE POSITION (%)

O
O
O
O

G
W
Y

Drawing No.:

O CHECK ITEM (V = CHECK MARK)

NECESSARY CONDITIONS
B

Certified By

N/O

CLOSE CMD: (Term: 1, 2)

CLOSE CMD: (Term: 1, 2)

OPEN CMD: (Term: 3,4)

PROT:

CLOSE CMD: (Term: 1, 2)

AUTO:

CLOSE P.B.
OPEN P.B.

DCS

OPERATION

O
O

CLOSE ACTIV. (Term: 37, 41)

AUTO

INDICATION

1 of 1

OPEN ACTIV. (Term: 39, 41)

SYSTEM READINESS (CPU HEALTHY, NO
POINT FORCED, NO POINT IN BAD
QUALITY):

L.C.P.:

Test_Date
Sheet

Faceplate reference

CHECK NO.

DCS

Date

Description

Graphic reference

SEL SW:

Group

Device_Tag

Logic reference

CONDITION

Unit

Area

Name

BLOCK

Signature

MIMIC COLOR
COMMON ANNUNCIATION
INDIVIDUAL ANNUNCIATION

Date

Remarks