‫الــفـــريــــق الســتــشــــارات الســـالمــــة‬

TEAM SAFETY CONSULTANTS L.L.C

EXAMINATION AND TEST OF AIR COOLED CHILLER

Job No.: Certificate/Report No.:

Name & Address of the Owner of the Equipment: Name & Address of the Manufacturer of the Equipment:

Location: Survey Requested by: Type of Inspection:

Model / Model No: Serial No.: Year of Manufacture / Installation:

Manufacturer / Owner Identification No: Refrigerant: Cooling Capacity.:

Max. Allowable Working Pressure: Unladen Weight: Electric Supply:

TSC Test Method No.: TSC Test Equipment No.: Reference Regulation:

TSC / TM / TSC / EQ/

Date of Previous Test: Previous Test Done By:

Date of Test: Date of Expiry:

EQUIPMENT STATUS:
Name and position of person who
Carried out the inspection and test:
SATISFACTORY

_______________ NOT SATISFACTORY

Inspection Engineer

TEAM SAFETY CONSULTANTS L.L.C, TRADE LICENSE NO. 500714, AL-GARHOUD, P. O. BOX: 112349, DUBAI -UAE,
TEL: 04-2828868,FAX: 04-2865265 EMAIL: info@tsc-uae.ae, WEBSITE: https://www.tsc-uae.ae/

TSC-F-91Q (Rev.05) (22/01/2023) Page 1 of 2

Continuation of Job No.: Certificate/Report No.:
COMPONENTS REMARKS
Equipment manufacturer’s instruction & operational
manual & last test report/certificate details available
Electrical Connections
Wiring Insulation
Vibrations
Panel Board
Discharge Pressure Cut Out
Low Pressure Cut Out
Condenser Fan And Its Control
Condensor
Discharge Pressrue
Suction Pressure
Oil Pressure
Refrigeration Level
Oil Level
Oil Pump
Oil Failure Switch
Oil Heater
Mounting And Foundation
Motor Protector
Drier Core
Painting

General Condition
maintenance

RECOMMENDATION / REMARKS

TSC-F-91Q (Rev.05) (22/01/2023) Page 2 of 2