Start up - Supp. Form 1

Record start up operating parameters below:

Data Design Actual Actual Actual Actual Actual
Tag#
Voltage
Current
Phase
MotorRPM
Horsepower(HP)
ServiceFactor
BeltSize&Quantity

Record start up operating parameters below:

Data Design
Tag #
Voltage
Current
Phase
Motor RPM
Horsepower(HP)
Service Factor
Belt Size&Quantity

Record start up operating parameters below:

Data Design
Tag#
Voltage
Current
Phase
MotorRPM
Horsepower(HP)
ServiceFactor
BeltSize&Quantity

Note: Insert N/A in those deemed not applicable.

Performed By: Print Name Initials Date