C

COMMENTS:

DEFICIENCIES:

03

VDC

MANUFACTURER'S DISCHARGE RATE

END CELL VOLTAGETEST CURRENT OVERALL END BATTERY VOLTAGE TIME

EQPT. INVENTORY NO. TESTED BY:

10000, REVISED 3/6/2008COPYRIGHT 2002-2008 POWERDB, INC. www.powerdb.com

CATALOG NO.

BATTERY DISCHARGE TEST

TELEPHONE

CUSTOMER

ADDRESS

SAMPLE FORMS COMPANY

USER SAMPLE FORMS COMPANY OWNER REPRESENTATIVE

PAGE

JOB # FORMS-ALL

5/7/2008 TEMPERATURE HUMIDITY %FSUBSTATION

DATE

BATTERIESEQPT. LOCATION

POSITION GENERAL

MA

MFR'S RATED CAPACITY TIME - MINUTES

ACTUAL DISCHARGE TIME - MINUTES

BATTERY CAPACITY - PERCENT

TEMPERATURE CORRECTED CURRENT

CELL VOLTAGE ALARM

CELL VOLTAGE DEVIATION ALARM

CELL VOLTAGE SHUTDOWN LEVEL

BATTERY VOLTAGE ALARM

BATTERY VOLTAGE SHUTDOWN LEVEL

MANUFACTURER

OVERALL BATTERY VOLTAGE

OTHER

BATTERY CHARGE STATUS: CHARGED EQUALIZED

CELL TYPE

SPECIFIC GRAVITY RANGE

NUMBER OF CELLS

CELL VOLTAGE

AMP HOUR RATING

BATTERY TEMP.

TEST PARAMETERS

NAMEPLATE DATA

BATTERY INSPECTIONSPECIFIC GRAVITY

TELEPHONE

CUSTOMER

ADDRESS

SAMPLE FORMS COMPANY

USER SAMPLE FORMS COMPANY OWNER REPRESENTATIVE

PAGE

JOB # FORMS-ALL

5/7/2008 TEMPERATURE HUMIDITY %FSUBSTATION

DATE

BATTERIESEQPT. LOCATION

POSITION GENERAL

123456789101112131415161718192021222324252627282930313233

SPEC. GRAVITY VOLTAGE

34353637383940

10100, PAGE 1 OF 3, REVISED 4/18/2006COPYRIGHT 2002-2008 POWERDB, INC. www.powerdb.com

C

CELL

4243444546474849505152535455565758596061626364656667686970717273

SPEC. GRAVITY VOLTAGE

74757677787980

CELL41

NAMEPLATE DATA

MANUFACTURER

CATALOG NO.

OVERALL BATTERY VOLTAGE VDC

BATTERY TEMP.

OTHER

BATTERY CHARGE STATUS CHARGED DISCHARGED EQUALIZED TEMPERATURE CORRECTED READINGS YES NO

AMP HOUR RATING

CELL VOLTAGE CELL TYPE

SPECIFIC GRAVITY RANGE

NUMBER OF CELLS

84858687888990919293949596979899

100101102

SPEC. GRAVITY VOLTAGECELL81

104105106107108109110111112113114115116117118

103

120121122123124125126127128129130

119

82133134135136137138139140141142143144145146147148149150151152

SPEC. GRAVITY VOLTAGECELL131

154155156157158159160161162163164165166167168

153

170171172173174175176177178179180

169

13283

BATTERY INSPECTIONSPECIFIC GRAVITY

PAGE

10100, PAGE 2 OF 3, REVISED 4/18/2006COPYRIGHT 2002-2008 POWERDB, INC. www.powerdb.com

CELL NO. TEMP. CTEMP. C CELL NO. TEMP. C CELL NO.

186187188189190191192193194195196197198199200201202

SPEC. GRAVITY VOLTAGECELL181

204205206207208209210211212213214215216217218

203

220221222223224225

219

182183

229230231232233234235236237238239240241242243244245246247

SPEC. GRAVITY VOLTAGECELL226

249250251252253254255256257258259260261262263

248

265266267268269270

264

227228

COMMENTS:

DEFICIENCIES:

03

EQPT. INVENTORY NO. TESTED BY:

10100, PAGE 3 OF 3, REVISED 4/18/2006COPYRIGHT 2002-2008 POWERDB, INC. www.powerdb.com

184185

BATTERY INSPECTIONSPECIFIC GRAVITY

PAGE

PILOT CELLS

CVDC

COMMENTS:

DEFICIENCIES:

03

UPS BATTERY DISCHARGE

TELEPHONE

CUSTOMER

ADDRESS

SAMPLE FORMS COMPANY

USER SAMPLE FORMS COMPANY OWNER REPRESENTATIVE

PAGE

JOB # FORMS-ALL

5/7/2008 TEMPERATURE HUMIDITY %FSUBSTATION

DATE

BATTERIESEQPT. LOCATION

POSITION GENERAL

TEMPERATURE CORRECTED CURRENT

CELL VOLTAGE ALARM

CELL VOLTAGE DEVIATION ALARM

CELL VOLTAGE SHUTDOWN LEVEL

BATTERY VOLTAGE ALARM

BATTERY VOLTAGE SHUTDOWN LEVEL

MFR.'S RATED CAPACITY - MINUTES

ACTUAL DISCHARGE - MINUTES

PERCENTAGE BATTERY CAPACITY

EQPT. INVENTORY NO. TESTED BY:

10500, REVISED 11/27/2007COPYRIGHT 2002-2008 POWERDB, INC. www.powerdb.com

UPS NAMEPLATE DATA

%

BATTERY NAMEPLATE DATA

TEST PARAMETERS

MANUFACTURER

CATALOG NO.

INPUT VOLTAGE

DC VOLTAGE INPUT

VOLTAGE OUTPUT

OTHER

kVA RATING

INPUT CURRENT

DC INPUT CURRENT

CURRENT OUTPUT

MODEL

POWER FACTOR

INPUT FREQUENCY

OUTPUT FREQUENCY

SERIAL NO.

TYPE STATIC ROTARY

OUTPUT PHASE

INPUT PHASE

MANUFACTURER

CATALOG NO.

OVERALL BATTERY VOLTAGE

OTHER

CELL TYPE

SPECIFIC GRAVITY RANGE

NUMBER OF CELLS

CELL VOLTAGE

AMP HOUR RTG

BATTERY TEMP

BATTERY TEST

TELEPHONE

CUSTOMER

ADDRESS

SAMPLE FORMS COMPANY

USER SAMPLE FORMS COMPANY OWNER REPRESENTATIVE

PAGE

JOB # FORMS-ALL

5/7/2008 TEMPERATURE HUMIDITY %FSUBSTATION

DATE

BATTERIESEQPT. LOCATION

POSITION GENERAL

EQPT. INVENTORY NO. TESTED BY:

10750, REVISED 2/7/2008COPYRIGHT 2002-2008 POWERDB, INC. www.powerdb.com

STRING NAME:

INSTALLATION DATE:

NUMBER OF CELLS: HIGH LIMIT:

LOW LIMIT:

NOMINAL:

for

to

0

0

DUTY CYCLE:

VPC

AmpsMinutes0

VOLTS PER CELL:

NUMBER OF STRAPS:

CHARGER

VOLTAGE:

EQUALIZATION VOLTAGE:MANUFACTURER:

MODEL:

Volts

Volts

/ 1HYDROMETER. START/SKIP CELLS 1

IMPEDANCE (ohms)% VARIANCE

(Baseline)% DEVIATION

(String)% CHANGE

(Last)VALUENOTESCELL # VOLTAGE (volts)

SPECIFIC GRAVITY

TEMPERATURE F TIME MODEL

Min. Voltage: 999.000 0.000Max. Voltage:

STRAP # RESISTANCE (ohms)MEASUREMENT

TIMECELL

CONNECTED TO TYPE

1

COMMENTS:DEFICIENCIES:

BATTERY TEST

PAGE

BATTERY TEST

PAGE

BATTERY TEST

PAGE

BATTERY TEST

PAGE