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HYDRAULIC SURVEY FORM
Page 1 of 2
Phone: (804) 225-5530 ● Fax: (804) 225-0116 ● Email: [email protected]
Company: Purchase Order # Address: Date:
Job Name:
Attn.: Phone: Job Location:
Fax: Installation By: Email: Number of Cars:
Ship To: Contact: Address: Phone:
Lift Gate Truck: Yes No
Delivery Notification:
24 hrs* 48 hrs* *Freight Company Fee Applies.
Notification by VC Requested Ship Date:
Certification: UL/CUL CSA TSSA Other _____________________
Office Prints: 11”x17” Submittals
Service: Passenger Freight Jack Type: Telescopic Hole-less In-Ground Roped
Controller: Vision 2.0 w/Car Top Inspection Station (Serial I/O) MH-3000 (Discrete) PLC (GE RX3i) PLC (A-B CompactLogix) PLC (A-B ControlLogix) Other_________________________
Building Power: ______V - ___ - ___Hz Car: Capacity: ______________ Speed: ________________
Landings/Travel: No. of Landings: ________ Total Travel: ___________ Short Floors Travel Between Ldgs.: 1_________2_________3_________4_________5_________6
6_________7_________8_________9_________10
Vision 2.0 Traveler Cable: _________ ft Jute Core w/grips (suspended < 200Ft) Steel Core w/hangers (suspended > 200Ft)
Operation: Single Automatic Pushbutton Selective Collective Single Button Collective
Call & Send Simplex Machine Room Monitoring
Constant Pressure Pushbutton Real Time Dispatching Duplex Group___________________
Machine Room Monitoring with Remote Access
Doors: GAL MOVFR GAL Other _________ VC MODSS Door Controller MAC SS MAC STD ECI: ______________ Swing Door Other:____________________________________ Manual: Fixed Cam
Retiring Cam AC: _____V - __φ - ___Hz @ _____ Amps DC: _____V- _______Ω- _____ Amps Power Freight: Manuf. & Model: __________________________________ Auto-open Auto-close
Fire & Safety Code: A17 ’19 A17 ’16 CAN B44-___________ (year) Fire Service Phase 1 Only
A17 ’13 A17 ’10 A17 _______________ (year) Local Code: _______________ Other: ___________________
NO FIRE SERVICE
Floor Labels / Ldg Numbers
Main / Alt
Front / Rear
10
9
8
7
6
5
4
3
2
1
Front Rear Fire Access
HYDRAULIC SURVEY FORM
Page 2 of 2
Phone: (804) 225-5530 ● Fax: (804) 225-0116 ● Email: [email protected]
Fixtures: Car / C.O.P. Hall / Hoistway
Fixture Voltage: Vision 2.0 Standard 24V DC 24V DC MH-3000 Standard 115V AC 115V AC
Other ____V AC DC _____V AC DC
Hall I/O Boards: Screw Terminal Connections – CANbus Cable by Virginia Controls
Pre-Wire Fixtures. Send schematic and/or boards to: Fixture Company: _____________________ Fixture Co. Contact: ___________________Fixture Co. Email: _____________________ Ship by Date:_________________________
Plug-In (RJ45) Connections – CAT5 Cable by Installer
Car Position Indicator Hall Position Indicator - digital Hall PI’s @ Non-Main Ldg. Hall Position Indicator - multi-light C.E. Electronics PI Driver Board (Floor Labels Required)
Direction Arrows Voice Annunciator
____V AC
½ Stroke Gong Programming by VC ½ Stroke Gong Programming by VC
____V AC DCDC
Passing Gong Call Register Lights Car Travel Lantern Hall Lanterns Door Open Bell In-Use Lights Barrier Free Gong
____V AC DC Serial (from driver board) ____V AC DC Serial (from driver board) ____V AC DC ____V AC DC ____V AC DC BFG @ Ldg.#_______
Features: Hoistway Insp. Access Top Btm Other __________ In-Car Inspection Independent Service Emergency Power Auto Manual Lower Only Battery Lowering “BORIS” Door Nudging with Timed Electric Eye Cutout Infrared Curtain Unit (Nudge on Fire Service) Safety Edge with Elect. Eye Oil Viscosity Control Oil Pressure Switch Hospital Service -- “Code Blue” Massachusetts EMT Hospital Service PI Blanking on Fire Service Anti-Nuisance
Load Weighing Bypass Low Oil Switch Flood Switch Car-to-Lobby Switch Key or Card Lockout in C.O.P. @ Ldg.#’s: _________
Homing - Specify Landing#: ________ Jack Resynchronization (telescoping piston) Door Hold Open-- Switch Button Reverse Phase Monitor Fan & Light Auto K/O Governor Reset Circuit 24VDC 120VAC WiFi Mobile Interface Router+Tablet Router Only Other: ______________________________ Other: ______________________________
Enclosures: Back Panel Only Hinged Enclosure Wall Mounted Free Standing
NEMA 1 NEMA 12 NEMA 4 NEMA 4x Other: ____________________________ Special Dimensions: ____” H x ____” W x ____” D
Positioning/Leveling System: ELGO Absolute Positioning System (Vision 2.0 Controllers ONLY) IP-8300 IP-8700 NEMA 1 w/Steel Tape NEMA 12/4/4X w/Poly-coated Tape Landing/Leveling by Others: Output/Floor Pulsing
Valve: Standard is (4) Coils @ 115VAC Maxton EECO [ Blain Other _______________________________
ESCO CEMCO Dover/TKE (I2-I3) Non-Standard Coil Voltage: __________V AC DC
Motor: _______ HP ________ Volts _______ F.L. Amps _________ SPH (Branch circuit protection by others!!) Across-the-Line Wye-Delta Solid State 3/9 Motor Leads 6/12 Motor Leads IEC NEMA Motor Starter by Others (Attach Schematic) _________________________________________ Dual with Sequential Starting Branch Circuit Protection for 2nd Starter