Company Name*
Contact Name*
Title*
Address*
Phone*
Fax
Email*
Retype Email Address*
1. What product(s) does your facility manufacture?*
2. What is the age of your facility?*
3. What is the square footage of your facility?*
4. Total Number of Employees*
5. How many maintenance or electrical employees do you have that work on energized electrical components? *
6. Can Lewellyn Technology collect data during normal working hours?* Yes No
7. Will you provide an electrician or someone familiar with your electrical system to accompany the data collector to assist in tracing circuits and identifying loads?* Yes No
8. Will you provide a man lift or scissor lift with an operator to access overhead busways, if needed? * Yes No
9. How many services come in from the electric utility?*
a. At what voltage?*
10. What is the KVA of each utility transformer?*
11. Does the facility have its own transformers that are greater than 125KVA?* Yes No Not Sure
a. IF yes, how many?*
b. What is the KVA of each transformer?*
12. What percent of your electrical distribution panels, breakers, etc are accurately labeled as to what they feed? *
13. Does the facility have any equipment operating at voltages above 480V, such as compressors, circuit breakers, fuses, etc.?* Yes No Not Sure
a. If so, please explain. If possible, quantify terms of HP or KVA.
14. How many MCCs (motor control centers) does the facility have? *
a. What is the approximate number of buckets total in all MCC's?*
15. How many overhead busways does the facility have? *
a.) Estimated number of drops/bussplugs?*
16. Estimate the number of 3-Phase panel boards in the facility: *
17. Does the facility have any generators on-site for co-generation or power back-up?* Yes No Not Sure
a.) If so, how many?
b. What size?
18. What percentage of your facility has exposed ceilings?*
19. What percentage of your facility has drop ceilings?*
20. Does your facility have any large panels that require two people for opening?* Yes No Not Sure
Questions or Comments?
