TESTING COMMISIONING REPORT

TELEPHONE
Project _______________________
FM/IK/ODR/MEP-004-02 Rev: 0 Halaman 1 dari 1

Location : _______________________________ Equipment No. : _____________________________

Level : _______________________________ Service : _____________________________
Test Date : _______________________________ Drawing Ref. : _____________________________
Report Date : _______________________________

Telephone Data :
Manufacture : ______________________ Direct Line : _______________________
Type : ______________________ Extension Line : _______________________
Serial no. : ______________________ Fax Line : _______________________
Telkom Line : ______________________ Type of Connection : _______________________
MDF : ______________________ Cable Line : _______________________
IDF : ______________________

Test Result :

Unit Cleaning : Yes No

Bolt & Nut Tightening : Yes No

Grounding System : Yes No

Input Voltage : Phase-N __________ V Phase-G __________ V N-G __________ V

Ambient Temperature : ______________________

Battery : ______________________

Line Function Test

Location
Code Direct Line Telp. Ext. Line Telp. Fax Line

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

_________________________ _________________________ _________________________

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