Control Panel Worksheet
Motor Control Panel Questionaire
Customer Name: _______________________________
DATE REQ FOR COMPLETED QUOTE:_____________
RFQ #:______________________________
YES
(X)
QUESTIONS - PLEASE ANSWER ALL LISTED QUESTIONS
1)Application Details:
NO
(X)
Yes/No check boxes with space to detail if
needed/required!
DETAILS HERE:
AREA CLASSIFICATION
Hazardous?
Non-Hazardous?
TOTAL POWER RATING
INPUT VOLTAGE?
208V
220/230-240
400-440
460-480
575-600
PHASE ?
SINGLE (1) PHASE
THREE (3) PHASE
CYCLE(S) HERTZ?
50 HZ
60HZ
ENCLOSURE REQUIREMENTS
Enclosure Limitations?
Yes?
No?
DETAILS HERE:
INSTALLATION ENVIRONMENT
Indoor ?
Outdoor?
Outdoor with direct sunlight?
Washdown Required?
Hazardous Class?
N/A?
Div#?
Group #?
ENCLOSURE NEMA RATING
NEMA 12 (ventilation reduces to NEMA1)?
NEMA3R Ventilated?
NEMA 4X
NEMA 4 X STAINLESS STEEL?
AMBIENT TEMPERATURES
Degrees F Minimum
Degrees F Maximum
CORROSIVE ENVIRONMENT
Yes?
NO?
DETAILS HERE:
DETAILS HERE:
DETAILS HERE:
DETAILS HERE:
TECHNICAL SPECIFICATION(S)
SIZING
Motor HP & RPM?
Motor FLA (Full Load Amps)?
Service Factor?
APPLICATION /ENVIRONMENT:
Replacing standard NEMA sizes (Yes/No)
Full Voltage?
Wye-Delta?
Part Winding?
Non-Reversing?
Reversing?
SPECIFY MAXIMUM # of Starts Per Hour
DETAILS HERE:
DETAILS HERE:
DETAILS HERE:
SPECIFY NEMA SIZE HERE:
DETAILS HERE:
CONTROL CIRCUIT:
Common Control (Same as Power to Motor )?
Control Circuit Transformer (Specify secondary voltage )?
DETAILS HERE:
DETAILS HERE:
Transformer with extra capacity VA ( Please specify here )?
DETAILS HERE:
COVER MOUNTED 22MM DEVICES (if yes enter Quantities)
Start /Stop push buttons?
HOA (Hand/Off/Auto) Selector Switch?
ON/OFF Selector Switch?
Motor Run Light?
Other?
AGENCY APPROVALS
None?
UL 508?
Other?
MAIN POWER DISCONNECT/SHORT CIRCUIT PROTECTION
Yes?
No?
Molded Case Circuit Breaker w/through door disconnect?
Non-Fusible Disconnect?
Fusible Disconnect?
Special Requirements?
QUANTITY HERE:
QUANTITY/DETAILS HOW TO BE USED HERE:
QUANTITY/DETAILS HOW TO BE USED HERE:
QUANTITY HERE:
DETAILS HERE:
DETAILS HERE:
DETAILS HERE:
SPECIAL FEATURES
On/Off Switch?
Load Fusing?
Load Circuit Breakers?
Enclosure Heater?
Enclosure Floor Stand?
Pilot Lights? (Please specify)
Audible Alarm?
Dry Contact Output?
OTHER SPECIAL REQUIREMENTS?
Additional Notes Here:
DETAILS HERE:
DETAILS HERE:
DETAILS HERE:
DETAILS HERE:
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