Standard Panel Survey Form

Use the following graphic guide and procedure for each standard panel to complete the Panel Survey for each circuit breaker panel:

Four Measurements for Each Panel

#1 : Measure the spacing between the circuit breaker center lines (see "1" on diagram)

#2 : Count the number of potential breaker spaces on just one (1) side of the panel (see "2" on diagram)

#3 : Measure the distance from the centerline between the two columns of breakers to the maximum position of the breaker handle in the "off" position. (see "3" on diagram)

#4 : Measure the distance from the surface of the front panel to the top surface of the circuit breaker. Indicate "actual" height as appropriate. (see "4" on the diagram)

Name (required)

Company (required)

Company Address (required)

City (required)

State (required)

Zip Code (required)

Telephone (required)

E-mail (required)

Facility Name

Facility Location

Enter the Circuit-Breaker Panel Information for each panel:

Panel #

Panel Location:

Building:

Columns:
12

#1 Spacing

#2 Number

#3 Distance

#4 Height

Panel #

Panel Location:

Building:

Columns:
12

#1 Spacing

#2 Number

#3 Distance

#4 Height

Panel #

Panel Location:

Building:

Columns:
12

#1 Spacing

#2 Number

#3 Distance

#4 Height

Panel #

Panel Location:

Building:

Columns:
12

#1 Spacing

#2 Number

#3 Distance

#4 Height

Alternatively, you may choose to print a Panel Survey Procedure and a blank Standard Panel Survey
Data Sheet and fax them to Stranco Inc. upon completion.