[HOLCOMB SGS REPORT PAGE 5 EXTRACT START]
Page 5 Report No.
4827740 FEB-01
This document is issued by the Company subject to its General Conditions of Service printed overleaf, available on request or accessible at www.sgs.com/terms_and_conditions.htm and, for electronic format documents, subject to Terms and Conditions for Electronic Documents at www.sgs.com/terms_e-document.htm. Attention is drawn to the limitation of liability, indemnification and jurisdiction issues defined therein.
Any holder of this document is advised that information contained hereon reflects the Company’s findings at the time of its intervention only and within the limits of Client’s instructions, if any.
The Company’s sole responsibility is to its Client and this document does not exonerate parties to a transaction from exercising all their rights and obligations under the transaction documents.
This document cannot be reproduced except in full, without prior written approval of the Company. Any unauthorized alteration, forgery or falsification of the content or appearance of this document is unlawful and offenders may be prosecuted to the fullest extent of the law.
Unless otherwise stated the results shown in this test report refer only to the sample(s) tested and such sample(s) are retained for 90 days only. Form QSF27-4-01 Rev 1.3, Rev. date: Oct. 01, 2019 Original Issue date: 11-26-08 Field Evaluation Report 1.0
Purpose 1.1.
The purpose of this inspection is to provide assurance that the equipment being evaluated meets the requirements of the appropriate codes & safety standards as outlined in our report.
1.2.
These requirements are required by the local AHJ (Authority Having Jurisdiction) when equipment is not listed or recognized by a Third Party Nationally Recognized Testing Laboratory “NRTL”. This evaluation addresses only the electrical aspects of the equipment with respect to electrical fire & electrical shock hazards only.
The environment where the equipment will be used & installed has been taken into consideration during the evaluation of the product.
1.3.
In some jurisdictions, the AHJ may have established requirements and/or practices for field evaluation & labeling. SGS’s policy is to comply with such additional requirements in those jurisdictions.
1.4.
The field evaluation has also taken into consideration those requirements outlined in The National Electrical Code Sections 90.7 & 110.3 (A).
1.5.
This document can be used by the AHJ in assessing the completeness & the adequacy of the evaluation process that was used during the field labeling process of the equipment identified in this report as performed by SGS.
1.6.
The field evaluation process was applied to this particular system since it was not a “listed” product.
1.7.
This field evaluation process for this product listed in this report was for a one-of–a-kind, limited production, used, or modified products that were not listed or labeled under a full listing & certification program.
1.8.
This process could have been completed @ the point of manufacturing, interim points of distribution, in the company’s facilities or at the final installation site or a combination of the above. In the report, the labeling location was identified.
2.0 Summary
2.1.
The equipment was labeled as indicated in the table below & modifications outlined in the field evaluation checklist were completed prior to the equipment being labeled.
Manufacturer Model No. Serial No. SGS Label No
Holcomb Inline Power Generator ILPG 100 001 Q32997
Holcomb Inline Power Generator ILPG 40 001 Q32998
Holcomb Power Converter Inline Power
Generator PC ILPG 40 001 Q3299
2.2.
The equipment listed in this field evaluation report complies with the requirements as outlined in the report & the field evaluation shall not be considered the equivalent of a listing & it is suitable for the installation location as identified in the report.
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