Circuit-Safe: Large Breaker Survey Form

Use this page to submit the Panel Survey for larger panels with large breakers. Each panel must be submitted individually.

Large Breaker Survey Form
First Name*:
Last Name*:
Company Address*:
Zip Code:
Facility Name:
Facility Location*:
Panel #*:
Panel Location:
Building Name:

Fig. A) Center Column: Raised or flush with panel front? Raised Flush
Fig. B) Distance from center line to handle in the off position?
Fig C) Distance from edge of breaker to handle in off position?
Fig D) Distance between breaker center lines?
Fig E) Distance between breaker and raised center column?
Fig. F) Distance between breaker and edge of panel?
Fig G) If rail will be installed "outside" the breaker column,
what is the distance from the rail location to the
breaker handle in the off position (closer is better)?
Fig H) Distance between surface of breaker
and the surface of the panel?
Fig I) Number of breakers on the left?
Fig J) Number of breakers on the right?


Alternatively, you may choose to print a blank Large Breaker Panel Survey Sheet for each panel and fax it to Stranco Inc. upon completion.

Contact Stranco Inc.