Form No. 17A (Prescribed under Rule 56A) Test Report
Dust Extraction System 1. Description of system 2. Hood (a) Serial No. of Hood. (b) Contaminant captured. (c) Capture velocities (at points to be specified). (d) Volume exhausted at Hood. (e) Hood static pressure Design Actual Value 3. Total pressure drop at (a) Joints (b) Other points of system (to be specified) 4. Transport Velocity in Dust (at points alone dust to be specified) 5. Air cleaning Device. (a) Type used. (b) Velocity at inlet. (c) Static Pressure at inlet. (d) Velocity at outlet. (e) State Pressure at outlet. 6. Fan. (a) Type used. (b) Volume handled. (c) Static pressure. (d) Pressure drop at outlet of fan. 7. Fan Motor. (a) Type. (b) Speed and horse Power. 8. Particulars of defects, if any, disclosed during test in any of the above components. I certify that on this
day of
..the above dust extraction system was thoroughly cleaned and (so far as its construction permits) made accessible for thorough examination. I further certify that on the said date, I thoroughly examined the above dust extraction system including its components and that the above is a true report of my examination. Signature
Qualification
Address
...
Date
. If employed by a Company or Association give name and address. | 
