UFC 3-570-06
JANUARY 31 2003
CATHODIC PROTECTION INSTALLATION REPORT
ACTIVITY:
DATE:
IMPRESSED CURRENT SYSTEM
Location of Rectifier
Identification Number
Structure(s) Protected
Reference Drawing Number(s)
Showing CP System
Anode
Description
Type:
Quantity:
Size:
dia.
X
long
Rectifier Manufacturer
Rectifier Rated Capacity
A.C. Input
Amps:
Volts:
Phases:
Cycles:
Hz
D.C. Output
Amps:
Volts:
Date Unit Turned On
Number of Test Stations
System Maintained By
SACRIFICIAL SYSTEM
Location of Sacrificial Anodes
Structure(s) Protected
Reference Drawing Number(s)
Showing CP System
Anode
Description
Type:
Quantity:
Weight:
Size:
Date Installed
Number of Test Stations
System Maintained By
Notes:
1. Submit a one-time report for each impressed current rectifier.
2. Submit a one-time report for each structure protected by a sacrificial anode system.
3. Report CP installations within three months of installation. Attach initial test data information.
FIGURE B-1
CATHODIC PROTECTION INSTALLATION REPORT
B-5
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