SURGE PROTECTIVE DEVICE AT POINT OF USE

Effective Date: 06/17/2015

Document Identifier: CM-620-2.7.2-01

Printed copies are for reference only; they are not controlled. Latest version is on-line.

FDOT Traffic Engineering Research Laboratory (TERL) Surge Protective Device (SPD) at Point of Use Compliance Matrix	By signing this form, the applicant declares that he/she has read and understands the provisions of Section 620 of the FDOT Standard Specifications for Road and Bridge Construction and all implemented modifications. The requirements listed on this matrix are derived from Section 620, and are the basis for determining a product’s compliance and its acceptability for use on Florida’s roads.

Date:	Click here to enter a date.	Applicant’s Name (print):
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ID No	Section	Requirement	Item Comply? (Yes/No)	Comments (Applicant must provide information as indicated)	TERL Evaluation Method
1	620-2.7.2	SPD is intended for installation at the point that devices receive 120V power and connected in series with the circuits.	Provide product literature, specifications, user manual, or similar information that indicates compliance. (Indicate specific configurations by model number or series).	Document Review and Physical Inspection
Indicate location of requested information in submittal.
2	SPD is rated at 15 or 20 amps load.	Provide product literature, specifications, user manual, or similar information that indicates compliance. (Indicate specific configurations by model number or series).	Document Review
Indicate location of requested information in submittal.
3	SPD is configured with receptacles.	Provide product literature, specifications, user manual, or similar information that indicates compliance. (Indicate specific configurations by model number or series).	Document Review and Physical Inspection
Indicate location of requested information in submittal.
4	SPD has internal fuse protection.	Provide product literature, specifications, user manual, or similar information that indicates compliance. (Indicate specific configurations by model number or series).	Document Review
Indicate location of requested information in submittal.
5	SPD provides common mode (L+N-G) protection.	Provide product literature, specifications, user manual, or similar information that indicates compliance. (Indicate specific configurations by model number or series).	Document Review
Indicate location of requested information in submittal.
6	SPD nominal operating voltage is 120VAC.	Provide product literature, specifications, user manual, or similar information that indicates compliance. (Indicate specific configurations by model number or series).	Document Review
Indicate location of requested information in submittal.
7	SPD clamping voltage is between 150-200V.	Provide a first or third-party test report that demonstrates the device meets this requirement. The test report must meet the requirements of FDOT Product Certification Handbook (PCH), section 7.2.	Document Review
Indicate location of requested information in submittal.
8	SPD surge capacity is 20kA per mode (8x20 μs) or greater.	Provide a first or third-party test report that demonstrates the device meets this requirement. The test report must meet the requirements of FDOT PCH, section 7.2.	Document Review
Indicate location of requested information in submittal.
9	SPD maximum let-through voltage is <550 Vpk.	Provide a first or third-party test report that demonstrates the device meets this requirement. The test report must meet the requirements of FDOT PCH, section 7.2.	Document Review
Indicate location of requested information in submittal.
10	620-2.7.4	SPD is permanently marked with manufacturer name or trademark, part number, and date of manufacture or serial number.	Applicant may provide comments in this field.	Physical Inspection
11	All parts are made of corrosion-resistant materials, such as plastic, stainless steel, anodized aluminum, brass, or gold-plated metal.	Provide product literature, specifications, user manual, or similar information that indicates compliance. (Indicate specific configurations by model number or series).	Document Review and Physical Inspection
Indicate location of requested information in submittal.
12	620-2.7.5	SPD operates properly during and after being subjected to the temperature and humidity test described in NEMA TS 2, Section 2.2.7, and the vibration and shock tests described in NEMA TS 2, Sections 2.2.8., and 2.2.9.	Provide a first or third-party test report that demonstrates the device meets this requirement. The test report must meet the requirements of FDOT PCH, section 7.2.	Document Review
Indicate location of requested information in submittal.