EPISENSOR | ANALOGUE SIGNAL ACCEPTANCE RECORD (4-20 mA / 0-10 V) Revision: 22 September 2026 Guide: https://episensor.com/knowledge-base/analogue-signal-commissioning One record for each analogue signal. Keep it with the site documents. Keep credentials, passwords and access tokens out of this file. 1. INSTRUMENT Instrument tag and location: _____________________________________________ Make, model and configuration: ___________________________________________ Quantity, range and unit (e.g. 0-10 bar): __________________________________ Signal type (4-20 mA / 0-10 V / other): ___________________________________ Calibration certificate reference: _______________________________________ 2. LOOP OR SIGNAL CIRCUIT Loop-powered or separately powered: ______________________________________ Supply voltage: _________________________________________________________ Transmitter minimum terminal voltage: _____________________________________ Series elements and resistance (input, cable, barriers, indicators): _______ _________________________________________________________________________ Headroom at 20 mA: _______________________________________________________ Input model and channel: _________________________________________________ 3. KNOWN POINTS Applied / observed Raw input Scaled value Expected ____________________ ________________ ________________ __________ ____________________ ________________ ________________ __________ ____________________ ________________ ________________ __________ 4. FAULT STATES Open circuit reported as fault? (yes / no): _______________________________ At or below 3.6 mA reported as fault? (yes / no / n/a): ____________________ At or above 21 mA reported as fault? (yes / no / n/a): _____________________ Out-of-range behaviour (clamp / extrapolate / flag): ________________________ 5. SAMPLING Input sample rate: ______________________________________________________ Filter or averaging period: ______________________________________________ Publication interval: ____________________________________________________ 6. ACCEPTANCE Accepted by: ____________________________ Date: _______________________ Open items and owners: ___________________________________________________ _________________________________________________________________________