MECHS .
VCT -L -J-2004 00203 AM - F. 0.z:
ATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -
Buil darName
Tela none Plan Number
Yetephpne Sampie Group Nxrnbor
Eying Signature ate Sample House Number
F,�rm: orG �'�Sla+Gi�t: HERS ProviderG��O�SrS�CS
Sl.ee'Address, %iL &d:Forl /1i" I.�.._ Cltylstatuaip;
Copies to: 6ui10er r.ERS P°ovider
�sRS RATP I CES gTdAJMEPIT_
'he House was: IwTostec ® Aoproved as part of sample testing, but was net tested
As the HERS rater providing diagnostic testing and held verification., I certify that the houses identifled on th:9 form
comply with the diagnostic tested compliance requ;rernents as chocked on this form.
CiatribAlon system Is fuliy eucted (i.e., does not use building cavit!ee as plenums or platform returns in iiyu
f ducts)
where cloth backed, rubber adhcalve duct tape is installed. Blastic and drewbands are used in corribirstion
-Kith cloin backed, rubber adhesive duct tape to seal leeks at duct connectlons.
MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREW
Duct Diagnostic Leakage Testing Results (Maximum 0% Duct Leakage)
Niessuired
Duct Press4,nzietl0n Test Results (CFM (a 25 Pc) values
Test Leakage Flow In CFM .
f for now is calculated as 400cfm1ton x number of tons enter
Calculated value here
If fan flow Is ms®suroo enter`measured value here
Leakage Percentage (900 x Test Leakage/Fan Flow) a 71�
Checi( Box for Pass or Fall (Passe$% or less)
❑
FasI
Fail
I D(THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved egvivalent
•t
es ❑ Nn Thermostatic Expansion Valva (or Commission approved
equivalent) is !nstalled and'Access is provided for inspection❑
Yes Is a pass
pass Fs,i
❑ MINIMUM REQUIREMENTS POR DUCT DESIGN COMPLIANCE CREDIT
t. C Yes C N.o ACOA Manuel D Design requirements have been met
(rater mass verified that actual instellatlon metches value3 it•
CF -1R tanc.•9esign ori pian.
2. C Yea G Np TXV IS installed o', Fan flow has been varlf ed. if no TXV,
verified fan +low matches design from CF.1 R.
Maasi,red Fan Flow F
Q O
Yee for both t and 2 is a Peas
Paas Fair