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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