11-0337 - CF-4R and CF-6RCERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21
Duct Leakage Test – Existing Duct System (Page 1 of 2)
Site Address:
52050 AVE CARRANZA, La Quinta CA 92253 (System
1)
Enforcement Agency:
City of La Quinta
Permit Number:
11-???
Enter the Duct System Name or Identification/Tag: System 1
Enter the Duct System Location or Area Served: Whole House
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the
dwelling.
This installation certificate is required for compliance for alterations and additions in existing dwellings to
space conditioning systems and duct systems.
Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of
the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible
and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling,
use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System."
Duct Leakage Diagnostic Test - existing duct system
Select one compliance method from the following four choices.
1. Measured leakage less than 15% of fan flow
2. Measured leakage to outside less than 10% of Fan Flow
3. Reduce leakage by 60% and conduct smoke and fix all leaks
4. Fix all accessible leaks using smoke and HERS rater verify
Note: (One of Options 1, 2, or 3 must be attempted before utilizing Option 4.)
Determine nominal Fan Flow using one of the following three calculation methods.
Cooling system method: Size of condenser in Tons 4 x 400 = 1600 CFM
Heating system method: 21.7 x Output Capacity in Thousands of Btu/hr = CFM
Measured system airflow using RA3.3 airflow test procedures: CFM
1
Option 1 used then:
Allowed leakage = Fan Flow 1600 x 0.15 = 240 CFM
Actual Leakage = 185 CFM
Pass if Leakage Actual is less than Allowed Pass Fail
2
Option 2 used then:
Allowed leakage = Fan Flow x 0.10 = CFM
Actual Leakage to outside = CFM
Pass if Leakage Actual is less than Allowed Pass Fail
3
Option 3 used then:
Initial leakage prior to start of work = CFM
Final leakage after sealing all accessible leaks using smoke test = CFM
Initial leakage - Final leakage = Leakage reduction CFM
((Leakage reduction / Initial leakage ) x 100% = % Reduction
Pass if % Reduction > 60% Pass Fail
4
Option 4 used then:
All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke
allowed to leak from system. Including ducts, plenums, air handler and door panel.
Pass if all accessible leaks have been repaired using smoke Pass Fail
_____________________________________________________________________________________________________________________
Reg: 211-A0049450A-M2100001A-M21A Registration Date/Time: 2011/09/25 19:10:52 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21
Duct Leakage Test – Existing Duct System (Page 2 of 2)
Site Address:
52050 AVE CARRANZA, La Quinta CA 92253 (System
1)
Enforcement Agency:
City of La Quinta
Permit Number:
11-???
Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off
during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA
ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may
be configured to the closed position during duct leakage testing.
All supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance
– applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible
leaks) described above.
New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts.
Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal
leaks at all new duct connections
DECLARATION STATEMENT
I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater).
The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the
installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified
on the Certificate(s) of Compliance (CF-1R) approved by the local enforcement agency.
The information reported on applicable sections of the Installation Certificate(s) (CF-6R), signed and submitted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF-1R) approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate (CF-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
BUDGET - AIR
Responsible Person's Name: CSLB License:
JAIME VASQUEZ 796186
HERS Provider Data Registry Information
Sample Group # (if applicable): 253759 tested/verified dwelling not-tested/verified dwelling in
a HERS sample group
HERS Rater Information CalCERTS Certificate # CC1-1798594341
HERS Rater Company Name:
All About Air
Responsible Rater's Name:Responsible Rater's Signature:
Roman Diaz Roman Diaz
Responsible Rater's Certification Number w/ this HERS Provider:Date Signed: 6/24/2011
CC2004535
_____________________________________________________________________________________________________________________
Reg: 211-A0049450A-M2100001A-M21A Registration Date/Time: 2011/09/25 19:10:52 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5)
Site Address:
52050 AVE CARRANZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11-???
Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for
compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with
the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized
for compliance.
As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for
any additional systems in the dwelling as applicable.
Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement
Sensors (STMS)
Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is
required for compliance, TMAH are also required for compliance. STMS are only required for completely new or
replacement space-conditioning systems that utilize prescriptive compliance method.
TMAH - Access Holes in Supply and Return Plenums of Air Handler
System Name or Identification/Tag System 1
System Location or Area Served Whole House
1 Yes No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and
labeled according to Figure in Section RA3.2.2.2.2.
2 Yes No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum
and labeled according to Figure in Section RA3.2.2.2.2.
Yes to 1 and 2 is a pass.Enter Pass or Fail Pass Fail
STMS - Sensor on the Evaporator Coil
System Name or Identification/Tag System 1
3 Yes No
The sensor is factory installed, or field installed according to manufacturer's
specifications, or is installed by methods/specifications approved by the Executive
Director.
4 Yes No
The sensor wire is terminated with a standard mini plug suitable for connection to a
digital thermometer. The sensor mini plug is accessible to the installing technician
and the HERS rater without changing the airflow through the condenser coil
5 Yes No When attached to a digital thermometer, the sensor provides an indication of the
saturation temperature of the coil.
Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not
applicable. Otherwise enter Pass or Fail N/A Pass Fail
STMS - Sensor on the Condenser Coil
System Name or Identification/Tag System 1
6 Yes No
The sensor is factory installed, or field installed according to manufacturer's
specifications, or is installed by methods/specifications approved by the Executive
Director.
7 Yes No
The sensor wire is terminated with a standard mini plug suitable for connection to a
digital thermometer. The sensor mini plug is accessible to the installing technician
and the HERS rater without changing the airflow through the condenser coil
8 Yes No When attached to a digital thermometer, the sensor provides an indication of the
saturation temperature of the coil.
Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not
applicable. Otherwise enter Pass or Fail N/A Pass Fail
_____________________________________________________________________________________________________________________
Reg: 211-A0049450A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:55 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5)
Site Address:
52050 AVE CARRANZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11-???
Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F)
Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential
Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for
any additional systems in the dwelling as applicable.
The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure.
The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test.
If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure.
Space Conditioning Systems
System Name or Identification/Tag System 1
System Location or Area Served Whole House
Outdoor Unit Serial # MSD110401830
Outdoor Unit Make MAYTAG
Outdoor Unit Model MSA4BE048K
Nominal Cooling Capacity Btu/hr 48000
Date of Verification 6/24/2011
Calibration of Diagnostic Instruments
Date of Refrigerant Gauge Calibration 6/15/2011 (must be re-calibrated monthly)
Date of Thermocouple Calibration 6/15/2011 (must be re-calibrated monthly)
Measured Temperatures (°F)
System Name or Identification/Tag System 1
Supply (evaporator leaving) air dry-bulb
temperature (T supply, db) 51
Return (evaporator entering) air dry-bulb
temperature (Treturn, db) 71
Return (evaporator entering) air wet-bulb
temperature (T return, wb) 58
Evaporator saturation temperature
(T evaporator, sat) 41
Condensor saturation temperature
(Tcondensor, sat) 86
Suction line temperature (Tsuction ) 50
Liquid Line Temperature (Tliquid) 77
Condenser (entering) air dry-bulb
temperature (T condenser, db) 94
_____________________________________________________________________________________________________________________
Reg: 211-A0049450A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:55 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5)
Site Address:
52050 AVE CARRANZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11-???
Minimum Airflow Requirement
Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge
Verification. The temperature split method is specified in Reference Residential Appendix RA3.2.
System Name or Identification/Tag System 1
Calculate: Actual Temperature Split = Treturn,
db - Tsupply, db 20.00
Target Temperature Split from Table RA3.2-3
using Treturn, wb and Treturn, db 19.3
Calculate difference: Actual Temperature Split -
Target Temperature Split = 0.7
Passes if difference is between -4°F and +4°F or,
upon remeasurement, if between -4°F and
-100°F
Enter Pass or Fail
PASS
Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the
airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is
measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below.
Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton)
System Name or Identification/Tag
Calculated Minimum Airflow Requirement (CFM)
Measured Airflow using RA3.3 procedures (CFM)
Passes if measured airflow is greater than or
equal to the calculated minimum airflow
requirement.
Enter Pass or Fail
Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used
for fixed orifice metering device systems
System Name or Identification/Tag
Calculate: Actual Superheat =
Tsuction - Tevaporator, sat
Target Superheat from Table RA3.2-2 using
Treturn, wb and Tcondenser, db
Calculate difference:
Actual Superheat - Target Superheat =
System passes if difference is between -6°F and
+6°F
Enter Pass or Fail
_____________________________________________________________________________________________________________________
Reg: 211-A0049450A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:55 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5)
Site Address:
52050 AVE CARRANZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11-???
Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used
for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems.
System Name or Identification/Tag System 1
Calculate: Actual Subcooling =
Tcondenser, sat - Tliquid 9.0
Target Subcooling specified by manufacturer 10
Calculate difference:
Actual Subcooling - Target Subcooling = -1
System passes if difference is between
-4°F and +4°F
Enter Pass or Fail
PASS
Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for
thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems.
System Name or Identification/Tag System 1
Calculate: Actual Superheat =
Tsuction - Tevaporator, sat 9.0
Enter allowable superheat range from
manufacturer's specifications (or use range
between 3°F and 26°F if manufacturer's
specification is not available)
4=15
System passes if actual superheat is within the
allowable superheat range
Enter Pass or Fail
PASS
_____________________________________________________________________________________________________________________
Reg: 211-A0049450A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:55 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5)
Site Address:
52050 AVE CARRANZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11-???
Standard Charge Measurement Summary:
System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil
airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all
applicable verification criteria must be re-measured and/or recalculated.
System Name or Identification/Tag System 1
System meets all refrigerant charge and airflow
requirements.
Enter Pass or Fail
PASS
DECLARATION STATEMENT
I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater).
The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the
installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified
on the Certificate(s) of Compliance (CF-1R) approved by the local enforcement agency.
The information reported on applicable sections of the Installation Certificate(s) (CF-6R), signed and submitted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF-1R) approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate (CF-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
BUDGET - AIR
Responsible Person's Name: CSLB License:
JAIME VASQUEZ 796186
HERS Provider Data Registry Information
Sample Group # (if applicable): 253759 tested/verified dwelling not-tested/verified dwelling in
a HERS sample group
HERS Rater Information CalCERTS Certificate # CC1-1798594341
HERS Rater Company Name:
All About Air
Responsible Rater's Name:Responsible Rater's Signature:
Roman Diaz Roman Diaz
Responsible Rater's Certification Number w/ this HERS Provider:Date Signed: 6/24/2011
CC2004535
_____________________________________________________________________________________________________________________
Reg: 211-A0049450A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:55 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21
Duct Leakage Test – Existing Duct System (Page 1 of 2)
Site Address:
52681 AVE MENDOZA, La Quinta CA 92253 (System
1)
Enforcement Agency:
City of La Quinta
Permit Number:
11???
Enter the Duct System Name or Identification/Tag:
Enter the Duct System Location or Area Served:
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the
dwelling.
This installation certificate is required for compliance for alterations and additions in existing dwellings to
space conditioning systems and duct systems.
Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of
the original duct system (e.g., register boots, air handler, coil, plenums, etc.) if those parts are accessible
and they can be sealed. For a completely new or replacement duct system installed in an existing dwelling,
use the Installation Certificate titled "Duct Leakage Test - Completely New or Replacement Duct System."
Duct Leakage Diagnostic Test - existing duct system
Select one compliance method from the following four choices.
1. Measured leakage less than 15% of fan flow
2. Measured leakage to outside less than 10% of Fan Flow
3. Reduce leakage by 60% and conduct smoke and fix all leaks
4. Fix all accessible leaks using smoke and HERS rater verify
Note: (One of Options 1, 2, or 3 must be attempted before utilizing Option 4.)
Determine nominal Fan Flow using one of the following three calculation methods.
Cooling system method: Size of condenser in Tons x 400 = CFM
Heating system method: 21.7 x Output Capacity in Thousands of Btu/hr = CFM
Measured system airflow using RA3.3 airflow test procedures: CFM
1
Option 1 used then:
Allowed leakage = Fan Flow x 0.15 = CFM
Actual Leakage = CFM
Pass if Leakage Actual is less than Allowed Pass Fail
2
Option 2 used then:
Allowed leakage = Fan Flow x 0.10 = CFM
Actual Leakage to outside = CFM
Pass if Leakage Actual is less than Allowed Pass Fail
3
Option 3 used then:
Initial leakage prior to start of work = CFM
Final leakage after sealing all accessible leaks using smoke test = CFM
Initial leakage - Final leakage = Leakage reduction CFM
((Leakage reduction / Initial leakage ) x 100% = % Reduction
Pass if % Reduction > 60% Pass Fail
4
Option 4 used then:
All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke
allowed to leak from system. Including ducts, plenums, air handler and door panel.
Pass if all accessible leaks have been repaired using smoke Pass Fail
_____________________________________________________________________________________________________________________
Reg: 211-A0049448A-M2100001A-M21A Registration Date/Time: 2011/09/25 19:10:53 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-21
Duct Leakage Test – Existing Duct System (Page 2 of 2)
Site Address:
52681 AVE MENDOZA, La Quinta CA 92253 (System
1)
Enforcement Agency:
City of La Quinta
Permit Number:
11???
Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off
during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA
ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may
be configured to the closed position during duct leakage testing.
All supply and return register boots must be sealed to the drywall if smoke test is utilized for compliance
– applies to duct leakage compliance option 3 (leakage reduction by 60%) and option 4 (fix all accessible
leaks) described above.
New duct installations cannot utilize building cavities as plenums or platform returns in lieu of ducts.
Mastic and draw bands must be used in combination with cloth backed rubber adhesive duct tape to seal
leaks at all new duct connections
DECLARATION STATEMENT
I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater).
The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the
installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified
on the Certificate(s) of Compliance (CF-1R) approved by the local enforcement agency.
The information reported on applicable sections of the Installation Certificate(s) (CF-6R), signed and submitted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF-1R) approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate (CF-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
BUDGET - AIR
Responsible Person's Name: CSLB License:
JAIME VASQUEZ 796186
HERS Provider Data Registry Information
Sample Group # (if applicable): 253759 tested/verified dwelling not-tested/verified dwelling in
a HERS sample group
HERS Rater Information CalCERTS Certificate # CC1-1798594339
HERS Rater Company Name:
All About Air
Responsible Rater's Name:Responsible Rater's Signature:
Roman Diaz Roman Diaz
Responsible Rater's Certification Number w/ this HERS Provider:Date Signed: 6/24/2011
CC2004535
_____________________________________________________________________________________________________________________
Reg: 211-A0049448A-M2100001A-M21A Registration Date/Time: 2011/09/25 19:10:53 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 1 of 5)
Site Address:
52681 AVE MENDOZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11???
Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for
compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with
the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized
for compliance.
As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for
any additional systems in the dwelling as applicable.
Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement
Sensors (STMS)
Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is
required for compliance, TMAH are also required for compliance. STMS are only required for completely new or
replacement space-conditioning systems that utilize prescriptive compliance method.
TMAH - Access Holes in Supply and Return Plenums of Air Handler
System Name or Identification/Tag
System Location or Area Served
1 Yes No 5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and
labeled according to Figure in Section RA3.2.2.2.2.
2 Yes No 5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum
and labeled according to Figure in Section RA3.2.2.2.2.
Yes to 1 and 2 is a pass.Enter Pass or Fail Pass Fail
STMS - Sensor on the Evaporator Coil
System Name or Identification/Tag
3 Yes No
The sensor is factory installed, or field installed according to manufacturer's
specifications, or is installed by methods/specifications approved by the Executive
Director.
4 Yes No
The sensor wire is terminated with a standard mini plug suitable for connection to a
digital thermometer. The sensor mini plug is accessible to the installing technician
and the HERS rater without changing the airflow through the condenser coil
5 Yes No When attached to a digital thermometer, the sensor provides an indication of the
saturation temperature of the coil.
Yes to 3, 4, and 5 is a pass. Enter N/A if STMS are not
applicable. Otherwise enter Pass or Fail N/A Pass Fail
STMS - Sensor on the Condenser Coil
System Name or Identification/Tag
6 Yes No
The sensor is factory installed, or field installed according to manufacturer's
specifications, or is installed by methods/specifications approved by the Executive
Director.
7 Yes No
The sensor wire is terminated with a standard mini plug suitable for connection to a
digital thermometer. The sensor mini plug is accessible to the installing technician
and the HERS rater without changing the airflow through the condenser coil
8 Yes No When attached to a digital thermometer, the sensor provides an indication of the
saturation temperature of the coil.
Yes to 6, 7, and 8 is a pass. Enter N/A if STMS are not
applicable. Otherwise enter Pass or Fail N/A Pass Fail
_____________________________________________________________________________________________________________________
Reg: 211-A0049448A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:56 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 2 of 5)
Site Address:
52681 AVE MENDOZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11???
Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F)
Procedures for determining Refrigerant Charge using the Standard Charge Measurement Procedure are available in Reference Residential
Appendix RA3.2. As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for
any additional systems in the dwelling as applicable.
The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure.
The system must meet minimum airflow requirements as prerequisite for a valid refrigerant charge test.
If outdoor air dry-bulb is 55°F or below, the installer must use the Alternate Charge Measurement Procedure.
Space Conditioning Systems
System Name or Identification/Tag
System Location or Area Served
Outdoor Unit Serial #
Outdoor Unit Make
Outdoor Unit Model
Nominal Cooling Capacity Btu/hr
Date of Verification
Calibration of Diagnostic Instruments
Date of Refrigerant Gauge Calibration (must be re-calibrated monthly)
Date of Thermocouple Calibration (must be re-calibrated monthly)
Measured Temperatures (°F)
System Name or Identification/Tag
Supply (evaporator leaving) air dry-bulb
temperature (T supply, db)
Return (evaporator entering) air dry-bulb
temperature (Treturn, db)
Return (evaporator entering) air wet-bulb
temperature (T return, wb)
Evaporator saturation temperature
(T evaporator, sat)
Condensor saturation temperature
(Tcondensor, sat)
Suction line temperature (Tsuction )
Liquid Line Temperature (Tliquid)
Condenser (entering) air dry-bulb
temperature (T condenser, db)
_____________________________________________________________________________________________________________________
Reg: 211-A0049448A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:56 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 3 of 5)
Site Address:
52681 AVE MENDOZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11???
Minimum Airflow Requirement
Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge
Verification. The temperature split method is specified in Reference Residential Appendix RA3.2.
System Name or Identification/Tag
Calculate: Actual Temperature Split = Treturn, db -
Tsupply, db
Target Temperature Split from Table RA3.2-3 using
Treturn, wb and Treturn, db
Calculate difference: Actual Temperature Split -
Target Temperature Split =
Passes if difference is between -4°F and +4°F or,
upon remeasurement, if between -4°F and -100°F
Enter Pass or Fail
Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the
airflow measurement procedures specified in Reference Residential Appendix RA3.3. If actual cooling coil airflow is
measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below.
Calculated Minimum Airflow Requirement (CFM) = Nominal Cooling Capacity (ton) X 300 (cfm/ton)
System Name or Identification/Tag
Calculated Minimum Airflow Requirement (CFM)
Measured Airflow using RA3.3 procedures (CFM)
Passes if measured airflow is greater than or equal
to the calculated minimum airflow requirement.
Enter Pass or Fail
Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used
for fixed orifice metering device systems
System Name or Identification/Tag
Calculate: Actual Superheat =
Tsuction - Tevaporator, sat
Target Superheat from Table RA3.2-2 using
Treturn, wb and Tcondenser, db
Calculate difference:
Actual Superheat - Target Superheat =
System passes if difference is between -6°F and
+6°F
Enter Pass or Fail
_____________________________________________________________________________________________________________________
Reg: 211-A0049448A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:56 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 4 of 5)
Site Address:
52681 AVE MENDOZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11???
Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used
for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems.
System Name or Identification/Tag
Calculate: Actual Subcooling =
Tcondenser, sat - Tliquid
Target Subcooling specified by manufacturer
Calculate difference:
Actual Subcooling - Target Subcooling =
System passes if difference is between
-4°F and +4°F
Enter Pass or Fail
Metering Device Calculations for Refrigerant Charge Verification. This procedure is required to be used for
thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems.
System Name or Identification/Tag
Calculate: Actual Superheat =
Tsuction - Tevaporator, sat
Enter allowable superheat range from
manufacturer's specifications (or use range
between 3°F and 26°F if manufacturer's
specification is not available)
System passes if actual superheat is within the
allowable superheat range
Enter Pass or Fail
_____________________________________________________________________________________________________________________
Reg: 211-A0049448A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:56 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification - Standard Measurement Procedure (Page 5 of 5)
Site Address:
52681 AVE MENDOZA, La Quinta CA 92253
Enforcement Agency:
City of La Quinta
Permit Number:
11???
Standard Charge Measurement Summary:
System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil
airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all
applicable verification criteria must be re-measured and/or recalculated.
System Name or Identification/Tag
System meets all refrigerant charge and airflow
requirements.
Enter Pass or Fail
DECLARATION STATEMENT
I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater).
The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the
installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified
on the Certificate(s) of Compliance (CF-1R) approved by the local enforcement agency.
The information reported on applicable sections of the Installation Certificate(s) (CF-6R), signed and submitted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF-1R) approved by the
enforcement agency.
Builder or Installer information as shown on the Installation Certificate (CF-6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
BUDGET - AIR
Responsible Person's Name: CSLB License:
JAIME VASQUEZ 796186
HERS Provider Data Registry Information
Sample Group # (if applicable): 253759 tested/verified dwelling not-tested/verified dwelling in
a HERS sample group
HERS Rater Information CalCERTS Certificate # CC1-1798594339
HERS Rater Company Name:
All About Air
Responsible Rater's Name:Responsible Rater's Signature:
Roman Diaz Roman Diaz
Responsible Rater's Certification Number w/ this HERS Provider:Date Signed: 6/24/2011
CC2004535
_____________________________________________________________________________________________________________________
Reg: 211-A0049448A-M2500001A-M25A Registration Date/Time: 2011/09/25 19:14:56 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010