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09-1142 (RC) HVAC Diagnostic ReportHVAC DIAGNOSTIC REPORT CEC Approved 2005 Building Energy Efficiency Standards Job Name DRMC Outpatient Imaging 47-647 Caleo Bay — Suite 100 .La Quinta, California 92253 Prepared For The Penta Building Group 44-250 Monterey Avenue Palm Desert, California 92260 red Jack LaFontaine CABEC Certified Energy Analyst R 08-03-2341NR 08-05-521 EMSEnergy Management Services CASEC CEPE/CEA Energy Consultants 41-485 Adams Street, Unit C — Bermuda Dunes, Ca. 92203 — (760) 360-4631 / Fax (760) 360-3074 C20 License No. 315890 - E-mail: jlafontaine(&dc.rr.com CHEERS / RESNET Rater - Building Energy Auditing - NBI Certified Air Balance Tests - T24 Reports — HVAC Mechanical Design EMSEnergy Management Services Air Test and Balance Report FOR DRMC Outpatient Imaging and Physician Suite 47-647 Caleo Bay — Suite 100 La Quinta, California 92253 Architect: Christopher S. Mills, Palm Springs, CA Engineer: MRC Engineering Inc, Palm Desert, CA HVAC Contractor: SSW Mechanical, Palm Springs, CA THIS IS TO CERTIFY THAT ENERGY MANAGEMENT SERVICES COMPANY HAS BALANCED THE SYSTEMS DESCRIBED HEREIN TO THEIR OPTIMUM PERFORMANCE CAPABILITIES, UNLESS OTHERWISE NOTED IN THE PROJECT TEXT LETTER. THE TESTING AND BALANCING HAS BEEN PERFORMED IN ACCORDANCE WITH THE STANDARD REQUIREMENTS AND PROCEEDURES OF THE NATIONAL BALANCING INSTITUTE AND THE RESULTS OF THESE TESTS ARE HEREIN RECORDED. CERTIFICATION # 00-043-11 DATE: CIeRnoFoE® ril 3 4 2010 00-043-1 > APPROVED ack/LaFontaine — Cabec CEA 41-485 Adams Street, Unit C — Bermuda Dunes, California 92203 Phone: 760-360-4631/Fax: 760-360-3074 Building Air Balance Report Bldg - DRMC Outpatient Imaging and Physician Suite 47-647 Caleo Bay, Suite 100 La Quinta, CA 92253 Att: Brian Schell - Asst Project Superintendent - 760-828-0583 The Penta Building Group This 42 page report is complete in it's entirety. It covers DRMC Outpatiel Imaging Suite 100 building air balance and the T24 Mech reports. A total of 6 HVAC Split Heat Pump Systems and one Ductless split Heat Pump totaling 23 tons of cooling capacity and 2 exhaust systems with ductwoi are included. The design criteria shown on the corrected as -built blueprint page M-2.0 dated 10/20/2009 were referenced for this air balance testing. The outdoor fresh air specifications are taken from the Title 24 report, Job #09260800 dated 10/20/2009. We have adjusted all outdoor air and return dampers to suit. The general building areas are under a slight positive pressure. Test instruments to accomplish the diagnostic and air balance test are listed herein. The results of this diagnostic and air balance test are within acceptable limits. J k I1dFontaine I Certified Testing Principal ertification # 00-043-11 Energy Management Services 1994 NCI DATE April 13/14, 2010 PROJECT DRMC Outpatient Imaging ' TO DRMC Outpatient Imaging and Physician Suite JOB NUMBER EMSWO#03302010A (/A o W N > O _ L m co �/ uj O O // VJ SM O ♦� M O � (O 7r— 1= ^C: W �ccU M LL m Z U—OC) M �oLO C �(� M ch O r- CM G U N E O U 0) N L J -0 a — i Q co 0 U w � 04. � o e� CER. I E0 00— O t HANDLER NAMEPLATE DATA �NUFACTURER Carrier )DEL ' IFX4CNF048 RIAL NUMBER Ina PE 1Heat Pump - Split NNAGE C4 1208-230/l/60 X6.0 FLA Cw/7 Dav Thermostat SUPPLY AIR CFM 1515 15 INDOOR RETURN AIR CFM 1370 14 OUTSIDE AIR "from T-24 **145 **1 TOTAL RETURN AIR CFM 1515 15 STATIC PRESSURE + (SA) 104% 0.54"' STATIC PRESSURE - (RA) SA 0.14',' TOTAL STATIC PRESSURE 0.7"wc 0.68"' k � CONDENSER NAMEPLATE DATA MITI• .. MANUFACTURER Carrier U61 MODEL ' 138QRRO48-601 RETURN AIR --RAT SERIAL NUMBER 11609X93463 OUTSIDE AIR --OAT TONNAGE 4 -- 460/3160. 8.6FLA MIXED AIR --MAT 75.2` 84.3` ;,76.1 ' E Exterior A SA 156 220 180 87% E Exterior B SA 308 337 320 104% E Exterior C SA 220 209 225 102% E Exterior D SA 96 113 100 104% E Exterior E SA 158 194 175 111% E Exterior F SA 288 196 300 104% E Exterior G SA 288 415 284 9706 E Exterior AA RA 154 160 142 92% E Exterior BB RA 308 259 290 94% E Exterior CC RA 1 220 167 205 93% E Exterior DD RA 96 106 90 94% E Exterior EE RA 158 162 146 920!0 E Exterior FF RA 577 4741 564 98% Total Supply Air = 1584 cfm // Total Return Air = 1594 cfm // % of Design = 101% ** MINIMUM POSITION OUTSIDE AIR DAMPER SETTING. OA/SA=OA% (145=1515=10%OA) (OA%xOAT°f)+(RA%xRAT°f)=OAT°f+RAT°f=MAT°f /// (10°/ux84.3°)+(90%x75.2°)=8.4°+67.7°=76.1"MAT REMARKS: **Outside air and return air were adjusted to meet T24 requirements. NCI EMS© CONTENTS 2010 DATE April 13/14, 2010 PROJECT DR MC Outpatient Imaging SYSTEM FC-1/CU-1 READINGS Jack LaFontaine Johnny LaFontaine JOB NUMBER EMS -04132010A (� o U CN N rn USC) C) 0 CMO ''^^ VJ �C �pC) ^I✓ WE E X O U a� LL E � 0) o (0-_ }' M M O O ' m U U5 m E O U L ', 0 U LI J CERTIFIED 0 AIR HANDLER NAME MANUFACTURER MODEL SERIAL NUMBER TYPE TONNAGE PLATE DATA Carrier AIR HANDLER DESIGN ACTUAL IFX4CNF036 SUPPLY AIR CFM 107210.42"wc B SA Ina INDOOR RETURN AIR CFM 885 97% (Heat Pump - Split OUTSIDE AIR "from T-24 *187 108 13 TOTAL RETURN AIR CFM 1072 D SA 78 STATIC PRESSURE + (SA) 74 95% 1/2 STATIC PRESSURE - (RA) 91 106 E208-230/1/60 TOTAL STATIC PRESSURE 0.7"wC F SA (4.1 FLA Cw/7 Day Thermostat M i NDENSER NAMEPLATE DATA • ... . • . -. NUFACTURER Carrier • DEL 138QRRO36-601 RETURN AIR --RAT 74.8' RIAL NUMBER 4407X91203 OUTSIDE AIR --OAT 84.4 NNAGE 13 -- 460/3/60. 6.8FLA MIXED AIR --MAT 76.5' E Exterior A SA 1 78 80 81 104% E Exterior B SA 91 79 88 97% E Exterior C SA 91 108 89 98% E Exterior D SA 78 84 74 95% E Exterior E SA 91 106 86 95% E Exterior F SA 911 88 84 92% E Exterior G SA 78 395 75 96% E Exterior H SA 235 248 ' 231 98% E Exterior J SA 235 365. 228 97% E Exterior AA RA 150 68 150 100% E Exterior BB RA 150 65 152 101% E Exterior CC RA 175 39 170 970/6 E Exterior DD RA 175 82 165 94% E Exterior EE RA 235 2251 222 95% ** MINIMUM POSITION OUTSIDE AIR DAMPER SETTING. OA/SA=OA% (187=1072=17%OA) (OA%xOAT°f)+(RA%xRAT°f)=OAT°f+RAT°f=MAT°f /// (17%x84.4°)+(83%x74.8°)=14.4°+62.1°=76.5"MAT REMARKS: **Outside air and return air were adjusted to meet T24 requirements. TotalSupply Air = 1036 cfm // Total Return Air = 1061 cfm // % of Design = 102% The results of this air flow and diagnostic test are within acceptable limits. 2002 NCI EMS C CONTENTS 2010 DATE April 13/14, 2010 PROJECT DRMC Outpatient Imaging SYSTEM FC-2/CU-2 READINGS Jack LaFontaine Johnny LaFontaine JOB NUMBER EMS -04132010A � . o U °' U � � o 0 NMp ''^^ VJ C) 4t +r c; mo.— Qi (0j= Ex°D N CU MD , 00 �z Uro c w Co . �o- M --'chM CD 1 ti �oU E O v L -0 Q_ Q �o LO U UJ IT cE�an�En a B El R HANDLER NAMEPLATE DATA A SA 1 81 DRMC Outpatient ANUFACTURER Carrier _ Misc B SA ODEL IFX4CNF060 SUPPLY AIR CFM 1767 169 =RIAL NUMBER Ina INDOOR RETURN AIR CFM 1354 122 ePE IHeat Pump - Split OUTSIDE AIR **from T-24 **413 **39 :)NNAGE (5 TOTAL RETURN AIR CFM E SA 161 151 128 STATIC PRESSURE + (SA) Misc 0.52"w 53 3/4 hp IFM STATIC PRESSURE - (RA) 91% 0.0991w G SA 1208-230/1/60 ITOTAL STATIC PRESSURE 0.7"wC 0.61"w Misc (6.0 FLA 53 83 57 108% 1w/7 Dav Thermostat J SA 54 66 0 CONDENSER NAMEPLATE DATA rerSTOTH-1van 0 . • . -. MANUFACTURER Carrier • MODEL 138QRRO48-601 RETURN AIR --RAT 75.2*f SERIAL NUMBER 1609X93463 OUTSIDE AIR --OAT 84.3*f TONNAGE 15 -- 460/3/60, 8.6FLA MIXED AIR --MAT 77.30f Misc A SA 1 81 DRMC Outpatient 63 83 103% Misc B SA 74 Johnny LaFontaine 67 69 93% Misc C SA 74 78 76 103% Misc D SA 88 63 84 96% Misc E SA 1341 151 128 96% Misc F SA 53 40 48 91% Misc G SA 73 76 72 99% Misc H SA 53 83 57 108% Misc J SA 54 66 55 102% Misc K SA 53 47 54 102% Misc L SA 53 55 50 94% Misc M SA 53 47 49 93% Misc N SA 53 79 54 102% Misc 0 SA 59 `' 731 591 100% ** MINIMUM POSITION OUTSIDE AIR DAMPER SETTING. DA/SA=OA% (413=1767=23%OA) (OA%xOAT°f)+(RA%xRAT°f)=OAT°f+RAT°f=MAT°f /// (23%x84,3°)+(77%x75.2°)=19.4°+57.9°=77.3°MAT REMARKS: **Outside air and return air were adjusted to meet T24 requirements. Total Supply Air = 1692 cfm // Total Return Air = 1617 cfm // % of Design = 96% The results of this air flow and diagnostic test are within acceptable limits. 2002 NCI EMS c0 CONTENTS 2010 DATE April 13114, 2010 PROJECT DRMC Outpatient Imaging SYSTEM FC-3/CU-3 Page One READINGS Jack LaFontaine Johnny LaFontaine JOB NUMBER EMS -04132010A W o W N U CD M SO �N/ VJ �( co �0 7 � � Ex°� N m CO z U M c C to_ M (D i C G N CD O U U) a� N E 0 U Q LO coo U LU ERTs�7ED -0 3-11 GRILLE REPORTCONTINUED DATE April 13/14. 2010 Room Misc Outlet Number P i Code SA FC-3/CU-3 Page Two - Size Test CFM 53 1 82 CFM 50 Design 94% PROJECT DRMC Outpatient Imaging Misc Q SA 118 104 112 95% SYSTEM FC-3/CU-3 Page Two Misc R SA 152 187 148. 97% Misc S SA 152 190 154 103% Misc T SA 591 78 54 92% Misc U SA 53 103 57 108% Misc V SA. 86 97 91 106% Misc W SA 86 87 88 102% READINGS BY Jack LaFontaine Misc AA RA 88 77 84 96% Misc BB RA 140 104 120 103% Misc CC RA 81 631 78 96% Misc DD RA 73 83 70 96% Misc EE RA 77 155 67 105% JOB NUMBER Misc FF RA 167 173 141 102% Misc GG RA 1591 163 128 97% Misc HH RA 1591 177 134 101% Misc JJ RA 238 234 194 98% 0 U V/ f+ WN cc� 2) L' I` w IT Cn �M � O 7 C7 N E x N (0U m Z Fn U(0C> .E r -:MM N CD 6 O G (n U c E O C, Q CL Ln U qT � Misc KK RA 304 284 247 98% Misc LL RA 172 67 139 98%C) CERT11F1E0 � 00-043 11 Vtot REMARKS: c 1994 NO DATE "AS HVAC SPLIT SYSTEM BUILT" REPORT . April 13/14, 2010 AIR HANDLER NAMEPLATE DATA _ HANDLER DESIGN ACTUAL PROJECT MANUFACTURER Carrier MODEL IFX4CNF060 SUPPLY AIR CFM 1900 1933 DRMC Outpatient SERIAL NUMBER [na INDOOR RETURN AIR CFM 1864 1734 Imaging TYPE Heat Pump - Split OUTSIDE AIR "from T-24 **36 **104 TONNAGE C5 TOTAL RETURN AIR CFM 1900 1838 SYSTEM STATIC PRESSURE + (SA) 0.41'wc 3%4 hp IFM ISTATIC PRESSURE - (RA) 1 0.13"wc 1208-230/l/60 TOTAL STATIC PRESSURE 0.7"wC 0.54"wc FC-5/CU-5 J7.8 FLA Gw/7 Day Thermostat READINGS Jack LaFontaine C Johnny LaFontaine K � JOB NUMBER EMS -04132010A M CONDENSER NAMEPLATE DATA � • ... . • Cn . N MANUFACTURER Carrier • - U_ MODEL 138ORRO60-601 RETURN AIR -RAT 75.4*f SERIAL NUMBER 12509X92932 OUTSIDE AIR --OAT 85.21 vi o 0 TONNAGE 15 -- 460/3/60, 8.6FLA MIXED AIR -MAT 75.6*f 3 0 4t � OrcOOutlet i� Room N � Number CFM CFM Design E E m m - v 0° CO (0 0) MRI Equip A SA 950 965 102% MRI Equip B SA 950 968 102% MRI Equip AA RA 1864 1734 93%c �C)LO CC G M M i (n C U r` i , i C c � E O U c d -� �. 00 U w I 13.4 �,al CEIRTIFIED - 00-043-11 ** MINIMUM POSITION OUTSIDE AIR DAMPER SETTING. OA/SA=OA% (36+1900=2%OA) (OA%xOAT°f)+(RA%xRAT°f)=OAT'f+RAT'f=MAT°f /// (2%x85.2°)+(98%x75.4")=1.7°+73.9°=75.6"MAT REMARKS: **Outside air and return air were adjusted to meet T24 requirements. Total Supply Air = 1933 cfm // Total Return Air = 1838 cfm // % of Design = 95% ---"—" The results of this air flow and diagnostic test are within acceptable limits. a 2002 NCI EMS© CONTENTS 2010 ��SL EXHAUST P•R A REPORT DATE April 13/14, .2010 FAN NAMEPLATE DATA MANUFACTURER jPenfiBARRY FAN DESIGN ACTUAL PROJECT MODEL IDX11B-31 EXHAUST AIR CFM TOTAL 1060 968 DRMC Outpatient SERIAL NUMBER JG06AA89754 VOLTS/PHASE 115/1160 115/1/60 Imaging TYPE JUpblast Exhauster FULL LOAD AMPS 8.5 6.9 DRIVE jBelt Drive EXISTING or NEW NNew SYSTEM TOTAL VENT STATIC PRE 0.80"wC 1.24"WC EF -4 MRI SCAN ROOM • •R AR "AMP DRAW @120vac 8.5 "*6.9 READINGS MOTOR RPM 1735 1735 HORSEPOWER 1/2 1/2 Jack LaFontaine EXHAUST GRILLE REPORT JOB NUMBER OutletRoom Number CFM CFM Design EMS -04132010A MRI Rm 2 EAG 18x18 1060 659 968 91% Cl) o `) N .� U�v �o 0 aic?0 Q M N ca 0 ._ N M U m U- a0 Z .- co0 (� 56w o - r- ��o c E C J a LOco U co W � AM 00- 043-11 REMARKS: Exhaust air grill for leaking helium during filling. The results of this air flow and diagnostic test are within acceptable limits. c 2005 EMS EMS @ CONTENTS 2010 Dimensional Information & Performance Data Domex Centrifugal Fans I Belt Drive OX11 B 1 DX11B Belt Drive Fan Curves > DX11B Belt Drive Fan Dimensional Data 1.800 3 1.600 U) L 1.400 V C 1.200 j 1.000 h 1191 RPA 0.800 10931 U)z 0.600 V 0.400 a 0.200 N 0.000 0 500 1000 1500 2000 2500 3000 AIRFLOW - CFM +37s RPM ( I ♦ I 1 I BHP ---------------- \\ \\ 1369 RPM - I \ _ RPM L > DX11B Belt Drive Fan Performance Data Gate. Steel Base = 16 Gage Aluminum Base = 0.064' Discharge Apron = 0.050' RaoUWall Opening =16' SO. Damper Size= 15'/.' SO. . Max. Motor Frame Size = 56 Peak BHP = (RPM/1700)' Max. RPM = 1810 (3!4 HP) Est Ship Weight= 551bs. PENN BARRY" I 14 7116" Trp 0.000" SP 0.125" SP 0.250" SP 0.375" SP 0.500" SP 0.625" SP 0.750" SP 0.875" SP 1.000" SP 1.125" SP HP RPM Speed FPM Sones BHP Sones BHP Sones BHP Sones BHP Sones BHP Sones BHP Sones BHP Sones BHP Sones BHP Sones BHP 650 2345 1120 905 535 - - 4.7 0.05 4.1 0.05 3.4 0.05 - 675 2435 1164 959 638 - - - - - - 4.9 0.05 4.3 0.06 3.6 0.06 700 2526 1207 1011 737 - - - - - - 5.1 0.06 4.6 0.07 K4.7 .07 725 2616 1250 1062 - - - 5.5 0.07 4.9 0.07 .08 750 2706 1293 1113 252 - - - - 5.8 0.07 5.3 0.08 .09 4.1 0.05 800 28861379 1213 76726.6 0.09 6.1 0.10 .10 5.0 0.10 825 2976 1422 1263 1067 775 - - - 1/4 6.8 0.10 6.3 0.10 5.7 0.11 5.2 0.11 - - - - - 1465 1312 1126 874 850 3067 - - - 7.0 0.11 6.5 0.11 5.9 0.12 5.4 0.12 900 3247 1552 1407 1238 1028 665 - 7.8 0.13 7.2 0.13 6.5 0.14 6.0 0.15 5.7 0.13 950 3427 1638 1502 1347 1159 884 - - - - - 8.5 0.15 7.9 0.16 7.3 0.16 6.7 0.17 6.3 0.17 1000 3608 1724 1596 1451 '1282 1080 706 - - - - 9.2 0.17 8.7 0.18 8.0 0.19 7.3 0.20 7.0 0.20 6.8 0.18 1810 1689 1553 1400 1217 939 1050 3788- 9.7 0.20 9.2 0.21 8.5 0.22 7.8 0.23 7.4 0.23 7.1 0.22 1075 3878 1853 1735 1603 1456 1284 1040 847 - - - 10.0 0.21 9.4 0.23 8.6 0.23 8.1 0.24 7.7 0.25 7.4 0.25 7.5 0.21 1093 3943 1884 1768 1639 1496 1329 1111 758 - - - 10.2 0.23 9.6 0.24 9.1 0.24 8.3 0.26 7.9 0.26 7.7 0.26 7.7 0.23 1125 4059 1940 1827 1703 1566 1408 1227 924 10.6 0.25 10.0 0.26 9.5 0.27 8.8 0.27 8.2 0.29 8.0 0.29 8.1 0.27 1/3 1150 4149 1983 1673 1753 1621 1469 1296 1028 489 - 11.0 0.26 10.4 0.27 9.8 0.28 9.1 0.29 8.5 0.31 8.3 0.31 8.3 0.29 8.4 0.21 1191 4297 2053 1948 1834 1708 1568 1406 1193 883 - - 11.5 0.29 11.0 0.30 10.5 0.31 9.8 0.32 9.0 0.34 8.8 0.34 8.6 0.34 8.6 0.31 1220 4402 2103 2001 1889 1767 1634 1481 1306 1019 - 11.9 0.31 11.4 0.33 10.9 0.34 10.2 0.34 9.6 0.36 9.2 0.37 9.0 0.37 6.9 0.34 1250 4510 2155 2056 1947 1829 1700 1555 1393 1142 801 1/2 12.4 0.34 11.9 0.35 11.4 0.36 10.8 0.37 10.0 0.38 9.6 0.39 9.4 0.39 9.3 0.38 9.3 0.33 1300 4690 2241 2147 2042 1930 1811 1677 1528 1342 1071 - 13.0 0.38 12.6 0.39 12.2 0.40 11.6 0.41 10.9 0.42 10.2 0.44 10.1 0.44 9.9 0.44 9.9 0.42 1369 4939 2360 2271 2172 2069 1959 1838 1703 1556 1352 1095 14.0 0.44 13.6 0.48 13.2 0.47 12.8 0.48 12.1 0.49 11.4 0.51 11.0 0.52 10.8 0.52 10.9 0.51 10.9 0.48 M17.4 2379 2290 2193 2091 1982 1862 1730 1585 1396 1141 14.1 0.45 13.8 0.47 13.4 0.48 13.0 0.49 12.3 0.50 11.6 0.52 11.1 0.53 10.9 0.53 11.0 0.52 11.1 0.50 2431 2344 2249 2150 2044 1929 1803 1666 1513 1265 14.6 0.48 14.2 0.50 13.8 0.51 13.5 0.52 12.8 0.53 12.1 0.55 11.5 0.56 11.4 0.56 11.4 0.57 11.5 0.54 31 -22 Performance shown is for installation type A: Free Inlet, Free Outlet. Power rating (BHP) does not include drive losses. For further information on estimating belt drive ' e losses and motor service factors see page 11. The sound ratings shown are for loudness values in fan sones at 5'0'(1.5m) in a hemispherical free field per AMCA Standard 301. Values shown are for installation Type A: free inlet sone levels. Performance ratings do not include the effects of appurtenances in the airs 4 2535 2451 2361 2288 2166 2061 1946 1818 1681 1505 15.6 0.55 15.2 0.56 14.8 0.58 14.5 0.58 13.9 0.60 13.2 0.61 12.6 0.64 12.3 0.64 12.2 0.64 12.3 0.63 2586 2504 2416 2325 2227 2126 2014 1892 1761 1620 16.1 0.56 15.8 0.60 15.4 0.61 15.1 0.62 14.5 0.63 13.9 0.64 13.2 0.67 12.6 0.68 12.7 0.68 12.8 0.66 27162638 2555246823772262 2180 207319521825 0.67 17.2 0.69 16.9 0.71 16.6 0.72 16.3 0.73 15.6 0.74 15.0 0.76 14.4 0.78 14.3 0.79 14.3 0.79 tream. X r PENNBAHRY v'1MN'd FENVBARRY.CON. a ell Ico tr fc nV y co co :z Cc, q CD :z ' 00 ft... £` s. ` g Ed A. f, ,�. .. 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SF`s r `�' �,¢ ' ` M - f #�Lzoft� _ l � _ t is 44 40, r v ¢ J f All a zz- �'t }K) CERTIFIED LIGHT COMMERCIAL AIR BALANCING AND DIAGNOSTIC TECHNICIAN JACK LAFONTAINE Has successfully completed the 301 training seminar and passed the required written light commercial examination by the NATIONAL BALANCING INSTITUTE to perform HVAC alrflow diagnostics and air balancing for light commercial systems according to NO practical procedures and standards. O10 Be�eO 14 c�a Certi led since: September 7, 1001 '4C�ENTIFIEO �nBtttuCO Rob Falke, National Balancing Institute � W rs 7 ^ i a Pr c to x o b CERTIFIED LIGHT COMMERCIAL AIR BALANCING AND DIAGNOSTIC TECHNICIAN JACK LAFONTAINE Has successfully completed the 301 training seminar and passed the required written light commercial examination by the NATIONAL BALANCING INSTITUTE to perform HVAC alrflow diagnostics and air balancing for light commercial systems according to NO practical procedures and standards. O10 Be�eO 14 c�a Certi led since: September 7, 1001 '4C�ENTIFIEO �nBtttuCO Rob Falke, National Balancing Institute The ENERGY ' CONSERVATORY Digital Gauge Calibration Certlfitato o.ma®nap: em 2uwa e.iw lwswr rec aemo e.ro...om enim emee 1r�r 1 er.c rue+ r�t2 ,v c.,®ra moo-u.l4.lam wveaw� o.y.tvn. a+q.exxse P"a.wrnv bloom acme 7491 Olsaa smmmu w xra w aA w ori WO pox aA a2w sit at1 ns oaa m aA mo nos mr zv ori ma aA x411 ori 101 ori m ons m ons bird nA rna aA 1� +OaI �] CA +m0 COIL Daae oo..t,e o®oo a®+ -x.s w .rte w nos au aA -Wd SOA 42s MA Ons au au nos ass aA ax+ en atm - -+m.1 an+ aA wn1 nos am beer ams ave a+u su ori nos CC1 �] aA .+ban -nvA 4A non nos �a aaerm �.]taem 1M6m r+ 3, r f L Lam, •1i�;•-�La � r"'��.::� ; � cZ�1 �,L�''�#�,� ��'jtl� �; o,y :IRayteke ' 1201 Shq Mox.P.0 Om I-aasGee.lbbni 45o61.18ID.(900) 21/574. FM (831)42 561 CERTIFICATE OF CALIBRATION ACCURACY } Y I Cuslaner Test Report Number. 23695904.001 y Instrument Model/ Temperature Range: RAYST6OXBCRUS / -2$to 1100•F $ t Y5 1 Instnlmeni Serial Number. 2369690x01-0001 Calibration Date: 7/12ooa a ACCURACY VERIFICATION Dafafde Unit No. 0 Y PT MEASURED > SOURCE TEMPERATURE EMISSAVaY INSTRUMENT READING r. r f ` �, 43.4 'F 24 •C E= OM F4.8 -F S? •C a1D.D If 314,4 'C £= 28;! 410.1 'F 210.1 'C . .., X. 6610 'F 46.11 •C £= 28§ KU 'F aeo.B 'C a yrA. All mvasutvw.s mads a pdm of readirlp on door body calibriIed with N.I.S.T. a D.W. 4 r ",,Us hsaunert mWall," comber: 1Qlrt Motor 1502A/8N1084 PRr 58f4/g/15/86 i yam, NIST Traceable Y. M212022152426 N. V. V.P. lab o0da 2063x84 - - - _ - _ v �-••�y-.•. yi r TM 1a"balbn o/ the Pedud was Oarlormed in 4C[aldanCe with w OOosnar+ts0 e..4ty ayslsm lahv Prxadu2 Nalco: ST60/80 ATP Prowdwo Roisim '#s a TEST PARAMETERS 0 ; 4 Probable uncertainty of temperature slues reported is estimated to be 0.25'% for IernWmtunn Iris than 600•C and ./- 2•C for temperatures groaler lhan 6001C. Ambient room temperature maintained for this calibration: ZZ •C y y , All points on scale certified 4o be accurate within: -18.01-15 ro 0'FI: lJ'GalS'Fl ®32 m-26•Cf-25 t0 -15•F) t under Nese Mrdii(On9 and Customer conditbns 5091 d471 1'lY - ei emissivity and/or atmospheric and reBdUtbn IaUors we 14('� a• " acalmteN evaluated and cemponeated for. Cordfidalion SO] i applies for all points if above data is not logged. Customers p �^ �' eF n ust request such In advance If actual data Is required. otherwise Instrument Is only Insured to be within sped6catii... All test equipment oscilloscopes, mulOmetere, and thermometers 4. t i used in ftproduction calibration process and service ae calibrated m1' 17$-90 and ANSUNCSL Z540.1. Rayttek Corp. is ISO 9001-1x used. 7/12004 2.L- dprba �� W . .4 DATE J u 7ECHNIq + ,r"'"_e,°°°ve%.T•ws° "„bb-'"ax^x cos .e+v+'a.,.ax•F.'•'�e H`":'r°""^","i°",^1'3,b +-"T'x"I� ZV '=AIRFLOW" . �Po� Aiadoviir, w DTe21 Spx64s1s In.A4 M....t Toteft leper Tod (973) 7068986 Ftoc (473) 78G75M Certif)cafe of Calibration ' As-FourW/Rrial Data Report Issued Ta. .CerWlt:ate Number 0426051A . Mtatad0obeer. Attlbw . Instrument Modet LCA 30 VA . . Serial Number. A . _ hNWak�Order Ntenber 4564 - Purchase Older Nmnber: P-135060 . Afr3rw Teidricsl P1ad//da, n1c wrQbs Def Ore above gafedhchtereMb oa4bd b mtatoaseedpuMefrd 6pedkeboro Nbaro= �ratiions"psrforrred urig aysbrn and Stadards traweble b go Alationd tr1� dStivrAaW andT 9Y andcarob I+ eiANZWWMzb I.Ak&WiBapw**"Vmwn0erd0s Ar SpeoO Rdletsrmy Tesfbg Carmor0wn. A►Berk CloOndiln Lab h NUP1C cer15111IA. . . This reperfineynotae reprolllced, elmlpfh ruR coke perndssi rl bur tits pndRm6an den n;proved asbsae6t is adffiredh aTbgSom AiPolrr TedrYuW Plo�67c rot Ha Date: 41262DOS Bic Pierm C)C Mare9 _ Caminglim.5ZWce TechNcian vl i i -7 , Os fY' : �' `- �V,,Y . y -, v V�. ',. .; •, "` ii "`s. I ra = CERTIFICATE OF CALIBRATION AND TESTING I . I1kr .« ;- TSI Model 8386 Serial No. 00110403 _ DMTiptirm VEI.UCICALC PLUS PORTABLE AIR VELOCITY NEPER 111 - 8100026003 09-30-02 09-30-03 - Calibration Standard WIND TUNNEL CALIBRATION SYSTEM, SERIAL NO. 110 Observed Units: FPM :.. I Test Prooedlre: T"I1-3 Mandecbae's Statement of Aecuracir.H-1%.L 10 V locia 836/260311 03-30-04 NIST AS -Found. . Final - .' '.50•BOl)ll 100 e8 983000 r$1 Final Jun 06, 2003• 99.3 Et/mia 99.6 EC/min 0.31 PASS - 2888 2988 - ' - 0000 - 8047 0047 enMN 53126 USA 561 AOdr1i SOD Road C.' rk®c SOD) T7i-8355 or ( lu-ta490 M i r•.s <�6su�a967a74 650.4 Wain 653.9 [C/min 0.51 PASS 995.2 ft/min 1004.1 ft/min 0.9\ PASS 1 Ei `i 1x61.3 ft/min 1.76.9 ft/min 1.21 PASS 2492.1 ft/min 2526.0 ft/min 1.41 PASS 4503-9 ftloin 4539.7 ft /min 0.at PASS Nobs: - 7960.1 Et/min 8030.8 ft/min 0.9\ PA59 'Our OITOla s nce 0 Marked 70°F . 32.0 •P 31.7 •P -0.3 •P PASS ecru:-�; 140.0 •P 140.1 •i 0.1 •9 PASS VcsXa7:-fl ai rad -3ft"" : 39%. 1 Humornetrk Ressu it 29.51n. Ha f -4.054 10.0120 -4.035 .820 ♦0.019 PASS Mdduaeru dreae� 16.077 .324 ♦18.023 i.a.mo -0.054 PA55 Te+4+rremrr: t03 'F 28.7 \rto 28.8 \rh 0.1 \rh PASS Mmm'ry: 23.OEdr 69.1 t- 69.0 trto -0.1 :,ch PASA Ae®rr. =1.01" of lace" t0.401m,/QO , I', - i. N J - 1 CeCbrffiIon Dale: Due Oats:.. -_,_...... NLSCTesU4mtber. ,let Wkd Trlmel -. 03240115 092409 _ Preasue Sgtdard 1®M 500 SIM4095M 05/26104 .. - 11926109 838Z702454)IA ' velocity Smndad: AV6 81"16739 U//48S/f•L/05128 O8!OBem - - OOA)M - - 839270245-04C ..8362711245-048 n Auttiorizgjd Slanatures for Certiticet ow �, n rot Ha Date: 41262DOS Bic Pierm C)C Mare9 _ Caminglim.5ZWce TechNcian vl i i -7 , Os fY' : �' `- �V,,Y . y -, v V�. ',. .; •, "` ii "`s. I ra = CERTIFICATE OF CALIBRATION AND TESTING I . I1kr .« ;- TSI Model 8386 Serial No. 00110403 _ DMTiptirm VEI.UCICALC PLUS PORTABLE AIR VELOCITY NEPER 111 - 8100026003 09-30-02 09-30-03 - Calibration Standard WIND TUNNEL CALIBRATION SYSTEM, SERIAL NO. 110 {. :.. CALIBRATION VERERCA71ON RESULTS Presaure e C hb-- harnoeau Error Campanrd r0 Tohmncs Olnmse S/ardsrd 0 -pm Diff- T01- V locia 836/260311 03-30-04 Li 0.0 EC/min 0.D C[/vin PASS u !- O U (+ 266696-02 12-02-02 12-30043 xk t 34.6 ft/min 34.1 ft/vin 64.2 ft/min 64-3 ft/min 0.21 PASS •4 r$1 Final Jun 06, 2003• 99.3 Et/mia 99.6 EC/min 0.31 PASS - 751 IOmrperoted 158.5 ft/mix 150.7 ft/vin 0.1\ PASS 339.3 Et/min 332.1 ft/min 0.91 PASS t yam. enMN 53126 USA 561 AOdr1i SOD Road C.' rk®c SOD) T7i-8355 or ( lu-ta490 M i r•.s <�6su�a967a74 650.4 Wain 653.9 [C/min 0.51 PASS 995.2 ft/min 1004.1 ft/min 0.9\ PASS 1 Ei `i 1x61.3 ft/min 1.76.9 ft/min 1.21 PASS 2492.1 ft/min 2526.0 ft/min 1.41 PASS 4503-9 ftloin 4539.7 ft /min 0.at PASS _ 7960.1 Et/min 8030.8 ft/min 0.9\ PA59 1�` 32.0 •P 31.7 •P -0.3 •P PASS ecru:-�; 140.0 •P 140.1 •i 0.1 •9 PASS VcsXa7:-fl ai rad -3ft"" f -4.054 10.0120 -4.035 .820 ♦0.019 PASS Mdduaeru dreae� 16.077 .324 ♦18.023 i.a.mo -0.054 PA55 Te+4+rremrr: t03 'F 28.7 \rto 28.8 \rh 0.1 \rh PASS Mmm'ry: 23.OEdr 69.1 t- 69.0 trto -0.1 :,ch PASA Ae®rr. =1.01" of lace" t0.401m,/QO , I', - i. N J - 1 Vdodly Cellbrn/lon COedlllonr: Ambfad Tempi: 23.8•C Bammarfc Prams: 731.9..Hg Velodw Carrel rM m Sd C-Aff a of.- Ambi u T : 21.1 •C B-,fc Prrsare: 760.0..Hi :oaenme .eCOw"a.rm��`�m�srma.reed.��w,°j�'d+��a giro a� tea. l3� Applicable Test Report Report Number Date last Verified Dale Due DC wl"ge 8100026003 09-30-02 09-30-03 - Berpeetru Pressure TesVerature 10.01 E001329 OS -13-03 05-31-04 77377 07-00-02 0]-30-03 "} Tostp-I-0 (19-35•C) Temperature (60•C) 77370 07-00-03 07-30-03 77375 07 -OB -02 07-30-03 - Presaure e 206730 02-a7-03 01-281-D04 23P -6-03 01 V locia 836/260311 03-30-04 Dewpo 266696-02 12-02-02 12-30043 xk t r$1 Final Jun 06, 2003• ra Function Check rauon Date 751 IOmrperoted MsOirlg Ad@� P.O. Bos 6.39. St Pad, MN 5316. Fnvlre0meaml MnslDmnmts and CoOtmb Division enMN 53126 USA 561 AOdr1i SOD Road C.' rk®c SOD) T7i-8355 or ( lu-ta490 M i r•.s <�6su�a967a74 -•J4'S.I rL,� i iF'r'a�•- ryr• �l S" 2 1 n 11 II 11 (STATEMENT OF ACCEPTANCE This Certificate of Acceptance summarizes the results of the acceptance tests related to building mechanical requirements per Title 24, Part 6. (Sections 10-103.b, 1211, 122.h, 125.a, 125.b, 125.c, 125.c.5, 125.d) Please check one: I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document as the person responsible for Ws preparation; and that I am licensed in the State of California as a civil engineer or mechanical engineer, or I am a licensed architect. r` I affirm that I am eligible under the exemption to Division 3 of the Business and Professions Code by Section 5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed contractor performing this work. ' I affirm that I am eligible under the exemption to Division 3 of the business and Professions Code to.sign this document because it pertains to a structure or type of work described pursuant to Business and Professions Code sections 5537, 5538, and 6737.1. rT'h-&cnn♦inne of fh= Ptioineac ---Anti ore nrinfiwl in fl ill in tr7P_ NnnrP_Cir}P_ntiAI Manual I TESTJAIG AUTHORITY - NAME Isle, RE DATE LIC.# C - 2 V // v1ZA/6n 9;/1IA)L� '��% -Zola tJ NSTRUCTIONS TO For Detailed instructions on the use of this and all Energy efficiency sta Nonresidential Manual published by the California Energy Commission. Part 1 of 2 - Statement of Acceptance Part 2 of 2 - Summary of Acceptance Tests acceptance 2005 Nonresidential Acceptance Forms September 2005 12005 CERTIFICATE OF ACCEPTANCE (Part 2 of 2) MECH-1 SYSTEM ACCEPTANCE DOCUMENT (Form _of ___j FTESTING AUTHORITY DATE OF TEST PASS I FAIL 2005 Nonresidential Compliance Forms September 2005 P4 Vy. -0-a AJL:5.< - PA V NOTE., Use additional sheets as necessary 2005 Nonresidential Compliance Forms September 2005 t, 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2-A7] 1 Intent: Verify mee Standards 11 Construction Inspection rithin t 10% of the total required outside airflow Column H or Column 1), per 121(f). 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Means to measure airflow (hot wire anemometer or. pilot tube) 2 Check one of the following: ❑ Variable Air Volume (VAV) - Check as appropriate: a. Sensor used to control outdoor air flow must have calibration certificate or be field calibrated ❑ Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) Constant Air Volume (CAV) - Check as appropriate: System is designed to provide a fixed minimum OSA when the unit is on Certification Statement: I certify that all statements are true on this MECH-2-A form including the PASS/FAIL Evaluation. I affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-1 A Name: 1// C��t/�i 714 Company: Signature: , J G V�'�'z al6Ls✓ Date: 2005 Compliance Acceptance Forms December 2005 1 �1 1 1 1 1 1 1 1 1 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2 A VAV Ste 1: % Outdoor Air = Measured outside air /Re uired outside air Ste 1:2/Ste 1:3% Ventilation System Acceptance Document 7 olJL G- NJ.3.1, NJ.3.2 Outside air damper position stabilizes within 15 minutes (Step 1:4 < 15 minutes)N Form -7- of 2 Ste 2: % Outdoor Air = Measured outside air /Required outside air Step2:2/Ste 2:3) 90% > %Outdoor Air < 110% PROJECT NAME U � c 6 U i f) �t c; �1 ,4 rrJ 1- DATE �-/ t/ -%7/f7' A. Equipment Testing (Check appropriate column) CAV VAV a. lVerify unit is not in economizer mode during test - check appropriate column Ste 1: CAV and VAV testing at full supply airflow 1 Drive boxes open check 2 Measured outdoor airflow cfm 3 Required outdoor airflow (cfm) (from MECH-3-C, Column 1) 4 Time for outside air damper to stabilize after VAV boxes open minutes 51 Return to initial conditions (check) Ste 2: VAV testing at reduced supply airflow 1 Drive boxes to minimum check 2 Measured outdoor airflow cfm 3 Required outdoor airflow (cfm) (from MECH-3-C, Column 1 4 Time for outside air damper to stabilize after VAV boxes open minutes 5 Retum to initial conditions (check) B. Testing Calculations & Results VAV Ste 1: % Outdoor Air = Measured outside air /Re uired outside air Ste 1:2/Ste 1:3% % 90% > %Outdoor Air < 110% N Y / N Outside air damper position stabilizes within 15 minutes (Step 1:4 < 15 minutes)N ICA' Y / N Ste 2: % Outdoor Air = Measured outside air /Required outside air Step2:2/Ste 2:3) 90% > %Outdoor Air < 110% Y / N Outside air damper position stabilizes within 15 minutes (Step 2:4 < 15 minutes)Y / N wore: zinaaea Dozes co nor apply Tor rear paracurar test pruveaure C. PASS I FAIL Evaluation check one): PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive - es ❑ FAIL: Any Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in Testing Calculations & Results section. Provide explanation below. Use and attach additional pages if necessary. 2005 Compliance Acceptance Forms December 2005 II 11 11 11 11 11 1 I� 1 1 1 1 1 1 1 X2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2-A Ventilation System Acceptance Document70— s�s NJ.3.1, NJ.3.2 Form _of Z Intent: ferify measured outside airflow CFM is within t 10% of the total required outside airflow value found in the >tandards Mechanical Plan (MECH-3-C, Column H or Column 1), per 121(f). Construction Inspection 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Means to measure airflow (hot wire anemometer or pilot tube) 2 Check one of the following- 0 ollowing❑ Variable Air Volume (VAV) - Check as appropriate: a. Sensor used to control outdoor air flow must have calibration certificate or be field calibrated ❑ Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) Constant Air Volume (CAV) - Check as appropriate: System is designed to provide a foxed minimum OSA when the unit is on Certification Statement: I certify that all statements are true on this MECH-2-A form including the PASSIFAIL Evaluation. I affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-I-A Name: r'/'� �� l� Company: Signature: 2005 Compliance Acceptance Forms VL Cate: / �1� / 2 0 December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2 A Ventilation System Acceptance Document�� G -Z NJ.3.1, NJ.3.2 FormZ of -Z"- PROJECT PROJECT NAME DATE A. Equipment Testing (Check appropriate column) CAV VAV a. lVerify unit is not in economizer mode during test - check appropriate column Ste 1: CAV and VAV testing at full supply airflow 1 Drive boxes open check 2 Measured outdoor airflow cfm 3 Required outdoor airflow cfm from MECH-3-C, Column I) 4 Time for outside air damper to stabilize after VAV boxes open minutes 51 Return to initial conditions (check) Ste 2: VAV testing at reduced supply airflow 1 Drive boxes to minimum check 2 Measured outdoor airflow cfm 3 Required outdoor airflow (cfm) (from MECH-3-C, Column 1 F4 Time for outside air damper to stabilize after VAV boxes open minutes 1 5 Return to initial conditions (check) Ste 1: % Outdoor Air = Measured outside air /Required outside air Ste 1:2/Ste 1:3 UN % % 90% > %Outdoor Air < 110% Y '/ N Y / N Outside air damper position stabilizes within 15 minutes (Step 1:4 < 15 minutes) Y N Y / N Ste 2: % Outdoor Air = Measured outside air /Required outside air Ste 2:2/Ste 2:3 90% > %Outdoor Air < 110% Y / N Outside air damper position stabilizes within 15 minutes (Step 2:4 < 15 minutes) Y / N Note: Shaded boxes do not apply for that particular test procedure C. PASS / FAIL Evaluation check one): PASS: All Construction Inspection responses are complete and Testing Calculations & Results.responses are positive - es ❑ FAIL: Any Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in Testing Calculations & Results section. Provide explanation below. Use and attach additional pages if necessary. 2005 Compliance Acceptance Forms December 2005 I I I- Intent: 12005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE 1MECH-2-A I Verify measured outside airflow CFM is within t 10% of the total required outside airflow value found in the Standards Mechanical Plan (MECH-3-C, Column H or Column 1), per 121(f). Construction Inspection 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Means to measure airflow (hot wire anemometer or pilot tube) 2 Check one of the following: ❑ Variable Air Volume (VAV) -Check as appropriate: a. Sensor used to control outdoor air flow must have calibration certificate or be field calibrated ❑ Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) V- V Constant Air Volume (CAV) - Check as appropriate: System is designed to provide a foxed minimum OSA when the unit is on Certification Statement: I certify that all statements are true on this MECH-2-A form . including the PASSIFAIL Evaluation. I affirm I am eligible to sign this form under the provisions described in the Statement of/Acceptance on form MECH-1-A Name: Company: Signature: Date: 2005 Compliance Acceptance Forms December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2 A PROJECTNAME / \ E 7_A4 / /;l �U (T DATA/ ell - , Z-/' Z V A. Equipment Testing (Check appropriate column) CAV VAV a. =Verify is not in economizer mode during test - check appropriate column Ste 1: CAV and VAV testing at full su airflow, 1 I Drive boxes open check 21 Measured outdoor airflow cfm 3 Required outdoor airflow cfm from MECH-3-C, Column q 4 Time for outside air damper to stabilize after VAV boxes open minutes 5 Return to initial conditions check Ste 2: VAV testing at reduced sueply airflow 1 Drive boxes to minimum check 2 Measured outdoor airflow cfm 3 Required outdoor airflow (cfm) (from MECH-3-C, Column'l 4 Time for outside air damper to stabilize after VAV boxes open minutes 5 Return to initial conditions (check) Ste 1: % Outdoor Air = Measured outside air /Required outside air Ste 1:2/Ste 1:3 % J 90% > %Outdoor Air < 110% Y / N Y / N Outside air damper position stabilizes within 15 minutes (Step 1:4 < 15 minutes) Y N Y / N Ste 2: % Outdoor Air = Measured outside air /Required outside air Ste 2:2/Ste 2:3 90% > %Outdoor Air < 110% Y I N Outside air damper position stabilizes within 15 minutes (Step 2:4 < 15 minutes) I I Y / N Note: Shaded boxes do not avol v for that particular test procedure C. PASS / FAIL Evaluation check one): PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive - es 0 FAIL: Any Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in Testing Calculations S Results section. Provide explanation below. Use and attach additional sages if necessary. 2005 Compliance Acceptance Forms December 2005 1 Ej PROJEC �I ' PROJEC TESTII-M ' � N VENTIU ' Intent: 12005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2 A measured outside airflow CFM is within t 10% of the total required outside airflow value found in the ards Mechanical Plan (MECH-3-C, Column H or Column 1), per 121(f). Construction Inspection 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Means to measure airflow (hot wire anemometer or pilot tube) 2 Check one of the following: ❑ Variable Air Volume (VAV) -Check as appropriate: a. Sensor used to control outdoor air flow must have calibration certificate or be field calibrated ❑ Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) Constant Air Volume (CAV) - Check as appropriate: System is designed to provide a faed minimum OSA when the unit is on Certification Statement: I certify that all statements are true on this MECH-2-A form including the PASS/FAIL Evaluation.. I affirm I am eligible to sign this form under the provisions described in the Statement of/Acceptance on form MECH-1 A Name: Company: Signature: 2005 Compliance Acceptance Forms "'r k :� a Llm 'C2 ✓ Date: / / ' 2 0 December 2005 ' 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2 A F entilation System Acceptance Document U�� J.3.1, NJ.3.2 lFormZ of Z PROJECT NAME b-'L��' ",44)r DATE I A. Equipment Testing (Check appropriate column) CAV VAV a. Iverify unit is not in economizer. mode dudng test - check appropriate column Ste 1: CAV and VAV testing at full supply airflow, 1 I Drive boxes open check 2 1 Measured outdoor airflow cfm 3 R uired outdoor airflow (cfm) (from MECH-3-C, Column 1 4 Time for outside air damper to stabilize after VAV boxes open minutes 5 Return to initial conditions (check) Ste 2: VAV testing at reduced supply airflow 1 Drive boxes to minimum check 2 Measured outdoor airflow cfm 3 Required outdoor airflow (cfm) (from MECH-3-C, Column I F4 Time for outside air damper to stabilize after VAV boxes open minutes 1 5 Retum to initial conditions (check) Ste 1: % Outdoor Air = Measured outside air /Required outside air Ste 1:2/Ste 1:3 % % 90% > %Outdoor Air < 110% Y / N Y / N Outside air damper position stabilizes within 15 minutes (Step 1:4 < 15 minutes) Y / N Y / N Ste 2: %Outdoor Air =Measured outside air /Required outside air(Step2:2/Ste 2:3 90%.> %Outdoor Air < 110°% Y / N Outside air damper position stabilizes within 15 minutes (Step 2:4 < 15 minutes) Y / N C. PASS / FAIL Evaluation check onel: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive - es ❑ FAIL: Any Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in Testing Calculations & Results section. Provide explanation below. Use and attach additional oases if necessary. 2005 Compliance Acceptance Forms December 2005 I I 12005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2-A 1 Intent: Verify measured outside airflow CFM is within t 100A of the total required outside airflow value found in the Standards Mechanical Plan MECH-3-C, Column H or Column 1), per 121(f). Construction Inspection 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Means to measure airflow (hot wire anemometer or pilot tube) 2 Check one of the following: ❑ Variable Air Volume (VAV) - Check as appropriate: a. Sensor used to control outdoor air flow must have calibration certificate or be field calibrated ❑ Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) Constant Air Volume (CAV) - Check as appropriate: System is designed to provide a fixed minimum OSA when the unit is on Certification Statement: I certify that all statements are true on this MECH-2-A form including the PASSIFAIL Evaluation. I affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-1-A Name: Company: Signature: 2005 Compliance Acceptance Forms Cs 6-- 4'-z (//CL ✓ Date: December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2 A Ste 1: % Outdoor Air = Measured outside air /Required outside air Ste 1:21Ste 1:3 °° % ation S stem Acce tance Document t)�L= E , NJ.3.2 Form of Z Y N Y / N Ste 2: % Outdoor Air = Measured outside air /Required outside air Step2:2/Ste 2:3) PROJECT NAE ]v� C y iell DATE Z- A. Equipment Testing (Check appropriate column) CAV VAV a. Verify unit is not in economizer mode during test -check appropriate column Ste 1: CAV and VAV testing at full supply airflow 1 Drive boxes open cheek 2 Measured outdoor airflow cfm 3 Required outdoor airflow (cfm) (from MECH-3-C, Column I) 4 Time for outside air damper to stabilize after VAV boxes open minutes 5 Return to initial conditions (check) Ste 2: VAV testing at, reduced supply airflow 1 Drive boxes to minimum check 2 Measured outdoor airflow cfm 3 Required outdoor airflow (cfm) (from MECH-3-C, Column 1 4 Time for outside air dampefto stabilize after VAV boxes open minutes 51 Return to initial conditions (check) B. Testing Calculations & Results CAV VAV Ste 1: % Outdoor Air = Measured outside air /Required outside air Ste 1:21Ste 1:3 °° % 90% > %Outdoor Air < 110% Y t Y / N Outside air damper position stabilizes within 15 minutes (Step 1:4 < 15 minutes) Y N Y / N Ste 2: % Outdoor Air = Measured outside air /Required outside air Step2:2/Ste 2:3) 90% > %Outdoor Air < 110% Y / N Outside air damper position stabilizes within 15 minutes (Step 2:4 < 15 minutes) Y / N mote: snaaeo poxes ao not apply ror Tnar parucu►ar iam p. -m -v PCalculationsAIL: ASS I FAIL Evaluation check one : ASS: All Construction Inspection responses are complete and Testing & Results responses areositive - es Any Construction Inspection responses are incomplete OR there is one or more negative (N - no) esponses in Testing Calculations & Results section. Provide explanation below. Use and attach addition{aaes if necessary. 2005 Compliance Acceptance Forms December 2005 12005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-2-A 1 Intent: Verify measured outside airflow CFM is within t 10% of the total required outside airflow value found in the 1 Standards Mechanical Plan (MECH-3-C, Column H or Column 1), per 121(f). I Construction Inspection 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Means to measure airflow (hot wire anemometer or pilot tube) 2 Check one of the following: ❑ Variable Air Volume (VAV) - Check as appropriate: a. Sensor used to control outdoor air flow must have calibration certificate or be field calibrated ❑ Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) Constant Air Volume (CAV) - Check as appropriate: System is designed to provide a fixed minimum OSA when the unit is on Certification Statement: I certify that all statements are true on this MECH-2-A form including the PASSIFAIL Evaluation. 1 affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-I-A Name: ' i L�9" �'j %4�NL Company: Signature: 2005 Compliance Acceptance Forms L VL- n (1/C L ✓ Date: / �V / December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE AflECH-2-A Ventilation S stem Acce tance Document .D G NJ.3.1, NJ.3.2 lFormZ of 7Z - PROJECT PROJECT NAME b C J 7-/1 l' L A) (t) 6- DATE Gell `-� A. Equipment Testing (Check appropriate column) CAV VAV a. lVerify unit is not in economizer mode during test - check appropriate column Z71 N Y / N Ste 1: CAV and VAV testing at full supply airflow Y N Y / N 11 Drive boxes open check 21 Measured outdoor airflow cfm Y / N 3 Required outdoor airflow (cfm) (from MECH-3-C, Column 1) Y / N 4 Time for outside air damper to stabilize after VAV boxes open minutes 5 Return to initial conditions (check) Ste 2: VAV testing at reduced supply airflow 11 Drive boxes to minimum check 21 Measured outdoor airflow cfm 3 R uired outdoor airflow (cfm) from MECH-3-C, Column 1 4 Time for outside air damper to stabilize after VAV boxes open minutes 5 Return to initial conditions (check) B. Testing Calculations & Results CAV VAV Ste 1: % Outdoor Air = Measured outside air /Required outside air Ste 1:2/Ste 1:3 % % 90% > %Outdoor Air < 110% Z71 N Y / N Outside air damper position stabilizes within 15 minutes (Step 1:4 < 15 minutes) Y N Y / N Ste 2: % Outdoor Air = Measured outside air /Required outside air Ste 2:2/Ste 2:3 90% > %Outdoor Air < 110% Y / N Outside air damper position stabilizes within 15 minutes (Step 2:4 < 15 minutes) Y / N Note: Shaded boxes do not apply for that particular test procedure C. PASS / FAIL Evaluation check one): PASS: All Construction Inspection responses are complete and Testing Calculations S Results responses are positive - es ❑ FAIL: Any Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in Testing Calculations & Results section. Provide explanation below. Use and attach additional pages if necessary. 2005 Compliance Acceptance Forms December 2005 11 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-5-A NJ.5.1Air Distribution Acceptance Document &/`IJLs� (Part 1 of 3) PROJECT NAME\\ p n f DATE TELEPHONE PROJECT ADDRESS TESTING AUTHORITY � � AIR A$DISTRIBUTOR NAME / DESIGNATION PERMIT NUMBER �..� � 'R \ �v w �� Che ed by/Date. C L. V �- �Q�� • °`ir k Enforcement encjrUses s* -` Intent: New single zone supply ductwork must be less than 6% leakage rate per §144(k) or §149(b)Di, existing single zone ductwork must be less than 15% leakage or other compliance path per §149(b)Dii or §149(b) Construction Inspection 1 Scope of test —New Buildings —this test required on New Buildings only if all checkboxes 1(a) through 1(c) are checked Existing Buildings — this test required if 1 a through 1 d are checked -Ductwork conforms to the following note if any of these are not checked, then this testis not required): 1 a Connected to a constant volume, single zone air conditioners, heat pumps, or furnaces 1b Serves less than 5000 square feet of floor area 1c NHas more than 25% duct surface area located in one or more of the following spaces - Outdoors - A space directly under a roof where the U -factor of the roof is greater than U -factor of the ceilin - A space directly under a roof with fixed vents or openings to the outside or unconditioned - An unconditioned crawls ace - Other unconditioned spaces (` 1 d) A duct is extended or any of the following replaced: air handler, outdoor condensing unit of a split sstem, cooling or heating coil, or the furnace heat exchanger. 2 Instrumentation to perform test includes: a. Duct Blaster 3 Material and Installation. Complying new duct systems shall have a checked box for all of the following categories a throul Ih f. a. Choice of drawbands (check one of the following) p Stainless steel worm -drive hose clamps UV -resistant nylon duct ties b. Flexible ducts are not constricted in any way c. Duct leakage tests performed before access to ductwork and connections are blocked d. Joints and seams are not sealed with doth back rubber adhesive tape unless used in combination with Mastic and drawbands e. Duct R-values.are verged R-8 per 124(a) f. Ductwork located outdoors has insulation that is protected from damage and suitable for outdoor service Certification Statement I certify that all statements are true on this MECH-5-A form including the PASS/FAIL Evaluation. I affirm i am eliqible to siqn this form under the provisions described in the Statement of Acceptance on form MECH-1 A Name: [g' Company: /v !2 G ��ii L7 LS �'' �'L (// C 6V _Qinn_-,i„n- I W1 Date: z-71 -- / r/5// v 2 o/ U 2005 Nonresidential Acceptance Forms December 2005 11 II II n 11 11 INSTALLER CERTIFICATION /(Part 2 of 3) MECH-5-A PROJECT N E 4 o G "! C' DATE - / I -Z O / U SITE ADDRESS L d 6 PERMIT NUMBER COPY TO: Building Department, Builder, Building Owner at Occupancy, HERS Provider VERIFIED DUCT TIGHTNESS BY INSTALLER The installing contractor must pressure test every new HVAC systems that meet the requirements of Section 144(k) and every retrofit to existing HVAC systems that meet the requirements of section 149(b)D or E (see Scope of Test under Construction Inspection) RATED FAN FLOW (applies to all systems) Measured values 1 Cooling capacity or for heating only units heating capacity yi!� 1-104 1a a) Cooling capacity (for all units but heating only units) in tons t,�w u; •.* b) Heating capacity (for heating only units) kBtu/h 2 Fan flow calculation a) Cooling capacity in ons t (Line # 1 a) x 400 cfm/ton) b) Heating only cap. kBtu/h f (Line # 1b) x (21.7 cfm/kBtu/h)] / b U :� � •�.:.i. 3 Total calculated supply fan flow 2(a) or 2(b) cfm NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) 4 Enter Tested Leakage Flow in CFM: (p 2 ✓ ✓ 5 Pass if Leakage Percentage <6%: f &Z (Line # 4) / 17 (Line # 3)] x 100 t(, % Pass O Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. yk 7 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change Out TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out Use one of the following Three Tests or Verification Standards for compliance: 8 Pass if Leakage Percentage <15% [ (Line # 7) / (Line # 3)] x 100 % 0 Pass 0 Fail 9 Pass if Leakage Reduction Percentage >60% Leakage reduction = [1 - [ (Line#7) / (Line#S)D x 100 % 0 Pass 0 Fail 1 0 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and Verification by HERS rater (sampling rate 100%) 0 Pass 0 Fail Pass if One of Lines #8 through # 10 pass 0 Pass 0 Fail INSTALLER CQMPLIANCE STATEMENT . The building was: ✓ WTested at Final 0 Tested at Kougn-In 1, the undersigned, verify that the above diagnostic test results and the work 1 performed associated with the t st(s 1sIn conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 124- of the 2005 Building Energy Efficiency Standards. Name: Company: Signature: License: V A) Ls' %G N L 1,A L Date: I Expires: ' 2005 Nonresidential Acceptance Forms December 2005 11 11 11 INSTALLER CERTIFICATION '& I (Part3 & 3) MECH-5-A HERS Rater - Telephone: 7=G� 0 6,45 A �� p- d ,7 Sample Group Number. Certifying Signat Sample building Number. C -0b _ , / ZLL:-:�&4AJA•l�LM E�V'cs` f1 &, r'' HERS Provider. Copies to: Builder, Building Owner at Occupancy, Building Department (wet signature), HERS Provider For new buildings the HERS rater must test and field verify the first individual single zone package space conditioning equipment unit ' of each building. After the first unit passes the builder shall identify a group of up to seven package units in the building from which one sample will be selected for testing. If this first sampled unit fails the HERS rater must pick another package unit from the group for testing. If the second unit in the group does not pass the HERS rater must test all package units in the group. ' For existing buildings the HERS rater must pressure test one out of every seven units a contractor changes. Same rules apply for sampling above. This page must be filled out by the HERS rater for all tested and sampled buildings. If the installer has not tested every system and provided a MECH-5-A to the HERS rater sampling must not occur. ' The unit was: %/Y -Jested ✓ ❑ Approved as part of sample testing but was not tested 11 11 11 11 11 � I As the HERS rater providing diagnostic testing and field verification, I certify that the building identified on this form complies with the diagnostic tested compliance requirements as checked -'on this form. The HERS rater must verify the distribution system on every new TESTED system to make sure that it is fully ducted and correct tape is used before a MECH-5-A may be released. The installer has provided a completed MECH-5-A for every system in the group In new duct systems, where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. RATED FAN FLOW (applies to all systems) Measured Values 1 1 Cooling capacity or for heating only units heating capacity, • a) Cooling capacity (for all units but heating only units) tons x 400 cWtonj 1140,00 - b) Heating capacity (for heating only units) L— kBtuh x 21.7 cfm/kBtuh] 2 Total calculated supply fan flow 1(a) or 1(b) cfm �p DO NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) 3 Enter Tested Leakage Flow in CFM: f�2 ✓ ✓ 4 Pass if Leakage Percentage <6%: L_(Line # 3) / 66(Line # 2)j x 100 , 9 % Pass 0 Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out 5 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct ,;;; ;t s System for Duct System Alteration and/or Equipment Change -Out. TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, Use one of the following Three Tests or Verification Standards for compliance: 6 Pass if Leakage Percentage <15% f (Lune # 5) / (Line # 2)j x 100 % ❑ Pass ❑ Fail For systems certified by the installer as reducing leakage, pass if Leakage Reduction >60%. 7 (Line#5 BERSTestedLeakage) LeakageReduction= l — —Ix 100 (Line#6 Installer's CertifiedPre- Test Leakage) % 0 Pass ❑ Fail 8 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and ❑ Pass ❑ Fail Verification by HERS rater (sampling rate 100%) Pass if One of Lines # 6 through # 8 pass 0 Pass 0 Fail 2005 Nonresidential Acceptance Forms December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-5-A NJ.5.1Air Distribution Acceptance Document 10649 FG --- (Part 1 of 3) PROJECT NAME DATE t�t30G� r�r:yj` TELEPHONE G--271.,- 4o PROJECT ADDRESS -% / � / Lc�C� U U JN�/�"+ _Ch e ecked by/ Enf �mera eeUse TESTING AUTHORITY `AIRDIISTRIBUTOR NAME/ DESIGNATION / PERMIT NUMBER `� • Y L 1/ L GD4jT� Intent: New single zone supply ductwork must be less than 6% leakage rate per §144(k) or §149(b)Di, existing single zone ductwork must be less than 15% leakage or other compliance path per §149(b)Dii or §149(b) Construction Inspection 1 Scope of test — New Buildings — this test required on New Buildings only if all checkboxes 1(a) through 1(c) are checked Existing Ductwork (` y Buildings — this test required if 1 a through 1 d are checked conforms to the following note if any of these are not checked, then this test is not required): 1 a Connected to a constant volume, single -zone air conditioners, heat pumps, or furnaces 1b) Serves less than 5000 square feet of floor area 1 c Has more than 25% duct surface area located in one or more of the following spaces - Outdoors - A space directly under a roof where the U -factor of the roof is greater than U -factor of the ceiling - A space directly under a roof with fixed vents or openings to the outside or unconditioned spaces -An unconditioned crawls ace - Other unconditioned spaces 1 d) A duct is extended or any of the following replaced: air handler, outdoor condensing unit of a split system, cooling orheating coil or the furnace heat exchanger. 2 Instrumentation to perform test includes: a. Duct Blaster 3 Material and Installation. Complying new duct systems shall have a checked box for all of the following categories a throu h f. a. Choice of drawbands (check one of the following) 0 Stainless steel worm -drive hose clamps UV -resistant nylon duct ties b. Flexible ducts are not constricted in any way c. Duct leakage tests performed before access to ductwork and connections are blocked d. Joints and seams are not sealed with cloth back rubber adhesive tape unless used in combination with Mastic and drawbands. e. Duct R -values are verified R-8 per 124(a) f. Ductwork located outdoors has insulation that is protected from damage and suitable for outdoor service Certification Statement I certify that all statements are true on this MECH-5-A form including the PASS/FAIL Evaluation. I affirm 1 am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-1 A Name: c.:� Company: 6 ,f rt (%/ 6 &V/- ✓Signature: - -- Date: -- / I'/' / y — 2 a/ U Signature: 2005 Nonresidential Acceptance Forms December 2005 INSTALLER CERTIFICATION 00A)a-5- /t��-Z (Part 2 of 3) MECH-5-A PROJECT E (� ` /V v DATE i Z610 SITE ADDRESS LAZ-L:---b d� PERMIT NUMBER COPY TO: Building Department, Builder, Building Owner at Occupancy, HERS Provider VERIFIED DUCT TIGHTNESS BY INSTALLER The installing contractor must pressure test every new HVAC systems that meet the requirements of Section 144(k) and every retrofit to existing HVAC systems that meet the requirements of section 149(b)D or E (see Scope of Test under Construction Inspection) RATED FAN FLOW (applies to all systems) Measured values 1 Cooling capacity or for heating only units heating capacity (o a) Cooling capacity (for all units but heating only units) in tons b) Heating capacity (for heating only units) kBtu/h 2 Fan flow calculation a) Cooling capacity in tons (Line # 1a) x 400 cfm/ton] b) Heating only cap. kBtu/h f (Line # 1 b) x (21.7 cf rdkBtu/h)] ! Z 0 (D 3 Total calculated supply fan flow 2(a) or 2(b) cfm . . 1 a v NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) 4 Enter Tested Leakage Flow in CFM: ( ✓ ✓ 5 Pass if Leakage Percentage <60/6: (V-1-0 (Line # 4) / / Zoo (Line # 3)] x 100 4-1. 7 % KPass 0 Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out 6 Enter Tested Leakage Flow in CFM: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. !, r 7 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. TEST OR VERIFICATION STANDARDS: For Altered Duct System andfor HVAC Equipment Change -Out Use one of the following Three Tests or Verification Standards for compliance: ✓ ✓ 8 Pass if Leakage Percentage <15% [ (Line # 7) / (Line # 3)] x 100 % 0 Pass 0 Fail 9 Pass if Leakage Reduction Percentage >60% Leakage reduction = [1 - [ (LinW) / (Une#6)]) x 100 % 0 Pass 0 Fail 1 0 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and Verification by HERS rater (sampling rate 100%) 0 Pass 0 Fail Pass if One of Lines #8 through # 10 pass 0 Pass ❑Fail I INSTALLER CQIyPLIANCE STATEMENT The building was: ✓ WTested at Final 0 Tested at Rough -in ti4I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the srst inconformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 124 of the 2005 Building Energy Efficiency Standards. Name: Company: Signature: License: ✓ /1) L!�- - = �, /v C L /N t Date: / _ 2 6 I Expires: i 2005 Nonresidential Acceptance Forms December 2005 INSTALLER CERTIFICATION 0, 6 G Z (Part 3 of 3) MECH-5-A HERS Rater Telephone: 7 = GA X6,4;5 '4 �� " p - ,d 3 Sample Group Number: Irl C Certifying Signa Sample building Number. i'2 C b U Fii, HERS Provider. Copies to: Builder, Building Owner at Occupancy, Building Department (wet signature), HERS Provider For new buildings the HERS rater must test and field verify the first individual single zone package space conditioning equipment unit of each building. After the first unit passes the builder shall identify a group of up to seven package units in the building from which one sample will be selected for testing. If this first sampled unit fails the HERS rater must pick another package unit from the group for testing. If the second unit in the group does not pass the HERS rater must test all package units in the group. For existing buildings the HERS rater must pressure test one out of every seven units a contractor changes. Same rules apply for sampling above. This page must be filled out by the HERS rater for all tested and sampled buildings. If the installer has not tested every system and provided a MECH-5-A to the HERS rater sampling must not occur. lThe unit was: ✓ tQested ✓ ❑ Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, t certify that the building identified on this form complies with the diagnostic tested compliance requirements as checked ✓ on this form. The HERS rater must verify ' the distribution system on every new TESTED system to make sure that it is fully ducted and correct tape is used before a MECH-5-A may be released. u The installer has provided a completed MECH-5,A for every system in the group In new duct systems, where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive dud tape to seal leaks at duct connections. RATED FAN FLOW (applies to all systems) Measured Values 1 Cooling capacity or for heating only units heating capacity ell .^.t ,•.._ �. a) Cooling capacity (for all units but heating only units) tons x 400 cfm/ton] Z p p', b) Heating capacity (for heating only units) L kBtuh x 21.7 ctm/kBtuh] 2 Total calculated supply fan flow 1(a) or 1(b) cfm -NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) 3 Enter Tested Leakage Flow in CFM: �� ✓ ✓ 4 Pass if Leakage Percentage <6%: t'o '(Line # 3) / (Line # 2)] x 100 L-/.,%% Pass ❑Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Aftered Duct7�73 5 System for Duct System Alteration and/or Equipment Change -Out. TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, Use one of the following Three Tests or Verification Standards for compliance: 6 Pass if Leakage Percentage <15% (_(Line # 5) / Llne # 2 ] x 100 % ❑ Pass ❑ Fail For systems certified by the installer as reducing leakage, pass if Leakage Reduction >60%. 7 (Line#5 HERSTestedLeakage) LeakageReduction=l— I x 100 (Line#b Installert CertifiedPre- Test Leakage) % ❑ Pass ❑ Fail 8 Pass if all Accessible Leaks are seated as confirmed by Visual Inspection and ❑ Pass ❑ Fail Verification by HERS rater (sampling rate 100%) Pass If One of Lines # 6 through # 8 pass ❑ Pass D Fail 2005 Nonresidential Acceptance Forms December 2005 II II 11 11 11 11 11 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-S-A NJ.5.1Air Distribution Acceptance Document Q/l� C - (Part 1 of 3) PROJECT NAME C� i�r'! 600 G-� l�� DATE TELEPHONE PROJECT ADDRESS- -G� L)�N��.' * - '. Checked by/Date .'Enforcerrem TESTING AUTHORITY AI DISTRIBUTOR NAME I DESIGNATION `� �� , r PERMIT NUMBER ,l C U y lsV (� L GQ�T� • �` a Use . Intent:ew N single zone supply ductwork must be less than 6% leakage rate per §144(k) or §149(b)Di, existing single zone ductwork must be less than 15% leakage or other compliance path per §149(b)Dii or §149(b) ) Construction Inspection 1 Scope of test — New Buildings — this test required on New Buildings only if all checkboxes 1(a) through 1(c) are checked Existing Buildings — this test required if 1 a through 1 d are checked Ductwork conforms to the following note if any of these are not checked, then this test is not required): 1a Connected to a constant volume, single zone air conditioners, heat pumps, or furnaces 1 b Serves less than 5000 square feet of floor area 1 c Has more than 25% duct surface area located in one or more of the following spaces - Outdoors. - A space directly under a roof where the U -factor of the roof is greater than 1.1 -tactor of the ceiling - A space directly under a roof with fixed vents or openings to the outside or unconditioned spaces - An unconditioned crawls ace - Other unconditioned spaces (` 1 d) A duct is extended or any of the following replaced: air handler, outdoor condensing unit of a split sstem, cooling or heating coif or the fumace heat exchanger 2 Instrumentation to perform test includes: a. Duct Blaster 3 Material and Installation. Complying new duct systems shall have a checked box for all of the following categories a throu h f. a. Choice of drawbands (check one of the following) ❑ Stainless steel worm -drive hose clamps UV -resistant nylon duct ties b. Flexible ducts are not constricted in any way c. Duct leakage tests performed before access to ductwork and connections are blocked d. Joints and seams are not sealed with cloth back rubber adhesive tape unless used in combination with Mastic and drawbands e. Duct R -values are verified R-8 per 124(a) f. Ductwork located outdoors has insulation that is protected from damage and suitable for outdoor service Certification Statement I certify that all statements are true on this MECH-5-A form including the PASSiFAIL Evaluation. I affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-1-A Name: /v ✓z G i3 L� L3 L��'t L'✓ Company: Si nature: Date: — / l%' Sr — 2 U v—v 2005 Nonresidential Acceptance Forms December 2005 INSTALLER CERTIFICATION 0 L1N� o'52 -o7 (Part2 & 3) MECH-5-A "" M)6 U� ` Sr,1C--�,Q�iI1G DATE SITE ADDRESS 6AZ-L;--b I �r be, PERMIT NUMBER COPY TO: Building Department, Builder, Building Owner at Occupancy, HERS Provider VERIFIED DUCT TIGHTNESS BY INSTALLER The installing contractor must pressure test every new HVAC systems that meet the requirements of Section 144(k) and every retrofit to existing HVAC systems that meet the requirements of section 149(b)D or E (see Scope of Test under Construction Inspection) RATED FAN FLOW (applies to all systems) Measured values Cooling capacity or for heating only units heating capacity 4, p 174,14 a) Cooling capacity (for all units but heating only units) in tons • _ ' r21 b) Heating capacity (for heating only units) kBtu/h Fan flow calculation a) Cooling capacity in tons [_(Line # 1a) x 400 cfm/ton] b) Heating only cap. kBtu/h [ (Line # 1 b) x (21.7 cfm/kBtu/h)] Z 0 O c 3 Total calculated supply fan flow 2(a) or 2(b) cfm NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Dud Pressurization Test Results (CFM @ 25 Pa) 4 Enter Tested Leakage Flow in CFM: ✓ ✓ 5 Pass if Leakage Percentage <60/6: Line # 4) LZb66 (Line # 3)] x 100L/ �f % Pass ❑ Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out 6 Enter Tested Leakage Flow in CFM: Pre -Test of Existing Dud System Prior to Dud System Alteration and/or Equipment Change -Out. _. 7 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Dud System for Dud System Alteration and/or Equipment Change -Out = y3J} TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out Use one of the following Three Tests or Verification Standards for compliance: 8 Pass if Leakage Percentage <15% [ (Line # 7) / (Line # 3)] x 100 % ❑ Pass ❑ Fail 9 Pass if Leakage Reduction Percentage >60%, Leakage reduction = [1 - i (Line#7) / (Line#6)]) x 100 % ❑ Pass ❑ Fail 1 0 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and Verification by HERS rater (sampling rate 100%) ❑ Pass ❑ Fail Pass if One of Lines #8 through # 10 pass ❑ Pass ❑ Fail INSTALLER CQMPLIANCE STATEMENT The building was: ✓ WTested at f=inal ❑ i estea at Hougn-In ttI, the undersigned, verify that the above diagnostic test results and the work I performed associated with the t st(s in conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 124 of the 2005 Building Energy Efficiency Standards. Name: Company: Signature: License: /1) /N �. Date: - 2 v to y ZI Expires: 2005 Nonresidential Acceptance Forms December 2005 11 u I I I INSTALLER CERTIFICATION Z—DA%C 1' -"C -Y' (Part 3 of 3) MECH-5-A 11,_REater - Telephone: S GA RG4 i4j Sample Group Number. D 9 r -'t C Certifying Signa Sample building Number. f2 rl C b U Fi HERS Provider. Copies to: Builder, Building Owner at Occupancy, Building Department (wet signature), HERS Provider ' For new buildings the HERS rater must test and field verify the first individual single zone package space conditioning equipment unit of each building. After the first unit passes the builder shall identify a group of up to seven package units in the building from which one sample will be selected for testing. If this first sampled unit fails the HERS rater must pick another package unit from the group for testing. If the second unit in the group does not pass the HERS rater must test all package units in the group. ' For existing buildings the HERS rater must pressure test one out of every seven units a contractor changes. Same rules apply for sampling above. This page must be filled out by the HERS rater for all tested and sampled buildings. If the installer has not tested every system and provided a MECH-55--A to the HERS rater sampling must not occur. ' The unit was: ✓ Vjested V ❑ Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the building identified on this form ' complies with the diagnostic tested com Bance requirements as checked ✓ on this form. The HERS rater must verify the distribution system on every new TEASTED system to make sure that it is fully ducted and correct tape is used before a MECH-5 A may be released. u it The installer has provided a completed MECH-5A for every system in the group In new duct systems, where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive dud tape to seal leaks at duct connections. RATED FAN FLOW (applies to all systems) Measured Values 1 Cooling capacity or for heating only units heating capacity O HVr+ _ a) Cooling capacity (for all units but heating only units) tons x 400 cfm/ton] CJ O O b) Heating capacity (for heating only units) L— kBtuh x 21.7 cfim/kBtuh] 2 J Total calculated supp4y fan flow 1(a) or 1(b) cfm 2 C> 0 0 NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) 3 Enter Tested Leakage Flow in CFM: / 4 Pass if Leakage Percentage <6%: (Line # 3) / C W(Line # 2)] x 100 Lt,7 % KPass ❑ Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out 5 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, Use one of the following Three Tests or Verification Standards for compliance: 6 Pass if Leakage Percentage <15%(Llne # 5) / Line # 2) x 100 % ❑Pass ❑Fail For systems certified by the installer as reducing leakage, pass if Leakage Reduction >60%. 7 (Line45 HERSTestedLeakage) LeakageReduction= l– lX 100 (Line#6Installer's CertifiedPre- Test Leakage) % ❑ Pass ❑ Fail 8 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and ❑ Pass ❑ Fail Verification by HERS rater (sampling rate 100%) Pass if One of Lines # 6 through # 8 pass 0 Pass ❑ Fail 2005 Nonresidential Acceptance Forms December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-5-A NJ.5.9Air Distribution Acceptance Document ,-�7-QA,,f ie:' --C -41 (Part 1 of 3) PROJECT NAME\ {' , DATE 6 l� /"1 L () v l &L A TELEPHONE PROJECT ADDRESS a Checiceo by/Date TESTING AUTHORITY AIR DISTRIBUTOR NAME/ DESIGNATION PERMIT NUMBER p ' / . �/ D�9Erilbreerrient U (� 4 .Ag-epq Use Intent: New single zone supply ductwork must be less than 6% leakage rate per §144(k) or §149(b)Di, existing single zone ductwork must be less than 15% leakage or other compliance path per §149(b)Dii or §149(b) Construction Inspection 1 Scope of test — New Buildings — this test required on New Buildings only if all checkboxes 1(a) through 1(c) are checked Existing Buildings — this test required if 1 a through 1 d are checked Ductwork conforms to the following note if any of these are not checked, then this test is not r uired : 1a Connected to a constant volume, single zone air conditioners, heat pumps, or furnaces 1b) Serves less than 5000 square feet of floor area 1c Has more than 25% duct surface area located in one or more of the followin spaces - Outdoors - A space directly under a roof where the Wactor of the roof is greater than U -factor of the ceiling - A space directly under a roof with fixed vents or openings to the outside or unconditioned spaces - An unconditioned crawls ace (` - Other unconditioned spaces 1 d) A duct is extended or any of the following replaced: air handier, outdoor condensing unit of a split sstem, cooling or heating coil or the furnace heat exchanger. 2 Instrumentation to perform test includes: a. Duct Blaster 3 Material and Installation. Complying new duct systems shall have a checked box for all of the following categories a through f. a. Choice of drawbands (check one of the following) ❑ Stainless steel worm -drive hose clamps uv -resistant nylon duct ties b. Flexible ducts are not constricted in any way c. Duct leakage tests performed before access to ductwork and connections are blocked d. Joints and seams are not sealed with cloth back rubber adhesive tape unless used in combination with Mastic and drawbands e. Duct R -values are verified R-8 per 124(a) f. Ductwork located outdoors has insulation that is protected from damage and suitable for outdoor service Certification Statement I certify that all statements are true on this MECH-5-A form including the PASS/FAIL Evaluation. I affirm 1 am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-I-A Name: cSc Company: /�,) l2 G ,tip L,� Signature: Date: -- / /� / '71 2 0/ U V � V 1 2005 Nonresidential Acceptance Forms December 2005 11 INSTALLER CERTIFICATION 96A)& ' PROJE T E DATE 11 11 11 11 11 11 11 (Part 2 of 3) MECH-5 A -//ice - Zo/0 SITE ADDRESS i 7 611Z-� b e e '�166 I PERMIT NUMBER COPY TO: Building Department, Builder, Building Owner at Occupancy, HERS Provider VERIFIED DUCT TIGHTNESS BY INSTALLER The installing contractor must pressure test every new HVAC systems that meet the requirements of Section 144(k) and every retrofit to existing HVAC systems that meet the requirements of section 149(b)D or E (see Scope of Test under Construction Insnection) RATED FAN FLOW (applies to, all systems) Measured values L /ill L Cooling capacity or for heating only units heating capacity 8 ' % a Coolin capac' (for all units but heatin on units) in tons Z Z Pass if Leakage Reduction Percentage >60% Leakage reduction = [1 - I (Line#7) / (Line#6)]) x 100 r21 b) Heating capacity (for heating only units) kBtu/h 1 0 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and Verification by HERS rater (sampling rate 100%) Fan flow calculation a) Cooling capacity in tons L-7- y (Line # 1a) x 400 cfmAon] b) Heating only cap. kBtu/h [ (Line # 1 b) x (21.7 cfm/kBtu/h)] / (� " 3 Total calculated supply fan flow 2(a) or 2(b) cfm D O Q NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) 4 Enter Tested Leakage Flow in CFM: �—f ✓ ✓ 5 Pass if Leakage Percentage <6%: L�Line # 4) / 6QLtne # 3)] x 100 y- �o Pass O Fail ALTERATIONS: Preexisting Duct System with Duct Alteration and/or HVAC Equipment Change -Out 6 Enter Tested Leakage Flow in CFM: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. z 7 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered , Duct System for Duct System Alteration and/or Equipment Change -Out � 1 TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out Use one of the following Three Tests or Verification Standards for compliance: INSTALLER C LIANCE STATEMEN ii The building was: ✓ WTested at Final 0 Tested at Rough -in e undersigned, verify that the above diagnostic test results and the work I performed associated with the 2(�SI-Snn conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 124 of the 2005 Building Energy Efficiency Standards. Name: Company: Signature: " License: V 1-5 [." L /ill L ✓ ✓ 8 Pass if Leakage Percentage <15% [ (Line # 7) / (Line # 3)] x 100 % O Pass ❑ Fail 9 Pass if Leakage Reduction Percentage >60% Leakage reduction = [1 - I (Line#7) / (Line#6)]) x 100 % CI Pass 0 Fail 1 0 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and Verification by HERS rater (sampling rate 100%) ❑ Pass O Fail Pass if One of Lines #8 through # 10 pass 13 Pass ❑ Fail INSTALLER C LIANCE STATEMEN ii The building was: ✓ WTested at Final 0 Tested at Rough -in e undersigned, verify that the above diagnostic test results and the work I performed associated with the 2(�SI-Snn conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 124 of the 2005 Building Energy Efficiency Standards. Name: Company: Signature: " License: V 1-5 [." L /ill L Date: 1 Expires: 2005 Nonresidential Acceptance Forms December 2005 11 I I I I I I I I I I INSTALLER CERTIFICATION OoAJk- Li (Part 3 of 3) MECH-5-A HERS Rater Telephone: Sample Group Number. Certifying Signar�"��""',,' Sample twirling Number. -F,i HERS Prover: Copies to: Builder, Building Owner at Occupancy, Building Department (wet signature), HERS Provider For new buildings the HERS rater must best and field verify the first individual single zone package space conditioning equipment unit of each building. After the first unit passes the builder shall identify a group of up to seven package units in the building from which one sample will be selected for testing. If this first sampled unit fails the HERS rater must pick another package unit from the group for testing. If the second unit in the group does not pass the HERS rater must test all package units in.the group. For existing buildings the HERS rater must pressure test one out of every seven units a contractor changes. Same rules apply for sampling above. This page must be filled out by the HERS rater for all tested and sampled buildings. If the installer has not tested every system and provided a MECH-5-A to the HERS rater sampling must not occur. The unit was: ✓ PkTested ✓ ❑ Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the building identified on this form complies with the diagnostic tested co liance requirements as checked on this form. The HERS rater must verify ' the distribution system on every new TESTED system to make sure that it is fully ducted and correct tape is used before a MECH-5-A may be released. I __ The installer has provided a completed MECH-5-A for every system in the group In new duct systems, where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive dud tape to seal leaks at duct connections. RATED FAN FLOW (applies to all systems) Measured Values 1 Cooling capacity or for heating only units heating capacity a) Cooling capacity (for all units but heating only units) 2 tons x 400 dr -/ton] CG b) Heating capacity (for heating only units) (__ kBtuh x 21.7 cfm/kBtuh] 2 Total calculated supply fan flow 1(a) or 1(b) cfm b O U NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) CC,, % 3 Enter Tested Leakage Flow in CFM: G ✓ ✓ 4 Pass if Leakage Percentage <6%: (Line # 3) /00 (Line # 2)] x 100 q.,6% Pass 0 Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out 5 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, Use one of the following Three Tests or Verification Standards for compliance: 6 Pass if Leakage Percentage <15% (__(Line # 5) / Llne # 2)] x 100 % 0 Pass ❑ Fail For systems certified by the installer as reducing leakage, pass if Leakage Reduction >60%. 7 (Line45 HERSTestedLeakage) LeakageReduction= l — 1 x goo (Line #6 Installer's CerdfiedPre -Test Leakage) % 0 Pass 0 Fail t3 Pass if all Accessible' Leaks are sealed as confirmed by Visual Inspection and 0 Pass 0 Fail Verification by HERS rater (sampling rate 100%) Pass if One of Lines # 6 through # 8 pass 0 Pass 0 Fail 2005-Nonresidendal Acceptance Forms December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-5-A NJ.5.1Air Distribution Acceptance Document C- � (Part 1 of 3) PROJECT NAME < j DATE TELEPHONE PROJECT ADDRESS TESTING AUTHORITY -- K: -VL'nUl Z6, tib _Checked by/Dote AIR DISTRIBUTOR NAME ! DESIGNATION \4 PERMIT NUMBER c .- c t/ c. c©4iTa Enforcement a Use Intent:New single zone supply ductwork must be less than 6% leakage rate per §144(k) or §149(b)Di, existing single zone ductwork must be less than 15% leakage or other compliance path per §149(b)Dii or §149(b) Construction Inspection 1 Scope of test — New Buildings —this test required on New Buildings only if all checkboxes 1(a) through 1(c) are checked Existing Buildings — this test required if 1 a through 1 d are checked Ductwork conforms to the following note if any of these are not checked, then this test is not required): 1a) Connected to a constant volume, single zone air conditioners, heat pumps, or furnaces 1 b Serves less than 5000 square feet of floor area 1 c Has more than 25°x6 dud surface area located in one or more of the following spaces - Outdoors - A space directly under a roof where the U -factor of the roof is greater than U -factor of the ceiling - A space directly under a roof with fixed vents or openings to the outside or unconditioned spaces - An unconditioned crawlspace - Other unconditioned spaces (` 1d) A dud is extended or any of the following replaced: air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger. 2 Instrumentation to perform test includes: a. Duct Blaster 3 Material and Installation. Complying new duct systems shall have a checked box for all of the following categories a throu h f. a. Choice of drawbands (check one of the following) ❑ Stainless steel worm -drive hose clamps UV -resistant nylon dud ties b. Flexible duds are not constricted in any way c. Duct leakage tests performed before access to ductwork and connections are blocked d. Joints and seams are not sealed with cloth back rubber adhesive tape unless used in combination with Mastic and drawbands e. Duct R -values are verified R-8 per 124(a) f. Ductwork located outdoors has insulation that is protected from damage and suitable for outdoor service Certification Statement I certify that all statements are true on this MECH-5-A form including the PASS/FAIL Evaluation. I affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-I-A Name: c� Company: Date: / D / y — 2 a/ u Signature: v—v 2005 Nonresidential Acceptance Forms December 2005 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 INSTALLER CERTIFICATION ,e'—"C--\r(Part2 of 3) MECH-5 A PROJECT E b ( '�- ��/ /% r�//II VV 1 DATE / Z O v SITE ADDRESS PERMIT NUMBER COPY TO: Building Department, Builder, Building Owner at Occupancy, HERS Provider VERIFIED DUCT TIGHTNESS BY INSTALLER The installing contractor must pressure test every new HVAC systems that meet the requirements of Section 144(k) and every retrofit to existing HVAC systems that meet the requirements of section 149(b)D or E (see Scope of Test under Construction Inspection) RATED FAN FLOW (applies to all systems) Measured Values 1 Cooling capacity or for heating only units heating capacity jo p Tj a Coolingcapac' (for all units but heating only units) in tons b) Heating capacity (for heating only units) kBtu/h 2 Fan flow calculation a) Cooling capacity in tons (Line # 1a) x 400 cfmAon] b) Heating only cap. kBtu/h ( (Line # 1 b) x (21.7 cfm/kBtu/h)] Z b O V 3 1 Total calculated supply fart flow 2(a) or 2(b) cfrrr 2 000 NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) 4 Enter Tested Leakage Flow in CFM: /no o ✓ ✓ 5 Pass if Leakage Percentage <6%: t Z I to cLine # 4) L4 Ob (Line # 3)] x 100 % Pass O Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change -Out 6 Enter Tested Leakage Flow in CFM: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. I 7 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out. TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out Use one of the following Three Tests or Verification Standards for compliance: ✓ ✓ 8 Pass if Leakage Percentage <15% [ (Line # 7) / (Line # 3)] x 100 % O Pass O Fail 9 Pass if Leakage Reduction Percentage >60% Leakage reduction = [1 - I (Line#7) / (Une#S)]) x 100 % O Pass O Fail 1 0 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and Verification by HERS rater (sampling rate 100%) O Pass O Fail Pass if One of Lines #8 through # 10 pass O Pass O Fail INSTALLER Cgr4PLIANCE STATEMENT The building was: ✓ WTested at Final u I estea at Kougn-m t KI, the undersigned, verify that the above diagnostic test results and the work I performed associated with the t(s sin conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 124 of the 2005 Building Energy Efficiency Standards. Name: Company: Signature: License: V A) T L-fe - .- 6)441\J1 L pate: y Z fires: 2005 Nonresidential Acceptance Forms December 2005 11 11 11 I 11 INSTALLER CERTIFICATION(Part 3 of 3) MECH-5 A HERS Rater Telephone: Sample Gawp Number. Certifying Signa Sample building Number.. % ri C.0 b U Fi HERS Provider. Copies to: Builder, Building Owner at Occupancy, Building Department (wet signature), HERS Provider For new buildings the HERS rater must test and field verify the first individual single zone package space conditioning equipment unit of each building. After the first unit passes the builder shall identify a group of up to seven package units in the building from which one sample will be selected for testing. If this first sampled unit fails the HERS rater must pick another package unit from the group for testing. If the second unit in the group does not pass the HERS rater must test all package units in the group. For existing buildings the HERS rater must pressure test one out of every seven units a contractor changes. Same rules apply for sampling above. This page must be filled out by the HERS rater for all tested and sampled buildings. If the installer has not tested every system and provided a MECH-5-A to the HERS rater sampling must not occur. The unit was: ✓ ,Tested ✓ 13 Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, I cert that the building identified on this form complies with the diagnostic tested compliance requirements as checked certify this form. The HERS rater must verify the distribution system on every new TESTED system to make sure that it is fully ducted and correct tape is used before a MECH-5-A may be released. t'JiLThe installer has provided a completed MECH-5-A for every system in the group In new duct systems, where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive dud tape to seal leaks at duct connections. RATED FAN FLOW (applies to all systems) Measured Values 1 1 Cooling capacity or for heating only units heating capacity (oC,tills- a) Cooling capacity (for all units but heating only units) [_1i' tons x 400 cfrn/ton] p 6 u b) Heating capacity (for heating only. units) (-- kBtuh x 21.7 dm/kBtuh] 2 Total calculated supply fan flow 1(a) or 1(b) cfm .-Z 0 u NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) // 3 Enter Tested Leakage Flow in CFM: ✓ ✓ 4 Pass if Leakage Percentage <6%: (Line # 3) D (Line # 2)] x 100 , 8 % p(Pass ❑ Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration andlor HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct 5 System for Duct System Alteration and/or Equipment Change -Out. - t TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, Use one of the following Three Tests or Verification Standards for compliance: 6 Pass if Leakage Percentage <15% [__(Line # 5) / Line # 2)] x 100 % a Pass o Fail For systems certified by the installer as reducing leakage, pass if Leakage Reduction >60%. 7 (Line#5 HERSTestedLeakage) LeakageReduction= l — lx 100 (Line#6installer's CertifiedPre- Test Leakage) % ❑ Pass ❑ Fail 8 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and ❑ Pass ❑ Fail Verification by HERS rater (sampling rate 100%) Pass If One of Lines # 6 through # 8 pass 0 Pass ❑ Fail 2005 Nonresidential Acceptance Forms December 2005 2005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE MECH-5 A NJ.5.lAir Distribution Acceptance Document Z -Q& Lt� 4 -C -j (Part 1 of 3) PROJECT NAME 0 DATE TELEPHONE PROJECT ADDRESS TESTING AUTHORITY = ✓z G �,� r� Ui is ✓ r - �tl c��`1t L�YL . Checked by/08te AIRDISTRIBUTOR NAME/ DESIGNATION PERMIT NUMBER a v W C U/ e. GDiT Enforcement =Use EnforcemUse Intent: New single zone supply ductwork must be less than 6% leakage rate per §144(k) or §149(b)Di, existing single zone ductwork must be less than 15% leakage or other compliance path per §149(b)Dii or §149(b)E. Construction Inspection 1 Scope of test — New Buildings — this test required on New Buildings only if all checkboxes 1(a) through 1(c) are checked Existing Buildings — this test required if 1 a through 1 d are checked Ductwork conforms to the following note if any of these are not checked, then this test is not required): 1 a Connected to a constant volume, dingle zone air conditioners, heat pumps, or furnaces 1 b Serves less than 5000 square feet of floor area 1 c Has more than 25% duct surface area located in one or more of the following spaces - Outdoors - A space directly under a roof where the U -factor of the roof is greater than U -factor of the ceiling - A space directly under a roof with fixed vents or openings to the outside or unconditioned spaces - An unconditioned crawls ace. - Other unconditioned spaces 1 d) A duct is extended or any of the following replaced: air handier, outdoor condensing unit of a split sstem cooling or heating coil, or the furnace heat exchanger. 2 Instrumentation to perform test includes: a. Duct Blaster 3 Material and Installation. Complying new duct systems shall have a checked box for all of the following categories a throu h f. a. Choice of drawbands (check one of the following) ❑ Stainless steel worm -drive hose clamps UV -resistant nylon duct ties b. Flexible ducts are not constricted in any way c. Duct leakage tests performed before access to ductwork and connections are blocked d. Joints and seams are not sealed with cloth balk rubber adhesive tape unless used in combination with Mastic and drawbands e. Duct R -values are verified R-8 per 124(a) f. Ductwork located outdoors has insulation that is protected from damage and suitable for outdoor service Certification Statement I certify that all statements are true on this MECH-5 A form including the PASS/FAIL Evaluation. 1 affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form MECH-I-A Name: �,� vs /v G i�AJ Z� C.-' c,' (// L'✓ Company: Date: Signature: 2005 Nonresidential Acceptance Forms December 2005 i� 1 1 1 1 1 1 1 1 1 '1 i 1 1 1 1 INSTALLER CERTIFICATION OM,6 #�C-& (Part 2 of 3) MECH-5 A PROJECT E 6 Ci / 1 SnI� /% 4d7M)�i 14 DATE SITE ADDRESS Z/ 2- 1'4� -) LA La- b(' PERMIT NUMBER COPY TO: Building Department, Builder, Building Owner at Occupancy, HERS Provider VERIFIED DUCT TIGHTNESS BY INSTALLER The installing contractor must pressure test every new HVAC systems that meet the requirements of Section 144(k) and every retrofit to existing HVAC systems that meet the requirements of section 149(b)D or E (see Scope of Test under Inspection) RATED FAN FLOW (applies to all systems) Measured Values 1 Cooling capacityor for heating only units heatingcapacity Lj rConstruction a) Coolingcapaci (for all units but heatingonly units) in tons b) Heating capacity (for heating only units) kBtu/h 2 Fan flow calculation a) Cooling capacity in tons (Line # 1a) x 400 cfm/ton] b) Heating only cap. kBtu/h i (Line # 1 b) x (21.7 cfm/kBtu/h)] 00 3 Total calculated supply fan flow 2(a) or 2(b) cfrm NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Dud Pressurization Test Results (CFM @ 25 Pa) 4 Enter Tested Leakage Flow in CFM: •/ ./ 5 Pass if Leakage Percentage <60/6: t f 2 cline # 4) /-6 d o(Line # 3)] x 100 , U % KPass 0 Fail ALTERATIONS: Preexisting Duct System with Duct Alteration and/or HVAC Equipment Change -Out 6 Enter Tested Leakage Flow in CFM: Pre -Test of Existing Duct System Prior to Duct System Alteration and/or Equipment Change -Out. 7 Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct System for Duct System Alteration and/or Equipment Change -Out . TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out Use one of the following Three Tests or Verification Standards for compliance: 8 Pass if Leakage Percentage <15% [ (Line # 7) / (Line # 3)] x 100 % ❑ Pass ❑ Fail 9 Pass if Leakage Reduction Percentage >60% Leakage reduction = [1 - I (Line#7) / (Line#6)]) x 100 % O Pass O Fail 1 0 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and Verification by HERS rater (sampling rate 100%) p Pass O Fail Pass if One of Lines #8 through # 10 pass ❑ Pass 13 Fail JINSTALLERMELIANCE STATEMENT The building was: ✓ Nested at Final u I estea at rcougn-m Kt(srsnnIe undersigned, verify that the above diagnostic test results and the work I performed associated with the t conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 124 of the 2005 Building Energy Efficiency Standards. Name: Company: /N G Signature: J Date: — / - y 2Expires: License: 1 2005 Nonresidential Acceptance Forms December 2005 1 I I I I I I � I INSTALLER CERTIFICATION Z- vv6-- Vic- 1:;, (Part 3 of 3) MECH-5-A FR.SRater Telephone: A 0, .4 /,%j7 D Sample Group Number. 1) R H C Certifying Signa a Sample building Number. C zi: HERS Provider. Copies to: Builder, Building Owner at Occupancy, Building Department (wet signature), HERS Provider For new buildings the HERS rater must test and field verify the first individual single zone package space conditioning equipment unit of each building. Atter the first unit passes the builder shall identify a group of up to seven package units in the building from which one sample will be selected for testing. If this first sampled unit fails the HERS rater must pick another package unit from the group for testing. If the second unit in the group does not pass the HERS rater must test all package units in the group. For existing buildings the HERS rater must pressure test one out of every seven units a contractor changes. Same rules apply for sampling above. This page must be filled out by the HERS rater for all tested and sampled buildings. If the installer has not tested every system and provided a MECH-5-A to the HERS rater sampling must not occur. The unit was: ✓ Nested ✓ Q Approved as part of sample testing but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the building identified on this form complies with the diagnostic tested compliance requirements as checked on this form. The HERS rater must verify the distribution system on every new TESTED system to make sure that it is fully ducted and correct tape is used before a MECH-5-A may be released. The installer has provided a completed MECH-5-A for every system in the group In new duct systems, where cloth backed, rubber adhesive duct tape is installed, mastic and draw bands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. RATED FAN FLOW (applies to all systems) Measured Values 1 Cooling capacity or for heating only units heating capacity a) Cling capacity (for all units but heating only units) tons x 400 cfm/ton] C> o „ r b) Heating capacity (for heating only units) L__ kBtuh x 21.7 cf n/kBtuh] 2 Total calculated supply fan flow 1(a) or 1(b) cfm 8 C) v NEW CONSTRUCTION OR ENTIRE NEW DUCT SYSTEM ALTERATION: Duct Pressurization Test Results (CFM @ 25 Pa) �Z 3 Enter Tested Leakage Flow in CFM: ✓ ✓ 4 Pass if Leakage Percentage <6%: i Z Z (Line # 3) / 06(Line # 2)] x 100 _ U %Pass ❑ Fail ALTERATIONS: Pre-existing Duct System with Duct Alteration and/or HVAC Equipment Change-0ut Enter Tested Leakage Flow in CFM: Final Test of New Duct System or Altered Duct I 5 System for Duct System Alteration and/or Equipment Change -Out. I _ TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change -Out, Use one of the following Three Tests or Verification Standards for compliance: 6 Pass if Leakage Percentage <15% (Llne # 5) / (Line # 2)] x 100 % ❑ Pass ❑ Fail For systems certified by the installer as reducing leakage, pass if Leakage Reduction >60%. (Line#5 HERSTestedLeakage) LeakageReduction= l — 1" goo (Line #6 installer's CertifiedPre -Test Leakage) % ❑ Pass ❑ Fail 8 Pass if all Accessible Leaks are sealed as confirmed by Visual Inspection and , ❑ Pass ❑ Fail Verification by HERS rater (sampling rate 100%) Pass if One of Lines # 6 through # 8 pass ❑ Pass ❑ Fail 2005 Nonresidential Acceptance Forms December 2005