OMB Control No. 2060-0528
Approval Expires XX/XX/XX
United States ENVIRONMENTAL
PROTECTION AGENCY Washington,
DC 20460
Qualified
Product Information Form for Residential Ventilating Fans Office
of Atmospheric Programs
ENERGY STAR Product Information Form for Use by ENERGY STAR Qualified Residential Ventilating Fan Partners (Companies who have joined ENERGY STAR for Residential Ventilating Fans by signing the Partnership Agreement) You may use this form to report only those products that are sold under your company’s brand name. If your firm sells its models to another company that uses its own brand name, that company must join the program and report its own products. Information from this form will be added to the list of ENERGY STAR qualified residential ventilating fan products.
Product
Contact Information: (for
verification of product information) Name:
Tel:
Fax:
Email:
Company Name:
(As listed in Partnership Agreement)
Product
Type (check one): Range
Hood Bathroom/Utility
Room Fan In-line
(single-port) In-line
(multi-port)
Brand |
Model Name |
Model Number |
Warranty (yrs) |
Date Product Available |
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Product Performance
Airflow (cfm)
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Motor Wattage (W) |
Efficacy (cfm/W) |
Sound level (sones)* |
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* Sound level measurements not required for single and multi-port in-line fans.
Note: Ducted bathroom and utility room fans tested at 0.1 w.g. static pressure. Single and multi-port in-line fans tested at 0.2 w.g. static pressure. Non-ducted products tested at 0.3 w.g. static pressure. Range Hoods tested at Working Speed as defined in “HVI Supplement – Range Hood Working Speed.”
Ducted Bathroom and Utility Room Fans Only:
Airflow at 0.25 w.g. static pressure: ______ cfm ______ % of rated airflow at 0.1 w.g.
Tested By: (Name of Independent Testing Firm or Self-Tested)
Date Tested:
Is the product in the Home Ventilating Institute Directory (HVI) (circle one)? Yes No
If so, under what name?
All light sources: please complete the fields provided below (as applicable).
Fluorescent light sources: complete fields and provide data in table below.
Total Number of Lamps Used: ______
Maximum Total Listed Lamp Wattage: _____ watts
Maximum Total Night Light Wattage: ______ watts
Performance and Reporting Requirements for Fluorescent Sources |
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Ballast type (check one) |
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Ballast Manufacturer Name |
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Ballast Model Number |
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Lamp Manufacturer Name |
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Lamp Model Number |
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System Efficacy per Lamp Ballast Combination |
Lumens |
_____ Input Watts |
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_____ Lumens/Watt |
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Lamp Start Time |
milliseconds |
Lamp Life |
hours |
Color Rendering Index |
CRI |
Correlated Color Temperature |
Kelvin |
Noise |
dBA |
Does lamp ship with the unit (circle one)? |
Yes No |
Labeling Requirements
By checking the boxes below, you are confirming that you have reviewed and will meet the labeling requirements outlined in the ENERGY STAR Program Requirements for Residential Ventilating Fans. These requirements include:
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If answer to any of the above is no, explain why:
Additional Information
Please list all major retailers that carry the product (attach a list if necessary):
Please check one or more of the following international markets where these products are sold (if applicable):
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The public reporting and recordkeeping burden for this collection of information is estimated to average 4.85 hours per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
Please submit your completed QPI Form to ENERGY STAR for Ventilating Fans
Email: [email protected], Fax: (202) 862-1144
1725 Eye St., NW, Suite 1000, Washington, DC 20006
Energy Star, US EPA, 1200 Pennsylvania Ave., MC 6202J, Washington, DC 20460 USA
Toll-free number 1-888-STAR-YES, Web site http://www.energystar.gov
ENERGY STAR is a registered mark.
EPA Form No. 5900-63
File Type | application/msword |
Author | Gene Troy |
File Modified | 2007-11-01 |
File Created | 2007-05-17 |