5900-192 Performance Path Inspection Checklist for Energy Star Mo

Inspection Checklist for ENERGY STAR Qualified Modular Home – Performance Path p. 2

OMB Control No. xxxx-xxxx

Inspection Checklist

for ENERGY STAR Qualified Modular Home – Performance Path

Home Address: _____________________________________________________________________________________________ City: _____________________________________________ State: ______ Zip: _________ Home ID: ______________________ Instructions: Write your initials in each applicable box. If an item does not apply to the home, write “n/a”. Raters should attempt to inspect as many critical items as possible but may delegate a builder’s representative to verify and initial up to six (6) Thermal Bypass items (numbered items on the first page of this checklist). If the builder verifies any item, they must sign the second page of this checklist. Every line must contain at least one set of initials or “n/a”.
Thermal Bypass Item	Inspection Guidelines	Plant QC	Rater
		Pass	Pass	Fail
Overall Air Barrier and Thermal Barrier Alignment	General requirements: Insulation shall be installed in full contact with sealed interior and exterior air barrier except for alternate to interior air barrier under walls adjoining exterior walls or unconditioned spaces (see below).
	All climate zones:
	Overall alignment throughout home	_________	_________	_________
	Garage band joist air barrier (at bays adjoining conditioned space)	_________	_________	_________
	Attic eave baffles where vents/leakage exist	_________	_________	_________
	Only at Climate Zones 4 and higher:
	Slab-edge insulation (Up to 25% of the slab edge may be uninsulated in Climate Zones 4 and 5.)	_________	_________	_________
	Best practices encouraged, not required:
	Air barrier at all band joists (Climate Zones 4 and higher)	_________	_________
	Minimize thermal bridging (e.g., OVE framing, SIPs, ICFs)	_________	_________
Walls Adjoining Exterior Walls or Unconditioned Spaces	General requirements: Fully insulated wall aligned with air barrier at both interior and exterior, OR Alternate for Climate Zones 1 thru 3, sealed exterior air barrier aligned with RESNET Grade 1 insulation fully supported Continuous top and bottom plates or sealed blocking
	Wall behind shower/tub	_________	_________	_________
	Wall behind fireplace	_________	_________	_________
	Insulated attic slopes/walls	_________	_________	_________
	Attic knee walls	_________	_________	_________
	Skylight Shaft Walls	_________	_________	_________
	Wall adjoining porch roof	_________	_________	_________
	Staircase walls	_________	_________	_________
	Double walls	_________	_________	_________
Floors between Conditioned and Exterior Spaces	General requirements: Air barrier is installed at any exposed insulation edges Insulation is installed to maintain permanent contact with sub-floor above
	Insulated floor above garage	_________	_________	_________
	Cantilevered floor	_________	_________	_________
Shafts	General requirements: Openings to unconditioned space are fully sealed with solid blocking or flashing and any remaining gaps are sealed with caulk or foam (provide fire-rated collars and caulking where required)
	Duct shaft	_________	_________	_________
	Piping shaft/penetrations	_________	_________	_________
	Flue shaft	_________	_________	_________
Attic / Ceiling Interface	General requirements: All attic penetrations and dropped ceilings include a full interior air barrier aligned with insulation with any gaps fully sealed with caulk, foam or tape Movable insulation fits snugly in opening and air barrier is fully gasketed
	Attic access panel (fully gasketed and insulated)	_________	_________	_________
	Attic drop-down stair (fully gasketed and insulated)	_________	_________	_________
	Dropped ceiling/soffit (full air barrier aligned with insulation)	_________	_________	_________
	Recessed lighting fixtures (ICAT labeled and sealed to drywall)	_________	_________	_________
	Whole-house fan (insulated cover gasketed to the opening)	_________	_________	_________
Common Walls Between Dwellings	General requirements: Gap between drywall shaft wall (common wall) and structural framing between units is sealed at all exterior boundary conditions
	Common wall between dwelling units	_________	_________	_________

					Home ID: ______________________
Performance Path Item	Inspection Guidelines				Plant QC	Rater
					Pass	Pass	Fail
Performance Index	All performance path construction specifications have been adhered to and the home has achieved the required performance index.1 2004 IRC Climate Zones 1 – 5: Maximum HERS Index 85 2004 IRC Climate Zones 6 – 8: Maximum HERS Index 80				_________	_________	_________
Ductwork	General requirements:
	Leakage ≤ 6 cfm to outdoors per 100 sq. ft. of conditioned floor area				_________	_________	_________
	Ducts in unconditioned spaces wrapped with R-6 minimum insulation				_________	_________	_________
	All exterior ducts have been mechanically secured and supported off the ground				_________	_________	_________
ENERGY STAR Qualified Products	General requirements: Include at least one (1) of the following ENERGY STAR qualified product categories: 2
	Heating or cooling equipment OR Windows OR Water heating equipment OR Five (5) or more qualified light fixtures, appliances, ceiling fans equipped with lighting fixtures and/or ventilation fans.		Specify:		_________	_________	_________
Marriage Line Seal	General requirements: All vertical and horizontal marriage line areas filled with continuous non-porous insulating gaskets creating a permanent air barrier at joints in the ceiling, walls and floor. Gaskets may be one or two-part systems, including proprietary gaskets, foams, insulation wrapped in poly, or insulation covered by butyl or other long-life tape on one side. No visible signs of gaps or tears are permitted.				_________	_________	_________
Floors over Unconditioned Spaces	General requirements: Air barrier between floor and unconditioned crawlspace is continuous and sealed.				_________	_________	_________
Plant QC Date: _______________________________ Company: ___________________________ Signature: ___________________________ Initials:______________________________		Rater Date: _______________________________ Company: ___________________________ Signature: ___________________________ Initials:______________________________		Builder Date: _________________________________ Company: _____________________________ Signature: _____________________________ Initials:________________________________

EPA Form 5900-192

The government estimates the average time needed to fill out this form is 0.50 hours and welcomes suggestions for reducing this effort. Send comments (referencing OMB Control Number) to the Director, Collection Strategies Division, U.S. EPA (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.

1 On-site power generation may not be used to decrease the HERS Index to qualify for ENERGY STAR. A maximum of 20% of all screw-in light bulb sockets in the home may use compact fluorescent lamps (CFLs) to decrease the HERS Index for ENERGY STAR compliance. CFLs used for this purpose must be ENERGY STAR qualified.

2 For more information, see “ENERGY STAR Qualified Homes Codes and Standards Information.”