5900-180 HVAC QI Commission Report

Energy Star Program in the Residential Sector (Renewal)

ESQI_commissionreport_draft080509.xls

Energy Star Program in the Residential Sector: Private Sector

OMB: 2060-0586

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2060-0586 can be found here:

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Overview

AC-Heat Pump
AC-Furnace

Sheet 1: AC-Heat Pump

ENERGY STAR in Cooperation with ABC Electric Company
Installation Commissioning Report for Central AC and Heat Pump

OMB Control No. xxxx-xxxx

Site Information

Customer name (name on electric bill):

Customer electric utility account number:

Address:

City:

State:

Zip:

Design

Type of installation:

Replacement

New system - existing home

New system - new home

AC only

Heat only

AC & heat

Area of zone served by unit:

sq ft

# of units in home:

Is the unit self-contained, or is fan/airflow provided by external device (furnace)?

Heat gain method:

Manual J v7

Manual J v8

None

Other:

Duct design method:

Manual D

None

Other:

Equipment specification method:

Manual S

OEM recommendation

Other:

Latent heat gain:

BTUh

Sensible heat gain:

BTUh

Total heat gain:

BTUh

Design airflow:

CFM

Duct design static pressure:

IWC

Design heat loss:

BTUh

Equipment

Condenser

Manufacturer:

Model:

Serial number:

Evaporator

Manufacturer:

Model:

Serial number:

System

Metering device:

TXV

Fixed orifice

Other:

Refrigerant:

R-22

R-410a

Other:

Fan Motor Type:

Fixed speed (e.g. PSC)

Variable (e.g. ECM/ICM)

Other:

Cooling

Latent Capacity:

BTUh

ARI EER/SEER:

Sensible Capacity:

BTUh

ARI Ref #:

Total Capacity:

BTUh

Heating

HSPF:

At 17oF

Capacity:

BTUh

COP:

At 47oF

Capacity:

BTUh

COP:

Previous equipment - for replacements only

Cooling

Total capacity:

Btuh

ARI EER/SEER:

Heating

HSPF:

At 17oF

Capacity:

BTUh

COP:

At 47oF

Capacity:

BTUh

COP:

AC & Heat Pump Installation Commissioning Report (Page 2 of 3)

Equipment - continued

Does capacity meet requirement of 95-115% (or up to 125% for heat pumps with heat dominated requirements)

of calculated load or the next nominal size?

Yes

Refrigerant Tests - run system for 15 minutes before testing

Date:

Outdoor ambient temp. (at condenser):

oF DB

Time of test:

Outdoor relative humidity - optional:

Barometric pressure - optional:

Air temperatures measured in duct near evaporator (not in conditioned building space):

Cooling Mode

Return

oF DB

oF WB

Supply

oF DB

oF WB

Heating Mode

Return

oF DB

Supply

oF DB

Liquid line pressure:

psi

Liquid line temp.:

oF DB

Suction line pressure:

psi

Suction line temp.:

oF DB

Refrigerant Calculations

Condenser sat. temp. (from liquid pressure):

oF DB

Evaporator sat. temp. (from suction pressure):

oF DB

Subcooling (condensing temp. - liquid line temp.):

oF DB

Superheat (suction line temp. - evaporating temp.):

oF DB

For TXV

OEM subcooling goal:

oF DB

Subcooling deviation (subcooling - subcooling goal):

oF DB

For Fixed Orifice

Superheat goal (from superheat lookup tables, based on outdoor ambient and return air wet bulb temps.):

oF DB

Superheat deviation (superheat goal - superheat):

oF DB

Does system meet requirement of subcooling within ±3oF or superheat within ±5oF of goal?

Yes

Electrical Measurements - taken at time of refrigerant tests

Evaporator/air handler fan:

amps

volts

watts

Condenser fan:

amps

volts

watts

Compressor:

amps

volts

watts

Electrical Requirements

Does system meets requirements of ACCA QI 4.3?

Yes

Air Flow Tests

Date:

Outdoor ambient temp. (at condenser):

oF DB

Time of test:

Outdoor relative humidity - optional:

Barometric pressure - optional:

Measured air volume at evaporator:

CFM

AC & Heat Pump Installation Commissioning Report (Page 3 of 3)

Air Flow Tests - continued

Test peformed in heating or cooling mode?

Heating

Cooling

Static pressure

Return

Static:

IWC

Measurement location:

Supply

Static:

IWC

Measurement location:

Measurement method used:

TrueFlow

Pressure matching (with Duct Blaster)

Anemometer

Fan Curve

Temperature split (heating only)

Other:

Speed Setting

If fixed

qLow qMed-Low qMed qMed-High qHigh

CFM (at 0.5 IWC):

If variable

Fan set for

CFM/ton

Does air flow meet requirement of 350-450 cfm or within range recommended by OEM?

Yes

Duct Leakage

Initial Test

Date:

Time:

Final Test

Date:

Time:

Test method used:

Duct Blaster

Blower Door Subtraction

Other:

Existing system duct leakage:

CFM

Post Installation duct leakage:

CFM

Leakage % reduction ([existing-post]/existing):

Total % leakage (post leakage/design flow):

OR (post leakage/measured flow):

Does duct leakage meet one of the following requirements:

existing
homes:

No more than 20% of total air flow

A reduction of 50% or more from the initial measurement

new construction:

Leakage from ducts inside the thermal envelope is no more than 10% of total air flow

No more than 6% of total air flow from ducts outside the thermal envelope

Less than 4 CFM leakage to outdoors per 100 square feet of conditioned floor area

System Controls

Does system meets requirements of ACCA QI 4.6?

Yes

System Documentation & Owner Education

Copies of this report and OEM manuals left with owner?

Yes

Demonstrated system for owner?

Yes

Contractor/Technician Information

Technician name:

Company:

Address 1:

Address 2:

City:

State:

Zip:

Phone/Email:

Technician signature:

Please send completed forms to: System Implementer, 123 Main St, Town, ST, 01234, FAX 555-123-4567

EPA Form 5900-180

The government estimates the average time needed to fill out this form is 1.00 hour 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.

Sheet 2: AC-Furnace

ENERGY STAR in Cooperation with ABC Electric Company
Installation Commissioning Report for Central AC and Furnace

Site Information

Customer name (name on electric bill):

Customer electric utility account number:

Address:

City:

State:

Zip:

Design

Type of installation:

Replacement

New system - existing home

New system - new home

AC only

Heat only

AC & heat

Area of zone served by unit:

sq ft

# of units in home:

Heat gain method:

Manual J v7

Manual J v8

None

Other:

Duct design method:

Manual D

None

Other:

Equipment specification method:

Manual S

OEM recommendation

Other:

Latent Heat Gain:

BTUh

Sensible Heat Gain:

BTUh

Total Heat Gain:

BTUh

Design Airflow:

CFM

Duct Design Static Pressure:

IWC

Design heat loss:

BTUh

Equipment - AC

Condenser

Manufacturer:

Model:

Serial number:

Evaporator

Manufacturer:

Model:

Serial number:

System

Metering device:

TXV

Fixed orifice

Other:

Refrigerant:

R-22

R-410a

Other:

Fan Motor Type:

Fixed speed (e.g. PSC)

Variable (e.g. ECM/ICM)

Other:

Speed setting

If fixed

qLow qMed-Low qMed qMed-High qHigh

CFM (at 0.5 IWC):

If variable

Fan set for

CFM

Latent Capacity:

BTUh

ARI EER/SEER:

Sensible Capacity:

BTUh

ARI Ref #:

Total Capacity:

BTUh

Previous equipment - for replacements only

Total capacity:

Btuh

ARI EER/SEER:

Does capacity meet requirement of 95-115% of calculated load or the next nominal size?

Yes

AC & Furnace Installation Commissioning Report (Page 2 of 4)

Equipment - Furnace

Manufacturer:

Model:

Serial number:

AFUE:

Gross capacity:

Btuh

Net capacity:

Btuh

Previous equipment - for replacements only

Gross capacity:

Btuh

Net capacity:

Btuh

Fuel type:

Gas

Oil

Propane

Other:

Sealed combustion?

Yes

Fan Motor Type:

Fixed speed (e.g. PSC)

Variable (e.g. ECM/ICM)

Other:

Speed Setting

If fixed

qLow qMed-Low qMed qMed-High qHigh

CFM (at 0.5 IWC):

If variable

Fan set for

CFM

Does capacity meet requirement of 100-140% of calculated load or the next nominal size?

Yes

Refrigerant Tests - run system for 15 minutes before testing

Date:

Outdoor ambient temp. (at condenser):

oF DB

Time of test:

Outdoor relative humidity - optional:

Barometric pressure - optional:

Air temperatures measured in duct near evaporator (not in conditioned building space):

Cooling Mode

Return

oF DB

oF WB

Supply

oF DB

oF WB

Liquid line pressure:

psi

Liquid line temp.:

oF DB

Suction line pressure:

psi

Suction line temp.:

oF DB

Refrigerant Calculations

Condenser sat. temp. (from liquid pressure):

oF DB

Evaporator sat. temp. (from suction pressure):

oF DB

Subcooling (condensing temp. - liquid line temp.):

oF DB

Superheat (suction line temp. - evaporating temp.):

oF DB

For TXV

OEM subcooling goal:

oF DB

Subcooling deviation (subcooling - subcooling goal):

oF DB

For Fixed Orifice

Superheat goal (from superheat lookup tables, based on outdoor ambient and return air wet bulb temps.):

oF DB

Superheat deviation (superheat goal - superheat):

oF DB

Does system meet requirement of subcooling within ±3oF or superheat within ±5oF of goal?

Yes

AC & Furnace Installation Commissioning Report (Page 3 of 4)

Electrical Measurements - taken at time of refrigerant tests

Evaporator/air handler fan:

amps

volts

watts

Condenser fan:

amps

volts

watts

Compressor:

amps

volts

watts

Electrical Requirements

Does system meets requirements of ACCA QI 4.3?

Yes

Air Flow Tests

Date:

Outdoor ambient temp. (at condenser):

oF DB

Time of test:

Outdoor relative humidity - optional:

Barometric pressure - optional:

Measured air volume at evaporator:

CFM

Test peformed in heating or cooling mode?

Heating

Cooling

Static pressure

Return

Static:

IWC

Measurement location:

Supply

Static:

IWC

Measurement location:

Measurement method used:

TrueFlow

Pressure matching (with Duct Blaster)

Anemometer

Fan Curve

Temperature split (heating only)

Other:

Does air flow meet requirement of 350-450 cfm or within range recommended by OEM?

Yes

Duct Leakage

Initial Test

Date:

Time:

Final Test

Date:

Time:

Test method used:

Duct Blaster

Blower Door Subtraction

Other:

Existing system duct leakage:

CFM

Post Installation duct leakage:

CFM

Leakage % reduction ([existing-post]/existing):

Total % leakage (post leakage/design flow):

OR (post leakage/measured flow):

Does duct leakage meet one of the following requirements:

existing
homes:

No more than 20% of total air flow

A reduction of 50% or more from the initial measurement

new construction:

Leakage from ducts inside the thermal envelope is no more than 10% of total air flow

No more than 6% of total air flow from ducts outside the thermal envelope

Less than 4 CFM leakage to outdoors per 100 square feet of conditioned floor area

AC & Furnace Installation Commissioning Report (Page 4 of 4)

Gas Combustion Test

Altitude derating factor (from site elevation):

Return air:

oF DB

Supply air:

oF DB

Orifice size:

Manifold pressure:

psi

Gas meter test dial size:

Gas meter seconds for one revolution of meter:

Low:

High:

Gas combustion test calculations

Gas rate (from meter lookup tables):

Low speed:

High speed:

Actual firing rate:

Low speed:

High speed:

Percent:

Temperature rise:

Low speed:

High speed:

Combustion Analyzer - required for oil systems, optional for other fuels

O2:

Stack temperature:

Efficiency:

CO:

Draft pressure:

psi

System Controls

Does system meets requirements of ACCA QI 4.6?

Yes

System Documentation & Owner Education

Copies of this report and OEM manuals left with owner?

Yes

Demonstrated system for owner?

Yes

Contractor/Technician Information

Technician name:

Company:

Address 1:

Address 2:

City:

State:

Zip:

Phone/Email:

Technician signature:

Please send completed forms to: System Implementer, 123 Main St, Town, ST, 01234, FAX 555-123-4567

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Author	Preferred Customer
Last Modified By	ctsuser
File Modified	2009-09-17
File Created	2006-06-19