DOE F 220.39 Small Air Cooled 3 Phase Commercial Package and Variable

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Overview

Certification
Input
Product Group Codes

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Sheet 1: Certification

OMB Control Number: 1910-1400 (Expiration Date: XXXXXX XX, XXXX)

Version 5.1

DOE F 220.39

Small Air-Cooled 3-Phase Commercial Package and Variable Refrigerant Flow Air Conditioners and Heat Pumps

Product Type:

Small Air-Cooled 3-Phase Commercial Package and Variable Refrigerant Flow Air Conditioners and Heat Pumps

Status of This Certification Sheet

No Data

5.1

Overall Status of Template

No Data

Click here for instructions for completing this form

Each Importer and U.S. Manufacturer is legally required to certify the compliance of the products it imports, produces, assembles or manufactures. This party is the "Certifier" on this form. This certification may be submitted by the Importer or U.S. manufacturer or by a Third Party Representative. This party is the "Submitter" on this form.

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Certifier Contact Information

Third Party Representative Contact Information, if Applicable

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Full Legal Name of Company

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Email Address

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Compliance Statement

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Date (MM/DD/YYYY)

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OMB Control Number: 1910-1400 (Expiration Date: XXXXXX XX, XXXX)

Paperwork Reduction Act Statement

OMB Burden Disclosure Statement

This data is being collected for manufacturers to certify compliance to DOE's energy conservation, water conservation, or design standards. The data you supply will be used by the Department to monitor compliance with the energy conservation, water conservation, and design standards and testing requirements for the consumer products and commercial and industrial equipment mandated by the Energy Policy and Conservation Act, as amended. Public reporting burden for this collection of information is estimated to average 35 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of the Chief Information Officer, Records Management Division, IM-23, Paperwork Reduction Project (1910-1400), U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (1910-1400), Washington, DC 20503. Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number. Submission of this data is mandatory.

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Sheet 2: Input

Small Air-Cooled 3-Phase Commercial Package and Variable Refrigerant Flow Air Conditioners and Heat Pumps	Small Air-Cooled 3-Phase Commercial Package and Variable Refrigerant Flow Air Conditioners and Heat Pumps								Version 5.1		· Please enter your data in the columns shaded in gray below, using a separate line for each model. · Click on the column heading for instructions on how to complete cells in that column. · Cells highlighted in yellow indicate an "Error." "Error" means that information is missing or there is an issue with the entry. · If the "Status" for a row is "Error," you can see an explanation in the columns to the far right.
5.1
		Status of This Input Sheet		No Data			Overall Status of Template		No Data
																															The maximum number of indoor units available for each basic model in this template is 5. If a basic model has more than 5 indoor units, please send an email to [email protected].
	Certification Report			Click here for instructions for completing this form			If you are resubmitting a specific combination, you must enter data for the Indoor Units and Air Movers in the exact same order as in the original submission																																												The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".				The cells below provide an explanation for "Errors".
Line No.	Status	Manufacturer (Outdoor Unit or Single-Package Unit)	Brand Name(s) (Outdoor Unit or Single-Package Unit)	Basic Model Number	Individual Model Number Covered by Basic Model (Outdoor Unit or Single-Package Unit)	Product Group Code	For Split-System or VRF Indoor Unit 1 Only			For Split-System or VRF Air Mover 1 Only, if Applicable			For Split-System or VRF Indoor Unit 2 Only, if Applicable			For Split-System or VRF Air Mover 2 Only, if Applicable			For Split-System or VRF Indoor Unit 3 Only, if Applicable			For Split-System or VRF Air Mover 3 Only, if Applicable			For Split-System or VRF Indoor Unit 4 Only, if Applicable			For Split-System or VRF Air Mover 4 Only, if Applicable			For Split-System or VRF Indoor Unit 5 Only, if Applicable			For Split-System or VRF Air Mover 5 Only, if Applicable			Have Any of the Model Numbers Been Identified as Private by the Manufacturer?	Action	Sample Size (Number of Units Tested)	Is the Certification for this Basic Model Based on a Waiver of DOE's Test Procedure Requirements?	Date of Test Procedure Waiver, if Applicable	Is the Certification based upon any Exception Relief from an Applicable Standard by DOE's Office of Hearing and Appeals?	Date of Exception Relief, if Applicable	Is Certification Based on the use of an Alternative Efficiency Determination Method (AEDM)?	Name of AEDM (If Applicable)	Seasonal Energy Efficiency Ratio 2 (SEER2)	Heating Seasonal Performance Factor 2 (HSPF2)	Rated Cooling Capacity (Btu/hour)	Supplemental Testing Instructions PDF Filename		Manufacturer (Outdoor Unit or Single-Package Unit) Status	Brand Name(s) (Outdoor Unit or Single-Package Unit) Status	Basic Model Number Status	Individual Model Number Covered by Basic Model (Outdoor Unit or Single-Package Unit) Status	Product Group Code Status	For Split-System or VRF Indoor Unit 1 Only			For Split-System or VRF Air Mover 1 Only, if Applicable			For Split-System or VRF Indoor Unit 2 Only, if Applicable			For Split-System or VRF Air Mover 2 Only, if Applicable			For Split-System or VRF Indoor Unit 3 Only, if Applicable			For Split-System or VRF Air Mover 3 Only, if Applicable			For Split-System or VRF Indoor Unit 4 Only, if Applicable			For Split-System or VRF Air Mover 4 Only, if Applicable			For Split-System or VRF Indoor Unit 5 Only, if Applicable			For Split-System or VRF Air Mover 5 Only, if Applicable			Have Any of the Model Numbers Been Identified as Private by the Manufacturer? Status	Action Status	Sample Size (Number of Units Tested) Status	Is the Certification for this Basic Model Based on a Waiver of DOE's Test Procedure Requirements? Status	Date of Test Procedure Waiver, if Applicable Status	Is the Certification based upon any Exception Relief from an Applicable Standard by DOE's Office of Hearing and Appeals? Status	Date of Exception Relief, if Applicable Status	Is Certification Based on the use of an Alternative Efficiency Determination Method (AEDM)? Status	Name of AEDM (If Applicable) Status	Seasonal Energy Efficiency Ratio 2 (SEER2) Status	Heating Seasonal Performance Factor 2 (HSPF2) Status	Rated Cooling Capacity (Btu/hour) Status	Supplemental Testing Instructions PDF Filename Status
							Manufacturer	Brand(s)	Individual Model Number	Manufacturer	Brand(s)	Individual Model Number	Manufacturer	Brand	Individual Model Number	Manufacturer	Brand	Individual Model Number	Manufacturer	Brand	Individual Model Number	Manufacturer	Brand	Individual Model Number	Manufacturer	Brand	Individual Model Number	Manufacturer	Brand	Individual Model Number	Manufacturer	Brand	Individual Model Number	Manufacturer	Brand	Individual Model Number																				Manufacturer Status	Brand(s) Status	Individual Model Number Status	Manufacturer Status	Brand(s) Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status	Manufacturer Status	Brand Status	Individual Model Number Status
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Sheet 3: Product Group Codes

The following is a description of each product group code:
Product Group Code	Product Group Code Description	Cooling Capacity
1	Split-System Air Conditioners	<65,000 Btu/h
2	Single-Package Air Conditioners	<65,000 Btu/h
3	Split-System Heat Pumps	<65,000 Btu/h
4	Single-Package Heat Pumps	<65,000 Btu/h
5	Space-Constrained Split-System Air Conditioners	<=30,000 Btu/h
6	Space-Constrained Single-Package Air Conditioners	<=30,000 Btu/h
7	Space-Constrained Split-System Heat Pumps	<=30,000 Btu/h
8	Space-Constrained Single-Package Heat Pumps	<=30,000 Btu/h
9	Small-Duct, High-Velocity Split-System Air Conditioners	<65,000 Btu/h
10	Small-Duct, High-Velocity Split-System Heat Pumps	<65,000 Btu/h
11	VRF Air Conditioners	<65,000 Btu/h
12	VRF Heat Pumps	<65,000 Btu/h
13	Outdoor Air Conditioner Units With No Match	<65,000 Btu/h
14	Outdoor Heat Pump Units With No Match	<65,000 Btu/h