DOE F 220.59 Doors for Walk-In Coolers and Freezers Template

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Overview

Certification
Headers
Product Group Code

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Sheet 1: Certification

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

Version 5.x

DOE F 220.59

Doors for Walk-In Coolers and Freezers

Product Type:

Doors for Walk-In Coolers and Freezers

Status of This Certification Sheet

No Data

5.x

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.

Certifier - Party Legally Obligated to Certify Compliance

Submitter - Party Submitting This Report

The party responsible for certification is (select one only):

The party submitting this report is (select one only):

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Certifier Contact Information

Third Party Representative Contact Information, if Applicable

Full Legal Name of Individual

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Full Legal Name of Individual

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Full Legal Name of Company

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Full Legal Name of Company

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Complete Company Mailing Address

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Complete Company Mailing Address

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Phone Number

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Phone Number

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Email Address

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Email Address

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Compliance Statement

Select one of the options for 'Submitter - Party Submitting This Report' above

Submitter Signature (Type your Full Legal Name)

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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: Headers

Doors for Walk-In Coolers and Freezers - v5.x

Column Headers:

Status

Manufacturer

Brand Name(s)

Basic Model Number

Individual Model Number Covered by Basic Model

Action

Product Group Code

Was the U-factor Simulated in Accordance with NFRC 100?

Sample Size (Number of Units Tested), if Applicable

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 the Certification for this Basic Model based on Section 342(f) Relief (42 USC 6313(f)(6))?

Date of DOE Letter Granting Request, if Applicable

Does the Model Have a Transparent Reach-In Door or Window?

Glass Type of Doors and Door Windows, If Applicable

Antisweat Heater Power Draw (Watts per Square Foot of Door Opening), if Applicable

R-Value of the Door Insulation, if Applicable

Does the Model Incorporate All Applicable Design Requirements?

Energy Consumption (kWh/day)

Door Surface Area (sq ft)

For Doors with Antisweat Heater Controls Activated by Temperature, the Temperature at Which the Antisweat Heater Turns On (F°), if Applicable

For Doors with Antisweat Heater Controls Activated by Humidity, the Relative Humidity at Which the Antisweat Heater Turns On (%), if Applicable

Total Rated Power of Light #1 (W)

Does Light #1 Have a Timer, Control System, or Other Demand-Based Control Reducing the Light's Power Consumption? (if Applicable)

Total Rated Power of Light #2 (W), if Applicable

Does Light #2 Have a Timer, Control System, or Other Demand-Based Control Reducing the Light's Power Consumption? (if Applicable)

Total Rated Power of Heater Wire #1 (W)

Does Heater Wire #1 Have a Timer, Control System, or Other Demand-Based Control Reducing the Wire's Power Consumption? (if Applicable)

Total Rated Power of Heater Wire #2 (W), if Applicable

Does Heater Wire #2 Have a Timer, Control System, or Other Demand-Based Control Reducing the Wire's Power Consumption? (if Applicable)

Total Rated Power of Other Electricity Consuming Device #1 (W)

Does Other Electricity Consuming Device #1 Have a Timer, Control System, or Other Demand-Based Control Reducing the Device's Power Consumption? (if Applicable)

Total Rated Power of Other Electricity Consuming Device #2 (W), if Applicable

Does Other Electricity Consuming Device #2 Have a Timer, Control System, or Other Demand-Based Control Reducing the Device's Power Consumption? (if Applicable)

Conduction Load Through Door (Btu/h)

Pop-Up Headers

Status

Manufacturer

Brand Name(s)

Basic Model Number

Individual Model Number

Action

Product Group Code

U-Factor Simulated?

Sample Size, if Applicable

Certification Based on Waiver?

Date of Waiver, if Applicable

Cert. Based on Exception Relief?

Date of Relief, if Applicable

Cert Based on Sec 342(f) Relief?

Date Relief Granted, if Appl.

Transparent ReachIn Door/Window?

Glass Type of Doors and Windows

Antisweat Heater Power Draw

R-Value of Door Insulation

Does Model Incorp Design Req'ts?

Energy Consumption

Door Surface Area

Temp Antisweat Heater Turns On

Humid. Antisweat Heater Turns On

Light #1 Power

Light #1 Controls? If Applicable

Light #2 Power, if Applicable

Light #2 Controls? If Applicable

Heater Wire #1 Power

Heater Wire #1 Controls? If Appl

Heater Wire #2 Power, if Appl.

Heater Wire #2 Controls? If Appl

Device #1 Power

Device #1 Controls? If Appl

Device #2 Power, if Appl.

Device #2 Controls? If Appl

Conduction Load Through Door

Pop-Up Contents

The cells below show whether there are any issues with the data on that line. If the status is "ok," there are no issues. If the status is "Error," there are issues with the data. See columns to the right for an indication of the issues with the data.

Enter the Manufacturer name in the cells below.

Enter the Brand Name(s) in the cells below.

Enter the Basic Model Number in the cells below.

Enter the Individual Model Number covered by the Basic Model in the cells below.

Enter one of following in cells below: N new model ETO engineered to order D discontinued model C correction to previous CCMS submission E submit report on existing (carryover) model F failed Industry Certification Program .

Enter an integer between 1 and 8 in the cells below. See the Product Group Codes worksheet for details on product group codes.

Answer whether the U-factor was simulated in accordance with NFRC 100 in the cells below. An affirmative answer can be either 'yes' or 'y' and a negative answer can be either 'no' or 'n'.

If U-factor was not simulated in accordance with NFRC 100, enter the # of units that were tested to determine U-factor in the cells below. This should be an integer > 0. If U-factor was simulated in accordance with NFRC 100, entry is not allowed.

Answer whether the certification for the basic model was based on a waiver of DOE's test procedure requirements in the cells below. An affirmative answer can be either 'yes' or 'y' and a negative answer can be either 'no' or 'n'. .

If you enter 'yes' under "Is the certification for this basic model based on a waiver of DOE's test procedure requirements?", enter the date of the waiver in the cells below. The entry should be in the M/D/YYYY format.

Answer whether the certification was based upon any exception relief from an applicable standard by DOE's Office of Hearing and Appeals in the cells below. An affirmative answer can be either 'yes' or 'y' and a negative answer can be either 'no' or 'n'.

If you enter 'yes' under "Is the certification based upon any exception relief from an applicable standard by DOE's Office of Hearing and Appeals?", enter the date of the exception relief in the cells below. The entry should be in the M/D/YYYY format.

Answer whether the certification was based upon Section 342(f) relief in the cells below. An affirmative answer can be either 'yes' or 'y' and a negative answer can be either 'no' or 'n'.

If you enter 'yes' under "Is the Certification for this Basic Model based on Section 342(f) Relief (42 USC 6313(f)(6))?", enter the date of the letter granting relief in the cells below. The entry should be in the M/D/YYYY format.

Answer whether the model has a Transparent Reach-In Door or Window in the cells below. An affirmative answer can be either 'yes' or 'y' and a negative answer can be either 'no' or 'n'.

If the model has a transparent reach-in door or window, enter the Glass Type of Doors and Door Windows in the cells below. If the model does not have a transparent reach-in door or window, the entry is optional.

If model has transparent reach-in door/window, enter Antisweat Heater Power Draw (based on full power w/o controls modulating) in watts/sqft of door opening. Should be decimal >= 0. If model does not have transp. reach-in door/window, entry optional.

If answer to Sec. 342(f) col. is 'yes', make no entry. If ans. is 'no': - PGC 5-6, make no entry. - PGC 7-8, entry optional & should be R-Value of Door Insulation, not glass. - Else, enter R-Value of Door Insul. Enter decimal #>0 only, not the "R".

Answer whether the Model incorporates all applicable design requirements in the cells below. An affirmative answer can be either 'yes' or 'y' and a negative answer can be either 'no' or 'n'.

Enter the door energy consumption in kWh/day in the cells below. This should be a decimal number > zero.

Enter the door surface area in square feet in the cells below. This should be a decimal number > zero.

Only for doors with Antisweat heaters activated by temperature, enter the Temperature at Which the Antisweat Heater Turns on in degrees Fahrenheit in the cells below. This should be a decimal number greater than zero. Otherwise, leave the cell blank

Only for doors with Antisweat heaters activated by humidity, enter the Humidity at Which the Antisweat Heater Turns on in percentage in the cells below. This should be a percentage between 0 and 100. Otherwise, leave the cell blank.

Enter the Total Rated Power of Light #1 in watts in the cells below. Entry should be full rated power of lighting without controls modulating power and a decimal number >= 0. Enter 0 if the door does not have any lights.

If Applicable, enter whether Light #1 has a Timer, Control System, or Other Demand-Based Control Reducing the Light's Power Consumption in the cells below. An affirmative entry can be either 'yes' or 'y' and a negative entry can be either 'no' or 'n'.

If Applicable, enter the Total Rated Power of Light #2 in watts in the cells below. Entry should be full rated power of lighting without controls modulating power and a decimal number >= 0.

If Applicable, enter whether Light #2 has a Timer, Control System, or Other Demand-Based Control Reducing the Light's Power Consumption in the cells below. An affirmative entry can be either 'yes' or 'y' and a negative entry can be either 'no' or 'n'.

Enter the Total Rated Power of Heater Wire #1 in watts in the cells below. Entry should be full rated power of Heater Wire without controls modulating power and a decimal number >= 0. Enter 0 if the door does not have any Heater Wire.

If Applicable, enter whether Heater Wire #1 has a Timer, Control System, or Other Demand-Based Control Reducing the Heater Wire's Power Consumption in the cells below. An affirmative entry can be 'yes' or 'y' and a negative entry can be 'no' or 'n'.

If Applicable, enter the Total Rated Power of Heater Wire #2 in watts in the cells below. Entry should be full rated power of Heater Wire without controls modulating power and a decimal number >= 0.

If Applicable, enter whether Heater Wire #2 has a Timer, Control System, or Other Demand-Based Control Reducing the Heater Wire's Power Consumption in the cells below. An affirmative entry can be 'yes' or 'y' and a negative entry can be 'no' or 'n'.

Enter Total Rated Power of Other Electricity Consuming Device #1 in watts in cells below. Entry should be full rated power of device w/o controls modulating power & decimal # >= 0. Enter 0 if door does not have any other electricity consuming devices.

If Appl., enter whether Other Electricity Consuming Device #1 has Timer, Control System, or Other Demand-Based Control Reducing device's Power Consumption in the cells below. Affirmative entry can be 'yes' or 'y', negative entry can be 'no' or 'n'.

If Applicable, enter the Total Rated Power of Other Electricity Consuming Device #2 in watts in the cells below. Entry should be full rated power of device without controls modulating power and a decimal number >= 0.

If Appl., enter whether Other Electricity Consuming Device #2 has Timer, Control System, or Other Demand-Based Control Reducing device's Power Consumption in the cells below. Affirmative entry can be 'yes' or 'y', negative entry can be 'no' or 'n'.

Enter the conduction load through the door in British thermal units per hour (Btu/h) in the cells below. This should be a decimal number greater than zero.

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Sheet 3: Product Group Code

The following is a description of each product group code:
Product Group Code	Product Group Code Description
1	Passage door, Medium Temperature
2	Passage Door, Low Temperature
3	Freight Door, Medium Temperature
4	Freight Door, Low Temperature
5	Fully Glass/Transparent Display Door, Medium Temperature
6	Fully Glass/Transparent Display Door, Low Temperature
7	Display Door Other Than Fully Glass/Transparent Door, Medium Temperature
8	Display Door Other Than Fully Glass/Transparent Door, Low Temperature