DOE F 220.101 Compressors

Compliance Statement Energy/Water Conservation Standards for Appliances

220.101 TEMPLATE_Compressors_v5.2.xlsx

Manufacturers

OMB:

Document [xlsx]
Download: xlsx | pdf

Overview

Certification
Input
Product Group Codes

Sheet 1: Certification
OMB Control Number: 1910-1400 (Expiration Date: XXXXXX XX, XXXX)









Version 5.2
DOE F 220.101











Compressors
Product Type: Compressors Status of This Certification Sheet No Data
5.2








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):






Please enter required data



Please enter required data




















Certifier Contact Information




Third Party Representative Contact Information, if Applicable

















Full Legal Name of Individual
Please enter required data
Full Legal Name of Individual
Please enter required data

Full Legal Name of Company
Please enter required data
Full Legal Name of Company
Please enter required data

Complete Company Mailing Address
Please enter required data
Complete Company Mailing Address
Please enter required data

Phone Number
Please enter required data
Phone Number
Please enter required data

Email Address
Please enter required data
Email Address
Please enter required data




























Compliance Statement











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















Submitter Signature (Type your Full Legal Name)
Please enter required data


Date (MM/DD/YYYY)
Please enter required data









































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.

Sheet 2: Input
Compressors Compressors
Version 5.2
· 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.






































































































































































































































































































































5.2















































































































































































































































































































































Status of This Input Sheet No Data Overall Status of Template No Data
























































































































































































































































































































































































































































































































































































































































































Certification Report

Click here for instructions for completing this form




























































































































































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". 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". 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".





































































































































































































































































































































































































































































































































































































































































































































If Any Ancillary Equipment was Installed for Test, But is Not Part of the Compressor Package as Distributed in Commerce, Complete the Cells Below for the 1st Ancillary Equipment Item Complete the Cells Below for the 2nd Ancillary Equipment Item, if Applicable Complete the Cells Below for the 3rd Ancillary Equipment Item, if Applicable Complete the Cells Below for the 4th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 5th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 6th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 7th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 8th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 9th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 10th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 11th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 12th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 13th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 14th Ancillary Equipment Item, if Applicable Complete the Cells Below for the 15th Ancillary Equipment Item, if Applicable. If more than 15 ancillary equipment items were used for test and not distributed in commerce with the compressor, please contact CCMS Technical Support at https://www.regulations.doe.gov/ccms/contact-us.




















1st Ancillary Equipment Item 2nd Ancillary Equipment Item 3rd Ancillary Equipment Item 4th Ancillary Equipment Item 5th Ancillary Equipment Item 6th Ancillary Equipment Item 7th Ancillary Equipment Item 8th Ancillary Equipment Item 9th Ancillary Equipment Item 10th Ancillary Equipment Item 11th Ancillary Equipment Item 12th Ancillary Equipment Item 13th Ancillary Equipment Item 14th Ancillary Equipment Item 15th Ancillary Equipment Item
Line No. Status Manufacturer Brand Name(s) Basic Model Number Individual Model Number Covered by Basic Model Action Product Group Code 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)? Full-Load Package Isentropic Efficiency, if Applicable Part-Load Package Isentropic Efficiency, if Applicable Full-Load Actual Volume Flow Rate (CFM) Compressor Motor Nominal Horsepower (hp) Full-Load Operating Pressure (psig) Maximum Full-Flow Operating Pressure (psig) Pressure Ratio at Full-Load Operating Pressure Ancillary Equipment Installation Instructions PDF Filename, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable General Description of Ancillary Equipment Manufacturer of Ancillary Equipment Brand of Ancillary Equipment, if Applicable Model Number of Ancillary Equipment Serial Number of Ancillary Equipment, if Applicable Input Voltage in Volts, if Applicable Number of Phases, if Applicable Input Frequency in Hz, if Applicable Size of Any Connections, if Applicable Type of Any Connections, if Applicable
Manufacturer Status Brand Name(s) Status Basic Model Number Status Individual Model Number Covered by Basic Model Status Action Status Product Group Code 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 Full-Load Package Isentropic Efficiency, if Applicable Status Part-Load Package Isentropic Efficiency, if Applicable Status Full-Load Actual Volume Flow Rate (CFM) Status Compressor Motor Nominal Horsepower (hp) Status Full-Load Operating Pressure (psig) Status Maximum Full-Flow Operating Pressure (psig) Status Pressure Ratio at Full-Load Operating Pressure Status Ancillary Equipment Installation Instructions PDF Filename, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status General Description of Ancillary Equipment Status Manufacturer of Ancillary Equipment Status Brand of Ancillary Equipment, if Applicable Status Model Number of Ancillary Equipment Status Serial Number of Ancillary Equipment, if Applicable Status Input Voltage in Volts, if Applicable Status Number of Phases, if Applicable Status Input Frequency in Hz, if Applicable Status Size of Any Connections, if Applicable Status Type of Any Connections, if Applicable Status
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68






















































































































































































































































































































































69






















































































































































































































































































































































70






















































































































































































































































































































































71






















































































































































































































































































































































72






















































































































































































































































































































































73






















































































































































































































































































































































74






















































































































































































































































































































































75






















































































































































































































































































































































76






















































































































































































































































































































































77






















































































































































































































































































































































78






















































































































































































































































































































































79






















































































































































































































































































































































80






















































































































































































































































































































































81






















































































































































































































































































































































82






















































































































































































































































































































































83






















































































































































































































































































































































84






















































































































































































































































































































































85






















































































































































































































































































































































86






















































































































































































































































































































































87






















































































































































































































































































































































88






















































































































































































































































































































































89






















































































































































































































































































































































90






















































































































































































































































































































































91






















































































































































































































































































































































92






















































































































































































































































































































































93






















































































































































































































































































































































94






















































































































































































































































































































































95






















































































































































































































































































































































96






















































































































































































































































































































































97






















































































































































































































































































































































98






















































































































































































































































































































































99






















































































































































































































































































































































100






















































































































































































































































































































































Sheet 3: Product Group Codes
The following is a description of each product group code:


Product Group Code Product Group Code Description
1 Rotary, Lubricated, Air-Cooled, Fixed-Speed Compressor
2 Rotary, Lubricated, Air-Cooled, Variable-Speed Compressor
3 Rotary, Lubricated, Liquid-Cooled, Fixed-Speed Compressor
4 Rotary, Lubricated, Liquid-Cooled, Variable-Speed Compressor
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00
© 2025 OMB.report | Privacy Policy