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May 10 05 08: 17a David Hegarty 2095996043 P. 3 <br /> CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING(Page l of 7) CF4R <br /> Protect Title Datc <br /> 9J-3-T <br /> Project Address Builder Name <br /> Builder Contact <br /> Telephone Plan Niliziber - — <br /> I "J— W,5 <br /> HERS'Zj Telephone Sample Group Number <br /> U r <br /> Certifying Sigriaulhc 1 DAe I Sa a House Number <br /> Firm:—�� n • jea-ice HERS Provider: <br /> Street Address: -C- Ld_ �yV (�,�M City/StatelZip: <br /> Copies to: Builder,HERS Provider <br /> HERS RATER COMPLIANCE STATEMENT <br /> The house was: Tested ❑ Approved as part of sample testing,but was not tested <br /> As the HERS rater providing diapostic testing and field verification,I certify that the houses identified on this form comply <br /> with the diagnostic tested compliance mquirzments as checked on this form. <br /> Xl^ ne installer has provided a copy of CF-6R(Installation Certificate. <br /> �� <br /> Distnbution system is fully ducted(i.e.,does not use building cavities as plenums or platform returns in lieu of ducts) <br /> Where cloth backed,rubber adhesive duct tape is installed,mastic and drawbands are used in combination with cloth <br /> backed,rubber adhesive duct tape to seal leaks at duct connections. <br /> tXRq]D <br /> A UM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT <br /> t Diagnostic Leakage Testing Results(Maximum 6%Duct Leakage) <br /> Duct Pressurization Test Results(CFM Q 25 Pa) Measured <br /> values <br /> Test Leakage Flow in CFM ,j z <br /> If fan flow is calculated as 400cfin/ton x number of torts enter calculated <br /> value here <br /> If fan flow is measured enter measured value here <br /> Leakage Percentage(100 x Test Leakage/Fan Flow) <br /> a_ <br /> Check Box for Pass or Fail(Pass=6%or less) ❑ <br /> Pass Fail <br /> ❑THERMOSTATIC EXPANSION VALVE(TXV) 6 <br /> ❑ ye ❑ No Thermostatic Expansion Valve is institlled and Access is <br /> provided for inspection ❑ <br /> Yes is a pass Pass Fail <br /> ❑ MMMUM REQUIREWNTS FOR DUCT DESIGN CONWLL46NCE CREDIT <br /> I' ❑ Yes ❑No ACCA Manual D Design requirements have been met(rater has <br /> verified that actual installation matches values in CF-1 R and <br /> design on plan. <br /> 2' ❑Yes ❑No TXV is installed or Fan flow has been verified If no TXV, <br /> verified fan flow matches design from CF-1 R <br /> Measured Fan Flow= <br /> ❑ Cl <br /> Yes for both 1 and 2 is a Pass Pass Fail <br /> Compliance Forms August 2001 A-16 <br /> I <br />