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May 10 05 08: 16a David Hegarty 2095996043 p. 2 <br /> CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING(Page I of CF-4R <br /> Pro'ect Title _ Dat <br /> I ,6 <br /> Project dress Bail rName <br /> 0C <br /> '[der CoritactTelephone Plan N <br /> C-�fi/�-ftil <br /> HESS Telephone Sample Groub Number <br /> }4rri <br /> Ccrtifyin ig°ature Date I Sample House Number <br /> Firm: HERS Provider: <br /> Street Address: <br /> 20 A) (?:A M City/State zip: <br /> Copies to: Builder,HERS Provider <br /> HERS RATER COMPLIANCE STATEMENT <br /> The house was: t2rTested ❑ Approved as part of sample testing,but was not tested <br /> As the HERS rater providing diagnostic testing and field verification,I certify that the houses identified on this form comply <br /> agnostic tested compliance requirements as checked on this form. <br /> The installer has provided a copy of CF-6R(Installation Certificate. <br /> ER--Distribution system is fully ducted(i-e.,does not use building cavities as plenums or platform returns in lieu of ducts) <br /> 1�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 /> ❑ MM4P4UM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT <br /> Duct Diagnostic Leakage Testing Results(Maximum 6%Duct Leakage) <br /> Duct Pressurization Test Results(CFM @ 25 Pa) Measured <br /> values <br /> Test Leakage Flow in CFM <br /> If fan flow is calculated as 400c8nhon x number of tons enter calculated <br /> value here <br /> If fan flow is measured enter measured value here <br /> Leakage Percentage(100 x Test Leakage/Fan Flow)— ,c/,S <br /> Check Box for Pass or Fail(Pass--6%or less) L IN ❑ <br /> VVXPass Fail <br /> ❑THERMOSTATIC EXPANSION VALVE(TXV) �`/f �c �'a 5-7 <br /> `ta;—c.�7 <br /> ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is <br /> provided for inspection ❑ ❑ <br /> Yes is a pass Pass Fail <br /> ❑ MINTM-UM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT <br /> 1. ❑Yes ❑No ACCA Manual D Design requirements have been met(rater has <br /> verified that aortal iustalknon matches values in CF-JR and <br /> design on plan. <br /> 2. ❑Yes ❑No TXV is installed or Fan flow has been verified If no TXV, <br /> verified fim flow matches design from CF-IR- <br /> Measured Fan Flow= <br /> a ❑ <br /> Yes for both I and 2 is a Pass Pass Fail <br /> Complianoe Forms August 2001 A_16 <br />