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Mai 10 05 08: 17a David Hegarty 2095996043 p. 3 <br /> CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING(Page 1 of 7) CF-4R <br /> Project Title Date <br /> i C 963 E <br /> Project Address Builder Name <br /> Builder ntact Telephone Plan Nimber <br /> HERS Telephone Sample Group Number <br /> Certifying Signaaw& D Samnle House Number <br /> / <br /> Firm: l 'Q iC ,.�.�/]o���g�e� p HERS Provider: <br /> Street Address: - r-21 02Z�— 62,,�,,,, ,d City/State/Zip. <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 verificatiox T Icertify that the houses identified on this form comply <br /> with the diagnostic tested compliance requirements as checked on this form. <br /> 'W—le installer has provided a copy of CF-6R(Installation Certificate. <br /> i�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 /> t <br /> NEIJ` M REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCECREDIT <br /> t DIagnostic Leakage Testing Results(Maximum 6%Duct Leakage) <br /> Measured <br /> Duct Pressurization Test Results(CFM @ 25 Pa) values <br /> Test Leakage Flow in CFM <br /> If fan flow is calculated as 400chWton 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)= J- yr'% <br /> Check Box for Pass or Fail(Pasy=6%or less) ❑ <br /> Pass Fail <br /> 13THERMOSTATIC EXPANSION VALVE(TXV) KO C 6 <br /> ❑ Yes ❑ No Thermostatic Expansion Valve is installed and Access is <br /> provided for inspection ❑ ❑ <br /> Yes is a pass Pass Fail <br /> ❑ N MWMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT <br /> 1 ❑ Yes ❑No ACCA Manual D Design requirements have been met(rater has <br /> verified that actual installation matches values in CF-I 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 /> ❑ ❑ <br /> Yes for both I and 2 is a Pass Pass Fail <br /> Compliance Fomis August 2001 A-16 <br />