Information

  • Residential Split System Site Visit Report

  • Dealer Name & Acct #

  • Individuals present during visit

  • Owner Name

  • Address
  • Conducted on

  • Customer Assurance Manager

Reason for site visit

  • Complaint or reason for site visitg

  • Indoor unit concerns related to?

  • Explain

  • Explain

Equipment

Equipment Component Information:

    System
  • System identification

  • Equipment Component Type

  • Equipment Component Model and Serial
  • Describe "Other".

  • Model number

  • Serial number

  • Start Date

  • Warranty

  • Unit Photo

  • Filter type

  • Model:

  • Serial:

  • Notes:

  • Quantity and size of filters.

Application

Application Information

    System
  • System identifier

  • Control Type

  • Brand / Model

  • T-Stat Photos.

  • UI Model

  • UI Serial

  • List UI Configurations

  • UI Photos

  • Describe Control

  • Photo of "Other Control".

  • Indoor unit location

  • Orientation

Detailed Operating Info

Detailed operational information

    System
  • System identifier

  • Equipment mode of operation?

  • Equipment

  • Furnace

  • High Voltage

  • Is polarity correct?

  • Grounded properly?

  • Low Voltage

  • Fault code displayed?

  • List fault codes

  • Furnace control board dip switch settings.

  • Fuel Type

  • Inlet Gas Pressure

  • Manifold Gas Pressure Low Fire

  • Manifold Gas Pressure high Fire

  • Is LP Conversion Kit Properly Installed?

  • Is low gas pressure control installed and correctly wired?

  • Inlet Gas Pressure

  • Manifold Gas PressureLow Fire

  • Manifold Gas PressureLow Fire

  • Manifold Gas Pressure High Fire

  • Furnace control board dip switch settings and/or speed taps used.

  • Is airflow correct?

  • Total External Static Pressure

  • Return static pressure

  • Supply static pressure

  • CFM

  • Method used to determine airflow

  • Temperature rise on high stage.

  • Flue type and size

  • Horizontal length?

  • Vertical length?

  • Photo of roof showing vent termination.

  • Flue temp

  • Combustion air location

  • Cased coil condition?

  • Explain

  • Cased coil 🔼P

  • Equipment

  • Furnace

  • High Voltage

  • Is polarity correct?

  • Grounded properly?

  • Low Voltage

  • Fault code displayed?

  • List fault codes

  • Is airflow correct?

  • External Static Pressure

  • Return external static pressure?

  • Supply external static pressure?

  • CFM

  • Method used to determine airflow

  • Cased Coil Condition?

  • Explain

  • Cased coil 🔼P

Observation

Field Observations

  • Observations

  • Observation
  • The following conditions were observed on this visit:

  • Add media

Recommendation

Recommendations

    Recommendations
  • We recommend the following be performed:

  • Photos to support recommendations

  • Is a follow up visit required?

  • Proposed date of follow up.

  • Proposed time of follow up.

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