Comfort Products Furnace - Ver 4.1

• Residential Split System Site Visit Report

• Dealer Name & Acct #

• Individuals present during visit

• Owner Name

• Address
  Address

• Conducted on

  Date

• Customer Assurance Manager

  John Zymola

• Yes

  No

  N/A

• Complaint or reason for site visitg

  Select Capacity Indoor unit Outdoor unit Other

  • Capacity
  • Indoor unit
  • Outdoor unit
  • Other

• Indoor unit concerns related to?

  Select Airflow Refrigerant leak Water leak Mechanical Other

  • Airflow
  • Refrigerant leak
  • Water leak
  • Mechanical
  • Other

• Explain

• Explain

Equipment Component Information:

System

• System identification

• Equipment Component Type

  Split HP

  Split A/C

  Furnace

  Dual Fuel
Equipment Component Model and Serial

• outdoor Unit

  Furnace

  Indoor Coil

  Fan Coil

  Other

• Describe "Other".

• Model number

• Serial number

• Start Date

  Date

• Warranty

  Select Expired 5 year 10 Year 10 year parts Contract 5 Year P & L 10 Year P & L

  • Expired
  • 5 year
  • 10 Year
  • 10 year parts Contract
  • 5 Year P & L
  • 10 Year P & L

• Unit Photo

  Media

• Filter type

  Select 1" Fiberglass/Poly 1" Pleated 2" Pleated 4" Media Air Purifier

  • 1" Fiberglass/Poly
  • 1" Pleated
  • 2" Pleated
  • 4" Media
  • Air Purifier

• Model:

• Serial:

• Notes:

• Quantity and size of filters.

Application Information

System

• System identifier

• Control Type

  User Interface (UI)

  Other

• Brand / Model

• T-Stat Photos.

  Media

• UI Model

• UI Serial

• List UI Configurations

• UI Photos

  Media

• Describe Control

• Photo of "Other Control".

  Media

• Indoor unit location

  Select Conditioned Space Unconditioned Attic Conditioned Attic Unconditioned Garage Unconditioned Crawl Space

  • Conditioned Space
  • Unconditioned Attic
  • Conditioned Attic
  • Unconditioned Garage
  • Unconditioned Crawl Space

• Orientation

  Select Upflow Downflow Horizontal Right Horizontal Left

  • Upflow
  • Downflow
  • Horizontal Right
  • Horizontal Left

Detailed operational information

System

• System identifier

• Equipment mode of operation?

  Cooling

  Heating

• Equipment

  Select A/C Furnace Heat Pump Fan Coil

  • A/C
  • Furnace
  • Heat Pump
  • Fan Coil

• Furnace

• High Voltage

• Is polarity correct?

  Yes

  No

• Grounded properly?

  Yes

  No

• Low Voltage

• Fault code displayed?

  Yes

  No

  N/A

• List fault codes

• Furnace control board dip switch settings.

• Fuel Type

  Natural Gas

  Liquid Propane

• Inlet Gas Pressure

• Manifold Gas Pressure Low Fire

• Manifold Gas Pressure high Fire

• Is LP Conversion Kit Properly Installed?

  Yes

  No

• Is low gas pressure control installed and correctly wired?

  Yes

  No

• 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?

  Yes

  No

• 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.

  Media

• Flue temp

• Combustion air location

• Cased coil condition?

  Clean

  Dirty

  Other

• Explain

• Cased coil 🔼P

• Equipment

  Select A/C Furnace Heat Pump Fan Coil

  • A/C
  • Furnace
  • Heat Pump
  • Fan Coil

• Furnace

• High Voltage

• Is polarity correct?

  Yes

  No

• Grounded properly?

  Yes

  No

• Low Voltage

• Fault code displayed?

  Yes

  No

  N/A

• List fault codes

• Is airflow correct?

  Yes

  No

  N/A

• External Static Pressure

• Return external static pressure?

• Supply external static pressure?

• CFM

• Method used to determine airflow

  Select Magnahellic Traverse Flow hood User Interface

  • Magnahellic
  • Traverse
  • Flow hood
  • User Interface

• Cased Coil Condition?

  Clean

  Dirty

  Other

• Explain

• Cased coil 🔼P

Field Observations

• Observations

Observation

• The following conditions were observed on this visit:

• Add media

  Media

Recommendations

Recommendations

• We recommend the following be performed:

• Photos to support recommendations

  Media

• Is a follow up visit required?

  Yes

  No

• Proposed date of follow up.

  Date

• Proposed time of follow up.

  Date