Title Page

  • This Document is Being Prepared by (name):

  • Customer/Client Name & WO/Job Number

  • Address

(Old) Unit Being Replaced

  • Manufacturer of Old Unit

  • Model Number of Old Unit

  • Serial Number

  • Old Unit Location

  • Old Unit#

  • Area That Old Unit Serviced

  • Refrigerant Type

  • Total Amount of Refrigerant in System

(New) Condensing Unit Information (Section 1 of 2)

(New) Condensing Unit Information (Section 1 of 2)

  • Manufacturer

  • Unit Number

  • New Model Number

  • New Serial Number

  • What Area Will Unit Be Serving?

  • Unit Tonage

  • Unit Voltage

  • Actual Voltage

  • Control Voltage

  • Sight Glass

  • Sight Glass Status

  • Outdoor Ambient

  • Condenser Air Temp

  • Were Compressor Shipping Mounts Checked?

  • Were Compressor Shipping Mounts Loose?

  • Transformer Taps

  • Sub Cooling

  • CCH Operational? <br>

  • Hot Gas Bypass Operational?

  • Hot Gas Bypass Setiing

  • Headmaster

  • Headmaster Setting

  • Low Ambient Kit?

  • Low Ambient Setting

(New) Condensing Unit Information (Section 2 of 2)

(New) Condensing Unit Information (Section 2 of 2)

  • Compressor Information

  • Compressor
  • Compressor Type

  • Model Number

  • Serial Number

  • Design Amps

  • Actual Amps

  • Suction Pressure

  • Discharge Pressure

  • Suction Temp

  • Superheat

  • LP Safety Trip @

  • HP Safety Trip @

  • Condenser Fan Information

  • Condenser Fan
  • HP

  • Design Amps

  • Actual Amps

Air Handling Unit Info

(OLD) Air Handling Unit Information

  • Manufacturer

  • Model Number

  • Serial Number

(NEW) Air Handling Unit Information

  • Manufacturer

  • Model Number

  • Serial Number

  • Unit Number

  • Unit Tonage

  • Design Voltage

  • Actual Voltage

  • Motor/ Pulley Alignment Verified?

  • Was Belt Tension Tested?

  • Metering Device Being Used

If TXV is being used please answer the following 3 questions regarding TXV

  • TXV Bulb Mount

  • Is TXV Mounted?

  • Is TXV Tight?

  • Insulated

  • Condensate Drain Trapped?

  • AHU Fan Info

  • Fan
  • Return Air Temperature

  • Supply Air Temperature

  • T-Stat Program

  • Fans

  • Fan
  • Fans H/P

  • Design Amps

  • Actual Amps

  • Belts
  • Size

  • Quantity

  • Filters
  • Size

  • Quantity

Economizer & Heating

Economizer

  • Changeover

  • Mixed Air

  • Minimum POS %

Heating: Electric Resistance

  • Phase

  • Volts

  • Amps

  • Stage
  • Amps

Heating: Gas Fired

  • Gas Piping Leak Checked?

  • BTU/HR

  • Number of Stages

  • W/C
  • W/C

  • Return Air Temp

  • Supply Air Temp

  • Ignition Type

  • Inlet Gas Press

  • Power Vent

  • High Limit Checked?

  • Any Additional Comments Regarding Heating

General

General

  • Has this job site been completely cleaned-up?

  • Have all electrical connections been checked?

  • Have all tools been picked up and returned?

  • Notes

  • Outdoor Air Temperature

  • Additional Comments Regarding This Job:

  • Do we need to return for Heating or Cooling start up?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.