Title Page
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This Document is Being Prepared by (name):
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Customer/Client Name & WO/Job Number
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Address
(Old) Unit Being Replaced
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Manufacturer of Old Unit
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Model Number of Old Unit
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Serial Number
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Old Unit Location
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Old Unit#
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Area That Old Unit Serviced
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Refrigerant Type
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Total Amount of Refrigerant in System
(New) Condensing Unit Information (Section 1 of 2)
(New) Condensing Unit Information (Section 1 of 2)
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Manufacturer
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Unit Number
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New Model Number
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New Serial Number
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What Area Will Unit Be Serving?
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Unit Tonage
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Unit Voltage
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Actual Voltage
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Control Voltage
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Sight Glass
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Sight Glass Status
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Outdoor Ambient
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Condenser Air Temp
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Were Compressor Shipping Mounts Checked?
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Were Compressor Shipping Mounts Loose?
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Transformer Taps
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Sub Cooling
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CCH Operational? <br>
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Hot Gas Bypass Operational?
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Hot Gas Bypass Setiing
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Headmaster
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Headmaster Setting
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Low Ambient Kit?
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Low Ambient Setting
(New) Condensing Unit Information (Section 2 of 2)
(New) Condensing Unit Information (Section 2 of 2)
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Compressor Information
Compressor
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Compressor Type
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Model Number
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Serial Number
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Design Amps
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Actual Amps
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Suction Pressure
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Discharge Pressure
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Suction Temp
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Superheat
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LP Safety Trip @
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HP Safety Trip @
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Condenser Fan Information
Condenser Fan
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HP
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Design Amps
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Actual Amps
Air Handling Unit Info
(OLD) Air Handling Unit Information
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Manufacturer
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Model Number
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Serial Number
(NEW) Air Handling Unit Information
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Manufacturer
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Model Number
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Serial Number
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Unit Number
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Unit Tonage
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Design Voltage
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Actual Voltage
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Motor/ Pulley Alignment Verified?
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Was Belt Tension Tested?
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Metering Device Being Used
If TXV is being used please answer the following 3 questions regarding TXV
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TXV Bulb Mount
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Is TXV Mounted?
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Is TXV Tight?
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Insulated
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Condensate Drain Trapped?
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AHU Fan Info
Fan
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Return Air Temperature
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Supply Air Temperature
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T-Stat Program
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Fans
Fan
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Fans H/P
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Design Amps
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Actual Amps
Belts
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Size
Filters
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Size
Economizer & Heating
Economizer
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Changeover
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Mixed Air
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Minimum POS %
Heating: Electric Resistance
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Phase
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Volts
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Amps
Stage
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Amps
Heating: Gas Fired
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Gas Piping Leak Checked?
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BTU/HR
W/C
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W/C
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Return Air Temp
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Supply Air Temp
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Ignition Type
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Inlet Gas Press
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Power Vent
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High Limit Checked?
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Any Additional Comments Regarding Heating
General
General
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Has this job site been completely cleaned-up?
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Have all electrical connections been checked?
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Have all tools been picked up and returned?
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Notes
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Outdoor Air Temperature
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Additional Comments Regarding This Job:
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Do we need to return for Heating or Cooling start up?