Information
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Work Order #
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Client / Site
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Conducted on
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Prepared by
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Location
Past
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Are there any areas in your home that get too warm?
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Are there any areas in your home that get too cold?
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Does your home get to Muddy or to Dry at any times of the year?
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Does anyone in your home suffers from Asthma or Airborn Allergens like Pollen?
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How often do you replace your filter?
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Do you currently have in place a HVAC Maintenance Plan?
Present Diagnostic
Controller
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Thermostat Location
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Cool
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Heat
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Blower
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Wiring
Filter
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Size
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Qty
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Size
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Qty
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Size
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Qty
Insulation
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Grills
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Access Ladder
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Insulation Quality
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Walkway
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Plenums
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Uvlight
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Carbon Monoxide Detector
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Attic Tent
Ducts
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Plenum Sealed?
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Ducts properly hanged?
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Ducts Properly Distributed?
Heating Cycle
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Type Of Heating
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Supply Temperature
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Temperature Difference
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Heating Cycle Completed
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Gas Leak Detection
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Heat strips/ Heat Exchanger Condition
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Sequencers Condition
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Ignition Control Condition
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Gas Valve Condition
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Hot Surface Ignitor Condition
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Pressure Switch Condition
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Vent Pipe Condition
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Inducer Motor
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Inducer Motor Rating
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Flame Sensor Condition
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Drip Leg existing and properly installed
Cooling Cycle (Indoor System)
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Indoor System Image
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Indoor System Tag
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System Age
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Tonnage
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Evaporator Coil System Image
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Evaporator Coil Tag
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System Age
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Tonage
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Supply Temp
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Temperature Difference
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Disconnect Switch
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Secondary Drain Pan
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Float Switch
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In-Line Switch
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Jones Valve
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Main Drain Line Quality
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Emergency Drain Line
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Emergency Line Insulation
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TXV Quality
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Copper Line Quality
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Copper Line Insulation
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Thermostat Wire Quality
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Blower Motor Quality
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Blower wheel
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Blower Motor Rating
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Door switch
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Contactor
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Capacitor
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Capacitor Rating
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Transformer
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Circuit boards
Cooling Cycle (Outdoor System)
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Condenser
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Condenser Tag
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Refrigerant Type
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System Age
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Tonnage
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Service Disconnect
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Electrical Whip
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Surge Protector
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UV Armaflex
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System Level
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Condenser Pad
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Condenser Coils
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Contactor
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Capacitor
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Capacitor Rating
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Start Assist
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Circuit Board
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Fan Blade
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Fan Motor
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Fan Motor Rating
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Compressor
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Compressor Rating
Signature
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Signature