Title Page
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Region: #
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Store Number: #
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Conducted on:
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Prepared by:
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Location:
Store Information
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Picture of Store Number
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Take Walk In Cooler/Freezer Photos
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Take Thermostat Photos
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Photo of Roof Access Point
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Wide Photo of Roof Top or Condenser Areas (Showing all units)
Unit Information
- Unit:
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Fan On or Auto?
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Full or Setback?
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RTU or Split System?
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Wide Photo of Unit
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Is the Unit powered on?
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Power off the Unit
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Take a Picture of the Electrical Cutoff showing its off
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Photo of Unit Label
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Manufacturer:
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Unit Model Number:
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Unit Serial Number:
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Motor Horsepower:
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Motor Voltage:
- 115
- 208/230
- 460
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Motor Phase:
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Compressor Voltage:
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Compressor Phase:
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Wide Relay Section Photos:
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Thermostat Connection / Terminal Strip:
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Compressor Area:
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Filters:
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Inflow Air: Economizer? Actuator? Dampers?
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VFD?
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Picture of VFD and any labels.
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Drive Type?
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Wide Blower Section:
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Motor Label:
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Motor Positioning: Any Clearance Issues?
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Belt Size:
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Belt Size:
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Motor Shaft Measurement:
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Motor Pully Measurement:
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Motor Base:
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Motor Manufacturer:
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Motor Model Number:
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Motor Voltage:
- 115
- 208/230
- 460
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Motor Phase:
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Motor Hertz:
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Motor HP:
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Motor Amps:
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Motor Frame Size:
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NEMA or Efficiency Code (If Applicable):
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Orientation:
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Wide Blower Photo:
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Angled Photo of Bracket:
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Motor Label
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Motor Manufacturer:
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Motor Model Number:
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Motor Voltage:
- 115
- 208/230
- 460
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Motor Phase:
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Motor Hertz:
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Motor HP:
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Motor Amps:
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NEMA or Efficiency Code (If Applicable):
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Orientation:
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Photo of Fan and any Labels
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Proceed to Compressor/Condenser Unit.
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Compressor/Condenser Unit Photo:
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Compressor/ Condenser Unit Label:
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Compressor Voltage:
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Compressor Phase:
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Number of Compressors
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Proceed to Evaporator Unit.
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Evaporator/Blower Unit Location
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Wide Photo of Unit
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Is the Unit powered on?
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Power off the Unit
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Take a Picture of the Electrical Cutoff showing its off
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Photo of Unit Label
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Manufacturer:
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Unit Model Number:
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Unit Serial Number:
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Motor Horsepower:
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Motor Voltage:
- 115
- 208/230
- 460
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Motor Phase:
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Wide Relay Section Photos:
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Thermostat Connection / Terminal Strip:
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VFD?
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Drive Type?
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Wide Blower Section:
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Motor Label:
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Motor Positioning: Any Clearance Issues?
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Belt Size:
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Belt Size:
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Motor Shaft Measurement:
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Motor Pully Measurement:
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Motor Base:
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Wide Blower Photo:
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Angled Photo of Bracket:
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Motor Label
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Motor Manufacturer:
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Motor Model Number:
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Motor Voltage:
- 115
- 208/230
- 460
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Motor Phase:
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Motor Hertz:
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Motor HP:
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Motor Amps:
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Motor Frame Size:
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NEMA or Efficiency Code (If Applicable):
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Orientation:
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Photo of Unit Turned On:
Wrap Up
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Are all Units as they were upon arrival?
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Time of Completion:
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Additional Notes:
