Home Address: 	City: 	State: 	

Equipment Specification, Design, and Documentation 

Equipment	1.1 Condenser mfr., model, & serial #: 



1.2 Evaporator mfr., model, & serial #:



1.3 ARI reference number:

	Design	2.1 Heat gain calculation method compliant with Manual J or
equivalent, using the following assumptions? 1               	Yes / No

	           2.1.1   Outdoor Design Temperature:

           a) 99.0% design as published in ASHRAE Handbook of
Fundamentals, OR

           b) Based on prevailing local practice reflecting documented
weather data	

Yes / No

Yes / No

	           2.1.2  Indoor setpoint set at 75° F	Yes / No

	           2.1.3   Infiltration rate set at ‘Tight’	Yes / No

	2.2 Duct design method compliant with Manual D or equivalent? 3        
          	Yes / No

	2.3 Equipment specification method compliant with Manual S or
equivalent? 3      	Yes / No

	2.4 Terminal design method compliant with Manual T or equivalent? 3	Yes
/ No

	2.5 In Warm, Humid counties in Climate Zones 1-3, equipment’s
sensible heat ratio < 0.70 or stand-alone ENERGY STAR qualified
humidifier installed? 4	Yes / No / N/A

	2.6  Corrosion-resistant drain pan, properly sloped to drainage system
5	Yes / No

Documentation	3.1 ARI certificate attached?	Yes / No

Field Verification	Design 

Value	Field 

Value	Variance In Values

Equipment Capacity	4.1 Latent heat gain (BTUH): 6





4.2 Sensible heat gain (BTUH): 6





4.3 Total heat gain (BTUH): 6



	Air Flow	5.1 Airflow at evaporator (CFM): 6,7





5.2 Duct static pressure – supply (WC): 6





5.3 Duct static pressure – return (WC): 6





5.4 Fan motor type (fixed speed, variable speed):

	N/A

	5.5 Fan speed setting (CFM): 6



	Refrigerant Charge 8

	6.1 Refrigerant type (R-22, R-410a):

	N/A

	6.2 Metering device (TXV, fixed orifice):

	N/A

	6.3 Return air temp. (°F dry bulb /  °F wet bulb): 9	N/A

N/A

	6.4 Supply air temp. ( °F dry bulb /  °F wet bulb): 9	N/A

N/A

	6.5 Outdoor ambient air temp. at condenser (°F dry bulb):	N/A

N/A

	6.6 Liquid line temperature & pressure (°F / psi):	N/A

N/A

	6.7 Suction line temperature & pressure (°F / psi):	N/A

N/A

	6.8 Condensing temperature (°F): 10	N/A

N/A

	6.9 Evaporating temperature (°F): 11	N/A

N/A

	6.10 For non-Lennox TXV devices:                                 
Subcooling temp. (condensing temp – liquid line temp.) 12





6.11 For Lennox TXV devices:                                           
Approach temp. (liquid line temp.–outdoor ambient temp.)13





6.12 For fixed orifice devices:                                         
Superheat temp. (suction line temp. – evaporating temp.):14



	Technician name: 	Equipment Installation Date: 	

Technician Signature: 	Company Name: 	





This checklist applies to split air conditioners, unitary air
conditioners, and air-source/water-source heat pumps up to 65,000 BTU/H.
 All other equipment is exempt.

This checklist shall be provided by the EPA-approved verifier to the
HVAC contractor who shall complete one checklist for each system.  Upon
completion, the HVAC contractor shall return the checklist(s) to the
EPA-approved verifier for review.

Cooling loads shall be calculated, equipment capacity shall be selected,
and duct systems shall be sized according to the latest editions of ACCA
Manuals J, S, D, & T, respectively, ASHRAE 2001 Handbook of
Fundamentals, or an equivalent procedure.  Maximum oversizing limit for
air conditioners and air-source and ground-source heat pumps is 15% with
the exceptions that single-speed air-source and ground-source heat pumps
in buildings with heating loads that exceed cooling loads have a limit
of 25%; and multi-stage heat pumps do not have a strict limit, but
should be sized to allow adequate humidity control in the cooling mode. 
The following operating conditions must be used in the sizing
calculations and verified by the rater: 

Outdoor temperatures must be the 99.0% design temperatures as published
in the ASHRAE Handbook of Fundamentals for the home’s location or most
representative city for which design temperature data are available.
Note that a higher outdoor air design temperature may be used if it
represents prevailing local practice by the HVAC industry and reflects
extreme climate conditions that can be documented with recorded weather
data;

 

Indoor temperatures must be 75°F for cooling, and;

Infiltration rate must be selected as “tight”, or the equivalent
term.

In specifying equipment, the next available size may be used. In
addition, indoor and outdoor coils must be matched in accordance with
ARI standards. 

Equipment shall have a sensible heat ratio < 0.70 or an ENERGY STAR
qualified stand-alone dehumidifier must be installed in home. This
requirement applies only to homes that are located in both Climate Zones
1, 2 or 3 and in Warm, Humid counties as identified by Tables N1101.2
and N1101.2.1 of the 2004 Supplement to the IRC, respectively.

Corrosion-resistant materials include stainless steel and plastic. 
Drain pan shall drain condensate line to drainage system, rather than
just depositing underneath foundation.

Measured field value shall be within 5% of design value.

Measured air volume shall be determined using a “true flow”
anemometer or pressure matching (i.e., duct blaster).

Climate conditions, such as cold weather, may make it impossible to
verify proper refrigerant charge. In such cases, a TXV must be
installed.

Air temperatures shall be measured in ducts near evaporator and not in
conditioned building space.

Calculated using liquid line pressure measured value.

Calculated using suction line pressure measured value.

Field value must be within 3°F of design value.

Field value must be within 1°F of design value.

Field value must be within 5°F of design value.

OMB Control No. xxxx-xxxx

ENERGY STAR Qualified Homes 

HVAC Quality Installation Contractor Checklist 1,2

EPA Form 5900-175

The government estimates the average time needed to fill out this form
is 1.00 hours and welcomes suggestions for reducing this effort. Send
comments (referencing OMB Control Number) to the Director, Collection
Strategies Division, U.S. EPA (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460.

