ENERGY STAR MULTIFAMILY HIGH RISE PROGRAM                                                     OMB Control No. 2060-0586
Photo Template Version 1.1



Project Name:            
Address:  
Date:  


INSTRUCTIONS

Use this template as a sample format to comply with the photo documentation requirements outlined in the ENERGY STAR MFHR Testing and Verification Protocols and Worksheets.  Add, delete or re-size photo boxes and descriptions as necessary.

EPA suggests compressing the resolution of photos prior to inserting into the template to make the file size more manageable, however all nameplates and details demonstrating compliance must be clearly identifiable.

Tip:  Once the cursor is inside the desired photo box, select `Insert''Picture''From File' from the menu above in order to automatically resize the photos to fit the boxes.
















EPA Form No. 5900-422

Table of Contents

INSTRUCTIONS	1
APPLIANCES  -  PROTOCOL 1.1	4
Refrigerators	4
Dishwashers	4
Clothes Washers	5
HVAC  -  HEATING AND DHW SYSTEMS  -  PROTOCOL 2.1, 2,2, 5.1, 5.3	6
Heating Units / Systems	6
DHW Units / Systems	7
Heating Pipe Insulation	8
DHW Pipe Insulation	9
Duct Insulation	10
PLUMBING FIXTURES  -  APARTMENT UNITS	11
Fixtures & Flow Rates	11
In-Unit DHW Delivery and Storage Temperature	12
ENVELOPE  -  BELOW GRADE WALLS  -  PROTOCOL 3.1	13
ENVELOPE  -  ABOVE GRADE WALLS  -  PROTOCOL 3.1	14
ENVELOPE  -  ROOF  -  PROTOCOL 3.2	17
Roof Insulation	17
ENVELOPE  -  FLOORS  -  PROTOCOL 3.3	19
Floor Insulation	19
ENVELOPE  -  WINDOWS  -  PROTOCOL 3.4	21
Window Thermal Ratings and Sealing	21
ENVELOPE  -  EXTERIOR DOORS  -  PROTOCOL 3.5	22
Exterior Doors	22
GARAGES - VENTILATION FANS WITH CO SENSORS (if applicable)  -  PROTOCOL 4.1	23
HVAC  -  COOLING  -  PROTOCOL 5.2, 5.4	24
Cooling Units	24
LIGHTING  -  PROTOCOL 6.1-6.3	25
Fixture A	25
Fixture B	26
Fixture C	27
Fixture D	28
Fixture E	29
LIGHTING CONTROLS  -  COMMON AREAS	30
Common Area Lighting Controls	30
LIGHTING CONTROLS  -  EXTERIOR	32
Exterior Lighting Controls	32
HVAC  -  MOTORS AND VFDs  -  PROTOCOL 7.1	33
ENVELOPE  -  EXTERIOR AIR BARRIER  -  PROTOCOL 3.1, 8.1	34
From the Exterior	34
From the Interior	36
INFILTRATION  -  COMPARTMENTALIZATION AND BLOWER DOOR TEST  -  PROTOCOL 8.1	37
From the Interior	37
VENTILATION  -  SCHEDULE AND OPERATION  -   PROTOCOL 8.2	41
VENTILATION  -  DUCT TIGHTNESS TEST  -  PROTOCOL 8.2	43
For central ventilation systems	43
For in-line fan exhaust systems	44
METERS  -  CONFIGURATION  -  PROTOCOL 9.1	46
Gas, Water, Electric Meters	46





APPLIANCES  -  PROTOCOL 1.1
Refrigerators
                                       
                                       
Notes:  Nameplate (list model number here if illegible)
Notes:  ENERGY STAR label

Dishwashers
                                       
                                       
Notes:  Nameplate (list model number here if illegible)
Notes:  ENERGY STAR label

Clothes Washers
                                       
                                       
Notes:  Clothes washer (s) Installed
Notes:  Nameplate (list model number here if illegible)

                                       
                                       
Notes:  ENERGY STAR label
Notes:

HVAC  -  HEATING AND DHW SYSTEMS  -  PROTOCOL 2.1, 2,2, 5.1, 5.3

Heating Units / Systems
                                       
                                       
Notes:  Apt equipment  -  (image of mechanical closet, boiler room, etc)
Notes: Apt equipment  -  nameplate (list model number here if illegible)

                                       
                                       
Notes:  Common Area equipment  -  (image of mechanical closet, boiler room, etc)
Notes: Common Area equipment  - nameplate (list model number here if illegible)


DHW Units / Systems
                                       
                                       
Notes:  DHW system   -  (image of mechanical closet, boiler room, etc)
Notes:  DHW system nameplate (list model number here if illegible)

                                       
                                       
Notes:  Central DHW tank storage insulation (if applicable)
Notes:   Central DHW Electronic mixing valve temperature set point


Heating Pipe Insulation
                                       
                                       
Notes:  Space Heating pipes insulation in boiler room
Notes:  Thickness measurement

                                       
                                       
Notes:  Space Heating pipe riser insulation
Notes:  Thickness measurement

DHW Pipe Insulation
                                       
                                       
Notes:  DHW pipes insulation 
Notes:  Thickness measurement

                                       
                                       
Notes:  DHW pipe riser insulation
Notes:  Thickness measurement

Duct Insulation
                                       
                                       
Notes:  Duct insulation (indoors)
Notes:  Duct insulation (outdoors)

                                       
                                       
Notes:  Duct insulation (in apartment units if applicable)
Notes:  

PLUMBING FIXTURES  -  APARTMENT UNITS

Fixtures & Flow Rates
                                       
                                       
Notes:  Kitchen faucet GPM (list model and GPM here if illegible)
Notes:  Bathroom faucet GPM (list model and GPM here if illegible)

                                       
                                       
Notes:  Showerhead GPM & WaterSense label (list model/GPM here if illegible)
Notes:  Toilet GPF & WaterSense label  (list model/GPF here if illegible)
In-Unit DHW Delivery and Storage Temperature
                                       
                                       
Notes:  Kitchen faucet temperature (not to exceed 125F)
Notes:  Bathroom faucet temperature (not to exceed 125F)

                                       
                                       
Notes:  Showerhead temperature (not to exceed 125F) 
Notes:  In-unit Storage DHW temperature (not to exceed 140F)
ENVELOPE  -  BELOW GRADE WALLS  -  PROTOCOL 3.1

                                       
                                       
Notes:  BG Wall Insulation type
Notes:  Thickness measurement

                                       
                                       
Notes:  Continuous insulation around corner, other challenging details
Notes:  Continuous insulation around corner, other challenging details
                                       
                                       
Notes:  Pre-insulation showing application of water/vapor/air  barrier
Notes:  Post-installation overall


ENVELOPE  -  ABOVE GRADE WALLS  -  PROTOCOL 3.1

                                       
                                       
Notes:  AG Wall Insulation type
Notes:  Thickness measurement

                                       
                                       
Notes:  Continuous insulation around corner, other challenging details
Notes:  Continuous insulation around corner, other challenging details

                                       
                                       
Notes:  Pre-insulation showing application of water/vapor/air  barrier
Notes:  Barrier general coverage and appropriate thickness


                                       
                                       
Notes:  Post-insulation indicating proper installation
Notes:  Pre-installation to verify framing construction

                                       
                                       
                                       
Notes:  Completion showing proper drywall installation
Notes:  Plank/Slab Edge and Rim Joist insulation between ceiling/floor levels before cladding is installed

ENVELOPE  -  ROOF  -  PROTOCOL 3.2
Roof Insulation
                                       
                                       
Notes:  Roof Insulation type
Notes:  Thickness measurement

                                       
                                       
Notes:  Continuous insulation around corner, other challenging details
Notes:  Continuous insulation around corner, other challenging details


                                       
                                       
Notes:  Post-insulation (pre-drywall for cavity insulation, prior to roof finish for exterior grid insulation) showing complete and even distribution of insulation
Notes:  Proper enclosure of insulated cavities (if applicable)


ENVELOPE  -  FLOORS  -  PROTOCOL 3.3
Floor Insulation
                                       
                                       
Notes:  Floor Insulation type
Notes:  Thickness measurement

                                       
                                       
Notes:  Continuous insulation around corner, other challenging details
Notes:  Continuous insulation around corner, other challenging details
   


                                       
                                       
Notes:  Sub-slab insulation before pouring of concrete or backfilling
Notes:  Proper moisture or insect protection (if required)

                                       
                                       
Notes:  Framed floors, post-insulation showing proper installation and  no signs of compromised R-value
Notes:  
ENVELOPE  -  WINDOWS  -  PROTOCOL 3.4
Window Thermal Ratings and Sealing 
                                       
                                       
Notes:  Each unique window type with third party verification of U-value, SHGC, and ENERGY STAR Label (if applicable)
Notes:  Each unique window type with third party verification of U-value, SHGC, and ENERGY STAR Label (if applicable)

                                       
                                       
Notes:  Installed window that verifies proper fit and effective connections to envelope's weather and air barriers
Notes:  Low-e detector for windows (if applicable)

ENVELOPE  -  EXTERIOR DOORS  -  PROTOCOL 3.5
Exterior Doors 
                                       
                                       
Notes:  Installed door that verifies proper fit and effective connections to envelope's weather and air barriers
Notes:  Each unique door type with 3[rd] party verification, NFRC and/or Energy Star label (if applicable)

GARAGES - VENTILATION FANS WITH CO SENSORS (if applicable)  -  PROTOCOL 4.1

                                       
                                       
Notes:  Garage fan
Notes:  Garage fan nameplate (list model number if illegible)

                                       
                                       
Notes:  CO/NO2 Sensors
Notes:  Air intake point
HVAC  -  COOLING  -  PROTOCOL 5.2, 5.4
Cooling Units
                                       
                                       
Notes:  Apartment equipment nameplate (list model number if illegible)
Notes:  Apartment equipment nameplate(list model number if illegible)

                                       
                                       
Notes:  Common area equipment nameplate(list model number if illegible)
Notes:  Common Are equipment nameplate(list model number if illegible)
                                       
LIGHTING  -  PROTOCOL 6.1-6.3
Instructions: Include photos of each unique fixture, showing nameplate, wattage, lumens output, fixture type (if T5/T8) or Energy Star label as applicable.

Fixture A  
Location (all that apply):
                                       
                                       
Location:  
Notes:  General

                                       
                                       
Notes:  Nameplate or wattage
Notes:  Bulb or ENERGY STAR label
Fixture B  
Location (all that apply):
                                       
                                       
Location:  
Notes:  General

                                       
                                       
Notes:  Nameplate or wattage
Notes:  Bulb or ENERGY STAR label

Fixture C  
Location (all that apply):
                                       
                                       
Location:  
Notes:  General

                                       
                                       
Notes:  Nameplate or wattage
Notes:  Bulb or ENERGY STAR label


Fixture D  
Location (all that apply):
                                       
                                       
Location:  
Notes:  General

                                       
                                       
Notes:  Nameplate or wattage
Notes: Bulb or ENERGY STAR label


Fixture E  
Location (all that apply):
                                       
                                       
Location:  
Notes:  General

                                       
                                       
Notes:  Nameplate or wattage
Notes:  Bulb or ENERGY STAR label

LIGHTING CONTROLS  -  COMMON AREAS
Common Area Lighting Controls 
                                       
                                       
Notes:  Corridor occupancy sensors
Notes:  Corridor space when sensors are activated

                                       
                                       
Notes:  Stairwell occupancy sensors
Notes:  Stairwell space when sensors are activated


                                       
                                       
Notes:  Trash room occupancy sensors
Notes:  Janitor's closet occupancy sensors
                                       
                                       
                                       
Notes:  Office occupancy sensors
Notes:  Bi-level lighting (if applicable)

LIGHTING CONTROLS  -  EXTERIOR  

Exterior Lighting Controls
                                       
                                       
Notes:  Photo cell or timer
Notes:  Photo cell or timer

                                       
                                       
Notes: Daylight sensor, fixture off during the day
Notes: Daylight sensor, fixture on when daylight sensor is covered

HVAC  -  MOTORS AND VFDs  -  PROTOCOL 7.1

                                       
                                       
Location and use:
Location and use:

                                       
                                       
Location and use:
Location and use:
ENVELOPE  -  EXTERIOR AIR BARRIER  -  PROTOCOL 3.1, 8.1
From the Exterior
                                       
                                       
Notes:  Areas with liquid-applied membranes showing appropriate thickness
Notes:  A/C Openings

                                       
                                       
Notes:  Windows
Notes:  Door Openings
                                       
                                       
Notes:  Door Frame
Notes:  Transition between wall and roof barrier

                                       
                                       
Notes:  Transition between wall and foundation barrier
Notes:  Plank/Slab Edge (Masonry and Steel Construction) or Rim Joist (Wood Framed Construction)
From the Interior
                                       
                                       
Notes:  Rough openings to windows and doors
Notes:  A/C Openings

                                       
                                       
Notes:  Additional photos (if necessary)
Notes:  Additional photos (if necessary)
INFILTRATION  -  COMPARTMENTALIZATION AND BLOWER DOOR TEST  -  PROTOCOL 8.1
From the Interior
                                       
                                       
Notes:  Window to interior gypsum board
Notes:  Air conditioner sleeve to drywall (cover is installed if A/Cs provided by building)

                                       
                                       
Notes:  Outlet/Electrical Box  -  Exterior to Demising Walls
Notes:  Heating pipe penetrations through exterior walls
                                       
                                       
Notes:  Heating pipe penetrations through interior  walls
Notes:  Plumbing/sprinkler pipe penetrations

                                       
                                       
Notes:  Range gas line penetrations
Notes:  Gypsum board to concrete ceiling plank connection  -  exterior walls and all interior partition walls
                                       
                                       

                                       
                                       
Notes:  Gap between take off duct and gypsum board
Notes:  Electrical panel

                                       
                                       
Notes:  HVAC access doors
Notes:  Thermostats

                                       
                                       
Notes:  Intercoms
Notes:  Lighting fixtures

                                       
                                       
Notes:  Door latch hole
Notes:  Medicine cabinet
VENTILATION  -  SCHEDULE AND OPERATION  -   PROTOCOL 8.2
                                       
                                       
Notes: Fan installation
Notes: Kitchen exhaust outlet to exterior (through-wall systems only)


                                       
                                       
Notes: Exhaust fan nameplate (list model number if illegible)
Notes: Exhaust fan nameplate (list model number if illegible)

                                       
                                       
Notes: Exhaust fan nameplate (list model number if illegible)
Notes: Exhaust fan nameplate (list model number if illegible) 
                                       
                                       
                                       
Notes: Exhaust fan nameplate (list model number if illegible)
Notes: Exhaust fan nameplate (list model number if illegible)


VENTILATION  -  DUCT TIGHTNESS TEST  -  PROTOCOL 8.2
For central ventilation systems
                                       
                                       
Notes:  Sealed roof curb penetration
Notes:  Mastic or other UL-181 compliant material applied within temperature range and according to all other manufacturer's requirements at ALL transverse joints and take offs
                                       
                                       
Notes: All duct transitional junctions sealed with mastic or other UL-181 compliant material
Notes:  Gap between take off duct and gypsum board effectively sealed
For in-line fan exhaust systems
                                       
                                       
Notes:  Mastic or other UL-181 compliant material applied within temperature range and according to all other manufacturer's requirements at ALL transverse joints and take offs
Notes:  All duct transitional junctions sealed with mastic or other UL-181 compliant material

                                       
                                       
Notes: If plank core is to be used as a duct  -  ceiling plank penetration sealed
Notes: If plank core is to be used as a duct  -  plank core effectively connected to exterior of building 
                                       
                                       
Notes: Appropriate plank core selected that aligns with exterior louver
Notes: Additional photos (if necessary)connected to exterior of building 


                                       

                                       
                                       
 METERS  -  CONFIGURATION  -  PROTOCOL 9.1
Gas, Water, Electric Meters
                                       
                                       
Notes:  Gas meters
Notes:  Water meter

                                       
                                       
Notes:  Electrical meters 
Notes:  Electrical meters








































The public reporting and recordkeeping burden for this collection of information is estimated to average 1 hour per response.  Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed form to this address.

