Install Information

Start Up Date

Installing Contractor

Installing Company Technician

Installing Company Phone

Homeowner Name

Homeowner Address

Homeowner City, State, Zip

Hydronic Circuit

Yes

Installation Application

New Construction Install

Replacing Existing DX System

Replacing Existing non-DX system

Old Brand

Equipment Information

Geothermal Model No:

Geothermal Serial No:

OEM Blower or Furnace Brand:

OEM Blower/Furnace Model No:

OEM Blower/Furnace Serial No:

OEM Coil Brand:

OEM Coil Model No:

OEM Coil Serial No:

Coil Tonnage:

Thermostat Model No:

Wall Thermostat Brand:

Earth Loop Protection System

CP1

CP2

Rectifier 1 Voltage Output DC:

Rectifier 2 Voltage Output DC:

All readings must be taken when water at the Outlet of the Heat Exchanger is within 10 degrees of the set point.

System Evacuation:

Has system held 400 microns for 5 min w/ vacuum pump off & isolated?

Yes

Refrigerant Type:

System Charge (Pounds and Ounces):

Outdoor Temperature:

Indoor Temperature:

Suction Pressure (PSI/TEMP) for Heating:

Suction Pressure (PSI/TEMP) for Cooling:

Suction Line Temp for Heating:*

Suction Line Temp for Cooling:*

Suction Superheat for Heating:

Suction Superheat for Cooling:

*Heating Mode: vapor line from earth loop field at back of unit

-get suction superheat while in heating mode

*Cooling Mode: heat exchanger vapor line inside of unit

-get suction superheat while in cooling mode

Discharge Pressure for Cooling:

Discharge Line Temp:

Discharge Pressure for Heating:

Discharge Line Temp for Cooling:

Discharge Superheat for Cooling:

Discharge Superheat for Heating:

Your Name

Must be submitted withing 60 days after install date.