Thank you for filling out the first part of the survey. Please continue to fill out the form below.

Pre-Lease HVAC Equipment Survey Part 2

Please fill out this form in its entirety for each unit. At the end of this form there will a link with an option to complete more of them should you need more. If you have any questions please feel free to contact us at 1-631-297-9292.

Step 1 of 8

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Information Sheet A

Unit #

Make

Model

Serial #

Is this unit numbered?

Yes

Unit Number on ROOF

Approximate age of unit

Actual age from serial #

Number of compressors

Number of condenser fan motors

Total tonnage

Volatage

Phase

Cycles

Fuse size

Fuse location:

Disconnect switch is in good condition?

Yes

Type of Unit (Select All That Apply) Note: For split systems fill out information sheets A-E for each piece of Equipment )Air Handler and Condenser)

Air Cooled

Air Curtain

Air Handler

Blower

Boiler

Built-Up Air Handler

Centrifugal Chiller

Chilled Water

Chiller

Compressor

Condensing Section

Cooling Tower

Electrical Coil

Evaporate Condenser

Evaporative Cooler

Exhaust Fan

Fan Powered VAV

Gas Fired

Heat Pump

Indoor Packaged

Make-Up Air

Mini- Split

Packaged Condenserless

Packaged Rooftop

Packaged With Remote Condenser

PTAC

Pump

Reciprocating chiller

Remote Condenser

Return Fan

Screw Chiller

Scroll Chiller

Steam Coil

Unit Heater

VAV

Water Coil

Water Cooled

Water Source Heat Pump

Other

Please provide description of "Other"

Location Of Unit

Above Ceilings

Basement

Equipment Room

Pad On Grade

Roof

In Conditioned Space

Controls Type

Manufacturer

Model #

Approximate Age

Location

Types

Direct Digital

Electromechanical

Electric

Ems

Pneumatic

Information Sheet B

Unit #

Filters Required

Filters Required (To add more than one click the "+" )

Quantity

Size

Filters Required

Belts Required (To add more than one click the "+" )

Quantity

Size

Physical damage to cabinet? Supply photos if "yes"

Yes

Image Hopper

Are all panels installed properly?

Yes

Electrical power to unit routed properly?

Yes

Physical damage to condenser coil? Supply photos if yes.

Yes

Image Of damaged condensor coils(Required)

Outside air filters installed properly?

Yes

Convenience receptacle installed?

Yes

Gas piping to unit routed properly?

Yes

Is gas piping painted or protected?

Yes

Is condensate P-trap required?

Yes

Is condensate P-trap installed?

Yes

Is splash block installed?

Yes

Is condensate piping installed properly?

Yes

Does unit have Power Exhaust accessory installed?

Yes

Is power exhaust operating properly?

Yes

Is relief damper installed?

Yes

Variable Frequency drive or Multi Speed Blower?

Yes

Information Sheet C

Unit #:

Is an outside air economizer installed?

Yes

Is economizer installed properly?

Yes

Does economizer operate properly?

Yes

How open are outside air dampers (minimum position)?

Is outside air enthalpy sensor installed?

Yes

Is return air enthalpy sensor installed?

Yes

If equipped with power exhaust, at what percent does the air damper opening power exhaust energize?

Is unit seated properly on curb?

Yes

Is curb level within tolerance?

Yes

What is set point of ethalpy control?

Yes

What is set point of discharge air control?

Yes

Are air filters clean? (Supply photos if "No")

Yes

Image of dirty air filters(Required)

Is evaporator coil clean? (Supply photos if "No")

Yes

Image of dirty evaporator coils(Required)

Is condenser coil clean? (Supply photos if "No")

Yes

Image of dirty condenser coils(Required)

Are outside air filters clean? (Supply photos if "No")

Yes

Image of dirty air filters(Required)

Any evidence of water leaks? (Supply photos if "Yes")

Yes

Image of water leaks(Required)

Is there severe corrosion? (Supply photos if "Yes")

Yes

Image of water leaks(Required)

Is condensate pan clean and clear of debris? (Supply photos if "Yes")

Yes

Is V-belt tight?

Yes

Is belt in good condition?

Yes

Are drive sheaves aligned and in good condition?

Yes

Information Sheet D

Operational Check From Terminal Strip

O.K. Test fan?

Yes

O.K. Test heat W1?

Yes

O.K. Test heat W2?

Yes

O.K. Test heat compressor Y1?

Yes

O.K. Test heat compressor Y2?

Yes

O.K. Test stage 1 cool Y2?

Yes

O.K. Test stage 2 cool Y2?

Yes

O.K. Test stage 3 cool Y3?

Yes

O.K. Test stage 4 cool Y4?

Yes

O.K. Test economizer Y1?

Yes

O.K. Refrigerant charge Circut 1?

Yes

O.K. Refrigerant charge Circut 2?

Yes

O.K. Refrigerant charge Circut 3?

Yes

O.K. Refrigerant charge Circut 4?

Yes

O.K. Heating Flame color?

Yes

Is draft inducer hood installed?

Yes

Is draft inducer hood installed?

Yes

Is control wiring of sufficient gage?

Yes

Is low ambient control installed on unit?

Yes

Is phase monitor installed on unit?

Yes

Have compressor mounts been loosened?

Yes

Is there any evidence of refrigerant leaks?

Yes

Do all condenser fans operate properly?

Yes

Life Expectancy? (Years)

Information Sheet E

Unit #

Blower Motors (To add more than one click the "+" )

Nameplate Amps

Measured Amps

Compressors (To add more than one click the "+" )

Nameplate Amps

Measured Amps

Measured Line Voltage

Phase 1

Phase 2

Phase 3

Is ductwork lined below curb?

Yes

Is control transformer wired for correct primary tap?

Yes

Is there any debris on or around unit?

Yes

Have all fasteners been installed on panels?

Yes

Are contractor contacts dirty, discolored, or pitted?

Yes

Are duct mounted smoke detectors present?

Yes

Require Repair & Comments

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Pre-Lease HVAC Equipment Survey Part 2

Information Sheet A

Information Sheet B

Filters Required

Filters Required

Information Sheet C

Information Sheet D

Operational Check From Terminal Strip

Information Sheet E

Measured Line Voltage