NRCA-MCH-02-A – Outdoor Air Acceptance Certificate
Ventilation Systems –Variable Air and Constant Volume System Acceptance Document
This form is used to document results of the minimum outdoor air ventilation tests for both constant and variable air volume fan systems. A separate form should be completed for each system tested. The form is separated into six basic sections: project information; certification statement; pre-test inspection; functional testing; testing calculations and results; and pass/fail evaluation. Each section consists of a combination of data entry requirements and check boxes.
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection
This pre-test section consists of check boxes and data entry requirements for both constant and variable air volume systems. Complete only the check boxes associated with the appropriate system type.
NA7.5.1.1 Outdoor Air Acceptance - Functional Testing
This section consists of check boxes and data entry requirements for both constant and variable air volume systems. Enter data associated with the appropriate system type as instructed.
Testing Calculations and Results
This section consists of data entry requirements for both constant and variable air volume systems. Enter data associated with the appropriate system type as instructed.
Evaluation
This section contains check boxes to indicate the pass/fail results of the test(s). Check the appropriate box. Any portion that fails should be explained in the given rows.
NRCA-MCH-03-A – Constant Volume, Single Zone, Unitary Air Conditioning and Heat Pump Systems Acceptance Document
This form is used to document results of packaged HVAC system operating tests. A separate form should be completed for each system tested. The form is separated into six basic sections: project information; certification statement; pre-test inspection; functional testing; testing calculations and results; and pass/fail evaluation. Each section consists of a combination of data entry requirements and check boxes.
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection
This pre-test section consists of check boxes. Complete check boxes as instructed.
Operating Modes
This section documents the various operating modes for packaged HVAC systems under which they will be tested. Note that operating modes “F” and “G” are associated with systems that do not have an economizer and operating modes.
Functional Testing
This section consists of check boxes arranged in a matrix pattern, with the various operating modes listed horizontally and expected system responses listed vertically. As the HVAC system is tested under each applicable operating mode, check the box associated with the expected system response. Again, note that operating modes “F” and “G” are mutually exclusive with operating modes “H” and “I”. If the unit does not have an economizer, only modes “F” and “G” should be checked. Conversely, “H” and “I” are used only for systems with an economizer.
Testing Results
This section consists of data entry requirements for all operating modes. Enter data associated with the appropriate operating mode as instructed.
Evaluation
This section contains check boxes to indicate the pass/fail results of the test(s). Check the appropriate box. Any portion that fails should be explained in the given rows.
NRCA-MCH-04-A – Air Distribution Systems Acceptance Document
This form is used to document results of both stand-alone and DDC controlled economizer operating tests. A separate form should be completed for each system tested. The form is separated into six basic sections: project information; certification statement; pre-test inspection; functional testing requirements; testing results; and pass/fail evaluation. Each section consists of a combination of data entry requirements and check boxes.
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection
This pre-test section consists of check boxes for both stand-alone and DDC controlled economizers. Complete the appropriate check boxes as instructed.
Functional Testing
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Testing Results
This section consists of data entry requirements for all tests. Enter data as instructed.
Evaluation
Check the appropriate pass/fail box as instructed.
NRCA-MCH-05-A – Air Economizer Controls Acceptance Document
This form is used to document results of duct leakage tests performed on specific packaged HVAC systems. A separate form should be completed for each system tested. The form is separated into six basic sections: project information; certification statement; pre-test inspection; functional testing; testing calculations and results; and pass/fail evaluation. Each section consists of a combination of data entry requirements and check boxes.
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection
This pre-test section consists of check boxes. Complete check boxes as instructed.
Functional Testing
This section consists of check boxes and data entry requirements for both constant and variable air volume systems. Enter data associated with the appropriate system type as instructed.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation
This section contains check boxes to indicate the pass/fail results of the test(s). Check the appropriate box. Any portion that fails should be explained in the given rows.
This form is used to verify duct tightness by the installer and/or HERS rater (third-party). Compliance credit requires third-party field verification.
Installer Certification
New Construction
•ENTER TEST LEAKAGE– enter the actual measured duct leakage value.
•FAN FLOW
•CALCULATED FAN FLOW – enter the calculated fan flow either by multiplying 400cfm/ton times the number of tons of cooling or by entering 21.7 times the heating capacity of the unit being stalled in kBtu/h. In case of more than one separate fan flow unit calculate the fan flow for each separately and enter the value in the Measured Values column.
•MEASURED FAN FLOW – enter the actual fan flow measured value in the Measured Values column.
•LEAKAGE PERCENTAGE – enter the leakage fraction by dividing the Test Leakage by either the calculated or measured fan flow. Enter the value in the Measured Values column.
•PASS OR FAIL – check the “Pass” box if duct leakage is less than 6 percent.
Alterations
•ENTER PRE-TEST LEAKAGE FLOW – enter the actual measured duct leakage value for existing ductwork where the single-zone unit is being replaced or having a major component replaced (§149(b)2E) including:
•Cooling coil
•Furnace
•Condenser coil (split system) or
•Condensing unit (split system)
Different levels of leakage requirements apply to new and existing ductwork (see §149(b)2D).
•ENTER FINAL TEST FOR LEAKAGE – enter the actual measured duct leakage value after alterations are complete. There are three options for meeting the leakage requirements.
•The measured duct leakage shall be less than 15 percent of fan flow; or
•The duct leakage shall be reduced by more than 60 percent relative to the leakage prior to the equipment having been replaced and a visual inspection shall demonstrate that all accessible leaks have been sealed; or
•If it is not possible to meet the duct sealing requirements of Subsections a. or b., all accessible leaks shall be sealed and verified through a visual inspection by a certified HERS rater.
Exception to §149(b)2Dii: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
Otherwise check the “Fail” box. See §149(b)1D for additional applicable information.
•ENTER REDUCTION IN LEAKAGE – This is option b. from above. If the leakage after the alteration is reduced by 60 percent then the system passes.
•NEW DUCTS – If all the ducts are new the leakage must not be over 6 percent. Enter these values here.
•TEST OR VERIFICATION STANDARDS
•Leakage Percentage must be less than 15 percent. After the alteration the duct leakage must be less than 15 percent of fan flow.
•Leakage Reduction - If a Pre-Test was conducted on the system before any alterations the final test after the alteration must less than 60 percent.
•If none of the above options a HERS rater can test the duct system to verify by smoke test that all accessible leaks have been sealed.
•SIGNATURE AND DATE – enter the signature of the installer and date of the test.
•NAME OF INSTALLING CONTRACTOR OR SUBCONTRACTOR – enter the name of the company of the contractor of subcontractor.
HERS Rater Compliance Statement
The HERS rater fills out the following information:
•HERS RATER INFORMATION
•HERS Rater – Rater prints name and telephone number.
•Certifying Signature – After tests passes the HERS Rater signs and dates form.
•FIRM – Enter company name
•SAMPLE GROUP NUMBER – Enter sample number here. Example, System 3 out of 7.
•ENTER TEST LEAKAGE– enter the actual measured duct leakage value.
•FAN FLOW
•CALCULATED FAN FLOW – enter the calculated fan flow either by multiplying 400 cfm/ton times the number of tons of cooling or by entering 21.7 times the heating capacity of the unit being stalled in kBtu/h. In case of more than one separate fan flow unit calculate the fan flow for each separately and enter the value in the Measured Values column.
•LEAKAGE PERCENTAGE – enter the leakage fraction by dividing the Test Leakage by either the calculated or measured fan flow. Enter the value in the Measured Values column.
•PASS OR FAIL – check the “Pass” box if duct leakage is less than 6 percent.
Alterations
•ENTER PRE-TEST LEAKAGE FLOW – enter the actual measured duct leakage value for existing ductwork where the single-zone unit is being replaced or having a major component replaced (§149(b)E) including:
•Cooling coil
•Furnace
•Condenser coil (split system) or
•Condensing unit (split system)
Different levels of leakage requirements apply to new and existing ductwork (see §141.0(b)2D).
•ENTER FINAL TEST FOR LEAKAGE – enter the actual measured duct leakage value after alterations are complete. There are three options for meeting the leakage requirements.
•The measured duct leakage shall be less than 15 percent of fan flow; or
•The duct leakage shall be reduced by more than 60 percent relative to the leakage prior to the equipment having been replaced and a visual inspection shall demonstrate that all accessible leaks have been sealed; or
•If it is not possible to meet the duct sealing requirements of Subsections a. or b., all accessible leaks shall be sealed and verified through a visual inspection by a certified HERS rater.
Exception to §141.0(b)1D2ii: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
Otherwise check the “Fail” box. See §149(b)1D for additional applicable information.
•ENTER REDUCTION IN LEAKAGE – This is option b. from above. If the leakage after the alteration is reduced by 60 percent then the system passes.
•NEW DUCTS – If all the ducts are new the leakage must not be over 6%. Enter this value here.
•TEST OR VERIFICATION STANDARDS
•Leakage Percentage must be less than 15 percent. After the alteration the duct leakage must be less than 15 percent of fan flow.
•Leakage Reduction - If a Pre-Test was conducted on the system before any alterations the final test after the alteration must less than 60 percent.
•If none of the above options a HERS rater can test the duct system to verify by smoke test that all accessible leaks have been sealed.
MECH-6-A – Demand Controlled Ventilation Systems Acceptance Document
This form is used to document results of operational tests for HVAC systems required to utilize demand ventilation control. A separate form should be completed for each system tested. The form is separated into six basic sections: project information; certification statement; pre-test inspection; functional testing; testing calculations and results; and pass/fail evaluation. Each section consists of a combination of data entry requirements and check boxes.
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection
This pre-test section consists of check boxes. Complete check boxes as instructed.
Functional Testing
This section consists of both check boxes and data entry for each test procedure. Complete all check boxes and enter data as instructed.
Testing Results
This section consists of data entry requirements for all tests. Enter data as instructed.
Evaluation
Check the appropriate box as instructed.
NRCA-MCH-07-A - Supply Fan VFD Acceptance Document
This form is used to document results of operational tests for HVAC supply fans required to utilize variable flow control. A separate form should be completed for each system tested. The form is separated into six basic sections: project information; certification statement; pre-test inspection; functional testing; testing calculations and results; and pass/fail evaluation. Each section consists of a combination of data entry requirements and check boxes.
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection
This pre-test section consists of check boxes and data entry requirements. Complete check boxes or enter data requested as instructed.
Functional Testing
This section consists of data entry requirements and yes or no questions for each test procedure or line item. Enter data or circle the correct answer as instructed.
Testing Results
This section consists of data entry requirements for all tests. Enter data as instructed.
Evaluation
Check the appropriate box as instructed.
NRCA-MCH-08-A – Valve Leakage Test Acceptance Document
This form is used to document the results for various hydronic system operating tests. The form was designed so that data from up to five hydronic systems (for example: chilled water; heating hot water; water-loop heat pump; etc.) could be recorded on one form. The form is separated into six basic sections: project information; certification statement; pre-test inspection; functional testing; testing calculations and results; and pass/fail evaluation. Each section consists of a combination of data entry requirements and check boxes.
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection
This pre-test section consists of check boxes. Complete check boxes as instructed.
Functional Testing
This section consists of check boxes, data entry requirements, and yes or no questions arranged by individual test. Check each box, enter requested data, or circle the correct answer for which the specific test or line item applies.
Testing Results
This section consists of data entry requirements for all tests. Enter data as instructed.
Evaluation
Check the appropriate box as instructed.
NRCA-MCH-09-A – Supply Water Temperature Reset Controls Acceptance
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-10-A – Hydronic System Variable Flow Control Acceptance
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-11-A – Automatic Demand Shed Control Acceptance
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-12-A – Fault Detection & Diagnostics (FDD) for Packaged Direct-Expansion Units
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-13-A – Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-14-A – Distributed Energy Storage DX AC Systems Acceptance
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-15-A – Thermal Energy Storage (TES) System Acceptance
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-16-A – Supply Air Temperature Reset Controls
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-17-A – Condenser Water Temperature Reset Controls
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.
NRCA-MCH-18-A – Energy Management Control System
Project Information
•PROJECT NAME is the title of the project, as shown on the Code Compliance forms.
•PROJECT ADDRESS is the address of the project, as shown on the Code Compliance forms.
•SYSTEM NAME OR IDENTIFICATION/TAG is the name or the identification number of the system under test, as shown on the Code Compliance forms.
•SYSTEM LOCATION OR AREA SERVED is the location of the system in the facility.
Declaration Statements of Acceptance
This section contains fillable fields for three declaration statements: one from the Documentation Author, one from the Field Technician, and one from the Responsible Person. Each area contains a combination of check boxes and data entry requirements, including signature; date; and license number. Complete check boxes and enter data as instructed.
The Documentation Author is the person completing the form. The Field Technician is responsible for performing and documenting the results of the acceptance procedures on the Certificate of Acceptance forms. The Field Technician must sign the Certificate of Acceptance to certify that the information he or she provides on the Certificate of Acceptance is true and correct. It is important to note that the Field Technician is not required to have a contractor’s, architect’s or engineer’s license. A Responsible Person is eligible under Division 3 of the Business and Professions code in the applicable classification to take responsibility for the scope of work specified by the Certificate of Acceptance document. The Responsible Person can also perform the field testing and verification work, and if this is the case the Responsible Person must complete and sign both the Field Technician’s signature block and the Responsible Person’s signature block on the Certificate of Acceptance form. The Responsible Person assumes responsibility for the acceptance testing work performed by the Field Technician agent or employee.
Construction Inspection:
This pre-test section consists of check boxes and data entry requirements. Complete check boxes and enter data as instructed.
Functional Testing:
This section consists of check boxes and yes or no questions arranged by individual test. Check each box or circle the correct answer for each specific test or line item.
Testing Results
This section consists of check boxes for each test procedure. Complete check boxes as instructed.
Evaluation:
Check the appropriate box as instructed.