U-5 IOM
19
Job Name ____________________________________________ Date ________________________________
Address ___________________________________________________________________________________
__________________________________________________________________________________________
Phone ______________________________________________ Unit No. _____________________________
Nameplate Data
Make _____________________________________________________________________________________
Model ______________________________________________ Serial No. ____________________________
R-22 Factory Charge_____oz.
Compressor RLA _____________________ LRA _____________________ Blower FLA __________________
Maximum Current Rating of Supply Circuit ______amps
Minimum Circuit Activity______amps
Branch Circuit Selection Current______amps
Running Conditions
HEAT
COOL
HEAT
COOL
Entering Air __________F ___________F Leaving Air ___________F___________F __________cfm
Entering Water________F ___________F Leaving Water_________F___________F _________GPM
Discharge___________PSI _________PSI
Suction _____________PSI__________PSI
Discharge____________F ___________F
Suction______________ F ___________F
Blower____________amps ________amps
Superheat____________ F ___________F
Compressor__________ F ___________F
Auxiliary Heat
Make _______________________________________________ Model _______________________________
Serial No. ____________________________________________ Maximum Fuse ____________________amps
Entering Air_________F
Leaving Air_________F
Comments _________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Form HP/COS-02
SAVE THIS FORM FOR MAINTENANCE REFERENCE
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Heat pump check-out sheet