GROUND SOURCE HEAT PUMP
PERFORMANCE REPORT
This performance check report should be filled out by installer and retained with unit.
DATE: |
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1. UNIT: |
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Mfgr |
| Model # |
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| S/N |
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THERMOSTAT: |
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Mfgr |
| Model # |
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| P/N |
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2.Person Reporting
3.Company Reporting
4. Installed By |
| Date Installed |
5.User’s (Owner’s) Name Address
6.Unit Location
WATER SYSTEM INFORMATION |
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7. Open Loop System (Water Well) | Closed Loop System |
A.If Open Loop where is water discharged?
8.The following questions are for Closed Loop systems only
A.Closed loop system designed by
B. Type of antifreeze used: |
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| % Solution |
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C. | System type: | Series |
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| Parallel |
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D. | Pipe Material |
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| Nominal Size |
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E. | Pipe Installed: |
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| 1. | Horizontal |
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| Total length of pipe |
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| No. pipes in trench |
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| Depth bottom pipe |
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| 2. | Vertical |
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| Total length of bore hole |
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Manual | |
Page | 45 of 46 |
