MINI-SPLIT FIELD DATA
Refrigerant Charge Verification
RATER
CONTRACTOR
A1 SERVICES
A-AVIS PLUMBING, HEATING & AIR
AC CONTROL
ACI
ACR
ACTION A/C
ACTIVE AIR
ADVANTAGE AIR
AG
AIR FORCE 1 HEATING & AIR
AIR FORCE A/C & HEATING
AIR PRODUCTS
AIRE SERV
ALISO AIR, INC.
ALL PRO
ALL SEASONS
ALL VALLEY AIR
AMERICAN AIR (AMERICAN COMPLETE HOME SERVICES INC)
AMERICAN COMFORT / KEN STARR
AMERICAN INTERNATIONAL ALLIANCE
ANAHEIM HEATING & A/C
ANDERSON
ARS TUSTIN
AUSTIN AIR
AVIS (ANAHEIM)
AZ
BILL HOWE
BILL PASLEY
BLAIR
CALCOMS
CHAMPION AIR
CLEARVIEW
CLIMATE AIR MASTERS
COLE SERVICES
COMFORT AIR (VOTTA)
COMPLETE COMFORT
CYPRESS
D S MECHANICAL
DCS
DEPENDABLE GRAHAM
DIRECT HES
ECO GREEN
ECONO AIR
ECONOMY AIR
ENERGY EXPERTS
ESSER
EVERLAST
FISHER AIR
GENERAL AIR
GRAYPOINT (AIRMEK)
GREEN AIR
GUARANTEED QUALITY
HACKNEY
HOME COMFORT
HOMEOWNER
JMS
J'S HEATING & AIR (SMART CHOICE)
JW HEATING & AIR, INC.
KAISER
KAPPL (AK HVAC)
KILOWATT HEATING, A/C & ELE.
KNIGHT
LANDMARK
LUCKY AIR, INC.
MARK WILMERS
MAUZY
MERICA AIR
MIKE DIAMOND
N.R.G. HEATING & AIR
ONE HOUR
PAYLESS
PELL AIR & HEATING
POWERSTAR HES
PMA MANAGEMENT
PRECISE AIR SYSTEMS
PREMIUM AIR
PROS360
RELAXED
RIGHT TIME
ROWLAND
SADDLEBACK
SCOTT AIR
SERVICE CHAMPIONS
SFV HVAC
SHERLOCK
SMART CHOICE
SOCAL (CODY)
SOUTHLAND HEATING & AIR
STUART ROSE
SUMMER AIR
THE RIGHT CHOICE HEATING & AIR
THOMSON
TIMO
TOTAL CARE
TOTAL COMFORT
TRABUCO AIR
TRI CITIES BEST HEATING & AIR
TRI COUNTY
TRIPLE E SERVICES
UNITED SERVICES
VACCO
VIKING HEATING & AIR
WC HEATING & AIR
WEST COAST AIR CONDITIONING
WEST COAST CHIEF
YES ELECTRIC
ZERO ENERGY
OTHER
OTHER CONTRACTOR
JOB #
CUSTOMER INFO
CUSTOMER NAME
*
First Name
Last Name
CUSTOMER ADDRESS
*
EX: 123 APPLE ST
CUSTOMER CITY
CUSTOMER ZIP
MINI-SPLIT DATA
TIME/DATE OF VERIFICATION
-
Month
-
Day
Year
Date Picker Icon
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
CONDENSER MODEL NUMBER
*
PHOTO OF CONDENSER NAME PLATE
*
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IS THIS A DUCTED MINI-SPLIT?
NO
YES
DUCT LEAKAGE:
NEW DUCTED MINI-SPLITS PASS @ 5%
DUCT LEAKAGE PASS OR FAIL?
PASS
FAIL
AIRFLOW
NEW MINI-SPLIT PASSES @ 400 PER TON
AIRFLOW PASS OR FAIL?
PASS
FAIL
HOW MANY HEADS ARE THERE?
1
2
3
4
PHOTO OF HEAD NAME PLATE #1
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PHOTO OF HEAD NAME PLATE #2
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PHOTO OF HEAD NAME PLATE #3
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PHOTO OF HEAD NAME PLATE #4
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HOW MANY TONS?
EX: 3
INSTALLED LIQUID LINE LENGTH (FEET)
TOTAL LINE-SET DISTANCE FROM COND. TO EACH HEAD, COMBINED
INSTALLED LIQUID LINE DIAMETERS (TYP. 3/8”)
FINISH
ADDITIONAL PHOTOS
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NOTES
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