Académique Documents
Professionnel Documents
Culture Documents
Certification........................................................................................................... 2
DATE:_____________
PROJECT:
NAME ________________________________________________________________
ADDRESS______________________________________________________________
______________________________________________________________
DESIGN ENGINEER:
NAME ________________________________________________________________
HVAC CONTRACTOR:
NAME ________________________________________________________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
1
CERTIFICATION
PROJECT____________________________________________________________________
SEAL
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
2
INSTRUMENT CALIBRATION REPORT
PROJECT ____________________________________________________________________
TAB SUPERVISOR
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
3
AIR HANDLING UNIT TEST REPORT
(Central Station)
PROJECT SYSTEM/UNIT
LOCATION DATE
UNIT DATA MOTOR DATA DESIGN ACTUAL
Unit Designation HP (Kw)
Manufacturer RPM
Model Number Rated Volts
Serial Number Rated Amps
Phase
Operating Hz
Service Factor
Operating Volts
Operating Amps
Fan RPM
REMARKS:
TEST DATE:
READINGS BY:
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
4
AIR HANDLING UNIT TEST REPORT
(Packaged/Unitary Belt Drive)
PROJECT SYSTEM/UNIT
LOCATION DATE
UNIT DATA MOTOR DATA DESIGN ACTUAL
Unit Designation HP (Kw)
Manufacturer RPM
Model Number Rated Volts
Serial Number Rated Amps
Phase
Operating Hz
Service Factor
Operating Volts
Operating Amps
Fan RPM
REMARKS:
TEST DATE:
READINGS BY:
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
5
AIR HANDLING UNIT TEST REPORT
(Packaged/Unitary Direct Drive)
PROJECT SYSTEM/UNIT
LOCATION DATE
UNIT DATA MOTOR DATA DESIGN ACTUAL
Unit Designation HP (Kw)
Manufacturer RPM
Model Number Rated Volts
Serial Number Rated Amps
r Phase
Operating Hz
Service Factor
Operating Volts
Operating Amps
Fan RPM
REMARKS:
TEST DATE:
READINGS BY:
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
6
FAN TEST REPORT
(Belt Drive)
PROJECT __________________________________________________________________
Motor HP (Kw)
Motor RPM
Motor Rated Volts
Motor Rated Amps
Motor Phase
Motor Operating Hz
Motor Service Factor
Motor Sheave OD
Motor Sheave Bore
Fan Sheave OD
Fan Sheave Bore
Sheave Center Distance
Number of Belts
Belt Size
Fan RPM
Operating Voltage
Operating Amps T1/T2/T3
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
7
FAN TEST REPORT
(Direct Drive) >1/8 hp
PROJECT __________________________________________________________________
Motor RPM
Motor Rated Volts
Motor Rated Amps
Motor Phase
Motor Operating Hz
Motor Service Factor
Operating Voltages
Operating Amperages
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
8
FAN TEST REPORT
(Direct Drive) < 1/6 hp
PROJECT __________________________________________________________________
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
9
AIR OUTLET TEST REPORT
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
10
VAV TERMINAL UNIT TEST REPORT
(Pressure Dependent)
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
11
VAV TERMINAL UNIT TEST REPORT
(Pressure Independent)
REMARKS:
TEST DATE _________________________ READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
12
FAN TERMINAL UNIT TEST REPORT
(Pressure Dependent)
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
13
FAN TERMINAL UNIT TEST REPORT
(Pressure Independent)
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
14
DUCT TRAVERSE TEST REPORT
(Rectangular)
POSITION 1 2 3 4 5 6 7 8 9 10 11 12 13
1
2
3
4
5
6
7
8
9
10
11
12
13
VELOCITY
SUBTOTALS
.
REMARKS:
READINGS BY ________________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
15
DUCT TRAVERSE TEST REPORT
(Round)
REMARKS:
TEST DATE _________ READINGS BY _______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
16
HYDRONIC PUMP TEST REPORT
PROJECT _________________________________________________________________________
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
17
BALANCING VALVE TEST REPORT
(Fixed or Adjustable Orifice)
PROJECT
Unit Service Manufacturer Model Size Design Flow Valve P Final Flow
Designation Number GPM Setting/ GPM
(L/s) Position (L/s)
REMARKS:
READINGS BY ________________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
18
BALANCING VALVE TEST REPORT
(Self Adjusting)
PROJECT
REMARKS:
READINGS BY ________________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
19
ULTRASONIC FLOW
MEASUREMENT TEST DATA
PROJECT
ACTUAL
Pipe Size
Pipe Material
Pipe Wall Thickness
Transducer Size
Spacing Distance
Application
REMARKS:
READINGS BY ________________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
20
COOLING COIL TEST DATA
(Hydronic)
PROJECT _________________________________________________________________________
Coil System Coil Design Air Design Water Actual Airflow Actual Water
Designation Served Location Flow Flow GPM (L/s) CFM (L/s) Flow GPM (L/s)
CFM (L/s)
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
21
COOLING COIL TEST DATA
(DX)
PROJECT _________________________________________________________________________
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
22
HEATING COIL TEST DATA
(Hydronic)
PROJECT _________________________________________________________________________
Coil System Coil Design Air Flow Design Water Actual Airflow Actual Water
Designation Served Location CFM (L/s) Flow GPM (L/s) CFM (L/s) Flow GPM (L/s)
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
23
HEATING COIL TEST DATA
(Steam)
PROJECT ________________________________________________________________
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
24
HEATING COIL TEST DATA
(Electric)
PROJECT _________________________________________________________________________
Coil System Coil Design Design Design Phase Actual Actual Actual
Designation Served Location Airflow Kw Voltage Airflow Voltage Amperage
CFM (L/s) CFM (L/s)
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
25
CHILLER TEST REPORT
(Water Cooled)
PROJECT
REMARKS:
TEST DATE:
READINGS BY:
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
26
CHILLER TEST REPORT
(Air Cooled)
PROJECT
REMARKS:
TEST DATE:
READINGS BY:
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
27
COOLING TOWER TEST REPORT
PROJECT _________________________________________________________________________
Unit Manufacturer Model No. Serial No. Design Water Actual Water
Designation Flow GPM (L/s) Flow GPM (L/s)
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
28
HOT WATER BOILER TEST REPORT
PROJECT _________________________________________________________________________
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
29
HEAT EXCHANGER TEST REPORT
(Water to Water)
PROJECT ___________________________
SECONDARY WATER
Water Flow GPM (L/s)
Water Pressure Drop
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
30
HEAT EXCHANGER TEST REPORT
(Steam to Water)
PROJECT _________________________________________________________________
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
31
ENERGY RECOVERY WHEELS TEST DATA
PROJECT ___________________________________________________________________
DESIGN DATA
Unit System Designation
Service
Location
Manufacturer
Model Number
Serial Number
ACTUAL DATA
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
32
DUCT AIR LEAKAGE TEST DATA
(Optional)
PROJECT ______________________________________________________________________
System Designation
Type of Service
Location
Zone
Altitude
Density
Leakage Class
Design Static Pressure
Pressure Class
Seal Class
Surface Area
Airflow per Surface Factor
Percent Allowable Leakage
ACTUAL DATA
Actual Static Pressure
Test Section Air Leakage
Test Section % Air Leakage
Test Witness
REMARKS:
READINGS BY ______________________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
33