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HEAT PUMP JOBSITE INFORMATION SHEET

SERVICING CONTRACTOR: DATE: _________________________


Name: _________________________________________________ Call Ticket number_____________________________
Street: _________________________________________________
City: ____________________________ Zip: _______________
State/Province: _______________________ Phone: ________________
Contact: _________________________________________________
DISTRIBUTOR:
Name: ___________________________________
State/Province: ______________________________
Street: ___________________________________
Phone: ___________________________________
City: _________________ Zip: ____________
Contact: ___________________________________
EQUIPMENT DATA:
OUTDOOR UNIT
Model#:______________________________ Serial #:_______________________________ Date Installed: _______________

EVAPORATOR
Model #: ______________________________ Serial #:_______________________________ Date Installed: _______________

AIR HANDLER
Model #: ______________________________ Serial #:_______________________________ Date Installed: _______________

FURNACE
Model #: ______________________________ Serial #:_______________________________ Date Installed:_______________

Type of Thermostat:______________________

PROBLEM SUMMARY:
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DISCRIPTION OF TROUBLESHOOTING TO THIS POINT:
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ACCESSORIES INSTALLED

Low Ambient Kit High Pressure Cutout


Compressor Time Delay Low Pressure Cutout
Mild Weather Kit Discharge Line Muffler
Crankcase Heater Hot Gas Bypass
Hard Start Kit Accumulator
Filter-Drier Fossil Fuel Kit: type: ________________________
Compressor Sound Blanket Other: __________________________
HEAT PUMP JOBSITE SHEET
1. Circle Metering device used. Formula For Super Heat Formula For Sub Cooling
REMEMBER: 2. Circle Yes or No at drier locations. Vapor Line Sat Temp.
3. Sat. Temp. is pressure converted to Temp. Temp.

Minus Minus Liquid


Sat Temp. Line Temp.
Circle One
Saturation Saturation
Temp. Temp.
Heat Mode Equals Equals
Super Heat Sub Cooling
Cool Mode
Inside Temp. Leaving
Low side PSIG High side PSIG
DB: __________

WB: __________

Liquid Line Temp. Liquid Line Temp.

Drier LIQ UID LINE


Yes or No
Metering Device Metering Device

TXV or Piston TXV or Pistion size


Piston size
Line Temp.

Circle one: Upflow - Downflow - Horizontal Outdoor Coil


Suction Line Temp. Outdoor Temp.

VAPOR LINE
Indoor Coil
DB:__________
WB: __________
Reversing Valve
ADDITIONAL TION
VOLTS:
1. Liquid Line Size: _________
________
2. Liquid Line Length Vertical/Horizontal: _________ Discharge Line Temp.
3. Vapor Line Size: _________ AMPS: .
NOTE: An outdoor
4. Vapor Line Length: Vertical/Horizontal: _________ C: ______ ambient tempera-
ture between 40F
5. Vertical Separation Below/Above: _________ S: ______ Accumulator and 50F for heat
mode and above
6. Air Handler CFM: ______Method Used for CFM: __________ 70F for cool mode
R: ______ is recommended for
7. Dipswitch Settings Cooling completion of
Compressor
this sheet.
8. Dipswich Setting Heating

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