SYSTEM REPLACEMENT
HVAC Field Assessment
1. Customer Information
Customer Name
Date
Address
Technician
2. System Information
System Tonnage
Select...
2 Tons
2.5 Tons
3 Tons
3.5 Tons
4 Tons
5 Tons
Fuel Type
Select...
Gas
Electric
Other
Other Fuel Type
Heat Kit Size
Select...
7.5 kW
10 kW
15 kW
Gas Furnace Efficiency
Select...
80%
98%
System Position
Select...
Horizontal
Vertical
Closet
Other
Other Position
System Type
Select...
Single Stage
Two Stage
Heat Pump
Communicating
Zone System
Select...
Yes
No
Ductwork Type
Select...
Flex Duct
Hard Pipe Duct
Equipment Brand
Select...
Trane
Trane Communicating
Carrier
Infinity
Amana
Goodman
Lennox
Lennox Communicating
Specify Type
Return Plenum Replacement
Select...
Yes
No
Supply Plenum Replacement
Select...
Yes
No
Media Filter Cabinet
Select...
Yes
No
Thermostat Replacement
Select...
Yes
No
Thermostat Type (Specify)
3. Access Dimensions
Attic Access Dimensions
Closet Access Dimensions
Condenser Access Dimensions
4. Outdoor Unit
System Tonnage
Select...
2 Tons
2.5 Tons
3 Tons
3.5 Tons
4 Tons
5 Tons
Equipment Brand
Select...
Trane
Trane Communicating
Carrier
Infinity
Amana
Goodman
Lennox
Lennox Communicating
Specify Type
Copper Line Routing
Select...
Inside Wall
Outside Wall
Condenser Pad
Select...
Yes
No
Whip
Select...
Yes
No
Disconnect
Select...
Yes
No
5. Line Set (Copper)
Suction Line
Select...
3/4"
7/8"
1 1/8"
Liquid Line
Select...
1/4"
3/8"
1/2"
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Report recipients: benitezirael@gmail.com, israel@rossair.com