Kentucky Housing Corporation Department of Design & Construction Review



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WX-900G

(REV. 08/09




Kentucky Housing Corporation

Department of Design & Construction Review

(Weatherization)

Natural Gas -Liquid Propane Heat System Evaluation:




Clients Name:




Job #:




Date:







Heating Unit Location

Model #

Unit Type

BTU Rating

Primary/Secondary




A.


























































B.


























































C.


































Repairs

1st. Post




Completed

Inspection

"ALL REPAIRS/REPLACEMENTS SHALL COMPLY WITH NFPA 54"

(Applies to any and all units)

Yes

No

Pass

Fail

General: Check interior CO level. Yes _____ PPM _____ No_____













Piping- Checking all piping for gas leaks, If yes, correct immediately. Yes _____ NO_____













Is approved piping materials used? Yes _____ No _____













Is an approved manual shut off valve present? Yes _____ No _____













Is an approved Sediment Trap in place? Yes _____ No _____













Is gas piping sized to provide adequate BTU capacity? Yes _____ No _____













Are any combustion appliances located in confined space? Yes _____ No _____

(NFPA 54 using 50 Cubic Feet per 1000 BTU/Hr aggregate input)















Is unit converted to proper fuel? Yes _____ No _____













VENTING - NFPA 54, Chapter 10













Is the appliance venting into a properly lined masonry chimney?













Is venting material that passes through unconditioned space type B?













Does the vent & connectors meet clearance requirements?













Is the vent/chimney termination correct?



















Repairs

1st. Post




Completed

Inspection

"ALL REPAIRS/REPLACEMENTS SHALL COMPLY WITH NFPA 54"

Yes

No

Pass

Fail

NATURAL GAS/LP UNITS (indicate unit by letter) Unit ____

Tune: Yes ____ No ____ Replace: Yes ____ No ____















CO in ports: Before: ____ , ____ ,____, ____ ppm After: ____ , ____ ,____, ____ ppm













Draft: Before: _______ w.c. in. After: _______ w.c. in.













Stack Temperature: Before: ______ ◦ F After: ______ ◦ F













Unit BTU Input rating: _____ k BTU'S Actual: _____ k BTU'S (clock meter)













SAFETY CONTROLS













Is unit wired correctly (dedicated circuits, breakers size & general wiring) Yes ____ No ____













Perform temperature rise test. Supply temp: ___ ◦ F Return Temp: ___ ◦ F Temp rise: ___◦ F













Temperature rise in accordance to manufacturers spec & established standard? Yes __ No __













SSE: Before _____ After: _____ O2: Before: _____ After: _____













NATURAL GAS/LP UNITS (indicate unit by letter) Unit ____

Tune: Yes ____ No ____ Replace: Yes ____ No ____















CO in ports: Before: ____ , ____ ,____, ____ ppm After: ____ , ____ ,____, ____ ppm













Draft: Before: _______ w.c. in. After: _______ w.c. in.













Stack Temperature: Before: ______ ◦ F After: ______ ◦ F













Unit BTU Input rating: _____ k BTU'S Actual: _____ k BTU'S (clock meter)













SAFETY CONTROLS













Is unit wired correctly (dedicated circuits, breakers size & general wiring) Yes ____ No ____













Perform temperature rise test. Supply temp: ___ ◦ F Return Temp: ___ ◦ F Temp rise: ___◦ F













Temperature rise in accordance to manufacturers spec & established standard? Yes __ No __













SSE: Before _____ After: _____ O2: Before: _____ After: _____













NATURAL GAS/LP UNITS (indicate unit by letter) Unit ____

Tune: Yes ____ No ____ Replace: Yes ____ No ____















CO in ports: Before: ____ , ____ ,____, ____ ppm After: ____ , ____ ,____, ____ ppm













Draft: Before: _______ w.c. in. After: _______ w.c. in.













Stack Temperature: Before: ______ ◦ F After: ______ ◦ F













Unit BTU Input rating: _____ k BTU'S Actual: _____ k BTU'S (clock meter)













SAFETY CONTROLS













Is unit wired correctly (dedicated circuits, breakers size & general wiring) Yes ____ No ____













Perform temperature rise test. Supply temp: ___ ◦ F Return Temp: ___ ◦ F Temp rise: ___◦ F













Temperature rise in accordance to manufacturers spec & established standard? Yes __ No __













SSE: Before _____ After: _____ O2: Before: _____ After: _____













GENERAL:













Is the thermostat located properly? Yes _____ No _____













Does the filter need replacing? Yes ____ No ____














COOKING EQUIPMENT

Cooking Equipment PPM: Burner ____ Burner ____ Burner ____ Burner ____ Oven ____














TECHNICIANS ONLY

Is the high limit control the correct type & functioning properly? Yes _____ No_____













Is the fan control operating correctly? Temp on: _____◦ F Temp off _____ ◦ F















Comments:



































































POST INSPECTION CERTIFICATION: I certify that this Work has been performed in compliance with all Energy Systems policies and testing standards of the Kentucky Weatherization Program Manual, and to the best of my knowledge all energy systems are functioning properly and Regular Weatherization measures can now be performed.











Post Inspector




Date



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