Weatherization Manual Policies and Procedures Supporting Documents for United States Department of Energy (doe) United States Department of Health and Human Services (hhs) Bonneville Power Administration



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Weatherization Deferral Form


Project Number Audit Date

Client Name

Address

City & Zip Code

Home or Message phone Work Phone

Deferral of weatherization work on the above home is based on the following conditions:

Recommended measures for remedying the existing conditions are as follows:

I certify that the above information is complete and accurate.

Signature of Agency Representative Date



Client Information: I understand weatherization work has been deferred on my home for the above reasons. I understand the conditions under which weatherization work may continue. I understand I must contact the weatherization agency within 12 months of original application date if conditions have changed and that these changes may allow work to resume. I understand if I contact the weatherization agency more than 12 months after the original application date I need to reapply for weatherization services.

Client Signature Date

MOLD Assessment and Release Form


Client Label

Mold can be a problem in any home where there is an excessive amount of moisture or humidity present. An assessment of your home included a visual check for mold. This is not a mold inspection and the person making this assessment is not a certified mold inspector. Mold testing and identification of specific molds is beyond the scope of this program.


During the weatherization assessment of your dwelling on _____________date, our project coordinator visually inspected the following rooms in your home:
Living room mold not visibly present mold visibly present

Kitchen mold not visibly present mold visibly present

Bathroom(s) mold not visibly present mold visibly present

Bedroom(s) mold not visibly present mold visibly present

Water heater closet mold not visibly present mold visibly present

Attic mold not visibly present mold visibly present

Crawlspace/Basement mold not visibly present mold visibly present

Other location


Estimate in total square feet of existing mold
The U.S. Department of Energy generally does not allow Weatherization agencies to mitigate mold problems, however, some actions associated with a cost effective energy saving measure may be taken to reduce moisture problems. Local Agency plans to install the following measures that may help resolve existing moisture problems. The work proposed should not promote new mold growth.
1.
2.
3.
Mold/Moisture disclaimer: By signing below, I acknowledge I have received information concerning moisture and mold conditions in my home prior to Weatherization work being done and I will take steps to reduce excessive moisture.
Name of Applicant:

Signature of Applicant Date


Name of Landlord:

Signature of Local Agency Staff Date


White copy–agency file, yellow copy–applicant, pink copy-landlord



Link to Active Form: Exhibit 5.S3A, Diagnostic Test Report


Diagnostic Test Report Quick Reference



Pressure Pan Tests

In typical mobile home duct configurations, pre pressure pan tests help locate areas of significant leakage or disconnected duct work. After belly is filled with insulation, post pressure pan tests results may not be useful.

In site built homes with supply and return duct systems enclosed entirely within the thermal and pressure boundaries, pressure pan tests are not required.

Dominant Duct Leak Test

In typical mobile home duct configurations, dominant duct leak tests are especially useful. You can quantify the amount of duct leakage by using the Air Leakage Chart (aka Tooley Chart) if the return is isolated in the conditioned space and the supplies are isolated in the belly. No more than 100CFM of total supply duct leakage is recommended.



In site built homes with supply and return duct systems enclosed entirely within the thermal and pressure boundaries, dominant duct leak tests are not required.

Air Leakage Chart



Variance #17: DOE granted a variance from SWS Section 5.3003.3 Evaluating Air Flow allowing: WA Standard which requires a client interview, confirmation of flow at each register, measurement of heat rise, pressure pan, and room pressures. Unless duct systems are missing or destroyed and require repair or replace, WA will air seal but not resize ducts.

Variance #18: DOE granted a variance from SWS Section 6.6201.1a.b Kitchen Fan Airflow Testing allowing: WA allows kitchen fan air flows to be estimated using the air leakage chart, the measured blower door reading and the negative pressure reading from a manometer set to main body WRT to house, in Pascals with the kitchen fan on. See Air leakage chart

Variance #19: DOE granted a variance from SWS Section 6.6201.2a Room Pressure Testing allowing: WA Standard which for existing systems requires mitigation of excess room pressures when they cause combustion appliances to exceed CAZ depressurization limits and when room pressure imbalance exceeds 5pa. For new systems installed, WA must conform to the stricter 3pa limit.
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