AIR CONDITIONING SYSTEM JOBSITE INFORMATION SHEET

Inside Temp. Leaving WB. Indoor Coil Inside Temp. Entering WB. AIR CONDITIONING JOBSITE INFORMATION SHEET 1. Circle Metering device used. 2. Circle Yes or No at drier locations.

ACJSIS fillable
Name Address City Contact
Name Address City Contact
Name

AIR CONDITIONING SYSTEM JOBSITE INFORMATION SHEET

OWNER

Requestor

Date Requested

State

Zip Code

Phone

SERVICING CONTRACTOR

Model #

OUTDOOR UNIT

EQUIPMENT DATA
Model #

EVAPORATOR

Serial #

Serial #

Date Installed

Date Installed

Model #

AIR HANDLER

Model #

FURNACE

State

Zip Code Phone

Serial # Date Installed

Serial # Date Installed

DISTRIBUTOR

Problem Summary

Address City

State

Zip Code

Corrective Actions Taken

Contact

Phone

Application

Residential

Commercial

Additional Information

ACCESSORIES? (Check those installed):

Low Ambient kit

Filter-Drier

Compressor Time Delay

Compressor Sound Enclosure

Mild Weather Kit

Oil Separator

Crankcase Heater

High Pressure Cutout

Hard Start Kit

Low Pressure Cutout

Discharge Line Muffler Hot Water Recovery Hot Gas Bypass Pump Down Kit Accumulator

Other


Adobe LiveCycle Designer ES 8.2 Adobe LiveCycle Designer ES 8.2