Project Name: | ||||
Project Information | Project Address: | |||
Certified Commissioning Professional: | ||||
Certifying Body: | ||||
Commissioning Plan (Section 408.1.2) | □ | Commissioning Plan was used during construction | ||
Commissioned Systems | □ | Mechanical Systems were included in the Commissioning Process (Section C408.2) | ||
(Section C408.2, C408.3, C408.4 and C408.6) | Building mechanical systems have been tested to demonstrate the installation and operation of components, systems and system-to-system interfacing relationships in accordance with approved plans and specifications | |||
□ | There are unresolved deficiencies with the mechanical systems. These are described in the Preliminary Commissioning Report submitted to the owner. The following items are not in compliance with the energy code: | |||
□ | Electrical Power or Lighting Systems were included in the Commissioning Process (Section C408.4) | |||
Electrical power and automatic lighting controls have been tested to demonstrate the installation and operation of components, systems and system-to-system interfacing relationships in accordance with approved plans and specifications | ||||
□ | There are unresolved deficiencies with the electrical power and/or automatic lighting controls. These are described in the Preliminary Commissioning Report submitted to the owner. The following items are not in compliance with the energy code: | |||
□ | Service Water Heating Systems were included in the Commissioning Process (Section C408.5) | |||
Service water heating systems have been tested to demonstrate that control devices, components, equipment and systems are calibrated, adjusted and operate in accordance with approved plans and specifications | ||||
□ | There are unresolved deficiencies with the service water heating systems. These are described in the Preliminary Commissioning Report submitted to the owner. The following items are not in compliance with the energy code: | |||
□ | Additional Systems included in the Commissioning Process (Section C408.5) | |||
□ | There are unresolved deficiencies with systems required by Section C406 or Section C407. These are described in the Preliminary Commissioning Report submitted to the owner. The following items are not in compliance with the energy code: | |||
□ | Metering Systems were included in the Commissioning Process (Section C408.6) | |||
Energy source meters, energy end-use meters, the energy metering data acquisition system and required display are calibrated, adjusted and operate to minimally meet code requirements | ||||
□ | There are unresolved deficiencies with the metering system. These are described in the Preliminary Commissioning Report submitted to the owner. The following items are not in compliance with the energy code: | |||
Supporting Documents | □ | Manuals, record documents and training have been completed or are scheduled | ||
(Section C103.6) | • | System documentation has been provided to the owner or scheduled date: | ||
• | Record documents have been submitted to owner or scheduled date: | |||
• | Training has been completed or scheduled date: | |||
Preliminary Commissioning Report | □ | Preliminary Commissioning Report submitted to owner and includes items below | ||
(Section C408.1.4.1) | □ | Itemization of deficiencies found during testing that are part of the energy code and that have not been corrected at the time of report preparation | ||
□ | Deferred tests, which cannot be performed at the time of report preparation, with anticipated date of completion | |||
□ | Status of the project's record documents, manuals and systems operation training with respect to requirements in Section C103.6 | |||
Certification | □ | I hereby certify that all requirements for Commissioning have been completed in accordance with the Washington State Energy Code, including all items above | ||
Building Owner or Owner's Authorized Agent | Date | |||
Project Name: | ||||
Project Information | Project Address: | |||
Certified Commissioning Professional: | ||||
Type of ISO Certification and Number: | ||||
Supporting Documents | □ | Manuals, record documents and training have been completed or are scheduled (Section C103.6) | ||
• | Building operations and maintenance information (C103.6.2) have been submitted to the owner or scheduled date: | |||
• | Manuals (C103.6.2.1) have been submitted to the owner or scheduled date: | |||
• | Compliance documentation (C103.6.3) has been provided to the owner or scheduled date: | |||
• | System operation training (C103.6.4) has been provided to the owner or scheduled date: | |||
Commissioning Plan | □ | Commissioning Plan was used during construction (Section C408.1.2) | ||
Commissioning Report | □ | Commissioning Report has been submitted (Section C408.1.3) | ||
Commissioned Systems | □ | Mechanical Systems were included in the commissioning process (Section C408.2) | ||
□ | Testing, adjusting and balancing is complete (Section C408.2.2). | |||
□ | There are unresolved deficiencies with the mechanical systems. These are described in the attached Commissioning Report submitted to the owner. | |||
□ | Service Water Heating Systems were included in the commissioning process (Section C408.3) | |||
□ | There are unresolved deficiencies with the service water heating systems. These are described in the attached Commissioning Report submitted to the owner. | |||
□ | Controlled receptacles and lighting control systems were included in the commissioning process (Section C408.4) | |||
□ | There are unresolved deficiencies with the electrical power and/or automatic lighting controls. These are described in the attached Commissioning Report submitted to the owner. | |||
□ | Additional Systems included in the commissioning process (Section C408.5) | |||
□ | There are unresolved deficiencies with systems required by Section C406 or Section C407. These are described in the attached Commissioning Report submitted to the owner. | |||
□ | Metering Systems were included in the commissioning process (Section C408.6) | |||
□ | There are unresolved deficiencies with the metering system. These are described in the attached Commissioning Report submitted to the owner. | |||
□ | Refrigeration Systems were included in the commissioning process (Section C408.7) | |||
□ | There are unresolved deficiencies with the systems required by Section C410. These are described in the attached Commissioning Report submitted to the owner. | |||
Certification | □ | I hereby certify that all requirements for Section C408 System Commissioning have been completed in accordance with the Washington State Energy Code, including all items above. | ||
Certified Commissioning Professional | Date | |||
□ | I hereby certify that all requirements for Section C408 System Commissioning have been completed in accordance with the Washington State Energy Code, including all items above. | |||
Building Owner or Owner's Authorized Agent | Date | |||