SnuggPro DATA COLLECTION FORM

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1 SnuggPro DATA COLLECTION FORM Section 1: General Information Trade Ally: Trade Ally Telephone: Trade Ally Auditor Name: Auditor Telephone: Auditor Home Owner Name: Home Owner Telephone: Home Owner Billing Address: City: State: Zip Code (WI): Site Address: City: State: Zip Code (WI): Section 2: Building Model Year Built: Conditioned Area: Includes Basement? Avg. Wall Height: Overall House Length: Overall House Width: Heated Floors Above Grade: CO Detectors: Gr Main Upper # of Occupants: # of Bedrooms: Type of Home: Single Family Detached Single Family Attached Apartment 1-3 units Condo Mobile Shielding: Well Exposed rmal Floor Above Garage/ Cantilever Building Footprint Diagram (includes orientation): Section 3: Homeowner Concerns Concern 1: Concern 2: Electric Utility Provider: Account#: Gas Utility Provider: Account# Highest Monthly Summer Electric Bill: Lowest Monthly Electric Bill: Highest Monthly Heating Bill: Lowest Monthly Heating Bill: Oil/Propane Gallons in Past 12 Months: Oil/Propane Bill in Past 12 Months: Programmable Thermostat: Heating Home: Away: Cooling Home: Away: 1

2 Section 4: Heating & Cooling System 1 Type: Heating Cooling Both Primary Heat Energy Source: Elec Nat. Gas Other: Draft Type: Condensing Atmospheric Induced Gas Leak Detected? ppm/lel%: Combustion Safety tification Issued: Heating Equipment: Furnace Boiler Elec. Baseboard Heat Pump Cooling Equipment: Central AC Heat Pump Window Unit Whole House Fan Duct Location: Duct Leakage: Duct Insulation: Duct R-Value: System 1 Type: Heating Cooling Both Primary Heat Energy Source: Elec Nat. Gas Other: Draft Type: Condensing Atmospheric Induced Gas Leak Detected? ppm/lel%: Combustion Safety tification Issued: Heating Equipment: Furnace Boiler Elec. Baseboard Heat Pump Cooling Equipment: Central AC Heat Pump Window Unit Whole House Fan Duct Location: Duct Leakage: Duct Insulation: Duct R-Value: Existing Mechanical Ventilation: HRV/ERV Flow: CFM HVAC Return Fan Flow: CFM Continuous or Flow: CFM Intermittent Bath Fan Section 5: Appliances/Refrigerators/Bulbs/Doors Range Fuel Type: Dryer Fuel Type: Clothes Washer Type: Energy Star Washer? Dishwasher Installed? Energy Star Dishwasher? Refrigerator 1 Age: Size: Energy Star Frig? Lighting CFL s or LED s: 0% 1-25% 26-50% 51-75% 75-99% 100% Refrigerator 2 Age: Size: Energy Star Frig? Total # Light Bulbs: Door 1 Type: Door 2 Type: Section 6: Walls/Attics/Vaults Shared (multi-family only): Includes attic spaces over multiple condos/apartments Wall 1 Insulated? Well Poorly Wall 2 Insulated? Well Poorly Basement Front Wall: Back Wall: Right Wall: Left Wall: Attic Ext Siding: Ext Siding: Type of Basement: Conditioned = insulated or >50% insulated Unconditioned = t insulated or <50% insulated Attic 1 Insulation Depth: Attic 3 Insulation Depth: Vault 1 Insulation Depth: Exterior Exhaust Vents: Kitchen Dryer Bath Bath 2 Brick Metal/Vinyl Stucco Shingle Wood/Fiber/Cement Other: Brick Metal/Vinyl Stucco Shingle Wood/Fiber/Cement Other: Ext Wall Construction: Ext Wall Construction: Finished Partially Finished Unfinished Slab Attic 1 Insulation Type: Attic 2 Insulation Depth: Attic 2 Insulation Type: Attic/Vault % Attic 3 Insulation Type: Attic 4 Insulation Depth: Attic 4 Insulation Type: Vault 1 Insulation Type: Vault 2 Insulation Depth: Vault 2 Insulation Type: Roof Venting: Soffit Ridge Gable Pods Power Attic 1 Attic 2 Attic 3 Vault 1 Vault 2 Vault 3 Attic 4 Vault 4 Attic Access: Scuttle Drop Down Wall Panel Other: 2

3 Section 7: Foundation Foundation Type: % Basement % Crawl % Slab Above Grade Height: Foundation Wall Insulation: Basement Heating Model: Intentional Incidental Basement Cooling Model: Intentional Incidental - desired Intentional w/continuous circulation ne/undesired Incidental Insulation: Type: Area (ft 2) : Walls Wall Height Crawlspace: Wall Insulation: Spray Foam Rigid Foam Board Rim Joist ft 2 : Rim Joist Insulation: Spray Foam Rigid Foam Board Floor: Slab Soil Fiberglass Batt ne Fiberglass Batt ne Section 8: Windows Window Type 1: Single Single w/storm Window Frame Type 1: Wood Vinyl Metal Window Type 1: Double Triple Low-e Double Triple Low-e Window Area % of Wall 1 rth % South % East% West % (ft 2 ) Window Area % of Wall 2 rth % South % East% West % (ft 2 ) Overhang Depth 1 rth % South % East% West % (= width of the soffit/eve) Overhang Depth 2 rth % South % East% West % (= width of the soffit/eve) Section 9: Air Leakage Single Single w/storm Window Frame Type 2: Wood Vinyl Metal Skylight Area (ft 2) : Blower Door PRE-TEST: CFM Blower Door POST TEST: CFM ASHRAE Req. Ventilation Rate: CFM Fan Capacity: CFM Fan Run-time: (# of Min. Per Hour) Min Measured (CFM) Pre-Test: Bath 1: Bath 2: Bath 3: Bath 4: Other: Measured (CFM) Post-Test: Bath 1: Bath 2: Bath 3: Bath 4: Other: Section 10: Domestic Hot Water Equipment Primary Fuel: DHW Type: Built/ Age: Location: Nat. Gas Electricity Atmospheric Power Vented Indirect Tank Tank-less Other Temp Settings: Low ( ) Medium ( ) High ( ) Very High (150+) Swimming Pool: Pool Pump Type: Pool Pump Horsepower: Pool Pump Turnover: Existing Hot Tub: Size: Efficiency: tes: 3

4 Section 11: Combustion Safety Testing Exterior Reading Interior Reading Highest : ppm ppm CAZ Pressure Diagnostics Pre-Test Post -Test CAZ Location Baseline Pressure WRTO: Pa Pa Basement Worst Case Pressure WRTO: Pa Pa Attic Pressure Difference: Pa Pa Other Meets BPI Standards: Combustion Safety Tests (Fire smallest BTUh appliance first, then larger BTUh appliances, then combined) Appliance Pass Fail Pass Fail Pass Fail Pass Fail DHW Heating System 1 Heating System 2 Other: Time: (Seconds) Appliance #1 Oven Kitchen Other Commonly Vented Appliances (If any of the appliances fail the spillage test under WCD, re-test under natural conditions and record the results below. Re-test draft and CO) Pass Fail Pass Fail Pass Fail Pass Fail #2 tes: 2016 Focus on Energy MM

5 Snugg Pro DATA COLLECTION FORM Reference Material Combustion Safety Carbon Monoxide & Reference Action Levels (BPI-1200-S-201x Standard Practice for Basic Analysis of Buildings Annex D Action Levels for and Carbon Monoxide in Combustion Appliances (rmative) D.1 assessment and CO measurement results shall be based on the following criteria: CO measured at 5 minutes of main burner operation assessed at 2 minutes of main burner operation for warm vent assessed at 5 minutes of main burner operation for cold vent CO level at or below threshold in Section 7.9.5, Table 1 for the appliance being tested is ACCEPTABLE CO level exceeding threshold in Section 7.9.5, Table 1 for the appliance being tested is UNACCEPTABLE Table Air Free CO Thresholds for Fossil-Fuel Fired Combustion Appliances tes: Appliance Central Furnace (all categories) Boiler Floor Furnace Gravity Furnace Wall Furnace (BIV) Wall Furnace (Direct Vent) Vented Room Heater Unvented Room Heater Water Heater Oven/Broiler Clothes Dryer Refrigerator Gas Log (gas fireplace) Gas Log (installed in wood burning fireplace) Threshold Limit 225 ppm air free 25 ppm as measured 25 ppm as measured in vent in firebox 5

6 CAZ Worst Case Depressurization Worksheet (optional) Table D.1.A ACTION LEVELS FOR SPILLAGE IN COMBUSTION APPLIANCES The following actions shall be taken when spillage occurs under the specific circumstances detailed below. TEST RESULT Greatest CAZ depressurization occurs with the air handler on* Greatest CAZ depressurization occurs with door to CAZ closed, but is alleviated when door to CAZ is open* ACTION REQUIRED Conduct further analysis of the distribution system to determine if leaky ducts or other HVAC-induced imbalances are the cause of the spillage. If so, recommend distribution system repairs that will reduce or eliminate the CAZ depressurization. Recommend measures to improve air transfer between the CAZ and the core of the house The cause of spillage has been traced to excessive exhaust** independent of CAZ door position, air handler, or a problem with the flue Verify that sufficient combustion air is available per ANSI Z223.1/NFPA 54 for gas-fired appliances and NFPA 31 for oil-fired appliances or recommend verification by a qualified professional and/or Recommend further evaluation/service by a qualified professional to address the venting/combustion air issues *In the case where both spillage and excessive CO are present, in addition to the specific actions required above, recommend that the appliance be shut down until it can be serviced by a qualified professional. ** Refers to exhaust caused by mechanical ventilation and/or other means of exfiltration. When a recommendation to replace atmospherically-vented combustion equipment inside the pressure boundary is made, and when cost-effective, recommend replacement with direct-vented, or power-vented equipment (or non-combustion equipment, such as a heat pump), which is ENERGY STAR - labeled. Ranges and Ovens (continually monitor ambient CO levels during test) 1 Remove any items/foil in or on oven/range top. 2 Turn to bake at 500. Make sure self-cleaning features are not achieved. 3 Test oven in throat of oven exhaust, before dilution air. 4 Unacceptable CO Level -Advise the homeowner/occupant that the appliance should be serviced immediately by a qualified professional. Acceptable CO Level - Action Required Acceptable Appliance Periods Appliance Type Test Period (minutes) Warm Test Period (minutes) Water Heater, Gravity Furnace, Boiler Space Heater Forced Air Furnace Action Levels: 70 ppm or greater: Terminate the inspection, notify all building occupants to evacuate the building. tify emergency services. 36 ppm - 69 ppm: Advise homeowner that elevated levels were detected, windows and doors opened, turn off CO source immediately. 9 ppm - 35 ppm: Advise homeowner that CO has been detected and recommend all CO sources be checked and windows/doors opened. 6

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