PM Eval

EVALUATION FORM

Use this for PM Evaluation

Company
Date
MM slash DD slash YYYY
Time

: Hours
Minutes
AM/PM
Contact Person*
First Last
Authorizing Person (Owner, Manager, Supervisor)
Address*
Site Identification (state where the unit is located) Address City State ZIP Code
Email
Accessibility*
Steps required to physcially work on unit.
Location of AH (Inside) Unit
Location of Condenser (Outside) Unit
Distance Between Units*
Measured Amount of feet and inches between Inside and Outside Unit
Constraints
Roof Penetration
Electrical Clearance
Voltage*
Air Handler
Voltage
Condenser
Equipment
Equipment and Tool Rental anticipated to complete installation
Load Density
Measurements to creat Heat Load Calculation
Hours Required for service*

Parts List*

Make	Model	Serial	Filter Size & Qty	Belt Size & Qty	Compressor Qty	Location of Unit	Dist. of Inside & Out

Compressor Model / Serial Number*
Compressor Model / Serial Number*
Special Consideration
Anything not listed on form but pertinent to job
File Upload
Max. file size: 256 MB.
Picture, Drawings, anything pertinent to be reiviewed
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Name
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