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ATTACHMENT B

Client name:

Address:

Energy Auditor: Date:

Final Inspector: Date:

Date:

Comments:

Comments:

2.4.1

2.4.1

Interim Final Monitor

All signatures present: ⃝ ⃝

Y NY

⃝ x

N

2.1.2

Y

glossary

Material-labor accounting accurate: ⃝ ⃝

Documentation supports proper work flow: ⃝

⃝ x ⃝

⃝ x ⃝ x ⃝

Visual/ Sensory Inspection

x ⃝

Date of

report

x ⃝

All required documentation properly completed: ⃝ ⃝

N

2.5.2

Agency: Date home was built:

Final Monitor

Y N

Job Number:

Manufactured

Multi-Family

Y

Single Family

Interim

Y

Field Monitor:

N

Detail

Quality Control Inspection Report

2.8

Client Interview

⃝⃝ ⃝ ⃝

⃝ ⃝ ⃝

Adequate client education performed:

N

2.8

2.5.2⃝ ⃝

⃝ ⃝ ⃝

x

x

Detail

Client understands maintenance/warranty procedures:

Client expressed satisfaction with the work & workers:

⃝⃝⃝⃝⃝

x

Documentation Review

x

Documentation of all worker credentials:

Comments:

Detail

Comments:

⃝ ⃝ ⃝

x

x⃝

⃝ x

xHave all health and safety issues been addressed:

Measured CFM:

⃝⃝ glossary

9.2⃝

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12.3.3

12.3.3

12.3.3

12.3.3

Other (describe):

Y N

Are all completed incidental repairs appropriate:

12.3.3

Pressure difference to attached porch attic area

12.3.3

Detail

1.8.1

⃝ x

13.7

Audit Final Monitor

N Y N Y

Pressure difference to attic 1

x ⃝

Pressure difference to attic 2

Pressure difference to crawl or basement

Pressure difference to attached garage

N

N

Is the unit ASHRAE 62.2 compliant: x ⃝ x ⃝

Y N Y

Interim Final

Health and Safety/Incidental RepairsMonitor

Interim Final Monitor

All debris and trash removed from the jobsite:

No indication of lead dust. LSW pictures in client file:

Detail

Y

2.3.1

⃝ ⃝ x ⃝ x ⃝

1.6.3

Pressure Diagnostics

Blower Door CFM50 12.2.3

Audit Final

8.13.3

Living room

Audit

Living room

Bathroom

8.14.1

Return 2

Return 4

8.13.3

Detail

Bedroom Pressure Balancing

Bedroom 1

8.14.1

Bedroom 1

Final

8.14.1

Bedroom 4

Bath 1

Bath 2 8.14.1

Other

Return 1

Return 3

8.14.1

8.14.1

8.14.1

8.14.1

8.13.3

Bedroom 3

8.14.1

Monitor

8.14.1

8.14.1

Pressure Pan Readings

8.14.1

8.14.1

8.14.1

8.14.1

Dining room

Kitchen

8.13.3

Monitor Detail

8.13.3

Bedroom 2

Bedroom 2

Bedroom 4

Bedroom 3

Thermal Boundary-Attic

Y N

8.13.3

Audit Monitor

Detail

⃝ ⃝

4.2/11.2.

1⃝ ⃝ ⃝

⃝ ⃝⃝⃝ ⃝ ⃝

⃝ ⃝

N

10.3

Audit Final Monitor

⃝5.3.1/11.2.

2

Final

N

⃝ ⃝ ⃝ ⃝

⃝ ⃝ ⃝ ⃝ ⃝

N

2.5.2

Y N

Were wall cavities accessed to verify insulation: ⃝ ⃝ ⃝ ⃝

Y

Field Guide

⃝ ⃝ ⃝

Y

Is the attic properly insulated:

Y

Main Body PD

Main Body

Comments:

⃝ ⃝

Audit Final

Was infrared camera used to verify insulation:

4.1.1

2.5.2

Thermal Boundary-Above Grade Walls

Y N

5.3.1/11.2.

2

Detail

Has attic access been properly air sealed & insulated:

Monitor

⃝ ⃝ ⃝ ⃝

⃝ ⃝

4.2.1

Has all air sealing and attic prep been completed: 4.1

Clearance to combustibles requirements have been met: ⃝ ⃝ ⃝

Attic R-value

⃝ ⃝

The Certificate of Insulation includes accurate bag count:

4.2/11.2.

1

⃝ ⃝

8.16Are ducts in the attic insulated to the minimum of R8:

If NO, were the sidewalls dense packed:

Comments:

Are the sidewall insulated:

Inspection 1 Date:

Inspection 2 Date:

IHCDA Inspection Date:

⃝ ⃝ Inspected by QCI:

⃝ ⃝ Inspected by QCI:

Pass FailInspected by QCI:

⃝⃝Water heater system retrofit was appropriate:10.6.1/2/3

/4⃝x

Final Inspection/Client/Monitoring Response

⃝x

Is the rim joist insulated:

Thermal Boundary-Basement/Crawlspace

2.5.2

Y

Is the siding free of workmanship issues:

⃝ ⃝

N Y

Final

⃝ ⃝

Y N

The certificate of insulation includes accurate bag count:

⃝ ⃝

⃝ ⃝

5.3.2⃝

Monitor

Comments:

⃝ ⃝ ⃝ ⃝

6.3.1⃝

⃝ ⃝

Monitor Detail

6.3.4

5.3.2

⃝ ⃝

⃝⃝

⃝ 6.3.2

1.5.3

Base Load Measures

Audit

x ⃝

Detail

Y

Audit Final

Is lighting retrofit adequate & strategic ⃝ ⃝ x ⃝

Y N Y N N

⃝ ⃝

Has proper air sealing been completed: ⃝ ⃝⃝

Inspector verified complete coverage: ⃝ ⃝ ⃝

⃝⃝

Is crawlspace ceiling insulated:

Does crawl space have vapor barrier properly installed:

N

10.3

Is foundation wall insulated: ⃝ ⃝ ⃝ ⃝ ⃝ ⃝

6.3.1

Comments:

Client verifies satisfaction with the work performed

Client signature:

1 Y N

2 Y N

3 Y N

4 Y N

5 Y N

6 Y N

Total Amps of elements Any signs of burnt wires Y N

Voltage applied

watts

times 3.413

Supply temperature

Return temperature

Temperature rise

times 1.08 = total CFM

Section 1:

A.     Findings:

        There is nothing notated in this section. 1)

B.     Concerns:

        There is nothing notated in this section. 1)

A. Findings:

        There is an L.P gas leak on the L.P. tank. IHCDA was informed the L.P. supplier would be contacted. Please forward IHCDA the resolution of this leak. 1)

B. Concerns:

        There were several areas in the front attic where the old fiberglass insulation was not properly aligned. During the monitoring visit several areas of this insulation was re-aligned by IHCDA’s monitor. Area IV must discuss with their shell contractors the importance of existing insulation being properly aligned prior to being insulated over. 1)

Mechanical Inspection

Section 2: Shell Inspection

Rework Punch List Items

Y N

Date:

furnace, Model # - Serial # - water heater

Tamara Drew Mechanical inspection

Technical Monitoring Report

Comments and General Remarks

Sincerely,

IHCDA requests _____ respond to this report no later than Date ________. Each finding requires

documentation showing all findings have been alleviated. Each concern requires a written response.

Comments and General Observations require no response.

I want to thank you for your cooperation and courtesies extended to me during this visit. If you have

any questions regarding this report please contact Andy Hoff via email at anhoff@ihcda.in.gov.

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