HVAC System Energy Efficiency Inspection Form
General Information
Date of Inspection
Inspector Name
Location/Address
Contact Details
System Information
HVAC System Type
Equipment Model/Serial No.
Installation Date
Rated Efficiency (SEER/EER)
Inspection Checklist
Thermostat Operation
Pass
Fail
N/A
Air Filter Condition
Clean
Dirty
N/A
Ductwork Integrity & Insulation
Good
Poor
N/A
Refrigerant Level
OK
Low
High
N/A
Blower Components
Good
Needs Service
N/A
Condenser/Evaporator Coils
Clean
Dirty
N/A
Electrical Connections
Good
Poor
N/A
Measurements & Readings
Supply Air Temperature (°C)
Return Air Temperature (°C)
Differential Pressure (Pa)
Amp Draw (A)
Voltage (V)
Summary & Recommendations
Overall System Condition
Excellent
Good
Fair
Poor
Comments / Recommendations