Tab Forms PDF

TABLE OF CONTENTS
TAB SAMPLE FORMS
Report Title ........................................................................................................... 1
Certification........................................................................................................... 2
Instrument Calibration Report............................................................................... 3
Air Handling Unit (Central Station)........................................................................ 4
Air Handling Unit (Packaged/Unitary Belt Drive)................................................... 5
Air Handling Unit (Packaged/Unitary Direct Drive) ............................................... 6
Fan Test Report (Belt Drive)................................................................................. 7
Fan Test Report (Direct Drive >1/8 hp)................................................................. 8
Fan Test Report (Direct Drive <1/6 hp)................................................................. 9
Air Outlet Test Report......................................................................................... 10
VAV Terminal Unit Test Report PD .................................................................... 11
VAV Terminal Unit Test Report PI ...................................................................... 12
Fan Terminal Unit Test Report PD ..................................................................... 13
Fan Terminal Unit Test Report PI ....................................................................... 14
Duct Traverse Report (Rectangular)................................................................... 15
Duct Traverse Report (Round) ........................................................................... 16
Hydronic Pump Test Report ............................................................................... 17
Balancing Valve Test Report (Fixed or Adjustable Orifice)................................. 18
Balancing Valve Test Report (Self Adjusting) ..................................................... 19
Ultrasonic Flow Measurement Test Data............................................................ 20

Cooling Coil Test Data (Hydronic) ...................................................................... 21
Cooling Coil Test Data (DX) ............................................................................... 22
Heating Coil Test Data (Hydronic) ...................................................................... 23
Heating Coil Test Data (Steam).......................................................................... 24
Heating Coil Test Data (Electric) ........................................................................ 25
Chiller Test Report (Water Cooled) .................................................................... 26
Chiller Test Report (Air Cooled).......................................................................... 27
Cooling Tower Test Report................................................................................. 28
Hot Water Boiler Test Report.............................................................................. 29
Heat Exchanger Test Report (Water to Water)................................................... 30
Heat Exchanger Test Report (Steam to Water) .................................................. 31
Energy Recovery Wheels Test Data................................................................... 32
Duct Air Leakage Test Data (Optional)............................................................... 33

CERTIFIED TEST, ADJUST, AND
BALANCE REPORT
DATE:_____________
PROJECT:
NAME ________________________________________________________________
ADDRESS______________________________________________________________
______________________________________________________________
DESIGN ENGINEER:
NAME ________________________________________________________________
HVAC CONTRACTOR:
NAME ________________________________________________________________
NEBB TAB FIRM:

NAME ________________________________________________________________
ADDRESS_____________________________________________________________
______________________________________________________________
TAB CERTIFICATION NUMBER: _______________
COPYRIGHT, NEBB 2005 National Environmental Balancing Bureau Page _____ of _____
1
CERTIFICATION
PROJECT____________________________________________________________________
THE DATA PRESENTED IN THIS REPORT IS A RECORD OF SYSTEM MEASUREMENTS AND

FINAL ADJUSTMENTS THAT HAVE BEEN OBTAINED IN ACCORDANCE WITH THE CURRENT
EDITION OF THE NEBB PROCEDURAL STANDARDS FOR TESTING, ADJUSTING, AND
BALANCING OF ENVIRONMENTAL SYSTEMS. ANY VARIANCES FROM DESIGN QUANTITIES,
WHICH EXCEED NEBB TOLERANCES, ARE NOTED IN THE TEST- ADJUST- BALANCE REPORT
PROJECT SUMMARY.
SUBMITTED & CERTIFIED BY:
NEBB CERTIFIED TAB FIRM NAME _____________________________________________
CERTIFICATION NO. ____________ CERTIFICATION EXPIRATION DATE___________
REPORT DATE __________________________
SEAL
NEBB QUALIFIED TAB SUPERVISOR NAME _____________________________________

NEBB QUALIFIED TAB SUPERVISOR SIGNATURE________________________________
2
INSTRUMENT CALIBRATION REPORT
PROJECT ____________________________________________________________________
INSTRUMENT MANUFACTURER MODEL SERIAL DATES OF USE INSTRUMENT

TYPE NUMBER NUMBER CALIBRATION
DATE
NEBB TAB FIRM
TAB SUPERVISOR
3
AIR HANDLING UNIT TEST REPORT
(Central Station)
PROJECT SYSTEM/UNIT
LOCATION DATE
UNIT DATA MOTOR DATA DESIGN ACTUAL
Unit Designation HP (Kw)
Manufacturer RPM
Model Number Rated Volts
Serial Number Rated Amps
Phase
Operating Hz
Service Factor
Operating Volts
Operating Amps
FAN DATA DESIGN ACTUAL

Supply Air CFM (L/s)
OTHER DATA DESIGN ACTUAL
Outside Air CFM (L/s)
Motor Sheave OD
Return Air CFM (L/s)
Motor Sheave Bore
Total Outlet Air CFM (L/s)
Fan Sheave OD
Fan Sheave Bore
Fan Discharge S.P. in.
(Pa)
Sheave Center Distance
Fan Suction S.P. in. (Pa)
Number of Belts
Fan Total S.P in. (Pa)
Belt Size
External S.P. in. (Pa)
Fan RPM
REMARKS:
TEST DATE:
READINGS BY:
4
(Packaged/Unitary Belt Drive)
PROJECT SYSTEM/UNIT
LOCATION DATE
Manufacturer RPM
Phase
Operating Hz
Service Factor
Operating Volts
Operating Amps

Outside Air CFM (L/s) OTHER DATA DESIGN ACTUAL
Return Air CFM (L/s) Motor Sheave OD
Motor Sheave Bore
Fan Sheave OD
External Discharge S.P. Fan Sheave Bore
in. (Pa)
External Suction S.P. in. Sheave Center Distance
(Pa) Number of Belts
External S.P. in. (Pa) Belt Size
Fan RPM
REMARKS:
TEST DATE:
READINGS BY:
5
(Packaged/Unitary Direct Drive)
PROJECT SYSTEM/UNIT
LOCATION DATE
Manufacturer RPM
r Phase
Operating Hz
Service Factor
Operating Volts
Operating Amps

Outside Air CFM (L/s) OTHER DATA DESIGN ACTUAL
Return Air CFM (L/s)
External Discharge S.P.

in. (Pa)
External Suction S.P. in.
(Pa)
Fan RPM
REMARKS:
TEST DATE:
READINGS BY:
6
FAN TEST REPORT
(Belt Drive)
PROJECT __________________________________________________________________
FAN DATA FAN NO. FAN NO. FAN NO.

Unit Designation
Type of Service
Manufacturer
Model Number
Serial Number
TEST DATA DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL
Total Airflow CFM (L/s)
Total Outlet Airflow CFM(L/s)
Fan Suction SP in. (Pa)
Fan Discharge SP in. (Pa)
Total SP or ESP in. (Pa)
Motor HP (Kw)
Motor RPM
Motor Rated Volts
Motor Rated Amps
Motor Phase
Motor Operating Hz
Motor Service Factor
Motor Sheave OD
Motor Sheave Bore
Fan Sheave OD
Fan Sheave Bore
Sheave Center Distance
Number of Belts
Belt Size
Fan RPM
Operating Voltage
Operating Amps T1/T2/T3
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
7
FAN TEST REPORT
(Direct Drive) >1/8 hp
PROJECT __________________________________________________________________

Unit Designation
Type of Service
Manufacturer
Model Number
Serial Number

Total Outlet Airflow CFM(L/s)
Fan Suction SP in. (Pa)

Fan Discharge SP in. (Pa)
Total SP or ESP in. (Pa)
Motor HP (Kw)
Motor RPM
Motor Rated Volts
Motor Rated Amps
Motor Phase
Motor Operating Hz
Motor Service Factor
Operating Voltages
Operating Amperages
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
8
FAN TEST REPORT
(Direct Drive) < 1/6 hp
PROJECT __________________________________________________________________

Unit Designation
Type of Service
Manufacturer
Model Number

REMARKS:
TEST DATE _________________________
READINGS BY ______________________
9
AIR OUTLET TEST REPORT
PROJECT ______________________________ SYSTEM DESIGNATION_____________

OUTLET MANUFACTURER __________________ TEST APPARATUS________________
AREA OUTLET DESIGN FINAL

SERVED NO TYPE SIZE AK* VEL FLOW VEL FLOW
* NOTE: If AK = 1.00, velocity information and measurements are not required.
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
10
VAV TERMINAL UNIT TEST REPORT
(Pressure Dependent)
PROJECT ______________________________ SYSTEM DESIGNATION_____________

OUTLET MANUFACTURER _________________ OUTLET TEST APPARATUS________
VAV TERMINAL DATA

NUMBER DESIGN ACTUAL
TYPE PRIMARY MAXIMUM AIRFLOW CFM (L/S)
SIZE PRIMARY MINIMUM AIRFLOW CFM (L/S)
HEATING AIRFLOW CFM (L/S)
VAV OUTLET DATA
VAV TERMINAL DATA

VAV OUTLET DATA
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
11
VAV TERMINAL UNIT TEST REPORT
(Pressure Independent)
PROJECT _______________________________ SYSTEM DESIGNATION____________

OUTLET MANUFACTURER ______________ OUTLET TEST APPARATUS__________
VAV TERMINAL DATA

DDC CF HEATING AIRFLOW CFM (L/S)
DDC MAX/MIN AIRFLOWS CFM (L/S) -------- /
VAV OUTLET DATA
VAV TERMINAL DATA

DDC CF HEATING AIRFLOW CFM (L/S)
DDC MAX/MIN AIRFLOWS CFM (L/S) -------- /
VAV OUTLET DATA
REMARKS:
TEST DATE _________________________ READINGS BY ______________________
12
FAN TERMINAL UNIT TEST REPORT
(Pressure Dependent)
PROJECT ___________________________________ SYSTEM DESIGNATION_______________

OUTLET MANUFACTURER ____________________ OUTLET TEST APPARATUS_____________
VAV TERMINAL DATA

FAN AIRFLOW CFM (L/S)
DDC CF FAN SPEED (Hi,med,low,variable,etc) --------
VAV OUTLET DATA
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
13
FAN TERMINAL UNIT TEST REPORT
(Pressure Independent)
PROJECT _________________________________________ SYSTEM DESIGNATION_______________

OUTLET MANUFACTURER ___________________________ OUTLET TEST APPARATUS____________
VAV TERMINAL DATA

FAN AIRFLOW CFM (L/S)
DDC ADDR FAN SPEED (Hi,med,low,variable,etc) --------
DDC CF DDC MAX/MIN AIRFLOWS CFM (L/S) -------- /
VAV OUTLET DATA
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
14
DUCT TRAVERSE TEST REPORT
(Rectangular)
PROJECT_______________________________ SYSTEM DESIGNATION____________________

LOCATION ______________________________ TRAVERSE DESIGNATION_________________
INSTRUMENTATION_______________________
DUCT DESIGN AIRFLOW ACTUAL AIRFLOW

Size I.D. ____________ SCFM (sL/s) _______________ SCFM (sL/s) _______________
Area ft (m)____________ CFM (L/s) _________________ FPM (m/s) _________________
S.P. in. w.g. (Pa)________ CFM (L/s) _________________
POSITION 1 2 3 4 5 6 7 8 9 10 11 12 13
1
2
3
4
5
6
7
8
9
10
11
12
13
VELOCITY
SUBTOTALS
.
REMARKS:
TEST DATE _________________________
READINGS BY ________________________
15
DUCT TRAVERSE TEST REPORT
(Round)
PROJECT_______________________________ SYSTEM DESIGNATION____________________

LOCATION ______________________________ TRAVERSE DESIGNATION_________________
INSTRUMENTATION_______________________
DUCT DESIGN AIRFLOW ACTUAL AIRFLOW
Size Diameter__________ SCFM (s/Ls) _______________ SCFM (s/Ls) _______________
Area ft (m)____________ CFM (L/s) _________________ FPM (m/s) _________________
S.P. in. w.g. (Pa)________ CFM (L/s) _________________
REMARKS:
TEST DATE _________ READINGS BY _______________________
16
HYDRONIC PUMP TEST REPORT
PROJECT _________________________________________________________________________
UNIT DATA UNIT NO. UNIT NO. UNIT NO.

Unit Designation
Type of Service
Manufacturer
Model Number
Design Flow GPM (L/s)
Design Head Ft (kPa)
Impeller Size Inches (mm)
Serial Number
Motor Manufacturer

Motor Hp (Kw)
Pump/Motor Speed RPM
No Flow Suction Pressure ft (kPa)

No Flow Discharge Pressure ft (kPa)
No Flow Differential Pressure ft (kPa)
Actual Impeller Size
Final Suction Pressure ft (kPa)
Final Discharge Pressure ft (kPa)
Total Dynamic Head ft (kPa)
Final Flow GPM (L/s)
Motor Rated Amperage

Final Operating Voltages
Final Operating Amperages T1/T2/T3
Final Operating HZ
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
17
BALANCING VALVE TEST REPORT
(Fixed or Adjustable Orifice)
PROJECT
Unit Service Manufacturer Model Size Design Flow Valve P Final Flow
Designation Number GPM Setting/ GPM
(L/s) Position (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ________________________
18
BALANCING VALVE TEST REPORT
(Self Adjusting)
PROJECT
Unit Service Manufacturer Model Size Design Operating P Final Flow

Designation No. Flow Pressure GPM (L/s)
GPM (L/s) Range
REMARKS:
TEST DATE _________________________
READINGS BY ________________________
19
ULTRASONIC FLOW
MEASUREMENT TEST DATA
PROJECT
Reading Reading Reading Reading Reading Reading Reading

No. ___ No. ___ No. ___ No. ___ No. ___ No. ___ No. ___
DESIGN
Reading Designation
Service
Location
Design Flow GPM (L/s)
ACTUAL
Pipe Size
Pipe Material
Pipe Wall Thickness
Transducer Size
Spacing Distance
Application
Final Flow GPM (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ________________________
20
COOLING COIL TEST DATA
(Hydronic)
PROJECT _________________________________________________________________________
Coil System Coil Design Air Design Water Actual Airflow Actual Water
Designation Served Location Flow Flow GPM (L/s) CFM (L/s) Flow GPM (L/s)
CFM (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
21
COOLING COIL TEST DATA
(DX)
PROJECT _________________________________________________________________________
Coil System Coil Design Airflow Final Actual

Designation Served Location CFM (L/s) Airflow
CFM (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
22
HEATING COIL TEST DATA
(Hydronic)
PROJECT _________________________________________________________________________
Coil System Coil Design Air Flow Design Water Actual Airflow Actual Water
Designation Served Location CFM (L/s) Flow GPM (L/s) CFM (L/s) Flow GPM (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
23
(Steam)
PROJECT ________________________________________________________________
Coil System Coil Design Air Flow Actual Airflow

Designation Served Location CFM (L/s) CFM (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
24
(Electric)
PROJECT _________________________________________________________________________
Coil System Coil Design Design Design Phase Actual Actual Actual
Designation Served Location Airflow Kw Voltage Airflow Voltage Amperage
CFM (L/s) CFM (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
25
CHILLER TEST REPORT
(Water Cooled)
PROJECT
UNIT DATA DESIGN ACTUAL UNIT DATA DESIGN ACTUAL

Unit Designation Unit Designation
Manufacturer Manufacturer
Model Number Model Number
Serial Number Serial Number
EVAPORATOR DATA DESIGN ACTUAL EVAPORATOR DATA DESIGN ACTUAL

Flow GPM (L/s) Flow GPM (L/s)
Pressure Drop Pressure Drop
CONDENSER DATA CONDENSER DATA



CONDENSER DATA CONDENSER DATA

REMARKS:
TEST DATE:
READINGS BY:
26
CHILLER TEST REPORT
(Air Cooled)
PROJECT




REMARKS:
TEST DATE:
READINGS BY:
27
COOLING TOWER TEST REPORT
PROJECT _________________________________________________________________________
Unit Manufacturer Model No. Serial No. Design Water Actual Water
Designation Flow GPM (L/s) Flow GPM (L/s)
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
28
HOT WATER BOILER TEST REPORT
PROJECT _________________________________________________________________________

Unit Designation
Manufacturer
Model Number
Serial Number
Water Flow GPM (L/s)

Water Pressure Drop
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
29
HEAT EXCHANGER TEST REPORT
(Water to Water)
PROJECT ___________________________

Unit Designation
Location
Service
Manufacturer
Model No.
Serial No.

PRIMARY WATER
Water Pressure Drop
SECONDARY WATER
Water Pressure Drop
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
30
HEAT EXCHANGER TEST REPORT
(Steam to Water)
PROJECT _________________________________________________________________

Unit Designation
Location
Service
Manufacturer
Model No.
Serial No.

Water Pressure Drop
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
31
ENERGY RECOVERY WHEELS TEST DATA
PROJECT ___________________________________________________________________
DESIGN DATA
Unit System Designation
Service
Location
Manufacturer
Model Number
Serial Number
Primary Air Flow CFM (L/s)

Primary Air P
Secondary Air Flow CFM (L/s)
Secondary Air P
ACTUAL DATA
Primary Air Flow CFM (L/s)

Primary Air P
Secondary Air Flow CFM (L/s)
Secondary Air P
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
32
DUCT AIR LEAKAGE TEST DATA
(Optional)
PROJECT ______________________________________________________________________
Section Section Section Section Section Section

DESIGN DATA No. No. No. No. No. No.
System Designation
Type of Service
Location
Zone
Altitude
Density
Leakage Class
Design Static Pressure
Pressure Class
Seal Class
Airflow CFM (L/s)
Surface Area
Airflow per Surface Factor
Percent Allowable Leakage
ACTUAL DATA
Actual Static Pressure
Test Section Air Leakage
Test Section % Air Leakage
Test Witness
REMARKS:
TEST DATE _________________________
READINGS BY ______________________
33

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TABLE OF CONTENTS

TAB SAMPLE FORMS

Report Title ........................................................................................................... 1

Instrument Calibration Report............................................................................... 3

Air Handling Unit (Central Station)........................................................................ 4

Air Handling Unit (Packaged/Unitary Belt Drive)................................................... 5

Air Handling Unit (Packaged/Unitary Direct Drive) ............................................... 6

Fan Test Report (Belt Drive)................................................................................. 7

Fan Test Report (Direct Drive >1/8 hp)................................................................. 8

Fan Test Report (Direct Drive <1/6 hp)................................................................. 9

Air Outlet Test Report......................................................................................... 10

VAV Terminal Unit Test Report PD .................................................................... 11

VAV Terminal Unit Test Report PI ...................................................................... 12

Fan Terminal Unit Test Report PD ..................................................................... 13

Fan Terminal Unit Test Report PI ....................................................................... 14

Duct Traverse Report (Rectangular)................................................................... 15

Duct Traverse Report (Round) ........................................................................... 16

Hydronic Pump Test Report ............................................................................... 17

Balancing Valve Test Report (Fixed or Adjustable Orifice)................................. 18

Balancing Valve Test Report (Self Adjusting) ..................................................... 19

Ultrasonic Flow Measurement Test Data............................................................ 20

Cooling Coil Test Data (DX) ............................................................................... 22

Heating Coil Test Data (Hydronic) ...................................................................... 23

Heating Coil Test Data (Steam).......................................................................... 24

Heating Coil Test Data (Electric) ........................................................................ 25

Chiller Test Report (Water Cooled) .................................................................... 26

Chiller Test Report (Air Cooled).......................................................................... 27

Cooling Tower Test Report................................................................................. 28

Hot Water Boiler Test Report.............................................................................. 29

Heat Exchanger Test Report (Water to Water)................................................... 30

Heat Exchanger Test Report (Steam to Water) .................................................. 31

Energy Recovery Wheels Test Data................................................................... 32

Duct Air Leakage Test Data (Optional)............................................................... 33

NEBB TAB FIRM:

TAB CERTIFICATION NUMBER: _______________

THE DATA PRESENTED IN THIS REPORT IS A RECORD OF SYSTEM MEASUREMENTS AND

SUBMITTED & CERTIFIED BY:

NEBB CERTIFIED TAB FIRM NAME _____________________________________________

CERTIFICATION NO. ____________ CERTIFICATION EXPIRATION DATE___________

REPORT DATE __________________________

NEBB QUALIFIED TAB SUPERVISOR NAME _____________________________________

INSTRUMENT MANUFACTURER MODEL SERIAL DATES OF USE INSTRUMENT

NEBB TAB FIRM

FAN DATA DESIGN ACTUAL

FAN DATA DESIGN ACTUAL

FAN DATA DESIGN ACTUAL

Total Outlet Air CFM (L/s)

External Discharge S.P.

FAN DATA FAN NO. FAN NO. FAN NO.

FAN DATA FAN NO. FAN NO. FAN NO.

TEST DATA DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL

Fan Suction SP in. (Pa)

TEST DATE _________________________

FAN DATA FAN NO. FAN NO. FAN NO.

TEST DATA DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL

TEST DATE _________________________

PROJECT ______________________________ SYSTEM DESIGNATION_____________

AREA OUTLET DESIGN FINAL

* NOTE: If AK = 1.00, velocity information and measurements are not required.

TEST DATE _________________________

PROJECT ______________________________ SYSTEM DESIGNATION_____________

VAV TERMINAL DATA

VAV TERMINAL DATA

CERTIFICATION NO. __ CERTIFICATION EXPIRATION DATE_

PROJECT __________________ SYSTEM DESIGNATION_

PROJECT __________________ SYSTEM DESIGNATION_

PROJECT ___________________ SYSTEM DESIGNATION

PROJECT _____________________ SYSTEM DESIGNATION_

PROJECT ___________________________ SYSTEM DESIGNATION_

PROJECT___________ SYSTEM DESIGNATION

PROJECT___________ SYSTEM DESIGNATION