Print Form Submit by Email Replacement Unit Checklist (One RTU or Split System per form) Store Name Store Number Address: City State Unit No: Mfg: Model: Serial: Unit No *: Mfg: Model: Serial: * AHU Data (if split system) Application: Other Down Discharge RTU Gas/Electric Side Discharge Electric/Electric Split System Air Flow (CFM) Wire Size Heat Pump Circuit Ampacity Tonnage AHU Voltage Blower HP Cooling Only Unit Voltage Damper Type: Heating Data: Manual Modulating LP Gas Natural Gas DDC Controls: Smoke Detectors: Mechanical T'Stat Novar Electronic T'Stat Remote Sensor Johnson Controls Central Alarm Panel Self Standing Yes Standard Curb Pneumatic Controls Honeywell Controls Locking Cover Other Annunciator Required Unit Mounted No Duct Mounted Recommend coil coating? Distance from body of salt water: Curbs: Seismic Vibration Isolation Adapter Curbs: Output KW Are you licensed for this work? Coil Coating: Power Exhaust BTUH Input Electric Controls: Economizer Yes No Pitched Burglar Bars Curb/Other Is this a ducted or concentric system? Ducted Will the mall, landlord or municipality allow a curb adapter? No Yes Is the existing unit already installed on an adapter curb? No Yes Concentric Existing curb outside dimensions? Length Width * If concentric diffuser is existing, it must be determined if the duct transition is located within the curb. Adapter curbs may not be applicable in this application! Misc Information: Age of Unit Are there any special codes for: Disconnects Condition of Unit Yes No Existing Unit Weight Convenience Outlets Yes No Roof Lighting Yes No You are responsible for providing and coordinating any other trade required for a complete "Turn Key" installation of the equipment to be replaced. © 2013 Engineering Excellence, Inc Rev 06/14/2013
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