Ground Source Heat Pump Performance Report - Bard Q-TEC Series Literature Assembly

Ground Source Heat Pump Performance Report
Date: ____________________
Company Reporting: ________________________ Contact Phone: ____________________________
Owner's Name: ____________________________ Owner's Address: ___________________________
1. Model/Serial Numbers: (For 3‐Pc. Geo‐Trio system, include coil/compressor/blower information)

Model Number(s): ______________________________________________________________

Serial Number(s): _______________________________________________________________
2. Accessory Information:

Thermostat
 Flow‐Center* Mfgr. _____________________ Model/Part Number: ___________________
*if applicable
3. Open‐Loop Water Source Information:

Where/how is water discharged ___________________________________________________
4. Closed‐Loop Water Source Information:
Horizontal Trenches
Other (Describe) ________________________________________________________________

Type of Antifreeze________________ % of Antifreeze __________ Freezepoint °F _________
 Piping Material ____________ Diameter of Loop Pipe ______ Diameter of Header Pipe _____
 Length of Loops ________ Pressurized/Non‐Pressurized Flow Center _____________________

If Horz. Trench: Loops per trench ____ L x W x D of trenches ___________________________
Total Number of Trenches ________ Total Number of Loops _______

If Horz. Bored: Avg. Depth of Bores ________ Grout was used (Y/N) ___________
Total Number of Bores ___________ Total Number of Loops ___________

If Vert. Bored: Depth of Bores __________ Grout was used (Y/N) ____________
Total Number of Bores ___________ Total Number of Loops ____________

If Pond/Lake: Approx. Acreage of Pond/Lake _______________ Depth of Loops __________
Style of Loops: (coils, mats, Lake Plates) ____________ Total Number of Loops _____
General Notes: ________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Manual 2100-738A
Page 70 of 71
Technician: __________________________________________
Mfgr. _____________________ Model/Part Number: ___________________
Horizontally Bored Vertical Pond/Lake