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**Energy Star^^ product information form for use by Energy Star
qualified commercial solid door refrigerators and freezers partners
(Companies who have joined Energy Star for commercial solid door
refrigerators and freezers by signing the Partnership Agreement)**

*You may use this form to report only those products that are sold under
your company's brand name. If your firm sells its models to another
company that uses its own brand name, that company must join the program
and report its own products. Information from this form will be added to
the list of Energy Star qualified Commercial Solid Door Refrigerators
and Freezers products. Please send this form for each qualifying product
model to Energy Star for Commercial Solid Door Refrigerators and
Freezers via fax at **(202) 862-1144** or email*
**<commercialfoodservice@icfi.com>.**

**Product Contact Information**

**Company
Name:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(For public requesting product information)**

> **(As listed in Partnership Agreement)**
>
> **Name:
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

#### Tel:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Fax:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> **E-mail:
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Note: Please provide the following information on the tested model
ONLY.**

**Please complete all the fields below (see term definitions on page
2).**

  -------------- --------- --------- -------- --------- --------- -------------- --------- -------
  Brand Name/    Model     Product   Number   Cabinet   Defrost   Internal                 
  Manufacturer   Name &    Type      of Doors Type      Type      Volume (cu ft)           
                 Number                                                                    

                                                                  Refrigerator   Freezer   Total

                                                                                           
  -------------- --------- --------- -------- --------- --------- -------------- --------- -------

  ------------ ----- ------- ------ ------- ------ -------------- ------------- -----------
  External                                         Daily Energy   Refrigerant   Date
  Dimensions                                       Consumption    Type          Product
  (in and cm)                                      (kW-hrs/day)                 First
                                                                                Shipped

  Height             Width          Depth                                       

  in:          cm:   in:     cm:    in:     cm:                                 
  ------------ ----- ------- ------ ------- ------ -------------- ------------- -----------

Tested By: (Name of Independent Testing Firm or Self-Tested)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date Tested:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Per the requirements in the Energy Star Partnership Agreement, has the
label been placed**:

\_\_ in product literature? \_\_ on your Internet site where the product
information is displayed?

\_\_ on product packaging? \_\_ on the top/front of the product?

**Qualification**

This model meets all the requirements of the ENERGY STAR Commercial
Solid Door Refrigerators and Freezers Agreement. (*See Eligibility
Criteria section of the ENERGY STAR Commercial Solid Door Refrigerators
and Freezers Partnership Agreement*)

**Please sign below:**

Signature\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date\_\_\_\_\_\_\_\_\_\_

Printed
Name\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Term Definitions**

**Product Type**

Products included as commercial refrigerators and freezers are
refrigerator, freezer, or combination refrigerator-freezer with
self-contained condensing systems for storing food products or other
perishable items at specified temperatures and designed for use by
commercial or institutional facilities. Product types are defined as
follows:

> *Commercial Refrigerator*: A cabinet designed for storing food or
> other perishable items at temperatures above 32ºF and below 40ºF.
>
> *Commercial Freezer*: A reach-in cabinet designed for storing food or
> other perishable items at temperatures below 0ºF and above -5ºF.
>
> *Commercial Refrigerator-Freezer*: A cabinet with two or more
> compartments, at least one of which is designed for storing food or
> other perishable items at temperatures above 32ºF and below 40ºF and
> at least one of which is designed for storing food or other perishable
> items at temperatures below 0ºF and above -5ºF.
>
> *Ice Cream Freezer*: A commercial cabinet designed for storing food or
> other perishable items at temperatures below -5ºF.

**Cabinet Type**

Cabinet type included under commercial refrigerators and freezers are:

> *Reach-in Cabinet*: An upright commercial refrigeration cabinet with
> hinged, solid doors but excluding undercounter, roll-in, roll-through,
> or pass-through cabinets.
>
> *Undercounter Cabinet*: An upright commercial refrigeration cabinet
> without a worktop surface which has hinged, solid doors and which is
> intended for installation under a counter.
>
> *Roll-in or Roll-through Cabinet*: An upright commercial refrigeration
> cabinet with hinged, solid doors that allows wheeled racks of product
> to be rolled into or through the refrigerator or freezer.
>
> *Pass-through Cabinet*: An upright commercial refrigeration cabinet
> with hinged, solid doors on both the front and rear of the
> refrigerator or freezer.

# **Defrost Type**

# Defrost types include automatic, manual, and partial automatic.

# 

**Internal Volume**

The internal volume of the cabinet in cu. ft. determined according to
American National Standards Institute/Association of Home Appliance
Manufacture ANSI/AHAM HRF-1-2004.

**Daily Energy Consumption**

The daily energy consumption is to be measured using The American
Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc.
(ASHRAE) Standard 72-2005, "Method of Testing Commercial Solid Door
Refrigerators and Freezers." The energy consumption shall be reported in
kW-hours/day.

The public reporting and recordkeeping burden for this collection of
information is estimated to average 4.85 hours per response. Send
comments on the Agency\'s need for this information, the accuracy of the
provided burden estimates, and any suggested methods for minimizing
respondent burden, including through the use of automated collection
techniques to the Director, Collection Strategies Division, U.S.
Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460. Include the OMB control number in any
correspondence. Do not send the completed form to this address.