Document ID: EPA-HQ-OAR-2004-0500-0035
Agency: epa
Document Type: Supporting & Related Material
Title: 
Posted Date: 2009-10-26T04:00Z

OMB Control No. xxxx-xxxx

 for ENERGY STAR Qualified Modular Home – Performance Path

Home Address: 
________________________________________________________________________
_____________________

City: _____________________________________________  State: ______  Zip:
_________  Home ID: ______________________

Instructions: Write your initials in each applicable box.  If an item
does not apply to the home, write “n/a”.  Raters should attempt to
inspect as many critical items as possible but may delegate a
builder’s representative to verify and initial up to six (6) Thermal
Bypass items (numbered items on the first page of this checklist).  If
the builder verifies any item, they must sign the second page of this
checklist.  Every line must contain at least one set of initials or
“n/a”. 

Thermal Bypass Item	Inspection Guidelines	Plant QC	Rater

Pass	Pass	Fail

Overall Air Barrier and Thermal Barrier Alignment	General requirements:

Insulation shall be installed in full contact with sealed interior and
exterior air barrier except for alternate to interior air barrier under
walls adjoining exterior walls or unconditioned spaces (see below).

	All climate zones:

	Overall alignment throughout home	_________	_________	_________

	Garage band joist air barrier (at bays adjoining conditioned space)
_________	_________	_________

	Attic eave baffles where vents/leakage exist	_________	_________
_________

	Only at Climate Zones 4 and higher:

	Slab-edge insulation (Up to 25% of the slab edge may be uninsulated in
Climate Zones 4 and 5.)	_________	_________	_________

	Best practices encouraged, not required:

	Air barrier at all band joists (Climate Zones 4 and higher)	_________
_________

Minimize thermal bridging (e.g., OVE framing, SIPs, ICFs)	_________
_________

	Walls Adjoining Exterior Walls or Unconditioned Spaces	General
requirements:

Fully insulated wall aligned with air barrier at both interior and
exterior, OR

Alternate for Climate Zones 1 thru 3, sealed exterior air barrier
aligned with RESNET Grade 1 insulation fully supported

Continuous top and bottom plates or sealed blocking

	Wall behind shower/tub	_________	_________	_________

	Wall behind fireplace	_________	_________	_________

	Insulated attic slopes/walls	_________	_________	_________

	Attic knee walls	_________	_________	_________

	Skylight Shaft Walls	_________	_________	_________

	Wall adjoining porch roof	_________	_________	_________

	Staircase walls	_________	_________	_________

	Double walls	_________	_________	_________

Floors between Conditioned and Exterior Spaces	General requirements:

Air barrier is installed at any exposed insulation edges

Insulation is installed to maintain permanent contact with sub-floor
above

	Insulated floor above garage	_________	_________	_________

	Cantilevered floor	_________	_________	_________

Shafts	General requirements:

Openings to unconditioned space are fully sealed with solid blocking or
flashing and any remaining gaps are sealed with caulk or foam (provide
fire-rated collars and caulking where required)

	Duct shaft	_________	_________	_________

	Piping shaft/penetrations	_________	_________	_________

	Flue shaft	_________	_________	_________

Attic / Ceiling Interface	General requirements:

All attic penetrations and dropped ceilings include a full interior air
barrier aligned with insulation with any gaps fully sealed with caulk,
foam or tape

Movable insulation fits snugly in opening and air barrier is fully
gasketed

	Attic access panel (fully gasketed and insulated)	_________	_________
_________

	Attic drop-down stair (fully gasketed and insulated)	_________
_________	_________

	Dropped ceiling/soffit (full air barrier aligned with insulation)
_________	_________	_________

	Recessed lighting fixtures (ICAT labeled and sealed to drywall) 
_________	_________	_________

	Whole-house fan (insulated cover gasketed to the opening)	_________
_________	_________

Common Walls Between Dwellings	General requirements:

Gap between drywall shaft wall (common wall) and structural framing
between units is sealed at all exterior boundary conditions

	Common wall between dwelling units	_________	_________	_________



Home ID: ______________________

Performance Path Item	Inspection Guidelines	Plant QC	Rater

Pass	Pass	Fail

Performance Index	All performance path construction specifications have
been adhered to and the home has achieved the required performance
index.

2004 IRC Climate Zones 1 – 5: Maximum HERS Index 85

2004 IRC Climate Zones 6 – 8: Maximum HERS Index 80	_________
_________	_________

Ductwork	General requirements:

	Leakage ≤ 6 cfm to outdoors per 100 sq. ft. of conditioned floor area
_________	_________	_________

	Ducts in unconditioned spaces wrapped with R-6 minimum insulation
_________	_________	_________

	All exterior ducts have been mechanically secured and supported off the
ground	_________	_________	_________

ENERGY STAR Qualified Products	General requirements:

Include at least one (1) of the following ENERGY STAR qualified product
categories: 

	Heating or cooling equipment OR Windows OR Water heating equipment OR
Five (5) or more qualified light fixtures, appliances, ceiling fans
equipped with lighting fixtures and/or ventilation fans.	Specify:
_________	_________	_________

Marriage Line Seal	General requirements:

All vertical and horizontal marriage line areas filled with continuous
non-porous insulating gaskets creating a permanent air barrier at joints
in the ceiling, walls and floor. Gaskets may be one or two-part systems,
including proprietary gaskets, foams, insulation wrapped in poly, or
insulation covered by butyl or other long-life tape on one side. No
visible signs of gaps or tears are permitted.	_________	_________
_________

Floors over Unconditioned Spaces	General requirements:

Air barrier between floor and unconditioned crawlspace is continuous and
sealed. 	_________	_________	_________

Plant QC

Date: _______________________________

Company: ___________________________

Signature: ___________________________

Initials:______________________________	Rater

Date: _______________________________ 

Company: ___________________________

Signature: ___________________________

Initials:______________________________	Builder

Date: _________________________________ 

Company: _____________________________

Signature: _____________________________

Initials:________________________________

EPA Form 5900-192

The government estimates the average time needed to fill out this form
is 0.50 hours and welcomes suggestions for reducing this effort. Send
comments (referencing OMB Control Number) to the Director, Collection
Strategies Division, U.S. EPA (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460.

 On-site power generation may not be used to decrease the HERS Index to
qualify for ENERGY STAR.  A maximum of 20% of all screw-in light bulb
sockets in the home may use compact fluorescent lamps (CFLs) to decrease
the HERS Index for ENERGY STAR compliance.  CFLs used for this purpose
must be ENERGY STAR qualified.

 For more information, see “ENERGY STAR Qualified Homes Codes and
Standards Information.”

Inspection Checklist for ENERGY STAR Qualified Modular Home –
Performance Path     p. 2

Inspection Checklist for ENERGY STAR Qualified Modular Home –
Performance Path      p. 2