This Commissioning Checklist is to be completed in full by the competent person who commissioned the heat pump and associatedequipment as a means of demonstrating compliance with the appropriate Building Regulations and then handed to the customer to keep forfuture reference.Failure to install and commission this equipment to the manufacturer’s instructions may invalidate the warranty but does not affect statutory rights.GROUND SOURCE HEAT PUMP COMMISSIONING CHECKLISTCustomer name: Telephone number:Address:Heat Pump Make and ModelHeat Pump Serial NumberCommissioned by (PRINT NAME): &HUWL¿HG2SHUDWLYH5HJ1R>@Company name: Telephone number:Company address:Commissioning date:%XLOGLQJ5HJXODWLRQV1RWL¿FDWLRQ1XPEHU LIDSSOLFDEOH >@CONTROLS - SYSTEM AND HEAT PUMP (tick the appropriate boxes)Time and temperature control to heating Room thermostat and programmer/timer Programmable RoomstatLoad/weather compensation 2SWLPXPVWDUWFRQWUROTime and temperature control to hot water Cylinder thermostat and programmer/timer Combined with Heat pump main controls+HDWLQJ]RQHYDOYHV LQFOXGLQJXQGHUÀRRUORRSV Fitted Not requiredHot water zone valves Fitted Not requiredThermostatic radiator valves Fitted Not required+HDW3XPS6DIHW\,QWHUORFN>@ Built In Provided2XWGRRU6HQVRU Fitted Not requiredAutomatic bypass to system Fitted Not requiredBuffer Vessel Fitted Yes No If YES Volume: LitresALL SYSTEMS7KHKHDWLQJV\VWHPKDVEHHQ¿OOHGDQGSUHVVXUHWHVWHG Yes([SDQVLRQYHVVHOIRUKHDWLQJLVVL]HG¿WWHG FKDUJHGLQDFFRUGDQFHZLWKPDQXIDFWXUHU¶VLQVWUXFWLRQV Yes7KHKHDWSXPSLV¿WWHGRQDVROLGVWDEOHVXUIDFHFDSDEOHRIWDNLQJLWVZHLJKW Yes7KHV\VWHPKDVEHHQÀXVKHGDQGFOHDQHGLQDFFRUGDQFHZLWK%6DQGKHDWSXPSPDQXIDFWXUHU¶VLQVWUXFWLRQV YesWhat system cleaner was used?What inhibitor was used? Quantity litresAre all exposed external pipeworks insulated? YesBORE HOLE/GROUND LOOPSBore Hole Ground Loop Length/Depth m7KHJURXQGORRSVERUHKROHSLSHVKDYHEHHQ¿OOHGDQGSUHVVXUHWHVWHGLQDFFRUGDQFHZLWKUHOHYDQW%ULWLVK6WDQGDUGV Yes,IPRUHWKDQRQHFROOHFWRUKDVEHHQXVHGKDVWKHV\VWHPEHHQK\GUDXOLFDOO\EDODQFHG )ORZEDODQFLQJUHJXODWLQJYDOYHV¿WWHG DGMXVWHG " YesHas the system been vented/de-aired? Yes$UHV\VWHP¿OWHUV¿WWHG FOHDQ" YesIs the system topped up to the correct level? Yes:DVWKHV\VWHPFOHDQHG ÀXVKHGSULRUWRXVH" YesAre isolating valves in their correct position YesWhat system cleaner was used? Qty litresWhat antifreeze was used? Qty litresWhat temperature will the antifreeze protect to? °CWhat inhibitor was used (if not included in Antifreeze)? Qty litres5HFRUGLQFRPLQJFROOHFWRUÀXLGWHPSHUDWXUH °C5HFRUGRXWJRLQJFROOHFWRUÀXLGWHPSHUDWXUH °CCENTRAL HEATING MODE Measure and RecordHeating Flow Temperature °C Heating Return Temperature °CDOMESTIC HOT WATER MODE Measure and Record:Is the heat pump connected to a hot water cylinder? Unvented Vented Thermal Store Not ConnectedHot water has been checked at all outlets Yes +DYH7KHUPRVWDWLF%OHQGLQJ9DOYHVEHHQ¿WWHG" Yes Not requiredADDITIONAL SYSTEM INFORMATONAdditional heat sources connected: Gas Boiler 2LO%RLOHU Electric Heater Solar Thermal 2WKHUALL INSTALLATIONSThe heating, hot water and ventilation systems complies with the appropriate Building Regulations YesAll electrical work complies with the appropriate RegulationsThe heat pump and associated products have been installed and commissioned in accordance with the manufacturer’s instructions YesThe operation of the heat pump and system controls have been demonstrated to the customer YesThe manufacturer’s literature, including Benchmark Checklist and Service Record, has been explained and left with the customer YesCommissioning Engineer’s SignatureCustomer’s Signature7RFRQ¿UPVDWLVIDFWRU\GHPRQVWUDWLRQDQGUHFHLSWRIPDQXIDFWXUHU¶VOLWHUDWXUH1RWHV>@,QVWDOOHUVVKRXOGEHPHPEHUVRIDQDSSURSULDWH&RPSHWHQW3HUVRQV6FKHPH>@$OOLQVWDOODWLRQVLQ(QJODQGDQG:DOHVPXVWEHQRWL¿HGWR/RFDO$UHD%XLOGLQJ&RQWURO /$%& HLWKHUGLUHFWO\RUWKURXJKD&RPSHWHQW3HUVRQV6FKHPH$%XLOGLQJ5HJXODWLRQV&RPSOLDQFH&HUWL¿FDWHZLOOWKHQEHLVVXHGWRWKHFXVWRPHU>@0D\EHUHTXLUHGIRUV\VWHPVFRYHUHGE\*5HJXODWLRQV© Heating and Hotwater Industry Council (HHIC) www.centralheating.co.uk