FACT HVAC | SERVICE FORM Home » FACT HVAC | SERVICE FORM Please enable JavaScript in your browser to complete this form.CUSTOMER INFORMATIONCustomer Type *CODFAHW2-10FHWSUPERAHSCustomer Name *FirstLastWork Order# *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCustomer Concerns *System InformationSystem Type *Split System (Heat Pump)Split System (Gas)Package (Heat Pump)Package (Gas)Condensor Unit Condenser Model# Click or drag a file to this area to upload. Refrigerant TypeR-224-10aContactor GoodFairRecommend Replacement Outdoor Fan Motor Bearings PassFailOutdoor Fan Motor Run Capacitor Rating *Outdoor Fan Motor Run Capacitor Reading *Compressor Run Capacitor Rating *Compressor Run Capacitor Reading *Outdoor Fan Motor Amp DrawCompressor Amp Draw RatingCompressor Amp Draw ReadingHigh-side Pressure ReadingsHigh-side Sat. Temp. Readings High-side Temp. ReadingsSub-coolLow-side Pressure ReadingsLow-side Sat. Temp. ReadingsLow-side Temp ReadingsSuper-heatUnit ConditionExcellentFairPoorAir Handler // FurnaceAir Handler / Furnace Nomenclature Click or drag a file to this area to upload. Run Cap Rating Run Cap ReadingBlower Motor BearingsGoodFailingCoil ConditionGoodFairRequires AttentionPicture of indoor coil Click or drag a file to this area to upload. Secondary Drain Pan GoodFairRequires AttentionPicture of Secondary Drain Pan Click or drag a file to this area to upload. Furnace ConditionGoodFairBadHot Surface IgnitorPassFailSafety SwitchesPassFailCombustion MotorGoodFairBadBlower Motor Amp DrawStatic pressureReturn Air Temp.Supply Air Temp. Split ReadingsDIAGNOSIS *RECCOMENDED REPAIRS *NameSubmit