APPENDIX_B_Air Leakage Test Results Form.docx
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About this file
This is an appendix containing a standardized Air Leakage Test Results Form template for documenting building envelope air tightness testing and certification.
The form serves as a compliance checklist and certification document for testing agencies to verify that air leakage testing has been performed in accordance with specified standards and procedures. It requires the testing agency's authorized representative to certify and initial eight key compliance areas: envelope area verification from the architect of record, adherence to pressure testing setup conditions per specification, equipment compliance regarding accuracy and calibration, test procedure compliance with noted deviations, calculation accuracy per ASTM E 779 or the Air Barrier System specification, documentation of average leakage rate in CFM per square foot at 75 Pa, verification that all accuracies and data correlations remain within specified bounds, and a final pass/fail determination based on whether the envelope leakage rate meets the required goal. The form requires signature, printed name, date, and testing agency identification from the authorized representative, along with supporting documentation including digital photographs. This template does not address specific products or services required but rather establishes the standardized format and certification requirements for air leakage test documentation related to the Design-Bid-Build P1102 Weapons Magazine and Ordnance Operations Facility project at Naval Submarine Base New London in Groton, Connecticut.
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Text version
APPENDIX B
AIR LEAKAGE TEST RESULTS FORM
Testing Agency Certified Compliance
1 The envelope area was obtained from the architect of record and was checked on site for reasonableness.
__________________ (Initial)
2 Set up conditions were performed in accordance with the Pressure Testing a Building for Air Tightness specification and all deviations and their impact noted.
3 Test equipment used was in compliance respect to accuracy and calibration date.
4 The test procedure used was in compliance except as noted here.
5 The calculations were performed in strict accordance with ASTM E 779 or the Pressure Testing a Air Barrier System for Air Tightness specification except as noted.
6 Provide the average leakage rate calculated in step 5.13 of the Air Leakage Test Form.
__________________ CFM/sq ft at 75 Pa
7 All accuracies, pressure limits and data correlations and confidence intervals are within the bounds specified in steps 4 and 5 of the Air Leakage Test Form. Note all deviations. ___________________________________________________________________________________
8 The building envelope passes if there are no deviations in the criteria as stated in item 7 (immediately above) and if the value in step 5.13 of the Air Leakage Test Form is less than the required envelope leakage rate goal at 75 Pa.
Circle one: Pass / Fail
9 Supporting documentation described in Steps 1, 3, and 6 of the Air Leakage Test Form is attached to this test form, including all digital photographs of the building and test procedure.
I hereby certify that the results above are in conformance with the procedures outlined in this specification.
Testing Agency Name __________________________________________________________________
Testing Agency Authorized Representative Signature _________________________________________
Testing Agency Authorized Representative Printed Name _____________________________________
Date _____________________________
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