Blower Door Test Form
For Prescriptive and Performance Method
Air Infiltration Test Results
ACH (50) = CFM (50) X 60 / VOLUME = _________________
PASS (Mechanical Ventilation not Required)
PASS (With Mechanical Ventilation)
FAIL
Certification of Test Results
Please mark type of certification entity
Energy auditor or energy Rater as defined in Florida Statutes 553.993. Copy of
Certificate must be attached to this form.
Class A air-conditioning contractor, Class B, air conditioning contractor,
or Mechanical Contractor.
Professional Engineer or Architect licensed by Florida Statutes Section 471 or 481.
I hereby certify that the above Air Infiltration Test results demonstrate compliance
with Florida Energy Code requirements in accordance with the Florida Building
Code – Energy Conservation.
Signature:__________________________________________ Date:________________________
Printed Name:______________________________ License / Certification #__________________
Company:________________________________________________________________________
NOTE: Completed Form to be submitted at Final Building Inspection
Office of Building Services Page 1 of 1 BF78 Blower Door Testing
Updated January 09, 2018
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