Duct Sealing Rebate Application

PTCS® Duct Sealing Certification Form

All sections must be filled out, signed, and dated by a PTCS® Certified Technician at the time of installation. A copy of the completed form must be promptly submitted to the utility and homeowner in accordance with utility policy. Please enter this form online at https://ptcs.bpa.gov/ or fax to 877-848-4074. Questions? Call 800-941-3867 or email ResHVAC@bpa.gov.

SITE INFORMATION

Jefferson County PUD Customer Name(Required)
Available on PUD bill or in Smart Hub App
Mobile or home phone
Installation Address(Required)
Needs to be the same as PUD customer's service address.
MM slash DD slash YYYY
Home Type
Foundation Type
Super Good Cents?
Energy Star®?
Heating System
Duct Sealing?
Are at least 50% od the ducts in unconditioned space?

If more than 50% of the ducts are in conditioned space, the home does not qualify for PTCS® duct sealing. A conditioned space is a space that's heated and cooled with the rest of the house.

HOUSE PRESSURIZATION AND DUCT BLASTER TESTS

Duct Leakage Test: TYPICAL DUCT BLASTER CFM READING with Duct Pressure at 0 Pa and Blower Door at +50 Pa.

Duct Fan Pressure: Found using equipment; it is the fan pressure, not the house pressure. (ex. Ring 1, 78 Pa, 364 CFM).

PRE-TEST

Pre-Test Existing Home, Existing Ducts

Pre-Test Ring
Pre-Test Requirements (PBA only)

Pre-Test Manufactured Home

Pre-Test Ring
Pre-Test Requirements (PBA only)

POST-TEST

Post-Test New Construction

Post-Test Ring
Certification Req. (check all that apply)

Post-Test Existing Home, New Ducts

Post-Test Ring
Certification Req.

Post-Test Existing Home, Existing Ducts

Post-Test Ring
Certification Req. (check all that apply)

Post-Test Manufactured Home

Post-Test Ring
Certification Req. (check all that apply)

Combustion Appliance Zone (CAZ) Test

Are there any combustion appliances in the home?
Is there a UL-approved and functioning CO detector installed in the home?

A carbon monoxide (CO) detector installed in the home is required in all cases where a sealed or non-sealed combustion appliance is located in a conditioned space or attached structure i.e. garage. RECOMMENDED CO detector specifications: UL 2034/CSA 6.19-01, digital display, peak CO memory and recall.

Is a Combustion Air Zone (CAZ) test required by the electric utility?

With air handler fan ON, record gauge readings

Interior doors open

Interior doors closed

Interior doors open

Interior doors closed

Net Depressurization = Net (Pa) = All fans off Reading (Pa) (minus) Air Handler Fan on Reading (Pa)

Example: Baseline reading with all fans off = 1 Pa; Reading with air handler fan on = -2Pa. Net Depressurization = 1– (-2) = 3 Net Depressurization

“Net” equals how much the pressure goes down when the air handler is turned ON (compared to the fan off baseline pressure)

REQUIRED SIGNATURES

This section shall be filled out by the electrical utility account holder. This form must be signed by the person whose name appears on the electric utility account. ENERGY INFORMATION RELEASE: The undersigned utility customer requests and authorizes the specified utility to release billing and usage information for the account listed below to the PTCS® program. With this authorization, the PTCS® program can request billing information for up to two years pre-installation and two years post-installation. The utility customer also hereby releases the utility company from any and all liability arising from or connected with providing this information.

Who should the Rebate Check Be Mailed To?

By signing this form, technician certifies that this form and any accompanying documentation are complete and accurate, and that all measures associated with this project were completed as of the signature date.

Technician Name(Required)
Clear Signature
Drop files here or
Accepted file types: jpg, jpeg, gif, png, pdf, heic, doc, docx, Max. file size: 128 MB.

    PRIVACY ACT STATEMENT Basic authority for collecting this information is authorized by 16 U.S.C. §§ 832 et. seq., and 838 et. seq., pursuant to Bonneville Power Administration’s Conservation Program system of records established in 46 FR 31700. This information is primarily intended to further, but is incidental to the performance of, BPA’s overall Energy Efficiency Program, the objective of which is to acquire energy resources through energy efficiency, to determine what cost-effective conservation and direct application renewable resources measures should be installed or adopted under different circumstances, and to provide incentives for the installation of such measures. Other routine issues of this information include: aggregation into a public database on energy efficiency; furnished to authorized personnel for installation/repair of equipment; aggregated into a database for program publicity; and in some instances information regarding buildings will be made available to subsequent purchasers of the buildings. Your disclosure of the requested information is voluntary; however failure to provide requested information means that it will not be possible for you to participate in this BPA Energy Efficiency program.

    With my signature below, I certify that I meet all of the above rebate requirements and that the information I have provided is accurate and complete.

    Clear Signature
    This field is for validation purposes and should be left unchanged.