ENERGY STAR QUALIFIED PRODUCT INFORMATION FORM FOR INDOOR RESIDENTIAL LIGHT FIXTURES

Transcription

1 ENERGY STAR QUALIFIED PRODUCT INFORMATION FORM FOR INDOOR RESIDENTIAL LIGHT FIXTURES OMB No INDOOR ENERGY STAR product information form for use by ENERGY STAR qualified residential light fiture partners (Companies who have joined ENERGY STAR for residential light fitures by signing a Partnership Agreement) You may use this form to report those products that are sold under your company s brand name. If your firm sells models (fitures) under a brand name different from your company name, you must list the brand name and the associated retailer/organization. Please copy this form and return one for each lamp/ballast combination to the address below. MANUFACTURER (ENERGY STAR Partner): Sea Gull Lighting Products, Inc. SECTION I -- LAMP & BALLAST INFORMATION: Number of Lamps/ Fiture Number of Ballasts/ Fiture Individual Listed Lamp Wattage Lamp Type 1 Lamp Size 2 Lamp (e.g., lightbulb) Manufacturer & Model Number Ballast Manufacturer & Model Number CFL T4 GREENLITE CFQ13W/G24q/827 ROBERTSON RSF213T5120WC ENERGY STAR should review this submittal as a (circle one): Lamp &/or Ballast Platform 3 Complete Fiture Both 1. Lamp Type: For eample, CFL = Compact Fluorescent, CR = Circular, L = Linear 2. Lamp Size: For eample, T4, T5, or T8. 3. A lamp and ballast platform does not receive the ENERGY STAR mark and cannot be promoted as an ENERGY STAR qualified product. Rather, you may promote the qualified lamp, ballast, or lamp/ballast platform as a component that meets applicable ENERGY STAR Program Requirements when used in ENERGY STAR qualified residential light fitures. SECTION II -- TEST RESULTS: Enter results from test report (complete using average of tested samples) or manufacturer data as specified in the ENERGY STAR Program Requirements for Residential Light Fitures Version 4.0 and attach required documentation to this form. Performance Characteristic Test Result Required Documentation Combined Lamp & Ballast Requirements System Efficacy 1422 Total Lumen Output Input Power (watts) Lumens Per Watt (please attach to this form) or industry association. Lamp Requirements Lamp Life 10,000 Average Rated Hours Lumen Maintenance 86 Lamp Color Rendering Inde 82 CRI Lamp Correlated Color Temperature (CCT) Lamp/Lampholder Compatibility Lamp Labeling Requirement Target CCT (circle one) Samples falling within 7-step Mac Adam ellipse List ANSI-IEC Designated Lamp Base Type % of initial lumens at 40% rated lamp life (4,000 hour minimum) 2700K 3000K 3500K 4100K 5000K 6500K _>90 % G24q-1 ANSI-IEC Standardized Lamp? OR No If, list ANSI-IEC Lamp Standard Data Sheet Number Check bo if lamp labeling requirement has been met: _2513 OR ISO 9000 registered facility. or industry association. industry association, or a test from an ISO 9000 registered facility. For fitures that do not use an ANSI-IEC standardized lamp from ANSI C & C78.81 or IEC & 60081, supply a lamp manufacturer specification sheet. A copy of the actual language that will be included on the lamp base or glass.

2 SECTION II -- TEST RESULTS (continued): Enter results from test report (complete using average of tested samples) or manufacturer data as specified in the ENERGY STAR Program Requirements for Residential Light Fitures Version 4.0 and attach required documentation to this form. Ballast Requirements Lamp Start Time 78 Milliseconds Power Factor Lamp Current Crest Factor Ballast Case Hot Spot Location Maimum Recommended Ballast Case Temperature During Normal Operation Inside A Fiture Maimum Measured Ballast Case Temperature During Normal Operation Inside Fiture(s) Check bo if hotspot diagram has been included with this submittal: OSHA NRTL laboratory. industry association, or a test report from the ballast or fiture manufacturer. OSHA NRTL laboratory. Ballast manufacturer documentation.: ON FILE WITH NEMA MATRIX 75 degrees Celsius Ballast manufacturer documentation degrees Celsius or one of its MRA signatories, an OSHA NRTL laboratory, or the fiture or ballast manufacturer. Electromagnetic and Radio Frequency Interference Check bo if the ballast meets FCC requirements for consumer use: Ballast Frequency 48 khz Transient Protection End of Life Protection (Only required for ballasts with lamps sized T5 & smaller) Dimming Safety Ballasts and Non Edison base Fluorescent Adapters Check bo if ballast meets transient protection requirements: Testing requirements met? OR Maimum number of lamps shut down when lamp end of life event occurs: 2 OR Dimming-Capable Ballast? OR No Check one bo if ballast is dimmingcapable: 3-Way Switching Continuous Dimming Listed for Safety? OR Fiture Requirements (Only required for fiture submittals. Leave blank for lamp/ballast platform submittals.) Fiture Warranty Noise Replaceable Ballast Check bo if fiture warranty is included with fiture packaging: WAITING FOR INFO FROM MANUFACTURER dba Check bo if the submitted fitures meet the replaceable ballast requirement: industry association, or a test report from the ballast or fiture manufacturer. For T4 and T5 lamps, test report from a lab accredited by NVLAP or one of its MRA signatories, an EPA approved Platform Letter of Qualification, EPA-approved documentation from an industry association, or a test report from the ballast or fiture manufacturer. For T3 lamps and smaller, a circuit diagram and engineering description. submittal, ecept when torchiere fitures are submitted. Provide two-year fiture manufacturer written warranty language that is included with product packaging. A copy of the language that includes guidance on ballast replacement and states that the ballast is replaceable with the use of a qualified electrician without the cutting of wires.

3 SECTION II -- TEST RESULTS (continued): Enter results from test report (complete using average of tested samples) or manufacturer data as specified in the ENERGY STAR Program Requirements for Residential Light Fitures Version 4.0 and attach required documentation to this form. Safety Portable Fitures Listed for Safety? OR Safety Hardwired Fitures Listed for Safety? OR Decorative LEDs Permanent Conversions Line Voltage Socket (LVS) Standard Design Line Voltage Socket (LVS) Standard Design with Self-Ballasted Pin- Based Lamp Product Packaging for Consumer Awareness Requirements Do any of the submitted fitures use decorative LEDs? Do any of the submitted fitures use a factory-installed device to permanently convert an Edison lamp base to a pin-base for fluorescents? Do any of the submitted fitures use the twist-and-lock LVS standard design? Do any of the submitted fitures ship with self-ballasted pin-based lamps (i.e., integrated lamp and ballast) that use the twist-and-lock LVS standard design? For fitures that are not shipped with lamps: Does the packaging include a NEMA or ANSI generic lamp description, including a color designation? Does the packaging suggest that the consumer select a lamp with a rated lamp life of 10,000 hours or more? For fitures that are shipped with lamps: Does the packaging clearly describe the target CCT designation in Kelvin? For recessed downlight fitures that are IC-Rated: Does the packaging clearly state this rating? OR No OR No OR No OR No For recessed downlight fitures that are Air-Tight (AT) rated: Does the packaging include an air-tight or similar designation to clearly show that the fiture produces less air leakage than 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283? Is the fiture itself labeled air tight, or similar designation? Are installation instructions included? Manufacturer documentation including total wattage consumed by all LEDs, manufacturer warranty, and spec. sheet showing wattage, efficacy, LED life, color, and lumen depreciation. Written copy or PDF graphic of the language that will be displayed on product packaging and within the packaging, as required. ADDITIONAL TEST RESULTS FOR INDOOR RECESSED DOWNLIGHT RETROFIT KITS ONLY: When qualifying a recessed downlight retrofit kit for ENERGY STAR, the following documentation must be provided in addition to the information required above. Reflector Type No supplemental documentation required Aperture Size Inches No supplemental documentation required Air Tight For Restricted Air Movement Electrical Connections Safety Fiture Conversions, Retrofits Product Packaging for Consumer Awareness Requirements Check bo if submitted fitures meet air tight requirement: Check bo if submitted fitures have an Edison lamp socket with wire pigtail to the ballast: Check bo if submitted fitures meet safety requirements for conversions & retrofits: Fiture Compatibility List? ASTM E283 Compliance Language? Installation Instructions? Manufacturer or laboratory data Manufacturer engineering description and/or diagram describing electrical connection coverage statement included Written copy or PDF graphic of the language that will be displayed on product packaging as well as installation instructions

4 SECTION III -- FIXTURE MODELS WITH SAME LAMP/BALLAST COMBINATION: Does the lamp Manufacturer Model Number /Retail SKU 1 Brand Name Fiture Type2 ship with fiture? 4924BLE-02 Sea Gull Lighting Products, Inc. (for all) Y N 4957BLE-61 Y N Typed Fiture Description Attached 3 OMB No Intended Use (circle all that apply) Y N Garage, Laundry Room, Bathroom Hallway Y N Garage, Laundry Room, Bathroom Hallway 4957BLE-85 Y N Y N Garage, Laundry Room, Bathroom Hallway 4958BLE-02 Y N Y N Garage, Laundry Room, Bathroom Hallway 4958BLE-15 Y N Y N Garage, Laundry Room, Bathroom Hallway 4966BLE-15 Y N Y N Garage, Laundry Room, Bathroom Hallway 4966BLE-72 Y N Y N Garage, Laundry Room, Bathroom Hallway 4966BLE-755 Y N Y N Garage, Laundry Room, Bathroom Hallway 4967BLE-09 Y N Y N Garage, Laundry Room, Bathroom Hallway 4967BLE-26 Y N Y N Garage, Laundry Room, Bathroom Hallway 4969BLE-09 Y N Y N Garage, Laundry Room, Bathroom Hallway 4969BLE-26 Y N Y N Garage, Laundry Room, Bathroom Hallway 4974BLE-15 Y N Y N Garage, Laundry Room, Bathroom Hallway 4998BLE-02 Y N Y N Garage, Laundry Room, Bathroom Hallway 4999BLE-02 Y N Y N Garage, Laundry Room, Bathroom Hallway 5902BLE-15 Y N Y N 59328BLE-07 Y N Y N CM 59328BLE-15 CM Y N Y N 59328BLE-777 CM Y N Y N 59328BLE-782 CM Y N Y N 59328BLE-962 CM Y N Y N 5940BLE-02 CM Y N Y N 5940BLE-15 CM Y N Y N 5940BLE-962 CM Y N Y N 5941BLE-962 CM Y N Y N 5964BLE-02 Y N Y N 5976BLE-15 CM Y N Y N 79077BLE-02 CM Y N Y N

5 79156BLE-02 CM Y N Y N 7916BLE-68 Y N Y N 79177BLE-02 CM Y N Y N 79177BLE-15 CM Y N Y N 79177BLE-962 CM Y N Y N 79256BLE-02 CM Y N Y N 7926BLE-15 Y N Y N 7926BLE-68 Y N Y N 1. List all fiture models (and Retail SKU Number when applicable) that will use this lamp/ballast combination. Only one set of test results is required per lamp/ballast combination. 2. Fiture Type: CM = Ceiling Mounted, = Wall Mounted, RC = Recessed Canister, RCIC = IC-Rated Recessed Canister, RCAT = Air-Tight Recessed Canister, RCICAT = IC-Rated & Air-Tight Recessed Canister, RT = Recessed Troffer, SU = Suspended, PT = Portable, TO = Torchiere, UC = Under Cabinet, FC = Furniture/Cabinet Integrated, AR = Architectural, RDRK Recessed Downlight Retrofit Kit, O = Other. NOTE: Although you may indicate more than one fiture type, only your first selection will appear on the ENERGY STAR Web site. 3. E.g. This close-to-ceiling mount fiture features an antique brass finish coupled with a glass dome that has a subtle swirl pattern throughout the glass. This is a marketing tool; all electronic photos that are submitted will be included in the ENERGY STAR Visual Catalog, which is sent to interested utilities and used by ENERGY STAR in its presentations. SECTION IV -- MARKETING REQUIREMENTS: Upon approval of this product, the Partner will take steps to ensure that the ENERGY STAR mark will appear (check all that apply): On product packaging (required) In product literature (required) On Internet site (required) Following ENERGY STAR acceptance of a product, partner has 90 days to fulfill the labeling requirements. ENERGY STAR reserves the right to remove a non-compliant product from the Web site after 90 days. Eplain briefly in writing how you plan to implement the above listed labeling requirements within the timeline (use additional pages if necessary): _Sea Gull Lighting is committed to the Energy Star program and acknowledges the value in labeling and co-branding. All Sea Gull Lighting packaging will reflect the Energy Star rating when appropriate. The company strongly co-brands its collateral materials, as evidenced throughout its 74 page energy efficient lighting catalog, as well as by dedicating a website in support of Energy Star products. ( SECTION V -- SUBMITTAL PROCEDURE: 1. Fill out entire ENERGY STAR for Residential Light 6. Keep a copy of this form and attached Fiture Qualified Product Information Form. documentation for your records. 2. Fill out one form for each lamp/ballast combination. 7. Mail this form and attached documentation to: 3. For multiple fiture models using same lamp/ballast ICF Consulting combination list those fiture models in Section III. C/O Brooke Taylor 4. Attach ALL required testing and verification documentation Eye Street NW, Suite Sign and date Section VI below. Washington DC SECTION VI -- VERIFICATION: (To be signed by senior representative of the fiture manufacturer) I declare that the above information is accurate and true to the best of my knowledge. I understand that if any of the above information is found to be inaccurate by ENERGY STAR or any of ENERGY STAR s contractors that the above products will be removed from the ENERGY STAR qualified product list, and that EPA may terminate the ENERGY STAR agreement between EPA and the responsible manufacturer. Printed Name: Rebecca Gilmore Manufacturer Signature: Date: Contact Address: bgilmore@seagulllighting.com