/ ENERGY STAR®
Lab Report Cover Sheet
and Instructions /
Part 1: Standard Information (required fields are indicated in bold text)
Partner:
Company Name
OEM Name (if different)
Primary Contact Name
Primary Contact E-mail
Test Laboratory:
Relationship to Partner / Third-party Partner/OEM In-house
Laboratory Name
Laboratory Web URL (if third-party)
Accreditation Body (if accredited)
Accreditation Body Online Directory URL
Accreditation Certificate Number / ID
Primary Contact Name
Primary Contact E-mail
Product:
ENERGY STAR Product Category / Specification Version
Model Number
Product Type / Description
Serial Numbers of Tested Units
Safety Standards (if required in the ENERGY STAR specification):
Safety Standard Reference (if required)
Case / File Number
Part 2: Lab Report Instructions
An acceptable lab report must be in English, must be clearly legible, and must be in Adobe PDF, Microsoft Word, or Microsoft Excel format. The cumulative file size for all lab report documentation submitted to EPA in support of an ENERGY STAR qualified product submission must be less than 10 MB.
The lab report must also contain the following information, at a minimum, as per the test procedures specified in the ENERGY STAR program requirements for the appropriate product category:
§  Test procedure name(s)
§  Test date
§  Sample description (e.g., number of products tested)
§  Serial numbers of all tested units
§  Equipment calibration dates and next due date
§  Environmental conditions (e.g., temperature, humidity)
§  Test results, organized by applicable test procedure section and clearly marked to indicate results that are relevant to ENERGY STAR
§  Test engineer and witness signatures