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4 Certificate of Compliance (Sign Lighting) <br />1 Project Name: O.ji. .r.:L, <br />9 U119 <br />(Page 4 of 4)SLTG-:1C <br />Date:i 1 -29 1 3· <br />5. Specific Lighting'Source Method of Compliance <br />Certificate of Cbmpliance and Field Inspection Energy Checklist ' <br />Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 4 ofthis <br />i . f.ectificme of Compliance if there are signs using the maximum allowed lighting power method of compliance)A B C D E <br />OPTIONAL <br />UL <br />Symbol or other <br />or Description label <br />Code <br />(see <br />instructions <br />below) <br />Specific light source used for <br />compliance <br />Shall include only lighting <br />technologies listed below I <br />List all that apply I <br />Field <br />Inspector <br />Check that <br />Sign <br />Complies <br />. 4 <br />(Al{*l \€#ers 4 7 1. 0 <br />0 1 0 <br />O 0 <br />0 10 <br />0 0 <br />A Symbol or code used on the plans (wheh plans are required) anc other documents.B A narrative description of the sign, or location of sign on the building; and the location ofsign onconstruction documentsC OPTIONAL - Check this box only ifthis sign has a permanent, pre-printed, factory-installed label, listed with Underwriters Laboratory(UL) or other testing laboratoly accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) or InternationalStandards Organization (ISO) 17025 in accordance with ISO/IEC 17011 with the products produced under an ongoing inspection programcarried out by a Type A inspection body in accordance with ISOLIEC ] 7020, confinning that this sign complies with the Section 148 of theCalifornia 2008 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. For signs with such a label, column'D' is not required to be filled out. Note: Using a label is an optional method to validate compliance. A label is not needed for compliance. 1 <br />Specific Light Source Compliance Method. The sign(s) identified aboveruse only the following lighting technologies: <br />list all applicable numbers (1 through 10) that apply in column D above for each row. <br />1 . High pressure. sodium lamps . . ... . ,..... ... _ .___...........* ..._. <br />2..Pulse start.or.ceramic metal halide lamps ser.ved by. a ballastwith 288% efficiency3 . Pulse start met@l halide .lamps that are 5 320 watts, are not 250 watt or 175 watt lamps, and are!served by a ballast <br />with 2 80% efficiency4 Neon orcold cathode lamps with transformer or power supply efficiency 2 75% with rated output current < 50 mAD 3 Neon or cold cathode lamps with transformer or pewer supply efficiency 2 68% with rated output current 2.5 0 mA6 Fluorescent lamps with a minimum color rendering index (CRI) of 80(Note: when using electronic ballasts for compliance, lamps with a CRI < 80 may be used) <br />7 Light emitting diodes (LEI)s) with a power supply with Z. 80% efficiencySingle voltage LED external power supplies designed to convert 120 volt AC input into lower voltage DC or AC8 output, havihg a nameplate output power less than or equal to 250 watts, and certified to the Energy Commission ascomplying with the applicable requirements ofthe Appliance Efficiency Regulations (Title 20) <br />9 < Compact fluorescent lamps that do not contain a medium sore.w base sockets (E24/E26)1 10 Electronic ballasts with a fundamental output frequency 2 20 kHz <br />E | This page doubles as a field inspection checklist. <br />Field Inspector Notes: <br />2008 Nom·esidential Compliance Forms July 2010 <br />f