Basic Energy Audit

• Energy Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Form to be completed by consultant only.
  

• Company Name

• Company is LTD or PLC?

• Company Registered Number

• Registered or Head Office Address
  Address

• Telephone Number

• Website

• Contact Name

• Contact Position

• Contact Email Address

• Contact Direct Dial Number

• How did the client hear about us?

• Industry

• Brief Description of Business Activities

• Number of Employees

  Select 1-10 10-20 20-40 40-60 60-100 100+

  • 1-10
  • 10-20
  • 20-40
  • 40-60
  • 60-100
  • 100+

• Please note that this survey is to be kept confidential. Both consultant and client contact are to sign this document under the declaration section, acknowledging that all details herein are complete and correct to the best of their knowledge.

Site Information

• Buildings On Site

Building

• Building/Unit Name

• Current EPC/DEC Rating

  Select No EPC A B C D E F G

  • No EPC
  • A
  • B
  • C
  • D
  • E
  • F
  • G

• Building Length (metres)

• Building Width (metres)

• Building Sq. Metreage

• Number of Storeys

  Select 1 2 3 4 5

  • 1
  • 2
  • 3
  • 4
  • 5

• Ceiling Height (metres)

• How many hours is the building occupied per day?

• How many days is the building occupied per year?

• What (if any) energy saving measures have already been recommended?

• Have any of the measures above been completed?

  Off

  On

• Please detail the measures that have been completed

Heating

• Type of fuel used

  Mains Supply Natural Gas

  LPG

  Oil

  Gas Oil (Red Diesel)

  Electricity

• What is the price per litre?

• No. of kWh used per month

• Current fuel supplier

• Are they in a contract?

  Yes

  No

  N/A

• Current contract period ends

  Date

• Is the system vented or unvented?

  vented

  unvented

• Location of current boiler

• Current boiler make

• Current boiler model

• Does the boiler provide heating and hot water or heating only?

  heating only

  heating and hot water

• Current heating delivery system

  Select HVAC system radiators underfloor warm air blowers electric panel electric convector

  • HVAC system
  • radiators
  • underfloor
  • warm air blowers
  • electric panel
  • electric convector

• Current boiler output (kWh)

• Describe the access to the boiler (internal and external)

• Is there space available for an alternate heating source, i.e biomass?

• Is there an existing flue system?

• Please describe proposed route for flue

• Please draw proposed route

  Drawing

• Is a backup system required (if heat is used for manufacturing)?

Lighting

• Lighting Location

Area

• Location

• Number of fittings

• Height of fittings

• Fitting type

• Wattage per bulb

• Is the fitting a switch start fluorescent?

• Hours on per day

• Area usage in hours per day

• Recommended fitting type

  PIR sensors

  MCDB fittings

  LED Fittings

• Number of sensors recommended

Electrical

• Current energy supplier is the same as heating fuel?

• Current energy supplier

• Are they in a contract?

  Yes

  No

  N/A

• When is the contract end date?

  Date

• Annual usage (kWh)

• Current price per unit

• Location of main distribution board

• Location of main service head (origin)

• Is there half hourly data available on the energy bills?

• Is the supply 3 phase or single phase?

  3 phase

  single phase

• Total amps

• Total voltage

• Maximum demand

• MPAN Number

• Distribution board make

• Distribution model

• Spare fuse way in board?

• Voltage optimisation installed?

• Is there a backup generator?

Glazing & Access

• Are draft excluders fitted to all external doors?

• Add entrance/exit with NO draft exclusion fitted

Entrance/exit

• Area description

• Type of glazing

  Select single glazing any double glazing wood double glazing aliminum double glazing PVC Triple Glazing PVC Triple glazing Aliminum

  • single glazing any
  • double glazing wood
  • double glazing aliminum
  • double glazing PVC
  • Triple Glazing PVC
  • Triple glazing Aliminum

• Is there secondary glazing installed

• Recommended replacement windows

Window

• Area

• Height (mm)

• Width (mm)

• Frame replacement?

• Quick design sketch (show openings)

  Drawing

• Percentage of double glazing in property

• Recommended replacement windows

Window

• Area

• Height (mm)

• Width (mm)

• Frame replacement?

• Quick design sketch of window design showing openings

  Drawing

• Is energy saving glass installed (after 2002)?

Insulation

• Type of wall construction

  solid brick / stone

  cavity brick

  panel

  concrete

• Is any wall insulation currently installed?

• Is there scope to install wall insulation?

• Insulation material used

• Insulation thickness

• Type of roof construction

  tile

  slate

  single skin metal

  double skin metal

• Is there any roof insulation currently installed?

• Is there scope to install roof insulation?

• Insulation material used

• Insulation thickness

External

• Is there a suitable elevation for solar panels?

• Length of elevation (metres)

• Width of elevation (metres)

• Height to guttering

• Angle of roof

• Angle from south

• Percentage shading

• Rough sketch of layout

  Drawing

• Is there space available for a ground mount solar PV system?

• Width of area

• Length of area

• Sq. meterage of area

• Distance to transformer

• Rough sketch of layout

  Drawing

• Is there any other relevant information for this site?

• Other information

• Place any pictures here

  Media

• Draw any sketches here

  Drawing

• I acknowledge that this form has been completed to the best of my knowledge and that all information contained within it is correct. I understand that all the information provided within this document is confidential and I will treat it as such

• Signed

  Sign

• I understand that all of the information contained within this report will be kept confidential and only those employed and contracted by CRT will have access to the data provided herein. I understand that signing this document DOES NOT in anyway form a contract or part thereof.

• Signed

  Sign