Title Page

  • Mandir Name

  • Energy Audit Date

  • Age Of Facility (Yrs)

  • P. Vicharan Sant

  • Mandir Coordinator

  • Facility Admin

  • Auditor Names

  • Mandir Picture (Take a picture showing the front of the Facility)

General Questions

  • Online Access to Electricity Provider?

  • Online Access to Gas Provider?

  • Online Access to Water Provider?

  • Online Access to Oil / Propane Provider?

  • Utilities bills reviewed with MC & Admin Team?

  • Access to Mandir Events Calendar (Date/Time/POC)

Facility Exterior

Exterior building elements

  • Type of Parking Lot Lights (Pole/Bollards/Perimeter)?

  • How are Parking Lot Pole Lights managed?

  • How many Parking Lot Pole Lights are there?

  • Type of Landscaping Lights?

  • How are Landscaping Lights managed?

  • How many Landscaping Lights are there?

  • Type of Bldg Exterior Lights (attached to building - including decoration Lights)

  • How are Bldg Exterior Lights managed?

  • How many Bldg Exterior Lights are there?

  • Type of Exits Door Wall Fixture?

  • How are All Exits Door Wall Fixture managed?

  • How many Exit Door Wall Fixture are there?

  • What type of Mandir Sign Light is there?

  • How are Mandir Sign managed?

  • Solar Pannels?

  • Access to Solar Pannels Controls/Generation Data?

  • Solar Pannels Maintenance appraoch?

  • Exterior - Lawn Sprinklers

  • Exterior - Lawn Sprinkler Maintenance

Facility Interior - Zone A

Mandir Entrance/Shoe Room

Doors/Windows

  • Mandir Entrance - Doors properly Insulated & Close?

  • Mandir Entrance - Type of Doors?

  • Mandir Entrance - How many doors?

Lights

  • Mandir Entrance - Type of Lights?

  • Mandir Entrance - How are the lights managed?

  • Mandir Entrance - How many lights?

  • Mandir Entrance - Gaps or Missing Ceiling Tiles?

HVAC Control

  • Mandir Entrance - HVAC Temp Controls?

  • Mandir Entrance - Access to HVAC Controls?

  • Mandir Entrance - Baseboard Controls?

  • Mandir Entrance - Current Set Point?

Hallway

Doors/Windows

  • Hallway - Exterior Doors properly Insulated & Close?

  • Hallway - Windows properly Insulated & Close?

  • Hallway - Type of Windows?

  • Hallway - Blinds/Curtains on Windows?

Lights

  • Hallway - Type of Lights?

  • Hallway - How are the lights managed?

  • Hallway - How many lights?

  • Hallway - Type of Special Lights?

  • Hallway - How are the lights managed?

  • Hallway - How many lights?

  • Hallway - Gaps or Missing Ceiling Tiles?

HVAC Supply

  • Hallway - Supply/Return Vent?

  • Hallway - Type or Return?

  • Hallway - Portable Heaters (in Winter) Used?

HVAC Control

  • Hallway - Temp Controls for HVAC?

  • Hallway - Access to HVAC Controls?

  • Hallway - Baseboard Controls?

  • Hallway - Current Set Point?

Aksharpith

Doors/Windows

  • Aksharpith - Exterior Doors properly Insulated & Close?

  • Aksharpith - Windows properly Insulated & Close?

  • Aksharpith - Type of Windows?

  • Aksharpith - Blinds/Curtains on Windows?

Lights

  • Aksharpith - Type of Lights?

  • Aksharpith - How are the lights managed?

  • Aksharpith - How many lights?

  • Aksharpith - Gaps or Missing Ceiling Tiles?

  • Aksharpith - Type of Special Lights?

  • Aksharpith - How are the lights managed?

  • Aksharpith - How many lights?

HVAC Supply

  • Aksharpith - Supply/Return Vent?

  • Aksharpith - Type or Return?

  • Aksharpith - Portable Heaters (in Winter) Used?

HVAC Control

  • Aksharpith - Temp Controls for HVAC?

  • Aksharpith - Access to HVAC Controls?

  • Aksharpith - Baseboard Controls?

  • Aksharpith - Current Set Point?

Shayona

Doors/Windows

  • Shayona - Extrior Doors properly Insulated & Close?

  • Shayona - Windows properly Insulated & Close?

  • Shayona - Type of Windows?

  • Shayona - Blinds/Curtains on Windows?

Lights

  • Shayona - Type of Lights?

  • Shayona - How are the lights managed?

  • Shayona - How many lights?

  • Shayona - Gaps or Missing Ceiling Tiles?

  • Shayona - Type of Special Lights?

  • Shayona - How are the lights managed?

  • Shayona - How many lights?

HVAC Supply

  • Shayona - Supply/Return Vent?

  • Shayona - Type or Return?

  • Shayona - Portable Heaters (in Winter) Used?

HVAC Control

  • Shayona - Temp Controls for HVAC?

  • Shayona - Access to HVAC Controls?

  • Shayona - Baseboard Controls?

  • Shayona - Current Set Point?

Fridge/Freezer

  • Shayona - Type of Fridge?

  • Shayona - How many?

  • Shayona - Type of Freezer?

  • Shayona - How many?

  • Shayona - Food Warmers?

  • Shayona - How many?

Facility Interior - Zone B

M/W Restroom (+Family Restrooms)

Doors/Windows

  • M/W Bathrooms - Extrior Doors properly Insulated & Close?

  • M/W Bathrooms - Windows properly Insulated & Close?

  • M/W Bathrooms - Type of Windows?

  • M/W Bathrooms - Blinds/Curtains on Windows?

Lights

  • M/W Bathrooms - Type of Lights?

  • M/W Bathrooms - How are the lights managed?

  • M/W Bathrooms - How many lights?

  • M/W Bathrooms - Gaps or Missing Ceiling Tiles?

  • M/W Bathrooms - Type of Special Lights?

  • M/W Bathrooms - How are the lights managed?

  • M/W Bathrooms - How many lights?

  • M/W Bathrooms - How many Hand Dryers?

HVAC Supply

  • M/W Bathrooms - Supply/Return Vent?

  • M/W Bathrooms - Exhaust Fans - Adequete Size?

  • M/W Bathrooms - Exhaust Fans - Controls?

  • M/W Bathrooms - Exhaust Fans - How Many?

HVAC Control

  • M/W Bathrooms - Temp Controls for HVAC?

  • M/W Bathrooms - Access to HVAC Controls?

  • M/W Bathrooms - Baseboard Controls?

  • M/W Bathrooms - Current Set Point?

Plumbing

  • M/W Bathrooms - Sink - Aerators intalled?

  • M/W Bathrooms - Sink - Type of Faucet?

  • M/W Bathrooms - Urinals Type?

  • M/W Bathrooms - Toliets Type?

Sabha Hall

Doors/Windows

  • Sabha Hall - Exterior Doors properly Insulated & Close?

  • Sabha Hall - Windows properly Insulated & Close?

  • Sabha Hall - Type of Windows?

  • Sabha Hall - Blinds/Curtains on Windows?

Lights

  • Sabha Hall - Type of Lights?

  • Sabha Hall - How are the lights managed?

  • Sabha Hall - How many lights?

  • Sabha Hall - Gaps or Missing Ceiling Tiles?

  • Sabha Hall - Type of Special Lights?

  • Sabha Hall - How are the lights managed?

  • Sabha Hall - How many lights?

HVAC Supply

  • Sabha Hall - Supply/Return Vent?

  • Sabha Hall - Type or Return?

  • Sabha Hall - Portable Heaters (in Winter) Used?

HVAC Control

  • Sabha Hall - Temp Controls for HVAC?

  • Sabha Hall - Access to HVAC Controls?

  • Sabha Hall - Baseboard Controls?

  • Sabha Hall - Current Set Point?

  • Sabha Hall - Radiant Heating?

  • Sabha Hall - Current Set Point?

  • Sabha Hall - Multiple Temperature Sensors acorss Sabha Hall?

Stage

Lights

  • Stage - Type of Lights?

  • Stage - How many lights?

  • Stage - Gaps or Missing Ceiling Tiles?

  • Stage - Backdrop Type?

  • Stage - Number of Projectors?

Garbagruh/Sinhasan

Lights

  • Garbagruh/Sinhasan - Type of Lights?

  • Garbagruh/Sinhasan - How are the lights managed?

  • Garbagruh/Sinhasan - How many lights?

  • Garbagruh/Sinhasan - Gaps or Missing Ceiling Tiles?

  • Garbagruh/Sinhasan - Type of Special Lights?

  • Garbagruh/Sinhasan - How are the lights managed?

  • Garbagruh/Sinhasan - How many lights?

HVAC Supply

  • Garbagruh/Sinhasan - Supply/Return Vent?

  • Garbagruh/Sinhasan - Type or Return?

  • Garbagruh/Sinhasan - Portable Heaters (in Winter) Used?

HVAC Control

  • Garbagruh/Sinhasan - Temp Controls for HVAC?

  • Garbagruh/Sinhasan - Access to HVAC Controls?v

  • Garbagruh/Sinhasan - Baseboard Controls?

  • Garbagruh/Sinhasan - Radiant Heating?

  • Garbagruh/Sinhasan - Current Set Point?

Facility Interior - Zone C

Dining Hall

Doors/Windows

  • Dining Hall - Exterior Doors properly Insulated & Close?

  • Dining Hall - Windows properly Insulated & Close?

  • Dining Hall - Type of Windows?

  • Dining Hall - Blinds/Curtains on Windows?

Lights

  • Dining Hall - Type of Lights?

  • Dining Hall - How are the lights managed?

  • Dining Hall- How many lights?

  • Dining Hall - Gaps or Missing Ceiling Tiles?

  • Dining Hall - Type of Special Lights?

  • Dining Hall - How are the lights managed?

  • Dining Hall - How many lights?

HVAC Supply

  • Dining Hall - Supply/Return Vent?

  • Dining Hall - Type or Return?

  • Dining Hall - Portable Heaters (in Winter) Used?

HVAC Control

  • Dining Hall - Temp Controls for HVAC?

  • Dining Hall - Access to HVAC Controls?

  • Dining Hall - Baseboard Controls?

  • Dining Hall - Current Set Point?

  • Dining Hall - Radiant Heating?

  • Dining Hall - Current Set Point?

Classrooms/Meeting Rooms

Doors/Windows

  • Classrooms - Exterior Doors properly Insulated & Close?

  • Classrooms - Windows properly Insulated & Close?

  • Classrooms - Type of Windows?

  • Classrooms - Blinds/Curtains on Windows?

Lights

  • Classrooms - Type of Lights?

  • Classrooms - How are the lights managed?

  • Classrooms - How many lights?

  • Classrooms - Gaps or Missing Ceiling Tiles?

  • Classrooms - TV or Projectors

HVAC Supply

  • Classrooms - Supply/Return Vent?

  • Classrooms - Type or Return?

  • Classrooms - Portable Heaters (in Winter) Used?

HVAC Control

  • Classrooms - Temp Controls for HVAC?

  • Classrooms - Access to HVAC Controls?

  • Classrooms - Baseboard Controls?

  • Classrooms - Current Set Point?

Storage/Other Rooms

Doors/Windows

  • Storage/Other Rooms - Exterior Doors properly Insulated & Close?

  • Storage/Other Rooms - Windows properly Insulated & Close?

  • Storage/Other Rooms - Type of Windows?

  • Storage/Other Rooms - Blinds/Curtains on Windows?

Lights

  • Storage/Other Rooms - Type of Lights?

  • Storage/Other Rooms - How are the lights managed?

  • Storage/Other Rooms - How many lights?

  • Storage/Other Rooms - Gaps or Missing Ceiling Tiles?

HVAC Supply

  • Storage/Other Rooms - Supply/Return Vent?

  • Storage/Other Rooms - Type or Return?

  • Storage/Other Rooms - Portable Heaters (in Winter) Used?

HVAC Control

  • Storage/Other Rooms - Temp Controls for HVAC?

  • Storage/Other Rooms - Access to HVAC Controls?

  • Storage/Other Rooms - Baseboard Controls?

  • Storage/Other Rooms - Current Set Point?

Facility Interior - Zone D

Pujari Nivas - Rooms

Doors/Windows

  • Pujari Nivas - Rooms - Exterior Doors properly Insulated & Close?

  • Pujari Nivas - Rooms - Windows properly Insulated & Close?

  • Pujari Nivas - Rooms - Type of Windows?

  • Pujari Nivas - Rooms - Blinds/Curtains on Windows?

Lights

  • Pujari Nivas - Rooms - Type of Lights?

  • Pujari Nivas - Rooms - How are the lights managed?

  • Pujari Nivas - Rooms - How many lights?

  • Pujari Nivas - Rooms - Gaps or Missing Ceiling Tiles?

HVAC Supply

  • Pujari Nivas - Rooms - Supply/Return Vent?

  • Pujari Nivas - Rooms - Type or Return?

  • Pujari Nivas - Rooms - Portable Heaters (in Winter) Used?

HVAC Control

  • Pujari Nivas - Rooms - Temp Controls for HVAC?

  • Pujari Nivas - Rooms - Access to HVAC Controls?

  • Pujari Nivas - Rooms - Baseboard Controls?

  • Pujari Nivas - Rooms - Current Set Point?

Pujari Nivas - Bathroom

Doors/Windows

  • Pujari Nivas - Bathroom - Extrior Doors properly Insulated & Close?

  • Pujari Nivas - Bathroom - Windows properly Insulated & Close?

  • Pujari Nivas - Bathroom - Type of Windows?

  • Pujari Nivas - Bathroom - Blinds/Curtains on Windows?

Lights

  • Pujari Nivas - Bathroom - Type of Lights?

  • Pujari Nivas - Bathroom - How are the lights managed?

  • Pujari Nivas - Bathroom - How many lights?

  • Pujari Nivas - Bathroom - Gaps or Missing Ceiling Tiles?

  • Pujari Nivas - Bathroom - Type of Special Lights?

  • Pujari Nivas - Bathroom - How are the lights managed?

  • Pujari Nivas - Bathroom - How many lights?

  • Pujari Nivas - Bathroom - Hand Dryers - How many?

HVAC Supply

  • Pujari Nivas - Bathroom - Supply Vent?

  • Pujari Nivas - Bathroom - Exhaust Fans - Adequate Size?

  • Pujari Nivas - Bathroom - Exhaust Fans - Controls?

  • Pujari Nivas - Bathroom - Exhaust Fans - How Many?

HVAC Control

  • Pujari Nivas - Bathroom - Temp Controls for HVAC?

  • Pujari Nivas - Bathroom - Access to HVAC Controls?

  • Pujari Nivas - Bathroom - Baseboard Controls?

  • Pujari Nivas - Bathroom - Current Set Point?

Facility Interior - Zone E

Sant Nivas - Rooms

Doors/Windows

  • Sant Nivas - Rooms - Exterior Doors properly Insulated & Close?

  • Sant Nivas - Rooms - Windows properly Insulated & Close?

  • Sant Nivas - Rooms - Type of Windows?

  • Sant Nivas - Rooms - Blinds/Curtains on Windows?

Lights

  • Sant Nivas - Rooms - Type of Lights?

  • Sant Nivas - Rooms - How are the lights managed?

  • Sant Nivas - Rooms - How many lights?

  • Sant Nivas - Rooms - Gaps or Missing Ceiling Tiles?

HVAC Supply

  • Sant Nivas - Rooms - Supply/Return Vent?

  • Sant Nivas - Rooms - Type or Return?

  • Sant Nivas - Rooms - Portable Heaters (in Winter) Used?

HVAC Control

  • Sant Nivas - Rooms - Temp Controls for HVAC?

  • Sant Nivas - Rooms - Access to HVAC Controls?

  • Sant Nivas - Rooms - Baseboard Controls?

  • Sant Nivas - Rooms - Current Set Point?

Sant Nivas - Bathroom

Doors/Windows

  • Sant Nivas - Bathroom - Exterior Doors properly Insulated & Close?

  • Sant Nivas - Bathroom - Windows properly Insulated & Close?

  • Sant Nivas - Bathroom - Type of Windows?

  • Sant Nivas - Bathroom - Blinds/Curtains on Windows?

Lights

  • Sant Nivas - Bathroom - Type of Lights?

  • Sant Nivas - Bathroom - How are the lights managed?

  • Sant Nivas - Bathroom - How many lights?

  • Sant Nivas - Bathroom - Gaps or Missing Ceiling Tiles?

  • Sant Nivas - Bathroom - Type of Special Lights?

  • Sant Nivas - Bathroom - How are the lights managed?

  • Sant Nivas - Bathroom - How many lights?

  • Sant Nivas - Bathroom - Hand Dryers - How many?

HVAC Supply

  • Sant Nivas - Bathroom - Supply Vent?

  • Sant Nivas - Bathroom - Exhaust Fans - Adequate Size?

  • Sant Nivas - Bathroom - Exhaust Fans - Controls?

  • Sant Nivas - Bathroom - Exhaust Fans - How Many?

HVAC Control

  • Sant Nivas - Bathroom - Temp Controls for HVAC?

  • Sant Nivas - Bathroom - Access to HVAC Controls?

  • Sant Nivas - Bathroom - Baseboard Controls?

  • Sant Nivas - Bathroom - Current Set Point?

Facility Interior - Zone F

Kitchen

Doors/Windows

  • Kitchen - Rooms - Exterior Doors properly Insulated & Close?

  • Kitchen - Rooms - Windows properly Insulated & Close?

  • Kitchen - Rooms - Type of Windows?

  • Kitchen - Rooms - Blinds/Curtains on Windows?

Lights

  • Kitchen - Rooms - Type of Lights?

  • Kitchen - Rooms - How are the lights managed?

  • Kitchen - Rooms - How many lights?

  • Kitchen - Rooms - Gaps or Missing Ceiling Tiles?

HVAC Supply

  • Kitchen - Rooms - Supply/Return Vent?

  • Kitchen - Rooms - Type or Return?

  • Kitchen - Rooms - Portable Heaters (in Winter) Used?

  • Kitchen - Hood Cleaning Contract?

  • Kitchen - Hood Fresh Air Intake?

HVAC Control

  • Kitchen - Rooms - Temp Controls for HVAC?

  • Kitchen - Rooms - Access to HVAC Controls?

  • Kitchen - Rooms - Baseboard Controls?

  • Kitchen - Rooms - Current Set Point?

Fridge/Freezer

  • Kitchen - Type of Fridge?

  • Kitchen - How many?

  • Kitchen - Air Curtain Installed?

  • Kitchen - Type of Freezer?

  • Kitchen - How many?

  • Kitchen - Air Curtain Installed?

  • Kitchen - Maintenance Contract?

Equipments

  • Kitchen - Food Warmers/Ovens Type?

  • Kitchen - How many Warmers/Ovens?

  • Stove

  • Grill

  • Pizza Own

  • Food Warmer

Facility Interior - Zone G

Janitor Closet

Doors/Windows

  • Janitor Closet - Exterior Doors properly Insulated & Close?

  • Janitor Closet - Windows properly Insulated & Close?

  • Janitor Closet - Type of Windows?

  • Janitor Closet - Blinds/Curtains on Windows?

Lights

  • Janitor Closet - Type of Lights?

  • Janitor Closet - How are the lights managed?

  • Janitor Closet - How many lights?

  • Janitor Closet - Gaps or Missing Ceiling Tiles?

HVAC Supply

  • Janitor Closet - Supply Vent?

  • Janitor Closet - Exhaust Fans - Adequate Size?

  • Janitor Closet - Exhaust Fans - Controls?

  • Janitor Closet - Exhaust Fans - How Many?

HVAC Control

  • Janitor Closet - Temp Controls for HVAC?

  • Janitor Closet - Access to HVAC Controls?

  • Janitor Closet - Baseboard Controls?

  • Janitor Closet - Current Set Point?

Equipments

  • Janitor Closet - How many Washers?

  • Janitor Closet - How many dryers?

  • Janitor Closet - Type of dryers?

Mechanical/Utility Rooms

Doors/Windows

  • Mechanical/Utility - Exterior Doors properly Insulated & Close?

  • Mechanical/Utility - Windows properly Insulated & Close?

  • Mechanical/Utility - Type of Windows?

  • Mechanical/Utility - Blinds/Curtains on Windows?

Lights

  • Mechanical/Utility - Type of Lights?

  • Mechanical/Utility - How are the lights managed?

  • Mechanical/Utility - How many lights?

  • Mechanical/Utility - Gaps or Missing Ceiling Tiles?

HVAC Supply

  • Mechanical/Utility - Supply Vent?

  • Mechanical/Utility - Type or Return?

  • Mechanical/Utility - Portable Heaters (in Winter) Used?

HVAC Control

  • Mechanical/Utility - Temp Controls for HVAC?

  • Mechanical/Utility - Access to HVAC Controls?

  • Mechanical/Utility - Baseboard Controls?

  • Mechanical/Utility - Current Set Point?

Domestic Water

  • Domestic Water - Type of Water Heater?

  • Domestic Water - Type of Unit?

  • Domestic Water - How many?

  • Domestic Water - Brand?

  • Domestic Water - PM Checklist Attached?

  • Domestic Water - Hot Water Piping Insulated?

  • Domestic Water - Leak/IOT Sensor?

  • Domestic Water - Maintenance Contract?

  • Domestic Water - Hot Water Pump (For Bathrooms or Kitchen)

Domestic Water Softener

  • Domestic Water Softener - Do you have it?

  • Domestic Water Softener - How many?

  • Domestic Water Softener - Brand?

  • Domestic Water Softener - PM Checklist Attached?

  • Domestic Water Softener - Maintenance Contract?

Furnace

  • Furnace - Type of Unit?

  • Furnace - How many?

  • Furnace - Brand?

  • Furnace - PM Checklist Attached?

  • Furnace - Filter Change History Attached?

  • Furnace - Maintenance Contract?

Split Unit

  • Split Unit - Type of Unit?

  • Split Unit - How many?

  • Split Unit - Brand?

  • Split Unit - PM Checklist Attached?

  • Split Unit - Maintenance Contract?1

Boilers

  • Boilers - Usage for Baseboard/Radiator

  • Boilers - Usage for Infloor Heating

  • Boilers - Type?

  • Boilers - Brand?

  • Boilers - How many?

  • Boilers - Age?

  • Boilers - PM Checklist Attached?

  • Boilers - Maintenance Contract?

Makeup Air Units

  • Makeup Air Units - Type?

  • Makeup Air Units - How many?

  • Makeup Air Units - Brand?

  • Makeup Air Units - Age?

  • Makeup Air Units - PM Checklist Attached?

  • Makeup Air Units - Maintenance Contract?

Heatpump

  • Heatpump - Type?

  • Heatpump - How many?

  • Heatpump - Brand?

  • Heatpump - Age?

  • Heatpump - PM Checklist Attached?

  • Heatpump - Maintenance Contract?

BMS

  • BMS - BMS System Enabled?

  • BMS - Demand Reduction by programming or staggering operations

Roof

Door/Windows

  • Roof Access - Doors properly Insulated & Close?

Rooftop Units (RTUs)

  • RTUs - Type of Unit?

  • RTUs - How many?

  • RTUs - Brand?

  • RTUs - Filture Change Record?

  • RTUs - PM Checklist Attached?

  • RTUs - Maintenance Contract?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.