Audit info
-
Document No.
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Audit Title
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Conducted on
-
Prepared by
Authoirzation Form
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Enter one copy of this form per utility bill
Utility Bill
Customer Information (Pepco Account Holder)
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Company Name (AS IT APPEARS ON THE UTILITY BILL)
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Business Type (general)
- Agriculture
- Industrial
- Large Commercial
- Small Commercial
- Government
- Healthcare
- Education
- Non-Profit
- Other (Describe)
-
Business Type (specific)
- Farms
- Dairies
- Livestock farm
- Greenhouse
- Refrigerated Warehouse
- Food Processor
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Business Type (specific)
- Fabrication
- Process
- Heavy manufacturing
- Warehouse
- Laboratories
- Biotech
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Business Type (specific)
- Office building
- General retail
- Big box retail
- Large grocery store chain
- Warehouse
- Convenience Store
- Hospitality/Lodging
- Assusted Living
- Data Center
- Multifamily
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Business Type (specific)
- Grocery Stores
- Convenience store
- Restaurants
- Food services
- Car dealerships
- Small Retail
- Small office
- Multifamily
-
Business Type (specific)
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Business Type (specific)
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Business Type (specific)
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Business Type (specific)
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Describe
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Address
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City
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Zip
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Contact Person
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Title
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Telephone number
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Email
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Fax
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Secondary contact?
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Secondary contact name
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Title
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Phone number
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Email
Project site information
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Expected completion date
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Building type
-
Company name different than Site name?
-
Facility Name (project site)
-
Project address
-
City
-
Zip
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Pepco Electric Account Number at Project Site
No Cost Measures
-
Check and adjust thermostat's programmable setting
-
Activate energy saving features of computers, monitors and copiers
-
Install reminder signs to turn off lights when not in use and in daylighted areas
-
Check outdoor light controls for proper operation and settings
-
Open window blinds to allow natural light to fill an area instead of artificial light
-
Check and adjust water heater thermostat's settings to 115F - 120F range if dish washing is not a factor
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Encourage the purchase of energy efficient equipment (Energy Star Certified) as a standard practice
Low Cost Measures
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Clear blocked supply and return air distribution vents (HVAC and refrigeration equipment, limit: 3 per building)
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Clean or replace air filter and exposed/accessible condenser coils associated with A/C and refrigeration units (limit: 3 per bldg)
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Replace incandescent lamps with CFLs (limit: 6 per building)
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Replace incandescent lamps with LED (limit: 1 per building)
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Replace incandescent lamps with LED (limit: 1 per building)
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Install timers on coffee makers and water coolers (limit: 5 per building)
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Install "Smart Strips" for computer equipment and associated multiple plug-in loads (limit: 3 per building)
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Add external insulation blanket to electric water heater (limit: 3 per building)
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Insulate exposed water heater pipes and accessible refrigerant piping (payment per 6 foot length, limit: 3 lengths per building)
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Replace worn gaskets on refrigerator (Payment per foot of length, limit: 20 feet per building)
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Replace worn weather stripping on exterior doors (Payment per foot of length, limit: 40 feet per building)
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Install insulation gaskets on switch and outlet plates on exterior walls (limit: 10 per building)
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Reduce air infiltration using caulk and spray foam (apply latter to increase insulation) (Payment per tube of can, limit: 6 per building)
Customer Agreement
WTEA Agreement
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The Walk-through energy assessment process of the Small Business program requires the installation of at least three (3) different No Cost / Low Cost measures. All lamps and power strips installed through the C&I Energy Savings Program should be purchased through a distributor. Materials purchased through a retailer for the purpose of installing in a commercial facility are not eligible for reimbursement through the Program. I certify that the recommended measures checked above have been installed or performed and the customer and building staff have been informed of these actions. I further certify that they have also been informed of the necessity of performing ongoing maintenance to continue to achieve energy savings. I attest that if the customer was charged, it was only for measures that exceeded the printed Program limits or items not contained on the No Cost / Low Cost checklists above.
NCLC Agreement
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I have read the entire application and agree to meet all requirements and abide by the Terms and Conditions of this application. I am authorized to sign on behalf of the Customer listed above, and represent that all information provided within is true and correct.
By signing, customer attests that all low cost/no cost measures identified in the Walk-through Assessment has been completed.
LIA Agreement
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1. Customer agrees not to purchase or install any equipment until notified that the proposed project is approved.
2. Customer agrees to allow Trade Ally to review the company's twelve month billing period.
3. Customer understands that an approved Small Business Trade Ally or Program Representative will conduct the Walk-Through Energy Assessment.
Customer Signature
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Authorized Representative Signature
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Authorized Representative Title
Facility Info
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Facility Description e.g.
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Age of building
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
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Facility Sqft.
- 0-500
- 500-1000
- 1000-1500
- 1500-2000
- 2000-2500
- 2500-3000
- 3000-3500
- 3500-4000
- 4500-5000
- 5000+
-
# Employees
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
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# Workstations
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
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Max Occupancy
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Max Occupancy if more
-
Are there computers?
-
# Computers
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
# Computers if more
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Are there cash registers?
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# Cash Registers
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25+
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# Cash Registers if more
Map
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Drawing
-
Notes
Energy sources
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Electricity
-
Natural Gas
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Heating Oil
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Propane
Gas Uses
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Gas Heat
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Gas Water Heat
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Gas Cooking
Business Hours
-
Monday open time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Monday close time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Tuesday Same as above?
-
Tuesday open time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Tuesday close time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Wednesday Same as above?
-
Wednesday open time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Wednesday close time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Thursday Same as above?
-
Thursday open time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Thursday close time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Friday Same as above?
-
Friday open time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Friday close time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Saturday Same as above?
-
Saturday open time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Saturday close time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Sunday Same as above?
-
Sunday open time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
-
Sunday close time
- 12:00 AM
- 1:00 AM
- 2:00 AM
- 3:00 AM
- 4:00 AM
- 5:00 AM
- 6:00 AM
- 7:00 AM
- 8:00 AM
- 9:00 AM
- 10:00 AM
- 11:00 AM
- 12:00 PM
- 1:00 PM
- 2:00 PM
- 3:00 PM
- 4:00 PM
- 5:00 PM
- 6:00 PM
- 7:00 PM
- 8:00 PM
- 9:00 PM
- 10:00 PM
- 11:00 PM
- 11:59 PM
Lighting
Lighting Fixtures - record all existing lighting fixtures in the facility
-
Lighting Fixture
Indoor Lighting
-
Room info
-
Room Served
-
Floor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25+
-
A/C?
-
Install Occ. Sensor?
-
Switch plate type
-
Room Type
- Private office
- Conference room
- Corridor
- copier room
- break room
- general
- exterior
- storage room
-
Footcandles
-
Lamp Type
- Incandescent
- Halogen
- CFL
- T12
- T8
- T5
- Metal Halide
- Mercury Vapor
- LED
- U-Tube T12
- U-Tube T8
- Case LED
- HTS
-
Watts
- 15
- 25
- 40
- 60
- 75
- 100
-
Watts
- 13
- 23
- 26
- 32
- 42
- 57
-
Base type
-
Watts
-
Base type
-
Watts
- 35
- 50
- 70
- 100
- 150
- 175
- 200
- 250
- 320
- 350
- 400
- 450
- 1000
- 1500
-
Watts
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
-
Base type
-
Ballast Type
- Magnetic
- Electronic
- Rapid Start
- Instant Start
- Programmed Start
- Dimmable
- Tandem-Wired
-
# of lamps per ballast
-
Base type
-
Base type
-
Ballast Type
- Magnetic
- Electronic
- Rapid Start
- Instant Start
- Programmed Start
- Dimmable
- Tandem-Wired
-
Size (ex. 2 lamps with 4 foot lamps = 2x4)
- 1x2
- 2x2
- 1x4
- 2x4
- 3x4
- 4x4
- 1x8
- 2x8
- 3x8
- 4x8
- 5x8
- 6x8
- 7x8
- 8x8
-
Shape
- A-Lamp
- R20
- R30
- R40
- Par20
- Par30
- Par38
- Flat Par20
- Flat Par30
- Flat Par38
- capsule
- deco
- MR-16
- Glober
- Flame Tip
-
Lamp Color
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Height from ground (ft.)
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25+
-
Existing Controls
-
Controls Working?
-
Picture - Take one per unique fixture and room combo, and pictures of any abnormalities.
-
Notes (optional)
Exit Signs
-
Are there exit signs?
-
Room Served
-
Lamp Type
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Height from ground (ft.)
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25+
-
Picture
-
Notes (optional)
HVAC
HVAC
-
HVAC
-
Unit ID
-
Location
-
Room Served
-
Type
-
Size (tons)
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25+
-
Make & Model
-
Age
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Control Type (Thermostat, EMS) & Manufacturer
-
Occupied set point (F)
-
Unoccupied set point (F)
-
Does it have an economizer?
-
Yrs since Last Tuneup
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
-
Programmable Thermostat?
-
Recommendations
- Tune-Up
- Econ Test
- Econ Repair
- Dual-Enth
- AQ Op
- DCV
Water Heating
Water Heating
-
Existing Water Heating
Water Heating
-
Type
-
Energy Star
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25+
-
Size (gals)
-
Pipes Insulated?
-
Tank wrapped?
-
Age
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25+
-
Condition/Comments
-
Picture
Kitchen Equipment
Refrigeration Equipment
-
Existing Refrigerator Equipment
Refrigerator
-
Refrigerator Type
- Comm refrigerator, solid door
- Commercial freezer
- Refrigerated display, glass door
- Refrigerated display, no door
- Refrig. display, freezer, glass door
- Refrig. display, coffin type freezer
- Residential type refrigerator, small
- Residential type refrigerator, med
- Residential type refrig. w/ice dispenser
- Residential type chest freezer
- Residential type upright freezer
-
Energy Star?
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Picture
Walk Ins
-
Existing Walk Ins
Walk Ins
-
Walk In Type
-
Energy Star?
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Picture
Ice Makers
-
Existing Ice Makers
Ice Makers
-
Ice Maker Type
- Ice maker, self contained, small
- Ice maker, self contained, med
- Ice maker, self contained, large
- Ice maker, water cooled small
- Ice maker, water cooled med
- Ice maker, water cooled large
- Ice maker, remote Cond. Unit, small
- Ice maker, remote Cond. Unit, med
- Ice maker, remote Cond. Unit, large
-
Energy Star?
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Picture
Food Services
-
Existing Food Service Equipment
Food Service Equipment
-
Food Service Type
- Standard Fat Fryer
- Standard Steam Cookers
- Standard Hot Food Holding Cabinet (Full-size cabinet)
- Standard Hot Food Holding Cabinet (Three-Quarter size cabinet)
- Standard Hot Food Holding Cabinet (Half-size cabinet)
- Standard Griddles
- Standard Combination Ovens
- Standard Convection Ovens
-
Energy Star?
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Picture
Motors
Motors
-
Motors
Motor
-
Existing Motors
- Air Compressor
- Air Conditioning Chiller Compressor
- Boiler Draft Fan
- Boiler Feedwater Pump
- Building Exhaust Fan
- Chilled Water (ChW) Pump
- Condensate Pump (for AC)
- Condensate Pump (steam system)
- Condenser Water Pump
- Cooling Tower Fan
- Domestic Water Booster Pump
- Domestic Water Circ Pump
- Hot Water Pump
- HVAC Exhaust Fan
- HVAC Return Air Fan
- HVAC Supply Air Fan
- Make-Up Air Fan
- Other
- Pool Pump
- Process Cooling Pump
- Process Exhaust Fan or Fume Hood
- Transfer Pump
- Wastewater Pump
- Well Pump
- WSHP Circ Loop Pump
-
VFD Annual kWh Reduction
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
HP
-
Room Served
-
Age (yrs)
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Condition/ Comments
-
Picture
Control Equipment
Control Equipment
-
Existing Control Equipment
Control equipment
-
Existing Control Equipment
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Location
-
Comments
-
Picture
Vending Machines
-
Are there any non-refrigerated vending machines?
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Controls
-
Age (years)
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Conditions/Comments
-
Picture
-
Are there any refrigerated vending machines?
-
Quantity
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Controls
-
Age (years)
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- 61
- 62
- 63
- 64
- 65
- 66
- 67
- 68
- 69
- 70
- 71
- 72
- 73
- 74
- 75
- 76
- 77
- 78
- 79
- 80
- 81
- 82
- 83
- 84
- 85
- 86
- 87
- 88
- 89
- 90
- 91
- 92
- 93
- 94
- 95
- 96
- 97
- 98
- 99
- 100+
-
Conditions/Comments
-
Picture
Custom
Custom measures
-
Custom fixtures?
Fixture type
-
Custom Measures
- Lighting & Controls
- Building Controls
- Chiller
- VFD
- HVAC
- Refrigeration
- Fluid Flow
- Thermal Insulation
- Wndows
- Process Improvement
- Compressed Air
- Water Heating
- Other
-
Measure location
-
Notes
-
Picture
Recommended Measures
-
Replace T12 lamps and magnetic ballasts with T8 lamps and electronic ballasts.
-
Replace T12/T8 lamps with higher efficiency T8 or T5 fixtures.
-
Replace T12/T8 lamps with LED fixtures
-
Replace incandescent and compact fluorescent lamps with LEDs.
-
Install new lighting fixtures with T8 lamps and electronic ballasts.
-
Replace HID light fixtures with new high bay fluorescent fixtures.
-
Replace standard HID lights with Pulse Start HID lights.
-
Install new energy efficient outdoor lighting.
-
Install occupancy sensors in your restrooms, equipment rooms, and storage rooms.
-
Install LED/LEC exit lights.
-
Optimize the performance of existing HVAC systems.
-
Replace HVAC units with new high efficiency HVAC units.
-
Replace existing food service equipment with high efficiency food service equipment.
-
Replace small, shaded-pole motors with ECM motors on refrigeration evaporator fans.
-
Install VFDs on motors over 2HP
-
Install evaporative fan controllers for walk-in coolers.
-
Install automated refrigerator door closes.
-
Install vending machine controllers
-
Install anti-sweat heater controls for glass refrigerated display doors.
-
Install new high efficiency or Energy Star water heaters
-
Install hotel room occupancy controls
-
Install office equipment controls
No Cost Low Cost Measures
-
Check and adjust thermostat's programmable settings
-
Activate energy-saving features of computers, monitors and copiers
-
Install reminder signs to turn off lights in daylit areas
-
Check outdoor light controls for proper operation and settings
-
Use window blinds to allow natural light to fill an area instead of artificial lights
-
Check and adjust water heater thermostat settings to 115F - 120F range if dish washing is not a factor
-
Encourage the purchase of energy efficient equipment (Energy Star Qualified) as a standard practice
