Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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1. System Data
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Chiller Full-Load Capacity (tons):
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Chiller Full-Load Rating (kW/ton, or 1,000 lb/ton):
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Equivalent Full-Load Operating Hours (hr):
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Energy Cost Rate ($/kWh, or $/1,000 lbs):
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2. Annual Energy Cost - Design Conditions
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Chiller Capacity (tons)✖️Chiller Rating (kW/ton) or (1,000 lb/ton)✖️Equivalent Full - Load Hours (hr)✖️Energy Rate ($/kWh) or ($/1,000 lb) = ___________ (Design Annual Energy Cost ($) )
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3. Annual Energy Cost - Actual Conditions
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Design Annual Energy Cost ($)✖️[1➕Efficiency Loss] = __________ (Improved Annual Energy Cost ($) )
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4. Annual Energy Cost - Improved Fouling Factor
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Design Annual Energy Cost ($) ✖️[1➕Efficiency Loss] = __________ Improved Annual Energy Cost ($)
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5. Annual Energy Savings
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Actual Annual Energy Cost ($) ➖Improved Annual Energy Cost ($) = Annual Energy Savings ($)
