Title Page
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Client / Site
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Conducted on
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Prepared by
Equipment & Appliances
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Instructions:
1. Based on inspection, select whether an equipment or appliance is "efficient" or "inefficient".
2. Include notes to explain your findings and recommendations to improve efficiency and reduce energy costs.
Check lighting systems, HVAC Systems, and Electrical Appliances for energy efficiency, and recommend possible improvements to cut energy costs.
Lighting Systems - Internal
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Floor plan (if available)
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Waiting Zone
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Reception
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Kitchen
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Cafe Lounge
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Office A
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Office B
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Office C
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File/Stock Room
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Conference Room
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IT/Support Office
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Retreat/Break Room
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Open Office A
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Open Office B
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Copy Center
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Notes
Lighting Systems - External
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Pole-mounted lights
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Canopy lighting
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Notes
Heating, Ventilation, and Air Conditioning (HVAC)
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Air conditioner
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Furnace
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Notes
Electrical Appliances
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Computer CPU
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Computer monitor
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Printer
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Scanner
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TVs
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Refrigerator
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Microwave
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Coffee machine
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Shredder
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Notes
Office Composition
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Check for insulation and proper sealing.
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Windows
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Doors
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Walls
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Notes
Energy Consumption Habits
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Are computers turned off when not in use?
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Are appliances unplugged when not in use?
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Are some lights turned off in the daytime to take advantage of natural light?
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Are external lights turned off during daylight hours?
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Are lights turned off at the end of office hours?
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Is an automatic thermostat installed and setup for efficiency?
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Is solar panel installation an option?
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Notes
Findings and Recommendations
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Summary Report
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Name and Signature of auditor
