Vista Solar LLC

Customer Personal Information

• Document No.

• Lead Date / Lead Time

  Date

• Appointment Date / Time

  Date

• How did you know about us?

• Energy Efficiency Technician

• Customer Name

• Customer Address
  Address

• Phone

• Alt. Number

• E-Mail

• Attached Energy Bill?

  Yes

  No

  N/A

• Highest Electric Bill

• Lowest Electric Bill

• House Measure

• Type of Building

  Residential

  Commercial

  Industrial

  Public

System Type

• Solar Panels

  Yes

  No

  N/A

• Solar Cool Heating & A/C

  Yes

  No

  N/A

• Solar Thermal Water Heater

  Yes

  No

  N/A

• Solar Canopy

  Yes

  No

  N/A

• Helicol Heat Pool Pump

  Yes

  No

  N/A

• Sedna Power Plant

  Yes

  No

  N/A

• Solar Attic Fan

  Yes

  No

  N/A

Customer Priorities

• Decrease Energy Bill

  1

  2

  3

  4

• Tax Incentives

  1

  2

  3

  4

• Environment

  1

  2

  3

  4

• Increase House Value

  1

  2

  3

  4

Energy Analysis

• Air Leaks

  Low

  High

• Are Windows Energy Efficient?

  Yes

  No

  N/A

• Ductwork needs to be:

  Installed

  Repaired

  Replaced

  NONE

• Attic Temperature in Fº

• Attic Ventilation

  GOOD

  BAD

  ACCEPTABLE

• Attic Insulation

  GOOD

  BAD

  ACCEPTABLE

• Floor Insulation

  GOOD

  BAD

  ACCEPTABLE

• Walls Insulation

  GOOD

  BAD

  ACCEPTABLE

Heating & A/C Information (UNIT 1)

• Tonnage

  2 TON

  3 TON

  4 TON

  5 TON

  + 5 TON

• SEER Rating

  0-10 SEER

  11-13 SEER

  14-18 SEER

  19-22 SEER

• Furnace / Air Handler

  Gas

  Electric

• System Age

  Select 1 2 3 4 5 6 7 8 9 10 11-15 More than 15

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11-15
  • More than 15

Heating & A/C Information (UNIT 2)

• Tonnage

  2 TON

  3 TON

  4 TON

  5 TON

  + 5 TON

• SEER Rating

  0-10 SEER

  11-13 SEER

  14-18 SEER

  19-22 SEER

• Furnace / Air Handler

  Gas

  Electric

• System Age

  Select 1 2 3 4 5 6 7 8 9 10 11-15 More than 15

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11-15
  • More than 15

Heating & A/C Information (UNIT 3)

• Tonnage

  2 TON

  3 TON

  4 TON

  5 TON

  + 5 TON

• SEER Rating

  0-10 SEER

  11-13 SEER

  14-18 SEER

  19-22 SEER

• Furnace / Air Handler

  Gas

  Electric

• System Age

  Select 1 2 3 4 5 6 7 8 9 10 11-15 More than 15

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11-15
  • More than 15

• Additional Information: