Energy Retrofit Site Inspection Form
Use this form to document site details, building conditions, retrofit opportunities, access notes, and inspector observations for an energy retrofit inspection.
Site and Contact Details
Site Name or Address
*
Inspection Date
*
-
Month
-
Day
Year
Date
Inspector Name
*
First Name
Middle Name
Last Name
Client / Contact Name
*
First Name
Middle Name
Last Name
Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Contact Email
*
example@example.com
Building and Existing Conditions
Building Type
*
Single-family home
Multi-family building
Commercial building
Mixed-use
Other
Approximate Building Age (years)
Number of Floors
*
Approximate Floor Area (sq ft)
Current Heating System Type
Please Select
Gas furnace
Boiler
Heat pump
Electric resistance
District heating
Wood/pellet stove
Other
Current Cooling System Type
Please Select
Central air conditioning
Heat pump
Window/portable units
Evaporative cooling
None
Other
Visible Condition Notes
Energy Retrofit Opportunities and Site Access
Observed Retrofit Opportunities
*
Insulation
Air Sealing
Windows/Doors
HVAC Upgrade
Lighting
Solar/PV
Ventilation
Water Heating
Controls
Other
Main Priorities / Issues Identified
*
Site Access Constraints and Recommended Next Steps
*
Inspector Observations / Photo Notes
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