Energy Audit Report Form

Energy Audit Report
Auditor Name
First NameLast Name
Building Status*
Date and time of the Audit
MonthDayYearHourMinutesAM/PM Option
Identify any equipment that was running that should not have been...
Plug Load*
Office CopiersFaculty CopiersOffice ComputersOffice MonitorsOffice PrintersPC-Lab ComputersPC-Lab MonitorsClass ComputersClass MonitorsClass PrintersTV-VCR-DVDAV EquipmentVending MachinesDrinking FountainsPersonal DevicesNothing left on
Lighting*
OfficeHallwayClassroomBreakroomWork RoomLibraryCafeteriaGymLocker RoomsRestroomsAuditoriumStageStorage RoomsMechanical RoomsWork ShopsNothing Left On
HVAC*
BoilersPumpsAir Handler (AHU)Roof Top Unit (RTU)Baseboard HeatersWall HeatersVestibule HeatersUni-Vent HeatersFan-Coil HeatersExhaust FansWater HeatersRecirculation PumpsKitchen EquipmentHood FansAir Filters Need ReplacingNothing Left On
Facility Items Checked/Adjusted, Safety & Security Concerns...
Facility Concerns*
EMS ScheduleProgrammable ThermostatsNon-Programmable ThermostatsWeather StrippingDoor SweepsDigital TimersMechanical TimersInterior PlumbingOutside PlumbingSprinkler Systems Ok
Safety Concerns*
Leaks or Puddles InsideLeaks or Puddles OutsideTrip Hazards InsideTrip Hazards OutsideExtension Cords In UseIce or Slick ConditionsSecurity Lights outSecurity Lights AdjustedUnsecured ShelvingExit Signs Not WorkingExit Maps Missing¡No Concerns!
Security Concerns*
Windows OpenWindows UnlockedInterior Doors OpenExterior Doors OpenExterior Doors UnlockedDoors Propped OpenCameras Not workingCameras Need Adjusting¡No Concerns!
Comments*
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