AuditSampleForms Master Sept 27 2011

COVER PAGE
Commercial Building Energy Audit Sample Forms

Copyright 2011, Rocky Mountain Institute www.rmi.org
Purpose
Gathering the right data, with the appropriate amount of detail, is a key component to realizing the
maximum savings from an energy audit. However, the process for audit data collection is currently
non-standardized, and crucial data can be overlooked or the level of detail is insufficient for the
required energy and financial analyses. To address these issues, we have created these template data
collection forms. The purpose of these sample forms are to assist building energy auditors collect data
required to complete comprehensive energy and financial analyses of proposed modifications to the
building. These forms are best suited to Level II and Level III audits.
Acknowledgements
Rocky Mountain Institute, Integral Group, Taylor Engineering, kW Engineering
Sample Form Recommended Use
Identify which of the information listed in these sample forms are needed for your project.
Identify your anticipated source for each piece of data. Typical data sources are listed below.
Use
column
where
available
inthat
casehave
you been
need filled
to clarify
the information
Use the
the "citation"
"Guidance"
Sample
Forms
provided
in sample
data as at a later time.
an example of the type of information you should be collecting; you may want to print
them out and take them with you to the site.
Collect as much data as possible prior to a site visit.
Print the Sample Forms (sometimes multiples of each) and bring them (or the electronic version) with you to the s
Typical Data Sources
Facility manager
As-built drawing sets
Utility bills
BAS trend data
On-site spot measurements
Temporary logger data
Tools for a
Tools for a
Level
I
Level
II and meter (light meter)
Identification
Illuminance
Audit
:
III
Audit
Notebook / Clipboard
Infrared :temperature spot meter
Phone
Electronic ballast spinner/detector
Audit forms appropriate to the site
Power meter and/or data loggers
Digital Camera
Temperature loggers
Multi-Tool
Light loggers
Flashlight
Motor runtime status loggers
Digital thermometer and/or humidity meter
Hearing protection (for mechanical rooms)
Specialized equipment for detailed assessments may also include:
Boiler stack gas analyzer (for combustion tests)
Ultrasonic flow meters (for monitoring chilled water, condenser water, or heating water flows
Infrared camera
Centralized data logging systems
Construction hard hat
COVER PAGE
n) with you to the site.
TABLE OF CONTENTS
GENERAL INFORMATION
1.0 Basics
1.1 Capital Improvement Plan
1.2 Utility Cost Data
1.3 Delivered Consumption Data
1.4 Preliminary Energy Use Analysis
1.5 Operations and Maintenance Cost
GEOMETRY &ENVELOPE
2.0 Sketches
2.1 Opaque Surfaces
2.2 Fenestration
2.3 Opaque Doors
SCHEDULES
3.0 Occupancy
3.1 Lighting
3.2 Plug Loads
3.3 Thermostat Schedule
PEAK LOADS
4.0 Peak Occupancy
4.1 Interior Lighting
4.2 Exterior Lighting
4.3 Peak Plug Loads
DOMESTIC HOT WATER
5.0 Equipment
5.1 Fixtures and Use
HVAC & CONTROLS OPTIONS
6.0 Boilers
6.1 Chillers
6.2 Cooling Towers and Fluid Coolers
6.3 Pumps and Piping Systems
6.4 Air Handling System Equipment
6.5 Air Handling System Controls
6.6 Air System Terminal Units
6.7 Zone Heating Equipment
6.8 Fan Coil Units
6.9 Exhaust/Return Fans
6.10 Packaged Units: DX, Heat Pumps
6.11 Condensing Unit and Condensers
SPECIALTY LOADS SAMPLE FORMS
7.0 Swimming Pools
7.1 Kitchen Equipment
7.2 Lab Equipment
7.3 Refrigeration Equipment
7.4 Datacenters/IT Rooms
7.5 Process Equipment
TABLE OF CONTENTS
1.0 BASICS

Name
Project
Name:
Information
Client Name:
City / State:
Building
Type:
(CBECS if
possible)
No. of
Stories
Gross Area
Building Age
No. of
tenants /
Lease type
Key Contacts Name and position
Economic Criteria for Energy Projects
Previous Audit Availability
Notes:
Phone/Email
Citation
1.1 CAPITAL IMPROVEMENT PLAN

To calculate the marginal capital costs of efficiency measures, it is necessary to document any plans for capital
improvement. Since a whole-building retrofit may alter the course of almost any type of planned improvements,
it is important to document them all (several types are indicated below). Print multiple sheets as necessary.
Capital
Improvement
Type: (circle one)
HVAC
Other
Envelope
Electrical
Plumbing
Aesthetic
Year
Description of planned replacement, renewal, or system expansion Planned
Life Safety
Cost
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL
#VALUE!
Citation
1.2 UTILITY COST DATA

Three years of data should be obtained for each meter in the building. If the meter cannot be checked,
then obtain utility bills from the client or tenants. Print multiple utility sheets as necessary.
ELECTRIC
Utility Name:
Account Number:
Meter Number:
Rate Schedule Name:
Notes on Rate:
YEAR:
Bill
Date
Actual
Billed Electric
Days in
Ave
Demand Electric Other Total Bill
Demand Demand
Use
Period Temp (F)
Cost ($) Use ($) Fees ($)
($)
(kW)
(kW)
(kWh)
January
$0
February
$0
March
$0
April
$0
May
$0
June
$0
July
$0
August
$0
September
$0
October
$0
November
$0
December
$0
Annual Totals
Peak Demand (kW)
Total Annual Cost ($)
$0
Average kW Cost ($)
#DIV/0!
Average kWh Cost ($)
#DIV/0!
$0
$0
$0
$0

NATURAL GAS
Utility Name:
Account Number:
Meter Number:
Rate Schedule Name:
Notes on Rate:
YEAR:
Actual
Billed
Days in
Ave
Demand Demand Gas Use* Demand Gas Use Other Total Bill
Bill Date
Period Temp (F)
*
*
(_______) Cost ($)
($)
Fees ($)
($)
(_______) (_______)
January
$0
February
$0
March
$0
April
$0
May
$0
June
$0
July
$0
August
$0
September
$0
October
$0
November
$0
December
$0
Annual Totals
$0
* Choose appropriate units for gas (typically MMBtu, MMBtu, therms, or MCF)
Peak Demand (______)
0
$0.00
Average _______ Cost ($)
#DIV/0!
#DIV/0!
$0
$0
$0

OTHER
Utility Name and Type*:
Account Number:
Meter Number:
Rate Schedule Name:
Notes on Rate:
* Other utilities might be purchased steam, purchased chilled water, LPG, or fuel oil.
YEAR:
Actual
Billed
Days in
Ave
Demand Demand
Use*
Demand Gas Use Other Total Bill
Bill Date
Period Temp (F)
*
*
(_______) Cost ($)
($)
Fees ($)
($)
(_______) (_______)
January
$0
February
$0
March
$0
April
$0
May
$0
June
$0
July
$0
August
$0
September
$0
October
$0
November
$0
December
$0
Annual Totals
* Units should be whatever appears on the bill
Peak Demand (______)
0
$0
#DIV/0!
#DIV/0!
$0
$0
$0
$0
1.3 DELIVERED CONSUMPTION DATA

Three years of data should be obtained for each delivered service. Get delivered information
from the client or the service provider. Print multiple utility sheets as necessary.
Utility Company:
Account Number:
Rate Number:
Energy Type:
Units:1
Delivery Date
Delivery
Amount
Total Cost2
1
2
3
4
5
6
7
8
9
10
11
12
Use of Inventory C
13
14
15
At Date 0
365 Days after Date 0
Use of Inventory (A-B)
16
17
Value of Inventory Used
18
Latest Price
19
Value (CxD)
20
USE OF
INVENTORY
TOTAL
CONSUMPTION
1. gal, lbs, etc.
2. Costs should include tax, fees, contract charges, etc.
D
$0.00
1.4 PRELIMINARY ENERGY USE ANALYSIS

Energy Type
Total
Annual Use
Units
Conversion
Multiplier
Thousand
Total Annual
s BTU
Cost ($)
(kBtu)
Electricity
MMBtu
1000
Natural Gas
therms
100
Purchased Steam
Purchased Hot Water
Purchased Chilled Water
Oil #_________________
Propane
Coal
Thermal - On-Site Generated
Other
Electricity - On-Site Generated
Thermal or Electricity - Exported
Total
Gross Conditioned Square Feet

EUI (energy use intensity)
#DIV/0!
Target Finder Score

ECI (energy cost index or $/sf)
Notes:
#DIV/0!
1.5 OPERATIONS AND MAINTENANCE

Documenting annual operations and maintenance costs will allow you to calculate changes in
these costs as a result of the retrofit. If possible, gather at least three years of data. Print
additional sheets for each year.
Year: ________
Description
Cost
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL
#VALUE!
Citation /
Receipt No.
2.0 SKETCHES
This sketch should show a plan view of the building footprint and its surroundings (e.g.,
adjacent buildings, roadways, water bodies, large trees). Attach site plans or use satellite
images if available and mark any changes in layout. Mark the orientation of north and the
front or entrance to the building.
2.0 SKETCHES
PROFILE SKETCH
This sketch should show a profile view of the building. Attach actual elevations if
available. Print multiple sheets as necessary (at least four). Mark dimensions,
including floor-to-floor and plenum height.
2.1 OPAQUE SURFACES

Use this sheet to describe each major type of opaque surface in the building. Print multiple sheets as
necessary.
Surface Name:
Surface type:
(circle one)
Exterior Wall
Roof
Ceiling
Floor
Slab Total Exposed Perimeter Length:

If Slab on
Grade or
Underground
Wall
Exterior Solar
Interior Surface
Reflectivity (%):
Reflectance (%):
Location(s):
(also use Notes
below)
Description
Interior Wall
Slab on Grade
Insulation Type and Thickness:

Perimeter Insulation Depth:
Overall R-Value:
No. of Units:
Framing
Layer 1
Exterior
Layer 2
Layer 3
Layer 4
Layer 5
Layer 6
Layer 7
Drawings / Notes
Use this space to draw sections, or to make drawings or take notes about opaque surface location.
Undergr
2.2 FENESTRATION
Fenestration
type: (circle one)
Location(s):
Vertical
Angle:
(degrees
from horizontal)
Overhead
No. of Units:
(also use Notes

below)
Type:
(circle all that apply)
Fixed
Operable
Other:
Glass door
Storefront/Site-built
Curtainwall
Ga
Fenestration Age:
(specify)
Frame Depth:
Glazing dimensions:
Frame Width:
(HxW)
(used to consider additional glazing)
Name:
Model:
Manufacturer:
(if applicable)
AAMA Product ID:

NFRC Product ID:
U-Value
SHGC
Performance:
Frame Type:
(circle one)
Frame
Condition:
Glazing Type:
VT
Center-of-Glass:
Overall
Fenestration:
Aluminum
Aluminum with Thermal Break
Wood, Clad with Vinyl/Aluminum

Good
Poor
Single-glazed
If Skylight:
Curb:
Interior
Shade: (circle
None
Yes
Wood
Fiberglass
Other:
Vinyl
(describe)
Describe: (e.g., leaking)
Double-glazed
No
Overall
Fenestration:
Center-of-Glass:
Height:
Top Down
Clear Glass
Tinted Glass:
Domed or Flat?
Bottom Up
one)
Other:
(describe)
Diffuse or Clear?
(describe)
Exterior
Shade: Use
space below
Drawings / Notes
Use this space to draw any interior or exterior shading (mark dimensions), or to make drawings or take notes about fenestration location.
2.3 OPAQUE DOORS

Use this sheet to describe each type of opaque door in the building. Print multiple sheets as necessary.
Location(s): (also
No. of Units:
use Notes below)
Type:
Swinging
Sectional
Rolling
Site-built Door Age:
Other: (specify)
Dimensions
(HxW):
Name:
Manufacturer:
(if
applicable)
Model:
U-Value: Not including frame:
Frame
Condition:
Good
Poor
Describe:
Door Condition: Good
Poor
Describe:
Exterior Solar
Reflectivity (%):
Including frame:
Frame
Material:
Door
Material:
Interior Surface
Reflectance (%):
Drawings / Notes
Use this space to make drawings or take notes about opaque door location.
3.0 SCHEDULES - OCCUPANCY
Fraction of Peak

Zone
Name/Description
Days
12-1 am
1-2am
2-3am
3-4am
4-5am
5-6am
6-7am
7-8am
8-9am
9-10am
10-11am
11-12pm
12-1pm
1-2pm
2-3pm
3-4pm
4-5pm
5-6pm
6-7pm
7-8pm
8-9pm
9-10pm
10-11pm
11-12am
Drawings / Notes
Use this space to make drawings or take notes.
TH
Sat
Sun
Hol
3.1 SCHEDULES - LIGHTING
Fraction of Peak

Zone
Name/Description
Days
12-1 am
1-2am
2-3am
3-4am
4-5am
5-6am
6-7am
7-8am
8-9am
9-10am
10-11am
11-12pm
12-1pm
1-2pm
2-3pm
3-4pm
4-5pm
5-6pm
6-7pm
7-8pm
8-9pm
9-10pm
10-11pm
11-12am
TH
Drawings / Notes
Sat
Sun
Hol
3.2 SCHEDULES - PLUG LOADS
Fraction of Peak

Zone
Name/Description
Days
12-1 am
1-2am
2-3am
3-4am
4-5am
5-6am
6-7am
7-8am
8-9am
9-10am
10-11am
11-12pm
12-1pm
1-2pm
2-3pm
3-4pm
4-5pm
5-6pm
6-7pm
7-8pm
8-9pm
9-10pm
10-11pm
11-12am
TH
Drawings / Notes
Sat
Sun
Hol
3.3
SCHEDULES - THERMOSTAT

Zone Name/
Description:
Heating Set Point:
Occupied
Cooling Set point:
Unoccupied
Check box to indicate each occupied hour:
Days
M
T
W
12-1 am
1-2am
2-3am
3-4am
4-5am
5-6am
6-7am
7-8am
8-9am
9-10am
10-11am
11-12pm
12-1pm
1-2pm
2-3pm
3-4pm
4-5pm
5-6pm
6-7pm
7-8pm
8-9pm
9-10pm
10-11pm
11-12am
Notes
Occupied
Unoccupied
TH
Sat
Sun
Hol
4.0 PEAK OCCUPANCY

Zone
Name/Description:
Peak No. of Fulltime Occupants:
Description of
Activity Level:
Description of
Clothing Insulation
Level:
Peak No. of
Transient
Occupants:
Description of
Activity Level:
Description of
Clothing Insulation
Level:
Zone Watts/SF:
Corresponding
Schedule: (Reference
Sample Form 1.31)
Drawings / Notes
4.1 INTERIOR LIGHTING

Use this sheet to describe the electric lighting plan for each zone in your building. Print multiple sheets as
necessary.
Zone
Name/Description
Area (SF):
:
Fixture
Manufacturer/Mo
del:
No. of Fixtures:
Fixture Type:
Area
Task
Exit
Track
Display
Other:
No. of Lamps/Fixture:
Mounting:
Recessed Suspended Surface Mount Other:
Fluorescent
Wattage of Lamps:
Diameter:
T12 T8 T5
Length:
Other:
Tube
Lamp Type:
Circle one: CFL Incandescent Halogen LED HID Other:
Ballast:
Control Type:
(circle one)
WorkPlane Height:
Lamp Color Temp:
Fixture
Manufacturer/Mode
l
Fixture Type:
Mounting:
Lamp Type:
Ballast:
Control Type:
(circle one)
WorkPlane Height:
Fixture
Manufacturer/Mode
l
Fixture Type:
Mounting:
Lamp Type:
Ballast:
Control Type:
(circle one)
WorkPlane Height:
Zone Watts/SF:
Notes
Circle one:
Magnetic Electronic
No. of Ballasts/Fixture:
Manual Switch Bi-Level Switch

Time Clock
Daylight Sensor
Occupancy Sensor Dimming StepDimming Other:
Horizontal Illuminance:
Vertical Illuminance Sensitivity:
Area
Task
Exit
Track
Display
Other:
Fluorescent
Diameter: T12 T8 T5
Length:
Other:
Tube
Circle one: CFL Indcandescent Halogen LED HID Other:
Circle one:
Magnetic Electronic
BF:
Watts:
Total Watts:
No. of Fixtures:
Wattage of Lamps:
BF:
Watts:

Time Clock
Daylight Sensor
Total Watts:
Lamp Color Temp:
Area
Task
Exit
Track
Display
Other:
Fluorescent
Diameter: T12 T8 T5
Length:
Other:
Tube
Circle one: CFL Indcandescent Halogen LED HID Other:
Circle one:
Magnetic Electronic
No. of Fixtures:
Wattage of Lamps:
BF:
Watts:

Time Clock
Daylight Sensor
Total Watts:
Lamp Color Temp:
Corresponding
Sample Form 1.32)
4.2 EXTERIOR LIGHTING

Use this sheet to describe the electric lighting plan for the exterior of the building. Print multiple sheets
as necessary.
Zone
Area (SF):
Name/Descriptio
n
Manufacturer/Mod
el
Use Type:
Security
Advertising ParkingLot
Faade Landscape
Other:
Mounting:
Pole Bollard BuildingFacade Ceiling Other
Lamp Type:
(circle one)
Ballast:
Control Type:
(circle one)
Flourescent or
Neon Tube
Halogen LED HPS MH MV

Other:
Magnetic Electronic
Manual Switch PhotoCell TimeClock PhotoCell/Timeclock
MotionSensor Other:

Flourescent or
Neon Tube
ParkingGarage
Neon Diameter (mm):

Other:
Circle one: Magnetic Electronic
MotionSensor Time Clock Other:
Mounting:
(circle one)
Flourescent or
Neon Tube
ParkingGarage
Bldg
Neon Diameter (mm):
CFL

Other:
Magnetic Electronic
MotionSensor Time Clock Other:
BF:
Watts:
Total Watts:
Lamp Color Temp:
Corresponding
Sample Form 1.32)
Notes
No. of Fixtures:
FL Diameter: T12 T10 T8 T5 Wattage of Lamps:
Circle one:
Zone Watts/SF:
Length:
BF:
Watts:
Total Watts:
Lamp Color Temp:
Security
Faade Landscape
Other:
Ballast:
Control Type:
No. of Fixtures:
Use Type:
Lamp Type:
(circle one)
Bldg
CFL
Manufacturer/Mod
el
Length:
BF:
Watts:
Total Watts:
Lamp Color Temp:
Mounting:
(circle one)
CFL
Security
Faade Landscape
Other:
Ballast:
Control Type:
No. of Fixtures:

Neon Diameter (mm):
Use Type:
Lamp Type:
(circle one)
Bldg
Circle one:
Manufacturer/Mod
el
Length:
ParkingGarage
4.3 PEAK PLUG LOADS

Use this sheet to describe the electric lighting plan for the exterior of the building. Print multiple sheets
as
necessary.
Zone
Area (SF):
Name/Descriptio
n:
Manufacturer/Mod
el:
Equipment Type: Desktop Computer
Power Draw
(kW):
Control Type:
Laptop
Fax
Other:
If cycling occurs,
what is the rate?
(e.g.
mins per hour)
Occupancy Sensor
Other:
Laptop
(circle one)
Printer
No. of units
Stand-by
power
(kW):
Circuit No.
Manufacturer/Mod
el:
Power Draw
(kW):
Control Type:
Fax
Other:
If cycling occurs,
what is the rate?
(e.g.
mins per hour)
Occupancy Sensor
Other:
Laptop
(circle one)
Printer
No. of units
Stand-by
power
(kW):
Circuit No.
Manufacturer/Mod
el:
Power Draw
(kW):
Control Type:
(circle one)
Printer
Fax
Other:
If cycling occurs,
what is the rate?
(e.g.
mins per hour)
Occupancy Sensor
Stand-by
power
(kW):
Other:
Circuit No.
Zone Watts/SF:
Corresponding
Sample Form 1.33)
Notes
No. of units
5.0 DOMESTIC HOT WATER - EQUIPMENT

Packaged Storage Water Heater

Instantaneous (tankless)
Boiler
Dishwasher Booster
Purchased Hot Water
Purchased Steam Heat Pump Solar
Solar Backup Other:_____
Location(s):
No. of Units:
Fuel Type:
Natural Gas
Electric
Fuel Oil
LPG
Heat recovery
Other: ____________________
(circle
Type:
(circle one)
one)
Name and Model:

Serial No.:
Manufactur Tank Capacity: (if applicable)
gallons
er
Rated Input Capacity: (circle units)
kBtu/h
kW
Information
Energy Factor Thermal Efficiency AFUE
Efficiency
Rating:
(circle units)
:
COP
Tank Internal Insulation R-Value: (if applicable)
Tank Dimensions:
Age: (years)
Condition: (describe)
Does the tank have an external insulation jacket?
Yes
No
What is the R-Value? __________
Average Hot Water Temperature: __________ (F)
Are the hot water pipes insulated?
Yes
No
How thick?
__________
Loop Design Delta T:
Is there a recirculation pump? Yes
Min Flow: (gpm)
No
Max Flow: (gpm)
Recirculatio Pump head (ft):
Continuous
Temperature
Timer
Demand
Other
n pump:
Control (circle one):
__________
Average recirculation time: (mins)
Drawings / Notes
Use this space to make drawings or take notes about the hot water equipment.
5.1 DOMESTIC HOT WATER - FIXTURES AND USE

Use this sheet to document the hot water fixtures and their use. This will allow you to calculate
hot water heating load reductions resulting from more efficient fixtures.
Lavatory Faucet
Kitchen Faucet
Dishwasher
Laundry Washer
Type:
(circle one)
Shower
Other: ________________
Location(s):
No. of Units:
Name
and
Model:
Manufacture
Serial No.:
r
Information: Flow/Cycle Rate: (circle units)
GPM:
Gallons per Cycle
Age: (years)
Does the fixture leak?
Yes
No
Estimate how much:
Fixture Condition:
Good
Poor
Describe:
Applicable to:
Cycles per Day:
Use Rates:
(enter
information where
applicable)
Dishwasher
Laundry
Washer
Shower
When do most cycles occur?

Morning
Mid-day
Evening
Average No. of Users per DayWhen does most use occur?

Lavatory
Faucet
Other Fixture
Kitchen
Faucet
Other Fixture
Morning
Average Time of Use per
Day: (mins)
Mid-day
Evening
When does most use occur?

Morning
Mid-day
Drawings / Notes
Use this space to make drawings or take notes about the fixture location or hot water use.
Evening
5.1 DOMESTIC HOT WATER - FIXTURES AND USE

6.0 BOILERS
SAMPLE FORM
General Information
Site Name:
Boiler ID/Tag:
Location/Service:
Mfr/Model #:
Year Built:
Serial Number:
Boiler Type
Fire Tube
Water Tube
Electric
Natural Draft
Forced Draft
Condensing
Other _________
Boiler Fuel
Natural Gas
Fuel Oil
Propane
Electricity
Other _________
Combustion Fan Data

Quantity
Manufacturer
Full Load hp
Frame Size
ODP/TEFC
Full Load RPM
Fan Efficiency
Motor Efficiency
Full Load Amps
Drive Type
Design/Measured Data
Design
Boiler
Input/Output (Btu)
GPM
WPD (feet)
EWT/LWT (oF)
Design
Fan
Volts
Phase
FLA
kW
PF
Heating Fluid
Water (HWS/HWR) oF
Glycol?
yes / no
Glycol %
Steam psi
Other _____________
Accessories
Measured
Draft Control
Flue Gas Recirculation
Oxygen Trim Control
Stack Economizer
Blowdown Economizer
Measured
Piping Configuration
Primary-Secondary
Primary-Only
Variable Flow
Temperature Control
LWT Setpoint (oF)
EWT Setpoint (oF)
Reset?
yes / no If yes, describe: _________
Controls
Time of Day Scheduling _____________________________________________________________________
_________________________________________________________________________________________
Boiler Staging ____________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
6.0 BOILERS
SAMPLE FORM GUIDANCE

General Information
Site Name:
Provide name of site
Boiler ID/Tag:
Near boiler nameplate, as-built boiler schedule
Location/Service: Observe boiler location and area of building it is serving, as-built boiler schedule
Mfr/Model #:
Boiler nameplate, as-built boiler submittal
Serial Number: boiler nameplate
Year Built:
Boiler nameplate, as-built boiler submittal
Boiler Type
Fire Tube
Water Tube
Electric
Natural Draft
Forced Draft
Condensing
Other _________
specify boiler
type, see asbuilt boiler
submittal
Combustion Fan Data

Quantity
Manufacturer
as-built boiler
Full Load hp
submittal, or
Frame Size
visual inspection
ODP/TEFC
Full Load RPM
Enter the fan
Fan Efficiency
static efficiency
Motor Efficiency
Full Load Amps
Drive Type
(not the same as

motor
efficiency), see
as-built boiler
submittal
as-built boiler
submittal, or
visual inspection
Boiler Fuel
Natural Gas
Fuel Oil
Propane
Electricity
Other _________
Heating Fluid
specify
boiler fuel
used, see
as-built
boiler
submittal
Water (HWS/HWR) oF
specify heating
Glycol?
fluid type, as well
as temperatures or
Glycol %
working pressure,
Steam psi
Other
see as-built boiler

submittal
Design/Measured Data
Accessories
Design Measured
Draft Control
Boiler
Flue Gas
Input/Output (Bt
Check all that
Recirculation
Oxygen Trim apply, see as-built
GPM*
Control boiler submittal or
WPD (feet)
Stack Economizer visual inspection
control
EWT/LWT (oF)
system,wdown Economizer
as-built
logger
Fan
boiler
trends,
Volts
submittal or direct Piping Configuration
measure
Phase
Specify piping
ment Primary-Secondary
FLA
Primary-Only configuration, see
as-built piping
kW
Variable Flow diagram or visual
inspection
PF
*For variable flow systems, enter the maximum flow rate
Temperature Control
LWT Setpoint (oF) Enter boiler leaving water temperature set point if applicable, see as-built sequence of opera
EWT Setpoint (oF) Enter boiler entering water temperature set point if applicable, see as-built sequence of oper
Indicate whether set point is reset, see as-built sequence of operations
Reset?
If yes, describe: Explain reset strategy, see as-built sequence of operations, interview facilities staf
Controls
Time of Day Scheduling
Boiler Staging
Explain boiler scheduling, including lockouts, see as-built sequence of operations, control
system, or logger trends.
Explain boiler staging scenario for plants with multiple boilers, see as-built sequence of
operations, control system, or logger trends.
6.1 CHILLERS
SAMPLE FORM
General Information
Site Name
Chiller ID/Tag
Location/Service
Manufacturer/Model
Year Built
Chiller Data
Air or Water Cooled
Refrigerant Type
Piping Arrangement
Chilled Water GlycolProp / Eth / None
Glycol %
Capacity (tons)
Compressor Data
Quantity
Type
RLA
Volts
Phase
HP
VFD
Compressor Stages
Condenser Fan Data
Quantity
Manufacturer
Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Efficiency
Volts
Phase
Full Load Amps
Service Factor
Waterside free cooli
yes / no
Controls Notes
Chiller Sequencing
Serial Number
Design/Operating Conditions
Design
kW/ton @ 100% load
kW/ton @ 50% load
EER at ARI Conditions
Evap GPM
Evap EWT/LWT (oF)
Evap WPD (Ft)
Cond GPM
Cond EWT/LWT (oF)
Cond WPD (Ft)
Measured
Temperature Control
Cond water supply set point
Chilled water supply set point
Computerized / Electronic / Pneumatic
Condenser Pump Control
Pumps Cycled w/Respective Chillers
yes / no
Pumps Operate Independent of Chiller L yes / no
Pumps Headered / Chiller Headered
yes / no
Automatic Isolation Valves
yes / no
Provide Unusual Piping Arrangement Description/Sch
Evaporator Pump Control
Pumps Cycled w/Respective Chillers
yes / no
Pumps Operate Independent of Chiller L yes / no
Pumps Headered / Chillers Headered
yes / no
yes / no
Provide Unusual Piping Arrangement Description/Sch
6.1 CHILLERS

General Information
provide name of site
Site Name
near chiller nameplate, as-built chiller schedule
Chiller ID/Tag
observe chiller location and area of building it is serving, as built chiller schedule
Location/Service
Manufacturer/Model # chiller nameplate, as-built chiller submittal
chiller nameplate, as-built chiller submitt
Year Built
Serial Number chiller nameplate
Chiller Data
Air or Water Cooled
Refrigerant Type
Piping Arrangement
Chilled Water Glycol
Glycol %
Capacity (tons)
Compressor Data
Quantity
Type
RLA
Volts
Phase
HP
VFD
Compressor Stages
Condenser Fan Data
Quantity
Manufacturer
Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Efficiency
Volts
Phase
Full Load Amps
Service Factor
Waterside free cooling
Controls Notes
Chiller Sequencing
as-built chiller schedule

parallel, series, or primarysecondary for evaporator;
and parallel or series for
condenser? as-built piping
schematic
as-built chiller submittal
Design
kW/ton @ 100% load
kW/ton @ 50% load
NPLV
Evap GPM
as-built
chiller
Evap EWT/LWT (oF)
submittal
Evap WPD (Ft)
Cond GPM
Cond EWT/LWT (oF)
Cond WPD (Ft)
Measured
control system or logger

trends

Temperature Control
deg F
as-built sequence of operations
Cond water supply set point
Chilled water supply set point
as-built controls submittal
Computerized / Electronic / Pneum


Condenser Pump Control

Pumps Cycled w/Respective Chilleas-built sequence of operations
Pumps Operate Independent of Chi
Pumps Headered / Chiller Header as-built sequence of operations
as-built piping schematic
Provide Unusual Piping Arrangement Description/Schematic

Evaporator Pump Control

Pumps Cycled w/Respective Chilleas-built sequence of operations
Pumps Operate Independent of Chi
Pumps Headered / Chillers Headeas-built sequence of operations
as-built piping schematic
Provide Unusual Piping Arrangement Description/Schematic

as-built sequence of operations, control system, or logger trends of chiller kW

as-built sequence of operations, control system, or logger trends of chiller kW
6.1 CHILLERS
of operations
of operations
of operations
of operations
of operations
on/Schematic
of operations
of operations
of operations
on/Schematic
6.2 COOLING TOWERS AND FLUID COOLERS

SAMPLE FORM
General Information
Site Name
Tower ID/Tag
Location/Service
Manufacturer
Model Number
Quantity of Cells
Serial Number
Year Built
Heat Rejection Type

Cooling Tower:
Induced Draft
Forced Draft
Natural Draft
Wetted Media
Fluid Cooler:
Air Cooled
Evaporatively Cooled
Fan Data
Fan Control
Fan Drive
Fan Type
Piping Arrangement
Basins Headered
Piped to Individ. Chillers
Valves on Supply Headers
Fluid Cooler Pump Data
Quantity
Fluid Type
GPM (each pump)
Manufacturer
Full Load HP
ODP/TEFC
Full Load RPM
Pump Efficiency
Motor Efficiency
Full Load Amps
Volts / Phase
Power Demand (kW)
Power Factor
Design
n/a
Measured
VFD / Single-speed /
Two-Speed
Belt / Direct / Gear
Centrifugal / Propeller
/ Other: ______________
Fan Data
Quantity
CFM (each fan)
Full Load HP
ODP/TEFC
Full Load RPM
Fan Efficiency
Motor Efficiency
Full Load Amps
Volts / Phase
Power Demand (kW)
Power Factor
Design
Condenser Water
GPM
EWT/LWT (oF)
Ambient DB/WB (oF)
Design
Measured
Basin Heater
Power Demand (kW)
Full Load Amps
Volts / Phase
Power Factor
Design
Measured
Measured
n/a
n/a
Controls
Time of Day Scheduling _______________________________________________________________________
___________________________________________________________________________________________
Tower/Cooler Staging ________________________________________________________________________
___________________________________________________________________________________________
Condenser Water Flow Rate ___________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
6.2 COOLING TOWERS AND FLUID COOLERS


General Information
Information Location/Description
Enter the name of the building site/campus and building number (if applicable).
Site Name
Enter the unit identifier, e.g. "CT-1."
Tower ID/Tag
Location/Service Add any other information that helps identify what the system is serving.
Enter the unit manufacturer. Use nameplate or submittal data.
Manufacturer
Enter the unit model number. Use nameplate or submittal data.
Model Number
Enter the unit serial number. Use nameplate or submittal data.
Serial Number
Quantity of Cells For cooling towers, enter number of individual cells.
Enter year of manufacture. Use nameplate or submittal data.
Year Built
Heat Rejection TypeCheck whether unit is a cooling tower or fluid cooler, and what type.
Piping ArrangementPrimarily applicable to cooling towers. Check arrangement that applies.
Fan Control
Fan Drive
Fan Type
Circle single-speed, two-speed, or VFD operation. Use nameplate or submittal data.

Circle belt drive, direct drive, or gear drive. Use nameplate or submittal data.
Circle centrifugal or propeller, or enter other type.
Fan and Fluid Cooler Pump Data

Qty of fans/pumps Determine by inspection and enter quantity of fans or pumps.
Enter the type of fluid that is being cooled. Use submittal or as-built schedule.
Fluid Type
Enter the pump GPM or the fan CFM. Use nameplate or submittal data.
GPM/CFM
Enter unit manufacturer. Use nameplate or submittal data.
Manufacturer
Enter full load horsepower. Use nameplate or submittal data.
Full Load HP
Specify motor enclosure: ODP = open drip proof; TEFC = Totally enclosed fan-cooled.
ODP/TEFC
Enter motor full load rotational speed. Use nameplate or submittal data.
Full Load RPM
Pump/Fan EfficiencEnter pump or fan static efficiency. Note this is not the same as motor efficiency.
Motor Efficiency Enter motor efficiency. Use nameplate or submittal data.
Enter full load motor current in Amperes. Use nameplate or submittal data.
Full Load Amps
Enter nominal motor voltage & phase (1 or 3). Use nameplate or submittal data.
Volts/Phase
Enter full load motor power.
Power Demand
Enter motor power factor. Use control system or logger trends.
Power Factor
Condenser Water Data
Enter condenser water flow rate for constant volume systems, and max flow rate for variable flow systems.
GPM
EWT=Temp of water entering condenser/cooling tower; LWT=water temp leaving condenser/tower.
EWT/LWT
Ambient DB/WB Record current outdoor dry bulb and wet bulb temperatures.
Basin Heater
Power Demand
Full Load Amps
Volts/Phase
Power Factor
Enter full load heater power.

Enter full load heater current in Amperes. Use nameplate or submittal data.
Enter nominal heater voltage & phase (1 or 3). Use nameplate or submittal data.
Enter heater power factor. Use control system or logger trends.
Controls
Tower/Cooler Staging
Condenser Water Flow Rate
Describe if unit is on an occupancy schedule, or enabled to run continuously.

For systems with multiple units, describe lead/lag, and staging of units.
Describe flow rate control: constant or variable. Use sequence of operation or control
system/logger flow rate trends.
6.3 PUMP AND PIPING SYSTEMS

General Information
Site Name
Pump ID/Tag
Location/Service
Year Built
Pump Data
Manufacturer
Model Number
Serial Number
Pump Type
Impeller Size
Pump Efficiency
Pump Motor Data
Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Synch. RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Connection Type
Pumping Configuration
Primary Only Variable Flow
Primary Only Constant Flow
Primary/Secondary Variable
Primary/Secondary/Tertiary
Other _________________
Controls Notes
Pump Staging
Design
Total Head (ft. w.g.)
GPM
Pump Motor RPM
Volts
Amps
Power Demand (kW)
Power Factor
n/a
Pump Control
Constant Volume
Variable Volume
VFD
Multi-Speed
Other
Connected to DDC?
Yes/No
Miscellaneous Accessories
Suction Difusers
Triple Duty Valves
Throttling Valves
Circuit Setters
Other _____________
Measured
Notes
__________________
__________________
__________________
__________________
__________________
__________________



General Information
Site Name
near fan nameplate, as-built pump schedule
Pump ID/Tag
Location/Servic observe pump location/as-built pump sched
pump nameplate, as-built pump submittal
Year Built
Pump Data
Manufacturer
Model Number
Serial Number
Pump Type
pump nameplate, as-built pump schedule
Pump Control
Constant Volume
Variable Volume
VFD
Multi-Speed
Other
Connected to DDC?
as-built sequence of operation

as-built pump schedule
pump nameplate, as-built pump schedule

pump nameplate
e.g. end suction, vertical, split case; asbuilt pump submittal
Impeller Size pump nameplate, as-built pump schedule

Pump Efficiencypump nameplate, as-built pump schedule
Pump Motor Data
motor nameplate, as-built motor submittal
Full Load HP
Frame Size
Enclosure Type motor nameplate, as-built motor submittal
Full Load RPM motor nameplate, as-built motor submittal
Synch. RPM
Motor Efficiencymotor nameplate, as-built motor submittal
Volts
Phase
Full Load Amps motor nameplate, as-built motor submittal
as-built fan schedule, as-built fan submittal
Drive Type
Design
Total Head
GPM
Pump Motor RP as-built pump schedule
Volts
Amps
Power Demand as-built pump schedule
n/a
Power Factor
Controls Notes
Pump Staging
Pumping Configuration
as-built sequence of operation, asPrimary Only
built pump schedule, observe
Variable Flow
VFDs on all pumps
Primary Only
Constant Flow
as-built sequence of operation, asbuilt pump schedule, observe no

VFDs on any pumps
Primary/Secondary
Variable Flow
as-built sequence of operation, asbuilt pump schedule, observe

VFDs on secondary pumps only
Primary/Secondary/
Tertiary
as-built sequence of operation, asbuilt pump schedule, observe

pumps
Other
as-built sequence of operation, asbuilt pump schedule,
Miscellaneous Accessories
Suction Difusers
Triple Duty Valves
observe piping system; as-built
Throttling Valves
plumbing drawings
Circuit Setters
Other
Measured
Test and Balance report
building control system or logger trends
as-built sequence of operation, control system or logger trends of pump speed (or Amps or k
as-built sequence of operation, control system or logger trends of pump speed (or Amps or k



6.4 AIR HANDLING SYSTEM EQUIPMENT

SAMPLE FORM
General Information
Site Name
Air Handler ID/Tag
Location/Service
Manufacturer/Model #
Year Built
Supply Fan Data
Manufacturer
Model Number
Serial Number
Fan Type / Size
Fan Efficiency
Supply Fan Motor Data
Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Synch. RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Yes/No
Motor In Supply Airstrea
Drive Type
Supply Fan Design/Operating Conditions
Design Measured
Total Static Pressure
Occupied CFM
Unoccupied CFM
Fan RPM
Volts
Occupied Amps
Unoccupied Amps
n/a
Occupied kW
Unoccupied kW
n/a
Power Factor
n/a
Filter Data
Manufacturer
Model Number
Type
Efficiency
Initial/Final Pressure Drop
Serial Number
Fan Configuration
Blow-thru
Draw-thru
Return Air Path
Ducted
Plenum
Humidifier
Type
Capacity (lbs/hr)
NONE
Cooling Coil
Chilled Water (2 Way/3 Way Valve)
Sensible/Latent Capacity
Design CFM / GPM
Design EDB / EWB
Design LDB / LWB
Design EWT / LWT
Measured EWT / LWT
Air Pressure Drop
Pre-Heat Coil
Medium Type
Capacity (MBTUH)
Design CFM / GPM
Design EDB / LDB
Design EWT / LWT
Measured EWT / LWT
NONE
Heating Coil
Medium Type
Capacity (MBTUH)
Design CFM / GPM
Design EDB / LDB
Design EWT / LWT
Measured EWT / LWT
NONE


General Information
Site Name
near AHU nameplate, as-built AHU schedule
Air Handler ID/Tag
observe fan location/as-built AHU schedule
Location/Service
Manufacturer/Model # AHU nameplate, as-built AHU submittal
Year Built/Serial NumberAHU nameplate, as-built AHU submittal
Supply Fan Data
Manufacturer
Model Number
Serial Number
Fan Type / Size
Fan Efficiency
Return Air Path

Ducted or Plenum as-built ductwork plan
Humidifier
Type
AHU nameplate, as-built AHU schedule

Capacity (lbs/hr)
electric, steam, or adiabatic;

as-built humidifier schedule
as-built AHU schedule
AHU nameplate

Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Synch. RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Motor In Supply Airstre motor nameplate, as-built motor submittal
Drive Type
Pre-Heat Coil
Medium Type
Capacity (MBTUH)
Design CFM / GPM
Design EDB / LDB
Design EWT / LWT
Measured EWT / LWT
Fan Configuration
Blow or Draw-thru as-built AHU schedule
Cooling Coil
Chilled Water
Sens/Lat Capacity as-built AHU schedule
Design CFM/GPM as-built AHU schedule
Design EDB/EWB as-built AHU schedule
Design LDB/LWB as-built AHU schedule
Design EWT/LWT as-built AHU schedule
control system or logger trends
Meas EWT/LWT
Air Pressure Drop as-built AHU schedule
Heating Coil
water, steam, or electric
Medium Type
Capacity (MBTUH) as-built AHU schedule
Design CFM/GPM as-built AHU schedule
Design EDB/LDB as-built AHU schedule
Design EWT/LWT as-built AHU schedule
Meas EWT/LWT
water, steam, or electric

Filter Data
Manufacturer
Model Number
Type
Efficiency
Initial/Final PD
nameplate; as-built submittal

as-built submittal
Supply Fan Design/Operating Conditions

Design
Measured
Test and Balance report
basis of design, as-built sequence of operatibuilding control system or logger trends
Occupied CFM
basis of design, as-built sequence of operatibuilding control system or logger trends
Unoccupied CFM
as-built fan schedule
Fan RPM
Volts
Occupied Amps
n/a
Unoccupied Amps
Occupied kW
n/a
Unoccupied kW
n/a
Power Factor

ogger trends
ogger trends
6.5 AIR HANDLING SYSTEM CONTROLS

SAMPLE FORM
General Information
Site Name
Air Handler ID/Tag
Location/Service
Year Built
Serial Number
Supply Fan Control

Constant Air Volume
VFD
Discharge Damper
Multi-Speed
DDC
Electronic Controls
Pneumatic Controls
Room Thermostat
Humidifier Control
Humidity Control?
Humidity Sensor Locatio
RH Setpoint, Max
RH Setpoint, Min
Outside Air (OA) Control

Fixed OA CFM
Economizer?
Minimum OA %
Economizer Control
Econo Upper Limit
Econo Lower Limit
Econo Control Point
Yes/No
Yes/No
Temperature Control
Occupied Room Temperature Setpoi
Unoccupied Room Temperature Setp
Heating Supply Air Temperature Setp
Cooling Supply Air Temperature Setp
Supply Air Temperature Setpoint Res
Operating Schedule
Occupied Hours
Unoccupied Hours
Morning Warm-Up Hours
Supply Fan Static Pressure Control

Constant Static Pressure Setpoint
Static Pressure Reset
Ductwork Control Accessories

Turning Vanes?
Single / Dual Duct
Other ________________
Louver/Damper Control
Location(s)
% Free Area
Pressure Drop
Control Method
Controls Notes
Yes/No


General Information
Site Name
near AHU nameplate, as-built AHU schedul
Air Handler ID/Tag
observe fan location/as-built AHU schedule
Location/Service
Manufacturer/Model # AHU nameplate, as-built AHU submittal
AHU nameplate, as-built AHU submittal
Year Built
Supply Fan Control
Constant Air Volume
VFD
Discharge Damper
Multi-Speed
DDC
Electronic Controls
Pneumatic Controls
Room Thermostat

Serial Number AHU nameplate

Fixed OA CFM
as-built sequence of operation,
Economizer?
control system trends of
economizer damper position

Minimum OA %

Economizer
Control
e.g. drybulb, RH, enthalpy; asbuilt sequence of operation,

control system trends
Econo Upper
Limit
e.g. upper OA drybulb temp

lockout; as-built sequence of
operation, control system trends
Supply Fan Static Pressure (SP) Control

Constant SP Setpoint
Static Pressure Reset
Econo Lower
Limit
e.g. lower OA drybulb temp

Econo Control
Point
e.g. MA temp, CO2 sensor, asbuilt sequence of operation
Humidifier Control
Humidity Control?
Humidity Sensor Locatioas-built sequence of operation, visual
Temperature Control
Occ Room Temp control system or logger trends
Unocc Room Temcontrol system or logger trends
Heating SAT
Cooling SAT
SAT Setpoint Res control system or logger trends

observation
RH Setpoint, Max
RH Setpoint, Min
%, as-built sequence of operation, control

system or logger trends
%. as-built sequence of operation, control
Operating Schedule
Specify occupied hours for each day of the week; as-built sequence of operation
Occupied Hours
Specify unoccupied hours for each day of the week; as-built sequence of operation
Unoccupied Hours
Morning Warm-Up Hours
Specify when air handling system turn on for pre-occupancy warm-up for each day of the week; as-built
sequence of operation, control system trends of supply fan speed and supply air temperature
Ductwork Control Accessories

observe duct interiors; as-built ductwork p
Turning Vanes?
as-built ductwork plan
Single / Dual Duct
as-built ductwork plan
Other
Louver/Damper Control
observe; as-built ductwork plan
Location(s)
measure; as-built ductwork plan
% Free Area
measure; as-built ductwork plan
Pressure Drop
Control Method as-built sequence of operation

6.6 AIR SYSTEM TERMINAL UNITS

SAMPLE FORM
General Information
Site Name:
Location/Service:
Terminal Units
Mfr./
AHU/Source Tag/I.D. Model
#
Type
Max.
CFM
Htg.
Min.
CFM
Clg.
Min.
CFM
Heat
Cool Control
Source Source Type
Notes




General Information
Site Name:
Location/Service:
Provide information to identify what the system is serving, observe and see as-built equipment schedule
Terminal Units
AHU/Source Enter/identify the equipment from which the air originates before supplying the terminal unit. See as-built floor plans.
Enter the terminal unit identifier, e.g. "VAV-27," if applicable, see nameplate or as-built equipment schedule
Tag/ID
Mfr./Model # Enter the manufacturer and model number of the terminal unit, see nameplate or as-built equipment submittal
Enter the following indicators of terminal unit type:
Type
VAV=Variable Air Volume Terminal Unit
CAV=Constant Air Volume Terminal Unit
FPB=Fan-Powered Box (provide fan specs in notes section)
Other=Explain in notes section
Max CFM
Heating Min
Cooling Min
For CAV and FPB, enter CFM. For VAV, enter maximum CFM. Provide source in notes section (measured, TAB report, drawi
Heat Source
Enter the source of heating, see as-built equipment schedule and floor plans. (e.g. if hot water reheat coil, give source
of hot water, e.g. "Boiler #1."; If eclectic resistance reheat coil, enter "elec")
Cool Source
Enter the source of cooling, see as-built equipment schedule and floor plans. If cooling occurs in central AHU, enter
"None." If chilled water coil in terminal unit, enter 'CHW.' If DX cooling coil in terminal unit enter 'DX'.
Control Type
For digital thermostat, enter "D-T."

For on/of control enter "on/of"
For other, enter "other" and explain in Notes Section
Notes
For VAV only. Enter minimum heating CFM (provide source in Notes section)
For VAV only. Enter minimum cooling CFM (provide source in Notes section)
Use this space to enter any additional notes or comments including those stated above.



pment schedule


6.7 ZONE HEATING EQUIPMENT

SAMPLE FORM
General Information
Site Name
Heating Equip. ID/Tag
Location/Service
Year Built
Serial Number
Room Conditions
Air Delivery Sys Type
Actual Room Temp.
Room Temp Set Point (htg)
Equipment Data
Radiator Convector Furnace
Quantity
Medium
Dimensions
Material
Capacity
Design Flow rate
Meas. Flow rate
Design SAT
Meas. SAT
Design EWT
Meas. EWT
Design Pd
Meas. Pd
Condensing/Non
Combustion Method
MUA required
Thermal Efficiency
Stages
Volts
Design Amps
Meas. Amps
Design kW
Measured kW
Power Factor
Controls Notes
Operating Schedule
Method of Control (Tstat, occ. Sensor, etc.)
Infrared
Heater
Radiant
Panel
Radiant
Slab
Chilled
Beam
Other


General Information
Site Name
near equipment nameplate, as-built equipment schedule
Heating Equip. ID/Tag
observe location and equipment it is serving, as built equipment schedule
Location/Service
equipment nameplate, as-built equipment submittal
nameplate, or as-built submittal
Year Built
Serial Number nameplate
Room Conditions
Actual Room Temp.
Room Temp Set Point (htg)
Equipment Data
basis of design, as-built floor plans

basis of design or control system
Radiator Convector Furnace
Infrared
Heater
Radiant
Panel
Radiant
Slab
Chilled
Beam
Other
Observe actual quantity, also see as-built equipment schedules

Quantity
as-built equipment submittal
Medium
Observe actual dimensions, also see as-built equipment submittal
Dimensions
Material
Capacity
Design Flow rate as-built equipment schedule
Meas. Flow rate control system or logger trends
as-built equipment schedule
Design SAT
Meas. SAT
Design EWT
Meas. EWT
Design Pd
Meas. Pd
Condensing/Non as-built equipment submittal
Combustion Meth as-built equipment submittal
MUA required
Thermal Efficienc as-built equipment submittal
Stages
Volts
Design Amps
Meas. Amps
Design kW
Measured kW
Power Factor
Note: Not all data categories apply to every zone heating equipment type!!
Controls Notes
Operating ScheduAs-Built sequence of operation, observe at least one week of control system trends of equipment status, or use
data logger to monitor equipment power consumption for at least one week
Method of Control (Tstat, occ. Sensor, eas-built sequence of operation, as-built floor plans

6.8 FAN COIL UNITS

SAMPLE FORM
General Information
Site Name
Fan Coil ID/Tag
Location/Service
Year Built
Serial Number
Room Conditions
Actual Room Temperature
Room Temp Setpoint (htg)
Room Temp Setpoint (clg)
RH Setpoint
Cooling Coil Data

Design
Fan Data
Fan Type/Size
Fan Efficiency
Fan Motor Data
Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Synch. RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Drive Type
Filter Data
Manufacturer
Model Number
Type
Efficiency
Initial / Final Pressure Drop
Fan Controls
Constant Air Volume
VFD
Discharge Damper
Multi-Speed
Staged Control
Other
DDC
Electronic / Pneumatic
Measured
Medium Type
2-Way / 3-Way Valve
Sensible/Total Capacity
CFM
EDB/WB
LDB/WB
EWT
LWT
Air Pressure Drop
Water Pressure Drop
Yes/No
Heating Coil Data

Medium Type
2-Way / 3-Way Valve
Capacity
CFM
EDB
LDB
EWT
LWT
Air Pressure Drop
Water Pressure Drop
Fan Design/Operating Conditions
Airflow
Fan RPM
Volts
Amps
kW
Power Factor
n/a
Operating Schedule
Thermostat
Occupancy Sensor
On/Of
Twist Timer
Manual
Notes
6.8 FAN COIL UNITS


General Information
Site Name
near FCU nameplate, as-built FCU schedule
Fan Coil ID/Tag
observe FCU location and equipment it is serving, as built FCU schedule
Location/Service
Manufacturer/Model # FCU nameplate, as-built FCU submittal
FCU nameplate, or as-built FCU submittal
Year Built
Serial Number FCU nameplate
Room Conditions
basis of design, as-built floor plans
Actual Room Temperaturecontrol system or logger trends
Room Temp Setpoint (htgbasis of design or control system
Room Temp Set Point (clgbasis of design or control system
basis of design or control system
RH Set Point
Fan Data
Fan Type/Size
Fan Efficiency
Fan Motor Data
Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Synch. RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Drive Type
Filter Data
Manufacturer
Model Number
Type
Efficiency
Initial / Final Pressure Dr
Fan Controls
Constant Air Volume
VFD
Discharge Damper
Multi-Speed
Staged Control
Other
DDC
Electronic / Pneumatic
as-built FCU or filter schedule/submittal

Cooling Coil Data

Design Measured
as-built FCU schedule
Medium Type
2-Way / 3-Way Valve as-built FCU controls diagram
Sensible/Total Cap. as-built FCU schedule
CFM
EDB/WB
control
as-built FCU
system or
LDB/WB
schedule
logger
trends
EWT
LWT
Air Pressure Drop
Water Pressure Drop as-built FCU schedule
Heating Coil Data

Medium Type
motor nameplate, as-built motor submittal 2-Way / 3-Way Valve as-built FCU controls diagram
motor nameplate, as-built motor submittal Capacity
motor nameplate, as-built motor submittal CFM
motor nameplate, as-built motor submittal EDB
control
as-built FCU
system or
motor nameplate, as-built motor submittal LDB
schedule
logger
trends
motor nameplate, as-built motor submittal EWT
motor nameplate, as-built motor submittal LWT
as-built FCU schedule, as-built FCU submittaAir Pressure Drop
Water Pressure Drop as-built FCU schedule

as-Built sequence of operation
Fan Design/Operating Conditions

TAB report
Airflow
Fan RPM
as-built FCU
control
schedule
Volts
system or
logger
Amps
trends
kW
n/a
Power Factor

Operating Schedule
Thermostat
As-Built sequence of
Occupancy Sensor operation, observe at least
one week of control system
trends of fan power or
On/Of
on/of status, or use data
Twist Timer
logger to monitor fan power
for at least one week
Manual
6.8 FAN COIL UNITS

easured
ols diagram
ols diagram
6.9 EXHAUST / RETURN FANS

SAMPLE FORM
General Information
Site Name
Exhaust/Return Fan ID/Ta
Location/Service
Year Built
Fan Data
Manufacturer
Model Number
Serial Number
Fan Type / Size
Fan Efficiency
Fan Motor Data
Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Synch. RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Motor In Exhaust Airflow
Drive Type
Operating Schedule
Always On
Occupancy Sensor
On/Of Schedule
Controls Notes
Design
Measured
Occupied CFM
Unoccupied CFM
Fan RPM
Volts
Occupied Amps
Unoccupied Amps
n/a
Occupied kW
Unoccupied kW
n/a
Power Factor
n/a
Yes/No
Fan Control
Constant Air Volume
VFD
Discharge Damper
Multi-Speed
Staged Control
Other
DDC
Electronic Controls
Pneumatic Controls
Notes
__________________
__________________
__________________
__________________
_______________
__________________
__________________
_______________
__________________


General Information
Site Name
near fan nameplate, as-built fan schedule
Fan ID/Tag
observe fan location/as-built fan schedule
Location/Service
fan nameplate, as-built fan submittal
Year Built
Fan Data
Manufacturer
Model Number
Serial Number
Fan Type / Size
Fan Efficiency
fan nameplate, as-built fan schedule

fan nameplate
Fan Control
Constant Air Volum as-built sequence of operation
VFD
Discharge Damper as-built sequence of operation,
damper(s) located
downstream of fan

Multi-Speed
Staged Control
Other
DDC
Electronic Controls as-built sequence of operation
Pneumatic Controlsas-built sequence of operation
Fan Motor Data

Full Load HP
Frame Size
Enclosure Type
Full Load RPM
Synch. RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Motor In Exhaust Airflo motor nameplate, as-built motor submittal
Drive Type
Operating Schedule
Always On
Occupancy Sensor
On/Of Schedule
as-built sequence of operation, observe at least one week of control system trends of fan power or on/of
status, or use data logger to monitor fan power for at least one week
as-built sequence of operation, observe at least one week of control system trends of fan power with
occupancy schedule, or use data logger to monitor fan power for at least one week with occupancy
schedule
as-built sequence of operation, observe at least one week of control system trends of fan power or on/of
status, or use data logger to monitor fan power for at least one week
Design
Measured
test and balance report
Total Static Pressure as-built fan schedule
Basis of Design, as-built sequence of operabuilding control system or logger trend
Occupied CFM
Basis of Design, as-built sequence of operabuilding control system or logger trend
Unoccupied CFM
building control system or logger trend
Fan RPM
as-built
fan
schedule
Volts
Occupied Amps
n/a
Unoccupied Amps
as-built
fan
schedule
Occupied kW
n/a
Unoccupied kW
n/a
Power Factor

6.10 PACKAGED UNITS: DX, HEAT PUMPS

SAMPLE FORM
General Information
Site Name
Unit ID/Tag
Location/Service
Manufacturer
Model Number
Serial Number
Year Built:
No. of zones served by unit
Unit Type
Rooftop Unit
Split System
Window A/C
VAV
CAV
Other _________
Condenser Type
Air-cooled
Water-cooled
Evap-cooled
GSHP
WSHP
Other________
Preheat/Heating Coil
Water (HWS/HWR) (oF)
Steam (psi)
Electric (kW)
Heating Capacity (MBH)
Fuel type________________
Compressor Data
Quantity
RLA
Volts
Phase
Type
Condenser Fan Data

Quantity
Full Load Amps
Volts
Phase
Nominal HP
Supply Fan Data

Manufacturer
Model Number
Serial Number
Fan Type / Size
Fan Efficiency
Cooling Type
DX: Refrigerant
Type
Number of
Circuits
CFM
EDB/EWB (oF)
LDB/LWB (oF)
Cooling Cap. (MBH)
EER
EER incl. evap. fan Y / N
Supply Fan Control

VFD
Discharge Damper
Multi-Speed
DDC
Pneumatic
Room Thermostat

Fixed OA CFM
Economizer?
Minimum OA %

Quantity
Full Load HP
Frame Size
Enclosure Type
Operating RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Power Demand (kW)
Drive Type
Humidity Control
NONE
Humidifier Type
Humidity Sensor Location
RH Setpoint, Max
RH Setpoint, Min
Electrical Data
MCA
MOCP
Controls Notes
Time of Day Scheduling __________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Unit Staging ________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________


General Information
Site Name
near nameplate, as-built schedule
Unit ID/Tag
facilities operator
Location/Svce
nameplate, as-built schedule
Year Built
Manufacturer
Model Number
Serial Number
Unit Type
Rooftop Unit
Split System
Window A/C
VAV
CAV
Other
No. Zones
Served by Unit
nameplate

as-built mechanical
drawings
Condenser Type
as-built submittal
Air-cooled
as-built submittal
Water-cooled
as-built submittal
Evap-cooled
observe location
observe; as-built drawings
observe location
GSHP
WSHP
Other
as-built submittal
as-built submittal
as-built submittal
as-built submittal
as-built submittal
as-built submittal
Compressor Data
count; as-built equip. schedule
Quantity
RLA
Volts
Phase
Type
Condenser Fan Data

nameplate; as-built
Quantity
Supply Fan Data

Manufacturer
Model Number nameplate; as-built submittal
Serial Number nameplate; as-built submittal
Fan Type/Size
Fan Efficiency
Cooling Type
Refrigerant Type
No. of Circuits
CFM
EDB/EWB
LDB/LWB
Capacity
EER
Evap fan incl.?
Supply Fan Control

as-built sequence of
VFD
operation; building control
Damper
Multi-Speed
DDC
Pneumatic
Room T-stat
Controls Notes
Unit Staging
Full Load Amps

Volts
Phase
Nominal HP
Preheat/Heating Coil
as-built submittal
HWS/HWR
as-built submittal
Steam
as-built submittal
Electric
as-built submittal
Capacity
as-built submittal
Fuel type
nameplate; as-built
nameplate; as-built
nameplate; as-built
nameplate; as-built
as-built submittal
as-built submittal
as-built submittal

nameplate; as-built
Quantity
nameplate; as-built
Full Load HP
nameplate; as-built
Frame Size
Enclosure Type nameplate; as-built
Operating RPM nameplate; as-built
Motor Efficiency nameplate; as-built
nameplate; as-built
Volts
nameplate; as-built
Phase
Full Load Amps nameplate; as-built
Power Demand ( control system/logger trends
nameplate; as-built
Drive Type
as-built submittal
as-built submittal
as-built submittal
as-built submittal
as-built submittal

as-built SOO
Fixed OA CFM
as-built SOO
Economizer?
Minimum OA % as-built SOO
Humidity Control
Humidifier Type as-built submittal
Sensor Location SOO, observation
RH Setpoint, Maxas-built SOO
RH Setpoint, Min as-built SOO
Electrical Data
nameplate; as-built
MCA
nameplate; as-built
MOCP
as-built sequence of operation, building control system or logger trends

as-built sequence of operation, building control system or logger trends

ogger trends
6.11 DX CONDENSING UNIT AND CONDENSERS

SAMPLE FORM
General Information
Site Name
Equipment ID/Tag
Location/Service
Manufacturer
Model Number
Associated Equipment
Serial Number
Year Built
Type of Equipment
Condensing Unit
Condenser
Condenser Fan Data

Quantity
Full Load Amps
Volts
Phase
Nominal HP
Condenser Type
Air-cooled
Evap-cooled
Fluid-cooled
Fan Control
Compressor Data
Quantity
RLA
Volts
Phase
Type
Electrical Data
Volts
Phase
MCA
MOCP
Cooling Type
DX: Refrigerant Type
Number of Circuits
Cooling Cap. (MBH)
EER/SEER
EER incl. supply fan?
Heat Pump?
Heating Cap. (MBH)
HSPF/COP
Fluid-Cooled Data
Fluid
GPM
EWT/LWT (oF)
WPD (ft w.g)
VFD / Single-speed /
Two-Speed
Yes / No
Yes / No
Controls Notes
Time of Day Scheduling _______________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Unit Staging ________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
7.0 SWIMMING POOLS

SAMPLE FORM
General Information
Site Name
Location of Pool
Size (gallons)
Activity Schedule
Surface Area
Year Built
Outdoor Conditions
Avg temp for coldest month of use
Saturation vapor pressure
Atmospheric pressure
Wind speed
Annual Solar Radiation
% Shaded area in pool area
Indoor Conditions
Room Temp Setpoint
Room RH Setpoint
Method of Air Delivery
Filter Pump Data
Filter Type
Filter Pressure Drop
Power Demand (kW)
Hours on per day
VFD
Heating Conditions
Heating Method
Cover Type
Cover U-value
Cover Schedule
Desired Water Temp
Measured Water Temp
Warm up time
Heating Schedule___________________________________
Gas Pool Heaters

Capacity
Fuel Type
Efficiency
Power Demand (kW)
yes/no
Solar Pool Heaters

Total Collector Area
Collector Orientation/Tilt
Collector Type
Distance from pool to collectors
Pumping power per collector area
Heat Exchanger Efectiveness
Heat Pump Pool Heaters

Capacity
Air/Water Source
COP
Compressor Type
Refrigerant Type
Power Demand (kW)
Pool Accessories
Ozone Generator
Oxygen Concentrator
Air Compressors
Additional Notes/Comments
Power Hours on
Demand per day
yes/no
yes/no
yes/no
7.0 SWIMMING POOLS


General Information
Site Name
Location of Pool
Size (gallons)
Activity schedule

Observe location in relation to building
as-built plans or direct measure
Indicate what pool is used for
(recreation, teaching, training,
etc) and typical weekly
schedule
Outdoor Conditions
Avg temp for coldest month ofASHRAE Fundamentals
ASHRAE Fundamentals
Saturation vapor pressure
ASHRAE Fundamentals
Atmospheric pressure
ASHRAE Fundamentals
Wind speed
ASHRAE Fundamentals
Annual Solar Radiation
% Shaded area in pool area Estimate avg. percentage
Indoor Conditions
Room Temp Setpoint
Room RH Setpoint
Method of Air Delivery
Filter Pump Data
Filter Type
Power Demand
Hours on per day
VFD
as-built plans or direct
Surface Area measurement

Year Built as-built plans or submittals
based on observations
throughout one day
Heating Conditions
as-built submittal
Heating Method
as-built submittal
Cover Type
as-built submittal
Cover U-value
interview facilities staf
Cover Schedule
Desired Water Tem as-built sequence of operations
Meas Water Temp control system or direct measureme
control system, interview staf
Warm up time
Heating Schedule

as-built submittal
as-built submittal
control system, logger trends
as-built sequence of operations,

control system, and interview staf;
obtaining annual hours of heating
is desired, how is it controlled?
Gas Pool Heaters

as-built submittal
Capacity
as-built submittal
Fuel Type
as-built submittal
Efficiency
control/logger trends; spot measure
Power Demand
control system, logger trends

as-built submittal
Solar Pool Heaters

as-built submittal
Total Collector Area
observe/measure
Collector Orientation/Tilt
as-built submittal
Collector Type
Distance from pool to collecto as-built plans or measure
Pumping power per collector aas built submittal
Heat Exchanger Efectiveness as built submittal
Additional Notes/Comments
Heat Pump Pool Heaters

as-built submittal
Capacity
Air/Water Source as-built submittal
as-built submittal
COP
Compressor Type as-built submittal
Refrigerant Type as-built submittal
control/logger trends; spot measure
Power Demand
Pool Accessories
Power
Demand
Ozone Generator
as-built
Oxygen Concentratschedules
, observe
Air Compressors
if present
submittals,
also
recommend
measuring
actual kW
use
Hrs on
per
day
control
system,
logger
trends
7.0 SWIMMING POOLS

7.1 KITCHEN EQUIPMENT

SAMPLE FORM
General Information
Site Name
Room Name
Location/Service
Year Built
Floor Area (sq. ft.)
Oven Data
Quantity
Manufacturer
Model Number
Capacity
Fuel Type
Efficiency
Power Demand (kW)
Hours On per Day
Year Installed
Other Equipment Data

Equipment Type
Quantity
Manufacturer
Model Number
Power Demand (kW)
Hours On per Day
Year Installed
Energy Star Rated?
Refrigerator Data
Quantity
Manufacturer
Model Number
Capacity
Compressor Type
Efficiency
Power Demand (kW)
Hours On per Day
Year Installed
Motor Data
Quantity
Full Load HP
Frame Size
Enclosure Type
Operating RPM
Motor Efficiency
Volts
Phase
Full Load Amps
Power Demand (kW)
Drive Type
Hours On per Day
Year Installed
Compressor Data
Quantity
Capacity
Manufacturer
Model Number
Type
Efficiency
Power Demand (kW)
Hours On per Day
Year Installed
Controls Notes
Room Conditions
Room Temp Setpt (heat/cool)
Cooling System Type
Air Delivery System Type
Heating System Type
Range Hoods
Quantity
Type
Max/Min CFM
Control Method
Yes/No


General Information
Site Name
provide name of kitchen room
Room Name
facilities operator
Location/Service
as-built drawings, facilities operator
Year Built
Oven Data
Quantity
Manufacturer
Model Number
Capacity
Fuel Type
Efficiency
count at site
nameplate, as-built oven submittal
nameplate, as-built oven submittal,
compute from building control system or
logger trends
Floor Area measure from as-built floor plans

Other Equipment Data
Equipment Type nameplate, as-built submittal
nameplate, as-built submittal
Quantity
Manufacturer
Model Number
Power Demand (k building control system or logger trends
Hours On per Day building control system or logger trends
Year Installed
Power Demand (kW)if electric,
building control system or

logger trends
Hours On per Day

Year Installed

Refrigerator Data
count at site
Quantity
nameplate, as-built refrigerator submittal
Manufacturer
Model Number
Capacity
Compressor Type nameplate, as-built refrigerator submittal
Efficiency
Power Demand (kW)building control system or logger trends
Year Installed
Compressor Data
count at site
Quantity
nameplate, as-built compressor submittal
Capacity
Manufacturer
Model Number
Type
Efficiency
Power Demand (kW)building control system or logger trends
Year Installed
Controls Notes
as-built sequence of operation, control system or logger trends of
equipment power demand (kW) (or Amps)
Motor Data
Quantity
Full Load HP
Frame Size
Enclosure Type
Operating RPM
Motor Efficiency nameplate, as-built submittal
Volts
Phase
Amps
Power Demand (k building control system or logger trends
Drive Type
Year Installed
Room Conditions
Room Temperaturebuilding control system or logger trends
Cooling System as-built mechanical drawings
Air Delivery Syste as-built mechanical drawings
Heating System as-built mechanical drawings
Range Hoods
Quantity
Type
count; as-built equipment schedule
Max/Min CFM
as-built submittal; spot measurement

or control system/logger trends
Control Method
e.g. condensate, grease; as-built

submittal

ogger trends
ogger trends
ogger trends
ogger trends
ogger trends
ogger trends
ogger trends
ogger trends
ogger trends
7.2 LAB EQUIPMENT

SAMPLE FORM
General Information
Site Name
Room Name
Floor Area (sf)
Airflow Determinant
Ventilation Data
CAV/VAV
Occupied ACH
Unoccupied ACH
Particle Counting
Contaminant Sensor
Occ. Sensors
CO2 Sensors
Exhaust Data
Quantity
yes
yes
yes
yes
/
/
/
/
Fume Hoods
Snorkels
Gas Cabinets
BS Cabinets
Other
no
no
no
no
Equipment Data
Tag ID & type
Mfr /
Model
NP Pwr
Rating
Low Pwr/
Standby
Mode W
VAV /
CAV
Min
Max
Airflow Airflow
Time of
Day
Scheduling
Time of
Other
Typ
Day
Efficiency
Active Cooling
hr/wee Sched Features
Mode W Req't
k
7.2 LAB EQUIPMENT


General Information
Site Name
Room Name & Area Provide name of room

as-built floor plan
Floor Area
Airflow DeterminantIs airflow supplied to the room dominated by ventilation, exhaust, or cooling requirements? Refer to as-built
room plans or basis of design
Ventilation Data
submittals/trend data
CAV/VAV
Occupied ACH
Unoccupied ACH submittals/trend data
Particle Counting submittals/trend data
Cont. Sensors
Occ. Sensors
CO2 Sensors
Exhaust Data
Qty
Fume Hoods
Snorkels
as-built
Gas Cabinetsequipme
BS Cabinets nt
submittal
Other
VAV /
CAV
as-built
equipment
submittal,
also look at
control
system or
logger
trends to
verify
Min
Airflow
Max
Airflow
as-built
equipment
submittal,
also look at
control
system or
logger
trends to
verify
as-built
equipment
submittal,
also look at
control
system or
logger
trends to
verify
Time of
Day
Scheduling
as-built
sequence of
operations, also
look at control
system or
logger trends to
verify
Equipment Data
Tag ID & type
Near equipment nameplate or as-built equipment schedule for tag ID. List all types of lab equipment in room
including but not limited to: autoclaves, freezers, refrigerators, ovens, lasers, spectrometers, cage washers,
centrifuges, glove boxes, vacuum pumps, chromatographs, cryo coolers, dry baths, glass washers, growth
chambers, heat blocks, incubators, and thermal cyclers.
Mfr / Model
Nameplate or as-built equipment submittal
Nameplate Pwr
Rating
Nameplate or as-built equipment submittal
Low Pwr/Standby logger trends, also see if this is specified in equipment submittal
Mode W
Active Mode W
Cooling Req't
logger trends, also see if this is specified in equipment submittal
Typ hr/week
interview lab users to quantify typical usage, also use data logger to monitor power for at least one week
Time of Day
Scheduling
interview lab users, logger trends
Other Efficiency
Features
as-built equipment submittal, also interview lab users to see if there any energy saving opportunities in behavior
7.3 REFRIGERATION EQUIPMENT

SAMPLE FORM
General Information
Site Name
Room/Area Name
Location/Service
Conditioned Floor Area (sq. ft.)
Compressor Data
Manufacturer
Type
Quantity
Model Number
Serial Number(s)
Tag Number
Refrigerant Type
Suction Press/Temp
Discharge Press/Temp
Capacity (MBH)
Power Demand (kW)
Hours On per Day
Year Installed
Evaporator Coil Data

Manufacturer
Type
Coil Quantity
Model Number
Serial Number(s)
Tag Number
Suction Group
Location
Room Temperature
Defrost Type
Defrost Duration
Number of Defrost/day
Defrost Power Draw (kW)
Condenser Data
Manufacturer
Type
Quantity
Model Number
Serial Number(s)
Tag Number
Capacity (MBH)
Fan Motor HP
Fan Motor Efficiency
Fan Motor Quantity
Fan Amps / Volts /
Fan Power Draw (kW)
Year Fan Installed
Pump Motor HP
Pump Motor Efficiency
Pump Motor Quantity
Pump Amps / Volts /
Pump Power Draw (kW)
Year Pump Installed
Evaporator Fan Data

Manufacturer
Quantity
Model Number
Serial Number(s)
Fan Type / Size
Fan Efficiency
Controls Notes
Heat Recovery?
Evaporator Fan Motor Data

Fan Motor HP
Fan Motor Quantity
Fan Amps / Volts /
Fan Power Draw (kW)
Year Fan Installed
Drive Type
Controls
Conditioned Area
Enclosed?


General Information
Site Name
provide name of conditioned room or area
Room Name
provide are served; from facilities operator
Location/Service
measure from as-built floor plans
Floor Area
Compressor Data
Manufacturer
Type
count; as-built equipment sched
Quantity
Model Number
nameplate
Serial Number(s)
located near nameplate
Tag Number
Refrigerant Type
Suction Press/Temp nameplate; as-built submittal
Discharge Press/Tempnameplate; as-built submittal
Capacity (MBH)
Power Demand (kW) control system or logger trends
Hours On per Day
Year Installed
Evaporator Coil Data

Manufacturer
Type
nameplate; as-built equipment sched
Coil Quantity
Model Number
nameplate
Serial Number(s)
Tag Number
Suction Group
observe; as-built submittal
Location
Room Temperature
as-built submittal
Defrost Type
Defrost Duration
Number of Defrost/day control system or logger trends
Defrost Power Draw (kW)control system or logger trends
Condenser Data
Manufacturer
Type
Quantity
Model Number
nameplate
Serial Number(s)
Tag Number
Capacity (MBH)
Fan Motor HP
Fan Motor Efficiency nameplate; as-built submittal
Fan Motor Quantity count; as-built equipment sched
Fan Amps / Volts / nameplate; as-built submittal
Fan Power Draw (kW)control system or logger trends
Year Fan Installed
Pump Motor HP
Pump Motor Efficienc nameplate; as-built submittal
Pump Motor Quantitycount; as-built equipment sched
Pump Amps / Volts / nameplate; as-built submittal
Pump Power Draw (k control system or logger trends
Year Pump Installed nameplate; as-built submittal
Evaporator Fan Data

Manufacturer
Serial Number(s)
Model Number
Serial Number
Fan Type / Size
Fan Efficiency

nameplate
nameplate
Evaporator Fan Motor Data

Fan Motor HP
Fan Motor Quantity
Fan Amps / Volts /
Fan Power Draw (kW)
Year Fan Installed
as-built submittal
Drive Type
Controls
Conditioned Area
Enclosed?
observe; e.g. strip curtains,

enclosing doors
Controls Notes
Time of Day Scheduli as-built sequence of operation, control system or logger trends of equipment power demand (kW) (or Amps)
Heat Recovery?
describe type of heat recovery employed

pment sched
(or Amps)
7.4 DATA CENTERS / IT Rooms

SAMPLE FORM
General Information
Site Name
Room Name
Location/Service
Year Built
CRAC/CRAH Units - General
Quantity
Nominal Capacity
Compressor Type
CRAC/CRAH Fan Data
Manufacturer
Model Number
Serial Number(s)
Fan Type / Size
Fan Efficiency
CRAC/CRAH Fan Motor Data
Full Load HP
Frame Size
Enclosure Type
Motor Efficiency
Yes/No
Motor In Supply Airflow?
Drive Type
Total Floor Area (sf)

Total Server Load (kW)
Design
PUE
Supply CFM
Fan RPM
Volts
Amps
Fan Power Demand (kW)
Power Factor
n/a
Return Air Temperature
Supply Air Temperature
Fan Control
Constant Air Volume
VFD
Multi-Speed
Connected to DDC?
Configuration
Open, No Hot/Cold Aisles
Open Hot/Cold Aisle
Hot/Cold Aisle w/ Ducted Return
Fully Enclosed Hot/Cold Aisles
Humidity Control
None
Humidifier Type
Humidity Sensor Location
RH Setpoint, Max
RH Setpoint, Min
Uninterruptible Power Supply

Quantity
Capacity
Manufacturer
Model Number
Operating Output Power
Operating Input Power
Operating Load Factor (%)
Equipment Served
Transformers
Quantity
Capacity
Manufacturer
Model Number
Operating Output Power
Operating Input Power
Operating Load Factor (%)
Equipment Served
Controls Notes
Server Operation/HVAC System Schedule
Air Side Economizing

Economizer Control
Economizer Upper Limit
Economizer Lower Limit
Economizer Control Point
CRAC/CRAH Staging
Yes/No
Measured



General Information
Site Name
provide name of datacenter or IT room
Room Name
facilities operator
Location/Service
as-built drawings, facilities operator
Year Built
as-built floor plans
Total Floor Area
measure with power meter
Total Server Load
CRAC/CRAH Units - General
count at site
Quantity
as-built CRAC/H schedule
Nominal Capacity
DX or CHW plant, as-built CRAC/H schedul
Compressor Type
CRAC/CRAH Fan Data
as-built CRAC/H
Manufacturer
as-built CRAC/H
Model Number
as-built CRAC/H
Serial Number(s)
as-built CRAC/H
Fan Type / Size
as-built CRAC/H
Fan Efficiency
schedule
schedule
schedule
schedule
schedule
Fan Control
Constant Air Volumeas-built sequence of operation
inside CRAH unit
VFD
as-built motor submittal
Multi-Speed
Connected to DDC? as-built sequence of operation
Humidity Control
Humidifier Type
Humidity Sensor
Location
as-built humidifier schedule

visual observation
RH Setpoint, Max
% or dewpoint; as-built
sequence of operation, control
RH Setpoint, Min
% or dewpoint; as-built
sequence of operation, control
Transformers
as-built electrical line diagram
Quantity
as-built transformer submittal
Capacity
nameplate
Manufacturer
nameplate
Model Number
Oper Output Power measure with power meter
Oper Input Power measure with power meter
Operating Load (%) output power capacity
Equipment Served as-built electrical line diagram
CRAC/CRAH Fan Motor Data

motor nameplate, as-built CRAC/H schedul
Full Load HP
Frame Size
Enclosure Type
motor nameplate, as-built motor submittal Uninterruptible Power Supply
Motor Efficiency
as-built electrical line diagram
Motor in Supply Airflo motor nameplate, as-built motor submittal Quantity
as-built fan schedule, as-built fan submitta Capacity
as-built transformer submittal
Drive Type
nameplate
Manufacturer
nameplate
Model Number
Configuration
observe server racks
Open, No Hot/Cold
Oper Output Power measure with power meter
Oper Input Power measure with power meter
Open Hot/Cold Aisle observe server aisles, measure
temperatures in aisles
Operating Load (%) output power capacity
observe
server
aisles
and
ducting
to
Equipment Served as-built electrical line diagram
Hot/Cold Aisle w/
return opening in CRAC/CRAHs, measure
Ducted Return
Fully Enclosed
Hot/Cold Aisles
observe server aisles and enclosure at

tops and ends of aisles, measure
Air Side Economizing

Economizer Control e.g. drybulb, RH, or enthalpy;

control system trends
as-built CRAC/CRAH schedule
Design
Measured
Economizer Upper
Limit
e.g. upper OA drybulb temp

Server
Controls Notes
Operation/
HVAC
Schedule
CRAC/CRAH Staging
Economizer Lower
Limit
e.g. lower OA drybulb temp

Economizer Control e.g. return air drybulb temp; asbuilt sequence of operation
Point
as-built sequence of operation, building

as-built sequence of operation, building



7.5 PROCESS EQUIPMENT

SAMPLE FORM
General Information
Site Name
Location/Service
Year Built
Compressed Air System
Type of Compressor
Compressor Efficiency
Compressor Controls
Quantity of Filters
Filter Type
After cooler Efectiveness
Condensate Separation Efficiency
Dryer Size
Dryer Efficiency
Dryer Pressure Drop
Dryer Purge Rate
Dryer Purge Rate Control
Receiver Tank Size
Receiver Tank Location
Compressed Air Design / Operating Conditi
Central Vacuum System

Type of Pumps
Quantity of Pumps
Pump Controls
Uses of Central Vacuum System:
Central Vacuum Design / Operating Conditi
Process Chilled Water System

Portable Process Chillers
Separate High Temp Chiller pla
Low Temp Chiller plant w/ mixi
Water Side Free Cooling
Required
Flow rate
Pressure
Dew Point
Hrs on per day
Compressor Power Demand
Pressure / Flow Controller?
Leaks Detected?
If so, where?
Measured
yes / no
yes / no
Uses of Compressed Air System:
Required
Flow rate
Pressure
Hrs on per day
Pump Power Demand
Leaks Detected?
If so, where?
Measured
yes/no
Chilled Water Design / Operating Condition

yes
yes
yes
yes
/
/
/
/
no
no
no
no
Required
Measured
Flow rate
Head
Supply Temp
Uses of Process Chilled Water:
Elevators
Capacity (lbs)
Year Built
Type (hydraulic, traction, etc)
Frequency of Use
Machine Room Cooling Load
Elevator Design / Operating Conditions

Rated
Measured
Speed
Riding Power
Standby Power



General Information
Site Name
Location/Service
Year Built
Compressed Air System
Type of Compressor
Compressor Efficiency
Compressor Controls
Quantity of Filters
Filter Type
After cooler Efectiveness
Condensate Separation Effici
Dryer Size
Dryer Efficiency
Dryer Pressure Drop
Dryer Purge Rate
Dryer Purge Rate Control
Receiver Tank Size
Receiver Tank Location

observe location and purpose of process equipment
as-built drawings, equipment submittals
Compressed Air Design/Oper Conditions

Required
as-built submittal
as-built submittal
as-built schedule
Flow rate
Pressure
Dew Point
Measured
as-built schedule
as-built submittal
as-built submittal
as-built submittal
as-built submittal
Pressure / Flow Controller?

Leaks Detected?
If so, where?
as-built schedule
Visual inspection and
as-built submittal
as-built submittal
Uses of Compressed Air System:
as-built submittal
as-built schedule, and floor plans, also interview facilities staf
to ensure there are not inappropriate uses of compressed air
as-built sequence of operations (i.e. diaphragm pumps, pneumatic controls, etc)
as-built submittal
as-built schedule
as-built floor plans
Central Vacuum System

Central Vacuum Design/Oper Conditions
as-built submittal
Required
Measured
Type of Pumps
as-built
schedule
Quantity of Pumps
Flow rate
control system or
as-built schedule
logger trends
as-built sequence of operations Pressure
Pump Controls
Uses of Central Vacuum System:
Leaks Detected?
Visual inspection and
If so, where?
Process Chilled Water System

as-built schedule
Portable Process Chillers
Separate High Temp Chiller plas-built schedule
Low Temp Chiller plant w/ mixas-built schedule
as-built schedule
Water Side Free Cooling
Chilled Water Design/Oper Conditions

Required
Flow rate
Head
Supply Temp
Measured
as-built schedule
as-built schedule
control system or
logger trends
as-built schedule
note: circle all that apply
Uses of Process Chilled Water:

Elevators
as-built submittal
Capacity (lbs)
as-built submittal
Year Built
Type (hydraulic, traction, etc) as-built submittal
Frequency of Use
Machine Room Cooling Load as-built submittal
Elevator Design/Oper Conditions

Rated
Measured
Speed
control system or
Riding Power as-built submittal logger trends
Standby Power


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COVER PAGE

Commercial Building Energy Audit Sample Forms

n) with you to the site.

Commercial Building Energy Audit Sample Forms

Economic Criteria for Energy Projects

Previous Audit Availability

1.1 CAPITAL IMPROVEMENT PLAN

1.2 UTILITY COST DATA

Commercial Building Energy Audit Sample Forms

Peak Demand (kW)

Total Annual Cost ($)

Average kW Cost ($)

Average kWh Cost ($)

1.2 UTILITY COST DATA

Commercial Building Energy Audit Sample Forms

Average _______ Cost ($)

Average _______ Cost ($)

1.2 UTILITY COST DATA

Commercial Building Energy Audit Sample Forms

Average _______ Cost ($)

Average _______ Cost ($)

1.3 DELIVERED CONSUMPTION DATA

Commercial Building Energy Audit Sample Forms

365 Days after Date 0

Use of Inventory (A-B)

Value of Inventory Used

2. Costs should include tax, fees, contract charges, etc.

1.4 PRELIMINARY ENERGY USE ANALYSIS

Purchased Hot Water

Purchased Chilled Water

Thermal - On-Site Generated

Electricity - On-Site Generated

Thermal or Electricity - Exported

Gross Conditioned Square Feet

Target Finder Score

1.5 OPERATIONS AND MAINTENANCE

2.1 OPAQUE SURFACES

Slab Total Exposed Perimeter Length:

Insulation Type and Thickness:

(also use Notes

(circle all that apply)

(used to consider additional glazing)

AAMA Product ID:

Aluminum with Thermal Break

Wood, Clad with Vinyl/Aluminum

Describe: (e.g., leaking)

2.3 OPAQUE DOORS

Commercial Building Energy Audit Sample Forms

Site-built Door Age:

Door Condition: Good

3.0 SCHEDULES - OCCUPANCY

Commercial Building Energy Audit Sample Forms

Use this space to make drawings or take notes.

3.1 SCHEDULES - LIGHTING

Commercial Building Energy Audit Sample Forms

3.2 SCHEDULES - PLUG LOADS

Commercial Building Energy Audit Sample Forms

Commercial Building Energy Audit Sample Forms

Heating Set Point:

Cooling Set point:

4.0 PEAK OCCUPANCY

4.1 INTERIOR LIGHTING

Manual Switch Bi-Level Switch

Vertical Illuminance Sensitivity: