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| Building Envelope Assessment (STEP) | | |
| Wall R-Value (Current) (NUMBER) | | |
| Roof R-Value (Current) (NUMBER) | | |
| Window Type (Predominant) (SELECTION options: Single Pane, Double Pane, Low-E Coated, Other) | | |
| Notes on Wall Condition (Cracks, Damage) (TEXT) | | |
| Door Sealing Condition (SELECTION options: Excellent, Good, Fair, Poor) | | |
| Photos of Building Envelope (Optional) (UPLOAD) | | |
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| HVAC System Evaluation (STEP) | | |
| Refrigerant Charge (lbs) (NUMBER) | | |
| Supply Air Temperature (°F) (NUMBER) | | |
| Return Air Temperature (°F) (NUMBER) | | |
| Static Pressure (inches of water) (NUMBER) | | |
| Filter Condition (Visual) (SELECTION options: Excellent, Good, Fair, Poor) | | |
| Blower Motor Operation (SELECTION options: Normal, Audible Noise, Overheating, Not Operating) | | |
| Last Maintenance Date (DATE) | | |
| Notes/Observations (TEXT) | | |
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| Lighting & Electrical Systems (STEP) | | |
| Current Lighting Wattage per Square Foot (NUMBER) | | |
| Target Lighting Wattage per Square Foot (Post-Upgrade) (NUMBER) | | |
| Lighting Types in Use (SELECTION options: LED, Fluorescent, Incandescent, Halogen, Other) | | |
| Lighting Control System Present? (SELECTION options: Yes, No) | | |
| Last Electrical System Inspection Date (DATE) | | |
| Number of Occupancy Sensors Installed (NUMBER) | | |
| Dimming Capabilities Present? (SELECTION options: Yes, No) | | |
| Notes on Electrical System Condition (TEXT) | | |
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| Water Usage & Conservation (STEP) | | |
| Current Water Bill (Monthly) (NUMBER) | | |
| Estimated Water Usage (Gallons) (NUMBER) | | |
| Type of Irrigation System (if applicable) (SELECTION options: Sprinkler, Drip, Manual, None) | | |
| Water-Saving Fixtures Present? (SELECTION options: Low-Flow Toilets, Aerators on Faucets, WaterSense Certified Appliances, None) | | |
| Leaks Detected? (SELECTION options: Yes, No, Unsure) | | |
| Details of any leaks detected (if applicable) (TEXT) | | |
| Date of last irrigation system maintenance (DATE) | | |
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| Equipment & Appliances (STEP) | | |
| Refrigerator Energy Star Rating (if applicable) (NUMBER) | | |
| Dishwasher Cycle Usage (cycles/week) (NUMBER) | | |
| Oven Temperature Calibration (degrees) (NUMBER) | | |
| Type of Washing Machines (if multiple) (SELECTION options: Front-load, Top-load, Energy Star Certified) | | |
| Estimated Monthly Usage (kWh) - HVAC (NUMBER) | | |
| Last Maintenance Date - HVAC (DATE) | | |
| Notes on Equipment Condition & Usage (TEXT) | | |
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| Building Management System (BMS) (STEP) | | |
| Current BMS Version (NUMBER) | | |
| BMS Vendor (SELECTION options: Honeywell, Siemens, Johnson Controls, Schneider Electric, Other) | | |
| Summary of Recent BMS Events/Alarms (TEXT) | | |
| Last BMS System Backup Date (DATE) | | |
| Key Performance Indicators (KPIs) Monitored (SELECTION options: Energy Consumption, Temperature, Humidity, Lighting Usage, Equipment Runtime) | | |
| Alarm Notification Method (SELECTION options: Email, SMS, Dashboard Alerts, Phone Call) | | |
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| Employee Awareness & Behavior (STEP) | | |
| Estimated Employee Participation in Energy Saving Initiatives (Scale of 1-10) (NUMBER) | | |
| Are energy-saving behaviors part of employee training? (SELECTION options: Yes, No, Not sure) | | |
| Describe current methods for communicating energy-saving tips to employees. (TEXT) | | |
| Which of the following employee behaviors contribute to energy waste? (SELECTION options: Leaving lights on in unoccupied rooms, Leaving computers on overnight, Adjusting thermostats excessively, Using hot water unnecessarily, Other (please specify in a long text field)) | | |
| Is there a designated 'Energy Champion' or team responsible for promoting energy conservation? (SELECTION options: Yes, No, Not sure) | | |
| Suggestions for improving employee engagement in energy conservation (optional) (TEXT) | | |
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| Renewable Energy Potential (STEP) | | |
| Annual Solar Irradiance (kWh/m²) (NUMBER) | | |
| Roof Orientation (for Solar) (SELECTION options: North, South, East, West) | | |
| Available Roof Area (m²) (NUMBER) | | |
| Local Incentive Programs Available? (SELECTION options: Yes, No, Unsure) | | |
| Notes on Obstructions (Trees, Buildings) (TEXT) | | |
| Potential Wind Turbine Feasibility? (SELECTION options: High, Medium, Low, Not Suitable) | | |
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| Measurement & Verification (STEP) | | |
| Baseline Energy Consumption (kWh) (NUMBER) | | |
| Post-Implementation Energy Consumption (kWh) (NUMBER) | | |
| Percentage Reduction in Energy Consumption (%) (NUMBER) | | |
| Date of Baseline Measurement (DATE) | | |
| Date of Post-Implementation Measurement (DATE) | | |
| Notes on Measurement Methodology (TEXT) | | |
| Measurement Standard Used (e.g., IPMVP) (SELECTION options: IPMVP, ISO 50001, Other) | | |
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| Cost Savings & ROI Analysis (STEP) | | |
| Estimated Annual Energy Cost Savings ($) (NUMBER) | | |
| Estimated Implementation Cost ($) (NUMBER) | | |
| Estimated Payback Period (Years) (NUMBER) | | |
| Discount Rate (%) (NUMBER) | | |
| Financing Options Considered (SELECTION options: Internal Funds, Loan, Grant, Lease) | | |
| Assumptions & Calculations Notes (TEXT) | | |
| Sensitivity Analysis Performed? (SELECTION options: Yes, No) | | |
| Date of ROI Calculation (DATE) | | |
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