AuditSampleForms Master Sept 27 2011

COVER PAGECommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Purpose

AcknowledgementsRocky Mountain Institute, Integral Group, Taylor Engineering, kW Engineering

Sample Form Recommended Use

Typical Data Sources

Specialized equipment for detailed assessments may also include:

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.

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 the "citation" column where available in case you need to clarify the information at a later time. Use the "Guidance" Sample Forms provided that have been filled in sample data as 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 site.

Facility manager As-built drawing sets Utility bills BAS trend data On-site spot measurements Temporary logger data

Tools for a Level I Audit :

Tools for a Level II and III Audit :

Identification Illuminance meter (light meter) 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)

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 PAGECommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Print the Sample Forms (sometimes multiples of each) and bring them (or the electronic version) with you to the site.

TABLE OF CONTENTSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

GENERAL INFORMATION1.01.11.21.31.41.5

GEOMETRY &ENVELOPE2.02.12.22.3

SCHEDULES3.03.13.23.3

PEAK LOADS4.04.14.24.3

DOMESTIC HOT WATER5.05.1

HVAC & CONTROLS OPTIONS 6.06.16.26.36.46.56.66.76.86.9

6.106.11

SPECIALTY LOADS SAMPLE FORMS7.07.17.27.37.47.5

BasicsCapital Improvement PlanUtility Cost DataDelivered Consumption DataPreliminary Energy Use AnalysisOperations and Maintenance Cost

SketchesOpaque SurfacesFenestrationOpaque Doors

OccupancyLightingPlug LoadsThermostat Schedule

Peak OccupancyInterior LightingExterior LightingPeak Plug Loads

EquipmentFixtures and Use

BoilersChillersCooling Towers and Fluid CoolersPumps and Piping SystemsAir Handling System EquipmentAir Handling System ControlsAir System Terminal UnitsZone Heating EquipmentFan Coil UnitsExhaust/Return Fans Packaged Units: DX, Heat PumpsCondensing Unit and Condensers

Swimming PoolsKitchen EquipmentLab Equipment Refrigeration Equipment Datacenters/IT RoomsProcess Equipment

TABLE OF CONTENTSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

1.0 BASICSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Name Information Citation

Client Name:

City / State:

Gross Area

Building Age

Key ContactsName and position Phone/Email

Economic Criteria for Energy Projects

Previous Audit Availability

Notes:

Project Name:

Building Type: (CBECS if possible)No. of Stories

No. of tenants / Lease type

1.1 CAPITAL IMPROVEMENT PLANCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Description of planned replacement, renewal, or system expansion Cost Citation

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

TOTAL #VALUE!

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 Envelope Electrical Plumbing Aesthetic Life Safety Other

Year Planned

1.2 UTILITY COST DATACommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

ELECTRIC

Utility Name:

Account Number:

Meter Number:

Rate Schedule Name:

Notes on Rate:

YEAR:

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 $0 $0 $0 $0

Peak Demand (kW) 0

Total Annual Cost ($) $0

Average kW Cost ($) #DIV/0!

Average kWh Cost ($) #DIV/0!

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.

Bill Date

Days in Period

Ave Temp (F)

Actual Demand

(kW)

Billed Demand

(kW)

Electric Use

(kWh)

Demand Cost ($)

Electric Use ($)

Other Fees ($)

Total Bill ($)


NATURAL GAS

Utility Name:

Account Number:

Meter Number:

Rate Schedule Name:

Notes on Rate:

YEAR:

Bill Date

January $0

February $0

March $0

April $0

May $0

June $0

July $0

August $0

September $0

October $0

November $0

December $0


* Choose appropriate units for gas (typically MMBtu, MMBtu, therms, or MCF)

Peak Demand (______) 0

Total Annual Cost ($) $0.00

Average _______ Cost ($) #DIV/0!



Days in Period

Ave Temp (F)

Actual Demand

* (_______)

Billed Demand

* (_______)

Gas Use* (_______)

Demand Cost ($)

Gas Use ($)

Other Fees ($)

Total Bill ($)


OTHER

Utility Name and Type*:

Account Number:

Meter Number:

Rate Schedule Name:

Notes on Rate:

YEAR:

* Other utilities might be purchased steam, purchased chilled water, LPG, or fuel oil.

Bill Date

January $0

February $0

March $0

April $0

May $0

June $0

July $0

August $0

September $0

October $0

November $0

December $0


* Units should be whatever appears on the bill

Peak Demand (______) 0

Total Annual Cost ($) $0




Days in Period

Ave Temp (F)

Actual Demand

* (_______)

Billed Demand

* (_______)

Use* (_______)

Demand Cost ($)

Gas Use ($)

Other Fees ($)

Total Bill ($)

1.3 DELIVERED CONSUMPTION DATACommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Utility Company:

Account Number:

Rate Number:

Energy Type:

Delivery Date

1

2

3

4

5

6

7

8

9

10

11

12 Use of Inventory C13 At Date 0 A14 365 Days after Date 0 B15 Use of Inventory (A-B) 0 C16

17 Value of Inventory Used18 Latest Price D19 Value (CxD) $0.0020

C D

1. gal, lbs, etc. 2. Costs should include tax, fees, contract charges, etc.

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.

Units:1

Delivery Amount

Total Cost2

USE OF INVENTORY

TOTAL CONSUMPTION

1.4 PRELIMINARY ENERGY USE ANALYSISCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Energy TypeUnits

Electricity MMBtu 1000 0

Natural Gas therms 100 0

Purchased Steam 0 0

Purchased Hot Water 0 0

Purchased Chilled Water 0 0

Oil #_________________ 0 0

Propane 0 0

Coal 0 0

Thermal - On-Site Generated 0 0

Other 0 0

Electricity - On-Site Generated 0 0

Thermal or Electricity - Exported 0 0

Total 0 0

Gross Conditioned Square Feet

EUI (energy use intensity) #DIV/0!

ECI (energy cost index or $/sf) #DIV/0!

Notes:

Total Annual Use

Conversion Multiplier

Thousands BTU (kBtu)

Total Annual Cost ($)

Target Finder Score

http://www.energystar.gov/targetfinder

1.5 OPERATIONS AND MAINTENANCECommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

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!

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.

Citation / Receipt No.

2.0 SKETCHESCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

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 SKETCHESCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

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 SURFACESCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Surface Name:

Exterior Wall Roof Ceiling Floor Interior Wall Slab on Grade Undergr

Slab Total Exposed Perimeter Length:Insulation Type and Thickness:

Perimeter Insulation Depth:

Overall R-Value:

No. of Units:

Description Framing

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.

Use this sheet to describe each major type of opaque surface in the building. Print multiple sheets as necessary.

Surface type: (circle one)

If Slab on Grade or Underground WallExterior Solar Reflectivity (%):

Interior Surface Reflectance (%):

Location(s): (also use Notes below)

Layer 1 Exterior

2.2 FENESTRATIONCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Vertical Overhead

No. of Units:

Fixed Operable Glass door Storefront/Site-built Curtainwall Ga

Frame Width:

Name:

Model:

AAMA Product ID:

NFRC Product ID:

Performance:U-Value SHGC VT

Center-of-Glass: Center-of-Glass:

Aluminum Aluminum with Thermal Break Wood Vinyl

If Skylight: Domed or Flat? Diffuse or Clear?

Drawings / Notes

Use this space to draw any interior or exterior shading (mark dimensions), or to make drawings or take notes about fenestration location.

Fenestration type: (circle one)

Angle: (degrees from horizontal)

Location(s): (also use Notes below)Type: (circle all that apply)

Other: (specify)Fenestration Age:

Glazing dimensions: (HxW)

Frame Depth: (used to consider additional glazing)

Manufacturer: (if applicable)

Overall Fenestration:

Overall Fenestration:

Frame Type: (circle one) Wood, Clad with Vinyl/Aluminum Fiberglass Other: (describe)

Frame Condition: Good Poor Describe: (e.g., leaking)

Glazing Type: (circle all that apply)

Single-glazed Double-glazed Clear Glass Tinted Glass: (describe)

Curb: Yes No Height:

Interior Shade: (circle one)

None Top Down Bottom Up Other: (describe)Exterior Shade: Use space below

2.3 OPAQUE DOORSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Use this sheet to describe each type of opaque door in the building. Print multiple sheets as necessary.

No. of Units:

Swinging Sectional Rolling Site-built Door Age:

Name:

Model:

U-Value: Not including frame: Including frame:

Door Condition:

Drawings / Notes

Use this space to make drawings or take notes about opaque door location.

Location(s): (also use Notes below)

Type: (circle all that apply)

Other: (specify)

Dimensions (HxW):

Manufacturer: (if applicable)

Frame Condition:

Good Poor Describe:Frame Material:

Good Poor Describe:Door Material:

Exterior Solar Reflectivity (%):

Interior Surface Reflectance (%):

3.0 SCHEDULES - OCCUPANCYCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Fra

cti

on

of

Peak

Days M T W TH F Sat Sun Hol12-1 am1-2am2-3am3-4am4-5am5-6am6-7am7-8am8-9am9-10am10-11am11-12pm12-1pm1-2pm2-3pm3-4pm4-5pm5-6pm6-7pm7-8pm8-9pm9-10pm10-11pm11-12amDrawings / NotesUse this space to make drawings or take notes.

Zone Name/Description

3.1 SCHEDULES - LIGHTINGCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Fra

cti

on

of

Peak

Days M T W TH F Sat Sun Hol12-1 am1-2am2-3am3-4am4-5am5-6am6-7am7-8am8-9am9-10am10-11am11-12pm12-1pm1-2pm2-3pm3-4pm4-5pm5-6pm6-7pm7-8pm8-9pm9-10pm10-11pm11-12am

Drawings / NotesUse this space to make drawings or take notes.


3.2 SCHEDULES - PLUG LOADSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Fra

cti

on

of

Peak




3.3 SCHEDULES - THERMOSTATCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Heating Set Point:Occupied

Cooling Set point:Occupied

Unoccupied Unoccupied


Notes

Zone Name/ Description:

Check box to indicate each occupied hour:

4.0 PEAK OCCUPANCYCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Zone Watts/SF:


Zone Name/Description:

Peak No. of Full-time Occupants:

Description of Activity Level:

Description of Clothing Insulation Level:

Peak No. of Transient Occupants:

Description of Activity Level:

Description of Clothing Insulation Level:

Corresponding Schedule: (Reference

Sample Form 1.31)

4.1 INTERIOR LIGHTINGCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Area (SF):

Fixture Type: Area Task Exit Track Display Other: No. of Fixtures:

Mounting: Recessed Suspended Surface Mount Other: No. of Lamps/Fixture:

Lamp Type:Length: Wattage of Lamps:

Ballast: No. of Ballasts/Fixture: BF: Watts:Total Watts:





WorkPlane Height: Horizontal Illuminance: Vertical Illuminance Sensitivity: Lamp Color Temp:





WorkPlane Height: Horizontal Illuminance: Vertical Illuminance Sensitivity: Lamp Color Temp:

Zone Watts/SF:

Notes

Use this sheet to describe the electric lighting plan for each zone in your building. Print multiple sheets as necessary.Zone Name/Description:Fixture Manufacturer/Model:

Fluorescent Tube

Diameter: T12 T8 T5 Other:

Circle one: CFL Incandescent Halogen LED HID Other: Circle one: Magnetic Electronic

Control Type: (circle one)

Manual Switch Bi-Level Switch Time Clock Daylight Sensor Occupancy Sensor Dimming StepDimming Other:

WorkPlane Height: Horizontal Illuminance: Vertical Illuminance Sensitivity: Lamp Color Temp:Fixture Manufacturer/Model

Fluorescent Tube


Circle one: CFL Indcandescent Halogen LED HID Other: Circle one: Magnetic Electronic



Fixture Manufacturer/Model

Fluorescent Tube


Circle one: CFL Indcandescent Halogen LED HID Other: Circle one: Magnetic Electronic




Sample Form 1.32)

4.2 EXTERIOR LIGHTINGCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Area (SF):

Use Type: No. of Fixtures:

Mounting: Pole Bollard BuildingFacade Ceiling Other No. of Lamps/Fixture:

Length: Wattage of Lamps:


Horizontal Illuminance: Vertical Illuminance Sensitivity: Lamp Color Temp:











Zone Watts/SF:

Notes

Use this sheet to describe the electric lighting plan for the exterior of the building. Print multiple sheets as necessary.Zone Name/DescriptionManufacturer/Model

Security Advertising ParkingLot ParkingGarage Bldg Façade Landscape Other:

Lamp Type: (circle one)

Flourescent or Neon Tube

FL Diameter: T12 T10 T8 T5 Neon Diameter (mm):

CFL Halogen LED HPS MH MV Other: Circle one: Magnetic Electronic


Manual Switch PhotoCell TimeClock PhotoCell/Timeclock MotionSensor Other:

Manufacturer/Model







Manual Switch PhotoCell TimeClock PhotoCell/Timeclock MotionSensor Time Clock Other:

Manufacturer/Model







Manual Switch PhotoCell TimeClock PhotoCell/Timeclock MotionSensor Time Clock Other:


Sample Form 1.32)

4.3 PEAK PLUG LOADSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Area (SF):

Equipment Type: Desktop Computer Laptop Printer Fax Other: No. of units

Occupancy Sensor Other:

Circuit No.



Circuit No.



Circuit No.

Zone Watts/SF:

Notes

Use this sheet to describe the electric lighting plan for the exterior of the building. Print multiple sheets as necessary.Zone Name/Description:Manufacturer/Model:

Power Draw (kW):

If cycling occurs, what is the rate? (e.g. mins per hour)

Stand-by power (kW):


Manufacturer/Model:

Power Draw (kW):




Manufacturer/Model:

Power Draw (kW):





Sample Form 1.33)

5.0 DOMESTIC HOT WATER - EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Packaged Storage Water Heater Instantaneous (tankless) Boiler Dishwasher BoosterPurchased Hot Water Purchased Steam Heat Pump Solar Solar Backup Other:_____

Location(s): No. of Units:

Natural Gas Electric Fuel Oil LPG Heat recovery Other: ____________________

Name and Model:Serial No.:

gallonskBtu/h kW

Tank Dimensions:

Loop Design Delta T:

Drawings / Notes

Use this space to make drawings or take notes about the hot water equipment.

Type: (circle one)

Fuel Type: (circle one)

Manufacturer Information:

Tank Capacity: (if applicable)

Rated Input Capacity: (circle units)

Efficiency Rating: (circle units)Energy Factor Thermal Efficiency AFUE COP

Tank Internal Insulation R-Value: (if applicable)

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? __________

Recirculation pump:

Is there a recirculation pump? Yes No

Min Flow: (gpm)

Pump head (ft): Max Flow: (gpm)

Control (circle one):Continuous Temperature Timer Demand Other __________

Average recirculation time: (mins)

5.1 DOMESTIC HOT WATER - FIXTURES AND USECommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

Lavatory Faucet Kitchen Faucet Dishwasher Laundry Washer Shower Other: ________________

Location(s): No. of Units:Name and Model:Serial No.:

GPM: Gallons per Cycle

Applicable to:Cycles per Day:

Morning Mid-day EveningShower

Average No. of Users per Day

Morning Mid-day Evening

Morning Mid-day Evening

Drawings / NotesUse this space to make drawings or take notes about the fixture location or hot water 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.

Type: (circle one)

Manufacturer Information:

Flow/Cycle Rate: (circle units)

Age: (years)

Does the fixture leak? Yes No Estimate how much: Fixture Condition: Good Poor Describe:

Use Rates: (enter information where applicable)

When do most cycles occur? Dishwasher Laundry Washer

When does most use occur? Lavatory Faucet Other Fixture

Average Time of Use per Day: (mins)

When does most use occur? Kitchen Faucet Other Fixture

5.1 DOMESTIC HOT WATER - FIXTURES AND USECommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

6.0 BOILERSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite Name:Boiler ID/Tag:Location/Service:Mfr/Model #:Year Built: Serial Number:

Boiler Type Boiler Fuel Heating FluidFire Tube Natural GasWater Tube Fuel Oil Glycol? yes / no

Electric Propane Glycol %Natural Draft Electricity Steam psiForced Draft Other _________ Other _____________CondensingOther _________

Combustion Fan Data Design/Measured Data AccessoriesQuantity Boiler Design Measured Draft Control

Manufacturer Input/Output (Btu) Flue Gas Recirculation

Full Load hp GPM Oxygen Trim Control

Frame Size WPD (feet) Stack EconomizerODP/TEFC Blowdown EconomizerFull Load RPM Fan Design Measured

Fan Efficiency Volts Piping ConfigurationMotor Efficiency Phase Primary-SecondaryFull Load Amps FLA Primary-OnlyDrive Type kW Variable Flow

PFTemperature Control

Reset? yes / no If yes, describe: _________

ControlsTime of Day Scheduling ______________________________________________________________________________________________________________________________________________________________

Boiler Staging ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Water (HWS/HWR) oF

EWT/LWT (oF)

LWT Setpoint (oF)EWT Setpoint (oF)

6.0 BOILERSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORM GUIDANCEGeneral InformationSite 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

Year Built: Boiler nameplate, as-built boiler submittalSerial Number: boiler nameplate

Boiler Type Boiler Fuel Heating FluidFire Tube Natural GasWater Tube Fuel Oil Glycol?

Electric Propane Glycol %

Natural Draft Electricity Steam psi

Forced Draft Other _________ OtherCondensingOther _________

Combustion Fan Data Design/Measured Data AccessoriesQuantity Boiler Design Measured Draft Control

Manufacturer Input/Output (BtFull Load hp GPM*Frame Size WPD (feet) Stack EconomizerODP/TEFC wdown EconomizerFull Load RPM FanFan Efficiency Volts Piping Configuration

Phase Primary-SecondaryFLA Primary-OnlykW Variable Flow

Motor Efficiency PFFull Load Amps *For variable flow systems, enter the maximum flow rate

Drive Type

Temperature ControlEnter boiler leaving water temperature set point if applicable, see as-built sequence of opera

Enter boiler entering water temperature set point if applicable, see as-built sequence of oper

Reset? Indicate whether set point is reset, see as-built sequence of operations

If yes, describe: Explain reset strategy, see as-built sequence of operations, interview facilities staf

ControlsTime of Day Scheduling

Boiler Staging

specify boiler type, see as-built boiler submittal

specify boiler fuel used, see as-built boiler

submittal

Water (HWS/HWR) oFspecify heating

fluid type, as well as temperatures or working pressure, see as-built boiler

submittal

as-built boiler submittal, or

visual inspection

Check all that apply, see as-built boiler submittal or visual inspection

as-built boiler

submittal

control system, logger trends,

or direct measure

ment

Flue Gas RecirculationOxygen Trim

Control

EWT/LWT (oF)

Enter the fan static efficiency (not the same as

motor efficiency), see as-built boiler

submittal

Specify piping configuration, see

as-built piping diagram or visual

inspectionas-built boiler submittal, or

visual inspection

LWT Setpoint (oF)EWT Setpoint (oF)

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 CHILLERSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameChiller ID/TagLocation/ServiceManufacturer/ModelYear Built Serial Number

Chiller Data Design/Operating ConditionsAir or Water Cooled Design MeasuredRefrigerant Type kW/ton @ 100% loadPiping Arrangement kW/ton @ 50% loadChilled Water GlycolProp / Eth / None EER at ARI ConditionsGlycol % Evap GPMCapacity (tons)

Evap WPD (Ft)Compressor Data Cond GPMQuantityType Cond WPD (Ft)RLAVolts Temperature ControlPhase Cond water supply set pointHP Chilled water supply set pointVFD Computerized / Electronic / PneumaticCompressor Stages

Condenser Pump ControlCondenser Fan Data Pumps Cycled w/Respective Chillers yes / noQuantity Pumps Operate Independent of Chiller L yes / noManufacturer Pumps Headered / Chiller Headered yes / noFull Load HP Automatic Isolation Valves yes / noFrame Size Provide Unusual Piping Arrangement Description/SchEnclosure TypeFull Load RPM Evaporator Pump ControlEfficiency Pumps Cycled w/Respective Chillers yes / noVolts Pumps Operate Independent of Chiller L yes / noPhase Pumps Headered / Chillers Headered yes / noFull Load Amps Automatic Isolation Valves yes / noService Factor Provide Unusual Piping Arrangement Description/SchWaterside free cooli yes / no

Controls NotesTime of Day Scheduling

Chiller Sequencing

Evap EWT/LWT (oF)

Cond EWT/LWT (oF)


SAMPLE FORM GUIDANCEGeneral InformationSite Name provide name of site

Chiller ID/Tag near chiller nameplate, as-built chiller schedule

Location/Service observe chiller location and area of building it is serving, as built chiller schedule

Manufacturer/Model # chiller nameplate, as-built chiller submittal

Year Built chiller nameplate, as-built chiller submitt Serial Number chiller nameplate

Chiller Data Design/Operating ConditionsAir or Water Cooled as-built chiller schedule Design MeasuredRefrigerant Type as-built chiller schedule kW/ton @ 100% loadPiping Arrangement kW/ton @ 50% load

NPLVChilled Water Glycol Evap GPMGlycol %Capacity (tons) as-built chiller schedule Evap WPD (Ft)

Cond GPMCompressor DataQuantity as-built chiller submittal Cond WPD (Ft)Type as-built chiller submittal

RLA as-built chiller submittal Temperature Control deg FVolts as-built chiller submittal Cond water supply set point as-built sequence of operations

Phase as-built chiller submittal Chilled water supply set point as-built sequence of operations

HP as-built chiller submittal Computerized / Electronic / Pneumas-built controls submittal

VFD as-built chiller submittal

Compressor Stages as-built chiller submittal Condenser Pump ControlPumps Cycled w/Respective Chilleas-built sequence of operations

Condenser Fan Data Pumps Operate Independent of Chias-built sequence of operations

Quantity as-built chiller submittal Pumps Headered / Chiller Header as-built sequence of operations

Manufacturer as-built chiller submittal Automatic Isolation Valves as-built piping schematic

Full Load HP as-built chiller submittal Provide Unusual Piping Arrangement Description/SchematicFrame Size as-built chiller submittal

Enclosure Type as-built chiller submittal Evaporator Pump ControlFull Load RPM as-built chiller submittal Pumps Cycled w/Respective Chilleas-built sequence of operations

Efficiency as-built chiller submittal Pumps Operate Independent of Chias-built sequence of operations

Volts as-built chiller submittal Pumps Headered / Chillers Headeas-built sequence of operations

Phase as-built chiller submittal Automatic Isolation Valves as-built piping schematic

Full Load Amps as-built chiller submittal Provide Unusual Piping Arrangement Description/SchematicService Factor as-built chiller submittal

Waterside free cooling as-built chiller submittal

Controls NotesTime of Day Scheduling as-built sequence of operations, control system, or logger trends of chiller kW

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

as-built chiller

submittal

control system or logger trends

parallel, series, or primary-secondary for evaporator; and parallel or series for condenser? as-built piping schematic

Evap EWT/LWT (oF)

Cond EWT/LWT (oF)


as-built sequence of operations





Provide Unusual Piping Arrangement Description/Schematic




Provide Unusual Piping Arrangement Description/Schematic

6.2 COOLING TOWERS AND FLUID COOLERSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameTower ID/TagLocation/ServiceManufacturerModel Number Serial NumberQuantity of Cells Year Built

Heat Rejection Type Fan DataCooling Tower:

Fan ControlInduced DraftForced Draft Fan Drive Belt / Direct / GearNatural Draft

Fan TypeWetted Media

Fluid Cooler:Air Cooled Fan Data Design Measured

Evaporatively Cooled QuantityCFM (each fan)

Piping Arrangement Full Load HPBasins Headered ODP/TEFCPiped to Individ. Chillers Full Load RPMValves on Supply Headers Fan Efficiency

Motor EfficiencyFluid Cooler Pump Data Design Measured Full Load AmpsQuantity Volts / PhaseFluid Type Power Demand (kW)GPM (each pump) Power Factor n/aManufacturerFull Load HP Condenser Water Design Measured

ODP/TEFC GPMFull Load RPMPump EfficiencyMotor EfficiencyFull Load Amps Basin Heater Design Measured

Volts / Phase Power Demand (kW)Power Demand (kW) Full Load AmpsPower Factor n/a Volts / Phase

Power Factor n/a

ControlsTime of Day Scheduling __________________________________________________________________________________________________________________________________________________________________Tower/Cooler Staging ___________________________________________________________________________________________________________________________________________________________________Condenser Water Flow Rate _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

VFD / Single-speed / Two-Speed

Centrifugal / Propeller / Other: ______________

EWT/LWT (oF)Ambient DB/WB (oF)

6.2 COOLING TOWERS AND FLUID COOLERSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORM GUIDANCEGeneral Information Information Location/DescriptionSite Name Enter the name of the building site/campus and building number (if applicable).

Tower ID/Tag Enter the unit identifier, e.g. "CT-1."

Location/Service Add any other information that helps identify what the system is serving.

Manufacturer Enter the unit manufacturer. Use nameplate or submittal data.

Model Number Enter the unit model number. Use nameplate or submittal data.

Serial Number Enter the unit serial number. Use nameplate or submittal data.

Quantity of Cells For cooling towers, enter number of individual cells.

Year Built Enter year of manufacture. Use nameplate or submittal data.

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 Circle single-speed, two-speed, or VFD operation. Use nameplate or submittal data.

Fan Drive Circle belt drive, direct drive, or gear drive. Use nameplate or submittal data.

Fan Type Circle centrifugal or propeller, or enter other type.

Fan and Fluid Cooler Pump DataQty of fans/pumps Determine by inspection and enter quantity of fans or pumps.

Fluid Type Enter the type of fluid that is being cooled. Use submittal or as-built schedule.

GPM/CFM Enter the pump GPM or the fan CFM. Use nameplate or submittal data.

Manufacturer Enter unit manufacturer. Use nameplate or submittal data.

Full Load HP Enter full load horsepower. Use nameplate or submittal data.

ODP/TEFC Specify motor enclosure: ODP = open drip proof; TEFC = Totally enclosed fan-cooled.

Full Load RPM Enter motor full load rotational speed. Use nameplate or submittal data.

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.

Full Load Amps Enter full load motor current in Amperes. Use nameplate or submittal data.

Volts/Phase Enter nominal motor voltage & phase (1 or 3). Use nameplate or submittal data.

Power Demand Enter full load motor power.

Power Factor Enter motor power factor. Use control system or logger trends.

Condenser Water DataGPM Enter condenser water flow rate for constant volume systems, and max flow rate for variable flow systems.

EWT/LWT EWT=Temp of water entering condenser/cooling tower; LWT=water temp leaving condenser/tower.

Ambient DB/WB Record current outdoor dry bulb and wet bulb temperatures.

Basin HeaterPower Demand Enter full load heater power.

Full Load Amps Enter full load heater current in Amperes. Use nameplate or submittal data.

Volts/Phase Enter nominal heater voltage & phase (1 or 3). Use nameplate or submittal data.

Power Factor Enter heater power factor. Use control system or logger trends.

ControlsTime of Day Scheduling Describe if unit is on an occupancy schedule, or enabled to run continuously.

Tower/Cooler Staging For systems with multiple units, describe lead/lag, and staging of units.

Condenser Water Flow Rate Describe flow rate control: constant or variable. Use sequence of operation or control system/logger flow rate trends.

6.3 PUMP AND PIPING SYSTEMSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

General InformationSite NamePump ID/TagLocation/ServiceYear Built

Pump Data Design/Operating ConditionsManufacturer Design MeasuredModel Number Total Head (ft. w.g.)Serial Number GPMPump Type Pump Motor RPMImpeller Size VoltsPump Efficiency Amps

Power Demand (kW)Pump Motor Data Power Factor n/aFull Load HPFrame Size Pump Control NotesEnclosure Type Constant Volume __________________Full Load RPM Variable Volume __________________Synch. RPM VFD __________________Motor Efficiency Multi-Speed __________________Volts Other __________________Phase Connected to DDC? Yes/No __________________Full Load AmpsConnection Type

Pumping Configuration Miscellaneous AccessoriesPrimary Only Variable Flow Suction DifusersPrimary Only Constant Flow Triple Duty ValvesPrimary/Secondary Variable Throttling ValvesPrimary/Secondary/Tertiary Circuit SettersOther _________________ Other _____________


Pump Staging



SAMPLE FORM GUIDANCEGeneral InformationSite Name provide name of site Pump ControlPump ID/Tag near fan nameplate, as-built pump schedule Constant Volume as-built sequence of operation

Location/Servic observe pump location/as-built pump sched Variable Volume as-built sequence of operation

Year Built pump nameplate, as-built pump submittal VFD as-built pump schedule

Multi-Speed as-built sequence of operation

Pump Data Other as-built sequence of operation

Manufacturer pump nameplate, as-built pump schedule Connected to DDC? as-built sequence of operation

Model Number pump nameplate, as-built pump schedule

Serial Number pump nameplate Pumping ConfigurationPump Type

Impeller Size pump nameplate, as-built pump schedule

Pump Efficiencypump nameplate, as-built pump schedule

Pump Motor DataFull Load HP motor nameplate, as-built motor submittal

Frame Size motor nameplate, as-built motor submittal

Enclosure Type motor nameplate, as-built motor submittal OtherFull Load RPM motor nameplate, as-built motor submittal

Synch. RPM motor nameplate, as-built motor submittal

Motor Efficiencymotor nameplate, as-built motor submittal Miscellaneous AccessoriesVolts motor nameplate, as-built motor submittal Suction DifusersPhase motor nameplate, as-built motor submittal Triple Duty ValvesFull Load Amps motor nameplate, as-built motor submittal Throttling ValvesDrive Type as-built fan schedule, as-built fan submittal Circuit Setters

Other Design/Operating Conditions

Design MeasuredTotal Head as-built pump schedule Test and Balance report

GPM as-built pump schedule building control system or logger trends

Pump Motor RP as-built pump schedule building control system or logger trends

Volts as-built pump schedule building control system or logger trends

Amps as-built pump schedule building control system or logger trends

Power Demand as-built pump schedule building control system or logger trends

Power Factor n/a building control system or logger trends

Controls NotesTime of Day Scheduling as-built sequence of operation, control system or logger trends of pump speed (or Amps or k

Pump Staging as-built sequence of operation, control system or logger trends of pump speed (or Amps or k

e.g. end suction, vertical, split case; as-built pump submittal

Primary Only Variable Flow

as-built sequence of operation, as-built pump schedule, observe VFDs on all pumps

Primary Only Constant Flow

as-built sequence of operation, as-built pump schedule, observe no VFDs on any pumps

Primary/Secondary Variable Flow

as-built sequence of operation, as-built pump schedule, observe VFDs on secondary pumps only

Primary/Secondary/Tertiary

as-built sequence of operation, as-built pump schedule, observe pumps

as-built sequence of operation, as-built pump schedule,

observe piping system; as-built plumbing drawings




6.4 AIR HANDLING SYSTEM EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameAir Handler ID/TagLocation/ServiceManufacturer/Model #Year Built Serial Number

Supply Fan Data Fan ConfigurationManufacturer Blow-thruModel Number Draw-thruSerial NumberFan Type / Size Return Air PathFan Efficiency Ducted

PlenumSupply Fan Motor DataFull Load HP HumidifierFrame Size TypeEnclosure Type Capacity (lbs/hr)Full Load RPMSynch. RPM Cooling Coil NONE

Motor EfficiencyVolts Sensible/Latent Capacity Phase Design CFM / GPMFull Load Amps Design EDB / EWBMotor In Supply Airstrea Yes/No Design LDB / LWBDrive Type Design EWT / LWT

Measured EWT / LWTSupply Fan Design/Operating Conditions Air Pressure Drop

Design MeasuredTotal Static Pressure Pre-Heat Coil NONE

Occupied CFM Medium TypeUnoccupied CFM Capacity (MBTUH)Fan RPM Design CFM / GPMVolts Design EDB / LDBOccupied Amps Design EWT / LWTUnoccupied Amps n/a Measured EWT / LWTOccupied kWUnoccupied kW n/a Heating Coil NONE

Power Factor n/a Medium TypeCapacity (MBTUH)

Filter Data Design CFM / GPMManufacturer Design EDB / LDBModel Number Design EWT / LWTType Measured EWT / LWTEfficiencyInitial/Final Pressure Drop

Chilled Water (2 Way/3 Way Valve)


SAMPLE FORM GUIDANCEGeneral Information Fan ConfigurationSite Name provide name of site Blow or Draw-thruas-built AHU schedule

Air Handler ID/Tag near AHU nameplate, as-built AHU schedule

Location/Service observe fan location/as-built AHU schedule Return Air PathManufacturer/Model # AHU nameplate, as-built AHU submittal Ducted or Plenum as-built ductwork plan

Year Built/Serial NumberAHU nameplate, as-built AHU submittal

HumidifierSupply Fan Data TypeManufacturer AHU nameplate, as-built AHU schedule

Model Number AHU nameplate, as-built AHU schedule Capacity (lbs/hr) as-built AHU schedule

Serial Number AHU nameplate

Fan Type / Size AHU nameplate, as-built AHU schedule Cooling CoilFan Efficiency AHU nameplate, as-built AHU schedule Chilled Water as-built AHU schedule

Sens/Lat Capacity as-built AHU schedule

Supply Fan Motor Data Design CFM/GPM as-built AHU schedule

Full Load HP motor nameplate, as-built motor submittal Design EDB/EWB as-built AHU schedule

Frame Size motor nameplate, as-built motor submittal Design LDB/LWB as-built AHU schedule

Enclosure Type motor nameplate, as-built motor submittal Design EWT/LWT as-built AHU schedule

Full Load RPM motor nameplate, as-built motor submittal Meas EWT/LWT control system or logger trends

Synch. RPM motor nameplate, as-built motor submittal Air Pressure Drop as-built AHU schedule

Motor Efficiency motor nameplate, as-built motor submittal

Volts motor nameplate, as-built motor submittal Heating CoilPhase motor nameplate, as-built motor submittal Medium Type water, steam, or electric

Full Load Amps motor nameplate, as-built motor submittal Capacity (MBTUH)as-built AHU schedule

Motor In Supply Airstre motor nameplate, as-built motor submittal Design CFM/GPM as-built AHU schedule

Drive Type as-built fan schedule, as-built fan submittal Design EDB/LDB as-built AHU schedule

Design EWT/LWT as-built AHU schedule

Pre-Heat Coil Meas EWT/LWT control system or logger trends

Medium Type water, steam, or electric

Capacity (MBTUH) as-built AHU schedule Filter DataDesign CFM / GPM as-built AHU schedule Manufacturer nameplate; as-built submittal

Design EDB / LDB as-built AHU schedule Model Number nameplate; as-built submittal

Design EWT / LWT as-built AHU schedule Type nameplate; as-built submittal

Measured EWT / LWT control system or logger trends Efficiency nameplate; as-built submittal

Initial/Final PD as-built submittal

Supply Fan Design/Operating ConditionsDesign Measured

Total Static Pressure as-built AHU schedule Test and Balance report

Occupied CFM basis of design, as-built sequence of operatibuilding control system or logger trends

Unoccupied CFM basis of design, as-built sequence of operatibuilding control system or logger trends

Fan RPM as-built fan schedule building control system or logger trends

Volts as-built fan schedule building control system or logger trends

Occupied Amps as-built fan schedule building control system or logger trends

Unoccupied Amps n/a building control system or logger trends

Occupied kW as-built fan schedule building control system or logger trends

Unoccupied kW n/a building control system or logger trends

Power Factor n/a building control system or logger trends

electric, steam, or adiabatic; as-built humidifier schedule




6.5 AIR HANDLING SYSTEM CONTROLSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameAir Handler ID/TagLocation/ServiceManufacturer/Model #Year Built Serial Number

Supply Fan Control Outside Air (OA) ControlConstant Air Volume Fixed OA CFMVFD Economizer? Yes/NoDischarge Damper Minimum OA %Multi-Speed Economizer Control DDC Econo Upper LimitElectronic Controls Econo Lower LimitPneumatic Controls Econo Control PointRoom Thermostat

Humidifier Control Temperature ControlHumidity Control? Yes/No Occupied Room Temperature SetpoiHumidity Sensor Locatio Unoccupied Room Temperature SetpRH Setpoint, Max Heating Supply Air Temperature SetpRH Setpoint, Min Cooling Supply Air Temperature Setp

Supply Air Temperature Setpoint Res Yes/No

Operating Schedule Supply Fan Static Pressure ControlOccupied Hours Constant Static Pressure SetpointUnoccupied Hours Static Pressure ResetMorning Warm-Up Hours

Ductwork Control Accessories Louver/Damper ControlTurning Vanes? Location(s)Single / Dual Duct % Free AreaOther ________________ Pressure Drop

Control Method

Controls Notes



Air Handler ID/Tag near AHU nameplate, as-built AHU schedul

Location/Service observe fan location/as-built AHU schedule

Manufacturer/Model # AHU nameplate, as-built AHU submittal

Year Built AHU nameplate, as-built AHU submittal Serial Number AHU nameplate

Supply Fan Control Outside Air (OA) ControlConstant Air Volume as-built sequence of operation Fixed OA CFM as-built sequence of operation

VFD as-built sequence of operation Economizer?Discharge Damper as-built sequence of operation

Multi-Speed as-built sequence of operation Minimum OA %DDC as-built sequence of operation

Electronic Controls as-built sequence of operation

Pneumatic Controls as-built sequence of operation

Room Thermostat as-built sequence of operation

Supply Fan Static Pressure (SP) ControlConstant SP Setpoint as-built sequence of operation

Static Pressure Reset as-built sequence of operation

Humidifier Control Temperature ControlHumidity Control? as-built sequence of operation Occ Room Temp control system or logger trends

Humidity Sensor Locatio Unocc Room Temcontrol system or logger trends

Heating SAT control system or logger trends

RH Setpoint, Max Cooling SAT control system or logger trends

SAT Setpoint Rescontrol system or logger trends

RH Setpoint, Min

Operating ScheduleOccupied Hours Specify occupied hours for each day of the week; as-built sequence of operation

Unoccupied Hours Specify unoccupied hours for each day of the week; as-built sequence of operation

Morning Warm-Up Hours

Ductwork Control Accessories Louver/Damper ControlTurning Vanes? observe duct interiors; as-built ductwork p Location(s) observe; as-built ductwork plan

Single / Dual Duct as-built ductwork plan % Free Area measure; as-built ductwork plan

Other as-built ductwork plan Pressure Drop measure; as-built ductwork plan

Control Method as-built sequence of operation

as-built sequence of operation, control system trends of economizer damper position

as-built sequence of operation, as-built AHU schedule

Economizer Control

e.g. drybulb, RH, enthalpy; as-built sequence of operation, control system trends

Econo Upper Limit

e.g. upper OA drybulb temp lockout; as-built sequence of operation, control system trends

Econo Lower Limit

e.g. lower OA drybulb temp lockout; as-built sequence of operation, control system trends

Econo Control Point

e.g. MA temp, CO2 sensor, as-built sequence of operation

as-built sequence of operation, visual observation

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

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

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


6.6 AIR SYSTEM TERMINAL UNITSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite Name:Location/Service:

Terminal Units

AHU/Source Tag/I.D. Type NotesMfr./

Model #

Max. CFM

Htg. Min. CFM

Clg. Min. CFM

Heat Source

Cool Source

Control Type




SAMPLE FORM GUIDANCEGeneral InformationSite Name: Provide name of site

Location/Service: Provide information to identify what the system is serving, observe and see as-built equipment schedule

Terminal UnitsAHU/Source Enter/identify the equipment from which the air originates before supplying the terminal unit. See as-built floor plans.

Tag/ID Enter the terminal unit identifier, e.g. "VAV-27," if applicable, see nameplate or as-built equipment schedule

Mfr./Model # Enter the manufacturer and model number of the terminal unit, see nameplate or as-built equipment submittal

Type

Max CFM For CAV and FPB, enter CFM. For VAV, enter maximum CFM. Provide source in notes section (measured, TAB report, drawi

Heating Min For VAV only. Enter minimum heating CFM (provide source in Notes section)

Cooling Min For VAV only. Enter minimum cooling CFM (provide source in Notes section)

Heat Source

Cool Source

Control Type

Notes Use this space to enter any additional notes or comments including those stated above.

Enter the following indicators of terminal unit type:VAV=Variable Air Volume Terminal UnitCAV=Constant Air Volume Terminal UnitFPB=Fan-Powered Box (provide fan specs in notes section)Other=Explain in notes section

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")

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'.

For digital thermostat, enter "D-T."For on/of control enter "on/of"For other, enter "other" and explain in Notes Section




Provide information to identify what the system is serving, observe and see as-built equipment schedule



6.7 ZONE HEATING EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORM

General InformationSite NameHeating Equip. ID/TagLocation/ServiceManufacturer/Model #Year Built Serial Number

Room ConditionsAir Delivery Sys TypeActual Room Temp.Room Temp Set Point (htg)

Equipment DataRadiator Convector Furnace Other

QuantityMedium DimensionsMaterialCapacityDesign Flow rateMeas. Flow rateDesign SATMeas. SATDesign EWTMeas. EWTDesign PdMeas. PdCondensing/NonCombustion MethodMUA requiredThermal EfficiencyStagesVoltsDesign AmpsMeas. AmpsDesign kWMeasured kWPower Factor

Controls NotesOperating Schedule

Method of Control (Tstat, occ. Sensor, etc.)

Infrared Heater

Radiant Panel

Radiant Slab

Chilled Beam



Heating Equip. ID/Tag near equipment nameplate, as-built equipment schedule

Location/Service observe location and equipment it is serving, as built equipment schedule

Manufacturer/Model # equipment nameplate, as-built equipment submittal

Year Built nameplate, or as-built submittal Serial Number nameplate

Room ConditionsAir Delivery Sys Type basis of design, as-built floor plans

Actual Room Temp. control system or logger trends

Room Temp Set Point (htg) basis of design or control system

Equipment DataRadiator Convector Furnace Other

Quantity Observe actual quantity, also see as-built equipment schedules

Medium as-built equipment submittal

Dimensions Observe actual dimensions, also see as-built equipment submittal

Material as-built equipment submittal

Capacity as-built equipment submittal

Design Flow rate as-built equipment schedule

Meas. Flow rate control system or logger trends

Design SAT as-built equipment schedule

Meas. SAT control system or logger trends

Design EWT as-built equipment schedule

Meas. EWT control system or logger trends

Design Pd as-built equipment schedule

Meas. Pd control system or logger trends

Condensing/Non as-built equipment submittal

Combustion Methas-built equipment submittal

MUA required as-built equipment submittal

Thermal Efficienc as-built equipment submittal

Stages as-built equipment submittal

Volts as-built equipment schedule

Design Amps as-built equipment schedule

Meas. Amps control system or logger trends

Design kW as-built equipment schedule

Measured kW control system or logger trends

Power Factor control system or logger trends

Note: Not all data categories apply to every zone heating equipment type!!

Controls NotesOperating Schedu

Method of Control (Tstat, occ. Sensor, eas-built sequence of operation, as-built floor plans

Infrared Heater

Radiant Panel

Radiant Slab

Chilled Beam

As-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


6.8 FAN COIL UNITSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameFan Coil ID/TagLocation/ServiceManufacturer/Model #Year Built Serial Number

Room Conditions Cooling Coil DataAir Delivery Sys Type Design MeasuredActual Room Temperature Medium TypeRoom Temp Setpoint (htg) 2-Way / 3-Way ValveRoom Temp Setpoint (clg) Sensible/Total CapacityRH Setpoint CFM

EDB/WBFan Data LDB/WBFan Type/Size EWTFan Efficiency LWT

Air Pressure DropFan Motor Data Water Pressure DropFull Load HPFrame Size Heating Coil DataEnclosure Type Medium TypeFull Load RPM 2-Way / 3-Way ValveSynch. RPM CapacityMotor Efficiency CFMVolts EDBPhase LDBFull Load Amps EWTMotor In Supply Airstrea Yes/No LWTDrive Type Air Pressure Drop

Water Pressure DropFilter DataManufacturer Fan Design/Operating ConditionsModel Number Total Static PressureType AirflowEfficiency Fan RPMInitial / Final Pressure Drop Volts

AmpsFan Controls kWConstant Air Volume Power Factor n/aVFD Discharge Damper Operating Schedule NotesMulti-Speed ThermostatStaged Control Occupancy SensorOther On/Of DDC Twist TimerElectronic / Pneumatic Manual



Fan Coil ID/Tag near FCU nameplate, as-built FCU schedule

Location/Service observe FCU location and equipment it is serving, as built FCU schedule

Manufacturer/Model # FCU nameplate, as-built FCU submittal

Year Built FCU nameplate, or as-built FCU submittal Serial Number FCU nameplate

Room Conditions Cooling Coil DataAir Delivery Sys Type basis of design, as-built floor plans Design MeasuredActual Room Temperaturecontrol system or logger trends Medium Type as-built FCU schedule

Room Temp Setpoint (htgbasis of design or control system 2-Way / 3-Way Valve as-built FCU controls diagram

Room Temp Set Point (clgbasis of design or control system Sensible/Total Cap. as-built FCU schedule

RH Set Point basis of design or control system CFMEDB/WB

Fan Data LDB/WBFan Type/Size as-built FCU or filter schedule/submittal EWTFan Efficiency as-built FCU or filter schedule/submittal LWT

Air Pressure Drop as-built FCU schedule

Fan Motor Data Water Pressure Drop as-built FCU schedule

Full Load HP motor nameplate, as-built motor submittal

Frame Size motor nameplate, as-built motor submittal Heating Coil DataEnclosure Type motor nameplate, as-built motor submittal Medium Type as-built FCU schedule

Full Load RPM motor nameplate, as-built motor submittal 2-Way / 3-Way Valve as-built FCU controls diagram

Synch. RPM motor nameplate, as-built motor submittal Capacity as-built FCU schedule

Motor Efficiency motor nameplate, as-built motor submittal CFMVolts motor nameplate, as-built motor submittal EDBPhase motor nameplate, as-built motor submittal LDBFull Load Amps motor nameplate, as-built motor submittal EWTMotor In Supply Airstrea motor nameplate, as-built motor submittal LWTDrive Type as-built FCU schedule, as-built FCU submittaAir Pressure Drop as-built FCU schedule

Water Pressure Drop as-built FCU schedule

Filter DataManufacturer as-built FCU or filter schedule/submittal Fan Design/Operating ConditionsModel Number as-built FCU or filter schedule/submittal Total Static Pressure TAB report

Type as-built FCU or filter schedule/submittal AirflowEfficiency as-built FCU or filter schedule/submittal Fan RPMInitial / Final Pressure Dr as-built FCU or filter schedule/submittal Volts

AmpsFan Controls kWConstant Air Volume as-Built sequence of operation Power Factor n/a

VFD as-Built sequence of operation

Discharge Damper as-Built sequence of operation Operating ScheduleMulti-Speed as-Built sequence of operation ThermostatStaged Control as-Built sequence of operation Occupancy SensorOther as-Built sequence of operation On/Of DDC as-Built sequence of operation Twist TimerElectronic / Pneumatic as-Built sequence of operation Manual

as-built FCU schedule

control system or

logger trends

as-built FCU schedule

control system or

logger trends

as-built FCU schedule control

system or logger trends

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


Measured

as-built FCU controls diagram

as-built FCU controls diagram

6.9 EXHAUST / RETURN FANSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameExhaust/Return Fan ID/TaLocation/ServiceYear Built

Fan Data Design/Operating ConditionsManufacturer Design MeasuredModel Number Total Static PressureSerial Number Occupied CFMFan Type / Size Unoccupied CFMFan Efficiency Fan RPM

VoltsFan Motor Data Occupied AmpsFull Load HP Unoccupied Amps n/aFrame Size Occupied kWEnclosure Type Unoccupied kW n/aFull Load RPM Power Factor n/aSynch. RPMMotor EfficiencyVolts Fan Control NotesPhase Constant Air Volume __________________Full Load Amps VFD __________________Motor In Exhaust Airflow Yes/No Discharge Damper __________________Drive Type Multi-Speed __________________

Staged Control _______________Operating Schedule Other __________________Always On DDC __________________Occupancy Sensor Electronic Controls _______________On/Of Schedule Pneumatic Controls __________________

Controls Notes


SAMPLE FORM GUIDANCEGeneral InformationSite Name provide name of site Fan ControlFan ID/Tag near fan nameplate, as-built fan schedule Constant Air Volumas-built sequence of operation

Location/Service observe fan location/as-built fan schedule VFD as-built fan schedule

Year Built fan nameplate, as-built fan submittal Discharge Damper

Fan DataManufacturer fan nameplate, as-built fan schedule Multi-Speed as-built sequence of operation

Model Number fan nameplate, as-built fan schedule Staged Control as-built sequence of operation

Serial Number fan nameplate Other as-built sequence of operation

Fan Type / Size fan nameplate, as-built fan schedule DDC as-built sequence of operation

Fan Efficiency fan nameplate, as-built fan schedule Electronic Controls as-built sequence of operation

Pneumatic Controlsas-built sequence of operation

Fan Motor DataFull Load HP motor nameplate, as-built motor submittal

Frame Size motor nameplate, as-built motor submittal

Enclosure Type motor nameplate, as-built motor submittal

Full Load RPM motor nameplate, as-built motor submittal

Synch. RPM motor nameplate, as-built motor submittal

Motor Efficiency motor nameplate, as-built motor submittal

Volts motor nameplate, as-built motor submittal

Phase motor nameplate, as-built motor submittal

Full Load Amps motor nameplate, as-built motor submittal

Motor In Exhaust Airflo motor nameplate, as-built motor submittal

Drive Type as-built fan schedule, as-built fan submittal

Operating ScheduleAlways On

Occupancy Sensor

On/Of Schedule

Design/Operating ConditionsDesign Measured

Total Static Pressure as-built fan schedule test and balance report

Occupied CFM Basis of Design, as-built sequence of operabuilding control system or logger trend

Unoccupied CFM Basis of Design, as-built sequence of operabuilding control system or logger trend

Fan RPM as-built fan schedule building control system or logger trend

Volts as-built fan schedule building control system or logger trend

Occupied Amps as-built fan schedule building control system or logger trend

Unoccupied Amps n/a building control system or logger trend

Occupied kW as-built fan schedule building control system or logger trend

Unoccupied kW n/a building control system or logger trend

Power Factor n/a building control system or logger trend

as-built sequence of operation, damper(s) located downstream of fan

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


6.10 PACKAGED UNITS: DX, HEAT PUMPSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameUnit ID/TagLocation/ServiceManufacturerModel NumberSerial Number Year Built: No. of zones served by unit

Unit Type Condenser Type Preheat/Heating CoilRooftop Unit Air-cooledSplit System Water-cooled Steam (psi)Window A/C Evap-cooled Electric (kW)VAV GSHP Heating Capacity (MBH)CAV WSHP Fuel type________________Other _________ Other________

Supply Fan Motor DataCompressor Data Condenser Fan Data QuantityQuantity Quantity Full Load HPRLA Full Load Amps Frame SizeVolts Volts Enclosure TypePhase Phase Operating RPMType Nominal HP Motor Efficiency

VoltsSupply Fan Data Cooling Type PhaseManufacturer Full Load AmpsModel Number Power Demand (kW)Serial Number CFM Drive TypeFan Type / SizeFan Efficiency

Cooling Cap. (MBH) Humidifier TypeSupply Fan Control EER Humidity Sensor LocationVFD EER incl. evap. fan Y / N RH Setpoint, MaxDischarge Damper RH Setpoint, MinMulti-Speed Outside Air (OA) ControlDDC Fixed OA CFM Electrical DataPneumatic Economizer? MCARoom Thermostat Minimum OA % MOCP

Controls NotesTime of Day Scheduling ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Unit Staging ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Water (HWS/HWR) (oF)

DX: Refrigerant TypeNumber of Circuits

EDB/EWB (oF)LDB/LWB (oF) Humidity Control NONE


SAMPLE FORM GUIDANCE

Site Name provide name of site

Unit ID/Tag near nameplate, as-built schedule

Location/Svce facilities operator

Manufacturer nameplate, as-built schedule Year Built nameplate, as-built schedule

Model Number nameplate, as-built schedule

Serial Number nameplate

Unit Type Condenser Type Preheat/Heating Coil

Rooftop Unit observe location Air-cooled as-built submittal HWS/HWR as-built submittal

Split System observe; as-built drawings Water-cooled as-built submittal Steam as-built submittal

Window A/C observe location Evap-cooled as-built submittal Electric as-built submittal

VAV as-built submittal GSHP as-built submittal Capacity as-built submittal

CAV as-built submittal WSHP as-built submittal Fuel type as-built submittal

Other as-built submittal Other as-built submittal

Supply Fan Motor Data

Compressor Data Condenser Fan Data Quantity nameplate; as-built

Quantity count; as-built equip. schedule Quantity nameplate; as-built Full Load HP nameplate; as-built

RLA nameplate; as-built submittal Full Load Amps nameplate; as-built Frame Size nameplate; as-built

Volts nameplate; as-built submittal Volts nameplate; as-built Enclosure Type nameplate; as-built

Phase nameplate; as-built submittal Phase nameplate; as-built Operating RPM nameplate; as-built

Type nameplate; as-built submittal Nominal HP nameplate; as-built Motor Efficiency nameplate; as-built

Volts nameplate; as-built

Supply Fan Data Cooling Type Phase nameplate; as-built

Manufacturer nameplate; as-built submittal Refrigerant Type as-built submittal Full Load Amps nameplate; as-built

Model Number nameplate; as-built submittal No. of Circuits as-built submittal Power Demand ( control system/logger trends

Serial Number nameplate; as-built submittal CFM as-built submittal Drive Type nameplate; as-built

Fan Type/Size nameplate; as-built submittal as-built submittal

Fan Efficiency nameplate; as-built submittal LDB/LWB as-built submittal Humidity Control

Capacity as-built submittal Humidifier Type as-built submittal

Supply Fan Control EER as-built submittal Sensor Location SOO, observation

VFD Evap fan incl.? as-built submittal RH Setpoint, Maxas-built SOO

Damper RH Setpoint, Min as-built SOO

Multi-Speed Outside Air (OA) Control

DDC Fixed OA CFM as-built SOO Electrical DataPneumatic Economizer? as-built SOO MCA nameplate; as-built

Room T-stat Minimum OA % as-built SOO MOCP nameplate; as-built

Controls Notes

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

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

General Information

No. Zones Served by Unit

as-built mechanical drawings

EDB/EWB

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


control system/logger trends

6.11 DX CONDENSING UNIT AND CONDENSERSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameEquipment ID/TagLocation/ServiceManufacturerModel NumberAssociated EquipmentSerial Number Year Built

Type of Equipment Condenser Fan DataCondensing Unit QuantityCondenser Full Load Amps

VoltsCondenser Type PhaseAir-cooled Nominal HPEvap-cooled

Fan ControlFluid-cooled

Compressor Data Electrical DataQuantity VoltsRLA PhaseVolts MCAPhase MOCPType

Cooling Type Fluid-Cooled DataDX: Refrigerant Type FluidNumber of Circuits GPMCooling Cap. (MBH)EER/SEER WPD (ft w.g)EER incl. supply fan? Yes / No

Heat Pump? Yes / No

Heating Cap. (MBH)HSPF/COP

Controls NotesTime of Day Scheduling ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Unit Staging ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

VFD / Single-speed / Two-Speed

EWT/LWT (oF)

7.0 SWIMMING POOLSCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameLocation of PoolSize (gallons) Surface AreaActivity Schedule Year Built

Outdoor Conditions Heating ConditionsAvg temp for coldest month of use Heating MethodSaturation vapor pressure Cover TypeAtmospheric pressure Cover U-valueWind speed Cover ScheduleAnnual Solar Radiation Desired Water Temp% Shaded area in pool area Measured Water Temp

Warm up timeIndoor ConditionsRoom Temp Setpoint Heating Schedule___________________________________Room RH SetpointMethod of Air Delivery

Gas Pool HeatersFilter Pump Data CapacityFilter Type Fuel TypeFilter Pressure Drop EfficiencyPower Demand (kW) Power Demand (kW)Hours on per dayVFD yes/no Heat Pump Pool Heaters

CapacitySolar Pool Heaters Air/Water SourceTotal Collector Area COPCollector Orientation/Tilt Compressor TypeCollector Type Refrigerant TypeDistance from pool to collectors Power Demand (kW)Pumping power per collector areaHeat Exchanger Efectiveness Pool Accessories

Ozone Generator yes/noOxygen Concentrator yes/noAir Compressors yes/no

Additional Notes/Comments

Power Demand

Hours on per day


SAMPLE FORM GUIDANCEGeneral InformationSite Name Provide name of site

Location of Pool Observe location in relation to building

Size (gallons) as-built plans or direct measure Surface AreaActivity schedule Year Built as-built plans or submittals

Outdoor Conditions Heating ConditionsAvg temp for coldest month ofASHRAE Fundamentals Heating Method as-built submittal

Saturation vapor pressure ASHRAE Fundamentals Cover Type as-built submittal

Atmospheric pressure ASHRAE Fundamentals Cover U-value as-built submittal

Wind speed ASHRAE Fundamentals Cover Schedule interview facilities staf

Annual Solar Radiation ASHRAE Fundamentals Desired Water Temas-built sequence of operations

% Shaded area in pool area Meas Water Temp control system or direct measureme

Warm up time control system, interview staf

Indoor ConditionsRoom Temp Setpoint as-built sequence of operations Heating ScheduleRoom RH Setpoint as-built sequence of operations

Method of Air Delivery as-built sequence of operations

Gas Pool HeatersFilter Pump Data Capacity as-built submittal

Filter Type as-built submittal Fuel Type as-built submittal

Filter Pressure Drop as-built submittal Efficiency as-built submittal

Power Demand control system, logger trends Power Demand control/logger trends; spot measure

Hours on per day control system, logger trends

VFD as-built submittal Heat Pump Pool HeatersCapacity as-built submittal

Solar Pool Heaters Air/Water Source as-built submittal

Total Collector Area as-built submittal COP as-built submittal

Collector Orientation/Tilt observe/measure Compressor Type as-built submittal

Collector Type as-built submittal Refrigerant Type as-built submittal

Distance from pool to collectoas-built plans or measure Power Demand control/logger trends; spot measure

Pumping power per collector aas built submittal

Heat Exchanger Efectivenessas built submittal Pool Accessories

Ozone GeneratorOxygen ConcentratAir Compressors

Additional Notes/Comments

as-built plans or direct measurementIndicate what pool is used for

(recreation, teaching, training, etc) and typical weekly schedule

Estimate avg. percentage based on observations throughout one day

as-built sequence of operations, control system, and interview staf; obtaining annual hours of heating is desired, how is it controlled?

Power Demand

Hrs on per day

as-built schedules, observe if present

submittals, also

recommend measuring actual kW

use

control system, logger trends


7.1 KITCHEN EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameRoom NameLocation/ServiceYear Built Floor Area (sq. ft.)

Oven Data Other Equipment DataQuantity Equipment TypeManufacturer QuantityModel Number ManufacturerCapacity Model NumberFuel Type Power Demand (kW)Efficiency Hours On per DayPower Demand (kW) Year InstalledHours On per Day Energy Star Rated? Yes/NoYear Installed

Refrigerator Data Motor DataQuantity QuantityManufacturer Full Load HPModel Number Frame SizeCapacity Enclosure TypeCompressor Type Operating RPMEfficiency Motor EfficiencyPower Demand (kW) VoltsHours On per Day PhaseYear Installed Full Load Amps

Power Demand (kW)Compressor Data Drive TypeQuantity Hours On per DayCapacity Year InstalledManufacturerModel NumberType Room ConditionsEfficiency Room Temp Setpt (heat/cool) Power Demand (kW) Cooling System TypeHours On per Day Air Delivery System TypeYear Installed Heating System Type

Controls Notes Range HoodsTime of Day Scheduling Quantity

TypeMax/Min CFMControl Method



Room Name provide name of kitchen room

Location/Service facilities operator

Year Built as-built drawings, facilities operator Floor Area measure from as-built floor plans

Oven Data Other Equipment DataQuantity count at site Equipment Type nameplate, as-built submittal

Manufacturer nameplate, as-built oven submittal Quantity nameplate, as-built submittal

Model Number nameplate, as-built oven submittal Manufacturer nameplate, as-built submittal

Capacity nameplate, as-built oven submittal Model Number nameplate, as-built submittal

Fuel Type nameplate, as-built oven submittal Power Demand (k building control system or logger trends

Efficiency Hours On per Day building control system or logger trends

Year Installed nameplate, as-built submittal

Power Demand (kW)

Hours On per Day building control system or logger trends

Year Installed nameplate, as-built oven submittal

Refrigerator Data Motor DataQuantity count at site Quantity nameplate, as-built submittal

Manufacturer nameplate, as-built refrigerator submittal Full Load HP nameplate, as-built submittal

Model Number nameplate, as-built refrigerator submittal Frame Size nameplate, as-built submittal

Capacity nameplate, as-built refrigerator submittal Enclosure Type nameplate, as-built submittal

Compressor Type nameplate, as-built refrigerator submittal Operating RPM building control system or logger trends

Efficiency nameplate, as-built refrigerator submittal Motor Efficiency nameplate, as-built submittal

Power Demand (kW)building control system or logger trends Volts building control system or logger trends

Hours On per Day building control system or logger trends Phase building control system or logger trends

Year Installed nameplate, as-built refrigerator submittal Amps building control system or logger trends

Power Demand (k building control system or logger trends

Compressor Data Drive Type nameplate, as-built submittal

Quantity count at site Hours On per Day building control system or logger trends

Capacity nameplate, as-built compressor submittal Year Installed nameplate, as-built submittal

Manufacturer nameplate, as-built compressor submittal

Model Number nameplate, as-built compressor submittal Room ConditionsType nameplate, as-built compressor submittal Room Temperaturebuilding control system or logger trends

Efficiency nameplate, as-built compressor submittal Cooling System as-built mechanical drawings

Power Demand (kW)building control system or logger trends Air Delivery Syste as-built mechanical drawings

Hours On per Day building control system or logger trends Heating System as-built mechanical drawings

Year Installed nameplate, as-built compressor submittal

Range HoodsControls Notes Quantity count; as-built equipment schedule

Time of Day Scheduling Type

Max/Min CFM

Control Method as-built sequence of operation

nameplate, as-built oven submittal, compute from building control system or logger trends

if electric, building control system or logger trends

e.g. condensate, grease; as-built submittal

as-built sequence of operation, control system or logger trends of equipment power demand (kW) (or Amps) as-built submittal; spot measurement

or control system/logger trends


building control system or logger trends









7.2 LAB EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameRoom NameFloor Area (sf)Airflow Determinant

Ventilation Data Exhaust DataCAV/VAV

QuantityOccupied ACHUnoccupied ACH Fume HoodsParticle Counting yes / no SnorkelsContaminant Sensor yes / no Gas CabinetsOcc. Sensors yes / no BS CabinetsCO2 Sensors yes / no Other

Equipment Data

Tag ID & type

VAV / CAV

Min Airflow

Max Airflow

Time of Day

Scheduling

Low Pwr/ Standby Mode W

Time of Day

Sched

Other Efficiency Features

Mfr / Model

NP Pwr Rating

Active Mode W

Cooling Req't

Typ hr/wee

k

7.2 LAB EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org


Room Name & AreaProvide name of room

Floor Area as-built floor plan

Airflow Determinant

Ventilation Data Exhaust DataCAV/VAV submittals/trend data

QtyOccupied ACH submittals/trend data

Unoccupied ACH submittals/trend data Fume HoodsParticle Counting submittals/trend data SnorkelsCont. Sensors submittals/trend data Gas CabinetsOcc. Sensors submittals/trend data BS CabinetsCO2 Sensors submittals/trend data Other

Equipment Data

Tag ID & type

Mfr / Model Nameplate or as-built equipment submittal

Nameplate or as-built equipment submittal

logger trends, also see if this is specified in equipment submittal

Active Mode W logger trends, also see if this is specified in equipment submittal

Cooling Req't as-built equipment submittal

Typ hr/week interview lab users to quantify typical usage, also use data logger to monitor power for at least one week

interview lab users, logger trends

as-built equipment submittal, also interview lab users to see if there any energy saving opportunities in behavior

Is airflow supplied to the room dominated by ventilation, exhaust, or cooling requirements? Refer to as-built room plans or basis of design

VAV / CAV

Min Airflow

Max Airflow

Time of Day

Scheduling

as-built equipment submittal

as-built equipment submittal, also look at control system or logger trends to verify



as-built sequence of operations, also look at control system or logger trends to verify

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.

Nameplate Pwr Rating

Low Pwr/Standby Mode W

Time of Day Scheduling

Other Efficiency Features

7.3 REFRIGERATION EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameRoom/Area NameLocation/ServiceConditioned Floor Area (sq. ft.)

Compressor Data Evaporator Coil DataManufacturer ManufacturerType TypeQuantity Coil QuantityModel Number Model NumberSerial Number(s) Serial Number(s)Tag Number Tag NumberRefrigerant Type Suction GroupSuction Press/Temp LocationDischarge Press/Temp Room TemperatureCapacity (MBH) Defrost TypePower Demand (kW) Defrost DurationHours On per Day Number of Defrost/dayYear Installed Defrost Power Draw (kW)

Condenser Data Evaporator Fan DataManufacturer ManufacturerType QuantityQuantity Model NumberModel Number Serial Number(s)Serial Number(s) Fan Type / SizeTag Number Fan EfficiencyCapacity (MBH)Fan Motor HP Evaporator Fan Motor DataFan Motor Efficiency Fan Motor HPFan Motor Quantity Fan Motor Efficiency

Fan Motor QuantityFan Power Draw (kW)Year Fan Installed Fan Power Draw (kW)Pump Motor HP Year Fan InstalledPump Motor Efficiency Drive TypePump Motor Quantity

ControlsPump Power Draw (kW)Year Pump Installed


Heat Recovery?

Fan Amps / Volts / Fan Amps / Volts /

Pump Amps / Volts / Conditioned Area Enclosed?



Room Name provide name of conditioned room or area

Location/Service provide are served; from facilities operator

Floor Area measure from as-built floor plans

Compressor Data Evaporator Coil DataManufacturer nameplate; as-built submittal Manufacturer nameplate; as-built submittal

Type nameplate; as-built submittal Type nameplate; as-built submittal

Quantity count; as-built equipment sched Coil Quantity nameplate; as-built equipment sched

Model Number nameplate; as-built submittal Model Number nameplate; as-built submittal

Serial Number(s) nameplate Serial Number(s) nameplate

Tag Number located near nameplate Tag Number located near nameplate

Refrigerant Type nameplate; as-built submittal Suction Group nameplate; as-built submittal

Suction Press/Temp nameplate; as-built submittal Location observe; as-built submittal

Discharge Press/Tempnameplate; as-built submittal Room Temperature control system or logger trends

Capacity (MBH) nameplate; as-built submittal Defrost Type as-built submittal

Power Demand (kW) control system or logger trends Defrost Duration control system or logger trends

Hours On per Day control system or logger trends Number of Defrost/day control system or logger trends

Year Installed nameplate; as-built submittal Defrost Power Draw (kW)control system or logger trends

Condenser Data Evaporator Fan DataManufacturer nameplate; as-built submittal Manufacturer nameplate; as-built submittal

Type nameplate; as-built submittal Serial Number(s) nameplate

Quantity count; as-built equipment sched Model Number nameplate; as-built submittal

Model Number nameplate; as-built submittal Serial Number nameplate

Serial Number(s) nameplate Fan Type / Size nameplate; as-built submittal

Tag Number located near nameplate Fan Efficiency nameplate; as-built submittal

Capacity (MBH) nameplate; as-built submittal

Fan Motor HP nameplate; as-built submittal Evaporator Fan Motor DataFan Motor Efficiency nameplate; as-built submittal Fan Motor HP nameplate; as-built submittal

Fan Motor Quantity count; as-built equipment sched Fan Motor Efficiency nameplate; as-built submittal

nameplate; as-built submittal Fan Motor Quantity count; as-built equipment sched

Fan Power Draw (kW)control system or logger trends nameplate; as-built submittal

Year Fan Installed nameplate; as-built submittal Fan Power Draw (kW) control system or logger trends

Pump Motor HP nameplate; as-built submittal Year Fan Installed nameplate; as-built submittal

Pump Motor Efficiencnameplate; as-built submittal Drive Type as-built submittal

Pump Motor Quantitycount; as-built equipment sched

nameplate; as-built submittal ControlsPump Power Draw (k control system or logger trends

Year Pump Installed nameplate; as-built submittal

Controls NotesTime of Day Schedulias-built sequence of operation, control system or logger trends of equipment power demand (kW) (or Amps)

Heat Recovery? describe type of heat recovery employed

Fan Amps / Volts / Fan Amps / Volts /

Pump Amps / Volts / Conditioned Area Enclosed?

observe; e.g. strip curtains, enclosing doors


nameplate; as-built equipment sched

as-built sequence of operation, control system or logger trends of equipment power demand (kW) (or Amps)

7.4 DATA CENTERS / IT RoomsCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameRoom NameLocation/Service Total Floor Area (sf)Year Built Total Server Load (kW)

CRAC/CRAH Units - General Design/Operating ConditionsQuantity Design MeasuredNominal Capacity PUECompressor Type Total Static Pressure

Supply CFMCRAC/CRAH Fan Data Fan RPMManufacturer VoltsModel Number AmpsSerial Number(s) Fan Power Demand (kW)Fan Type / Size Power Factor n/aFan Efficiency Return Air Temperature

Supply Air TemperatureCRAC/CRAH Fan Motor DataFull Load HP Fan ControlFrame Size Constant Air VolumeEnclosure Type VFD Motor Efficiency Multi-SpeedMotor In Supply Airflow? Yes/No Connected to DDC?Drive Type

Humidity ControlConfiguration NoneOpen, No Hot/Cold Aisles Humidifier TypeOpen Hot/Cold Aisle Humidity Sensor LocationHot/Cold Aisle w/ Ducted Return RH Setpoint, MaxFully Enclosed Hot/Cold Aisles RH Setpoint, Min

Uninterruptible Power Supply TransformersQuantity QuantityCapacity CapacityManufacturer ManufacturerModel Number Model NumberOperating Output Power Operating Output PowerOperating Input Power Operating Input PowerOperating Load Factor (%) Operating Load Factor (%)Equipment Served Equipment Served

Controls Notes Air Side Economizing Yes/NoServer Operation/HVAC System Schedule Economizer Control

Economizer Upper LimitCRAC/CRAH Staging Economizer Lower Limit

Economizer Control Point



SAMPLE FORM GUIDANCEGeneral Information Fan ControlSite Name provide name of site Constant Air Volumeas-built sequence of operation

Room Name provide name of datacenter or IT room VFD inside CRAH unit

Location/Service facilities operator Multi-Speed as-built motor submittal

Year Built as-built drawings, facilities operator Connected to DDC? as-built sequence of operation

Total Floor Area as-built floor plans

Total Server Load measure with power meter Humidity ControlHumidifier Type as-built humidifier schedule

CRAC/CRAH Units - GeneralQuantity count at site

Nominal Capacity as-built CRAC/H schedule RH Setpoint, MaxCompressor Type DX or CHW plant, as-built CRAC/H schedul

RH Setpoint, MinCRAC/CRAH Fan DataManufacturer as-built CRAC/H schedule TransformersModel Number as-built CRAC/H schedule Quantity as-built electrical line diagram

Serial Number(s) as-built CRAC/H schedule Capacity as-built transformer submittal

Fan Type / Size as-built CRAC/H schedule Manufacturer nameplate

Fan Efficiency as-built CRAC/H schedule Model Number nameplate

Oper Output Power measure with power meter

CRAC/CRAH Fan Motor Data Oper Input Power measure with power meter

Full Load HP motor nameplate, as-built CRAC/H schedul Operating Load (%)Frame Size motor nameplate, as-built CRAC/H schedul Equipment Served as-built electrical line diagram

Enclosure Type motor nameplate, as-built CRAC/H schedul

Motor Efficiency motor nameplate, as-built motor submittal Uninterruptible Power SupplyMotor in Supply Airflo motor nameplate, as-built motor submittal Quantity as-built electrical line diagram

Drive Type as-built fan schedule, as-built fan submitta Capacity as-built transformer submittal

Manufacturer nameplate

Configuration Model Number nameplate

Open, No Hot/Cold observe server racks Oper Output Power measure with power meter

Open Hot/Cold Aisle Oper Input Power measure with power meter

Operating Load (%)Equipment Served as-built electrical line diagram

Air Side EconomizingEconomizer Control

Design/Operating ConditionsDesign as-built CRAC/CRAH schedule

Measured building control system or logger trends

Controls Notes

CRAC/CRAH Staging

Humidity Sensor Location as-built sequence of operation,

visual observation

% or dewpoint; as-built sequence of operation, control system or logger trends

% or dewpoint; as-built sequence of operation, control system or logger trends

output power ÷ capacity

observe server aisles, measure temperatures in aisles

output power ÷ capacity

Hot/Cold Aisle w/ Ducted Return

observe server aisles and ducting to return opening in CRAC/CRAHs, measure temperatures in aisles

Fully Enclosed Hot/Cold Aisles

observe server aisles and enclosure at tops and ends of aisles, measure temperatures in aisles e.g. drybulb, RH, or enthalpy;

as-built sequence of operation, control system trends

Economizer Upper Limit

e.g. upper OA drybulb temp lockout; as-built sequence of operation, control system trends

Economizer Lower Limit

e.g. lower OA drybulb temp lockout; as-built sequence of operation, control system trends

Economizer Control Point

e.g. return air drybulb temp; as-built sequence of operation

Server Operation/HVAC Schedule

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

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




7.5 PROCESS EQUIPMENTCommercial Building Energy Audit Sample FormsCopyright 2011, Rocky Mountain Institute www.rmi.org

SAMPLE FORMGeneral InformationSite NameLocation/ServiceYear Built

Compressed Air System Compressed Air Design / Operating ConditiType of Compressor Required Measured

Compressor Efficiency Flow rateCompressor Controls PressureQuantity of Filters Dew PointFilter Type Hrs on per dayFilter Pressure Drop Compressor Power DemandAfter cooler Efectiveness Pressure / Flow Controller? yes / noCondensate Separation Efficiency Leaks Detected? yes / noDryer Size If so, where?Dryer EfficiencyDryer Pressure Drop Uses of Compressed Air System:Dryer Purge RateDryer Purge Rate ControlReceiver Tank SizeReceiver Tank Location

Central Vacuum System Central Vacuum Design / Operating ConditiType of Pumps Required Measured

Quantity of Pumps Flow ratePump Controls PressureUses of Central Vacuum System: Hrs on per day

Pump Power DemandLeaks Detected? yes/noIf so, where?

Process Chilled Water System Chilled Water Design / Operating ConditionPortable Process Chillers yes / no Required Measured

Separate High Temp Chiller pla yes / no Flow rateLow Temp Chiller plant w/ mixi yes / no HeadWater Side Free Cooling yes / no Supply Temp

Uses of Process Chilled Water:

Elevators Elevator Design / Operating ConditionsCapacity (lbs) Rated MeasuredYear Built SpeedType (hydraulic, traction, etc) Riding PowerFrequency of Use Standby PowerMachine Room Cooling Load




Location/Service observe location and purpose of process equipment

Year Built as-built drawings, equipment submittals

Compressed Air System Compressed Air Design/Oper ConditionsType of Compressor as-built submittal Required Measured

Compressor Efficiency as-built submittal Flow rateas-built schedulecontrol system or logger trendsCompressor Controls as-built sequence of operations Pressure

Quantity of Filters as-built schedule Dew PointFilter Type as-built submittal

Filter Pressure Drop as-built submittal Pressure / Flow Controller? as-built schedule

After cooler Efectiveness as-built submittal Leaks Detected?Condensate Separation Effici as-built submittal If so, where?Dryer Size as-built submittal

Dryer Efficiency as-built submittal Uses of Compressed Air System:Dryer Pressure Drop as-built submittal

Dryer Purge Rate as-built submittal

Dryer Purge Rate Control as-built sequence of operations

Receiver Tank Size as-built schedule

Receiver Tank Location as-built floor plans

Central Vacuum System Central Vacuum Design/Oper ConditionsType of Pumps as-built submittal Required Measured

Quantity of Pumps as-built schedule Flow rateas-built schedule

Pump Controls as-built sequence of operations PressureUses of Central Vacuum System:

as-built schedule, and floor plans, also interview facilities staf

Leaks Detected?If so, where?

Process Chilled Water System Chilled Water Design/Oper ConditionsPortable Process Chillers as-built schedule Required Measured

Separate High Temp Chiller plas-built schedule Flow rate as-built schedule

Low Temp Chiller plant w/ mixas-built schedule Head as-built schedule

Water Side Free Cooling as-built schedule Supply Temp as-built schedule

note: circle all that apply

Uses of Process Chilled Water:

as-built schedule, and floor plans, also interview facilities staf

Elevators Elevator Design/Oper ConditionsCapacity (lbs) as-built submittal Rated MeasuredYear Built as-built submittal Speed

as-built submittalType (hydraulic, traction, etc) as-built submittal Riding PowerFrequency of Use control system or logger trends Standby PowerMachine Room Cooling Load as-built submittal

Visual inspection and interview facilities staf

as-built schedule, and floor plans, also interview facilities staf to ensure there are not inappropriate uses of compressed air (i.e. diaphragm pumps, pneumatic controls, etc)


Visual inspection and interview facilities staf





Compressed Air Design/Oper Conditions

Central Vacuum Design/Oper Conditions


Documents

AuditSampleForms Master Sept 27 2011