NORMIPro Environmental TASC Force .

Energy Consumption Survey    

Service Provider
Anthony cabe
QMI, QST
6 bo Court
Lake Ronkonkoma, NY   11795
516.808.7997
Inactive NORMI Member
  

Summary of Energy Assessment

Thank you for taking the time to complete this summary of the Energy Assessment Booklet you received with your PSP Kit. This summary takes the most relevant parts of your assessment and develops a report of recommendations from which your Professional Screening Partner may assist you with solutions. Please make sure each question is answered.



Name  
Address  
City  
State/Province  
Zip/Postal Code  
Phone  
eMail  
     
Page 8 of the Energy Assessment Booklet - Perimeter Walls
Please enter your answer to question 7 Yes No
Please enter your answer to question 8 Yes No
  
Page 9 of the Energy Assessment Booklet - Floors
Please enter your answer to question 9 Yes No
Please enter your answer to question 10 Yes No
Please enter your answer to question 11 Yes No
Please enter your answer to question 12 Yes No
  
Page 9 of the Energy Assessment Booklet - Ceilings
Please enter your answer to question 1 Yes No
Please enter your answer to question 2 Yes No
Please enter your answer to question 3 Yes No
  
Page 10 of the Energy Assessment Booklet - Heating & Cooling
Please enter your answer to question 1 Yes No
Please enter your answer to question 3 Yes No
Please enter your answer to question 4 Yes No
  
Page 11 of the Energy Assessment Booklet - Heating & Cooling
Please enter your answer to question 5 Yes No
Please enter your answer to question 6 Yes No
Please enter your answer to question 7 Yes No
Please enter your answer to question 8 Yes No
Please enter your answer to question 9 Yes No
Please enter your answer to question 10 Yes No
Please enter your answer to question 11 Yes No
  
Page 12-15 of the Energy Assessment Booklet - Electrical Appliances
Do any of the appliances you listed on pages 12-15 have LED Lights? Yes No
  
Page 16-19 of the Energy Assessment Booklet - Electrical Lighting
Page 16 Total Usage
Page 17 Total Usage
Page 18 Total Usage
Page 19 Total Usage
 
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