Syntergy Energy Management Solutions

"The Bet" Energy Management Partnership Program

Facility Audit Request Form

Try to answer as many questions as possible. More information will allow us to accurately calculate the potential saving for your facility.

Contact Information for the individual responsible for the operation and maintenance of your facility:

Name: *

Phone Number: *

Email: *

Facility Name: *

Size (sq feet):

Age of Facility (years):

Facility type and function with corresponding % sq footage (ex. 20% Office, 50% Manufacturing, 30% Warehouse):

Description of Manufacturing (if applicable):

Number of Occupants:

Hours of Operation:

Mechanical/HVAC Systems:

Air Cooled Chillers:

Air Cooled Chiller (tons):

Water Cooled Chillers:

Water Cooled Chiller (tons):

Split Systems and/or Package Units:

Split System/Package Unit (tons):

Description of Air Distribution Systems (ex. AHU's, VAV boxes, fan-powered boxes, etc.):

Description of Heating Systems (ex. electric strip heat, boilers, etc.):

Description of Temperature Control Systems (ex. wall mount mech stats, DCC Controls, time clocks, etc.):

Energy Reducing Strategies Employed (load shedding, demand limiting or thermal storage):
Yes
No

Description of Energy Reducing Strategies:

Description of Occupancy Scheduling Strategy:

Lighting Systems:

Description of Primary Lighting Systems (ex. T12, T8, etc.):

Any lighting control system?:
Yes
No

Description of Lighting Control Systems:

Does the facility have a parking garage?:
Yes
No

Parking Garage Automobile Capacity:

Does the facility have HID fixtures?:
Yes
No

Location of HID fixtures:

What percentage of the building's exterior has glass or windows?:

Is any glass tinted or has window film?
Yes
No

Building Automation Systems/Control Systems:

Does the facility currently have a building automation system?
Yes
No

Automation System Manufacturer:

Does the automation system monitor real time energy consumption?
Yes
No

Are there any security systems?
Yes
No

Security System Manufacturer:

Is the security system monitored by the BAS/Control system?
Yes
No

BAS/Control system strategy for occupancy scheduling:

List any current comfort or production issues:

List capital projects currently planned or in progress:

Utility usage history for 18-24 months including electric (usage and demand), natural gas, and water:

Upload files of actual energy bills (copies of actual bills are preferred for benchmarking purposes):