Ames Electric Department

Energy Audit Worksheet

Equipment/General

Thermostat

Setting: Day ___ °F Night___ °F

Furnace

Type: __ Gas __ Propane __ Electric

Condition: __ Good __ Fair __ Poor

Age:___ yrs.

Water heater

Type: __ Gas __ Propane __ Electric

Water Temp.: _____°F

Condition: __ Good __ Fair __ Poor

Age:___ yrs.

Air Conditioner

Type: __ Window __ Central __ None

  Condition: __ Good __ Fair __ Poor

  Age:___ yrs.

Other:_________________________

Insulation

Ceiling: __Y __N ____ inches

Wall: __Y __N ____ inches

Rim Joist: __Y __N ____ inches

Foundation: __Y __N ____ inches

Water heater: __Y __N

Water Pipe: __Y __N ____ feet

Floor/Crawlspace

Insulation: __ Y __ N ___ inches

Ducts in unconditioned space

Insulation: __ Y __ N ___ inches

Other:__________________________

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Air Infiltration

Windows

Number panes: _____

Storms: __Y __N

Seal: __ Good __ Fair __ Poor

Caulk: __ Good __ Fair __ Poor

Weatherstrip: __ Good __ Fair __ Poor

Doors

Seal: __ Good __ Fair __ Poor

Caulking: __ Good __ Fair __ Poor

Weatherstrip:__ Good __ Fair __ Poor

  Threshold: __ Good __ Fair __ Poor

Foundation

Condition: __ Good __ Fair __ Poor

Penetrations/Holes: __ Y __ N

Lighting

Incandescent

Number:___ Hours On:___ hrs.

Fluorescent

Number:___ Hours On:___ hrs.

Other: Number:___ Hours:___

Comments/To Do

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