Worksheet #1: Characteristics, Energy Sources, and Equipment (Establishments) |
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2012 Commercial Buildings Energy Consumption Survey Sponsored by the U.S. Energy Information Administration Conducted by Westat |
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The following are some of the topics that will be discussed in the upcoming interview. Completing this worksheet and having it available will facilitate and shorten the interview.
Thinking of calendar year 2012, please provide the following for the establishment listed above. |
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Box 1. Gross/Total Square Footage of Establishment
(Both finished and unfinished, including basements, hallways, lobbies, stairways, and elevator shafts.)
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Box 2. Number of Employees
(The number of employees that work in the establishment during its main shift, the shift when most employees are in the building. Include volunteers; do not include employees who always work outside of the establishment, customers, patients, students, or institutionalized residents.) |
Box 3. Heating Energy Sources
Which energy sources, if any, were used for heating during 2012?
Check all that apply:
Which of these was the main energy source for heating? (Please circle the energy source used to heat most of the square footage in the establishment most of the time.) |
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Box 4. Heating Equipment
Check all that apply:
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Box 5. Type of Packaged Heating (if applicable)
Check all that apply:
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Box
6. Boiler or District Steam/
Check all that apply:
Go to Box 7 |
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Form EIA-871G OMB No.: 1905-0145 Expires: 09/30/20xx
Box 7. Type of Heat Pump Used for Heating (if applicable)
Check all that apply:
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Box
8. Individual Space Heater
Check all that apply:
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Box 9. Cooling Energy Sources
Which energy sources, if any, were used for cooling during 2012?
Check all that apply:
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Box 10. Cooling Equipment
Check all that apply:
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Box 11. Type of Packaged Cooling (if applicable)
Check all that apply:
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Box 12. Type of Chiller (if applicable)
Check all that apply:
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Box 13. Chiller or District Chilled Water Distribution System (if applicable)
Check all that apply:
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Box 14. Type of Heat Pump Used for Cooling (if applicable)
Check all that apply:
Go to Box 15 |
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Box 15. Ventilation and Distribution Equipment for Heating and Cooling
Indicate all that apply: B—heating and cooling H—heating only C—cooling only
Does the establishment use either of the following?
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Box 16. Water Heating Energy Sources
Which energy sources, if any, were used for water heating during 2012?
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Box 17. Cooking Energy Sources
Which energy sources, if any, were used for cooking during 2012?
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Box 18. Sources for On-Site Electricity Generation
Which energy sources, if any, were used for on-site electricity generation during 2012?
Check all that apply:
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Box
19. Areas for Food Preparation or Service Check all of the types of food preparation or serving areas found in the establishment:
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Box 20. Refrigeration Equipment
Check all the types of refrigeration or freezer equipment that apply and indicate the number used in the establishment in 2012:
Go to Box 21 |
Box 21. Office and Other Equipment
Check all that apply and indicate number used in the establishment during 2012:
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Box 22. Lighting Equipment
Was any of the square footage in this establishment lit by the following during 2012?
Check all that apply:
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Box 23. Lighting Controls or Lighting Control Strategies
Check all types of lighting controls or lighting control strategies that were used in the establishment:
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | PSL |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |