EIA-871H Energy Amounts Used and Dollars Spent

Worksheet #2:

Energy Amounts Used and Dollars Spent (Buildings)

2012 Commercial Buildings Energy Consumption Survey

Sponsored by the U.S. Energy Information Administration

Conducted by Westat

Instructions

For electricity and natural gas, if used in this building, provide the following:

• Account number: If energy source is not used, write NA in box.

• Month: In column A, specify the months that electricity and/or natural gas were used for 2012. Ideally this will be January 2012 through December 2012. Otherwise provide the most recent 12 months available.

• Amount of energy used:

In column B, specify the amount of energy used in each month, across all of the building’s accounts, for 2012.

• Cost of energy per month:

In column C, specify the dollar amount billed, across all of the building’s accounts for the 2012 twelve months/billing cycle. Include state and local taxes, fuel adjustment charges, system charges, distribution charges, and demand charges. Exclude merchandise, repair charges, and service charges (hookup or disconnect fees, late payment charges).

• Total: In line D, provide totals for columns B and C, across all of the building’s accounts, for the twelve months. Some buildings have several accounts/tenants for each energy source—include all of them in the energy total.

Box 1. Electricity Account Number

Box 2. Natural Gas Account Number

Square footage covered under this electricity account:

	This entire building only
	This building plus other
	building(s)
	Only part of this building

Specify amount of additional or excluded square footage:

Square footage covered under this natural gas account:

	This entire building only
	This building plus other
	building(s)
	Only part of this building

Specify amount of additional or excluded square footage:

A. Month

(and year if not 2012)

B. Amount of electricity used per month

(Kilowatthours)

C. Amount billed/dollars spent per month

(Dollars)

A. Month

(and year if not 2012)

B. Amount of natural gas used per month—Check the units used:

	Cubic feet (cf)		Dekatherms
	100 cu. ft. (Ccf)		Therms
	1,000 cu. ft. (Mcf)

C. Amount billed/dollars spent per month

(Dollars)

D. Total

D. Total

Go to Box 2

Go to Box 3

Instructions: For totals, include all accounts for each energy source used in the building for which you are responsible, for year 2012. For amount billed, include state and local taxes, but exclude merchandise, repair charges, and service charges (hookup or disconnect fees, late payment fees).

Box 3. Fuel Oil/
Diesel/
Kerosene

Account Number

Box 4. District
Steam

Account Number

Box 5. District
Hot

Water

Account Number

Square footage covered under this fuel oil/diesel/
kerosene account:

	This entire building only
	This building plus other
	building(s)
	Only part of this building

Specify amount of additional or excluded square footage:

Square footage covered under this district steam account:

	This entire building only
	This building plus other
	building(s)
	Only part of this building

Specify amount of additional or excluded square footage:

Square footage covered under this district hot water account:

	This entire building only
	This building plus other
	building(s)
	Only part of this building

Specify amount of additional or excluded square footage:

Total fuel oil/diesel/kerosene purchased (across all accounts for 2012):

Gallons

Total district steam used (across all accounts for 2012):

Check the units used:

Total district hot water used (across all accounts for 2012):

Million Btu

If measured or metered, what is the amount of fuel oil/diesel/kerosene actually consumed in calendar year 2012?

Gallons

	Thousand pounds
	Pounds
	Million Btu

$

Total amount billed/dollars spent (across all accounts for 2012):

$

Total amount billed/dollars spent (across all accounts for 2012):

$

Total amount billed/dollars spent (across all accounts for 2012):

Beginning and ending dates (If the building had multiple accounts with different beginning and ending dates, provide the dates for the largest account.):

/ /	to	/ /
month/day/year		month/day/year

Beginning and ending dates (If the building had multiple accounts with different beginning and ending dates, provide the dates for the largest account.):

/ /	to	/ /
month/day/year		month/day/year

Beginning and ending dates (If the building had multiple accounts with different beginning and ending dates, provide the dates for the largest account.):

/ /	to	/ /
month/day/year		month/day/year

Go to Box 4

Go to Box 5

Go to Box 6

Instructions: For totals, include all accounts for each energy source for which you are responsible, for year 2012. For amount billed, include state and local taxes, but exclude merchandise, repair charges, and service charges (hookup or disconnect fees, late payment fees).

Water Use in Commercial Buildings

Why are there water questions in an energy survey? Water use and energy are connected in many ways. Energy is used to extract, purify, and pump water for domestic and other uses. In addition, energy is used to treat and dispose of wastewater.

With the following questions we want to determine how much water was used in this building for everyday use, such as for restrooms, kitchens, laundries, showers, building heating and cooling, and landscape irrigation.

Domestic water is generally supplied to commercial buildings by a municipal water system that collects, purifies, transports, and distributes water via a pipeline system. In some cases, the building may have a private or on-site source, such as a water well that may be either the sole source of water or a supplement to the municipal supply.

If water is supplied from multiple sources, provide the total from all sources, including municipally supplied potable, municipally supplied reclaimed and other sources of freshwater, including wells.

Box 6. Total Water

Total water used (across all accounts, municipal and other, for calendar year 2012):

Check the units used:

	Gallons		Cubic feet (cf)
	Thousand gallons		Hundred cubic feet (Ccf, HCF)
	Million gallons		Thousand cubic feet (Mcf)
			Other

Beginning and ending dates (If the building had multiple accounts with different beginning and ending dates, provide the dates for the largest account.):

/ /	to	/ /
month/day/year		month/day/year

How much of the total water was used outside the building if separately metered (in same units)?

Thank you!

The interviewer will collect this worksheet.

Method of measurement of water use:

	Metered		Both metered and estimated
	Estimated		Other

Cooling Tower

If the building has a cooling tower and it is metered, what is the amount of water used by the cooling tower (in same units as above)?

Form EIA-871H

OMB No.: 1905-0145

Expires: 09/30/xxxx