| Assessment Date | |
|---|---|
| Assessor Name | |
| Facility/Location | |
| Department/Area | |
| Equipment Name | |
| Equipment ID/Tag |
| Manufacturer | Model | ||
|---|---|---|---|
| Year of Installation | Rated Power (kW) | ||
| Operating Hours/Day | Operating Days/Year |
| Energy Source | Consumption/Month | Units | Metered (Y/N) |
|---|---|---|---|
| Parameter | Value | Unit | Remarks |
|---|---|---|---|
| Observations | |
|---|---|
| Potential Improvements | |
| Estimated Savings |