| Address | |
|---|---|
| Auditor Name | |
| Date | |
| Occupants |
| Item | Condition / Comments |
|---|---|
| Insulation (Attic/Ceiling) | |
| Insulation (Walls) | |
| Doors (Weatherstripping/Seals) | |
| Windows (Type & Condition) | |
| Air Leakage (Drafts) |
| System | Type | Age/Condition | Comments |
|---|---|---|---|
| Heating System | |||
| Cooling System | |||
| Thermostat | |||
| Ductwork |
| Item | Type/Model | Condition | Comments |
|---|---|---|---|
| Water Heater | |||
| Piping Insulation |
| Location | Type (LED/Incandescent/etc.) | Operational | Notes |
|---|---|---|---|
| Appliance | Quantity | Age/Condition | Notes |
|---|---|---|---|
| Refrigerator | |||
| Dishwasher | |||
| Washer/Dryer | |||
| Other |