Retail Store Energy Consumption Inspection Form
Store Name
Store Address
Date of Inspection
Inspector Name
General Information
Total Floor Area (sq. ft.)
Operating Hours Per Day
Number of Employees
Energy Consumption
Type
Monthly Consumption (kWh)
Remarks
Electricity
Natural Gas
Other
Equipment Inventory
Equipment
Quantity
Age (years)
Condition
Lighting Fixtures
Good
Fair
Poor
HVAC Units
Good
Fair
Poor
Refrigeration Units
Good
Fair
Poor
Observations / Recommendations
Inspector Signature