Facility Energy & Emissions Audit Form
Facility Name
Location/Address
Auditor Name
Audit Date
Facility Details
Facility Type
Facility Size (sq meters)
Average Occupancy
Operating Hours (per week)
Energy Consumption
Electricity Usage (kWh/year)
Natural Gas Usage (therms/year)
Fuel Oil Usage (liters/year)
Other Energy Use
Emissions Data
CO₂ Emissions (metric tons/year)
CH₄ Emissions (kg/year)
N₂O Emissions (kg/year)
Other Emissions
Energy Efficiency Measures
Implemented Measures
Planned Measures
Comments & Recommendations
Additional Notes