Leased Facilities Walk Thru SurveyDate:Lessor:SRL Project #

Legend:YYesItem is already in place

NNoItem not in place

N/ANot ApplicableItem does not apply to this space

CACorrective ActionIndicates Corrective Action needed

Electric Meter

a)Demand MeterYNN/A

b)If yes, Demand Charge on the billsYNN/A

  1. Insulation

a)Roof TypeThicknessYNN/A

b)Ceiling TypeThicknessYNN/A

c)Walls TypeThicknessYNN/A

d)Floor TypeThicknessYNN/A

e)Reflective coating on roofYNN/A

f)Insulation lying on ceiling grid (If yes, should be removed & mitigated elsewhere, if practical)YNN/A

g)Heating and cooling pipes insulatedYNN/A

h)Insulation between heated and unheated spacesYNN/A

Operation and Maintenance Procedure Information

  1. Windows

a)Windows double glazedYNN/A CA

b)Frame caulking in good conditionYNN/A CA

c)Weather stripping in good conditionYNN/ACA

d)Reflective filmYNN/ACA

e)Blinds or drapes installed atexterior windowsYNN/ACA

  1. Doors

a)Main entrance has vestibuleYNN/A CA

b)Vestibule doors open consecutively, not simultaneously

YNN/ACA

c)Frame caulking in good conditionYNN/ACA

d)Exterior doors weather-stripped tightlyYNN/ACA

e)Exterior door closers function properlyYNN/ACA

  1. Lighting

a)Fluorescent fixtures in all office spacesYNN/ACA

b)Fixtures have electronic ballasts and T-8 lamps per Leased Space RequirementsYNN/ACA

c)Rooms are individually switchedYNN/ACA

d)Areas adjacent to windows separately switchedYNN/ACA

e)Fixture Maintenance:

1)Clean lensesYNN/ACA

2)Clear lenses (not yellow)YNN/ACA

f)Exterior lighting:

1)Energy efficient fixturesYNN/ACA

FluorescentMercury VaporHP/LP SodiumIncandescent

2)Controls:ManualPhotocellOperational(circle applicable)

3)Timer turns off exterior lights at set timeYNN/ACA

Type:ElectronicElectric motor clock

  1. Ceiling

a)Ceiling tile in placeYNN/ACA

b)Ceiling tile in good condition (no stains)YNN/ACA

c)Evidence of roof leaking on ceiling or insulationYNN/A CA

  1. Water

a)Hot water temperature is no greater than120FYNN/ACA

b)Faucets maintained (no leaking, etc)YNN/ACA

Hot water tank has insulation coverYNN/ACA

(Insulation is not desirable when tank is in insulated space)

d)Hot water heater:gaselectricYNN/ACA

  1. HVAC Design

a)Type of fuel:ElectricGasOilOther

If other than gas, is gas available?YNN/ACA

(cost to convert?)

a)Central air HVAC systemYNN/ACA

b)Exhaust fans switched with room light YNN/ACA

c)Air return grilles in each spaceYNN/ACA

d)Perimeter baseboard heatersYNN/ACA

e)Above-ceiling fan coil unitsYNN/ACA

f)Heat pumpsYNN/ACA

g)Ceiling mounted space heatersYNN/ACA

h)Other YNN/ACA

  1. HVAC Performance

a)Outside Air dampers closed during unoccupied

and warm-up periodsYNN/ACA

b)Occupants experience drafts/fan noise during heating/cooling

YNN/ACA

c)Any areas or offices unusually hot or coldYNN/ACA

d)Occupants in same office experience simultaneous heating and cooling or system cycling on and off rapidlyYNN/ACA

e)Occupants experience unusual odors from heating system

YNN/ACA

f)Are T-stats programmable with lockout capabilities?YNN/ACA

g)Occupants indicate heating/cooling unsatisfactoryYNN/ACA

  1. HVAC Maintenance

a)Maintenance schedule followed for

1)FiltersYNN/ACA

2)BurnersYNN/ACA

3)CoilsYNN/ACA

4)CondensersYNN/ACA

5)HeatersYNN/ACA

6)Other YNN/ACA

b)Baseboard units regularly cleaned? YNN/ACA

b)Fresh air intake grille/ regularly maintained? YNN/ACA

  1. HVAC Equipment Settings

a)Thermostats set at F (heating)F (cooling)

YNN/ACA

b)Automatic setback thermostats for nights/weekends/holidays

YNN/ACA

Settings:F (heating)F (cooling)

c)Agency actively participating in energy conservation?

1)Turning off unused lightsYNN/ACA

2)Closing blindsYNN/ACA

3)Space heatersYNN/ACA

  1. Electricity

a)Breakers trip under normal usageYNN/ACA

b)Loads balanced in panels (Electrician using an amp probe needed to check this) Line A Line B Line C

YNN/ACA

Certification by Lessor:I hereby certify that the information contained herein is accurate and complete to the best of my knowledge.

SignatureDate:

NOTES & COMMENTS:

2/27/02