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First Name* |
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| Last Name* |
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| Address:* |
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| City:* |
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| State:* |
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| Zip Code:* |
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| Contact Email* |
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| Home Phone: |
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| Mobile Phone: |
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| Business Phone: |
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| Subject* |
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Requested Appointment Date:
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| Requested Appointment Date - Month: |
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| Requested Appointment Date - Day |
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| Requested Appointment Date - Year |
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| Year home was built: |
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| Total Conditioned Space: |
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| Number of floors: |
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| Type of home: |
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| Type of Foundation: |
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| Number of Heating and Air Conditioning Systems: |
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| Type of heating fuel: |
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| Type of water heater: |
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| Number of water heaters: |
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| Electric Meter ESI ID#: (found on utility bill) |
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| Services Requested:* |
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| If other, please specify: |
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| Comment* |
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Tips to an effective Energy Audit:
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Have 12 months of Gas and Electric bills on hand (can be obtained from
utility company)
- Write down any problems with
comfort, dust, humidity, or any other concerns
- Be
available for a 30-60 minute interview and walk through
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Allow 1 hour for Basic Assessment and 4 hours for Comprehensive Home
Energy Audit
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