Poudre Valley REA

Kid's Corner

Energy Audit Application

* Required Fields

Consumer Information
Consumer Name: *
Account Number: *
Consumer Address: *
City: *
State: *
Zip Code: *
Home Phone: *
Mobile Phone:
Work Phone:
Email Address: *
Home Information
Year Built:
Square Feet:
Number of Rooms:
Style of Home:
Basement:
Remarks:
Home Heating Information
Age of Heating System:
Primary Heating
Source:
Type:
Secondary Heating
Source:
Type:
Remarks:
Water Heating Information
Primary Water Heating Source:
Location of Water Heater:
Remarks:
Insulation
  Ceilings Walls Floors Basement Walls
Insulated:
Existing Type:
Square Feet:
R Value:
Inches:
Needs Improvement:
Remarks:
Air Filtration
Caulking:
Window Frames:
Foundation:
Fireplace:
Weatherstripping:
Plumbing Openings:
Electric Openings:
Exterior Doors:
Remarks:
Glass
Windows:
Adequate Coverings:
Storm Doors:
Remarks:
Miscellaneous
Thermostat Location:
Automatic Setback:
Water Pipe Insulation:
Ductwork Insulation:
Remarks:
Prepared By
Prepared By:

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Poudre Valley REA • PO Box 272550, 7649 REA Parkway, Fort Collins, CO 80527-2550 - Map
Phone: 970.226.1234 • FAX: 970.226.2123 • Email: pvrea@pvrea.com