If your company spends more than $80,000/month 
on energy expenses, complete our following 

On-Site Power & Energy Survey   

for an initial, no-cost consultation and review.

E-mail completed form to: info@cogeneration.net

          YES, Cogeneration/Trigeneration Technologies, please contact us about our facility's energy and power requirements.  Our completed form is enclosed for your review. 

     Your name: _______________________________________

     Title: _________________________

     Company name: ____________________________________

     Company address: __________________________________

     City: _______________________     State: ______________  Zip code: ___________

     Telephone: __________________  ext. ________

     Fax:  _______________________

     Best time to call for us to call: ______________

1.  What is the nature of your business or operation?  If manufacturing, what are the products  manufactured at this location?    

2.  Do you now or will you soon require steam at your facility?  __________   If yes, how much steam is required?  ____________ MMBtu @  ________ psi

3.  How many hours per week does your company operate?   _______ hours/week

4.  How many days per week does your company operate?    _____ days/week

5.  Do you have natural gas available?  _____________  If yes, how far from your facility is the natural gas main or pipeline located?  ____________

6.  What is your facility's annual electric bill?   $____________ 

7.  Have your company's electric rates/bills been increasing?  __________     If yes, please answer the following:  Our company's electric rates/bills have increased by  $____________  over the past 12 months. 

8.  Has your company experienced any blackouts, brownouts or other power interruptions? ________  If yes, please answer the following:  Our company has experienced __________ black-outs/power interruptions over the past 12 months?

9.  If you have experienced power interruptions, has your company lost money as a direct result of the power interruption(s)?  ___________    If yes, please answer the following:  Our company has lost $______________  per interruption  or $______________ over the past 12 months.

10.  Does your company use more than 2000 Kwh/hr electrical power?  _________   Indicate the present amount here: _________________    Indicate FUTURE (planned) Kwh/hr electrical power requirements here: _________________

11.  Does your company plan on any remodeling, expansion, construction or other changes to your existing  facility? __________

Electrical requirements

• Average demand during operating hours
  __________ kW
  
  
• Minimum demand during operating hours
  __________ kW
   
• Peak demand during operating hours
  __________ kW
  
  
• Annual electricity consumption
  __________ kWh

• Voltage Requirements:  ____________________
  

Thermal requirements

• Form of thermal energy use
  __________ steam  __________ hot water __________ chilled water  
  
  __________ other (specify)

• What is the primary application for thermal or (waste heat recovery) energy at the plant?________________________________________________________
   
• Average demand during operating hours
             lbs/hr, Btu/hr, Btu fuel/hr (circle correct units)
   
• Minimum demand during operating hours
             lbs/hr, Btu/hr, Btu fuel/hr
   
• Peak demand during operating hours
             lbs/hr, Btu/hr, Btu fuel/hr
   
• Required conditions
             lbs/hr, Btu/hr, Btu fuel/hr

Operating conditions

• Nominal operating hours per year
            
• Number of hours per year that electrical and thermal loads are simultaneously at or above average values
            

Energy rates

• Average retail electric rate
             cents/kWh
   
• Peak demand charge (if applicable)
             $/kW/month
   
• Fuel price
             $/mmBtu, $/therm, $/gal (circle appropriate units)

Existing Site Conditions

• Is there sufficient floorspace (inside or outside for an on-site power generation, cogeneration or trigeneration power plant installation?*)
             Yes            No
   
• Is adequate fuel accessible/available for an on-site power generation, cogeneration or trigeneration installation?
             Yes            No
   
• Are there specific environmental or zoning restrictions that may preclude an on-site power generation, cogeneration or trigeneration installation?*
             Yes            No

Please tell us how you found Cogeneration Consultants:

        Advertisement    _______________                        Link from other site _____________

        Article                _______________                        Other                      _____________

        Search engine     _______________                        

Please add any additional information or comments that may help our engineering team provide you with the best possible energy & power solutions for your company.

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