Site Inquiry Sheet

Day : / /

Bldg. Name
Address

Your Name (Dept.) (Name)

Telephone Facsimile
e-mail

Bldg. Data Use

Number of Stories
Structure RC SRC Other
Site Area m2
Construction Area m2
Total Floor Area m2
Completion Year
Renovation Year
Renovation Content

Drawing Architecture Electricity Air-conditioning Scematic Diagram Facilitiy List

(as-build) Factory Layout Process Layout Plumbing Clean Room Layout

Facility Outline
Electricity Contract Type
Contract Demand kW
Service Voltage kV

Lighting Control System Remote Control Other

Manufacturer
Model Number
Remote Control Type
Specification LED Hf FL
 Site Inquiry Sheet

Day : / /

Bldg. Name

Air Conditioning Type Air-cooled Packaged Air-conditioner

Central Air-conditioning System
Air Deliver Constant Air Volume Single Duct System
Variable Air Volume Single Duct System
Individual Distributed System
Unit Type AHU FCU Packaged Other
In case of Central Heat Source System
Cooling Motor DrivenHeat Pump Chiller
Absorbtion Refrigerating Chiller (Steam/Hot Water)
Self-fired Adsorbtion Water Chiller Boiler
Capacity RT
Storage m3 (Water/Ice)
Heating Self-fired Adsorbtion Water Chiller Boiler (Gas/Oil)
Boiler (Gas/OiSteam Boiler (Gas/Oil)
Capacity (MJ/h.Mcal/h)
Storage m3 (Water/Ice)
Energy Saving System
Total Heat Exchanger Outdor Air Cooling
Exhaust Heat Recovery Other ( )

Plumbing System
Water Supply System
City Water Well Water
Recycled Water (Rain/Non-potable Water) Industrial Water
Water Receiving Tank m3
Gravity Tank m3
Booster Pump System
Hot Water System
Boiler (Gas/Oil) (Steam/Hot Water) Gas Water Heater
Electric Water Heater
Capacity (MJ/h.Mcal/h)
Storage m3
Waste Water
Effluent Control BOD COD etc
Actual BOD COD etc
Energy Source
Gas LNG LPG
Other (Type : , Heat Generation Rate MJ/m3)
Oil Kerosene Gas Oil Heavy Oil
 Site Inquiry Sheet

Day : / /

Bldg. Name

Energy Management
District Heating and Cooling No Yes
Service HoursAnnual Service Days Days
Service Hours _______:______ - _______:_______
Operation Hours _______:______ - _______:_______

Operational Situation
Bldg. User Weekly ___________Holiday _____________
Term Cooling __________ - ____________ / Heating __________ - ____________
Set Point Cooling ______ ᵒC ______ % / Heating _______ ᵒC _______ %

Energy Consumption Ratio Of Major Equipment (Approximate Value)

Electricity Ratio
Heat Source ____________%
Heat Transport ____________%
Lighting/ Electrical Outlet ____________%
Motive Power ____________%
Other ____________%

Fuel [ ] Ratio
Power Generation ____________%
Heat Source ____________%
Hot Water / Steam ____________%
Other ____________%
________________ ____________%

(NOTE) The consumption ratio (%) is acceptable in the summary of the designated day or year

Process Utility
Steam Steam Pressure at Boiler Outlet (kPa)
Steam Temperature at Boiler Outlet (ᵒC)
Process Cooling Water (m3/h)
Temperature (ᵒC)
Compressed Air Working Pressure of Machinery (kPa)
Entering Air Temperature (ᵒC)
Dew point
Daily Operating Time (system)
Daily Operating Time (compressors)
Exhaust Scrubber System
 Other Gas

Site Inquiry Sheet

Day : / /

Bldg. Name
Energy Consumption and Cost (Past 3 years data)
(NOTE) If you have more than one power contract, please fill in more than one section in respone to each segment.

Category Electricity Fuel Oil LNG

Compressed
Maximum Purchased Generated Kerosene LPG Steam Air
Power Power Power A-B-C (________)
Year/
Months (kW) (kW) (kWh) (k Ɩ) (k Ɩ) (m3) (kg) (kg/m3) (Nm3)
/Jan.
/Feb.
/Mar.
/Apr.
/May.
/Jun.
/Jul.
/Aug.
/Sep.
/Oct.
/Nov.
/Dec.
Total
Annual
Total Cost Rp Rp Rp Rp Rp Rp Rp Rp Rp
/Jan.
/Feb.
/Mar.
/Apr.
/May.
/Jun.
/Jul.
/Aug.
/Sep.
/Oct.
/Nov.
/Dec.
Total
Annual
 Total Cost Rp Rp Rp Rp Rp Rp Rp Rp Rp

Site Inquiry Sheet

Day : / /

Bldg. Name

Water Consumption & Cost

(Past 3 years data)
Category City Waste Water
Own Wells
Year/ Water (Sewerage System)
Months (m3) (m3) (m3)
/Jan.
/Feb.
/Mar.
/Apr.
/May.
/Jun.
/Jul.
/Aug.
/Sep.
/Oct.
/Nov.
/Dec.
Total
Annual
Total Cost Rp Rp Rp
/Jan.
/Feb.
/Mar.
/Apr.
/May.
/Jun.
/Jul.
/Aug.
/Sep.
/Oct.
/Nov.
/Dec.
 Total
Annual
Total Cost Rp Rp Rp

Site Inquiry Sheet

Day : / /

Bldg. Name

Power Load Profile of the day (To be recorded within a range that has been grasped
(Past 3 years data)
Dry Season (kWh) Rainy Season (kWh) Other (kWh)
Time
/ / / / / /
̴ 1:00
0
̴02:00
̴ 03:00
̴ 04:00
̴ 05:00
̴ 06:00
̴ 07:00
̴ 08:00
̴ 09:00
̴ 10:00
̴ 11:00
̴ 12:00
̴ 13:00
̴ 14:00
̴ 15:00
̴ 16:00
̴ 17:00
̴ 18:00
̴ 19:00
̴ 20:00
̴ 21:00
̴ 22:00
̴ 23:00
̴ 24:00
 Power Heat Load Exhaust Cold Water General Industrial Gas Perticular Gas Commpress Industrial City Waste
ROOM NAME No Size Part Waste Gas Hydrogen Ｈ２ Ｏ２ Ｎ２ Ａｒ Ｈｅ ＣＦ４ ＣO２ ＣＬ２ Air Water Water Water
W*D*H Capacity Heat Remarks

Process E.Q Name (set) (m) V×A kcal/h m3/h m3/h m3/h SLM SLM SLM SLM SLM SLM SLM SLM SLM Nm3/min m3/day m3/day m3/day
Total
SubTOTAL
Load Calculate
Jakarta
℃（DB） %(RH) ℃(WB) kJ/kg(DA) kg/kg(DA)
Outside air Summer

Inside air Summer

CR Area F Room name Square Hight Capacity Cleanness Level Summer

Sensible Heat Outside Air
Inside PC Exhaust Pressurization Processing OA
TEMP Building Frame Lighting Person 0.23kW/台 Total Building EQ Load Total sensibl Unit Part Waste Gas Hydrogen Total Ventilation Ventilation
Unit Load Load Unit Load Load Density No Unit Load Load No Heat heat Load H/L Frequency Frequency
㎡ ㎡ m ㎥ ㎥ W/㎡ kW W/㎡ kW ㎡/person person W/person kW set kW kW kW kW W/㎡ ㎥/h ㎥/h ㎥/h ㎥/h times/h ㎥/h ㎥/h times/h
- - - 0.0 0.0 - 0.0 0.0 0.0 - #DIV/0! - - #DIV/0!
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
- 0.0 0.0 - 0.0 0.0 0.0
Total - - - - - - - - - - - - - - - -
 Site Inquiry Sheet
Process Utility

Day : / /

Bldg. Name

Boiler Room
Number Of Boilers
Total Capacity
Total annual production of heat energy (TJ/yr)
Total annual fuel consumption (h/yr)
Total annual operating time (h/yr)
Total annual quantities of water supplied to the system (h/yr)

Steam Boiler :
Type of Boiler
Design Capacity (t/h)
Fuel
Total annual operating time (h/yr)
Age (years)
Rated capacity (t/h)
Annual fuel consumption (yr)
Annual operating period

Pressure and Temperatures :

Steam Pressure at boiler outlet (kPa)
Steam temperature at boiler outlet (ᵒC)
Water temperature at boiler inlet (ᵒC)
Combustion air temperature (ᵒC)
Temperature of gas leaving the boiler (ᵒC)
Fuel temperature (ᵒC)

Flue Gas Analyses :

CO2
O2
CO
N2
Excess air

Electric Power :
Annual need for electric power satisfied by
Distribution system (%)
Your own CHP plant (%)
Voltage of the power supply system (kV)
Voltage tansformation (kV)
Number of transformer stations
Number of transformers
Total installed capacity (kVA)
Installed capacity per units (kVA)

Energy End-user :
Process Machine
Design quantity
Annual Operating Time
Daily Operating time
Type of Regulation
Air Conditioning
Design quantity
 Site Inquiry Sheet
Process Utility

Day : / /

Bldg. Name

Annual Operating Time

Daily Operating time
Type of Regulation

Other
Design quantity
Annual Operating Time
Daily Operating time
Type of Regulation

Compressed Air System :

Number of Compressor
Total Capacity (nm3/min)
Capacity per unit (nm3/min)
Output pressure (kPa)
Total capacity of electric motors (kW)
Unit capacity of electric motors (kW)
Volume of the tank (m3)
Type of regulation
Air cooling system
Parameter :
Working pressure of machinery (kPa)
Entering air temperature (ᵒC)
Daily operating time (system)
Daily operating time (compressor)

Cooling Water System

Number of Cooling Tower
Total Capacity (m3/hr)
Capacity per-unit (m3/hr)
Total capacity of electric motors (kW)
Unit capacity of electric motor (kW)
Paramenter :
Inlet water temperature (ᵒC)
Outlet water temperature (ᵒC)
Wet Bulb temperature (ᵒC)
Drift loss (%)
Evaporation loss (at design) (%)
Blowdown loss (%)
Make-up water (%)

Number of Cooling Water Pumps

Total Capacity (m3/hr)
Capacity per-unit (m3/hr)
Total capacity of electric motors (kW)
Unit capacity of electric motor (kW)