Energy Audit Application | Mid-Ohio Energy Cooperative

Mid-Ohio Energy Cooperative offers an on-site home energy audit for a fee of $100. The audit includes a blower door test, infrared camera, and full home walkthrough. Members can receive reimbursement for the entire $100 fee (in the form of an energy credit) by making recommended changes.

Personal Information

First

Middle

Last

Address

City/Town

State/Province

ZIP/Postal Code

Telephone Number

Email

Home Specifications

Reason for Audit

Home Type

Year Built

Approximate Square Footage

Foundation Type

Number of Bedrooms

Number of Occupants

Heating Method

Cooling Method

Number of Portable Heaters Used

Preferred Time of Day for Audit

Since the test depressurizes the house, sucking air in through all the openings (including flues), it is important that all combustion devices be disabled during the test. Heating systems and gas water heaters must be shut off. Pilot lights should be extinguished. All wood‐burning appliances in the house need to be out. It is recommended that houses dependent upon wood‐burning appliances for heat avoid scheduling audits during periods of extreme cold. In the winter a temporary reduction in a home’s indoor temperature can be expected—please plan accordingly.

I willingly assume all risks associated with my participation and I grant this release of liability. I understand the intent of the service offered is to identify potential energy efficiency improvement opportunities, and any action taken on my behalf may have unintentional side effects. I understand that Mid‐Ohio Energy Cooperative and its employees assume no liability for any attempted improvements made to my home. Any suggestions given are based on building science theory. As the homeowner, I assume all liability for any changes made in the home.

Member Signature

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