EIA-871H Worksheet 2 (establishment version)

Worksheet #2:
Energy Amounts Used and Dollars Spent
(Mall Establishments)
Commercial Buildings Energy Consumption Survey
Sponsored by the U.S. Energy Information Administration
Conducted by NORC

Instructions
For electricity and natural gas, if used
in this establishment, provide the
following:
• Account number: If energy source
is not used, write NA in box.
• Month: In column A, specify the
months that electricity and/or natural
gas were used for 2007. Ideally this
will be January, 2007 through
December, 2007. Otherwise provide
the most recent 12 months available.
• Amount of energy used:
In column B, specify the amount of
energy used in each month, across all
of the establishment’s accounts for
which you are responsible, for 2007.
• Cost of energy per month:
In column C, specify the dollar
amount billed, across all of the
establishment’s accounts for which
you are responsible, for the 2007
twelve months/billing cycles. Include
state and local taxes, fuel adjustment
charges, demand charges, and
distribution charges. Exclude
merchandise, repair charges, and
service charges (hookup or disconnect
fees, late payment charges).
• Total: In line D, provide totals for
columns B and C, across all of the
establishment’s accounts, for the
twelve months. Some establishments
have several accounts for each energy
source—include all of them in the
energy total.

Box 1. Electricity

Box 2. Natural Gas

Account Number

Square footage covered under
this electricity account:
This entire establishment only
This establishment plus other
establishment(s)
Only part of this establishment
A. Month
(and year if
not 2007)

Account Number

Specify amount of additional or
excluded square footage:

B. Amount of electricity used per
month
(Kilowatt-hours)

C. Amount
billed/dollars
spent per
month
(Dollars)

Square footage covered under
this electricity account:
This entire establishment only
This establishment plus other
establishment(s)
Only part of this establishment
A. Month
(and year if
not 2007)

B. Amount of natural gas used
per month—Check the units
used:
Cubic feet (cf)

Dekatherms

100 cu.ft. (Ccf)

Therms

1,000 cu.ft. (Mcf)

D. Total

D. Total

Specify amount of additional
or excluded square footage:

C. Amount
billed/dollars
spent per
month
(Dollars)

Go to Box 2

Go to Box 3 on the back of this worksheet

Instructions: For totals, include all accounts for each energy source, for which you are responsible, for calendar year 2007. For amount billed, include state and local taxes, but
exclude merchandise, repair charges, and service charges (hookup or disconnect fees, late payment fees).

Box 3. Fuel Oil/Diesel/Kerosene

Box 4. District Steam

Account Number

Box 5. District Hot Water

Account Number

Total fuel oil/diesel/kerosene purchased: across all
accounts, for the last twelve months

Account Number

Total district steam used: across all accounts, for 2007

Gallons
If measured or metered, what is the amount of fuel
oil/diesel/kerosene actually consumed in calendar year
2007?

Total district hot water used: across all accounts, for
2007

Million Btu
Check the units used:
Thousand pounds
Pounds
Million Btu

Gallons
Total amount billed/dollars spent: across all accounts, for
2007

Total amount billed/dollars spent: across all accounts, for
2007
$

$

Beginning and ending dates: If the establishment had
multiple accounts with different beginning and ending
dates, provide the dates for the largest account.

/

/

Total amount billed/dollars spent: across all accounts,
for 2007

to

month/day/year

/

/

month/day/year

Go to Box 4

$

Beginning and ending dates: If the establishment had
multiple accounts with different beginning and ending
dates, provide the dates for the largest account.

/

/

to

month/day/year

/

/

month/day/year

Go to Box 5

The interviewer will collect this worksheet.

Beginning and ending dates: If the establishment had
multiple accounts with different beginning and ending
dates, provide the dates for the largest account.

/

/

to

month/day/year

/

/

month/day/year

Thank you!
Form EIA-871H
OMB No.: 1905-0145
Expires: xx/xx/xxxx