5900-179 Home Improvement Profile Form

Energy Star Program in the Residential Sector (Renewal)

ENERGY STAR HIP Profile 05 04 09

Energy Star Program in the Residential Sector: Households

OMB: 2060-0586

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OMB Control No. xxxx-xxxx

Change the World, Start with ENERGY STAR

Home Improvement Profile



Step 1

W hat’s Your Score? Use our Home Energy Yardstick to compare your home’s energy use to others across the country. Is higher or lower than average? If your score is low, set a goal to increase efficiency. Even if your home scores well, there are always opportunities to increase performance!


Step 2

G et Recommendations. Our online Home Advisor will quickly give you recommendations to improve your home’s energy efficiency. You can also contact a professional energy consultant to give you more customized recommendations and guide you through the improvement process. They can use specialized software to estimate what improvements will help you reach your goal.


Step 3

T ake the Pledge. “Change the World, Start with ENERGY STAR” is a national campaign that encourages all Americans to take steps to help fight global warming by using less energy at home, at work, and in their communities. Through the ENERGY STAR Pledge, you can commit to taking specific actions to improve energy efficiency.



S tep 4

Track Your Progress. Twelve months after you make the improvements, come back to the Home Energy Yardstick and see how much your score gone up. Complete the ‘Home Improvement Profile’ to show the changes you’ve made and the results you’ve achieved. If you wish, send us the completed Profile – and your project might be featured on the ENERGY STAR Web site!













Homeowner Name

[City, State]

[Annual Energy Saved]

Project Cost

Project Professionals

[$500]

[Consultant X]

[Contractor Y]

ENERGY USE

Electric

(kWh)

Natural Gas (therms)

Oil

(gallons)

Other

Yardstick

Score

Pre Project






[Dates]

Post Project






[Dates]

How We Changed the World with ENERGY STAR (check all the apply)

ENERGY STAR

Products Installed

ENERGY STAR

Home Improvements Made

Recommended

Behavior Changes Made

Appliances:

Refrigerator/Freezer # ______

Dishwasher

Clothes Washer

Water Heater

Room Air Conditioner

Central Conditioner

Ceiling Fans # ______

Heat Pump

Furnace

Boiler


Lighting:

Light Fixtures # ______

CFLs #_______


Home Office Equipment:

Computers/Laptops #_______

Printer/Scanner/Copier #_______


Electronics:

Televisions #_______

DVD/VCR Players #_______

Cable Box #_______

Home Audio Equipment #______

Portable Phone #_______

Battery Charger #_______

Installed weather stripping around doors and windows


Sealed air leaks in attic and basement


Reduced whole-house air leakage (________ACH @ 50 Pa)


Added attic insulation

(R-value_________)


Added wall insulation

(R-value_________)


Added floor insulation

(R-value ________)


Added crawlspace insulation


Sealed and insulated ductwork


Installed ENERGY STAR windows, doors, and/or skylights (#_______)


Installed a programmable thermostat


Other _________________________ __________________________________________________________________

Cleared registers and vents covered by furniture or rugs


Changed furnace air filter regularly


Removed leaves, dirt, and debris from outdoor parts of HVAC system


Used ceiling fans to reduce need for air conditioning


Lowered water heater thermostat to 120o


Wrapped water heater with an insulating jacket


Installed low-flow shower heads and faucets


Turned off lights when you leave a room (or install a motion sensor)


Unplugged chargers and power adaptors when not in use


Used power strips to shut off electronics when not in use


Tightly closed fireplace damper when not in use


Other _______________________


EPA Form 5900-179

The government estimates the average time needed to fill out this form is 0.10 hours and welcomes suggestions for reducing this effort. Send comments (referencing OMB Control Number) to the Director, Collection Strategies Division, U.S. EPA (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.

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File TitleENERGY STAR Home Show
AuthorDale H
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File Modified2009-09-17
File Created2009-05-04

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