5900-381 Water Data Verification

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OMB Control No. 2060-0347

ater Data Verification Form

Due to EPA 4/17/2015

Step 1: Verify building name and address

Property Name (note that this is the name that will be used on Yes, the property name is correct.

the recognition certificate and any outreach materials): No, this is incorrect. I would like the name of the property

3190 Fairview Park to be listed as:

Portfolio Manager Building ID#: ____________________________
1345536 Yes, the building address is correct

No, this is incorrect. I have corrected the address in Portfolio Property Address: Manager to read:

3190 Fairview Park Drive, Falls Church, Virginia 22042 ___________________________

Step 2: Verify gross floor area: 260924 sq. ft.

Does this square footage include all supporting functions such as kitchens and break rooms used by staff, storage areas, administrative areas, elevators, stairwells, atriums, vent shafts, etc.?

Also note that existing atriums should only include the base floor area that they occupy. Interstitial (plenum) space between the floors should not be included in the total.

Finally, gross floor area is not the same as leasable space. Leasable space is a subset of gross floor area.

Yes, this is correct.

No, this is incorrect. I have added and/or corrected this data in my Portfolio Manager account, and resubmitted my property data using this link: https://portfoliomanager.energystar.gov/pm/reports/dataRequest/accept/41005f7b-d45e-4039-bd34-34fef7cf633e

Step 3: Verify meter data

Verify that each water meter entry that appears in Portfolio Manager for the baseline and competition periods (January through December of 2013 and 2014) is correct and matches the actual meter readings as reported by the utility.

Also verify that ALL water use associated with this property is represented in Portfolio Manager, and that no meter is shared with another property. Also verify that the property was operating business as usual throughout the competition period.

Yes, all meters are represented and all entries are correct.

No, one or more meters, or meter entries, is incorrect or missing. I have added and/or corrected them in my Portfolio Manager account, and resubmitted my property data using this link:

https://portfoliomanager.energystar.gov/pm/reports/dataRequest/accept/41005f7b-d45e-4039-bd34-34fef7cf633e

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Professional Engineer or Registered Architect Stamp

tep 4: Signature of Professional Engineer or Registered Architect

I certify that the information contained on this form is true and accurate to

the best of my knowledge.

Name: _______________________________ Date: ________________

Signature: ____________________________________________________

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EPA Form No. 5900-381

tep 5: Send form to EPA

Send a signed, scanned PDF of this document to EPA by April 17. If this is a

hardship, please contact EPA to make other arrangements prior to April 17.

All correspondence can be sent to: [email protected]

The public reporting and recordkeeping burden for this collection of information is estimated to average 1.5 hour per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

EPA Form No. 5900-381