ASSESSMENT INFORMATION

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checklist Water Audit Data Collection Sheet This data collection sheet is designed to assist auditors during assessments. Some items may not be applicable for all assessment situations or conditions. ASSESSMENT INFORMATION Company Name Date of Assessment Address Phone # Fax # Lead Assessor Company Contact Person/Title Email Address Assessment Team Leader Assessment Objectives (List Special Concerns) Water and Wastewater: Treatment/Volume Reduction Manual Toolbox: Water Audit Data Collection 1

BACKGROUND INFORMATION ABOUT WATER USE Average water use/bill (for previous year) Average water use/bill (for year before last) Size and location of meter(s) Primary water source Secondary water source Should credit be obtained for water that does not go to the sewer? (cooling towers, landscaping) Is an additional meter required to monitor water not being sewered? WATER BALANCE AND COSTS Source of water use Gallons per Year (est.) Percent of Total Water Cost ($/yr) Sewer Cost ($/yr) Energy/Other Costs ($yr) Domestic Heating/cooling Rinsing/cleaning Landscaping Unaccounted for Total: WATER BALANCE AND COSTS Number of Employees Shifts Per Day Operating days/week Size of and type of plant (sq. ft.) Business type (manufacturing, college, offi ce, etc.) If manufacturing, list products and annual production rate If service or institutional sector, list clients, occupancy rates, meals served per year, etc. Current and past water effi ciency program measures (policies, training, awareness and goals) 2 BrewersAssociation.org

Checklist: Water Audit Data Collection Sheet SYSTEM PARAMETERS Number, types and sizes of buildings at complex Grounds (approximate size in acres) Garages/motor pool/support buildings (approx. sq. ft.) On-site water treatment description, rate and costs Wastewater treatment description, rates and operating costs WATER USED IN MANUFACTURING PROCESSES Volume used directly in product, per year Description of water used in processing Volume used in production (i.e., packaging) WASHING, RINSING AND SANITATION Volume used in cleaning, rinsing and sanitation Description of washing and sanitation processes Number of mop sinks, etc Have improved rinsing techniques (such as counter-current systems, conductivity fl ow controls, improved spray nozzle/pressure rinsing, etc.) been considered? Are dry clean-up practices used instead of hosing down and fi rstpass pre-cleaning conducted with squeegees, brushes or brooms? Is water cut off when not in use by fl ow timers, limit switches or manually? Description of cooling tower evaporative coolers (rated tonnage, types and uses) Water rate used in cooling towers and equipment COOLING AND HEATING Is condensate being reused? Description of once-through cooling requirements Volume used in once-through cooling (air conditioners, air compressors, vacuum pumps, rectifi ers, hydraulic equipment, degreasers, etc.) Water and Wastewater: Treatment/Volume Reduction Manual 3

Or has once-through cooling water for these uses been eliminated through use of chill- ers, cooling towers or air-cooled equipment? Has blow-down bleed-off control on boilers and cooling towers been optimized? DOMESTIC USE Toilets (number, type and tank volume) Urinals (number and volume) Lavatory sinks (number and estimated fl ow) Showers (number and estimated fl ow) Are code-conforming commodes (1.6 gpf), faucet aerators (0.5-1.0 gpm) and low-fl ow showerheads (2.5 gpm) in use? LANDSCAPING/OUTDOOR USE Landscape irrigation (estimated gallons per unit of time) Acreage/square footage landscaped and description Watering/irrigation system techniques and schedule Are low-fl ow sprinklers, trickle-drip irrigation, optimized watering schedules and water placement, preventive maintenance and xeriscaping techniques in place? 4 BrewersAssociation.org

Checklist: Water Audit Data Collection Sheet KITCHEN Kitchen faucet/pre-rinse sprayers [number and fl ow rate (gpm)] Icemakers, air-or water-cooled and water usage Garbage disposals in use? Are electric eye sensors for conveyor dishwashers installed? Have new and water- and energy-effi cient dishwashers been considered for future purchse? OTHER USES, LEAKS AND UNACCOUNTED-FOR WATER List any quantifi able leaks and estimated rates Any other miscellaneous uses of water (car washes, wet scrubbers, ornamental ponds, dust control, etc.) ADDITIONAL NEEDS Factors that could affect, increase or decrease water use Any other major opportunities and assessment opportunities revealed, including: - Energy Effi ciency - Lighting - Heat Recovery - Solid Waste Reduction - Pollution Prevention Water and Wastewater: Treatment/Volume Reduction Manual 5