Site Survey

Initial Site Survey for Clean and Alternative Energy

(Note: * Indicate Required Field)

Date:

Name*:

Street Address:

City:

State:

Country:

Business Phone:

Mobile Phone:

Fax:

eMail*:

How did you hear about Helios System Innovations?

Internet
Nagazine
Tradeshow
Consultant/Representative

Is this something you've been curious about, or have you been looking into solar or other energy alternatives for a while?

What's your main reason for looking into Alternative Energy?

How soon will you start the project?

1 Month
3 Months
6 Months
9 Months and beyond

Do you have electrical generation available?

Yes - Grid Power
Yes - Other
NO
Not Sure

If you checked "Yes - Other" above, please specify:

System type desired? (e.g. Standalone, Grid Tie, Supplemental Generator, etc...)

Type of cooling? Passive night time air? Please specify:

Active chilling A/C? Please specify type and brand if known:

Type of primary heating?

Forced Air
Oil or Gas
Radiant Heat
Other (specify below)

AC Voltage used?

110V
220/230
430

Phase used?

1 Phase
2 Phase
3 Phase

Specify in hours the amount of back-up that you need, if any:

What is your average monthly electrical bill in $ or expected usage in KWh?

What is the size in KVA of installed circuit or circuits?

How much of your total KWh or KVA needs do you want to support using Alternative Energy? (Please specify in %)

Information about your home:

Do you have a home business?

yes
no

Is your home?

One-Story
Two-Story

What is the square footage of your home?

What is the age of your home?

What is the type of structure or home construction? (Please specify)

Roof type?

Roof age?

Roof pitch?

Roof area?

Land Area? Acreage, lot size, etc.. (Please specify)

Is your water heater:

Gas
Electric

How many water heaters?

Home heat?

Gas
Electric
Wood
Heat Pump
Swamp Cooler
Pool
Spa
Well
Irrigation Pumps

Do you have adequate sun on your property?

yes
no
not sure

Do you have a south facing roof?

yes
no
not sure

Do you have an open area for ground mount?

yes
no
not sure

Do you have a barn?

yes
no

Please provide us with the following images/documents:

A plot map of home or compound (if applicable)

Pictures or architectural drawings of structure (including roof)

If existing roof, provide pictures (highlight obstructions)