View source for Structure of data collected during heat source survey in Grodzisk Mazowiecki

== Questionnaire - inventory of heating systems ==

Address of the building ...............................
Building
() Detached () Semi-detached () Multi-family house

Usable area of the building in [m2]
(please complete below)
 ………………………………………

Year of start of use
(please complete below)
 …………………………………………

Were the walls in the building insulated?
() Yes () No

Was the roof in the building insulated?
() Yes () No

Type of external doors and windows in the building
() PVC () Wooden () Other

The condition of the windows in the building
() Good () Sufficient () Bad

The method of heating the building
() tiled stove
() heating in the rooms: grate stove
() central heating: solid fuel boiler ........................... ..
(Please specify type)
() central heating: gas boiler
() central heating: oil boiler
() other…………………………………

The type of fuel used in the building
() coal () gas () heating oil () wood () electricity () other

Are thermostatic controllers for temperature control in the room mounted on the radiators?
() Yes () No

Data from the information plate on the heating device
(kW power, year of production, energy class/norm):
 ………………………………………………………………………………….

The amount of coal consumption in [tonnes] (if present)
(Please indicate consumption for the last year - 2018)
 …………………………………………………………………………………..

Gas consumption in [m3] (if present)
(Please indicate consumption for the last year - 2018)
 
The amount of wood consumption in [m3] (if present)
(Please indicate consumption for the last year - 2018)
  …………………………………………………………………………………..

Other sources used for heating purposes
If they exist please enter their type and consumption
 …………………………………………………………………………………..

Electricity
Total annual electricity consumption in the household in [kWh]
(Please indicate consumption for the last year - 2018)
  …………………………………………………………………………………..

Renewable energy sources
Are renewable energy sources used in the building? *
() Yes () No

If so, please indicate their kind
() Solar collectors, area in [m2]: …………………..
() Photovoltaic cells, power in [ kWp ], () on-grid or () off grid type
() Wind farm, power in [kW…………………..
() Heat pump, power in [kW]: ………………….., () horizontal () vertical type
() Air heat pump, power in [kW]: …………………..
() Other: …………………..
Are you interested in replacing your heat sources with new, ecological ones? *
() Yes () No
Are you aware of the incentive of the Grodzisk Mazowiecki Municipal Council on co-financing the replacement of coal boilers?
() Yes () No