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Industrial Energy Innovators Reporting Template

Industrial Energy Innovators make a public commitment to establish energy efficiency targets, quantify base-year energy consumption and greenhouse gas (GHG) emissions, and report annually on energy-efficient measures implemented and results achieved at their company.

A short reporting template is available to help companies prepare their report on their energy efficiency actions and achievements. This template has been designed for companies that lack the resources or time to prepare more comprehensive reports for Natural Resources Canada's (NRCan's) Industrial Energy Innovators initiative.

Once you have completed the online report form, you can submit the report electronically to the Canadian Industry Program for Energy Conservation (CIPEC) at NRCan's Office of Energy Efficiency. Please print a copy for your records before you submit it.

Instructions

Fill in the template. Use the most recent full calendar year (January to December) as the basis for reporting on activity.
Print a copy of your report before you submit it electronically to NRCan.
Submit your report no later than June 30 following the reporting year.

Send us an e-mail if you have any questions.

Industrial Energy Innovators Reporting Template

Company Name and Address

Submitted by (Name and Title):

E-mail address:

Date

Here's How Our Company is Meeting The Challenge to Become More Energy Efficient:

1. We are involved in manufacturing the following products (please specify; e.g. auto parts, chemicals, food products, textiles,etc.):

2. This report represents the activities at:
one establishment
more than one establishment (please specify number)

3. At the establishments noted above, we employ:
less than 100 people
100 to 499 people
more than 500 people

4. Most of our energy consumption can be attributed to (please select the most significant uses, to a maximum of four):
process heating
process refrigeration
process drying
production and process operations
water systems
compressed air systems
space heating, ventilation and air conditioning
lighting
vehicular fleets
other (please specify)

5. Our energy needs are met by the following forms of energy (please select the most significant, to a maximum of four):

electricity
natural gas
propane
butane
diesel
middle distillates

heavy fuel oil
steam
wood
coal
coke
other (please specify)

6. We have had success reducing energy consumption by establishing the following (please select initiatives undertaken within the last three years):
a strong executive commitment to improving energy efficiency
a corporate plan regarding energy management
an energy management team
an energy management "champion" (individual or department)
a program to upgrade and/or replace ageing equipment
a system to monitor, track and report energy use
specific energy efficiency improvement targets
ongoing involvement in ISO quality assurance programs
purchasing criteria that recognize energy-efficient suppliers
an employee training system to increase the awareness and practice of energy efficiency
a program to reward employee efforts to improve corporate energy efficiency
other (please specify)

7. We have improved the energy efficiency of the following components of our industrial processes and facilities (please select improvements made within the last calendar year):
boiler plant systems
process furnaces, dryers and kilns
refrigeration systems
compressed air systems
water systems
motor drive systems
heating, ventilation and air conditioning systems
building envelope
lighting systems
production process systems
other (please specify)
Note: In the space below, briefly describe the improvements you have made.

8. These improvements have resulted in the following (please select appropriate answers and, if possible, specify reduction amounts):
a relative reduction in energy used per unit of output (of percent per year)
an absolute reduction in energy use (of percent per year)
a reduction of greenhouse gas emissions (of tonnes CO₂e per year)
none of the above
Note: If you have quantified energy use for a base year and can compare your energy consumption for the last calendar year to this baseline, we encourage you to include this information below as further evidence of your commitment to energy efficiency.

9. Looking ahead, we have set a target to reduce the energy used per unit of output (i.e. energy intensity) by:
less than 1 percent per year
1 percent to 5 percent per year
more than 5 percent per year
not applicable

10. To achieve this target, we will implement the following measures (please list measures below and, where possible, note expected impacts in terms of energy and GHG emissions reductions):

If you prefer to submit a corporate energy or environmental report which describes these initiatives, please indicate this in the box below. Your report should be sent to:

Philip B. Jago
Industrial Programs Division
Office of Energy Efficiency
Natural Resources Canada
580 Booth Street, 18th Floor
Ottawa ON K1A 0E4
E-mail

When you click on "submit", your report will be transmitted to the Industrial Programs Division of Natural Resources Canada's Office of Energy Efficiency.

Please print a copy for your records before you submit.