The Biggest Reducer

1. The Biggest Reducer Project

100% of survey complete.

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* 1. Applicant Information

Name:

Address:

City/Town:

State:

ZIP/Postal Code:

Email Address:

Phone Number:

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* 2. Do you currently recycle?

Yes

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* 3. Water Supplier

City Water

Rural Water

Well

Other (please specify)

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* 4. Electric Utility

Marshall Municipal Utilities

Lyon-Lincoln Electric Cooperative

Excel

Otter Tail Power Company

Minnesota Valley Power

Other (please specify)

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* 5. Gas/Propane Supplier

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* 6. This information may be used for comparison of past and present usage and may be used for promotion of this project. If selected for this project, your family’s energy use maybe profiled through local media venues. If selected, would you allow your utility providers to share information regarding your usage with the project coordinators?

Yes

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* 7. How would you describe the residence?

Conventional house

Manufactured home

Condominium, townhouse, duplex, twin home

Apartment

Other (please specify)

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* 8. When was the residence built?

2000- present

1980-1999

1960-1979

1940-1959

Before 1940

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* 9. Do you own or rent this home?

Own

Rent

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* 10. What is the approximate heated area of your residence?
(Mark only one. Multiply the house length (in feet) by the house width (in feet) by the number of levels. Do not include the garage or unfinished areas.)

Less than 1,000 square feet

1,000-1,499 square feet

1,500-1,999 square feet

2,000-2,499 square feet

2,500-2,999 square feet

3,000 or more square feet

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* 11. How many people live at your residence for each age group?

	1	2	3	4 or more
Less than 6 years old	Less than 6 years old 1	Less than 6 years old 2	Less than 6 years old 3	Less than 6 years old 4 or more
6-12 years old	6-12 years old 1	6-12 years old 2	6-12 years old 3	6-12 years old 4 or more
13-20 years old	13-20 years old 1	13-20 years old 2	13-20 years old 3	13-20 years old 4 or more
21-30 years old	21-30 years old 1	21-30 years old 2	21-30 years old 3	21-30 years old 4 or more
31-50 years old	31-50 years old 1	31-50 years old 2	31-50 years old 3	31-50 years old 4 or more
51-65 years old	51-65 years old 1	51-65 years old 2	51-65 years old 3	51-65 years old 4 or more
Over 65 years old	Over 65 years old 1	Over 65 years old 2	Over 65 years old 3	Over 65 years old 4 or more

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* 12. Do you operate a business from your home?

Yes

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* 13. If you answered yes to Question 12, please indicate the type of business.

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* 14. In the past two years, have you taken any of the following energy saving measures? (Check the ones which apply.)

Adjust your thermostat?

Adjust your water heater?

Upgrade to Energy Star appliances?

Turn off the lights?

Install water saving measures?

Unplug unused devices?

Have an energy audit?

Replace windows?

Install additional insulation?

Weather proofing

Other (please specify)

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* 15. In the past two years, how many CFL light bulbs have you installed in your home?

A few of my lights

About half of my lights

Most of my lights

None

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* 16. In the next 3 years, do you plan to remodel your home to make it more energy efficient?

Yes

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* 17. What type of fuel is used by the primary heating system for this residence? (Choose only one.)

Electricity

Natural Gas

Coal

Propane (LP or bottle gas)

Fuel Oil

Solar

Wood/Corn

Other (please specify)

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* 18. What is the approximate age of your home's primary heating system?

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* 19. Does this home have a central air conditioner?

Yes

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* 20. Please indicate the approximate age of the air conditioning unit.

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* 21. Which one of the following best describes the primary water heater for this residence? (Mark all that apply.)

Standard electric (less than 90% efficient)

High efficiency electric (more than 90% efficient)

Natural Gas

Propane gas (LP or bottle)

On-demand

Solar

Other (please specify)

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* 22. What is the age of the water heater unit?

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* 23. Please indicate which of the following household items are used in this residence. Mark the number of units in use for each device. If any of the items are rated as "Energy Star," please mark the last column.

	One	Two	Three or more	None	Energy Star?
Electric range	Electric range One	Electric range Two	Electric range Three or more	Electric range None	Electric range Energy Star?
Gas range	Gas range One	Gas range Two	Gas range Three or more	Gas range None	Gas range Energy Star?
Separate freezer	Separate freezer One	Separate freezer Two	Separate freezer Three or more	Separate freezer None	Separate freezer Energy Star?
Dishwasher	Dishwasher One	Dishwasher Two	Dishwasher Three or more	Dishwasher None	Dishwasher Energy Star?
Microwave oven	Microwave oven One	Microwave oven Two	Microwave oven Three or more	Microwave oven None	Microwave oven Energy Star?
Clothes washer	Clothes washer One	Clothes washer Two	Clothes washer Three or more	Clothes washer None	Clothes washer Energy Star?
Electric clothes dryer	Electric clothes dryer One	Electric clothes dryer Two	Electric clothes dryer Three or more	Electric clothes dryer None	Electric clothes dryer Energy Star?
Gas clothes dryer	Gas clothes dryer One	Gas clothes dryer Two	Gas clothes dryer Three or more	Gas clothes dryer None	Gas clothes dryer Energy Star?
Television 32" or smaller	Television 32" or smaller One	Television 32" or smaller Two	Television 32" or smaller Three or more	Television 32" or smaller None	Television 32" or smaller Energy Star?
Television larger than 32"	Television larger than 32" One	Television larger than 32" Two	Television larger than 32" Three or more	Television larger than 32" None	Television larger than 32" Energy Star?
Computer	Computer One	Computer Two	Computer Three or more	Computer None	Computer Energy Star?
Video/audio equipment	Video/audio equipment One	Video/audio equipment Two	Video/audio equipment Three or more	Video/audio equipment None	Video/audio equipment Energy Star?
Electric water softener	Electric water softener One	Electric water softener Two	Electric water softener Three or more	Electric water softener None	Electric water softener Energy Star?
Air exchanger	Air exchanger One	Air exchanger Two	Air exchanger Three or more	Air exchanger None	Air exchanger Energy Star?
Water distiller	Water distiller One	Water distiller Two	Water distiller Three or more	Water distiller None	Water distiller Energy Star?
Dehumidifier	Dehumidifier One	Dehumidifier Two	Dehumidifier Three or more	Dehumidifier None	Dehumidifier Energy Star?
Hot tub/Spa/Sauna	Hot tub/Spa/Sauna One	Hot tub/Spa/Sauna Two	Hot tub/Spa/Sauna Three or more	Hot tub/Spa/Sauna None	Hot tub/Spa/Sauna Energy Star?
Refrigerator	Refrigerator One	Refrigerator Two	Refrigerator Three or more	Refrigerator None	Refrigerator Energy Star?
Room Air Conditioner	Room Air Conditioner One	Room Air Conditioner Two	Room Air Conditioner Three or more	Room Air Conditioner None	Room Air Conditioner Energy Star?

Thank you for completing this application.

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* 1. Applicant Information

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* 2. Do you currently recycle?

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* 3. Water Supplier

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* 4. Electric Utility

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* 5. Gas/Propane Supplier

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* 7. How would you describe the residence?

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* 8. When was the residence built?

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* 9. Do you own or rent this home?

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* 10. What is the approximate heated area of your residence? (Mark only one. Multiply the house length (in feet) by the house width (in feet) by the number of levels. Do not include the garage or unfinished areas.)

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* 11. How many people live at your residence for each age group?

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* 12. Do you operate a business from your home?

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* 13. If you answered yes to Question 12, please indicate the type of business.

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* 14. In the past two years, have you taken any of the following energy saving measures? (Check the ones which apply.)

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* 15. In the past two years, how many CFL light bulbs have you installed in your home?

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* 16. In the next 3 years, do you plan to remodel your home to make it more energy efficient?

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* 17. What type of fuel is used by the primary heating system for this residence? (Choose only one.)

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* 18. What is the approximate age of your home's primary heating system?

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* 19. Does this home have a central air conditioner?

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* 20. Please indicate the approximate age of the air conditioning unit.

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* 21. Which one of the following best describes the primary water heater for this residence? (Mark all that apply.)

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* 22. What is the age of the water heater unit?

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* 23. Please indicate which of the following household items are used in this residence. Mark the number of units in use for each device. If any of the items are rated as "Energy Star," please mark the last column.

* 10. What is the approximate heated area of your residence?
(Mark only one. Multiply the house length (in feet) by the house width (in feet) by the number of levels. Do not include the garage or unfinished areas.)