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THERMAL PERFORMANCE ASSESSMENTS
BASIX DATA INPUT FORM
BASIX DATA INPUT FORM
Your Details:
First Name *:
Last Name:
Contact Phone:
Your Email *:
Project Details:
Lot No:
Street Address:
Suburb & Postcode:
Name of council:
Deposited Plan No:
Water Details:
Water tank size (litres):
Prefered roof to tank area (m2):
Tank plumbed to toilets:
Not sure
Yes
No
Tank plumbed to laundry:
Not sure
Yes
No
Kitchen tap rating:
Not sure
3 star
4 star
5 star
6 star
Bathroom tap rating:
Not sure
3 star
4 star
5 star
6 star
Toilet tap rating:
Not sure
3 star
4 star
5 star
Waterless
Shower rating:
Not sure
4.5 - 6L
6 - 7.5L
7.5 - 9L
Energy Details:
Hot Water System:
Not sure
Solar Gas Boosted
Solar Electric Boosted
Electric Heat Pump
Gas Instant
Gas Storage
Wood Combustion
Electric Instant
Electric Storage
System performance:
Not sure
1 star
1.5 star
2 star
2.5 star
3 star
3.5 star
4 star
4.5 star
5 star
5.5 star
6 star
Less than 15 RECs
15-20 RECs
21-25 RECs
26-30 RECs
31-35 RECs
36-40 RECs
41-45 RECs
More than 45 RECs
Cooling system ‐ living areas:
Not sure
No active system
Ceiling fans
Evaporative air-con
Ceiling fans & 1 phase
Ceiling fans & 3 phase
1 phase air-con
3 phase air-con
Air-conditioning ducting only
System performance:
Not sure
Not rated
1 star
1.5 star
2 star
2.5 star
3 star
3.5 star
4 star
4.5 star
5 star
5.5 star
6 star
EER less than 2.5
EER 2.5-3.0
EER 3.0-3.5
EER 3.5-4.0
EER more than 4.0
Cooling system ‐ bedrooms:
Not sure
No active system
Ceiling fans
Evaporative air-con
Ceiling fans & 1 phase
Ceiling fans & 3 phase
1 phase air-con
3 phase air-con
Air-conditioning ducting only
System performance:
Not sure
Not rated
1 star
1.5 star
2 star
2.5 star
3 star
3.5 star
4 star
4.5 star
5 star
5.5 star
6 star
EER less than 2.5
EER 2.5-3.0
EER 3.0-3.5
EER 3.5-4.0
EER more than 4.0
Heating system ‐ living areas:
Not sure
No active system
Gas fixed flue heating
Gas hydronic
1 phase heating
3 phase heating
Electric floor heating
Wood heater
Air-conditioning ducting only
System performance:
Not sure
Not rated
1 star
1.5 star
2 star
2.5 star
3 star
3.5 star
4 star
4.5 star
5 star
5.5 star
6 star
EER less than 2.5
EER 2.5-3.0
EER 3.0-3.5
EER 3.5-4.0
EER more than 4.0
Heating system ‐ bedrooms:
Not sure
No active system
Gas fixed flue heating
Gas hydronic
1 phase heating
3 phase heating
Electric floor heating
Wood heater
Air-conditioning ducting only
System performance:
Not sure
Not rated
1 star
1.5 star
2 star
2.5 star
3 star
3.5 star
4 star
4.5 star
5 star
5.5 star
6 star
EER less than 2.5
EER 2.5-3.0
EER 3.0-3.5
EER 3.5-4.0
EER more than 4.0
Is heating/cooling day/night zoned:
Not sure
Yes
No
Cooktop/oven type:
Not sure
Gas cooktop & gas oven
Gas cooktop & electric oven
Electric cooktop & electric oven
Wood stove
Induction cooktop & electric oven
Vented fridge space:
Not sure
Yes
No
Outdoor clothes line:
Not sure
Yes
No
Indoor or sheltered clothes line:
Not sure
Yes
No
Comments:
Enter code *:
Contacts us
PO BOX 239
BEACONSFIELD, 3807
Tel: (03) 8786 7753
Mob: 0425 871 060
Email:
kellie@2dr.net.au
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