Solar Site Survey Checklist
Date
First Name
Last Name
Street Address
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
Phone Number
Cell Phone Number:
Email Address
Request For:
Domestic Hot Water
Space Heating
Pool/Spa Heating
Commercial Hot Water
Other
Installation Area
Flat Roof
Ground Mount
Wall Mount
Sloped Roof
Roof Construction
Asphalt
Metal
Tar and Gravel
Rubber
Other
Shading
None
Partial
Large Trees/Buildings
Age of Home:
Domestic Hot Water Load
Please complete the questions
Number of people in home?
Number of bathrooms?
Hot water consumption (gallons)?
Multi-family: Number of apartments?
Dear Valued Customer:
Existing Heating System:
Hot water
Warm Air
Steam
Electric
Hydro Air
Other
Heat Distribution:
Radiant Floor
Baseboard
Radiators
Forced Air
Other
Existing Hot Water:
Oil
Gas
Electric
Indirect
Tank Size:
Pool Heating:
Complete Pool Info Below
Dimension (length/width)
Average Depth
Pool Cover (yes/no)
Desired Temperature
Hours Pool is Covered
Gallons if known
Solar Cover Use
Thank you for taking the time to complete our Solar Site Survey Checklist. A representative from our company will be contacting you soon.
Sincerely,
Country Oil Inc.
Country Oil Inc., 540 Northfield Road, Bernardston, MA 01337 1-800-327-9992
Powered by
FormSite.com