Annex А

To Energy Management System Manual

Form EnSR 4.4.3-01
Register of energy review and its impact assessment for 20__
Approved:
Management Representative

(name) (signature) (date

)

products in the reporting

Equipment (Installation
year) /operation type*

Personnel who influence

Consumed energy type
Structural subdivision

consumed during the

Total manufactured
energy consumption

GJ conversion factor
Energy type

Quantity of energy

reporting period
registration Total (The sum of all
types of consumed
Date

(Calculation Estimated /
# energy per unit) per

measurementDirect
day/ month/ year
(GJ)

period (t)
1 2 3 4 5 6 7 8 9 10 11 12

Total for the Variable energy consumption for the month

13
structural (GJ):
subdivision for Constant energy consumption (electricity,
14
the month steam, heat, etc.) for the month (GJ):
Total for the Variable energy consumption for the year
15
structural (GJ):
subdivision for Constant energy consumption (electricity,
16
the year steam, heat, etc.) for the year (GJ):
* - represent repairs, etc.

Structural subdivision leader Date Energy management team of structural subdivision (Name/ Date
(Name/ Signature) Signature)

Explanation on completing the Register of energy review and its impact assessment:
Column
# 1
Structural subdivision
Equipment (Installation
year) /operation type*
Date
Consumed energy type
Personnel who
influence energy
consumption
Quantity of energy
consumed during the
reporting period
Direct measurement
Estimated /
(Calculation formula)
GJ conversion factor
Total (The sum of all types
of consumed energy per
unit) per day/ month/
year (GJ)
Total manufactured
products in the
reporting period (t)
Variable energy
consumption for the
month (GJ):
Constant energy
consumption (electricity,
steam, heat, etc.) for the
month (GJ):
Variable energy
consumption for the year
(GJ):
Constant energy
consumption (electricity,
steam, heat, etc.) for the
year (GJ):
Annex А (Continue)
To Energy Management System Manual
# What to enter?
Index number
2 Name of the structural subdivision, site or department
3 Name of the equipment unit according to the passport with the year of
installation
4 Actual date of collection of information
5 Information on the types of energy consumed by the equipment (electrical
energy, water, etc.),
6 Information on the position of the employee responsible for consuming the
type of energy
7 Information on the actual consumption of a particular type of energy daily
8 The name and number of the measuring equipment that measures this type of
energy
9 Information on the calculation formula used by the energy management team
when calculating this type of energy
1 Information is entered according to the table of energy (fuel) type conversion
0 factors into GJ
1  the sum of all types of energy consumed per unit per day,
1  after the last day of the month - the sum of all types of consumed energy
per unit per month,
 after the last day of the year - the sum of all types of consumed energy
per unit for the year,
1 Data on the actual production on this equipment:
2  per day,
 after the last day of the month - in the past month,
 after the last day of the year - for the year
1 Information on the actual amount of energy consumed in (GJ) relevant to the
3 produced products
1 Information on the actual amount of energy consumed in (GJ) not relevant to
4 the produced products
1 Information on the actual amount of energy consumed for the year in (GJ)
5 relevant to the produced products
1 Information on the actual amount of energy consumed for the year in (GJ) not
6 relevant to the produced products,
 Annex B
To Energy Management System Manual
Form EnSR 4.4.3-02

Register of Significant Energy Consumers

Name of Quantity of
Structural Personnel influencing
# equipment / type energy consumed
subdivision energy consumption
of work per year

Structural subdivision leader Date Energy management team of structural Date

(Name/ Signature) subdivision (Name/ Signature)

Annex C
T0 Energy Management System Manual
Form EnSR 4.4.4-01

Energy Consumption Data

Name of equipment [equipment]

Manufactured The sum of all types of energy consumed by

# Date
products quantity the unit per type of work per day (GJ)
 Annex D
To Energy Management System Manual

Energy baseline example

Energy consumption

Area of points worse Energy baseline

than average

Area of points better than

average

Manufactured products quantity