StepWise Application

Please fill out and submit the application form. The answers are used to determine program eligibility and place your facility in the assessment queue.

If there are multiple buildings or locations for which you are interested in having an energy assessment completed, please include details in the ‘Brief Description of Facility’ section or submit an additional application for each facility of interest. 

We will be in contact shortly with further assessment information.

DEU Application

Date *

Company name *

Address *

Address

Address

Address

City

City

State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia 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

State/Province

Zip/Postal

Zip/Postal

Contact person *

Phone *

Email *

Preferred Method of Contact: *

Email

Phone

Are you a current Dominion Energy Utah customer or located within the Dominion Energy Utah service area? *

Yes

No

As a Dominion customer, what rate schedule are you on? *

General Service (GS)

Fixed Service (FS)

Transport Service (TS)

Other

Please enter the meter number or numbers for this location:

Was your annual natural gas usage (most recent 12 months) greater than 2,500 Dth? *

Yes

No

Annual Natural Gas Usage (Most recent 12 months):

Annual Natural Gas Costs (Most recent 12 months):

Annual Electric Usage (Most recent 12 months):

Annual Electric Costs (Most recent 12 months):

Facility Type: *

Office

School

Retail

Inpatient/Outpatient Healthcare

Multi-family Residential

Lodging

Manufacturing

Restaurant

Public/Institutional

Agriculture Producer

OtherOther

Brief Description of Facility and/or Operations: *

If Available:

Gross Floor Area (SF):

Number of Floors/Units:

Building Age (year of construction or age):

Natural Gas Fired Equipment

Please indicate which of the following are used at your facility:

Boilers

# of hot water boilers:

# of steam boilers:

Indicate Boiler Use(s):

Space/comfort heating

Process heating

Domestic hot water

Pools/spa

OtherOther

Largest boiler size (Btu/hr):

Gas furnace or oven

Hanging gas-unit heater

Direct/indirect fired air-handling units

OtherOther

By Submitting an Application, does the facility further agree that if selected for an energy assessment under this program:

To participate in reasonable follow-up implementation reviews: *

Yes

No

To permit to have the company name listed as a program participant, and if selected for a project to be brought to the State of Utah Public Service Commission to request an incentive, have the type of project and the amount of Sustainable Transportation and Energy Program (STEP) funds requested be identified in the public filing: *

Yes

No

To affirm that the facility has not had an energy assessment performed by Rocky Mountain Power or Purchaser or any other comparable public or ratepayer-funded entity in the past (5) years: *

Yes

No

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