Building Asset Management System Critical System Form
AC Package Unit
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Condenser Type:
Air CooledWater CooledOther
Unit Heating Type:
ElectricGasHydronicLPG ButaneNatural GasOilPropaneRadiantNo HeatOther
Location:
Computer RoomOfficeResidenceShopOther
BTU:
kW: Tonnage:
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Air Handling Unit
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Unit Type:
Single ZoneMulti ZoneVariable Air VolumeOther
Heat System Type:
ElectricGasHydronicLPG ButaneNatural GasOilPropaneRadiantNo HeatOther
Cooling Coils:
DXChilled WaterNoneOther
Heating Coils:
ElectricHeat PumpHot WaterSteamNoneOther
CFM: BTU/MBH: Tonnage:
Horsepower: kW: Voltage:
Amperage: Motor Frame Size: RPM:
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Boiler
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Boiler Type:
Cast IronCast Iron Sect.Pulse CondensingResidentialScotch MarineSteelWater Tube PackOther
Fuel Type:
ElectricFuel OilNatural GasLPG/PropaneOther
Boiler Gross Output Rating (Specify BTU or MBH): Capacity (lbs/hr):
GPM: Boiler Heat Transfer Medium:
Hot WaterGlycolSteamOther
Pressure (PSI): Boiler Efficiency Rating:
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Chiller
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Tonnage: Chiller Power Source:
Alternative ElectricFuel Oil GasolineKerosene Natural GasOther PropaneSteam
Chiller Cooled Type:
Air CooledWater CooledOther
Chiller Type:
Absorption Centrifugal ReciprocatingScrew Scroll OtherNone
Coolant Type:
BrineEthyleneGlycolPropylene GlycolWaterOther
Water Treatment:
YesNo
Amperage: RPM:
Motor Frame Size: Motor Housing Type:
Explosion ProofStandardSubmersibleOther
Phase:
1 Phase3 PhaseOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Condenser Unit
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Condenser Type:
Air CooledWater CooledOther
Tonnage:
Building Asset Management System Critical System Form
Exterior Windows
* Please use a separate form for each type and size window
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Type:
AwningCasementDouble HungFixedJalousieSingle HungSkylightSlidingOther
Material:
Alum Frame StormAlum Frame ScreenAluminumGlass BlockLouver (Alum)Louver (Steel)Louver (Wood)Metal GratingMetal Wire MeshShutter (Alum)Shutter (Steel)Shutter (Wood)SteelSteel Frame StormSteel Frame ScreenVinyl Clad WoodWindow WallWoodWood Frame ScreenWood Frame StormOther
Height: Width:
Window Operating:
ElectricFixedOperatingOther
Window Insulated Glass:
InsulatedNon-insulated
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Exterior Finish
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Exterior Wall Material:
AdobeAluminum SidingAsphalt ShinglesBrickCementClapboardCMUCompositeConcreteCorrugated MetalFiberglass Exterior Wall PanelGlass BlockInsulated Steel Sandwich PanelLogMasonryMetalPlasticStoneOther
Exterior Wall Finish:
CoatedGold LeafLime PlasterNaturalPaintPaint Oil BasePaint Water BasePatinaSealantStainStain Oil BaseStain Water BaseVinylNo FinishOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Exterior Door
*Please us a separate form for each type and size door
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Door Type:
Emergency EgressGarageHangerOverheadRevolvingScreenSlidingStandardStormSwingingOther
Fire Rated:
YesNo
Door Material:
AluminumGlassScreenSteelWoodOther
Frame Material:
SteelMetalWoodAluminum
Door Core:
HollowSolid
Height: Width:Door Automated:
YesNo
Closing Device:
Door CloserSpring HingeNoneOther
Door Single or Double:
SingleDouble
Door Painted:
YesNo
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Electrical Panel
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Electric Meter Number: Electric Service Provider:
EversourceUnited IlluminatingSolarOther
AMPs: Voltage:
12120/208120/240242400/4160277/48036Other
Number of Poles: Underground Service Connection:
YesNo
Transformers:
YesNo
Emergency/Backup Power:
YesNo
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Fan
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Type:
Axial CentrifugalPropeller UtilityVehicle PropaneOther
Use:
ExhaustRecirculatingSupplyOther
CFM: Extraction Blower HP:Extraction Blower Vacuum (IN):
Horsepower: Voltage: RPM: Amperage:
Motor Frame Size: Pressure (PSI): Phase:
1 Phase3 PhaseOther
Motor Housing Type:
Explosion ProofStandardSubmersibleOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Foundation
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Foundation Sub Material:
BituminousConcreteEpoxy OverlayGravelMasonryMetalPaver BlockPlasticRiprapSoilSteel PilingWoodNoneNot ApplicableOther
Foundation Surface Material:
BituminousConcreteEpoxy OverlayGravelIntegral ConcreteLow Slump ConcreteMasonryMetalModified ConcreteMonolithic ConcretePaver BlockPlasticRiprapSoilSteel PilingWoodNoneNot ApplicableOther
Foundation Type:
WallsPiersSlab on GradeOther
Length: Width:
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Furnace
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Furnace Input (Specify MBH or BTU): Furnace Efficiency Rating:
Furnace Cooling Coils:
YesNo
CFM: Cooling Coil Tonnage:
Furnace Fuel Type:
BiofuelCoalDieselElectricFuel OilGasolineLPG/PropaneMulti-FuelNatural GasOil/GasolineWoodOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Generator
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Voltage:
12120/208120/240242400/4160277/48036Other
kW:
Fuel Type:
BiofuelCoalDieselElectricFuel OilGasolineLPG/PropaneMulti-FuelNatural GasOil/GasolineWoodOther
KVA Rating: Generator PF Rating:
Phase:
1 Phase3 PhaseOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form Liquid and Gas Storage Tank
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Tank Contents:
ChemicalGaseous FuelLiquid FuelOilWastewaterWaterOther
Tank Material:
AluminumCMUConcreteFiberglassPlasticPolyethylenePolypropyleneStainless SteelSteelWoodOther
Tank Capacity: Fuel Type:
CoalElectricGasMulti-FuelNatural GasOilOil/GasPropaneWoodOther
Tank Function:
Hydro-pneumaticPressureSepticStorageTransferTreatmentVacuumOther
Tank Location:
Above GroundElevatedInteriorUnder GroundOther
Tank Leak Protection:
Double WalledSingle WalledNoneOther
Tank Insulation:
Ceramic Fiber BlanketFiberglass BlanketMineral WoolPolyurethane FoamRigid FiberglassNot InsulatedOther
Tank Lining:
EpoxyGalvanizedGlassPaintUnlinedOther
Tank Baffled:
YesNo
Tank Cathodic Protection:
ActivePassiveNone
Tank Alarmed:
YesNo
Date Last Inspected by Regulator: Monitoring System:
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Water Heater
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Tank Contents:
ChemicalGaseous FuelLiquid FuelOilWastewaterWaterOther
Tank Material:
AluminumCMUConcreteFiberglassPlasticPolyethylenePolypropyleneStainless SteelSteelWoodOther
Tank Capacity: Fuel Type:
CoalElectricGasMulti-FuelNatural GasOilOil/GasPropaneWoodOther
Tank Insulation:
Ceramic Fiber BlanketFiberglass BlanketMineral WoolPolyurethane FoamRigid FiberglassNot InsulatedOther
Tank Lining:
EpoxyGalvanizedGlassPaintUnlinedOther
Building Asset Management System Critical System Form
HVAC/Heat Pump
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:
Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Unit Type:
Geothermal Heat Pump Straight AC Other
Condenser Unit Cooling Type:
Air Cooled Water Cooled Other
Split System Unit SEER: Heating Capacity MBH: Split System Cool Capacity Tonnage:
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560.
If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Roof Surface
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Roof Surface Material:
AsbestosAsphaltBuilt-UpClay TileCompositeConcreteCopperElast Roof CoatFiberglassGlass PanelInverted MembraneLead-Coated CopperMetal PanelMod BitumPlasticPoly Spray-OnRoll RoofingShingle-ArchitectShingle-AsphaltShingle-CedarSingle MembraneSlate TileStand Seam MetalTarTar PaperTin/TarWoodWood Shake RoofNoneOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Solar/Alternative Energy
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Energy Equipment Unit of Measure:
Amp-HourAmpsHertzkAkVkVARSingle PhaseThree PhaseVoltsWattsOther
PV Length: PV Width:PV Peak Power at STC:
Number of Panels: Battery Type:
Lead AcidNickel CadmiumOther
Connected to Power Grid:
YesNo
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Transformer
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Type:
DryWet
Transformer Primary Voltage: Transformer Secondary Voltage:
KVA Rating: Function:
AutotransformerDistributionInstrumentPowerOther
Style:
Pad MountPole MountN/AOther
Phase:
1 Phase3 PhaseOther
Location:
IndoorOutdoorUndergroundOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Unit Heater
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Type:
ElectricGasHot WaterLPG ButaneLPG PropaneNatural GasSteamOther
Capacity (Specify BTU or MBH): CFM:
kW: Amperage: Voltage:
12120/208120/240242400/4160277/48036Other
Phase:
1 Phase3 PhaseOther
Mounting:
Anti-vibrationBase/Pad MountCeilingClose CoupledFlange MountedFoot MountedHorizontal MountIn-line MountRoof MountSuspendedVertical MountWall MountOther
Building Asset Management System Critical System Form
Water Supply (Well)
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
PWSID:Seasonal Operational Period Start Date:
Seasonal Operational Period End Date:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price:Replacement Cost: Latitude: Longitude:
Date Well Completed: Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Type:
GasMonitorTestWaterOther
Use:
Cathodic ProtectionDewateringExtractionGeotechnical ExplorationHeat ExchangeInjectionRemediationSpargingVapor ExtractionWater DomesticWater IndustrialWater IrrigationOther
Well Drilling Method:
Air/Hammer DrillBucket AugerCable ToolDrivenDual-Wall Reverse Circ.Hand DugJettedReverse CirculationRotaryOther
Depth (Ft.):Well Casing Diameter (In.):
Well Water Level Static:
Well Water Level Drawdown:
Well Water Yield (GPM):
Well Casing Depth: Well Casing Material:
SteelABSConcreteCPVCPVCPEX Cross LinkOther
Screened:
YesNoPerforated
Well Treatment:
YesNo
Well Sanitary Seal:
BentoniteConcreteFilter PackNoneOther
Well Production Meter:
YesNo
Public Water Supply:
YesNo
Water Treatment:
YesNo
Raw Water Sample Tap:
YesNo
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.
Building Asset Management System Critical System Form
Pump
Site ID/Facility ID: Site Description/Facility Name:
OPM Building Number: Building Description/Name:
Manufacturer: Model Number:
Serial Number: Quantity:Unit of Measure (Quantity):
Purchase Price: Replacement Cost:
Installation Date:Estimated Design Life: Estimated Remaining Life:
Replacement Date: Warrantee Period:
Type:
HandpumpJetSubmersibleVertical TurbineWellOther
Pump Depth:
Horsepower: Pumping Capacity (GPM):
Voltage: Mounting:
Anti-VibrationBase/Pad MountCeilingClose CoupledFlange MountedFoot MountedHorizontal MountIn-line MountRoof MountSuspendedVertical MountWall MountOther
Once form has been completed, please submit it to [email protected] or fax to 860-344-2560. If you have any questions or require building related information please contact Andrea Lane at 860-424-4118 or David Cooley at 860-424-4120.