Site Assessment Form


  1. The names and descriptions used here will become the project titles on your proposals, photometrics, etc..
  2. For multiple spaces even within a single facility, use multiple forms.
  3. The x and y facility dimensions must relate to the same x and y orientation as the luminaire layout.
  4. The more information you provide, the more we can help.

    Prepared By*



    Space Description*

    Address or Location*


    Select One*

    New ConstructionRetrofitOther

    Space Dimensions*

    by x (ceiling height) in ft.

    Layout Dimensions*

    Use Existing LayoutLayout is flexibleSuggested X by Y by Z layout

    For Existing

    by by (bottom of luminaire) in ft.

    Existing layout is

    Centered on SpaceOffset by and

    Layout Comments

    Mounting Method

    Pipe DropFlush to J-BoxCable/ChainSuspended (T-bar) CeilingOther

    Facility Finishes (used in photometric reflectances; skip this if area/site lighting)




    Other influences (i.e. racks, machinery)


    Existing Luminaire Count

    Existing Luminaire Technology

    Watts per Bulb

    # Bulbs/Luminaire

    Existing Lighting Level

    at above floor.

    Natural light (through windows, skylights, etc.) isis not influencing existing lighting level measurements.


    Desired Lighting Level

    at above floor.

    Desired Color Temperature  5650K4100KOther

    Photocell and/or Occupancy Sensors may apply  YesNo

    Other Controls desired

    Input Voltage

    120-277 V347-480 V

    Cost Savings Study information (skip this section if you wish to do your own cost analysis)

    Existing kWh rate USD $ or in other currency

    Average 5 year rate to use in cost savings study USD $ other currency

    Luminaire Unit Price USD $ other currency

    Average Daily Hours of Lighting Operation

    Customer is interested in leasing

    YesNo if Yes, lease term(s) to consider (months): 24364860

    Utility Company Rebates Available


    Customer is a taxpayer and EPAct federal deduction ($0.60/ft2) should be considered YesNo

    If yes above, federal income tax bracket to use %

    Additional Comments