EMGS 3-Star Application
Energy Management Gold Standard
Assessment Level
1
2
3
Star Rating
Site Name
(Example: Malaysian Green Technology and Climate Change Corporation)
Type of Location
Please Select
Commercial
Industry
Type of Area Assessed
(Example: Healthcare Facilities - Minor Specialist, Major Specialist, General, District or Special Institute, Education Facilities, Office Building, Laboratory, Data Centre, Others)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Director/President/CEO/MD Name
First Name
Last Name
Director/President/CEO/MD Email
example@example.com
CEM Name
First Name
Last Name
CEM Registration No.
CEM Email
example@example.com
CEM Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Representative Name
First Name
Last Name
Organization Representative Email
example@example.com
Organization Representative Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Have your organization been registered or certified for any standard or system?
(Example: ISO50001, OHSAS, etc.)
Monthly Energy Consumption (kWh)
Please state the baseline you employed for energy performance measurement
Please state year & total energy consumption (kWh) for baseline.
Please state annualized energy consumption for current year
Please state year & annualized energy consumption (kWh)
Energy performance/Saving declared during 2-Star assessment (%)
(% of energy saving achieved during 2-Star assessment)
Current energy performance/Saving compared to baseline (%)
(% of current energy saving compared to baseline)
EMGS Preparation Checklist for 3-Star
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Data Form for Applicants
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When would you recommend the date of the assessment?
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Day
-
Month
Year
Start Date
Remarks
Note: Please specify if there any additional factors influences energy performance (Example: static factors, etc.)
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