Manufacturing and Energy Division, Energy Section
Establishment Number
Contact Information
Correct contact information if necessary
Confidential when completed
Reporting Period January – December 2011
Purpose of the survey
The purpose of this survey is to obtain information on the demand for energy in Canada. This information serves as an important indicator of Canadian economic performance and is used by all levels of government in establishing informed policies in the energy area. The private sector also uses this information in the corporate decision-making process.
Authority
This survey is conducted under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S19. Completion of this questionnaire is a legal requirement under this Act.
Confidentiality
Statistics Canada is prohibited by law from releasing any information from this survey which would identify any person, business, or organization, or any information related to them, unless consent has been given by the respondent or as permitted by the Statistics Act. The confidentiality provisions of the Statistics Act are not affected by either the Access to Information Act or any other legislation. Information from this survey will be used for statistical purposes only and will be published in aggregate form only.
Data sharing agreements
To reduce respondent burden, Statistics Canada has entered into data sharing agreements with provincial and territorial statistical agencies and other government organizations, who must keep the data confidential and use them only for statistical purposes. For further information on data sharing, please see the enclosed reporting guide.
Data Linkage
To enhance the data from this survey and for the purpose of statistical studies, Statistical Canada may combine it with information from other surveys or from administrative sources.
Retention
Please keep a copy of the completed questionnaire with your secure records until March 31, 2014.
Completion and return
Complete and return within 20 days after the receipt of this questionnaire. If you require assistance in the completion of the questionnaire, contact tool free 1-800-461-1662 or by fax 1-888-883-7999.
Statistics Canada advises you that there could be a risk of disclosure during the facsimile or other electronic transmission. However, upon receipt of your information, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the authority if the Statistics Act.
Who should complete this questionnaire?
An engineer, a production manager, an operation manager or someone knowledgeable about the energy consumption and production process of this enterprise should complete this questionnaire.
Certification
I certify that the information contained herein is complete and correct to the best of my knowledge.
Signature:
Date (DD/MM/YYYY):
Name of signer (please print):
Official position of signer:
Name of contact for further information:
E-mail address:
Fax:
Telephone and Extension:
Units of Measure
Instructions: The following is a list of possible units of measure. For each energy form, select the unit of measurement which you are reporting in and enter the corresponding abbreviation provided (see below in brackets), in the column titled Unit of Measure
- 100 Cubic feet (CCF)
- 33- pound Cylinder (33lb cyl)
- Barrel (Bbl)
- Cubic Foot (cf)
- Cubic Meter (m)
- Gallon: Imperial Gallon (gal Imp)
- Gallon: U.S. Gallon (gal US)
- Gigajoule (GJ)
- Kilogram (kg)
- Kilowatt-hour (kWh)
- Litre (L)
- Long Ton (It)
- Megawatt-hour (MWh)
- Metric Tonne (MT)
- Million British thermal units (MMBtu)
- Pound (lb)
- Short Ton (st)
- Thousands of cubic meters (10M)
- Other (specify) (OTH)
Type of energy commodity | Unit of measure | Amount consumed | |||
---|---|---|---|---|---|
Please report only the consumed portion | As fuel | To produce steam for sale | To produce electricity | For non-energy use | |
Electricity | |||||
Purchased | |||||
Self-generated | |||||
Natural gas | |||||
Propane | |||||
Middle distillates | |||||
Diesel (on-site only) | |||||
Light fuel oil | |||||
Kerosene and other middle distillates | |||||
Heavy fuel oil | |||||
Canadian | |||||
Foreign | |||||
Wood and wood waste | |||||
Spent pulping liquor | |||||
Refuse (specify type) |
|||||
Steam | |||||
Self-generated | |||||
Purchased |
Did you consume any coal or coal by-products (such as bituminous coal, lignite, anthracite, coal coke and coal by-products)? No > Go to Section 3 |
|||||
Type of energy commodity | Unit of measure | Amount consumed | |||
---|---|---|---|---|---|
Please report only the consumed portion / Veuillez déclarer seulement la partie consommée | As fuel | To produce steam for sale | To produce electricity | For non-energy use | |
Canadian coal | |||||
Bituminous | |||||
Sub-bituminous | |||||
Lignite | |||||
Foreign coal | |||||
Bituminous | |||||
Sub-bituminous | |||||
Anthracite | |||||
Coal coke | |||||
Canadian | |||||
Foreign | |||||
Coal by-products | |||||
Coal tar | |||||
Light coal oil | |||||
Coke oven gas |
Did you consume any petroleum coke, refinery fuel gas, coke on catalyst, bitumen emulsion, ethane, butane, naphtha, by-product gas or flared gas? No > Go to Section 4 |
|||||
Type of energy commodity | Unit of measure | Amount consumed | |||
---|---|---|---|---|---|
Please report only the consumed portion | As fuel | To produce steam for sale | To produce electricity | For non-energy use | |
Petroleum coke | |||||
Canadian | |||||
Foreign | |||||
Refinery fuel gas | |||||
Coke on catalyst | |||||
Bitumen emulsion (orimulsion) | |||||
Ethane | |||||
Butane | |||||
Naphtha | |||||
By-product gas | |||||
Flared gas |
Did you consume any other type of fuel or energy not listed above? No > Go to Section 5 |
|||||
Type of energy commodity | Unit of measure | Amount consumed | |||
---|---|---|---|---|---|
Please report only the consumed portion | As fuel | To produce steam for sale | To produce electricity | For non-energy use | |
Specify type, quantity consumed and unit of measure |
Statistics Canada compares responses to this questionnaire with those from previous years. In order to reduce the necessity for further inquiries, please check the boxes that best describe the reasons for significant changes in your energy consumption from the previous year, and provide an explanation. |
---|
New contract or loss of contract |
Organizational change |
Plant expansion or contraction |
Change in product line |
Fuel switch |
Fuel price changes |
Technology changes |
Process changes |
Awareness of energy efficiency |
Other (specify) |
Did you sell steam to external clients? No > Thank you for your cooperation |
---|
Residential (include apartment buildings) |
Agriculture |
Paper manufacturing |
Chemical manufacturing |
All other manufacturing |
Public administration |
Commercial and other institutional |
Total |
Thank you for your cooperation