VENTILATION SYSTEM EVALUATION FORM
Please complete this form in accordance with instructions in the accompanying guidance document
Part 1.0 General Inf r ation
')ate of eva1uati0n Jo 3 I Building contact name and phone:
Evaluation team (list name ana affiliation):
(Environmental professional)
`moo _ f c-'- uS' iz (HVACprofessional)
;Milding address: Type of Facility (check all that apply):
w A J2 .T VResidential
~,,-1 7o (L Multi-use
Other (describe)
Date of construction:
Number of residential units: Number of floors:
Prior inspection report/maintenance records available for review?:
Other comments
Ventilation system types (check all that apply and indicate total no. of units)
I Central ventilation system Mechanical exhaust system
Est. no. of units Est. no. of units 1
Mechanical make-up air system Passive shaft/duct
Est. no. of units Est, no. of units
Other (describe)
I certify that to the best of my knowledge, 'the information and observations recorded on this form
including all attachmentsyare a true and accurate representation of site conditions.
Ventil io v to AC) Evaluator Date
21y 03
Pa isual nspection Forms
Use the attached forms to document visual inspections. Complete the forms in accordance with
instructions in the accompanying guidance document.
NYC-WTC 000113713
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000113713Source: NYC Law Department, mirrored locally
An HVAC inspection report from Cole Consulting Corporation dated February 13, 2003, recommending cleaning of units at 275 Greenwich Street due to WTC dust.
An HVAC inspection report from Cole Consulting Corporation dated February 13, 2003, recommending cleaning of units at 295 Greenwich Street due to WTC dust.
An HVAC inspection report from Cole Consulting Corporation dated February 13, 2003, recommending cleaning of units at 275 Greenwich Street due to WTC dust.
License agreement between NYC DEP and a landowner dated October 2002 regarding the removal of foreign material from building exteriors at 130 Water Street.