Chain of custody letter for 333 Rector Place HVAC samples

NYC 9/11 Public Portal Document y r lv i s i,A 1! MN S Y S t -EI%l EVALUATION FORM Part 1.0 General Information Date of Evaluation: ltillo2s(02. J Building contact name and phone: AVID ,AN 2s2 -9L --143At tK Role C.'o H PAPiY Evaluation Team (list name and affiliation): E A A - T t:`N t C (Environmental Professional) f of /.- uapy g (HVAC/Electrical Professional) (Sheet Metal Professional) Building Address: Type of Facility (check all that apply): jj~ Residential Multi-use Other (describe) Number of residential units: 2 Number of floors: HVAC System Types (check all that apply) Unit ventilator (single residence unit) p Wall/window AC unit (single residence unit) fl Fan coil unit (single residence unit) Central ventilation system Heat pump unit (single residence unit) gj Passive shaft/duct Other (describe) Location of outside air intake: Outside air intake accessible for inspection Y N (explain) Part 2.0 Checklists 2.1 Ventilators, wall air conditioning units and window air conditioning units in common spaces Ventilation System Identification: ,A V S T AID/ Location: ?3AsEyme"! AWA SE*VE-5 30V&#`te4J7 Access adequate for inspection of components: cs Dust/Dirt / Debris I Suspect WTC-Related Dust System Component Substrate Material (sheet metal wrapped) Light Heavy System Components (sheet metal lined) None (<1/16 inch (2 1/16 inch Present? Estimate % of total dust (fiberglass) depth) depth O'/N) loading (flexible connector) (double walled) Outside air intake louvers, grates and/or screens Outside air duct Outside air damper(s) Return air grille A L m 1%) . Return air plenum ytE At SFo e Filter rack Filter media Coils (evaporator) Blower assembly Condensate drain pan 44EET L

In-line electrical resistance strip heaters (in sipply ducts connected to unit ventilators)

PT ampers SW ET M{7 L 'ummg vanes y air plenum or supp y duct y air plenum or supp y duct ner Supp y air diffuser

2.1 Ventilators, wall air conditioning units and window air conditioning units in common spaces (cont.)

NYC-WTC 000114025