WTC building inspection form, 320 Albany Street

NYC 9/11 Public Portal Document

VENTILATION SYSTEM EVALUATION FORM Please complete this form in accordance with Instructions In the accompanying guidance document .. rart 1:U General lntarmatlon Date of evaluation: 1f 7/03 I Building contact name and phone: Evaluation team (list name and affiliation): 1 (Environmental professional) (HVAC professional) Building address: Type of Facili (check all that apply): 3Qv t. Ary Residential 1V w rL le_ Multi-use Other (describe) Date of construction: Number of residents units: Number of floors: Prior inspection report/maintenance records available for review?: N:3 I Other comments

Ventilation system types (check all that apply and indicate total no. of units) Central ventilatio system Mechanical exhaust system

Est. no. of units Est. of units no. >' 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 attachmei is are a true and accurate representation of site conditions. f

Ventil do • t#i VAC) Evaluator . Date

l art 2.0 Visual Inspection Forms Use the attached forms to document visual Inspections. Complete the forms In accordance with instructions in the accompanying guidance`dkcument. N

NYC-WTC 000116172