HVAC inspection report for 250 South End Ave, Jan 2003

NYC 9/11 Public Portal Document

VENTILATION SYSTEM EVALUATION FORM Please complete this form in accordance with instructions in the accompanying guidance document Part 1.0 General Information Date of evaluation: I 0 v3 I Building contact name and hone: 4. i'"' Evaluation team (list name and affiliation): tLi Lt. KAZAKôV— TH t v. (Environmental professional) us r ' (HVAC professional) Building address: Type of Facility (check all that apply): t So"-rW &,.i f) . Residential ~„1 ►c ,.j../. Multi-use Other (describe) Date of construction: Number of residents units: /0 Number of floors: J Prior inspection report/maintenance records available for review?:

tic) Other comments

Ventilation system types (check all that apply and indicate total no, of units) Central ventilation system Mechanical exhaust system 1111 Est. no. of units O Est. no. of units , .~-T 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 attachments are a true and accurate representation of site conditions.

Ve on y to VAC) Evaluator Dat

2. isual Inspection Forms Use the attached forms to document visual inspections. Complete the forms in accordance with instructions In the accompanying guidance document.

NYC-WTC 000117348