NYC 9/11 Public Portal Document
Part 1.0 General Information
., Date of Evaluation: p Building contact name and phone:"r
Evaluation Team (list name and affiliation):
04
K ZA U G9r (Environmental Professional)
o — Dici Vu 5T& (HVAC/Electrical Professional)
— fl i A " 'Z~ucrf usTE (Sheet Metal Professional)
Building Address: Type of Facility (check all that apply):
L Residential
f Multi-use
Other (describe)
Number of residential units: p0 Number of floors: 3
HVAC System Types (check all that apply)
Unit ventilator (single residence unit) Will/window AC unit (single residence unit)
Fan coil unit (single residence unit) Central ventilation system
Heat pump unit (single residence unit) Passive shaft/duct
Other (describe)
Location of outside air intake:
Outside air intake accessible for inspection V N (explain)
Part 2.0 Checklists
2.1 Ventilators, wall air conditioning units and window air conditioning units in common
spaces
Ventilation System identification:
I. N it.n o N T n AYra ,'.1
Location: , .,- _ -
Access adequate for inspection of components:
Dust/Dirt /Debris 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 (YIN) loading
(flexible connector)
(double walled)
Outside air intake louvers, grates
and/or screens
Outside air duct
Outside air damper(s)
Return air grille
Return air plenum r kt Kc."fst[.
Filter rack
Filter media
Coils (evaporator)
Blower assembly
Condensate drain pan
In-line electrical resistance strip
heaters (in supply ducts
connected to unit ventilators)
Fire dampers
Turning vanes `" "'
y air plenum or supply duct
ly air plenum or supply duct
Nliner
y air diffuser
2.1 Ventilators, wall air conditioning units and window air conditioning units in
common spaces (cont.)
NYC-WTC 000117563
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000117563Source: NYC Law Department, mirrored locally