Fax transmission header, Jan 2000

NYC 9/11 Public Portal Document • • rniv 4 pMJfl1KM PartI.fl General Inform$tion • . .. . •

Date of five nation: ti /c2.... • I Building:contact naive and phone:

Evaluation Team (list •name-and affiliation):. •• . . u.c.: u✓i (EnvironuientalProfessional) •r ~- ' •' (HVAC/Electrical Professional) (Sheet Metal Professional) Building Address: Type of Facility (check all that apply): F -' t5R ; . Sr. XResidentia1 NE k ,,j y 0 Multi-use Other'(desgibe) Number.of residential units: Number of floors: HVAC Systegi Types (check all that apply) Unit ventilator (single residence unit). \VaWUwindow-AC unit (single residence ugit) fl Fan coil unit (single residence unit) Central ventilation system ' Heat.ptrmp unit (single residence unit) • Passive shaft/duct. Other (describe) Location of outside air intake: Outside.air intake accessible for'irispection • V N (explain) . • Part 2..0 Checklists . 2.1 Ventilators, wall air conditioning units and window air conditioning';-nits in common spaces Ventilation SystemIdentification: '. ~ µ • Location: •. J p- .. Access adequate lot inspection of components: • Dust/Dirt/Debris Suspect WTC-Related Dust System Component Substrate Material (sheet metal „rapped) Light Heavy System Components (sheet metal Iined) None (<1/16 inch (~ 1/16 inch present? Estimate % of total dust (fiberglass) depth) depth (YT) loading (flexible connector) (double walled) . Outside sir intake louvers, grates and/or screens • • ' Outside air duct ' Outside air damper(s) Return air grille ' - Return air plenum 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 Supply.air plenum or supply.duct Supply air plenum or supply duct liner ' Supply air diffuser . • •. ..

2.1 Ventilators, wall air conditioning units and window air conditioning units In common spaces (cent.)

NYC-WTC 000117664