NYC 9/11 Public Portal Document
2.4 Passive Shaft/Duct Visual Inspection Form
Page l of I
Passive Shaft-Duct Identification:
Location: _ Area Served:
System Components Surface Component
Dust/ WTC not
)NOTE: if component not present (NP), not found (NF) or inaccessible (I) please Debris Dust present
indicate in last column) Present? Present? c
5 not
found
Outside air intake (if servicing supply air): inaccessible
Location:
Accessible for inspection? Y N___(explain):
louver's. erates. screens or weather cap
Exhaust outlet/louver (if servicing exhaust air): Location: D t=
Accessible for inspection? Y/N .(explain): ~f
louvers, grates, screens or eather cap :
Supply air distribution (if servicing supply air):
Supply air outlet(s) Est. total qty No. locations inspected__^ _
Specify shaft substrate (circle): mewl f Brous elas lined moral misonr.
fibrous etas: board fler-duct ood
Accessible fire dampers Est. total qr: No. 1r -ati n; inspected
Pi es'mechanical equipment. etc. located in shaft p
Return air distribution (if servicing exhaust air):
Exhaust air inlet(s) Est. total qty ~ No. locations inspected 0
Specify shaft substrate (circle): met I fibrous class lined metal masonry
fibo s c' h :J f':.• .
Accessible fire dam ers Est. total c•; No. locations ins e.t•:d {~
.
Pipes'meehanical equipment. etc. located in shaft
Other (specify): Nn
Other Information: I. I
General impression (indicate recommendations for cleaning based on finding of
W1'TC dust):
5 .J' (
rhE~: NP=not present:I\h = r,~; iuund:I=inaccessible• U=unknown
I
NYC-WTC 000130414
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