VENTILATION SYSTEM EVALUATION FORM
Please complete this form in accordance with instructions in the accompanying
guidance document
Part 1.0 General Inf t-m '.ion
Date of evaluation: I Building contact name and e:
• Evaluation team (list name and affiliation):
(Environmentalprofessional)
Tv:.. - C, i►,., .• - t '- (H\'ACprofessional)
Building address: yT~e of Facility (check all that apply):
wa S. ~Residential
£w ti Multi-use
Other (describe)
Date of construction:
Number of residential units: Number of floors:
Prior inspection repo'rt'maintenance records available for review?:
Other comments
Ventilation system types (check all that apply and indicate total no. of units)
Central ventilation system I Mechanical exhaust system
_ Est. no. of units .-) Est. no. of units
Mechanical make-up air system Passive shaft'duct
Fs!. no. of '.'nits
utner (describe)
I certify that to the best of my knowledge, the information and observations
recorded on this form
including all :attaclrntents are a true and accurate representation of site conditions.
Vent' at' n S st
2ii
t AC) Evaluator Date
Lt C.'s
tsual Inspection Forms
Use the attached forms to document visual inspections. Complete the
forms in accordance with
instructions in the accompanying guidance document.
•
NYC-WTC 000130420
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000130420Source: NYC Law Department, mirrored locally
An HVAC inspection report from Cole Consulting Corporation dated February 13, 2003, recommending cleaning of units at 275 Greenwich Street due to WTC dust.