NYC 9/11 Public Portal Document
2.4 Passive Shaft/Duct Visual Inspection Form
Page l of I
Passive ShaftDuct Identification: -
a . '
/
Location: Area Served:
System Components Surface Component
Dust/ W1'TC not
(NOTE: if component not present (NP), not found (NF) or inaccessible (1)
please Debris Dust present
indicate in last column) Present? Present? not
found
Outside air intake (if servicing supply air): inaccessible
Location:
Accessible for inspection? Y- 1\ (explain):
louvers, grates. s.r:•ens or weather cap
Exhaust outlet louver (if servicing exhaust air): Location
Accessible for inspection? Y__L'_ —_ -_(explain):
louvers, crates, screens or weather cap
Y IN
Supply air distribution (if servicing supply air):
Supply air outlet(s) Est. total qt) No. locations inspected_
Specify shaft substrate (circle): metal fibrous glass lined metal
masonry
fibrous class hoard flex-duct wood
Accessible fire dampers Est. total gtv No. locations inspected
1'ipcs'n;e:h :ii -a! e: d n _n•. located in shaft
Return air distribution (if servicing exhaust air):
Exhaust air inlet(s) Est. total qq' No. locations inspected O
Specify shaft substrate (circle): metal fibrous class lined metal masonry
I
Accessible fire dampers _Est. totallgh• No. locations inspected
_ Pipes'mechanical e ui;+r.:en . et:. located in shaft
her (specify):
v►ner uuormalion:
ucuc1II Impression (inaicate reconunendations for cleaning
based on finding of W'TC dust):
N3
t t
NP = not ores ent; NF' = not found; I = inaccessible; Ij = un flown
NYC-WTC 000130430
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