NYC 9111 Public Portal Document
2.4 Passive Shaft/Duct Visual Inspection Form Page 1 of 1
Passive Shaft/Duct Identification: 4r
Location: Area Served:
Surface Component
System Components Dust/ WTC l; not
[NOTE: if component not present (NP), not found (NF) or inaccessible (I) please Debris Dust present
indicate in last column] Present? Present?
4 not
found
4
inaccessible
Outside air intake (if servicing supply air): Location:
Accessible for inspection? Y N (explain):
louvers, ates, screens or weather ca
Exhaust outlet/louver (if servicing exhaust air): Location: Qr-
Accessible for inspection? YV"N (explain): y !)
l
louvers, grates, screens or weather cap
Supply air distribution (if servicing supply air):
Supply air outlet(s) Est. total qty No. locations inspected
Specify shaft substrate (circle): metal fibrous glass lined metal masonry
fibrous glass board flex-duct wood
Accessible fire dam ers Est. total No. locations ins ected
Pipes/mechanical equipment, etc. located in shaft P
eturn air distribution (if servicing exhaust air):
Exhaust air inlet(s) Est. total qty 5 No. locations inspected._
Specify shaft substrate (circle): metal fibrous glass lined metal masonry (J
fibrous glass board flex-duct wood
Accessible fire dampers Est. total qty No. locations inspected 1%.J
Pi es'mechanical equipment, etc. located in shaft P
Other (specify):
Other Information:
General impression (indicate recommendations for cleaning based on finding of VTC dust):
-F
I KEY: NP = not present; NF = not found; I = inaccessible; U = unknown
NYC-WTC 000133801
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