NYC 9/11 Public Portal Document
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General Information . . .
'Part 1.0
Date of Evaluation: , •1- . • Z
.. .
Building contact name and phone: :
S
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•Evaluation Team (list narne•and affiliation):.
cw; . ..
(Environments .Professional)
.
•
► '- • (}VAC/Electrical Professional)
' . (Sheet Metal Pro essional)
Building Address:
•F -+12 ;
Type of Facility (check all that apply):
Residential
Multiuse ••. . . . 0
t,& :
Other (describe)
. S
. '
:. 1
Number.of residential units: Number of floors:
HVAC System Types (check all that apply)
Unit ventilator (single residence unit). -Wall/ivindow•AC unit (single residence unit)
fl Fan coil unit (tingle residence unit)
Heat.pumpunit (single residence unit)
Oiber'(desen'be)
•,. Central ventilation system
Passive shaft/duct •
Location of outside air intake: .
Outside .air intake accessible for inspection • •Y N (explain) . 0
Part 2.0 •. Checklists .
2.1 Ventilators, wall air conditioning units and window air conditioning:nits in common spaces
Ventilation System Identifications ,~.
6~•- i G qKs s — 5~~ A,) q t,.e
Location: G
Access adequate for inspection of components: ry .
Dust/Dirt /Debris Suspect WTC-Related Dust
System Component .
Substrate Material
(sheet metal wrapped) Light Heavy
System Components (sheet metal lined) None (<1/16 inch (2 1/16 inch Present? Estimate % of total dust
(fiberglass) depth) depth (Y/) loading
(flexible connector)
Outside air intake louvers, grates
and/or screens
(double walled)
.
. .
'
. .
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
Supplyair diffuser .
. I . .. S . . ____________________
2.1 Ventilators, wall air conditioning units and window air conditioning units In common spaces
(coot.)
NYC-WTC 000135341
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