NYC 9/11 Public Portal Document
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• ?art Y.0 '" General Y or n
Date of Evaluatio;l: - f. Buildilag contact name and phone
•
valuation Team (list name and affiliation)::;
f (Envfronuientaljr.ofessjonal)
= — • 'ice: " '_`'- ;' (HVAC/Electr cal'Professional)
;:''. ';' :~: ~: ;r ' ~c `; •> ._.;', j,n '' (SheetMetal Professional)
Building Address: R• Type of Facility (check all that apply)
q • — esidential ,'
`•` ;• U Mu tr'use
t Other (descn )
umber•o residenliaJ units• - u
Trrnber of floprs
BVAC Systept Types (check all that ripply) ;:
Unit'. entilator•(single residence unit).:.'' '.,'" • ' Va indov4 AC unit (single residence unit)
fl Fan toll unit (single re rdencc unit) 1 Cenal enhlatiori system ::~ •:' . 1•
Heat:pump unit (single residence unit) - Passive'shaft/duct
Other (describe)
Location of outside air intake:
Outside air intake accessible for inspection • ' • •Y . . T (explain)
Part 2 0 Checklists
2.1 Ventilators, %t all air conditioning units and window air conditioning:nits in common spaces
~rentiIation System}dentifica.tion: ' • e S .4tit
Location:
Access adequate for inspection of components ` ~
Dust/Dirt/Debris Suspect WTC-Related Dust
System Component ,,..
Substrate Material
(sheet rrteal wrapped) -Light ••:'' Heavy . r .•
System Components ...
p (sheet medal lined):
~ • None ' ' (<1/16 inch (a 1/16 inch • Present? Estimate % of total dust
• -(f berglass) , - depth) ' .. , depth ` . n'n)• - loading
(flexible connector)
(double walled)
Outside air intake louvers, grates ' '
and/or screens
Outside air duct
Outside air dampers)
Return air grille ' ' -
Return air plenum . .
Filter rack ''
Filter media • .
Coils (evaporator)
Blower assembly
Condensate drain pan
In-line a ectrica iesistance strip
heaters (in supply ducts
connected to unit ventilators) '
Fire dampers . .
Tumin vanes -
Supplyair plenum or supply duet
Supply air plenum or supply duct
liner
Supply air diffuser • .
21 'Ventilators; wall air conditioningunits and v►indow air conditioning units in common spaces (tout)
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NYC-WTC 000135907
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