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Ventilation system evaluation form template, 2002

Machine-extracted title · confidence 100%

Blank form for recording building details, facility type, and ventilation system characteristics during inspection.

NYC-WTC_000139935–000139936

Folder label: “EPA HVAC ACTION PLAN (Indoor Clean up)

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Scanned page image, NYC-WTC_000139935
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NYC 9/11 Public Portal Document

2.1 Central Ventilation System Visual Inspection Form Page 1 of 2 Ventilation System Identification:

Location: Area Served:

Associated mechanical room: clean Y N dry Y stored chemicals/refuse N Y N Surface Component System Components Dust/ WTC • not present [NOTE: if component not present (NP), not found (NF) or inaccessible (I) please Debris Dust • not found indicate in last column] Present? Present? • Inaccessible Outside air intake: Location:

Accessible for inspection? Y N (explain):

- louvers, grates and/or screens - outside air duct - outside air damper(s) Airhandlingunit___________________________________________________________ - outside air mixing chamber_______________________________________________ - filter rack(s)_____________________________________________________________ - filter media___________________________________________________________ - blower assembly incl. blower wheel, blower housing, air vanes, in-line noise attenuators - blower housing acoustical lining__________________________________________ - pre-heat coils___________________________________________________________ - heating coils____________________________________________________________ - cooling coils - re-heat coils - condensate drain pan - supply air plenum_____________________________________________________ - supply air plenum damper(s) - vibration collars Supply air distribution: - Supply air ducts Est. total In ft No. locations inspected Specify type (circle): metal fibrous glass lined metal masonry fibrous glass board flex-duct wood - Accessible in-line fire dampers Est. total qty No. locations inspected - Accessible turning vanes Est. total qty No. locations inspected - In-line reheat/cooling coils Est. total qty No. locations inspected - Supply air diffusers Est. total qty No. locations inspected Return air distribution: - Return air ducts Est. total In ft No. locations inspected Specify type (circle): metal fibrous glass lined metal masonry fibrous glass board flex-duct wood - Return air plenum Est. total RA plenum areas No. locations inspected - Return air plenum damper Est. total qty No. locations inspected - Accessible in-line fire dampers Est. total qty No. locations inspected - Accessible turning vanes Est. total qty No. locations inspected - Return air grilles Est. total qty No. locations inspected

NYC-WTC_000139935

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NYC-WTC_000139935Source: NYC Law Department, mirrored locally

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