VENTILATION SYSTEM EVALUATION FORM
Please complete this form in accordance with instructions in the accompanying guidance document
Part 1.0 General Information
Date of evaluation: | Building contact name and phone:
Evaluation team (list name and affiliation):
__________________________ (Environmental professional)
__________________________ (HVAC professional)______
Building address: Type of Facility (check all that apply):_____________ ______
Residential______________________________________
Multi-use________________________________________
Other (describe)
Date of construction:
Number of residential units: Number of floors:
Prior inspection report/maintenance records available for review?:
Other comments
Ventilation system types (check all that apply and indicate total no. of units)
Central ventilation system Mechanical exhaust system
Est. no. of units Est. no. of units
Mechanical make-up air system Passive shaft/duct
Est. no. of units Est. no. of units
Other (describe)
I certify that to the best of my knowledge, the information and observations recorded on this form
including all attachments are a true and accurate representation of site conditions.
Ventilation System (HVAC) Evaluator Date
Part 2.0 Visual Inspection Forms
Use the attached forms to document visual inspections. Complete the forms in accordance with
instructions in the accompanying guidance document
NYC-WTC_000140017
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000140017Source: NYC Law Department, mirrored locally
Instructional guidance for completing ventilation system evaluation forms, including documentation of prior inspections, maintenance records, and WTC dust assessment.
1 shared topics · Same agency, volume and box · similarity 0.908
EPA correspondence transmitting the final HVAC system inspection checklist and implementation guidance for use by contractors in post-9/11 building cleanup and ventilation system…
EPA correspondence transmitting the final HVAC system inspection checklist and implementation guidance for use by contractors in post-9/11 building cleanup and ventilation system…
An HVAC inspection report from Cole Consulting Corporation dated February 13, 2003, recommending cleaning of units at 275 Greenwich Street due to WTC dust.
Internal memo expressing concerns about advising residents of potential health risks from 15 months of unrealistic HVAC assessment and cleanup, requesting urgent decision-making.
Memo requesting EPA ensure factual information about HVAC matters be prepared for presentation at meeting with City officials, FEMA, and public communications consultant.