Chain of Custody Form Instructions for WTC Building Sampling

NYC 9/11 Public Portal Document

SECTION 5. Information for samples taken from RESIDENTIAL UNIT 1 (continued)

Q. Is this unit currently occupied? Y N Is there a separate HVAC system for this residential unit? Y N Is there a significant amount of dust that would preclude aggressive sampling? Y N Recommend: Aggressive samplingfor tmoccupied resdential tmits that have their own HVAC ondDO NOT have a significant amount ofdust.

R. Did this unit meet the criteriato be aggressively sampled? Y N

If YES, was this unit aggressively sampled? Y N

If this unit met the criteria for aggressive sampling and was not aggressively sampled, why not?

If this unit does not have it’s own HVAC system, please skip to question W. S. What type of filter is used? High Efficiency Filter Regular Filter Not Sure Filter Name Filter Size Filter Type Paper Elecfrostatic Fiberglass _____ Other (describe) Filter Efficiency Rating Has the filter been changed since the WTC collapse? Y N Not Sure If yes, date________________________________ Have the ducts been cleanedsince the WTC collapse? Y N Not Sure If yes, date________________________________ Does the system recycle air? Y N Not Sure If yes, what percent of the air is recycled? % Not Sure Has the system been recycling since the WTC collapse? Y N Not Sure

T. Has the HVAC system been SERVICED since the WTC collapse? Y N Not Sure If yes, date__________________________________ U. Has the HVAC system beenCLEANED since the WTC collapse? Y N Not Sure If yes, date__________________________________ V. Was the HVAC fan ON during the entire air sampling period Y N Not Sure If NO, how long did the fan run (in hours)? hours

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