NYC 9/11 Public Portal Document
****DRAFT Version 10, October 29, 2001****
7. Is your HVAC (heating/AC) system in your apartment/condominium (vs. a bldg-controlled
system)?
Yes No
TTYES, whdnype of filter do you have (describe)?
Name
Size
Type —.........
What was the date of the last filter change?
Have you been using your HVAC system since the WTC event?
Yes No
TTYES, is it recirculating air or drawing from the outside?
Has the HVAC system been service or cleaned since the WTC event?
Yes No
Have the ducts been cleaned since the WTC event?
Yes No
TTYES, provrSe date(s) of cleaning
8. Do you or does anyone who lives here, or visits frequently, smoke tobacco products?
Yes No
9. During this air and dust sampling, did you;
Cook on the stove
Yes No
If yes, was the exhaust fan on
Yes No
Have a fire in your fireplace
Yes No
Smoke cigarettes or other tobacco
Yes No
Clean or vacuum
Yes No
TTyes, descrtBF
Bum candles, incense, etc.
Yes No
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