School
              
          Assessor
          Jeffrey Klenk
        Date
              Air Distribution and Terminal System (Assess 2-3 Locations per HVAC Zone)
| Check | OK | Comments | 
|---|---|---|
| Condition | ||
| 
        No odors, noise or vibration
         | Yes | |
| 
        Clean, no obstructions
         | Yes | |
| 
        Free from signs of moisture/mold, insects or rodents?
         | Yes | |
| 
        No noticeable air leaks
         | Yes | |
| Check | OK | Comments | 
|---|---|---|
| Ceiling Tiles | ||
| 
        Tight seal on all tiles
         | Yes | |
| 
        No stained/damaged tiles indicating high RH or moisture problem
         | Yes | |
| Check | OK | Comments | 
|---|---|---|
| Condition | ||
| 
        No odors or unusual sounds
         | Yes | |
| 
        Clean, no excess dirt or moisture
         | Yes | |
| 
        No obstruction to air flow
         | Yes | |
| 
        No purposely placed obstruction indicating occupant distress
         | Yes | |
| Location | ||
| 
        No short circuiting between supply and return
         | Yes | |
| Doors | ||
| 
        Doors not tight or difficult to close indicating large pressure differential
         | Yes | |
Building
| Check | OK | Comments | 
|---|---|---|
| Foundation | ||
| 
        No moisture penetration or signs of mold?
         | Yes | |
| Doors and Windows | ||
| 
        Caulking and weather stripping in good condition
         | Yes | |
| Check | OK | Comments | 
|---|---|---|
| Condition | ||
| 
        Room is free of dust and clutter
         | Yes | |
| 
        No stained or damage ceiling tiles
         | Yes | |
| 
        No visible mold present (walls, cabinets, under sinks, behind posters)
         | No | 
        Mold growth observed in portable wing 267 in classrooms 4 (fabric chair) and 12 (fabric chair and edges of a couple of student desks).  Chairs discarded by school and/or HEPA vacummed and wiped with disinfectant.
         | 
| Relative Humidity | ||
| 
        Not above 70%
         | No | 
        In several classrooms in portable wing 267 (in 90's with surfaces wet and slick).  Building Services contacted contractor to review thermostats and individual classroom units the same day of finding.  
         | 
| Check | OK | Comments | 
|---|---|---|
| Condition | ||
| 
        Clean
         | Yes | |
| 
        No unusual noise or odor
         | Yes | |
| 
        No mold growth on insulation
         | Yes | |
| 
        Traps contain water
         | Yes | |
| Chemical Storage | ||
| 
        Containers capped
         | Yes | |
| 
        No evidence of an active spill
         | Yes | |
| Check | OK | Comments | 
|---|---|---|
| Condition | ||
| 
        No odors, or unusual noise or vibration
         | No | 
        The thermostat tamper resistant  guard in portable 169 was broken.  Work Order 204242.
         | 
