School
              
          Assessor
          Christopher Madden
        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
         | No | 
        81 - Ceiling tile bowed out of place. 21 - Tile bowed out of place. Adjusted while onsite. If it comes out of place again, replace. 68 - Missing ceiling tile.128 - Ceiling tile out of place above stage stairs.
         | 
| 
        No stained/damaged tiles indicating high RH or moisture problem
         | No | 
        Bowed Ceiling Tiles in various locations throughout facility indicating elevated relative humidity (most likely occurs July-September). Building Maintenance is aware and is planning a controls upgrade project to address the issue, pending available funding.
         | 
| Check | OK | Comments | 
|---|---|---|
| Condition | ||
| 
        No odors or unusual sounds
         | Yes | |
| 
        Clean, no excess dirt or moisture
         | No | 
        FACS Storage - Supply diffuser dirty. Kitchen (Dishwashing) - Supply diffuser rusted (WO #205355).
         | 
| 
        No obstruction to air flow
         | No | 
        Room 22 - Return air grille blocked. 
         | 
| 
        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?
         | No | 
        Industrial Arts Storage (S10) - Stair-step cracking in block and damaged drywall (WO #205357). Industrial Arts Storage (131) - Salts on roof deck (WO #205357).  
         | 
| Doors and Windows | ||
| 
        Caulking and weather stripping in good condition
         | Yes | |
| Check | OK | Comments | 
|---|---|---|
| Condition | ||
| 
        Room is free of dust and clutter
         | No | 
        FACS Storage Closet - Dirt/Debris behind washer and drier. 
         | 
| 
        No stained or damage ceiling tiles
         | No | 
        18 - Hole in corner of tile (above teacher desk). Outside of 13 (above Locker 456), 41 (2 tiles), 67 (minor), 89 - Stained Ceiling Tile(s)
         | 
| 
        No visible mold present (walls, cabinets, under sinks, behind posters)
         | No | 
        Relative humidity mold was observed on the inside of the cabinet doors in Rooms 18, 75 , and 89. The doors were cleaned/disinfected upon discovery.  Building Maintenance (Plumbing) assessed the fixture in these areas and did not identify any deficiencies with leaks/moisture. Additionally, relative humidity mold growth was observed on a tool cabinet in Room 180. Custodial Services cleaned/disinfected the mold growth in Room 180.
         | 
| Relative Humidity | ||
| 
        Not above 70%
         | No | 
        Room 007, Cafeteria, 68 (room also too cold) - Building Maintenance is aware and is planning a controls upgrade project to address the issue, pending available funding.
         | 
| 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
         | Yes | |
