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
|
Yes Work Order Closed by Building Maintenance
|
A35 - Missing ceiling tile.
|
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 Work Order Closed by Building Maintenance
|
MDF Room - Wall-mounted HVAC Unit (CDSS-2) needs to be cleaned (WO #232049).
|
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 Work Order Closed by Building Maintenance
|
Stairwell A and B12- Dead bugs in lights (Custodial).
Boys Bath Across from 212- Wet paper towel stuck to ceiling (Custodial).
A39 - Artificial Plants (collect dust and difficult to clean, staff member who brought it is to remove).
Gym - Spilled food (cereal) on bleachers (Custodial).
|
No stained or damage ceiling tiles
|
Yes Work Order Closed by Building Maintenance
|
B57 - Stained ceiling tile. Place a work order for Building Maintenance to assess if a work order is not already in progress.
|
No visible mold present (walls, cabinets, under sinks, behind posters)
|
Yes
|
|
| Relative Humidity | ||
Not above 70%
|
Yes
|
|
| Check | OK | Comments |
|---|---|---|
| Condition | ||
Clean
|
Yes Work Order Closed by Building Maintenance
|
215 - Eye Wash Covered with Mop Heads. Not easily accessible in case of emergency. Mop heads were removed during assessment. Custodian is to make team aware not to store items on the eye wash station.
|
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
|
|
Work Order Number(s)
232049
Issues found durring this assessment have been assigned to the above
work order(s).