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EPA Building Air Quality Guide-1991

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Page 198 of 227

Indoor Air Quality Forms 196 Building: _________________________________________________________ File Number: ________________________________ Completed by: __________________________________ Title: _____________________________ Date Checked: _____________ HVAC Checklist - Long Form Page 2 of 14 Needs Attention Not Applicable OK Component Comments 196 Indoor Air Quality Forms Actuators operational? Outdoor Air (O.A.) Quantity (Check against applicable codes and ASHRAE 62-1989.) Minimum % O.A. __________________ Measured % O.A. _________________ Note day, time, HVAC operating mode under "Comments" Maximum % O.A. _________________ Is minimum O.A. a separate damper? For VAV systems: is O.A. increased as total system air-flow is reduced? Mixing Plenum Clean? Floor drain trapped? Airtightness ■ of outside air dampers ■ of return air dampers ■ of exhaust air dampers All damper motors connected? All damper motors operational? Air mixers or opposed blades?

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