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EPA Building Air Quality Guide-1991

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Page 213 of 227

Building Name: ___________________________________________ Address: ____________________________________ Completed by: ____________________________________ Date: _______________ File Number: ___________________ Indoor Air Quality Forms 213 Pollutant and Source Inventory Using the list of potential source categories below, record any indications of contamination or suspected pollutants that may require further investigation or treatment. Sources of contamination may be constant or intermittent or may be linked to single, unrepeated events. For intermittent sources, try to indicate the time of peak activity or contaminant production, including correlations with weather (e.g., wind direction). Page 1 of 6 Source Category Checked Needs Attention Location Comments Sections 2, 4 and 6 discuss pollutant sources. Appendix A provides guidance on common measurements. SOURCES OUTSIDE BUILDING Contaminated Ambient Air Pollen, dust Industrial contaminants General vehicular contaminants Emissions from Nearby Sources Vehicle exhaust (parking areas, loading docks, roads) Dumpsters Re-entrained exhaust Debris near outside air intake Soil Gas Radon Leaking underground tanks Sewage smells Pesticides

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