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EPA Building Air Quality Guide-1991

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Indoor Air Quality Forms 223 Building Name: ____________________________________________________ File Number: _______________________________ Address: ______________________________________________________________________________________________________ Completed by: ________________________________________________________________________________________________ Complaint Area (may be revised as the investigation progresses): __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ Complaints (e.g., summarize patterns of timing, location, number of people affected): __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ HVAC: Does the ventilation system appear to provide adequate outdoor air, efficiently distributed to meet occupant needs in the complaint area? If not, what problems do you see? __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ Is there any apparent pattern connecting the location and timing of complaints with the HVAC system layout, condition or operating schedule? __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ Pathways: What pathways and driving forces connect the complaint area to locations of potential sources? __________________________________________________________________________________________________________________ Are the flows opposite to those intended in the design? ___________________________________________________________ Sources: What potential sources have been identified in the complaint area or in locations associated with the complaint area (connected by pathways)? __________________________________________________________________________________________________________________ Is the pattern of complaints consistent with any of these sources? __________________________________________________ Hypothesis Form Page 1 of 2

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