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EPA Building Air Quality Guide-1991

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Building Name: ____________________________________________ Address: __________________________________________ Completed by: ___________________________________________ Date: ______________ File Number: ___________________ HVAC Checklist - Short Form Indoor Air Quality Forms 192 Page 2 of 4 AIR HANDLING UNIT ■ Unit identification Area served Outdoor Air Intake, Mixing Plenum, and Damper ■ Outdoor air intake location ■ Nearby contaminant sources? (describe) ■ Bird screen in place and unobstructed? ■ Design total cfm outdoor air (O.A.) cfm date last tested and balanced ■ Minimum % O.A. (damper setting) Minimum cfm O.A. = ■ Current O.A. damper setting (date, time, and HVAC operating mode) ■ Damper control sequence (describe) ■ Condition of dampers and controls (note date) Fans ■ Control sequence ■ Condition (note date) ■ Indicated temperatures supply air mixed air return air outdoor air ■ Actual temperatures supply air mixed air return air outdoor air Coils ■ Heating fluid discharge temperature ∆T cooling fluid discharge temperature ∆T ■ Controls (describe) ■ Condition (note date) Humidifier ■ Type if biocide is used, note type ■ Condition (no overflow, drains trapped, all nozzles working?) ■ No slime, visible growth, or mineral deposits? (total cfm x minimum % O.A.) 100

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