Exhibit A Ventilation Assessment Form.xlsx

XLSX spreadsheet 16 KB Posted

Attached to
COVID-19 Ventilation Assessments for BIE Federal contract opportunity
Solicitation number
140A1621Q0061
Issued by
Department of the Interior Bureau of Indian Affairs Central Office

About this file

Written by GovTribe AI ·

This document contains an Exhibit A Ventilation Assessment Form template to be used for conducting ventilation assessments of HVAC systems at Bureau of Indian Education schools. The form includes sections to document inspection dates, inspectors' information, school details, equipment details including type and location, and a checklist of inspection items related to filters, outdoor air intake and control systems, indoor air quality, and HVAC system components. Identification and condition information would be recorded for each identified piece of HVAC equipment on additional pages as needed.

The related federal contract opportunity is solicitation number 140A1621Q0061 seeking offers to perform COVID-19 ventilation assessments for Bureau of Indian Education schools. The solicitation was issued by the Department of the Interior Bureau of Indian Affairs Central Office to evaluate HVAC systems and identify necessary upgrades or repairs to improve ventilation and indoor air quality in light of COVID-19. Offerors would use the Exhibit A Ventilation Assessment Form template to document inspection findings and recommendations.

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Inspection Elements

EXHIBIT A
VENTILATION ASSESSMENT FORM
INSPECTION DATE:
INSPECTOR NAME/CONTACT INFORMATION:
SCHOOL NAME:
ADDRESS:
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
LEGEND:
X: Checked/Acceptable C: Critical Repair Needed
R: Repaired/Adjusted N/A: Not Applicable
A: Additional Work Needed Y/N: Yes or No
Inspection ItemResponseComments (additional page if necessry)
FILTERS:
Visual Condition:
Fitted Properly:
Current MERV Value:
Upgrade to MERV 13 Capable (Y/N):
OUTDOOR AIR:
Demand Control Present (Y/N):
Capability to Disable Demand Control w/o Damage to System (Y/N):
Control of Outside Air Dampers Present (Y/N):
Operable Windows (%):
Exhaust Fans (restrooms, laundry room, kitchens, roof gables, attic vents):
OUTSIDE AIR INTAKE:
Adequate distance from contamination sources:
Infestations (birds, rodents, etc.):
Intake > 10 feet from exausts:
CONTROL SYSTEM:
Capability to operate 100% outside air 2 hours before and after school:
Capability to set fan to continuously run (Y/N):
INDOOR AIR QUALITY:
Obvious signs of water intrusion or mold:
Outiside Air Estimate as Configured:
Locations of ceiling fans installed:
Meets ASHRAE 62.1 or 62.2:
Directional Air Flow:
Disinfection Technology Used (UV, Ionization, etc.):
Evaluate air vents and registers:
Set Temperature IAQ ASHRAE 55:
Set Humidity to 40-60% if possible:
CLEAN EVAPORATOR:
INSPECT OUTDOOR CONDENSER COIL:
INSPECT CABINET AIR RELIEFS:
CHECK PRIMARY CONDENSATE DRAIN:
CHECK SECONDARY CONDENSATE DRAIN:
ELECRICAL CONNECTIONS:
Tight connections:
Measured voltage:
Current on motors:
Running AMPS:
Starting AMPS:
STARTING CYCLE:
REFRIGERANT LEVEL:
BLOWER COMPONENTS:
CONTROL BOX and ELECTRICAL PARTS:
INSPECT COMPRESSOR AND TUBING:
ABNORMAL NOISES:
UNUSUAL ODORS:
VENT SYSTEM:
MONITOR SYSTEM FOR CORRECT LINE LOAD:
DUAL UNITS VERIFY LOAD SHARING:
HVAC FAILURE LIKELY WITHIN 5 YEARS:

Additional Comments

ADDITIONAL COMMENTS

Additional Equipment

EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):
EQUIPMENT (see subsequent pages for additional equipment):
EQUPMENT TYPE (boiler, chiller, AHU, UV, Ionization Disinfection, etc.):
MODEL NUMBER:
SERIAL NUMBER:
LOCATION/ROOM (if applicable):

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