Exhibit_A_Ventilation_Assessment_Form.xlsx

XLSX spreadsheet 16 KB Posted

Attached to
COVID-19 Ventilation Assessments for BIE Federal contract opportunity
Solicitation number
140A1621Q0104
Issued by
Department of the Interior Bureau of Indian Affairs Central Office

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This document contains an Excel template for conducting ventilation assessments of heating, ventilation, and air conditioning (HVAC) systems in Bureau of Indian Education (BIE) schools. The template requires inspectors to provide school names, physical addresses, and equipment details including type, model number, serial number, and location for each assessed unit. Inspectors must evaluate over 50 inspection items for each unit, including filter condition and MERV rating, outdoor air controls, exhaust fans, control systems, indoor air quality, temperature and humidity settings, electrical connections, refrigerant level, noises, and odors. Inspectors document their responses and note any needed repairs.

The related federal contract opportunity is solicitation number 140A1621Q0104 for COVID-19 Ventilation Assessments for BIE. The solicitation seeks assessments of HVAC systems in BIE schools to evaluate ventilation and indoor air quality to mitigate the spread of COVID-19.

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Sol_140A1621Q0104_Amd_0001.pdf PDF
Sol_140A1621Q0104.pdf PDF
SOW.pdf PDF
Exhibit_B_Ventilation_Assessment_Locations.xlsx XLSX spreadsheet

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Inspection Elements

EXHIBIT A
VENTILATION ASSESSMENT FORM
INSPECTION DATE:
INSPECTOR NAME/CONTACT INFORMATION:
SCHOOL NAME(S):
PHYSICAL 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:
Filter Fitted and Seated Properly:
Current filter MERV rating (estimate if not a MERV rated filter):
Upgrade to MERV 13 Capable (Y/N) if no, comment on reason:
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):
Estimated Operable Windows in Building (%):
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 (if not, specify in comments):
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:
CLEAN OUTDOOR CONDENSER COIL:
INSPECT CABINET AIR RELIEFS:
CHECK AND SERVICE PRIMARY CONDENSATE DRAIN IF OBSTRUCTED:
CHECK AND SERVICE SECONDARY CONDENSATE DRAIN IF OBSTRUCTED:
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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