A02. SOW - Appendix B - MPLD & LD27 HVAC Inspection Form.pdf

Indoor Air Quality Forms 195

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form

Appendix B discusses HVAC system components in relation to indoor air quality.

Needs Attention

Not ApplicableOKComponent Comments

Outside Air Intake

Location

Open during occupied hours?

Unobstructed?

Standing water, bird droppings in vicinity?

Odors from outdoors?

(describe)

Carryover of exhaust heat?

Cooling tower within 25 feet?

Exhaust outlet within 25 feet?

Trash compactor within 25 feet?

Near parking facility, busy road, loading dock?

Bird Screen

Unobstructed?

General condition?

Size of mesh? (1⁄2" minimum)

Outside Air Dampers

Operation acceptable?

Seal when closed?

Indoor Air Quality Forms 196

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 2 of 14

Needs Attention

Not ApplicableOKComponent Comments

196 Indoor Air Quality Forms

Actuators operational?

Outdoor Air (O.A.) Quantity (Check against applicable codes and ASHRAE 62-1989.)

Minimum % O.A. __________________

Measured % O.A. _________________ Note day, time, HVAC operating mode under "Comments"

Maximum % O.A. _________________

Is minimum O.A. a separate damper?

For VAV systems: is O.A. increased as total system air-flow is reduced?

Mixing Plenum

Clean?

Floor drain trapped?

Airtightness

■ of outside air dampers

■ of return air dampers

■ of exhaust air dampers

All damper motors connected?

All damper motors operational?

Air mixers or opposed blades?

Indoor Air Quality Forms 197

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 3 of 14

Needs Attention

Not ApplicableOKComponent Comments

Mixed air temperature control setting OF

Freeze stat setting OF

Is mixing plenum under negative pressure? Note: If it is under positive pressure, outdoor air may not be entering.

Filters

Type

Complete coverage?

(i.e., no bypassing)

Correct pressure drop? (Compare to manufacturer's recommendations.)

Contaminants visible?

Odor noticeable?

Spray Humidifiers or Air Washers

Humidifier type

All nozzles working?

Complete coil coverage?

Pans clean, no overflow?

Drains trapped?

Biocide treatment working?

Note: Is MSDS on file?

Spill contaminant system in place?

Indoor Air Quality Forms 198

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 4 of 14

Needs Attention

Not ApplicableOKComponent Comments

198 Indoor Air Quality Forms

Face and Bypass Dampers

Damper operation correct?

Damper motors operational?

Cooling Coil

Inspection access?

Clean?

Supply water temp. OF

Water carryover?

Any indication of condensation problems?

Condensate Drip Pans

Accessible to inspect and clean?

Clean, no residue?

No standing water, no leaks?

Noticeable odor?

Visible growth (e.g., slime)?

Drains and traps clear, working?

Trapped to air gap?

Water overflow?

Indoor Air Quality Forms 199

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 5 of 14

Needs Attention

Not ApplicableOKComponent Comments

Mist Eliminators

Clean, straight, no carryover?

Supply Fan Chambers

Clean?

No trash or storage?

Floor drain traps are wet or sealed?

No air leaks?

Doors close tightly?

Supply Fans

Location

Fan blades clean?

Belt guards installed?

Proper belt tension?

Excess vibration?

Corrosion problems?

Controls operational, calibrated?

Indoor Air Quality Forms 200

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 6 of 14

Needs Attention

Not ApplicableOKComponent Comments

200 Indoor Air Quality Forms

Control sequence conforms to design/specifications?

(describe changes)

No pneumatic leaks?

Heating Coil

Inspection access?

Clean?

Contol sequence conforms to design/specifications?

(describe changes)

Supply water temp. OF

Discharge thermostat?

(air temp. setting OF)

Reheat Coils

Clean?

Obstructed?

Operational?

Steam Humidifier

Humidifier type

Treated boiler water

Standing water?

Indoor Air Quality Forms 201

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 7 of 14

Needs Attention

Not ApplicableOKComponent Comments

Visible growth?

Mineral deposits?

Control setpoint OF

High limit setpoint OF

Duct liner within 12 feet? (If so, check for dirt, mold growth.)

Supply Ductwork

Clean?

Sealed, no leaks, tight connections?

Fire dampers open?

Access doors closed?

Lined ducts?

Flex duct connected, no tears?

Light troffer supply?

Balanced within 3-5 years?

Balanced after recent renovations?

Short circuiting or other air distribution problems? Note location(s)

Pressurized Ceiling Supply Plenum

No unintentional openings?

All ceiling tiles in place?

Indoor Air Quality Forms 202

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 8 of 14

Needs Attention

Not ApplicableOKComponent Comments

202 Indoor Air Quality Forms

Barrier paper correctly placed and in good condition?

Proper layout for air distribution?

Supply diffusers open?

Supply diffusers balanced?

Noticeable flow of air?

Short circuiting or other air distribution problems? Note location(s) in"Comments"

Terminal Equipment (supply)

Housing interiors clean and unob-structed?

Controls working?

Delivering rated volume?

Balanced within 3-5 years?

Filters in place?

Condensate pans clean, drain freely?

VAV Box

Minimum stops %

Minimum outside air % (from page 2 of this form)

Minimum airflow cfm

Minimum outside air cfm

Indoor Air Quality Forms 203

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form Page 9 of 14

Needs Attention

Not ApplicableOKComponent Comments

Supply setpoint OF (summer)

OF (winter)

Thermostats

Type

Properly located?

Working?

Setpoints OF (summer)

OF (winter)

Space temperature OF

Humidity Sensor

Humidistat setpoints % RH

Dehumudistat setpoints % RH

Actual RH %

Room Partitions

Gap allowing airflow at top?

Gap allowing airflow at bottom?

Supply, return each room?

Indoor Air Quality Forms 204

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form

Needs Attention

Not ApplicableOKComponent Comments

Stairwells

Doors close and latch?

No openings allowing uncontrolled airflow?

Clean, dry?

No noticeable odors?

Return Air Plenum

Tiles in place?

No unintentional openings?

Return grilles?

Balancing capability?

Noticeable flow of air?

Transfer grilles?

Fire dampers open?

Ducted Returns

Balanced within 3-5 years?

Unobstructed grilles?

Unobstructed return air path?

Return Fan Chambers

Clean and no trash or storage?

No standing water?

Floor drain traps are wet or sealed?

204 Indoor Air Quality Forms

Indoor Air Quality Forms 205

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form

Needs Attention

Not ApplicableOKComponent Comments

No air leaks?

Doors close tightly, kept closed?

Return Fans

Location

Fan blades clean?

Belt guards installed?

Proper belt tension?

Excess vibration?

Corrosion problems?

Controls working, calibrated?

Controls sequence conforms to design/specifications?

(describe changes)

Exhaust Fans

Central?

Distributed (locations)

Operational?

Controls operational?

Toilet exhaust only?

Gravity relief?

Indoor Air Quality Forms 206

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form

Needs Attention

Not ApplicableOKComponent Comments

Total powered exhaust cfm

Make-up air sufficient?

Toilet Exhausts

Fans working occupied hours?

Registers open, clear?

Make-up air path adequate?

Volume according to code?

Floor drain traps wet or sealable?

Bathrooms run slightly negative rela-tive to building?

Smoking Lounge Exhaust

Room runs negative relative to building?

Print Room Exhaust

Room runs negative relative to building?

Garage Ventilation

Operates according to codes?

Fans, controls, dampers all operate?

206 Indoor Air Quality Forms

Indoor Air Quality Forms 207

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form

Needs Attention

Not ApplicableOKComponent Comments

Garage slightly negative relative to building?

Doors to building close tightly?

Vestibule entrance to building from garage?

Mechanical Rooms

General condition?

Controls operational?

Pneumatic controls:

■ compressor operational?

■ air dryer operational?

Electric contols?

EMS (Energy Management System) or DDC (Direct Digital Control):

■ operator on site?

■ controlled off-site?

■ are fans cycled "off" while building is occupied?

■ is chiller reset to shed load?

Preventive Maintenance

Spare parts inventoried?

Spare air filters?

Control drawing posted?

Indoor Air Quality Forms 208

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form

Needs Attention

Not ApplicableOKComponent Comments

PM (Preventive Maintenance) schedule available?

PM followed?

Boilers

Flues, breeching tight?

Purge cycle working?

Door gaskets tight?

Fuel system tight, no leaks?

Combustion air: at least 1 square inch free area per 2000 Btu input?

Cooling Tower

Sump clean?

No leaks, no overflow?

Eliminators working, no carryover?

No slime or algae?

Biocide treatment working?

Dirt separator working?

Chillers

No refrigerant leaks?

Purge cycle normal?

Waste oil, refrigerant properly disposed of and spare refrigerant properly stored?

Condensation problems?

208 Indoor Air Quality Forms

Indoor Air Quality Forms 209

Building: _________________________________________________________ File Number: ________________________________

Completed by: __________________________________ Title: _____________________________ Date Checked: _____________

HVAC Checklist - Long Form

Needs Attention

Not ApplicableOKComponent Comments

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