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B2:
PERIODIC IAQ MAINTENANCE INSPECTION
Building _________________ Location__________________
Prepared by_________ ____Date______
Equipment ____________ Manufacturer _________________Other
ID _________________File # _____
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
AIR HANDLING UNIT
|
|
Outdoor air intake and outdoor air dampers
(Id. #
_______) |
|
Outdoor pollution:
No pollution sources w/i
25 ft.
(e.g. dumpster, chimney stack) |
|
|
|
1 mo |
|
|
Louvers and access doors:
Operating properly?
|
|
|
|
1 mo |
|
|
Deflectors & screens:
No debris? |
|
|
|
1 mo
|
|
|
Dampers:
Operate
properly, secure connections, no obstructions? |
|
|
|
1mo |
|
|
Lubricate:
Lubricate as per manufacturers instructions |
|
1mo |
|
|
Outdoor air intake filter:
Change as per
manufacturer’s instructions. |
|
2mo |
|
|
Mixing
Plenum (Id # _______) |
|
|
|
|
|
|
1 mo |
|
Insulation:
Secure and clean?
|
|
|
|
Floor drain:
Charged with liquid?
|
|
1 mo |
|
Dampers:
Airtight?
Connections OK?
Motors operate to design
specifications?
Air moving OK?
Fire dampers open? |
|
1 mo |
|
|
Filters (id # _____
) |
|
No bypassing, excessive
loading, dampness or odor?
Flow direction correct? |
|
1 mo |
|
|
Change filters:
Change as per manufacturers recommendation |
|
3 mo |
|
|
Heating coil (id.
# _______ ) |
|
Clean:
Clean, no noticeable leaks, no obstruction, no |
|
|
|
1 mo |
|
|
Clean coils:
Clean coils & drain pan. |
|
3 mo |
|
| |
|
|
|
|
|
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
Cooling coils (Id
# _________) |
|
Clean:
Coils clean? |
|
|
|
1mo |
|
|
Access: No
obstructions in area that may affect access? |
|
|
|
1mo |
|
|
Condensation: No
excess condensation problems? |
|
|
|
1mo |
|
|
Blowoff: No water
from coil blowoff? |
|
|
|
1mo |
|
|
Condensate pan and drain line:
No
noticeable odor?
No
visible bacterial or fungal growth,?
Clean, no
residue, no standing water?
No
overflow, no leakage, no blockage, no damage?
Proper
slope, drain line ok, drainage acceptable, discharge ok? |
|
|
|
1mo |
|
|
Clean coils/pan: Clean
coils, condensate drains, and external parts. |
|
3 mo |
|
|
Steam
humidifier (id #
_____ ) |
|
Contaminants: No
mineral deposits, or biological growth? |
|
|
|
1 mo |
|
|
Duct
liner: If duct
liner within 12 feet,
no dirt or mold growth? |
|
|
|
1 mo |
|
|
Steam
lines: Condition
OK |
|
|
|
6mo |
|
|
Humidistat :
Operation OK |
|
|
|
6 mo |
|
|
Traps,
strainers, and drains:
Condition OK, no bacterial or fungal growth ? |
|
|
|
6 mo |
|
|
Spray
humidifier or Air washer (id
# __________ ) |
|
Condition:
All parts clean?
No noticeable leaks? |
|
|
|
1mo |
|
|
Biocide: Biocide
treatment ok? |
|
|
|
1mo |
|
|
Operation: Floats,
pumps, filters, nozzles operate properly? |
|
|
|
6 mo |
|
|
Pans:
Draining properly,
no bacterial or fungal growth? |
|
|
|
6 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
Spray
humidifier or Air washer (id
# __________ ) continued |
|
Coil:
Complete coverage? |
|
|
|
6 mo |
|
|
Motor:
No unusual sounds?
Operation acceptable?
Wiring secure, brushes OK?
|
|
|
|
6 mo |
|
|
Fans
and Motors (Id#____________) |
|
Condition:
No unusual odors, noise, or
vibration?
RPM and heat acceptable?
Wiring, voltage, and amp OK? ? |
|
|
|
1 mo |
|
|
Belts
and sheaves:
No excessive wear?
Alignment and tension OK? |
|
|
|
3 mo |
|
|
Hangers and mounting:
All secure, in good condition? |
|
|
|
3 mo |
|
|
Terminals: Starter
and terminal connections OK? |
|
|
|
3 mo |
|
|
Drive:
No wear on drive shaft?
Drive section is aligned? |
|
|
|
3 mo |
|
|
Chains and guards:
No missing chain links or
teeth?
Sprocket and chain guards in
place? |
|
|
|
3 mo |
|
|
Chain tension: Adjust tension. |
|
3 mo |
|
|
Bolts: Tighten mounting bolts. |
|
3 mo |
|
|
Bearings: Repack and lubricate per
manufacturer’s instructions. |
|
12 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
AIR DISTRIBUTUON AND TERMINAL SYSTEM
|
|
Ductwork (supply and return) (id
# __________________ ) |
|
Condition:
No odors, noise or vibration?
Clean, no obstructions,
debris? No signs of moisture/mold, insects or rodents?
No noticeable air leaks? |
|
|
|
1 mo |
|
|
Connections and seals: Tight,
no damage or denting? |
|
|
|
3 mo |
|
|
Duct
lining:
No dirt, dampness, mold?
No deterioration? |
|
|
|
3 mo |
|
|
Fire
and smoke detectors and
dampers: Condition ok? |
|
|
|
3mo |
|
|
Plenum
(id #
__________________ ) |
|
Condition:
No odors, unusual sounds, or
vibration?
Clean, no obstructions,
debris? No signs of moisture/mold, insects or rodents?
No leaks from supply or
exhaust into return? |
|
|
|
1 mo |
|
|
Ceiling tiles:
Tight seal of all tiles?
No
stained/damaged tiles indicating high RH or moisture problem?
|
|
|
|
1 mo |
|
|
Insulation & fireproofing:
Condition OK? |
|
|
|
3 mo |
|
|
Fire
dampers: Open? |
|
|
|
3 mo |
|
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
|
Supply
diffusers, return grilles, exhaust grilles (id
# ___ ) |
|
Condition:
No odors or unusual sounds?
Clean, no excess dirt or
moisture?
No obstruction to air flow?
No purposely placed
obstruction indicating occupant distress? |
|
|
|
1 mo |
|
|
Louvers: Adjustable
louvers move freely? |
|
|
|
3 mo |
|
|
Location: No short
circuiting between supply and return? |
|
|
|
3 mo |
|
|
Doors: Closed
tightly? |
|
|
|
|
|
|
Supply
diffuser:
Supply diffusers have proper
air flow—not too high or too low?
Air temperature under cooling
conditions ok? |
|
|
|
3 mo |
|
|
Inspect:
Clean and clear obstructions on all diffusers and grilles. Determine and
fix source of excess dirt, dust or moisture (e.g. dirty filter media or air
bypassing media). Investigate signs of occupant distress. |
|
3mo |
|
|
|
|
|
|
|
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
CAV /
VAV Boxes (id #
__________) |
|
General:
Clean, clear air pathways?
No odors or unusual noise or
vibration? |
|
|
|
3 mo |
|
|
Condition:
Condition of ducts, hangers /
mounting, smoke detection, motor, wiring, acceptable?
No noticeable leaks? |
|
|
|
3 mo |
|
|
Controls:
Wiring connections OK?
Control operates
properly?
Minimum flow is
sufficient to ventilate space, meet standards? |
|
|
|
3 mo |
|
|
Reheat
coils: Clean,
functioning, no obstruction ? |
|
|
|
3 mo |
|
|
Fans:
No unusual noise or vibration?
Belt condition, alignment, and
tension OK?
(See Fan Maintenance in AHU) |
|
|
|
3 mo |
|
|
Filters:
Change filters |
|
3 mo |
|
|
Fan-coil unit /Heat pump (id.
# ________ ) |
|
Condition: No
odors, or unusual noise or vibration? |
|
|
|
|
|
|
Convectors;
Condition OK?
No HW/CW leaks? |
|
|
|
3 mo |
|
|
Air
intake:
Clean, no blockage to air?
Damper mobility OK?
|
|
|
|
3 mo |
|
|
Insulation :
Clean?
No
deterioration? |
|
|
|
3 mo |
|
|
Covers: Fit tight,
no vibration? |
|
|
|
3 mo |
|
|
Fans
No
unusual noise or vibration? Belt condition, alignment, and tension OK?
(See fan
maintenance in AHU) |
|
|
|
3 mo |
|
|
Filters:
Change filters |
|
3 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
Exhaust Systems in Special Use
Areas (ID#_________)
|
Operation:
Operates whenever source of pollution is present?
Drawing sufficient air?
Room under negative pressure?
Make up air path unobstructed? |
|
|
|
1mo
|
|
|
Filters: Change filters. |
|
|
|
3 mo
|
|
CENTRAL PLANT
|
|
Boiler (id
# ______________) |
Condition:
Chemical treatment proper?
No back drafting?
Fresh water use and temp. OK? |
|
|
|
1 mo |
|
Condensate &
return:
Operation and
temperature acceptable?
|
|
|
|
1 mo |
|
Controls:
Operation and calibration OK?
|
|
|
|
1 mo |
|
Expansion tank:
Condition OK?
|
|
|
|
1 mo |
|
Circulating pump:
Condition OK?
|
|
|
|
1 mo |
|
Perform combustion and flue gas test.
|
|
1mo |
|
Clean boiler
|
|
12 mo |
|
|
Chiller (id. #
_____________ ) |
|
Condition/operation:
No Leaks?
Operation OK?
Analyze chemicals in of water in chiller and HVAC loop and adjust as needed |
|
|
|
1 mo |
|
|
Crankcase :
Crankcase heater operation OK? |
|
|
|
3 mo |
|
|
Refrigerant:
Refrigerant charge OK? |
|
|
|
3 mo |
|
|
Leaks: No
air, refrigerant, or oil leaks? |
|
|
|
3 mo |
|
|
PM: Inspect
and perform maintenance of chiller |
|
12 mo |
|
|
Procurement: Purchase
chemicals for chiller |
|
12 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
Condensing equipment ( cooling tower)
(id # ________ ) |
|
Leaks: No
leaks in cooling tower, reservoir, or storage tank? |
|
|
|
1mo |
|
|
Chemicals:
Analyze chemicals for cooling tower water and adjust as needed. |
|
1mo |
|
Mist Eliminator:
Operation OK?
|
|
|
|
1mo |
|
Baffles:
No slime or algae?
|
|
|
|
|
|
Chemical
dispenser:
Proper operation? Adjust as needed.
|
|
|
|
1mo |
|
|
PM: Perform
maintenance of cooling tower |
|
6 mo |
|
Procurement:
Purchase chemicals for cooling tower
|
|
12 mo |
|
|
Air
compressor and pneumatic system (Id#_____________) |
|
Condition:
No odors or unusual noise?
No leaks?
Cycling on/off OK? |
|
|
|
1mo |
|
|
Water:
Drain water from compressor tank. |
|
1mo |
|
|
Corrosion: Unit
free of deterioration and corrosion? |
|
|
|
3 mo |
|
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Oil:
Oil level and condition OK? |
|
|
|
3 mo |
|
|
Safety
valve:
Head pressure safety
valve OK? |
|
|
|
3 mo |
|
|
Filter:
Clean / change air filter. |
|
3 mo |
|
|
Belts:
Inspect condition, adjust alignment and tension, change as needed. |
|
3 mo |
|
|
Bearings: Inspect
bearing and operating surface temperature. |
|
3 mo |
|
|
Vibration: Investigate
vibration and tighten bolts. |
|
3 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
HVAC
pumps and pipes (id
# ___________ ) |
|
Condition:
No unusual noises, vibration?
No corrosion or deterioration?
Insulation in place,
acceptable condition?
No steam, water, or gas leaks?
Water circulates with pump
when cooled? |
|
|
|
1mo |
|
|
Valves
and gaskets:
Valves open & close OK ?
No corrosion or leaks?
Hand hold not leaking or
deteriorating?
Inspect/test safety valves & devices. |
|
|
|
1 mo |
|
|
Tanks:
Expansion and other tanks and
receivers operate properly?
No leaks or deterioration? |
|
|
|
1mo |
|
|
Drains
and traps:
Drains clean and
unobstructed?
Traps charged? |
|
|
|
1mo |
|
|
Heat
and lubrication:
No excessive heat or sparking?
Lubrication OK? |
|
|
|
3 mo |
|
|
Hangers, connectors, fittings:
No loose, missing parts in
hangers?
Fittings and connectors are
not deteriorating? |
|
|
|
3 mo |
|
|
Couplings:
Shaft security, and safety
guards of couplings OK?
Alignment OK? (If belt
coupled, check tension and condition.)
No uneven wear? |
|
|
|
3 mo |
|
|
Impeller: Impeller
moving medium through pipe OK?. |
|
|
|
3 mo |
|
|
Housing: Packing,
seals, gaskets OK? No leaks?. |
|
|
|
3 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
HVAC
pumps and pipes (id
# ___________ ) continued |
|
Wiring:
No broken, frayed, and loose wiring? |
|
|
|
3 mo |
|
|
Pipes:
No leaks, corrosion? No loose connections? |
|
|
|
3 mo |
|
|
Pumps:
Inspect and perform preventive maintenance on pumps over 1 H.P. |
|
|
|
3 mo |
|
|
Bypass
valves:
Bypass valves operating properly? |
|
|
|
6 mo |
|
|
Motors:
Pumps running smoothly?
Pumps not running excessively?
No excessive heat or sparking?
Lubricate as needed
|
|
|
|
6mo |
|
|
Emergency generators (id
# _________ ) |
|
PM:
Perform preventive maintenance program |
|
|
|
3 mo |
|
|
Procurement: Purchase
emergency generator fuel |
|
|
|
6 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
Control system: |
|
Testing equipment:
Calibrate according to manufacturer’s instructions.
Perform PM on all testing equipment. |
|
1 mo |
|
|
Pressure Control:
Inspect pressure control: Confirm that pressure meets design specs |
|
3 mo |
|
|
Leaks:
No compressed air and
pneumatics leaks in connections, valves, and hoses? |
|
|
|
3 mo |
|
|
Calibration check:
HVAC
equipment controls calibrated? |
|
|
|
3 mo |
|
|
Operation:
Controls operation OK?
Control sequence meets design
specs?
Set points meet specs? |
|
|
|
3 mo |
|
|
Central system clocks:
Set appropriately?
Check standard/daylight
savings. Location appropriate (e.g. (thermostat not near draft or heat
source)
|
|
|
|
6 mo |
|
|
Economizer:
Operates at correct settings?
Humidity control not a
problem? |
|
|
|
6 mo |
|
|
Gauges:
Inspect for proper equipment operation , and calibration |
|
6 mo |
|
|
Checklist & Action Items
(Action items in italics) |
Y |
N |
Actions taken / Notes
|
Freq
(possible) |
Date |
|
BUILDING |
|
Envelope (Id#____________________) |
|
Roof:
In good
condition?
No leaks? |
|
|
|
3 mo |
|
|
Foundation:
Has
proper drainage?
No
moisture penetration or signs of mold? |
|
|
|
3 mo |
|
|
Doors
and windows:
Caulking and weather stripping in good condition? |
|
|
|
3 mo |
|
|
|
|
|
|
|
Room is ventilated under
negative pressure? |
|
|
|
1 mo |
|
|
Elevator Shafts (Id#__________) |
|
Condition:
Dry,
clean?
Evacuating odors? |
|
1 mo |
|
|
Stairwells (Id#__________) |
|
Condition:
Dry, clean, no odors?
Doors close and latch?
No penetrations allowing
uncontrolled air flow? |
|
1 mo |
|
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Click product logo for details
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