IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
IAQ Check List
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
1. Ground Level Indoor Inspection
a. Univents are on and air discharge grills are free of obstructions.
If false, send email to building principal and facilities director asking staff to be instructed to keep vents
clear at all times. Record locations here:
2. Ground Level Outdoor Inspection (weather permitting)
a. Univent air intakes are free of obstructions.
If false, record locations here:
b. Filters
i. Medium efficiency filters are installed in all univents.
If false, list locations and create work orders to initiate corrective action.
ii. High efficiency filters are installed in the air handling units.
If false, list locations and create work orders to initiate correction action.
iii. Filters are being changed every six months and the installed date is written on the outer filter casing.
If filter is older than 6 months, list locations and create work orders to initiate corrective action.
c. Insects, bird nests, or droppings are not evident near outdoor air intakes.
If false, indicate locations here:
d. Trash dumpsters are located away from doors, windows, and outdoor air intakes.
e. Potential sources of air contaminants do not exist near the building. (e.g. chimneys, stacks, industrial
plants, exhaust from nearby buildings)
f. Trucks and buses are not allowed to keep their engines idling near the building.
Page 1 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
g. No evidence of drainage problems exist. Water drains away from the building including roof
downspouts.
h. Sprinklers do not spray directly toward the building or into outdoor air intakes.
i.
j.
Grass clippings from mowers are directed away from the building air intakes.
The landscaper has been intructed to blow clippings away from the building. This is being
monitored weekly.
Clean walk-off mats are present at exterior entrances.
3. Roof (Inspections conducted weather permitting)
a. Roofing consultant has not found any issues requiring immediate repair.
Most recent roofing inspection date/company: 5-year roofing plan completed 5/25/2010 with C. E.
Crowley & Associates.
b. There is no evidence of water ponding on the roof.
This is a rock ballasted roof but no evidence of ponding was visible.
c. Intake ventilation units are operating properly and free of debris.
d. All exhaust fans are operating properly and free of debris.
e. Air intake dampers are set to allow air flow even at minimum setting.
f. Insects, birds, animal nests or droppings are not evident near outdoor air intakes.
g. Plumbing stacks and exhaust vents are located away from air intakes.
4. Attic
a. There is no evidence of roof or plumbing leaks.
There is no attic.
Page 2 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
IAQ Check List
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
b. There is no evidence in attic of insects, birds, animals, or nests.
No Attic.
5. General Considerations
a. Classrooms, offices and/or common areas appear recently cleaned.
If examples of poor housekeeping are found, record locations below:
First floor gave evidence of not being vacuumed in the hallways. This was addressed with GCA
supervisors.
b. Only vacuums with HEPA filters are being used.
c. All supply and exhaust ventilation units are working properly.
The re-commissioning of the Building automation system is on-going which means that some fan
units may be off for brief periods of time as we confirm connections.
d. Occupied space temperatures and relative humidity levels are within the standards listed below.
i. Temperature range:
Winter temperatures 70-73 degrees.
Summer temperatures 74-80 in air-conditioned spaces and 74-85 in non-air-conditioned
spaces.
Outdoor air temperature: 32.5 degrees.
Highest temperature – Location: A206; Reading of 74.3 degrees.
Lowest temperature – Location: B126, B210; Reading of 69.7 degrees.
ii. Relative humidity range is 30% to 60%.
Non-air-conditioned spaces may be higher on rainy or humid summer humid days.
All spaces may be less than 30% when the out-door air temperature is less than 32 degrees.
Outdoor relative humidity: 51%
Highest relative humidity – Location: A109; Reading of 28.3%
Lowest relative humidity – Location: Main Office;Reading of 23.1%
Page 3 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
IAQ Check List
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
Readings not within acceptable standards will result in the creation of a work order, requesting
maintenance to address. (Readings are noted on the attached test data sheet)
e. Occupied space readings of carbon monoxide (CO) levels are less than 9.0 PPM.
Outdoor Air CO Reading: .5
Highest CO Location: A200, A202, B208, B213 Reading: 0.2
Lowest CO Location: Numerous Rooms
Reading: 0
If the CO level is greater than 9.0 PPM in any space as measured with a handheld device or “leave-in”
monitor, the space must be cleared of all occupants and steps taken to correct the problem. The issue
will be immediately addressed by maintenance and the Fire Department. (Readings are noted on the
attached test data sheet)
f. CO2 levels in any occupied space are below threshold limits.
i. Perform CO2 check with Gray Wolf or other portable device. Measure four times yearly or more
often if needed. Measure only in fully occupied rooms. Reading should be less than 700 PPM plus
outside air CO2 PPM.
700 PPM + 350 PPM = 1050 PPM
Assume outside CO2 is 350 if temperature is below 41 degrees and air is not stagnant with no- wind.
Record all occupied space CO2 levels on forms provided. Provide the outdoor CO2 level as well as
the high and low CO2 extremes below:
Outdoor reading: 410 PPM
Highest CO2 reading – Location: B204; Reading of 956 PPM
Lowest CO2 reading – Location: B118; Reading of 518 PPM
2 hour occupancy requirement met. There is a need to confirm room numbers and locations to
sync rawings with actual building layout.
Page 4 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
IAQ Check List
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
ii. If reading is above threshold, check univent and air handling dampers to ensure a value is set to
provide at least 15 cfm of fresh air intake per student based on average space occupancies. If
reading is consistently elevated, then use data logging to monitor CO2 concentrations over time and
look for other sources of problems.
iii. CO2 levels were checked three months ago.
g.
h.
i.
j.
iv. CO2 levels on “leave-in” devices, where present, where checked.
No Leave In devices
Offensive odors are not apparent.
If false, list problem areas: Offensive gas smell has been reported. Corrective action has been
identified and is in process.
Water damage is not evident.
Check for roof leaks, pipe leaks, spills, stained ceiling tiles, etc, visually and with moisture meter. Look
for the source of any water leaks and schedule repairs. Discard porous items such as ceiling tiles if wet
for more than 24 hours. For carpeting, if less than 9 square feet of wet area, shampoo with germicide
and fan dry. For areas greater than 9 square feet, replace carpet with tile in reasonable timeframe. If
carpet is over ACM tile, replace during next unoccupied break time (winter break, spring break,
summer).
If false, record findings and locations here: Stained ceiling tile in stairwell by door 21, Prep Room by
B206. Also water is penetrating through the window in Todd's office.
Mold or mildew growth is not evident.
If false, record findings and locations here:
All pest management issues are being handled by Integrated Pest Management.
k. No other unresolved concerns or complaints by building personnel are known.
If false, list any pending issues not previously mentioned in this report here:
l. There are no incomplete HVAC preventative maintenance (PM) work requests.
If false, list any incomplete HVAC work request here:
Page 5 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
IAQ Check List
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
6. Bathrooms and General Plumbing
a. All locker or restroom exhaust fans are working.
Inoperable or malfunctioning fans are listed as follows:
Location:
Problem:
b. All of the following drain-trap maintenance procedures are being conducted according to the frequency
indicated.
If false, indicate all deviations and locations:
i. Water is poured into floor drains once per week (approximately 1 quart of water) or water and a
teaspoon of cooking oil poured into the drain once a month.
Drafting a PM procedure to confirm that all floor drains are consistantly checked and that a
record of this data is maintained.
ii. Water is poured into sinks at least once per week (about 2 cups of water).
iii. Toilets are flushed at least once per week.
7. Lab Chemicals & Maintenance Supplies
a. Lab chemicals are used with exhaust fans turned on.
Just for reference, the science exhaust hoods will be inspected, balanced and certified over the
summer.
b. Lab chemical storage areas have been inspected yearly by ROE and Fire Department.
Record last inspection dates below:
ROE: 10/10
LZFD: 10/10
c. Flammables are not stored with igniters.
d. All chemicals that may react or produce toxic or explosive by-products are separated and maintained in
Page 6 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
approved containers stored in approved storage. (e.g. lockable, with appropriate ventilation).
e. Chemical disposal records for all lab chemicals are available for review.
f. All cleaning products used in building contain no/low VOC.
List any exceptions:
g. Increased ventilation is considered when installing new carpets, cleaning upholstered furniture,
shampooing carpets, etc.
h. Exhaust ventilation systems in chemical and trash storage areas are turned on and functioning properly.
i.
Portable fuel containers are properly closed.
j.
Power equipment, like snow blowers and lawn mowers, have been serviced and maintained according to
manufacturers’ guidelines.
k. Oil based paints are stored in approved storage cabinets.
No oil based paints allowed in the district.
l. Green Cleaning products and processes are used in this building.
8.
Combustion Appliances
a. Combustion analysis is performed at the start of the heating season on all boilers. Adjustments are
made to the burners to correct any abnormalities and improve efficiency.
b. In rooms that contain combustion appliances, there is no evidence of combustion gas or fuel odors.
If false, record locations here:
c. No leaks, disconnections, and/or deterioration were found on exhaust hoods.
Page 7 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
IAQ Check List
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
d. Flue components are clean and free of soot.
e. All combustion appliances have flues or exhaust hoods and vent NO2.
i. If false, inspect cooking hoods, chemical hoods. Assure that cooking stoves and appliances are
correctly installed, used, and maintained according to manufacturers’ specifications.
ii. If not vented, ensure that “leave-in” CO monitors are placed in room. Record locations here:
iii. CO levels in rooms with combustion appliances are measured and recorded with an IAQ monitor. CO
readings outside of normal CO range will result in an immediate response by maintenance to reduce
CO level or vacating the room/building, if necessary.
Record locations here:
9. Other
a. Paint
No peeling and/or flaking paint found.
If planned building renovation will damage paint or if peeling paint is discovered, lead testing may be
necessary. If peeling paint is found, send email to the building Principal and the Facilities Director
alerting them of the problem. Staff and teachers need to pick up any flakes of paint to prevent
children from being exposed. The Facilities Director will advise the Facilities Coordinator (a Certified
Lead Paint Renovator) to test the paint for lead. Lead paint was discontinued in 1978. Buildings built
after 1978 are exempt from lead paint testing.
If lead is present, required repairs should be done immediately using lead-safe methods and, if
necessary, a licensed lead contractor.
Location(s) of known peeling paint in building:
b. The following preventive measures are being taken to reduce lead exposure.
i. Play areas and toys are cleaned nightly.
Page 8 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: May 14, 2011
ii.
IAQ Check List
Building Inspection Performed by: Skip Lubenow, Denys Armashov, Lyle
Report Compiled by: Lyle Erstad
Check List
True False N/A
Floors are mopped nightly.
iii. Dust at least weekly.
c. Radon testing is recommended by IEMA every 5 years. Last testing date listed below:
Date:
; Reading of
d. The IAQ testing equipment used for this inspection was calibrated and is in good working order.
Equipment Used: Gray Wolf
Last date of calibration: 2/4/11
Page 9 of 9
Revised 3/21/2011 AMJ
Created 11/2010
Middle School North 95 Hubbard Ln. Spring 2011 IAQ Readings
Site
Location
Date/Time
Temperature °F
Relative
Carbon Monoxide Carbon Dioxide
Occupants
Humidity %RH
ppm
ppm
Middle School North
Outdoor Air
20-Apr-11 11:03:34 AM
32.5
51.0
0.5
410
Middle School North
A104
20-Apr-11 12:53:52 PM
70.9
27.1
0.0
686
22
Middle School North
A109
20-Apr-11 12:55:31 PM
71.6
28.3
0.0
817
29
Middle School North
A110
20-Apr-11 12:57:29 PM
72.2
26.9
0.1
613
3
Middle School North
A112
20-Apr-11 01:00:28 PM
73.7
26.4
0.0
579
12
Middle School North
A200
20-Apr-11 01:29:37 PM
73.3
27.6
0.2
916
29
Middle School North
A202
20-Apr-11 01:27:57 PM
73.4
27.0
0.2
873
27
Middle School North
A204
20-Apr-11 01:24:49 PM
74.0
26.3
0.1
861
25
Middle School North
A205
20-Apr-11 01:23:02 PM
74.2
24.9
0.1
700
7
Middle School North
A206
20-Apr-11 01:26:23 PM
74.3
25.6
0.0
736
11
Middle School North
A207
20-Apr-11 01:21:30 PM
73.8
24.2
0.1
556
3
Middle School North
A208
20-Apr-11 01:15:17 PM
72.7
25.3
0.0
677
20
Middle School North
A209
20-Apr-11 01:13:40 PM
72.8
24.5
0.1
593
9
Middle School North
A210
20-Apr-11 01:09:13 PM
73.5
27.9
0.0
695
14
Middle School North
A211
20-Apr-11 01:12:03 PM
73.6
27.1
0.1
843
12
Middle School North
A212
20-Apr-11 01:07:08 PM
72.3
26.3
0.1
720
16
Middle School North
A213
20-Apr-11 01:03:42 PM
72.7
26.1
0.0
703
20
Middle School North
A214
20-Apr-11 01:05:37 PM
72.5
26.5
0.1
774
22
Middle School North
A215
20-Apr-11 01:02:24 PM
72.4
26.6
0.1
788
22
Middle School North
B102
20-Apr-11 12:32:40 PM
72.6
27.2
0.0
812
24
Middle School North
B104
20-Apr-11 12:34:42 PM
72.1
25.8
0.0
630
29
Middle School North
B106
4/20/2011 12:39
72.4
26.8
0.0
741
28
Middle School North
B110
20-Apr-11 12:36:34 PM
71.9
25.7
0.1
629
9
Middle School North
B112
20-Apr-11 12:41:21 PM
72.5
26.7
0.0
696
17
Middle School North
B114
20-Apr-11 12:44:30 PM
70.1
25.2
0.0
477
3
Middle School North
B118
20-Apr-11 12:46:13 PM
70.2
25.6
0.0
518
5
Middle School North
B126
20-Apr-11 12:48:20 PM
69.7
25.9
0.0
556
5
Middle School North
B202
20-Apr-11 01:33:30 PM
73.3
24.5
0.0
651
11
Middle School North
B203
20-Apr-11 01:31:46 PM
73.2
24.6
0.0
599
8
Middle School North
B204
20-Apr-11 01:35:02 PM
73.0
25.4
0.1
770
19
Middle School North
B206
20-Apr-11 01:36:53 PM
73.2
27.3
0.0
956
23
Middle School North
B207
20-Apr-11 01:38:47 PM
73.3
25.8
0.1
699
19
Middle School North
B208
20-Apr-11 01:45:29 PM
72.4
25.7
0.2
759
22
Middle School North
B209
20-Apr-11 01:40:21 PM
73.4
26.4
0.1
822
29
Middle School North
B210
20-Apr-11 01:48:52 PM
69.7
24.8
0.1
560
23
Middle School North
B211
20-Apr-11 01:47:03 PM
71.9
26.1
0.1
842
13
Middle School North
B212
20-Apr-11 01:50:17 PM
72.0
27.4
0.0
880
17
Middle School North
B213
20-Apr-11 01:51:43 PM
71.8
26.3
0.2
762
16
Middle School North
Main office
20-Apr-11 01:54:04 PM
71.5
23.1
0.0
529
5
Middle School North
A102
20-Apr-11 12:51:38 PM
70.9
27.4
0.0
670
9
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Middle School North
Outdoor Air
11-May-11 12:44:13 PM
86.1
66.1
0.3
368
Middle School North
A103
11-May-11 12:04:19 PM
74.2
51.7
0.1
755 2
Middle School North
A105
11-May-11 12:09:49 PM
74.8
51.9
0.1
811 4
Middle School North
A106
11-May-11 12:06:52 PM
75.1
53.2
0.1
1120 29
Middle School North
A107
11-May-11 12:11:37 PM
74.8
52.5
0.1
906 12
Middle School North
A108
11-May-11 12:13:31 PM
74.9
52.8
0.1
844 19
Middle School North
A111
11-May-11 12:15:36 PM
74.4
53.1
0.1
Middle School North
A113
11-May-11 12:17:24 PM
74.7
53.6
0.1
1057 2
Middle School North
A114
11-May-11 12:22:03 PM
74.9
53.5
0.1
1127 2
Middle School North
A115
11-May-11 12:19:18 PM
74.7
53.1
0.1
993 2
Middle School North
A203
11-May-11 12:26:31 PM
75.2
52.2
0.1
816 2
Middle School North
B104
11-May-11 12:40:34 PM
74.5
54.6
0.0
876 28
Middle School North
B116
11-May-11 12:37:54 PM
74.8
52.9
0.1
829 2
Middle School North
B200
11-May-11 12:32:36 PM
75.3
52.3
0.1
847 5
Middle School North
B201
11-May-11 12:30:50 PM
75.0
52.6
0.1
773 3
Middle School North
B205
11-May-11 12:34:40 PM
74.9
52.6
0.2
832 10
Middle School North
A100
11-May-11 12:02:07 PM
74.6
54.9
0.1
885 26
988 19
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Denys
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
Gray Wolf
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