IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
IAQ 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.
In process now.
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 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
g. No evidence of drainage problems exist. Water drains away from the building including roof
downspouts.
IAQ Check List
True
False
N/A
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.
Landscaper is instructed to blow clippings away from the building.
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 ballasted roof but no evidence of ponding was apparent.
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.
Some individual units have been set higher to bring in more outside air.
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.
No Attic
Page 2 of 9
Revised 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
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:
IAQ Check List
True
False
N/A
b. Only vacuums with HEPA filters are being used.
c. All supply and exhaust ventilation units are working properly.
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: 70.7; 78.5; 70.5; 70.1; 58.3 degrees.
Highest temperature – Location: 800; 511; 704; 803; 213 ; Reading of 77.8; 83.4; 79.9; 76.9; 76.1
degrees.
Lowest temperature – Location: 804; 114; 140; 801; 410; Reading of 76; 76.7; 77.2; 74.1; 70
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: 48.5; 83.8; 61.4; 42.8; 53.3%
Highest relative humidity – Location: 804; 100; 803; 801; 213 ; Reading of 49.9; 78.3; 70.7; 50.7;
53.5%
Lowest relative humidity – Location: 96; Lib Comp Rm; 600; 803; 213;Reading of 44.9; 46.6;
Page 3 of 9
Revised 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
IAQ Check List
True
False
N/A
48.8; 41.1; 46.2%
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: 1; 0; .5; 0; 1
Highest CO Location: 800; 506; 600; 801; 410 Reading: .6; .3; .3; .4; .5
Lowest CO Location: 804; Several rooms; 140; 803; 212, 213
Reading: 0; 0; 0; 0; .2
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 + 436; 346; 374; 378; 388 PPM = 1136; 1046; 1074; 1078; 1088
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: 436; 346; 374; 378; 388 PPM
Highest CO2 reading – Location: 129; 803; 803; 801; 212; Reading of 1641; 1307; 1602;
969; 959 PPM
Lowest CO2 reading – Location: 804; 506; 140; 803; 524; Reading of 571; 412; 597; 649;
Page 4 of 9
Revised 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
IAQ Check List
True
False
N/A
524 PPM
Work orders were written to address the high readings. We will be entering into an agreement
with Siemens. This is the company who has the Building Automation System (BAS). They will
be replacing some controls and resetting set points.
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.
iv. CO2 levels on “leave-in” devices, where present, where checked.
NONE
g. Offensive odors are not apparent.
If false, list problem areas:
h. 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: Room 802 had a leak that needed to be addressed. After
having been repaired, the last round of rains had the room dry. Also 304 had a stained ceiling tile.
Page 5 of 9
Revised 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
IAQ Check List
True
False
N/A
This was investigated and repaired.
i.
j.
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:
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.
The custodial department is reminded of these procedures regularly.
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.
Page 6 of 9
Revised 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
b. Lab chemical storage areas have been inspected yearly by ROE and Fire Department.
Record last inspection dates below:
ROE: 11/2011
LZFD: 11/2011
IAQ Check List
True
False
N/A
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
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 paint is allowed in the district.
l. Green Cleaning products and processes are used in this building.
Page 7 of 9
Revised 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
8.
IAQ Check List
True
False
N/A
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.
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: NONE
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
Page 8 of 9
Revised 3/7/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School South
Date: May 11, 2012
Building Inspection Performed by: Lyle Erstad
Report Compiled by: Lyle Erstad
Check List
after 1978 are exempt from lead paint testing.
IAQ Check List
True
False
N/A
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.
ii.
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: 12/19 - 21/2011; Reading of (Highest) <1.7 pCi/L in Room 94.
National concern: Greater than 4.0 pCi/L
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: 1-20-2012
Page 9 of 9
Revised 3/7/2011 AMJ
Created 11/2010
Middle School South
Site
Location
Middle School South Outdoor Air
Middle School South
95
Middle School South
96
Middle School South
98
Middle School South
129
Middle School South
138
Middle School South
800
Middle School South
802
Middle School South
804
Date/Time
5/1/2012 - 2:21:14 PM
5/1/2012 - 1:59:36 PM
5/1/2012 - 2:02:02 PM
5/1/2012 - 2:04:18 PM
5/1/2012 - 2:08:43 PM
5/1/2012 - 2:10:43 PM
5/1/2012 - 2:12:29 PM
5/1/2012 - 2:14:15 PM
5/1/2012 - 2:18:18 PM
Temperature °F
70.7
76.1
77.1
77.5
77
77.6
77.8
77.2
76
Relative Humidity %RH
48.5
46.4
44.9
45.3
47.7
47.3
47
48.4
49.9
Carbon Monoxide ppm
1
0.4
0.3
0.4
0.3
0.4
0.6
0.4
0
Carbon Dioxide ppm
436
638
798
852
1641
1073
810
579
571
Occupant
Window
22
42
32
23
21
23
14
18
Yes
Date/Time
5/3/2012 - 10:58:57 AM
5/3/2012 - 12:30:31 PM
5/3/2012 - 11:02:40 AM
5/3/2012 - 11:03:52 AM
5/3/2012 - 11:05:47 AM
5/3/2012 - 12:35:42 PM
5/3/2012 - 1:56:45 PM
5/3/2012 - 1:55:33 PM
5/3/2012 - 1:58:34 PM
5/3/2012 - 11:08:06 AM
5/3/2012 - 11:09:35 AM
5/3/2012 - 11:12:44 AM
5/3/2012 - 11:12:44 AM
5/3/2012 - 11:15:29 AM
5/3/2012 - 12:34:03 PM
5/3/2012 - 11:17:45 AM
5/3/2012 - 11:21:42 AM
5/3/2012 - 12:49:27 PM
5/3/2012 - 12:51:14 PM
5/3/2012 - 12:53:35 PM
5/3/2012 - 11:33:23 AM
5/3/2012 - 12:55:48 PM
5/3/2012 - 11:34:56 AM
5/3/2012 - 11:38:01 AM
5/3/2012 - 11:39:59 AM
5/3/2012 - 11:42:09 AM
5/3/2012 - 12:57:46 PM
5/3/2012 - 1:00:13 PM
5/3/2012 - 11:44:34 AM
Temperature °F
78.5
82.6
77.4
77.3
77.1
80.9
82
82.7
81.7
77
76.7
76.8
76.8
78.4
80.3
78.8
80.3
82
82.4
82.7
80.5
83.4
80.4
81.1
80.9
81.4
83
82.3
81.6
Relative Humidity %RH
83.8
67.6
78.3
78.1
75.8
67.2
63
62.6
65.1
75.4
75.4
73.3
73.3
78
64.3
77.8
71.5
67.7
69
70.1
74.2
70.5
71
73.8
73.3
73.3
68.1
67
72.8
Carbon Monoxide ppm
0
0.1
0.1
0
0
0.2
0.1
0
0.1
0.1
0.1
0.2
0.2
0
0.2
0.2
0.1
0.2
0
Carbon Dioxide ppm
346
598
425
460
464
553
505
457
504
478
461
447
447
454
946
684
592
573
586
523
717
679
649
508
801
715
500
426
497
Occupant
Window
25
2
2
1
1
1
2
1
2
1
1
1
49
8
300
29
15
30
25
20
26
5
22
23
23
2
21
70
Yes
Formual: 700 + 436 = 1136
Site
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Location
Outdoor Air
94
100
101
105
107
108
109
110
112
114
115
115
120
129
203
208
209
211
303
304
305
306
307
308
309
404
405
406
0.1
0.1
0.2
0.1
0.1
0.1
0.1
0
0
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
Middle School South
407
408
410
503
504
505
506
507
508
509
511
603
604
605
606
607
608
705
706
707
803
806
808
208 A
208 A
Lib Comp
5/3/2012 - 11:49:16 AM
5/3/2012 - 11:50:56 AM
5/3/2012 - 11:52:48 AM
5/3/2012 - 12:47:13 PM
5/3/2012 - 11:56:17 AM
5/3/2012 - 11:58:33 AM
5/3/2012 - 12:00:33 PM
5/3/2012 - 12:02:06 PM
5/3/2012 - 1:03:01 PM
5/3/2012 - 1:05:14 PM
5/3/2012 - 1:07:23 PM
5/3/2012 - 12:13:00 PM
5/3/2012 - 12:06:25 PM
5/3/2012 - 12:04:26 PM
5/3/2012 - 1:10:03 PM
5/3/2012 - 12:10:45 PM
5/3/2012 - 12:08:03 PM
5/3/2012 - 12:14:50 PM
5/3/2012 - 12:16:15 PM
5/3/2012 - 1:12:35 PM
5/3/2012 - 12:18:30 PM
5/3/2012 - 1:16:02 PM
5/3/2012 - 12:20:39 PM
5/3/2012 - 11:25:30 AM
5/3/2012 - 11:25:30 AM
5/3/2012 - 12:45:08 PM
81.6
81.1
81.9
82.3
82.3
82.6
81.5
81.8
83
83.3
83.4
81.1
82
81.6
83
80.3
81.7
81.2
81
82.7
81.2
83
81.6
80.5
80.5
79.3
71.4
70.7
73.7
68
73.3
71.1
71
69.6
69.3
67.9
68.1
71.2
70.7
70.5
67.1
69.6
70.1
71.7
71.5
69.1
68.5
68.3
70
68.5
68.5
46.6
0.1
0
0
0
0
0
0.3
0
0.1
0.1
0.1
0
0
0
0
0.2
0.2
0
0.1
0
0
0
0
0.2
0.2
0.1
590
634
1168
836
789
837
412
482
744
775
878
579
526
544
477
489
635
692
503
624
1307
768
643
526
526
1007
17
27
21
33
27
27
20
3
24
7
25
23
24
29
27
17
23
21
22
23
19
17
27
1
1
29
Yes
Yes
Yes
Temperature °F
70.5
77.2
79.9
79.4
77.6
79.1
79.2
79.8
78.5
Relative Humidity %RH
61.4
65.9
62.4
62.5
48.8
62.8
59.3
61.9
70.7
Carbon Monoxide ppm
0.5
0
0.1
0.1
0.3
0.2
0.1
0.1
0.2
Carbon Dioxide ppm
374
597
618
634
682
808
903
1017
1602
Occupant
Window
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Formula: 700 + 346 = 1046
Site
Location
Middle School South Outdoor Air
Middle School South
140
Middle School South
704
Middle School South
302
Middle School South
600
Middle School South
501
Middle School South
602
Middle School South
604
Middle School South
803
Formula: 700 + 374 = 1074
Date/Time
5/4/2012 13:28
5/4/2012 13:33
5/4/2012 13:52
5/4/2012 13:48
5/4/2012 14:12
5/4/2012 13:44
5/4/2012 13:59
5/4/2012 13:54
5/4/2012 13:38
16
14
2
1
1
3
3
26
Yes
Site
Location
Date/Time
Middle School South Outdoor Air 5/8/2012 - 11:22:22 AM
Middle School South
801 5/8/2012 - 11:24:53 AM
Middle School South
803 5/8/2012 - 11:41:28 AM
Temperature °F
70.1
74.1
76.9
Relative Humidity %RH
42.8
50.7
41.1
Carbon Monoxide ppm
0
0.4
0
Carbon Dioxide ppm
378
969
649
Occupant
Window
20
26
Yes
Yes
Temperature °F
58.3
74.1
76.1
70
Relative Humidity %RH
53.3
48.2
46.2
53.5
Carbon Monoxide ppm
1
0.2
0.2
0.5
Carbon Dioxide ppm
388
959
821
524
Occupant
Window
3
23
18
Yes
Formula: 700 + 378 = 1078
Site
Location
Date/Time
Middle School South Outdoor Air 5/9/2012 - 11:32:41 AM
Middle School South
212 5/9/2012 - 12:17:16 PM
Middle School South
213 5/9/2012 - 12:23:35 PM
Middle School South
410 5/9/2012 - 11:39:24 AM
Formula: 700 + 388 = 1088