IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
IAQ Check List
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
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: March 6, 2015
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
Check List
True False
g. No evidence of drainage problems exist. Water drains away from the building including roof
downspouts.
N/A
h. Sprinklers do not spray directly toward the building or into outdoor air intakes.
i.
Grass clippings from mowers are directed away from the building air intakes.
j.
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. No signs of ponding were evident.
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.
Page 2 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
Check List
True False
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:
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: 21.2; 10.9; 12.7; 18.1; 31 degrees.
Highest temperature – Location: B210; A100; A107; A200; A214; Reading of 74.5; 75.3; 72.6;
75.2; 74.3 degrees.
Lowest temperature – Location: Gym N; B205; B100; A110; Reading of 71.7; 68.5; 68.8; 71;
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: 17.3; 33.7; 19.2; 20; 21.7%
Highest relative humidity – Location: Lounge; A213; A110; A214; A214; Reading of 15; 18.1;
20.3; 14.2; 15.5%
Lowest relative humidity – Location: Gym N; B118; A107; C130;Reading of 8.3; 13.1; 11.6; 9.1%
Page 3 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
IAQ Check List
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
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: 0; 1.3; 0; 0; 0
Highest CO Location: All Rooms; A203, B203; All Rooms, A109; A214
2.8; 0
Lowest CO Location: Several Rooms; A213
Reading: 0; .9
Reading: 0;.4; 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: 448; 443; 397; 325; 473 PPM
Highest CO2 reading – Location: B212; A213; A110; A214; A214; Reading of 1190; 1183;
1727; 1093; 1067 PPM
Lowest CO2 reading – Location: Gym S; B203; 107; A110; Reading of 450; 719; A107;
792; PPM
Page 4 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
IAQ Check List
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
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.
iv. CO2 levels on “leave-in” devices, where present, where checked.
No Leave In devices
g. Offensive odors are not apparent.
If false, list problem areas: See Smells/Odor report.
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:
i. Mold or mildew growth is not evident.
Page 5 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
j.
IAQ Check List
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
Check List
True False
N/A
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 staff is reminded regularly of these procedures.
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.
b. Lab chemical storage areas have been inspected yearly by ROE and Fire Department.
Record last inspection dates below:
ROE: 10/2014
Page 6 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
IAQ Check List
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
Check List
True False
N/A
LZFD: Yet to be scheduled.
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 paints allowed in the district.
l. Green Cleaning products and processes are used in this building.
Page 7 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
8.
IAQ Check List
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
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.
Industry Heating conducted combustion analysis on December 1, 2015.
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:
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.
Page 8 of 9
Revised 3/21/2011 AMJ
Created 11/2010
IAQ Check List
Building: Lake Zurich Middle School North
Date: March 6, 2015
IAQ Check List
Building Inspection Performed by: Lyle Erstad, Greg Fleming
Report Compiled by: Lyle Erstad, Greg Fleming
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: 12/14/2011 - 12/16/2011; Reading of 1.5pCi/L (Highest) in multiple rooms
National concern: 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: 1/6/2015; 3/3/2015 (The second
calibration was done to a borrowed unit as the District owned probe was sent out for repair.)
Page 9 of 9
Revised 3/21/2011 AMJ
Created 11/2010
Middle School North 2015 Winter IAQ Data
Site
Location
Date/Time
North Outdoor Air 2/25/2015 1:22:06 PM
North
Ass't Prin. 2/25/2015 1:06:28 PM
North
B104 2/25/2015 12:11:01 PM
North
B108 2/25/2015 12:07:50 PM
North
B112 2/25/2015 12:06:00 PM
North
B114 2/25/2015 12:04:08 PM
North
B116 2/25/2015 11:59:21 AM
North
B124 2/25/2015 12:01:39 PM
North
B206 2/25/2015 11:54:14 AM
North
B210 2/25/2015 11:57:00 AM
North
B211 2/25/2015 11:55:48 AM
North
B212 2/25/2015 1:16:04 PM
North
Cafeteria 2/25/2015 12:21:07 PM
North
D100 2/25/2015 12:23:50 PM
North
Gym N 2/25/2015 12:27:20 PM
North
Gym S 2/25/2015 12:26:05 PM
North
Honegger 2/25/2015 1:09:21 PM
North
Library 2/25/2015 11:48:59 AM
North
Lounge 2/25/2015 12:13:04 PM
North Main office 2/25/2015 1:03:08 PM
North
Nurse 2/25/2015 1:07:50 PM
North
Principal 2/25/2015 1:05:01 PM
North
Vastine 2/25/2015 1:10:13 PM
North
Zabel 2/25/2015 1:11:10 PM
°F
22.1
74.1
73.6
73.5
73.9
73.2
73.8
73.7
74.3
74.5
73.6
73.2
74.2
74.1
71.7
72.6
74
73.8
73.8
73.6
74.1
73.7
74.3
74
%RH
17.3
10.2
14.2
13.3
13.6
13
12.4
12.8
12.8
12.4
11.9
14.3
11.5
11
8.3
8.5
10.6
8.8
15
9.8
10.2
9.5
9.4
9.4
CO ppm CO2 ppm Occupancy
0
448
0
534
1
0
1030
26
0
898
10
0
1048
27
0
950
4
0
889
5
0
1018
6
0
881
3
0
882
4
0
855
14
0
1190
19
0
625
75
0
785
26
0
485
3
0
450
3
0
677
1
0
556
7
0
995
6
0
620
3
0
652
5
0
529
2
0
554
1
0
570
1
AC
Window
Note
°F
10.9
75.3
74.6
%RH
33.7
15.9
15.5
CO ppm CO2 ppm Occupancy
1.3
443
0
1015
18
0
1033
28
AC
Window
Note
CO2 Formula: 700 + 350 = 1050
Site
Location
North Outdoor Air
North
A100
North
A102
Date/Time
2/26/2015 10:38
2/26/2015 12:13
2/26/2015 12:11
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
North
A103
A104
A105
A106
A108
A109
A110
A111
A112
A113
A114
A115
A202
A203
A204
A206
A207
A208
A209
A210
A211
A212
A213
A214
A215
B118
B126
B200
B203
B204
B205
B206
B207
B208
2/26/2015 12:08
2/26/2015 12:03
2/26/2015 11:59
2/26/2015 12:06
2/26/2015 11:57
2/26/2015 11:55
2/26/2015 11:51
2/26/2015 11:53
2/26/2015 11:47
2/26/2015 12:45
2/26/2015 11:48
2/26/2015 11:42
2/26/2015 11:06
2/26/2015 11:11
2/26/2015 11:16
2/26/2015 11:19
2/26/2015 11:20
2/26/2015 11:22
2/26/2015 11:25
2/26/2015 11:28
2/26/2015 11:27
2/26/2015 11:37
2/26/2015 11:33
2/26/2015 11:40
2/26/2015 11:36
2/26/2015 12:17
2/26/2015 12:18
2/26/2015 11:03
2/26/2015 11:02
2/26/2015 12:31
2/26/2015 10:59
2/26/2015 12:35
2/26/2015 12:28
2/26/2015 12:25
74.1
73.9
74.6
74.3
74.6
74.3
74.7
74.1
74.4
75.1
74.1
74
70.5
70.8
71.5
71.9
72.3
72.1
72.8
72.8
72.7
73.5
73.8
73.9
74
73.7
74
69.9
69.4
74.4
68.5
74.9
74.2
74.4
14.8
14.5
14.9
14.4
14.8
16.1
17.3
14.9
15.5
14.1
15.5
14.5
17.5
16.7
16.7
17.3
16.3
16.9
17.4
16.9
16.4
16.8
18.1
16.9
15.8
13.1
13.2
17.5
16.5
14.3
16.6
15.9
14.8
15.2
0
0
0
0
0
0
0
0
0
0
0
0
0.3
0.4
0.1
0.1
0.1
0.1
0
0.2
0.1
0.1
0
0
0.1
0
0
0.3
0.4
0
0.3
0
0
0
1014
949
939
1044
979
1110
1145
1039
1012
1066
1024
1025
932
959
923
1058
983
1037
1106
1006
1044
1161
1183
1153
1007
769
786
813
719
992
757
1164
1073
982
9
13
7
21
26
25
23
26
23
24
23
22
31
7
13
24
7
18
24
20
20
25
23
20
24
3
7
6
5
19
4
27
24
27
North
North
B212
B213
2/26/2015 12:22
2/26/2015 12:21
73.6
73.6
14.1
13.6
0
0
971
940
15
26
Date/Time
2/27/2015 10:07:49 AM
2/27/2015 1:03:14 PM
2/27/2015 1:00:42 PM
2/27/2015 12:57:35 PM
2/27/2015 10:55:43 AM
2/27/2015 12:52:57 PM
2/27/2015 10:38:04 AM
2/27/2015 1:06:27 PM
2/27/2015 12:49:38 PM
2/27/2015 12:46:05 PM
°F
12.7
72.6
71.9
72.3
70.6
71
68.8
72.5
70.1
69
%RH
19.2
11.6
14.5
20.3
14.3
12
14.9
15.2
13
14.9
CO ppm CO2 ppm Occupancy
0
397
0
746
5
0
1107
22
0
1727
20
0
988
24
0
840
8
0
874
1
0
1019
25
0
783
6
0
994
18
AC
Window
Note
°F
18.1
71
75.2
72.7
74.6
73.6
71.2
74
73.9
73.9
71.9
74
%RH
20
12
10.2
10.9
9.1
12.3
13.1
13
11.9
12.5
13.9
14.2
CO ppm CO2 ppm Occupancy
0
325
2.3
792
22
1.2
827
8
2.2
827
24
2.4
860
1
0.9
909
21
2.6
946
20
1.3
971
26
2.2
977
26
2.3
1037
25
2.8
1038
20
1.1
1093
22
AC
Window
Note
CO2 Formula: 700 + 350 = 1050
Site
Location
North Outdoor Air
North
A107
North
A109
North
A110
North
A113
North
A205
North
B100
North
B102
North
B202
North
B209
CO2 Formula: 700 + 350 = 1050
Site
Location
North Outdoor Air
North
A110
North
A200
North
B106
North
C130
North
A213
North
B207
North
A206
North
A209
North
A212
North
A109
North
A214
Date/Time
3/5/2015 11:29:31 AM
3/5/2015 12:13:51 PM
3/5/2015 1:57:39 PM
3/5/2015 12:17:57 PM
3/5/2015 12:36:27 PM
3/5/2015 1:30:31 PM
3/5/2015 12:07:04 PM
3/5/2015 1:34:29 PM
3/5/2015 12:40:34 PM
3/5/2015 12:41:56 PM
3/5/2015 12:11:02 PM
3/5/2015 1:32:18 PM
CO2 Formula: 700 + 350 = 1050
Site
Location
North Outdoor Air
North
A214
Date/Time
3/6/2015 2:01:41 PM
3/6/2015 1:38:41 PM
CO2 Formula: 700 + 350 = 1050
°F
31
74.3
%RH
21.7
15.5
CO ppm CO2 ppm Occupancy
0
473
0
1067
22
AC
Window
Note