mode|01.01 Project|01.02 Date|01.03 Building Name|01.04 Building Number|01.05 Street|01.06 City|01.07 State|01.08 Zip|02.01 Ventilation Type|02.02 HVAC Zone Name|02.03 HVAC Model Number|02.04 HVAC Fan Size CFM|02.05 Number of Rooms Serviced by this Zone|02.06 Total Cubic Feet Serviced By This Zone|02.07 List Room Survey Numbers|02.08 HVAC Zone a-AUC|02.09 HVAC Automated Alarms|02.10 Manual Dampers in Ducts|02.11 Thermostat Control by Users|02.12 Thermostat Locks Removed|02.13 Visible Vent Manually Controlled|02.14 System Fans on ALL the time|02.15 System Fans on when public is present|03.01 Number|03.02 Room Name|03.03 Length|03.04 Width|03.05 Height|03.06 Square Feet|03.07 SQFT Height|03.08 Cubic Feet|04.01 Number Of Windows|04.02 Windows Fully Open|04.03 Windows Not Blocked|04.04 Door Open|04.05 Door Not Blocked|04.06 w-AUC|05.01 Exhaust Fan Type|05.02 Number of Exhaust Fans|05.03 Intake Vents Fully Open|05.04 Intake Vents Not Blocked|05.05 Total Exhaust Fans CFM|05.06 Total Exhaust Fans fAUC|06.01 Forced Air Heating|06.02 Forced Air Heating Cooling|06.03 Forced Air Fan Option|06.04 Number of Exhaust Vents|06.05 Exhaust Vents Fully Open|06.06 Exhaust Vents Not Blocked|06.07 Number of Intake Vents|06.08 HVAC Intake Vents Fully Open|06.09 HVAC Intake Vents Not Blocked|06.10 Visual Streamers|06.11 t-AUC|06.12 a-AUC|07.01 Number of UV-C Fixtures|07.02 UV-C Model|07.03 UV-C Total Watts|07.04 UV-C eAUC|07.05 UV C Public View On/Off Indicators|07.07 UV-C Automated Alarms|08.01 Number of Far UV Fixtures|08.02 Far-UV Model|08.03 Far-UV Total Watts|08.04 Far-UV eAUC|08.05 Far UV Public View On/Off Indicators|08.06 Far UV Automated Alarms|09.01 Number of Air Sanitizers|09.02 Air Sanitizers Model|09.03 Air Sanitizers Total CFM|09.04 Air Sanitizers sAUC|09.05 Air Sanitizers Public View On/Off Indicators|09.06 Air Sanitizers Automated Alarms|10.01 Number of PCO/other units|10.02 PCO/other Model|10.03 Claimed effective ep AUC|10.04 Claimed effective ep AUC Test Authority|10.05 PCO/other units Total CFM|10.06 PCO/other units Public View On/Off Indicators|10.07 PCO/other units Automated Alarms|13.01 Occupancy Number|13.02 Room Occupancy Sign Posted|13.03 Public Present During Site Survey|13.04 Data Entered Directly Into Computer|13.05 Printout Attached To Paper Form|14.01 Notes and Observations|15.01 Inspector Name|15.02 Signature Date|16.01 Total AUC|16.02 Large Room Factor|16.03 Final AUC|16.04 Cert Level|16.05 Final AUC Mitigation|16.06 Cert Level Mitigation|16.07 Cert Level Controls
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43||||||each room|||1|||||||||||Anna Blakiston Day Elementary School- Main Building|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||||
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||186|1|||||||||||101|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|22|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||194|1|||||||||||102|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|22|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||45|1|||||||||||103|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||75|1|||||||||||104|classroom||||1440||11520||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||32||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||126|1|||||||||||105|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||1|1|1|1|21|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||0|1|||||||||||106|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||210|1|||||||||||107|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|22|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||0|1|||||||||||108|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43||||||each room|||1|||||||||||109|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43||||||each room|||1|||||||||||111|Classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43||||||each room|||1|||||||||||112|Classroom||||260||2080||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||5||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||255|1|||||||||||201|classroom||||875||7000||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||19||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|22|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||257|1|||||||||||202|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|22|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||0|1|||||||||||203|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||365|1|||||||||||204|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||3|1|3|1|23|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||0|1|||||||||||205|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||84|1|||||||||||206|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||1|1|1|0|21|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||0|1|||||||||||207|classroom||||575||4600||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||13||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||47|1|||||||||||208|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||235|1|||||||||||209|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|22|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||0|1|||||||||||210|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||0|1|0|0|20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||Unit Ventilator|each room||244|1|||||||||||211|classroom||||880||7040||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|22|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43||||||each room|||1|||||||||||214|Classroom||||228||1824||||||||||||||||||||||||||||||||||||||||||||yes Active Pure|20|Active Pure 3 min claim||||5||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||20|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||0|1|||||||||||-|Auditorium||||3300||26400||||||||||||||||||||||||||||||||||||||||||||||||||0||||||Chadwick Part 2 and Exhaust Exhaust ||0|1.06|0|0|0|0|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||573|1|||||||||||-|GYM||||5000||40000||||||||||||||||||||||||||||||||||||||||||||||||||38||||||Chadwick Part 2 and Exhaust Exhaust ||1|1.06|1.06|0|1|0|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||RTU|each room||0|1|||||||||||-|Library||||2700||21600||||||||||||||||||||||||||||||||||||||||||||||||||0||||||Chadwick Part 2 and Exhaust Exhaust ||0|1.06|0|0|0|0|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43||||||each room|||1|||||||||||Anna Blakiston Day Elementary School- Little School House|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||||
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||322|1|||||||||||1|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||21||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||274|1|||||||||||2|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||18||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||322|1|||||||||||3|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||21||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||510|1|||||||||||4|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||24||||||Chadwick Part 2 and Exhaust Exhaust ||4|1|4|1|4|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||302|1|||||||||||5|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||325|1|||||||||||6|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||21||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||302|1|||||||||||7|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||325|1|||||||||||8|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||21||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||302|1|||||||||||9|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||325|1|||||||||||10|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||21||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||302|1|||||||||||11|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||20||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||325|1|||||||||||12|classroom||||1056||8448||||||||||||||||||||||||||||||||||||||||||||||||||21||||||Chadwick Part 2 and Exhaust Exhaust ||2|1|2|1|2|1|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||1,136.00|1|||||||||||-|Lunchroom||||1750||14000||||||||||||||||||||||||||||||||||||||||||||||||||39||||||Chadwick Part 2 and Exhaust Exhaust ||5|1|5|2|5|2|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||N/A|each room||159|1|||||||||||-|Staff Bathroom Staff Toilet||||120||960||||||||||||||||||||||||||||||||||||||||||||||||||2||||||Chadwick Part 2 and Exhaust Exhaust ||10|1|10|2|10|2|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||N/A|each room||277|1|||||||||||-|Staff Bathroom Staff Toilet ||||120||960||||||||||||||||||||||||||||||||||||||||||||||||||2||||||Chadwick Part 2 and Exhaust Exhaust ||17|1|17|3|17|3|
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||392|1|||||||||||-|Various Office||||||||||||||||||||||||||||||||||||||||||||||||||||||||0||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||||
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||FCU|each room||224|1|||||||||||-|Corridor||||||||||||||||||||||||||||||||||||||||||||||||||||||||0||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||||
Import|Phila-Schools|4/29/2021|Anne Blakiston Day Elementary School Little School House|43|||||AHU|each room||374|1|||||||||||-|Various Storage ||||||||||||||||||||||||||||||||||||||||||||||||||||||||0||||||Chadwick Part 2 and Exhaust Exhaust |||1|0||||