Building or Space Type *
Select... Mall Big Box Store School Library Clubhouse Recreational Building Restroom Building Hotel Restaurant Bar Movie Theater Concert Hall Retail Store Grocery Store Condominium Building Apartment Building Government Facility Office Building Lab Warehouse Distribution Facility Factory Medical Facility Dental Facility Eye Care Facility Hospital Assisted Living Facility Elder Care Facility Shelter Airport Train Station Bus Terminal Airplane Train Bus Other
If you selected Other or have more info

Establishment Name *

Address

City

State / Province

Country

Date Time (e.g. 01/30/2022 07:45 AM)

Data Source *
Select... Facility Staff Facility Owner Internet Facility User Customer Parent Other
If you selected Other or have more info

Assessment Performed By
Select... Facility Staff Facility Owner External Company Facility User Customer Other
If you selected Other or have more info

If you selected External Company,
provide company name address contact

Requirement Source
Select... Local Building Code Philadelphia Restaurant Program CDC Guideline for airborne room contagions WHO Guideline for airborne room contagions Other
If you selected Other or have more info

Technology select multiple if needed
Select... HVAC System HVAC Continuous Ventilation - always on HVAC Demand Controlled Ventilation - timers CO2 sensors HVAC Manual On Demand Ventilation - fan option HVAC In Duct UV System Exhaust Fans Wall In Room Ventilator Wall In Room Ventilator School 360 Cassette Inverter Ceiling Level UV-C FAR UV-222 Room Sanitizers Photocatalytic Oxidizer PCO Room Sanitizers NPBI Needlepoint Bipolar Ionization Natural Ventilation Open Windows Natural Ventilation Open Windows and Doors Natural Ventilation Open Entry Natural Ventilation Open Walls Natural Ventilation Patio Outside Unblocked Outside Courtyard Outside Massive Crowds Other
If you selected Other or have more info

Performance Levels

ACH Calculation Help
Use ACH calculation tool to enter ACH values

(0, 1, 4, 6, 12, 20, 24, 40, etc)
Min ACH
Max ACH
Avg ACH (if only 1 value Enter here)
eACH

Filter MERV (0, 1-13, HEPA = 17 - 20)

% Percent Outside Air

Select... Yes No Fail Unknown ON and Ventilates Entire Indoor Area

Select... Yes No Unknown Vent Clearances min 6 feet

No of Rooms
sqft
cuft
No of Buildings

Comments