HVAC Checklist - Long Form Page 1 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
HVAC system components in relation to indoor air quality.
Needs Not
Component OK Attention Applicable Comments
Outside Air Intake
Location
Open during occupied hours?
Unobstructed?
Standing water, bird droppings
in vicinity?
Odors from outdoors?
(describe)
Carryover of exhaust heat?
Cooling tower within 25 feet?
Exhaust outlet within 25 feet?
Trash compactor within 25 feet?
Near parking facility, busy road,
loading dock?
Bird Screen
Unobstructed?
General condition?
Size of mesh? (1⁄2" minimum)
Outside Air Dampers
Operation acceptable?
Seal when closed?
Indoor Air Quality Forms
HVAC Checklist - Long Form Page 2 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Actuators operational?
Outdoor Air (O.A.) Quantity
(Check against applicable codes
and ASHRAE 62-1989.)
Minimum % O.A. __________________
Measured % O.A. _________________
Note day, time, HVAC operating mode
under "Comments"
Maximum % O.A. _________________
Is minimum O.A. a separate damper?
For VAV systems: is O.A. increased as
total system air-flow is reduced?
Mixing Plenum
Clean?
Floor drain trapped?
Airtightness
■ of outside air dampers
■ of return air dampers
■ of exhaust air dampers
All damper motors connected?
All damper motors operational?
Air mixers or opposed blades?
Indoor Air Quality Forms 196
HVAC Checklist - Long Form Page 3 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Mixed air temperature control
O
setting F
O
Freeze stat setting F
Is mixing plenum under negative
pressure? Note: If it is under
positive pressure, outdoor air
may not be entering.
Filters
Type
Complete coverage?
(i.e., no bypassing)
Correct pressure drop? (Compare to
manufacturer's recommendations.)
Contaminants visible?
Odor noticeable?
Spray Humidifiers or
Air Washers
Humidifier type
All nozzles working?
Complete coil coverage?
Pans clean, no overflow?
Drains trapped?
Biocide treatment working?
Note: Is MSDS on file?
Spill contaminant system in place?
Indoor Air Quality Forms
HVAC Checklist - Long Form Page 4 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Face and Bypass Dampers
Damper operation correct?
Damper motors operational?
Cooling Coil
Inspection access?
Clean?
O
Supply water temp. F
Water carryover?
Any indication of condensation
problems?
Condensate Drip Pans
Accessible to inspect and clean?
Clean, no residue?
No standing water, no leaks?
Noticeable odor?
Visible growth (e.g., slime)?
Drains and traps clear, working?
Trapped to air gap?
Water overflow?
Indoor Air
Indoor Quality
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Forms
Quality
HVAC Checklist - Long Form Page 5 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Mist Eliminators
Clean, straight, no carryover?
Supply Fan Chambers
Clean?
No trash or storage?
Floor drain traps are wet or sealed?
No air leaks?
Doors close tightly?
Supply Fans
Location
Fan blades clean?
Belt guards installed?
Proper belt tension?
Excess vibration?
Corrosion problems?
Controls operational, calibrated?
Indoor Air Quality Forms
HVAC Checklist - Long Form Page 6 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Control sequence conforms
to design/specifications?
(describe changes)
No pneumatic leaks?
Heating Coil
Inspection access?
Clean?
Contol sequence conforms to
design/specifications?
(describe changes)
O
Supply water temp. F
Discharge thermostat?
O
(air temp. setting F)
Reheat Coils
Clean?
Obstructed?
Operational?
Steam Humidifier
Humidifier type
Treated boiler water
Standing water?
Indoor
IndoorAir
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HVAC Checklist - Long Form Page 7 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Visible growth?
Mineral deposits?
O
Control setpoint F
O
High limit setpoint F
Duct liner within 12 feet? (If so,
check for dirt, mold growth.)
Supply Ductwork
Clean?
Sealed, no leaks, tight connections?
Fire dampers open?
Access doors closed?
Lined ducts?
Flex duct connected, no tears?
Light troffer supply?
Balanced within 3-5 years?
Balanced after recent renovations?
Short circuiting or other air
distribution problems? Note
location(s)
Pressurized Ceiling
Supply Plenum
No unintentional openings?
All ceiling tiles in place?
Indoor Air Quality Forms
HVAC Checklist - Long Form Page 8 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Barrier paper correctly placed and
in good condition?
Proper layout for air distribution?
Supply diffusers open?
Supply diffusers balanced?
Noticeable flow of air?
Short circuiting or other air
distribution problems? Note
location(s) in"Comments"
Terminal Equipment (supply)
Housing interiors clean and unob-
structed?
Controls working?
Delivering rated volume?
Balanced within 3-5 years?
Filters in place?
Condensate pans clean, drain
freely?
VAV Box
Minimum stops %
Minimum outside air %
(from page 2 of this form)
Minimum airflow cfm
Minimum outside air cfm
Indoor
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HVAC Checklist - Long Form Page 9 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
O
Supply setpoint F (summer)
O
F (winter)
Thermostats
Type
Properly located?
Working?
O
Setpoints F (summer)
O
F (winter)
O
Space temperature F
Humidity Sensor
Humidistat setpoints % RH
Dehumudistat setpoints % RH
Actual RH %
Room Partitions
Gap allowing airflow at top?
Gap allowing airflow at bottom?
Supply, return each room?
Indoor Air Quality Forms
HVAC Checklist - Long Form Page 10 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Stairwells
Doors close and latch?
No openings allowing
uncontrolled airflow?
Clean, dry?
No noticeable odors?
Return Air Plenum
Tiles in place?
No unintentional openings?
Return grilles?
Balancing capability?
Noticeable flow of air?
Transfer grilles?
Fire dampers open?
Ducted Returns
Balanced within 3-5 years?
Unobstructed grilles?
Unobstructed return air path?
Return Fan Chambers
Clean and no trash or storage?
No standing water?
Floor drain traps are wet or sealed?
Indoor Air Quality Forms 204
HVAC Checklist - Long Form Page 11 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
No air leaks?
Doors close tightly, kept closed?
Return Fans
Location
Fan blades clean?
Belt guards installed?
Proper belt tension?
Excess vibration?
Corrosion problems?
Controls working, calibrated?
Controls sequence conforms to
design/specifications?
(describe changes)
Exhaust Fans
Central?
Distributed (locations)
Operational?
Controls operational?
Toilet exhaust only?
Gravity relief?
Indoor Air Quality Forms
HVAC Checklist - Long Form Page 12 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Total powered exhaust cfm
Make-up air sufficient?
Toilet Exhausts
Fans working occupied hours?
Registers open, clear?
Make-up air path adequate?
Volume according to code?
Floor drain traps wet or sealable?
Bathrooms run slightly negative rela-
tive to building?
Smoking Lounge Exhaust
Room runs negative relative to
building?
Print Room Exhaust
Room runs negative relative
to building?
Garage Ventilation
Operates according to codes?
Fans, controls, dampers all operate?
Indoor
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HVAC Checklist - Long Form Page 13 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Garage slightly negative relative
to building?
Doors to building close tightly?
Vestibule entrance to building
from garage?
Mechanical Rooms
General condition?
Controls operational?
Pneumatic controls:
■ compressor operational?
■ air dryer operational?
Electric contols?
EMS (Energy Management System) or
DDC (Direct Digital Control):
■ operator on site?
■ controlled off-site?
■are fans cycled "off" while
building is occupied?
■ is chiller reset to shed load?
Preventive Maintenance
Spare parts inventoried?
Spare air filters?
Control drawing posted?
Indoor Air Quality Forms
HVAC Checklist - Long Form Page 14 of 14
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
PM (Preventive Maintenance)
schedule available?
PM followed?
Boilers
Flues, breeching tight?
Purge cycle working?
Door gaskets tight?
Fuel system tight, no leaks?
Combustion air: at least 1 square
inch free area per 2000 Btu input?
Cooling Tower
Sump clean?
No leaks, no overflow?
Eliminators working, no carryover?
No slime or algae?
Biocide treatment working?
Dirt separator working?
Chillers
No refrigerant leaks?
Purge cycle normal?
Waste oil, refrigerant properly
disposed of and spare refrigerant
properly stored?
Condensation problems?
Indoor
Indoor AirAir Quality
Quality Forms208
Forms
HVAC Checklist - Long Form Page ___ of ___
Building: _________________________________________________________ File Number: ________________________________
Completed by: __________________________________ Title: _____________________________ Date Checked: _____________
Needs Not
Component OK Attention Applicable Comments
Indoor Air Quality Forms
