NORMI Environmental TASC Force Program .

The Environmental TASC Force Program    

Service Provider
Ben Pequeno
CMI
Pure N Simple
14 Parker St.
Lincoln, RI   02865
401.728.9606
Inactive NORMI Member
  

Summary of IAQ Assessment

These questions are a compilation of the answers you gave in the PSP-IAQ Assessment Booklet and represent that main pieces of information needed by your PSP (Professional Screening Partner) to offer suggestions, recommendations, and possible solutions. You will NOT be required to put all of the information from your booklet into this summary but the information you CAN supply will be very helpful and expedite the solutions stage of this program. Thank you.



Name  
Address  
City  
State/Province  
Zip/Postal Code  
Phone  
eMail  
     
Do you have a living room? Yes No
 
Do you have a family room or large den? Yes No
 
How many bedrooms do you have?
 
How many bathrooms do you have?
 
Do you have a separate laundry room closed off by a door? Yes No
 
How many central air conditioning systems (or furnaces) do you have with a duct system?
 
On page 15, question number 12, did you answer Y or N? Yes No
 
GENERAL LIVING AREAS (Pages 7-8)
Please enter your answer to question 10 Yes No
Please enter your answer to question 11 Yes No
  
BEDROOMS (Pages 9-11)
Please enter your answer to question 10 Yes No
Please enter your answer to question 11 Yes No
Please enter your answer to question 12 Yes No
Please enter your answer to question 13 Yes No
  
BATHROOMS (Page 12)
Please enter your answer to question 1 Yes No
Please enter your answer to question 2 Yes No
Please enter your answer to question 7 Yes No
Please enter your answer to question 11 Yes No
  
KITCHEN (Page 13)
Please enter your answer to question 7 Yes No
  
LAUNDRY AREA (Page 13)
Please enter your answer to question 4 Yes No
Please enter your answer to question 6 Yes No
  
BASEMENT (Page 14)
Please enter your answer to question 1 Yes No
  
ATTIC (Page 14)
Please enter your answer to question 1 Yes No
Please enter your answer to question 2 Yes No
Please enter your answer to question 4 Yes No
Please enter your answer to question 5 Yes No
Please enter your answer to question 6 Yes No
  
AIR CONDITIONING SYSTEMS (Page 15)
Did you answer yes to any of questions 1 - 11? Yes No
Please enter your answer to question 12 Yes No
Please enter your answer to question 13 Yes No
  
Enter Security Code Below:   
 

 

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