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The following IAQ Forms have been developed as components of the North Dakota State University IAQ Standard Operating Procedure (SOP). The are used when documenting information regarding IAQ concerns. Occupant FormsINDOOR AIR QUALITY (IAQ) Concern Form This form is a component of the North Dakota State University Indoor Air Quality (IAQ) Standard Operating Procedure (SOP). Use this form to report to your supervisor any concerns you have related to the indoor air quality/environment in your workplace. Indoor air quality concerns may include issues with temperature, humidity, ventilation, odors, or air pollutants that may be causing health or discomfort symptoms. If you have questions when completing this form, contact North Dakota State University IAQ Coordinator at 231-7759. When completed, deliver to your immediate supervisor. INDOOR AIR QUALITY (IAQ) Diary of Concerns This form is a component of an Indoor Air Quality (IAQ) investigation. If you have questions when completing this form, contact North Dakota State University IAQ Coordinator at 231-7759. Please record each occasion when you experience a symptom of ill-health or discomfort that you think may be linked to an IAQ condition in your workplace. It is important that you record the time and date and your location within the building as accurately as possible, because that will help to identify conditions (e.g., equipment operation) that may be associated with the problem. Also, please try to describe the severity of your symptoms (e.g., mild, severe) and their duration (the length of time that they persist). Any other observations that you think may help in identifying the cause of the problem should be noted in the "Comments" column. Feel free to attach additional pages or use more than one line for each event if you need more room to record your observations INDOOR AIR QUALITY (IAQ) Employee Questionnaire This form is a component of an Indoor Air Quality (IAQ) investigation, and should be completed by all occupants in an area/building affected by an IAQ concern. It is a lengthy and detailed questionnaire that should be completed by all occupants whether or not they are concerned with IAQ. If you have questions when completing this form, contact North Dakota State University IAQ Coordinator at 231-7759. Supervisor FormsINDOOR AIR QUALITY (IAQ) Supervisor Initial Response Form This form is used to assist a supervisor with an Initial Response to an IAQ concern. It is completed following the receipt of a completed IAQ Concern Form. Please thoroughly read all completed IAQ Concern Forms before beginning Supervisor Initial Response. This is not intended to be an intensive or detailed inspection, but rather a quick overview of conditions that can affect IAQ. The Supervisor's Initial Response consists of a walk-through inspection of the workplace. During the walk-through use your senses of sight, smell, feeling and hearing to assess conditions. The form is an instructional guide designed to address easily discernible conditions which can adversely affect IAQ. If you have questions when completing this form, contact North Dakota State University IAQ Coordinator at 231-7759. INDOOR AIR QUALITY (IAQ) Supervisor Questionnaire Form This form is required to initiate an Indoor Air Quality (IAQ) investigation, and should be completed AFTER you (the supervisor) have had an opportunity to visually inspect the area and you have attempted but are unable to identify the cause for any IAQ concern by completing the Supervisor Initial Response Form. If you have questions when completing this form, contact North Dakota State University IAQ Coordinator 231-7759. IAQ Coordinator FormsINDOOR AIR QUALITY (IAQ) Initial Investigation Form This form is a component of an Indoor Air Quality (IAQ) investigation, and is completed by the North Dakota State University IAQ Coordinator. This form is completed AFTER receipt of Supervisor Questionnaire and during a walk through of the area/building. INDOOR AIR QUALITY (IAQ) Employee Questionnaire This form is a component of an Indoor Air Quality (IAQ) investigation, and should be completed by all occupants in an area/building affected by an IAQ concern. It is a lengthy and detailed questionnaire that should be completed by all occupants whether or not they are concerned with IAQ. When IAQ Coordinator has received all completed form she/he can use the IAQ Questionnaire Evaluation Form to evaluate the data. INDOOR AIR QUALITY (IAQ) Questionnaire Evaluation Form This form is designed to assist the IAQ Coordinator when evaluating completed IAQ Questionnaires. INDOOR AIR QUALITY (IAQ) Hypothosis Form This form is designed to assist the IAQ Coordinator when evaluating IAQ Information. The form is designed to compile information from various sources (All completed forms, interviews, building records etc.) in order to identify causes of IAQ concerns
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