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CWAIlI
<br />SEISMIC SCREENING CHECKLIST Reviewer Name
<br />Pro)eGt Nb' Total Bldg. Sq. Ft. —
<br />Age y ct Total Lease Sg. Ft..
<br />C6c2tinn',;,; Hours of Use
<br />,
<br />1 Retrofit since 6
<br />No furtherscroening required if documentation of retrofit Is provided.
<br />2 Ac
<br />Ty
<br />e of Builaing & , '
<br />pe of Con'stru'ctlon
<br />Tilt-U
<br />Pro 1933
<br />8
<br />1933 to 1976
<br />11IRM X4. r "r'
<br />Post 1976
<br />� IR.4dKs3L
<br />Score
<br />Mgs—o'nry
<br />10
<br />1 6
<br />1
<br />Reinforced Concrete
<br />7
<br />5
<br />1
<br />Wood Frame
<br />3
<br />2
<br />1
<br />Steel
<br />7
<br />3
<br />1
<br />1
<br />3'.Height.of,BgildltlB:Irw;S,f.Gries...4';',:r_•`:r; ..:.
<br />Max, numbarofstories allowableforsoreaningls6. Assign one point
<br />per story, I.e., 1 min., 6max. (1•e} 4
<br />Assign points as Indicated for counties as grouped in a, b, & c below
<br />(a) 12 points in Los Angeles, West 1/3 of San Bernardino, 12
<br />Contra Costa, Riverside, Santa Clara, Alameda, Ventura,
<br />San Francisco, Morin
<br />(b) 9 points In Sonoma, Santa Barbara, Ben Mateo, 9 9
<br />Orange, San Diego, Inyo, San Luis Obispo, Napa, Kern,
<br />Monterey, Solano, Humboldt, Mendocino
<br />(c) 3 points to all other counties not listed above, 3
<br />'6,Conflqu"raEib.nlV.ertic;all`;:•.::.;,,',
<br />®ran m n an MM ed; K I
<br />LVI
<br />s a 7 yo 7 1 7
<br />All other configurations 1
<br />6 Configuration, (plan View),
<br />1 3 7 7 7
<br />7 Visible Defects
<br />Subjective scoring: 10 points max. assignable for all defects
<br />observed. The following list Is of fyploal things to look for.
<br />a Dry rot; look for water stains on calling tiles and walls,
<br />b Damaged foundations; look for large cracks and misalignment
<br />c Sagging or shifted beams; look for bowing in center, check for
<br />position (parallel) relative to other members
<br />d Tilted walls or columns
<br />a Corrosion of steel; look for rust, Flaking, etc. Check for water stains.
<br />f Cracks greater then 1/6" in masonry or concrete
<br />g Check for any material that crumbles (wood, plaster, conc., etc) (1.10)
<br />TOTAL 26
<br />Total score of 20 or above requires standard seismic certification.
<br />copy 01 sm.w cU9LXI:41•BU,15fI.N8
<br />80A-716
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