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SEISMIC SCREENING CHECKLIST <br />Reviewer Name <br />Project No.. :: ,, <br />Total Bldg. Sq. Ft. <br />Agency <br />Total Lease Sq, Ft. <br />Location' ' <br />Hours of Use <br />1 Retrofit since 1976 <br />No further screening required if documentation of retrofit is provided. <br />2 Ag <br />Ty <br />e of Building & <br />ae of Constructlon <br />Tilt -Up <br />Pre 1933 <br />8 <br />1933 to 1976 <br />Post 1976 <br />MO9r?1. <br />Score <br />Masonry <br />'10 <br />8 <br />1 <br />Reinforced Concrete <br />. 7 <br />b a <br />1 <br />Wood Frame_; " . .. <br />3 <br />2 <br />1 <br />Steel ' <br />7 <br />,. 3 <br />1 <br />1 <br />3 .Holght of Building In Stories, <br />Moll"' <br />ox nurriker of stoups allowable for screening is 6. Assign one point <br />per 'at ory, l.el 1 min., 6 Max (1.6) 4 <br />4 Seisrntcjty <br />Assign pointy as Indicated for counties as grouped, in a, b, & c below <br />(a) 12 points 1n Los Angeles, West 1/3 of San Bernardino, 12 <br />Contra Costa, Riverside, Santa Clara, Alameda, Ventura, . <br />San Francisco, Merin <br />(b) 9 points in Sonoma, Serttaaraara San Mateo,- 9 9 <br />Orange, S9rrDiago, Inyo,-Ssn ' ui'Obispo, Napa;,efn, <br />Monfar_ey, clano;-.HUmboldt, Men?ooino <br />(c) 3 points to all other counties'ilot Ilstea <br />above. 3 <br />S.ConfAura#ioniVewlicall. 'r <br />®� E mm 2tt. CID 0 <br />®�®fflo EM <br />r cv �, na. <br />All otherconffgurations 1 <br />6 Configuratio n,(Plan View) <br />_,.. <br />3 7 7 ., 7 <br />7 Visible Defects " <br />subj4ctive scoring.' 10 points max. a'ssignahlaforail defects <br />observed The folibwinj-list is of typical things to took for. <br />a Dry rot, look for Water''stains,on ceiling tiles.:and walls . <br />b Damaged foundations,'fook fd[ iai'ge,cracks.erid hiisaligr ment <br />c Sagging or shifted beams look for bowing In enter, check for <br />position (parallel) relative to other members <br />d Tilted walls or columns <br />e Corrosion of steel; look for rust, flaking, etc. Check for water stains. <br />f Cracks greater than 1/8" in masonry or concrete <br />g Check for any material that crumbles (wood, plaster, conc., etc) (1-10) <br />TOTAL 28 <br />Total score of 20 or above requires standard seismic certification. <br />Capy 0f Smsm cilB M,si-�Ited.AS <br />