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SEISMIC SCREENING CHECKLIST Reviewer Name <br />Pro)ec6Nb Total Bldg. Sq: Ft. <br />Agency Total Lease Sq, Ft.. <br />'Location 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 Bullding & <br />ae of Constructlon <br />Tilt-Up8d4aa',o <br />Pre 1933 <br />1933 to 1976 <br />tY37�$x`u_.;r"--hd'd�Lry§sr�'I <br />Post 1976 <br />zi <br />Score <br />Masonry <br />10 <br />8 <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 ,of13001ng,In.S�orios . <br />Max. number of stories allowable for screening Is6. Assign one point <br />per story, I.e., 1 min., 6max. <br />4:.Seismic1ty <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, <br />Contra Costa, Riverside, Santa Clara, Alameda, Ventura, <br />San Francisco, Marin <br />(b) 9 points in Sonoma, Santa Barbara, San Mateo, <br />Orange, San Diego, Inyo, San Luis Obispo, Napa, Kern, <br />Monterey, Sclano, Humboldt, Mendocino <br />(c) 3 points to all other counties not listed above. <br />(1.6) <br />12 <br />9 <br />3 <br />5.4`onfi4urafian (Verticalf:i <br />® e� <br />® 0 ®gym v <br />5 8 7 10 7 1 7 <br />All other configurations 1 <br />6 Configuration (Plan View) <br />t <br />7 <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 typical things to look for. <br />a Dry rot; look for water stains on ceiling 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 />e Corrosion of steel; lock 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 />copy of Sm,mc O.Oi,m -wm.ws <br />