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SEISMIC SCREENING CHECKLIST <br />Reviewer Name <br />PtojectNb;` <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 />ie of Construction <br />Tilt-Up8 <br />Pre 1933 <br />1933 to 1976 <br />*�._ <br />Ss IC'19�ai3 <br />Post 1976 <br />Al"edit 95T Ix _ <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:.of Bufidmg In§tpries <br />Max. number of stories allowable for screening is 6. Assign one point <br />per story, La., 1 min., 6 max, <br />4-$$ismlcjtY";. <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 />5:Cdnfm6ration (Verticals <br />v z e t .• "fl rN f1w RD So EM <br />C•9 C7 L7 <br />MUM o L. <br />5-10 1 <br />6 S 11 <br />7 10 7 1 <br />All other configurations <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 typical things to look for. <br />a Dry rot; look for water stains on ceiling tiles and wails. <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; 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, piaster, conc., etc) (1-10) <br />TOTAL <br />Total score of 20 or above regriires standard seismic certification. <br />Copy W Ser s,m .+ kli st-U,tedx15 <br />YI <br />7 <br />28 <br />