HomeMy WebLinkAboutMotel 6 200047 CO2 Risk AssessmentASSESSMENT OF CARBON MONOXIDE RISK REDUCTION
IN LODGING ESTABLISHMENTS
Name of Establishment:_________________________________________ Operator:___________________________
Location Address: Mailing Address:
City:__________________ Zip City:______________________ State:______ Zip:____________
Appliance Type:
Location:
Enclosed
Area
Yes No
CO
Detector
Yes No
Adjoining Rooms:
CO Detectors Provided Meet
ANSI/UL 2034 or 2075?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Appliance Type:
Location:
Enclosed
Area
Yes No
CO
Detector
Yes No
Adjoining Rooms:
CO Detectors Provided Meet
ANSI/UL 2034 or 2075?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Appliance Type:
Location:
Enclosed
Area
Yes No
CO
Detector
Yes No
Adjoining Rooms:
CO Detectors Provided Meet
ANSI/UL 2034 or 2075?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Appliance Type:
Location:
Enclosed
Area
Yes No
CO
Detector
Yes No
Adjoining Rooms:
CO Detectors Provided Meet
ANSI/UL 2034 or 2075?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Appliance Type:
Location:
Enclosed
Area
Yes No
CO
Detector
Yes No
Adjoining Rooms:
CO Detectors Provided Meet
ANSI/UL 2034 or 2075?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
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