About this Form
Form number: 230-23
Audience: MCPS Staff
Last revised: August 2001
The indoor air quality complaint is the first step in a potential three-phase process. Step one involves reporting a concern. Step two requires Building Services staff to complete the building services indoor air quality checklist in the area of concern. Step three involves an investigation by Environmental Safety/IAQ and support personnel when appropriate.
INSTRUCTIONS: Complete this form if you believe you have been affected by an indoor air quality problem in your classroom or work place and submit it to your principal/supervisor. The principal/supervisor will return the completed form to you within three (3) working days regarding the area of concern.
Forms require Adobe Acrobat Reader 8 or higher. Get Acrobat