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BSR/ASHRAE Standard 55P , Thermal Environmental Conditions for Human Occupancy 2/24/03 Most Current Draft Standard

(This is an informative appendix and is not part of this standard.)

Appendix E - Thermal Environment Survey:

THERMAL ENVIRONMENT SURVEY Survey Number:

WHITE SECTIONS TO BE FILLED IN BY OCCUPANT Surveyors Name:

1. Occupants Name:

2. Date:

3. Time:

4. Approx. Outside Air Temperature:

oF 5. Sky: (If applicable)

Clear Mixed (Sun & Clouds)Overcast6. Seasonal Conditions

Winter Spring Summer Fall

11. Occupant Location in Area(Place an X in the approximate

place where you most oftenwork.)

7. Occupants ClothingPlease refer to the attached Table 1. Place a check marknext to the articles of clothing that you are currentlywearing as you fill out this sheet. If you are wearingarticles of clothing not listed in the table, please enterthem into the space provided below.Article:

SURVEYORS USE ONLY

Clothing Insulation Summary:

Total I cl = ____________ clo

Article:8. Occupant Activity Level (Check the one that is mostappropriate)

1. Reclining2. Seated Quite3. Office, school4. Standing Relaxed5. Light Activity Standing6. Medium Activity, Standing7. High Activity

Metabolic Rates (met)

1. 0.8 met2. 1.0 met3. 1.2 met4. 1.2 met5. 1.6 met6. 2.0 met7. 3.0 met

9. Equipment (Equipment adding or taking away from theheat load.)Item (computers, copiers, fans, etc.) Quantity Total Heat Added/ Subtracted

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8/11/2019 Ashrae Thermal Survey Form 44_45

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BSR/ASHRAE Standard 55P , Thermal Environmental Conditions for Human Occupancy 2/24/03 Most Current Draft Standard

10. General Thermal Comfort (Check the one that is mostappropriate)

1. Hot2. Warm3. Slightly Warm4. Neutral5. Slightly Cool6. Cool7. Cold

Thermal Sensation Scale1. + 32. + 23. + 14. 05. 16. 27. 3

General Environment Comments: Area Summary: Room/Building Type:

Outside Relative Humidity:%Thermostat Setting:oFHumidity set-point:%Total Number of Occupants:

Table 1. Clothing Ensembles DescriptionTrousers, short-sleeve shirtTrousers, long-sleeve shirtTrousers, long-sleeve shirt plus suit jacketTrousers, long-sleeve shirt plus suit jacket, vest, T-shirtTrousers, long-sleeve shirt plus long sleeve sweater, T-shirtTrousers, long-sleeve shirt plus long sleeve sweater, T-shirt plus suit jacket, longunderwear bottomsKnee-length skirt, short-sleeve shirt (sandals)Knee-length skirt, long-sleeve shirt, full slipKnee-length skirt, long-sleeve shirt, half slip, long-sleeve sweaterAnkle-length skirt, long-sleeve shirt, suit jacketWalking shorts, short-sleeve shirtLong-sleeve coveralls, T-shirtOveralls, long-sleeve shirt, T-shirtInsulated coveralls, long-sleeve thermal underwear tops and bottomsAthletic sweat pants, long-sleeve sweatshirt

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