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[]
[]
["別表１　法第28条第２項又は第３項に基づき換気設備が設けられた居室（換気設備を設けるべき調理室等を除く。）の換気状況評価表（Ａ４）"]
[]
["測定年月日",{"$nulls":17},"測定機器 メーカー名",{"$nulls":33},"型式番号等",{"$nulls":51},"㎥／h"]
["階",{"$nulls":5},"室名",{"$nulls":11},"必要換気量(ｍ3/h)",{"$nulls":10},"換　気　方　式",{"$nulls":11},"換気設備機種名＊注1)",{"$nulls":10},"換気状況の評価＊注2)",{"$nulls":19},"判　定",{"$nulls":31},"ppm"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[{"$nulls":30},"一種",null,"・",null,"二種",null,"・",null,"三種",{"$nulls":34},"指摘なし",{"$nulls":4},"・","要是正"]
[]
["　注1) 室ごとに単独の換気扇がある場合など、換気設備が特定されている場合は、その名称を記入する。"]
["　注2) 「換気状況の評価」欄には、外気取り入れ口における風量測定を行うことが最も確実であり、換気量測定を行った場合は、その測定結果を記入する。"]
["　　　 これに代わる方法として、各室の二酸化炭素濃度の測定を行い、居住者数と測定値に矛盾がないか確認する等を行った場合には、その結果を記入する。"]