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{"sheet":"⑥換気状況評価表（別１）","index":0,"n_rows":24,"n_cols":24,"rows_kept":24,"cut":false,"hidden":false,"merged":[[23,1,23,14],[9,2,9,8],[10,2,10,8],[11,2,11,8],[20,2,20,8],[12,2,12,8],[13,2,13,8],[14,2,14,8],[15,2,15,8],[18,2,18,8],[20,11,20,12],[16,11,16,12],[17,11,17,12],[18,11,18,12],[19,11,19,12],[2,1,4,1],[8,2,8,8],[2,9,4,9],[2,2,4,2],[2,3,4,3],[2,4,4,4],[2,5,4,5],[2,6,4,6],[2,7,4,7],[2,8,4,8],[2,10,4,12],[2,13,4,14],[2,15,4,15],[19,2,19,8],[15,11,15,12],[16,2,16,8],[17,2,17,8],[2,18,4,23],[13,0,14,0],[5,11,5,12],[8,11,8,12],[9,11,9,12],[10,11,10,12],[11,11,11,12],[5,2,5,8],[6,2,6,8],[7,2,7,8],[6,11,6,12],[7,11,7,12],[0,17,14,17],[12,11,12,12],[13,11,13,12],[14,11,14,12]]}
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,"　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）"]
[null,"測定年月日","令和",null,"年",null,"月",null,"日","測定機器　メーカー名",null,null,null,"型式番号等",null,null,null,null,"測定風速（m/s）"]
[]
[]
[null,"階","室名",null,null,null,null,null,null,"必要換気量　（ｍ3/ｈ）","換気方式","換気設備機種名＊注１",null,"換気状況の評価＊注２",null,"判定",null,null,"（Ⅰ) ","（Ⅱ) ","（Ⅲ) ","（Ⅳ) ","（Ⅴ) ","（ｖ）"]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,{"$f":"IF(COUNT(S7:W7)=0,\"\",ROUNDDOWN(AVERAGE(S7:W7),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null," ",null,null,null,null,{"$f":"IF(COUNT(S8:W8)=0,\"\",ROUNDDOWN(AVERAGE(S8:W8),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[" ",null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,"一種　・　二種　・　三種",null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,null,""]
[]
[null,"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。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"注意"]
[null,"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。\n　　　　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。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（Ⅰ）～（Ⅴ）にそれぞれの測定値を記入する。（ｖ）には平均値が表示される。"]

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[]
[null,"　別表２　換気設備を設けるべき調理室等の換気風量測定表（Ａ４）"]
[null,"測定年月日","令和",null,"年",null,"月",null,"日","測定機器　メーカー名",null,null,null,null,null,"型式番号等",null,null,null,"測定風速（m/s）"]
[]
[]
[null,"室番（場所）",null,null,"使用器具",null,null,null,"発熱量（ｋW）",null,null,"換気型式（ｎ）",null,"必要換気量　（ｍ3/ｈ）","開口面積（ｍ2）","測定風速＊注（ｍ/ｓ）","測定風量（ｍ3/ｈ）","判定",null,"（Ⅰ) ","（Ⅱ) ","（Ⅲ) ","（Ⅳ) ","（Ⅴ) ","（ｖ）"]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null," "," ",{"$f":"Y7","v":""}," ","指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(COUNT(T7:X7)=0,\"\",ROUNDDOWN(AVERAGE(T7:X7),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,{"$f":"Y8","v":""},null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(COUNT(T8:X8)=0,\"\",ROUNDDOWN(AVERAGE(T8:X8),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(COUNT(T9:X9)=0,\"\",ROUNDDOWN(AVERAGE(T9:X9),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[" ",null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正"," ",null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,"40・30・20・2",null,null,null,"",null,"指摘なし・要是正",null,null,null,null,null,null,""]
[]
[null,"注）　測定風速欄には、原則的に測定した箇所の平均風速を記入する。"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,"　別表３　排煙風量測定記録表　（Ａ４）　＊注１）"]
[null,"測定年月日",null,null,"令和",null,"年",null,"月",null,"日","測定機器　メーカー名",null,null,null,null,null,"型式番号等"]
[null,1,"排煙機系統（機器番号等）",null,null,null,null,null,null,null,null,null,"排煙機銘板表示",null,null,null,"排煙機の規定風量"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"最大防煙区画面積"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"m2 × １ 　or 　2  =",null,"m3/min"]
[]
[null,2,"排　　　　　　煙　　　　　　口",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"判定",null,"測定風速"]
[null,null,"階","室　　　　　　　　名",null,null,null,null,null,null,"排煙口面積　（ｍ２）",null,null,"測定風速　（ｍ/ｓ）＊注2)",null,"測定風量　（ｍ３/min）",null,"規定風量　（ｍ３/min）",null,null,null,1,2,3,4,5,"平均風速"]
[null,null,null,null,null,null,null,null,null,null," ",null,null,{"$f":"AA10","v":""},null," ",null," ",null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V10:Z10)=0,\"\",ROUNDDOWN(AVERAGE(V10:Z10),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"AA11","v":""},null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V11:Z11)=0,\"\",ROUNDDOWN(AVERAGE(V11:Z11),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V12:Z12)=0,\"\",ROUNDDOWN(AVERAGE(V12:Z12),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[" ",null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[]
[null,3,"排煙機",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"判　　　　　　定"]
[null,null,"排煙機　（番号等）",null,null,null,null,null,null,null,"排煙出口面積（ｍ２）",null,null,"測定風速　（ｍ/ｓ）",null,"測定風量　（ｍ３/min）",null,"規定風量　（ｍ３/min）",null,null,null,"測定風速"]
[null,null,null,null,null,null,null,null,null,null," ",null,null," ",null," ",null," ",null,"指摘なし・要是正",null,1,2,3,4,5,"平均風速"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ",null,null,null,null,{"$f":"IF(SUM(V24:Z24)=0,\"\",ROUNDDOWN(AVERAGE(V24:Z24),4))","v":""}]
[null,4,"直結エンジン（内燃エンジン）の有無",null,null,null,null,null,null,"予備電源又は直結エンジン\n切り替え",null,null,null,null,5,"排煙系統図　（排煙機と排煙口の対応関係がわかる図を記入すること）"]
[null,null,"有　　　　・　　　無",null,null,null,null,null,null,null,null,"指摘なし　・　要是正"]
[]
[null,"注１）　本記録表は、排煙機系統ごとに記入する。"]
[null,"注２）　「測定風速」欄には、原則として測定した箇所の平均風速を記入する。"]
[null,"注３）　自主点検等による排煙風量測定記録がある場合は、実施時期、測定方法、測定値等が\n　　　　適正であるか否かを判定すること。"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,"　別表３－２　排煙風量測定記録表　（Ａ４）　給気式（特殊な構造の排煙設備）　＊注１）"]
[null,"測定年月日",null,null,"令和",null,"年",null,"月",null,"日","測定機器　メーカー名",null,null,null,null,null,"型式番号等"]
[null,1,"給気送風機系統（機器番号等）",null,null,null,null,null,null,null,null,null,"給気送風機銘板表示",null,null,null,"給気送風機の性能（風量）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"m3/min"]
[]
[null,2,"排　　　　　　煙　　　　　　口",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"判定",null,"測定風速"]
[null,null,"階","室　　　　　　　　名",null,null,null,null,null,null,"排煙口面積　（ｍ２）",null,null,"測定風速　（ｍ/ｓ）＊注2)",null,"測定風量　（ｍ３/min）",null,"規定風量　（ｍ３/min）",null,null,null,1,2,3,4,5,"平均風速"]
[null,null,null,null,null,null,null,null,null,null," ",null,null,{"$f":"AA10","v":""},null," ",null," ",null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V10:Z10)=0,\"\",ROUNDDOWN(AVERAGE(V10:Z10),4))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[" ",null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"",null,null,null,null,null,"指摘なし・要是正",null,null,null,null,null,null,""]
[]
[null,3,"給気送風機",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"判　　　　　　定"]
[null,null,"吸込口面積　（㎡）",null,null,null,null,null,null,null,"測定風速　（ｍ/ｓ）　　＊注2）",null,null,null,null,"測定風量　（ｍ３/min）",null,"規定風量　（ｍ３/min）",null,null,null,"測定風速"]
[null,null,null,null,null,null,null,null,null,null," ",null,null,null,null," ",null," ",null,"指摘なし・要是正",null,1,2,3,4,5,"平均風速"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ",null,null,null,null,{"$f":"IF(SUM(V24:Z24)=0,\"\",ROUNDDOWN(AVERAGE(V24:Z24),4))","v":""}]
[null,4,"直結エンジン（内燃エンジン）の有無",null,null,null,null,null,null,"予備電源又は直結エンジン\n切り替え",null,null,null,null,5,"排煙系統図　（給気送風機と排煙口の対応関係がわかる図を記入すること）"]
[null,null,"有　　　　・　　　無",null,null,null,null,null,null,null,null,"指摘なし　・　要是正"]
[]
[null,"注１）　本記録表は、排煙機系統ごとに記入する。"]
[null,"注２）　「測定風速」欄には、原則として測定した箇所の平均風速を記入する。"]
[null,"注３）　自主点検等による排煙風量測定記録がある場合は、実施時期、測定方法、測定値等が\n　　　　適正であるか否かを判定すること。"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,"　別表３－３　排煙風量測定記録表　（Ａ４）　加圧式（加圧防排煙設備）"]
[null,"測定年月日",null,null,"令和",null,"年",null,"月",null,"日","測定機器　メーカー名",null,null,null,null,null,"型式番号等"]
[null,1,"給気送風機系統（機器番号等）",null,null,null,null,null,null,null,null,null,"給気送風機銘板表示",null,null,null,"給気送風機の性能（風量）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"m3/min"]
[]
[null,2,"排　　　　　　煙　　　　　　口",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"判定",null,"測定風速"]
[null,null,"階","室　　　　　　　　名",null,null,null,"空気逃し口の方式＊注１）",null,null,null,"測定排出風速＊注2)　（m/s）",null,"規定排出風速＊注3)　（ｍ/ｓ）",null,"算定式＊注3）",null,"遮煙開口部の高さ（ｍ）",null,null,null,1,2,3,4,5,"平均風速"]
[null,null,null,null,null,null,null,"１．自然方式",null,null,null,{"$f":"AA10","v":""},null,null,null,"",null," ",null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V10:Z12)=0,\"\",AVERAGE(V10:Z12))","v":""}]
[null,null,null,null,null,null,null,"2．機械方式"]
[null,null,null,null,null,null,null,"3．併用方式"]
[null,null,null,null,null,null,null,"１．自然方式",null,null,null,{"$f":"AA13","v":""},null,null,null,"",null,null,null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V13:Z15)=0,\"\",AVERAGE(V13:Z15))","v":""}]
[null,null,null,null,null,null,null,"2．機械方式"]
[null,null,null,null,null,null,null,"3．併用方式"]
[null,null,null,null,null,null,null,"１．自然方式",null,null,null,{"$f":"AA16","v":""},null,null,null,"",null,null,null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V16:Z18)=0,\"\",AVERAGE(V16:Z18))","v":""}]
[" ",null,null,null,null,null,null,"2．機械方式"]
[null,null,null,null,null,null,null,"3．併用方式"]
[null,null,null,null,null,null,null,"１．自然方式",null,null,null,{"$f":"AA19","v":""},null,null,null,"",null,null,null,"指摘なし・要是正",null,null,null,null,null,null,{"$f":"IF(SUM(V19:Z21)=0,\"\",AVERAGE(V19:Z21))","v":""}]
[null,null,null,null,null,null,null,"2．機械方式"]
[null,null,null,null,null,null,null,"3．併用方式"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,""]
[null,3,"直結エンジン（内燃エンジン）の有無",null,null,null,null,null,null,"予備電源又は直結エンジン\n切り替え",null,null,null,null,4,"排煙系統図　（給気送風機と空気逃し口の対応関係がわかる図を記入すること）"]
[null,null,"有　　　　・　　　無",null,null,null,null,null,null,"指摘なし　・　要是正"]
[]
[null,"注1）　「空気逃し口の方式」欄には、該当するチェックボックスに「レ」マークを入れる。"]
[null,"注2）　「測定排出風速」欄には、原則として測定した箇所の平均風速を記入する。"]
[null,"注3）　隣接室を区画する当該区画の使用及び隣接室の使用に応じて、規定排出風速Ｖの算定式を\n        以下の①から③のいずれかを選択し、「算定式」欄に記入する。また、当該算定式により排出\n        風速を算出し、「規定排出風速」欄に記入する。この場合において、Ｖは排出風速、Ｈは遮煙\n        開口部の高さを表す。"]
[]
[]
[null,null,"①V=2.7√H",null,"②V=3.3√H",null,null,"③V=3.8√H"]
[null,"注4）　自主点検等による排煙風量測定記録がある場合は、実施時期、測定方法、測定値等が\n　　　　適正であるか否かを判定すること。"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"①V=2.7√H"]
[null,null,"②V=3.3√H"]
[null,null,"③V=3.8√H"]

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[]
[null,"　別表４　非常用の照明装置の照度測定表　（Ａ４）"]
[null,"測定年月日",null,null,"令和",null,"年",null,"月",null,"日","測定機器　　メーカー名",null,null,null,null,"型式番号等"]
[null,"光源の種類",null,null,"最低照度の測定場所",null,null,null,null,null,null,null,null,null,null,"最　低　照　度　（ｌｘ）",null,"判定"]
[null,null,null,null,"階",null,null,null,null,"部屋　・　廊下等"]
[null,"白　　熱　　灯",null,null,null,null,null,null,null,null,null,null,null,null,null," ",null,"指摘なし　・　要是正"]
[null,"蛍　　光　　灯",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし　・　要是正"]
[null,"その他（　　　　　　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指摘なし　・　要是正"]
[]
[null,"（別紙）"]
[null,"階別",null,"測　定　場　所",null,null,null,null,null,null,null,null,"測　定　位　置＊注１",null,null,"光　源　の　種　類＊注２",null,"照　　度　（ｌｘ）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n"]
[]
[]
[" "]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"注　１）　測定位置欄には、例示として次のように　「出入口付近」、「右壁中央付近」　等と明記する。\n注　２）　光源の種類欄には、白熱灯、蛍光灯、その他を明記する。"]

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[]
["換気設備　換気量測定実施状況報告書"]
[]
["換気設備の定期検査において、換気量測定の実施状況を下記の通り報告します。"]
[]
[null,null,null,null,"検査者(換気設備)　氏名　"]
["全（",null,"）箇所"]
["系統名",null,null,"階","室名",null,"実施状況"]
[null,null,null,null,null,null,"年度",null,null,"年度",null,null,"年度",null,null,"年度"]
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["注１）３年以内に全数検査を実施すること。"]
["注２）測定を実施した年度に○を記入すること。"]
["注３）「中央管理方式による制御及び作動状態の監視」を行っている場合はその状況の確認も合わせて行うこと。"]

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[]
["排煙設備　排煙風量測定実施状況報告書"]
[]
["排煙設備の定期検査において、排煙風量測定の実施状況を下記の通り報告します。"]
[]
[null,null,null,null,"検査者(排煙設備)　氏名　"]
["全（",null,"）箇所"]
["系統名",null,null,"階","室名",null,"実施状況"]
[null,null,null,null,null,null,"年度",null,null,"年度",null,null,"年度",null,null,"年度"]
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[]
[]
[]
[]
[]
[]
[]
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[]
[]
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[]
[]
[]
["注１）３年以内に全数検査を実施すること。"]
["注２）測定を実施した年度に○を記入すること。"]
["注３）「中央管理方式による制御及び作動状態の監視」を行っている場合はその状況の確認も合わせて行うこと。"]