Environment Forms

Environmental Log

Indoors

Location:_______________________ Date:________________________

Starting: Ending

___________________ Time ____________________ a.m. p.m.

___________________ Temp ____________________ F C

___________________ Humidity ____________________ + -

___________________ Barometric Pressure ____________________ + -

Is the weather...

Clear Cloudy Dry Damp Clearing Foggy Misty Humid Dusty Rainy Overcast Sunny

Are you near a ...

Lake Pond River Creek Stream Well Spring Swamp Mountain Desert Forest Factory Highway

Railway Transmission Tower Transformer Cemetary Field Radio Station Microwave Tower Power Station

Other:_______________________________________________________________________________________

Building is being environmentaly controlled by the use of...

Cooling Heating

Floor Fans Ceiling Fans Window Fans NONE Heat Pump Furnace Space Heater

Heat Pump Central Air Window Units Fire Place Wood Heater Wall Unit

Electric Gas Propane Steam Kerosene Coal Wood Oil Solar Other: _____________________________

Wall Vents Ceiling Vents Floor Vents Other:__________________________________________

Radio Frequencies:

AM _______Clear ________Pulsing ________Light Static ________Heavy Static

FM _______Clear ________Pulsing ________Light Static ________Heavy Static

How many of the following objects which are present.

____Plant(s) ___Dog(s) ___Cat(s) ___Fish ___Bird(s) ___Candles/Incense burning ____Mirrors

____Antique(s) _____Artifact(s) Comments:_________________________________________________

The lighting is:

Bright Dim Light Dark Shadowy Flickering Candles Lanterns Firelight Other: _________________

The neighborhood is:

Quiet Noisy Busy Varies Secluded City Suburb Rural Old New Well kept Run down

The immediate outdoor areas are...

Open Wooded Partially Wooded Rolling Hilly Mountainous Level Pasture Field Landscaped

and the following are present:

Boulders Large Rocks Gravel River rock Flagstone Fieldstone Granite Quartz Fountain Spa Pool

Other: ___________________________________________________________________________________

The exterior of the house is...

Brick Rock Plank Log Masonite Siding Vinyl Aluminum Other_______________________________

The interior walls are...

Sheetrock Paneling Other:_________________________________________________________________

Comments:____________________________________________________________________________________________

____________________________________________________________________________________________

Compiled by:__________________________________________________________________________________