Explain in writing if the address of the building is different than the address on this form:

Size: px
Start display at page:

Download "Explain in writing if the address of the building is different than the address on this form:"

Transcription

1 ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO SCHOOL DIST Escanaba Chicago, IL, 6633 DATE LAST THREE YEAR REINSPECTION WAS COMPLETED 3/14/213 If the address on this form is different than the address of the building, submit a written explanation. SECTION II (Please type or print) PLEASE COMPLETE THE FOLING FOR YOUR THREE YEAR REINSPECTION: DATE REINSPECTION COMPLETED: 5/18/216 ENROLLMENT IDPH INSPECTOR LICENSE NUMBER: IDPH LICENSED INSPECTOR NAME (Please Print): Allizon Brooks IDPH MP LICENSE NUMBER: IDPH LICENSED MANAGEMENT PLANNER NAME (Please Print): Jigar Shah DESIGNATED PERSON (Please Print): Robert Christlieb PHONE: 379 (773) /18/216 Signature of Designated Person Date SECTION III PLEASE COMPLETE THE FOLING INFORMATION FOR ANY CHANGES WITHIN THE SCHOOL DISTRICT. School building has been sold. Date of Sale: School has been closed. Date closed: School building has been demolished. School building is asbestos free since last reinspection: Please explain in writing why the school building is now asbestos free and include the supporting documentation. If a new school building has been added to the district, submit either and exclusionary statement or a management plan and inspection report. Include the complete name, address and city of school building. Explain in writing if the address of the building is different than the address on this form: IL Revised 1.3

2 THREE YEAR REINSPECTION CHICAGO SCHOOL DIST Escanaba Chicago, IL, 6633 Unit: Building ID: 358 IDPH ID Number: REPORT DATE: Wednesday, May 18, 216 Prepared for: 125 S. Clark Street Chicago, IL 663 Prepared by: 855 W. Adams St., Ste. 2 Phone (312) Fax (312) DO NOT REMOVE FROM SCHOOL REQUIRED BY FEDERAL LAW

3 February 19, 216 Mr. R. Kent Cook Asbestos Program Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois Re: Three-Year Reinspections Dear Mr. Cook:, Managing Environmental Consultant (MEC), conducted the Three-Year Reinspections and performed management plan updates for the (CPS) facilities in Region 1,2,6 Elementary Schools. Please update your records with the following information. School District: 299 Unit: School: Region: 6 IDPH ID: Building ID: 358 Address: 1281 Escanaba Chicago, IL, 6633 Building Contact: O'Shea, John Contact Phone: Current Building Owners: Review 4/25/216 Inspector: Allizon Brooks Management Planner: Jigar Shah Inspector IDPH License: Management Planner IDPH License: If you have any questions or comments, please contact us at (312) Sincerely, Jigar Shah

4 Environmental tification to Occupants To: Faculty, Staff and Parents From: February 19, 216 RE:, Unit 1281 Escanaba Chicago, IL, 6633 Dear Faculty, Staff and Parents, This letter is to notify you that the 216 asbestos three year re-inspection has been completed at, following the Federal Asbestos Hazard Emergency Response Act (AHERA), 4 CFR Part 763, Subpart E and is available for your review at the main office of the school. Although asbestos-containing materials have been identified at, there is no reason to believe that any threat to the health of students or staff exists at this time. CPS will continue to carefully monitor the condition of asbestos-containing materials and if conditions warrant, all appropriate steps will be taken to maintain the health and safety of all building occupants. If you have any questions regarding this matter or require additional information, please feel free to contact Robert Christlieb, the designated Local Education Authority's Designated Person at (773)

5 Table of Contents I. School and Inspection Information II. Executive Summary III. Methodology IV. Abatement History V. Reassessments and Recommendations VI. Conclusions Table I: Inspector's Reinspection Findings Table II: Management Planner's Review APPENDICES: Appendix A: Assessment Sheets, Drawings and Photos Appendix B: Inspector and Management Planner Licenses Appendix C: Laboratory Accreditations Appendix D: Laboratory Results Appendix E: Chain of Custody Forms

6 SCHOOL AND INSPECTION INFORMATION 1. School Information School: Address: IDPH ID: Contact: Escanaba O'Shea, John Unit: Chicago, IL, 6633 Building ID: 358 Phone: Description of Facility Original Construction: 1999 Total Square Footage: Current Occupancy: Additional Construction: of Floors: Phone: (773) Managing Environmental Consultant MEC: Contact: Arturo Saenz Address 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector Inspector Name: Allizon Brooks Signature: 2/19/216 Inspector IDPH license # LEA Designated Person Contact: Robert Christlieb Address: 125 South Clark Street, 17th Floor Chicago, IL Region: 6 Management Planner Management Planner Name: Jigar Shah Management Planner IDPH license # Review 4/25/ LEA Designated Person's Acknowledgement Signature: 4/25/216 The reinspection report and recommendations have been received by me and appropriate action will be taken by the School District. Signature: 5/18/216 Name: Robert Christlieb Unit : Building: 358

7 II. EXECUTIVE SUMMARY was retained by the (CPS) to perform a threeyear asbestos reinspection of the. This inspection was conducted in accordance with the United States Environmental Protection Agency (USEPA) Asbestos Hazard Emergency Response Act (AHERA) part (b), and the ongoing Operations and Maintenance Program (O&M) originally designed in the School's Asbestos Management Plan. The purpose of this three-year reinspection is to record any condition changes in the asbestos-containing building material (ACBM) in the school since the previous three-year reinspection and the six-month periodic surveillance, to identify, assess, and include any Homogeneous Areas (HA) not identified in the Management Plan, and to recommend an appropriate response action to manage asbestos. The inspector conducted a three-year reinspection of this facility under Illinois Department of Public Health (IDPH) school reinspection requirements and AHERA, sections and The main building and each addition to the main building, if constructed at different dates, were inspected separately. Laboratory accreditations are included in Appendix C, laboratory results are included in Appendix D, and chain of custody forms are included in Appendix E. te: During previous inspections, some of the HA(s) were identified together as 9" x 9" floor tile (FT), mastics assoc. with 9" x 9" FT, 12" x 12" FT, mastics assoc. with 12" x 12" FT, pipe insulation, etc. Some of these HA(s) have been re-identified by areas that are uniform in color, texture, construction date, application date, and general appearance. The inspector has determined the following: A. The following HAs have changed assessment categories for Building 358: Unit: Building: 358

8 B. The following new homogenous areas have been identified for Building 358: Unit: Building: 358

9 C. This reinspection covered only physically accessible and visible areas and materials that were identified in the LEA's management plan. The following materials were concealed and/or contained in areas that were inaccessible for sampling and have been classified as Assumed: ` 33 E F Insulation in Fire Rated Doors Black Vinyl Baseboard Black Vinyl Baseboard Mastic Dark Gray Vinyl Baseboard Dark Gray Vinyl Baseboard Mastic Interior Window Glazing Interior Window Glazing Carpet Mastic 2' x 4' Acoustical Ceiling Tile Spray-on Insulation Off-White Baseboard Off-White Baseboard Mastic 12"X12" Red Floor Tile!2"X12" Red Floor Tile Mastic Red and Cream Speckled Terrazzo Pink, Tan and White Ceramic Tile Grout Pink, Tan and White Ceramic Tile Adhesive Light Green Speckled Green Ceramic Tile Grout Light Green Speckled Green Ceramic Tile Adhesive White and Grey Ceramic Tile Grout White and Grey Ceramic Tile Adhesive Yellow and White Ceramic Tile Grout Yellow and White Ceramic Tile Adhesive 12x12 Cream w/ White Specs VFT 12x12 Cream w/ White Specs VFT Mastic Gray Carpet Mastic MJP on Fiberglass Gasket on Air Handling Unit Vibration Damper Gasket The following areas were deemed to be inaccessible: 5B 5C 5D 5F 5G Unit: 12x12 Tan w/ Brown Specks Floor Tile Mastic 12x12 Dark Brown Floor Tile Mastic 12x12 Off White w/specks Floor Tile Mastic 12x12 Medium Brown w/specks Floor Tile Mastic 12x12 Light Green Floor Tile Mastic Insulation in Fire Rated Doors Black Vinyl Baseboard Mastic Dark Gray Vinyl Baseboard Mastic Building: 358

10 A D 2' x 4' Acoustical Ceiling Tile Spray-on Insulation Pink, Tan and White Ceramic Tile Adhesive Light Green Speckled Green Ceramic Tile Adhesive White and Grey Ceramic Tile Adhesive Yellow and White Ceramic Tile Adhesive 12x12 Cream w/ White Specs VFT Mastic Cementitious Pipe Joint Insulation Insulation in Vault Door Materials were also listed as "assumed" if they were in good condition and sampling was not conducted to avoid damage. This reinspection was conducted by Allizon Brooks, IDPH License # The Management Plan was updated by Jigar Shah, IDPH License # Inspector and Management Planner Licenses are included in Appendix B. Unit: Building: 358

11 III. METHODOLOGY Tasks performed on-site included the following: IV. 1. Review current management plan, identify HA(s) and extract appropriate information. 2. Examine and verify abatement records. 3. Touch and visually and physically reinspect and reassess the condition of all friable known or assumed ACBM. 4. Touch and visually and physically reinspect all non-friable known or assumed ACBM to determine whether these materials have become friable since the last inspection or periodic surveillance. 5. Identify any condition changes that may affect Hazard Ranking of known ACBM or Assumed ACBM, as well as any HA(s) that have become friable since the last reinspection. 6. Collect bulk samples from each newly discovered friable HA or previously assumed and submit for laboratory analysis. 7. Tabulate reinspection findings and submit for management planner review and recommendations with appropriate response actions based on the AHERA Damage Category of the ACBM. 8. Submit reinspection findings and management planner recommendations to the LEA within thirty (3) days for inclusion into the management plan. ABATEMENT HISTORY The information collected from the existing management plan and inspection report(s) and from interviews with the school official revealed that the following asbestos abatement was conducted at the school since the previous Three year Reinspection. Abatement Dates: V. REASSESSMENTS AND RECOMMENDATIONS The reassessments and recommendations are summarized in Tables I and II on the following pages. Detailed Hazard Assessment Sheets and Drawings and Photos (if applicable) are included in Appendix A. VI. CONCLUSIONS The Building 358 Three-Year reinspection has been completed and response actions have been recommended for both friable and non-friable materials. A timely execution of the response actions recommended will enable the LEA and the Designated Person(s) to effectively manage the existing ACBM. This three-year reinspection report should be inspected in the current Management plan at the CPS Central Office, and one (1) copy should be kept at the school for use when planning any renovation and/or demolition activities in areas where ACBM has been identified. Also, periodic surveillance documentation and any summary reports from any response actions that are executed at the school should be used to update the Management Plan. Unit: Building: 358

12 Table I Inspector's Reinspection Findings

13 School Unit Building ID 358 Address 1281 Escanaba Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Material Description 2A 12x12 Light Brown w/specks Floor Tile 2B 12x12 Tan w/ Brown Specks Floor Tile 2C 12x12 Dark Brown Floor Tile 2D 2E 12x12 Off White w/specks Floor Tile Mastic 12x12 Off White Floor Tile 2F Material Quantity Material Units Material Location Asbestos Type Material Category Friable Damage Type Damage Quantity Damage Units 46 Room 16 CHR N NONE Change in Assessment Category 1, CHR N NONE CHR N NONE CHR N CHR N UNKNO WN NONE CHR N NONE CHR N NONE ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage MODERATE ACBM with the potential for damage MODERATE ACBM with the potential for damage MODERATE ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage MODERATE ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage 83 6,68 12x12 Medium Brown w/specks Floor Tile 51 2G 12x12 Light Green Floor Tile 78 2H 12x12 Blue w/white Specks Floor Tile 5 CHR N NONE 5A 12x12 Light Brown w/specks Floor Tile Mastic 12x12 Tan w/ Brown Specks Floor Tile Mastic 46 Room 16 CHR N NONE 1, Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1st and 2nd Floor Corridor Edgings Room 16, Mobile Unit Rooms 12, 18, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room CHR N NONE CHR N NONE CHR N NONE CHR N NONE 12x12 Dark Brown Floor Tile Mastic 83 5D 12x12 Off White w/specks Floor Tile Mastic 12x12 Off White Floor Tile Mastic 46 6,68 5E Disturbance Potential MODERATE 1,46 5C Damage Reason ACBM with the potential for damage ACBM with the potential for damage Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1st and 2nd Floor Corridor Edgings Room 16, Mobile Unit Rooms 12, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room, Room 18 Kitchen, Main Office Vault and Supply Room Engineer's Office and Closets, and Rooms 22, 25 Room 18 5B Damage Category MODERATE MODERATE

14 School Unit Building ID 358 Address 1281 Escanaba Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Material Description 5F 12x12 Medium Brown w/specks Floor Tile Mastic 5G 5H Material Quantity Material Units Material Location Asbestos Type Material Category Friable Damage Type 51 CHR N NONE 12x12 Light Green Floor Tile Mastic 78 CHR N 5 CHR 7 12x12 Blue w/white Specks Floor Tile Mastic Insulation in Fire Rated Doors Kitchen, Main Office Vault and Supply Room Engineer's Office and Closets, and Rooms 22, 25 Room 18 4 ASSUMED 8 Black Vinyl Baseboard 9 9 Black Vinyl Baseboard Mastic 9 1 Dark Gray Vinyl Baseboard 2 11 Dark Gray Vinyl Baseboard Mastic 2 12 Interior Window Glazing 1,42 13 Interior Window Glazing 1,42 14 Carpet Mastic ' x 4' Acoustical Ceiling Tile 2, 16 Spray-on Insulation 2, 17 Off-White Baseboard 5 18 Off-White Baseboard Mastic "X12" Red Floor Tile 1,5 Boiler Room, All Purpose Room, Utility Room Near Gym Rooms 13, 14, 16, 25, 26, 27, and Teachers Restroom Rooms 13, 14, 16, 25, 26, 27, and Teachers Restroom Rooms 12, 16, 18, 28 (Counter Footings) Rooms 12, 16, 18, 28 (Counter Footings) Throughout First Floor Throughout Second Floor Room 27, Principal's Office, Main Office Throughout Building Troughout Building; Above Ceiling Tile Throughout Mobile Unit Throughout Mobile Unit 1st Floor Main Entry Lobby & South Entrance Damage Quantity Damage Units Damage Category Change in Assessment Category Damage Reason Disturbance Potential ACBM with the potential for damage NONE ACBM with the potential for damage N NONE TSI N NONE ACBM with the potential for damage ACBM with the potential for damage ASSUMED N NONE ACBM with the potential for damage ASSUMED N NONE ACBM with the potential for damage ASSUMED N NONE ACBM with the potential for damage ASSUMED N NONE ACBM with the potential for damage ASSUMED N NONE ASSUMED N NONE ASSUMED N NONE ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ASSUMED Y NONE ASSUMED Y NONE ASSUMED N NONE ASSUMED N NONE ASSUMED N NONE ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage HIGH MODERATE

15 School Unit Building ID 358 Address 1281 Escanaba Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Material Description 2!2"X12" Red Floor Tile Mastic 21 Red and Cream Speckled Terrazzo 22 Pink, Tan and White Ceramic Tile Grout Material Units Material Location Asbestos Type Material Category Friable Damage Type 1,5 ASSUMED N NONE 1,152 ASSUMED N 824 ASSUMED Y Pink, Tan and White Ceramic Tile Adhesive 824 ASSUMED 724 ASSUMED Light Green Speckled Green Ceramic Tile Grout Light Green Speckled Green Ceramic Tile Adhesive White and Grey Ceramic Tile Grout 2 27 White and Grey Ceramic Tile Adhesive 2 28 Yellow and White Ceramic Tile Grout Yellow and White Ceramic Tile Adhesive x12 Cream w/ White Specs VFT 2, x12 Cream w/ White Specs VFT Mastic 2,5 32` Gray Carpet Mastic 5 33 MJP on Fiberglass 1 A Cementitious Pipe Joint Insulation 95 C D Incinerator Brick - NOT OBSERVED Insulation in Vault Door 18 E Gasket on Air Handling Unit 14 1st Floor Main Entry Lobby & South Entrance NE and SE Stairwells 1st and 2nd Floor Girls Restrooms and 1st Floor Womens Restroom 1st and 2nd Floor Girls Restrooms and 1st Floor Womens Restroom 1st and 2nd Floor Boys Restrooms 1st and 2nd Floor Boys Restrooms 1st and 2nd Floor Janitor's Closet 1st and 2nd Floor Janitor's Closet 1st and 2nd Floor Mens and Womens Restrooms 1st and 2nd Floor Mens and Womens Restrooms All purpose Room and stage vestibules All purpose Room and stage vestibule Main Office and Principal Office Kitchen, 2nd Floor Janitor's Closet Chases above the Ceiling and Fan Room, Kitchen and 2nd Floor janitor closet chase Boiler Room 1st Floor Office Vault Fan Room near Gym 25 Material Quantity Damage Quantity Damage Units Damage Category Change in Assessment Category Damage Reason Disturbance Potential ACBM with the potential for damage NONE ACBM with the potential for damage ACBM with the potential for damage NONE N NONE ACBM with the potential for damage Y NONE ASSUMED N NONE ASSUMED Y NONE ASSUMED N NONE ASSUMED Y NONE ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ASSUMED N NONE ACBM with the potential for damage ASSUMED N NONE MODERATE ASSUMED N NONE ASSUMED N NONE ASSUMED TSI Y NONE CHR TSI Y NONE ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage CHR TSI TSI N NONE N NONE ACBM with the potential for damage ACBM with the ASSUMED

16 School Unit Building ID 358 Address 1281 Escanaba Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Material Description F Vibration Damper Gasket Material Quantity 18 Material Units Material Location Asbestos Type Material Category Friable Damage Type Boiler Room ASSUMED N NONE Damage Quantity Damage Units Change in Assessment Category Damage Category potential for damage ACBM with the potential for damage Damage Reason Disturbance Potential

17 School Unit Building ID 358 Address 1281 Escanaba Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report Reinspection Date 2/19/216 Inspector Name Inspector's Comments Allizon Brooks /28/216 Inspector's IDPH License Number / Expiration Date HA Number: 2A 2B 2C 2D 2E 2F 2G 2H 5A 5B 5C 5D 5E 5F 5G 5H Inspector Comments: Carpet Observerd - Floor tile seen on floor in principal's office

18 School Unit Building ID 358 Address 1281 Escanaba Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Number: ` 33 A C D E F Inspector Comments:

19 School Unit Building ID 358 Address 1281 Escanaba Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report

20 Table II Management Planner's Review

21 School Address Unit 1281 Escanaba Building ID Chicago, IL, Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Management Planner's Comments Summarized at the End of the Report HA Num Material Description Material Quantity Material Units Material Location Asbestos Type Material Category Friable Damage Quantity Damage Units Damage Category Response 2A 2B 12x12 Light Brown w/specks Floor Tile 12x12 Tan w/ Brown Specks Floor Tile 46 1, Chrysotile Chrysotile 2C 2D 2E 12x12 Dark Brown Floor Tile 12x12 Off White w/specks Floor Tile Mastic 12x12 Off White Floor Tile 83 1,46 6,68 Chrysotile Chrysotile Chrysotile 2F 12x12 Medium Brown w/specks Floor Tile 51 Chrysotile 2G 12x12 Light Green Floor Tile 78 Chrysotile 2H 5A 5B 12x12 Blue w/white Specks Floor Tile 12x12 Light Brown w/specks Floor Tile Mastic 12x12 Tan w/ Brown Specks Floor Tile Mastic , Chrysotile Chrysotile Chrysotile 5C 5D 5E 12x12 Dark Brown Floor Tile Mastic 12x12 Off White w/specks Floor Tile Mastic 12x12 Off White Floor Tile Mastic ,68 Chrysotile Chrysotile Chrysotile 5F 12x12 Medium Brown w/specks Floor Tile Mastic 51 Chrysotile 5G 12x12 Light Green Floor Tile Mastic 78 Chrysotile 5H 7 12x12 Blue w/white Specks Floor Tile Mastic Insulation in Fire Rated Doors 5 4 Chrysotile Assumed TSI 8 Black Vinyl Baseboard 9 Assumed 9 Black Vinyl Baseboard Mastic 9 Room 16 Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1st and 2nd Floor Corridor Edgings Room 16, Mobile Unit Rooms 12, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room, Room 18 Kitchen, Main Office Vault and Supply Room Engineer's Office and Closets, and Rooms 22, 25 Room 18 Room 16 Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1st and 2nd Floor Corridor Edgings Room 16, Mobile Unit Rooms 12, 18, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room Kitchen, Main Office Vault and Supply Room Engineer's Office and Closets, and Rooms 22, 25 Room 18 Boiler Room, All Purpose Room, Utility Room Near Gym Rooms 13, 14, 16, 25, 26, 27, and Teachers Restroom Rooms 13, 14, 16, 25, 26, 27, and Teachers Restroom Assumed

22 School Address Unit 1281 Escanaba Building ID Chicago, IL, Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Management Planner's Comments Summarized at the End of the Report HA Num Material Description Material Quantity Material Units Material Location Asbestos Type Material Category Friable Damage Quantity Damage Units Damage Category Response 1 Dark Gray Vinyl Baseboard 2 Assumed 11 Dark Gray Vinyl Baseboard Mastic 2 Assumed Interior Window Glazing Interior Window Glazing Carpet Mastic 1,42 1,42 9 Assumed Assumed Assumed ' x 4' Acoustical Ceiling Tile Spray-on Insulation Off-White Baseboard Off-White Baseboard Mastic 12"X12" Red Floor Tile 2, 2, 5 5 1,5 Assumed Assumed Assumed Assumed Assumed Yes Yes 2!2"X12" Red Floor Tile Mastic 1,5 Assumed Red and Cream Speckled Terrazzo Pink, Tan and White Ceramic Tile Grout 1, Assumed Assumed Yes 23 Pink, Tan and White Ceramic Tile Adhesive 824 Assumed Assumed Assumed Yes Light Green Speckled Green Ceramic Tile Grout Light Green Speckled Green Ceramic Tile Adhesive White and Grey Ceramic Tile Grout White and Grey Ceramic Tile Adhesive Yellow and White Ceramic Tile Grout Rooms 12, 16, 18, 28 (Counter Footings) Rooms 12, 16, 18, 28 (Counter Footings) Throughout First Floor Throughout Second Floor Room 27, Principal's Office, Main Office Throughout Building Troughout Building; Above Ceiling Tile Throughout Mobile Unit Throughout Mobile Unit 1st Floor Main Entry Lobby & South Entrance 1st Floor Main Entry Lobby & South Entrance NE and SE Stairwells 1st and 2nd Floor Girls Restrooms and 1st Floor Womens Restroom 1st and 2nd Floor Girls Restrooms and 1st Floor Womens Restroom 1st and 2nd Floor Boys Restrooms 1st and 2nd Floor Boys Restrooms Assumed Assumed Assumed Yes Yes 29 Yellow and White Ceramic Tile Adhesive 324 Assumed ` 33 A 12x12 Cream w/ White Specs VFT 12x12 Cream w/ White Specs VFT Mastic Gray Carpet Mastic MJP on Fiberglass Cementitious Pipe Joint Insulation 2,5 2, st and 2nd Floor Janitor's Closet 1st and 2nd Floor Janitor's Closet 1st and 2nd Floor Mens and Womens Restrooms 1st and 2nd Floor Mens and Womens Restrooms All purpose Room and stage vestibules All purpose Room and stage vestibule Main Office and Principal Office Kitchen, 2nd Floor Janitor's Closet Chases above the Ceiling and Fan Room, Kitchen and 2nd Floor janitor Assumed Assumed Assumed Assumed Chrysotile TSI TSI Yes Yes

23 School Address Unit 1281 Escanaba Building ID Chicago, IL, Region 6 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Management Planner's Comments Summarized at the End of the Report HA Num Material Description C D E F Incinerator Brick - NOT OBSERVED Insulation in Vault Door Gasket on Air Handling Unit Vibration Damper Gasket Material Quantity Material Units Material Location closet chase Boiler Room 1st Floor Office Vault Fan Room near Gym Boiler Room HA Number Asbestos Type Material Category Chrysotile Assumed Assumed TSI TSI Management Comments Friable Damage Quantity Damage Units Damage Category Response

24 School Address 1281 Escanaba Unit Building ID Chicago, IL, 6633 Region ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Management Planner's Comments Summarized at the End of the Report 4/25/216 Review Date Manager Planner Name Jigar Shah /19/217 Manager IDPH License /Expiration HA Number 2A 2B 2C 2D 2E 2F 2G 2H 5A 5B 5C 5D 5E 5F 5G 5H Management Comments

25 School Address 1281 Escanaba Unit Building ID Chicago, IL, 6633 Region ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 855 W. Adams St., Ste. 2 Phone: (312) Fax: (312) Management Planner's Comments Summarized at the End of the Report HA Number ` 33 A C D E F Management Comments

26 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2A 12x12 Light Brown w/specks Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: MODERATE Room COMMENTS: Inspector's Signature: 2/19/216

27 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba A 12x12 Light Brown w/specks Floor Tile Room In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

28 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2B 12x12 Tan w/ Brown Specks Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: MODERATE Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1 COMMENTS: Inspector's Signature: 2/19/216

29 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba B 12x12 Tan w/ Brown Specks Floor Tile Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

30 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2C 12x12 Dark Brown Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: MODERATE 1st and 2nd Floor Corridor Edgings 83 COMMENTS: Inspector's Signature: 2/19/216

31 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba C 12x12 Dark Brown Floor Tile 1st and 2nd Floor Corridor Edgings 83 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

32 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2D 12x12 Off White w/specks Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: Room 16, Mobile Unit 146 COMMENTS: Inspector's Signature: 2/19/216

33 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba D 12x12 Off White w/specks Floor Tile Mastic Room 16, Mobile Unit 146 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

34 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2E 12x12 Off White Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: MODERATE Rooms 12, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room, Room COMMENTS: Carpet Observerd - Floor tile seen on floor in principal's office Inspector's Signature: 2/19/216

35 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba E 12x12 Off White Floor Tile Rooms 12, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room, Room In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

36 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2F 12x12 Medium Brown w/specks Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: MODERATE Kitchen, Main Office Vault and Supply Room 51 COMMENTS: Inspector's Signature: 2/19/216

37 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba F 12x12 Medium Brown w/specks Floor Tile Kitchen, Main Office Vault and Supply Room 51 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

38 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2G 12x12 Light Green Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: MODERATE Engineer's Office and Closets, and Rooms 22, COMMENTS: Inspector's Signature: 2/19/216

39 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba G 12x12 Light Green Floor Tile Engineer's Office and Closets, and Rooms 22, In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

40 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 2H 12x12 Blue w/white Specks Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: MODERATE Room 18 5 COMMENTS: Inspector's Signature: 2/19/216

41 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba H 12x12 Blue w/white Specks Floor Tile Room 18 5 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

42 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 5A 12x12 Light Brown w/specks Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: Room COMMENTS: Inspector's Signature: 2/19/216

43 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba A 12x12 Light Brown w/specks Floor Tile Mastic Room In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

44 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 5B 12x12 Tan w/ Brown Specks Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1 COMMENTS: Inspector's Signature: 2/19/216

45 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba B 12x12 Tan w/ Brown Specks Floor Tile Mastic Rooms 13, 14, 21, 23, Nurse's Office, 1st & 2nd Floor Corridors, MDF Room 1 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

46 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 5C 12x12 Dark Brown Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: 1st and 2nd Floor Corridor Edgings 83 COMMENTS: Inspector's Signature: 2/19/216

47 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba C 12x12 Dark Brown Floor Tile Mastic 1st and 2nd Floor Corridor Edgings 83 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

48 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 5D 12x12 Off White w/specks Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: Room 16, Mobile Unit 46 COMMENTS: Inspector's Signature: 2/19/216

49 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba D 12x12 Off White w/specks Floor Tile Mastic Room 16, Mobile Unit 46 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

50 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 5E 12x12 Off White Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: Rooms 12, 18, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room 668 COMMENTS: Inspector's Signature: 2/19/216

51 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba E 12x12 Off White Floor Tile Mastic Rooms 12, 18, 28, 26, 24, Counselor's Room, Main Office & Principal's Office, Teacher's Room, Storage Room 668 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

52 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 358 AHERA INSPECTOR: Allizon Brooks INSPECTION DATE: 2/19/ Escanaba INFORMATION FROM PREVIOUS INSPECTION 5F 12x12 Medium Brown w/specks Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: Chrysotile FRIABLE: RESULTS OF REINSPECTION AND REASSESSMENT This homogeneous area was reinspected and reassessed in accordance with Section and of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection. The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage DAMAGE REASON: DISTURBANCE POTENTIAL: Kitchen, Main Office Vault and Supply Room 51 COMMENTS: Inspector's Signature: 2/19/216

53 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Jigar Shah REVIEW DATE: 4/25/ Escanaba F 12x12 Medium Brown w/specks Floor Tile Mastic Kitchen, Main Office Vault and Supply Room 51 In accordance with Sections and of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The original inspection of the above identified homogeneous area has been reviewed in accordance with Sections and with the following recommendations. The RESPONSE ACTION recommendation is: Comments: Management Planner's Signature: 4/25/216

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-3760

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2268

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2121

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-3278

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2270

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2059

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2286

More information

Noble Street Charter - UIC College Prep

Noble Street Charter - UIC College Prep ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2207

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-3770

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2497

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2356

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2724

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2059

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2053

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-3013

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2080

More information

Learn Charter School Excel Campus

Learn Charter School Excel Campus ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2490

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Perspectives Charter School - IIT Math and Science Academy

Perspectives Charter School - IIT Math and Science Academy ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-3553

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-3759

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2168

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-381X

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Youth Connection - Community Service West Acad. Of Scholastic Achievement

Youth Connection - Community Service West Acad. Of Scholastic Achievement ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-0043

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-2841

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-0027

More information

Chicago Technology Academy High School (Medill ES)

Chicago Technology Academy High School (Medill ES) ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Explain in writing if the address of the building is different than the address on this form:

Explain in writing if the address of the building is different than the address on this form: ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Whitney Young Magnet High School

Whitney Young Magnet High School ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: ADDRESS OF SCHOOL: CITY: CHICAGO

More information

Chicago Public Schools 6 Month Asbestos Surveillance Fall

Chicago Public Schools 6 Month Asbestos Surveillance Fall Chicago Public Schools 6 Month Surveillance 2016 - Fall School: Frederic Chopin School Oracle Unit: 22721 Building ID: 2770 Address: 2450 W. Rice Street Region: 02 Mail Room: 35 Surveyor: Rivera, Mr. Robert

More information

Chicago Public Schools 6 Month Asbestos Surveillance Fall

Chicago Public Schools 6 Month Asbestos Surveillance Fall Chicago Public Schools 6 Month Surveillance 2017 - Fall School: Erie Elementary Charter School Oracle Unit: 66331 Building ID: 7510 Address: 1405 N. Washtenaw Region: 02 Mail Room: 35 Surveyor: McCormick,

More information

ASBESTOS REINSPECTION SURVEY REPORT GENERAL SERVICES ADMINISTRATION AUBURN ADMINISTRATION BUILDING BUILDING WA0811KA AUBURN, WASHINGTON

ASBESTOS REINSPECTION SURVEY REPORT GENERAL SERVICES ADMINISTRATION AUBURN ADMINISTRATION BUILDING BUILDING WA0811KA AUBURN, WASHINGTON ASBESTOS REINSPECTION SURVEY REPORT GENERAL SERVICES ADMINISTRATION AUBURN ADMINISTRATION BUILDING BUILDING WA0811KA AUBURN, WASHINGTON May 23, 2007 Prepared for: Mr. Ron Smith GSA 400-15 th Street SW

More information

Chicago Public Schools 6 Month Asbestos Surveillance Fall

Chicago Public Schools 6 Month Asbestos Surveillance Fall Chicago Public Schools 6 Month Surveillance 2017 - Fall School: South Loop Elementary School Oracle Unit: 23751 Building ID: 3961 Address: 1915 South Federal Street Region: 03 Mail Room: 38 Surveyor: Bulvan,

More information

THREE-YEAR RE-INSPECTION and ASBESTOS MANAGEMENT PLAN for the

THREE-YEAR RE-INSPECTION and ASBESTOS MANAGEMENT PLAN for the SCHOOL DISTRICT OF PHILADELPHIA Asbestos Hazard Emergency Response Act AHERA THREE-YEAR RE-INSPECTION 215-216 and ASBESTOS MANAGEMENT PLAN for the Andrew Jackson Elementary School ULCS# 251 Building #

More information

Chicago Public Schools 6 Month Asbestos Surveillance Fall

Chicago Public Schools 6 Month Asbestos Surveillance Fall Chicago Public Schools 6 Month Surveillance 2017 - Fall School: North River Elementary School Oracle Unit: 26841 Building ID: 7890 Address: 4416 N. Troy Region: 01 Mail Room: 31 Surveyor: Dye, Ms. Venguanette

More information

Asbestos Hazard Emergency Response Act Three-Year Asbestos Re-Inspection and Management Plan Update for Schaghticoke Middle School

Asbestos Hazard Emergency Response Act Three-Year Asbestos Re-Inspection and Management Plan Update for Schaghticoke Middle School Asbestos Hazard Emergency Response Act Three-Year Asbestos Re-Inspection and Management Plan Update for Schaghticoke Middle School For Compliance with State of Connecticut Department of Public Health Asbestos-Containing

More information

Enclosed please find the inspection report for the above-referenced location.

Enclosed please find the inspection report for the above-referenced location. January 7, 2010 Ted Sherman Saint Paul Public Schools 360 Colborne Street Saint Paul, MN 55102 RE: Nokomis Montessori School Asbestos Inspection Project #0924022 Dear Ted, Enclosed please find the inspection

More information

AHERA ASBESTOS INSPECTION & MANAGEMENT PLAN. for. Administration Building Parkland Drive Shaker Heights, Ohio

AHERA ASBESTOS INSPECTION & MANAGEMENT PLAN. for. Administration Building Parkland Drive Shaker Heights, Ohio AHERA ASBESTOS INSPECTION & MANAGEMENT PLAN for Administration Building 15600 Parkland Drive Shaker Heights, Ohio March 2017 CONTENTS OF INSPECTION REPORT AND MANAGEMENT PLAN PART I BUILDING INSPECTION/REINSPECTION

More information

Limited Asbestos Demolition Survey

Limited Asbestos Demolition Survey Limited Asbestos Demolition Survey Limited Asbestos Demolition Survey Former Fire Station Facility 25 to 45 S. Orlando Avenue Cocoa Beach, Florida Client: City of Cocoa Beach Public Works Department 1600

More information

Chicago Public Schools 6 Month Asbestos Surveillance Fall

Chicago Public Schools 6 Month Asbestos Surveillance Fall Chicago Public Schools 6 Month Surveillance 2016 - Fall School: Noble Street Charter High School - Muchin College Prep Campus Oracle Unit: 66573 Building ID: 1137 Address: 1 N State Street Region: Mail

More information

ROY CONSULTING GROUP CORPORATION 9823 Balmoral Circle Charlotte, North Carolina Phone: Fax:

ROY CONSULTING GROUP CORPORATION 9823 Balmoral Circle Charlotte, North Carolina Phone: Fax: ROY CONSULTING GROUP CORPORATION 9823 Balmoral Circle Charlotte, North Carolina 28210 Phone: 704.968.4111 Fax: 704.553.9458 March 27, 2015 Mr. Barry Blevins Harnett County General Services 103 East Ivey

More information

December 16, Ted Sherman Saint Paul Public Schools 360 Colborne Street Saint Paul, MN 55102

December 16, Ted Sherman Saint Paul Public Schools 360 Colborne Street Saint Paul, MN 55102 December 16, 2008 Ted Sherman Saint Paul Public Schools 360 Colborne Street Saint Paul, MN 55102 RE: Galtier Magnet Asbestos Inspection Project #0824003 Dear Ted: Enclosed please find the inspection report

More information

SanAir Technologies Laboratory. Analysis Report. Rockbridge Environmental Consulting, Inc.

SanAir Technologies Laboratory. Analysis Report. Rockbridge Environmental Consulting, Inc. SanAir Technologies Laboratory Analysis Report prepared for Rockbridge Environmental Consulting, Inc. 10/26/2016 Project #: SanAir ID#: 804.897.1177 www.sanair.com Page 1 of 17 October 26, 2016 SanAir

More information

POTENTIALLY HAZARDOUS MATERIALS BUILDING INSPECTION REPORT. for. Barton Malow/Clark MSU Spartan Stadium 58 Shaw Lane East Lansing, Michigan

POTENTIALLY HAZARDOUS MATERIALS BUILDING INSPECTION REPORT. for. Barton Malow/Clark MSU Spartan Stadium 58 Shaw Lane East Lansing, Michigan POTENTIALLY HAZARDOUS MATERIALS BUILDING INSPECTION REPORT for Barton Malow/Clark MSU Spartan Stadium 58 Shaw Lane East Lansing, Michigan 48824-1215 at Michigan State University I.M. West Building East

More information

MICHIGAN STATE UNIVERSITY

MICHIGAN STATE UNIVERSITY ASBESTOS SURVEY REPORT MICHIGAN STATE UNIVERSITY CENTER FOR INTEGRATIVE PLANT SYSTEMS EAST LANSING, MICHIGAN Prepared By: TEK Environmental & Consulting Services, Inc. 9670 Chilson Commons Circle Suite

More information

40 CFR 763 THREE-YEAR AHERA ASBESTOS RE-INSPECTION SUMMARY REPORT

40 CFR 763 THREE-YEAR AHERA ASBESTOS RE-INSPECTION SUMMARY REPORT 69 Bridge Street Dedham, MA 02026 Phone 781.251.0040 Fax 781.251.0901 40 CFR 763 THREE-YEAR AHERA ASBESTOS RE-INSPECTION SUMMARY REPORT for WHITMAN MIDDLE SCHOOL 100 Corthell Avenue Whitman, MA 02382 Initial

More information