Explain in writing if the address of the building is different than the address on this form:
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- Josephine Allison
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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 Chicago, IL, 668 DATE LAST THREE YEAR REINSPECTION WAS COMPLETED 2/26/213 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: 3/22/216 ENROLLMENT IDPH INSPECTOR LICENSE NUMBER: IDPH LICENSED INSPECTOR NAME (Please Print): Evan Christian IDPH MP LICENSE NUMBER: IDPH LICENSED MANAGEMENT PLANNER NAME (Please Print): Todd Huffer DESIGNATED PERSON (Please Print): Robert Christlieb PHONE: 328 (773) /22/216 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 299 Chicago, IL, 668 Unit: Building ID: 293 IDPH ID Number: REPORT DATE: Tuesday, March 22, 216 Prepared for: 125 S. Clark Street Chicago, IL 663 Prepared by: 6 West Van Buren St., Ste 5 Phone (312) Fax (312) DO NOT REMOVE FROM SCHOOL REQUIRED BY FEDERAL LAW
3 March 2, 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 ThreeYear Reinspections and performed management plan updates for the (CPS) facilities in Region 3,4,5 Elementary Schools. Please update your records with the following information. School District: 299 Unit: School: Region: 3 IDPH ID: Building ID: 293 Address: Chicago, IL, 668 Building Contact: Sandoval, Michael Contact Phone: Current Building Owners: Review 3/22/216 Inspector: Evan Christian Management Planner: Todd Huffer Inspector IDPH License: Management Planner IDPH License: If you have any questions or comments, please contact us at (312) Sincerely, Todd Huffer 1-987
4 Environmental tification to Occupants To: Faculty, Staff and Parents From: March 2, 216 RE:, Unit Chicago, IL, 668 Dear Faculty, Staff and Parents, This letter is to notify you that the 216 asbestos three year re-inspection has been completed at Perez School, 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: Sandoval, Michael Unit: Chicago, IL, 668 Building ID: 293 Phone: Description of Facility Original Construction: Total Square Footage: Current Occupancy: Additional Construction: of Floors: 3 LEA Designated Person Contact: Robert Christlieb Address: 125 South Clark Street, 17th Floor Chicago, IL Phone: (773) Managing Environmental Consultant MEC: Contact: Dan Juneau Address 6 West Van Buren St., Ste 5 Phone: (312) Fax: (312) Inspector Inspector Name: Evan Christian Signature: 3/2/216 Inspector IDPH license # Region: 3 Management Planner Management Planner Name: Todd Huffer Signature: 3/22/216 Management Planner IDPH license # Review 3/22/ LEA Designated Person's Acknowledgement The reinspection report and recommendations have been received by me and appropriate action will be taken by the School District. Signature: 3/22/216 Name: Robert Christlieb Unit : Building: 293
7 II. EXECUTIVE SUMMARY was retained by the (CPS) to perform a three-year 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 293: Unit: Building: 293
8 B. The following new homogenous areas have been identified for Building 293: Unit: Building: 293
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 : Stair Treads 12" x 12" Beige w/gray Streaks Floor Tile Mastic 4" Black Vinyl Baseboard 4" Brown Vinyl Baseboard 4" Brown Vinyl Baseboard Adhesive Brown Carpet Mastic Beige Carpet Mastic Blue Carpet Mastic Cinder Block Cinder Block Mortar Stair Tread Adhesive Lab Tops, Counters & Sinks Elevator Brake Shoes Ceiling Material Sprayed-on coating on stainless steel sinks 12"x12" White w/ Blue Floor Tile 12"x12" White w/ Blue Floor Tile Mastic Drywall Drywall Joint Compound Window Caulk Spray on Fire Proofing Door Caulk Green Carpet Adhesive Green Carpet Mastic 2' x 4' Fissured Lay-In Ceiling Panels 2' x 4' Random Dot Lay-In Ceiling Panels 12" x 12" White Floor Tile w/gray Streaks 12" x 12" White w/gray Streaks Floor Tile Mastic 12" x 12" Beige w/gray Streaks Floor Tile The following areas were deemed to be inaccessible: Unit: 12" x 12" Beige w/gray Streaks Floor Tile Mastic Brown Carpet Mastic Beige Carpet Mastic Blue Carpet Mastic Stair Tread Adhesive Elevator Brake Shoes 12"x12" White w/ Blue Floor Tile Mastic Green Carpet Mastic Building: 293
10 8 12" x 12" White w/gray Streaks Floor Tile Mastic 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 Evan Christian, IDPH License # The Management Plan was updated by Todd Huffer, IDPH License # Inspector and Management Planner Licenses are included in Appendix B. Unit: Building: 293
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 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 293 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: 293
12 Table I Inspector's Reinspection Findings
13 School Unit Building ID 293 Address Region 3 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Material Description 1 Stair Treads 1 12" x 12" Beige w/gray Streaks Floor Tile Mastic 11 4" Black Vinyl Baseboard Material Quantity Material Units Material Location Asbestos Type Material Category Friable Damage Type 45, Stairways ASSUMED N NONE Change in Assessment Category 32, LF ASSUMED N NONE 32, LF ASSUMED N NONE 4" Black Vinyl Baseboard Adhesive 3, LF CHR N NONE 4" Brown Vinyl Baseboard 1, LF Faculty Center, Main Office, 2nd Floor Stair Landing and room 23 Main Office and Library Main Office and Library Throughout Facility ASSUMED N NONE 14 4" Brown Vinyl Baseboard Adhesive 1, LF Throughout Facility ASSUMED N NONE 15 Brown Carpet Mastic 2,4 ASSUMED N NONE 16 Beige Carpet Mastic 9 Rooms 25, 26, and Office Room 23 ASSUMED N NONE 17 Blue Carpet Mastic 8 Room 27 ASSUMED N NONE 18 Cinder Block 1, All Walls in Facility ASSUMED N NONE 19 Cinder Block Mortar 1, All Walls in Facility ASSUMED N NONE 2 Stair Tread Adhesive 312 Stairways ASSUMED N NONE 2 Lab Tops, Counters & Sinks 1 Room 21 ASSUMED N NONE Fiberglass Insulation on Pipes, Joints, Boiler etc Elevator Brake Shoes 23 Ceiling Material 24 Sprayed-on coating on stainless steel sinks 25 12"x12" White w/ Blue Floor Tile 26 12"x12" White w/ Blue Floor Tile Mastic 27 Drywall Throughout Facility Damage Quantity Damage Units Damage Category Damage Reason Disturbance Potential 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 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 ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage ACBM with potential for significant damage ACBM with the potential for damage HIGH 2 Elevator Shaft ASSUMED N NONE 2, ASSUMED N NONE 3 ASSUMED SURFACE N NONE ACBM with the potential for damage 12 ASSUMED N NONE 12 ASSUMED N NONE ASSUMED Y NONE ACBM with the potential for damage ACBM with the potential for damage Any remaining friable 5, Lunchroom, Janitor's Closet, Washrooms and Stairways Rooms 11, 12, 13, copy room, and nurse's office As Patching in Lunchroom As Patching in Lunchroom Cafe MODERATE
14 School Unit Building ID 293 Address Region 3 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Material Description 28 Drywall Joint Compound 29 Material Quantity Material Units Material Location Asbestos Type Material Category Friable Damage Type Damage Quantity Damage Units Change in Assessment Category Damage Category 5, Cafe ASSUMED Y NONE Window Caulk 6, Throughout ASSUMED N NONE 3 Spray on Fire Proofing 1,6 ASSUMED SURFACE Y NONE 3 Door Caulk 1, Above Ceilings on Beams and Structural Supports Throughout ASSUMED N NONE 31 Green Carpet Adhesive 8 Room 24 ASSUMED N NONE 4 Green Carpet Mastic 6 Library ASSUMED N NONE 5 2' x 4' Fissured Lay-In Ceiling Panels 15, Throughout Facility ASSUMED Y NONE 6 2' x 4' Random Dot Lay-In Ceiling Panels 1, Kitchen ASSUMED Y NONE 7 12" x 12" White Floor Tile w/gray Streaks 12, ASSUMED N NONE 8 12" x 12" White w/gray Streaks Floor Tile Mastic 1, ASSUMED N NONE ACBM with the potential for damage 9 12" x 12" Beige w/gray Streaks Floor Tile 1, All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & 211 All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & 211 Faculty Center, Main Office, 2nd Floor Stair Landing ASSUMED N NONE ACBM with the potential for damage ACBM or friable suspect ACBM Any remaining friable ACBM or friable suspect ACBM ACBM with the potential for damage Any remaining friable ACBM or friable suspect ACBM ACBM with the potential for damage ACBM with the potential for damage ACBM with the potential for damage Any remaining friable ACBM or friable suspect ACBM Any remaining friable ACBM or friable suspect ACBM ACBM with the potential for damage Damage Reason Disturbance Potential
15 School Unit Building ID 293 Address Region 3 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report Reinspection Date 3/2/216 Inspector Name Inspector's Comments Evan Christian /15/216 Inspector's IDPH License Number / Expiration Date HA Number: Inspector Comments: Fiberglass not suspect material.
16 School Unit Building ID 293 Address Region 3 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Inspector's Reinspection Findings Table 1 Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 Phone: (312) Fax: (312) Inspector's Comments are Summarized at the End of the Report HA Number: Inspector Comments:
17 Table II Management Planner's Review
18 School Address Unit Building ID Chicago, IL, Region 3 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 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 1 Stair Treads 12" x 12" Beige w/gray Streaks Floor Tile Mastic 45, 32, LF LF " Black Vinyl Baseboard 4" Black Vinyl Baseboard Adhesive 4" Brown Vinyl Baseboard 4" Brown Vinyl Baseboard Adhesive Brown Carpet Mastic Beige Carpet Mastic Blue Carpet Mastic Cinder Block Cinder Block Mortar Stair Tread Adhesive Lab Tops, Counters & Sinks Fiberglass Insulation on Pipes, Joints, Boiler etc Elevator Brake Shoes 32, 3, 1, 1, 2, , 1, LF LF LF LF Chrysotile LF LF LF LF 2 Stairways Faculty Center, Main Office, 2nd Floor Stair Landing and room 23 Main Office and Library Main Office and Library Throughout Facility Throughout Facility Rooms 25, 26, and Office Room 23 Room 27 All Walls in Facility All Walls in Facility Stairways Room 21 Throughout Facility Elevator Shaft 23 Ceiling Material 2, 24 Sprayed-on coating on stainless steel sinks 3 SURFACE "x12" White w/ Blue Floor Tile 12"x12" White w/ Blue Floor Tile Mastic Drywall , Lunchroom, Janitor's Closet, Washrooms and Stairways Rooms 11, 12, 13, copy room, and nurse's office As Patching in Lunchroom As Patching in Lunchroom Cafe 5 ACBM with potential for significant damage Yes 28 Drywall Joint Compound 5, Cafe Yes 29 3 Window Caulk Spray on Fire Proofing 6, 1,6 SURFACE Yes Door Caulk Green Carpet Adhesive Green Carpet Mastic 2' x 4' Fissured Lay-In Ceiling Panels 1, , Throughout Above Ceilings on Beams and Structural Supports Throughout Room 24 Library Throughout Facility Yes 7 Any remaining friable ACBM or friable suspect ACBM 7 Any remaining friable ACBM or friable suspect ACBM 7 Any remaining friable ACBM or friable suspect ACBM 7 Any remaining friable ACBM or friable suspect ACBM
19 School Address Unit Building ID Chicago, IL, Region 3 ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 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 6 2' x 4' Random Dot Lay-In Ceiling Panels 1, Kitchen Yes 7 12" x 12" White Floor Tile w/gray Streaks 12, 8 12" x 12" White w/gray Streaks Floor Tile Mastic 1, 9 12" x 12" Beige w/gray Streaks Floor Tile 1, All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & 211 All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & 211 Faculty Center, Main Office, 2nd Floor Stair Landing 7 Any remaining friable ACBM or friable suspect ACBM
20 School Address Unit Building ID Chicago, IL, 668 Region ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 Phone: (312) Fax: (312) Management Planner's Comments Summarized at the End of the Report 3/22/216 Review Date Manager Planner Name Todd Huffer /15/216 Manager IDPH License /Expiration HA Number Management Comments Fiberglass is not a suspect material
21 School Address Unit Building ID Chicago, IL, 668 Region ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS Management Planner's Review Table II Managing Environmental Consultant (MEC) 6 West Van Buren St., Ste 5 Phone: (312) Fax: (312) Management Planner's Comments Summarized at the End of the Report HA Number Management Comments
22 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 1 Stair Treads HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Stairways 45 COMMENTS: Inspector's Signature: 3/2/216
23 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Stair Treads Stairways 45 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: 3/22/216
24 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 1 12" x 12" Beige w/gray Streaks Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Faculty Center, Main Office, 2nd Floor Stair Landing and room LF LF COMMENTS: Inspector's Signature: 3/2/216
25 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " x 12" Beige w/gray Streaks Floor Tile Mastic Faculty Center, Main Office, 2nd Floor Stair Landing and room LF LF 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: 3/22/216
26 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 11 4" Black Vinyl Baseboard HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Main Office and Library 32 LF LF COMMENTS: Inspector's Signature: 3/2/216
27 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " Black Vinyl Baseboard Main Office and Library 32 LF LF 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: 3/22/216
28 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 12 4" Black Vinyl Baseboard Adhesive 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: Main Office and Library 3 LF LF COMMENTS: Inspector's Signature: 3/2/216
29 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " Black Vinyl Baseboard Adhesive Main Office and Library 3 LF LF 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: 3/22/216
30 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 13 4" Brown Vinyl Baseboard HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Throughout Facility 1 LF LF COMMENTS: Inspector's Signature: 3/2/216
31 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " Brown Vinyl Baseboard Throughout Facility 1 LF LF 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: 3/22/216
32 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 14 4" Brown Vinyl Baseboard Adhesive HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Throughout Facility 1 LF LF COMMENTS: Inspector's Signature: 3/2/216
33 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " Brown Vinyl Baseboard Adhesive Throughout Facility 1 LF LF 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: 3/22/216
34 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 15 Brown Carpet Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 25, 26, and Office 24 COMMENTS: Inspector's Signature: 3/2/216
35 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Brown Carpet Mastic Rooms 25, 26, and Office 24 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: 3/22/216
36 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 16 Beige Carpet Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 23 9 COMMENTS: Inspector's Signature: 3/2/216
37 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Beige Carpet Mastic Room 23 9 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: 3/22/216
38 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 17 Blue Carpet Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 27 8 COMMENTS: Inspector's Signature: 3/2/216
39 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Blue Carpet Mastic Room 27 8 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: 3/22/216
40 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 18 Cinder Block HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: All Walls in Facility 1 COMMENTS: Inspector's Signature: 3/2/216
41 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Cinder Block All Walls in Facility 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: 3/22/216
42 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 19 Cinder Block Mortar HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: All Walls in Facility 1 COMMENTS: Inspector's Signature: 3/2/216
43 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Cinder Block Mortar All Walls in Facility 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: 3/22/216
44 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 2 Stair Tread Adhesive HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Stairways 312 COMMENTS: Inspector's Signature: 3/2/216
45 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Stair Tread Adhesive Stairways 312 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: 3/22/216
46 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 2 Lab Tops, Counters & Sinks HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 21 1 COMMENTS: Inspector's Signature: 3/2/216
47 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Lab Tops, Counters & Sinks Room 21 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: 3/22/216
48 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 21 Fiberglass Insulation on Pipes, Joints, Boiler etc HISTORICAL AHERA DAMAGE CATEGORY ACBM with the potential for damage HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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. DAMAGE REASON: DISTURBANCE POTENTIAL: Throughout Facility COMMENTS: Fiberglass not suspect material. Inspector's Signature: 3/2/216
49 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Fiberglass Insulation on Pipes, Joints, Boiler etc Throughout Facility 293 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: Fiberglass is not a suspect material Management Planner's Signature: 3/22/216
50 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 22 Elevator Brake Shoes HISTORICAL AHERA DAMAGE CATEGORY 5 ACBM with potential for significant damage HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 5. ACBM with potential for significant damage DAMAGE REASON: DISTURBANCE POTENTIAL: HIGH Elevator Shaft 2 COMMENTS: Inspector's Signature: 3/2/216
51 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Elevator Brake Shoes Elevator Shaft 2 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: 3/22/216
52 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 23 Ceiling Material HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 Lunchroom, Janitor's Closet, Washrooms and Stairways 2 COMMENTS: Inspector's Signature: 3/2/216
53 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Ceiling Material Lunchroom, Janitor's Closet, Washrooms and Stairways 2 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: 3/22/216
54 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 24 Sprayed-on coating on stainless steel sinks HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 11, 12, 13, copy room, and nurse's office 3 COMMENTS: Inspector's Signature: 3/2/216
55 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Sprayed-on coating on stainless steel sinks Rooms 11, 12, 13, copy room, and nurse's office 3 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: 3/22/216
56 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 25 12"x12" White w/ Blue Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: As Patching in Lunchroom 12 COMMENTS: Inspector's Signature: 3/2/216
57 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ "x12" White w/ Blue Floor Tile As Patching in Lunchroom 12 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: 3/22/216
58 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 26 12"x12" White w/ Blue Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: As Patching in Lunchroom 12 COMMENTS: Inspector's Signature: 3/2/216
59 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ "x12" White w/ Blue Floor Tile Mastic As Patching in Lunchroom 12 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: 3/22/216
60 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 27 Drywall HISTORICAL AHERA DAMAGE CATEGORY 7 Any remaining friable ACBM or friable suspect ACBM HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: FRIABLE: Yes 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 7. Any remaining friable ACBM or friable suspect ACBM DAMAGE REASON: DISTURBANCE POTENTIAL: Cafe 5 COMMENTS: Inspector's Signature: 3/2/216
61 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Drywall Cafe 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: 3/22/216
62 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 28 Drywall Joint Compound HISTORICAL AHERA DAMAGE CATEGORY 7 Any remaining friable ACBM or friable suspect ACBM HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: FRIABLE: Yes 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 7. Any remaining friable ACBM or friable suspect ACBM DAMAGE REASON: DISTURBANCE POTENTIAL: Cafe 5 COMMENTS: Inspector's Signature: 3/2/216
63 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Drywall Joint Compound Cafe 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: 3/22/216
64 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 29 Window Caulk HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Throughout 6 COMMENTS: Inspector's Signature: 3/2/216
65 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Window Caulk Throughout 6 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: 3/22/216
66 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 3 Spray on Fire Proofing HISTORICAL AHERA DAMAGE CATEGORY 7 ACBM with the potential for damage HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: FRIABLE: Yes 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 7. Any remaining friable ACBM or friable suspect ACBM DAMAGE REASON: DISTURBANCE POTENTIAL: Above Ceilings on Beams and Structural Supports 16 COMMENTS: Inspector's Signature: 3/2/216
67 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Spray on Fire Proofing Above Ceilings on Beams and Structural Supports 16 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: 3/22/216
68 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 3 Door Caulk HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Throughout 1 COMMENTS: Inspector's Signature: 3/2/216
69 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Door Caulk Throughout 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: 3/22/216
70 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 31 Green Carpet Adhesive HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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 24 8 COMMENTS: Inspector's Signature: 3/2/216
71 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Green Carpet Adhesive Room 24 8 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: 3/22/216
72 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 4 Green Carpet Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Library 6 COMMENTS: Inspector's Signature: 3/2/216
73 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ Green Carpet Mastic Library 6 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: 3/22/216
74 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 5 2' x 4' Fissured Lay-In Ceiling Panels HISTORICAL AHERA DAMAGE CATEGORY 7 Any remaining friable ACBM or friable suspect ACBM HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: FRIABLE: Yes 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 7. Any remaining friable ACBM or friable suspect ACBM DAMAGE REASON: DISTURBANCE POTENTIAL: Throughout Facility 15 COMMENTS: Inspector's Signature: 3/2/216
75 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ ' x 4' Fissured Lay-In Ceiling Panels Throughout Facility 15 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: 3/22/216
76 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 6 2' x 4' Random Dot Lay-In Ceiling Panels HISTORICAL AHERA DAMAGE CATEGORY 7 Any remaining friable ACBM or friable suspect ACBM HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: FRIABLE: Yes 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 7. Any remaining friable ACBM or friable suspect ACBM DAMAGE REASON: DISTURBANCE POTENTIAL: Kitchen 1 COMMENTS: Inspector's Signature: 3/2/216
77 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ ' x 4' Random Dot Lay-In Ceiling Panels Kitchen 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: 3/22/216
78 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 7 12" x 12" White Floor Tile w/gray Streaks HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & COMMENTS: Inspector's Signature: 3/2/216
79 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " x 12" White Floor Tile w/gray Streaks All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & 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: 3/22/216
80 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 8 12" x 12" White w/gray Streaks Floor Tile Mastic HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & COMMENTS: Inspector's Signature: 3/2/216
81 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " x 12" White w/gray Streaks Floor Tile Mastic All Corridors, Gym, Lunch Area, Part of all 2nd Floor Classrooms, 21 & 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: 3/22/216
82 216 AHERA REINSPECTION Inspector Assessment Form (REASSESSMENT) 293 AHERA INSPECTOR: Evan Christian INSPECTION DATE: 3/2/ INFORMATION FROM PREVIOUS INSPECTION 9 12" x 12" Beige w/gray Streaks Floor Tile HISTORICAL AHERA DAMAGE CATEGORY HISTORICAL DAMAGE REASON: HISTORICAL RESPONSE ACTION: ASBESTOS TYPE: 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: Faculty Center, Main Office, 2nd Floor Stair Landing 1 COMMENTS: Inspector's Signature: 3/2/216
83 216 AHERA REINSPECTION Management Planner Review Form MANAGEMENT PLANNER: Todd Huffer REVIEW DATE: 3/22/ " x 12" Beige w/gray Streaks Floor Tile Faculty Center, Main Office, 2nd Floor Stair Landing 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: 3/22/216
84 216 AHERA REINSPECTION
85 APPENDIX B Inspector and Management Planner Licenses
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Youth Connection - J. Addams Alter HS
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 informationExplain in writing if the address of the building is different than the address on this form:
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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
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