5/10/2013 - CPSschoolreports.cps.edu/AsbestosInspectionReport_2013/29261 Poe S… · Re: Chicago...

ILLINOIS DEPARTMENT OF PUBLIC HEALTHAHERA THREE YEAR REINSPECTIONASBESTOS ABATEMENT PROGRAM

SCHOOL INFORMATION FORM

SECTION I

NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299SCHOOL ID NUMBER: 14-016-2990-2809SCHOOL NAME: Poe SchoolADDRESS OF SCHOOL: 10538 S Langley AvenueCITY: Chicago, IL, 60628

DATE LAST THREE YEAR REINSPECTION WAS COMPLETED 3/9/2010If 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 FOLLOWING FOR YOUR THREE YEAR REINSPECTION:

DATE REINSPECTION COMPLETED: 5/10/2013 ENROLLMENT 194

IDPH INSPECTOR LICENSE NUMBER: 100-11255

IDPH LICENSED INSPECTOR NAME (Please Print): Esteban Nunez

IDPH MP LICENSE NUMBER: 100-06325

IDPH LICENSED MANAGEMENT PLANNER NAME (Please Print): Santiago Garcia

DESIGNATED PERSON (Please Print): Ms. Lynn Crivello PHONE: (773) 553-3113

5/10/2013

Signature of Designated Person Date

SECTION III

PLEASE COMPLETE THE FOLLOWING 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. Date:

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-482-1026 Revised 10.03

THREE–YEAR REINSPECTION

CHICAGO SCHOOL DIST 299

Poe School

10538 S Langley AvenueChicago, IL, 60628

Unit: 29261Building ID: 5460

IDPH ID Number: 14-016-2990-2809

REPORT DATE:Friday, May 10, 2013

Prepared for:Chicago Public Schools

125 S. Clark StreetChicago, IL 60603

Prepared by:GSG Consultants, Inc.

855 W. Adams St., Ste. 200

Phone (312) 733-6262

Fax (312) 733-5612

DO NOT REMOVE FROM SCHOOLREQUIRED BY FEDERAL LAW

March 20, 2013

Mr. R. Kent CookAsbestos ProgramIllinois Department of Public Health525 West Jefferson StreetSpringfield, Illinois 62761

Re: Chicago Public Schools - 2013 Three-Year Reinspections

Dear Mr. Cook:

GSG Consultants, Inc., Managing Environmental Consultant (MEC), conducted the Three-Year Reinspections and performed management plan updates for the Chicago Public Schools (CPS) facilities in Region 1,2,6 Elementary Schools. Please update your records with the following information.

School District: 299 Unit: 29261 Region: 06 IDPH ID: 14-016-2990-2809

School: Poe School Building ID: 5460

Address: 10538 S Langley Avenue

Chicago, IL, 60628

Building Contact: Barnotes, Raymond Contact Phone: 773-535-5525

Current Building Owners: Chicago Public Schools

Review Date: 5/10/2013

Inspector: Esteban Nunez Inspector IDPH License: 100-11255Management Planner: Santiago Garcia Management Planner IDPH License: 100-06325

If you have any questions or comments, please contact us at (312) 733-6262

Sincerely,GSG Consultants, Inc.

Santiago Garcia100-06325

Environmental Notification to Occupants

To: Faculty, Staff and ParentsFrom: Chicago Public SchoolsDate: March 20, 2013

RE: Poe School, Unit 29261 10538 S Langley Avenue Chicago, IL, 60628

Dear Faculty, Staff and Parents,

This letter is to notify you that the 2013 asbestos three year re-inspection has been completed at Poe School , following the Federal Asbestos Hazard Emergency Response Act (AHERA), 40 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 Poe School, there is no reason to believe that any threat to the health of students or staff exists at this time. CPS will continue to carefullymonitor 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 Ms. Lynn Crivello, the designated Local Education Authority's Designated Person at (773) 553-3113 .

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

SCHOOL AND INSPECTION INFORMATION

1. School Information

School: Poe School Unit: 29261 Region: 06Address: 10538 S Langley Avenue Chicago, IL, 60628IDPH ID: 14-016-2990-2809 Building ID: 5460Contact: Barnotes, Raymond Phone: 773-535-5525

2. Description of Facility

Original Construction: Additional Construction: Total Square Footage: 37250 No of Floors: Current Occupancy: 194

3. LEA Designated Person

Contact: Ms. Lynn Crivello Phone: (773) 553-3113Address: 125 South Clark Street, 17th Floor Chicago, IL 60603

4. Managing Environmental Consultant

MEC: GSG Consultants, Inc.Contact: Arturo SaenzAddress 855 W. Adams St., Ste. 200Phone: (312) 733-6262 Fax: (312) 733-5612

5. Inspector

Inspector Name: Esteban Nunez

Signature: Inspector IDPH license # 100-11255 Date: 3/20/2013

6. Management Planner

Management Planner Name: Santiago Garcia

Signature: Management Planner IDPH license # 100-06325 Date: 5/10/2013

7. Review Date: 5/10/2013

8. 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: Date: 5/10/2013

Name: Ms. Lynn Crivello

Unit : 29261 Poe School Building: 5460

Unit: 29261 Poe School Building: 5460

II. EXECUTIVE SUMMARY

GSG Consultants, Inc. was retained by the Chicago Public Schools (CPS) to perform a three-year asbestos reinspection of the Poe School. This inspection was conducted in accordance with the United States Environmental Protection Agency (USEPA) Asbestos Hazard Emergency Response Act (AHERA) part 763.92 (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 763.85 and 763.88. 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.

Note: 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 5460:

D MJP E/F/V on Fiberglass Pipe Insulation


B. The following new homogenous areas have been identified for Building 5460:

30 12x12 cream floor tile VFT

31 12x12 Cream Floor Tile VFT(Mastic)

32 Gray Linoleum

33 Gray Linoleum (Mastic)

34 Spray on Fire-Proofing


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/orcontained in areas that were inaccessible for sampling and have been classified as Assumed:

05 12"x12" Green Floor Tile (NOT OBSERVED)05A 12"x12" Gray w/White Specks Floor Tile05B 12"x12" Beige Speckled Floor Tile05C 12"x12" Light Grey w/Brown & White Specks Floor

Tile05F 12"x12" Light Gray w/White Blotches Floor Tile08 12"x12" Green Floor Tile Mastic (NOT

OBSERVED)08B 12"x12" Beige Speckled Floor Tile Mastic08C 12"x12" Light Grey w/Brown & White Specks Floor

Tile Mastic08F 12"x12" Light Gray w/White Blotches Floor Tile

Mastic10 Drywall (NOT OBSERVED)11 Insulation in Fire Rated Doors14 Marlite (NOT OBSERVED)16 Drywall Compound (NOT OBSERVED)17 Carpet Mastic Brown21 Carpet Mastic Brown22 12 x 12 White/Grey Specs Floor Tile22M 12 x 12 White/Grey Specs Floor Tile Mastic23 Brown Speckled Terrazzo24 1 x 1 Ceiling Tile25 Aqua Green Ceramic Tile Grout26 Aqua Green Ceramic Tile Adhesive27 12 x 12 Gold with Brown Speckles Floor Tile27M 12 x 12 Gold with Brown Speckles Floor Tile Mastic28 Grey Ceramic Tile Grout29 Grey Ceramic Tile Adhesive30 12x12 cream floor tile VFT31 12x12 Cream Floor Tile VFT(Mastic)32 Gray Linoleum34 Spray on Fire-ProofingC Cardboard Pipe Insulation (NOT OBSERVED)D MJP E/F/V on Fiberglass Pipe InsulationE Plaster

The following areas were deemed to be inaccessible:

04 9"x9" Beige w/Brown Streaks Floor Tile(NotObserved)

08C 12"x12" Light Grey w/Brown & White Specks Floor


Tile Mastic09 Cream Colored Linoleum Mastic22M 12 x 12 White/Grey Specs Floor Tile Mastic26 Aqua Green Ceramic Tile Adhesive27M 12 x 12 Gold with Brown Speckles Floor Tile Mastic29 Grey Ceramic Tile AdhesiveD MJP E/F/V on Fiberglass Pipe Insulation

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 Esteban Nunez, IDPH License # 100-11255. The Management Plan was updated by Santiago Garcia, IDPH License # 100-06325. Inspector and Management Planner Licenses are included in Appendix B.


III. METHODOLOGY

Tasks performed on-site included the following:

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 thesematerials 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 anyHA(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 appropriateresponse actions based on the AHERA Damage Category of the ACBM.

8. Submit reinspection findings and management planner recommendations to the LEA within thirty (30) days forinclusion into the management plan.

IV. ABATEMENT HISTORYThe information collected from the existing management plan and inspection report(s) and from interviews with the schoolofficial revealed that the following asbestos abatement was conducted at the school since the previous Three year Reinspection.

Abatement Dates:

V. REASSESSMENTS AND RECOMMENDATIONSThe reassessments and recommendations are summarized in Tables I and II on the following pages. Detailed Hazard AssessmentSheets and Drawings and Photos (if applicable) are included in Appendix A.

VI. CONCLUSIONSThe Poe School Building 5460 Three-Year reinspection has been completed and response actions have been recommended forboth friable and non-friable materials. A timely execution of the response actions recommended will enable the LEA and theDesignated 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 hasbeen identified. Also, periodic surveillance documentation and any summary reports from any response actions that are executedat the school should be used to update the Management Plan.

Table IInspector's Reinspection Findings

Chicago Public Schools School Poe School Unit 29261 Building ID 5460 Address 10538 S Langley Avenue Region 06

ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONSInspector's Reinspection Findings Table 1

Managing Environmental Consultant (MEC) GSG Consultants, Inc.

855 W. Adams St., Ste. 200 Phone: (312) 733-6262 Fax: (312) 733-5612

Inspector's Comments are Summarized at the End of the Report

HA No Material Description Material Quantity

Material Units

Material Location Asbestos Type

Material Category

Friable Damage Type

Damage Quantity

Damage Units Change in Assessment Category

Damage Category Damage Reason Disturbance Potential

04 9"x9" Beige w/Brown Streaks Floor Tile(Not Observed)

1,600 SF Room 202, Teachers Lounge, Tank Room Storage,Principal's Office (under the carpet)

CHR MISC N NONE 0 No ACBM with the potential for damage

LOW

05 12"x12" Green Floor Tile (NOT OBSERVED)

SF Teacher's Lounge ASSUMED MISC No

05A 12"x12" Gray w/White Specks Floor Tile 1,500 SF 3rd Floor Corridor, Rooms 201 and 303

ASSUMED MISC N No ACBM with the potential for damage

MODERATE

05B 12"x12" Beige Speckled Floor Tile 4,300 SF Rooms 102, 103, 204, 205, 305, Library, MDF RM, and Teacher's Lounge

ASSUMED MISC N No ACBM with the potential for damage

MODERATE

05C 12"x12" Light Grey w/Brown & White Specks Floor Tile

14 SF 3rd Floor Under Water Fountain

ASSUMED MISC N NONE 0 No ACBM with the potential for damage

MODERATE

05D 12"x12" Cream w/Caramel Specks Floor Tile

3,130 SF Gym Office, and Rooms 001. 201 (under existing flooring), 301


LOW

05E 12"x12" Light Beige w/Dark Brown Streaks Floor Tile under carpet (NOT OBSERVED)

124 SF Room 302 CHR MISC N NONE 0 No ACBM with the potential for damage

LOW

05F 12"x12" Light Gray w/White Blotches Floor Tile

940 SF Room 101and 3rd Floor Janitor's Closet


MODERATE

06 Cream Colored Linoleum 1,500 SF Gym 3rd Floor CHR MISC N NONE 0 No ACBM with the potential for damage

LOW

07 9"x9" Beige w/Brown Streaks Floor Tile Mastic(Not Observed)

1,600 SF Room 202, Tan Room Storage, Principal's Office (under the carpet)


LOW

08 12"x12" Green Floor Tile Mastic (NOT OBSERVED)

SF Teachers Lounge ASSUMED MISC No

08A 12"x12" Gray w/White Specks Floor Tile Mastic

1,500 SF 3rd Floor Corridor and Room 303


LOW

08B 12"x12" Beige Speckled Floor Tile Mastic 4,300 SF Rooms 102, 103, 203, 204, 205, 305, Library, and Teacher's Lounge


LOW

08C 12"x12" Light Grey w/Brown & White Specks Floor Tile Mastic

14 SF 3rd Floor Under Water Fountain


LOW

08D 12"x12" Cream w/Caramel Specks Floor Tile Mastic

3,130 SF Gym Office, and Rooms 001. 201


LOW







Material Units


Material Category

Friable Damage Type

Damage Quantity



(under existing flooring), and 301

08E 12"x12" Light Beige w/Dark Brown Streaks Floor Tile (NOT OBSERVED)

124 SF Room 302 CHR MISC N NONE 0 No ACBM with the potential for damage

LOW

08F 12"x12" Light Gray w/White Blotches Floor Tile Mastic

940 SF Room 101 ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

09 Cream Colored Linoleum Mastic 1,500 SF Gym 3rd Floor NO_ACBM MISC N NONE 0 No ACBM with the potential for damage

LOW

10 Drywall (NOT OBSERVED) 16,500 SF 1, 2, 3rd Floors ASSUMED MISC No11 Insulation in Fire Rated Doors 3 EA Playrooms & Tank

RoomsASSUMED TSI N NONE 0 No ACBM with the

potential for damageLOW

12 Boiler Door Insulation (Abated 2006) Boiler Room ABATED MISC No13 Transite (Abated 2006) Incinerator ABATED MISC No14 Marlite (NOT OBSERVED) 185 SF 1st Floor Center

RestroomsASSUMED MISC No

15 Lab Tops- REMOVED Room 305 ABATED No16 Drywall Compound (NOT OBSERVED) 1st, 2nd, 3rd Floors ASSUMED MISC No17 Carpet Mastic Brown 1,350 SF Main Office,

Principal's OfficeASSUMED MISC N NONE 0 No ACBM with the


18 Brown Vinyl Baseboard 220 LF Throughout Basement

NO_ACBM MISC No

19 Brown Baseboard Mastic 220 LF Throughout Basement

NO_ACBM MISC N No

20 Interior Window Caulking 5,000 LF 1st, 2nd, 3rd Floors and Basement


LOW

21 Carpet Mastic Brown 124 SF Room 302 ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

22 12 x 12 White/Grey Specs Floor Tile 640 SF 3rd Floor Girls Restroom, 2nd FloorBoys Restroom, and 1st Floor Main Office


LOW

22M 12 x 12 White/Grey Specs Floor Tile Mastic

640 SF 3rd Floor Girls Restroom, 2nd FloorBoys Restroom, and 1st Floor Main Office


LOW

23 Brown Speckled Terrazzo 400 SF Kindergarden Restroom, North, South and East Entrances


LOW

24 1 x 1 Ceiling Tile 520 SF Principal's Office ASSUMED MISC Y NONE 0 No ACBM with the potential for damage

LOW

25 Aqua Green Ceramic Tile Grout 308 SF Basement Boys ASSUMED MISC Y NONE 0 No ACBM with the LOW







Material Units


Material Category

Friable Damage Type

Damage Quantity



Restroom potential for damage26 Aqua Green Ceramic Tile Adhesive 308 SF Basement Boys

RestroomASSUMED MISC N NONE 0 No ACBM with the


27 12 x 12 Gold with Brown Speckles Floor Tile

324 SF Basement and Womens Restrooms


LOW

27M 12 x 12 Gold with Brown Speckles Floor Tile Mastic

324 SF Basement Womens Restrooms


LOW

28 Grey Ceramic Tile Grout 308 SF Basement Girls Restroom

ASSUMED MISC Y NONE 0 No ACBM with the potential for damage

LOW

29 Grey Ceramic Tile Adhesive 308 SF Basement Girls Restroom


LOW

30 12x12 cream floor tile VFT 4,000 SF 1st, 2nd, and 3rd floor elevator lobby, stage lobby, 1st, 2nd, and 3rd floor toilets, Room 204 storage, Room 103 storage, Room 203, Basement Men's andUnisex Toilet

ASSUMED MISC N NONE 0 ACBM with the potential for damage

MODERATE

31 12x12 Cream Floor Tile VFT(Mastic) 4,000 SF 1st, 2nd, and 3rd floor elevator lobby, stage lobby, 1st, 2nd, and 3rd floor toilets, Room 204 storage, Room 103 storage, Room 203, Basement Men's andUnisex Toilet


LOW

32 Gray Linoleum 200 SF Room 001 (Music Room)


MODERATE

33 Gray Linoleum (Mastic) 200 SF Room 001 (Music Room)

ABATED MISC N NONE 0 ACBM with the potential for damage

LOW

34 Spray on Fire-Proofing 1,000 SF Attic on Beams supporting fan unit

ASSUMED SURFACE Y NONE 0 ACBM with the potential for damage

LOW

A Tank Insulation - ABATED Tank Room ABATED TSI NoB Aircell Pipe Insulation 350 LF Kindergarten &

Basement Hallway Near Music Room, Storage Room 004

CHR MISC Y LOC 3 No ACBM with the potential for damage

LOW

C Cardboard Pipe Insulation (NOT OBSERVED)

not observed ASSUMED TSI No

D MJP E/F/V on Fiberglass Pipe Insulation 150 LF Throughout Basement and 1st

ASSUMED SURFACE Y LOC 3 Yes Damaged friable surfacing ACBM

5 MODERATE







Material Units


Material Category

Friable Damage Type

Damage Quantity



Floor South Stairs, Pipe chase in Room 305 and 205, Main office storage rooms, and Music Room

E Plaster 40,000 SF Throughout School ASSUMED SURFACE Y DIST 6 No ACBM with the potential for damage

LOW






Reinspection Date 3/20/2013

Inspector Name Esteban Nunez

100-11255 5/15/2013

Inspector's IDPH License Number / Expiration Date

Inspector's Comments

HA Number: Inspector Comments:040505A05B05C05D05E05F06070808A08B08C08D08E08F09101112131415






HA Number: Inspector Comments:1617181920212222M232425262727M28293031323334 no drawing of atticAB Damage located in Kindergarten and Storage Room CD Damage in basement E

Table II

Management Planner's Review

Chicago Public SchoolsSchool Poe School Unit 29261 Building ID 5460

Address 10538 S Langley Avenue Chicago, IL, 60628 Region 06

ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS

Management Planner's Review Table II



Phone: (312) 733-6262 Fax: (312) 733-5612

Management Planner's Comments Summarized at the End of the ReportHA Num

Material Description Material Quantity

Material Units

Material Location AsbestosType

Material Category

Friable Damage Quantity

Damage Units

Damage Category Response

04 9"x9" Beige w/Brown Streaks Floor Tile(Not Observed)

1,600 SF Room 202, Teachers Lounge, Tank Room Storage, Principal's Office (underthe carpet)

Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

05 12"x12" Green Floor Tile (NOT OBSERVED) SF Teacher's Lounge Assumed MISC SF Operations and Maintenance05A 12"x12" Gray w/White Specks Floor Tile 1,500 SF 3rd Floor Corridor, Rooms 201 and 303 Assumed MISC No SF 6 ACBM with the potential for damage Operations and Maintenance05B 12"x12" Beige Speckled Floor Tile 4,300 SF Rooms 102, 103, 204, 205, 305,

Library, MDF RM, and Teacher's Lounge

Assumed MISC No SF 6 ACBM with the potential for damage Operations and Maintenance

05C 12"x12" Light Grey w/Brown & White Specks Floor Tile

14 SF 3rd Floor Under Water Fountain Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

05D 12"x12" Cream w/Caramel Specks Floor Tile 3,130 SF Gym Office, and Rooms 001. 201 (under existing flooring), 301


05E 12"x12" Light Beige w/Dark Brown Streaks Floor Tile under carpet (NOT OBSERVED)

124 SF Room 302 Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

05F 12"x12" Light Gray w/White Blotches Floor Tile 940 SF Room 101and 3rd Floor Janitor's Closet Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance06 Cream Colored Linoleum 1,500 SF Gym 3rd Floor Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance07 9"x9" Beige w/Brown Streaks Floor Tile Mastic(Not

Observed)1,600 SF Room 202, Tan Room Storage,

Principal's Office (under the carpet)Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

08 12"x12" Green Floor Tile Mastic (NOT OBSERVED)

SF Teachers Lounge Assumed MISC SF Operations and Maintenance

08A 12"x12" Gray w/White Specks Floor Tile Mastic 1,500 SF 3rd Floor Corridor and Room 303 Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance08B 12"x12" Beige Speckled Floor Tile Mastic 4,300 SF Rooms 102, 103, 203, 204, 205, 305,

Library, and Teacher's LoungeAssumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

08C 12"x12" Light Grey w/Brown & White Specks Floor Tile Mastic

14 SF 3rd Floor Under Water Fountain Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

08D 12"x12" Cream w/Caramel Specks Floor Tile Mastic

3,130 SF Gym Office, and Rooms 001. 201 (under existing flooring), and 301


08E 12"x12" Light Beige w/Dark Brown Streaks Floor Tile (NOT OBSERVED)

124 SF Room 302 Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

08F 12"x12" Light Gray w/White Blotches Floor Tile Mastic

940 SF Room 101 Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

09 Cream Colored Linoleum Mastic 1,500 SF Gym 3rd Floor No ACBM MISC No 0 SF 6 ACBM with the potential for damage10 Drywall (NOT OBSERVED) 16,500 SF 1, 2, 3rd Floors Assumed MISC SF Operations and Maintenance11 Insulation in Fire Rated Doors 3 EA Playrooms & Tank Rooms Assumed TSI No 0 EA 6 ACBM with the potential for damage Operations and Maintenance12 Boiler Door Insulation (Abated 2006) Boiler Room Abated MISC 13 Transite (Abated 2006) Incinerator Abated MISC







Phone: (312) 733-6262 Fax: (312) 733-5612



Material Units


Material Category


Damage Units


14 Marlite (NOT OBSERVED) 185 SF 1st Floor Center Restrooms Assumed MISC SF Operations and Maintenance15 Lab Tops- REMOVED Room 305 Abated 16 Drywall Compound (NOT OBSERVED) 1st, 2nd, 3rd Floors Assumed MISC Operations and Maintenance17 Carpet Mastic Brown 1,350 SF Main Office, Principal's Office Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance18 Brown Vinyl Baseboard 220 LF Throughout Basement No ACBM MISC LF 19 Brown Baseboard Mastic 220 LF Throughout Basement No ACBM MISC No LF 20 Interior Window Caulking 5,000 LF 1st, 2nd, 3rd Floors and Basement Chrysotile MISC No 0 LF 6 ACBM with the potential for damage Operations and Maintenance21 Carpet Mastic Brown 124 SF Room 302 Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance22 12 x 12 White/Grey Specs Floor Tile 640 SF 3rd Floor Girls Restroom, 2nd Floor

Boys Restroom, and 1st Floor Main Office

Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance

22M 12 x 12 White/Grey Specs Floor Tile Mastic 640 SF 3rd Floor Girls Restroom, 2nd Floor Boys Restroom, and 1st Floor Main Office


23 Brown Speckled Terrazzo 400 SF Kindergarden Restroom, North, South and East Entrances


24 1 x 1 Ceiling Tile 520 SF Principal's Office Assumed MISC Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance25 Aqua Green Ceramic Tile Grout 308 SF Basement Boys Restroom Assumed MISC Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance26 Aqua Green Ceramic Tile Adhesive 308 SF Basement Boys Restroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance27 12 x 12 Gold with Brown Speckles Floor Tile 324 SF Basement and Womens Restrooms Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance27M 12 x 12 Gold with Brown Speckles Floor Tile Mastic 324 SF Basement Womens Restrooms Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance28 Grey Ceramic Tile Grout 308 SF Basement Girls Restroom Assumed MISC Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance29 Grey Ceramic Tile Adhesive 308 SF Basement Girls Restroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance30 12x12 cream floor tile VFT 4,000 SF 1st, 2nd, and 3rd floor elevator lobby,

stage lobby, 1st, 2nd, and 3rd floor toilets, Room 204 storage, Room 103 storage, Room 203, Basement Men's and Unisex Toilet


31 12x12 Cream Floor Tile VFT(Mastic) 4,000 SF 1st, 2nd, and 3rd floor elevator lobby, stage lobby, 1st, 2nd, and 3rd floor toilets, Room 204 storage, Room 103 storage, Room 203, Basement Men's and Unisex Toilet


32 Gray Linoleum 200 SF Room 001 (Music Room) Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance33 Gray Linoleum (Mastic) 200 SF Room 001 (Music Room) Abated MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance34 Spray on Fire-Proofing 1,000 SF Attic on Beams supporting fan unit Assumed SURFACE Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance







Phone: (312) 733-6262 Fax: (312) 733-5612



Material Units


Material Category


Damage Units


A Tank Insulation - ABATED Tank Room Abated TSI B Aircell Pipe Insulation 350 LF Kindergarten & Basement Hallway

Near Music Room, Storage Room 004Chrysotile MISC Yes 3 LF 6 ACBM with the potential for damage Repair

C Cardboard Pipe Insulation (NOT OBSERVED) not observed Assumed TSI Operations and MaintenanceD MJP E/F/V on Fiberglass Pipe Insulation 150 LF Throughout Basement and 1st Floor

South Stairs, Pipe chase in Room 305 and 205, Main office storage rooms, and Music Room

Assumed SURFACE Yes 3 LF 2 Damaged friable surfacing ACBM Repair

E Plaster 40,000 SF Throughout School Assumed SURFACE Yes 6 SF 6 ACBM with the potential for damage Repair







Phone: (312) 733-6262 Fax: (312) 733-5612

Management Planner's Comments Summarized at the End of the Report

Review Date 5/10/2013

Manager Planner Name Santiago Garcia100-06325 5/15/2013Manager IDPH License No/Expiration

HA Number Management Comments040505A05B05C05D05E05F06070808A08B08C08D08E08F091011121314151617







Phone: (312) 733-6262 Fax: (312) 733-5612

Management Planner's Comments Summarized at the End of the ReportHA Number Management Comments181920212222M232425262727M28293031323334AB Repair Damage as soon as possible CD Repair Damage as soon as possible E Repair Damage as soon as possible







Phone: (312) 733-6262 Fax: (312) 733-5612

Management Planner's Comments Summarized at the End of the Report

Chicago Public Schools

GSG Consultants, Inc.

2013 AHERA REINSPECTION

Inspector Assessment Form (REASSESSMENT) LEA NAME: Chicago Public Schools UNIT NUMBER: 29261 BUIDLING ID: 5460

CITY/STATE: Chicago, Illinois AHERA INSPECTOR: Esteban Nunez

SCHOOL NAME: Poe School INSPECTION DATE: 3/20/2013

ADDRESS: 10538 S Langley Avenue IDPH LICENSE NO: 100-11255

INFORMATION FROM PREVIOUS INSPECTION

HOMOGENEOUS AREA: 04

MATERIAL DESCRIPTION: 9"x9" Beige w/Brown Streaks Floor Tile(Not Observed)

HISTORICAL AHERA DAMAGE CATEGORY 6 ACBM with the potential for damage

HISTORICAL DAMAGE REASON:

HISTORICAL RESPONSE ACTION: Operations and Maintenance

ASBESTOS TYPE: Chrysotile FRIABLE: No

RESULTS OF REINSPECTION AND REASSESSMENT

This homogeneous area was reinspected and reassessed in accordance with Section 763.85 and 763.88 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: LOW

MATERIAL LOCATION: Room 202, Teachers Lounge, Tank Room Storage, Principal's Office (under the carpet)

MATERIAL QUANTITY: 1600 MATERIAL UNITS: SF

DAMAGE QUANTITY: DAMAGE UNITS: SF

COMMENTS:

Inspector's Signature: Date: 03/20/2013




Management Planner Review FormLEA NAME: Chicago Public Schools UNIT NUMBER: 29261 BUIDLING ID: 5460

CITY/STATE: Chicago, Illinois MANAGEMENT PLANNER: Santiago Garcia

SCHOOL NAME: Poe School REVIEW DATE: 5/10/2013

ADDRESS: 10538 S Langley Avenue

IDPH LICENSE NO: 100-11255


MATERIAL DESCRIPTION: 9"x9" Beige w/Brown Streaks Floor Tile(Not Observed)

MATERIAL LOCATION: Room 202, Teachers Lounge, Tank Room Storage, Principal's Office (under the carpet)


DAMAGE QUANTITY: 0 DAMAGE UNITS: SF

In accordance with Sections 763.88 and 763.90 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 763.88 and 763.90 with the following recommendations.

The RESPONSE ACTION recommendation is:

Operations and Maintenance

Comments:

Management Planner's Signature: Date: 05/10/2013










MATERIAL DESCRIPTION: 12"x12" Green Floor Tile (NOT OBSERVED)

HISTORICAL AHERA DAMAGE CATEGORY


HISTORICAL RESPONSE ACTION:

ASBESTOS TYPE: Assumed FRIABLE:



The current AHERA DAMAGE CATEGORY is determined to be .

DAMAGE REASON:

DISTURBANCE POTENTIAL:

MATERIAL LOCATION: Teacher's Lounge

MATERIAL QUANTITY: MATERIAL UNITS: SF


COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Green Floor Tile (NOT OBSERVED)

MATERIAL LOCATION: Teacher's Lounge





Comments:










HOMOGENEOUS AREA: 05A

MATERIAL DESCRIPTION: 12"x12" Gray w/White Specks Floor Tile

HISTORICAL AHERA DAMAGE CATEGORY 6



ASBESTOS TYPE: Assumed FRIABLE: No




DAMAGE REASON:

DISTURBANCE POTENTIAL: MODERATE

MATERIAL LOCATION: 3rd Floor Corridor, Rooms 201 and 303



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Gray w/White Specks Floor Tile

MATERIAL LOCATION: 3rd Floor Corridor, Rooms 201 and 303





Comments:










HOMOGENEOUS AREA: 05B

MATERIAL DESCRIPTION: 12"x12" Beige Speckled Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: Rooms 102, 103, 204, 205, 305, Library, MDF RM, and Teacher's Lounge



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Beige Speckled Floor Tile

MATERIAL LOCATION: Rooms 102, 103, 204, 205, 305, Library, MDF RM, and Teacher's Lounge





Comments:










HOMOGENEOUS AREA: 05C

MATERIAL DESCRIPTION: 12"x12" Light Grey w/Brown & White Specks Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: 3rd Floor Under Water Fountain



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Light Grey w/Brown & White Specks Floor Tile






Comments:










HOMOGENEOUS AREA: 05D

MATERIAL DESCRIPTION: 12"x12" Cream w/Caramel Specks Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: Gym Office, and Rooms 001. 201 (under existing flooring), 301



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Cream w/Caramel Specks Floor Tile

MATERIAL LOCATION: Gym Office, and Rooms 001. 201 (under existing flooring), 301






Comments:










HOMOGENEOUS AREA: 05E

MATERIAL DESCRIPTION: 12"x12" Light Beige w/Dark Brown Streaks Floor Tile under carpet (NOTOBSERVED)








DAMAGE REASON:


MATERIAL LOCATION: Room 302



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Light Beige w/Dark Brown Streaks Floor Tile under carpet (NOT OBSERVED)







Comments:










HOMOGENEOUS AREA: 05F

MATERIAL DESCRIPTION: 12"x12" Light Gray w/White Blotches Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: Room 101and 3rd Floor Janitor's Closet



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Light Gray w/White Blotches Floor Tile

MATERIAL LOCATION: Room 101and 3rd Floor Janitor's Closet





Comments:











MATERIAL DESCRIPTION: Cream Colored Linoleum








DAMAGE REASON:


MATERIAL LOCATION: Gym 3rd Floor



COMMENTS:











MATERIAL DESCRIPTION: Cream Colored Linoleum







Comments:











MATERIAL DESCRIPTION: 9"x9" Beige w/Brown Streaks Floor Tile Mastic(Not Observed)








DAMAGE REASON:


MATERIAL LOCATION: Room 202, Tan Room Storage, Principal's Office (under the carpet)



COMMENTS:











MATERIAL DESCRIPTION: 9"x9" Beige w/Brown Streaks Floor Tile Mastic(Not Observed)

MATERIAL LOCATION: Room 202, Tan Room Storage, Principal's Office (under the carpet)






Comments:











MATERIAL DESCRIPTION: 12"x12" Green Floor Tile Mastic (NOT OBSERVED)








DAMAGE REASON:


MATERIAL LOCATION: Teachers Lounge



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Green Floor Tile Mastic (NOT OBSERVED)

MATERIAL LOCATION: Teachers Lounge





Comments:











MATERIAL DESCRIPTION: 12"x12" Gray w/White Specks Floor Tile Mastic








DAMAGE REASON:


MATERIAL LOCATION: 3rd Floor Corridor and Room 303



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Gray w/White Specks Floor Tile Mastic

MATERIAL LOCATION: 3rd Floor Corridor and Room 303






Comments:











MATERIAL DESCRIPTION: 12"x12" Beige Speckled Floor Tile Mastic








DAMAGE REASON:


MATERIAL LOCATION: Rooms 102, 103, 203, 204, 205, 305, Library, and Teacher's Lounge



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Beige Speckled Floor Tile Mastic

MATERIAL LOCATION: Rooms 102, 103, 203, 204, 205, 305, Library, and Teacher's Lounge





Comments:











MATERIAL DESCRIPTION: 12"x12" Light Grey w/Brown & White Specks Floor Tile Mastic








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Light Grey w/Brown & White Specks Floor Tile Mastic






Comments:











MATERIAL DESCRIPTION: 12"x12" Cream w/Caramel Specks Floor Tile Mastic








DAMAGE REASON:


MATERIAL LOCATION: Gym Office, and Rooms 001. 201 (under existing flooring), and 301



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Cream w/Caramel Specks Floor Tile Mastic

MATERIAL LOCATION: Gym Office, and Rooms 001. 201 (under existing flooring), and 301






Comments:











MATERIAL DESCRIPTION: 12"x12" Light Beige w/Dark Brown Streaks Floor Tile (NOT OBSERVED)








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Light Beige w/Dark Brown Streaks Floor Tile (NOT OBSERVED)







Comments:











MATERIAL DESCRIPTION: 12"x12" Light Gray w/White Blotches Floor Tile Mastic








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Light Gray w/White Blotches Floor Tile Mastic






Comments:











MATERIAL DESCRIPTION: Cream Colored Linoleum Mastic




ASBESTOS TYPE: No ACBM FRIABLE: No




DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: Cream Colored Linoleum Mastic






Comments:











MATERIAL DESCRIPTION: Drywall (NOT OBSERVED)








DAMAGE REASON:


MATERIAL LOCATION: 1, 2, 3rd Floors



COMMENTS:











MATERIAL DESCRIPTION: Drywall (NOT OBSERVED)

MATERIAL LOCATION: 1, 2, 3rd Floors





Comments:











MATERIAL DESCRIPTION: Insulation in Fire Rated Doors








DAMAGE REASON:


MATERIAL LOCATION: Playrooms & Tank Rooms

MATERIAL QUANTITY: 3 MATERIAL UNITS: EA

DAMAGE QUANTITY: DAMAGE UNITS: EA

COMMENTS:











MATERIAL DESCRIPTION: Insulation in Fire Rated Doors

MATERIAL LOCATION: Playrooms & Tank Rooms

MATERIAL QUANTITY: 3 MATERIAL UNITS: EA

DAMAGE QUANTITY: 0 DAMAGE UNITS: EA




Comments:











MATERIAL DESCRIPTION: Boiler Door Insulation (Abated 2006)




ASBESTOS TYPE: Abated FRIABLE:




DAMAGE REASON:


MATERIAL LOCATION: Boiler Room

MATERIAL QUANTITY: MATERIAL UNITS:

DAMAGE QUANTITY: DAMAGE UNITS:

COMMENTS:











MATERIAL DESCRIPTION: Boiler Door Insulation (Abated 2006)

MATERIAL LOCATION: Boiler Room





Comments:











MATERIAL DESCRIPTION: Transite (Abated 2006)








DAMAGE REASON:


MATERIAL LOCATION: Incinerator



COMMENTS:











MATERIAL DESCRIPTION: Transite (Abated 2006)

MATERIAL LOCATION: Incinerator





Comments:











MATERIAL DESCRIPTION: Marlite (NOT OBSERVED)








DAMAGE REASON:


MATERIAL LOCATION: 1st Floor Center Restrooms



COMMENTS:











MATERIAL DESCRIPTION: Marlite (NOT OBSERVED)

MATERIAL LOCATION: 1st Floor Center Restrooms





Comments:











MATERIAL DESCRIPTION: Lab Tops- REMOVED








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: Lab Tops- REMOVED






Comments:











MATERIAL DESCRIPTION: Drywall Compound (NOT OBSERVED)








DAMAGE REASON:


MATERIAL LOCATION: 1st, 2nd, 3rd Floors



COMMENTS:











MATERIAL DESCRIPTION: Drywall Compound (NOT OBSERVED)

MATERIAL LOCATION: 1st, 2nd, 3rd Floors





Comments:











MATERIAL DESCRIPTION: Carpet Mastic Brown








DAMAGE REASON:


MATERIAL LOCATION: Main Office, Principal's Office



COMMENTS:












MATERIAL LOCATION: Main Office, Principal's Office





Comments:











MATERIAL DESCRIPTION: Brown Vinyl Baseboard




ASBESTOS TYPE: No ACBM FRIABLE:




DAMAGE REASON:


MATERIAL LOCATION: Throughout Basement

MATERIAL QUANTITY: 220 MATERIAL UNITS: LF

DAMAGE QUANTITY: DAMAGE UNITS: LF

COMMENTS:











MATERIAL DESCRIPTION: Brown Vinyl Baseboard






Comments:











MATERIAL DESCRIPTION: Brown Baseboard Mastic




ASBESTOS TYPE: No ACBM FRIABLE: No




DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: Brown Baseboard Mastic






Comments:











MATERIAL DESCRIPTION: Interior Window Caulking








DAMAGE REASON:


MATERIAL LOCATION: 1st, 2nd, 3rd Floors and Basement



COMMENTS:











MATERIAL DESCRIPTION: Interior Window Caulking

MATERIAL LOCATION: 1st, 2nd, 3rd Floors and Basement


DAMAGE QUANTITY: 0 DAMAGE UNITS: LF




Comments:



















DAMAGE REASON:





COMMENTS:


















Comments:











MATERIAL DESCRIPTION: 12 x 12 White/Grey Specs Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: 3rd Floor Girls Restroom, 2nd Floor Boys Restroom, and 1st Floor Main Office



COMMENTS:











MATERIAL DESCRIPTION: 12 x 12 White/Grey Specs Floor Tile







Comments:










HOMOGENEOUS AREA: 22M

MATERIAL DESCRIPTION: 12 x 12 White/Grey Specs Floor Tile Mastic








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: 12 x 12 White/Grey Specs Floor Tile Mastic







Comments:











MATERIAL DESCRIPTION: Brown Speckled Terrazzo








DAMAGE REASON:


MATERIAL LOCATION: Kindergarden Restroom, North, South and East Entrances



COMMENTS:











MATERIAL DESCRIPTION: Brown Speckled Terrazzo

MATERIAL LOCATION: Kindergarden Restroom, North, South and East Entrances






Comments:











MATERIAL DESCRIPTION: 1 x 1 Ceiling Tile




ASBESTOS TYPE: Assumed FRIABLE: Yes




DAMAGE REASON:


MATERIAL LOCATION: Principal's Office



COMMENTS:











MATERIAL DESCRIPTION: 1 x 1 Ceiling Tile

MATERIAL LOCATION: Principal's Office






Comments:











MATERIAL DESCRIPTION: Aqua Green Ceramic Tile Grout








DAMAGE REASON:


MATERIAL LOCATION: Basement Boys Restroom



COMMENTS:











MATERIAL DESCRIPTION: Aqua Green Ceramic Tile Grout







Comments:











MATERIAL DESCRIPTION: Aqua Green Ceramic Tile Adhesive








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: Aqua Green Ceramic Tile Adhesive







Comments:











MATERIAL DESCRIPTION: 12 x 12 Gold with Brown Speckles Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: Basement and Womens Restrooms



COMMENTS:











MATERIAL DESCRIPTION: 12 x 12 Gold with Brown Speckles Floor Tile

MATERIAL LOCATION: Basement and Womens Restrooms






Comments:











MATERIAL DESCRIPTION: 12 x 12 Gold with Brown Speckles Floor Tile Mastic








DAMAGE REASON:


MATERIAL LOCATION: Basement Womens Restrooms



COMMENTS:











MATERIAL DESCRIPTION: 12 x 12 Gold with Brown Speckles Floor Tile Mastic

MATERIAL LOCATION: Basement Womens Restrooms






Comments:











MATERIAL DESCRIPTION: Grey Ceramic Tile Grout








DAMAGE REASON:


MATERIAL LOCATION: Basement Girls Restroom



COMMENTS:











MATERIAL DESCRIPTION: Grey Ceramic Tile Grout







Comments:











MATERIAL DESCRIPTION: Grey Ceramic Tile Adhesive








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: Grey Ceramic Tile Adhesive







Comments:










HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: Tank Insulation - ABATED








DAMAGE REASON:


MATERIAL LOCATION: Tank Room



COMMENTS:










HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: Tank Insulation - ABATED

MATERIAL LOCATION: Tank Room





Comments:










HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: Aircell Pipe Insulation




ASBESTOS TYPE: Chrysotile FRIABLE: Yes




DAMAGE REASON:


MATERIAL LOCATION: Kindergarten & Basement Hallway Near Music Room, Storage Room 004



COMMENTS: Damage located in Kindergarten and Storage Room










HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: Aircell Pipe Insulation

MATERIAL LOCATION: Kindergarten & Basement Hallway Near Music Room, Storage Room 004






Comments:

Repair Damage as soon as possible










HOMOGENEOUS AREA: C

MATERIAL DESCRIPTION: Cardboard Pipe Insulation (NOT OBSERVED)








DAMAGE REASON:


MATERIAL LOCATION: not observed



COMMENTS:










HOMOGENEOUS AREA: C

MATERIAL DESCRIPTION: Cardboard Pipe Insulation (NOT OBSERVED)

MATERIAL LOCATION: not observed





Comments:










HOMOGENEOUS AREA: D

MATERIAL DESCRIPTION: MJP E/F/V on Fiberglass Pipe Insulation

HISTORICAL AHERA DAMAGE CATEGORY 2 Damaged or significantly damaged friable thermal system insulating ACBM

HISTORICAL DAMAGE REASON: Physical Damage

HISTORICAL RESPONSE ACTION: RepairOperations and Maintenance




The current AHERA DAMAGE CATEGORY is determined to be 2. Damaged friable surfacing ACBM

DAMAGE REASON: Physical Damage


MATERIAL LOCATION: Throughout Basement and 1st Floor South Stairs, Pipe chase in Room 305 and 205, Main office storage rooms, and Music Room



COMMENTS: Damage in basement










HOMOGENEOUS AREA: D

MATERIAL DESCRIPTION: MJP E/F/V on Fiberglass Pipe Insulation

MATERIAL LOCATION: Throughout Basement and 1st Floor South Stairs, Pipe chase in Room 305 and 205, Main office storage rooms, and Music Room





RepairOperations and Maintenance

Comments:











HOMOGENEOUS AREA: E

MATERIAL DESCRIPTION: Plaster








DAMAGE REASON:


MATERIAL LOCATION: Throughout School



COMMENTS:










HOMOGENEOUS AREA: E

MATERIAL DESCRIPTION: Plaster

MATERIAL LOCATION: Throughout School






Comments:






Inspector Assessment Form (New Homogeneous Area)

LEA NAME: Chicago Public Schools UNIT NUMBER: 29261 BUIDLING ID: 5460




INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: 33

MATERIAL DESCRIPTION: Gray Linoleum (Mastic)

MATERIAL LOCATION: Room 001 (Music Room)


MATERIAL CATEGORY: MISC FRIABLE: No

ASBESTOS TYPE: Abated

DISTURBANCE POTENTIAL: LOW CONDITION:

AHERA DAMAGE CATEGORY: 6 ACBM with the potential for damage

ACCESSIBILITY: Barely Reachable DAMAGE REASON:DAMAGE REASON:DAMAGE REASON:


COMMENTS:










MATERIAL DESCRIPTION: Gray Linoleum (Mastic)




In accordance with Sections 763.88 and 763.90 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 originalinspection of the above identified homogeneous area has been reviewed in accordance with Sections 763.88 and 763.90 with the following recommendations.


COMMENTS:











MATERIAL DESCRIPTION: 12x12 Cream Floor Tile VFT(Mastic)

MATERIAL LOCATION: 1st, 2nd, and 3rd floor elevator lobby, stage lobby, 1st, 2nd, and 3rd floor toilets, Room 204 storage, Room 103 storage, Room 203, Basement Men's and Unisex Toilet



ASBESTOS TYPE: Assumed



ACCESSIBILITY: Barely Reachable DAMAGE REASON:DAMAGE REASON:DAMAGE REASON:


COMMENTS:










MATERIAL DESCRIPTION: 12x12 Cream Floor Tile VFT(Mastic)






COMMENTS:











MATERIAL DESCRIPTION: Gray Linoleum





DISTURBANCE POTENTIAL: MODERATE CONDITION:


ACCESSIBILITY: Within Reach DAMAGE REASON:DAMAGE REASON:DAMAGE REASON:


COMMENTS:










MATERIAL DESCRIPTION: Gray Linoleum






COMMENTS:











MATERIAL DESCRIPTION: 12x12 cream floor tile VFT





DISTURBANCE POTENTIAL: MODERATE CONDITION:




COMMENTS:










MATERIAL DESCRIPTION: 12x12 cream floor tile VFT






COMMENTS:











MATERIAL DESCRIPTION: Spray on Fire-Proofing

MATERIAL LOCATION: Attic on Beams supporting fan unit


MATERIAL CATEGORY: SURFACE FRIABLE: Yes






COMMENTS:no drawing of attic










MATERIAL DESCRIPTION: Spray on Fire-Proofing

MATERIAL LOCATION: Attic on Beams supporting fan unit





COMMENTS:


APPENDIX B

Inspector and Management Planner Licenses

APPENDIX C

Laboratory Accreditations

APPENDIX D

Laboratory Results

APPENDIX E

Chain of Custody Forms

Three-Year Reinspection Key to Terms

CODE KEYMATERIAL

ACBM Asbestos Containing Building MaterialsMATERIAL CATEGORY

MISC Miscellaneous

SURF Surfacing

TSI Thermal System InsulationMATERIAL UNITS

LF Linear Feet

SF Square Feet

CF Cubic FeetDAMAGE TYPE

Loc Localized

Dist Distributed

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