3/27/2013 - CPSschoolreports.cps.edu/AsbestosInspectionReport_2013... · 06D 9x 9 gray with black specks A fiberglass joint compound AA-1 12" X 12" White Ceiling Tile Glue AB-1 12"

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: 14-016-2990-2065SCHOOL NAME: Banneker SchoolADDRESS OF SCHOOL: 6656 S. NormalCITY: Chicago, IL, 60621

DATE LAST THREE YEAR REINSPECTION WAS COMPLETED 2/17/2010If 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: 3/27/2013 ENROLLMENT 335

IDPH INSPECTOR LICENSE NUMBER: 100-02950

IDPH LICENSED INSPECTOR NAME (Please Print): Keith Clough

IDPH MP LICENSE NUMBER: 100-09870

IDPH LICENSED MANAGEMENT PLANNER NAME (Please Print): Todd Huffer

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

3/27/2013

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

Banneker School

6656 S. NormalChicago, IL, 60621

Unit: 26161Building ID: 6880

IDPH ID Number: 14-016-2990-2065

REPORT DATE:Wednesday, March 27, 2013

Prepared for:Chicago Public Schools

125 S. Clark StreetChicago, IL 60603

Prepared by:Carnow, Conibear and Associates

600 West Van Buren St., Ste 500

Phone (312) 762-2900

Fax (312) 782-5145

DO NOT REMOVE FROM SCHOOLREQUIRED BY FEDERAL LAW

March 7, 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:

Carnow, Conibear and Associates, Managing Environmental Consultant (MEC), conducted the Three-Year Reinspections and performed management plan updates for the Chicago Public Schools (CPS) facilities in Region 3,4,5 Elementary Schools. Please update your records with the following information.

School District: 299 Unit: 26161 Region: 05 IDPH ID: 14-016-2990-2065

School: Banneker School Building ID: 6880

Address: 6656 S. Normal

Chicago, IL, 60621

Building Contact: Mong, Mba Contact Phone: 773-535-3020

Current Building Owners: Chicago Public Schools

Review Date: 3/27/2013

Inspector: Keith Clough Inspector IDPH License: 100-02950Management Planner: Todd Huffer Management Planner IDPH License: 100-09870

If you have any questions or comments, please contact us at (312) 762-2900

Sincerely,Carnow, Conibear and Associates

Todd Huffer100-09870

Environmental Notification to Occupants

To: Faculty, Staff and ParentsFrom: Chicago Public SchoolsDate: March 07, 2013

RE: Banneker School, Unit 26161 6656 S. Normal Chicago, IL, 60621

Dear Faculty, Staff and Parents,

This letter is to notify you that the 2013 asbestos three year re-inspection has been completed at Banneker 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 Banneker 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: Banneker School Unit: 26161 Region: 05Address: 6656 S. Normal Chicago, IL, 60621IDPH ID: 14-016-2990-2065 Building ID: 6880Contact: Mong, Mba Phone: 773-535-3020

2. Description of Facility

Original Construction: Additional Construction: Total Square Footage: 64100 No of Floors: 1Current Occupancy: 335

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: Carnow, Conibear and AssociatesContact: Dan JuneauAddress 600 West Van Buren St., Ste 500Phone: (312) 762-2900 Fax: (312) 782-5145

5. Inspector

Inspector Name: Keith Clough

Signature: Inspector IDPH license # 100-02950 Date: 3/7/2013

6. Management Planner

Management Planner Name: Todd Huffer

Signature: Management Planner IDPH license # 100-09870 Date: 3/27/2013

7. Review Date: 3/27/2013

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: 3/27/2013

Name: Ms. Lynn Crivello

Unit : 26161 Banneker School Building: 6880

Unit: 26161 Banneker School Building: 6880

II. EXECUTIVE SUMMARY

Carnow, Conibear and Associates was retained by the Chicago Public Schools (CPS) to perform a three-year asbestos reinspection of the Banneker 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 previousthree-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 6880:

09 Carpet mastic

10 12x12 green vft

10A 12x12 white vft

11A Mastic for white 12x12 vft

12 black vinyl mop board

13 Black vinyl mop board

C Fiberglass pipe wrap

D Mag block pipe insulation


B. The following new homogenous areas have been identified for Building 6880:

AA 12" X 12" White Ceiling Tile

AA-1 12" X 12" White Ceiling Tile Glue

AB 12" X 12" Floor Tile

AB-1 12" X 12" Floor Tile Mastic

AC Troweled on Ceiling


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:

06D 9x 9 gray with black specks09 Carpet mastic10 12x12 green vft10A 12x12 white vft11A Mastic for white 12x12 vft12 black vinyl mop board13 Black vinyl mop board14 12x12 white floor tileAA 12" X 12" White Ceiling TileAA-1 12" X 12" White Ceiling Tile GlueAB 12" X 12" Floor TileAB-1 12" X 12" Floor Tile MasticAC Troweled on CeilingC Fiberglass pipe wrap

The following areas were deemed to be inaccessible:

06D 9x 9 gray with black specksA fiberglass joint compoundAA-1 12" X 12" White Ceiling Tile GlueAB-1 12" X 12" Floor Tile MasticB Mag block pipe wrapC Fiberglass pipe wrapD Mag block 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 Keith Clough, IDPH License # 100-02950. The Management Plan was updated by Todd Huffer, IDPH License # 100-09870. 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 Banneker School Building 6880 Three-Year reinspection has been completed and response actions have been recommendedfor both 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 Banneker School Unit 26161 Building ID 6880 Address 6656 S. Normal Region 05

ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONSInspector's Reinspection Findings Table 1

Managing Environmental Consultant (MEC) Carnow, Conibear and Associates

600 West Van Buren St., Ste 500 Phone: (312) 762-2900 Fax: (312) 782-5145

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

01 Hard coat plaster 11,000 SF Toilets, corridors, stairwells, storage rooms and boiler room

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

MODERATE

06 9x9 beige w/tan specks flr tile 9,000 SF rooms 112, 212, 213, 214, 215, 312, 314, 315, women's lounge, 1st flr offices,

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

MODERATE

06A 9x9 tan/beige streak vft 1,100 SF 1st, 2nd, 3rd flr corridors east wing


MODERATE

06B 9x9 lt beige tan specks vft 1,100 SF 1st, 2nd, 3rd flr corridor north wing


MODERATE

06C 9x9 Gray/white vft 200 SF Storage Room CHR MISC N NONE 0 No ACBM with the potential for damage

MODERATE

06D 9x 9 gray with black specks 2,400 SF gym ASSUMED MISC N ACBM with the potential for damage

Moderate

08 mastic under 9x9 beige/tan speckled vft 9,000 SF rooms 112, 212, 213, 214, 215, 312, 314, 315, women's lounge, 1st flr offices,


MODERATE

08A Mastic under 9x9 tan/beige streaked vft 1,100 SF 1st, 2nd, fl north corridors wing


MODERATE

08B mastic under 9x9 beige/tan streaks 1,100 SF 1st 2nd , 3rd flr corridors north wing


MODERATE

08C Mastic 9x9 black/white vft 0 SF gym CHR MISC N ACBM with the potential for damage

09 Carpet mastic 4,500 SF rooms 200, 201, 202 ASSUMED MISC N Yes ACBM with the potential for damage

10 12x12 green vft 2,500 SF 1st, 2nd, 3rd flr corridors

ASSUMED MISC N Yes ACBM with potential for significant damage

LOW

10A 12x12 white vft 8,000 SF rm 107, 106, 108, 105, 109, 104, 103, 102, 101, 203- 209, 303- 309

ASSUMED MISC N Yes ACBM with the potential for damage

11 Mastic for green 12x12 vft 2,500 SF 1st, 2nd and 3rd flr corridors


MODERATE

11A Mastic for white 12x12 vft 8,000 SF rms 107, 106, 108, 105, 109, 104, 103, 102, 101, 203- 209, 303- 309

ASSUMED MISC N Yes ACBM with the potential for damage

12 black vinyl mop board 22 LF 1st flr office ASSUMED MISC N Yes ACBM with the potential for damage






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

13 Black vinyl mop board 22 SF 1st flr office ASSUMED MISC N Yes ACBM with the potential for damage

14 12x12 white floor tile 2,600 SF gym ASSUMED MISC N NONE 0 No ACBM with the potential for damage

MODERATE

A fiberglass joint compound 580 SF mech, pipe chases CHR TSI Y NONE 0 No ACBM with the potential for damage

MODERATE

AA 12" X 12" White Ceiling Tile 1,050 SF Room 201, 202, 203,310, 311, 312, 313, 314, 315, and Lunchroom

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

LOW

AA-1 12" X 12" White Ceiling Tile Glue 1,050 SF Room 201, 202, 203,310, 311, 312, 314, 315, and Lunchroom

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

LOW

AB 12" X 12" Floor Tile 1,500 SF Lunchroom ASSUMED MISC Y NONE 0 No ACBM with the potential for damage

LOW

AB-1 12" X 12" Floor Tile Mastic 1,500 SF Lunchroom ASSUMED MISC Y NONE 0 No ACBM with the potential for damage

LOW

AC Troweled on Ceiling 2,600 SF Throughout school ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

B Mag block pipe wrap 60 LF mechanics room/boiler room

AMO TSI Y NONE 0 No ACBM with the potential for damage

MODERATE

C Fiberglass pipe wrap 3,400 SF mechanics room/boiler room

ASSUMED TSI N Yes ACBM with the potential for damage

D Mag block pipe insulation 680 LF Boiler room AMO_CHR TSI Y NONE 0 Yes ACBM with the potential for damage

LOW






Reinspection Date 3/7/2013

Inspector Name Keith Clough

100-02950 5/15/2013

Inspector's IDPH License Number / Expiration Date

Inspector's Comments

HA Number: Inspector Comments:010606A06B06C06D Material not observed - tiled over - 20130808A08B08C Material not Observed - 2013091010A1111A121314AAAAA-1ABAB-1AC






HA Number: Inspector Comments:BCD

Table II

Management Planner's Review

Chicago Public SchoolsSchool Banneker School Unit 26161 Building ID 6880

Address 6656 S. Normal Chicago, IL, 60621 Region 05

ASBESTOS REINSPECTION FINDINGS AND RECOMMENDATIONS

Management Planner's Review Table II



Phone: (312) 762-2900 Fax: (312) 782-5145

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

01 Hard coat plaster 11,000 SF Toilets, corridors, stairwells, storage rooms and boiler room

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

06 9x9 beige w/tan specks flr tile 9,000 SF rooms 112, 212, 213, 214, 215, 312, 314, 315, women's lounge, 1st flr offices,

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

06A 9x9 tan/beige streak vft 1,100 SF 1st, 2nd, 3rd flr corridors east wing Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance06B 9x9 lt beige tan specks vft 1,100 SF 1st, 2nd, 3rd flr corridor north wing Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance06C 9x9 Gray/white vft 200 SF Storage Room Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance06D 9x 9 gray with black specks 2,400 SF gym Assumed MISC No SF 6 ACBM with the potential for damage Operations and Maintenance08 mastic under 9x9 beige/tan speckled vft 9,000 SF rooms 112, 212, 213, 214, 215, 312,

314, 315, women's lounge, 1st flr offices,

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

08A Mastic under 9x9 tan/beige streaked vft 1,100 SF 1st, 2nd, fl north corridors wing Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance08B mastic under 9x9 beige/tan streaks 1,100 SF 1st 2nd , 3rd flr corridors north wing Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance08C Mastic 9x9 black/white vft 0 SF gym Chrysotile MISC No SF 6 ACBM with the potential for damage Operations and Maintenance09 Carpet mastic 4,500 SF rooms 200, 201, 202 Assumed MISC No SF 6 ACBM with the potential for damage Operations and Maintenance10 12x12 green vft 2,500 SF 1st, 2nd, 3rd flr corridors Assumed MISC No SF 5 ACBM with potential for significant

damageOperations and Maintenance

10A 12x12 white vft 8,000 SF rm 107, 106, 108, 105, 109, 104, 103, 102, 101, 203- 209, 303- 309

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

11 Mastic for green 12x12 vft 2,500 SF 1st, 2nd and 3rd flr corridors Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance11A Mastic for white 12x12 vft 8,000 SF rms 107, 106, 108, 105, 109, 104, 103,

102, 101, 203- 209, 303- 309Assumed MISC No SF 6 ACBM with the potential for damage Operations and Maintenance

12 black vinyl mop board 22 LF 1st flr office Assumed MISC No LF 6 ACBM with the potential for damage Operations and Maintenance13 Black vinyl mop board 22 SF 1st flr office Assumed MISC No SF 6 ACBM with the potential for damage Operations and Maintenance14 12x12 white floor tile 2,600 SF gym Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and MaintenanceA fiberglass joint compound 580 SF mech, pipe chases Chrysotile TSI Yes 0 SF 6 ACBM with the potential for damage Operations and MaintenanceAA 12" X 12" White Ceiling Tile 1,050 SF Room 201, 202, 203, 310, 311, 312,

313, 314, 315, and LunchroomAssumed SURFACE Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance

AA-1 12" X 12" White Ceiling Tile Glue 1,050 SF Room 201, 202, 203, 310, 311, 312, 314, 315, and Lunchroom

Assumed SURFACE Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance

AB 12" X 12" Floor Tile 1,500 SF Lunchroom Assumed MISC Yes 0 SF 6 ACBM with the potential for damage Operations and MaintenanceAB-1 12" X 12" Floor Tile Mastic 1,500 SF Lunchroom Assumed MISC Yes 0 SF 6 ACBM with the potential for damage Operations and MaintenanceAC Troweled on Ceiling 2,600 SF Throughout school Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and MaintenanceB Mag block pipe wrap 60 LF mechanics room/boiler room Amosite TSI Yes 0 LF 6 ACBM with the potential for damage Operations and Maintenance







Phone: (312) 762-2900 Fax: (312) 782-5145

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

C Fiberglass pipe wrap 3,400 SF mechanics room/boiler room Assumed TSI No SF 6 ACBM with the potential for damage Operations and MaintenanceD Mag block pipe insulation 680 LF Boiler room Amosite,

ChrysotileTSI Yes 0 LF 6 ACBM with the potential for damage Operations and Maintenance

Review Date 3/27/2013

Manager Planner Name Todd Huffer

HA Number Management Comments01







Phone: (312) 762-2900 Fax: (312) 782-5145

Management Planner's Comments Summarized at the End of the Report100-09870 5/15/2013Manager IDPH License No/Expiration

HA Number Management Comments0606A06B06C06D Material not observed - may have been tiled over0808A08B08C091010A1111A121314AAAAA-1ABAB-1ACBCD







Phone: (312) 762-2900 Fax: (312) 782-5145

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

Chicago Public Schools

Carnow, Conibear and Associates

2013 AHERA REINSPECTION

Inspector Assessment Form (REASSESSMENT) LEA NAME: Chicago Public Schools UNIT NUMBER: 26161 BUIDLING ID: 6880

CITY/STATE: Chicago, Illinois AHERA INSPECTOR: Keith Clough

SCHOOL NAME: Banneker School INSPECTION DATE: 3/7/2013

ADDRESS: 6656 S. Normal IDPH LICENSE NO: 100-02950

INFORMATION FROM PREVIOUS INSPECTION

HOMOGENEOUS AREA: 01

MATERIAL DESCRIPTION: Hard coat plaster

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: MODERATE

MATERIAL LOCATION: Toilets, corridors, stairwells, storage rooms and boiler room

MATERIAL QUANTITY: 11000 MATERIAL UNITS: SF

DAMAGE QUANTITY: DAMAGE UNITS: SF

COMMENTS:

Inspector's Signature: Date: 03/07/2013




Management Planner Review FormLEA NAME: Chicago Public Schools UNIT NUMBER: 26161 BUIDLING ID: 6880

CITY/STATE: Chicago, Illinois MANAGEMENT PLANNER: Todd Huffer

SCHOOL NAME: Banneker School REVIEW DATE: 3/27/2013



MATERIAL DESCRIPTION: Hard coat plaster

MATERIAL LOCATION: Toilets, corridors, stairwells, storage rooms and boiler room


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: 03/27/2013










MATERIAL DESCRIPTION: 9x9 beige w/tan specks flr tile








DAMAGE REASON:


MATERIAL LOCATION: rooms 112, 212, 213, 214, 215, 312, 314, 315, women's lounge, 1st flr offices,



COMMENTS:










MATERIAL DESCRIPTION: 9x9 beige w/tan specks flr tile







Comments:










HOMOGENEOUS AREA: 06A

MATERIAL DESCRIPTION: 9x9 tan/beige streak vft








DAMAGE REASON:


MATERIAL LOCATION: 1st, 2nd, 3rd flr corridors east wing



COMMENTS:










MATERIAL DESCRIPTION: 9x9 tan/beige streak vft

MATERIAL LOCATION: 1st, 2nd, 3rd flr corridors east wing






Comments:










HOMOGENEOUS AREA: 06B

MATERIAL DESCRIPTION: 9x9 lt beige tan specks vft








DAMAGE REASON:


MATERIAL LOCATION: 1st, 2nd, 3rd flr corridor north wing



COMMENTS:










MATERIAL DESCRIPTION: 9x9 lt beige tan specks vft

MATERIAL LOCATION: 1st, 2nd, 3rd flr corridor north wing






Comments:










HOMOGENEOUS AREA: 06C

MATERIAL DESCRIPTION: 9x9 Gray/white vft








DAMAGE REASON:


MATERIAL LOCATION: Storage Room



COMMENTS:










MATERIAL DESCRIPTION: 9x9 Gray/white vft

MATERIAL LOCATION: Storage Room






Comments:










HOMOGENEOUS AREA: 06D

MATERIAL DESCRIPTION: 9x 9 gray with black specks




ASBESTOS TYPE: Assumed FRIABLE: No




DAMAGE REASON:

DISTURBANCE POTENTIAL: Moderate

MATERIAL LOCATION: gym



COMMENTS: Material not observed - tiled over - 2013









HOMOGENEOUS AREA: 06D

MATERIAL DESCRIPTION: 9x 9 gray with black specks







Comments:

Material not observed - may have been tiled over











MATERIAL DESCRIPTION: mastic under 9x9 beige/tan speckled vft








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: mastic under 9x9 beige/tan speckled vft







Comments:











MATERIAL DESCRIPTION: Mastic under 9x9 tan/beige streaked vft








DAMAGE REASON:


MATERIAL LOCATION: 1st, 2nd, fl north corridors wing



COMMENTS:










MATERIAL DESCRIPTION: Mastic under 9x9 tan/beige streaked vft

MATERIAL LOCATION: 1st, 2nd, fl north corridors wing






Comments:











MATERIAL DESCRIPTION: mastic under 9x9 beige/tan streaks








DAMAGE REASON:


MATERIAL LOCATION: 1st 2nd , 3rd flr corridors north wing



COMMENTS:










MATERIAL DESCRIPTION: mastic under 9x9 beige/tan streaks

MATERIAL LOCATION: 1st 2nd , 3rd flr corridors north wing






Comments:











MATERIAL DESCRIPTION: Mastic 9x9 black/white vft

HISTORICAL AHERA DAMAGE CATEGORY 6


HISTORICAL RESPONSE ACTION:





DAMAGE REASON:

DISTURBANCE POTENTIAL:




COMMENTS: Material not Observed - 2013










MATERIAL DESCRIPTION: Mastic 9x9 black/white vft






Comments:











MATERIAL DESCRIPTION: Carpet mastic








DAMAGE REASON:


MATERIAL LOCATION: rooms 200, 201, 202



COMMENTS:










MATERIAL DESCRIPTION: Carpet mastic

MATERIAL LOCATION: rooms 200, 201, 202





Comments:











MATERIAL DESCRIPTION: 12x12 green vft







The current AHERA DAMAGE CATEGORY is determined to be 5. ACBM with potential for significant damage

DAMAGE REASON:

DISTURBANCE POTENTIAL: LOW

MATERIAL LOCATION: 1st, 2nd, 3rd flr corridors



COMMENTS:










MATERIAL DESCRIPTION: 12x12 green vft

MATERIAL LOCATION: 1st, 2nd, 3rd flr corridors





Comments:











MATERIAL DESCRIPTION: 12x12 white vft








DAMAGE REASON:


MATERIAL LOCATION: rm 107, 106, 108, 105, 109, 104, 103, 102, 101, 203- 209, 303- 309



COMMENTS:










MATERIAL DESCRIPTION: 12x12 white vft

MATERIAL LOCATION: rm 107, 106, 108, 105, 109, 104, 103, 102, 101, 203- 209, 303- 309





Comments:











MATERIAL DESCRIPTION: Mastic for green 12x12 vft








DAMAGE REASON:


MATERIAL LOCATION: 1st, 2nd and 3rd flr corridors



COMMENTS:










MATERIAL DESCRIPTION: Mastic for green 12x12 vft

MATERIAL LOCATION: 1st, 2nd and 3rd flr corridors






Comments:











MATERIAL DESCRIPTION: Mastic for white 12x12 vft








DAMAGE REASON:


MATERIAL LOCATION: rms 107, 106, 108, 105, 109, 104, 103, 102, 101, 203- 209, 303- 309



COMMENTS:










MATERIAL DESCRIPTION: Mastic for white 12x12 vft

MATERIAL LOCATION: rms 107, 106, 108, 105, 109, 104, 103, 102, 101, 203- 209, 303- 309





Comments:











MATERIAL DESCRIPTION: black vinyl mop board








DAMAGE REASON:


MATERIAL LOCATION: 1st flr office

MATERIAL QUANTITY: 22 MATERIAL UNITS: LF

DAMAGE QUANTITY: DAMAGE UNITS: LF

COMMENTS:










MATERIAL DESCRIPTION: black vinyl mop board






Comments:











MATERIAL DESCRIPTION: Black vinyl mop board








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: Black vinyl mop board






Comments:











MATERIAL DESCRIPTION: 12x12 white floor tile








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: 12x12 white floor tile







Comments:










HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: fiberglass joint compound




ASBESTOS TYPE: Chrysotile FRIABLE: Yes




DAMAGE REASON:


MATERIAL LOCATION: mech, pipe chases



COMMENTS:









HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: fiberglass joint compound

MATERIAL LOCATION: mech, pipe chases






Comments:










HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: Mag block pipe wrap




ASBESTOS TYPE: Amosite FRIABLE: Yes




DAMAGE REASON:


MATERIAL LOCATION: mechanics room/boiler room



COMMENTS:









HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: Mag block pipe wrap



DAMAGE QUANTITY: 0 DAMAGE UNITS: LF




Comments:










HOMOGENEOUS AREA: C

MATERIAL DESCRIPTION: Fiberglass pipe wrap








DAMAGE REASON:





COMMENTS:









HOMOGENEOUS AREA: C

MATERIAL DESCRIPTION: Fiberglass pipe wrap






Comments:










HOMOGENEOUS AREA: D

MATERIAL DESCRIPTION: Mag block pipe insulation




ASBESTOS TYPE: Amosite, Chrysotile FRIABLE: Yes




DAMAGE REASON:

DISTURBANCE POTENTIAL: LOW

MATERIAL LOCATION: Boiler room



COMMENTS:









HOMOGENEOUS AREA: D

MATERIAL DESCRIPTION: Mag block pipe insulation

MATERIAL LOCATION: Boiler room


DAMAGE QUANTITY: 0 DAMAGE UNITS: LF




Comments:





Inspector Assessment Form (New Homogeneous Area)

LEA NAME: Chicago Public Schools UNIT NUMBER: 26161 BUIDLING ID: 6880




INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: AC

MATERIAL DESCRIPTION: Troweled on Ceiling

MATERIAL LOCATION: Throughout school


MATERIAL CATEGORY: MISC FRIABLE: No

ASBESTOS TYPE: Assumed

DISTURBANCE POTENTIAL: LOW CONDITION:

AHERA DAMAGE CATEGORY: 6 ACBM with the potential for damage

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


COMMENTS:









HOMOGENEOUS AREA: AC

MATERIAL DESCRIPTION: Troweled on Ceiling

MATERIAL LOCATION: Throughout school



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:










INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: AA

MATERIAL DESCRIPTION: 12" X 12" White Ceiling Tile

MATERIAL LOCATION: Room 201, 202, 203, 310, 311, 312, 313, 314, 315, and Lunchroom


MATERIAL CATEGORY: SURFACE FRIABLE: Yes




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


COMMENTS:









HOMOGENEOUS AREA: AA

MATERIAL DESCRIPTION: 12" X 12" White Ceiling Tile

MATERIAL LOCATION: Room 201, 202, 203, 310, 311, 312, 313, 314, 315, and Lunchroom





COMMENTS:










INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: AB-1

MATERIAL DESCRIPTION: 12" X 12" Floor Tile Mastic

MATERIAL LOCATION: Lunchroom


MATERIAL CATEGORY: MISC FRIABLE: Yes




ACCESSIBILITY: Not Reachable DAMAGE REASON:DAMAGE REASON:DAMAGE REASON:


COMMENTS:









HOMOGENEOUS AREA: AB-1

MATERIAL DESCRIPTION: 12" X 12" Floor Tile Mastic






COMMENTS:










INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: AA-1

MATERIAL DESCRIPTION: 12" X 12" White Ceiling Tile Glue

MATERIAL LOCATION: Room 201, 202, 203, 310, 311, 312, 314, 315, and Lunchroom


MATERIAL CATEGORY: SURFACE FRIABLE: Yes




ACCESSIBILITY: Not Reachable DAMAGE REASON:DAMAGE REASON:DAMAGE REASON:


COMMENTS:









HOMOGENEOUS AREA: AA-1

MATERIAL DESCRIPTION: 12" X 12" White Ceiling Tile Glue

MATERIAL LOCATION: Room 201, 202, 203, 310, 311, 312, 314, 315, and Lunchroom





COMMENTS:










INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: AB

MATERIAL DESCRIPTION: 12" X 12" Floor Tile



MATERIAL CATEGORY: MISC FRIABLE: Yes




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


COMMENTS:









HOMOGENEOUS AREA: AB

MATERIAL DESCRIPTION: 12" X 12" Floor Tile






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

Documents

3/27/2013 - CPSschoolreports.cps.edu/AsbestosInspectionReport_2013... · 06D 9x 9 gray with black specks A fiberglass joint compound AA-1 12" X 12" White Ceiling Tile Glue AB-1 12"