ILLINOIS DEPARTMENT OF PUBLIC HEALTH …schoolreports.cps.edu/AsbestosInspectionReport_2016/23001 - John C...THREE–YEAR REINSPECTION CHICAGO SCHOOL DIST 299 Dore School 6108 S. Natoma

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: 14-016-2990-2167SCHOOL NAME: Dore SchoolADDRESS OF SCHOOL: 6108 S. NatomaCITY: Chicago, IL, 60638

DATE LAST THREE YEAR REINSPECTION WAS COMPLETED 5/14/2013If 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: 7/20/2016 ENROLLMENT 745

IDPH INSPECTOR LICENSE NUMBER: 100-04208

IDPH LICENSED INSPECTOR NAME (Please Print): James Lehnhardt

IDPH MP LICENSE NUMBER: 100-03613

IDPH LICENSED MANAGEMENT PLANNER NAME (Please Print): Daniel Juneau

DESIGNATED PERSON (Please Print): Robert Christlieb PHONE: (773) 553-3197

7/20/2016

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

Dore School

6108 S. NatomaChicago, IL, 60638

Unit: 23001Building ID: 3080

IDPH ID Number: 14-016-2990-2167

REPORT DATE:Wednesday, July 20, 2016

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 15, 2016

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

Re: Chicago Public Schools - 2016 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: 23001 Region: 05 IDPH ID: 14-016-2990-2167

School: Dore School Building ID: 3080

Address: 6108 S. Natoma

Chicago, IL, 60638

Building Contact: Mcgovern, Dennis Contact Phone: 773-908-4299

Current Building Owners: Chicago Public Schools

Review Date: 07/20/2016

Inspector: James Lehnhardt Inspector IDPH License: 100-04208Management Planner: Daniel Juneau Management Planner IDPH License: 100-03613

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

Sincerely,Carnow, Conibear and Associates

Daniel Juneau100-03613

Environmental Notification to Occupants

To: Faculty, Staff and ParentsFrom: Chicago Public SchoolsDate: March 15, 2016

RE: Dore School, Unit 23001 6108 S. Natoma Chicago, IL, 60638

Dear Faculty, Staff and Parents,

This letter is to notify you that the 2016 asbestos three year re-inspection has been completed at Dore 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 Dore 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 Robert Christlieb, the designated Local Education Authority's Designated Person at (773) 553-3197 .

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: Dore School Unit: 23001 Region: 05Address: 6108 S. Natoma Chicago, IL, 60638IDPH ID: 14-016-2990-2167 Building ID: 3080Contact: Mcgovern, Dennis Phone: 773-908-4299

2. Description of Facility

Original Construction: 1957 Additional Construction: 1996,1960,2003Total Square Footage: 13369 No of Floors: 1Current Occupancy: 745

3. LEA Designated Person

Contact: Robert Christlieb Phone: (773) 553-3197Address: 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: James Lehnhardt

Signature: Inspector IDPH license # 100-04208 Date: 3/15/2016

6. Management Planner

Management Planner Name: Daniel Juneau

Signature: Management Planner IDPH license # 100-03613 Date: 07/20/2016

7. Review Date: 07/20/2016

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: 7/20/2016

Name: Robert Christlieb

Unit : 23001 Dore School Building: 3080

Unit: 23001 Dore School Building: 3080

II. EXECUTIVE SUMMARY

Carnow, Conibear and Associates was retained by the Chicago Public Schools (CPS) to perform a three-year asbestos reinspection of the Dore 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 3080:

24 12"x12" White w/Blue Specks Floor Tile

25 12"x12" White w/Blue Specks Floor Tile Adhesive

45 12" x 12" Tan Mottled Floor Tile

46 Mastic Associated w/ 12" x 12" Tan Mottled FloorTile

47 Smooth Composite Wall Panels

48 Texture Composite Wall Panels

49 4" Brown Baseboard

50 Mastic Associated w/ 4" Brown Baseboard

51 Blue Sheet Flooring


52 Mastic Associated w/ Blue Sheet Flooring

53 Red Sheet Flooring

54 Mastic Associated w/ Red Sheet Flooring

55 2' x 2' Ceiling Tile w/ Pinholes

56 Exterior Composite Wall Panels


B. The following new homogenous areas have been identified for Building 3080:

45 12" x 12" Tan Mottled Floor Tile

46 Mastic Associated w/ 12" x 12" Tan Mottled FloorTile

47 Smooth Composite Wall Panels

48 Texture Composite Wall Panels

49 4" Brown Baseboard

50 Mastic Associated w/ 4" Brown Baseboard

51 Blue Sheet Flooring

52 Mastic Associated w/ Blue Sheet Flooring

53 Red Sheet Flooring

54 Mastic Associated w/ Red Sheet Flooring

55 2' x 2' Ceiling Tile w/ Pinholes

56 Exterior Composite Wall Panels


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:

008 Tank Lagging009 Boiler Tank Lagging-ABATED010 Boiler Gaskets019 floor tile 12 x 12 blue020 Chalkboards021 Chalkboard Adhesive07 Aircell Pipe Insulation22 12"x12" Blue Floor Tile22B black baseboard23 12"x12" Blue Floor Tile Adhesive24 12"x12" White w/Blue Specks Floor Tile25 12"x12" White w/Blue Specks Floor Tile Adhesive27 12"x12" blue floor tile mastic28 12x12 brown w/specks29 12"x12 " brown floor tile mastic30 2' x 4' ceiling tile with fake 2'x2' ceiling tile31 4" beige baseboard32 4" beige baseboard mastic33 Drywall Ceillings in Annex34 2'x 2' smooth ceiling tile35 Drywall installed in 200736 12" x 12" black floor tile37 12" x 12" black floor tile mastic38 12" x 12" Yellow with White Specks Floor Tile39 12" x 12" Yellow with White Specks Floor Tile

Mastic40 1' x 1' Ceiling Tile (Pinhole & Wormy)41 1' x 1' Ceiling Tile (Pinhole & Wormy) Adhesive42 1' x 1' Ceiling Tile (Small Pinhole)43 1' x 1' Ceiling Tile (Small Pinhole) Adhesive44 2' x 4' Fissured Ceiling Tile45 12" x 12" Tan Mottled Floor Tile46 Mastic Associated w/ 12" x 12" Tan Mottled Floor

Tile47 Smooth Composite Wall Panels48 Texture Composite Wall Panels49 4" Brown Baseboard50 Mastic Associated w/ 4" Brown Baseboard51 Blue Sheet Flooring52 Mastic Associated w/ Blue Sheet Flooring53 Red Sheet Flooring54 Mastic Associated w/ Red Sheet Flooring


55 2' x 2' Ceiling Tile w/ Pinholes56 Exterior Composite Wall PanelsFT-3 9x9 tan w/brown & cream streaks floor tileMB-1 12"x12" White w/Gray Floor TileMB-10 4" Beige Vinyl BaseboardMB-11 4" Beige Vinyl Baseboard AdhesiveMB-12 Textured PaintMB-2 12"x12" White w/Gray Floor Tile AdhesiveMB-3 Blue Floor SheetingMB-4 Blue Sheet Flooring AdhesiveMB-5 Orange Sheet FlooringMB-6 Orange Sheet Flooring AdhesiveMB-7 DrywallMB-8 Drywall CompoundMB-9 2'x2' Lay In Ceiling Panels

The following areas were deemed to be inaccessible:

021 Chalkboard Adhesive23 12"x12" Blue Floor Tile Adhesive25 12"x12" White w/Blue Specks Floor Tile Adhesive27 12"x12" blue floor tile mastic29 12"x12 " brown floor tile mastic32 4" beige baseboard mastic37 12" x 12" black floor tile mastic39 12" x 12" Yellow with White Specks Floor Tile

Mastic40 1' x 1' Ceiling Tile (Pinhole & Wormy)41 1' x 1' Ceiling Tile (Pinhole & Wormy) Adhesive43 1' x 1' Ceiling Tile (Small Pinhole) Adhesive46 Mastic Associated w/ 12" x 12" Tan Mottled Floor

Tile50 Mastic Associated w/ 4" Brown Baseboard52 Mastic Associated w/ Blue Sheet Flooring54 Mastic Associated w/ Red Sheet FlooringMB-11 4" Beige Vinyl Baseboard AdhesiveMB-2 12"x12" White w/Gray Floor Tile AdhesiveMB-4 Blue Sheet Flooring AdhesiveMB-6 Orange Sheet Flooring AdhesiveMB-8 Drywall Compound

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 James Lehnhardt, IDPH License # 100-04208. The


Management Plan was updated by Daniel Juneau, IDPH License # 100-03613. Inspector andManagement 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 Dore School Building 3080 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 Dore School Unit 23001 Building ID 3080 Address 6108 S. Natoma 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

004 boiler breaching-ABATED boiler room ABATED TSI008 Tank Lagging 960 Building Boiler

RoomASSUMED TSI

009 Boiler Tank Lagging-ABATED 1957 Buillding Boiler Room

ASSUMED TSI

010 Boiler Gaskets Boiler Room ASSUMED TSI013 9x9 tan w/green & cream streaks floor tile '57 building Play

room 100, 102, 104, 108, 110, 107, 105, 103, corridor gym

CHR MISC None Low

014 9x9 tan w/cream streaks floor tile '60 building Rooms 114, 112, 111, 109, and corridor.

CHR MISC None Low

015 9x9 tan w/green & cream streaks floor tile mastic

'57 building CHR MISC None Low

016 9x9 tan w/cream streaks floor tile mastic '60 building CHR MISC None Low017 baseboard 1957 building

Rooms 110,108,106,104,102,107,105,103,101, and Corridor.

CHR MISC

018 Baseboard Mastic '57 building Rooms 110,108,106,104,102,107,105,103,101, and corridor.

NO_ACBM MISC

019 floor tile 12 x 12 blue 4,500 SF library, gym, room 110 office, corridors,classrooms in 1957/1960 building

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

LOW

020 Chalkboards 2,400 SF Throughout Classrooms


LOW

021 Chalkboard Adhesive 2,400 SF Throughout Classrooms


LOW

03 Pipe Fitting Insulation - abated Throughout 1957 Building - tunnel & bathrooms

ABATED

07 Aircell Pipe Insulation 1957 Building ASSUMED22 12"x12" Blue Floor Tile 3,000 SF Activity Room,

corridors, and classrooms in 1957/1960 building


LOW

22B black baseboard 100 LF Main Office ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

23 12"x12" Blue Floor Tile Adhesive 4,500 SF Activity Room, ASSUMED MISC N NONE 0 No ACBM with the LOW







Material Units


Material Category

Friable Damage Type

Damage Quantity



corridors, and classrooms in 1957/1960 building

potential for damage

24 12"x12" White w/Blue Specks Floor Tile 1,568 SF Classroom 107 and Office 102

ASSUMED MISC N NONE 0 Yes ACBM with the potential for damage

LOW

25 12"x12" White w/Blue Specks Floor Tile Adhesive

1,568 SF Classroom 107 and Office 102


LOW

27 12"x12" blue floor tile mastic 3,000 SF Library, gym, room 110, corridors, and classrooms in 1957/1960 building


LOW

28 12x12 brown w/specks 19,000 SF Annex - New Building


LOW

29 12"x12 " brown floor tile mastic 19,000 SF Annex - 1996 building


LOW

30 2' x 4' ceiling tile with fake 2'x2' ceiling tile 19,000 SF 1996 Annex Building corridor and classrooms

ASSUMED MISC Y NONE 0 No Any remaining friable ACBM or friable suspect ACBM

LOW

31 4" beige baseboard 1,400 LF 1996 Annex building all classrooms and corridor


LOW

32 4" beige baseboard mastic 1,400 LF Classrooms and Corridor 1996 Annex


LOW

33 Drywall Ceillings in Annex 1,600 SF Restrooms, art, MDF room ,and fire pump room


LOW

34 2'x 2' smooth ceiling tile 360 SF Annex vestibule ASSUMED MISC Y NONE 0 No Any remaining friable ACBM or friable suspect ACBM

LOW

35 Drywall installed in 2007 2,300 SF 1957 building Boys and girls rest rooms, 102,120, and 104


LOW

36 12" x 12" black floor tile 320 SF Food service area ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

37 12" x 12" black floor tile mastic 320 SF Food service room ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

38 12" x 12" Yellow with White Specks Floor Tile

1,000 SF Gym ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

39 12" x 12" Yellow with White Specks Floor Tile Mastic

1,000 SF Gym ASSUMED MISC N NONE 0 No ACBM with the potential for damage

LOW

40 1' x 1' Ceiling Tile (Pinhole & Wormy) 1,000 SF Gym ASSUMED MISC Y NONE 0 No Any remaining friable ACBM or friable

LOW







Material Units


Material Category

Friable Damage Type

Damage Quantity



suspect ACBM41 1' x 1' Ceiling Tile (Pinhole & Wormy)

Adhesive1,000 SF Gym ASSUMED MISC N NONE 0 No ACBM with the

potential for damageLOW

42 1' x 1' Ceiling Tile (Small Pinhole) 6,000 SF Classrooms 111, 112, 113, 114, Copy/Store Room and Corridor

ASSUMED MISC Y NONE 0 No Any remaining friable ACBM or friable suspect ACBM

LOW

43 1' x 1' Ceiling Tile (Small Pinhole) Adhesive

6,000 SF Classrooms 111, 112, 113, 114, Copy/Store Room and Corridor


LOW

44 2' x 4' Fissured Ceiling Tile 600 SF Food Service Area ASSUMED MISC Y NONE 0 No Any remaining friable ACBM or friable suspect ACBM

LOW

45 12" x 12" Tan Mottled Floor Tile 8,750 SF New Mobile Unit - Classrooms, Halls, Fire Pump Room


LOW

46 Mastic Associated w/ 12" x 12" Tan Mottled Floor Tile

8,750 SF New Mobile Unit - Classrooms, Halls, Fire Pump Room


LOW

47 Smooth Composite Wall Panels 7,500 SF New Mobile Unit - Classrooms, Halls, Fire Pump Room


LOW

48 Texture Composite Wall Panels 2,000 SF Bathroom's and Janitor's Closet


LOW

49 4" Brown Baseboard 1,300 LF Halls and Classrooms


LOW

50 Mastic Associated w/ 4" Brown Baseboard 1,300 LF Halls and Classrooms


LOW

51 Blue Sheet Flooring 150 SF Boy's Washroom ASSUMED MISC N NONE 0 Yes ACBM with the potential for damage

LOW

52 Mastic Associated w/ Blue Sheet Flooring 150 SF Boy's Washroom ASSUMED MISC N NONE 0 Yes ACBM with the potential for damage

LOW

53 Red Sheet Flooring 350 SF Girl's Washroom and Unisex Washroom


LOW

54 Mastic Associated w/ Red Sheet Flooring 350 SF Girl's Washroom and Unisex Washroom


LOW

55 2' x 2' Ceiling Tile w/ Pinholes 8,750 SF Classrooms, Hall, Fire Pump room


LOW

56 Exterior Composite Wall Panels 2,500 SF Exterior Walls ASSUMED MISC N NONE 0 Yes ACBM with the potential for damage

LOW

A Pipe Joint Insulation on Aircell Insulated 1960 Building ABATED TSI







Material Units


Material Category

Friable Damage Type

Damage Quantity



Piping - abated Classrooms 114,111,112,109, Boy's & Girl's Washrooms, Storeroom and Corridor

B Aircell Pipe Insulation- abated 1960 Building ABATED TSICTM-1 Ceiling Tile Mastic (Large Hole) 1960 Building

Classroom 109, Boy's & Girl's Washrooms and Corridor

NO_ACBM MISC

CTM-2 Ceiling Tile Mastic (Large Hole) 1960 Building Classroom 109, Boy's & Girl's Washrooms and Corridor

NO_ACBM MISC

FT-1 9x9 black w/cream streaks floor tile 1960 building Rooms 114,112,111,109, and corridor.

CHR MISC

FT-2 9x9 green floor tile copy/store room CHR MISC None LowFT-3 9x9 tan w/brown & cream streaks floor tile 1960 building/store

roomASSUMED MISC None Low

FT-4 9x9 black w/cream & green streaks floor tile

'57 building - classrooms & corridor

CHR MISC None Low

FT-5 9x9 tan w/black streaks floor tile '57 building - room 101 & corridor

CHR MISC None Low

FT-6 9x9 black w/cream streaks floor tile room 101 & corridor CHR MISC None LowFTM-1 9x9 black w/cream streaks floor tile mastic 1960 building

Rooms 114,112,111,109, and Corridor.

CHR MISC None Low

FTM-2 9x9 green floor tile mastic copy/store room in bldg "60

CHR MISC None Low

FTM-3 9x9 tan w/brown & cream streaks floor tile mastic

storage room in copy room - '60 building

CHR MISC None Low

FTM-5 9x9 tan w/black streaks floor tile mastic '57 building - room 101 & corridor

CHR MISC None Low

FTM-6 9x9 black w/cream streaks floor tile mastic room 101 & corridor CHR MISC None LowMB-1 12"x12" White w/Gray Floor Tile 3,718 SF Throughout Modular

Building With the ASSUMED MISC N NONE 0 No ACBM with the

potential for damageLOW







Material Units


Material Category

Friable Damage Type

Damage Quantity



Exception of the Washrooms

MB-10 4" Beige Vinyl Baseboard 900 LF Throughout ModularBuilding with the Exception og the Washrooms


LOW

MB-11 4" Beige Vinyl Baseboard Adhesive 900 LF Throughout ModularUnit with the Exception of the Washrooms


LOW

MB-12 Textured Paint 260 SF Modular Building: Washroom Ceilings


LOW

MB-2 12"x12" White w/Gray Floor Tile Adhesive 3,718 SF Throughout ModularBuilding With the Exception of the Washrooms


LOW

MB-3 Blue Floor Sheeting 80 SF Modular Building: Boy's Washroom


LOW

MB-4 Blue Sheet Flooring Adhesive 80 SF Mosular Building: Boy's Washroom


LOW

MB-5 Orange Sheet Flooring 160 SF Modular Building: Girl's Washroom


LOW

MB-6 Orange Sheet Flooring Adhesive 160 SF Modular Building: Girl's Washroom


LOW

MB-7 Drywall 9,500 SF Modular Building: All Walls and Ceilings


LOW

MB-8 Drywall Compound 9,500 SF Modular Building: All Walls and Ceilings


LOW

MB-9 2'x2' Lay In Ceiling Panels 3,700 SF Throughout ModularBuilding with the Exception of the Washrooms


LOW

WC-1 Window Caulk - abated 1957 building ABATED MISCWC-2 Window Caulk - abated 1960 Building ABATED MISCWG-1 Window Glazing - abated 1957 Building ABATED MISCWG-2 Window Glazing - abated 1960 Building ABATED MISC






Reinspection Date 3/15/2016

Inspector Name James Lehnhardt

100-04208 5/15/2016Inspector's IDPH License Number / Expiration Date

Inspector's Comments

HA Number: Inspector Comments:004008 Not observed 2016009 Not observed 2016010 Not observed 2016013 Not observed 2016014 Not observed 2016015 Not observed 2016016 Not observed 2016017 Not observed 20160180190200210307 Not observed 20162222B23242527282930






HA Number: Inspector Comments:3132333435363738394041424344454647484950515253545556ABCTM-1






HA Number: Inspector Comments:CTM-2FT-1 Not observed 2016FT-2 Not observed 2016FT-3 Not observed 2016FT-4 Not observed 2016FT-5 Not observed 2016FT-6 Not observed 2016FTM-1 Not observed 2016FTM-2 Not observed 2016FTM-3 Not observed 2016FTM-5 Not observed 2016FTM-6 Not observed 2016MB-1MB-10MB-11MB-12MB-2MB-3MB-4MB-5MB-6MB-7MB-8MB-9WC-1WC-2WG-1WG-2






Table II

Management Planner's Review

Chicago Public SchoolsSchool Dore School Unit 23001 Building ID 3080

Address 6108 S. Natoma Chicago, IL, 60638 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

004 boiler breaching-ABATED boiler room Abated TSI 008 Tank Lagging 960 Building Boiler Room Assumed TSI 009 Boiler Tank Lagging-ABATED 1957 Buillding Boiler Room Assumed TSI 010 Boiler Gaskets Boiler Room Assumed TSI 013 9x9 tan w/green & cream streaks floor tile '57 building Play room 100, 102, 104,

108, 110, 107, 105, 103, corridor gymChrysotile MISC

014 9x9 tan w/cream streaks floor tile '60 building Rooms 114, 112, 111, 109, and corridor.

Chrysotile MISC

015 9x9 tan w/green & cream streaks floor tile mastic '57 building Chrysotile MISC 016 9x9 tan w/cream streaks floor tile mastic '60 building Chrysotile MISC 017 baseboard 1957 building Rooms

110,108,106,104,102,107,105,103,101,and Corridor.

Chrysotile MISC

018 Baseboard Mastic '57 building Rooms 110,108,106,104,102,107,105,103,101,and corridor.

No ACBM MISC

019 floor tile 12 x 12 blue 4,500 SF library, gym, room 110 office, corridors, classrooms in 1957/1960 building

Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan

020 Chalkboards 2,400 SF Throughout Classrooms Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan021 Chalkboard Adhesive 2,400 SF Throughout Classrooms Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan03 Pipe Fitting Insulation - abated Throughout 1957 Building - tunnel &

bathroomsAbated

07 Aircell Pipe Insulation 1957 Building Assumed 22 12"x12" Blue Floor Tile 3,000 SF Activity Room, corridors, and

classrooms in 1957/1960 buildingAssumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan

22B black baseboard 100 LF Main Office Assumed MISC No 0 LF 6 ACBM with the potential for damage Follow O&M Plan23 12"x12" Blue Floor Tile Adhesive 4,500 SF Activity Room, corridors, and


24 12"x12" White w/Blue Specks Floor Tile 1,568 SF Classroom 107 and Office 102 Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan25 12"x12" White w/Blue Specks Floor Tile Adhesive 1,568 SF Classroom 107 and Office 102 Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan27 12"x12" blue floor tile mastic 3,000 SF Library, gym, room 110, corridors, and


28 12x12 brown w/specks 19,000 SF Annex - New Building Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan29 12"x12 " brown floor tile mastic 19,000 SF Annex - 1996 building Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan30 2' x 4' ceiling tile with fake 2'x2' ceiling tile 19,000 SF 1996 Annex Building corridor and

classroomsAssumed MISC Yes 0 SF 7 Any remaining friable ACBM or friable

suspect ACBMFollow O&M Plan







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



Material Units


Material Category


Damage Units


31 4" beige baseboard 1,400 LF 1996 Annex building all classrooms andcorridor

Assumed MISC No 0 LF 6 ACBM with the potential for damage Follow O&M Plan

32 4" beige baseboard mastic 1,400 LF Classrooms and Corridor 1996 Annex Assumed MISC No 0 LF 6 ACBM with the potential for damage Follow O&M Plan33 Drywall Ceillings in Annex 1,600 SF Restrooms, art, MDF room ,and fire

pump roomAssumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan

34 2'x 2' smooth ceiling tile 360 SF Annex vestibule Assumed MISC Yes 0 SF 7 Any remaining friable ACBM or friable suspect ACBM

Follow O&M Plan

35 Drywall installed in 2007 2,300 SF 1957 building Boys and girls rest rooms, 102,120, and 104


36 12" x 12" black floor tile 320 SF Food service area Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan37 12" x 12" black floor tile mastic 320 SF Food service room Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan38 12" x 12" Yellow with White Specks Floor Tile 1,000 SF Gym Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan39 12" x 12" Yellow with White Specks Floor Tile

Mastic1,000 SF Gym Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan

40 1' x 1' Ceiling Tile (Pinhole & Wormy) 1,000 SF Gym Assumed MISC Yes 0 SF 7 Any remaining friable ACBM or friable suspect ACBM

Follow O&M Plan

41 1' x 1' Ceiling Tile (Pinhole & Wormy) Adhesive 1,000 SF Gym Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan42 1' x 1' Ceiling Tile (Small Pinhole) 6,000 SF Classrooms 111, 112, 113, 114,

Copy/Store Room and CorridorAssumed MISC Yes 0 SF 7 Any remaining friable ACBM or friable

suspect ACBMFollow O&M Plan

43 1' x 1' Ceiling Tile (Small Pinhole) Adhesive 6,000 SF Classrooms 111, 112, 113, 114, Copy/Store Room and Corridor


44 2' x 4' Fissured Ceiling Tile 600 SF Food Service Area Assumed MISC Yes 0 SF 7 Any remaining friable ACBM or friable suspect ACBM

Follow O&M Plan

45 12" x 12" Tan Mottled Floor Tile 8,750 SF New Mobile Unit - Classrooms, Halls, Fire Pump Room


46 Mastic Associated w/ 12" x 12" Tan Mottled Floor Tile

8,750 SF New Mobile Unit - Classrooms, Halls, Fire Pump Room


47 Smooth Composite Wall Panels 7,500 SF New Mobile Unit - Classrooms, Halls, Fire Pump Room


48 Texture Composite Wall Panels 2,000 SF Bathroom's and Janitor's Closet Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan49 4" Brown Baseboard 1,300 LF Halls and Classrooms Assumed MISC No 0 LF 6 ACBM with the potential for damage Follow O&M Plan50 Mastic Associated w/ 4" Brown Baseboard 1,300 LF Halls and Classrooms Assumed MISC No 0 LF 6 ACBM with the potential for damage Follow O&M Plan51 Blue Sheet Flooring 150 SF Boy's Washroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan52 Mastic Associated w/ Blue Sheet Flooring 150 SF Boy's Washroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan53 Red Sheet Flooring 350 SF Girl's Washroom and Unisex

WashroomAssumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan







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



Material Units


Material Category


Damage Units


54 Mastic Associated w/ Red Sheet Flooring 350 SF Girl's Washroom and Unisex Washroom


55 2' x 2' Ceiling Tile w/ Pinholes 8,750 SF Classrooms, Hall, Fire Pump room Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan56 Exterior Composite Wall Panels 2,500 SF Exterior Walls Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M PlanA Pipe Joint Insulation on Aircell Insulated Piping -

abated1960 Building Classrooms 114,111,112,109, Boy's & Girl's Washrooms, Storeroom and Corridor

Abated TSI

B Aircell Pipe Insulation- abated 1960 Building Abated TSI CTM-1 Ceiling Tile Mastic (Large Hole) 1960 Building Classroom 109, Boy's &

Girl's Washrooms and CorridorNo ACBM MISC

CTM-2 Ceiling Tile Mastic (Large Hole) 1960 Building Classroom 109, Boy's & Girl's Washrooms and Corridor

No ACBM MISC

FT-1 9x9 black w/cream streaks floor tile 1960 building Rooms 114,112,111,109,and corridor.

Chrysotile MISC

FT-2 9x9 green floor tile copy/store room Chrysotile MISC FT-3 9x9 tan w/brown & cream streaks floor tile 1960 building/store room Assumed MISC FT-4 9x9 black w/cream & green streaks floor tile '57 building - classrooms & corridor Chrysotile MISC FT-5 9x9 tan w/black streaks floor tile '57 building - room 101 & corridor Chrysotile MISC FT-6 9x9 black w/cream streaks floor tile room 101 & corridor Chrysotile MISC FTM-1 9x9 black w/cream streaks floor tile mastic 1960 building Rooms 114,112,111,109,

and Corridor.Chrysotile MISC

FTM-2 9x9 green floor tile mastic copy/store room in bldg "60 Chrysotile MISC FTM-3 9x9 tan w/brown & cream streaks floor tile mastic storage room in copy room - '60

buildingChrysotile MISC

FTM-5 9x9 tan w/black streaks floor tile mastic '57 building - room 101 & corridor Chrysotile MISC FTM-6 9x9 black w/cream streaks floor tile mastic room 101 & corridor Chrysotile MISC MB-1 12"x12" White w/Gray Floor Tile 3,718 SF Throughout Modular Building With the

Exception of the WashroomsAssumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan

MB-10 4" Beige Vinyl Baseboard 900 LF Throughout Modular Building with the Exception og the Washrooms


MB-11 4" Beige Vinyl Baseboard Adhesive 900 LF Throughout Modular Unit with the Exception of the Washrooms


MB-12 Textured Paint 260 SF Modular Building: Washroom Ceilings Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M PlanMB-2 12"x12" White w/Gray Floor Tile Adhesive 3,718 SF Throughout Modular Building With the

Exception of the WashroomsAssumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan

MB-3 Blue Floor Sheeting 80 SF Modular Building: Boy's Washroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan







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



Material Units


Material Category


Damage Units


MB-4 Blue Sheet Flooring Adhesive 80 SF Mosular Building: Boy's Washroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M PlanMB-5 Orange Sheet Flooring 160 SF Modular Building: Girl's Washroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M PlanMB-6 Orange Sheet Flooring Adhesive 160 SF Modular Building: Girl's Washroom Assumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M PlanMB-7 Drywall 9,500 SF Modular Building: All Walls and

CeilingsAssumed MISC No 0 SF 6 ACBM with the potential for damage Follow O&M Plan

MB-8 Drywall Compound 9,500 SF Modular Building: All Walls and Ceilings


MB-9 2'x2' Lay In Ceiling Panels 3,700 SF Throughout Modular Building with the Exception of the Washrooms


WC-1 Window Caulk - abated 1957 building Abated MISC WC-2 Window Caulk - abated 1960 Building Abated MISC WG-1 Window Glazing - abated 1957 Building Abated MISC WG-2 Window Glazing - abated 1960 Building Abated MISC







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

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

Review Date 7/20/2016

Manager Planner Name Daniel Juneau100-03613 5/15/2016Manager IDPH License No/Expiration

HA Number Management Comments004008 If identified, implement O&M009 If identified, implement O&M010 If identified, implement O&M013 If identified, implement O&M014 If identified, implement O&M015 If identified, implement O&M016 If identified, implement O&M017 If identified, implement O&M0180190200210307 If identified, implement O&M2222B23242527282930







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

Management Planner's Comments Summarized at the End of the ReportHA Number Management Comments3132333435363738394041424344454647484950515253545556A







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

Management Planner's Comments Summarized at the End of the ReportHA Number Management CommentsBCTM-1CTM-2FT-1 If identified, implement O&MFT-2 If identified, implement O&MFT-3 If identified, implement O&MFT-4 If identified, implement O&MFT-5 If identified, implement O&MFT-6 If identified, implement O&MFTM-1 If identified, implement O&MFTM-2 If identified, implement O&MFTM-3 If identified, implement O&MFTM-5 If identified, implement O&MFTM-6 If identified, implement O&MMB-1MB-10MB-11MB-12MB-2MB-3MB-4MB-5MB-6MB-7MB-8MB-9WC-1







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

Management Planner's Comments Summarized at the End of the ReportHA Number Management CommentsWC-2WG-1WG-2

Chicago Public Schools

Carnow, Conibear and Associates

2016 AHERA REINSPECTION

Inspector Assessment Form (REASSESSMENT) LEA NAME: Chicago Public Schools UNIT NUMBER: 23001 BUIDLING ID: 3080

CITY/STATE: Chicago, Illinois AHERA INSPECTOR: James Lehnhardt

SCHOOL NAME: Dore School INSPECTION DATE: 3/15/2016

ADDRESS: 6108 S. Natoma IDPH LICENSE NO: 100-04208

INFORMATION FROM PREVIOUS INSPECTION

HOMOGENEOUS AREA: 004

MATERIAL DESCRIPTION: boiler breaching-ABATED

HISTORICAL AHERA DAMAGE CATEGORY

HISTORICAL DAMAGE REASON:

HISTORICAL RESPONSE ACTION:

ASBESTOS TYPE: Abated FRIABLE:

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 .

DAMAGE REASON:

DISTURBANCE POTENTIAL:

MATERIAL LOCATION: boiler room

MATERIAL QUANTITY: MATERIAL UNITS:

DAMAGE QUANTITY: DAMAGE UNITS:

COMMENTS:

Inspector's Signature: Date: 03/15/2016




Management Planner Review FormLEA NAME: Chicago Public Schools UNIT NUMBER: 23001 BUIDLING ID: 3080

CITY/STATE: Chicago, Illinois MANAGEMENT PLANNER: Daniel Juneau

SCHOOL NAME: Dore School REVIEW DATE: 7/20/2016



MATERIAL DESCRIPTION: boiler breaching-ABATED

MATERIAL LOCATION: boiler room



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:

Comments:

Management Planner's Signature: Date: 07/20/2016










MATERIAL DESCRIPTION: Tank Lagging




ASBESTOS TYPE: Assumed FRIABLE:




DAMAGE REASON:


MATERIAL LOCATION: 960 Building Boiler Room



COMMENTS: Not observed 2016










MATERIAL DESCRIPTION: Tank Lagging

MATERIAL LOCATION: 960 Building Boiler Room





Comments:

If identified, implement O&M











MATERIAL DESCRIPTION: Boiler Tank Lagging-ABATED








DAMAGE REASON:


MATERIAL LOCATION: 1957 Buillding Boiler Room













MATERIAL DESCRIPTION: Boiler Tank Lagging-ABATED

MATERIAL LOCATION: 1957 Buillding Boiler Room





Comments:












MATERIAL DESCRIPTION: Boiler Gaskets








DAMAGE REASON:


MATERIAL LOCATION: Boiler Room













MATERIAL DESCRIPTION: Boiler Gaskets

MATERIAL LOCATION: Boiler Room





Comments:












MATERIAL DESCRIPTION: 9x9 tan w/green & cream streaks floor tile




ASBESTOS TYPE: Chrysotile FRIABLE:




DAMAGE REASON:

DISTURBANCE POTENTIAL: Low

MATERIAL LOCATION: '57 building Play room 100, 102, 104, 108, 110, 107, 105, 103, corridor gym













MATERIAL DESCRIPTION: 9x9 tan w/green & cream streaks floor tile

MATERIAL LOCATION: '57 building Play room 100, 102, 104, 108, 110, 107, 105, 103, corridor gym





Comments:












MATERIAL DESCRIPTION: 9x9 tan w/cream streaks floor tile








DAMAGE REASON:


MATERIAL LOCATION: '60 building Rooms 114, 112, 111, 109, and corridor.













MATERIAL DESCRIPTION: 9x9 tan w/cream streaks floor tile

MATERIAL LOCATION: '60 building Rooms 114, 112, 111, 109, and corridor.





Comments:












MATERIAL DESCRIPTION: 9x9 tan w/green & cream streaks floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: '57 building













MATERIAL DESCRIPTION: 9x9 tan w/green & cream streaks floor tile mastic






Comments:












MATERIAL DESCRIPTION: 9x9 tan w/cream streaks floor tile mastic








DAMAGE REASON:















MATERIAL DESCRIPTION: 9x9 tan w/cream streaks floor tile mastic






Comments:












MATERIAL DESCRIPTION: baseboard

HISTORICAL AHERA DAMAGE CATEGORY ACBM with the potential for damage


HISTORICAL RESPONSE ACTION: Follow O&M Plan





DAMAGE REASON:


MATERIAL LOCATION: 1957 building Rooms 110,108,106,104,102,107,105,103,101, and Corridor.













MATERIAL DESCRIPTION: baseboard

MATERIAL LOCATION: 1957 building Rooms 110,108,106,104,102,107,105,103,101, and Corridor.





Follow O&M Plan

Comments:












MATERIAL DESCRIPTION: Baseboard Mastic




ASBESTOS TYPE: No ACBM FRIABLE:




DAMAGE REASON:


MATERIAL LOCATION: '57 building Rooms 110,108,106,104,102,107,105,103,101, and corridor.



COMMENTS:










MATERIAL DESCRIPTION: Baseboard Mastic

MATERIAL LOCATION: '57 building Rooms 110,108,106,104,102,107,105,103,101, and corridor.





Comments:











MATERIAL DESCRIPTION: floor tile 12 x 12 blue

HISTORICAL AHERA DAMAGE CATEGORY 6 ACBM with the potential for damage



ASBESTOS TYPE: Assumed FRIABLE: No



The current AHERA DAMAGE CATEGORY is determined to be 6. ACBM with the potential for damage

DAMAGE REASON:

DISTURBANCE POTENTIAL: LOW

MATERIAL LOCATION: library, gym, room 110 office, corridors, classrooms in 1957/1960 building

MATERIAL QUANTITY: 4500 MATERIAL UNITS: SF

DAMAGE QUANTITY: DAMAGE UNITS: SF

COMMENTS:










MATERIAL DESCRIPTION: floor tile 12 x 12 blue

MATERIAL LOCATION: library, gym, room 110 office, corridors, classrooms in 1957/1960 building


DAMAGE QUANTITY: 0 DAMAGE UNITS: SF



Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Chalkboards








DAMAGE REASON:


MATERIAL LOCATION: Throughout Classrooms



COMMENTS:










MATERIAL DESCRIPTION: Chalkboards






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Chalkboard Adhesive








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: Chalkboard Adhesive






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Pipe Fitting Insulation - abated








DAMAGE REASON:


MATERIAL LOCATION: Throughout 1957 Building - tunnel & bathrooms



COMMENTS:










MATERIAL DESCRIPTION: Pipe Fitting Insulation - abated

MATERIAL LOCATION: Throughout 1957 Building - tunnel & bathrooms





Comments:











MATERIAL DESCRIPTION: Aircell Pipe Insulation








DAMAGE REASON:


MATERIAL LOCATION: 1957 Building













MATERIAL DESCRIPTION: Aircell Pipe Insulation






Comments:












MATERIAL DESCRIPTION: 12"x12" Blue Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: Activity Room, corridors, and classrooms in 1957/1960 building



COMMENTS:










MATERIAL DESCRIPTION: 12"x12" Blue Floor Tile






Follow O&M Plan

Comments:










HOMOGENEOUS AREA: 22B

MATERIAL DESCRIPTION: black baseboard








DAMAGE REASON:


MATERIAL LOCATION: Main Office

MATERIAL QUANTITY: 100 MATERIAL UNITS: LF

DAMAGE QUANTITY: DAMAGE UNITS: LF

COMMENTS:









HOMOGENEOUS AREA: 22B

MATERIAL DESCRIPTION: black baseboard

MATERIAL LOCATION: Main Office


DAMAGE QUANTITY: 0 DAMAGE UNITS: LF



Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12"x12" Blue Floor Tile Adhesive








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: 12"x12" Blue Floor Tile Adhesive






Follow O&M Plan

Comments:











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

HISTORICAL AHERA DAMAGE CATEGORY 6







DAMAGE REASON:


MATERIAL LOCATION: Classroom 107 and Office 102



COMMENTS:










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






Comments:











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

HISTORICAL AHERA DAMAGE CATEGORY 6







DAMAGE REASON:





COMMENTS:










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






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12"x12" blue floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: Library, gym, room 110, corridors, and classrooms in 1957/1960 building



COMMENTS:










MATERIAL DESCRIPTION: 12"x12" blue floor tile mastic

MATERIAL LOCATION: Library, gym, room 110, corridors, and classrooms in 1957/1960 building





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12x12 brown w/specks








DAMAGE REASON:


MATERIAL LOCATION: Annex - New Building



COMMENTS:










MATERIAL DESCRIPTION: 12x12 brown w/specks

MATERIAL LOCATION: Annex - New Building





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12"x12 " brown floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: Annex - 1996 building



COMMENTS:










MATERIAL DESCRIPTION: 12"x12 " brown floor tile mastic

MATERIAL LOCATION: Annex - 1996 building





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 2' x 4' ceiling tile with fake 2'x2' ceiling tile

HISTORICAL AHERA DAMAGE CATEGORY 7 Any remaining friable ACBM or friable suspect ACBM



ASBESTOS TYPE: Assumed FRIABLE: Yes



The current AHERA DAMAGE CATEGORY is determined to be 7. Any remaining friable ACBM or friable suspect ACBM

DAMAGE REASON:


MATERIAL LOCATION: 1996 Annex Building corridor and classrooms



COMMENTS:










MATERIAL DESCRIPTION: 2' x 4' ceiling tile with fake 2'x2' ceiling tile

MATERIAL LOCATION: 1996 Annex Building corridor and classrooms





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 4" beige baseboard








DAMAGE REASON:


MATERIAL LOCATION: 1996 Annex building all classrooms and corridor



COMMENTS:










MATERIAL DESCRIPTION: 4" beige baseboard

MATERIAL LOCATION: 1996 Annex building all classrooms and corridor





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 4" beige baseboard mastic








DAMAGE REASON:


MATERIAL LOCATION: Classrooms and Corridor 1996 Annex



COMMENTS:










MATERIAL DESCRIPTION: 4" beige baseboard mastic

MATERIAL LOCATION: Classrooms and Corridor 1996 Annex





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Drywall Ceillings in Annex








DAMAGE REASON:


MATERIAL LOCATION: Restrooms, art, MDF room ,and fire pump room



COMMENTS:










MATERIAL DESCRIPTION: Drywall Ceillings in Annex

MATERIAL LOCATION: Restrooms, art, MDF room ,and fire pump room





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 2'x 2' smooth ceiling tile








DAMAGE REASON:


MATERIAL LOCATION: Annex vestibule



COMMENTS:










MATERIAL DESCRIPTION: 2'x 2' smooth ceiling tile

MATERIAL LOCATION: Annex vestibule





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Drywall installed in 2007








DAMAGE REASON:


MATERIAL LOCATION: 1957 building Boys and girls rest rooms, 102,120, and 104



COMMENTS:










MATERIAL DESCRIPTION: Drywall installed in 2007

MATERIAL LOCATION: 1957 building Boys and girls rest rooms, 102,120, and 104





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12" x 12" black floor tile








DAMAGE REASON:


MATERIAL LOCATION: Food service area



COMMENTS:










MATERIAL DESCRIPTION: 12" x 12" black floor tile

MATERIAL LOCATION: Food service area





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12" x 12" black floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: Food service room



COMMENTS:










MATERIAL DESCRIPTION: 12" x 12" black floor tile mastic

MATERIAL LOCATION: Food service room





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12" x 12" Yellow with White Specks Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: Gym



COMMENTS:










MATERIAL DESCRIPTION: 12" x 12" Yellow with White Specks Floor Tile






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 12" x 12" Yellow with White Specks Floor Tile Mastic








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: 12" x 12" Yellow with White Specks Floor Tile Mastic






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Pinhole & Wormy)








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Pinhole & Wormy)






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Pinhole & Wormy) Adhesive








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Pinhole & Wormy) Adhesive






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Small Pinhole)








DAMAGE REASON:


MATERIAL LOCATION: Classrooms 111, 112, 113, 114, Copy/Store Room and Corridor



COMMENTS:










MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Small Pinhole)






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Small Pinhole) Adhesive








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: 1' x 1' Ceiling Tile (Small Pinhole) Adhesive






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 2' x 4' Fissured Ceiling Tile








DAMAGE REASON:


MATERIAL LOCATION: Food Service Area



COMMENTS:










MATERIAL DESCRIPTION: 2' x 4' Fissured Ceiling Tile

MATERIAL LOCATION: Food Service Area





Follow O&M Plan

Comments:










HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: Pipe Joint Insulation on Aircell Insulated Piping - abated








DAMAGE REASON:


MATERIAL LOCATION: 1960 Building Classrooms 114,111,112,109, Boy's & Girl's Washrooms, Storeroom andCorridor



COMMENTS:









HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: Pipe Joint Insulation on Aircell Insulated Piping - abated

MATERIAL LOCATION: 1960 Building Classrooms 114,111,112,109, Boy's & Girl's Washrooms, Storeroom and Corridor





Comments:










HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: Aircell Pipe Insulation- abated








DAMAGE REASON:





COMMENTS:









HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: Aircell Pipe Insulation- abated






Comments:










HOMOGENEOUS AREA: CTM-1

MATERIAL DESCRIPTION: Ceiling Tile Mastic (Large Hole)








DAMAGE REASON:


MATERIAL LOCATION: 1960 Building Classroom 109, Boy's & Girl's Washrooms and Corridor



COMMENTS:
















Comments:



















DAMAGE REASON:





COMMENTS:
















Comments:










HOMOGENEOUS AREA: FT-1

MATERIAL DESCRIPTION: 9x9 black w/cream streaks floor tile








DAMAGE REASON:


MATERIAL LOCATION: 1960 building Rooms 114,112,111,109, and corridor.














MATERIAL LOCATION: 1960 building Rooms 114,112,111,109, and corridor.





Comments:












MATERIAL DESCRIPTION: 9x9 green floor tile








DAMAGE REASON:


MATERIAL LOCATION: copy/store room













MATERIAL DESCRIPTION: 9x9 green floor tile

MATERIAL LOCATION: copy/store room





Comments:












MATERIAL DESCRIPTION: 9x9 tan w/brown & cream streaks floor tile








DAMAGE REASON:


MATERIAL LOCATION: 1960 building/store room













MATERIAL DESCRIPTION: 9x9 tan w/brown & cream streaks floor tile

MATERIAL LOCATION: 1960 building/store room





Comments:












MATERIAL DESCRIPTION: 9x9 black w/cream & green streaks floor tile








DAMAGE REASON:


MATERIAL LOCATION: '57 building - classrooms & corridor













MATERIAL DESCRIPTION: 9x9 black w/cream & green streaks floor tile

MATERIAL LOCATION: '57 building - classrooms & corridor





Comments:












MATERIAL DESCRIPTION: 9x9 tan w/black streaks floor tile








DAMAGE REASON:


MATERIAL LOCATION: '57 building - room 101 & corridor













MATERIAL DESCRIPTION: 9x9 tan w/black streaks floor tile






Comments:




















DAMAGE REASON:


MATERIAL LOCATION: room 101 & corridor



















Comments:











HOMOGENEOUS AREA: FTM-1

MATERIAL DESCRIPTION: 9x9 black w/cream streaks floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: 1960 building Rooms 114,112,111,109, and Corridor.














MATERIAL LOCATION: 1960 building Rooms 114,112,111,109, and Corridor.





Comments:












MATERIAL DESCRIPTION: 9x9 green floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: copy/store room in bldg "60













MATERIAL DESCRIPTION: 9x9 green floor tile mastic

MATERIAL LOCATION: copy/store room in bldg "60





Comments:












MATERIAL DESCRIPTION: 9x9 tan w/brown & cream streaks floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: storage room in copy room - '60 building













MATERIAL DESCRIPTION: 9x9 tan w/brown & cream streaks floor tile mastic

MATERIAL LOCATION: storage room in copy room - '60 building





Comments:












MATERIAL DESCRIPTION: 9x9 tan w/black streaks floor tile mastic








DAMAGE REASON:















MATERIAL DESCRIPTION: 9x9 tan w/black streaks floor tile mastic






Comments:




















DAMAGE REASON:





















Comments:











HOMOGENEOUS AREA: MB-1

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








DAMAGE REASON:


MATERIAL LOCATION: Throughout Modular Building With the Exception of the Washrooms



COMMENTS:










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






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 4" Beige Vinyl Baseboard








DAMAGE REASON:


MATERIAL LOCATION: Throughout Modular Building with the Exception og the Washrooms



COMMENTS:










MATERIAL DESCRIPTION: 4" Beige Vinyl Baseboard

MATERIAL LOCATION: Throughout Modular Building with the Exception og the Washrooms





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 4" Beige Vinyl Baseboard Adhesive








DAMAGE REASON:


MATERIAL LOCATION: Throughout Modular Unit with the Exception of the Washrooms



COMMENTS:










MATERIAL DESCRIPTION: 4" Beige Vinyl Baseboard Adhesive

MATERIAL LOCATION: Throughout Modular Unit with the Exception of the Washrooms





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Textured Paint








DAMAGE REASON:


MATERIAL LOCATION: Modular Building: Washroom Ceilings



COMMENTS:










MATERIAL DESCRIPTION: Textured Paint

MATERIAL LOCATION: Modular Building: Washroom Ceilings





Follow O&M Plan

Comments:











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








DAMAGE REASON:





COMMENTS:










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






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Blue Floor Sheeting








DAMAGE REASON:


MATERIAL LOCATION: Modular Building: Boy's Washroom



COMMENTS:










MATERIAL DESCRIPTION: Blue Floor Sheeting

MATERIAL LOCATION: Modular Building: Boy's Washroom





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Blue Sheet Flooring Adhesive








DAMAGE REASON:


MATERIAL LOCATION: Mosular Building: Boy's Washroom



COMMENTS:










MATERIAL DESCRIPTION: Blue Sheet Flooring Adhesive

MATERIAL LOCATION: Mosular Building: Boy's Washroom





Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Orange Sheet Flooring








DAMAGE REASON:


MATERIAL LOCATION: Modular Building: Girl's Washroom



COMMENTS:










MATERIAL DESCRIPTION: Orange Sheet Flooring






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Orange Sheet Flooring Adhesive








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: Orange Sheet Flooring Adhesive






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Drywall








DAMAGE REASON:


MATERIAL LOCATION: Modular Building: All Walls and Ceilings



COMMENTS:










MATERIAL DESCRIPTION: Drywall






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: Drywall Compound








DAMAGE REASON:





COMMENTS:










MATERIAL DESCRIPTION: Drywall Compound






Follow O&M Plan

Comments:











MATERIAL DESCRIPTION: 2'x2' Lay In Ceiling Panels








DAMAGE REASON:


MATERIAL LOCATION: Throughout Modular Building with the Exception of the Washrooms



COMMENTS:










MATERIAL DESCRIPTION: 2'x2' Lay In Ceiling Panels

MATERIAL LOCATION: Throughout Modular Building with the Exception of the Washrooms





Follow O&M Plan

Comments:










HOMOGENEOUS AREA: WC-1

MATERIAL DESCRIPTION: Window Caulk - abated








DAMAGE REASON:


MATERIAL LOCATION: 1957 building



COMMENTS:











MATERIAL LOCATION: 1957 building





Comments:



















DAMAGE REASON:





COMMENTS:
















Comments:










HOMOGENEOUS AREA: WG-1

MATERIAL DESCRIPTION: Window Glazing - abated








DAMAGE REASON:





COMMENTS:
















Comments:



















DAMAGE REASON:





COMMENTS:
















Comments:





Inspector Assessment Form (New Homogeneous Area)

LEA NAME: Chicago Public Schools UNIT NUMBER: 23001 BUIDLING ID: 3080




INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: 48

MATERIAL DESCRIPTION: Texture Composite Wall Panels

MATERIAL LOCATION: Bathroom's and Janitor's Closet


MATERIAL CATEGORY: MISC FRIABLE: No

ASBESTOS TYPE: Assumed

DISTURBANCE POTENTIAL: LOW CONDITION:

AHERA DAMAGE CATEGORY: 6 ACBM with the potential for damage

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


COMMENTS:










MATERIAL DESCRIPTION: Texture Composite Wall Panels

MATERIAL LOCATION: Bathroom's and Janitor's Closet



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: Mastic Associated w/ Red Sheet Flooring

MATERIAL LOCATION: Girl's Washroom and Unisex Washroom






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


COMMENTS:










MATERIAL DESCRIPTION: Mastic Associated w/ Red Sheet Flooring






COMMENTS:











MATERIAL DESCRIPTION: 2' x 2' Ceiling Tile w/ Pinholes

MATERIAL LOCATION: Classrooms, Hall, Fire Pump room






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


COMMENTS:










MATERIAL DESCRIPTION: 2' x 2' Ceiling Tile w/ Pinholes

MATERIAL LOCATION: Classrooms, Hall, Fire Pump room





COMMENTS:











MATERIAL DESCRIPTION: 12" x 12" Tan Mottled Floor Tile

MATERIAL LOCATION: New Mobile Unit - Classrooms, Halls, Fire Pump Room








COMMENTS:










MATERIAL DESCRIPTION: 12" x 12" Tan Mottled Floor Tile






COMMENTS:











MATERIAL DESCRIPTION: Mastic Associated w/ Blue Sheet Flooring

MATERIAL LOCATION: Boy's Washroom








COMMENTS:










MATERIAL DESCRIPTION: Mastic Associated w/ Blue Sheet Flooring






COMMENTS:











MATERIAL DESCRIPTION: Mastic Associated w/ 4" Brown Baseboard

MATERIAL LOCATION: Halls and Classrooms








COMMENTS:










MATERIAL DESCRIPTION: Mastic Associated w/ 4" Brown Baseboard






COMMENTS:











MATERIAL DESCRIPTION: Mastic Associated w/ 12" x 12" Tan Mottled Floor Tile









COMMENTS:










MATERIAL DESCRIPTION: Mastic Associated w/ 12" x 12" Tan Mottled Floor Tile






COMMENTS:











MATERIAL DESCRIPTION: 4" Brown Baseboard









COMMENTS:










MATERIAL DESCRIPTION: 4" Brown Baseboard






COMMENTS:











MATERIAL DESCRIPTION: Blue Sheet Flooring









COMMENTS:










MATERIAL DESCRIPTION: Blue Sheet Flooring






COMMENTS:











MATERIAL DESCRIPTION: Red Sheet Flooring









COMMENTS:










MATERIAL DESCRIPTION: Red Sheet Flooring






COMMENTS:











MATERIAL DESCRIPTION: Smooth Composite Wall Panels









COMMENTS:










MATERIAL DESCRIPTION: Smooth Composite Wall Panels






COMMENTS:











MATERIAL DESCRIPTION: Exterior Composite Wall Panels

MATERIAL LOCATION: Exterior Walls








COMMENTS:










MATERIAL DESCRIPTION: Exterior Composite Wall Panels

MATERIAL LOCATION: Exterior Walls





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

ILLINOIS DEPARTMENT OF PUBLIC HEALTH …schoolreports.cps.edu/AsbestosInspectionReport_2016/23001 - John C...THREE–YEAR REINSPECTION CHICAGO SCHOOL DIST 299 Dore School 6108 S. Natoma