4/12/2013 - cpsschoolreports.cps.edu/asbestosinspectionreport_2013/66148 noble... · three–year...

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: 14-016-2990-2420SCHOOL NAME: Noble Street Charter - Johnson College PrepADDRESS OF SCHOOL: 6350 S. StewartCITY: Chicago, IL, 60621

DATE LAST THREE YEAR REINSPECTION WAS COMPLETED 3/9/2010If the address on this form is different than the address of the building, submit a written explanation.

SECTION II (Please type or print)PLEASE COMPLETE THE FOLLOWING FOR YOUR THREE YEAR REINSPECTION:

DATE REINSPECTION COMPLETED: 4/12/2013 ENROLLMENT 0

IDPH INSPECTOR LICENSE NUMBER: 100-04437

IDPH LICENSED INSPECTOR NAME (Please Print): Mary Hicks

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

4/12/2013

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

Noble Street Charter - Johnson College Prep

6350 S. StewartChicago, IL, 60621

Unit: 26151Building ID: 6870

IDPH ID Number: 14-016-2990-2420

REPORT DATE:Friday, April 12, 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 19, 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: 26151 Region: 05 IDPH ID: 14-016-2990-2420

School: Noble Street Charter - Johnson College Prep Building ID: 6870

Address: 6350 S. Stewart

Chicago, IL, 60621

Building Contact: Contact Phone:

Current Building Owners: Chicago Public Schools

Review Date: 4/12/2013

Inspector: Mary Hicks Inspector IDPH License: 100-04437Management 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 19, 2013

RE: Noble Street Charter - Johnson College Prep, Unit 26151 6350 S. Stewart 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 NobleStreet Charter - Johnson College Prep , 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 Noble Street Charter - Johnson CollegePrep, there is no reason to believe that any threat to the health of students or staff exists at this time. CPS will continue to carefully monitor the condition of asbestos-containing materials and if conditions warrant, all appropriate steps will be taken to maintain the health and safety of all building occupants.

If you have any questions regarding this matter or require additional information, please feel free to contact 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: Noble Street Charter - Johnson College Prep

Unit: 26151 Region: 05

Address: 6350 S. Stewart Chicago, IL, 60621IDPH ID: 14-016-2990-2420 Building ID: 6870Contact: Phone:

2. Description of Facility

Original Construction: Additional Construction: Total Square Footage: No of Floors: Current Occupancy: 0

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: Mary Hicks

Signature: Inspector IDPH license # 100-04437 Date: 3/19/2013

6. Management Planner

Management Planner Name: Todd Huffer

Signature: Management Planner IDPH license # 100-09870 Date: 4/12/2013

7. Review Date: 4/12/2013

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: 4/12/2013

Name: Ms. Lynn Crivello

Unit : 26151 Noble Street Charter - Johnson College Prep

Building: 6870

Unit: 26151 Noble Street Charter - Johnson College Prep

Building: 6870

II. EXECUTIVE SUMMARY

Carnow, Conibear and Associates was retained by the Chicago Public Schools (CPS) to perform a three-year asbestos reinspection of the Noble Street Charter - Johnson College Prep. 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 designedin the School's Asbestos Management Plan. The purpose of this three-year reinspection is to record any condition changes in the asbestos-containing building material (ACBM) in the school since the previous three-year reinspection and the six-month periodic surveillance, to identify, assess, and include any Homogeneous Areas (HA) not identified in the Management Plan, and to recommend an appropriate response action to manage asbestos.

The inspector conducted a three-year reinspection of this facility under Illinois Department of Public Health (IDPH) school reinspection requirements and AHERA, sections 763.85 and 763.88. The main building and each addition to the main building, if constructed at different dates, were inspected separately. Laboratory accreditations are included in Appendix C, laboratory results are included in Appendix D, and chain of custody forms are included in Appendix E.

Note: During previous inspections, some of the HA(s) were identified together as 9" x 9" floor tile (FT), mastics assoc. with 9" x 9" FT, 12" x 12" FT, mastics assoc. with 12" x 12" FT, pipe insulation, etc. Some of these HA(s) have been re-identified by areas that are uniform in color, texture, construction date, application date, and general appearance.

The inspector has determined the following:

A. The following HAs have changed assessment categories for Building 6870:

03 12x12 white floor tile in checkerboard pattern withHA4

04 12x12 brown floor tile in checkerbaord pattern withHA3

05A 12x12 off white floor tile

10 1x1 ceiling tile

15 1x1 ceiling tile mastic

25 Sink Insulation


Building: 6870

B. The following new homogenous areas have been identified for Building 6870:

29 12"x12" White w/Blue and Red Specks VFT

29A 12"x12" White w/Blue and Red Specks VFT Mastic

30 12"x12" Blue w/Streaks VFT

30A 12"x12" Blue w/Streaks VFT Mastic

31 12"x12" Red w/Streaks VFT

31A 12"x12" Red w/Streaks VFT Mastic

32 Bluish Grey Carpet mastic


Building: 6870

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:

03 12x12 white floor tile in checkerboard pattern withHA4

04 12x12 brown floor tile in checkerbaord pattern withHA3

05A 12x12 off white floor tile10 1x1 ceiling tile15 1x1 ceiling tile mastic18E Burgundy Carpet Mastic19 Incinerator20 Vibration Isolator21 12x12 Brown Mottle Floor Tile22 12x12 Brown Mottle Floor Tile Mastic23 12x12 White w/Gray Mottle Floor Tile24 12x12 White w/Gray Mottle Floor Tile Mastic25 Sink Insulation26 12x12 Yellow Floor Tile w/Blue Flecks29 12"x12" White w/Blue and Red Specks VFT29A 12"x12" White w/Blue and Red Specks VFT Mastic30 12"x12" Blue w/Streaks VFT30A 12"x12" Blue w/Streaks VFT Mastic31 12"x12" Red w/Streaks VFT31A 12"x12" Red w/Streaks VFT Mastic32 Bluish Grey Carpet mastic

The following areas were deemed to be inaccessible:

13A 12x12 white floor tile mastic13B 12x12 brown floor tile mastic13C 12x12 rust floor tile mastic13D 12x12 off white floor tile mastic14 9x9 tan floor tile mastic15 1x1 ceiling tile mastic18E Burgundy Carpet Mastic22 12x12 Brown Mottle Floor Tile Mastic24 12x12 White w/Gray Mottle Floor Tile Mastic29A 12"x12" White w/Blue and Red Specks VFT Mastic30A 12"x12" Blue w/Streaks VFT Mastic31A 12"x12" Red w/Streaks VFT Mastic32 Bluish Grey Carpet masticA breachingC Feed Water Tank formerly known as condensate

return tank


Building: 6870

E fittings

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 Mary Hicks, IDPH License # 100-04437. The Management Plan was updated by Todd Huffer, IDPH License # 100-09870. Inspector and Management Planner Licenses are included in Appendix B.


Building: 6870

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: 6/24/20126/24/2012

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 Noble Street Charter - Johnson College Prep Building 6870 Three-Year reinspection has been completed and responseactions have been recommended for both friable and non-friable materials. A timely execution of the response actionsrecommended will enable the LEA and the Designated Person(s) to effectively manage the existing ACBM.

This three-year reinspection report should be inspected in the current Management plan at the CPS Central Office, and one (1)copy should be kept at the school for use when planning any renovation and/or demolition activities in areas where ACBM 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 Noble Street Charter - Johnson College Prep Unit 26151 Building ID 6870 Address 6350 S. Stewart 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

03 12x12 white floor tile in checkerboard pattern with HA4

20,000 SF 1st, 2nd, 3rd floor corridors, custodial breakroom, engineers office, classrooms 201, 307,309, 308, 313

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

LOW

04 12x12 brown floor tile in checkerbaord pattern with HA3

20,000 SF 1st, 2nd, 3rd floor corridors and, Custodial Breakroom, engineers office, class rooms 201, 307, 309, 308, 313


LOW

05 12x12 rust floor tile 1,500 SF 1st floor kitchen CHR MISC N NONE 0 No ACBM with the potential for damage

MODERATE

05A 12x12 off white floor tile 23,000 SF classrooms, 1st, 2nd,3rd floors


LOW

06 9x9 tan floor tile 2,880 SF room 301, 305, 311, Boiler room storage room

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

MODERATE

09 acoustical plaster 22,500 SF 1st floor sw corridor,& 2nd floor corridor,lunchroom

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

LOW

10 1x1 ceiling tile 500 SF SE Lobby ASSUMED MISC N NONE 0 Yes ACBM with the potential for damage

LOW

13A 12x12 white floor tile mastic 20,000 SF 1st,2nd,3rd floor corridor


MODERATE

13B 12x12 brown floor tile mastic 20,000 SF 1st, 2nd, 3rd floor corridors and classrooms


MODERATE

13C 12x12 rust floor tile mastic 1,500 SF 1st floor kitchen CHR MISC N NONE 0 No ACBM with the potential for damage

MODERATE

13D 12x12 off white floor tile mastic 21,200 SF classrooms, 1st, 2nd,3rd floors


MODERATE

14 9x9 tan floor tile mastic 2,880 SF room 301, 305, 311, and boiler room storage room


MODERATE

15 1x1 ceiling tile mastic 500 SF SE LOBBY ASSUMED MISC N NONE 0 Yes ACBM with the potential for damage

LOW

16 interior window glaze 416 EA all windows - interior


LOW

18E Burgundy Carpet Mastic 1,300 SF Room 126 ASSUMED MISC N NONE 0 No ACBM with the potential for damage

MODERATE

19 Incinerator 150 SF Insulation ASSUMED TSI N NONE 0 No ACBM with the MODERATE







Material Units


Material Category

Friable Damage Type

Damage Quantity



potential for damage20 Vibration Isolator 40 LF Fan Room ASSUMED MISC N NONE 0 No ACBM with the

potential for damageMODERATE

21 12x12 Brown Mottle Floor Tile 750 SF Rm 303 ASSUMED MISC N NONE 0 No ACBM with the potential for damage

MODERATE

22 12x12 Brown Mottle Floor Tile Mastic 750 SF Rm 303 ASSUMED MISC N NONE 0 No ACBM with the potential for damage

MODERATE

23 12x12 White w/Gray Mottle Floor Tile 3,900 SF Gym ASSUMED MISC N NONE 0 No ACBM with the potential for damage

MODERATE

24 12x12 White w/Gray Mottle Floor Tile Mastic

3,900 SF Gym ASSUMED MISC N NONE 0 No ACBM with the potential for damage

MODERATE

25 Sink Insulation 15 SF Art Room, 109 ASSUMED SURFACE Y NONE 0 Yes ACBM with the potential for damage

MODERATE

26 12x12 Yellow Floor Tile w/Blue Flecks Rm 112 ASSUMED MISC None Moderate27 12x12 Off White Floor Tile w/Brown

FlecksRm 112 ABATED MISC None Moderate

28 12 X12 Yellow FT w/Blue Flecks Mastic, 12X12 Off white FT w/Brwn Mastic

Rm 112 ABATED MISC None Moderate

29 12"x12" White w/Blue and Red Specks VFT

1,400 SF Room 109,110,310,312,313, 3rd unisex bathroom, elevator area, lunchroom

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

LOW

29A 12"x12" White w/Blue and Red Specks VFT Mastic

1,400 SF Room 109,110,310,312,313, 3rd unisex bathroom, elevator area, lunchroom


LOW

30 12"x12" Blue w/Streaks VFT 680 SF Lunchroom,3rd floorwater fountain area, elevator area, room 310


LOW

30A 12"x12" Blue w/Streaks VFT Mastic 680 SF Lunchroom,3rd floorwater fountain area, elevator area, room 310,unisex bathroom


LOW

31 12"x12" Red w/Streaks VFT 480 SF Lunchroom, 2nd and3rd floor water fountain, elevator area, room 310

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

LOW

31A 12"x12" Red w/Streaks VFT Mastic 680 SF Lunchroom,3rd floorwater fountain area, elevator area, room 310


LOW







Material Units


Material Category

Friable Damage Type

Damage Quantity



32 Bluish Grey Carpet mastic 650 SF Room 97(Main Office) Room 100


LOW

A breaching 600 SF boiler room CHR TSI Y NONE 0 No ACBM with the potential for damage

LOW

B heat exchange cover 270 SF boiler room CHR TSI Y NONE 0 No ACBM with the potential for damage

LOW

C Feed Water Tank formerly known as condensate return tank

24 SF boiler room CHR TSI Y NONE 0 No ACBM with the potential for damage

LOW

E fittings 530 LF pipe chases, boiler room, fan room

CHR TSI Y LOC 10 No Damaged or significantly damaged friable thermal system insulating ACBM

10 LOW






Reinspection Date 3/19/2013

Inspector Name Mary Hicks

100-04437 5/15/2013

Inspector's IDPH License Number / Expiration Date

Inspector's Comments

HA Number: Inspector Comments:03040505A 97,100,102,104,118 removed 6/26/201206091013A13B13C13D Tiles replaced in rooms 310,312,31314151618E1920212223242526 Removed in 201027






HA Number: Inspector Comments:282929A3030A3131A32ABCE Pipechases washrooms removed 6/22-7/16/20120

Table II

Management Planner's Review

Chicago Public Schools

SchoolNoble Street Charter - Johnson College Prep Unit 26151 Building ID 6870

Address 6350 S. Stewart 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

03 12x12 white floor tile in checkerboard pattern with HA4

20,000 SF 1st, 2nd, 3rd floor corridors, custodial breakroom, engineers office, classrooms 201, 307, 309, 308, 313

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

04 12x12 brown floor tile in checkerbaord pattern with HA3

20,000 SF 1st, 2nd, 3rd floor corridors and, Custodial Breakroom, engineers office, class rooms 201, 307, 309, 308, 313


05 12x12 rust floor tile 1,500 SF 1st floor kitchen Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance05A 12x12 off white floor tile 23,000 SF classrooms, 1st, 2nd, 3rd floors Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance06 9x9 tan floor tile 2,880 SF room 301, 305, 311, Boiler room

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

09 acoustical plaster 22,500 SF 1st floor sw corridor, & 2nd floor corridor, lunchroom

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

10 1x1 ceiling tile 500 SF SE Lobby Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance13A 12x12 white floor tile mastic 20,000 SF 1st,2nd,3rd floor corridor Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance13B 12x12 brown floor tile mastic 20,000 SF 1st, 2nd, 3rd floor corridors and

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

13C 12x12 rust floor tile mastic 1,500 SF 1st floor kitchen Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance13D 12x12 off white floor tile mastic 21,200 SF classrooms, 1st, 2nd, 3rd floors Chrysotile MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance14 9x9 tan floor tile mastic 2,880 SF room 301, 305, 311, and boiler room

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

15 1x1 ceiling tile mastic 500 SF SE LOBBY Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance16 interior window glaze 416 EA all windows - interior Chrysotile MISC No 0 EA 6 ACBM with the potential for damage Operations and Maintenance18E Burgundy Carpet Mastic 1,300 SF Room 126 Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance19 Incinerator 150 SF Insulation Assumed TSI No 0 SF 6 ACBM with the potential for damage Operations and Maintenance20 Vibration Isolator 40 LF Fan Room Assumed MISC No 0 LF 6 ACBM with the potential for damage Operations and Maintenance21 12x12 Brown Mottle Floor Tile 750 SF Rm 303 Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance22 12x12 Brown Mottle Floor Tile Mastic 750 SF Rm 303 Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance23 12x12 White w/Gray Mottle Floor Tile 3,900 SF Gym Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance24 12x12 White w/Gray Mottle Floor Tile Mastic 3,900 SF Gym Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and Maintenance25 Sink Insulation 15 SF Art Room, 109 Assumed SURFACE Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance26 12x12 Yellow Floor Tile w/Blue Flecks Rm 112 Assumed MISC 27 12x12 Off White Floor Tile w/Brown Flecks Rm 112 Abated MISC 28 12 X12 Yellow FT w/Blue Flecks Mastic, 12X12 Off

white FT w/Brwn MasticRm 112 Abated MISC








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

29 12"x12" White w/Blue and Red Specks VFT 1,400 SF Room 109,110,310,312,313, 3rd unisexbathroom, elevator area, lunchroom


29A 12"x12" White w/Blue and Red Specks VFT Mastic 1,400 SF Room 109,110,310,312,313, 3rd unisexbathroom, elevator area, lunchroom


30 12"x12" Blue w/Streaks VFT 680 SF Lunchroom,3rd floor water fountain area, elevator area, room 310


30A 12"x12" Blue w/Streaks VFT Mastic 680 SF Lunchroom,3rd floor water fountain area, elevator area, room 310,unisex bathroom


31 12"x12" Red w/Streaks VFT 480 SF Lunchroom, 2nd and 3rd floor water fountain, elevator area, room 310

Assumed MISC No 0 SF 5 ACBM with potential for significant damage

Operations and Maintenance

31A 12"x12" Red w/Streaks VFT Mastic 680 SF Lunchroom,3rd floor water fountain area, elevator area, room 310


32 Bluish Grey Carpet mastic 650 SF Room 97(Main Office) Room 100 Assumed MISC No 0 SF 6 ACBM with the potential for damage Operations and MaintenanceA breaching 600 SF boiler room Chrysotile TSI Yes 0 SF 6 ACBM with the potential for damage Operations and MaintenanceB heat exchange cover 270 SF boiler room Chrysotile TSI Yes 0 SF 6 ACBM with the potential for damage Operations and MaintenanceC Feed Water Tank formerly known as condensate

return tank24 SF boiler room Chrysotile TSI Yes 0 SF 6 ACBM with the potential for damage Operations and Maintenance

E fittings 530 LF pipe chases, boiler room, fan room Chrysotile TSI Yes 10 LF 1 Damaged or significantly damaged friable thermal system insulating ACBM

Remove








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

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

Review Date 4/12/2013

Manager Planner Name Todd Huffer100-09870 5/15/2013Manager IDPH License No/Expiration

HA Number Management Comments03040505A 97,100,102,104,118 removed 6/26/201206091013A13B13C13D Tiles replaced in rooms 310,312,31314151618E1920








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

Management Planner's Comments Summarized at the End of the ReportHA Number Management Comments212223242526 Removed in 201027282929A3030A3131A32ABCE Bathroom Pipe Chases were abated in 2012. Remove/Repair damaged Materials and maintian O&M.


Carnow, Conibear and Associates

2013 AHERA REINSPECTION

Inspector Assessment Form (REASSESSMENT) LEA NAME: Chicago Public Schools UNIT NUMBER: 26151 BUIDLING ID: 6870

CITY/STATE: Chicago, Illinois AHERA INSPECTOR: Mary Hicks

SCHOOL NAME: Noble Street Charter - Johnson College Prep

INSPECTION DATE: 3/19/2013

ADDRESS: 6350 S. Stewart IDPH LICENSE NO: 100-04437

INFORMATION FROM PREVIOUS INSPECTION

HOMOGENEOUS AREA: 03

MATERIAL DESCRIPTION: 12x12 white floor tile in checkerboard pattern with HA4

HISTORICAL AHERA DAMAGE CATEGORY 6

HISTORICAL DAMAGE REASON:

HISTORICAL RESPONSE ACTION:

ASBESTOS TYPE: Assumed FRIABLE: No

RESULTS OF REINSPECTION AND REASSESSMENT

This homogeneous area was reinspected and reassessed in accordance with Section 763.85 and 763.88 of AHERA and it's condition HAS NOT CHANGED when compared to the conditions of the last AHERA reinspection.

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

DAMAGE REASON:

DISTURBANCE POTENTIAL: LOW

MATERIAL LOCATION: 1st, 2nd, 3rd floor corridors, custodial breakroom, engineers office, classrooms 201, 307, 309, 308, 313

MATERIAL QUANTITY: 20000 MATERIAL UNITS: SF

DAMAGE QUANTITY: DAMAGE UNITS: SF

COMMENTS:

Inspector's Signature: Date: 03/19/2013




Management Planner Review FormLEA NAME: Chicago Public Schools UNIT NUMBER: 26151 BUIDLING ID: 6870

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


REVIEW DATE: 4/12/2013



MATERIAL DESCRIPTION: 12x12 white floor tile in checkerboard pattern with HA4

MATERIAL LOCATION: 1st, 2nd, 3rd floor corridors, custodial breakroom, engineers office, classrooms 201, 307, 309, 308, 313


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:

Comments:

Management Planner's Signature: Date: 04/12/2013











MATERIAL DESCRIPTION: 12x12 brown floor tile in checkerbaord pattern with HA3



HISTORICAL RESPONSE ACTION: Operations and Maintenance





DAMAGE REASON:


MATERIAL LOCATION: 1st, 2nd, 3rd floor corridors and, Custodial Breakroom, engineers office, class rooms 201, 307, 309, 308, 313



COMMENTS:











MATERIAL DESCRIPTION: 12x12 brown floor tile in checkerbaord pattern with HA3

MATERIAL LOCATION: 1st, 2nd, 3rd floor corridors and, Custodial Breakroom, engineers office, class rooms 201, 307, 309, 308, 313






Comments:












MATERIAL DESCRIPTION: 12x12 rust floor tile

HISTORICAL AHERA DAMAGE CATEGORY 6 ACBM with the potential for damage



ASBESTOS TYPE: Chrysotile FRIABLE: No




DAMAGE REASON:

DISTURBANCE POTENTIAL: MODERATE

MATERIAL LOCATION: 1st floor kitchen



COMMENTS:











MATERIAL DESCRIPTION: 12x12 rust floor tile







Comments:











HOMOGENEOUS AREA: 05A

MATERIAL DESCRIPTION: 12x12 off white floor tile








DAMAGE REASON:


MATERIAL LOCATION: classrooms, 1st, 2nd, 3rd floors



COMMENTS: 97,100,102,104,118 removed 6/26/2012











MATERIAL DESCRIPTION: 12x12 off white floor tile






Comments:

97,100,102,104,118 removed 6/26/2012












MATERIAL DESCRIPTION: 9x9 tan floor tile








DAMAGE REASON:


MATERIAL LOCATION: room 301, 305, 311, Boiler room storage room



COMMENTS:











MATERIAL DESCRIPTION: 9x9 tan floor tile

MATERIAL LOCATION: room 301, 305, 311, Boiler room storage room






Comments:












MATERIAL DESCRIPTION: acoustical plaster




ASBESTOS TYPE: Chrysotile FRIABLE: Yes




DAMAGE REASON:


MATERIAL LOCATION: 1st floor sw corridor, & 2nd floor corridor, lunchroom



COMMENTS:











MATERIAL DESCRIPTION: acoustical plaster

MATERIAL LOCATION: 1st floor sw corridor, & 2nd floor corridor, lunchroom






Comments:












MATERIAL DESCRIPTION: 1x1 ceiling tile








DAMAGE REASON:


MATERIAL LOCATION: SE Lobby



COMMENTS:











MATERIAL DESCRIPTION: 1x1 ceiling tile

MATERIAL LOCATION: SE Lobby





Comments:












MATERIAL DESCRIPTION: 12x12 white floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: 1st,2nd,3rd floor corridor



COMMENTS:











MATERIAL DESCRIPTION: 12x12 white floor tile mastic

MATERIAL LOCATION: 1st,2nd,3rd floor corridor






Comments:











HOMOGENEOUS AREA: 13B

MATERIAL DESCRIPTION: 12x12 brown floor tile mastic








DAMAGE REASON:


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



COMMENTS:










HOMOGENEOUS AREA: 13B

MATERIAL DESCRIPTION: 12x12 brown floor tile mastic

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






Comments:











HOMOGENEOUS AREA: 13C

MATERIAL DESCRIPTION: 12x12 rust floor tile mastic








DAMAGE REASON:





COMMENTS:










HOMOGENEOUS AREA: 13C

MATERIAL DESCRIPTION: 12x12 rust floor tile mastic







Comments:











HOMOGENEOUS AREA: 13D

MATERIAL DESCRIPTION: 12x12 off white floor tile mastic








DAMAGE REASON:





COMMENTS: Tiles replaced in rooms 310,312,313










HOMOGENEOUS AREA: 13D

MATERIAL DESCRIPTION: 12x12 off white floor tile mastic







Comments:

Tiles replaced in rooms 310,312,313












MATERIAL DESCRIPTION: 9x9 tan floor tile mastic








DAMAGE REASON:


MATERIAL LOCATION: room 301, 305, 311, and boiler room storage room



COMMENTS:











MATERIAL DESCRIPTION: 9x9 tan floor tile mastic

MATERIAL LOCATION: room 301, 305, 311, and boiler room storage room






Comments:












MATERIAL DESCRIPTION: 1x1 ceiling tile mastic








DAMAGE REASON:


MATERIAL LOCATION: SE LOBBY



COMMENTS:











MATERIAL DESCRIPTION: 1x1 ceiling tile mastic

MATERIAL LOCATION: SE LOBBY





Comments:












MATERIAL DESCRIPTION: interior window glaze








DAMAGE REASON:


MATERIAL LOCATION: all windows - interior

MATERIAL QUANTITY: 416 MATERIAL UNITS: EA

DAMAGE QUANTITY: DAMAGE UNITS: EA

COMMENTS:











MATERIAL DESCRIPTION: interior window glaze

MATERIAL LOCATION: all windows - interior

MATERIAL QUANTITY: 416 MATERIAL UNITS: EA

DAMAGE QUANTITY: 0 DAMAGE UNITS: EA




Comments:











HOMOGENEOUS AREA: 18E

MATERIAL DESCRIPTION: Burgundy Carpet Mastic








DAMAGE REASON:


MATERIAL LOCATION: Room 126



COMMENTS:










HOMOGENEOUS AREA: 18E

MATERIAL DESCRIPTION: Burgundy Carpet Mastic

MATERIAL LOCATION: Room 126






Comments:












MATERIAL DESCRIPTION: Incinerator








DAMAGE REASON:


MATERIAL LOCATION: Insulation



COMMENTS:











MATERIAL DESCRIPTION: Incinerator

MATERIAL LOCATION: Insulation






Comments:












MATERIAL DESCRIPTION: Vibration Isolator








DAMAGE REASON:


MATERIAL LOCATION: Fan Room

MATERIAL QUANTITY: 40 MATERIAL UNITS: LF

DAMAGE QUANTITY: DAMAGE UNITS: LF

COMMENTS:











MATERIAL DESCRIPTION: Vibration Isolator

MATERIAL LOCATION: Fan Room


DAMAGE QUANTITY: 0 DAMAGE UNITS: LF




Comments:












MATERIAL DESCRIPTION: 12x12 Brown Mottle Floor Tile








DAMAGE REASON:


MATERIAL LOCATION: Rm 303



COMMENTS:











MATERIAL DESCRIPTION: 12x12 Brown Mottle Floor Tile







Comments:












MATERIAL DESCRIPTION: 12x12 Brown Mottle Floor Tile Mastic








DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: 12x12 Brown Mottle Floor Tile Mastic







Comments:












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








DAMAGE REASON:


MATERIAL LOCATION: Gym



COMMENTS:











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







Comments:












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








DAMAGE REASON:





COMMENTS:











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







Comments:












MATERIAL DESCRIPTION: Sink Insulation




ASBESTOS TYPE: Assumed FRIABLE: Yes




DAMAGE REASON:


MATERIAL LOCATION: Art Room, 109



COMMENTS:











MATERIAL DESCRIPTION: Sink Insulation

MATERIAL LOCATION: Art Room, 109






Comments:












MATERIAL DESCRIPTION: 12x12 Yellow Floor Tile w/Blue Flecks

HISTORICAL AHERA DAMAGE CATEGORY ACBM with the potential for damage



ASBESTOS TYPE: Assumed FRIABLE:



The current AHERA DAMAGE CATEGORY is determined to be .

DAMAGE REASON:

DISTURBANCE POTENTIAL: Moderate


MATERIAL QUANTITY: MATERIAL UNITS:

DAMAGE QUANTITY: DAMAGE UNITS:

COMMENTS: Removed in 2010











MATERIAL DESCRIPTION: 12x12 Yellow Floor Tile w/Blue Flecks







Comments:

Removed in 2010












MATERIAL DESCRIPTION: 12x12 Off White Floor Tile w/Brown Flecks




ASBESTOS TYPE: Abated FRIABLE:




DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: 12x12 Off White Floor Tile w/Brown Flecks







Comments:












MATERIAL DESCRIPTION: 12 X12 Yellow FT w/Blue Flecks Mastic, 12X12 Off white FT w/Brwn Mastic




ASBESTOS TYPE: Abated FRIABLE:




DAMAGE REASON:





COMMENTS:











MATERIAL DESCRIPTION: 12 X12 Yellow FT w/Blue Flecks Mastic, 12X12 Off white FT w/Brwn Mastic







Comments:











HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: breaching








DAMAGE REASON:


MATERIAL LOCATION: boiler room



COMMENTS:










HOMOGENEOUS AREA: A

MATERIAL DESCRIPTION: breaching







Comments:











HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: heat exchange cover








DAMAGE REASON:





COMMENTS:










HOMOGENEOUS AREA: B

MATERIAL DESCRIPTION: heat exchange cover







Comments:











HOMOGENEOUS AREA: C

MATERIAL DESCRIPTION: Feed Water Tank formerly known as condensate return tank

HISTORICAL AHERA DAMAGE CATEGORY 6 Damaged or significantly damaged friable thermal system insulating ACBM


HISTORICAL RESPONSE ACTION: RemoveSee Comments





DAMAGE REASON:





COMMENTS:










HOMOGENEOUS AREA: C

MATERIAL DESCRIPTION: Feed Water Tank formerly known as condensate return tank






RemoveSee Comments

Comments:











HOMOGENEOUS AREA: E

MATERIAL DESCRIPTION: fittings

HISTORICAL AHERA DAMAGE CATEGORY 1 Damaged or significantly damaged friable thermal system insulating ACBM

HISTORICAL DAMAGE REASON: Water

HISTORICAL RESPONSE ACTION: Remove




The current AHERA DAMAGE CATEGORY is determined to be 1. Damaged or significantly damaged friable thermal system insulating ACBM

DAMAGE REASON: Water


MATERIAL LOCATION: pipe chases, boiler room, fan room


DAMAGE QUANTITY: DAMAGE UNITS: LF

COMMENTS: Pipechases washrooms removed 6/22-7/16/20120










HOMOGENEOUS AREA: E

MATERIAL DESCRIPTION: fittings

MATERIAL LOCATION: pipe chases, boiler room, fan room


DAMAGE QUANTITY: 10 DAMAGE UNITS: LF



Remove

Comments:

Bathroom Pipe Chases were abated in 2012. Remove/Repair damaged Materials and maintian O&M.





Inspector Assessment Form (New Homogeneous Area)

LEA NAME: Chicago Public Schools UNIT NUMBER: 26151 BUIDLING ID: 6870





INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: 29A

MATERIAL DESCRIPTION: 12"x12" White w/Blue and Red Specks VFT Mastic

MATERIAL LOCATION: Room 109,110,310,312,313, 3rd unisex bathroom, elevator area, lunchroom


MATERIAL CATEGORY: MISC FRIABLE: No

ASBESTOS TYPE: Assumed

DISTURBANCE POTENTIAL: LOW CONDITION:

AHERA DAMAGE CATEGORY: 6 ACBM with the potential for damage

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


COMMENTS:











MATERIAL DESCRIPTION: 12"x12" White w/Blue and Red Specks VFT Mastic




In accordance with Sections 763.88 and 763.90 of the Asbestos Hazard Emergency Response Act (AHERA) the LEA must select a management planner to review the results of the inspection and assessment and recommend appropriate response actions. The originalinspection of the above identified homogeneous area has been reviewed in accordance with Sections 763.88 and 763.90 with the following recommendations.


COMMENTS:











INFORMATION FROM CURRENT INSPECTIONHOMOGENEOUS AREA: 30

MATERIAL DESCRIPTION: 12"x12" Blue w/Streaks VFT

MATERIAL LOCATION: Lunchroom,3rd floor water fountain area, elevator area, room 310






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


COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Blue w/Streaks VFT






COMMENTS:












MATERIAL DESCRIPTION: 12"x12" Red w/Streaks VFT

MATERIAL LOCATION: Lunchroom, 2nd and 3rd floor water fountain, elevator area, room 310





AHERA DAMAGE CATEGORY: 5 ACBM with potential for significant damage



COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Red w/Streaks VFT

MATERIAL LOCATION: Lunchroom, 2nd and 3rd floor water fountain, elevator area, room 310





COMMENTS:












MATERIAL DESCRIPTION: 12"x12" White w/Blue and Red Specks VFT









COMMENTS:











MATERIAL DESCRIPTION: 12"x12" White w/Blue and Red Specks VFT






COMMENTS:












MATERIAL DESCRIPTION: 12"x12" Red w/Streaks VFT Mastic









COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Red w/Streaks VFT Mastic






COMMENTS:












MATERIAL DESCRIPTION: 12"x12" Blue w/Streaks VFT Mastic

MATERIAL LOCATION: Lunchroom,3rd floor water fountain area, elevator area, room 310,unisex bathroom








COMMENTS:











MATERIAL DESCRIPTION: 12"x12" Blue w/Streaks VFT Mastic

MATERIAL LOCATION: Lunchroom,3rd floor water fountain area, elevator area, room 310,unisex bathroom





COMMENTS:












MATERIAL DESCRIPTION: Bluish Grey Carpet mastic

MATERIAL LOCATION: Room 97(Main Office) Room 100








COMMENTS:











MATERIAL DESCRIPTION: Bluish Grey Carpet mastic

MATERIAL LOCATION: Room 97(Main Office) Room 100





COMMENTS:


APPENDIX B

Inspector and Management Planner Licenses

APPENDIX C

Laboratory Accreditations

APPENDIX D

Laboratory Results

APPENDIX E

Chain of Custody Forms

Three-Year Reinspection Key to Terms

CODE KEYMATERIAL

ACBM Asbestos Containing Building MaterialsMATERIAL CATEGORY

MISC Miscellaneous

SURF Surfacing

TSI Thermal System InsulationMATERIAL UNITS

LF Linear Feet

SF Square Feet

CF Cubic FeetDAMAGE TYPE

Loc Localized

Dist Distributed

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