Chicago Public Schools - CPS

[Pages:25]Chicago Public Schools

6 Month Asbestos Surveillance 2015 - Fall

School: George Washington School Address: 3611 E 114th Street

X CHECK HERE IF NO CHANGE TO ASBESTOS

Asbestos Surveyor: Survey Date: Email Address:

Oracle Unit: Region:

Allen, Mr. Darren 10/19/2015 dallen7@cps.edu

25771 06

Building ID: 6360 Mail Room: 47

A copy of the 2013/2014 notice to parents and staff regarding the asbestos management plan notifications was distributed via:

Each child's backpack

X Notice printed in school's newsletter

HA No

01

Material Description

12x12 Cream w/Tan & 12x12 Tan w/Cream Checkerboard Floor Tile

Material Quantity

1000

Material Units

SF

Material Location

South Lunchroom Entrance

Asbestos Type

2013 - Fall: No Change Comments:

Notice printed in school's calendar

Other

Material Category

Friable

Damage Type

Damage Quantity

Damage Change in Assessment Category Units

Miscellaneous No

None

0

YES

X NO

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 1

HA No

Material Description

05

Insulation in Fire Doors

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

27

Each

Throughout Facility

Asbestos Type

Material Category

TSI

Friable No

Damage Type

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

HA No

Material Description

06

Black Baseboard

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Quantity

8000

Material Units

LF

Material Location

Throughout Facility with the exception of the gym

Asbestos Type

Material Category

Miscellaneous

Friable No

Damage Type

Damage Quantity

Damage Change in Assessment Category Units

YES

X NO

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 2

HA No

07

Material Description Black Baseboard Adhesive

Material Quantity

8000

Material Units

LF

Material Location

Throught Facility with the exception og the Gym

Asbestos Type

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Category

Miscellaneous

Friable No

Damage Type

Damage Quantity

Damage Change in Assessment Category Units

YES

X NO

HA No

Material Description

08

Drywall

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

90260

SF

Throughout Facility

Asbestos Type

Material Category

Miscellaneous

Friable No

Damage Type

Damage Quantity

Damage Change in Assessment Category Units

YES

X NO

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 3

HA No

Material Description

09

Transite

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

150

SF

Kitchen Service Area

Asbestos Type

Material Category

Miscellaneous

Friable No

Damage Type

Damage Quantity

Damage Change in Assessment Category Units

YES

X NO

HA No

Material Description

12x12 Cream w/Tan &

10

12x12 Tan w/Cream Checkerboard Floor Tile

Mastic

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

1000

SF

South Lunchroom Entrance

Asbestos Material

Type

Category

Friable

Damage Type

Miscellaneous No

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 4

HA No

11

Material Description

Transite Counter Top (NOT OBSERVED)

Material Quantity

20

Material Units

SF

Material Location Room 209

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

HA No

Material Description

12

Drywall Compound

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

2000

SF

Throughout Facility

Asbestos Type

Material Category

Miscellaneous

Friable

Damage Type

Damage Quantity

Damage Change in Assessment Category Units

YES

X NO

Asbestos Type

Material Category

Miscellaneous

Friable No

Damage Type

Damage Quantity

Damage Change in Assessment Category Units

YES

X NO

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 5

HA No

13

Material Description Brown Ceramic Tile Grout

Material Material Material Location Quantity Units

200

SF

SE and SW Vestibules

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Asbestos Type

Material Category

Miscellaneous

Friable Yes

Damage Type

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

HA No

Material Description

14

Brown Ceramic Tile Adhesive

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

200

SF

SE and SW Vestibules

Asbestos Type

Material Category

Miscellaneous

Friable No

Damage Type

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 6

HA No

Material Description

15

Gray Ceramic Tile Grout

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

60

SF

North Vestibule

HA No

Material Description

16

Gray Ceramic Tile Adhesive

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Material Material Location Quantity Units

60

SF

North Vestibule

Asbestos Type

Material Category

Miscellaneous

Friable Yes

Damage Type

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

Asbestos Type

Material Category

Miscellaneous

Friable No

Damage Type

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 7

HA No

Material Description

17

Tan Mosaic Ceramic Tile Grout

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Quantity

280

Material Units

SF

Material Location

Principal's Office, Offices, Locker Rooms, Men's Toilet, Rooms 101 and 107, 2nd Floor All Toilets

Asbestos Type

Material Category

Miscellaneous

Friable Yes

Damage Type

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

HA No

Material Description

18

Tan Mosaic Ceramic Tile Adhesive

2013 - Fall: No Change Comments:

2014- Spring: No Change Comments:

2014 - Fall: No Change Comments:

2015- Spring: No Change Comments:

2015 - Fall: No Change Comments:

Material Quantity

280

Material Units

SF

Material Location

Principal's Office, Offices, Locker Rooms, Men's Toilet, Rooms 101 and 107, 2nd Floor All Toilets

Asbestos Type

Material Category

Miscellaneous

Friable No

Damage Type

None

Damage Quantity

0

Damage Change in Assessment Category Units

YES

X NO

VFT = Vinyl Floor Tile Friable = Can be crumbled, pulverized, or reduced to powder by hand pressure.

Oracle Unit: 25771 Page 8

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