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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