UNVERSITY HIGH SCHOOL U W. Gregory St. Normal, IL School Asbestos Management Plan. Supplemental.
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1 UNVERSITY HIGH SCHOOL U W. Gregory St. Normal, IL School Asbestos Management Plan Supplemental Prepared By: David Martin Management Planner Environmental Health and Safety 202 Nelson Smith Building Campus Box 1320 Normal, IL
2 ILLINOIS STATE UNIVERSITY Laboratory School Unit Director 06 DeGarmo Hall 5300 Illinois State University Normal, IL Telephone: (309) TDD: (309) Facsimile: (309) University High School School Asbestos Management Plan Table of Contents Amendments to Management Plan...Section I Annual Notification and Training Certificates.. Section II 6 Month Surveillance and 3 Re-inspections.Section III Materials Report and Bulk Sample Results..Section IV Response Actions Records..Section V Short Term Worker Acknowledgement Forms..Section VI
3 SECTION I AMENDMENTS TO PLAN Return To TOC
4 ILLINOIS STATE UNIVERSITY Laboratory School Unit Director 06 DeGarmo Hall 5300 Illinois State University Normal, IL Telephone: (309) TDD: (309) Subject: Appointment of Designated Person and Management Planner The Designated Person and Management Planner for this facility is: Name:_David Martin Date appointed: March 31, 2005_ Title: Safety Officer III Home Phone:_ Address: 202 NSB Campus Box 1320 Phone:
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7 SECTION II ANNUAL NOTIFICATIONS AND TRAINING CERTIFICATES Return To TOC
8 ILLINOIS STATE UNIVERSITY Laboratory School Unit Director 06 DeGarmo Hall 5300 Illinois State University Normal, IL Telephone: (309) TDD: (309) Facsimile: (309) Subject: Annual Asbestos Notification Each year, building occupants and parents are notified of the presence and condition of asbestos-containing building materials (ABCM) in University High School, pursuant to the Local Education Authority (LEA) requirements of the Asbestos Abatement Act (a) (3). Illinois State University s Environmental Health and Safety Office (EHS) conduct surveys of those areas twice per year. During this cycle the materials were found to be in good condition. The semi-annual surveys are completed by a licensed asbestos building inspector under the supervision of EHS. All response actions and post response actions that disturb ABCM are completed under the oversight and supervision of EHS. This information is then made available to building occupants and parents, through required notices and updates to the school Asbestos Management Plan. 1. On June 22, 2006, our in-house licensed asbestos workers removed 2.5 LF of thermal systems insulation (TSI) from the water meter in ME Room 120 of University High School. 2. June 13, 2006, a licensed asbestos contractor removed 1,400 SF of 9 X 9 floor tile and mastic from Hallway 119. The project was overseen by a licensed Air Sampling Professional/Project Manager. 3. July 31, 2006, a licensed asbestos contractor removed 884 SF of 9 X 9 floor tile and mastic from Hallway 125 and Stairwell 126E. The project was overseen by a licensed Air Sampling Professional/Project Manager. A complete, updated copy of the Management Plan is maintained by the University s EHS Office and is available for viewing during normal office hours without cost or restriction for inspection by representatives of the EPA, the State, and the public. It shall also be available to short term workers and/or contractors prior to any work beginning in any area of the schools. Copies of the plan are available. However, a nominal fee will be charged to reproduce it. A supplement to the plan is available for viewing on the EHS Web site. If you have any questions, please contact: David Martin, at demart2@ilstu.edu or (309) office (309) department
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12 Section III 6 Month Surveillance and Three Year Re-inspections Return To TOC Date of Original Inspection May 08, 1989
13 RECORD OF SIX MONTH SURVEILLANCE OF ACBM FACILITY ID:_ Lab School BUILDING: _UH DATE OF SURVEILLANCE: 09/30/06 INSPECTOR ID:_ Dave Martin No significant change to ACM condition was noted. Return To TOC
14 UNIVERSITY HIGH SCHOOL Three Year REINSPECTION OF ACBM FACILITY ID: Lab School BUILDING: UH DATE OF RE-INSPECTION: 03/22/07 INSPECTOR ID:_ DAVID MARTIN AREA FT-1 FT-2 FT-3 FT-6 Black Mastic MATERIAL DESCRIPTION 9 x 9 Floor Tile 130,000 SF Tan w Brn White Streaks 9 X 9 Floor Tile Grey w White Streaks 1,160 SF 9 x 9 Floor Tile 180 SF 9 X 9 Floor Tile 880 SF Floor Tile Mastic 35,160 SF FT-7 12 X 12 Floor Tile LOCATION(S) OF ACBM Thru-out, Halls, Corridors, Classrooms, Etc. Rm 103, Stairs 251,254,304 & 319 THREE YEAR SURVEILLANCE FINDINGS OF ACBM P N ASSESS CATEGORY/ CONDITION JUSTIFICATION OF CATEGORY Y 5 Remains in non-friable condition Y 5 Low Physical and Low Water Damage CHANGE IN CONDITION COMMENTS No Change Removed Hall 248 summer of 1998 & Halls 232 & 255 in summer of 2000 planned response actions No Change Continue O & M, until renovation requires removal under NESHAPS. Rm 106 A-C Y 5 Low Physical and Low Water Damage No Change Continue O & M, until renovation requires removal under NESHAPS. Hall 322, Rm 306 & N Removed Removed Planned response action in summer Stair 304 of 2000 Thru-out, Halls, Y 5 Low Physical and Low No Change Removed in Room 222 in summer Corridors, Water Damage of 2001, planned response action Classrooms, ETC Beige/Marbled in Hall 248, 232 & 255 Y 5 No physical or water damage Mastic Under FT - 7 Halls 248, 232 & 255 Y 5 No physical or water damage FT - 8 Blk Mastic 2 12 X 12 Floor Tile Tan w red & white Streaks 100 SF A-2 Acoustical Ceiling 3, 930 SF Rm 103 Y 5 Moderate Physical and Low Water Damage Under FT - 8 Rm 103 Y 5 Moderate Physical and Low Water Damage Library Room 230. Y 5 Low Physical & Low Water damage NEW NEW NEW No Change Material is not likely to contain asbestos, however, NESHAPS requires sampling prior to removing or renovation. Material is not likely to contain asbestos, however, NESHAPS requires sampling prior to removing or renovation. Assumed, NESHAPS requires sampling prior to removing or renovation. Assumed, NESHAPS requires sampling prior to removing or renovation. Continue O & M, until renovation requires removal under NESHAPS
15 A-3 Fire Proofing 48, 168 SF CT-2 MUD-1 Ceiling Tile 408 SF Fitting Insulation On Beams above Stroud Auditorium Y 6 Moderate Physical Damage/Minor Water Damage Rms 107,217,219A Y 5 Low Physical and Low Water damage 1,905 SF, Pipe Chases and Tunnels Y 5 Low Physical and Low Water Damage No Change Continue O & M, access to area is restricted. Response actions are documented. No Change Hall 248 removed summer of 1998 as planned response action. Continue O & M, until renovation requires removal under NESHAPS. No Change Continue O & M, until renovation requires removal under NESHAPS MUD-2 TSI -1 Fitting Insulation Compressed Paper Ins. 20 LF 2,870 SF, Room ,232, Tunnels Room 321, BSW Closet Bench Top Black Bench Tops Not quantified, Rm 112B Lab Lab Tops Rms Tops 1,100 SF 112,D,130,209,213,C, 307,309, Transite Fumes Hoods 240 SF, Rms 112, D, 313 & 315 Misc - 1 Tile Grout Mens RRm 259 and Terrazo Locker Rms and Misc 2 Gypsom Divider Panels Showers Clrms, 220, 222, 207,204 Y 5 Low Physical and Low Water damage Y 5 Low Physical and Low Water Damage Y 5 Low Physical and Low Water Damage Y 5 Low Physical and Low Water Damage Y 5 Low Physical and Low Water Damage Y Assumed Low Physical and Low Water Damage Y Assumed Low Physical and No Water Damage No Change Continue O & M, until renovation requires removal under NESHAPS. NEW Presumed to contain Asbestos, Continue O & M, until renovation requires sampling under NESHAPS. No Change Continue O & M, until renovation requires removal under NESHAPS. No Change Rm 215 removed in summer 2000, as planned response action. No Change Rm 215 removed in summer 2000, as planned response action NEW Assumed, Continue O & M, until renovation requires sampling under NESHAPS. NEW Assumed, Continue O & M, until renovation requires sampling under NESHAPS.
16 AHERA Assessment Categories: 1) Damaged or significantly damaged TSI ACBM. 2) Damaged friable surfacing ACBM. 3) Significantly damaged friable surfacing ACBM. 4) Damaged or significantly damaged friable miscellaneous ACBM. 5) ACBM with potential for damage. 6) ACBM with potential for significant damage. 7) Any remaining friable ACBM or friable suspected ACBM. Response Actions Key: 1) Isolate area and restrict access. Remove ASAP. 2.) Continue O & M. Remove ASAP or repair and reduce potential for disturbance. 3) Continue O & M. Schedule removal when practical and cost-effective, or reduce disturbance. 4-5) Continue O & M. Schedule removal when practical and cost-effective, number indicates priority for removal. 6-7) Continue O & M. Take preventative measure to reduce disturbance. Number indicates priority for removal. 8) Continue O & M until major renovation or demolition requires removal under NESHAP, or until hazard assessment factors change. Preventative Measures & Cleans Key: A) Don not cut, sand, drill, abrade or disturb in any manner which may create dust. B) Additional wet cleans shall be performed by licensed workers whenever friable, visible debris present. C) Do not hang pictures or other items from ceiling tile or grid. D) Do not move or disturb ceiling tiles in a manner which may create dust. E) Sanding of floor tile or its mastic is prohibited. Stripping of finishes shall be conducted using low abrasion pads at speeds lower than 300 rpm and wet methods. Burnishing or dry buffing may be performed only on flooring which has sufficient finish so that the pad cannot contact the flooring material. F) Do not expose glue or mastic. Return To TOC
17 Section IV Materials Report and Bulk Sample Results Return To TOC New Materials Found During this Three Year Re-inspection Are Presumed or Assumed to contain Asbestos Until Removal under NESHAPS requires sampling.
18 Section V Response Actions Return To TOC
19 RESPONSE ACTION REPORT for UNIVERSITY HIGH SCHOOL DESIGNATOR DATE COMPLETED ROOM OR AREA MATERIAL REMOVED /19/02 IT Shop, heater valves /03/03 Room 230, heater valve /03/03 Laundry Room, ceiling water leak Abatement 11/26/03 1 st and 3 rd Flr Elev. Foyers Abatement 7/27/04 ME Space behind Rm 214 Abatement 7/27/04 ME Space behind Rm /08/04 ME Rm 120 for pipe hanger /30/04 Shop Room 108, Ceiling Abatement 06/05/05 ME Room above Rm 233B Abatement 06/05/05 ME Room above Rm 233B /22/05 Shop Office Room 112A Ceiling AMOUNT REMOVED TSI pipe 2 LF insulation TSI Fitting Cover 2 LF TSI Fitting Cover 2 LF 9 X 9 Floor Tile and mastic Spray on Fireproofing TSI Pipe Cover 150 SF 200 SF 50 SF TSI pipe 1 LF insulation TSI Fitting Cover 1 LF Spray on Fireproofing TSI Pipe Cover 200 LF 50 LF TSI Fitting Cover 1.5 LF 2/28/05 Shop Office Floor tile and 366 SF 112A Mastic /7/05 South ME Room TSI Fitting Cover 1.0 LF Closet /28/05 Shop Classroom TSI Fitting Cover 2.5 LF 108C Ceiling /18/05 MR Room 116A TSI Pipe Cover 1.0 LF /13/05 Room 110 TSI Pipe Cover 2.5 LF Ceiling Abatement 06/06 Hallway X 9 Tile and 1,400 SF Mastic Abatement 07/06 Hallway 125 & Stair 126E 9 X 9 Tile and Mastic 884 SF
20 Section VI Short Term Worker Acknowledgement Return To TOC
21 ASBESTOS NOTIFICATION and ACKNOWLEDGEMENT for SHORT TERM WORKERS AND MULTI-EMPLOYER WORKSITES This form must be signed before work commences Prior to be beginning work in an Illinois State University (ISU) building or facility the ISU Asbestos Program Coordinator (APC) will inform contractors and short term workers of the presence of asbestos containing materials (ACM) or presumed asbestos containing materials (PACM) which may disturbed during work activities. On multi-employer worksites the General Contractor (GC) is responsible for informing other employers or sub-contractors on the site the nature of the work may disturb ACM and/or PACM. The GC must implement measures to ensure those materials are not disturbed. In addition, a competent person must be on site who can take corrective action to stabilize an asbestos hazard using recognized industry standards with, asbestos trained and licensed personnel. ACM and/or PACM which are disturbed and create hazards shall be abated by the contractor who created the source of asbestos contamination. Any activities which disturb ACM must be reported to the ISU Project Manager and Asbestos Program Coordinator immediately. Contractor Certification: I was provided with adequate information regarding the presence and locations of ACM or PACM in and the work which I am performing may cause me to come in contact with ACM or PACM. Contractor Signature: Company Name: ISU Asbestos Program Coordinator: Signature Work being performed:
If the address on this form is different than the address of the building, submit a written explanation.
ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: SCHOOL ID NUMBER: SCHOOL NAME: ADDRESS OF SCHOOL:
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