Chicago Public Schools 6 Month Surveillance 2015- Spring School: John W Garvy School Oracle Unit: 23301 Building ID: 3510 Address: 5225 N Oak Park Avenue Region: 01 Mail Room: 30 Surveyor: Zacarias, Mr. Charlie E X CHECK HERE IF NO CHANGE TO ASBESTOS Survey Date: 4/30/2015 Email Address: cezacarias@cps.edu A copy of the 2013/2014 notice to parents and staff regarding the asbestos management plan notifications was distributed via: Each child's backpack Notice printed in school's newsletter Notice printed in school's calendar X Other school web site HA No Description Location Change in Assessment 03 Acoustical Plaster 6000 SF Assembly Hall 1951 Surface Yes Loc 20 YES X NO 2014 - Fall: Deteriorated some plaster falling behind door stage left = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 1
HA No Description Location Change in Assessment 04 12"x12" Beige VFT 690 SF Computer Room 1937 Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 05 9"x9" Dark Brown VFT 20 SF Engineer's Bathroom 1937 Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 2
HA No Description Location Change in Assessment 08 12"x12" Beige VFT Mastic 690 SF Computer Room 1937 Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 09 9"x9" Dark Brown VFT Mastic 20 SF Engineer's Bathroom - 1937 Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 3
HA No Description Location Change in Assessment 10 12"x12" Tan VFT 2430 SF Room 101, 102, 103, 104, 201, 202, 204, 206, Main Office, Teacher's Lounge - 1951 Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 11 12"x12" Tan VFT Mastic 2430 SF Room 101, 102, 103, 104, 201, 202, 204, 206, Main Office, Teacher's Lounge - 1951 Miscellaneous No None 0 YES X NO 2014- Spring: Other main office entry abated, office and clerk area covered over 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 4
HA No Description Location Change in Assessment 13 12"x12" Blue/Gray VFT 2430 SF Room 101, 102, 103, 104, 105, 201, 202, 204, 206, Main Office, Teacher's Lounge - 1951 Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 14 12"x12" White w/ Tan Speckles VFT 5130 SF Room 109, 111, 1st & 2nd Floor Corridor - 1937 Miscellaneous No None 0 X YES NO 2013 - Fall: Other 109 111 no change. 2nd fl abated sept 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 5
HA No Description Location Change in Assessment 15 12"x12" White w/ Tan Specks VFT 5260 SF 1st & 2nd Floor Corridors, Room 203, Main Office Entrance - 1951 Miscellaneous No None 0 YES X NO 2014 - Fall: Abated corridors abated 2010 HA No Description Location Change in Assessment 16 12"x12" Brown VFT 895 SF Cafeteria (108/110), Cafeteria Office, Cafeteria Storage - 1937 Miscellaneous No None 0 YES X NO 2014 - Fall: Other cafeteria office and storage cover over years ago = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 6
HA No Description Location Change in Assessment 17 12"x12" White VFT 895 SF Cafeteria (108/110), Cafeteria Office, Cafeteria Storage - 1937 Miscellaneous No None 0 X YES NO 2013 - Fall: Other encapsulated with 3/8" plywood and retiled in kitchen and LRM office. 108/110 still intact 2014 - Fall: Other cafeteria office and storage cover over years ago HA No Description Location Change in Assessment 18 12"x12" Tan VFT 28 SF NE Gym Vestibule 1937 Miscellaneous No None 0 X YES NO 2013 - Fall: Abated abated sept 2011 with new addition to build 2014- Spring: Abated abated 2011 as written in past 2014 - Fall: Abated abated 2011 during addition of building = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 7
HA No Description Location Change in Assessment 19 12"x12" Blue/Gray VFT 28 SF NE Gym Vestibule 1937 Miscellaneous No None 0 X YES NO 2013 - Fall: Abated sept 2011 when we got new addition to building. 2014- Spring: Abated abated 2011 as written in past 2014 - Fall: Abated abated 2011 during addition of building HA No Description Location Change in Assessment 20 12"x12" Off White VFT 150 SF Engineer's Office 1937 Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 8
HA No Description Location Change in Assessment 21 12"x12" Blue/Gray VFT Mastic 2430 SF Room 101, 102, 103, 104, 201, 202, 204, 206, Main Office, Teacher's Lounge - 1951 Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 22 12"x12" White w/ Tan Specks VFT Mastic 5130 SF Room 109, 111, 1st & 2nd Floor Corridor - 1937 Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 9
HA No Description Location Change in Assessment 23 12"x12" White w/ Tan Specks VFT Mastic 5260 SF 1st & 2nd Floor Corridors, Room 203, Main Office Entrance - 1951 Miscellaneous No None 0 X YES NO 2013 - Fall: Abated all of these areas have been abated. 2014 - Fall: Abated corridors abated 2010 HA No Description Location Change in Assessment 24 12"x12" Brown VFT Mastic 895 SF Cafeteria (108/110), Cafeteria Office, Cafeteria Storage - 1937 Miscellaneous No None 0 YES X NO 2014 - Fall: Other cafeteria office and storage cover over years ago = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 10
HA No Description Location Change in Assessment 25 12"x12" White VFT Mastic 895 SF Cafeteria (108/110), Cafeteria Office, Cafeteria Storage - 1937 Miscellaneous No None 0 X YES NO 2013 - Fall: Other encapsulated with 3/8" plywood and retiled in kitchen and LRM office 2014 - Fall: Other cafeteria office and storage cover over years ago HA No Description Location Change in Assessment 26 12"x12" Tan VFT Mastic 28 SF NE Gym Vestibule 1937 Miscellaneous No None 0 X YES NO 2013 - Fall: Abated abated sept 2011 with new addition to buil 2014- Spring: Abated abated 2011 as written in past 2014 - Fall: Abated abated 2011 during addition of building = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 11
HA No Description Location Change in Assessment 27 12"x12" Blue/Gray VFT Mastic 28 SF NE Gym Vestibule 1937 Miscellaneous No None 0 X YES NO 2013 - Fall: Abated sept 2011 when we got new addition to building. 2014- Spring: Abated abated 2011 as written in past 2014 - Fall: Abated abated 2011 during addition of building HA No Description Location Change in Assessment 28 12"x12" Off White VFT Mastic 150 SF Engineer's Office - 1937 Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 12
HA No Description Location Change in Assessment 29 12 x 12 inch White w/tan Specks VFT 4000 SF Rooms: 201, 202, 204, Teacher's Lounge - 1951 Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 29 A 12 x 12 inch White w/tan Specks VFT Mastic 4000 SF Rooms: 201, 202, 204, Teacher's Lounge - 1951 Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 13
HA No Description Location Change in Assessment 30 12 x 12 inch White VFT 750 SF Room 109-1937 Building Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 30 A 12 x 12 inch White VFT Mastic 750 SF Room 109-1937 Building Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 14
HA No Description Location Change in Assessment 31 12"X12" White w/blue Gray Specks VFT 2500 SF 1st Floor Corridor Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 31A 12"X12" White w/blue Gray Specks VFT Mastic 2500 SF 1st Floor Corridor Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 15
HA No Description Location Change in Assessment 32 18"X18' Carpet Squares Mastic 450 SF Main Office Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 101 12" x 12" Gray with Dark Streaks VFT 500 SF First Floor Teachers Lounge, 1951 Building Miscellaneous No None 0 X YES NO 2013 - Fall: Abated abated 2002 now called rm 105a 2014- Spring: Abated abated due to water damage 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 16
HA No Description Location Change in Assessment 101 A 12" x 12" Gray with Dark Streaks VFT Mastic 500 SF First Floor Teachers Lounge, 1951 Building Miscellaneous No None 0 X YES NO 2013 - Fall: Abated abated 2002 now called rm 105a 2014- Spring: Abated abated due to water damage 2010 HA No Description Location Change in Assessment 102 12"x12" Off White w/ Tan Specks VFT 3000 SF Rooms 301-304, 301-304 Store Rooms, Sprinkler Room, Men's & Women's Toliets - 2000 Mobile Miscellaneous No None 0 X YES NO 2013 - Fall: Other mobile units removed early 2011 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 17
HA No Description Location Change in Assessment 103 12"x12" Off White w/ Tan Specks VFT Mastic 3000 SF Rooms 301-304, 301-304 Store Rooms, Sprinkler Room, Men's & Women's Toliets - 2000 Mobile Miscellaneous No None 0 X YES NO 2013 - Fall: Other mobile units removed early 2011 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 HA No Description Location Change in Assessment 104 2'x2' White Ceiling Tile 2013 - Fall: Other mobiles have been gone for 2.5 years 301-304 Rooms & Storage - 2000 Mobile Miscellaneous X YES NO 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 18
HA No Description Location Change in Assessment 105 Drywall Throughout - 2000 Mobile Miscellaneous X YES NO 2013 - Fall: Other mobiles have been gone for 2.5 years 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 HA No Description Location Change in Assessment 106 Drywall Joint Compound Throughout - 2000 Mobile X YES NO 2013 - Fall: Other mobiles ahev been gone for 2.5 years 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 19
HA No Description Location Change in Assessment 107 Vinyl Baseboard Throughout - 2000 Mobile X YES NO 2013 - Fall: Other mobiles ahev been gone for 2.5 years 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 HA No Description Location Change in Assessment 108 Vinyl Baseboard Mastic Throughout - 2000 Mobile X YES NO 2013 - Fall: Other mobiles ahev been gone for 2.5 years 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 20
HA No Description Location Change in Assessment 109 Textured Drywall Sprinkler Room, Men's & Women's Toliets - 2000 Mobile X YES NO 2013 - Fall: Other mobiles ahev been gone for 2.5 years 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 HA No Description Location Change in Assessment 110 Textured Drywall Joint Compound Sprinkler Room, Men's & Women's Toliets - 2000 Mobile X YES NO 2013 - Fall: Other mobiles ahev been gone for 2.5 years 2014- Spring: Other no longer have these rooms from mobile unit since 2010 2014 - Fall: Other mobile units removed 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 21
HA No Description Location Change in Assessment 111 12"x12" White with Black Specs Floor Tile 1900 SF 1st Floor: Corridor and Storage ROOM; 2ND Floor Corridor, Room 211 and 214 Miscellaneous No None 0 X YES NO 2013 - Fall: Abated 1st fl corridor abated 2009 storage no change,2nd fl corridor abated 2010, 211 and 214 abated during construction of addition in 2011. 2014- Spring: Abated abated corridor but not 211 2014 - Fall: Abated corridors abated 2010 HA No Description Location Change in Assessment 112 12"x12" White with Black Specs Floor Tile Mastic 1900 SF 1st Floor: Corridor and Storage Room; 2nd Floor Corridor, Room 211 and Room 214 Miscellaneous No None 0 X YES NO 2013 - Fall: Abated storage no change,all other areas have been abated, most recently because of new addition to building. rm 214(old) doesn't exist. 2014- Spring: Abated abated corridor but not 211 2014 - Fall: Abated corridors abated 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 22
HA No Description Location Change in Assessment 113 2'x2' Smooth White Ceiling Tile 675 SF 1st Floor: Corridor and Vestibule 106; 2nd Floor Corridor Miscellaneous Yes None 0 X YES NO 2013 - Fall: Other we have 2x4 ceiling tiles at 1st fl corridor. 106 is main office, no ceiling tiles, 2nd fl has painted ceilings, no tiles. is this for our school? these are all new to me. 2014- Spring: Abated abated corridor but not 106 HA No Description Location Change in Assessment 114 Beige Terrazzo 215 SF 1st Floor: Vestibule 106 Miscellaneous No None 0 YES X NO multicolored terrazzo = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 23
HA No Description Location Change in Assessment 115 Drywall 750 SF 2nd Floor: Corridor Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 116 Drywall Joint Compound 750 SF 2nd Floor: Corridor Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 24
HA No Description Location Change in Assessment 117 VFT 12 'X 12" White w/black specs 1800 SF Room 105, 2nd floor corridor Miscellaneous No None 0 X YES NO 2013 - Fall: Abated both areas tested neg and were abated sept 2010 2014 - Fall: Abated abated 2010 HA No Description Location Change in Assessment 118 VFT 12' X 12' White w/ black specs mastic 1800 SF Room 105, 2nd floor corridor Miscellaneous Yes None 0 X YES NO 2013 - Fall: Abated both areas tested neg and were abated sept 2010 2014 - Fall: Abated abated 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 25
HA No Description Location Change in Assessment 119 Fire Door 7 EA Room 205, Bookroom, Auditorium and gymnasium Miscellaneous No None 0 YES X NO HA No Description Location Change in Assessment 120 VFT 12' X 12" Red and Mastic 72 SF 2nd floor corridor Miscellaneous No None 0 X YES NO 2013 - Fall: Abated both areas tested neg and were abated sept 2010 = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 26
HA No Description Location Change in Assessment 121 VFT 12' X 12" Red and Mastic 72 SF 2nd floor corridor Miscellaneous No None 0 X YES NO 2013 - Fall: Abated both areas tested neg and were abated sept 2010 HA No Description Location Change in Assessment 122 VFT 12' X 12": Gray and Mastic 72 SF 2nd floor corridor Miscellaneous No None 0 X YES NO 2013 - Fall: Abated both areas tested neg and were abated sept 2010 abated years ago and noted on previous reports. = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 27
HA No Description Location Change in Assessment 123 VFT 12' X 12" Gray and Mastic 72 SF 2nd floor corridor Miscellaneous No None 0 X YES NO 2013 - Fall: Abated both areas tested neg and were abated sept 2010 2014- Spring: Abated abated years ago and noted on previous reports. HA No Description Location Change in Assessment 124 Curtain Wall 700 SF Gymnasium platform Miscellaneous No None 0 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 28
HA No Description Location Change in Assessment A Cardboard Pipe Insulation 430 LF All Unfinished Pipe Areas, Boiler Room, Engineer Storage, Janitor Room - 1937 TSI Yes Dist 40 YES X NO 2014 - Fall: Deteriorated appears to be separating at some places 2014- Spring: d water pipe burst and damaged 2 ft section. pieces fell to ground and were left. clamped leak. HA No Description Location Change in Assessment B MJP E/F/V on Cardboard Pipe Insulation 41 LF All Unfinished Pipe Areas, Boiler Room, Engineer Storage, Janitor Room - 1937 TSI Yes Dist 3 YES X NO 2014 - Fall: Deteriorated appears to be separating at some places = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 29
HA No Description Location Change in Assessment C MJP E/F/V on Fiberglass Pipe Insulation 30 LF Basement Storage Area by Electrical Room - 1937 TSI Yes None 0 YES X NO 2014 - Fall: Deteriorated appears to be separating at some places HA No Description Location Change in Assessment E Aircell Pipe Insulation 880 LF All Unfinished Pipe Areas, Boiler Room, Janitor Room, Tunnel, Engineer Storage - 1937 TSI Yes Dist 20 YES X NO 2014 - Fall: Deteriorated appears to be separating at some places = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 30
HA No Description Location Change in Assessment F MJP E/F/V on Aircell Pipe Insulation 136 LF All Unfinished Pipe Areas, Boiler Room, Janitor Room, Tunnel, Engineer Storage - 1937 TSI Yes Dist 5 YES X NO HA No Description Location Change in Assessment G Aircell Duct Covering 2400 SF Unexcavated Areas, Boiler Room - 1937 TSI Yes Dist 200 YES X NO = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 31
HA No Description Location Change in Assessment K Cardboard Pipe Insulation 450 LF Pump Room, Fan Room, All Unfinished Areas - 1951 TSI Yes Dist 30 YES X NO 2014 - Fall: Deteriorated humidity has damaged and some is hanging HA No Description Location Change in Assessment L MJP E/F/V on Cardboard Pipe Insulation 45 LF Pump Room, Fan Room, All Unfinished Areas - 1951 TSI Yes Dist 3 YES X NO 2014 - Fall: Deteriorated humidity has damaged and some is hanging = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 32
HA No Description Location Change in Assessment M Aircell Pipe Insulation 635 LF Pump Room, Fan Room, All Unfinished Areas - 1951 TSI Yes Dist 60 YES X NO 2014 - Fall: Deteriorated humidity has damaged and some is hanging HA No Description Location Change in Assessment N MJP E/F/V on Aircell Pipe Insulation 64 LF Pump Room, Fan Room, All Unfinished Areas - 1951 TSI Yes Dist 5 YES X NO 2014 - Fall: Deteriorated humidity has damaged and some is hanging = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 33
HA No Description Location Change in Assessment O Mag Block Pipe Insulation 35 LF Boiler Room - 1937 TSI Yes Dist 10 YES X NO HA No Description Location Change in Assessment P MJP E/F/V on Mag Block Pipe Insulation 8 LF Boiler Room - 1937 TSI Yes None 0 YES X NO 2014- Spring: Other had slight deterioration to jacket. wrapped with steel vent pipe and taped shut. area of old plenum. = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 34
ALL LEA Responsibilities, for this school, will be met. Lynn A.Crivello = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 35
NOTICE TO PARENTS AND STAFF REGARDING THE ASBESTOS MANAGEMENT PLAN NOTIFICATION School: Date: 4/20/2015 John W Garvy School This is to notify you in accordance with Illinois and Federal Regulations, that a copy of the Management Plan is available at each school during school hours by appointment. Requests to review the Management Plan must be made at least 24 hours in advance. Also please be advised that CPS conducts asbestos inspections of all Schools every three years. The last inspection was completed in 2013. surveillances are conducted every six months. CHECK ONE A copy of this notice was sent home in each child's backpack. A copy of this notice was printed in the school's newsletter and sent home with each child A copy of this notice was printed in the school's calendar and sent home with each child X Other. school web site A COPY OF THIS NOTICE MUST BE PLACED IN THE SCHOOL'S ASBESTOS MANAGEMENT PLAN. = Can be crumbled, pulverized, or reduced to powder by hand pressure. Page 36