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Illinois Administrative Code (Last Updated: March 27, 2024) |
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TITLE77. PUBLIC HEALTH |
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PART855. ASBESTOS ABATEMENT FOR PUBLIC AND PRIVATE SCHOOLS AND COMMERCIAL AND PUBLIC BUILDINGS IN ILLINOIS |
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SUBPARTF. FINES, PENALTIES, ADMINISTRATIVE HEARINGS AND EMERGENCY STOP WORK ORDERS |
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Section855.APPENDIX B. Illustrations – Inspection and Management Plan Forms |
§855.ILLUSTRATION B. Inspection Report Form
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Category
Sample Area I.D.
Inspection Date
School I.D. #
School Name
School Address
City
State
Zip
Room(s)
Sample Numbers
Inspector Name(s) and I.D. #(s)
Location of Area:
Description of Material Sampled:
Friability:
High
Moderate
Low
Area Estimate:
Ft.
Water Damage:
Yes
No
Pipe Diameter:
In.
Physical Damage:
Heavy
Moderate
Low
None
Type of Wall:
Smooth Concrete
Gypsum Board
Textured Concrete
Masonry
Other
Type of Floor:
Concrete
Carpet
Tile
Wood
Other
Type of Ceiling:
Acoustic Tile
Exposed Structure
Textured Plaster
Accessibility:
Height of friable material from floor:
Ft.
Existence of barriers:
Suspended Ceiling
Other
Proximity to items requiring maintenance:
Electrical
Plumbing
Other
Less than 1 Ft.
More than 1 Ft.-Less than 5 Ft.
More than 5 Ft.
Ventilation Systems:
Vents near friable material:
Yes
No
Distance
Ft.
Return Grille
Supply Grille
Air Movement:
Heavy
Moderate
Low
Activity and Movement:
Use of Room:
Activity:
High
Moderate
Low
What is above the room?
What is adjacent to the room?
Comments: