Section 855.APPENDIX B   Illustrations – Inspection and Management Plan Forms

Section 855.ILLUSTRATION H   Protocol for Asbestos Management Plan

a)         The name and address of each school building and whether the school building contains friable ACBM, and friable and nonfriable suspected ACBM assumed to be ACBM.

b)         For each inspection conducted:

1)         The date of the inspection.

2)         A blueprint, diagram, or written description of each school building that identified clearly each location and approximate square or linear feet of any homogeneous or sampling area where material was sampled for ACBM, and, if possible, the exact locations where each bulk sample was collected, date of collection, homogeneous areas where nonfriable suspected ACBM is assumed to be ACBM.

3)         A copy of the analyses of any bulk samples, dates of analyses, and a copy of any other laboratory reports pertaining to the analyses.

4)         A description of any response actions or preventive measures taken to reduce asbestos exposure, including the names, addresses and IDPH license I.D. numbers of all contractors involved, start and completion dates of the work, and results of any air samples analyzed during and upon completion of the work.

5)         A description of assessment, required to be made under 40 CFR 763.88, of material that was identified as friable ACBM or friable suspected ACBM assumed to be ACBM, and the name, IDPH license I.D. number, signature and copies of accreditation certificates of the licensed inspector.

c)         For each inspection and reinspection conducted under 40 CFR 763.85:

1)         The date of the inspection or reinspection and the name, IDPH license I.D. number and signature of each licensed inspector performing the inspection or reinspection.

2)         A blueprint, diagram, or written description of each school building that identifies clearly each location and approximate square or linear feet of homogeneous areas where materials were sampled for ACBM, the exact location where each bulk sample was collected, date of collection, homogeneous areas where friable suspected ACBM is assumed to be ACBM, and where nonfriable suspected ACBM is assumed to be ACBM.

3)         A description of the manner used to determine sampling locations, and the name, IDPH license number and signature of each inspector collecting samples.

4)         A copy of the analyses of any bulk samples collected and analyzed, the name and address of any laboratory that analyzed bulk samples, a statement that the laboratory meets the applicable requirements of 40 CFR 763.87(a), the date of analysis, and the name and signature of the person performing the analysis.

5)         A description of assessments, required to be made under 40 CFR 763.88, of all ACBM and suspected ACBM assumed to be ACBM, and the name, IDPH license I.D. number, signature and accreditation certificates of the licensed inspector.

6)         The name, address, and telephone number of the person designated under 40 CFR 763.84 to ensure that the duties of the local education agency are carried out, and the course name, and dates and hours of training completed by that person to carry out the duties.

7)         The recommendations made to the local agency regarding response actions, under 40 CFR 763.88(d), the name, IDPH license I.D. number and signature of each person making the recommendations.

8)         A detailed description of preventive measures and response actions to be taken, including methods to be used, for any friable ACBM, the locations where such measures and action will be taken, reasons for selecting the response action or preventive measure and response action.

9)         With respect to the person or persons who inspected for ACBM and who will design or carry out response actions, except for operations and maintenance, the person(s) shall be licensed in accordance with Section 855.100 of this Part.

10)         A detailed description in the form of a blueprint, diagram, or in writing of any ACBM or suspected ACBM assumed to be ACBM which remains in the school once response actions are undertaken pursuant to 40 CFR 763.90.  This description shall be updated as response actions are completed.

11)         A plan for reinspection under 40 CFR 763.85, a plan for operations and maintenance activities under 40 CFR 763.91, and a plan for periodic surveillance under 40 CFR 763.92, a description of the recommendation made by the IDPH licensed management planner regarding additional cleaning under 40 CFR 763.91(c)(2) as part of an operations and maintenance program, and the response of the local education agency to that recommendation.

12)         A description of steps taken to inform workers and building occupants, or their legal guardians, about inspections, reinspections, response actions, and post-response action activities, including periodic reinspection and surveillance activities that are planned or in progress.

13)         An evaluation of the resources needed to complete response actions successfully and carry out reinspection, operations and maintenance activities, periodic surveillance and training.

14)         With respect to each consultant who contributed to the management plan, the name, IDPH license I.D. number, and signature of the consultant.

15)         A local education agency may require each management plan to contain a statement signed by a Department licensed management planner that such person has prepared or assisted in the preparation of such plan or has reviewed such plan, and that such plan is in compliance with Section 855.325 of this Part. Such statement may not be signed by a person who, in addition to preparing or assisting in preparing the management plan, also implements (or will implement) the management plan.