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District CitYSchool MountVernon SuPerintendent JudithJohnsonn NY 10553 MountVernon' Avenue, 165NorthColumbus 5,7017 December
School ) Inspected:Ceeil H. ParkerElementary
'.
IVE if the *at !? determine Act (AHERA) inspection Response HazafiEmergency ive of this Asbestos objective' this
il1":"idffirl"i"*.a
ProtectlonAgency (EPA)' The tment receiveda complaint from the united states Ernvironmental
cal l rece'yd"lLlt phone ithan w gi nated ori Y::l'"l*ll:: l#" T::l'L?:lli#*' off lbeen toseal used had that door """;t;;; rbiir"e ilH,f!}}fiffiffi;;ffi;;,fiil "ff"r;cioset rntaininsmaterialipaclassroomcloset.Uponinspection,itwasdetermiTl,tllllT5i*5tsj offto taped were closets rhe ctosets. i" the oJ*ie' &'!|ifi:?iiffi'dffi;ffiffi;;ffiil;'
andmoldissues. dueto moisture vernoncity schoolDistrictvia U's' mail on to thelVlount wasprovided r of AHERA inspection (see (NYsDoH) inspectors of Health er 5,20l2New YorkstaieD:partmen! on Decemb 13,2012. porrions school Parker
H. the cecil o.f ;ffi#:,ffiffiilffiil;;;;;".oJ*,,ui**. AHERA of the findings thepreliminary heldto review
ponferJnce was d anda closing
aud De1
asperAHERAregulations' thatmustbeaddressed theaudi'inspection during :ieswereidentified notethatall below'Please outlined are alongwith othJrobservations/recommendalions ficiencies exist' may otherdeficiencies therefore werenot inspected, tuilOingloJations Y OF FINDINGSAND RECOMMENDATION$ andthereis a lackof surveillance' managed pooily. (ACM)arebeing Materials Containing Asbestos *uitiiil" anaaOdrellaccordingly'n;riofic.s-11i:t]lT::.t: is to identifydamaged nse of surveitlance in
materialsthat exist Thereare damaged every6 monthsand this hasnoi beenf,erform"d,in"r, 2005' (2010) was not re-inspection The lasttriennial ;taing, which shouldbe a priority foi response. -emenf asbestosmanagement
are for thosespecific albove mentioned and recornmendlations observations ote that deficiencies, ft: tllat ris strongly recommended visited;however, 1Et,l"]3 i"-':^::ilreviewedand locations in rll LEA records improvements unA qnd observations recommendations uru tlium to matri
Report
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NYSDOH Corning Tower, Room 1325 Empire Stirte Plaza Albany, NY L2737
Dateof IruPectiion: Name of lndividual to Whom Notice is Given: Superintendent Judith Johtlson
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promulgated d regulations
Pen;on: Designated
-- 7/ge"/ Notincation:
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TheSummaryofob,"*usear.asofconcernattheear1iestpossibletime.Itisnot
Conlrol Act andregulations of the Toxic Substances intendedto bL a complerelist of p;bntial deviatiois fiom the requirements
apparent' readily those and/or concern of imme{iate conclitions a list of those but rather thereto,
hltlr: irvu'iv.epa.gov'rrestouu-4/alrera lintr to nHfRA guidancetools are locatedat the fQllowingEPA websiLte: 'l Name/Title of LEA Representative:
Kevin Malone, Section Chief
FOR DOCUMENTS
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ERA-Acronyms
il;i;;;" +!Py Asbestos-containiig H*il fi;;;; f fl*o-lsbesros r"orrrri.rTyeiil"i +|[A- American plan Managemenr lyl - Asbestos NySDoL puit'so rzN-ycnn llso u
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iation
regulations al Program
Luuo.J,J., program ccreditation ilYl*k - New N_YsDoH 'Health v*t "n,u", sr"ir"n purr*ili, yorkState n*O**r", liIlDOL - - New Labor york New " state rJd;;; ryYlED
inistration . +vourrrsu rrsoeslos_Uontaining Asbestos_ContaininE :i:l"r - rresumed M ial " Phase Contrasr tvticroscof;l9lrl polarized Light
I]?PA: HA - HomogeneousArea
*t'i:"ir, v:r
9*y
Report t of HestthAHERAAUdit/Inspection
information
Note: Sign-in
(whomay workers short-term with in tlhe school) ith asbestos ofACBM? thelocations
f* Yes 17 No
f N/A
teaghers. and |ir Yes f- No f N/A in writing pargnts. of the of theavailabilitv is provided Thenotification coPY of yearlyinrtheschool adated asrequired? Isthere calendar.
763.ea(a)(t)
trainingon the minimum asbestos awareness fqllowing topics: Information
effectso locations which they work, and location of usesand forms, health ing asbestos ACBM in eachschoolbuilding in the DP name ition of damage,
|7 Yes f- No
f N/A
Was thistraining
f* ves |7 No r* N/A a planfor Mustdevelop of training within60 days hire. f* Yes [- No 17N/A bY O&M is not conducted school employees.
it;
763.e2(a)(2) of ACBM in thedisturbance aativities that wil result where training, the of additional received applicable? Note:NYSDOL andcertification -t63.94(c)
Do the trai
the staffinclude
Datetraining Locationof train Numberof hours
.e2(aXl)
t of HealthAllERAAudit/Inspection Rerport
#24
#25
Did theinspector theACBM and t for classiffing written to beAIOMin theschool ACB assumed srirspected
blrildinginto one f the following categories?
I* Yes f* No |7 N/A
(l)
TSIACM. damaged
friable surfacingACM.
(s)
ACM. misc. friable darnaged icantly ial for damage. damage. ial for significant bleor suspectedlACBM. (763.90) for requirements Actions
'/63.93(eX2)
dbes befirre J2114/87, conducted For each include: tlle management 'llhe dateof the ton.
(i) (ii)
[* Yes [* No P N/A
A blueprint, schoolbuilding approximate or lpmogeneous forACII spmpled bulk where epllection. A copyofthe
and a analyses,
f- Yes l* No
of thework,and dat,es start completion involved, duringand uPon analyzed of anyai rBsults work. of completion to bemade requrired of A description before was identified qnder materialthat 763.88, $
14. I December quspected ACB
and signature, S
f- Yes [* No
la N/A
NewYork State
#37 763.85(bXr)
of all friableand Did theLEA conructa reinspecliotl school ACBM in each nonfiiableknownor assumed useasa own,or otlrerwise thattheylease, building p : least once everv three vears? building, school
l* Yes [- No 17N/A
#38
by anaccredited lF Yes [* No T N1A 763.85(bX2) Wereall reinspeconsconducted i;nthemanagement here signatures andare 763.e3(eX3Xi) inspector plan?
Signedbut not dated.
763.8s(bX3)
did not conduct The Ins;oector for re-inspection a thorourgh the 2010 triennial.
the under andreassesso reinspeci, Visually $ 763'88, ACBM? at;sumed or frfiable known all of condition
l* Yes F No f N1A
niraterial thatwaspreviously Visuallyinspect [- Yes F No T N/A to andtouchthematerial nonfrifible ACBM considered thelast since frriable it hasbecome whethdr determine or rein$pection? inspection has f* Yes f- No P- N/A with materialthat areas Identiffanyhomfgeneous or thelastinsperction friablesihce bpcome reinspection? (763,86 l* Yes [* No |7 NiA fur analysis andsubmit lectbulksamples Cof newly of area homogeneous for e[ch 763.8?) and to beACBM? assumed t$atis already friablematerial of thenewly under Assess, $ 7Ol.gt,thecondition l7 N/A arecollected, l* Yes [- No samples where iit areas material friable to thatareassumed in area,s andnewlyfriabl! materials ACBM? be of friable under Reassess, thecondition $ 763.88, identified? ACBM previously or assumld known l* Yes l* No P N/A
#43
(v)
#44
(vi)
NewYork StateDepa
Audi#InspectionR:eport t ofiHealth,AlflERA
#98
763.e4(g)
under activitY Foreach time thrt rnajorasbestos f- Yes [- No |7 N/A provide the JLEA did the 763.91{e) wasS rformed, person of each signature, md acmeditation name, dates performing thestartandcompletion thea rtivity, activity where,such of theactivity,th I locations the a descrptionandifACElM is removed, occurred, siteofthe ordisposal name andlocaticr ofstorage ACM?
notification requrired Note: NESHAPf procedures aftera Did theLEA usethedescribed of 3 (fallingor dislodging ;eepisode minorfiberrelea sq.ftllf or less)?
#99
763.er(fx|)
l- Yes f* No
17NiA
# l 0 r 763.94(h)
of each planinclud,e a record Doesthe manag(ment l- Yes l- No F N/A information: epit de with thefolkrwing fiber release
Date and locatio rofthe episode? Methodof repair) actiontaken? Preventivemeas re or response thework? Nameof eachpt sonperformin$
of the location anrd IfACBMis remved,thename anddisp salsiteof theACM? storage sl+";ltj:ifi#ffiffi&.s #102 763.95(a) 763.84(e) immediatelY label:i ch waryrine Did the LEA atta ACBM located f riable and nonfrizrble to any adjacent Inance areas? in routinemaintt l* Yes F No f NiA
on ACBM(Picture directly in is missing 4). Laloeling (picture 8). some areas
Some labels have been Placed
# t 0 3 763.e5(b)
ly visible readi
l* Yes f- No tr N/A
#104 763.95(c)
Doesthe warnin l labelread,in print whieh is readily visible in larges ze or bright colorr? CAUTION:ASI ESTOS.HAZATI.DOUS. DO NOT DISTI RB WITHOUT PROPER TRAININC AN ) EQUIPMENT.
F Yer; l- No T N/A
NewYorkState
#82
(by an collected 763.eo(ix2xi) Wereaggressive clearance air samples persor *ctions? accredited r)afterresponse
[- Yes [- No
|a N/A
#83
for PCM laboratory 763.e0(ixzxii) Did theLEA usem accredited (AIHA) or TEM NVLAP)air clearance sampling after a r sponse action? analysis
f- Yes [- No
l7 N/A
#84
763.e0(ix3)
763.eO(ix4) 763.e0(ix5)
lf., act rnsgreater thanll60sq;ft./260 Forresponse by TEM? werelJ air saml escollected andanalyled
l* Yes l- No
|7 N/A
#85 #86
ta NiA
to 160sq. Forresponse act rnsless thanor equal [* Yes l* No tu NiA j air $amples andanalyzed were collected ft.12601f.0 by PCM(Nlosl 7400)? Notefor NYSU L Part 56:was>2 LPMand>1200 literscollected? afterthe next for 3 y'ears Did theLEA retiin records all where rach area homogeneouts for reinspection rernoved? ACBM hasbeen
Did rhe LEA ma rtain recordsfor eachBrplrentive and resl onseaction taken for friable and nea.su-re ACBI I and friable and nonfriable suspected nonfriable ACBM assumed io be ACM including: l* Yes f- No |7 N/A or action, of tlhemeasure A detailedwritte r description includingmetho s used,the location wherethe for selectingthe or actio r was taken,reasons measure datesof the or actio r, start and complletion measure involved, of all r;ontractors work, namesant addresses and and if applicabletheir Stateof ac,oreditation, the and ifACIlM is removed, accreditationnur rbers. site of the or disposal nameand locitir n of storage ACM. collectingany The nameand si inature of any person the comPletion at air samplerequi :d to be collected the by $ 763.90(i), ie actionsspecified of certain resp"or of date where ampleswere colllected, locations of the laboratorY collection,the n; me and address the results analyzingthesa rples,the dateof analysis, and the narne t remethodof anallysis, of the analysis, and a analysis, performing fhe of the erson signature that th r laboratorymeetsthe aPPlicable statement of 763.e0(ix2xii), requirements
t-.Yes l-- No |a N/A
#87
763.94(a)
l* Yes [* lto
17N/A
763.e4(b)
#88
(l)
#89
(2\
#qs'
#66 #67 #68
763.92?f* Yes l- No F N/A A planfor ppfiod ic suwejll4ircq required under 's plannef A description of thernaJragement l* Yesr [* No |7 N/A recommendation under for additional cle4ning 763.91(c)(2), as1 rartof anoperatirlns andmaintenance program, andtheresponse of the l,EA to thatrecommenda :ion?
#69
763.93(eXl I)
of Doesthe manage mentplaninclud,e anevalu4tion actionso resourc.es neededto carry out response operationsand maintenance. and reinspections, periodicsurveillr nce and trainingll
[* Yesr f* No
17N/A
#70
763.e3(g(2)
a Did theLEA mai ntainin itsadministrativegffipe f" Yesr F No l* Nle plan for each complete, update d copy of a management Not updated/completeschoolunder its irdministrative or direction? control
Did each complete, that school,and office a f* Yesr Ii' No f N/A ntain in its admiqistrAtive plan for copy of the marnagement Not updated/complete. without cost or ke the plan available
#71 763.e3(eX3)
restriction as
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#72 #73 763.90(a)
in a time.ly acl;ions Did the LEA coriductresponse manne{consisteftwith assessmenits? Weretheseresp{nseactionssufficient to protect humanhealthandthe environment?
ffi
f* Yes f* No l* Yes [* No
|7 N/A |7 N/A
#7i ?63.r06t--
*-
| ) damage{ or.significantlydam4ged For(Category areaor TSl, did the LEA at leastreoairthedamaged all TSI and andmaintain material remove thedamriged andgndamaged in ari intac!state its covering condition?
f* Yes Fl No f N/A area storage TSI in custodial (pictures 4 and5)andin the neartheelevator basement (picture 7).
Report of HealthATIERAAudit/Inspection
#s3
bulk sufficient Did theLEA takeandhaveanalyzed to not assumed fromea$h area, samples homogeneous beasbestos?
[* Yes I- No l7 N/A
- upto 1000 sq.ft. 3 samples minimum - 100l-5000 sq.ft. 5 samples minimum >5000 sq.ft. 7 samples minimum TSI minimum 3 samples < 6 sq.ft. or lf. minimqm of patches I sample (2 rnin.) for fittings In a manner sufficient to determin,e (friable) M isc-el laneouS (2 min.) sufficient ln a manner to determino
(2 min.) ln a manner sufficientto determine
(bxl)
(bx3)
(c)
(d)
(bx2)
thefollowing include 763.87(d) andhas samples bulk the on ttJre analysis of 763.93(eX3Xiv) information in theplan to theDPfor inc;lusion it been submiued within30 days of theanalysis: collected l- Yes l- No F N/A samples of theanflysis of anybulk. Copies that laboratory of any N{meandaddress andanalyzed, laboratory any that bulk safnples, A statement analyzed accreditation used meets thealplicablelaboratory p0 of any Dates requirements of CFR$ 763.87(a),
perforniedand the nameand signatureof the analyses personperformifigeachanalysis
763.e2(b)(t)
in each periodic surveillangq DidtheLEA corfduct asa uses building thatit l$ases, owns, or otherwise to is assumed or ACIIM building contains school ihat onc.e everysix monjhs? ACBM dt lg3st contain Did theperson
visually management
[* Yer; |7 No f N/A since anY Therehaven'tbeen 2005andmanyarmissing priorto thatyear. l* Yes F No T N/A
763.e2(b)(2) 763.94(d)
periodic surveillance
that are iidentifiedin the asACBM, recordthe datqof the
surveillance, !i
conditionof the
DPfor i
lg!1rE:III F":rry.d"d
SUMMARYOF OBSERVATIONS
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requirements of theAHERAregulations areproperly implemented? 763.84(g)(2) on thehealth effects ofasbestos, detection, identification, andassessment ofACM, options for controllingACBM, asbestos managemenf programs andregulations conceming asbestosi in orderto properly perform his/her duties?
763.e3(e)@)
Does thernanagement plancontain thename, address, l- Yes [* No ta N/A andtelephone person number of the Desigmated and thecourse namen anddates andhours of training taken? Does theman4gement plancontain a trueandqgrrect state{nenl, by the individual clesignated peison, ^sjgneU whichcertifies rhanhegeneral LEA responsiUitities have been metor will bemet? Note:Statement should besigned by c.urrent Dp
[* Yes |7 No T N/A The "Consultantand LEA Information and Sign:off' providedin the 2010 rriennial doesnot comply with the expectations provided by the EPAfor an AHERA True and Coffect Slatement.
763.e3(e)( l0)
Inform workersand buildinq occupar[g.or their legal guardrans, aboutinqpections, reinsperctions, response actions, andpost,response actionactivities, inciuding periodicreinspections andsurveillance activitiesthai are plannedor in progress?
The2010re-inspection report discusses notification, buta desmiption of steps is not included. lrleed to develop anddefine procedures steps/ for notifications. f-- Yes Fi No f* N/A
763.e3(g(a)
763.84(c)
Have gplkpfs 4nd building occqpants, oG.i. f"gul l* Yes f- No guardians, beeninbrmed at leasi onei:eachschool ysalabout inspections, response actions,and post_ response actionactivities, includingprariodi c reinspection and surveillance activitiesthat are planned or in progress?
l"- N/A
# r 4 763.85(aX |)
DidtheLEA inspbct each school building.that they lease, own,or othprwise useasa school building before October 12,1988 to identify all locations of friable andnonfriable ACBM?
School building means: suitablr,. { l) Any structure tbr use asa classroom. including aschool fbcilitysuch asa laboratory library, school eating lacility,or fhcilityused lor thepreparation of'food.lflAny.gymnasium or otherfbcilitywhichis specially designed firr alhl,.tic or recrealional adtivities I'oranacadernig coum in physical (3) Any other cdu:ation. tacilityused t'ortheinstnfction or housing ofstudents or lor the administration of educatibnal or progrlms. (4) Ar,ly rnaintenance, storage, or utility lircility, leTar.qh including.any hallway, esscntial to rheoperatioiofany hiility d*cribed in thisdellnition of "schoot buitding"under poragnrphsi I ), (2):or (J). (5) Any.ponico or covered exterior (6) Anyexterior halluayor ualkr.ray. portion ofa mechanical rystem used to condition interior space.
763.85(a)(2)
12,1988, did theUEAinspect priorto these buildings useasa school building? If emergerncy use of an uninspected building wasnecessitatr;d, wasthe building inspected within30 days?
f* Yes f* No
Fr N/A
763.8s(aX3) tVas each inspectiqn conducted by anaccredited f- Yes l* No |7 NiA 763.e3(eX3Xi) inspector andis thgre a signature in themanagement
plan? #t7 763.85(a)(a)(i) Did the LEA visuallyinspect all arersto idgntiqv all_
locations of suspect materials, both I'riable and nonfriable,in eachschbolbuilding?
l- Yes l* No |7 N/A
[- Yes [- No F N/A
(A) (B)
Datedinspectionreportsignedby acr:redited inspector. Inventoryof the exqct locationsof the homogeneous areaswheresampleB werecollectedand datesthat samples werecolleoted.
f- Yes [* No f- Yes f- No
ls N/A l? N/A
(c)
(D)
Description of the rnanner usedto determine sampling f- Yes [-'No locations. List of whether the homogeneous areimidentifiedare surfacing material, thermalsysteminsulation, or miscellaneous material. Assessments madeof friablematerialis. f* Yes l* No
|7 N1A
|i' N/A
#23 (E)
f- Yes l* No
|7 N/A
#31 (i)
#33 (iii)
A description of themanner used to determine f- Yes l* No |7 N/A sampling locations, andthename andsignature of each accredited inspectqr collecti ples,-the ng sam State of accreditation, andif ippticuUle, tri, or her accreditation number.
A c:py of the analyses of any bulk sramples collected and analyzed, the nameand address ofany laboratory that analyzedbulk samples, a statement f- Yes [- No 17 N/A
#34
(iv)
tT,-,F meeis theappl icalble requirements lt9".ratory of 763.87(a) thed4te of analyiis, and thenarne and signature of theperpon performing theanalysis.
#35
(v)
A descriptionof assessments, requirdto be made l* Yes f* No under 763.88, of all ACBM and susprected ACBM to be ACI\,f,and the name,iignature, 11ume! Stateof accreditation, and if applicab,li, accreditation numberof eachaccredited pursonmaking the assessments.
lir N/A
#36 763.9e(a[7)
f_ Yes |7 No T N/A An exclusionary statement exists for a2002 abatement project. However,there does not appearto an exclusionarv statement for the parker Elementary additionthat wascompleted in ZOO7.
3:1i"
may be missing as
#45 l(A)
Dateof reinspection, name/signature/ accreditation of lnspector.al{uny changes in thecondition of known or |7 Yes l* No T N/A assumed ACBM? Exactlocation where samples werecollected, a man1e1 used ro determ inesamp Ii ng lXrf::r::f^1h1 rocatlons andthename/signature/ accreditation of inspector who collected simples?
f* Yes f- No F N/a
of FYes I No f N/A
763.e3(e)(3) (i)
A blueprint,.diaqram, or written description of each l* Yes |7 No f NiA scnoot Durtding thatidentifies clearlly to the information each location and According approxtmate squarp or linearfootage in rhe2010 of homogeneousprovided areas. wherematerial theZO04 wassampled im nCU, tfreexact trienniaf, reinspection wfereeach wasconducted butk,u*pt" *uu,of fr.i"d, dateof 9:lll." without buitding drawings/ homogqneous areas whercfriablesuspectedoragrams. :oj[:tjgn, ACBM is assumed spaces to beACM, *nO*frrrc nlnfriable should Functional beused to identiru suspected ACBM ipassumed to bel CM. locations asroomnumbers A des.cription of themanner used to determine locations,_ andname/signalrure/ accreditation f- Yes f- No |7 N/A :lTpl,.ng or me tnspector collecting samples? A copy,of theanalyses of anybulksarmples, thename andaddress f* Yes l- No F N/A of anylaboratory, a statemCnt ,1"j l meets the appl icablerequ iremenrs T:_ t$ratory of g 763.s7(a), rhedate of anaiysis, andtf,J # signature of theperson perform i ng'th".r"ili,"r*, f
Adescriptionof assessments under7ti3.gg, of all f* Yes [* No suspecred ACBM assumed to beACM, and l:-:lyl ilg rne.name/slgnature/ accreditationof eachinspector making assessments? |a N/A
can change.
M*t*
h*"**un'
763.e3(d)
ElleYe lpp an, *r;ffi ffi ^oj^ttf,! r,besta$ ur t ouffiffi y,* j::l r,^", H** own, orotherwise use as schoor [iliilirepi
Leemaintain ana.qpdate ''rr rr*8,*rr 3tl^* to Keep it current
F Yeb I- No r N/A
icsurieil rini,i i;ro.d;, Tl il*i:*, period rernspection, and response activiti es aJl*q"i*or
Inaccurate.
pt;;e;er,op,Ju, * *r.Jir"a
l7 Yes I- No
f N/A
Does rhe management ,t" r*rfl31,"rt,,J:;tir, F Yes f* No f N/A "f Manoicenffi'etherthe schoot bu ird ing 6a5ffiffi & ^;:ffi :lfr ,;ililT|Hil, and non-friabte suspeced ACBM assumed to be l3lf
.--..-.noesthe 1ugesemcItebn;;tai;hs resommendatio-ru made toltreliGjlilication agency f- Yes f- No |7 N/A regard ingresponse actions, ggid;'ihs under Ze;:.
763.e3(e)(s)
name, signature, State oru".r"Jituu._ person making the recommenoutionr, "iX.t, his unJjiroo,ari,., or heraccreditation number 2
::::lT"igactions? response
#63 763.93(e)(6)
Did a^Ir::raleT,ent olaqner rfire resutts of each {e.vie-w Inspectton,.reinspection, andissfimunt in o.O*,to f* Yes f". No l;| NIA in witing
l- Yes f* No
17 N/A
taken-r"r"^," ;; *:::::^rrrtr't5urss res ponse acr io n". o,*,t;;fr T:f#::'ffj :-.:'?, u, * and compretirs ;il;;;dffi
meas ure
f- Yes P No f N/A Floorplans do notindicate wnere ACBMcanbefound. j..l.J,lno:tdbeupdared using runctional
spaces/homogeneous areas.
763.e3(e{8)
#7s f763.e0(c)
ff;'!::[Te.ilffiffi:t,o,n" Iufr
{* Yed f- No |7 N/A
f* Yes P No
f N/A
notnecessary to protect human treaittr andthl envtronment AND remove thematerial in the functional spae or, depending ,prrn*t rtt enclosure or encapsulation wouldbesufucient ", human Kindergarten to p.oi..t closet mayneed health andtheenvironment, response enclosie or rnruprutut"f actionpending 5) ,friabte. surfacingACfrA, fSf eCfr4, f9r.lCategory misc. ACM that has poi",ii,,j "i roiouiuee, ti"fl: oio at leastimplemenr an opemtions and llre.L.EA matntenance (O&M) program?
results of sampling (pictures I and2)
Ceiling plaster in the boiler room ( picture 3) and water damage to plasterarounda window in the west stairwell (picture6)
I- Yes f* No ta N/A
6) friabte. surfr;i"slGM, TSIACM,; f91(cate_eory friabte misc. ACMthar has ooi.n?iui fo,,ie;nrun, damase, didtheLEA:
f- Yes l-- No
|7 N/A
envrronment.
areaandres*ict"d;ilf#,:Sf il:jfl1li,llfllT:,'h,
"Jrt *,f,""'
irnir"lr"nt lfLl"rll.^:^:ll-s unless other.response *" o.i"r,ii."i'i" p-"" c,o, "",ion" humanhealthand theenr
#79
763.90(e)
Were response actions,(otfr". I},*ESOIG ien.d by persons acmedited to design (projectDeiigner;and conduct response actions ?
Weremaintenance activities(otherrhanSSSD)
f- Yes f- No |a N/A
#80
763.9l(e)
763.eO(ix t)
persons acc red itedto a"s f- Yes l- No 17 N/A iln orion." :::ls:93. actions (project Designer) una if'p.oon. a_ccredited "onoui,'t?o to cond uct-response action s? At theconclusion of anyac_tion to removern.uprufu*, f* Yes f- No |7 N/A or enclose ACBM or material assumed to L" eCgM, wasthere a visgalinspectiuof each tin.tionur,pu.e where such action wa, conducted to d,ttermine whether theactionlrasbeen properly ,o*piet.,j'iirr"j'..t
Monitor)?
763.91(a)
Did the LEA develop andimplement anoperations and maintenance (O&M) planwhenever anyfiiableACBM is present or assurned to bepresent in a buildingthat the LEA leases, owns, or otherwise uses asa school building?
l* Yes F No f N/A
Someof the information provided in the O&M program is incorrect. This shouldbe updatedto reflect currentpractices,procedures, and regulations.
(b) 763.er
Did theLEAcomply with either theOSHAAsbesros [* Yes l* No 17N/A Construction Standard (29CFR 1926.110l) or the Asbestos Worker Protection Rule(40CFR763.120)? [- Yes l- No |7 NiA
763.e1(c)(2)
Did the management plannermake lvritten recommendations as to whetheraddiitional cleaningis neededo and ifso, the methods and firequency ofsuch cleaning?
l- Yes l- No |7 NiA
763.e4(e)
Foreach timethatcleaning under 76;3.91(c) was [- Yes [* No 17N/A performed, did theLEA record the name of each person performing thecleaning, therdate of such cleaning, thelocations cleaned, andthemethods used to perform such cleaning?
Did the LEA follow described procedures for all O&M I- Yes l- No |7 N/A activities? Note: NYSDOL part 56 requirements
763.9t(d)
763.94(f)
#97
763.90(g\ 763.9t(e)
For eachtime that operations and maintenance I* Yes [- No F N/A activitiesunder763.91(d) wereperfo,rmed, did the LEA recordthe nameof eachpersonperforming the acfivity, the start and completiondaters of the activity, the locations wheresuchactivity occurred, a description of the activity includingprreventive measures used,and ifACBM is removed, the nameand locationof storage or disposal site of theACM? Wereresponse actionsor maintenance activities f* Yes [- No |7 N/A conducted by persons
NewYork State.Department of HealthAlHERAAudit/J[nspection Report - CecllH. Parker Elernentarg INSPECTIONPICTURES $chosl- December 5r,Z$12
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and staffby district andbuilding Number of students plan developed reportandthe management plans- Initial inspection original rnspection/Management for eachschoolbuilding' at leasteverysix reports'conducted records- Periodicsurve:illance 6 month periodic surveillance months,in buildings that containACBM' 3year(triennial)re-inspections_Re-inspectionreporl;sfrominspectionsconductedeverythreeyears $ planner' by a certified inspector/management availability of management notificationsregar:ding Annual reporting/notifications copies of annual actions' Plansand any resPonse and custodialstaff 2- hour --Documentati'sn of maintenance Stafftraining records/listof personnel activitiesthat hc,urtrainin! for staffwho conduct training and any ,ooiri"r"ii+ awareness asbestos will result in disturbance' activities asbestos to oversee person_ The nameof the inclividualthat hasbeendesignated Designated and Jnsurecompliancewith AHERA requirements'
a 1,
thatthegeneral certifies tlhat person - Statement by thedesignated signed Trueandconect statement metor will be met' been t.tpo"tiuilitiesof theLEAhave by thedistrict' work completed - Documentation of anyabatement records abatement Asbestos