Title Page:

Document title, name and address of school facility, name and IDPH license number of the inspector and management planer, date of inspection and building owner name and address.

Policy Statement:

A policy or position statement should be included to define the position of the building owner and management planner.  This shall be signed by both parties.

Document Summary:

Prepared in accordance with guidance contained in 40 CFR 763.

Procedure for updating the document (response action completion, interim 6 month and annual surveys).

Responsible parties and certificates of documentation.

Table of Contents:

Sections and Appendices

Section I

General building description

General facility layout

History of asbestos detection and abatement efforts

Summary of the building inspection, including inspection protocol, number of samples collected, analytical protocol, quality control, and a listing of areas where ACM (Asbestos Containing Building Material) was identified.

Section II

ACBM functional characterization, assessment, and responses (each homogeneous functional area is addressed separately)

Narrative description

ACBM physical assessment

Hazard assessment

Response action determined

Health and Safety measures

Section III

Surveillance and Reinspection

6 month periodic surveillance, responsible personnel, tentative schedule, survey parameters, documentation provided

Three year reinspection, licensed inspector and management planner, tentative schedule, survey parameters, documentation provided

Section IV

Training

Mandatory 2 hours training session for maintenance and custodial personnel, responsible individuals, course content, tentative schedule

Optional additional 14 hours for personnel potentially coming into contact with ACMB, responsible individuals, course content documentation of training

Section V

Operation and maintenance (including a policy statement of the intent to integrate O & M with response actions, and that contractors will accomplish all cleaning, recleaning, patch and spot repairs, etc.)

Posting requirements

Contingency plan for minor fiber release episodes and major fiber release episodes

Asbestos coordinator responsibilities

Method of notification

Documentation

Appendix A

Bulk sample results

Appendix B

Response action documentation, including location of response action for each functional area, type of response action (e.g., removal, cleaning), names and addresses of all contractors, IDPH license I.D. numbers of all contractors, starting and completion dates of the work, results of pre-, during, and post-abatement air sampling data, type and quality of material involved, disposal, cost

Appendix C

Six month periodic surveillance records, including general description (visually surveyed for changes in material conditions), date of survey, and name of surveyor

Appendix D

Three year reinspection records, including name and IDPH license I.D. number, copies of the license and accreditation certifications of inspector and management planner, date of inspection, visual inspection summary assessment of material conditions (type and extent of damage, accessibility, etc.), record of any bulk samples collected with locations and analytical results.

Appendix E

Training documentation, including certificates of 2-hour training courses for custodial and maintenance personnel, name of person who conducted the training, and additional training certificates for asbestos worker training program

Appendix F

Management Plan availability, including copies of notices posted and dates of such posting