MES Project Number: Asbestos Six-Month Periodic Survey October 2010 Washington Elementary School Lyndhurst, NJ Prepared For: Lyndhurst Board

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33 MES Project Number: Asbestos Six-Month Periodic Survey October 2010 Washington Elementary School Lyndhurst, NJ Prepared For: Lyndhurst Board of Education 420 Fern Avenue Lyndhurst, New Jersey Prepared By: McCabe Environmental Services L.L.C. 464 Valley Brook Avenue Lyndhurst, New Jersey October 13, 2010 Certified Women, Disadvantaged & Small Business Enterprise (WBE/DBE/SBE)

35 LYNDHURST PUBLIC SCHOOLS AHERA 6-MONTH PERIODIC SURVEILLANCE 1 Building: Washington Homogenous Location ACM Quantity Condition Response Quantity 6-Month Surveillance ID # Description Damaged Apr-09 Oct-09 Apr-10 Oct-10 Apr-11 BBL Boiler Room Boiler Insulation 150 sf good O & M none N/A N/A N/A N/A N/A Boiler replaced Dec , 2006 JT Boiler Room Joint/Seam Tape 10 sf good O & M none HVAC System joint/seam tape P-2 Storage Area Pipe Insulation (aircell) At ceiling, above electrical boxes and small storage area (duct tape drying out) 5 lf good O & M none N/A N/A N/A N/A N/A Removed during boiler replacement Dec , 2006 N/A N/A N/A N/A N/A Removed during boiler replacement Dec , 2006 FT-1, 1A Teacher's Room Mixed floor tile colors of dark, lt. green, tan and olive Two tiles at hallway damaged (18 square inches) FT-2, 2A Basement Room 12 9 x 9 green floor tile and mastic 9 x 9 gray/red floor tile and mastic 200 sf good O & M none 1500 sf good O & M none CTS Assumed ACM PL 2nd Floor Office & Store Room Throughout building Spline Ceiling Tile 300 sf good O & M none Non-ACM Non-ACM Non-ACM Non-ACM Non-ACM Sampled 12/30/2003 and determined to be non-asbestos containing material. Plaster N/D good O & M none Non-ACM Non-ACM Non-ACM Non-ACM Non-ACM Sampled 7/11/06 (Rms. 2,3,6,9,10,Teacher's,Custodial) and determined to be non-asbestos containing material. PL Basement Plaster N/D good O & M none Non-ACM Non-ACM Non-ACM Non-ACM Non-ACM M-1 Throughout building Slate Chalk Board N/D good O & M none Rooms 2,3 (covered by cork board),6,7,8,9,10 Sampled 12/30/03 and determined to be non-asbestos containing material M-2 Throughout building Assumed within walls. Recessed Radiator Insulation N/D good O & M none S-1 2nd Floor Troweled-on Ceiling 600 sf good O & M none

36 LYNDHURST PUBLIC SCHOOLS AHERA 6-MONTH PERIODIC SURVEILLANCE 2 Building: Washington Homogenous Location ACM Quantity Condition Response Quantity 6-Month Surveillance ID # Description Damaged Apr-09 Oct-09 Apr-10 Oct-10 Apr-11 PL Inaccessible Areas Plaster N/D good O & M none T-1 Basement Rm.12 Duct Insulation 80 sf good O & M none T-1 Basement Rear Storage Room 8" x 5" damage infront of storage room door. Duct Insulation 100 sf good O & M none M-1, 1A Basement Library M-2, 2A Basement Rm x 12 tan floor tile and mastic All purpose room FT installed summer 2010 (not indicated whether old FT was removed) Computer Room 12 x 12 white-grey floor tile and mastic 850 sf good O & M none 775 sf good O & M none M-3, 3A 1st Fl. Rm. 2 Bathroom 12 x 12 tan-brown floor tile and mastic 150 sf good O & M none M-3, 3A 1st Fl. Rm. 3 Bathroom No longer used by students; teacher storage 12 x 12 tan-brown floor tile and mastic 25 sf good O & M none M-1, 1A Grey 12 x 12 FT over original floor 1st Fl. Teacher's Rm. Bathroom 12 x 12 tan floor tile and mastic 25 sf good O & M none M-1, 1A 1st Fl. Principal's Bathroom 12 x 12 tan floor tile and mastic 35 sf good O & M none Carpet over tile M-4, 4A 2nd Fl. Rm. 8 New FT installed August x 12 wood pattern floor tile and mastic 875 sf good O & M none

37 LYNDHURST PUBLIC SCHOOLS AHERA 6-MONTH PERIODIC SURVEILLANCE 3 Building: Washington Homogenous Location ACM Quantity Condition Response Quantity 6-Month Surveillance ID # Description Damaged Apr-09 Oct-09 Apr-10 Oct-10 Apr-11 M-5, 5A 2nd Fl. Room 3 12 x 12 white-tan floor tile and mastic 875 sf good O & M none M-6, 6A 2nd Fl. Rm x 12 blue floor tile patch (25 sf) 12 x 12 dk. Grey floor tile and mastic 750 sf good O & M none M-4, 4A Rm. 7 closet 12 x 12 wood pattern floor tile and mastic 875 sf good O & M none M-3, 3A 2nd Fl. Storage CST Office 12 x 12 tan-brown floor tile and mastic 150 sf good O & M none M-7, 7A Throughout Stair thread and mastic N/D good O & M none M-8 Exterior Built-up roof insulation N/D good O & M none 3/23/2010 M-9 Exterior Caulk N/D good O & M none 3/23/2010

If the address on this form is different than the address of the building, submit a written explanation.

If the address on this form is different than the address of the building, submit a written explanation. ILLINOIS DEPARTMENT OF PUBLIC HEALTH AHERA THREE YEAR REINSPECTION ASBESTOS ABATEMENT PROGRAM SCHOOL INFORMATION FORM SECTION I NAME OF SCHOOL DISTRICT: CHICAGO SCHOOL DIST 299 SCHOOL ID NUMBER: 14-016-2990-0050