Health & Life Safety Manual - Electronic Resource Center

ANNUAL INSPECTION REPORTTO: The Board of Education of __________________________, __________, _________________District Name District Number CountyPursuant to Section 3-14.21 of the School Code, and the provisions of the Health/Life Safety Code for PublicSchools (23 Illinois Administrative Code Part 180), I have conducted or caused to be conducted inspections ofyour schools and make the findings as listed below.FACILITY(Including Temporary)INSPECTIONDATESTATUS**StatusA=In Full Compliance (Attach Statement of Building Compliance Form 36-15)B=Ma king Acceptable ProgressC=Extension of Time Requested: Date Requested (Attach Application for Extension of Time Form 36-25)D=Non-ComplianceE=Continued Usage for Temporary FacilityA copy of this report is being forwarded to the State Board of Education pursuant to the provisions of Section 3-14.21 of the School Code of Illinois.____________________________________________ __________________________________________Typed Name of Regional Superintendent Date Signature of Regional SuperintendentForm 35-54 (3/04) (Prescribed by ISBE for Regional Superintendents)180.300 b2-33