Health & Life Safety Manual - Electronic Resource Center

REGIONAL SUPERINTENDENT’S ANNUAL REPORTfor fiscal year ending: ___________Regional Superintendent Assistant Superintendent County Name (s) Phone Number Fax NumberEach Regional Superintendent shall report annually to the State Board of Education on before October 1, summarizing all of the transactions relating tothe enforcement of Part 180 for the fiscal year ended on the preceding June 30. Please submit this completed form to School Business and SupportServices Division, 100 North 1 st Street, Springfield, IL 62777-0001.CONSTRUCTION ORFACILITY IDENTIFICATION“LIKE ACTIVITY” CERTIFICATES OF OCCUPANCY H/LS INSPECTIONS REQUESTS TO USE FP&S FUNDSDISTRICT NAMEFACILITY NAMEBUILDINGPERMITDATECOMPLETIONDATECERTIFICATETYPECERTIFICATEOFOCCUPANCYISSUE DATEANNUAL10-YEARAMENDNO.APPROVALDATE (ISBE)H/LS WORKSTATUSForm 35-75 (3/04) (Prescribed by ISBE for Regional Superintendent use) PAGE 1 of ______ 180.502-35