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THE TEN-YEAR SAFETY SURVEY PROCESS23 Ill Adm. Code Part 180, Sections 180.310-180.340Licensed Design Professional or Architect/Engineer• Conducts on-site inspections• Prepares a safety survey report conforming to the requirements of Section 2-3.12 of the SchoolCode and including the following:a) A sketch map showing district boundaries and locations of all facilities.b) A sketch showing facilities on each site owned or used by the district for schoolpurposes.c) For each facility, either1) A certificate of compliance, if the survey revealed no violations of applicablerequirements; or2) A violation and recommendation schedule.• Checks the accuracy of the Safety Reference Plans. (Guidelines (page 3-9) and Sample 10-YearSurvey Report (page 3-12) per Section 180.310)• Verifies facility inventory records per Section 180.310• Makes corrections where necessaryLocal Board• Completes Form 35-86, the Application for Approval of Ten-Year Safety Survey Report (page 3-5).• Forwards application to the Regional Superintendent.NOTE: If the district seeks authorization to use fire prevention and safety funds for correctinghealth/life safety code violations on the ten-year safety survey, the amendment forms (Form 35-84, 35-48, and 35-76) must be approved by the regional and state superintendent to levy or sell bonds for fireprevention and safety funds.Regional Superintendent• Reviews the Application and Safety Survey Report for accuracy and completeness.a) Approves application and report if accurate and complete, orb) Notifies the board in writing of missing or deficient items.State Superintendent• Reviews the Safety Survey Report within 90 days for accuracy and completenessa) Issues a Certificate of Approval if accurate and complete, orb) Notifies the board in writing of missing or deficient items. Failure to submitaccurate and complete Safety Survey Reports as required shall subject a schooldistrict to recognition provisions Section 2-3.25• Reviews resubmitted Safety Survey Report for accuracy and completeness.a) Issues Certificate of Approval if accurate and complete, orb) Issues Notice of Disapproval if the district fails to correct errors or omissions, andreturns the report to the regional superintendent for return to the local board.3-3
CHAPTER 3FORMS AND DOCUMENTS• Application for Approval of Ten-Year Safety Survey Report -(Form 35-86) (3/04) (Page 3-5)• Certificate of Building Compliance (Form 35-40) (3/04) (Page 3-6)• Violation and Recommendation Schedule (Form 35-84) (3/04) (Page 3-7)• Instructions for Completing the Violation and Recommendation Schedule (Page 3-8)• Certificate of Approval of Safety Survey Report (Form 35-92) (3/04) (Page 3-19)• Notice of Incomplete Safety Survey Report (Form 35-94) (3/04) (Page 3-20)• Notice of Disapproval of Safety Survey Report (Form 35-98) (3/04) (Page 3-21)3-4
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Health/LifeEffectiveMarch 20042 nd
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FOREWORDThe information in this pub
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TABLE OF CONTENTSForeword----------
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• Application for Extension of Ti
Page 9 and 10: School Building Construction/Recons
Page 11 and 12: CHAPTER 1FORMS• Application for B
Page 13 and 14: Pre-Construction Plans and Specific
Page 15 and 16: Regional Superintendent’s Verific
Page 17 and 18: SCHOOL BUILDING PERMITREGIONAL OFFI
Page 19 and 20: ______________________________ COUN
Page 21 and 22: PARTIAL FACILITY OCCUPANCY RESTRICT
Page 23 and 24: Annual Building InspectionOverviewT
Page 25 and 26: CHAPTER 2FORMS• Notice of Annual
Page 27 and 28: HEALTH/LIFE SAFETY ANNUAL INSPECTIO
Page 29 and 30: Y N NA Boiler Room(s) 175 185 180 R
Page 31 and 32: Y N NA Music Practice Room 175 185
Page 33 and 34: HEALTH/LIFE SAFETY CHECKLIST/GLOSSA
Page 35 and 36: 23. Hold-Open Devices (185.370b11A;
Page 37 and 38: 52. Door Closers (185.390e2E; 185.3
Page 39 and 40: 72. Door Closers (185.380c10E; 185.
Page 41 and 42: GREENHOUSE121. Fire Detectors (185.
Page 43 and 44: 153. Hold-Open Devices (185.370b11A
Page 45 and 46: 185. Illuminated Exit Signs (185.37
Page 47 and 48: 228. Flammable Storage (185.370b4H;
Page 49 and 50: 263. Hold-Open Devices (185.370b11A
Page 51 and 52: 312. Door Closers (185.380c10E; 185
Page 53 and 54: GLOSSARYNUMBERLOCATION(i.e. Fire Ar
Page 55 and 56: Posted Occupancy NoticeNOTICEFOR YO
Page 57 and 58: REGIONAL SUPERINTENDENT’S ANNUAL
Page 59: OVERVIEW OF TEN-YEAR SURVEY PROCESS
Page 63 and 64: CERTIFICATE OF BUILDING COMPLIANCE(
Page 65 and 66: Form 35-84 (3/04)INSTRUCTIONS FOR C
Page 67 and 68: 5) Utility supply services (water,
Page 69 and 70: SAMPLE 10-YEAR SURVEY REPORT(To be
Page 71 and 72: paneling on stud walls with either
Page 73 and 74: water converter to heat these secti
Page 75 and 76: X. LEAD-BASED PAINT Peeling paint w
Page 77 and 78: NOTICE OF INCOMPLETE SAFETY SURVEY
Page 79 and 80: CHAPTER 4HEALTH/LIFE SAFETY AMENDME
Page 81 and 82: State Superintendent on the Approva
Page 83 and 84: Step #4The state superintendent che
Page 85 and 86: Procedures for Health/Life SafetyEm
Page 87 and 88: HEALTH/LIFE SAFETYCERTIFICATE OF AU
Page 89 and 90: Fire Prevention and Safety Funds--E
Page 91 and 92: CHAPTER 4FORMS AND DOCUMENTS• Eme
Page 93 and 94: CERTIFICATION OF NEED FOR FIRE PREV
Page 95 and 96: Instructions for CompletingSchedule
Page 97 and 98: Instructions for CompletingRecommen
Page 99 and 100: REGIONAL SUPERINTENDENT’S CERTIFI
Page 101 and 102: ORDER TO EFFECT COMPLIANCE WITH THE
Page 103 and 104: This application is to befilled out
Page 105 and 106: STATEMENT OF COMPLETION FORHEALTH/L
Page 107 and 108: REGIONAL OFFICE OF EDUCATIONAPPLICA
Page 109 and 110: Sample wording for notices of publi
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CHAPTER 5TEMPORARY FACILITIES• Te
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Temporary vs Permanent Facility Pro
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Application for Approval for Use of
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c c c 29. Is the insulation materia
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CHAPTER 6CONDEMNATION/DEMOLITION PR
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ORDER OF CONDEMNATIONDISTRICT NAME
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DISTRICT NAMEFACILITY NAMEAPPLICATI
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cccccc9. Removal of debris:Verify t
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Code InformationWhen are Part 180,
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Reference List of Codes for Public
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Asbestos Abatement for Public and P
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The Illinois Water Well and Pump In
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ARTICLE 14. CHILDREN WITH DISABILIT
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