Health & Life Safety Manual - Electronic Resource Center

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School District - Regional Office of EducationEMERGENCY HEALTH/LIFE SAFETY FUNDING REQUEST FORPRELIMINARY AUTHORIZATIONSchool Name and AddressDistrictCountyIn accordance with the Health/Life Safety Code for Public Schools (23 Ill. Adm. Code 180 - Section180.530 Emergency) an emergency situation exists that: (Please check the appropriatestatement(s)).CONDITION(S):c presents an imminent and continuing threat to the health and safety of students or otheroccupantsc requires complete or partial evacuation of the buildingc consumes one or more of the 5 emergency days or cause school to fall short of the minimumschool calendar requirements.Brief description of the nature of the emergency, how it correlates to the above conditions andthe interim measures to sustain operations: (Use additional sheets or attachments asnecessary.)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.FUNDING:c Fire Prevention and Safety Financing will be required to address the emergency.Signature of District Superintendent Fax Number DateSignature of Regional Superintendent Fax Number DateISBE USEONLYISBE Authorization to ProceedForm 35-95 (3/04) (Prescribed by ISBE for local board use)Datec Approvedc Disapproved180.530 b4-8
HEALTH/LIFE SAFETYCERTIFICATE OF AUTHORIZATIONFOR EMERGENCY PROCEDURESThe Illinois State Board of Education has received and reviewed the required documentation andhereby concurs that the condition described in the Health/Life Safety Preliminary EmergencyAuthorization Request constitutes an emergency classification for:SCHOOL NAME AND ADDRESSDISTRICTCOUNTYThe school district is authorized to initiate work to be financed with fire prevention and safetyfunds or funds loaned to the Fire Prevention and Safety Fund prior to the formal approval of suchwork through the normal process provided that:Proper application for use of fire prevention and safety funds will be initiated in atimely manner by the district (forms enclosed).The work undertaken shall, in all respects conform to the requirements of theHealth/Life Safety Code for Public Schools (23 Ill. Adm. Code 180).Final approval of the use of fire prevention and safety funds will be predicated onthe verification of the findings in the board resolution.Illinois State Board of Education SignatureDateForm 35-96 (3/04) (Prescribed by ISBE for ISBE use)180.530 b4-9
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Health/LifeEffectiveMarch 20042 nd
Page 3 and 4:
FOREWORDThe information in this pub
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TABLE OF CONTENTSForeword----------
Page 7 and 8:
• Application for Extension of Ti
Page 9 and 10:
School Building Construction/Recons
Page 11 and 12:
CHAPTER 1FORMS• Application for B
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Pre-Construction Plans and Specific
Page 15 and 16:
Regional Superintendent’s Verific
Page 17 and 18:
SCHOOL BUILDING PERMITREGIONAL OFFI
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______________________________ 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
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HEALTH/LIFE SAFETY ANNUAL INSPECTIO
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Y N NA Boiler Room(s) 175 185 180 R
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Y N NA Music Practice Room 175 185
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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 and 60: OVERVIEW OF TEN-YEAR SURVEY PROCESS
Page 61 and 62: CHAPTER 3FORMS AND DOCUMENTS• App
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: Procedures for Health/Life SafetyEm
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
Page 111 and 112: CHAPTER 5TEMPORARY FACILITIES• Te
Page 113 and 114: Temporary vs Permanent Facility Pro
Page 115 and 116: Application for Approval for Use of
Page 117 and 118: c c c 29. Is the insulation materia
Page 119 and 120: CHAPTER 6CONDEMNATION/DEMOLITION PR
Page 121 and 122: ORDER OF CONDEMNATIONDISTRICT NAME
Page 123 and 124: DISTRICT NAMEFACILITY NAMEAPPLICATI
Page 125 and 126: cccccc9. Removal of debris:Verify t
Page 127 and 128: Code InformationWhen are Part 180,
Page 129 and 130: Reference List of Codes for Public
Page 131 and 132: Asbestos Abatement for Public and P
Page 133 and 134: The Illinois Water Well and Pump In
Page 135 and 136: ARTICLE 14. CHILDREN WITH DISABILIT
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