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Home My WebLink AboutPermit Demolition 2007-10-12 I Building/Combination Permit PERMIT NO: COM2007-01545 ISSUED: lQ112/2007 APPLIED: 10/12/2007 EXPIRES: 04/12/2008 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I CITY OF SPRINGFIELD - SITE ADDRESS: 1614 8TH ST ASSESSOR'S PARCEL NO.: 1703264202100 Springfield TYPE OF WORK: Site Work Only PROJECT DESCRIPTION: Demolition and sanitary cap TYPE OF USE: n~molition Residential Owner: SAMUEL RECINOS Address: 655 GOODPASTURE ISLAND RD # 16 EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type General Contractor BELFOR USA GROUP INC License 146973 BUILDING INFORMATION I # of Units: /\,.._,., ._ # of Stories: Primary Occupancy Group:.' ' i R:'3'f\/: 0, Height of Structure: Secondary Occupancy Group: '/ 'Ii 3, _r:~G.- O/li-(t>'e-of.H:-eat: . . -.' 'L't'['~d b JP -"IU1res Primary Construction Typ~ ii, . ~,<l:I:-VB-, ~nter \.,' Wa'tercrt'8l~A YO~ to - , ''1 9- " 0 . I .1r"<;:Q :'V'~lJn Utility Secondary Construction T~pe:, . 'y'- ,.'<:.- 07 -001 0 th-KllnglBs3EY~i # of Bedrooms: c~/iin au may obtain c'EI!e.J/gYJJ3.fl~~~et forth nUmb 9 ,the center (N ~iinUif~>> r{(lJ1.. nla er Or th^ ,.,' ate.. th", . _. es;;}' <Jenter is~v:E~QitM~~;J$-ciRMATION I - 4\),*4)~ I.. Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: N I PUBLIC IMPROVEMENTS I onCE- . THIS PERMIT S E;~~~: l~~~E~!~~~~~r~: D. Phone Number: 541-206-3288 Expiration Date 02/16/2009 Phone 541-726-9905 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Pal!e 1 of 2 Value Date Calculated Status Issued CITY OF SPRINGFIELD Building/Co'mbination Permit PERMIT NO: COM2007-01545 ISSUED: 101/12/2007 APPLIED: 10/12/2007 EXPIRES: 04/12/2008 VALUE: I 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project 'I Fees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Demolition Sanitary or Storm Sewer Cap Amount Paid Date Paid Receipt Number $10.00 10/12/07 2200700000000001579 $5.00 10/12/07 2200700000000001579 $8.00 10/12/07 2200VOOOOOOOOOO1579 $50.00 10/12/07 2200~00000000001579 $50.00 10/12/07 2200700000000001579 Total Amount Paid $123.00 I Plan Reviews I I To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will pe made the following work day. . L ReQuired Insoections I Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. Sanitary Sewer Cap: Capped within five (5) feet of the property line and capped with an approved material as required by the code. I I By signature, I state and agree, that I have carefully e~amined the completed application and do h~reby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all timesd~:t~I! lo!z/07 o~ntractors Signature Date Pal!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0 1545 COM2007-01545 COM2007-0 1545 COM2007-01545 COM2007-01545 Payments: Type of Payment Check cReceintl RECEIPT #: Description Demolition Sanitary or Storm Sewer Cap + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By BELFOR USA GROUP lNC ( ! City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001579 10:17:51AM Date: 10/12/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 50.00 50.00 5.00 8.00 10.00 $123.00 Amount Paid djb $123.00 $123.00 19031 In Person Payment Total: Page 1 of 1 10/12/2007 CITY OF SPRINGFIELD, OREGON SPRINGFIELD 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 - DEMOLITION PERMIT APPLICATION Address,/t/r ;J, ttisf Structure to be Demolished: 1'5 h ~ l1e ;J Job Number: CP~ ~oo., 0 I r ~ S- ~, JIk 1J ~t4 v The applicant is hereby notified that any redevelopment of the subject site must comply with all of the applicable laws, codes, ordinances, polices and plans in effect at the time the redevelopment proposal is accepted as complete for City review. This would include correction of substandard conditions associated with the present development. Examples of such corrections may include modification of inadequate drainage facilities; compliance with building set- backs from property lines; correction of substandard sidewalks and street improvements, including driveway width and placement; and other corrections which may be necessary to comply with existing development standards. \ T - .': ::" ~,I' l)rCO(,C."l !T'J r",r-juirf,s you to Furthermore, if an existing use is demolished!il.r qth~.t:Wi.s~ TemO~~~J1~dJ)t1lPtyhe development of the proposed use, thenithesyste.Hl.d_eve10,pmellt1@h~.:rg~GNdittfor the previously existing use shall expiretwo;"y-eatsJafterliliEhdaib~bKisSiham~eOO1t-he demolition permit or other removak6fthe 'pl'ewo1jlstjo'exfsti1l1Jgi 18:5e1f(!$f>rmgfIelp Municipal Code 3.416(1)). Cc.!:ii,g the center. (Note: the telephone number for the Oregon Utility Notification My signature below indicates that I have recQe~\lt\rertili1d~Aa4i?@~f!lbve conditions relating to the demolition of the above mentioned structure. \ \) ~--::: ;:r--. . ( ") tX /~. - ~ I Signature / - =-=-=-.- (17 //.2-/ d 7 Date ~~~~~~~6 ~~~~~ ~~~R~~~~~TEI~~~~ COMMENCED OR IS ABANDONED FOR . ANY 180 DAY PERIOD. ,~~ ~~ "t ~~ c;Iq:~ Q)]jf 8PRm~FIELID, ~@REG()l\r~~~:11~~,":":_,~", t" ~ .: "' l~ ~ >;.-. " " """ -- '"'" ;:- SPRINGFIELD 225 FIFTH STREET I> SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 '\ 1:.._ - DEMOLITION PERMIT APPLICATIONS Your demolition permit is currently being processed. There may be a slight delay, of up to 2 working days for small structures, due to the time required to review the history of the structure to determine if it needs to be documented before demolition, This documentation is for archival purposes only and will not affect th~ granting of the demolition permit, If the structure is very large or complicated the documentation process may take up to a maximum of 4 working days. ! Documentation will consist of photographing the building, taking measurements and making scaled drawings. The documentation will be undertaken by thk City at no cost to you, Documentation is being done on all structures dated prior to 1440 that may have historic importance to the City's development. J THIS DOCUMENTATION WILL NOT IMPEDE THE DEMOLITION :PROCESS. I I An age cut-off of 1940 was chosen because this is the date that the National Parks Service and The Springfield Development Code use to determine poterltial historic , 'fi ires yOU\to slgm lcance, T\O..... Oregon taw requ Ut'lih' ATTEN r... d b the Oregon I "1 ~ rules adopte y ~~e set torth If you would prefer to complete this fa ~~a\\~R~ffier.y1)nts@ ~M1I'ide the City with the following informationr ~~;;oni~t~ttffiH ~~i\flDlfh elevation, a floor plan with measure60~{HS1cumDaYJ~~~~~\\%i~p~gS with measurements, calling the cen~~~gon Utility Notification number tor th~iS 1_800-332-2344). Thank you for your patience. Cents ! j I grant the City of Springfield permission to enter my property to cOITlplete documentatiopyrior to the requested demolition offhe structure lodted at: ~ Address: /b/~ /iJv f{t}. S~. ..';!P ~ _ ~\\~~~~ J /. . ... ~\.\..~~ Vt.~~\~ ()~ Property Owner Signature: 1/ "."---- '. .. ~ ~~s:. \\\~ t f/ \ \S \"~\\\1.t.WU~'~ S ~~P\ - Job Number: (j::>/;CA"zoc7- 0,) ~~\~\('l~~ 0 ? C()~ ?,(J U~ \ ~~"{ '\ ::.. ,,' ,'- Asbestos Survey Report; 1614 North 8th Street Springfield, Oregon Performed by BELFOR Environmental fir' / \ /, " ,:/ I l, ( -. \ " Asbestos Surv:~y Report; 1614 North 8th Street I Springfie!!d, Oregon I. Summary " !, Ii I' On October 3, 2007 Casey Lewis (AHERA Inspector Numb~r 1017773) conducted an post-fire inspection for suspect building materials on!: the property located at 1614 North 8th Street, in Springfield, Oregon. The interiotr and exterior (, of the structure; a duplex with the left side fire demolished and Ithe right side severely smoke damaged, was inspected and samples of susd~ct asbestos containing building materials were taken. The samples were )~nalyzed for asbestos content using polarized light microscopy. In addition, thel quantities of asbestos containing building materials were estimated using)'! square foot measurements taken during the inspection for the purpose'~'of asbestos abatement declarations to LR~PA. Please see Table 2 for a list of sampled building materials. The building was unoccupied at the time of the survey and access to all previously occupied areas was given. In discussion with the orner, it was determined that. the structure was partially gutted by fire and haa outlived its usefulness. After abatement of popcorn ceiling material contaminatibn caused by the fire, and abatement of vinyl asbestos tile (Bottom Layer) in th~ entry ways, the duplex is to be demolished by mechanical means. Table 1 Sample ID Material Location Asbestos % Fri,ability ~ 2030-7 -001 Ceiling Ceiling and As 2% Chrysotile Friable . Texture Contamination I I ! 2030-7 -002 Vinyl Entry Way 2% Chrysotile No~-Friable Asbestos Floor Tile (Left Unit) ( '( II. Introduction Purpose: This survey is designed to uncover potential sources of asbestos c'ontamination from the demolition by mechanical means of the surveyed propert~; show good faith on the part of the property owner to comply with Federal and ID,regon State laws pertaining to the demolition of structures with asbestos contair ing building materials. I: Soecial Terms & Conditions: . Ii A post-fire inspection had been performed on the property (COmPlet~IY gutted left portion) prior to the October 3 survey to look for PACM in fire affected areas before restoration work was to commence. The last investigation w~s performed on October 3, 2007 and is a pre-demolition survey. After consililtations with BELFOR, the owner has decided to demolish the structure by mech~nical means with all costs to sample and analyze building materials being the re~ponsibility of owner. A minimum number of samples were taken to ensure full ~ccounting of suspect building materials while keeping sampling and analysis costs at an acceptable level to owner. III. Site Description Descriotion: . 1614North 8th Street Springfield, Oregon , I Property is a double family duplex composed of 12 rooms with approximately 1700 square feet of interior space each. The left portion of the~ duplex was destroyed by fire and the right portion left standing. ' IV. Environmental Records Review: No regulatory records were reviewed for this survey and no prior asbestos survey or environmental site assessment records exist for the property.; . v. Information from Site Survey and Owner Interview Initial information gathered from interview with owner was used to d~termine age of building materials used in structure. The structure dates to the 19:60's. The left unit was completely gutted by fire and the right unit was significantly damaged. All portions of both sides of the duplex that were not burned coh,pletely, I:, I k d d d. f II b d. I (bl . were severe y smo e amage an In u' measure, eyon reaSOrla e repair due to monetary and insurance considerations. VI. Sampling Methodology Objectives The objective of the survey was to determine the locations of buildir 9 materials which would be considered potentially asbestos containing (PACM) sample those materials and submit samples for asbestos analysis. . Asbestos SamDlina Plan Protocol .. '\ This survey was performed using a protocol adopted from the Asbestos Hazard Emergency Response Act (AHERA). The protocol is as follows: , 1. All areas in the structure were grouped into homogenous areas oased on use or sameness of building materials used in that area; e.g. Sheet~o:ck or paint encapsulated texture being from same manufacturing sources aqd; applied at same time, insulation having same manufacturer, roofing same' ~exture and aggregate, etc. 2. Each area was sampled for those materials which were suspect as PACM. I 3. When sampling, all samples were collected to the maximum eX~rnt possible (taken to substrate) to ensure all components were present in sample which might include asbestos. : 4. Sampling was performed by a Certified Building Inspector, and the use of proper equipment and procedures was followed to ensure accurate re1sults 5. Samples were numbered using sequential numbering system to ~nsure quality control and replication of results for further surveys if needed during q1emolition. \ Asbestos Laboratorv Analvsis All samples collected were analyzed in NVLAP Accredited laboratory (NVLAP Code 200794-0) using stereo light microscopy to prepare sampl~sl along with polarized light microscopy to petrologically analyze samples. The slamples were , .. I analyzed with dispersion staining methods in accordance with EPA method 600/R-93/116 as specified in 40CFR Chapter 1(7-1-93 edition) Part V~3, Subpart F, Appendix A, pages 499-504. Polarizing light microscopy can quantify asbestos . Ii 1 concentrations between 1 . and 100% detection levels. All levels below 1 % can only be stated as "trace". All asbestos concentrations in samples ar~ determined by visual estimation. For each sample, 3 separate slides were I: prepared to ensure accuracy and prior to analysis; blind quality control s$ nples were selected and analyzed to ensure accuracy in sample analysis. : VII. Regulatory Compliance :; '\ The intent of the asbestos survey is to comply with federal ana' state laws I pertaining to the release of asbestos from structure renovations or demolitions. Currently, the state of Oregon requires a full writtetj "good faith inspection" to determine the presence of friable and non-friallile asbestos containing building materials on all structures which are to be r~novated or demolished through any means mechanical or fire. This requHement was adopted by the Environmental Quality Commission (EQC) on January 25, 2002 and all related rules became effective on February 4, 2002. Duri~~ demolition work, it is the responsibility of the owner and any contractor$1 performing demolition work to make this survey document available to all concerned parties who may handle the building materials. The copy of the survey!~~eport must include documentation of all samples collected, locations of where the samples were collected, results of laboratory analysis and an evaluation of t~e materials to assess their condition (friable or non-friable). ) The survey is required to be performed in accordance with 40CFR 7~3.86. These federal standards require inspections to be conducted by an EP1 Accredited Building Inspector. The resulting survey must be given to the pr9perty owner within 30 days of completion of survey work. All survey work was~onducted in compliance with standards set forth in 40CFR 763.86. \ I VIII. Conclusions and Recommendations Removal of all asbestos-containing materials was completed on OcttJ,ber 5, 2007. All ACM will have been removed prior to demolition of any part ofl,the structure which might disturb these materials. During demolition, extreme c'ilLtion should be taken to ensure that in the event areas not able to be accesJed become accessible during demolition, they be looked at, sampled and ,[ ~nalyzed to determine presence of asbestos containing materials in them not previously sampled and listed on the survey report. II Asbestos Containina Material Dispositions By virtue of classification as asbestos-containing material (ACM), Vlrl,yl Asbestos Tile flooring in the entry way areas (Bottom Layer) and all popcorn geiling debris has been removed and the structure visually and analytically""c1eared via aggressive air sampling methods and Phase Contrast Microscopic a,~bestos fiber counting clearance method (NIOSH Method 7400). Asbestos Asbestos-containing' materials are required to be removed and jisposed of according to Oregon state DEQ and federal EPA/OSHA regulations prior to any renovation or demolition which would disturb these materials. ~regon state regulations require that any asbestos abatement performed on structilires is done so by accredited and licensed asbestos abatement contractors usi~@ accredfted a'nd trained employees. Single family dwellings where the ownefhccupant is removing asbestos-containing materials are exempt from abatement requirements but still subject to regulatory disposal restrictions set forth by Or~gon DEQ and local sanitary waste facility regulators. ' In Oregon state, .c1assification of any building material containing over 1 % asbestos by weight is the threshold over which any such mate'rial must be regulated as to removal, release to the environment, and disposal. ,) . :~ IX. Limitations: Asbestos surveys are non-comprehensive by nature and subj~d to many limitations including those presented below. While all previously occ1upied areas . I' of the structure were free to be sampled, areas behind walls and covered by structural members or materials requiring destructive means to ~(i;cess which could not be found with reasonable diligence were not sampled duM,g the initial survey. 'I This survey was not designed to identify all potential concerns or, eliminate all risks associated with asbestos or it's presence in the structure. Other risks were not evaluated with this survey. These include. risks such as 1) toxic and hazardous substances in (or in contact with); 2) risks askociated with structural, electrical or mechanical working of the structure; 3) risK~ associated ~ith ,radon. gas, slope stabi~ity, str~cture settleme~t, moisture, molal' air quality, Interior tOXIC substances, site drainage and flooding. have not been evaluated during this survey. No warranty, expressed or implied, is made. BELFOR Environmental performed this survey in accordance with ~the generally accepted standards of care that exist in the environmental industry in the state of Oregon at .the time of the survey. The asbestos survey was herformed in preparation for removal of asbestos-containing materials prior to :8emolition in accordance with NESHAPS regulations. This survey report isnotfintended for use as asbestos abatement plans, specifications, or management of risks associated with asbestos. No part of this survey is intended to;! be used as renovation, addition or demolition plans and specifications. The findings of this I survey report assume that adequate, professional plans and spec'ifications are prepared to renovate or demolish the structure. :'} ) ') .,I. ; :\ 09/14/2007 09:54 FAX 1541l 8898 P NORTml'E STHAZ~lA T [4]01 If . .. .~. . . . . . - . .. .. .. . . . . - . . . . .. .. . . ... . . . . . .. . . .'. . . - . - . -. --..... - .. -- . . . . .. .. . . . - . . . .. .. . . . .. . .. . . .. . .. .. ... . . .. . .. . -.. . . ; . . -. . . . . .. . , , . , , . '" ..,..,...........,;... - . - . -- .. --. .. - - . . _.. -.... ... FROM: TESC.1nc. . FRX .NO. : 1813<17391753 5e'I='~ . 14 2007 12:<'.I4PM PB NorthWest H:lZMat Inc. 36 West Q Street, Springfield, Oregoi19\.7477 .. , ,::'.1~SOO.597~1323 S41-988~9823 . .) '."~- . '. " b.In2.ilwWv.-.nWhazmat com c.;ru \ 1ft ~ I Asbestos ChaH~ of Custody. I .} Your Name: Project NameINumber:.' {<&.IIS\ 0' Company: (3 f ' ~, Project Location ~ ,f:, Ilf ~"1f:fT S~et; 5'i$1 :;;:HEjl;.... 'S.T Jf(t.,,,'--F{l!hl Bot. #: S~ln/' t-Ie,.k ..,1'{ purcl:l1l..5!e Order #: .~.~ :.3:'59<72 . Zip: . 91''177- ..:. . Date o~Sarnple Subml~Slon: 9 It ;'!r.JZ ContactPhoneIFaJJE-~~l Resul.ts to: fJ;:jc(l. .) . Telephone #: 7.::n q9 oj- Fax #: ? ~? -I ;) b 3 E-Mwl:' \. ~AR01JN])..r u;;.]cr 1.4 H;.rs"" . \ TIME 1_ ;~~sn . ~>. . O'ver 24 Houn Circle One Non-RUSH SAMPLE TYPE Cu.cle (ne: I A.lr C"",,,eft<' Bulk .~ J " 'q SAMPLE # 1 2 3 14 5 6 , UJ" .ddll1uaal plIgeJ /facllllld. Site Sampling Ag'en.t IOtber I J'l-M BULK SA:.IW'Lk. ) ,. Customer Signa l:ure:.. . . ._--..' . . I : By ~Ignlnllllh"..". 0QI1g:m0l" RlJfC';l' I' t'lIoyrnon~ mrnJn@Omantl> IWI,I<: prlOf 10 tcriin~ or lit lim~ Qfo:wnpl~ 311bmI5~i.uri for IeSllnl. ..- I VOL. AIR (1..) I AREA (SQ. IIIChll) , I II I I II I t\SBESTOS .ANAL YSIS TYPE Circle One: I Pt.1\! - ..HR I sAM!PLE DESCRIPTIONJLO~A TION C~'I (\ rot.., urrzt., t~." . .~(..ut'C.. . - I AIIERA Iris.pec tors Certification # \ ( I i I K..u~~ . DlIfIr nme .::llgnahlro ~ _'- __J~f7fi7l1 .. =. ..u:__ __ ._',-=-=._..",,,__..:!_~-_,,_..!l . . ~ I DE_~-.. . Tim. SJI~""'tv... . I 1~'-mJ.l.N-. IYllii~.~r---:-PJ~iTtu",__ _ "":=:JL --...-...--'r . ......,.-: m 11 , ).,"'\ If "b~"'d ;.L.;pJ ;".. .'n-homoK""eno. J. ~~.-;.-;:., "'.~:;;..m ~I" .r -4. ':mpo...~:t1t b. anlllYLed aad l1lUod Hi :iepll~ :attllayen. BeealUe of e~JuJpmelltfmea3Urllm~Qr limjt.atJo~~, 118DestQlJ fiber content will be unable to be ( eterJlllned In ROml! ~l!JQPlei. Tho,e &IImples detennmed to con.taln Ilsbe.stQ$ nbcr~. will have the rallowing mUl!I;UrelnllOt percentage ranges (1% .. (}.3%, 5% -1-510/0., 10% -i $-15%, 6\O.~ '" lo-:30o~1 50% ... 40-60%) BS t!Ifletiltl(d per EPA method 60OJR-9J/1l6. If sampleS orc not c:ollectlJd by Iln .A.HERA Aeeredlted I"'pee.tor, tben ,he llccUrucy of rcsult3 will be determIned by the method llugy and Bculty of th~ Bllmplo \:Qlledor. ' . NonhWB3( H=Mat Ina. 315 Wcst Q Street, Springfield, Orf!gon 97477 I-SOO-Jf;7-1JZl 54N)S8-9823 lJ11E;f~, nll'h=maf. r::vm ~. .J '] 09114/200i 09: 54 FAX 15419,889833 NORTHWESTHAZMAT IgJ02 r . . . . . _. . - - . . - . . . . . . . - - ,_ - . , - . . . - - . . : .. .. . , . - . - , - . . ~ . . , - . . . - . . . - I ." . - . - ",' . - . . . - . , . '_' . - . _ . . . . . . . - . . . . . . . . ~ .', . . . I . . . , I . . . . . . . . _ . . . _ . _ _ . .' _ . . _ _ _ _ _ FROM : TESC,lnc. FAX NO. :18047391753 ; Sep, 1,4 .2007 12: 4-4PM P7 -IRIA~_~~_~~IRONME~I~!-_~~~~~_~~ CENTE~. ."JNC~ I~S49 rU:J Cove CiI"de. Mosel4!y, VA 23121H608 r 1104-739-1'31 'fll.J:: !104-739~J753 . PUJ.l{ ASHRSTOS SAMPLE ANALYS1~ ~UMMARY CLillNT: NortllWS5t IIa7Mi!.r, It Ie:. 36 West Q Street Sprint,:l'ieltl. OR 97477 TESC LOOIN #: 070914G ) DA TB OF RECEIPT: 9/1412007 DAlE OF'1NALYSLS: 9/1412007 DAT~ Of' RF.PORT: 9/141:2007 . Cl.IENT JOB' #; ,Rccinos JOB srn~: 1614 8th St, ~I, .\NAT.Y5T: I NON ASBESTOS % FIBERS F. Jlan~ NON FIBROUS '% MA TERlALS I n:sc I SAMPLE # CLIENT SAMP~E lD & CROSS DESCRlr I ION ESTfMA TED % ASBESTOS I I C'JT1ly ~wdcr 2% ChrysotUe 9lJ"/O ',. 2A. 2.Tile' B\!Iige viTlyl 2 % Ch ry.ltltiltl ') 98% 28 2-M1I91ic / Black. adhesive NAn 2% Cellule :e , I 98% Toml SamplesILayers Analyzro: 3 ! ) ~l " , j '[ Sal11l'lc~ lIfC wl\Jyz~ irlllllcorcl4nc~ wifh "Intcrlr \ Ml.JlttUlJ fur the f)e~rmin;![jon of A3b~tlJ5 m BIlI~ '""Illation San.plc:o", EPN600fR-93-t 16. July 199:1 (EPA.(ifJOfM4.llZ-fl20, I)ez; 19~), or the currenL .IS FrA method for the lIl:11uy:lis Qro.~~~ In b\lllrJlna IJ1rueTilll. N.pne lXk;~: DO~ derected all..,. ~k,w 1.11", ,lel.ecLed limi1: ofmc:thad (Rr;porl.ing limit: 1 % A:ibcst(}~). GllL'IS fiher is Ilnalyz:~ for quality control blanK, ~msc recommenllS I.'Iy p<1lnt counl or Tr1lDsrni.ssion r:lectmn MlcroSllOPY ("[EM), [I;/f nJgtflrialr; n:~IL\ll;d by th..I3F A NESI 1M' (Nlrtiunlll Emi:3~o(\ SW\dlfrds for Haamlou5 Air I'ollubnls) nod found tD coutllin Les~ thl\Il !Crl ~n[ (<.10%) 3.'lb::sto~ by Pulllri>'.eJ J.lghf MlcrOseepy (PLM), H1I1l11lt!!f"\Iiecs 1!rI;'llvllllllbli: flIT Dll additional fe;;, This rerll;llt mllst not be reproduced c^(:cpl in full with appr )val ofTritlngle ~n vironmental Service O:;nter. Inc. Thls tc5~ r~rl n::1Hk.1 only 10 tbl) lcem{,,) leucd. . t [LEG~ND NAlj.,.No AsbcrrtoJ De~ted. Ullo.;Umoh:lJl11. JC=Joint CompcundJ -;pl. .'.~ 'I N VLA!' Ln.b Cud,,: 200794.11 Rl!'Viel\'od By Autllnrlzed Slga..lory< } -u~ JiClIl!::" MS SeniOr Cr:olpgcst, rwm"{J!""_~ DIroc/(I1" ) iu..,jon:g Fang. S(I,I/or Grrofogiifr Prid'lY,8epltlP1W 14,2007 P~I.,(1 J . "" "'~, J -( , ,:nm~0(0412007 10, 39 FAX 15419899833 NORTBI!ESTHA~~D9/2l107 0\: 27 1l!i33 P. 01l2~~: .t' .-.,.......... - ------. - -.. -.. u.... .... ,..,., ......... .',". u.. ..-. -,.... .-.....,. ... '. --.,' ..-... --....................., ,............... \........,.. ......................... ....." FROM : TESC. 1nc. FRX NO. : 1l3~47391753 Oc~. 04 2007 01: 47PM P2 I NorthWest HazMat Inc. ~6 westQ Street, Springfield, Oregon 97~77 1-800-597..1323 541~988.9823 lmD,i/wWw J'lytfll1Zl1Ult.com 1 / o+-I l),C) q. (< I Asbestos Chafh of c~. od~ YOUIName: (3z.1 ~ ProjectNam ber. f<e.et(\o,5")'", Company: Project Location: (, ll... N lt7t ~ l' Street: j~1 ;)'"H.lle..... ~. . ~ft.u,c~~ ~ A'1'11' Box #:SfRl1""l(' ~'U; ('''tl. Purchase Order #: S.:s .3~1 / Zip: 97., 77- - -' Date of Sample Submission: I;! I U I-:, I g 7' Contact PhoneIFaxIE-MEiil Results to: PaG(( .j Telephone #: 7.?[, . ~q or Fax #: :; '-0 - ~ ;J b:1 E-Mail: ,I J ~ ./ .... uANAROtlND . TIME UlIClC'l' :w 1l0VrG . RUSH CIrcle One Ollor 14 Houn Non-RUsH . SAMPLE TVPE Circle One: I AIr ClWetto Bulk Ofh.r ASnESTOSANALYSlS TYPE Circle One: , ,pq.(-~ I PLM BULK SAMF:LE I Customer SigOtnure: ' \. By sleninc Ilbcrn;, _mer ~ 10 .payment 8ftl1llPlcnllll!llKl. pri;r IG ll:Itinll Of'" ~ ;t'IIDIPIc: 5ubmlsJloII foi' IatinU. . I SAMPLE II I SAMPLE IliSCluPT10NILOCATION /' VOL. Am (L) I AllEA (sa.lJ1cbcsl 1 J o~~..~-l. ~"'_ I (t.,-,., ~ ' I I I I ~~~ ~-, I I fl I I I I" 1.1 I I I J j I Rdlllllul&lIa1 BY Date . l1mt S.lllAturt .4 ' . ,;, II~fflAIl:'~~',~-..ID_~. H HlJe> II ,,-~~. .11 ~ ___ ~ Tlme 'Slol>lIDtaJ'Cl I ~::Pt..-~: :...~~.::: ~::~-,:f.o...m~~:~~~,)':~...~. ~UJ be ;snal)'2l!d and bUled 8J separate I.ayel"l. BeeaQ!(! ofequlpmcDtlmclllu~D1eDt nmltad~jni ~!besto! Ober contebt will be unable to be detennfned in some samples. Those samples de~rmrned 10 contafri asbesto, fibers, wlll bne1he tollO,.,iilg measUremuot lIen:eatags ranges (1% .. ()..3%. 5%.. J.9%, 10% "= 5-1:5%. 20%" JO.30%, 50%-4l1-60"(o) as specified per EPA methpd flOO/R.93nlG. Ifnnnples are not wll"icted by an AHERA AlXlredll.d Inspector, th8D ~be IlccurJlCY of l'Uulu will be de1ermined by tbe methOdology and tltuit)' of tIIo 5JlmplG ~OnDc:tor, .2 3 4 S 6 Vie id<llllonJ papa II attdtd, Site Sampling Agent AHERA Inspectors Certifi-cation # NorthWest HazMatln(;. 36 weSt Q Sr1'eCl. Spring/161t1.0I'egofl 97-177 1-800-597-/321 S41-98a.9823 l11I2:/IwWIV. t1w.lJg;mar. CDm J:. J ~~ I .From: 10/09/2007 09:28 #533 P.003/004 , 10/04120 07 10' 39 F AI 15 41.88.8 3 3 NOR '.'0 STIlAZItAT \ Ii!l " 2" .... u..: --. . ...... ....... .. .. . u ... . .. .. .., ...... .. , . .. ....... . .. . . .. ............ . ... ....... ....... .............. u _.. .. ... . .. .. . ... \........................ .................,. FRor:J,,:;"I'~~.~n~.. FAX NO. : 18047391753 OC~. 04 ~(01;46PM Pl .J "j TRIANGLE ENVIRONMENTAL SERVICE CE~ l~.R.llNC. II I ~, r 1s..~9 FCl~ Clive Clrde' Mosetey~ VA 23Uo-l608 804-139-]751 . fI111104.'39.1753 JillLK ASBESWS ~F. ANALYSIS SUMMARY I TES(; J . BAMPU: Il CLIENT SAMPLE ID .&. GROSS DESCRIPTION I ESTIM..4.Tt:J)~ 0,{" ASBESTOS I TESC 1.00lN #; 01l004K DAn=.: OF JECHIPT; 10/412007 DATE Of' ANM.YSJS: IO/4f.2007 DATE Of RlwoRT: 10/412007 I ANALYST: F. Jiang I NON ASBESTOS % FleERs NON FiBROUS 0/0 MATElUALCO CLIENT: NonhWest.H~M:l1, Inc. 36 West Q Street Sprillgt1old, OR 97477 "CLlENTJORI.#: Recinflll JOlJ Sl'l,}!: 1614 ~ 8th lit.. I I While powdcl. brown fibers <1 % CbO'sotile 40% Cellu l(>~e (2.% Ch'1g(l~1e in JC) ._ 60"10 2 2 / Rllick rolr-tilee. b1tlck libers NAn 300A. CclJr.llose '.I 20% ~ellUlo.~~) 5% Synlbetio 70% 3 3 I Y cllllw Jino.. gJ1lY tibc1'5 NAJ) 7.5% Total SamplelllLay~n Analyzed: 3 <( I \ f Sam(llcsilLfe llIl:l.lyzc:din nccurdun~" wi!h "lllwltn Method for the Dclcrminlltion or .o.~"'Utll~ In ~ulk In~mlliLion Samples", EPA/6001R-9:1-116, July 1993 (EPA;-6001M"-ll2.0211, LIce 1982). orthe QJ[TCI\! US EPA mclhod for tho IIIlIll)'si.~ of llSDestos lJJ buildiJIg I1\IIkrilll. Non~ Dc:tCCfCd: nN deteCWd BJlttr bcl"w tbodCl'tQ(;l6d UJJ1i! or rnemCld (Repnrting limit: I % A.>~SlOS). c'ilass fiber is Bnllly-/.ed For qll~.Iity control bl4lllc. Tl'.~C rlX\OIl1ltleodS by point (."UUOL 01 Tr.mmU!$ion EIQ.,U'gn Microscopy (TEM).. for matmllls n:.l!:U1lLl<<l by the IcP A lIIESHAP (N!ltiun81 F.ml~slon Standartli,for H:v.8l\'lOIl~ Air PollullllIlS) and roulHI to comnin l'eas tnlltl to, pc=t (<l'OOIO) llSbcstos by rolariZ.od l.U:ht Mil,:(\l~<;Ul'Y (ll1.M). [Joth services lUlO IlvBiJahle for an additionlll fee. "Jbis tcpOf1 muitnot be rrProl.luc~ c:xccf1\ In Nil ;..-ith a.....v "Bl ~TMPJ1sle 1~11Vlronmcnbs.l Sc:rvice Cenrer. lue, Thi~ !CSL Te['orr~l'Clate~ olll)' L.. Ill", item(s) ~l6I1. lUviewud 81 Authorized SignAtory: lJ.fr.~n ~;~~C:~ ~"C._ F,mq Jlaflg. /.IS Scnio" r;HtJlrlgl.PI. .Laborarcry f)freclOr rll~dong Fang. Still/or ('reolo~' NVW1.Iib CO<N~ 100791.1) Th~,Il). OeIoIlo1' 04, 200'7 hF1mJ