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Home My WebLink AboutPermit Demolition 2008-11-26 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01713 ISSUED: 11/2612008 APPLIED: 11/2612008 EXPIRES: ' OS/2612009 VALUE: '225 Fifth Street, Springfield, OR 54],726-3753 Phone 54] -726-3676, Fax 54]-726-3769 Inspection Line SITE ADDRESS: 353 DEADMOND FERRY RD ASSESSOR'S PARCEL NO.: ]703]54003700 SPRlNGFIETYPE OF WORK: Single Family Residence TYPE OF USE: Demolition Residential PROJECT DESCRIPTION: Demolish existing residence Owner: Address: PEACEHEALTH PO BOX ]479 EUGENE OR 97440 I CONTRACTOR INFORMATION I Contractor, Type Contractor License Expiration Date Pnone BUILDING INFORMATION I VB # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: . Sprinkled Building: Lot Size: Sq Ft ] st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedroom,s: R-3 n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side] Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Disl: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING I Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amoun't Value Date Calculated Paee] of2 CITY OF SPRINGFIELD' Building/Combination Permit St.atus ., Issued ~75 Fifth Street, Springfield, OR ,,541-726-3753.Phone , 541-726-3676 Fax 541-726-3769 Inspection Line .,l' :,':-';,.. , PE,RMIT Nq:, CQ.M209H17.J~~" "'n ISSUED;., _: nI261~008" ,.,,: ,:, ,.;, APPLIED:' "11/2612008"- ><,.. ,'- ,,' EXPIRES: " ," o5ii6/i669 ,',. ,-,,~. -~, - VALUE: Total Valne of Project Fee.s Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee Demolition . Amount Paid Date Paid Receipt Number $5.20 $2.60 $52.00 11/26/08 1l/26/08 1l/26/08 3200800000000000767 3200800000000000767 3200800000000000767 Total Amount Paid $59.80 , I Plan Reviews ,I , -.~ :Nl-';:~>J. ,~>" :., "?"": r-'.~:, ~.:<).?,\{'~'. ;,<';,:: ,...., ..',. _"f' ." '< .' ..',' -~. . . '. v. .. - .. " -.r- <',r, To, Request'an i!lSpection call the 24:hour recording at 726-3769, ,AIlil)spections reque'stecj.':before 7:00 ~.<%,will b~Lr.nade the same working day, inspectionsrequested afte(7/9:9:,a:I1kw.ilI;~e,~~~:~-~t~~"f,o}lowing r.\.wor.k'lday.:;:..;<;;, .,~:::u.:':'.:..::.:.o.-~..;.;-~" ~.--.-. ;',...;-.~' ~-..l ',;'.:..~."'P~-~.l:'."'::!:~ " f~~.f'''';)'''' .' ;~. -I ..:~~_,: J- I $,if' . I 'Re(luiredlnsnectionsl _1111111111 T r . .:. .:':'"~' .. Demolition: After demolition is complete, sewer is capped or septic is pumped and filled aud inspection is requested and approved, and all debris is removed from the site. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all -infor~ation hereon is true and cO,freet, and I further certify that ,IOY 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 ofthe Community Services Division, Building Safety.. I further certifytlIat 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 t!'e front of the property, and the approved set of plans will remain on the site at all times d in o~str:cf;; ~. / L /7. loR ~ I.! O\~ner or Contra~tors Signature 0 Date.' . "/,' , l .r , .... .,.... '~"'" '," ,-., r.:I'. -..: .n ~. . " ,..,....... , . ~ ~ ....'... , Paee 2 of 2 225 FIFTH STREET - SPRINGFIELD, OR 97477 - PH:(541)726-3753 -FAX: (541)726-3689 ~~ DEMOLITION PERMIT APPLICATION Address: .Jr;--s ))UfJtwAJ.P F&Io/ /loA-D JIp(}l E- CO}v(.L6iJ g -V171 <., Structure to be Demolished: Job Nwnber: The applicant is,hereby notified that any redevelopment of the subject site must comply with all of the app]icable laws, codes, ordinances, polices and plans in effect at the time the redeve]opment proposal is accepted as comp]ete for City review. This wou]d include correction of sl1bstandard conditions associated with the present development. Examp]es of sl1ch corrections may include modification of inadeql1ate drainage facilities; compliance with building set- backs from property lines; correction of sl1bstandard sidewalks and street improvements, including driveway width and placement; and other corrections which may be necessary to comp]y with existing deve]opment standardS. Furthermore, if an existing use is demo]ished or otherwise removed prior to the development of the proposed use, then the system deve]opment charge credit for the previol1s]y existing I1se shall expire two years after the date of issuance of the demolition permit or other removal of the previously existing I1se. (Springfield Municipal Code 3-416(1)). My signature be]ow indicates that I have read and understand the above conditions relating to the demo]ition of the above mentioned structure. rritf~ Signature llIZf;7 /of I Date 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 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 the granting of the demolition permit: If the structure is very large or complicated,the c 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 the City at no cost to you. Documentation is being done on all structUres dated prior to 1940 that may have historic importance to the City's development. . THIS DOCUMENTATION WILL NOT IMPEDE THE DEMOLmON PROCESS. , 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 potential historic significance. If you would'prefer to complete this documentation yourself you must provide the . City with the following information: 1) black and white photographs of each elevation, a floor plan with measurements, and 2) a set of elevation drawings with measurements. . Thank you for your patience. ,Address: I grant the City of Springfield permission to enter my property to complete. , documentation prior to the requested demolition of the structure located at: 35'3' ])&H)MCW,_ ~ /&). ,Property Owner Signatur:: (~m . " ~ L'lY./ 26Je. - ,0/7/3 Date: Job Number: ItjU/o e I c ,. 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-01713 COM2008-01713 COM2008,O 1713 Payments: Type of Payment CreditCard cRcceintl RECEIPT #: Description Demolition + 5% Technology Fee + 10% Administrative Fee Paid By PHILIP T FARRINGTON City of Springfield Official Receipt Development Services Department Public Works Department 3200800000000000767 Date: 11/26/2008 Item Total: Check. Number Authorization Received By Batch Number Number How Received dim 007354 In Person Payment Tot~l: ~' Page 1 of 1 12:06:18PM Amount Due 52,00 2,60 5.20 . $59.80 Amount Paid $59,80 $59.80 11/26/2008 'j '\.. 1 DOUGLAS INTERNATIONAL PO Box 1524 Veneta, Oregon 97487 (541) 9359656 (541) 9356270 fax drdintlrmhotmail.com www.dintl.org Page 1 September 24, 2008 Peace Health Property Planning and Development Attn: Phillip Farrington Re: Pre-demolition asbestos survey, Main house, storage building and garage at 353 Deadmonds Ferry Road Springfield, Oregon. On September 5, 2008 an inspection and site survey for asbestos containing building materials was conducted at the above-mentioned address, From the homogeneous list of building materials established, Roofing, window glazing compound, ceiling and wall textures, drywall composites, plaster wall composites, ceiling tile and several flooring materials were sampled and analyzed by an independent laboratory, Schneider Laboratories. The results indicated that asbestos was present in the silver roof patch material on the North, South and Garage roofs, in several types of 9" X9':Jloor tile and associated mastics. - - --' --- ,- ,- , ' On September 16 - 22,200">. ,. _..', this investigation were prop. ,. - -;, ," - ru' - of Eugene, Oregon, The wa\- Z rr - ~ Lane County Solid Waste Di, . 1 ~ .,. 0 -. Wednesday September 24, :---1 _ ~1l' lWtJ \ \ I' L- '~Is found in ,., '3roup Inc. I -j of at the I In -"I -, - ..J I J 1 l. Page 2 All of the structures at this address, following this exercise, are considered ready for demolition pursuant to the rules specified in DEQ Division 340-248-0270 and LRAPA's Title 43-015-10-A&B regarding asbestos. All documentation from these activities and the credentials of those who performed them are on file at the offices of Douglas International Inc. If you or any of your associates have any questions regarding the activities described, please don't hesitate to call me at 541- 935-9656 or 541-954-4369. Thanks for your patronage, 7>. L..J. '" Douglas J. Moore, Inspector. '..~. ' \ " , Environmental Site Assessment (Limited) Peace Health Property & Planning Riverbend Site Development For structures at: 353 Deadmond Ferry Road Springfield, Oregon September 15, 2008 By; Douglas International Douglas J. Moore " s 'U ~\1 M A R Y .' September 15,2008 Page 1 Peace Health Property Planning & Development 123 International Way Springfield, Oregon 97477 Attn: Phillip Farrington Re: Peace Health's Riverbend Development Site, Springfield, Oregon House, storage room and garage at 353 Deadmonds Ferry Road Springfield, Oregon. On September 5, 2008 at your request, a pre-demolition site investigation for hazardous materials was conducted at the above mentioned sites pursuant to the requirements set forth in Oregon Department of Environmental Quality Division 268 and The Lane Regional Air Pollution Authority's Title 43. The buildings all consist of multi-layered flat roofs, wood framing constructed on slab foundations. A wide array of wood, gypsum and various floor coverings make up the interior. From this exercise bulk material samples were collected from 46 locations and submitted to Schneider Laboratories for analysis for asbestos content. The results indicated that asbestos was present in the silver roof patch material on the main house North, South and Garage roofs, in several types of 9" X 9" floor tile and associated mastics. As previously disclosed, all asbestos containing building materials discovered will need be properly abated by a licensed asbestos abatement contractor prior to the demolition of the structures. Page 2 All samples collected were done so by individuals with current EP A AHERA / ASHARA asbestos itispection credentials. Copies of these credentials are on file at the Eugene office of Douglas International Inc. If we can be of any further assistance please call me at the following numbers: Office Fax 541 9359656 541 935 6270 Mobile E:mail 5419544369 dintl@dintl.org Thanks again for the opportunity to assist you and your facility. P-f2\,M- -- Douglas 1. Moore R. E S U ---'--" T S "21st CenturY Environmental Solutions~ DOUGLAS INTERNATIONAL PO Box 1524 Veneta, Oregon 97487 (541) 935 9656 (541) 935 6270 fax www,dintl.ora dintJ@dintl.orq Bulk Summary Sheet - Asbestos Page 1 Client: Peace Health Property Planning and Development DINTl Job #:OBRB353DF PDA , Attention: Phillip Farrington Sample Date 9/5/2008 Project Name: 353 Deadmonds Feny ProjE~ct Address: 353 Deadmonds Feny Springfield, Oregon Sample# location Material Friable Threshold Percent Asbestos 353DF- 03 Roof South section Silver patch yes 1% 3% 353DF- 09 Roof North section Silver patch yes 1% 3% 353DF- 13 S Dining room Floor tile Tan layer 1- 9" X 9" VAT no 1% 4% layer 2- mastic no 1% 5% 353DF- 14 S Dining room Floor tile Green layer 1- 9" X 9" VAT no 1% 5% layer 2- mastic no 1% 5% 353DF- 15 Kitchen Floor tile It, Green layer 1, 9" X 9" VAT no 1% 4% layer 2- mastic no 1% 4% 353DF- 16 Kitchen Floor tile Beige speckled' layer 1.. 9" X 9" VAT no 1% 4% layer 2,mastic no 1% 3% 353DF- 19 Center section Floor tile Lt, Green East entry layer 1- 9" X 9" VAT no 1% 4% layer 2, mastic no 1% 3% 353DF- 23 Center section Floor tile Tan bathroom layer 1,9" X 9" VAT no 1% 4% layer 2- mastic no 1% 3% 353DF- 29 Center section Floor tile Red hall closet layer 1, 9" X 9" VAT no 1% 5% layer 2- mastic no 1% 2% 353DF, 30 North section Floor tile Beige NE bedroom layer 1- 9" X 9" VAT no 1% 5% layer 2- mastic no 1% 2% 353DF- 31 North section Floor tile Dark Red NE bedroom layer 1- 9" X 9" VAT no 1% 5% layer 2- mastic no 1% 2% 353DF- 32 North section Floor tile Tan center bedroom layer 1, 9" X 9" VAT no 1% 5% layer 2- mastic no 1% 2% Quantity: Twenty two (22) Sampled By: Doug Moore Sample Analysis Type: Polarized light Microscopy ...~. .i';353t$iTEi~Jc2.{i . ,~. ':'::-:""""'--'-"-:iJ,< ~tile u ng~r"Misj)t '. -. '.,:., ..\"...... - ,,;.<:: .....:;"," . -' '~'I"" I""' :,-.... '.' " , "' "~ .-i.". ~~(\' - ,;:'X,~_~_~ I ~ '.,' . "':"',,,"',' --,- .. .. 'f;.'. ; :~;i.?:~/:/~ .' ;':"'-". 353DF - 2B ..'".. ;' 353DF - 30 Beige tit "21 sf Centurv Environmental Solutions': DOUGLAS INTERNATIONAL PO Box 1524 Veneta, Oregon 97487 (541) 935 9656 (541) 9356270 fax www.dintl.ara dint/@dintl.ora Bulk Summary Sheet - Non-Asbestos Client: Peace Health Property Planning and Development Attention: Phillip Farrington Project Name: 353 Deadmonds Ferry Project Address: 353 Deadmonds Ferry Springfield, Oregon DINTL Job #:08RB353DF PDA Sample Date 9/512008 Sample# Location Material Friable Threshold Percent Asbestos 353DF - 01 Storage bldg. Roofing layer 1 rolled roofing 00 1% None layer 2 fe" 00 1% None 353DF - 02 Storage West window glazing yes 1% None 353DF ,05 South section Roofing (5 layers) BUR no 1% None 353DF - 06 Ctr, Section skylghl Sealant (gray) 00 1% None 3S3DF - 07 Center section Roof comp, (3 layers) BUR 00 1% None 353DF - 08 North section Roof (rolled) no 1% None 353DF -10 Garage Fe" behind siding 00 1% None 353DF - tl Kitchen Ceiling drywall system yes 1% None 353DF,12 Kitchen vinyl shelf liner yes 1% None 353DF-17 Kitchen flX..II below floor tile yes 1% None 353DF -18 East enlry 1" X 1" ceiling tile yes 1% None 353DF - 20 firnace room Ceiling / wall board yes 1% None 353DF ' 21 Glr. Section bathroom Ceiling / Wall drywall system layer 1 drywall yes 1% None layer 21exture yes 1% None 353DF ' 22 Glr. Section E bathroom Sheet vinyl flooring yes 1% None layer 1 vinyl yes 1% None layer 2 adhesive yes 1% None 353DF - 24 elr. Section living room Wall / drywall system layer 1 drywall yes 1% None layer 2 mud yes 1% None layer 3 texture yes 1% None 353DF ' 25 Clr. Section hallway Ceiling I Wall drywall system layer 1 drywall yes 1% None layer 2 texture yes 1% None 353DF ' 26 elr. Section living room 1'Z' X 1'Z' Roortile layer 1 tile no 1% None layer 2 mastic 00 1% None 3S3DF - 27 etr. Section main bathroom 9" X 9'" floor tile layer llile no 1% None layer 2 mastic no 1% None Quantity: Twenty seven (27) Sampled By: Doug Moore Sample Analysis Type: Polarized Ligjhl Microscopy Relinquished By: Doug Moore Date I Time: 09/612008 1600 Turn Around Requested: 24 hour Anallzed By: Schneider Labs Results To: Doug Moore dinl/@dinl/,org ,.'.," ",:' i ';<"';';.~i;i;.'J~:::;'-).:<;3;5aDf:~~;j1{1?h ;~;~ Ctrt~~;l <~~,~"y , 353DF - 21 I ~ ~:f/;~<."< . ~i-~~, ,; i~:;~;%> ' ~~); .> .' ,;:' . :.'~~.: '35aD~;" ,. ,'. '. . '~~~12;ii;I' ",,". .^ ~" t,i.' - 'i';l;. ,'.;::.~ -' ."-~"::4', , ',t:it~1;~..> .-;,i1t,~:I\ ;~, ;-'!.i'tf South view ~"'nl"'::lur::n L~IjVn~ I Uklt:S, l!'fl,,;. /S Li 2512 West Cary Street, Richmond, Virginia 23220-5117 ~ .___. 804-353-6778' 800-78S-LABS (5227)' Fax 804-359-1475 _ ~.slabinc.~m e-mail: info(ii!sl~.com ~rOject Name: ~A~ \-l c;... LT(.l. Il.l \J l:::A ~ peciaJ Instructions [include requests for special reporting or data packages} rojectLO<:ation: ~?3. b&.OMo"'/)~ ~~. ~..<l (L ~C)'-r, .,..", 4r...-1-I:.O c:ll'&-{. 0...."1 'rojectNumber: R.tnS"5t:-r' P~Jo\ t:..q ~u~ I " . TO -,. "', .. __.. ."... urchase Order No.: IIsTA~~H~~~S~p'LESWE'RE CO~CTeo-, ~R.GG;c:::UU . "Tf',tl/iDf' ." .. "';S1!.'9iJ;i'~f~TJili1iiOliic* ' JSamedar*. AI~~mplesonfonnshouJdbeolSAAfE. _... ..., ;:> 1 businesS'day' malri'~,U"_formsa.n.Oded. /-IPCM(lIIrOSH7400) fEn ..._,... [.... . J 2 buslne.. days'. ' .) Air ( J Sol" I FEM{AHERA) " 1 PUt (EPA _ Count) 1 RCRA Metats J3businessdays' I Aoueous I JWaste /f,ITEM(EPALeVelll) , JPLM(CuaJit>tiveonly) I , jSTANOARD(5bu,;.day')ulk (JWastowat", I:.!.c. , I NYE1AP 198.11.41.6 ___'___ i. l::::::::~~~) I !f:::~' ii~~i~~~"'ti~~:~g;:~l Sd_ul.,,,-h~.... ISludge [J JSilica-XRD(NIOSH75:00) lYPE OF RESPIRATOR r . ..' i'" "..,....-.kflOd,...InMlrwrc.. I Soil u- _ __~~ .~ .. USED:. J r Organl.. . Wi.... InforrilalIon I.". AIr Sam".... . O....n'.. . .,' '~f~"~ ~:~';~- .:::-i. ,,::;;' ~r- ':-I~ 1~~I:='I. 11'11' 02- I" I" I~~~G~LO(" I I I I I I I I t I I I.' 'J "3 I ~I I" 1~~hL~~ I I I I I I I I ~. I ~,II r ot.{ I u I"IL<I~~~~/ ~O\C\-l I 1111 I I I ~'II' j 105 I" I " f~~'~L~'I'"~ I r I If I I I ~...' ILt I 0<0 I .' I.' 1~&qt~1~~ I I I I I I II ~I II. I I 07 I" I.f I~~~_~ P..~~c.. I I I I I I I ~. I 1'/ II /, I ~~:: :< I~;~~I I I II I I I ! 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Ckl-l fA LTl-l. /l.l\Jf::;A@,~iallns, tructions{includerequests fo.rspeCJ,'a.lrepO,rting or data p,acka~esJ lr' n' ~c 'C, ProjeclLoca6on: '~~3. t>60..0Mo....t>So. ...~'-( I' (.;;.M.,<lfL ~()L:r, """ d(....-t-I~ dctd-(. or, .. J'H-9"'r9o~'" rojectNumber: R:~)S~t>rr t't:>.>\ --II l;v<j 'J. ~ULT, TC f# ,.. , urchase Order No.: l,STATE WHERE SAMPLES WERE COLLECTED_, OR.GG;.c;:>t\.J . ~1-935-6270) L TumAroundr",,~)" MalriJ</SanqiJeT_rSeIectONEl r .. ". ..T....i~m,l...JlU.itMtAliPM. "I:Ol<j;ANiCSTE$rs'#dG/li.rAii3"~ ~ J Same da( AN sampies on form should be of SAME ~ .1 buSine~ day. matrix tVoe. Use adcfd.ions/ fonns 8S needed. J 2 business days. J Ajr ( J So!ic1 I 3 business days. J Aqueous ( J Waste J STANDARD (5 bus. days) Bulk I I Wastewater J Standard Fu/J TCLP (1Od) ,} Hi-Vol Filter (PM10) {iWater,Drinking J Weekend- ; J Hj..Vol Filter (TSP) ( ] Compliance 1 ~ ]011 IIW... not 8vaUable for aU tests ~ ] Paint ( 1 Wipe, ComposIte Sd>>duI.,.., 0IpIIic:c,. __ ~ 1 Sludge I J I .,.,. ~ w.eItwwJ 6tsts In --.c.. . J Soil r J 1 :~~=:;=COuMt. '1!rr:'~:~ aoi:?:)tD';-' ] TEM,(AHERA) I PLM (EPA Paint Count) ] '!EM (EPA Level II) I PLM (Qualitative only) L _ I NYELAP 198.1/,41.6 IiiScelIa;;.;ou,iteslil:" 'J CAELAP (EPA Interim) I ]TOlal Duot (NIOSH 0500) . J TEM (Chatfield) I Reop, Dust (NIOSH 0000) J j s;lica: FTIR (NIOSH 7602) FOR ASBESTOS AIR: J Silica - XRO (NIOSH 7500). TYPE OF RESPIRATOR IL USED: .i:~- :: . .~TotaI eonc:.' lLead J ReRA Metals U I ' '''''lals-&lr.lct. J TCLP I Lead J TCLPl RCRA Metals J TClP I Full (wi organics) I J NOTE: AJI samples for otganics .should be kept al 4~C frOm coUeotion until teSling. SChedule rUsh analyses in advaooe. Indicate pmserva~ ad~ a,'.-media type. Indicate llnalysn method tOI" organics tests. . .1 ~ I j ~ I f I Date Type' I Total' Samole # Sam led A,a,p.E I Ajr Vol' d ~"3 DF /9..,..COS I ' H I l"& I" I" I I I I I I, \ ~ I ~I I Ll I I I I I r lY / U I" I I I I I i ic;s I .. I .. I I I I I f \b I .' I" I I I I I ~ \1 I ., I" I I I / I , , \ ~ I .~, /, ,I I I I I I I I L'S) I ... I -I I I I I I ~ I '201 .. I.' I~~..:s:~_ I I I I I I ..1 ~'~~~'I;~-~~'---'~~~~~~~:;:.~~~~m.;~;~~~;~~.~__~~?~;~_~ E~TEIr::"";~;~:;; P70:~ 0.1_ ~ ~-;"; s::: :::I:::':~~ln u",nl II !Re"nQUlShed to lab by INAMEJ."'t;>""-^~ MocJ R....lC ISIGNATURE~Q I J f/', '~ATEfT'rMEl 9, 6 '0.8 1(,00 [ ] Ambient temp [ ] CooJ_'C '~eceived in lab by [NAME] ;)(.:;~,-_-{2/c.->r>-<-~^ JSIGNATURE1~ "~.'- ~~"""'-..- 'nATEITlMEl ~ ! (r ;;.",':, 'r [ ] pH_[ J CI_[ ]R [ ]8 [ JFX [ JOHL [JUPS [Jui,.,J[ JHD [JOB [JCOURIER Unusual Sample Condition Noted: _ ._ __ __ _ .WA YBILL # Ch~jn-of~Cu:stodY dor:.umentBtion can#nued internally within lab. f)rqanlcs Time Sample~ L06Q Infonnaticm for Air Sampla Time2 Flow Rate;J Start ,. "lOp Start I. Slop I I I I I I I I I Organics ) # con- I . tainers. . jl ../, I I I II I I I I I ~' I I I I I II' I I I I I ~ I I . " T I II I I I I I II I I I I I II I I I I II I I I I II I I I Sample Identification 8. . Em ee, SSN, BId. Material Kl~ ~tLI Qt.....r...l(LLL. ~~ I '""'\.~""^" s:i.lb'r II,"'-"{L. >UG:(~ U r\I~ IKlTOol.fWV 'T>t.~~~ "r\l.& .,-.,VV (K ~~ Iht,5 "'t-l'-E../ I K l 'l"CW ~ CL.l::>SEJr I ~,,~ TtL.b t..."r c.~ I~l~ cl.t.....S6! ,I 9-'.t ~ ~L. Cctt. -n L.E, "TO:l1VI l""l'TLI.I.t>'V VI~ A'-L- I tr....6c(l- t....Ci:Ui;U ~C ~ /......-:Q- ~~ c.~ Ct;.. Lt.vc. '1;"l '-6 I ~9-r ~ 9x.. 9 I I ~ .,.,~,t; I J ~LI a......."- UO:;;:;Jl vi::lry .::itreel, t:<lchmond, Virginia 23220-5117 ~ 804-353-6778' 800-785-LABS (5227)' Fax 804-359-1475 -- .- Jo;I-e-rre-~" 8-R--97 '; 2.7 WWW.sJabinc.com e-mail: infoslabinc.com . ..,~, .--- ~Ll- ~b<t LT(.l. fJ..1 \J bi\ 15 ~peciallnstruCtiOns [include requests for special reporting or data p~ckagesJ 'S":> 3. b&"O""<>o.Jt>So <;:e.a.e.....,. I ~A (L ~Cit.r<:: 7'0 d I...-r( ,.0 J ('1.+(. 0....., R.~~S~br PI:>.>\. I;:~ UL TO- TATE WHERE SAMPLES WERE COLLECTED O~~C!:lN II , /project Name: /prOject Location: l:project N"umOOr: I I Purchase O~er No.: =- I Tum~uO\d Tan.' I: ..."'" I Sample TYPe (So,... ONE! J Same day* AI samples on form should be of SA~E . 1 business day. matrix tvrHJ. Use add"tlionsl tonns 8S needed. J 2 busineSs days" 1 Air l 1 Soll\:f J 3 bus;ness days' u' j Aqueous ( j Waste J STANDARD (5 bus. days) Bulk r J Wastewater J Standard Full TClP (1Od) J HI-Vol Alter (PM10) [j'Water,Orinking ] Weekend" . J H;.Vol Folie>- (TSP) [ j Compliance j , 1011 (jW"", not available for aN tests ] Paint . [ ] Wipe, Composite ScJr.du1e,..,~~, ] SlUdge r J m-w."__WJdIa.esJn---. ]SoiI (] r Organks 1 I Date Time Sample IdentifICation ~ Samp.!.e # Sampled Sampled e.. Emplovee, $SN, Bldg, Material ~"3 DF 9.':).<>s L060 c.<.oV....EYL 'G;~ ~ -,.. l w.Q\.l/'Cbl... 11.0(:. l>a..,-""-4t. !<-!oR " I L' ~~O\ ,.i "'2... L- ,.,,~ VI.v(L ~"''t' ..., "'l... ~l "1A>tVl'&A- "'i .A~. II ~ 5l e...- .J "'rtLb l..OV VI"-"r'~ '"") LI ", ~c \..\V, ~QI"""" ~u..... (...., (;6I......-ut.. . Ql2ort.J... V- to, I r hl Q\..L-'-'f\. z..S t!.& L.,.JC b"., . _U" "'f:u ~ .., , .' ., tv~ ~ I~~I~ <-.'- 'U"C' T11...E:. .....,..., .. <, W4LLI...IA..... Jt e...- I ~I-D~ T"lt. ~n 1'" ,I ~i: c:.-"6 ""- <:7 'TI \... C'.. ,..., l'\ I'" .. tV E'- ~........ )L9 ~ R,--?:1---nLr Hc:, C-Go t_~...!....:.~.~.~l_~_~.~:~::~=.~.~~~.~_. 'Type~_...,...~E-=- Sampled by [NAME] '"l;) Ou.e;, ~ jSIGNATURE,l b_ I J"-'L , lDATE/TIMEl 9. S. o~ 10<90 RelinqUishedtolabbYINAMEI1>"'I.A<- ~cJ~ .rSIGNATURElL:-- () {JJII\. - IDATEITlMEj 9. 6.'02 16oa' V ..:::) / A CI) / ~ / ( 1 '.. L ReceIved in lab by [NAMEI /u'~,'-rrc",,-~.~, rSiGNATURE1:O::<] <"...,_ N ~~. '~ rDATE/TIMEl I \ '. ....c',> I [JFX [ JOHL [JUPS [JU~[ jHD [ JOB [JCOURIER Unusual Sample C~~n~~ition Noled: WAYBill # .-:J. . ~._"--.~~ ~~.,...Q-- l3.G.:.(. i-524. I"~i:"ll'",ri"'''' "'":'1 , A8IiUiDOAirIFlIoef~ '::.i\~1l,1~1Ii. ;; " 'liIOia""t_eonc:,:: W' JI'CM. (NIOSH'7400) PLM(EPAeoo.1982) jlead j TEM.(AHERA) . ~ J PLM (EPA P,,;nt Count) ] RCRA Metals J TEM (EPA lavelll) ~ J PLM (Qualitetive only) ) L I J NYElAP 199.11,41.6 I P', __j~t_,;... ~'JCAElAP(EPAlnlerim) ',,~ct.' f J Total Dust (NrOSH 0500) 'J II TEM (ChaUiekl, . ) JTCLP I lead ) R~sp, Dus;(':I'OSH 0600) t1 . 1 TClPI ROM Metals J SiDca : FTiR (NIOSH 7602) ! 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'G'''': " ''''', ' ," . ,co. c' "" ., 'VI.' , ".:::,.. ".~. '," "..:::.'..:'..:.~.';,.' c.:"': .........._" 2512 West Gary Street, Richmond, Virginia 23220-5117 ._ _. _ :::'-~.c...... ..Fl.G-:z:. ..1.~iZ4 . __ 804-353-6778' 800,785-LABS (5227)' Fax 804-359-1475 _.____ ---'.!_~'i'-a- qR- Q"ilC;'--- __. __'.___ www.slabinc.com e-mail:info@slabinc.com ",,'."- ':' ',.", ;,.' ,~rOjeCI Name: '~Ck- ~ c;.. LT\-I. ~ I tJ bI\ ~ &1i...-1lS[ peciallnstruclions (inCIU, de requests for special reporting or data packages] ProjeclLocation: 's':l3.l:>&<o.O""o"-'I>5. 'YGl2-R-'-1 f..;-tvt"<\tL ~U<.rs "';"'0 dl"L-rI,.[) .lftl--t-{. d"""f rojeclNumber: R.t!.~S?l>i"Pt>.... I l;:>"l.'ol ~UL':'<:' TO 'echase Order No.: . ' ,-dISTATE WHERE SAMPLESytE!!1: CO_L~~~.Q~~c;:>~ I . TuinAro.n~ T.... 1- ll;itri)( I Samp18 Typo (Select ONEi ': :tOo'li>)~~IlolIaAtl. jl;olA;iPlyl " ' I ~::= day' I m::::::t::: ::;:::,:~:::so;s s:.~:'d. 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'~~__endtuUltr..._. r I Soil r J (J JUSED: 1, I Organics Wipes Infonn.,tion for Afr Samples I Date I Tome I Sample Identification I Wiped Type' Timez I Flow RateJ Sample # ~ Sampled' Sampled Ce.Q.:. Emp!oxee, SSN. Bldp, Matarian Area lfP) ABcP,E Start Stoe Start Stoo ~'S3 DF /9''''COS/ LOo"'/ c.~ ~c-o~J I ~"\ 9>01. 9- ~'-""'-""'-'T"JI-,,", ~ . I" I" I - I I I I wI I" I I I I I I I" 1'< I I I I I I I .\ I " I I I I I I I .' I" I I I I I I .' I" I I I I I I ," I ,< I I I I I I I ... I -I I I I I I I I .. I~' I t I I I I I -'l 'f'" --,' 3~':(;:3 r~' 541-935-9656 - i:::r;,41~935-6;70) -J ~ _ 'f ORi>ANiCSttSt$:ai\dGil;er:;.R,~ '1 NOTE: An samples for organics ~Id be kepi at ".C I fnlm collection unlil tedmg. SChedule ~h analyses in sdvaDCe. Indicate preselVa~ adc!ed.&,media type. I Indicate analysis method for organ~ tests. ...Ji "~~.- Tola~ AirVoJ' I, I I I I I I I I I I I I I I I I I I I I \ \ Organics I # con- . tainers. I I I I I I I I , I I I I I I II ~. ~. 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LANE REGIONAL A]R PROTECTION AGENCY TlTLE 43 ASBESTOS REQUIREMENTS Section 43,001 Polic" The bom'd tinds and declares that certain air contaminants for which there is no ambient air standard may cause or contribute to an identitiable and significant increase in mOliality or to an increase in serious irrevcrsib]e or incapacitating reversible illness, and are therefore considered to be hazardous air contaminants, Under Section]] 2 of the Federal Clean Air Act, the federal EP A has declared asbestos to be hazardous, Title 43 contains requirements for handling of asbestos, (S''';on4),OOI Amenue" 06111102) Section 43-002 Aoolicability Sections 43-0 I 0 through 43-0 15-19apply to asbestos mi]ling, manufacturing, fabricating, abatement, disposal, or any situation where a potential for exposure to asbestos fibers exists, (S"1;01143,002 Amende" 06,11/02) Section 43-005 Definitions The tollowing definitions are relevant to this title, Additional general detinitions can be found in Title 12, "Abate" means to eliminate the nuisance or suspected nuisance by reducing or managing lhe emissions using reasonably available practices, The degree of abatement will depend on an evaluation of all of the circumstances of each case and does not necessarily mean comp]etely eliminating the emissions, "Accidental Release" means an unanticipated emission of a regu]ated substance or other extremel y bazardous substance into the anlbient air from a stationary source, "Accredited Inspector" means a person that has completed training and received accreditation under 40 CFR Jlart 763 subJlart E, appendix C (Model Accreditation Plan), Section B (Initial Training), Subsection 3 (Inspector), 1994. "Accredited Trainer" means a provider of asbestos abatement training courses authorized by the Department to offer training courses that satisfy requirements for worker training, "Act"mld "FCAA" mean the Federa] Clean Air Act, Public Law 88-206 as last amended by Public Law 101.549, "Adequately wet" means to sufficiently mix or penetrate asbestos-containing material with liquid to prevent the release of particulate asbestos materials, An asbestos-containing material is not adequate]y wetted ifvisible emissions originate from that materia];)lOwever, the absence AmetJded 07/01/07 43.1 of visible emissions is not sufficient evidence of being adequately wet. Precipitation is not an appropriate method for wetting asbestos-containing material. . "Agency" means the Lane Regional Air Protection Agency, "Agent," as used in Title 43, means an individuaJ:who works on an asbestos abatement project for a contractor but is not an employee of the contractor. "Asbestos" means the asbestiform varieties of serpentine (chrysotile), riebeckite (crocidolite), cumingtonite-grunerite (amosite), anthophyllite, actinolite and tremolite. . "Asbestos Abatement Project" means any demolition, renovation, repair, construction or maintenance activity of any public or private facility that involves the repair, enclosure, encapsulation, removal, salvage, handling, disturbance or disposal of any materia] with the potentia] of releasing asbestos fibers from asbestos-containing material into the air. "Asbestos-Containing Material" means asbestos or any material, including particulate material, that contains more than I % asbestos as determined using the method specified in 40 CFR Part 763 Appendix E, Sl1bpart E, Section 1, Polarized Light Microscopy. . "Asbestos-containing waste material" means any waste that contains asbestos tailings or any commercial asbestos and is generated by a source subject to 43-0]0 and 43-015-1 through 43- 015-19, including but not limited to asbestos mill tai]ings, control device asbestos waste, mable asbestos waste material, asbestos abatement project waste and bags or containers that previous- ly contained commercial asbestos. . "Asbestos manufacturing operation" means the combining of commercial asbestos, or in the case of woven mction products, the combining of textiles containing commercial asbestos with " any q,ther material(s) includingcommenrial asbestos, and the processing ofthis combination into a product as specified in Section 43~015-3. . "Asbestos mill" means any facility engaged in the conversion or any intermediate step in the conversion of asbestos ore into commercial asbestos. "Asbestos tailings" means any so]id waste product of asbestos mining or milling operations that contains asbestos. "Asbestos Waste generator" means any person performing an asbestos abatement project or any owner or operator ofa source subject to 43-010 and 43-015-1 through 43-015-19 whose act or process generates asbestos-containing waste material. . "Asbestos waste shipment record" means the shipment document, required to be originated and signed by the asbestos waste generator, used to track and substantiate the disposition of . asbestos-containing waste material. . "Board" meij11S, the Board of Directors 9f the Lane Regi~nal Air Protection Agency. . . Amended 07/01/07 43,1 . "Certified supervisor," as used in Title 43, means a person who has a current Oregon supervisor certification card. . "Certified worker," as used in Title 43, means a person who has a current Oregon worker certification card. . "Chair" means the chairperson of the Board of Directors of the Lane Regional Air Protection Agency, . "Commercial asbestos" means any variety of asbestos that is produccd by extracting asbestos from asbestos ore, . "Commission" means the Oregon Environmental Quality Commission, . "Contractor,"as used in Title 43, means a person who undertakes for compensation an asbestos abatement project for another person. A]so as used in Title 43, "compensation" means wages, salaries, commissions and any other fonn of remuneration paid to a person for personal servIces. . "Demolish" or "Demolition" means the wrecking or removal of any load-supporting structural member of a facility together with any related handling operations or the intentional burning of any facility, . "Department" means the Oregon Department of Environmental Quality. . "Director" means the Director of the Lane Regional Air Protection Agency or the Director of the Oregon Department of Environmental Quality and authorized deputies or officers. . . "Emission" means a re]ease into the ambient air of air contaminants. . "EP A" means the United States Environmental Protection Agency. . "Fabricating" means any processing (e.g" cutting, sawing, drilling) of a manufactured product that contains commercial asbestos, with the exception of processing at temporary sites (field fabricating) for the construction or restoration of facilities, In the case of friction products, . fabricating includes bonding, debonding, grinding, sawing, drilling, or other simi]ar operations perfonned as part of fabricating, . "Facility" means all or part of any public or private bl1ilding, Structure, installation, equipment, or vehicle or vessel including but not ]im,ited to ships. . "Filing" or "filed" means receipt in the office of the Director. Sl1ch receipt is adequate where filIng is required for a document on a matter before the Agency, except a claim of personal . liability, . . .. , "Friable asbestos-containing material" means any asbestos-containing material that can be crumbled, pulverized or reduced to powder by hand pressure when dry. ' Friable asbestos Amended 07/01/07 4J.J material includes any asbestos-containing material that is shattered or subjected to sanding, grinding, sawing, abrading or has the potenlial to release asbestos fibers. . "Fugitive emissions" means any emissions which escape from a point or area that is not identifiable as a stack, vent, duct or equivalent opening, . "Hazardous air contaminant" means any air contaminant considered by the Agency, Department or Commission to cause or contribute to an identifiable and significant increase in mortality or to an increase in seriol1s irreversible or incapacitating irreversib]e illness and for which no ambient air standard exists, "Hazardous air contaminant" means any air contaminant considered by the Agency or Department to cause or contribute to an identifiab]e and significant increase in morta]ity or to an increase in serious irreversib]e or incapacitating reversib]e illness and for which no ambient air standard exists. . "Hazardous Air Pollutant (HAP)" means an air pollutant listed by the EP A pursuant'to Section 112(b) of the FCAA or determined by the Commission and/or Board to cause, or reasonably be anticipated to cause, adverse effects to human hea]th or the environment. "Hazardous Waste" means a hazardous waste as defined in 40 CRF 261.3. . "HEP A filter" means a high-efficiency particu]ate air filter capable of filtering 0.3 micrometer particles with 99.97 percent efficiency. . "Inactive asbestos waste disposal site" means any disposa] site for asbestos-containing waste where the operator has allowed the Department's solid waste permit to lapse, has gone out of busi,ness, or no longer receives asbesto~ccontaining waste, "Interim storage of asbestos-containing material" means the storage of asbestos-containing waste material that has been placed in a container outside a regulated area until transported to an authorized landfill. "LRAP A" means the Lane Regional' Air Protection Agency, a regional air quality control authority. . "Major Source," as used in this Title, is the same as the definition ofmajor source in OAR 340- 200-0020. . "Negative pressure enclosure" means any enclosure ofan asbestos abatement project area where the ambient air pressure is greater than the air pressure within the enclosure, and the air inside the enclosure is changed at ]east four times an hour by exhausting it through a HEP A filter. . "N onfriable asbestos-containing material" means any asbestos-containing material that cannot be crumbled,: pulverized, or reduced'. to powder by J.land pressure. Nonfriab]e asbestos- containing material does not include niateriiil that has peen subjected to shattering, sanding, grinding, sawing, or abrading or that has thepotential to release asbestos fibers. Amended 07/01/07 43.4 "Open Accumu]ation" means any accumulation, including interim storage, of friab]e asbestos- containing materials or asbestos-containing waste material other than material securely enclosed and stored as required by43-0l5-18 and 43-015.19, . "Owner or operator," as used in Title43, means anyperson who owns, leases, operates, controls or supervises a facility being demolished or renovated or any person who owns, leases, operates, controls, or supervises the demolition or renovation operation, or both . "Particulate asbestos material" means any finely divided particles of asbestos material. . "Person" means any individua], pub]ic or private corporation, association, firm, partnership, joint stock company, pl1blic and municipal corporation, political subdivision, agency, board, department, or bureau of the state and any agency thereof, and the federal government and any agency thereof, municipa]ity, partnership, association, firm, trust, estate, or any other legal entity whatsoever which is recognized by law as the subject of rights and dl1ties. . "Person in Charge of Property" means an agent, occupant, Jessee, tenant, contract purchaser, or other person having possession or control of property. . "Renovate" or "renovation" means altering in any way one or more facility components. Operations in which ]oad-supporting structural members are wrecked or removed are considered demolition and are not included in the definition of renovation. . "Responsible person" means each person who is in ownership, control, or custody of the property on which the open burning occurs, including any tenant thereof; or who is in ownership, contro], or custody of the materials which are burned; or any person who causes or allows open burning to be iniliated or maintained. , , . "Roadways" mean surfaces on which vehicles travel. This term includes public and private highways, roads, streets, parking areas, and driveways, "Section] l2(b)" means that subsection of the FCAA that incll1des the list of hazardous air pollutants to be regu]ated, . "Shattered," as used in Title 43, means the condition of an asbestos-containing material iliat has .been broken into four (4) or more pieces from its original who]e condition. . "Smal]-scale, short-duration activity" means a task for which the removal of asbestos is not the primary objective of the job, including, but not limited to: A. Removal of asbestos-containing insulation on pipes, not to exceed amounts greater than those which can be contained in a single glove bag; B. Removal ofsmal] quantities of asbestos-containing insulation on beams or above ceilings; C. Repiacement of an asbestos-contailling gasket on a valve; . . Amended 01/01/07 43,5 D, ]nstallation or removal of a small section of drywall; E, ]nstallation of e]ectrical conduits through or proximate 10 asbestos-containing materials; F. Minor repairs to damaged thermal system insu]ation that does not require removal; G. Repairs to asbestos-containing wallboard; or H. Repairs involving encapsu]ation, enclosure, or removal of small amounts of friable asbestos-containing material in the performamce of emergency or rOl1tine maintenance activity amd not intended solely as asbestos abatement. Such work may not exceed amounts greater tham those that cam be contained in a single prefabricated mini-enclosure. Such am enclosure must conform spatially amd geometrically to the localized work area, in order to perform its intended containment function, I. No sl1ch activity described above shall result in airborne asbestos concentrations above 0.1 fibers per cubic centimeter of air (calculated on am 8-hour weighted average), . "Startup" meams commencement of operation of a new or modified source resulting in release of contaminamts to the ambient air. . "Structural member" meams amy load-supporting member, such as beams amd ]oad-supporting walls, or amy non-supporting member, such as ceilings amd non-]oad-supporting wal]s. . "Survey," as used in Title 43; meams to conduct a detailed inspection of a bui]ding, structure, or facility for the presence of asbestos-containing material, The survey must be conducted by am accredited inspector amd. include sampling of materials suspected to contain asbestos, am~lysis of those samples to determine ~sbestos content, amd evaluation of the materials in order to assess their condition. "Waste generator" meams amy person performing am asbestos abatement project or any owner or operator of a source covered by this section whose act or process generates asbestos- containing waste material. "Waste shipment record" meams the shipment docwnent, required to be originated amd signed . by the waste generator; used to track amd substamtiate the disposition of asbestos-containing waste material. (Section 43.005 amended 06/11102) Section 43-010 General Provisions ], . No person may openly accl1mulate friable asbestos-containing material or asbestos-containing waste material. 2. ContrilCtorsworking on asbestos abateme~ projects at a secure facility must insure that all security clearamce requirements are completed before 'asbestos ablltement projects at a secure., Amended 07/01/07 43.6 Faet'Sh@et Asbestos Advisory Important information you need to know before you demolish a building The Department of Environmental Quality (DEQ) and Lane Regional Air Pollution AuthOlity (LRAP A) have specific rules regarding the handling and disposal of asbestos- containing materials (ACM), DEQlLRAP A regldates the removal and disposal of ACM to prevent asb~tos fiber release and exposure. Asbestos fibers in the air pose a significant health threat to employees, the public, and the environment. Before any public or private facility is demolished, all ACM must be properly removed, handled and disposed. The DEQ requires an asbestos survey be perfonned by an accredited inspector to detennine the presence of ACM in or on a structure prior to any demolition activities. Asbestos hazard consultants and many of the asbestos abatement contractors can provide this service, There is a Fact Sheet specific to the building slli"vey requirement available that is outlined in a question/answer fonnat. A list of consultants, abatement contractOl'S and the building slrrvey Fact Sheet can be obtained by contacting a regional office listed below, In general, there are two types of ACMs: . Friable ACM will easily release fibers when Wished. Only DEQ licensed asbestos abatement contractors and certified asbestos workers can remove and dispose of friable ACM, DEQ has specific truining courses available that meet these certification needs. A list ofDEQ licensed asbestos abatement contractors and (mining information can be obtained by contacting a regional office listed below, Examples of friable ACM can include, but are not limited to the following: sheet vinyl flooring, insulation on piping, duct and boilers, fireprooting, ceiling texture and panel products, and soundproofmg, . Nonfriable ACM has a binder that holds the asbestos fibers within a solid matIix and will not allow asbestos fibers to release easily, tmless mishandled, damaged, or in badly worn or weathered condition. You do not need to be a DEQ licensed asbestos abatement contractor or a certified asbestos worker to perform nonfriable asbestos abatement. However, the nonfriable materials must remain in nonfriable condition (predominantly whole pieces) during the remnval and disposal process. Examples of nonfriable ACM can include, but are not limited to the following: vinyl floor tile, AC water pipe, and cement (transite) siding or roofiog, If you remove nonfriable ACM, follow the instIuctions in the DEQ guidance documents, In addition, a nonfriable project notification and fee are required to be submitted to the Department five (5) days prior to the start date of the project. NonfriabJe asbestos-containing waste material (ACWM) should be kept adequately wet and the DEQ recommends that the ACWM be packaged in leak tight containers, The ACWM must be disposed of at a landtill authorized to handle asbestos waste and should be accompanied by a waste shipment report (ASN 4) at the time of disposal, Make Slli"e and contact the landfill prior to delivering the ACWM, Landfills can be more stringent than the DEQ and may only accept ACWM by appoinlment. A copy of the guidance documents, project notification, list of authorized landtills and waste shipmenl report can be obtained by contacting a regional ollice listed below, If you disturb or mishandJe ACM and cause' employees, the public or the environment to be potentially exposed to asbestos fibers, you can be liable lor clean-up costs and an enforcement action for rule violations. An enforcement action may include a civil penalty assessment. Copies of the guidance documents, building survey Fact Sheet, consultant, abatement contmctor and landfill lists, project notification, and waste shipment forms can be fOlmd on the DEQ web page at www.de{1_s.ate_or.us/aa/asheslo.~. For further infonnation about the asbestos regulations, contact a regional oJlice, For Clackamas, Cia/sap, Columbia, MlIlrnol1lah, Ti//umook and Washington Counties. call the Greshalll ojjice at (503) 667-8414 ext. 55018, or 55022. or (800) 452-4011. ~ ~ Wl!J StaLe 01 Oregon Department of Environmental Quality Air Qualily 811 SW 6'~ Avenue_ Portland, OR 97204 Phone: (503) 229-5359 (800) 452,4011 Fax: (503) 229-5675 www.deqslaJe.or.II.1. 06cNWR_OIO Last Updated: 6/26/06 Kevin McCnllm For Benton, Lincoln, Linn, Marion, Polk and Yamhill COlin ties, call rhe Salem office at (503) 378,5086 or (800) 349-7677, ror Lane County call Lane Regional Air Polllltion AlI/hority at (541) 736,1056. For Jackson, Josephine and Eastern Douglas Cozll/ties, call the Medjord oltice ot (541) 776, 6010, ext. 135 or (877) 813-3216. For Coos, Curry and Western Doug/as Counties call the Coos Bay office at (541) 269,2711. ext, 22. For all lIreas east afthe Cascades, call the Bend oifice at (541) 388,6146, ext, 226, or the Pelldleton office at (541) 178-4626 or at 1,800- 304-3513. Alternative Formats AlternativejiJrmats oj'this document can be made available, Contact DEQ PlIblic ~ffoirsjor more in/ormation (5(3) 229-5696. Fact S h~€.t Asbestos Advisory DEQ's Building Survey Requirement What is the survey requirement? DEQ's survey rule requires that an inspection be performed before any demolition or reeovation activities to determine the presence of friable and nonfhable aSbestos,containing materials (ACMs), DEQ believes this rule wiU be an important preventive tool that wiU allow a building owner to prevent asbestos fiber exposme when ACM is in or on their facility, Who must get a survey done? All facility owners, including but not limiled to manufacturing facilities, public and private building owners, commercial facilities, apartment complexes"residential buildings with more than fOlU. dweJJing units, etc., undertaking a demolition or renovation project will be aflected by this rule. The slll'vey rule does not apply 10 residential buildings with four or fewer dwelling units or a single private residence that is not used as a cOlluuercial business. However, contractors and building owners or operntors are responsible for 'my asbestos nde violations that may OCCIU' from renovation or demolition work in or on their stnlcture whether a survey is pertbnned or not. What is a demolition or renovation project? Demolition is defmed as wrecking that involves the removal of load-supporting members and/or "intentional bUJning. Renovation is defined as altering in Hny way one or more facility components that does not involve removing 3 load-supporting member. Who can perlorlll the survey'? The niJe requires that an accredited inspector perfOlm the slII'Vey. DEQ wants to ensure that the individual doing the inspection is qualified and tmderstands what they need to look for to complete lhe:slU'vey, This tmining is in accordance with the Asbestos Hazard Emergency Response Act (AlIERA) progr.un regulations and the Model Accreditation Program training rules in 40 CFR Part 763, In Oregon there are two service providers that oner the AHERA training courses: Clayton Enviromnental in Ponland at (971) 244,1200 and PBS EnvironmentafBuilding Consultants at (503) 248-1939. The inspector training is three days, What does DEQ mean hy survey? Generally, DEQ will require a sample of each type of material suspected to be ACM be collected and analyzed before any demolition or renovation project takes place, DEQ will not require the inspector to conduct an AHER A type survey, AHERA surveys can be restrictive and expensive because of the detailed and extensive amOlmt of sampling and evaluation necessary. DEQ will continue to rely upon the types of surveys and sampling it has recommended in the past. For example: When complete demolition or extensive renovation is to be conducted, a complete building survey will be required. If only a partial renovation activity is to take place, such as a kitchen remodel, then only that area of the stl1lcture requires a survey. If a single material, such as sheet vinyl Door is to be removed and replaced then only one sample (each layer if applicable) will need to be collected (an accredited inspector need not be used to sample whee a single malerial is involved) and analyzed, When the suspected material involves either blown or troweled on surfacing matelials (i.e, ceiling textlU'e), the DEQ recommends that more than one sample be collected and analyzed, A copy of the survey report (or just a lab analysis repon when appropriate) must be kept onsite during the demolition or renovation project. A survey repon includes doclUnentation of all of the samples collected, locations of where the samples were collected, results of the laboratory analysis and an evaluation of the materiaJs to assess their condition (friable or nonfrjable) if applicable, Please keep in mind that a SlU'vey is not a 100% guanmtee that all ACMs have been identified, Discoverable materiaJs can be found in areas which were not accessible dlU'ing the survey (i,e, such as behind walls, under carpet, etc,). During the demolition and renovation activities, an appropriately trained person should be on site and attentive for the discovery of ACMs, When is . survey not required? Aoyone may presume that a single material contains asbestos and have it properly abated without conducting a survey. DEQ has discretion 10 approve a1temati ves to the asbestos requirements under OAR 340-248-0270(12), Such an alternative could allow an Owner or operator to assume that all suspect materials contain asbestos. In this instance, the owner or ~ ~ l!J.3!I Stale 01 Oregon Department of Environmental Quality Air Quality 811 sw 6lh Ayenue Portland, OR 97204 Phone: (503) 229-5359 (S00j452,401l :Fax.: (503) 229-5675 wwW.dt!tJ..I.lfllff.or.II.\" 06-NWR.008 Last Updated: 6/16/06 Kevin McCmnn operator must contact DEQ before starting the project to obtain permission to use that method of identification. Materials that commonJy contain asbestos, slIch as popcorn ceiling textlU'e. cement siding, and vinyl Boor tile, are amdidates for materials that may be presumed to contain asbestos and properly abated in accordance with the mles. However. you cannot assume tbat a materia~ does not contain asbestos, Only through laboratOlY analysis can a negative determination be made, DEQ can provide a list of materials suspected to contain asbestos. There may be times where DEQ asbestos staff will need 10 make a determination about your situation on a case by case basis. When will a survey always be required? A slU'vey will be required for all public and private bu.ildings and residential structures with more Ihan four dweJIing Wlits before renovation, demolition. I or intentional bwning unless otherwise exempted, DEQ strongly recommends that building owners determine if asbestos is present in all buildings (residential or commercial) belore conducting any demolition or belore having a SU'llcture intentionally burned, When will these requirements take elfeet? The rules were adopted by the Envirorunental Quality Commission (EQc) on January 25, 2002, and the rules became effective on February 4, 2002, A large number of the tacility and building owners are already aware of the existing EPA and OSHA building survey requirements, Copies of the gltidance document, building survey Fact Sheet, consultant, laboratory, abatement conU1lctor and landfill Jists, project notification and waste shipment reports Cfill be fmmd on the DEQ web page al www.deo....tate.nT.llslaolllshestos. For further intonnation about the asbestos regulations. contact a regional ofTice. For Clackamas, CJatsop, Columbia, Multnomah, TiJ/wnovk and Washington Counties, call the Greshllm Office lit (5113) 667,8414 ext,551118, or ext. 551122, or (8011) 452-4011, For Bemon, Lincoln, Linn, Marion, Polk and Yalllhill Counties, clllI the SlI/em OlJice at (503) 378,51186 or (8110) 349-7677. For Lane County call Lane Regional Air PlIlluti1l1l Allfhority at (541) 736-1056, For Jackson, Josephine and Eastern Douglas Counties. call the Medjord Office at (541) 776, 6010, ext, 235 or (877) 823,3216, For C'oos, Curry and Western Douglas Counties, cllll the Coos Bay Office lit (541) 269-2721, ext, 22. For aU areas east afthe Cascades, call the Bend OjJice lit (541) 388,6146, ext, 226, lIr the Pe1ld/et01l Ojfice at (541) 278-4626 or at 1,800- 3114-35/3. Alternative Formats Alternative fonnats of this document can be made available. Contact DEQ Public Affairs for more information (503) 229-5696, C -:~ E ~ E N T A L S . THIS IS TO CERTIFY THAT DOUGLAS J. MOORE p HAS SUCCESSFULLY COMPLETED THE TRAINING COURSE for ASBESTOS INSPECTOR REFRESHER In accordance with TSCA Title II, Part 763, Subpart E, Appendix C of 40 CFR Colirse Date: 04/24/2008 Course Location: Eugene, OR pas I;ngineerin.g + Envil'Ohnuintal Expiration Date: 04/24/2009 Certificate: IR-D8-1907A AHERA is the Asbestos Hazard Emergency Response Act enacting Title II of Toxic Substance Control Act (TSCA) . For verifocatioo of the authenticity of this certifocate contact: PBS Environmental 44 12 SW Co~1t Avenue Portland, OR 97239 (503) 248-1939 jO/J/ud,~P____ David Stover, Director of Training ;~~t~;r~:' , il;.' :\-;.'!' \~.::~: tT ~....,. ,~~; t ~:,:' ~' . .,~., . ,4,,'~ Ai"'';;;'"'.''' ,..,~,~ ",",[ ...', " >"\tI;,'.. ~/~,.,/~., ,~. .'.',;;;~:'\' I.',.> t~."'~.'", , ,.,",:,...,:,y,~',"'.~"'.~}.._l'';,..,; ." :,<..,->>>"J"<;> ~ (~\... .. ..,,"/:: '\",' ,,"~.'j;l ~,,,,,'!" ',' . ,.'Ii .,f" ~,..,}". ',: ,._'." ".--"d,:i'~" ',::. ' ~':;.i,,~;;gt~... .~.... Dou~las International [>,0. !')OK 1 H+ Veneta,OR 97+87 Tel, 5+1-9}~-96H Fa", 5+1-9".61.70 Emaii, dintl@dintl.o'S (www.dintl.org) . LIMITATIONS AND DECLARATIONS Professional services of Douglas International LLC have been performed using the degree of care and skill ordinarily exercised under similar circumstances by reputable environmental research and consulting firms practicing in this or similar localities. No other warranty expressed or implied is made as to the professional advice included in this report. The findings of this investigation should not be considered as scientific certainties but rather as professional opinion based on selected and limited data. This evaluation did not address any structural condition of the building. Completion of this environmental assessment and issuance of a final report does not compel Douglas International LLC to provide testimony or attend any legal proceedings without separate arrangements. Absolutely no portion of this report shall be disseminated to the public or published in any way without prior written consent of Douglas international LLC ..