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16-103682
1ID-103(0162 AL AML Department of Community Development Services 33325 8th Avenue South Federal Way, WA 98003-6325 CITY OF ��������D 253-835-2607; Fax253-835-2609 www.cilnffederalway_com Federal W., I-) 29 2016 CITY OF FEDERAL WAY SEPA ENVIROW6R TAL CHECKLIST Purpose ofchecklist.• Governmental agencies use this checklist to help determine whether the environmental impacts of your proposal are significant. This information is also helpful to determine if available avoidance, minimization, or compensatory mitigation measures will address the probable significant impacts, or if an environmental impact statement will be prepared to further analyze the proposal. Instructions for applicants: This environmental checklist asks you to describe some basic information about your proposal. Please answer each question accurately and carefully, to the best of your knowledge. You may need to consult with an agency specialist or private consultant for some questions. You may use "not applicable"or "does not apply" only whenyou can explain why it does not apply and not when the answer is unknown. You may also attach or incorporate by reference additional studies and/or reports. Complete and accurate answers to these questions often avoid delays with the SEPA process, as well as later in the decision -making process. The checklist questions apply to allparts ofyourproposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Insuuctlons for Lead Agencies: Additional information may be necessary to evaluate the existing environment, all interrelated aspects of the proposal, and an analysis of adverse impacts. The checklist is considered the first, but not necessarily the only source of information needed to make an adequate threshold determination. Once a threshold determination is made, the lead agency is responsible for the completeness and accuracy of the checklist and other supporting documents. Use ofcheckUstfornonprojectproposals: For nonproject proposals (such as ordinances, regulations, plans, and programs), complete the applicable parts of sections A and B, plus the SUPPLEMENTAL, SHEET FOR NONPRO]ECT ACTIONS (part D). Please completely answer all questions that apply and note that the words "project," "applicant," and "property or site" should be read as "proposal," "proponent," and "affected geographic area," respectively. The lead agency may exclude (for nonprojects) questions in Part B (Environmental Elements) that do not contribute meaningfully to the analysis of the proposal. Bulletin #050 — May 1, 2014 Page 1 of 14 kAHand outs\]3nvironmental Checklist A4gy 2014 A. BACKGROUND [ 1. Name of proposed project, if applicable: /I uo t Du 2. Name of applicant: t G 3. Address and phone number of applicant and contact person: J75`1 I�e, ,4vt.9 -Dt' O �rct[�td, we'. q'ko3c- 4. Date checklist prepared: 7 5. Agency requesting checklist: ry.dt"l W C 6. Proposed timing or schedule (including phasing, if applicable): 7- l -tic — 7 -. 1 i - 1l0 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. ,�v /A 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. vt//i4� 10. List any government approvals or permits that will be needed for your proposal, if known. ��►µD7-Rea 11. Give brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description) � ►uv flu x �''c,, i,Jo� ¢I� hu�Id Bulletin #050 — Nlay 1, 2014 Page 2 of 14 k:\Handouts\Environmental Checklist AYlay2014 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. (to .3,?�Ik Isr.41l 5 r-e dq'AA( W.-.q , CA) CI 0013 B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of th�site (underline/circle one): 1 ollin billy, steep slopes, mountainous, other b. What is the steepest slope on the site (approximate percent slope)? c. What general types of soils are found on the site (for example; clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any agricultural land of long-term commercial significance and whether the proposal results in removing any of these soils. C*e, t�, Rock, Soft d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. no e. Describe the purpose, type, total area, and approximate quantities and total affected area of any filling, excavation, and grading proposed. Indicate source of fill. a 'gets 6 he •pt d L'4L f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. A g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings) ? h. Proposed me sures to reduce or control erosion, or other impacts to the earth, if any: Bulletin #050 — May 1, 2014 Page 3 of 14 k:\Ilandouts\Environmental Checklist May 2014 2. Air a. What types of emissions to the air would result from the proposal during construction, operation, and maintenance when the project is completed? If any, generally describe and give approximate quantities if known. b. Are there any off -site sources of emissions or odor that may affect your proposal? If so, generally describe. -J 0 c. Proposed measures to reduce or control emissions or other impacts to air, if any. -cis-� C�au- 4l 3. Water a. Surface Water 1) Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. ✓ lA 2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. 3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. ,v(/A- 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approxxate quantities if known. N rfh' 5) Does the proposal lie within a 100-pear floodplain? If so, note the location on the site plan. rN Ik 6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. Al�; Bulletin #050 —May 1, 2014 Page 4 of 14 k:\Handouts\Environmental Checklist May2014 b. Ground Water 1) "Y1ill groundwater be withdrawn from a well for drinking water or other purposes? If so, give a general description of the well, proposed uses, and approximate quantities withdrawn from the well. NVill water be discharged to groundwater? Give general description, purpose, and approximate quantities if known. NIA- 2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: domestic sewage; industrial containing the following chemicals... ; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. c. Water runoff (including stormwater): 1) Describe the source of runoff (including stormwater) and method of collection and disposal, if any (include quantities, if known). Where will this water flow? Will this water flow into other waters? If so, describe. ,/,//,4 2) Could waste materials enter ground or surface waters? If so, generally describe. 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. NO d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: A- 4. Plants a. Check the types of vegetation found on the site: deciduous tree: alder, maple, aspen, other evergreen tree: fir, cedar, pine, other shrubs grass pasture crop or grain orchards, vineyards, or other permanent crops wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other other types of vegetation Bulletin #050 — May 1, 2014 Page 5 of 14 k:\Handouts\Environmental Checklist Mali 2014 b. What kind and amount of vegetation will be removed or altered? ./Vo l e e. List threatened and endangered species known to be on or near the site. ,,/C/0e d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any. ff e. List all noxious weeds and invasive species known to be on or near the site. 5. Animals a. List any birds and other animals which have been observed on or near the site, or are known to be on or near the site. Examples include: birds: hawk, heron, eagle, songbirds, other: mammals: deer, bear, elk, beaver, other: fish: bass, salmon, trout, herring, shellfish, other ii Nove- b. List any threatened and endangered species known to be on or near the site. c. Is the site part of a migration route? If so, explain. VV!A d. Proposed measures to preserve or enhance wildlife, if any. e. List any invasive animal species known to be on or near the site. N14- 6. Energy and Natural Resources a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, �c ufacturing, etc. 7�isG��c1 b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. Bulletin #050 — May 1, 2014 Page 6 of 14 k:\Handouts\Environmental Checklist A,10, 2014 c. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any. N% 7. Environmental Health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste that could occur as a result of this proposal? If so, describe. Allk 1) Describe any known or possible contamination at the site from present or past uses. 2) Describe existing hazardous chemicals/conditions that might affect project development and design. This includes underground hazardous liquid and gas transmission pipelines located within the project area and in the vicinity. / 3) Describe any toxic or hazardous chemicals that might be stored, used, or produced during the project's development or construction, or at any time during the operating life of the project. 4) Describe special emergency services that might be required. NA 5) Proposed measures to reduce or control environmental health hazards, if any. b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? N jA- 2) What types and levels of noise would be created by or associated with the project on a short-term or a long- term basis (for example: traffic, construction, operation, other)? Indicate what hours noise would come from the site. /Nd n� 3) . Proposed measures to reduce or control noise impacts, if any: N/v Bulletin #050 — May 1, 2014 Page 7 of 14 k:\Handouts\Environmental Checklist May 2014 8. Land and Shoreline Use a. What is the current use of the site and adjacent properties? Will the proposal affect current land uses on nearby or adjacent properties? If so, describe. 6400v - _ ' We a, Vx I tkAt 06-WP 6e 5 b. Has the project site been used as working farmlands or working forest lands? If so, describe. How much agricultural or forest land of long-term commercial significance will be converted to other uses as a result of the proposal, if any? If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or nonforest use? VUIA' 1) Will the proposal affect or be affected by surrounding working farm or forest land normal business operations, such as oversize equipment access, the application of pesticides, tilling, and harvesting? If so, how. N c. Describe any structures on the site GOd � d. Will any structures be demo shed? If so, what? ,41aef K lay v� e. What is the current zoning classification of the site? MIT�fgL:a f. What is the current comprehensive plan designation of the site? M&I/G 1G g. If applicable, what is the current shoreline master program designation of the site? "V&14-6 h. Has any part of the site been classified as a critical area by the city or county? If so, specify. i. Approximately how many people would reside or work in the completed project? N&At' j. Approximately how many people would the completed project displace? N&UX Bulletin #050 — May 1, 2014 Page 8 of 14 k:\Handouts\Environmental Checklist Mey 2014 k. Proposed measures to avoid or reduce displacement impacts, if any. leak 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any. m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest lands of long-term commercial significance, if any. NIA- 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle; or low-income housing. c. Proposed measures to reduce or control housing impacts, if any, /(J/A- 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed? / b. What views in the immediate vicinity would be altered or obstructed? N/A- c. Proposed measures to,, reduce or control aesthetic impacts, if any. /VIA 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? b. Could light or glare from the finished project be a safety hazard or interfere with views? N/V Bulletin #050 — May 1, 2014 Page 9 of 14 k:\Handouts\Environmental Checklist May 2014 c. What existing off -site sources of light or glare may affect your proposal? ,V&V,,'pp d. Proposed measures to reduce or control light and glare impacts, if any. 4-+ 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? jue'Re, b. Would the proposed project displace any existing recreational uses? If so, describe. NO c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any. 13. Historic and cultural preservation a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years old listed in or eligible for listing in national, state, or local preservation registers located on or near the site? If so, specifically describe. / b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation? This may include human burials or old cemeteries. Are there any material evidence, artifacts, or areas of cultural importance on or near the site? Please list any professional studies conducted at the site to identify such resources. OAJI - c. Describe the methods used to assess the potential impacts to cultural and historic resources on or near the project site. Examples include consultation with tribes and the department of archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc. A) // d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance to resources. Please include plans for the above and any permits that may be required. N11�- 14. Transportation a. Identify public streets and highways serving the site or affected geographic area and describe proposed access to the existing street system. Show on site plans, if any. Bulletin #050 — May 1, 2014 Page 10 of 14 k:\J-landouts\Environmental Checklist A2ay 2014 b. Is the site or affected geographic area currently served by public transit? If so, generally describe. If not, what is the approximate distance to the nearest transit stop? No c. How many additional parking spaces would the completed projector non -project proposal have? How many would the project or proposal eliminate? Ndw'� d. Will the proposal require any new or improvements to existing roads, streets, pedestrian, bicycle, or state transportation facilities, not including driveways? If so, generally describe (indicate whether public or private). A) /A e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. N � f. How many vehicular trips per day would be generated by the completed projector proposal? If known, indicate when peak volumes would occur and what percentage of the volume would be trucks (such as commercial and non -passenger vehicles). What data or transportation models were used to•make these estimates? V "'J / iq g. Will -the proposal interfere with, affect, or be affected by the movement of agricultural and forest products on roads or streets in the area? If so, generally describe. J/r� h. Proposed measures to reduce or control transportation impacts, if any. 15. Public services a. Would the project result in an increased need for public services (for example: fire protection, police protection, public transit, health care, schools, other)? f so, generally describe. NIA- b. Proposed measures to reduce or control direct impacts on public services, if any. ,A)1�- Bulletin #050 — May 1, 2014 Page 11 of 14 k:\Handouts\Environmental Checklist May 2014 16. Utilities a. Underline/circle utilities currently available at the site: electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system, other Mr -A e- b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. d1q- C. SIGNATURE The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Signature: �C Printed Name of Signee: � Position and Agency/Organization: Date Submitted: 7 2° ( V Bulletin #050 — May 1, 2014 Page 12 of 14 k:\Handouts\Environmental Checklist May 2014 D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (IT IS NOT NECESSARY to use this sheet for project actions.) Because these questions are very general, it may be helpful to read them in conjunction with the list of the elements of the environment. When answering these questions, be aware of the extent the proposal, or the types of activities likely to result from the proposal, would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented. Respond briefly and in general terms. 1. How would the proposal be likely to increase discharge to water; emissions to air; production, storage, or release of toxic or hazardous substances; or production of noise? AJIA- Proposed measures to avoid or reduce such increases are: 2. How would the proposal be likely to affect plants, animals, fish, or marine life? Proposed measures to protect or conserve plants, animals, fish, or marine life are: 3. How would the proposal be likely to deplete energy or natural resources? N/A- J7Ae,L4�(- Proposed measures to protect or conserve energy and natural resources are: 4. How would the proposal be likely to use or affect environmentally sensitive areas or areas designated (or eligible or under study) for governmental protection; such as parks, wilderness, wild and scenic rivers, threatened or endangered species habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands? ,it// A — Proposed measures to protect such resources or to avoid or reduce impacts are: Bulletin #050 — May 1, 2014 Page 13 of 14 k:\Handouts\Environmental Checklist Nfq 2014 5. How would the proposal be likely to affect land and shoreline use, including whether it would allow or encourage land or shoreline uses incompatible with existing plans? ti/A- Proposed measures to avoid or reduce shoreline and land use impacts are: 6. How would the proposal be likely to increase demands on transportation or public services and utilities? ,A)(& Proposed measures to reduce or respond to such demand(s) are: Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment. Bulletin #050 — May 1, 2014 Page 14 of 14 k:\IHandouts\Environmental Checklist May 2014 CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT REVIEW COMMITTEE TRANSMITTAL DATE: August 1, 2016 TO: Cole Elliott, Development Services Manager Peter Lawrence, Plans Examiner Brian Asbury, Lakehaven Utility District Vince Faranda, South King Fire & Rescue Rick Perez, City Traffic Engineer FROM: Dave Van De Weghe, Planning FOR DRC MTG. ON: Internal review - August 11, 2016 FILE NUMBER(s): 16-103682-00-UP RELATED FILE NOS.: 16-103683-00-DE PROJECT NAME: Bally Total Fitness demolition/SEPA PROJECT ADDRESS: 32818 1" Ave S ZONING DISTRICT: OP PROJECT DESCRIPTION: SEPA review for full demolition (underway) of North building. Leave slab, fill pools. LAND USE PERMITS: SEPA w/Project PROJECT CONTACT: MATERIALS SUBMITTED: Complete Construction Darrell Hurst 9757 Juanita Dr. NE Kirkland, WA 98034 SEPA Checklist Site Plan (1976) RECEIVE® MASTER LAND USE APPLICATION CITY OF Federal Way DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES JUL B 9 2016 33325 8`h Avenue South Federal Way, WA 98003-6325 CITY OF FEDERAL WAY 253-835-2607; Fax 253-835-2609 CD S www.cityaf tderal �viv.com �, - I o (OU- 00 APPLICATION NO(S) 4� —I-- 1(0 ` I O �) (6 D ��ft �+ Date r[ N Project Name c� eo.. d_ Olb Property Address/]Location .3ZOS 1JT14At 5 F�eAe11,Q1 ,4j, Parcel Number(s) 1 1-2- � (O`4 1 D✓%2O Project Description /00-k PLEASE PRINT Type of Permit Required Annexation Binding Site Plan Boundary Line Adjustment Comp Plan/Rezone Land Surface Modification Lot Line Elimination Preapplication Conference Process I (Director's Approval) Process II (Site Plan Review) Process III (Project Approval) Process IV (Hearing Examiner's Decision) Process V (Quasi -Judicial Rezone) ocess VI SEPA w/Project SEPA Only Shoreline: Variance/Conditional Use Short Subdivision Subdivision Variance: Commercial/Residential Required Information o� Y+ Zoning Designation �� CComprehensive Plan Designation Value of Existing Improvements Value of Proposed Improvements International Building Code (IBC): Occupancy Type Construction Type T- 2:-.2o((o Applicant �'y�s'T Name: Cd"'P � Address: KZ 5' 3 �'" 'a City/State: /_/, &1 Icstt,d1 -vh Zip: Is031 Phone: $Z -RS'g0 Email: -Dqcpz&I. A40060J4Id/d'd. CBwl SignaturrTD Agent (if different than Applicant) Name: SfIV� �4� Abow Address: City/State: Zip: Phone: Fax: Email: Signature: Owner Name: Address: q-757 ..l"a-Ae4 Pk~ CitylState:[+�kl[Wsf�� Zip: R 8034 Phone: 425 - Z SO Fax:4-Z6-L5-0 -Z-i5Z. dL��L.CtsF^'3 Elnail:�ae fq4.. t{u'" e WyI Signature: Bulletin #003 — January 1, 2011 Page 1 of 1 k:\Handouts\Master Land Use Application RECEIVED CITY OF Federal 'Inlay JUL 2 9 2016 CITY OF FEDERAL WAY CDS COMMUNITY DEVELOPMENT DEPARTMENT 33325 8"' Avenue South Federal Way, WA 98003-6325 253-835-2607;Fax 253-835-2609 www. ci tyoffederalway. corn DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure on a subject property. Demolition of separate structures may require separate permits. ElAddress of Demolition: 3 -2- _S1-3 / S'r � ❑ Prior to submitting a demolition permit, the following items must be signed by the respective agency or their approvals attached. Items not applicable to your project should be marked N/A. YQ A completed Construction PermitAppiication form is also required. 49 1. ASBESTOS ABATEMENT g�� g' 3Z l t (Provide copy of Notice oflntentfrom Puget Sound Clean Air Agency 5. ELECTRICITY • and copy of inspection report by AHERA-certified inspector) (City of Federal Way Building Official) (Puget Sound Energy) 2. FUEL STORAGE TANKS ❑ Under grade tank(s) is/are present ❑ Above grade tank(s) are present ❑ Tank(s) has been pumped or removed under South King Fire & Rescue permit prior to any dismTq- (Southing or excavation IG g Fire and Rescue) 3. SEPTIC SYSTEM N (King County Emir nmental Services) 4. SANITARY SEWER s 6. GAS SUPPLY r (Puget Sound Energy) 7. WATER - Public Source r 7 ts-r �U ter/y1 1jp]erj� - - r? /st. ► t!o S. WATER - Private Well (King County vi nmental Services) Bulletin # 122 —May 13, 2015 Page 1 of 1 k:lHandouts\Demolition Permit Requirements RECEIvED psclea nair.org Puget Sound Agency Notification Case #: 201603632 JUL 2 9 2016 CITY OF FEDERAL WAy CDS This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $105.00 Credit Card Transaction # AT0FE9E91C87 Transaction Date 07/26/16 Owner's Name Weidner Property Management Phone (425) 821-3844 Project Street Address 32818 ist Ave S. City Federal Way Zip 98003 Contact Person Shane Crosby Phone (425) 760-8487 Mailing Address 9757 Juanita drive ne Kirkland, WA 98034 This project includes a demolition. Demolition Start Date 07/26/16 Completion Date 08/15/16 Demolition will be completed by a demolition contractor Demo Contractor Tastad Construction, Inc. Contractor Job # Contact Shane Crosby Phone (425)760-8487 Mailing Address 1502 Bonneville Ave. Snohomish, WA 98290 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. INTERNATIONAL Ast>t:5it���1�t:St1`.i� L.'�t;C�t�;�tL)ti1t:S Feb 29, 2016 Mhguruhomes LLC RECEIVED JUL 2 9 2016 9000 Commerce Parkway Suite B CITY OF FEDERAL WAY Mt. Laurel,N108054 CDS Telephone: (856) 231-9449 Cover Letter Email: customerservice@iatl.com Thank you for choosing iATL for your analytical needs. The Report herein along with the chain of custody contains details of (1) the transmittal of the samples from you to our laboratory, (2) the acceptance and analysis of the samples, (3) the supporting documentation tied to this project, (4) any QA notifications or communications, and (5) our invoice for this project. In addition: • Please carefully look over these report deliverables and make sure that it meets your needs. Depending upon regulator and accrediting body limitations, you may have some choices for the formatting and data presentation beyond what follows. Please contact our customer service department for information on any options. • You may intend for all, or select, samples in this submittal to move forward in the laboratory for other testing procedures. The batch sheet in this Report may list that authorization to proceed. Please login to our secure client portal and check this status or to confirm any additional analyses. • If there are other offices, individuals, or customers who you think should receive this report — please send us that information and we will happily forward the report. iATL is always seeking to improve our services and the customer experience. Any feedback that you can supply would benefit our commitment to quality. Please consider emailing any of the contacts on the next page of this report. Finally, I wanted to take this opportunity to express our appreciation in your choice of iATL. We value our customers and seek to earn your business... one sample at a time. Regards, Eric Snyder President, iATL Page i Frank Ehrenfeld Laboratory Director, iATL I L 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 11A Telephone: 856-231-9449 $-r' Email: customerservice@iatl.com INTERNATIONALL vc_,, 14 Siot, 1 :SIi4C; L_-N130R..%[0R3L•S CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Project No.: Client: NMG330 PLM BULK SAMPLE ANALYSIS SUMMARY Lab No.: 5864476 Description: Lt Tan Sheetrock Location: Entry Client No.: 1 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 10 Cellulose 90 -_....-..-_..-.... _....----_.------- V-_..-------------------------- Lab No.: 5864477 _.. _.._-----_ _-_--_---.._-------..__--------__--_---_----------------------------------- Description: Lt Tan Sheetrock Location: Main Hall/Wall Client No.: 2 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 10 Cellulose 90 Lab No.: 5864477(L2) Description: White Texture Location: Main Hall/Wall Client No.: 2 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected None Detected 100 Lab No.: 5864478 Description: Lt Tan Sheetrock Location: Main Hall South Comer Client No.: 3 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 10 Cellulose 90 Lab No.: 5864478(L2) Description: White Texture Location: Main Hall South Comer Client No.: 3 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected None Detected 100 Lab No.: 5864479 Description: Lt Tan Sheetrock Location: Ceiling Main Hall West Client No.: 4 Facility: Percent Asbestos: Percent Nan -Asbestos Fibrous Material:, Percent Non -fibrous Material: None Detected 10 Cellulose 90 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix of this report for further information regarding your analysis. Date Received: 2/19/2016 Date Analyzed: 2/27/2016 12:00:00 AM Signature: Analyst: Ellen Smith Approved By: Frank E. Ehrenfeld, III Laboratory Director 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 r A -Telephone: 85 6-231-9449 Email: customerservice@iatl.com INTERNATIONAL Atit;i.slc� 1 F.SI l vc: LAliOl:AIORil:5 CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.: PLM BULK SAMPLE ANALYSIS SUMMARY Lab No.: 5864479(L2) Description: White Texture Location: Ceiling Main Hall West Client No.: 4 Facility: Percent Asbestos: Percent Nan -Asbestos Fibrous Material: Fercenthan-Fibrous Neat[ None Detected None Detected 100 Lab No.: 5864480 Description: Lt Tan Sheetrock Location: Wall Main Hall West Client No.: 5 Facility: Percent Asbestos: PercentNgn-Asbesta&_Fibrous Material: PercentNon-Fibrous Material: None Detected 10 Cellulose 90 Lab No.: 5864480(L2) Description: White Texture Location: Wall Main Hall West Client No.: 5 Facility: Percent Asbestos: Percent Non-Asbesto.�,_Fibrous Material: Percent No -Fibro s Material None Detected None Detected 100 ----------------------------------------------------- Lab No.: 5864481 ..,..___.._..--.,..r..-----------------_-----__------------------------------ Description: White Texture Location: Ceiling Main Hall West Client No.: 6 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected None Detected 100 Lab No.: 5864482 Description: Grey Grout Location: Main Entry Client No.: 7 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous_ Material: None Detected None Detected 100 ---------------------------------------------------------------------------------------------------------------------------- Lab No.: 5864483 Description: Lt Tan Sheetrock Location: Ladies Locker Wall Client No.: 8 Facility: Percent Asbestos: Percent Nan -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 10 Cellulose 90 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix of this report for further information regarding your analysis. Date Received: 2/19/2016 Date Analyzed: 2/27/2016 12:00:00 AM Signature: Analyst: Ellen Smith Approved By: Frank E. Ehrenfeld, III Laboratory Director '��V . INTERNATIONAL :�513l:SlOti � f:5f1ti�� 1..:\l1�7hAlOf2il_S CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.: PLM BULK SAMPLE ANALYSIS_SUMMARY Lab No.: 5864483(L2) Client No.: 8 Percent Asbestos: None Detected ------------------- Lab No.: 5864484 Client No.: 9 Percent Asbestos: None Detected Lab No.: 5864484(L2) Client No.: 9 Percent Asbestos: None Detected ------------------------ Lab No.: 5864485 Client No.: 10 Percent Asbestos: None Detected Lab No.: 5864485(L2) Client No.: 10 Percent Asbestos: None Detected ------------------------ Lab No.: 5864486 Client No.: 11 Percent Asbestos: None Detected Description: White Texture Facility: Percen Non -Asbestos Fibrous Material: None Detected ---------------------------------------- Description: Lt Tan Sheetrock Facility: Percent Non -Asbestos Fibrous, Material: 15 Cellulose Description: White Texture Facility: Percent Non -Asbestos_ Fibrous Material: None Detected Description: Lt Tan Sheetrock Facility: Percent Non -Asbestos Fibrous Material: 10 Cellulose Description: White Texture Facility: Percent Non -Asbestos Fibrous Material: None Detected 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 Telephone: 856-231-9449 Email: customerservice@iatl.com Location: Ladies Locker Wall Percent Nvn-Fibrous Material: 100 Location: Ladies Locker Ceiling Percent Non -Fibrous Material: 85 Location: Ladies Locker Ceiling Percent Non -Fibrous Materi-al: 100 Location: Mens Locker Ceiling Percent Non -Fibrous Material: 90 Location: Mens Locker Ceiling Percent Non -Fibrous Material: 100 Description: Grey Non -Fibrous Location: NE Wall Tex Hall Facility: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 100 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix of this report for further information regarding your analysis. Date Received: 2/19/2016 Date Analyzed: 2/27/2016 12:00:00 AM Signature: Analyst: Ellen Smith Approved By: �.4_ Frank E. Ehrenfeld, III Laboratory Director 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 Telephone: 856-231-9449 Email: customerservice@iatl.com iNTERNATIONAT CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.:, PLM BULK SAMPLE ANALYSIS SUMMARY Lab No.: 5864486(L2) Description: White Paint Location: NE Wall Tex Hall Client No.: 11 Facility: Percent Asbestos: Percent Nan -Asbestos Fibrous Material: Percent Non -Fib us None Detected None Detected 100 Lab No.: 5864487 Description: Tan Ceiling Tile Location: Mens Locker Room Client No.: 12 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 35 Cellulose 45 20 Fibrous Glass Lab No.: 5864488 Description: Tan Sheetrock Location: Main Entry East Room Client No.: 13 Facility: Percent Asbestos: Percent N n-Asbe tos Fib u at rial: Percent Non -Fibrous Material: None Detected 10 Cellulose 89 1 Fibrous Glass Lab No.: 5864488(L2) Description: Wnite Texture Location: Main Entry East Room Client No.: 13 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected None Detected 100 Lab No.: 5864489 Description: Lt Tan Sheetrock Location: Main Entry NE Room Client No.: 14 Facility: Percent Asbestos: Percent Nan -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 10 Cellulose 90 Lab No.: 5864490 Description: Lt Tan Sheetrock Location: Weight Room Client No.: 15 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous M=ial: Percent Non -Fibrous Material: None Detected 10 Cellulose 90 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix of this report for further information regarding your analysis. Date Received: Date Analyzed: Signature: Analyst: 2/19/2016 2/27/2016 12:00:00 AM Ellen Smith Approved By:�„�� Frank E. Ehrenfeld, III Laboratory Director F:T!!1.lf�d it A Pr INTERNATIONAL i�f1E5'I'05 ) L5I7� G LABORA FOR]F CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.: PLM BULK SAMPLE ANALYSIS SUMMARY Lab No.: 5864490(L2) Description: Lt Blue Paint Client No.: 15 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: None Detected None Detected Lab No.: 5864491 Description: Lt Tan Sheetrock Client No.: 16 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: None Detected 10 Cellulose Lab No.: 5864491(L2) Description: White Texture Client No.: 16 Facility: 1'erecrt Asbestos: Percent Non -Asbestos Fibrous Material: None Detected None Detected Lab No.: 5864492 Description: Lt Tan Sheetrock Client No.: 17 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: None Detected 10 Cellulose Lab No.: 5864492(L2) Description: White Texture Client No.: 17 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: None Detected None Detected Lab No.: 5864493 Description: Lt Tan Sheetrock Client No.: 18 Facility: Perr;ent Ash- tos: Percent Non Asbestos Fibrous Material: None Detected 10 Cellulose ^ 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 Telephone:856-231-9449 Email: customerservice@iatl.com Location: Weight Room Percent Non -Fibrous Material:_ 100 - Location: Large Exercise Room Percent Non -Fibrous Material: 90 Location: Large Exercise Room Percent Nan -Fibrous Material: 100 Location: Exercise Room Office Percent Non -Fibrous Material: 90 Location: Exercise Room Office Percent Non -Fibrous Material: 100 Location: Office Off Exercise Room Percent Non -Fibrous Material: 90 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix of this report for further information regarding your analysis. Date Received: Date Analyzed: Signature: Analyst: 2/19/2016 2/27/2016 12:00:00 AM Ellen Smith Approved By:� Frank E. Ehrenfeld, III Laboratory Director �1 P-r I A - 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 Telephone: 85 6-231-9449 Email: customerservice@iatl.com INTERNATIONAL :�tiLsl: lc�s Tt s! _\u LAl9C]f;AIONIi_S CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.: PLM BULK SAMPLE ANALYSIS SUMMARY Lab No.: 5864493(L2) Description: White Texture Location: Office Off Exercise Room Client No.: 18 Facility: Percent Asbestos, Percent Non -Asbestos FibrOUS Material: Percent N n- ibr Material: None Detected None Detected l00 Lab No.: 5864494 Description: White Texture Location: Upstairs Office Space NE Comer Client No.: 19 Facility: Percent Asbestos: Percent Nnn-Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected None Detected 100 Lab No.: 5864495 Description: Lt Tan Sheetrock Location: Upstairs Office Space NW Corner Client No.: 20 Facility: Percent Asbestos: j'ercent Non -Asbestos Fibrous M Wdal; Percent Non -Fibrous Material: None Detected 10 Cellulose 90 Lab No.: 5864495(L2) Description: Off -White Paint Location: Upstairs Office Space NW Corner Client No.: 20 Facility: Eer¢ent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected None Detected 100 Lab No.: 5864496 Description: Lt Tan Sheetrock Location: Upstairs Bath Client No.: 21 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: PercentNon-Fibrous eri None Detected 10 Cellulose 90 Lab No.: 5864497 Description: Lt Tan Sheetrock Location: Upstairs Office East Client No.: 22 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: Percent Non -Fibrous Material: None Detected 10 Cellulose 90 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix of this report for further information regarding your analysis. Date Received: Date Analyzed: Signature: Analyst: 2/19/2016 2/27/2016 12:00:00 AM Ellen Smith Approved By: �.� Frank E. Ehrenfeld, III Laboratory Director 9000 Commerce Parkway Suite B r 1A Mt. Laurel, New Jersey 08054 Telephone: 85 6-231-9449 Email: customerservice@iatl.com INTERNATIONAL CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.: PLM BULK SAMPLE ANALYSIS SUMMARY Lab No.: 5864497(L2) Description: White Texture Client No.: 22 Facility: Percent Asbestos: ftrcent Non -Asbestos Fibrous Ma gdal_: None Detected None Detected -------------------------------------------------------------------------------- Lab No.: 5864498 Description: Lt Tan Sheetrock Client No.: 23 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material_: None Detected 10 Cellulose Lab No.: 5864498(L2) Description: White Texture Client No.: 23 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous- Material: None Detected None Detected --------------------------------------------------------------------------------- Lab No.: 5864499 Description: Lt Tan Sheetrock Client No.: 24 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: None Detected 10 Cellulose Lab No.: 5864499(L2) Description: White Texture Client No.: 24 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: None Detected None Detected Lab No.: 5864500 Description: Lt Tan Sheetrock Client No.: 25 Facility: Percent Asbestos: Percent Non -Asbestos Fibrous Material: - None Detected 10 Cellulose Location: Upstairs Office East Percent Non -Fibrous Material: 100 Location: Upstairs Office East Percent Non -Fibrous Material. 90 Location: Upstairs Office East Percent Nan -Fibrous Material:- 100 Location: Room Overlooking Pool Percent Non -Fibrous Material: 90 Location: Room Overlooking Pool Percent Non -Fibrous Material: 100 Location: Room Overlooking Pool Percent Non -Fibrous Material: 90 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix of this report for further information regarding your analysis. Date Received: Date Analyzed: Signature: Analyst: 2/19/2016 2/27/2016 12:00:00 AM Ellen Smith Approved By:+,� Frank E. Ehrenfeld, III Laboratory Director ATL 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 Telephone: 856-231-9449 Email: customerservice@iatl.com INTERNATIONAL A, lmIsi'os Ti_s1'i>_c LABORAroxtl: CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC 14601 106th Ave Ct. E Puyallup WA 98374 Client: MHG330 Lab No.: 5864500(L2) Client No.: 25 Percent Asbestos: None Detected Report Date: 2/29/2016 Report No.: 503549 - PLM Project: Ballys Project No.: PLM BULK SAMPLE ANALYSIS SUMMARY Description: White Texture Facility: Percent Non -Asbestos Fibrous Material: None Detected Location: Room Overlooking Pool Percent Non -Fibrous Material; 100 Analytical Method -US EPA 600, R93-116. Please refer to the Appendix ofthis report for further information regarding your analysis. Date Received: Date Analyzed: Signature: Analyst: 2/19/2016 2/27/2016 12:00:00 AM Ellen Smith Approved By:�g Frank E. Ehrenfeld, III Laboratory Director 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 Telephone: 856-231-9449 Email: customerservice@iatl.com INTERNATIONAL Tr-sriNc L.-ABOs:ATORre':7, CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC 14601 106th Ave Ct. E Puyallup WA 98374 Client: MHG330 Customer Contact: Randy Marsh Analysis: US EPA 600, R93-116 Report Date: Report No.: Project: Project No.: 2/29/2016 503549 - PLM Ballys Appendix to Analytical Report: This appendix seeks to promote greater understanding of any observations, exceptions, special instructions, or circumstances that the laboratory needs to communicate to the client concerning the above samples. The information below is used to help promote your ability to make the most informed decisions for you and your customers. Please note the following points of contact for any questions you may have. iATL Customer Service: customerservice@iatl.com iATL Office Manager: cdavis@iatl.com iATL Account Representative: House Account Project Summary: Sample Login Notes: See Batch Sheet Attached Sample Matrix: Bulk Building Materials Exceptions Noted: See Following Pages General Terms, Warrants, Limits, Qualifiers: General information about iATL capabilities and client/laboratory relationships and responsibilities are spelled out in iATL policies that are listed at www.iATL.com and in our Quality Assurance Manual per ISO 17025 standard requirements. The information therein is a representation of iATL definitions and policies for turnaround times, sample submittal, collection media, blank definitions, quantification issues and limit of detection, analytical methods and procedures, sub -contracting policies, results reporting options, fees, terms, and discounts, confidentiality, sample archival and disposal, and data interpretation. iATL warrants the test results to be of a precision normal for the type and methodology employed for each sample submitted. iATL disclaims any other warrants, expressed or implied, including warranty of fitness for a particular purpose and warranty of merchantability. iATL accepts no legal responsibility for the purpose for which the client uses test results. Any analytical work performed must be governed by our Standard Terms and Conditions. Prices, methods and detection limits may be changed without notification. Please contact your Customer Service Representative for the most current information. This confidential report relates only to those item(s) tested and does not represent an endorsement by NIST-NVLAP, AIHA LAP LLC, or any agency of local, state or province governments nor of any agency of the U.S. government. This report shall not be reproduced except in full, without written approval of the laboratory. Information Pertinent to this Report: Analysis by US EPA 600 93-116: Determination of Asbestos in Bulk Building Materials by Polarized Light Microscopy (PLM). Certification: NIST-NVLAP No. 101165-0 NY -DOH No. 11021 AIHA-LAP, LLC No. 100188 Quantification at <0.25% by volume is possible with this method. (PC) Indicates Stratified Point Count Method performed. (PC -Trace) means that asbestos was detected but is not quantifiable under the Point Counting regimen. Analysis includes all distinct separable layers in accordance with EPA 600 Method. If not reported or otherwise noted, layer is either not present or the client has specifically requested that it not be analyzed (ex. analyze until positive instructions). Small asbestos fibers may be missed by PLM due to resolution limitations of the optical microscope. Therefore, PLM is not consistently reliable in detecting asbestos in non -friable organically bound (NOB) materials. Quantitative transmission electron microscopy (TEM) is currently the only method that can pronounce materials as non -asbestos containing. 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 r 1ATelephone: 856-231-9449 Email: customerservice@iatl.com INTERNATIONAL r�tif'>! S 1'i�5 1 L.S I I tiC LABORA I )KIES CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.: Analytical Methodology Alternatives: Your initial request for analysis may not have accounted for recent advances in regulatory requirements or advances in technology that are routinely used in similar situations for other qualified projects. You may have the option to explore additional analysis for further information. Below are a few options, listed as the matrix followed by the appropriate methodology. Also included are links to more information on our website. Bulk Building Materials that are Non -Friable Organically Bound (NOB) by Gravimetric Reduction techniques employing PLM and TEM: ELAP 198.6 (PLM-NOB), ELAP 198.4 (TEM-NOB) Loose Fill Vermiculite Insulation, Attic Insulation, Zonolite (copyright), etc.: US EPA 600 R-4/004 (multi -tiered analytical process) Sprayed On Insulation/Fireproofing with Vermiculite (SOF-V): ELAP 198.8 (PLM-SOF-V) Soil, sludge, sediment, aggregate, and like materials analyzed for asbestos or other elongated mineral particles (ex. erionite, etc.): ASTM D7521, CARB 435, and other options available Asbestos in Surface Dust according to one of ASTM's Methods (very dependent on sampling collection technique — by TEM): ASTM D 5755, D5756, or D6480 Various other asbestos matrices (air, water, etc.) and analytical methods are available. Disclaimers / Qualifiers: There may be some samples in this project that have a "NOTE:" associated with a sample result. We use added disclaimers or qualifiers to inform the client about something that requires further explanation. Here is a complete list with highlighted disclaimers pertinent to this project. For a full explanation of these and other disclaimers, please inquire at customerservice@iatl.com. 1) Note: No mastic provided for analysis. 2) Note: Insufficient mastic provided for analysis. 3) Note: Insufficient material provided for analysis. 4) Note: Insufficient sample provided for QC reanalysis. 5) Note: Different material than indicated on Sample Log / Description. 6) Note: Sample not submitted. 7) Note: Attached to asbestos containing material. 8) Note: Received wet. 9) Note: Possible surface contamination. 10) Note: Not building material. 1% threshold may not apply. 11) Note: Recommend TEM-NOB analysis as per EPA recommendations. 12) Note: Asbestos detected but not quantifiable. 13) Note: Multiple identical samples submitted, only one analyzed. 14) Note: Analyzed by EPA 600/R-93/116. Point Counting detection limit at 0.080%. 15) Note: Analyzed by EPA 600/R-93/116. Point Counting detection limit at 0.125%. Recommendations for Vermiculite Analysis: Several analytical protocols exist for the analysis of asbestos in vermiculite. These analytical approaches vary depending upon the nature of the vermiculite mineral being tested (e.g. un-processed gange, homogeneous exfoliated books of mica, or mixed mineral composites). IATL recommends initial testing using the EPA 600/R-93/116 method. This method is specifically designed for the analysis of asbestos in bulk building materials. It provides an acceptable starting point for primary screening of vermiculite for possible asbestos. Results from this testing may be inconclusive. EPA suggests proceeding to a multi -tiered analysis involving wet separation techniques in 9000 Commerce Parkway Suite B Mt. Laurel, New Jersey 08054 Telephone: 85 6-231-9449 Email: customerservice@iatl.com INTERNATIONAL i��E�E.51C.)5 l t:SE l\C� 1_1\IiC)K:'�EL�f:if:S CERTIFICATE OF ANALYSIS Client: Mhguruhomes LLC Report Date: 2/29/2016 14601 106th Ave Ct. E Report No.: 503549 - PLM Puyallup WA 98374 Project: Ballys Client: MHG330 Project No.: conjunction with PLM and TEM gravimetric analysis (EPA 600/R-04/004). Further information on this method and other vermiculite and asbestos issues can be found at the following: Agency for Toxic Substances and Disease Registry (ATSDR) www.atsdr.cdc.gov, United States Geological Survey (USGS) www.minerals.usgs.gov/minerals/, US EPA www.epa.gov/asbestos. The USEPA also has an informative brochure "Current Best Practices for Vermiculite Attic Insulation" EPA 747FO3001 May 2003, that may assist the health and remediation professional. The following is a summary of the analytical process outlines in the EPA 600/R-04/004 Method: 1)Analytical Step/Method: Initial Screening by PLM, EPA 60OR-93/116 Requirements/Comments: Minimum of 0.1 g of sample. —0.25% LOQ for most samples. Pricing/Turnaround Time: Please contact your client representative for options available. 2)Analytical Step/Method: Wet Separation by PLM Gravimetric Technique, EPA R-04/004 Requirements/Comments: Minimum 50g** of dry sample. Analysis of "Sinks" only. Pricing/Turnaround Time: Please contact your client representative for options available. 3)Analytical Step/Method: Wet Separation by PLM Gravimetric Technique, EPA R-04/004 Requirements/Comments: Minimum 50g** of dry sample. Analysis of "Floats" only. Pricing/Turnaround Time: Please contact your client representative for options available. 4)Analytical Step/Method: Wet Separation by TEM Gravimetric Technique, EPA R-04/004 Requirements/Comments: Minimum 50g** of dry sample. Analysis of "Sinks" only. Pricing/Turnaround Time: Please contact your client representative for options available. 5)Analytical Step/Method: Wet Separation by TEM Gravimetric Technique, EPA R-04/004 Requirements/Comments: Minimum 50g** of dry sample. Analysis of "Suspension" only. Pricing/Turnaround Time: Please contact your client representative for options available. LOQ, Limit of Quantitation estimates for mass and volume analyses. *With advance notice and confirmation by the laboratory. **Approximately 1 Liter of sample in double -bagged container (-9x6 inch bag of sample). *SH33NIE3Na EINI-OnSNOMe sRIvIcss,:)C3N.Av,'s VONa 00-1/N.3V\ n • 11 LL NAV:M A. W. : Ll 7-v lip -'t• TO, .�..rn vs-c,e cN .oei..caa,o a-+v na•w.wrr �bm`.x .u.,ea C;, iol '�. !�n%I r��ddfl tas SMai o • Sh_l737:lN1E)NB E3NLCrTSNOZ1 w y t. .S.3LdI=Ery 'J att., d VONariom / NEna /lio© Nvi\ car --•^rwy3 'iRW32A q •.s � fi . ,t«.,os � .+.Hai - _ • ws � .t�:=2 1tk r .�r� ) �'��� � n� a ri' Li � 3p 1,71 3 4 a a��rr Ra I I MPE jo�'gR+u 1• 'TT �, a i� Q • - -I i a .. IT 00. IT :r d J N '. ' O d u L• _ e j PERMI1 APPLICATION CITY OF g 2016 ` Way JUL � PERMIT CENTER t 33325 8� Avenue South +Federal Way, WA 98003-6325 Federal V ay 253-835-2607 + FAX 253-835-2609 + permitcenter cot cityoffederalway.com CIT`( OF FEDERAL WAY� � C 5 ! PERMIT NUMBER _ Q — � TARGET DATE ���LLL-999 — — SITE ADDRESS �/�� JI I/>1�/]y SUITE/UNIT # $ PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL # TYPE OF PERMIT ❑ BUILDING El PLUMBING ❑ MECHANICAL kDEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT �1 i1� ;oA/t9SS Od �Ji/�!/ PROJECT DESCRIPTION Detailed description of work to be included on this permit only PROPERTY OWNER CONTRACTOR APPLICANT PROJECT CONTACT (The individual to receive and respond to all correspondence concerning this application) PROJECT FINANCING When value is $5, 000 or more (RCW 19.27095) NAME MAILING ADDRESS C CITY z, NAME MAILING ADDRESS /,wZ- �Y Qe WA STATE CONTRA( N MAILING ADDRESS CITY NAME V4VY2041 %lAiLING ADDRESS CITY NAME STATE � ZIP eu,,- Wo sl -fdl c- 64/ .P� STATE ZI �� 7d,26/0 )R'S LICENSE # EXPIRATION DATE MAILING ADDRESS, CITY, STATE, ZIP STATE I ZIP STATE I ZIP PRIMARY PHONE E-MAIL II' PHONE E-MAIL &- EN54D FAX FEDERAL WAY BUSINESS LICENSE # PRIMARY PHONE E-MAIL FAX PRIMARY PHONE :4r� � E-MAIL FAX ❑ OWNER -FINANCED PHONE I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as apart of this application. _ DATE SIGNATURE:]� PRINT NAME: em Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application t - tk7Clt..F]�ASII1. SLH6DULE rK` t;L.ToP 3�4.A 35'd:Ra 3.�:5 ''36:45.' .�.4.'-i.o `.Sg(.x: •395,3-. '. }-E, l 12'-3y2.�1 - CFJs°- two �':5.1�..°45¢ZI '. L"EEUIJ: Yi:oS 6"E]3 os i;,34sp 0l 3- q{3� .. 1. E. 1Z E'�W-'��.o .�::uE. 349.53--�--.:. .. :U•'1.'S= �� 7TE5 oIL SEP. 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