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23-103696
-I - Demolition City of Federal way Community Development Dept 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Project Name: ILLAHEE MIDDLE SCHOOL BUILDING 600 Project Address: 36001 1ST AVE S Project Description: Demolition of detached structure. Permit #:23-103696-00-DE Inspection Request Line: (253) 835-3050 Parcel Number: 302104 9013 Owner Applicant Contractor FEDERAL WAY PUBLIC SCHOOLS FORMA CONSTRUCTION COMPANY FORMA CONSTRUCTION COMPANY 33330 8TH AVE S 500 COLUMBIA ST NW SUITE 201 FORMACC878OR (9/19/23) FEDERAL WAY WA 98003 OLYMPIA WA 98501 500 COLUMBIA ST NW SUITE 201 OLYMPIA WA 98501 Additional Permit Information PERMIT EXPIRES Sunday, 14 January, 2024 Permit Issued on Tuesday, July 18, 2023 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. % Q Owner or agent Date: THIS CARD IS TO REMAIN ON -SITE CITY OF: Construction Inspection Record Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 23 103696 00 Address: 36001 1ST AVE S Project: FEDERAL WAY PUBLIC SCHOOLS FEDERAL WAY WA 98003-8606 Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On -going inspections are logged on the back of this card. Q Final - Building (4050) Approved By '~ Date Id7J1J 3 Rough Electrical ❑ Final Electrical Right of Way Approved Approved Approved By Date By Date By Date I _�k RECEIVED PERMIT APPLICATION f7v OF � �1 JULi q 202� PERMIT CENTER + 33325 8� Avenue South +Federal Way, WA eralwa .co n J VL I 0 253-835-2607 + FAX 253-835-2609 + permitcente crcityoffederalway.com CITY OF FEDERAL WA GOMMUNfTY DFVEL44'T' , PERMIT NUMBER Z. 3 - [ 0 3 t � - D r.) TARGET DATE SUITE/UNIT # SITE ADDRESS PROJECT VALUATION ZONING ASSESSOR'S TAX/PAR EL # TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL�DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT T 1 e� ��' SClr,pj�jr PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME 71r h 5C k °Q PRIMARY PHONE PROPERTY OWNER KAL1140 ADDRESS 3. v Aj S E-MAIL CITY F A0.\ ! S Q ZIP 0 �V" �` W' ?0 lJ NAME COn���t�l�r PHONE MALL'IN} ADDRESS �J CONTRACTOR CC// VV [ V STATE ZIP /�j y CITY 1 elf � 1 ]C [ © t �' V V `� U_7 FAX I/e.l I 1 WA STATE CO TRAC OR'S LICENSE # EXPIRATION DATE UBI # T;z; E.— ^��4 PRIMARY PHONE APPLICANT MAILING ADDRESS J� _ 1 �� tAJ MAIL STA E ZI G } CITY r, I i FAX 11 � NAME PRIMARY PHONE PROJECT CONTACT (The individual to receive and Q MAILING ADDRESS P DTAIL 'A � S yv�� Gf �1 respond to all correspondence concerning this application) D CITY STATEe ZIP FAX PROJECT FINANCING NAME ElOWNER-FINANCED When value is $5, 000 or more MAILING ADDRESS, CITY, STATE, ZIP PHONE (RCW 19.27.095) I certify under penalty of perjury that! 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 ineurred 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. SIGNATURE: \ DATE' PRINT NAME:Q � Bulletin#100 —February 19, 2020 Page I of 2 k:\Handouts\Permit Application 4 �k Federal Way COMMUNITY DEVELOPMENT DEPARTMENT 33325 8`h Avenue South Federal Way, WA 98003 253-835-2607;Fax 253-835-2609 wwL,v.citvof aederalwa .eom DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure on a subject property. Demolition of separate structures may require separate permits. ❑ Address of Demolition: vets e��� ®° c1VQ3 ❑ 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. ❑ A completed Construction Permit Applicationform is also required. 1. ASBESTOS ABATEMENT (Provide copy of Notice of-intentfrom Puget Sound Clean Air Agency and copy of inspection report by AHERA-certified inspector) City of Federal Way Building official) 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 �pri(or to any dismantling or excavation (South King Fire and Rescue) 3. SEPTIC SYSTEM DECOMISSIONING eV A (King County Environmental Services) 4. SANITARY SEWER (Lakehave Utility Di5trlCt) 5. ELECTRICITY (� aN- _SJrec�- 7- L "2-Z (puget Sound EnergyjTacoma Power) 6. NATURAL GAS (Pug e Sound Energy) 7. WATE - ub# c ource �(�/�_5 [ k have Ut ity District) 8. WATER - Private Well {King Co Antynvircnmental Services) k-o� Please Note: Erosion control measures must be in place during the demolition and through completion of the site clean-up. (Applicant) Page 1 of 1 ic7'HandoutskDrmolition Permit Requirements Bulletin # 122 -March 16, 2017 construction group international • ILLAHEE MIDDLE SCHOOL 028213 Asbestos Abatement Pre -Work Submittal CGI Project #: A23041 Federal Way Public Schools 1211 South 332nd Street Federal Way, WA 98003 Forma Construction Company 500 Columbia ST. NW, Suite 201 Olympia, WA 98501 PBS Engineering'and Environmental Inc. 214 E. Galer St, Suite 300 Seattle, WA 98102 Construction Group International LLC 19407 144t' Avenue NE, Bldg. D Woodinville, Washington 98072 May 25"' 2023 specialty contractors washington office: nevada office: 19407144th Ave NE Bldg D • Woodinville, WA 98072 3640 S. Highland Dr_ • Las Vegas, NV 89103 T425.4872618 F425.487.2619 CONSTG1953NA T702.307.8002 F702.307.8010 NVLicense60686 www.cgius.net TABLE OF CONTENTS 1. ASBESTOS ABATEMENT WORK & SAFETY PLAN 2. LABORATORY QUALIFICATIONS 3. NOTIFICATIONS & INSURANCE 4. ASBESTOS SUPERVISOR S. CGI HEALTH & SAFETY POLICY Illahee Middle School 028213 Asbestos Abatement Work Plan ASBESTOS ABATEMENT WORK PLAN GENERAL SCOPE OF WORK Our scope of work is to remove and. dispose of asbestos containing materials prior to building demolition at Illahee Middle School — 3600111` Ave South, Federal Way, WA 98023. Asbestos Abatement Building 100 615 SF ACM SHEET VINYL FLOORING AND ASSOCIATED MASTIC 650 SF ACM MASTIC BEHIND WOOD PANEL 2 EA SINK WITH ACM UNDERCOAT 50 LF RESIDUAL ROOFING TAR ON ROOFTOP COMPONENTS Building 200 210 5F VAT AND ACM MASTIC ON CONCRETE 130 SF VAT AND ACM MASTIC ON WOOD Building 300 225 SF VAT AND ACM MASTIC ON CONCRETE Building 400 5 EA SINK WITH ACM UNDERCOAT Building 500 3100 SF VAT AND ACM MASTIC ON CONCRETE 50 LF RESIDUAL ROOFING TAR ON ROOFTOP COMPONENTS Building 600 9200 SF VAT AND ACM MASTIC ON CONCRETE 100 LF ACM WINDOW FRAME SEALANT 700 LF ACM WINDOW GLAZING COMPOUND 200 SF ACM TANK INSULATION 50 LF RESIDUAL ROOFING TAR ON ROOFTOP COMPONENTS Building 700 450 SF VAT AND ACM MASTIC ON CONCRETE 100 SF ACM SVF AND ASSOCIATED MASTIC 1 EA SINK WITH ACM UNDERCOAT 1 EA ACM INSULATION FROM ROOF DRAIN 50 LF RESIDUAL ROOFING TAR ON ROOFTOP COMPONENTS Building 800 250 SF WALL PANELS WITH ACM MASTIC Building 900 1950 SF VAT AND ACM MASTIC ON CONCRETE 650 5F VAT AND ACM MASTIC ON WOOD CGI1ob# A23041 5/25/2023 1 of 12 lllahee Middle School 028213 Asbestos Abatement Work Plan All Buildings / Site 1500 EA ACM HARD MUDDED FITTINGS 50 EA ACM FIRE DOORS 1000 LF CEMENT ASBESTOS PIPE TEMPORARY FACILITIES & CONTROLS The following temporary utilities and controls will be provided by CGI as indicated: ® Storage Work will not require any special storage needs, other than an enclosed trailer to store ACM's. Tools and equipment shall be stored within the confines of the project limits within our work trucks. CGI does not anticipate the need on this proiect for any flammable material storage. Parking All parking is self -provided within the project limits. Hoisting Self -provided. a Electrical Existing electrical connections. Power source to be provided by Forma. ® Lighting Ambient lighting, existing lighting and task lighting provided by CGI as required. o Water Existing water connections. Water source to be provided by Forma. ® Sanitary Portable toilet facilities to be provided by Forma. a Fire Protection CGI will supply one (1) ABC rated fire extinguisher for each 5,000 SF of work area during abatement operations. No "Hot Work" is to be performed on this project orecluding the need for anv Hot Work Permit. CGI Job# A23041 5/25/2023 2 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan PROJECT SCHEDULE & CREW Crew size will be a maximum of eight (8) for abatement personnel, including working supervisors. Work shifts shall be established to be 7:00 am to 3:30 pm Monday through Friday, unless otherwise agreed upon. Anticipated start date is June 26th, 2023. Abatement work sequence will be per Forma's Phase 1 Demo Logistics Plan. CGI will perform abatement in the following order: building 800 (1-2 day duration), building 400 (1-2 day duration), building 500 (2-3 days duration), building 600 (10 day duration), building 300 (1-2 day duration), building 700 (1-2 day duration), building 200 (1-2 day duration) and building 100 (2-3 day duration). Selective demolition work and asbestos abatement in the gym (building 900) will occur simultaneously as the rest of the asbestos abatement work. We have -5 days of abatement in building 900. WORK PLAN The intent of the work plan is to describe and clarify the processes and procedures to be utilized for this project and not to "simply reiterate the language already contained in the specifications. General Overview & Staging All primary staging for abatement and demolition tools, consumable materials, debris, and personnel shall be within the property boundries, adjacent to the structures. Staging of disposal containers, work vehicles shall be within the same areas. Abatement/Demolition Personnel Protection All abatement personnel shall don the following: ® Appropriate construction clothing. Full body disposable protective clothing with hood and booties for abatement. Full body disposable protective clothing for demolition is at the discretion of the employee. e % face respirators with HEPA cartridges for abatement work and %Z face respirator with HEPA cartridges for any work creating silica, nuisance dust. ® Full face PAPR respirators will be worn for all class 1 asbestos abatement. Protective gloves. Eye protection. o Protective footwear. Hardhats and safety vests. ib Hearing protection shall be worn when operating small tools or other loud machinery. CGI Job# A23041 5/25/2023 3 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan Regulated Work Area Demarcation All egress points into regulated work areas shall be clearly demarcated with asbestos signage on the exterior side. Emergency exits shall be clearly demarcated with orange or red spray paint or tape applied to the critical barriers consisting of 6-mil poly, which can be easily cut or removed in the event of a fire or other life- threatening emergency. All regulated abatement work areas shall be clearly demarcated with asbestos signage at the point of entry. All openings into regulated areas shall be sealed with one layer of 6-mil poly sheeting, which includes HVAC openings and doors at the perimeter. Any exterior work shall have a regulated area designated by asbestos banner tape. Decontamination Units for Glove Bag Work Areas and NPE's CGI utilizes Personnel Decontamination Units (PDU's) consisting of three (3) chambers, each with air locks will be utilized for and Class I friable materials. The PDU's shall consist of a dirty room, shower and clean room. CGI utilizes pre -fabricated 3' X 6' sheet metal pans for their PDU's that can accommodate a PVC pipe frame to support polyethylene sheeting (poly). The pans are also fitted with a drainage outlet so that any pan can be utilized as a shower chamber. The pans are large enough to accommodate two (2) showers, which are sufficient to support a crew of eight (8). All shower watershall be filtered through a .5 micron filtration system priorto discharge into the nearest sanitary sewer or storm drainage system (toilet). Shower pans shall have grating in order to elevate personnel above the water level. Material Decontamination Units (MDU's) consisting of two (2) chambers, each with air locks will be utilized. CGI also utilizes prefabricated sheet metal pans similar to the PDU's as MDU's, except the pans are 4' X 6' so they have the ability to accommodate megabox disposal containers. The work area side is utilized as a dirty room, one chamber shall be a wash down station and the next chamber shall be the clean room. Negative Air Machine Calculations (As Applies) There is (1) negative pressure enclosure anticipated in this scope of work, this is related to the tank insulation removal. This room is very small <1000 SF and will only require (1) negative air machine to reach negative pressure. One additional negative air machine will be on site as a back up. The calculations for negative air machines (NAM's) are based on the following (EXAMPLE): 1000 SF Work Area (NPE) 1000 SF X 10' Height = 10,000 FT3 10,000 FT' X 4 air changes/hr = 40,000 FT' 40,0000 FT/ 60 minutes = 666 CFM 666 CFM / 1,400 CFM (2,200 @ 70% efficiency) = 1 NAM per 1000 SF Space CGI Job# A23041 5/25/2023 4 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan Asbestos Abatement Class I — Thermal System Insulation TSI o Asbestos Pipe & Fitting Insulation Asbestos containing (ACM) pipe and fitting insulation is located throughout each building. Affected pipe insulation shall be placed in glove bags and securely fastened with an airtight seal to perform removal within the glove bag. All glove bags shall be connected to a running HEPA vacuum inducing negative pressure in the bag. A nozzle connected to a sprayer, containing water, will be placed in the glove bag, providing a continuous source of water to be used for wetting the asbestos insulation and for cleaning the piping substrate. A HEPA vacuum will be available in the immediate vicinity of the work in case of glove bag failure. Working in teams of two, as required by regulations, care shall be taken so as not to overload the glove bags causing glove bag failure or the glove bag to fall from the pipe. Glove bags will be supported from below as necessary to prevent falling. After all areas within the glove bag have been cleaned and encapsulated we will than collapse the glove bag using the attached HEPA vacuum, securing the bag using duct tape, placed above the portion of the glove bag that contains the asbestos waste. Glove bags shall then be removed from the pipe and placed directly into a properly labeled asbestos disposal bag, securing the second bag with duct tape in a similar manner as the glove bag. For detailed glove bag procedures, see CGI Health & Safety policy and corresponding WAC codes and CGI's Health & Safety Policy. The remaining piping insulation will then be wrapped in two layers of 6-mil poly and the pipe will be cut at the glove bag location. Pipe insulation that is located within an NPE will be stripped as part of the abatement process and the remaining piping will be cleaned as part of the cleaning process to obtain clearances within the NPE. ® Thermal Insulation (TSI) Wrap & Cut Fitting Removal Asbestos containing (ACM) pipe fitting insulation is located throughout the buildings. CGI will wrap affected fittings in 6-mil poly and duct tape and cut the fitting off of the pipe where there is fiberglass insulation. Multiple fittings will be placed into 6-mil disposal bags. ACM Tank Insulation This work will occur in a Negative Pressure Enclosure (NPE) with 3-stage decon and load out. Workers will wear full -face respirators power air purified respirators (PAPR). Tank insulation will be adequately wetted and manually removed with hand tools. Asbestos containing materials will be placed in (2) 6-mil poly bags for disposal. Once a visual CGI Job# A23041 5/25/2023 5 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan inspection has been completed by the consultant, the air -clearance will be ran. Once this is completed and clearance passed, the NPE will be torn down. Class II — Miscellaneous Materials Residual Roofing Tar Built-up roofing/sealants/tars shall be manually removed with small tools and/or removed as per WRD 23.35 during the demolition process, placed into leak tight disposal containers and disposed of as non -friable ACM. An asbestos supervisor shall be on -site during all roof removal activities, shall regulate the area, shall apply adequate amounts of water and shall conduct air sampling. All personnel involved with the BUR removal shall don PPE, including %Z face respirators. Vinyl Asbestos Tile (VAT) VAT shall be manually removed with "spud" bars or floor machines while lightly misted with amended water and placed into two (2) 6-mil yellow asbestos disposal bags and appropriately labeled for disposal. All waste shall be placed in two (2) 6-mil yellow disposal bags or a megabox lined with two 6-mil megabags. 7 Asbestos Containing Mastics on Concrete Work area will be demarcated with asbestos banner tape, the affected rooms will become a regulated area at the point of entry. Appropriate asbestos signage shall be placed on the outside of the door. Mastic will be adequately wetted prior to removal; a chemical solvent will be applied and the mastic will be removed manually with razor scrapers and placed into two (2) 6-mil disposal bags or lined Megabox/Trailer for proper disposal. Asbestos Containing Mastics on Wood Work area will be demarcated with asbestos banner tape, the affected rooms will become a regulated area at the point of entry. Appropriate asbestos signage shall be placed on the outside of the door. Mastic will be adequately wetted prior to removal and removed manually with "spud" bars by removing the wood subfloor/plywood while placed into two (2) 6-mil disposal bags or lined Megabox/Trailer for proper disposal. m ACM Fire Doors Work area will be demarcated with asbestos banner tape. The affected materials will be adequately wetted prior to removal. Fire Doors will be manually removed and wrapped in 2 layers of 6-mil poly for disposal or placed into a lined disposal can. s SVF w/ associated backing/mastic Asbestos containing sheet vinyl flooring (SVF) will be adequately wetted and manually removed using the strip -method and placed into (2) — 6 mil poly bags for disposal. CGI Job# A23041 5/25/2023 6 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan Sinks Sinks with ACM coating shall be separated from the countertops manually, intact, where possible and wrapped with 2 layers of 6 mil poly sheeting and/or placed in two (2) 6-mil yellow disposal bags or a mega -box lined with two 6-mil mega -bags for proper disposal. Caulking/Sealants/Mastics/Other Miscellaneous ACM's Caulking, Mastics, Sealants & other miscellaneous ACM materials shall be manually removed with small tools and placed into two (2) 6-mil disposal bags. Cement Asbestos Pipe This work will occur outdoors in a regulated work area with asbestos banner tape. Cement asbestos pipe will be adequately wetted prior to removal, broken into manageable sized pieces using hand tools, pipe sections will manually removed, wrapped in 2-layers of 6- mil poly and placed into appropriate disposal trailer. WASTE DISPOSAL Asbestos Asbestos containing waste shall be double bagged in 6-mil disposal bags, placed in mega -boxes with 2-6 mil mega -bags or wrapped in two (2) layers of 6-mil poly sheeting. Asbestos waste containers shall have labels bearing the date, project name, owner and asbestos contractor. Asbestos waste shall be transported to the exterior of the affected buildings and loaded into the CGI enclosed disposal vehicle or waste container. Asbestos containing waste shall be transported and disposed of as follows: Transporters, Transfer Station & Landfill Owners: Transporters: Construction Group International LLC 19407 144th Avenue NE, Bldg. D Woodinville, WA 98072 (425) 487-2618 Phone (425) 487-2619 Fax NTSI 1905 E. Lincoln Tacoma, WA 98421 (253) 383-3860 Phone Republic Services 2733 3rd Avenue South Seattle, WA 98134 CGI Job# A23041 5/25/2023 7 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan Landfills: Northern Wasco County Landfill 2550 Steele Road The Dalles, OR 97058 (541) 296-4082 Phone Roosevelt Regional Landfill 500 Roosevelt Grade Road Roosevelt, WA 99356 (509) 384-5641 Phone AIR MONITORING & LABORATORY ANALYSIS Pre -abatement and pre -clearance air sampling shall be provided by CGI. Contractor required air monitoring, will be collected by CGI supervisor and submitted to NVL Laboratories (NVL), a NIOSH and AIHA certified laboratory. NVL Laboratories, Inc. AIHA Lab #101861 4708 Aurora Avenue North Seattle, WA 98103 (206) 547-0100 Phone (206) 634-1936 Fax SAMPLING PLAN Air monitoring shall be performed by CGI in accordance with WAC 296-62-07709 and as follows: ® Representative eight -hour TWA employee exposures must be determined on the basis of one or more samples representing full -shift exposure for each shift for each employee in each job classification in each work area. Representative thirty -minute short-term employee (STEL) exposures must be determined on the basis of one or more samples representing thirty -minute exposures associated with operations that are most likely to produce exposures above the excursion limit for each shift for each job classification in each work area. Daily monitoring within regulated areas: The employer must conduct daily monitoring that is representative of the exposure of each employee who is assigned to work within a regulated area. Exception: When all employees within a regulated area are equipped with full facepiece supplied -air respirators operated in the pressure -demand mode equipped with either an auxiliary positive pressure self-contained breathing apparatus or a HEPA filter, the employer may dispense with the daily monitoring required by this subsection. CGI Job# A23041 5/25/2023 8 of12 Illahee Middle School 028213 Asbestos Abatement Work Plan C Monitoring outside negative -pressure enclosures (NPE's) if applies: The owners Environmental Consultant may conduct representative area monitoring of the airborne fiber levels at least every other day at the HEPA machine exhaust and entrance to the decontamination area. There are no NPE's on this project. Pre -abatement and pre -clearance sampling. a Final PCM clearance sampling. SITE SAFETY PROTOCOL It is the objective of CGI to maintain project sites that provide a safe environment to our employees and result in less time loss injuries. Safety is a concern of all company employees and each employee has a mandated responsibility to promote the safety of all as prescribed in the corporate Health & Safety Policy. All CGI supervisors are CPR and First Aid trained. Safety is an extremely important priority at CGI and we have a zero tolerance policy for unsafe work practices that consists of a progressive warning system for violators. The first warning for worker's is verbal for all violations not classified as a "willful" or "serious" infraction, the second warning is written and becomes an employee record and the third infraction will result in termination. The same applies to Supervisors, however the first warning is written. Serious violations, dependent on their severity may result in immediate termination, however, will result in a written notice for all personnel categories. A second serious violation will result in termination. Willful + serious violations will result in termination. All CGI field personnel must maintain a working knowledge of the applicable codes and standards in the WAC as administered by the Washington State Department of Labor & Industries (L&I) by the Washington Industrial Safety & Health Act (WISHA) that are applicable to asbestos and construction activities. All projects with a duration of more than a week will have a weekly project meeting, of which Safety is a continuous topic that will include both job specific safety concerns and general safety practices as continuing education. All project employees are required to attend and topics of discussion are recorded along with the names of all attendees. Daily reports will also reflect any safety concerns, occurrences or accidents. Regular job site inspections are conducted by supervisory personnel at the beginning of each work shift, during the work and at the end of each work shift to assure all engineering controls and safety measures are functioning properly and in compliance with regulations and specifications. All potential hazards will be communicated through CGI's on -site Supervisor to the owner's representative. All potential or known hazards will be recorded on a job site inspection form and/or daily log, both of which will be transmitted to the owner's representative. CGI company policy is to immediately rectify all hazards or safety concerns that impact our work and are within our control until proceeding further with regular work activities. Hazards and CGI Job# A23041 5/25/2023 9 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan safety concerns outside of our immediate control will be immediately reported to the owner's representative. RESPIRATORY PROTECTION PROG The overall, general safety program that shall be adhered to on this project is the CGI Health & Safety Policy and all applicable provisions contained therein, which also includes our Respiratory Protection Program. FALL PROTECTION PROGRAM The overall, general safety program that shall be adhered to on this project is the CGI Health & Safety Policy and all applicable provisions contained therein, which also includes our Fall Protection Program. A site specific fall protection plan will be developed on -site by our supervisory personnel utilizing the fall protection form. The following fall hazards have been specifically identified for this project: o Work from ladders or lifts shall be performed in accordance with procedures found in Section W.6.0 of CGI's Health & Safety Plan. Any otherfall protection hazards, as encountered, will be addressed by the project supervisor and a specific fall protection plan shall be developed. JOB HAZARD ANALYSIS The hazards of the project in order of precedence include fall protection, cuts and abrasions, falling debris and potential asbestos exposure. CGI written fall protection plan will be implemented on this project. Cuts & abrasions will be avoided with the use. of gloves, eye protection and appropriate work practices. Asbestos exposure to the public will be minimized through the use of regulated areas, controlled entry and compliant work practices. All workers will have PPE and the work area will not be accessible to the general public. On -site Job Safety Analysis Sheets shall be filled out by on -site supervisory personnel as applicable for any special conditions that are specific to the project that are not described above. CGfJob# A23041 5/25/2023 10 of12 Illahee Middle School 028213 Asbestos Abatement Work Plan HAZARD COMMUNICATION PROGRAM CGI's Hazard Communication Program is reflected in CGI's Health & Safety Plan. It is the ultimate responsibility of CGI to communicate hazards to employees, other entities/employers as per WAC 296-155-180. EMERGENCY PROCEDURES In the event of a minor fire, CGI shall extinguish with one of the ABC fire extinguishers located within or adjacent to each work area. In the event of a serious fire, the work area will be immediately evacuated via the nearest means of egress. Exit paths from work areas shall be pre- established before the commencement of work. In the event of minor work site injuries, the injured shall exit the work area and report to supervisory personnel and assess seeking medical attention. In the event of a more severe injury such as deep wounds, punctures, abrasions, etc. injury, the injured shall be assisted by other CGI personnel for immediate medical attention. In the event of a debilitating or life -threatening injury, the injured will be immediately attended to by the nearest CGI personnel but not be moved as recommended by the medical profession. 911 will be immediately called for the most expedient medical attention. CGI Certified Asbestos Supervisor personnel are First Aid/CPR certified. The nearest medical facilities are listed in the Emergency Contact section. CGI Job# A23041 5/25/2023 11 of 12 Illahee Middle School 028213 Asbestos Abatement Work Plan PROJECT & EMERGENCY CONTACT INFORMATION Contractor: Construction Group International LLC 19407144th Avenue NE, Bldg. D Woodinville, Washington 98072 WA License: CONSTG1953NA Project Manager: Janielle Linder, Project Manager (Hazmat) JanielleL@c�ius.net (425) 753-5148 Const. Manager: Carl Linder carll@cgius.net (425) 753-4724 Supervisor: Eustaquio Sanchez e ustaguios @cgi us. net (425) 761-4357 Owner: Federal Way Public Schools 3330 8th Ave South Federal Way, WA 98003 GC/CM: Forma Construction 500 Columbia St NW, Suite 201 Olympia, WA 98501 Project Engineer: David Hicks davidh@formacc.com (360) 561-5323 Owner Rep: PBS Environmental 214 E Galer Street, Suite 300 Seattle, WA 98102 Project Manager: Mark Hiley ivlark.Hile,q@pbsusa.com (206) 255-4356 For all emergencies dial 911. 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Z14a' -Z - w W� < Z- Z, Z- 'W. z <Z 2--,! z z . 02 0 0 z I x Pon <, lo -W, -,02 < z < L? o < 5 -Z a-zR-<!.- 09 ,I a - . < z 0 < 0 z Is > z w ow 'o > 51 lo.. o e �''6 15 Z�a 1 0 >vri 0, mu z <L 6. TgEow¢�� Z. < Z Ea L 52 P 214' W,UZ LLIJ 0 SNOIIV:)Ijiivnt) AHOIVHOG I 7 n• I: x NVL INDUSTRIAL HYGERE SERVICES LhERATORY • MANAGEMENT * TRAINING NVL- Industrial Hygiene- Health & Safety Services STATEMENT OF QUALIFICATIONS NVL is one of the leading industrial hygiene firms in the Northwest. Opening its doors in 1995, NVL successfully provides full -service to its clients including testing and environmental safety services. We provide innovative solutions to all your environmental and health & safety needs, in order to minimize your risks and overhead costs. Having NVL as your project partner ensures success for your clients. We take pride in offering a broad range of experiences in supporting both public and private entities. Our services are designed to meet the needs and standards of a diverse range of businesses including environmental engineering firms, architects, general contractors, industrial hygienists, facility/property managers, remodelers, government agencies, homeowners, and others involved with hazardous commercial or residential building materials. NVL's seasoned team of experts provides complete services and regulatory compliant hazardous material solutions ranging from project design, surveys/inspections, analytics, remediation plans, project oversight, O&M plans, to final project closeout. Our core values are strong teamwork, empowerment, quality, and consistency. Our core services include: Laboratory/Analytical Project Management Training LABORATORY/ANALYTICAL Operating both nationally and internationally, NVL is the premier testing laboratory in the Northwest. We are accredited by AIHA-LAP, NVLAP, Department of Defense (DoD-ELAP), CA-ELAP, and Washington Department of Ecology (WADOE). We are adequately staffed and equipped to handle all your projects, large or small. We provide high quality analytical results, specializing in asbestos fiber identification and a range of metals analyses using NIOSH, OSHA, and EPA methods. Our fast turnaround times (as quickly as an hour), 24/7, 365 days/year service, and easily accessible, concise "Lab Online" reports set us apart from others. Our analytical services include but are not limited to the following: • ASBESTOS in air and bulk samples • LEAD (Pb) in air and bulk samples (paint chips, dust wipes, soil, wastewater, and drinking water) • MOLD in air (fungal and particulates identification), and bulk (qualitative and quantitative) • PCB's analysis in air, bulk, and wipe samples • HEXAVALENT CHROMIUM in air and bulk samples • Silica (air and bulk) • TCLP (Toxicity Characteristic Leaching Procedure) for lead and other RCRA metals • RCRA METALS and welding fume panels NVL Laboratories Statement of Qualification 1 of 15 NVL PROJECT MANAGEMENT NVL is a pacesetter in quality service! We offer a combination of an excellent team of experts alongside the latest technology to manage your projects, start to finish. Being a trusted provider in the field of industrial hygiene and environmental health & safety services, NVL brings the best consulting expertise for the public and private sectors. Ensuring health & safety for both buildings and their occupants is our top priority. NVL offers comprehensive support through the duration of projects and is mindful of up to the date market responses and regulatory compliance requirements. Combining scientific expertise with a sector -driven approach, our project management services encompass the following: • Develop and implement an appropriate sampling plan that meets your needs, with your own health & safety personnel. • Recognize, evaluate, prevent, and control harmful or unsafe environmental factors that may arise in or from the workplace. • Assessment of indoor air quality and worker health & safety. • Exposure management and control. • Site assessment for hazardous building materials (asbestos, lead, mold, PCBs, silica, and more.) • Project oversight and health & safety plan development. • Project management for complex and multidisciplinary projects paired with the most appropriate technical expertise and resources. • Lead (Pb) and RCRA metals risk assessments, and clearance inspections as required by state and federal regulations TRAINING NVL is an EPA certified firm. It is one of the few organizations that provide training to its clients for the following: • Lead renovation, repair & painting (RRP) training • Lead inspector training • Lead risk assessor training • Lead dust wipe sampling technician • EM385 fall protection training • NIOSH 582 (PCM), meeting the requirements of AIHA Registry Programs, and more! Facility owners/managers often engage with maintenance, renovation, and/or repair work where they may come across hazardous building materials. OSHA (Occupational Safety and Health Administration) and L&I (Washington State Department of Labor & Industries) require that they must go through Hazard Awareness Training, in order to safely deal with such situations. NVL offers classes for health & safety training that satisfy those requirements. We provide the following training classes for any number of students to meet our clients' needs. We offer open enrollment and custom classes, both on and off -site with any number of students. • Hazard awareness training • Lead (Pb) safe work space training • Asbestos awareness training • Mold awareness in construction • Construction health & safety training • EM 385 competent person fall protection training, and more! NVL Laboratories Statement of Qualification 2 of 15 NW, PROFESSIONAL ACCREDITATIONS The laboratory is currently accredited for the following: 1. American Industrial Hygiene Association (AIHA-LAP, LLC) • Industrial Hygiene (asbestos, heavy metals, silica and nuisance/respirable Dust) • Environmental lead (recognized under EPA NLLAP program) • Environmental microbiology (mold spore identification) • Unique scopes (consumer products) • Asbestos Analyst Registry (AAR) 2. US Department of Defense- Environmental Laboratory Accreditation Program (DOD-ELAP) • Asbestos (bulk/air) • Heavy metals (bulk/air/TCLP) 3. National Voluntary Laboratory Accreditation Program (NVLAP) • Asbestos (bulk fiber analysis) 4. Washington Department of Ecology (WADOE) • Drinking water • PCBs • Heavy metals in solid and chemical materials S. California Department of Public Health -Environmental Laboratory Accreditation Program (ELAP) • Asbestos (bulk fiber analysis) 6. US Environmental Protection Agency— EPA: Renovation, Repair and Painting program (RRP) initial,trainer 7. US Environmental Protection Agency — EPA: RRP refresher trainer 8. US Environmental Protection Agency — EPA: dust wipe sampling technician trainer 9. Member of Society of American Military Engineers Permits & Registries: 1. US Department of Agriculture • Soil permit (shipment authorization from all foreign sources) 2. State of Hawaii asbestos laboratory registration (bulk/air) 3. State of Washington Community Trade & Economic Development (CTED) MBE Certification • State of Washington and Oregon Minority Business Enterprise NVL is more than just a formally certified minority owned business— underrepresented members of society comprise more than 50% of the staff, and we at NVL feel that our multiculturalism is one of our strengths. NVL maintains a culturally inclusive and competent atmosphere which enhances both our internal cooperative environment and our perspective toward providing customer service. At NVL, we understand that creating a professional environment dedicated to the achievement of excellence includes understanding the diversity within our staff, clientele, and community. NVL Laboratories Statement of Qualification 3 of 15 NVL LABORATORIES, IN.C. ORGANIZATIONAL CHART AbMiL] Acccunrinu MRrkoinp CI11-L 511-11 N.Cnrruan! 0.l�rFrwly Sprtrree j' Cncv3meloi Src•[mlal I Cl�nr 84oF"•eeP� 5elntes �' ipseral�� t ppn{ apvualnt t;lpnl ipenabn Technical Director Laboratory Director General Manager Office Manager Laboratory PrnJPct Manarterirrnt Industrial Regulated ng Hygiene I Material5ervices ervit Asbestos Metals/Org Env. Microbiology Supervisor Supervisor Supervisor IH Manager Manager RSMS IH 5upervisor Prnfq.S PrnfnL6 Rkerr,.g�r P.\.•'F:Ar ararrnl P�il9[V,RMIAH + PSIAjP:1.1 Ayy;t F r4M.A1L As wllYn { �1 old Rnalnl iulfiiYl PVa.?[AS :.r.y`y�r P{1,[PiV NwY�fl n,r.LPChA�naF st hSntab An]h7t !.Sold Anll)'ai -`. , �� Irnweu.t � ' I •03'A,Kl RnA,.1 RM Pitxnl011" AQr,TrP:M+nrt.fr M941A A114"L MOW Analyst f- I mrnr'r.cw� Ir+vntrr.N.,1y.1 nre PFMaxrinr � 6selal! AnnlysS �stlld�tkA1)s: R%T, I4r— NVL Laboratories Statement of Qualification 4 of 15 AI HA .•ratory Accreditation Programs, LLC Al HA Laboratory Accreditation Programs, LLC SCOPE OF ACCREDITATION NVL Laboratories, Inc. Laboratory ID: LAP-101861 4708 Aurora Ave N, Seattle, WA 98103-6516 Issue Date: 04/30/2021 The laboratory is approved for those specific field(s) of testing/methods listed in the table below. Clients are urged to verify the laboratory's current accreditation status for the particular field(s) of testing/Methods, since these can change due to proficiency status, suspension and/or withdrawal of accreditation. Industrial Hygiene Laboratory Accreditation Program (IHLAP) Initial Accreditation Date: 02/07/1997 i Technology sub- Published Reference Component, parameter p ' IHLAP Scope Category Field of Testing (FOT) type/Detector Method/Title of or characteristic tested In-house Method Asbestos/Fiber Phase Contrast - NIOSH 7400 Asbestos/Fibers Microscopy Core Microscopy (PCM) Miscellaneous Core Gravimetric - NIOSH 0500 Total Dust Miscellaneous Core Gravimetric NIOSH 0600 Respirable Dust Spectrometry Core Atomic Absorption FAA NIOSH 7082 Lead Spectrometry Core Inductively -Coupled Plasma ICP/AES NIOSH 7300 RCRA Metals Spectrometry Core X-ray Diffraction (XRD) NIOSH 7500 Silica A complete listing of currently accredited IHLAP laboratories is available on the AIHA-LAP, LLC website at: http:// www.. ai h aaccrerlii e drabs. a Effective: 11 /21 /2019 Revision: 9 Page 1 of 1 AIHA Iralt" Accreditation Programs, LLC AIHA Laboratory Accreditation Programs, LLC SCOPE OF ACCREDITATION NVL Laboratories, Inc. Laboratory ID: LAP-101861 4708 Aurora Ave N, Seattle, WA 98103-6516 Issue Date: 04/30/2021 The laboratory is approved for those specific field(s) of testing/methods listed in the table below. Clients are urged to verify the laboratory's current accreditation status for the particular field(s) of testing/Methods, since these can change due to proficiency status, suspension and/or withdrawal of accreditation. The EPA recognizes the AIHA-LAP, LLC ELLAP program as meeting the requirements of the National Lead Laboratory Accreditation Program (NLLAP) established under Title X of the Residential Lead -Based Paint Hazard Reduction Act of 1992 and includes paint, soil and dust wipe analysis. Air and composited wipes analyses are not included as part of the NLLAP. Environmental Lead Laboratory Accreditation Program (ELLAP) Initial Accreditation Date: 04/01/1997 Component, parameter or characteristic tested Technology sub-type/Detector Method Method Description (for intemal methods only) Airborne Dust AA EPA SW-846 3051 A NIA EPA SW-846 7000B NIA Paint AA EPA SW-846 3051A N/A EPA SW-846 7000B NIA Settled Dust by Wipe AA EPA SW-846 3051A N/A EPA SW-846 7000B N/A Soil AA I EPA SW-846 3051 A NIA EPA SW-846 7000B NIA A complete listing of currently accredited ELLAP laboratories is available on the AIHA-LAP, LLC website at: hap:// www. aihaaccreditedlabs. orc, Effective: 11 /21/2019 Revision: 8 Page 1 of 1 AIHA -8 ratory Accreditation Programs, LLC AIHA Laboratory Accreditation Programs, LLC SCOPE OF ACCREDITATION NVL Laboratories, Inc. Laboratory ID: LAP-101861 4708 Aurora Ave N, Seattle, WA 98103-6516 Issue Date: 04/30/2021 The laboratory is approved for those specific field(s) of testingimethods listed in the table below. Clients are urged to verity the laboratory's current accreditation status for the particular field(s) of testing/Methods, since these can change due to proficiency status, suspension and/or withdrawal of accreditation. Environmental Microbiology Laboratory Accreditation Program (EMLAP) EMLAP Scope Category Fungal Fungal Fungal Initial Accreditation Date: 02/07/1997 Field of Testing (FOT) Component, parameter Method or characteristic tested Air - Direct Examination Bulk - Direct Examination Surface - Direct Examination Spore Trap Bulk Surface Wipe SOP 12.133 SOP 12.133 SOP 12.133 Method Descriptioi (for internal methods o in House: Analysis of Spore Trap In House: Analysis of Spore Trap in House- Analysis of Spore Trap A complete listing of currently accredited EMLAP laboratories is available on the AIHA-LAP, LLC website at: Mtp:// www. alhaa ccreditedlabs. Orr: Effective: 11121 /2019 Revision: 7 Page 1 of 1 *��'AIHA .. ,ratory Accreditation Programs, LLC AIHA Laboratory Accreditation Programs, LLC SCOPE OF ACCREDITATION NVL Laboratories, Inc. 4708 Aurora Ave N, Seattle, WA 98103-6516 Laboratory ID: LAP-101861 Issue Date: 04/30/2021 The laboratory is approved for those specific field(s) of testing/methods listed in the table below. Clients are urged to verify the laboratory's current accreditation status for the particular field(s) of testing/Methods, since these can change due to proficiency status, suspension and/or withdrawal of accreditation. Unique Scopes Laboratory Accreditation Programs (Unique Scopes) Initial Accreditation Date: 04/01/2013 Unique Scopes Field of Testing (FOT) Component, parameter Method Method Description Scope Category or characteristic tested (forintemal methods only) Lead in Paint and Other Similar Surface Coatings Surface paint CPSC-CH-E1003-09 - Consumer Product Testing Total Lead in Metal Children's Products Metallicjewelry CPSC-CH-E1001-08 - Total Lead in Non -Metal Non-metallic CPSC-CH-E1002-08 Children's Products A complete listing of currently accredited Unique Scopes laboratories is available on the AIHA-LAP, LLC website at: fltf�.IzW—www.aihaaccre-ditedlab -ono Effective: 11121 /2019 Revision: 2 Page 1 of 1 21905 64th Ave W, #1001 W wMloke Twraw, WA 95043 (206) 285-337s This certifies that Eustaquio Sanchez 27M 24M Ave SE Ada Vidley WA 9" has $0jdart(X* CMPNOAW B hats of irwtlpl trail t cps a Lead ftroovator in wroia" with 40 CFR Part 746.225 and WAC 365-230 trokwV re"Mmer". Wuctor. David Walch - WA Trak*q Pravlder Cart; WI 5 -- -- CerL * R-1-9015WA 21-OW Class & yarn Date- Oct 12, 2021 ExPhfm Date: Oct 12, 2026 AdvanceOnline Solutions Online Institute IF r Eustaquio Sanchez has met the online course completion requirements for OSHA 10-Hour Construction Safety This student has completed the formal nistruction for the 10-Hour Construction Outreach Program. Topics covered in this program were Introduction to OSHA, Struck -by and Caught -In or Between Hazards, Electrical Safety, Excavation Safety, Fall Protection, Crane Safety, Ladder Safety, Materials Handling, Permit -Required Confined Spaces, Personal Protective Equipment, and Scaffold Safety. As an OSHA Outreach Training Program trainer, I ujljrm that I have conducted this OSHA Outreach Training Program training class in accordance with OSHA Outreach Training Program requirements. 114417 document This class to my OSHA Authorizing Training Organization- Upon successful review of my documentation, 1 will provide each student their course completion card within 90 calendar days of the end of the class. — Jason Cole Instructor Jason Cole Course ID A0301 Certificate ID 18081 1939003 Date 12/13/202211:42:00 PM Time Online 20:44:06 AdvanceOnline Solutions, Inc. 1220 Augusta Dr, Ste 250 Houston, Texas 77057 www.advanceonline.com (713) 621-1100 T Advanc.-----. 5 0 L U T 1 0 N 5 a 04 U a N N N N 0 0 0 0 w w w w w O O O O O r1� r r O1�i I�r Y L V a a O G� iTr U Q�V„ W w a d as d z � d z rq c G d a o w o w U w A O a w E a ® © ❑ ❑ El HVL QUALITY ASSURAIyCE Quality analytical data is defined by the following criteria: 1. Accurately reflect the state of the material being analyzed. 2. Consistent data precision. 3_ Reproducible test results. NVL's rigorous quality assurance program ensures that the analytical data we provide is scientifically sound and of the highest quality. Data accuracy is maximized through administrative, statistical, and investigative techniques, as well as through preventative and corrective action. Our technical and laboratory directors have designed very specific QA/QC objectives to ensure precision and reproducibility of data. These objectives include: • Requiring that individual analysts meet established performance standards. • Maintaining strict sample and sample data tracking procedures throughout the processes of sample preparation, analysis, report generation, communication, and data storage. • Participating in inter -laboratory testing programs designed to mainlain consistent data integrity. • Familiarizing lab personnel with the QA/QC policies and procedures. • Performance audits (once a month) of individual laboratory analysts to ensure their duties are performed within the guidelines of the NVL QA/QC plan. • Laboratory facilities and equipment are routinely inspected and maintained. • Data generated by NVL meets all applicable local, state, and federal guidelines. • Data generation, processing, and documentation procedures are reviewed and revised as necessary. Insurance A $2,000,000 general/professional liability and $5,000,000 excess liability insurance covers all services performed by NVL. MBE Certified NVL is a certified Minority Business Enterprise (MBE) under the state programs of: Alaska (#9710001), Oregon (#1766), and Washington (#D4M5014199). Please let me if you have any questions concerning our qualifications for the above listed. Sincerely, haista Khan General Manager, NVL Shaista.k@nvllabs.com www.nvllabs.com ph: 206.574.0100 1 Fax: 206.634.1936 tall Free: 1.888.NVL.LABS i685.5227) 4708 Aurora Avenue North, Seattle, WA 98103 NVL Laboratories Statement of Qualification 15 of 15 PBS Memorandum DATE: July 18, 2023 TO: Drew Hicks, Forma Construction FROM: Mark Hiley PROJECT: 41519.009 REGARDING: Illahee Middle School — Abatement Completion Notice — Building 600 PBS has completed post -abatement visual inspections and air sampling subsequent to the removal of asbestos - containing materials (ACMs) from Building 600 at Illahee Middle School located at 36001 1It Avenue South in Federal Way, Washington. 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