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11-104795w City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835 -2607 Fax: (253) 835 -2609 r-, 1�-' LT E ' Deiholition Pert #: 11- 104795 -00 -DE Inspection Request Line: (253) 835 -3050 Project Name: BIGFOOT JAVA Project Address: 4627 SW 320TH ST Parcel Number: 142103 9095 Project Description: Demolition of existing espresso building, and removal of debris. Owner Applicant Contractor BIG FOOT JAVA MIKE BAILY GENERATION CONSTRUCTION 402 ELINGSON SUITE 200 LDG ARCHITECTS GENERCL977MB (8/1/13) PACIFIC WA 98047 1319 DEXTER AVE W SUITE 245 202 FRONTAGE RD N SEATTLE WA 98109 PACIFIC WA 98047 Demolition Valuation ................... ..........................2500 PERMIT EXPIRES Sunday, December 1, 2013 Permit Issued on Friday, December 2, 2011 1 hereby certify that t above information is correct and that the construction on the above described property and the occupancy an a use will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent Date: _ FINAIIQ> (Z/1*/11 THIS CARD IS TO REMAIN ON -SITE �,r„ of THIS I1 ection Record Federal Way � INSPECTION REQUESTS: (253) 835 -3050 PERMIT #: 11- 104795 -00 -DE Address: 4627 SW 320TH ST Project: BIG FOOT JAVA FEDERAL WAY, WA 98023 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. U-1 a.,;ia ;..,.1Ancnv Approved By �� Date Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date C ffy PERMIT � Federal COMMUNnfYDEVELOPMENT 5ERVIC1Fq�� 253 -835 -2607• FAX 253 -835 -2609 v ky?XIICATION www.citiioffederalwau.com _. - /0- _(� qa SF MF CO ME P DE EN FP SITE ADD SUITE /UMT # PROJECT VALUATION ZONING ASSESSOR'S T /PARCEL # TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL EMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT (Tenant Name /Homeowner Last Name) PROJECT DESCRIPTION Detailed description of work to _ be included on this permit only PROPERTY OWNER NAME T-14 ( f e ^x:— Ltl PRDIARY PHONE MAILING ADDRESS EMAIL CITY STATE ZIP NAME PHONE MAnJNG ADDRESS n� 2' �C -JL �jT t"> E -MAD• CONTRACTOR CITY ,!, t'ri,.L. SjTAT�Ef�,... my ZIP 3 C O FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE ! NAME "IV_ a__ PHONE MARM0 ADDRESS ^ E-MAIL 1 ✓t APPLICANT CITY STATE t ZIP ( CZ FAX PROJECT CONTACT (The individual to receive and NAME 1V--2-- _?SA-( PHONE MAILING ADDRESS E-MAIL respond to all correspondence concerning this application) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E -MAD. PROJECT FINANCING NAME OWNER - FINANCED Required value of $5,000 or more (RCW 19.27.095) MAILING ADDRESS, CITY, STATE, ZIP PHONE I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the best of my knowledge, the information submittal 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 es not remove the owner's responsibility for compliance wi th local, state, or federal Laws regulating construction or enviro a tal laws. I further agree to o harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation an ewe of such claim), which may be made by any person, including the undersigned, and.111ed against the city, but only where such arises out AuLthe reliance of the city, including its ojyicers and employees, upon the accuracy of the information suppli o city as a part of this application. 2r SIGNATURE: DATE y� PRINT NAM`11 Bulletin #100 - January 1. 2011 Pave 1 of 3 k:\Handouts\Permit Annlication 11/29/2011 16:40 253 - 502 -1$4 WATER CITY - TACOMA PAGE 02/02 Nov [y 11 12:330 Mika Bail, 20691293 p,2 ., °_ DxraaaMrt�ra' of Cot►nnr��xv Drsv�,or�t,�vx 5cltvrCr� UTV OF 33325 eAvasue South 2"Ob way FadcrAl Fed el l Q 253.835.2607• F=2 3.835 2009 # �delf�w- a DEMOLITION PERMIT REQUIREMENTS A demolrtice permit is required to mmove Division rA see if the � st► nctvrE or atrlxtut= on a sabject prOpertY Check with 1nm=tal cxceeds thres]20lds that trigger an enviro><,mo��1 view. A,� cn $ie City`s �lttauria� c issued of an orrvirortmental ch�klivi May rmgaitrmd� whiff will rotul W Levi be issued. �vonrzieat8l rtv;ew �d ftE Plod before a damoligion permit can L7 Prior to subrnlittiog a deraouppn >aeraoie, the %X*Mng Rem$ (aa :ePPtieabkj must De a agen7' (see attached DevvorWora Perfraid Cvrttsct "$t). il;rted by the rrvapecciyc 1�arrsrf.�lrCM!t.• U( tll t!' IU: ltattt �OZrCD1f7MCMQtOpd .trrv�CL�CAnfiM1><iC' ��Jq(+eoAfe, o. fn r. •itcrns be! c ro b�3l�Ged —, ut�d �y th® ►rr/SOOn �� o +xy � ;e+ttarl+et. xcuance V rile *Avatluanperr a 4119Wica6k 2. (+HAAS SUP?[Y o (Gas to De shut 0, MWr ranx,,gd and final td oalq) ('a^ remove 'r tank W be drelned ant? 640), (KI^, rmllvnmenrel Services} A an"T•f-.. -- - -__ 5. GAINAGE (All h0u9atrplr oerbage yISpMa' oft and final bill f*d) d cotnplekd Commiction romit opikatfom farm 7. FUEL STaMME TANKS (Above or below 9r0de W tanks, have bean purn h ovW under P►re DtPW tent permit prior to any di n) (Wulh long pre and R k5e-) 8•MQW oo be ro w�W and fIn A (Check appticable box) moved and Gnat utU blrl Para rem nd P►Oe Md 01 yy.t„ a a.�rt�.wtr, hN A wt 7 _ ra 2, / i`ra.rer...r� ,a av ter Su dr) atft.,,r I pR ***&*. & hil«s.,L Prtt/afhe Well (C .,reek eppllcawe box) ci prw4-- wall nNet Ilnd capped a P k'Ae W81 to be LSW for ogler p:Mp / .no CoU1ly Ron - mertm FErvlo9t: Jv provide the f6j(Mag &cs: I. 1)QMoJitne1tr Perm's Poe 2. Antantafion pee $.0 anvNiuulon. 6 5at0leonpgaoftheaorstrueSon $0.00 pMtrit applicator., 3. WA Stste Sumbxrge 54.50 titl)klb trl x2 , - J�nanry :, 207 t P>txc r Or t PC%NaedlLeo alidcp Pwma lk9olrolecrrn ton.gao�j �e� 11146 pea. iu R473 60999fi8s5Z tVA ST:01 i' g/89 /IT Approved Transaction Page 1 of 1 psc lean air.org Puget Sound Clean Air Agency Notification Case #: 201103219 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 # VXJF8A9FAFA4 Transaction Date 11/28/11 Owner's Name TRIMARK -HOYT ROAD LLC Phone (253) 833 -7863 Project Street Address 4627 S 320TH ST City FEDERAL WAY Zip 98023 Contact Person AL JIWANI Phone (253) 833 -7863 Mailing Address 420 ELLINGSON ROAD PACIFIC, WA 98047 This project includes a demolition. Demolition Start Date 11/29/11 Completion Date 12/06/11 Demolition will be completed by a demolition contractor Demo Contractor GENERATION CONSTRUCTION Contact TIM CLEMENTS Mailing Address 202 FRONTAGE ROAD PACIFIC, WA 98047 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. Contractor Job # GENERCL977 Phone (253) 804 -0999 (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 flied 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. https: / /secure.pscleanair.org /Asbestos /Approved.aspx 11/28/2011 • • XOO W ENVIRONMENTAL SERVICES, INC. Environmental Consulting & Compliance November 22, 2011 Mike Bailey LDG Architects 1319 Dexter Ave N, Suite 215 Seattle, WA 98109 RE: Asbestos consulting at the Espresso Retail Structure located at 4627 S 320"' St in Federal Way, WA Dear Mr. Bailey, NOW Environmental Services is pleased to present this survey report for suspect asbestos - containing building materials analysis conducted at the Espresso Retail Structure located at 4627 S 320' St in Federal Way, Washington. We appreciate the opportunity to have been of service to you. If you have any questions regarding this report, please feel free to contact me at (253) 927 -5233. Sincerely, �•► �./ j AMR VA, Todd Rickert AHERA Building Inspector Accreditation No. I/MP- NESI- 0601 -11 (Exp. 6-01 -12) NOW Environmental Services Enclosure: Asbestos Survey Report 34004 9th Avenue South, Suite 12, Federal Way, Washington 98003 Phone: (253) 927 -5233 Fax: (253) 924 -0323 www.nowenvironmental.com 0 Asbestos Survey Prepared For: LDG Architects 1319 Dexter Ave N, Suite 215 Seattle, WA 98109 November 21, 2011 Subject Property: 4627 S 32Retail Structure Federal Way, Washington 98023 Prepared By: Now Environmental Services 34004 9 Avenue South, Suite 12 Federal Way, Washington 98003 9 Contents Section Introduction 1.0 Executive Summary 2.0 Regulatory Compliance 3.0 Sampling Plan and Laboratory Analysis 4.0 Survey Results 5.0 Conclusions and Recommendations 6.0 Limits of Survey 7.0 Appendices Laboratory Results A Maps B Certification(s) C • 0 Section 1.0 - Introduction On November 21, 2011, AHERA Building Inspector Todd Rickert of NOW Environmental Services conducted an inspection for suspected asbestos - containing building materials at the espresso retail structure located at 4627 S 320`h St in Federal Way, WA, Mr. Rickert is an Environmental Protection Agency (EPA) Accredited Building Inspector Accreditation No. I /MP -NEST -0601 -11 (Exp. 6 -01 -12). Accessible areas were visited and samples were taken of building materials suspected to contain asbestos (vinyl floor tile, gypsum wallboard, roofing etc.). These samples were analyzed for the presence of asbestos. In addition, the quantities of asbestos- containing materials were estimated."" Please see Table 2 for an inventory of sampled suspect building materials. Sample locations are indicated on the attached site drawings. "" QUANTITIES ARE APPROXIMATE AND ARE NOT TO BE USED FOR BIDDING PURPOSES. PROSPECTIVE BIDDERS MUST SITE VERIFY QUANTITIES AND SITE CONDITIONS. ESPRESSO RETAIL STRUCTURE - 4627 8 320TH ST IN FEDERAL WAY, WA PROJECT 0 N11 -1140 Section 2.0 - Executive Summary Building Description The espresso retail structure is a two story commercial building of approximately 450 square feet. The structure was built in approximately the year 2007 and is a wood framed structure on a concrete slab. Interior wall systems are gypsum wallboard with joint compound over wood framing. Other interior finishes include ceramic tile, painted concrete and cove base with mastic. The exterior finishes included fiberglass reinforced stucco with metal roofing. Asbestos No asbestos containing building materials were found in any samples taken. Please see Table 2 for an inventory of sampled suspect building materials found at the espresso retail structure located at 4627 S 320'h St in Federal Way, WA during this survey. Table 1 Summary of Asbestos Containing Building Materials sampled at the espresso retail structure located at 4627 S 320 "' St in Federal Way, WA Material Description Sample Number Material Sample Location Analytical (Laboratory) Results No Regulated Asbestos Building Materials Identified ESPRESSO RETAIL STRUCTURE - 4627 S 320TH ST IN FEDERAL WAY, WA PROJECT # N71 -1140 Section 3.0 - Regulatory Compliance Asbestos The intent of the asbestos survey is to comply with governing asbestos regulations required by the State of Washington and Puget Sound Clean Air Agency ( PSCAA). Currently, the State of Washington requires a written "good faith inspection" for identification of asbestos - containing materials prior to any remodeling or demolition work. During demolition and construction work it is the responsibility of the owner and the contractors to make this survey document available to all concerned parties who may be handling the building materials. In addition, PSCAA requires that a copy of the written asbestos survey be made available on -site for inspection by a PSCAA Control Officer during construction and demolition work. The survey is required to be performed in accordance with 40 CFR 763.86. These federal standards require inspections to be conducted by an EPA Accredited Building Inspector with analysis to be provided by an asbestos laboratory certified by the National Bureau of Standards. The requirements are described in Article 1 and Article 4, of PSCAA's Asbestos Control Standards. All survey work was conducted in compliance with the above mentioned standards. Asbestos - containing materials are required to be removed and disposed of in accordance with Washington State Regulation 296 -155 WAC, Part S prior to any demolition, renovation, or remodeling that would disturb these materials. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on -site supervision of a Certified Asbestos Supervisor in accordance with 296-65 WAC. Also see 296-62 WAC, Part 1- 1— General requirements for handling asbestos. ESPRESSO RETAIL STRUCTURE - 4627 S 320TH ST IN FEDERAL WAY. WA PROJECT # N11.1140 ILA Section 4.0 - Sampling Plan and Laboratory Analysis Asbestos Obiectives The objective of the survey was to determine the quantity and location of building materials (vinyl floor tile, roofing, gypsum wallboard, etc.) that contain asbestos within areas to be impacted by planned renovation work. Asbestos Sampling Plan Protocol This survey was conducted using a protocol adapted from the Asbestos Hazard Emergency Response Act (AHERA). The protocol is as follows: 1. Group materials into homogeneous sampling areas. 2. Quantify each homogeneous sampling area and collect samples from each area using the "3 -5-7" criteria for surfacing material to determine the number of samples needed. Quantify and collect a minimum of three samples of each thermal system insulation (the number of samples collected of miscellaneous materials was determined by the inspector). 3. Samples of each material were taken to the substrate, ensuring that all components of the material were included. 4. Sampling was performed by a Certified Building Inspector, and the use of proper protective equipment and procedures was followed. Asbestos Sampling Procedure 1. Spread the plastic drop cloth (if needed) and set up other equipment, e.g., ladder. 2. Put on protective equipment (respirator and protective clothing if needed). 3. Label sample container with its identification number and record number. Record sample location, and type of material sampled on a sampling data form. 4. Moisten area where sample is to be extracted (spray the immediate area with water). 5. Extract sample using a clean knife, drill capsule, or cork boring tool to cut out or scrape off approximately one tablespoon of the material. Penetrate all layers of material. 6. Place sample in a container and tightly seal it. 7. Wipe the exterior of the container with a wet wipe to remove any material that may have adhered to it during sampling. 8. Clean tools with wet wipes and wet mop or vacuum area with HEPA vacuum to dean all debris. 9. Seal the sampling location with caulking compound, spackle or duct tape. 10. Discard protective clothing, wet wipes and rags, cartridge filters, and drop cloth in a labeled plastic waste bag. Asbestos Laboratory Analysis The bulk samples were analyzed in our laboratory using polarized light microscopy (PLM) with dispersion staining in accordance with US EPA method 600 /R- 931116 as specified in 40 CFR Chapter 1 (7 -1 -93 edition) Part 763, Subpart F, Appendix A, pages 499 -504. Polarizing light microscopy quantifies asbestos concentrations at between 100% and 1% detection levels. Levels below 1% can only be stated as "trace." For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled L -1 for layer one and L -2 for layer two, etc.) and a total percentage for the entire sample. The asbestos concentration in the sample is determined by visual estimation. For those samples with asbestos concentrations between 1 and 10 percent based on visual estimation, the EPA recommends a procedure known as point counting (NESHAPS, 40 CFR Part 61). Point counting is a statistically more accurate means of quantification for samples with low concentrations of asbestos. ESPRESSO RETAIL STRUCTURE -4627 S 320TH ST IN FEDERAL WAY. WA PROJECT 0 N11 -1140 0 • Section 5.0 - Survey Results Asbestos Table II Summary of suspect Asbestos Containing Building Materials sampled at the espresso retail structure located at 4627 S 320th St in Federal Way, WA Material Description Sample Number Material Sample Location Analytical (Laboratory) Results Texture, Joint Compound and Gypsum Wallboard N11- 1140 -001 Throughout Non- Detect Texture, Joint Compound and Gypsum Wallboard N11- 1140 -002 Throughout Non - Detect Texture, Joint Compound and Gypsum Wallboard N11 -1140 -003 Throughout Non- Detect Exterior Stucco N11- 1140 -004 Throughout Non - Detect Exterior Stucco N11- 1140 -005 Throughout Non- Detect Exterior Stucco N11- 1140 -008 Throughout Non- Detect 4" Black Cove Base and Mastic N11- 1140 -007 Throughout Non- Detect Ceramic Tile Grout N11- 1140 -008 Bathroom Non - Detect White Ceramic Tile N11- 1140 -009 Bathroom Non - Detect Ceramic Tile Mastic N11- 1140 -010 Bathroom Non - Detect ESPRESSO RETAIL STRUCTURE - 4627 S 320TH ST IN FEDERAL WAY, WA PROJECT # 1411 -1140 • Section 6.0 - Conclusions and Recommendations NOW Environmental Services is not responsible for materials which require destructive means to access, or materials which are hidden from sight, those materials hidden behind walls, or materials which cannot be found with reasonable diligence. Extreme caution should be used during renovation or demolition to ensure that additional unidentified materials are not disturbed. In the event that additional materials are discovered, the material should be sampled by an EPA Accredited AHERA Building Inspector and analyzed to determine if it contains asbestos prior to disturbance. Asbestos According to Washington Administrative Code (WAC) 296 -62 -07721, prior to the start of work, a building owner must identify the presence, location, and quantity of ACM and /or presumed ACM (PACM) prior to renovation and demolition. This information must be communicated to contractors bidding on work, contractors performing other work, employees and tenants in or adjacent to the work area. The Puget Sound Clean Air Agency Regulation III, Article 4 requires that an asbestos survey be conducted prior to any renovation or demolition of existing buildings. This survey was intended to meet these regulatory requirements. Asbestos - containing materials are required to be removed and disposed of in accordance with Washington State Regulations prior to any demolition, renovation, or remodeling that would disturb these materials. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on -site supervision of a Certified Asbestos Supervisor. The only exemption is for resident owners performing removal of asbestos - containing materials other than furnace interiors and direct applied mudded asbestos insulation. ACM is identified as those building materials containing greater than one percent ( >1.0 %) of asbestos as verified by laboratory analysis. All building materials fabricated prior to 1980 are assumed to contain asbestos unless proven otherwise by a licensed building inspector. Materials that contain 1.0% or less asbestos are not regulated for disposal purposes. However, removal of materials containing 1.0% or less asbestos is considered an unclassified asbestos operation by OSHA and WISHA. Unclassified asbestos operations cover employees likely to be exposed in excess of the permissible exposure limit (PEL), and who are performing operations not covered by Class I through IV. For construction work involving unclassified asbestos the applicable requirements will include: an exposure assessment, use of vacuum cleaners equipped with HEPA filters, use of wet methods and prompt cleanup of debris, use of respirators and protective clothing, training, and record keeping. Asbestos - containing joint compound associated with non - asbestos gypsum wallboard (GWB) assemblies is sometimes found in specific locations of a building. The presence of asbestos in this material requires personnel impacting the material to adhere to regulatory requirement outlined in WAC 296 -62- 17712(2) and training as outlined in WAC 296 -62 -07722(5) and WAC 296-62 -07728. Personal protect equipment and proper work practices are required pending completion of a negative exposure assessment. Such an assessment may include air monitoring of workers' breathing zones. Refer to WISHA Regional Directive 23.30 for additional information. The possibility exists that additional ACMs may be present in wall and ceiling cavities. Any previously unidentified material encountered during construction activities should be sampled prior to impact. Work that may be impact asbestos should be performed by personnel having proper training and utilizing proper worker protection according WISHA standards. NOW Environmental Services recommends that a Certified Asbestos Project Designer design any asbestos abatement project to ensure that the job is completed according to regulatory standards. ESPRESSO RETAIL STRUCTURE -4627 S 320TH ST IN FEDERAL WAY, WA PROJECT # N11 -1140 9 41 Section 7.0 - Limits of Survey Asbestos surveys are non - comprehensive by nature and subject to many limitations including those presented below. Our assessment has considered risks pertaining to asbestos; however, this survey is limited to only those locations sampled. This survey was not designed to identify all potential concerns or eliminate all risk associated with asbestos. Materials sampled were limited by the scope of work as defined by the drawings provided. Lead based paint & TCLP testing, mercury light tubes and /or other hazardous materials were not included in the scope of work during the course of this survey. Other risks that were not evaluated with this survey; Risks such as 1) toxic and hazardous substances in (or in contact with or associated with) soil or ground water; 2) risks associated with structural, electrical, or mechanical working of the building; 3) risks associated with radon gas, slope stability, building settlement, moisture, or site drainage and flooding have not been evaluated during this survey. No warranty, expressed or implied, is made. The site visit consisted of a thorough visual walk - through of building for the purpose of viewing and sampling potential asbestos - containing material. A TCLP sample was not collected of the building to determine levels of leachable lead in building debris. Suspect PCB containing light ballasts were not estimated. Fluorescent bulbs were not quantified for recycling purposes. Mercury vapor lamps were not Identified during the survey. NOW Environmental Services performed this survey in accordance with the generally accepted standards of care that exist in the industrial hygiene profession in Washington State at the time of this study. The asbestos survey was performed in preparation for removal of asbestos - containing materials in accordance with NESHAPS regulations. This survey is not intended for use as plans and specifications. These estimates are for approximating actual bid prices from contractors only, and may not reflect the actual final costs of asbestos and /or lead abatement. They do not include sales tax, or Owner costs such as abatement project oversight and monitoring for compliance to law and /or compliance to project plans and specifications. These estimates assume that adequate, professional plans and specifications are prepared and the abatement costs are minimized by professional project management, and that all asbestos containing materials are abated during one project by the same asbestos contractor. Written By: Todd Rickert AHERA Building Inspector Accreditation No. I /MP -NEST- 0601 -11 (Exp. 6 -1 -12) Reviewed By: ( ) ;A, Zu-::� Donna McNeal AHERA Building Inspector, CEO ESPRESSO RETAIL STRUCTURE - 4627 S 320TH ST IN FEDERAL WAY, WA PROJECT 0 N11 -1140 0 APPENDIX A Laboratory Results 4) ORION Environmental Services 34004 Ninth Avenue South, Suite Al2, Federal Way, WA 98003 Phone: (253) 952 -6717 • Fax: (253) 927 -4714 Email: info @oriones.net • Web: www.oriones.net WBE W21`9219763 Polarized Light Microscopy Test Report EPA Method 600/R- 98/116 Client: LDG Architects Rpt. Date: 11/22/2011 Address: 1319 Dexter Ave N, Suite 215, Seattle, WA 98109 Page: 1 of 2 Attention: Mike Bailey Invoice: 115048 Project Name: Espresso Stand Date Rcvd: 11/21/2011 Project Number: Nil -1140 % Client Orion Material Sample nta�n g Asbestos Other Sample ID Sample ID Description j Treatment Material ' Type Fibers la 20111121.56 ! Texture ND r cellulose 1b Joint Compound ND cellulose i 1C Wallboard _ h ND cellulose 2a 20111121 -57 ", Texture ND I y _ cellulose 2b Joint Compound ND 1 cellulose 2c Wallboard ND cellulose 3a 120111121-58 Texture ND , cellulose 3b Joint Compound NO i cellulose 3c Wallboard i 1 NO } cellulose 4 20111121 -59 Stucco l crush , NO 5 20111121 -60 I Stucco I crush NO 4 6 20111121 -61 Stucco crush NO 7a 20111121 -62 ( Cove Bass j i NO ICI man -made fibers- 7b Mastic chloroform NO l .i 8 20111121 -63 Ceramic Tile Grout crush ND g { 20111121 -64 Ceramic Tile i Crush ND I I 10 � 20111121 -65 Ceramic Tile Mastic 111 i 1 'chloroform i NO � , 0 • Polarized light Microscopy Test Report (cont.) Client: LDG Architects Address: 1319 Dexter Ave N, Suite 215, Seattle, WA 98109 Attention: Mike Bailey Project Name: Espresso Stand Project Number: N11 -1140 Rpt. Date: 11/22/2011 Page: 2 of 2 Invoice: 11SO48 Date Rcvd: 11/21/2011 % P Asbestos Client Orion Material Sample Containing Asbestos Other Sample ID Sample ID Description Treatment Material Type Fibers Dup: Laboratory OA/QC Duplicate; M; Mastic [(a), (b), (c), etc.]: Sample layers numbered from front to back. Comments: For layered samples, each component has been analyzed separately. ND means non - detect for asbestos fibers by EPA Method 600 /R- 98 /116.Disciaimers: PLM has been known to miss asbestos in a small percentage of samples that contain asbestos. Thus, these laboratory results represent due diligence, however negative or <1 % PLM results can not be guaranteed. Per EPA guidelines samples will be archived for 30 days then will be disposed of. This report may only be reproduced in full with written approval of ORION Environmental Services. 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Y Y I . • . . ♦ • I 1 I , I r . t ♦ . . • 1 . • . • • • 1 I .............. • .... r ------------------------------- ............ • -------------- - - - • . • 1 t • 1 1 NOW ENVIRONMENTAL SERVICES, INC. 34004 - e Ave. S., Ste # 12 Federal Way, WA 98003 NOW ENVIRONMENTAL SERVICES _CLIENT NAME: ADDRESS: )31`1 TELEPHONE: FAX: CELLULAR: SAMPLE I LAB NO. NO. 11-Ilz -lb ill iat bo1 I I -57-( cvzIIs �y SAMPLE CUSTODY FORM SITE ADDRESS: s'e 77 ,71-7 " rl 4) �v1,4 . INSPECTOR: DATE SAMPLED: 4 HOUR 24 -HOUR MATERIAL DESCRIPTION PROJECT NUMBER N 11 ' % l5'o RE LiN UISHED DATE / TIME :> RECEIVED BY:.. DATE / TIME: 11- i _ 7 Y MATERIAL LAYER EACH ID AND LOCATION SUBSTRATE OF MATERIAL `oo,» QTY. I TREAT ! % 1 TYPE I FIBERS PAGE 1 OF •I NOW ENVIRONMENTAL SERVICES SAMPLE CUSTODY FORM PROJECT NUMBER /M-//`l0 CLIENT NAME: .7 SITE ADDRESS: RELINQUISHED BY: MATERIAL ID LAYER AND SUBSTRATE DATE / TIME: ADDRESS: TREAT % TELEPHONE: INSPECTOR: RECEIVED BY: FAX: DATE SAMPLED: DATE i TIME: CELLULAR: 4 HOUR 24 -HOUR 3DAY SAMPLE NO. LAB NO. MATERIAL DESCRIPTION MATERIAL ID LAYER AND SUBSTRATE LEA ON AL QTY. TREAT % TYPE OTHER FIBERS I PAGE OF • APPENDIX C Certifications 0 \i Ns e� , hxs'. ��L4441 ro CSDC eNtraprise - City of F0ral Way's Online Services Page 2 of 2 Floor sheathing Open IVR User 0 Insulation Open IVR User 0 Gypsum Wallboard Nalling Open IVR User 0 Suspended Ceiling Grid Open IVR User 0 Miscellaneous Inspection Open IVR User 0 Re -steel Open IVR User 0 Public Works Inspections Open Nov 4, 2011 Ann Dower (253 - 835.2732) 0 Final - Plumbing Open IVR User 0 Firwl- Mechanical Open IVR User 0 Final - Planning Open Matthew Herrera (253- 835.2638) 0 Final - Public Works Open Nov 4, 2011 Ann Dower (253- 835 -2732) 0 Final - Fire Department Open IVR User 0 Final - Building Open IVR User 0 Issue Certificate of Occupancy Open IVR User 0 As -built Drawing Review Open NOV 4, 2011 Ann Dower (253 - 835 -2732) 0 MA http:// epermits .cityoffederalway.com /AMANDA5/ eNtraprise /FederalWay /pubiic /p... 11/28/2011