15-100011r
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
•
s
Demolition
Permit #: 15 -100011 -00 -DE
Inspection Request Line: (253) 835-3050
Project Name: STRONG 1j 6gb
Project Address: 29810 23RD AVE SW Parcel Number: 012103 9156
Project Description: Demolition of single family residence.
Owner
Applicant
Contractor
ROBERT STRONG
G S BUILDERS AND DEVELOPERS INC
G S BUILDERS AND DEVELOPERS INC
SUSAN STRONG
PO BOX 3185
GSBUII*228BL (7/25/15)
33120 42ND PL SW
FEDERAL WAY WA 98063
PO BOX 3185
FEDERAL WAY WA 98023
FEDERAL WAY WA 98063
Additionat'Permit Information
Demolition Valuation.............................................8000
PERMIT EXPIRES Sunday, January 1, 2017
Permit Issued on Friday, January 2, 2015
1 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.
Owner or agent: MMI N I Date: l 2 S
• THIS CARD IS TO ON-SITE
CITY OF Construction In ction Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 15 -100011 -00 -DE Address: 29810 23RD AVE SW
Project: ROBERT STRONG 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.
Final - Building (4050)
Approved
By p �� Date 1.24 • 1 S -
EJ
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF A RwD PERMIT 'WPPLICATION
Federal Way
JAN 0 2 2015
OF FEDERAL WAY
PERMIT NUMBER (�� / — t_J E
L/ O O / C TARGET DATE � l
SITE ADDRESS
SUITE/UNIT #
3 ®o o e c,?v e -D A v�
PR,O63ECT VALUATION
ZONING
ASSESSOOAR'S TAX/PARCEL #
/_
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICALN DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
fJ"�S'/ Q(✓
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
/CogeA-?"
'?53 -
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
NAME
)U'(.Yo
PHONE
MAILING ADDRESS
0 Z3 0 -X
E-MAIL
of�� /
CONTRACTOR
CITY
co Lnlz6 uz
STATE
ZIP
YFl<� 6 3
AIC '0 A)-CJIi
_ - 3 5
WA STATE CONTRACTOR'S LI NSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
o77"e—,'e10 CI,E' �L%1//U� S�vEGiJYJ/hV
PRIMARY PHONE
Ulo ' �/ -oZ 9 5
MAILING ADDRESS �
,
E-MAIL
�
(The individual to receive and
respond to all correspondence
C;, v
CITY
STATE
ZIP
AX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCw 19.27.095)
- 1-206
_ 63C — / 3 p
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 Iaws 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.
SIGNATURE: DATE
PRINT / / 1 �;Z, ( /_r
eti�Janu 1, 2013
Page 1 of 3
k:lHandoutsTermit Application
x
0 •
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
It
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existingn. fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
FOR OFFICE USE
ASEMENT
$
Indicate how many o each type o
ure to be installed or relocated as
part o this project. Do not include existingjlxtures to remain.
BATHTUBS (or Tub/Shower Combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/utility)
WATER HEATERS (Electric)
DECK
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
FOR OFFICE USE
ASEMENT
in Square Feet
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
'
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
ASEMENT
in Square Feet
Type
FIRST FLOOR (or Mobile Home)
'
"
iF
15ECdND'FLOOR
,% „
COVERED ENTRY
ADDITION
DECK
GARAGE ❑ CARPORT ❑
AREA DESCRIPTION
Area
Occupancy Group(s)
- --- ----
,ff,Ile
OTHER (desr'
Additional Information
e----
_
Area Totals
EXISTING
PROPOSED
TOTAL
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL- NEW/ADDITION
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
Type
Stories
'
"
iF
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
Type
Stories
TOTAL' BUILDING""
TENANT AREA ONLY
PROJECT
Bulletin #100 - January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 81h Avenue South
Federal Way, WA 98003-6325
CITY OF - 253-835-2607; Fax 253-835-2609
Fedel
C1 I Way www.cityoffederalway.coin
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure or structures on a subject property. Check with the City's Planning
Division to see if the proposal exceeds thresholds that trigger an environmental review. An environmental review and
submittal of an environmental checklist may be required, which will extend the time period before a demolition permit can
be issued.
❑ Prior to submitting a demolition permit, the following items (as applicable) must be signed by the respective
agency (see attached Demolition Permit Contact List).
NOTE To APPLICANT. Utilities shall be disconnected and services performed, if applicable, prior to issuance of the demolition permit. All applicable
items below are to be siened and dated by the respective agency representatives.
r� co C, f W s b -e
C 0 f Nvh ce .6,f
1. ASBESTOS ABATEMENT J 6. ELECTRICITY
(Co of ap al form and a os survey from Puget Sound Clean Air (Electricity to be sh off and meter removed)
A pro ) r 0 /i�
cqj "'L kt-A— (Vet Sound Energy)
(City o a ay Building Official)
2. GAS SUPPLY
(Gas to be shut off, ry eter removed and final bill paid)
(Puget Sound Energy)
3. SEPTIC SYSTEM
(Tank to be removed or tank to be drained and filled)
a�" 6L
(King County Environmental Services)
4. SANITARY SEWER (Check applicable box)
❑ Sewer line capped at property line
❑ Existing sewer line to remain and be used by proposed new structure
(Lakehaven Utility District)
5. GARBAGE
(All household garbage isposed off and final bill paid)
'Waste Management/Other Company)
❑ Completed Construction Permit Application form
❑ Provide the following fees: 1. Demolition Permit Fee
2. Automation Fee
3. WA State Surcharge
7. FUEL STORAGE TANKS
(Above or below grade fuel tanks, have been pumped or removed
under Fire Department nermit prior to any dismantle/excavation)
South King Fre and Rescue)
8. WATER - Public Source (Check applicable box)
❑ Meter to be removed and final utility bill paid
im�w to remain__an be/protected
(Water Supplier)
****** OR ******
9. WATER - Private Well (Check applicable box)
o Private well filled and capped
o Private well to bej sed for other purposes
/(King County Environmental Services)
Based on valuation. See table on pg 4 of the construction permit application.
$6.00
$4.50
Bulletin #122 —January 1, 2011 Page 1 of 1 k:\Handouts\Demolition Permit Requirements
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8`h Avenue South
CITY OF Federal Way, WA 98003-6325
253-835-2607; Fax 253-835-2609
Federal
w
ww.citvoffedcralway.com
DEMOLITION PERMIT CONTACT LIST
This list of agencies may assist you in expediting the demolition permit process. Refer to the demolition permit
requirements for signature blocks. All applicable signatures are required prior to permit approval.
1. Asbestos Removal: Puget Sound Clean Air Agency
110 Union Street, Suite 500
Seattle, WA 98101-2038
5. Water: Lakehaven Utility District
206-343-8800 —OR— 800-552-3565
Technical Service Division
www.pscleanair.org
31623 First Avenue South
2. Electricity: Puget Sound Energy
Tacoma Public Utilities
Attn: Construction Coordinator
Customer Service
22828 68`h Avenue South, Suite #102 —OR—
747 Market Street
Kent, WA 98032
Tacoma, WA 98402
888-225-5773
253-383-9600 or 253-383-2471
3. Gas: Puget Sound Energy
805 156`h Avenue NE
Bellevue, WA 98004
888-225-5773
4. Telephone: Qwest Communications
801-962-2475 (phone) / 801-237-6491 (fax)
5. Water: Lakehaven Utility District
Tacoma Public Utilities
Technical Service Division
Customer Service
31623 First Avenue South
—OR— 747 Market Street
Federal Way, WA 98003
Tacoma, WA 98402
253-941-2288
253-383-9600 or 253-383-2471
6. Garbage: Waste Management
655 Second NW
Auburn, WA 98071
253-833-3333 (residential) — OR — 253-939-9792 (commercial)
7. Sewer: Lakehaven Utility District
Technical Services Division
31623 First Avenue South
Federal Way, WA 98003
253-941-2288
8. Septic: King County Environmental Services
14350 SE Eastgate Way
Bellevue, WA 98007
206-296-4932
9. Fire Department: South King Fire & Rescue
33325 81h Avenue South
Federal Way, WA 98003
253-946-7248
Bulletin #109—January 1, 2011 Page I of I k:\Handouts\Demolition Permit Contact List
D EPAR -MIRCr of CCMIMVNr 1YVVM0fl'4r `r SEavICES
33.125 S' Avmuc Sanh
Fedmal Way, WA 93003-6325
CRY OF 2: 3,S33.2607; Fax 253-333-2609
Federal Way W'a W&iMffZMhr4 pa
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure or structures on a subject property. Check with the City's Planning
Division to see if the proposal oxccWs thresholds that trigger an environmental review, An environmental review and
submittal of an environmental checklist may be required, whicb will oxtaad the tura period before a demolition permit can
be issued.
❑ Prior to submitting it. demolition permit, the following items (as applicable) taunt be signed by the respective
agency (see attached Demolition Permit Contact Litt}
Nom ro APRJcN7r MuNder shall be discomecre d and se -fees performed. rfappfkabre, prior to taume, ref Ike drww)inoa perur;r. AA applicable
Henn below are to be &WhQy11(,d901LbY rhe ,xrpect— agency represeaaaraes.
1. ASBESTOS ABATEMENT 6. ELECTRICITY
(Copy of approval form and. survey from Mullet Sa wl Clean Air (dtKWoty lD be Strut oR and soarer rtrrnova�
Ayemy pruvldeo
(City of Federal Way
2. GAS SUPPLY 7. FUEL STORAGE TANKS
(Cas to beshut o ter Immoral and final hilt pakl) (Above or below grade fuel tanks, have been pumped or renxrved
�%/�
i under Fire DepartrrKvR Aper raTT prior to any dismantle/excavation)
�(Fuga 5-M r—mi
Soubn F*V weave and Fxsox
3. SEPTIC SYSTEM S. WATER - Public Source (Check applicable box)
(T M be mwftd or tank to be drained sites) r, Meter to be removed ars anal utility bill paid
2�teter to wroln and be protected
)
! 7- �j! i e•nssss pR as»ts
4. SANITARY SEWER (Check applicable box) 9. WATER- private Well (Check applicable box)
*waver/tae capped at property dee aFr"trwaV AW and copped
o Elating Seng the to raron and be used by proposed new sLec4se o private well to �be,usW for other plapases
Yf obbfd, / • " " Canty 7om+err.E services
S.GARBAGE
(All hNSd10W � bN � Comparo
11 Completed Consdaction Permit AppUeatioa form
0 Provide the feHowing feest 1.DemoiKionPermit Fee Basedonvahntion.Seetableonpit4ofthecoroHoctionpenrtilapplicavon.
2. Aatematdoa Fee 56,00
3. WA State Surcharge $4.50
0.aemi,4121-Imwry 1, 2011 Paglarr ��---�kllimdwa?DeaWidon Mmdk Rt4uiemeaa
i
Public Health
Seattle R King Count
Retum completed torn to Pabnc iieelth- Seeuk dt king County. Emrhonmentsl Health Division, 14330 SE Eastgate Way,
Bellevue, W 98007 Tel. -06) 296.4932. Faxed co 'eS will nM be accepted due to dtaa entry pwiwses.
) � DATE. Jx' 3 0 r /V
PARCEL (APN): ./ oC
Instructions for tpmplering form: This fort is to be completed by any persons permanently removing a
septic tank, seepage pit, cesspool, or other on-site sewage system wastewater tanks from service.
Complete and submit this report to the health otticer within chitty (30) days of the abandonment.
Authority: Chapter 13.04.054 the Code of King County Board of Health Title 13.
General Information (Please print):
Name of Owner/Occuptmt of Property: LDA C%l 1� $12 ULc' LL
Address: _3 op O 8:3 en 4-1/45;. S'U9,
r=GJjL-ZAL— r'7 &M 9IrlS,�3
Wastewater Tank Data:
Type of Sewage Tank:,Z SgW'c Tank _ Pmp Tank _ Holding Tank Other.
Number of Compartments Pumped:
Number of Gations.Pumped: I SCJ
Checklist Item Yes No Not Applicable Comments
Septage removed by an approved purnpqM.
Tank lid removed or dacto ecu?
Tank void filled with compacted soil or
v� x �
•OSS Pumper Name: //!? CA/,V p,ea— .¢JvMS, �
AJG nc�5t
King County Certification Number. A"e 2�7 IVC.
Reason for wastewater tank abandonment:
Property being served by public sewers _ Property being served by replacement tank
Structure being demolished
Comments:
•
r " ,•
Report of waaawffier Tank Afmrdonnrcnt. Rovixd 11l9/2012
X
VC
12 Z'.ir01A
A:.:()rc.r:"Cfl T rfilStiCT�Ck1 •
PSC Ieanair.ora
'jyc:t'i urd . Agz* V
Single -Family Notification Case •#. 201404926
1 h s Rage mu;* t.c pnr,rc-d- ,1, p vu of r"(, nr t.,..,hc all Drll nd-l; n to nc,. `ir,,;:;m a d r , �,be:,;J- - r:c'y :,hadl 1-C a' ailrjt.l::
r msp :Cipn at a{! titres .21:tt F d_hc5ic- prc-?�.[t ,r dam . ,71:; n ..ilC..'Ren II,, 4.03(a; "'.1),
eE A'110iin, Paid $65.00
Crrcat Card I ran>ac1w-• # VUYFCA066967
Trar",•;ucUnr (_.rte 12/23/14
Ownu,"'s %,drr:c Robert Strong
n'�D,ccr c,rre,= Adm _; 30006 23rd, Ave. SW
Ciry Federal Way
Cr,nt�aA F.,,rsor' Mike Miller
tf:ailinq Acid -es. 33120 42nd. Place SW
Federal Way , WA 98023
R"',.!�1, (253) 838-1396
48423
F`:,rrie (253) 830-5945
This Project includes asbestos removal.
`cia;Ct Size 35 linear fcet r
.•t{.,are rc,. t
Pro;E=: 1 Star Date 01/05/15 01/05/15
Asbesti, ill o.., rernc.,ec tiu a licensed asbestos abatement contractor
This Project includes a demolition.
13rn� ii�ie.i� Start Da',tt 01/12/15 (.mpl�ti;,n D'Ac 01/30115
Dlmcdtlion v:111 De Co^-:plQ:ed ny a demolition contractor
I Cn,-tily --hat
1 i T Is ,'-,It,-`::=mlly Cf> lir ecr.._lir� =_aruct ,re is u:;4 ;d t ' 7ii.N F=m Iy .vr:<) o,,•ms thµ i,•
i
r _ prr,p:�r a, r Yr c.•au•:�ta�.
1 .. In: n rt,on �t pran lr c is -0 1110 b=>st of my knn:led _ �c.cur�t nrl cam_lca.c;.
t3 1 u-cnr5ldnd rho `.e rot th _ No. f:ia.or, i, i onr-funttdble,
Crate Arne 0Qr H ificatian View History. Loa Out
If YOU '-ave Cues,ions, .ontn17 ... at a0estosr71 pticlean arrvrg _r
Ar.,,^,tr:u:' asp
A HEP,A
B L U E
S K Y
TESTING LASS
Chemical Testing and Consulting - Indoor Air Quality Investigations
Robert & Susan Strong August 25, 2014
33120 - 42nd PL SW
Federal Way, WA 98023
RESULTS OF TESTING FOR ASBESTOS IN BUILDING MATERIALS
TESTED AT: 30006 - 23rd Av SW Lot #6, Federal Way, WA
On August 15th, I sampled building materials in the above house, and tested for the
presence of asbestos containing materials (ACM, asbestos over 1%), because you were
planning to purchase, then demolish. Some of the materials were ACM.
The materials sampled by AHERA survey procedures were analyzed by Polarized Light
Microscopy (PLM). For details about sampling and limitations, see the attached DETAILS
ABOUT SURVEY FOR ASBESTOS. The results of testing 33 samples are listed in the
attached 2 -page TABLE OF RESULTS. Only these areas were found to be ACM:
Area (TABLE lines) ACM description, location, amount:
FRIABLE ACM AREAS (easily crumbled; must remove before demolition):
No friable ACM was found.
NON -FRIABLE ACM AREAS (must remove, possibly after demolition):
#1 (line 35) window putty, 6 windows, 00 sq ft
ABATEMENT work (disturbing by removing or repairing) on ACM:
• Do abatement only by certified asbestos contractors.
NOTICE to Renovation or Demolition Contractors:
MATERIALS/LOCATIONS NOT INSPECTED (which should be surveyed or removed before
demolition):
INACCESSIBLE OR CONCEALED AREAS (& why not sampled):
Electrical power panel, baseboard heaters, light fixtures (still powered)
ATTACHMENTS: DETAILS, TABLE, RECOMMENDATIONS
Dr. Richard L. Knights, Ph.D., Analytical Chemistry, President (206)-721-2583
Blue Sky Testing Labs, 8655 - 39th Av S, Seattle, WA 98118-4517
blueskylab@pobox.com — www.inyourair.com
August 25, 2014
TO: Robert & Susan Strong, 33120 - 42nd PL SW, Federal Way, WA 98023
FROM: Richard Knights, Blue Sky Testing Labs, Seattle, WA (206)-721-2583
DETAILS ABOUT SURVEY FOR ASBESTOS IN BUILDING MATERIALS
TESTED AT: 30006 - 23rd Av SW Lot #6, Federal Way, WA
Purpose of Survey:
To find any asbestos containing materials (ACM), to comply with regulations required by
the Washington State Dept of Labor & Industries and the Puget Sound Clean Air Agency
(PSCAA) prior to any destructive work.
Background Information and Scope of Work:
BUYERS: Robert & Susan Strong.
DATE INSPECTED & SAMPLED: August 15, 2014.
AREAS SURVEYED: entire house, except for:
LIMITATIONS: did not look inside baseboard heaters, light fixtures, all wall cavities, in
uphill half of crawl space
AFTER SURVEY: planned total demolition
Building Description:
BUILDING TYPE: single-family residence
CONSTRUCTION DATE: 1943; later addition S end, & later SE laundry shed
STRUCTURAL SYSTEM: wood framing & foundation, 1 story, asphalt shingle exterior
ROOFING SYSTEM: asphalt shingles, 1 layer, over tarpaper
HEATING SYSTEM: baseboard electric
Building Inspector and Laboratory:
INSPECTOR: Richard Knights, AHERA Asbestos Building Inspector certification #146624
expiring 4/30/2015.
LABORATORY: Richard Knights, Blue Sky Testing Labs
Survey Methodology:
PROCEDURE: AHERA sampling protocol in 40 CFR 763.86
LOCATIONS: group into homogeneous areas of suspect ACM to sample
CATEGORIZE: surfacing, thermal system insulation (TSI), or miscellaneous materials
NUMBER OF SAMPLES: 3 per 1000 sq ft surfacing, 5 per 5000, 7 if more
SAMPLING METHODS: teaspoon size, to substrate, into labeled 2x2" plastic bags
RECORDS: list of material types, descriptions, layers, locations
Asbestos Identification Process:
ACM LOCATIONS AND RESULTS: all samples listed in the accompanying TABLE OF
RESULTS; all ACM areas listed in the accompanying RESULTS OF TESTING
Limits of Survey
Asbestos surveys are non -comprehensive by nature and subject to many limitations
including materials that are hidden, patched, non-uniform, or cannot be found with
reasonable diligence. Reports are not construction specifications. Areas are approximate.
The heating furnace was not dismantled. See details in cover letter.
•
August 25, 2014
TO: Robert & Susan Strong, 33120 - 42nd PL SW, Federal Way, WA 98023
FROM: Richard Knights, Blue Sky Testing Labs, Seattle, WA (206)-721-2583
TABLE OF RESULTS OF TESTING FOR ASBESTOS CONTAINING MATERIALS (ACM) IN BUILDING
TESTED AT: residence, 30006 - 23rd Av SW Lot #6, Federal Way, WA BUYERS: Robert & Susan Strong
SAMPLED: August 15, 2014 PAGE: 1 of 2
Samples collected from an AHERA survey of possible suspect ACM [40 CFR Part 763.85-86)
Sampled and analyzed by Richard Knights, Blue Sky Testing Labs, Seattle, 206-721-2583
Tested samples = 25 required (including some multiples) (+8 extra layers & materials
ACM Area = homogeneous sampling area (HSA) of ACM found
(no = asbestos not found, so less than 1%; chry = chrysotile type; friable = easily crumbled)
MATERIAL DESCRIPTION
SAMPLE LOCATION If ACM:
AREA NUMBER
Line
& /LAYERS UNDERNEATH
(& # tested if>1) & (%,type,friable?)
1
SURFACING MATERIALS:
2
Ceiling & wall texture, streaked
3: living, NE, E beds
no
3
Ceiling texture, troweled onto plywood
SE bedroom
no
4
THERMAL SYSTEM INSULATION (TSI) MATERIALS:
5
No TSI was found (baseboard heaters not
dismantled).
no
6
MISCELLANEOUS MATERIALS:
7_
FLOOR COVERINGS
8
Floor tiles, 9", black or white
porch
no
9
/Mastic, black, gummy, under above
porch
no
10
/Sheet, fibrous, gray, under above
porch
no
11
Floor sheet, fibrous
laundry room
no
12
Floor sheet, tile pattern, black & white
kitchen
no
13
/Floor sheet backing, black, under above
kitchen
no
14
/Adhesive, white, under above, & edges
kitchen
no
15
Floor sheet, tile pattern, beige+browns
bathroom
no
16
/Floor sheet backing, cream, under above
bathroom
no
17
/Adhesive, buff, under above, & edges
bathroom
no
18
_ WALLS & CEILINGS
19
Ceiling tiles, brown fiber + white paint
living & family rooms
no
20
Wallboard, white core + paper faces
laundry wall
no
21
+Joint compound, white, on above
laundry wall
no
22
_ BUILDING INSULATION
23
Insulation, attic, fibrous, batts
attic
no
24
_ ELECTRICAL INSULATION
25
Wire insulation, black
attic & S exterior
no
26
Light fixtures not dismantled
27
_ CRAWL SPACE
28
Tarpaper roll
crawl
no
(continued on page 2) (34 lines fit on page 1.)
August 25, 2014
TO: Robert & Susan Strong, 33120 - 42nd PL SW, Federal Way, WA 98023
FROM: Richard Knights, Blue Sky Testing Labs, Seattle, WA (206)-721-2583
TABLE OF RESULTS OF TESTING FOR ASBESTOS CONTAINING MATERIALS (ACM) IN BUILDING
TESTED AT: residence, 30006 - 23rd Av SW Lot #6, Federal Way, WA BUYERS: Robert & Susan Strong
SAMPLED: August 15, 2014 PAGE: 2 of 2
Samples collected from an AHERA survey of possible suspect ACM [40 CFR Part 763.85-86]
Sampled and analyzed by Richard Knights, Blue Sky Testing Labs, Seattle, 206-721-2583
Tested samples = 25 required (including some multiples) (+8 extra layers & materials
ACM Area = homogeneous sampling area (HSA) of ACM found
(no = asbestos not found, so less than 1%; chry = chrysotile type; friable = easily crumbled)
MATERIAL DESCRIPTION
SAMPLE LOCATION
If ACM: AREA NUMBER
Line
& /LAYERS UNDERNEATH
(& # tested if>1)
& (%,tvae.friable?)
(continued from page 1)
29
_ EXTERIOR SIDING
30
Asphalt -fiber shingles, thick, painted
all sides
no
31
/Tarpaper, under above
all sides
no
32
Asphalt shingles, porch -to -house
porch/house joint
no
33
Sealant on metal below S window
family room
no
34
_ EXTERIOR WINDOWS
35
Putty, hard, white, original
window frames
#1 (5%chry, nonfriable)
36
_ EXTERIOR ROOFING
37
Asphalt shingles, blue -gray
roof, main & porch
no
38
/Tarpaper, under above
roof, main & porch
no
39
Asphalt roofing, roll, black
roof, SE shed
no
40
/Tar sealant on above, against house
roof, SE shed
no
_ (END)
(END)