10-103853City of Federal Way
Apolicant
Community Development Services
P.O. Box 9718
RAYMOND E DINGES
Federal Way, WA 98063-9718
FILE
Ph: (253) 835-2607 Fax: (253) 835-2609
33919 9TH AVE S SUITE 105
Project Name: DINGES
Project Address: 1406 S 348TH ST
Project Description: Demolition of (1) residential structure
Demolition
Permit #: 10 -103853 -00 -DE
Inspection Request Line: (253) 835-3050
Parcel Number: 202104 9021
Owner
Apolicant
Contractor
RAYMOND E DINGES
COURT PIXTON
RUSS LLOYD CLEARING & DEMO
DINGES ENTERPRISES LLC
33919 9TH AVE S SUITE 105
RLCLEEI097N2 (4/15/12)
600 131 ST AVE N
FEDERAL WAY WA 98003
1741 S 356TH ST
BELLEVUE, WA 98005-3345
FEDERAL WAY WA 98003
Demolition Valuation.............................................5200
PERMIT EXPIRES Sunday, September 9, 2012
Permit Issued on Friday, September 10, 2010
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 of Federal Way.
Owner or agent: Dater ?
THIS CARD IS TO REMAIN ON-SITE
CITY OF THIS
Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 10 -103853 -00 -DE Address: 1406 S 348TH ST
Owner: RAYMOND E DINGES FEDERAL WAY, WA 98003-6855
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.
❑ Yinal - Buildu
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
C•Yi UY ':
el
COMMHNITY DEVELOPMENT SERVICES
253-835-2607• FAX 253-835-2609
r ru:r. iq,S;;ed^rale r_ �: ccm
PERMIT
APPLICATION
- 4 _(),=�3 2553
SI&F CO ME PLO EN FP
SITE ADDRESS
SUITE/UNIT
o Y-" S/-. ,
PROJECT VALUATION
ZONING
ASSESSOR'R'S� TAX/PARCEL # %
TYPE OF PERMIT
❑ BUILDING [IPLUMBING ❑ MECHANICAL
MOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
PROJECT DESCRIPTION
../ ii�
Detailed description of work to
be included on this permit only
10 HM
NAME - RI PHONE
�� O
.N
L6M
PROPERTY OWNER
ILI� !'
ZA49L> /��
MANG DRE 121_!/'.STAT
E-MAIL
CITY
ZIP
NAME ' 1.
r, ea w
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
Q
CITYTE
1T
D Q 3
FAX
Z 340 6G %
WA STATE CONTRACTOR'S LICENSE #
5ifl
PIRATION DATE
JEX
FEDERAL WAY BUSINESS LICENSE #
zo . - a
N
riv,
PHONE
A 53 yJQ
ADDRESSZT
33E Z-7 9�` S. le s—
E-MAIL
APPLICANTMAt;rNG
C
a,Lli,.t
STATE ZIP
4
FAX C.&A
S__j12)6
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
NAME
PHONE
MAILING ADDRESS
E-MAIL
concerning this application)
CITY
STATE
ZIP
FAX
ALTERNATE CONTACT NAME-.
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
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
ail applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim ses out o e r lance of the city, including its officers and employees, upon the accuracy of the
information supplied tot a ci asap fofthis pplication.
SIGNATURE: DATE
PRINT NAME: x
Bulletin #100 —April 14, 2010
Page 1 of 3
k:\lIandouts\Perinit Application
/
"
K8
�
^
TOTAL
FOR OFFICE USE
X.
WoRic $
(a copy of bid or estimate must be provided)
FIRST FLOOR (or Mobile Home)
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing JIxtures to remain.
AIR HANDLING UNITS
FANS GAS PIPE OUTLETS OTHER (Describe)
AIR COND TI ER
FIREPLACE INSERTS HOODS pom=rcisly
BOILERS
FURNACES HOT WATER TANKS
COMPRESSORS
GAS LOG SETS REFRIGERATION SYST
DUCTING
GAZ PIPING WOODSTOVES
X.
Indicate how many of eac��P_ e ofjlxture to be installed or relocated as part of this project. Do notinclude existing fixtures to remain.
BATHTUBS (or Tub/Sh—c—
LAVS (H�d Sinks) TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS
SHOWERS VACUUM BRiA. RS
DRINKING FOUNTAINS �_
SINKS oua=" n°�' __—�'
|HOSE
BIBBS
SUMPS WASHING CHINES
CRITICAL AREAS ON PROPERTY� WATER PURVEYOR SEWERPURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE (In Sq� t) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
AREA DESCRIPTION (in square feet)
EXISTINq
PROPOSED
TOTAL
FOR OFFICE USE
X.
FIRST FLOOR (or Mobile Home)
COVEREUENTRY
GARAGE 0 CARPORT 0
AREA DESCRIPT± Area Occupancy Group(s) Construction # of Additional Information
in Square Keet Type Stories
TENANT AREA ONLY
Bulletin #100—April ]4,zO0
k:\Handouts\PernIit Application
`
Approved Transaction • 0
Page 1 of 1
psdear a r.org
Faget Sound Gran Air Agency
Single -Family Notification Case #: 201002456
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 $75.00
Credit Card Transaction # VQEF5E85FE4A
Transaction Date 09/09/10
owner's Name Dinges Enterprises LLC Phone (253) 838 4100
Project Street Address 1406 South 348th St
City Federal Way Zip 98003
Contact Person Court Pixton Phone (253) 838 4100
Mailing Address 600 131st Ave
Bellevue, WA 98005
This project includes a demolition.
Demolition Start Date 09/10/10 Completion Date 09/10/10
Demolition will be completed by a demolition contractor
This is an emergency project. The emergency reason:
There was a sudden, unexpected event that resulted in a public health or safety hazard.
I certify that:
(1) This is a single-family residence project. The structure is used by one family who owns the property as their domicile.
(2) The information I have provided is to the best of my knowledge accurate and complete.
(3) I understand the fee for this Notification is 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
9/9/2010
• DEPARTMENOCommuNITY DEVELOPMENT SERVICES
33325 8`h Avenue South
d VED
PO Box 9718
CITY O Federal Way WA 98063-9718
'EP 77 253-835-2607; Fax 253-835-2609
Federal Way LI 1 0 2c,,,ea,iw.c ;of[-dera:"avcom
Wq k
DEMOLITION PtKMIT 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 ToAPPLiCANT. Utilities shall be disconnected and services performed, if applicable, prior to issuance of the demolition permit. All applicable
items below are to be sined and dated by the respective agency representatives.
1. ASBESTOS ABATEMENT
(Copy of approval form and asbestos survey from Puget Sound Clean Air
Agency provided)
44
f Federal Way Building Official)
2. GAS SUPPLY
(Gas to be shut off, e r e ved and final bill paid)
/ / (Pucjet Sound Energy)
3. SEPTIC SYSTEM
(Tank to be removed or tank to be drained and filled)
51fe oo d k S! �c. i [
(King 9bunty Environmental Services)
4. SANITARY SEWER (C ck applicable box)
o Sewer line capped at o�llne
o Existing sewer line toe d be used by proposed new structure
(Lalpr?/iavEn Utility District)
5. GARBAGE // j,
gdi
(All household garbagsgb Aoff and final bill paid)
er
❑ Completed Construction Permit Application form
❑ Provide the following fees:
1. Demolition Permit Fee
2. Automation Fee
3. WA State Surcharge
6. ELECTRICITY
(EI ctricity to be shut off an m �r removed)
(P get Sound Energy)
7. FUEL STORAGE TANKS
(Above or below grade fuel tanks, have been pumped or removed
under Fire Department e ft Aior to any dismantle/excavation)
TSO u in Fire and Rescue)
8. WATER- Public Source (Check applicable box)
o Meter to be removed and final utility bill paid
Meter to remain and be protected
(Water Supplier) `
****** OR ******
9. WATER- Private Well (Check applicable box)
o Private well filled and cappe
❑ Private well to be used r o urposes
(Ki Con vironmental Services)
ME
Based on valuation. See table on pg 4 of the construction permit application.
$6.00
$4.50
Bulletin #122 — January 26, 2010 Page 1 of 1 k:\Handouts\Demolition Permit Requirements
k 0
CITY OF V"'—'"0P
Federal Way
DEPARTMENT OF AMUNITY DEVELOPMENT SERVICES
333258 1h Avenue South
PO Box 9718
Federal Way WA 98063-9718
253-835-2607; Fax 253-835-2609
www.cityoffederalwa
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
9. Fire Department: South King Fire & Rescue
33325 80' Avenue South / PO Box 9718
Federal Way, WA 98063
253-946-7248
Bulletin #109 — March 1, 2007 Page 1 of I k:\Handouts\Demolition Permit Contact List
110 Union Street, Suite 500
Seattle, WA 98101-2038
206-343-8800 —OR— 800-552-3565
www.pscleanair.org
2. Electricity:
Puget Sound Energy
Tacoma Public Utilities
Attn: Construction Coordinator
Customer Service
22828 68`x' Avenue South, Suite 9102
—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 156a' Avenue NE
Bellevue,,WA 9$00,4, . .
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
Auburli; WA 98071
s
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 80' Avenue South / PO Box 9718
Federal Way, WA 98063
253-946-7248
Bulletin #109 — March 1, 2007 Page 1 of I k:\Handouts\Demolition Permit Contact List
30G&N Septic Tank Service ; r-
1 Military Rd. S Auburn, Washington 980
0.
(253) 838-1028 (253) 927-2860 (425) 255-9111 Fax: (253) 838-7971
www.gnseptic.com Date: X'`%``
Name:�r8 ,
IS&N
Address:'�� (11 4� '32Y'0 i
City:'` "? 11
Septic Tank Service Phone:
ESTABLISHED IN 1950 Mailing Address:
Description of Services:
Amount
Depth of Scum 1S'Compartment
VIVA
i„..
in.
Depth of Scum 2nd Compartment
in.
Depth of Sludge 2nd Compartment
(in.)
General Tank Condition
CITY OF WAN
Inlet Baffle Condition �t
Outlet Baffle -Condition
Tax %%:
:°..
Total:
Sewage Tank Data (check/circle all that apply):
Type of Sewage Tank: Septic Tank Pump Tank Holding Tank her
Number of Compartments Pumped:_ Number of Gallons Pumped:
Checklist Item:
Measurement Satisfactory Unsatisfactory N/A Action Taken:
Depth of Scum 1S'Compartment
(in.)
Depth of Sludge 1St Compartment
in.
Depth of Scum 2nd Compartment
in.
Depth of Sludge 2nd Compartment
(in.)
General Tank Condition
Riser(s) at Grade
Inlet Baffle Condition �t
Outlet Baffle -Condition
Effluent Baffle Screen Condition
Description of Other Service Performed and/or Recommendations:
Tank Location/Septic System Sketch:
Technician Signature:,.°
Customer Signature:
If this account is not paid as agreed, 1 agree to pay in addition to the foregoing, a reasonable attorney's fee, and if this account is placed in the hands of a collection
agency, 1 agree to pay any and all collection charges and fees not to exceed 50% fifty percent of the amount unpaid. $25 returned check fee.
Licensed in King & Pierce County -- Bonded & Insured Contractor Registration #: GNSEPNS940BD
G Ni'v
00 .1
f
Job #10164
1406 South 348th St.
Federal Way,, WA 98003
For
Puget Sound Commercial
33919 9th Ave South # 105
Federal Way, WA 98003
GS. Services, Inc.
4 57th Avenue East Suite A
Ilup, WA 98375
1e: 253-548-1011 Fax: 253-536-8488
F.B.�'GB.
SERVICES GS.
L INTERIOR
DEMOLITION
'IiecelvxjzD
C17 -Y SEP 10 2010
Or �SFRAL WAY
Prepared by:
(,6arfic'706e
HFA,7 (Bui
-f ing Inspector
" -d
0
•
--------------------------------
TYPE FACILITY:
' Single Family Residence '
ADDRESS:
1406 South 348th St. '
Federal Way, WA 98003
I -------------------------------J
INTENT OF SURVEY. The intent was to identify immediate or potential asbestos health
hazards for building renovation or demolition. Sampling was done on all accessible suspect
building materials.
DATE OF GOOD FAITH ASBESTOS SURVEY. 9-7-2010
AHERA INSPECTOR: Charlie Jobe (Certificate # 1066812 Expires: 5/19/2011).
LABORATORY CREDENTIALS: All suspect materials were analyzed by Schnieder Laboratories,
Inc. in accordance with 40 Code of Federal Register Chapter 1, Part 763, Subpart F. A1HA Bulk Asbestos
Analytical Testing Program (101 150-0).
DESCRIPTION OF BUILDING: Vacant, single family residence.
✓ INTERIOR — The interior has sheet vinyl and floor tile on a wood sub strait. The
walls and ceilings are clad with gypsum wall board with an orange peel texture.
There is fiberglass insulation in the attic.
✓ EXTERIOR — The exterior consists of a combination of wood lap and T-111 siding
with a grey and black 3 -tab roof.
A Puget Sound Clean Air Agency permit is required to obtain a demolition permit.
Prior to any demolition or renovation, all friable and non -friable asbestos containing materials
(ACM) are to be removed and disposed of in accordance with applicable Federal, State and
Local regulations. If there are any asbestos containing materials left on site that will not be
disturbed during the renovation or demolition process, we recommend an Asbestos Operational
and Maintenance Program (OM) be developed and implemented to monitor the remaining
ACM.
0 •
ASBESTOS SUMMARY
The AHERA regulation, 40 Code of Federal Regulations (CRF) 763, is the primary governing
regulation when performing asbestos surveys. This regulation was originally enacted for school
buildings, but has since been applied to public and commercial buildings.
Puget Sound Clean Air Agency (PSCAA) Regulation 111, Article 4.02(a) requires an Asbestos
survey before the renovation or demolition of any structure over 120 square feet.
AHERA Protocol determines the number of samples of each material to be collected, depending
on its category and amount of material present. AHERA regulations segregate suspect
materials into three categories:
❖ Surfacing Materials : A sprayed or troweled on texture applied to walls, ceilings, wall
cavities and structural members for acoustical, decorative or fireproofing purposes.
AHERA requires collection of a minimum of 3 to 7 samples per homogenous material
depending on the quantity of material.
❖ Thermal System Insulation: Insulation used to inhibit heat transfer or prevent
condensation on pipes, boilers, tanks, ducting, furnaces and other components of hot
and cold water systems and heating, ventilation, and air conditioning systems. AHERA
requires collection of at least 3 samples of each homogenous material.
❖ Miscellaneous Materials: Other, largely non -friable products and materials such as
floor coverings, ceiling tile, roofing, outdoor siding, concrete pipe, silver coatings and
many others building materials. AHERA requires the collection of at least one sample
per homogenous material.
After identifying the suspect materials, bulk samples were collected and taken to an
independent accredited laboratory to be analyzed for the amount and type of asbestos, if any.
The bulk samples were analyzed using Polarized Light Microscopy (PLM) stain dispersion
staining techniques in accordance with the EPA Method 600/R-93/166, which has a reliable limit
of quantification of one percent asbestos by volume.
Survey Findings at 1406 South 348th St.
There were a total of 8 (eight) suspect building materials (bulk samples) removed from this
structure during this survey. Based on the lab analysis, 0 of the 8 samples tested positive for
asbestos. The following materials were found to contain 1 % or more asbestos fibers.
Asbestos containing materials
None of the samples taken tested positive for asbestos.
F.S. & GS Services does not guarantee approximations of quantities of ACM, which may
be listed with this report. It is therefore recommended that professional abatement price
be obtained by an on site visit to verify quantities.
EPA AND LABOR & INDUSTRY EXTRACTS
Current federal regulations (NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR
POLLUTANTS, NESHAPS, CFR 40, PART; 61, SUBPART M [REVISED SUBPART B]) require
that no renovation or demolition activity release asbestos fibers to the environment. Therefore,
all affected asbestos containing materials must be removed by a certified asbestos contractor
prior to remodel or demolition.
WAC 296-62-07707, Identification, requires an owner to perform a good faith inspection to
determine whether materials to be worked on or removed contain asbestos.
LIMITATIONS
In accordance with your request, F.S. & GS. Services, Inc., has conducted an A.H.E.R.A. type
survey. F.S. & GS. warrants that the survey was performed with the usual thoroughness and
competence of this profession, and within the limits of accessibility to materials.
The survey was conducted within the guidance provided by 40 CFR Part 763, Subpart E,
Appendix C.
F.S. & GS. Services is not responsible for materials, hidden from sight, that cannot be found
with reasonable diligence, such as materials in foundations or slab floors. We are providing this
information for the express use of Puget Sound Commercial and we make no warranty of
sufficiency of data to any other parties. This survey and demo permit will need to be submitted
to the Puget Sound Clean Air Agency prior to renovation or demolition activity.
Charles Jobe
AHERA INSPECTION EXPIRES
CERTIFICATION NUMBER #1066812 5/19/2011
0
CHAIN OF. CUSTODY
0
r�L
F.S. & GS. SERVICES INC.
16214 -57TH Ave. East Suite A
PUYALLUP WA 98375
ASBESTOS
SAMPLE LOG AND SAMPLE NOTES
BUILDING NAME: Single Family Residence
ADDRESS: 1406 South 348th St.
Federal Way, WA 98003
TEL# 253-548-1011
FAX# 253-536-8488
DATE: 09-07-2010
PROJECT# 10164
CLIENT NAME: Puget Sound Commercial
ADDRESS: 33919 9th Ave South # 105
Federal Way, WA 98003
SAMPLE#
FLOOR
PHOTO#
AREA
TYPE OF MATERIAL
001
MAIN
1
MUDD ROOM
BROWN SQUARE PATTERN SHEET VINYL
6702
MAIN
2
MUDD ROOM
GREY FLOOR TILE
003
MAIN
3
DINING ROOM
ORANGE PEEL TEXTURE & DRY WALL
CJ04
MAIN
4
LIVING ROOM
ORANGE PEEL TEXTURE & DRY WALL
005
MAIN
5
HALLWAY
ORANGE PEEL TEXTURE & DRY WALL
CJ06
MAIN
6
LIVING ROOM
GOLD PEBBLE PATTERN SHEET VINYL
007
MAIN
7
BEDROOM
TAN MARBLE PATTERN SHEET VINYL
C308
EXTERIOR
8
ROOF
BLACK 3 -TAB ROOFING
RECEIVED BY:
DATE/TIME:'
INSPECTORS' SIGNATURE:
FOR LAB USE ONLY
_x_ Same Day
0
t LAB RESULTS
•
SCH IDER LABORATORIES
INCORPORATED
2512 W. Cary Street • Richmond, Virginia • 23220-5117
804-353-6778 • 800 -785 -LABS (5227) • (FAX) 804-359-1475
Excellence in Service and Technology
AIHA/ELLAP 100527, NVLAP 101150-0, NYELAP/NELAC 11413, CAELAP 2078, NC 593, SC 93003
LABORATORY ANALYSIS REPORT
Asbestos Identification by EPA Method' 600/M4/82/020
Using SLI A6
ACCOUNT #: 2269-10-3488
CLIENT: F.S. & G.S. SERVICES INCi DATE COLLECTED: 9/7/2010
DATE RECEIVED: 9/8/2010
ADDRESS: 16214 57TH AVE EAST STE A
DATE ANALYZED: 9/8/2010
PUYALLUP, WA 98375 DATE REPORTED: 9/9/2010
PROJECT NAME: Single Fam Residence
JOB LOCATION: 1406 South 348th St
PROJECT NO.: 10164
PO NO.:
SampleType: BULK
Client SLI Sample
Sample Sample/ Identification/
No. Layer ID Layer Name PLM Analysis Results
Asbestos Fibers Other Materials
CJ01 30722569 Mudd Rm Sheet Vinyl
Layer 1: Sheet Flooring
None Detected 10% MINERAL/GLASS WOOL
Brown, Organically Bound 90% NON FIBROUS MATERIAL
CJ02 30722570 Mudd Rm FL Tile
Layer 1: Floor Tile
None Detected 5% CELLULOSE FIBER
Gray, Organically Bound 95% NON FIBROUS MATERIAL
Layer 2: Mastic None Detectedo
Yellow, Soft 100 /o NON FIBROUS MATERIAL
CJ03 30722571 Dining Rm Drywall
Layer 1: Drywall
None Detected 10% MINERAUGLASS WOOL
Off White, Powdery 80% NON FIBROUS MATERIAL
Layer 2: Textured Material 10°% CELLULOSE FIBER
White, Granular None Detected 100°% NON FIBROUS MATERIAL
CJ04 30722572 Living Rm Drywall
Layer 1: Drywall System <1% CHRYSOTILE
Off White/Beige/White, Powdery/Granular 5�% CELLULOSE FIBER
95 /o NON FIBROUS MATERIAL
otal Number of Pages in Report: 2
results relate only to samples as received by the laboratory.
(mended Report 09/09/2010 14:54 Visit www.slabinc.com for current certifications.
ample #4 needs to be composited
.amples analyzed by the EPA Test Method are subject to the limitations of light microscopy including matrix interference. Gravimetric
eduction and correlative analyses are recommended for all non organically bound materials. This method has a reporting limit of
or greater. Visual estimation contains an inherent range of uncertainty. This report must not be reproduced except in full with the
:)proval of the lab, and must not be used to claim NVLAP or other govt agency endorsement.
4ccount -
Workorder 2269-10-3488
Layer 1:
(Continue#
Page 2 (Continued)
Ilient
SLI Sample
80% NON FIBROUS MATERIAL
Sample
Sample/ Identification/
PLM Analysis Results
Vo.
Layer ID Layer Name
Asbestos Fibers Other Materials
,J05
30722573 Hallway Drywall
None Detected 20% CELLULOSE FIBER
Layer 1:
Drywall
None Detected 10% CELLULOSE FIBER
Off White, Powdery
10% MINERAUGLASS WOOL
,J08
30722576 Roof 3 -Tab Roofing
80% NON FIBROUS MATERIAL
Layer 2:
Textured Material
None Detected 100% NON FIBROUS MATERIAL
Beige, Granular
80% NON FIBROUS MATERIAL
'J06
30722574 Living Rm Sheet Vinyl
Layer 1:
Sheet Vinyl/Mastic
None Detected 20% CELLULOSE FIBER
Gold/Brown, Org.Bound/Soft
80% NON FIBROUS MATERIAL
Unable to separate individual layers.
;J07
30722575 Bedroom Sheet Vinyl
Layer 1:
Sheet Vinyl/Mastic
None Detected 20% CELLULOSE FIBER
Tan/Brown, Org.Bound/Soft
80% NON FIBROUS MATERIAL
Unable to separate individual layers.
,J08
30722576 Roof 3 -Tab Roofing
Layer 1:
Roofing
None Detected 20% MINERAL/GLASS WOOL
Gray/Black, Granular/Bituminous
80% NON FIBROUS MATERIAL
ialyst:
SUSAN CHILDRESS
Reviewed By: Hind Eldanaf, Asbestos Area Supervisor
ital Number of Pages in Report: 2
)sults relate only to samples as received by the laboratory. Visit www.slabinc.com for current certifications
'nenaea rteport 0910912010 14:54
i'mple #4 needs to be composited
tmples analyzed by the EPA Test Method are subject to the limitations of light microscopy including matrix interference. Gravimetric
Duction and correlative analyses are recommended for all non -friable, organically bound materials. This method has a reporting limit of
or greater. Visual estimation contains an inherent range of uncertainty. This report must not be reproduced except in full with the
proval of the lab, and must not be used to claim NVLAP or other govt agency endorsement.
0
FLOOR PLAN
FLOORPLAN
JOB # 10164