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14-101798
City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 f +♦ i Demolition Permit #: 14 -101798 -00 -DE Inspection Request Line: (253) 835-3050 Project Name: POWELLSWOOD GARDEN Project Address: 30112 4TH AVE S Project Description: Demolition of 2 sheds and a wing of an existing house. Parcel Number: 052104 9012 Owner Applicant Contractor MONTE POWELL MONTE POWELL OWNER IS CONTRACTOR POWELLSWOOD GARDENS POWELLSWOOD GARDENS 29607 8TH AVE S 29607 8TH AVE S FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 Additional Permit Information Demolition Valuation.............................................15000 PERMIT EXPIRES Sunday, April 17, 2016 Permit Issued on Friday, April 18, 2014 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 d the City of Federal Way. _ Al Owner or agent: /i"v/L�L' Date: FINALED .1 . THIS CARD IS TO r'+ MAIN ON-SITE CITY OF .. Construction In�ection Record Federal Way INSPECTION REQUE;TS: (253) 835-3050 PERMIT #: 14 -101798 -00 -DE Address: 30112 4TH AVE S Project: MONTE POWELL FEDERAL WAY, WA 98003-3673 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. El Anal - Building (4U,U) Approved By il-V7 Date 1.I 3 I El Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date ' R�'CEIVED j c,rvoF � APR 18 �214 PERMIT 91PPLICATION Federal VI/ay CITY OF FEDERAL WAY `bII CDS �j PERMIT NUMBER _ / / L ,J `'//� 7� _ b E TARGET DATE SITE ADDRESS -5 ©l[ Z, SUITE/UNIT # PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL # TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICALEMOLITION ElENGINEERING ElFIRE PREVENTION NAME OF PROJECT G PROJECT DESCRIPTION ,—� Detailed description of work to be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER `,7/ MAILING ADDRESS CITY STATE ZIP NAME PHONE MAILING ADDRESS ` E-MAIL CONTRACTOR CITY STATE ZIP FAX rWA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # NAME OA PRIMARY PHONE APPLICANT MAILING DRESS 1�1 E-MAIL STATE ZIP FAX NAME l PRIMARY PHONE PROJECT CONTACT MAILING ADDRESS E-MAIL (The individual to receive and respond to all correspondence CITY STATE ZIP FAX concerning this application) PROJEC PI3ITANCING NAME OWNER -FINANCED Rec . aloe of $5, 000 or more MAILING ADDRESS, 5D4 -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 all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a partof this _. lication. SIGNATURE:�1 DATE % �� & PRINT NAME: Bulletin 4 100 — January 1, 2013 Pagel of 3 k:\Handouts\Permit Application GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR VALUE OF MECHANICAL WORK MECHANICAL PERMIT FOR OFFICE USE BASEMENT $ Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existingfixtures 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 Additional Information DUCTING GAS PIPING WOODSTOVES GARAGE ❑ CARPORT ❑ TENANT AREA ONLY OTI-IER (describe) r VALUE OF PLUMBING WORK PLUMBING PERMIT Area Totals Indicate how many of each type o re to be installed or relocated as part of this project. Do not include existigg fixtures to remain. BATHTUBS (or Tub/shower combo) LAVS (Hand Sinks) TOILETS W ER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS C5T ER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (&tchm/uwity) WATER HEATERS (Electric) HOSE BIBBS UMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS FOR OFFICE USE BASEMENT NEW BUILDING EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRIN R SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ADDITION 11 Yes No ❑ Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING OP'96D TOTAL FOR OFFICE USE BASEMENT NEW BUILDING FIRST FLOOR (or Mobile Home) ADDITION SECOND FLOOR COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION COVERED ENTRY Occupancy Group(s) Construction Type # of Stories Additional Information DECK GARAGE ❑ CARPORT ❑ TENANT AREA ONLY OTI-IER (describe) r PROJECT AREA ONLY Area Totals EHISTING PROPOSED AL *NEW HOMES ONLY" ESTIMATED SELLING PRIC $ *OF BEDROOMS COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction a # of Stories Additional Information NEW BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100 — January 1, 2013 Page 2 of 3 k: flandouts\Permit Application �: i; CITY OF 1� SmA�-rMIR14,;izu CONINI AiTV &ECQtiO%IIC D[i`LLOPME\1 DI.PDRillic t' 39323 Wh AVM1W SOW- 1 Federalttvay, WA 99003•0:3 353.395•:d67; Fa,�z33•t3�.3do� ti,yNv. c ityofkderala^ay. com DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure or structures on a subject property. Check Nvith the City's Planning Disision to see ifthe proposal exceeds thl'esliolds that trigger ail enN*otltnental revimv..Atl envi�oiut=italrevkw . tui subtnittalofan emi'ommival checklist may be requivd. which will extend tete tittle period betbie a detwItri pemA cats be issued. ❑ Prior to submitting a demolition permit, the following items (as applicable) must be signed by the 1 ,pective agent- (see attached Demolition Permit Contact List). VOTE r0.4PP,UC.a.N'r. L iiliries shall be disconnected grid seritces perforr»ed, applicable, prior to ustcane't of the deft ohnan perttttt, ,dll ophe able items below are to be;ipied_and ..dated:bi• the respee a agernct represeistativcs• 1. ASB TO ABATE NT (Copy p I form stos survey fr Puget and Clean Air Agenc ov ) I I (City)t"eral Way Buildno Official)' 2. GAS SUPPLY ✓'99,,;7 (Gas t,o..J(b�/�s t off, meter removed and final bill paid) (�P�nd Energy 3. SEPTIC SYSTEM (Tank to be removed or tank to b rained and filled) King Cou/t%Y'Erfvironmental Services 4. SANITARY SEWER (Check applicable box) ❑ Sewer line capped at property line ,�Existing jv3er liney remain and be used by proposed ne;, structure /(Lakehaven Utility District) S. GA/RBA E (All household r posed off and foirbill paid) ( iste Manag nt/Other Company 0 Completed Construction Permit Application form ❑ Protide the following fees: 1. Demolition Permit Fee 2. Automation Fee 3. NVA State Surrhatle 6. ELECTRICITY (Electricity to be shut off and meter removed) Puget Sound Enc -%y) T. FUEL STORAGE TANKS AIA (Above or below grace fuel tanKS, have been pumpec or removes unser Fire Department permit prior to any dismantle/excavation) south KinQ h nil and 8. WATER - Public Source (Check aPplicabl* box) a Meter to be removed and final utility bill Paid *Meter to remain and b"rotected � � (WaterauP�irfj�� «�. OR g. WATER - Private Well (Check appliCabie box) a Private Well filled and crapped c Private well other purpOiex (KingCountyErivironnlental Sorvf Basedoti-ahatiatt,SeetAbleatePMdceltreec49t7at1iicticlt>iel9ri A laliiiatti. 520.00 S4.50 Bullinin=122-Februwy14, 2013 pale 1dI k:'l3uki4w,Dttwlki�)hPe}tfikekegiiilffi'. i Approved Transaction bttps://secure.pscleanair.org/Asbestos/Approved.aspx pscIeanair.org Puget Sound Agency Notification Case #: 201401445 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 $275.00 Credit Card Transaction # VLFFAC4B9236 Transaction Date 04/18/14 Owner's Name Monte and Diane Powell Phone (253) 839-4405 Project Street Address 30112 4th Ave. South City Federal Way Zip 98003 Contact Person Monte Powell Phone (253) 839-4405 Mailing Address 29607 8th Ave. S. Federal Way, WA 98003 This project includes asbestos removal. Project Size linear feet / 500 square feet Project Start Date 04/28/14 Completion Date 04/28/14 Asbestos will be removed by a licensed asbestos abatement contractor Contractor Thematech Northwest Inc. Contractor Job # Contact Bob Gulley Phone (253) 606-4905 Mailing Address 10312 Sales Road South Lakewood, WA 98499 This project includes a demolition. Demolition Start Date 05/03/14 Completion Date 05/04/14 Demolition will be completed by a demolition contractor Demo Contractor AAA Excavating Contractor Job # Contact Jeremy Stendera Phone (206) 498-4160 Mailing Address 12419 57th Ave. S. Seattle, WA 98178 (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. 1 of 1 4/18/2014 2:54 PM AAA EXCAVATING 0 https://secure.Ini.w6/verify/Detail.aspx?UBI=601223048&LIC=... Washington State Department of kLabor& Industries AAA EXCAVATING Owner or tradesperson GIRTMAN, JOHN VICTOR Principals GIRTMAN, JOHN VICTOR Doing business as AAA EXCAVATING WA UBI No. 601 223 048 License 12419 57TH AVE SO SEATTLE, WA 98178 206-763-3097 KING County Business type Individual Governing persons JOHN GIRTMAN Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor Active. _.._..... 11.11.11. --- Meets current requirements. License specialties Excavation, Grading and Land Clearing License no. AAAEXE*885NS Effective — expiration 08/10/2012 — 08/10/2014 Bond American Contractors Indem CO $6,000.00 Bond account no. 100226336 Received by L&I Effective date 07/09/2013 08/09/2013 1 of 2 4/18/2014 2:50 PM AAA EXCAVATING Insurance Ohio Security Ins Co Policy no. BLS1355225321 Received by L&I 07/09/2013 Savings No savings accounts during the previous 6 year period. https: //secure.Ini.w a. gov/verify/Detai 1. aspx?LJBI=601223048&LIC=... 0 $1,000,000.00 Effective date 08/07/2013 Expiration date 08/07/2014 Lawsuits against the bond or savings No lawsuits against the bond or savings during the previous 6 year period. Tax debts .. .............. No tax debts during the previous 6 year period. License Violations ..........o_._._._...._....__._._............................. . Nlicense violations during the previous 6 year period. Workers' corn p Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. This company has multiple workers' comp accounts. Active accounts L&I Account I D 573,912-02 .................................... Account is current. Doing business as AAA EXCAVATING Estimated workers reported Quarter 4 of Year 2013 "1 to 3 Workers" L&I account representative T5 / THAO NGUYEN (360)902-4276 - Email: NGUV235@lni.wa.gov Track this contractor Workplace safety and health No inspections during the previous 6 year period. © Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington. 2 of 2 4/18/2014 2:50 PM Powell Home Builds inc - Monte Powell 301 120h Ave South Federal Way VVA 98003 doc Page 11 April 16, 2014 Powell Home Builders Inc. 22211 Marine View Drive South Des Moines, WA 98198 Email: monte@powell-homes.com RE: (Asbestos Removal) 301124 th Ave. South Federal Way, WA 98003 Asbestos abatement (excluding tax): $1.684.00 (Clean Air Agency Notification Fee if applicable is included) Scope: Remove asbestos containing the and mastic found in the garage (Am)rox. 500 SFI. Remove asbestos containing gray window glazing located on the south window of the addition. Remove asbestos containing black coating from the kitchen sink. Clarifications: 1) Price does not include any other hazardous material testing, removal or abatement. 2) Price only includes the specific areas listed above. *TTNW will not be responsible for damage to exterior or interior surfaces, sheetrock, woodwork, finishes, ducting, insulation etc. that may occur during the containment set up/teardown or abatement methods. General Conditions: • Payment to be made within 15 days of invoice. o In the event of payment default, customer agrees to pay Thermatech Northwest Inc. finance charges of 1.5% per month on any outstanding amount over 30 days from the date of invoice. • This proposal includes insurance. o General Liability @ $2Million o Auto $1Million o Pollution $2Million • All work will be performed in compliance with Federal, State, and Local regulations. Thernmtech Northwest Inc. 1o.31 -v Sales Road South, Lakewood, WA .98-199 Pb is is FX I886 Powell Horne Builders Inc - [Monte Powell 301124h Ave South Federal Way WA 98003.doc Page 12 ................ ' Thank you for giving Thermatech NW the opportunity to furnish a quote for this project. Any questions please contact Bob Guiley @ 253-606-4905 If you find the above bid acceptable please sign below and return to Thermatech Northwest Incorporated either by fax at 253-984-1886, email bobg@ttnw-inc.com or mailed to 10312 Sales Rd. South, Lakewood, WA 98499. Sincerely, Bob Guiley Estimator\Project Manager You are hereby authorized to furnish all materials and labor required to complete the work mentioned in the above proposal. Should the undersign default on any obligation incurred under this agreement and Thermatech Northwest Inc. refers this account to his attorney for collection and/or legal action, the undersigned agrees as follows: to pay the principal due, attorney fees and all costs of any nature incurred by Thermatech Northwest Inc. to pursue the delinquent obligation. Delinquent accounts will be accessed at the rate of 1- 1/2% per month (18% per year). ACCEPTED this day of By: Signature a� ,20 W Print Name Thermatech North west Inc. 10.111 e Sa1es Road South, Lakenwod, WA 98499 Ph 2.58.9S4. ISIS FA- 2".984..1886 0 0 Zjml�ft *� Thermatech Northwest Inc. 10312 Saies Road S, Tacoma WA 88489 Ph. (253)-9841818 301124 1h Avenue S Federal Way, WA 98003 #TMUM 1:14 ON Robert J. Guiley AHERA Certification #13-1276 Expiration Date September 12, 2014 Thermatech Northwest Inc. 10312 Sales Road S, Tacoma WA 98499 Ph, (253)-9841818 Address 30112 4th Ave S o�-, �. e Federal Way, WA 98003 °y3 288th St z Pte;?ni Si CS")Z' Nato VIII a id s '. �ra a �C3i811 .r: 4 s' -I3h '�t > iid:4h at S lU itt t S3(Mpf ;� •� � � • 3��"P, e; �� ttrxFh r t Map data 6201 "Oogle 02M 4 Goo* IF SCOPE OF WORK/BUILDING DESCRIPTION ....... -- ............................. Basic Construction Heating & Ventilation System Plumbing System Insulation Electrical System Interior Construction, Finishes & Flooring 6y, kv,10:0111 1 SUMMARY OF MATERIALS FOUND POSITIVE ........................................ 5 DEFINITIONS............... — ............. — ......... .............................................. ... 6 CONCLUSIONS....................... ...................... -- ... .................................... 7 Inspector's Certification Field Data/ Laboratory Results Garage Out Building Thermatech Northwest Inc. 10312 Sales Road S, Tacoma WA 98499 Ph. (253)-9841818 0 Good Faith Asbestos Survey SCOPE OF WORK • Prepared for Monte Powell On March 1, 2014, Robert J Guiley conducted a "Good Faith asbestos survey (per U.S.E.P.A / A.H.E.R.A. guidelines as designated by Puget Sound Clean Air Agency) of the residence addition, detached garage and out building located at 30112 4th Avenue S, Federal Way WA 98003. Field inspection, data collection and report generation were based on the following Scope of Work: • Perform visual inspection to identify and inventory all accessible suspect -asbestos containing materials, • Bulk sampling and analysis of all identified suspect asbestos - containing materials. • Provide written report. This survey is limited to the east addition of the house only BASIC CONSTRUCTION: The structure is a single story, single family residence covering approximately 1250 Sq. Ft... The exterior is painted T-111 siding on wood framing. The roof is peaked with asphalt shingles. The windows are single pane glass with steel frames. INSULATION: Fiberglass insulation was found in the walls. HEATING & VENTILATION SYSTEM: Heat is supplied by a gas fired forced air wall furnace located in the living room. PLUMBING SYSTIEW, The plumbing is copper pipe. No TSI was found. ELECTRICAL SYSTEM: The electrical system is a three wire bundle through a breaker box located in kitchen. INTERIOR CONSRTUCTION, FINISHES & FLOORING: The interior is finished with a gypsum wall board system on wood framing. The floor sheet Vinyl and carpet over wood. 1 I P ag P 0 Good Faith Asbestos Survey 10 Prepared for Monte Powell SAMPLE METHODS AND LABORATORY INFORMATION A walk- through inspection of all areas was performed to identify which building materials may have the potential for containing asbestos. After identifying the suspect asbestos -containing materials, bulk samples were collected, placed in plastic bags, numbered and recorded. Care was taken to clean all tools between sampling in order to avoid cross -contamination. The samples and appropriate chain of custody forms were then sent to CEI Laboratories to be analyzed for the type and content of asbestos, if any. The samples were analyzed using Polarized Light Microscopy (PLM) Stain Dispersion Technique in accordance with EPA METHOD 600/R-93/116. The following section contains tables listing all materials sampled by location, description, type, asbestos percentage (if any) category, and results of materials sampled. IM 0 0 . O . .. ....... . . (D a) a) 0 Q) 0 (D 0 (D 0 0) 0 a) 0 (1) a (1) 0 a) 0 0 C(1) W a (1) c a) c 0) c 0 c 4) c a) r_ 0 z 0 z 0 z 0 z 10 z 0 iz 0 z 0 z 0 z > tll 0 :3 0 0 d) cn a- E CL E a E 0 0 0 L) 0 to X x 4) 0 U) CE) E m 0 F- od m 06 m 06 m 0) W m m — m C (a lu as (D Z cc as as Z T2 T2 Z :a :5 a) LL LL m mr m c co r m r m c m r Cr 0 0 U- LL LL U- U- U- U- lu- z z as to 0 m > J9 0 0 Li .2 UL E 0 E 0 ca E 0 0 0 c E 0 0 2 0 E 0 E 0 (D I_- 2 r - -C m Co 2 cu uj I 0 0 0 0 0 0 0 0 0 < < — < 4 < Q < 1 2 ik CN m 'IT LO to t- CD CD Cl V-° EC4. dd- d- D. L1 a. a. a. L o. I Ail 0 0 Q t Q v v v 0 4) 0 z Mc =.0 0 _jr_ 0 z 0 lz 0 z 0 cri rn 0- P CO E C: c C: ss U 0 CL E 0 a E 0 CL E 06 0 0 0 - a) r - U) !o ad CLCL c0 0 0 0 < CL m 05 m *6 m 2 m 0230. t9 c9 C9 m a3 4) U- U- LL U- LL LL 0 0 0 Z Z Z Li- LL U- UL LL z z z 0 0 0 V as 00 0 0 (D Z5 (D 0) 4) m 0 C. 1� a) W (D 0) c 0 c 0 a 0 0 (9 0 (D 0 a i �t LO d- T- Eo w oL cL m rL CL CL Cl) 0 Good Faith Asbestos Survey 0 Prepared for Monte Powell SUMMARY OF MATERIALS FOUND POSITIVE Upon completion of the survey and review of the laboratory data, the following materials found, contained asbestos at the structures located at, 30112 4th Avenue S, Federal Way WA 98003. • The brown/salmon and white floor the and associated black mastic located on the garage floor. (Samples #P -2A, #P-213, #133A, #P313). • The grey window glazing located on the South window of the addition. (Sample #P-11). • The black coating located on the kitchen sink I the addition. (Sample #P-21). MATERIALS CONTAINING LESS THAN 1% ASBESTOS • The gypsum wallboard system as a composite contains less than 1% Asbestos. (Samples #P-5, #P-6, #P-7). 5� Good Faith Asbestos Survey 10 Asbestos means the asbestiform varieties of actinolite, amosite (cummingtonite- grunerite), tremolite, chrysotile (serpentinite), crocidolite (riebeckite), or anthophyllite. I&V1117W 9?s"J%=T percent (1 %) asbestos as determined using the method specified in EOA regulations (Polarized Light Microscopy), pressure. Homogeneous Areas — an area which appears similar throughout in terms of color, texture, and date of materials application. Surfacing Material -- material that is sprayed -on, troweled- on, or oth- •• -• pplied to surfaces, such as acoustical plaster on ceilings, and fireproofing materials on _#W;O_� woli P4 'j tfk A'jW fireproofing, or other purposes (AHERA definition). Thermal System Insulation — means material applied to pipes, fittings, boilers, breeching, tanks, ducts or other interior structural components to prevent heat loss or gain, or water condensation, or for other purposes. 0 Good Faith Asbestos Survey [U* ki LOA I 10 Prepared for Monte Powell Abatement and disposal of asbestos -containing materials must be conducted by a Washington State Licensed Asbestos Abatement Contractor using Washington State Certified Asbestos Abatement Workers. Should employees or contract personnel encounter any suspect asbestos -containing materials, it is their responsibility to: Contact a representative of the owners. Consult the inspection report to determine whether or not the suspect material contains asbestos. Ensure that all employees and contractors are informed and advised of the location and type of materials that contain asbestos Any additional hidden or covered suspect materials, discovered during demolition or renovation, that are similar to those identified in this survey must be treated as asbestos -containing materials unless determined otherwise by laboratory analysis. A copy of this report should be kept on site during any asbestos abatement, renovation, or demolition. Please contact the undersigned for any further assistance or if any questions or concerns arise relative to this report. Sincerely, Robert Guiley AHERA Building Inspector Thermatech Northwest Inc. 10312 Sales Road S Lakewood, WA 98499 7 1 P a g e 0 .` s s 0 E 0 THERMATECH NORTHWEST INC. 10312 Sales Road S Lakewood, WA 98499 PH: 253-984-1818 FAX: 253-984-1886 DATE: 3/1/1937 CLIENT: Monte Powell ADDRESS: 0 FIELD DATA SUMMARY TTNW JOB* 14-0359 INSPECTOR: BOB GUILEY SITE: NAME ADDRESS; 30112 4th Avenue S Federal Way, WA 98003 SAMPLE NO. Building LOCATION DESCRIPTION OF MATERIAL P-1 Garage Garage -Peaked Roof Brown/White Asphalt Shingles P-2 Garage Garage -Floor Salmon/Brown/Cream Tile & Mastic P-3 Garage Garage -Floor White Tile & Mastic P-4 Garage Garage -Dropped Ceiling Dots/Worm Tracks Ceiling Panels P-5 Garage Garage -West Wall GWB & Joint Compound P-6 Garage Garage -East Wali GWB & Joint Compound P-7 Garage Garage -North Wall GWB & Joint Compound P-8 Garage Garage -Wall Throughout Insulation Paper & Mastic P-9 House Addition -Peaked Roof Black As halt Shingles P-10 House Addition -Peaked Roof Black Pa er P-11 House Addition -SE Window Grey Glazing P-12 House Addition -Kitchen Floor Beige Squares Sheet Vinyl P-13 House Addition -Bathroom Floor Cream Squares Sheet Vinyl P-14 House Addition -Living Room Wall Wall Texture P-15 House Addition -Kitchen Wall Wall Texture P-16 House Addition -NE Bedroom Wall Wall Texture P-17 House Addition -Kitchen Wall GWB & Joint Com ound P-18 House Addition -Living Room Wali GWB & Joint Compound P-19 House Addition -Bathroom Wall GWB & Joint Compound P-20 House Addition -Bathroom Cove Base Tan Adhesive P-21 House Addition -Kitchen Sink Black Coating 0 "A, • • if • METHOD: EPA 600 1 R93 / 116 and EPA 600 1 M4-82 1020 ASBESTOS client ID Layer Lab W Color Sample Description % P-1 A1681346 Blackjan Shingle None Detected P-2 A1681347A Brown,Salmon Floor Tile A1681347B Black Mastic P-3 A1681348A White Floor Tile P-11 A1681356 Glazing P-12 A1681348B Black Mastic WEMMUwa- 0.4 A1681349 Whitejan Ceiling Tile None Detected P-5 A1681350 White Wallboard/Joint Compound Chrysotile <'1-%-- P-6 A1681351 White Wallboard/Joint Compound Chrysotile <1% Al 681360 A1681352 White Wallboard/Joint Compound Chrysotile <1% A1681361 A1681353 Black,Yellow Insulation Paper None Detected P-9 A1681354 Black,Grey Shingle None Detected P-10 A1681355 Black Tarpaper None Detected P-11 A1681356 Glazing P-12 A1681357 Beige,Off-white Sheet Vinyl None Detected P-13 A1681358 Cream,Off- Sheet Vinyl None Detected white P-14 A1681359 Tan,Off-white Wall Texture None Detected 0-15 Al 681360 Tan,Off-white Wall Texture None Detected P-16 A1681361 Purple, Off-white Wall Texture None Detected P-17 A1681362 White Wallboard/Joint Compound None Detected P-18 A1661363 White Wallboard/Joint Compound None Detected P-19 A1681364 Wnite Wallboard/Joint Compound None Detected P-20 A1681365 Tan Adhesive None Detected P-21 A1681366 Black Coating nam ASBESTOS BULK ANALYSIS 'CEIWRIM By: POLARIZING LIGHT MICROSCOPY LA'kB's Client: Thermatech Northwest, Inc. 10312 Sales Road S. Lakewood, WA 98499 Project: Monte Powell; 14-0359 CEI Lab Code: A14-3901 Date Received: 04-02-14 Date Analyzed: 04-03-14 Date Reported: 04-03-14 ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % P-1 Shingle Heterogeneous 45% Cellulose 10% Gravel None uetecteo A1681346 Blackjan 26% Fiberglass 20% Tar Fibrous Tightly Bound P-2 Floor Tile Heterogeneous <1% Cellulose 65% Vinyl 3% Chrysotile A16813477A Brown,Salmon 17% Cale Carb Fibrous 15% Binder Tightly Bound A1681347B Mastic Heterogeneous <1% Cellulose 72% Mastic 3%Chrysotile Black 25% Tar Fibrous Tightly Bound P-3 Floor Tile Heterogeneous <1% Cellulose 65% Vinyl 3% Chrysotile A1681348A White 17% Cale Garb Fibrous 15% Binder Tightly Bound A1681348B Mastic Heterogeneous <1% Cellulose 72% Mastic 3% Chrysotile Black 25% Tar Fibrous Tightly Bound P-4 Ceiling Tile Heterogeneous 12% Cellulose 5% Paint None Detected A1681349 White,Tan 45% Fiberglass 15% Perlite Fibrous 23% Binder Tightly Bound P-6 Wallboard/Joint Heterogeneous 15% Cellulose 75% Gypsum <I%Chrysotile A1681350 Compound White 3% Paint Fibrous 7% Binder Tightly Bound Lab Notes: 2% Chrysotile in Joint Compound only; <1% Chrysotile overall. Page 1 of 5 ASBESTOS BULK ANALYSIS C E By: POLARIZING LIGHT MICROSCOPY 11—�AkI955 Client: Thermatech Northwest, Inc. 10312 Sales Road S. Lakewood, WA 98499 Project: Monte Powell; 14-0359 CEI Lab Code: A14-3901 Date Received: 04-02-14 Date Analyzed: 04-03-14 Date Reported: 04-03-14 ASBESTOS BULK PLM, EPA 600 METHOD Client 1D Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Noes -Fibrous % P-6 Wallboard/Joint Heterogeneous 151/o Cellulose to% uypsum <i7otnrysowe A1681351 Compound White 3% Paint Fibrous Fibrous 7% Binder P-12 Sheet Vinyl P -g Shingle Tightly Bound 15% Cellulose 10% Gravel None Detected Lab Notes: 2% Chrysotile in Joint Compound only; <1% Chrysotile overall. 45% Fiberglass 20% Tar P-7 Wallboard/Joint Heterogeneous 15% Cellulose 75% Gypsum <1% Chrysotile A1681352 Compound White 3% Paint Fibrous 7% Binder Tightly Bound Lab Notes: 2% Chrysotile in Joint Compound only; <1% Chrysotile overall. P-8 Insulation Paper Heterogeneous 65% Cellulose 20% Mastic None Detected A1681353 Black,Yellow 15% Fiberglass 21% Binder Fibrous Fibrous Tightly Bound P-12 Sheet Vinyl P -g Shingle Heterogeneous 15% Cellulose 10% Gravel None Detected A1681354 Black,Grey 45% Fiberglass 20% Tar Fibrous 10% Binder Tightly Bound P-10 Tarpaper Heterogeneous 85% Cellulose 15% Tar None Detected A1681355 Black Fibrous Page 2 of 5 Tightly Bound P-11 Window Glazing Heterogeneous 2% Cellulose 75% Calc Carb 2% Chrysotile A1681356 Grey 21% Binder Fibrous Tightly Bound P-12 Sheet Vinyl Heterogeneous 50% Cellulose 50% Vinyl None Detected A1681357 Beige, Off-white Fibrous Tightly Bound Page 2 of 5 ASBESTOS BULK ANALYSIS iiia By: POLARIZING LIGHT MICROSCOPY E LAIC3S' Client. Thermatech Northwest, Inc. 10312 Sales Road S. Lakewood, WA 98499 Project: Monte Powell; 14-0359 CEI Lab Code: A14-3901 Date Received: 04-02-14 Date Analyzed. 04-03-14 Date Reported: 04-03-14 ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab 10 Description Attributes Fibrous Non -Fibrous % P-13 Sheet Vinyl Heterogeneous 50% Cellulose 50% Vinyl None Uetected A1681358 Gream,Off-white Fibrous Tightly Bound P-14 Wall Texture Heterogeneous <1% Cellulose 65% Cale Carb None Detected A1681359 Tan,Off-white 15% Paint Fibrous 20% Binder Tightly Bound P-15 Wall Texture Heterogeneous <1% Cellulose 65% Cale Carb None Detected A1681360 Tan,Off-white 15% Paint Fibrous 20% Binder Tightly Bound P-16 Wall Texture Heterogeneous <1% Cellulose 65% Cale Carb None Detected A1681361 Purple,Off-white 15% Paint Fibrous 20% Binder Tightly Bound P-17 Wailboard/Joint Heterogeneous 15% Cellulose 75% Gypsum None Detected A1681362 Compound White 3% Paint Fibrous 7% Binder Tightly Bound P_18 Wallboard/Joint Heterogeneous 15% Cellulose 75% Gypsum None Detected A1681363 Compound White 3% Paint Fibrous 7% Binder Tightly Bound P-1 9 Wallboard/Joint Heterogeneous 15% Cellulose 75% Gypsum None Detected A1681364 Compound White 3% Paint Fibrous 7% Binder Tightly Bound Page 3 of 5 Client: Thermatech Northwest, Inc. CEI Lab Code: A14-3901 10312 Sales Road S. Date Received: 04-02-14 Lakewood, WA 98499 Date Analyzed: 04-03-14 Date Reported: 04-03-14 Project: Monte Powell; 14-0359 kSBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON -ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non -Fibrous % P-20 Adhesive Heterogeneous 1001/o Mastic None vetactea A1681365 Tan Fibrous Tightly Bound P-21 Coating Heterogeneous <1% Cellulose 85% Tar 3% Chrysotile A1681366 Black 12% Binder Fibrous Tightly Bound Page 4 of 5 C E I LEGEND: Non-Anth= Non-Trem= Tremolite Calc Carb=Calcium Carbonate METHOD: EPA 600/R93/116and EPA 600/M4-82/020 The detection limit for the method is <1% byvisual estimation and O.25% by 400 point counts or0.1% by 1,000 point counts. Due to the limitations of the EPA 600 Method, norfriableorganically bound materials such as vinyl floor tiles can be difficult to analyze via polarizing light microscopy (PLM). EPA recommends that all NOBs analyzed by PLK8, and found not to contain asbestos, befurther analyzed by Transmission Electron Microscopy (TEM). Please note that PLM analysis of dust and soil samples for asbestos is not covered under NVLAPaccreditation. CEI Labs, Inc. can perform positive stop analysis if requested by customer. However, it is the This report may not be roprodumad, except in hmU, without written approval by CEI LABS. CEI LABS makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting onm|vdua| results. This report may not be used by the client to claim product endorsement bvWVLAporany other agency ofthe U.S.Government. ANALYST: OexAPPROVED BY: Ritika Seal 14V NVLAP Lab Co 114 , ". � /'/� r-, TianbaoBai,PbD. CEI Labs, 107 Now Edition Court, Cary, NC 27511, Phone. (866) 481-1412 Page 5 of 5 0 *Now C E IL_ AC3 107 New Edition Court, Cary, NC 27611 Teti 866481-1412: Fax: 919-X481,1442 0 ASBESTOS CHAIN OF CUSTODY GENERAL INST ILICTIONS POSITIVE STOP ANALYSIS PLM DUE DATE' ANALYZE NOWS BY TEM ❑ TEM DUE DATE: M1 1=140241-J11 #1u YV#,WAF#JXAr-' TWU MWIF M I i PROJtt�tINFOMAWN CLIENT#: 26425 lJob Contact: CqMPPy Thermatech Northwest, Inc. Reject Samples - Address: 10312 Sales Road S. Lakewood, WA 98499 ject Name: Monte Powell Proiect ID# 14-0359 �Emajl: bobsLOttnw4nc.com 4 HR I Tel: 253-9184-1818 Fax.253-984-1886 SAMPLES COLLECTED IN. Wast!�� GENERAL INST ILICTIONS POSITIVE STOP ANALYSIS PLM DUE DATE' ANALYZE NOWS BY TEM ❑ TEM DUE DATE: M1 1=140241-J11 #1u YV#,WAF#JXAr-' TWU MWIF M REMARKS: El Accept Samples TURN AROUND TIME Reject Samples Ruin d By: ASHES TOS METHOD 4 HR 8 HR 24 HIR 2 DAY 3 DAY $'DAY PLM BULK EPA 600 a ED 0 PLM POINT COUNT (400) EPA 600 ID PLM POINT COUNT (1000) EPA SOCA 0 PLM CRAY w POINT COUNT EPA 601 PCM AIR NIOSH 7400 TEM AIR AHERA EPA AHERA TEM AIR NIOSH NIOSH 7402 ED 0 E] E] 0 0 TEM BULK CHATFIELD ED 0 0 0 TEM DUST WIPE ASTM D6480-05 ❑ 0 1:1 0 0 E] TEM DUST MICROVAC ASTM D5755-09 13 TEM SOIL ASTM D7521- TEM VERMICULITE CINCINNATI METHOD '01 01 OTHER: REMARKS: El Accept Samples Reject Samples Ruin d By: Datemme DatelTime- 411/2014 Samples will be disposed of 30 days after One"!$ VERSION CCOC.0214.112.LD Customer COC Page 1 0 0 MTMO�� The garage is a single story structure covering 580 square feet. The roof is peaked with asphalt shingles over wood. The exterior is painted T-111 siding on wood framing, The window is single pane glass with aluminum frame. The interior is finished with a gypsum wallboard system on wood framing. There is a dropped ceiling with panels. The floor is tile over concrete. 9 0 Appendix #D The out building is a pole building with a Vinyl exterior and wood roof. There is plastic over the roof. The interior is unfinished with a dirt floor.