18-103551Demolition
City of Federal Way Permit #:18 -103551 -00 -DE
Commnaity U wiWmeat Dept. FILE
33325 8th Ave S Inspection Request Line: (253) 835-3050
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Project Name: ADAMS
Project Address: 32830 20TH AVE S Parcel Number: 797880 0520
Project Description: Demolish existing mobile home trailer as well as the 2 car garage.
Owner Applicant Contractor
YURIY NELNICHUK YURIY NffiLNICHUK OWNER IS CONTRACTOR
6821 UDALL PL SE UNIT E202 6821 UDALL PL SE UNIT E202
AUBURN WA 98092 1 AUBURN WA 98092
Additional Permit Information'
PERMIT EXPIRES Monday, 4 February, 2019
Permit Issued on Wednesday, August 8, 2018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
C
Owner or agenl�-��� / G Date:
��no'�tk
City of Federal Wry
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835.2609
r
Demolition
Permit #:18 -103551 -00 -DE
Inspection Request Line: (253) 835-3050
Project Name: ADAMS
Project Address: 32830 20TH AVE S Parcel Number: 797880 0520
Project Description: Demolish existing mobile home trailer as well as the 2 car garage.
Owner
Applicant
Contractor
GREGORY ADAMS
YURIY & LYUBOV NIELNICHUK
OWNER IS CONTRACTOR
6811 E SIDE DR NE
6821 UDALL PL SE UNIT E202
TACOMA WA 98422-1115
AUBURN WA 98092
Additional: Permit Information
PERMIT EXPIRES Monday, 4 February, 2019
Permit Issued on Wednesday, August 8, 2018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of
� Washington and the City of Federal Way.
Owner or agent: ^ ch Date: of
THIS CARD IS TO REMAIN ON-SITE
Federal Way Construction Inspection Record
y INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 1810355100 Address: 32830 20TH AVE S
Project: GREGORY C ADAMS FEDERAL WAY WA 98003-6430
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.
E]
SWM Precon Site Mtg (4400)
❑
Initial Erosion Control (4365)a❑
Final Electrical
Interim Erosion Control (4370)
Approved
To be done PRIOR to breaking ground
Approved
By
Date
By
Date
By
Date
] Final Erosion Control (4375) El Final - Building (4050)
Approved Approved
�+ Date By ArJ Date D %9l
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
CITY -9F
AUG 0 8 2018 PERMIT APPLICATION
�� `
CITY OF FECEPAL Wayp ERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
MENT 253-835-2607 +FAX 253-835-2609 + permitcenter@cityoffederalway.com
Federal Way COMMUNITY DEVELOP
PERMIT NUMBER
_ TARGET DATE 666
SITE ADDRESS �
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$11, 00
-7 9 7�� e
TYPE OF PERMIT
I --]BUILDING 11 PLUMBING ❑ MECHANICAL LSI DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
TA eQi. n Gill7� O�i's 1i '�%! G poor
PROJECT DESCRIPTION
Detailed description of work to
L /
/ /J o,," a 7l//" a /•1� a5 Lt/ Gl1 a `� > �? e
GCrr r fj 1'e,.4 /s e e e, -n are -I GV
be included on this permit only
NAME / PRIMARY PHONE
4'u r g n� L �C1�0✓ /'�")P�i� i e%u ,?a0'- -:7, 9.? -;Voo
PROPERTY OWNER
MAILING ADD S E-MAIL
3�a'32 / 6sr e A,P ae.'.40-14
CITY
Fc
STATE
ZIP
Moll ?
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY
STATE
ZIP FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE #
NAME PRIMARY PHONE
�'ur�' Gfr�c/ ` ✓ �lG�n� Giiu� ado- g3l- 56r/
MAILING AbDRESS E-MAIL
APPLICANT-
CI
�6u�y,
STATE I
c�a
ZIP FAX
9d�a 9 Ir -I '4vv. co
NAME PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE ___FiiP
FAX
concerning this application)
PROJECT FINANCING
NAME OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP PHONE
P cfi f 9 3 —
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certtN 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 apart of this application.
yas
�city
® 'e� / C �� e.4f —aCFf` /d'
SIGNAT / �` DATE
/
PRINT NAM
Bulletin #100 — January 29, 2016 Page 1 of 2 k:�Handouts\Permit Application
P
CITY OF
Federal Way
41k
RECEIVED
JUL 3 0 2018
EASTGATE
ENVIRONMENTAL HEALTH
COMMUNITY DEVELOPMENT DEPARTMENT
RECEIVE P3325 8`h Avenue South
ederal Way, WA 98003
253-835-2607; Fax 253-835-2609
AUG 0 8 20Ww.cityoffederalway.com
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure on a subject property. Demolition of separate
structures may require separate permits.
❑ Address of Demolition:ag 6b :Q7� �v�. S l e �r�� �/C, 41a 9d'Oo 3
❑ Prior to submitting a demolition permit, the following items must be signed by the respective
agency or their approvals attached. Items not applicable to your project should be marked N/A.
❑ A completed Construction Permit Application form is also required.
1. ASBESTOS ABATEMENT
(Provide copy of Notice of Intent from Puget Sound Clean Air Agency 5. ELECTRICITY
and co y of inspection report by AHERA-certified inspector)
lAt a_ 4�2=
(City of Fe I Way Building Official) (Puget Sound Energy/Tacoma Power)
2. FUEL STORAGE TANKS
o Under grade tank(s) is/are present
❑ Above grade tank(s) are present
❑ Tank(s) has been pumped or removed under South King Fire &
Rescue permit prior to any dismantling or excavation
(South King Fire and Rescue)
3.SVP
a� �TIC SYSTE ECOMISSI0
G
(King County EnvironmentalServices)
4. SANITARY SEWER
NI (I
(Lakehhven Utility Dist ict) ri
6. NATURAL GAS
(Puget Sound Energy)
7. WATER - Public Source
�n.ET�tiZ.
o -6 13E
(Lakehaven Utility District)"�iL� xc.T6a
-1 [-Io tlg
S. WATER - Private Well
(King CoN I;A-
unty Epvironmental Services)
❑ Please Note: Erosion control measures must be in place during the demolition and through
completion of the site clean-up.
(Applicant)
Bulletin # 122 — May 13, 2015 Page 1 of 1 k:\Handouts\Demolition Permit Requirements
RECFIVEC,''
A�t7f1 " ZU Ccmt�z»vt�ti>)F:�r�t.a3258rAvenu�';Soutr
�J 33325 8'a Avenue South
i'PdBfit l',rEi} WA 98803
A CITY OF FEI,FRA,L `V1 _ 2„ 835-^_G(tl Fax 253-835-2009
CITY OF
(;WMUNfTY DEVELOp�S�D'
F` . )}'vy'S6' ctt+offederai SY S°a AwFederal Way 11Vm
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure on a subJect property. Demolition of separate
Structures may require scparatc permits.
U Address of Demolition:` �33Z� r� 63Ev S Cft°r f ✓-,�__.. __. � ` �
❑ Prior to submitting a demolition permit, the following items must be signed by the respective
agency or their approvals attached. Items not applicable to your project should be marked N/A.
O A completed Construction Permit Application form is also required.
1. ASBESTOS ABATEMENT
(Provide copy of Motice n/Intenthom Puget Sound Clean Air Agency 5. ECTRICITY
and copy of inspection report by AHERA-certified inspector)
r s
_ �_..__._......__ (Puget Sound Energy/Tacoma Power)
(City of Federal Way Building Orficial)
2. FUEL STORAGE TANKS B. NATURAL GAS ,
r Under grade tank(s) is/are present Above )rade tank are went R� � t
g O L �_�_......
c Tanks has been pumped or removed under South King Fire & (Puget Sound Energy)
Rescue permit prior to any dismantling or exuavation
(Solith King Fire and Rescue)
3. SEPTIC SYSTEM RECOMISSIONING
(King County Environmental Services)
4. SANITARY SEWER
-_. �_......._._.__. _. t`�
veAU_t!_H4!_/�D_: istfict)
7. WATER - Public Source
� �.c�+t 'Cb '12.�1In1�11-1'la- l3_iv
(Lakehaven Utility Distr ct�pr4r
8. WATER - Private Well
(King County ` vironmental Services)
❑ Please Note: Erosion control measures must be in place during the demolition and through
completion of the site clean-up.
(Applicant)
i3ultetu: E22 —May I3.2G15 Page I of I k Allandomst ?emciition Permit Requirmnents
Public Health
Seattle & King County kv
RECEIVED
JUL 3 0 2018
RECEIVED
AUG 0 8 2018
OF FEDERA 4V.= y
NfTY DEVE:.OPtME 7
Return completed form to Public Health — Seattle & King County, Environmental Health Division, 14350 SE Eastgate Way,
Bellevue, WA, 98007, Tel. 206 296-4932. Faxed co ies will not be accepted due to data entry purposes.
- q -7 O O 502I DATE: C9 ?12(2 / PO IdP
PARCEL (AP1N):
Instructions for completing form: This form 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 officer within thirty (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/Occupant of Property: ?1(4ri G (�f aov m e/r GAS/ .�
Address: 3 cv? d-'::' Are
Fe
Wastewater Tank Data:
Type of Sewage Tank: ✓ Septic Tank Pump Tank Holding Tank Other:
Number of Compartments Pumped: f C5 ee Cts hilt
Number of Gallons Pumped:
Checklist Item Yes No Not Applicable Comments
Se to e removed by an approved pumper?*
Tank lid removed or destroyed?
Tank void filled with compacted soil or
ravel?
*OSS Pumper Name: d1rte W 1j'e (A,,c-, f fflt ye di., If Re A-d►lK
King County Certification Number:
Reason for wastewater tank abandonment:
Property being served by public sewers Property being served by replacement tank
✓Structure being demolished
Comments:
Report of Wastewater Tank Abandonment Revised 11/9/2012
Labor•
E
RECEIVE
VAC -TEC SEPTIC & WATER LLC
QB
Invoice # 8718
l
11603 Canyon Rd E, Puyallup, WA 98373
Office: (253) 268-0322
Rec
RME
AUG 201 DATE:
SEPW ORA WCEEAAffV `
WWW.VACTECSEPTIC.COM
RSS APPOF
CITY
•��'
RSS Issued
COMMUhii7Y DE'E` Oiti;i
Customer Name:
O
Address:
_City: Zip:
Phone:
Technician:
Truck#
Time in: Time Out:
Email:
Check/Credit #
Exp Date:
SC: Card Zip: Escrow_
Labor•
E
m
O
� w
Z 00
Mor ,Work To Follow Ye§ 1W Send
Bill: Yes " No
Type of work:
Property Sketch
Sub -Total
$ r
Safes Tax
F
i
^
Grand Total
Signature
DATE
TERMS: Net 2 days. We require to hold a credit card on file. If not paid within 48 hours the credit card will be charged in full. If credit card declines there will be a 1.5%
per month delinquency charge on past due accounts. Materialmen's Lien Notice- Signature of this truck invoice will be considered your notice of our intent to lien this
project if necessary. This invoice indicates certain characteristics of the onsite sewage system at the time of visit. In no way is this invoice a guarantee of operation of
future performance. View inspection reports online at www.onlinerme.com
8/7/2018
ps•cIeana i r.org
Puget Sound Clean Aiv Agency
Approved Transaction
RECEIVED
AUG 0 8 7018
Single -Family Notification Case #: 201803647 CITY OF FEDERAL WAY
This page must be printed. A printout of the notification, all amendments to the notification, 4Wb g&sLQfiall be available
for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)).
Fee Amount Paid $65.00
Credit Card Transaction # AKOF5DCD05CD
Transaction Date 08/07/18
Owner's Name Yuriy and Lyubov Melnichuk Phone (206) 793-7700
Project Street Address 32830 20th Ave S
City Federal Way Zip 98003
Contact Person Yuriy Melnichuk Phone (206) 793-7700
Mailing Address
This project includes a demolition.
Demolition Start Date 08/17/18 Completion Date 09/07/18
Demolition will be completed by the home owner
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
View History
If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
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OrderID: 511802257
SUSL ANALYTICAL. INC.
Asbestos Chain of Custody
EMSL Order Number (Lab use only):
#511802257
RECEVVED
NUG 0 8 'Z
CITY OF FEU''-RrUr"'r
)IIMUNn-)5pMp111E1
FAX-.
Company N i
EMSL Customer ID:
f'
Street C Statel'Province:
27 Posta! Code:Cour
Te[ ep hone Fax #: i
Report To Name :
Please Provide Results: Fax Email
Email Address-
gg1AO 6k. Purchase Order.
Project Name/Number. Q
®YcI EMSL Project ID Internal Use On
U.S. State Samples Tak
CT Sam les:U CommerclaUTaxable El ResidentiaUTax Exem t
EMSL-Bill to: Same JJ Different - If B® to is DdrereM note hstrudions in Conunents—
Thud Parry ffiffrrg mqubw written authorization from third party
Tumaroun Time A Options* – Please Check I
3 Hour I El 6 Hour I
U 24 Hour 1 JH48 Hour I VJ 72 Hour I Q 96 Hour 1 Week I El 2 Week
For TEM Air hr through 6 hr, please cag ahead to schedule. *Theib Is a premium charge for 3 Hour TEM AHERA or EPA Level Il TAT. You wiUDe Baked to sign an
authom abon form for this service. Anahlb corn ted in accordance with EMSL's Terms and C'ondidlans located in the Anel Price Guide.'
PCM - Alr Check if samples are
from NY
❑ NIOSH 7400
[] w/ OSHA W. TWA
TEN–A!r 04••4.6hr TAT WEPA Doty)
❑ AHERA 40 CFR, Part 763
❑ NIOSH 7402
❑ EPA Level 11
ISO 10312
TE us I
❑Microvac - ASTM D 5755
❑W" - ASTM 064W
❑Carpet Sonication (EPA 600/J-93/167)
P - Wk reoortina light)
PLM EPA 6W/R-931116 (<1%)
PLM EPA NOB (--I%)
Point Count
❑400 (<0.25%)❑1000 (<0.1%)
Point Count w/Gravimetric
❑400 (<0.250A) ❑10W (<0.1%)
❑ NYS 196.1 (friable in NY)
NYS 196.6 NOB (non -friable -NY)
NYS 198.8 SOF-V
NIOSH 9002 <1 %
Soil1Rock/Vermigulite
❑ PLM EPA 600/R-93/116 with milling prep (<I%
❑ PLM EPA 600/R-931116 with milling prep (<0.25%)
TEM EPA 600/R-931116 with milling prep (<0.1%)
TEM Qualitative via Filtration Prep 1
TEM Qualitative via Drop Mount Prep
Cincinnati Method EPA 6001114W004 – PLMITE M
only)
JEM -Bulk
M EPA NOS
S NOB 198.4 (non -friable -NY)
[]hatfield SOP
Mass Analysis -EPA 600 sec. 2.5
TEM –Water EPA 100.2
Fibers >101rm ❑Waste []Drinking
All Fiber Sizes ❑Waste []Drinking
mer: (I
u l
heck For Positive Stop – Clearly
I
Identify Homogenous Group Filter Pore Size Air Samples): [30.8wn M0.45pm!
Samplers Nam +
Samplers SignatuRe 1
Sample #
Sam le Description
Volume/Area (Air)
HA #(Bulk).Sam
Datef i ne'
led 1
I I
1
Client Sample # (a):
Total # of Samples:
Relinquished (Clien
Time;
Received (Lab): l
Date: % Time:
CommentslSpecialInstru ons:
CoeaoMd DoonrM-Asearioo CAC - RIO -05/00 MO
Page 1 of — pages
Paqe 1 Of 2
OrderID: 511802257 Asbestos Chain of Custody
EM, --L Aw4LY77CAL, WC.
rA► EMSL Order Number Lab Use aw. 3317 3RD AUE�S, SUITE D
�Q
SEATTLE, WA 98134
#5 q
A e 0 0 2 2.5 7 PHONE: (206)269-6370
Fax: (2 6)960-8789
Addidonal Pages of he Chain of Custody are only necessary ff Headed for addibonel sample Information
Sem
Volum Area (Air)
1OMPled
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Il
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1
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Paqe 2 Of 2 . I
EMSL Analytical, Inc.
3317 3rd Ave S, Suite D 2nd floor Seattle, WA 98134
Tel/Fax: (206) 269-6310 / (206) 900-8789
http://www,emsl com / seattlelab@emsl.com
Attention: Randy Marsh
Affordable Asbestos Inspections
4427 Meridian
Suite C #301
Puyallup, WA 98373
Project: 32830 20th
EMSL Order: 511802257
Customer ID: AFAS42
Customer PO:
Project ID:
Phone: (253) 381-0580
Fax:
Received Date: 08/06/2018 8:00 AM
Analysis Date: 08/07/2018
Collected Date:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R 93/116 Method using Polarized
Light Microscopy
Non -Asbestos
Asbestos
Sample
Description
Appearance
%. Fibrous
% Non -Fibrous
% Type
1
Kitchen lino
Gray/White/Green
35% Cellulose
50% Non-fibrous (Other)
None Detected
Fibrous
10% Synthetic
511802257-0001
Homogeneous
5% Glass
2 -Linoleum
Refer area lino
Gray/Tan/Gold
40% Cellulose
45% Non-fibrous (Other)
None Detected
Fibrous
15% Synthetic
511802257-0002
Homogeneous
2 -Mastic
Refer area lino
White
100% Non-fibrous (Other)
None Detected
Non -Fibrous
511802257-0002A
Homogeneous
3
Dining room lino
Gray/White/Green
40% Cellulose
42% Non-fibrous (Other)
None Detected
Fibrous
15% Synthetic
511802257-0003
Homogeneous
3% Hair
Result includes a small amount of inseparable attached material
4 -Texture
1 st Bedroom wall
White
45% Ca Carbonate
None Detected
Non -Fibrous
55% Non-fibrous (Other)
511802257-0004
Homogeneous
4 -Drywall
1st Bedroom wall
Brown/White
20% Cellulose
55% Gypsum
None Detected
Fibrous
25% Non-fibrous (Other)
511802257-0004A
Homogeneous
5 -Texture
Entry wall
White
45% Ca Carbonate
None Detected
Non -Fibrous
55% Non-fibrous (Other)
511802257-0005
Homogeneous
5 -Drywall
Entry wall
Brown/White
20% Cellulose
55% Gypsum
None Detected
Fibrous
25% Non-fibrous (Other)
511802257-0005A
Homogeneous
6 -Texture
Living room wall
White
40% Ca Carbonate
None Detected
Non -Fibrous
60% Non-fibrous (Other)
511802257-0006
Homogeneous
6 -Drywall
Living room wall
Brown/White
25% Cellulose
55% Gypsum
None Detected
Fibrous
20% Non-fibrous (Other)
511802257-0006A
Homogeneous
7 -Linoleum
Bath lino
Beige
100% Non-fibrous (Other)
None Detected
Non -Fibrous
511802257-0007
Homogeneous
7 -Mastic
Bath lino
Clear
100% Non-fibrous (Other)
None Detected
Non -Fibrous
511802257-M7A
Homogeneous
7 -Linoleum
Bath lino
Yellow/Green
35% Cellulose
45% Non-fibrous (Other)
None Detected
Fibrous
20% Synthetic
511802257-00078
Homogeneous
8 -Vinyl Floor Tile
Utility lino
Brown/Gray/White
100% Non-fibrous (Other)
None Detected
Non -Fibrous
511 8022 5 7.0008
Homogeneous
8 -Mastic
Utility lino
Clear
100% Non-fibrous (Other)
None Detected
Non -Fibrous
511802257-OW84
Homogeneous
8 -Linoleum
Utility lino
Green/Gold
40% Cellulose
40% Non-fibrous (Other)
None Detected
Fibrous
20% Synthetic
511802257-00088
Homogeneous
Initial report from: 08/07/2018 17:33:15
11
ASB_PLM_0008.0001.
1.78 Printed: 8!7/2018 2:33 PM
Page 1 of 2
EMSL Analytical, Inc. EMSL Order: 511802257
Customer ID: AFAS42
3317 3rd Ave S, Suite D 2nd floor Seattle, WA 98134
Customer PO:
TeVFax: (206) 269-6310 / (206) 900-8789
M http://www.emst.com / seattielab@emsl.com Project ID:
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
10 Ext. window sealant White 100% Non-fibrous (Other) None Detected
Non -Fibrous
511802257-0010 Homogeneous
Analyst(s)
Ehrin Saul (19)
Lauren Kerber, Laboratory Manager
or Other Approved Signatory
EMSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 "Interim
Method"), but augmented with procedures outlined in the 1993 ("final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without
written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. All
samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of
the federal government. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request.
Samples analyzed by EMSL Analytical, Inc. Seattle, WA NVLAP Lab Code 200613, CA 2733
Initial report from: 08/07/2018 17:33:15
ASB _PLIV 0008_0001 - 1.78 Printed: 8/7/2018 2:33 PM Page 2 of 2
Non -Asbestos
Asbestos
Sample Description
Appearance
% Fibrous % Non -Fibrous
% Type
8 -Mastic Utility lino
Brown
100% Non-fibrous (Other)
None Detected
Non -Fibrous
511802257-0008C
Homogeneous
9 Master bed wall
White
3% Quartz
None Detected
Non -Fibrous
30% Ca Carbonate
511802257-0009
Homogeneous
67% Non-fibrous (Other)
Inseparable point/ coating layer included in analysis
10 Ext. window sealant White 100% Non-fibrous (Other) None Detected
Non -Fibrous
511802257-0010 Homogeneous
Analyst(s)
Ehrin Saul (19)
Lauren Kerber, Laboratory Manager
or Other Approved Signatory
EMSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 "Interim
Method"), but augmented with procedures outlined in the 1993 ("final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without
written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. All
samples received in acceptable condition unless otherwise noted. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of
the federal government. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request.
Samples analyzed by EMSL Analytical, Inc. Seattle, WA NVLAP Lab Code 200613, CA 2733
Initial report from: 08/07/2018 17:33:15
ASB _PLIV 0008_0001 - 1.78 Printed: 8/7/2018 2:33 PM Page 2 of 2
Randy Marsh
4227 Meridian Suite C #301
Puyallup Wa. 98373
Ahera certificate # 168747
Asbestos Inspection
32830 20th
Federal Way
1. This sample was the Kitchen Lino, it proved to be negative for asbestos.
2. This sample was the refer area Lino, it proved to be negative for asbestos.
2. This sample was the mastic on the back of the lino in the refer area, it proved
negative for asbestos.
3 This sample was the lino in the dining room, it proved negative for asbestos.
4 This sample was the texture on 1 st bedroom wall , it proved negative for asbestos.
4 this sample was the drywall on the 1 st bedroom wall, it proved negative for asbestos.
5 This sample was the texture on the entry wall, it proved negative for asbestos.
5 This sample was the drywall on the entry wall, it proved negative for asbestos.
6 This sample was the texture on the living room wall, it proved negative for asbestos.
6 This sample was the sheetrock on the living room wall, it proved to be negative for
asbestos.
7 This sample was the lino in the bath, it proved negative for asbestos.
7 this sample was the mastic on the back of the lino in the bath, it proved negative for
asbestos.
7 this sample was the lino in the bath , it proved negative for asbestos.
8 this sample was the vinyl floor the in the utility, it proved negative for asbestos.
8 This sample was the mastic on the back of the lino in the utility, it proved negative for
asbestos.
8 This sample was the lino in the utility, it proved negative for asbestos.
8 This sample was the mastic on the back of the lino in the utility, it proved negative for
asbestos.
9 This sample was the master bedroom wall , it proved negative for asbestos.
10 This sample was the exterior sealant on the windows, it proved negative for
asbestos.
Note This unit is a manufactured home built on a concrete foundation, 2x6 floor joist,
3/4 inch decking. The sidewalls are 2x4 wood with wood paneling and batt strips. The
floor, wall insulation is fiberglass, the ceiling blown in rock wool, with fibered ceiling
panels.Roof framing is 2x2wood with galvanized metal roof with no roofing sealant.
exterior siding is metal siding, exterior windows are aluminum framed with double
pained glass, interior and exterior doors are wood , with wood frame. flooring is
linoleum with some carpet.hot water heater is free from tape or sealant, heater is
electric with one piece metal ducts with no suspicious tape.
eertt"ft'rate of Complett"On
This is to certify that
Randy L. Marsh
has satisfactorily completed
4 hours of refresher training as an
AHERA Building Inspector
to comply with the training requirements of
TSCA Title II, 40 CFR 763 (AHERA)
EPA Provider # 1085
`mom 1- 3 67':�
168747
Certificate Number
ARGUS�
TRAINING •COWI11TING n
A Irerracoo COMPANY
Aug 1, 2018
Dates) of Training
Exam Score:
If appropriate:
Expires in 1 year
Instructor
ARGUS PACIFIC, INC / 1900WEST NICKERSON ST,SUITE 315 / SEATTLE,WASHINGTON 98119 / 206.285.3373 /ARGUSPACIFIC.COM