17-104098City of Federal Way
Community Development Dept. 1 P
33325 8th Ave S
Federal Way, WA 98003 In
Ph: (253) 835-2607 Fax: (253) 835-2609
AM
Project Name: XU
Project Address: 1909 SW 356TH ST
Project Description: Demolition of single family residence
Demolition
:17 -104098 -00 -DE
Request Line: (253) 835-3050
Parcel Number: 252103 9004
Owner
A li
Contractor
LEON & SOPHIA XUMAYFAIR LLC
R LLC
LEON & SO013
R L CLEARING & EXCAVATING
31704 53RD AVE SW
317 V
RLCLEEI097N2 (5/2/18)
FEDERAL WAY WA 98023
FEDEI 98023
PO BOX 4203
FEDERAL WAY WA 98063
I hereby certify that the ab(
and the occupancy and
Owner or agent:
011111191�
why
>nal P it InfortA
C
'w
Tuesda 0 February, 2018
n u a. August 24, 2017
correct at the construction on the above described property
accor with the laws, rules and regulations of the State of
m anity of Federal Way.
d
Date: � /
THIS CARD IS TO REMAIN ON-SITE
C"orW Construction Inspection Record
Fec1Y INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 17144098 00 Address: 1909 SW 356TH ST
Project: LEON & SOPHIA XU FEDERAL WAY WA 98023-7254
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.
0 Final - Building (4050)
Approved
By Date
Rough Electrical
El
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
- Date
40k
GTY OF
Federal Way
RECEIVE® PERMIT APPLICATION
AUG 7 4 2017 PERMIT CENTER + 33325 8f Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
CITY OF FEDERAL WAY
1 - Qor"PMENT
PERMIT NUMBER — —( ITY —/ — —V c�- P
—( —
TARGET DATE �/ _
� ul / 2 —
SITE ADDRESS
SUITE/UNIT #
0 3S-6-tti T,4m ( Ww WA 9g�
,
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAX/PARCEL #
1
2 v 0
_2400
feco
-7�? J_- a - - � --
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL VDEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(A S o✓f 'f
otepnoZIR
h6eyty
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
31704_
E-MAAIL )� �
S7iiW �'�Tr''lai (om
CITY
(!A( "
STATE
I w
ZIP
a
NAME
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MAILING ADDRESS
E-MAIL
q Y1 �,Yeqv� 61, Ccz,
CONTRACTOR
CITY
STATEZIP
FAX
A,(bkrh
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
"1� i
PRIMARY PHONE � �(-
T LSA
APPLICANT-
MAILING ADDRESS /1 n �..
E -L _.,
� (IV f
CITY
STATE
ZIP
FAX
NAME L C0� �U
PRIMARY �v� P ( C e
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PROJECT CONTACT
MAILING ADDRESS, ( /y.r��
31 V Y`, ' /� ` SV✓
E-MAIL
�'
(The individual to receive and
respond to all correspondence
CITY
W �r
STATE
WA
ZIP
r A
FAX
concerning this application)
PROJECT FINANCING
NAME ),rV1
OWNER -FINANCED
When value is $5,000 or more
IRCW 19.27.095)
MAILING
+�ADDRESS,,,gTY, STATE, ZIP
� /� /�
�A
�/7 / PHONE
7170 1 �3Y�'i /R /C y� %'.1�
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 part of this application.
SIGNATURE: DATE
/ �(
LFO / A V it fNA
PRINT NAME:
Bulletin #100 –January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
VA
MECHANICAL PERMIT LUE OF MECHANICAb WORK ,
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing res to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commerciai)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
PLUMBING PERMIT
FOR OFFICE USE
r
# of
Additional Information
EXISTING/PREVIOUS USE
LOT SIZE (Ia Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing res to remain.
BATHTUBS (or Tub/slower combo)
LAVS (Band sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Pi6scribe)
DRAINS
SHOWERS
VACUUM BREAKERS
.:
` t
DRINKING FOUNTAINS
SINKS (Kitchen/utility)
WATER HEATERS (Electric)
t
HOSE BIBBS
SUMPS
WASHING MACHINES
TAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
FOR OFFICE USE
r
# of
Additional Information
EXISTING/PREVIOUS USE
LOT SIZE (Ia Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
s'..
❑ Yes ❑ No
s'
, ❑ Yes ❑ No
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FIRST FLOOR (or Mobile Home)
i
,
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RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING
PROPOSED
TOTAL j
FOR OFFICE USE
r
# of
Additional Information
Square Fee
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a
Stories
s'..
/ 'iA -Wr` 4"E. ••'$� ,f. ,?, ' � E' }Q
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AREA DESCRIPTION Square Occupancy Group(s)
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COVERED ENTRY
Additional Information
Feet
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Area Totals WaSTIHG
PROPOSED
TOTAL
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL — NEW/ADDITION
Bulletin
AREA DESCRIPTION ` rea In
Occupancy Groups),
Construction
# of
Additional Information
Square Fee
a
Stories
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AREA DESCRIPTION Square Occupancy Group(s)
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# of
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#100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application
40k
CITY OFV
Federal Way
COMMUNITY DEVELOPMENT DEPARTMENT
33325 8`h Avenue South
Federal Way, WA 98003
253-835-2607; Fax 253-835-2609
www.cityoffederalwU.com
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:
3AtA Sr> ee-r 5w, f -ea eot
❑ 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 Perm&Appiication form is also required.
1. ASBESTOS ABATEMENT
(Provide copy of Mbce oflntentfrocn Puget Sound Clean Air Agency
and copy ofirispection report by AHERA-certified inspector)
0 -4419 -y -D,
(City of Federal Way Buildi g Official)
2. FUEL STORAGE TANKS
❑ 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 andismantling or excavation
(Soufb King Fire and Rescue)
S. ELECTRICITY
(9 ,
t (Pug t and Energy/Tacoma Power)
L
6. NATURAL GAS
(Puget Sound Energy)
7. WATER - Pub ' Source
--,
(Lakehaven Utility District)
3. SEP C SY E .DECOMISSIONING
'410 I AA
___ __ 8. WATER - Private Well
(King County Environmental Services)c
Kk lh� ��U (King County Environmental Services)
4. SANITARY SEWER
1014
(Lakehave UtilityDistrict)
❑ 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
0%1NII Nil DEQ EI OPNII N I DEP %R rNlEN l
03
CITY OF
Federal Way
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove anv structure on a subject property. Demolition of separate
structures mai require separate permits. �.w
Iq 356t IN smart 2,3
71 Address of Demolition:
0 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.
F7. A completed Construction PermitApplication form is also required.
1. ASBESTOS ABATEMENT
(Provide copy of Notice of Intent from Puget Sound Clean Air Agency S. ELECTRICITY
and ropy of inspection report by AHERA-certifiedinspector)
(Puget Sound Energy Tacoma -Power)
(City of Federal Way Buiidino Official)
2. FUEL STORAGE TANKS
Under grade tank(s)is/are present
Above grade tank(s) are present
Tank(s) has been pumped or removed .ander South Kmg Fire &
Rescue permit nor to any dismantling or excavation
l�
(South King Fire and Rescue)
3. SEPTIC SYSTEM DECOMISSIONING
(King County Environmentai Services
4. SANITARY SEWER
(LikehaveV Uhlity District)
6. NATURAL GAS
(Pet Sound Energy)
7. WATER - PubliE Source /
(Lakehaven Utility District)
8. WATER - Private Well
(King County Environmental Services)
Please Note: Erosion control measures must be in place during the demolition and through
completion of the site clean-up.
I21111cUn 1' \1Jv 1', 'ft i
(Appi cart) _
t':i;� 1 .•d i I, iLmd++ut. I>enn,lni+a: i'crmn 12ryu:r, ,nnt.
8/24/2017 MM- - shiwy166@hotmaii.com
PSCAA notification
gabriel ruiz <ar.const.206@gmail.com>
fflR 2017/8/24 5:05
&q),,:sophi shi <shiwy166@hotmail.com>;
View Account History Create Amendment 201704046-2
Notification Details for Case *: 201704046-1
Fee Amount $210.00
Transaction Date 68/17/17
Owner's Name Mayfair LLC Phone (206) 61"863
Project street Address 1909 355th St Sw
City Federal Way Zip 98023
Contact Person Leon chane (206) 614 68d3
Mailing Address 31704 53W Ave Sw
Federal Way, WA 98023
This project includes asbestos reaserai.
Project Size 100 linear feet 1 330 square feet
Prajed Start Dine 08128/17 Complebon Date 08/29/17
Asbestos will be removed by a licensed asbestos abatemenk contractor
Contractor AaR Construction LLC Contractor lab r
CDatact Gabriel Ruiz Phone [208! 707-2089
M"ingAddress 15232 SE 272nd'St #107
Kent, WA 98042
Note: Notifications cannot be amended after the completion mate.
httpsJ/ouUook.live.com/0waqpath=/mailfinboxlrp&realm=hdmaii.com 1/12
A -T
Asbesto-Test,
Inc.
1429Ave. D. #/87, Snohomish, WA 98290
425-489-4040
www.asbestoiestcom
ASBESTOS SURVEY
House and Sheds (a, 1909 3560 St. SW., Federal Way, WA 98023
Page 1 of 9
August 1, 2017
C21 70 736
Mayfair LLC
31704 531d Ave. SW.,
Federal Way, WA 98023
206-666-4985;206-619-8863
Attn.: Sophi Shi
shin 166@botmail.com
On July 24, 2017, Asbesto-Test personnel conducted an Asbestos survey (per
U.S.E.P.AJA.H.E.R.A. guidelines as designated and specified by Puget Sound Clean Air
Agency and Washington State) of the house & sheds 0)1909 356 St. SW., Federal Way, King
County, Washington 98023. This survey purpose is to identify the Asbestos Containing
Materials that may be present and will require professional removal prior to renovation.
NARRATIVE OF FINDINGS
BASIC CONSTRUCTION: The house is a single story wood frame on a basement foundation.
The siding is wood. The siding vapor barrier materials were sampled. The roofing is composition.
The composition roofing materials were sampled.
INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior
construction is drywall. The drywall/taping materials were sampled. The vinyl flooring materials
with relating backing and mastic materials were sampled. The misc. mastic materials were
sampled. The masonry tile and associated mortar and mastic materials were sampled.
INSULATION: The insulation was sampled.
continue to page 2
1 a�a
BBB .
Nor .36073 1
Page 2 of 9 August 1, 2017
C2170736 Asbesto-Test, Inc. 425-489-4040
House and Sheds 6a 1909 356" St SW.. Federal Way, WA 98023
ELECTRICAL SYSTEM: The electrical wiring insulation did not appear to be the kind to be
ACM. The power may have been "on" at the time of the inspection, thus sampling was not safe.
Any suspect electrical wiring insulation or any suspect TSI (Thermal System Insulation) found
in, around, or behind any located fuse or breaker boxes should be considered to be ACM
(Asbestos Containing Material), unless determined otherwise by laboratory analysis.
HEATING AND VENTILATION SYSTEM: There is a forced air furnace in the house.
There is ACM TSI taping visible on misc. ducting joints. These materials were sampled along
with the flue mortar packing. THERE MAY BE ADDITIONAL ACM TSI PRESENT
(ASSOCIATED WITH THE FURNACE AND/OR DUCTING) IN THE STRUCTURE THAT
IS CONCEALED FROM VIEW (i.e. within the walls, ceilings, and/or floors, inside additional
ducting areas, or within the furnace unit itself). Note: It was not possible to dismantle the heat
ducting to locate and/or evaluate any additional suspect ACM which may be concealed from
view. If any additional relating suspect asbestos containing materials are located prior to and/or
during any demolition or renovation, any and all additional related suspect materials should be
considered to be ACM (Asbestos Containing Material), unless determined to be otherwise by
laboratory analysis. ALL TSI THAT MAY BE LOCATED THAT IS NOT VISIBLY
FIBERGLASS AND/OR FOAM MATERIAL IS PRESUMED ASBESTOS CONTAINING.
MISC.: The window glazing materials were sampled.
ADDITIONAL STRUCTURES INCLUDED IN SURVEY: There are two wood framed
sheds on the property. The glazing on the wood framed window units were sampled. Both sheds
have metal roofs.
# of structures included in survey: one house, two sheds
Requested by: Sophi Shi
Carl Dykstra
Inspector, certified A.H.E.R.A.
Accred. #1626911 exp. May 10, 2018
BBB
continue to page 3
1429Ave. D. #187, Snohomish, WA 98290
425-489-4040.f775-665-0420
www.asbestoiestcom info&sbiestoiestcom
Page 3 of 9 August 1, 2017
C2170736 Asbesto-Test, Inc. 425-489-4040
House and Sheds a 1909 356' Sk SW., Federal Way, WA 98023
THE ASBESTOS CONTAINING MATERIALS LISTED AS "NON -FRIABLE" REMAIN NON -FRIABLE (NOT EASILY AIRBORNE) UNTIL FORCES EXPECTED
Tp ACT ON THE MATERIAL WILL RENDER THE ACM AS FRIABLE (EASILY AIRBORNE). SUCH FORCES INCLUDE, BUT ARE NOT LIMITED TO,
EQUPMENT USED IN THE DEMOUTON PROCESS, WEATHER INCIDENTS, AND OTHER DAMAGES THAT RENDER THE ACM FROM NON -FRIABLE
TO FRIABLE
ANY AND ALL MATERIALS IDENTIFIED AS ACM OR PACM IN THIS REPORT (AND/OR ADDITIONAL MATERIALS ASSOCIATED WITH THE
STRUCTURE THAT MAY BE DISCOVERED AND LATER IDENTIFIED AS ACM OR PACM), MUST BE PROFESSIONALLY ABATED PRIOR TO
DEMOLITION. ASSESSMENT AND QUANTIFICATION OF ACM FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE
DETERMINED BY ON SITE EVALUATION.
SAMPLES #144 ARE ASBESTOS CONTAINING MATERIALS EXCEPT THOSE SAMPLES LISTED AS "NAD"
ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL
1.0 ACM TSI TAPING yes H chrysotile H 65% non-fibrous materials,
FRIABLE ACM cellulose
THERE IS ACM TSI TAPING VISIBLE INSIDE/AROUND THE VENT BOOTS AND ON MISC. DUCTING
THROUGHOUT THE HOUSE.
NOTE: THE INSPECTOR WAS NOT ABLE TO DETERMINE QUANTITIES OF ACM TSI THAT IS PRESENT AS
ADDITIONAL ACM TSI MATERIALS MAY BE CONCEALED WITHIN THE WALLS, CEILINGS, AND/OR
FLOORS. ALL TSI THAT IS NOT VISIBLY FIBERGLASS AND/OR FOAM MATERIAL IS PRESUMED ASBESTOS
CONTAINING. QUANTITIES OF ASBESTOS FOR ABATEMENT ASSESSMENT AND/OR PRICING FOR
REMOVAL SHOULD BE DETERMINED BY ON SITE EVALUATION.
2.0 FLUE MORTAR PACKING yes H chrysotile // 2%
NON -FRIABLE ACM
CIRCLE OF PACKING MATERIAL AROUND 2 FLUES
LESS THAN 2 SQ. FT.
3.0 LINOLEUM FLOOR TILE yes H chrysotile H 2%
NON -FRIABLE ACM
LIVING ROOM — COLOR: GREEN PAINTED WHITE
NOTE: THE ASBESTOS IN THE HARD TILE SURFACE MATERIAL
APPROX. 300 SQ. FT.
4.0 mastic/backing
beneath previous sample listed
NAD
non-fibrous materials
non-fibrous materials,
adhesive, cellulose, tar
NOTE: ANY ADDITIONAL COLORS OR KINDS OF VINYL FLOORING AND/OR TILE WITH ANY RELATING
MASTICS/BACKINGS THAT WERE NOT DISCOVERED IN THIS SURVEY AND MAY LATER BE LOCATED IN
THIS STRUCTURE ARE ALSO PRESUMED TO CONTAIN ASBESTOS UNLESS TESTED OTHERWISE BY
LABORATORY ANALYSIS
continue to page 4
1
0 B
PfB8
1429 Ave. D. #187, Snohomish, WA 94290
415-489-4040;f775-665-0420
i",wasbestotest.com; tnfbCa)asbtestotestcom
Page 4 of 9 August 1, 2017
C2170736 Asbesto-Test, Inc. 425-489-4040
House and Sheds 0)1909 356`" St. SW.. Federal Way WA 98023
ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL
THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES
BASEMENT:
5.0 burner gasket
on furnace face — color: cream
6.0 chimney brick
7.0 mortar
holding previous sample 1
7.1 mortar
holding previous sample 2
7.2 mortar
holding previous sample 3
8.0 CMU block foundation
9.0 mortar
holding CMU blocks sample 1
9.1 mortar
holding CMU blocks sample 2
9.2 mortar
holding CMU blocks sample 3
MAIN FLOOR:
10.0 masonry floor tile
kitchen & bathroom — color: tan
11.0 mortar/mastic
holding previous sample
12.0 backer board
beneath previous sample
13.0 drywall/taping compound/paint
bedrooms composite
14.0 drywall/taping compound/paint
bathroom composite
15.0 drywall/taping compound/paint
hall composite
NAD
fiberglass, cellulose
NAD non-fibrous materials
NAD non-fibrous materials,
cellulose
NAD non-fibrous materials,
cellulose
NAD non-fibrous materials,
cellulose
NAD non-fibrous materials
NAD
non-fibrous materials
NAD
non-fibrous materials
NAD
non-fibrous materials
ILIM. 1
non-fibrous materials
NAD
adhesive, cellulose,
CE)
non-fibrous materials
NAD
non-fibrous materials,
425-489-4040,f775-665-0420
cellulose, fiberglass
NAD
non-fibrous materials,
cellulose, gypsum
NAD
non-fibrous materials,
cellulose, gypsum
NAD
non-fibrous materials,
cellulose, gypsum
continue to page 5
- A6e
CE)
1429Ave. A #187, &whorish, WA 98290
425-489-4040,f775-665-0420
www.asbestotest.eam injoAasbiestotest.eom
Page 5 of 9
August 1, 2017
C2170736
Asbesto-Test, Inc. 425-489-4040
House and Sheds (a),1909
350 St SW..
Federal Way WA 98023
ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL
MAIN FLOOR cont:
16.0 drywall/taping compound/paint
NAD
non-fibrous materials,
living room composite
cellulose, gypsum
17.0 drywall/taping compound/paint
NAD
non-fibrous materials,
dining room composite
cellulose, gypsum
18.0 drywall/taping compound/paint
NAD
non-fibrous materials,
kitchen composite
cellulose, gypsum
19.0 masonry tile
NAD
non-fibrous materials
kitchen counter & backsplash
20.0 mortar/mastic
NAD
adhesive, cellulose,
holding previous sample
non-fibrous materials
21.0 insulating material
NAD
non-fibrous materials,
kitchen on underside of sink
cellulose, polymers
COMMON AREAS:
22.0 insulation
23.0 vapor barrier
material beneath siding exterior
24.0 composition roofing
25.0 vapor barrier
beneath composition roofing
26.0 mastic
holding composition roofing
SHED 1:
27.0 window glazing
SHED 2:
28.0 window glazing
0
BBB
NAD fiberglass, cellulose
NAD cellulose, tar
NAD cellulose, tar,
non-fibrous materials
NAD cellulose, tar, fiberglass
NAD
NAD
NAD
continue to page 6
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1429Ave. D. #187, Snohomish, WA 98290
425-489-4040;j775-665-0420
wew.asbestotest.eom info(rDnsbtestotesixom
cellulose, adhesive
non-fibrous materials,
cellulose
non-fibrous materials,
cellulose
Page 6 of 9
C2170736
BBB
August 1, 2017
Asbesto-Test, Ina 425-489-4040
House and Sheds 0)1909 3560 St. SW., Federal Way, WA 98023
continue to page 7
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1429Ave. D. #187, 9whomish, WA 98290
425-489-4040; (775.665-0420
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Page 8 of 9 August 1, 2017
C21 70 736 Asbesto-Test, Ina 425-489-4040
House and Sheds (a)1909 356"` S . SW., Federal Way, WA 98023
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continue to page 9
1429Ave. D. #187, Sholromish WA 98290
425-489-4040; f 775-665-0420
www.asbestotest.com; info(a)asbtesiotest.com
Page 9 of 9 August 1, 2017
C2170736 Asbesto-Test, Inc. 425-489-4040
House and Sheds a( )1909 350 SSC SW". Federal Way, WA 98023
Samples taken are listed with their corresponding analyses. If asbestos is detected, those samples containing asbestos are listed first and noted
with the initials ACM".
Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials, as
prescribed by A. H. E. R.A. guideline.
If, during demolition or renovation, any additional suspect asbestos containing materials are located (may include but not limited to: sheet vinyl
flooring, tile flooring, wall or ceiling texturings or paints, concrete siding or skirting, cement pipes, cement wallboard, electrical cloth, electrical
wiring insulation, thermal paper, wallboard, joint compounds, vinyl wall coverings, spackling compounds, or any other suspect TSI (Thermal
System Insulation)), those materials are presumed Asbestos Containing Materials unless determined to be non -asbestos by laboratory analysis.
Asbesto- Test, Inc does not guarantee approximations of quantities of ACM, which may be listed with the analyses. It is therefore recommended
professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material (i.e. square or linear
etc.), or by on site assessment.
Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance in renovation or demolition.
PLM (polarized light microscopy) has been known to miss asbestos in small percentages of some samples, which contain asbestos, thus negative
PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM (scanning electron microscope) or TEM (transmitting
electron microscope), to insure analytkal accuracy when asbestos is reported in small percentages
Analytical test method: USEPA 6WIR93/116•• (PLM); WAC 296-62-07753 App. J
—One percent is the USEPA regulatorylimit forasbestos in bulk samples.
&K FRIABLE'signifles TasilyAirborne"
ACM signifies Asbestos Cmtoinusg Materiar
PACM signifies TresumedAsbestos Containing Materiar
CAB signifies Concrete Asbestos Board'
< signifies less than'
731 signifft'rbermalsystem Insulation'
HVAC signifies 'Heating VentiWagAir-Conditioning'
NAD signifks "No Asbestos Detected'
END OF REPORT
ArLynn Hammond, Pres., BSc.
Analytical Chemist, AIHA proficient
Inspector, certified A.H.E.R.A.
accred.#1628675(Expires July 26, 2018)
1429Ave. D. #187, Snohomish, WA 98290
425-489-4040,f775-665-0420
wkw.asbestotestcom: infoCa)asbtestotesLcom