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20-102189 Demolition City of CommunityDevelFederal opmentDept. Permit #:20-102189-00-DE 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax:(253)835-2609 Project Name: SHAH/ANANTH Project Address: 30016 20TH PL SW Parcel Number:012103 9113 Project Description: Complete demolition of single family residence. Owner Applicant Contractor * APARNA ANANTH VIRAL SHAH G K INDER CONSTRUCTION LLC 30016 20TH PL S 30016 20TH PL SW GKINDIC873NK(7/9/20) FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 4413 S 146TH ST TUKWILA WA 98168 Additional Permit Information PERMIT EXPIRES Monday,30 November,2020 Permit Issued on Wednesday,June 3,2020 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. L Owner or agent: E Date: THIS CARD IS TO REMAIN ON-SITE `""�' Construction Inspection Record • Fede aI Way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 20 102189 00 Address: 30016 20TH PL SW Project: VIRAL S SHAH FEDERAL WAY WA 98023-3404 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) eyr 11/4,..)41 Approved By Lla"S Date 6,2y.117 E Rough Electrical E Final Electrical 0 Right of Way Approved Approved Approved .By Date By Date By Date Htu.tIVLU JUN 0 3 2020 PERMIT APPLICATION ' CITY OF Federal WaCITY OF FEDERAL WAY PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325 yCOMMUNITY DEVELOPMENT 253-835-2607 + FAX 253-835-2609 +permitcentth-$cityoffederalway.com PERMIT NUMBER 12. — , a 1 X f. _ / \ TARGET DA SITE ADDRESS SL ssS..��L SUITE/UNIT 41 30016 20th Place SW, Federal Way WA 98023 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL M $ $15, 000 0121039113 _ TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL El DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT Shah Ananth Demo Demolition of the existing house, patio, foundation and, haul away PROJECT DESCRIPTION debris. Detailed description of work to be included on this permit only NAME PRIMARY PHONE Viral Shah 2533476903 PROPERTY OWNER MAILING ADDRESS E-MAIL 2(0 1600B SW Dash Point Road #466 viralpandit@gmail .com CITY STATE ZIP .2.,4z4-33Federal Way WA 98023 NPHONE Bhhuupinder Singh Chandi 206-293-7100 MAILINGE- 13 5 146th S Street haanndisingh14@gmail .com CONTRACTOR CITY STATE ZIP FAX Tukwila WA 98168 WA STATE CONTRACTOR'S LICENSE 41 EXPIRATION DATE UBI 41 LLC GKINDIC873NK NAME PRIMARY PHONE Viral Shah APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX NAME PRIMARY PHONE PROJECT CONTACT Viral Shah (The individual to receive and MAILING ADDRESS E-MAIL respond to all correspondence concerning this application) CITY STATE ZIP FAX NAME PROJECT FINANCING El OWNER-FINANCED When value is$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 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 6/3/2020 PRINT NAME: Viral Shah Bulletin#100-February 19,2020 Page 1 of 2 k:\Handouts\Permit Application COMMUNITY DEVELOPMENT DEPARTMENT 333258`"Avenue South AiLirn&k, ......._ Federaldecal Way,WA 98003 CITY OF Wilmll 253-835-2607;Fax 253-835-2609 Federal Way ww�v.citvoffederalway.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: 300q, 2D ' P L A Ge SL.s / Ft~ Ec_DRAway t Igo 2.3 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. 0 A completed Construction Permit Application form is also required. 1.ASBESTOS ABATEMENT (Provi•- of Notice oflntentfrom Puget Sound Clean Air Agency 5. ELE and •1'�;r inspection r- by AHERA-certified inspector) i / r t ...16^-41Q i (Puget ";nd Energy/Tacoma Power) (a . Federal Way Buildin cial) 2. FUEL STORAGE TANKS 6.NATURAL GAS o Under grade tank(s)is/are present , ,G., - / o Above grade tank(s)are present �,�j:/t/�.�'Q K„/Le GC o Tank(s)has been pumped or removed under South King Are& (Puget Sound Energy) Rescue permit prior to�any dismantling 6— excavation III ' (So King Fire and Rescue) 7.WATER �-,,Public Source CtoeZel C.1Le f (Lakehaven Utility District) 3.SEF92) C SYSTEM DECOMISSIONING � — - ' 8.WATER- Private Well unty Environm tai Services) PPA (ling County Environmental Services) 4.SANITARY SEWER Lakehaven Utility District) Ngi Please Note: Erosion control measures must be in place during the demolition and through completion of the site clean-up. (Applicant) Bulletin#122—March 16,2017 Page 1 of I k:\Handouts\Demolition Permit Requirements Gmall Viral Shah <viralpandit@gmail.com> Application for water service connection Dawn Zern<dzern@lakehaven.org> Fri, May 22, 2020 at 3:43 PM To:Viral Shah <viralpandit@gmail.com> Hello, Thank you for confirming your fixture count and meter location.Just want to double check you are showing it visually North but said in your email it will be located to the South. I belive your visual depiction is accurate, please confirm. For your water service this'd be a cut-n-cap of the private water supply line for the property, and we wouldn't be able to 'sign' or confirm anything there (because svc/meter will still be active). Lakehaven does not do permitting on the supply line side. Please continue to send all emails, questions and submittals to de@lakehaven.org Have a good weekend. [Quoted text hidden] [Quoted text hidden] G ma i l Viral Shah <viralpandit@gmail.com>r 30016 20th PL SW--Federal Way--509321005 Russell, Jeremy <Jeremy.Russell@pse.com> Thu, May 21, 2020 at 2:31 PM To: "VIRALPANDIT@gmail.com" <VIRALPANDIT@gmail.com> Good Afternoon, I wanted to let you know I had conversation with my Supervisor concerning who will sign the demo permit once the cut and cap of the service is done. PSE is reaching out to the City of Federal Way to get clarification on that. Once I have answer I will let you know. Please let me know if you have any questions. Thank you, Jeremy Russell Project Manager Customer& System projects Southwest— Natural Gas PUGET SOUND ENERGY Cell: 253-213-2445 3130 S 38th ST Tacoma, WA 98409 jeremy.russell@pse.com 5 i t t g 1 1,',',. 1 14. ` °,ti's � 'h . 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Demolition is planned for this structure. This inspection report includes data that describes the type of materials found, their quantities, where appropriate and their asbestos content. The report can also be used as a planning aid for all construction, maintenance, abatement and demolition work associated with the structure. Facilities Description This structure covers an estimated 1,300 square feet on one level. It has a concrete perimeter foundation and is approximately 50 years old. It is a typical wood framed home with wood exterior siding and upgraded vinyl windows. It was remodeled extensively in the early 1990's with most of the wallboard, insulation and floors replaced. There is a double layer of wallboard on the master bedroom bathroom ceiling. Floors are hardwood with ceramic tiles covering the wet areas. Insulation is fiberglass. There is a forced-air gas furnace. Roofing is concrete tiles dating from major remodel. The garage roof is semi-flat and covered with a single ply rubber product. Inspection & Sampling Procedures Puget Sound Clean Air Agency and Labor & Industries regulations require an inspection of all buildings for the presence of asbestos containing materials prior to renovation and/or demolition. Asbestos containing materials are defined as those building materials containing one percent or more of asbestos as verified by laboratory analysis. Asbestos containing materials are sub-divided into three types: surfacing materials, thermal system insulation, and miscellaneous materials. Surfacing materials are defined as those materials that are sprayed-on, troweled-on or otherwise applied to surfaces including, but not limited to, acoustical plaster on ceilings, paints. fireproofing materials on structural members, or other materials on surfaces for decorative purposes. Thermal system insulation indicates material applied to pipes, fittings, boilers, tanks, ducts, or other structural components to prevent heat loss or gain. All other materials are considered to be miscellaneous materials. All surfacing materials, thermal system insulation and flooring installed in structures prior to 1980 are presumed to contain asbestos unless proven otherwise by a licensed building inspector. The number of samples collected depends on the type of material and its quantity. In order to prove that suspect or presumed surfacing Res,osed hti JLS' S materials do not contain asbestos at least three samples of each homogeneous area are required. Five samples are required for areas greater than 1,000 square feet and seven are required for areas greater than 5,000 square feet. Thermal system insulation requires at least three samples be collected. One sample of each suspect miscellaneous material must also be collected. Each sample was collected and placed into a separate, sealed, plastic bag. They were then individually numbered. When possible, samples were collected from areas or materials that were previously damaged. Sampling equipment was decontaminated after each sample was collected. Once collected, the samples were delivered to an accredited laboratory, accompanied by a chain of custody describing each sample. The samples were then analyzed using Polarized Light Microscopy (PLM) Stain Dispersion technique in accordance with EPA Method 600/R-93/116. Additional treatment and tests may have been used as required to define a sample's composition. Non-Asbestos Containing Materials The following materials have been shown by a laboratory to be non-asbestos or <1% by weight: Material Type Location Quantity Description Smooth paint wallboard. new material Gypsum Walls& 2,000 non-asbestos. Old wallboard mud Wallboard Ceilings sq/ft contains asbestos. Consult WRD, 23.30 for guidance on handling Chimney Pipe Furnace Chimney mortar for gas into concrete Mortar Room, HWT .5 sq/ftchimney Roofing Garage 500 sq/fl Rubber single ply on low pitch roof Asbestos Containing Materials Wallboard mud on old original wallboard contains asbestos. No additional materials were found to contain asbestos. Reviewed by JLS SES Conclusion The only asbestos material found was the original wallboard mud. only found in one ceiling location in the master bedroom. Wallboard and wallboard mud can be considered less than one percent asbestos(the EPA regulatory limit)as a non-separable unit. Washington DOSI-1 does have some handling requirements that are outlined in WRD, 23.30. It is recommended to review 23.30 prior to handling the wallboard. Should additional suspect materials be found, have them documented and sampled by a certified inspector. Puget Sound Air Clean Air Agency and Washington DOSH regulations require that all asbestos containing materials be properly handled during demolition and renovation and that a survey of the asbestos containing materials be provided to all contractors and posted at the site to prevent potential accidental asbestos exposure. Inspector Endorsement Roka F. 5Z.0.41+44. Inspector: Certified AHERA Building Inspector, SP-AP Inspector# 172402, Expires 3-26-2020 Attachments: Asbestos Northwest Laboratory Analysis Reviewed by JLS f dJ O +61 44 v O C O (3) 00 9830 S. 5ist St., Ste B-109 Phoenix,AZ 85044 gec'd:MAR 1 3 P.M. (480)940-5294 Fax (480) 893-1726 BILL TO: (ff Different Location} :oMPA:vr NAME. Environmental Specialties Environmental Specialties Address: 4227 S Meridian, Ste C,#625 42.27 S Meridian, Ste C,#625 Puyaiiup,WA 9837? Puyallup,WA 98373 CONTACT: Bober.Simons Phone/Fax: 253-683-1144 Email: rscrflS hOtmail.com / Sample $ / Layers Now Accepting: VISA-MASTERCARD Price Quoted: $ - COMPLETE ITEMS 1-4: (Failure to complete any items may cause a delay in processing or analyzing your samples) 1. TURNAROUND TIME: [Same Day Rush) 1-2 D� 13-4-5 Days] 16-10 Days) ****Lriot confirmation of turnaround time is required ****Additional charges for rush analysis(please call marketing department for pricing details) ****Laboratory analysis may be subject to delay Lcredit terms are not met 2. TYPE OF ANALYSIS: - it ' it-PCM] (Lead] [Point Count) [Fungi: AOC,W-C, Bulk, Swab,'repel 3. DISPOSAL INSTRUCTIONS: [Di... -' of samples at EMC] / [Return samples to me at m _exP i (If ou do not Indicate preference, EMC will disease of samples,X ctys from analysis J _,_„ — r �7 vet 4. Project Name: jlr �� P.O. Number: --- ProjectNumber. 73067,/4",,_ .2f j`e.—; Samples AIR SAMPLE INFO/COMMENTS EMC CLIENT DATE&TIME 1 LOCATION/MATERIAL Accepted ON ori row 1 TYPE RATE SAMPLE# SAMPLE# SAMPLED V. / No 1 .ry I1110111FAIIIIMIM.111111111 i11111111 �� MIN IIIIMIMIIIIIIMIIIIIIIt .- . 7 WM 1 i' • ki ' , IIIII 111111111111111111111111111111 111111E l 1111111111 liallialill 11111111111111111111111111111111111111111111111111111111111111111111111111111111 1 SPECIAL INSTRUCTIONS: - - �. 4 -- Sample Collector. (Print) A ,C7/i:kiet�{i (sic,na;ure) / �1 �a-ssy`i- 1 /474,0 Relinquished by: 1?� �' A - zt7---1 DaterTimej 4 (2_O Re:eived by " Date/Tim :2 r y r. Relinquished by: "S3tuxwrek1' DatefTime:/� Received by: /'� DatefTim'a ..f/ Relinquished by: Dateme Received by: Date/Tim_:_ a~* In the event of any dispute between the above parties for these services or otherwise,parties agree that jurisdiction and venue will t in Phoenix,Arizona and prevailing party will be entitled to attorney's fees and court costs. EMC LABS, INC. Laboratory Report 9830 S. 51st Street, Suite B109, Phoenix, AZ 85044 0234958 Phone: 800-362-3373 or 480-940-5294 - Fax: (480)893-1726 Bulk Asbestos Analysis by Polarized Light Microscopy NVLAP#101926-0 Client: ENVIRONMENTAL SPECIALTIES Job# / P.O. #. Address: 4227 MERIDIAN S. STE C#625 Date Received: 03/13/2020 PUYALLUP, WA 98373 Date Analyzed: 03/16/2020 Collected: 03/10/2020 Date Reported: 03/16/2020 Project Name: VIVAL SHOEH EPA Method: EPA 600/R-93/116 Address: 30016 20TH PL SW FW Submitted By: ROBERT SIMONS Collected By: Lab ID Sample Layer Name / Asbestos Asbestos Type Non-Asbestos Client ID Location Sample Description Detected (%) Constituents 0234958-001 WALL CLOSET LAYER 1 Na None Detected Cellulose Fiber 10% Gypsum Wallboard,White/Brown Fibrous Glass 2% 1 Gypsum Carbonates Mica Quartz 88% LAYER 2 No None Detected Texture,White/Beige Carbonates Note Samples mainly Paint- Mica little Texture present Quartz Binder/Filler 100% 0234958-002 MB CLOSET LAYER 1 No None Detected Cellulose Fiber 10% 2 Gypsum Wallboard,White/Brown Gypsum Carbonates Mica Quartz 90% LAYER 2 No None Detected Texture,White/Beige Carbonates Note: Sample is mainly Paint- Mica little Texture present Quartz Binder/Filler 100% 0234958-003 M.BATH NEW LAYER 1 No None Detected Cellulose Fiber 10% 3 Gypsum Wallboard,White/Brown Gypsum Carbonates Mica Quartz 90% LAYER 2 No None Detected Texture,White/Off White Carbonates Note: Sample is mainly Paint- Mica little Texture present Quartz Binder/Filler 100% Page 1 of 3 EMC LABS, INC. Laboratory Report 9830 S. 51st Street, Suite B109, Phoenix, AZ 85044 0234958 Phone: 800-362-3373 or 480-940-5294- Fax: (480)893-1726 Bulk Asbestos Analysis by Polarized Light Microscopy NVLAP#101926-0 Client: ENVIRONMENTAL SPECIALTIES Job#/ P.O. #: Address: 4227 MERIDIAN S. STE C#625 Date Received: 03/13/2020 PUYALLUP, WA 98373 Date Analyzed: 03/16/2020 Collected: 03/10/2020 Date Reported: 03/16/2020 Project Name: VIVAL SHOEH EPA Method: EPA 600/R-93/116 Address: 30016 20TH PL SW FW Submitted By: ROBERT SIMONS Collected By: Lab ID Sample Layer Name/ Asbestos Asbestos Type Non-Asbestos Client ID Location Sample Description Detected (%) Constituents 0234958-004 M. BATH OLD LAYER 1 No None Detected Cellulose Fiber 10% 4 Gypsum Wallboard,White/Brown Gypsum Carbonates Mica Quartz 90% LAYER 2 Yes Chrysotile 3% Cellulose Fiber 1% Joint Compound,White Carbonates Mica Gypsum Binder/Filler 96% LAYER 3 No None Detected Cellulose Fiber 95% Tape.Off White Carbonates 5% LAYER 4 No None Detected Cellulose Fiber 1% Texture,White Carbonates Mica Quartz Binder/Filler 99% 0234958-005 SEALED WATER Chimney Pipe Seale°, Gray No None Detected Thermally Altered Fibers 25% Wollastonite 25% 5 Carbonates Gypsum Binder/Filler 50% 0234958-006 Roofing,Black No None Detected Synthetic Fiber 20% 6 Carbonates Quartz Binder/Filler 80% Page 2 of 3 EMC LABS, INC, Laboratory Report 9830 S. 51st Street,Suite B109, Phoenix, AZ 85044 0234958 Phone: 800-362-3373 or 480-940-5294 -Fax: (480)893-1726 Bulk Asbestos Analysis by Polarized Light Microscopy NVLAP#101926-0 Client: ENVIRONMENTAL SPECIALTIES Job#/ P.O. #: Address: 4227 MERIDIAN S. STE C#625 Date Received: 03/13/2020 PUYALLUP, WA 98373 Date Analyzed: 03/16/2020 Collected: 03/10/2020 Date Reported: 03/16/2020 Project Name: VIVAL SHOEH EPA Method: EPA 600/R-93/116 Address: 30016 20TH PL SW FW Submitted By: ROBERT SIMONS Collected By: Lab ID Sample Layer Name / Asbestos Asbestos Type Non-Asbestos Client ID Location Sample Description Detected (%) Constituents 0234958-001 WALL CLOSET LAYER 1 No None Detected Cellulose Fiber 10% Gypsum Wallboard.White/Brown Fibrous Glass 2% 1 Gypsum Carbonates Mica Quartz 88% LAYER 2 No None Detected Texture,White/Beige Carbonates Note: Sample is mainly Paint- Mica little Texture present Quartz Binder/Filler 100% 0234958-002 MB CLOSET LAYER 1 No None Detected Cellulose Fiber 10% 2 Gypsum Wallboard,White/Brown Gypsum Carbonates Mica Quartz 90% LAYER 2 No None Detected Texture.Waite/Beige Carbonates Note: Sample is mainly Paint- Mica little Texture present Quartz Binder/Filler 100% 0234958-003 M.BATH NEW LAYER 1 No None Detected Cellulose Fiber 10% 3 Gypsum Wallboard,White/Brown Gypsum Carbonates Mica Quartz 90% LAYER 2 No None Detected Texture,White/Off White Carbonates Note: Sample is mainly Paint- Mica little Texture present Quartz Binder/Filler 100% Page 1 of 3 EMC LABS, INC. Laboratory Report 9830 S. 51st Street, Suite 8109, Phoenix, AZ 85044 0234958 Phone: 800-362-3373 or 480-940-5294 - Fax: (480)893-1726 Bulk Asbestos Analysis by Polarized Light Microscopy NVLAP#101926-0 Client: ENVIRONMENTAL SPECIALTIES Job# / P.O #. Address: 4227 MERIDIAN S. STE C#625 Date Received: 03/13/2020 PUYALLUP, WA 98373 Date Analyzed: 03/16/2020 Collected: 03/10/2020 Date Reported: 03/16/2020 Project Name: VIVAL SHOEH EPA Method: EPA 600/R-93/116 Address: 30016 20TH PL SW FW Submitted By: ROBERT SIMONS Collected By: Lab ID Sample Layer Name / Asbestos Asbestos Type Non-Asbestos Client ID Location Sample Description Detected (%) Constituents 0234958-004 M.BATH OLD LAYER 1 No None Detected Cellulose Fiber 10% 4 Gypsum Wallboard.Whtte/Brown Gypsum Carbonates Mica Quartz 90% LAYER 2 Yes Chrysotile 3% Cellulose Fiber 1% Joint Compound.White Carbonates Mica Gypsum Binder/Filler 96% LAYER 3 No None Detected Cellulose Fiber 95% Tape,Off White Carbonates 5% LAYER 4 No None Detected Cellulose Fiber 1% Texture.White Carbonates Mica Quartz Binder/Filler 99% 0234958-005 SEALED WATER Chimney Pipe Sealed, Gray No None Detected Thermally Altered Fibers 25% 5 Wollastonite 25% Carbonates Gypsum Binder/Filler 50% 0234958-006 Roofing, Black No None Detected Synthetic Fiber 20% 6 Carbonates Quartz Binder/Filler 80% Page 2 of 3 EMC LABS, INC. Laboratory Report 9830 S. 51st Street, Suite B109, Phoenix. AZ 85044 0234958 Phone: 800-362-3373 or 480-940-5294-Fax: (480)893-1726 Bulk Asbestos Analysis by Polarized Light Microscopy NVLAP#101926-0 Client: ENVIRONMENTAL SPECIALTIES Job#/ P.O. #: Address: 4227 MERIDIAN S. STE C#625 Date Received: 03/13/2020 PUYALLUP. WA 98373 Date Analyzed: 03/16/2020 Collected: 03/10/2020 Date Reported: 03/16/2020 Project Name. VIVAL SHOEH EPA Method: EPA 600/R-93/116 Address: 30016 20TH PL SW FW Submitted By. ROBERT SIMONS Collected By Lab ID Sample Layer Name I Asbestos Asbestos Type Non-Asbestos Client ID Location Sample Description Detected (%) Constituents P . 4 , ...S+�+ . S 41/1 Analyst- Kurt Kettler Signatory -Lab Manager-Ken Scheske Distinctly strained easily separable rayers of samples are anayzen as subsernpies of the whole and are reported separately for eacn discernible layer As analyses are denver trot calibrated visual estimate and measured et area percent unless otherwise noted The report applies to the standards or procedures identified and to the sample(si tested The test results are not rrecessaray ndicated or representative rut the qualities of the tot from which the sample was taken or of apparently Identical or similar products,nor do they represent an ongoing quality assurance program unless so noted These reports are for the exclusive use of the addressed client and that they WA not he reproduced wholly or in pan for advertlsng or other purposes over our stratum or in connecaan wan our name without special written pennissan.The report shah rot be rePrOdniStrrt except or Poll,without {written approval by our laboratory The samples not destroyed in testing are rearmed a fnadientan of thirty days.The laboratory measurement of uncertainty for tee test method a approximately less than I by area percent. Accredited by the National Instaute of Standards and Technology.Voluntary Laboratory AbSredeation Progam for selected test method for asbestos The accreditation or any reports generated by tors I.bwatory in no way constitutes or rttpMes product certificationapproval.or endorsement try the National Institute of Standards aro Tecinoiogy The report must not be used by the chat to claim product certrecaton.approval,cv endorsement by NVLAP.NIST,or any agency of the federal Government Polarised Light Microscopy may net be consistently reliable in detecting asbestos in floor cavenngs and similar non-friable organically bound materials. Page 3 of 3 - INC.MC LABS, INC' Laboratory Report 9830 S. 51st Street, Suite B109, Phoenix, AZ 85044 0234958 Phone: 800-362-3373 or 480-940-5294-Fax: (480)893-1726 Bulk Asbestos Analysis by Polarized Light Microscopy NVLAP#101926-0 Client ENVIRONMENTAL SPECIALTIES Job# / P O. #: Address: 4227 MERIDIAN S. STE C#625 Date Received: 03/13/2020 PUYALLUP, WA 98373 Date Analyzed: 03/16/2020 Collected: 03/10/2020 Date Reported: 03/16/2020 Project Name: VIVAL SHOEH EPA Method: EPA 600/R-93/116 Address: 30016 20TH PL SW FW Submitted By: ROBERT SIMONS Collected By: Y Lab ID Sample Layer Name/ Asbestos Asbestos Type Non-Asbestos Client ID Location Sample Description Detected (%) Constituents 7 5 ....12,0 16.4 ' / ..., Signatory -Lab Manager-Ken Scheske Analyst- Kurt Kettler measured In arreaeppe cent otl�ss essay therwise notedo The reportl appes toyzed as subserrpies of the whote and are thesunwards or procedures xdenbtied arrd to the�camp r�,ery for tested a The test results are not necelayer AN analyses anty ne atet a6repretibrated rasher estrmato and sentati at the quartiles of the lot from which the sample was taken or of apparently identical or snorter productsnor do they represent an orrgoatg quart,assurance program unless so noted.These reports are tot the exclusive use of the addressed cleat and I that they vat not be reproduced wholly or n pad for d`stro ed a other purposes Oval our Woe.*a in connection ny days Thelabborato t out name meeSUmunent at uncertainty tor the test method rrrussron The report ashalt ppeoOt be r p les than an 1 except area per-0Wthout mitten approval by Nah c'Insulut or samples not destroyed Technology testrogVonde are aborao a 1 I ry fl Program for selected test nethod for asbestos The accredllalron or any reports generated by Mrs laboratory to no way Nccreddas or the leu pro l tot dome et bonStaapprords and redtsar,,endorsement Voluntary NLatrona! ltt uct certificate-tn.Appmval Of endrifSernent by Ntaedes orN Smpaes product cyrtnWbFn approval or ent saoera by the Narcrns py may 4 be cortbrs Tae rr�n detecting asbestos ein floor ceocenes and similar nn-t be used by Me cheat to claim Maisie organically Wend materials. I M NVLAP,NIST,a any agency of the Federal Government Polarized light®.Nemsedpy may Y S Page 3 of 3