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Home My WebLink AboutBLD2023-01541 DEMO - BLD Inspections - 7/1/2024 INSPECTION CARD Mason County 615 W. Alder St. Building 8, Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov PERMIT# BLD2023-01541 PROJECT ADDRESS 261 E Gray Ave Shelton, WA 98584 PARCEL# 221325200010 PROJECT DESCRIPTION DEMO EXISTING 1968 DOUBLE WIDE TRAILER OWNER MOREN FAMILY TRUST JAMES BYRON & ADDRESS 32060 56TH AVE S PHONE CONTRACTOR ADDRESS PHONE CONTRACTOR LICENSE LENDER INSPECTION INSP DATE Comments INSPECTION INSP DATE Comments Demolition Final Inspection 1 Mason County m Mason County - Division of Community Development 615 W.Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BL 22023-01541 DEMO PROJECT DESCRIPTION: DEMO EXISTING 1968 DOUBLE WIDE ISSUED: 12/27/2023 TRAILER SITE ADDRESS: 261 E GRAY AVE SHELTON EXPIRES: 06/24/2024 PARCEL: 221325200010 APPLICANT: MOREN FAMILY TRUST JAMES BYRON& OWNER: MOREN FAMILY TRUST JAMES BYRON& CATHERINE ELIZABETH CO-TRUSTEES CATHERINE ELIZABETH CO-TRUSTEES 32060 56TH AVE S 32060 56TH AVE S AUBURN,WA 98001 AUBURN,WA 98001 FEES: Paid Due State Fee-Residential $6.50 $0.00 Demolition Fee $120.00 $0.00 Technology Flat Convenience $5.00 $0.00 Fee Totals : $131.50 $0.00 REQUIRED INSPECTIONS Demolition Final Inspection CONDITIONS All building permits shall have a final inspection performed and approved by Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. Printed by:Amber Selby on:12/27/2023 01:17 PM Page 1 of 2 f t Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov DEMO BLD2023-01541 OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. * The Washington State Clean Air Act prohibits the burning of any construction or demolition debris in an outdoor fire. * For public safety, it is the responsibility of the applicant to confirm through written verification all utility services (electric, gas, water, sewer, ...)have been terminated prior to demolishing a structure. * Proper erosion and sediment control practices must be used on the construction site and adjacent areas to prevent upland sediments from entering the aquatic environment. Erosion control measures must be in place prior to any clearing, grading, or construction. These control measures must be effective to prevent soil from being carried into surface water by stormwater runoff.Any discharge of sediment-laden runoff or other pollutants to waters of the state is in violation of state regulations. Any work in or adjacent to waterways that will adversely affect water quality must receive specific prior authorization from the Department of Ecology. Silt fencing, straw matting, etc. must be installed and maintained until seeding or upland vegetation has become established around all areas disturbed or newly created by construction activities. * The demolition and disposal of demolition debris must meet requirements as per Mason County regulations. it is unlawful for any person to cause or allow the demolition (or major renovation)of any structure unless all asbestos containing materials have been removed from the area to be demolished. work shall not commence on an asbestos project or demolition unless the owner or operator has obtained written approval from ORCAA @ 2490 B Limited Lane NW, Olympia WA 98502, 360-586-1044, 800-422-5623, www.orcaa.org * All construction debris must be removed from the site after project completion to an approved location. Proper disposal of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of aquatic environments. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws a Ordinances gover ing this type of work will be complied with whether specified herei r not he grantin of a _It does not presume to give authority to violate or cancel the provisi o any er state/I a e ulating construction or the performance of construction. Issued y: Contractor or Authorized Agent: Date: —( -2:1 -23 Printed by:Amber Selby on:12/27/2023 01:17 PM Page 2 of 2 MASON COUNTY PERMIT NOLL7ZOr,�.�Jr' w COMMUNITY SERVICES DEPARTMENT BUILDING•PLANNING• FIRE MARSHAL C E I V E D WWW.CO.MASON.WA.US (360)427-9670 Shelton e - Mason County Bldg.#8,615 W.Alder St (360)275-4467 Belfair ext.352 tHis "' Shelton,WA 98584 (360)482-5269 Elma ext. 35bEC 2 7 2023 DEMOLITION PERMIT APPLICATION 615 W. Alder Street OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:Jim and Cathy Moren NAME:Owner Contractor MAILING ADDRESS:261 E Gray Ave MAILING ADDRESS: CITY:Shelton STATE:wA ZIP:98485 CITY: STATE: ZIP: PHONE:253-561-3420 CELL:same PHONE: CELL: EMAIL:morenj04@msn.com EMAIL : L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER (12 DIGIT NUMBER) 22132-52-00010 FIRE DISTRICT 5 LEGAL DESCRIPTION (ABBREVIATED) Gray Acres#1 TRS 10-11 DPC#21-03 AF#2153515 SITE ADDRESS 261 E Gray Ave CITY Shelton DIRECTIONS TO SITE ADDRESS: From Shelton, head N on 3, turn right on Pickering, right on Phillps Lake Road, vere right on Clay, then right on Gray Ave. IS PROPERTY WITHIN 200 FT: SALTWATER[] LAKED RIVER/CREEK❑ POND[] WETLAND❑ SEASONAL RUNOFF[] STREAM ❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT- GREATER THAN 14% YES❑ NO ❑ IF YOUR PROJECT IS LOCATED ADJACENT TO OR WITHIN AN AREA THAT IS LISTED ABOVE,PLEASE CONTACT THE PLANNING DIVISION OF COMMUNITY DEVELOPMENT PRIOR TO DEMOLITION TO ENSURE REDEVELOPMENT. USE OF STRUCTURE BEING DEMOLISHED(RESIDENCE,GARAGE ETC.) Residence 1968 double wide trailer with attached laundry addition. HOW WILL THE DEBRIS BE DISPOSED OF?: Metal to be recycled,and land fill, PROVIDE A PLOT PLAN INDICATING LOCATION OF STRUCTURE TO BE DEMOLISHED I OWNER/CONTRACTOR acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPE N.INACTIVITY OF THIS R IT APR ICATIO OF 180 DAYS WILL INVALIDATE THE APPLICATION. X" 12-18-23 Igna ure of pplicant Date xJi/m and Cathy Moren DOWNER/❑✓ REPRESENTATIVE/OCONTRACTOR Print Name DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT RECEIVED DEC 2 7 2023 615 W. Alder Street 4 2 3 " s u:r: E VIRONiENT L KCBENVIRONMENTAL SERVICES a`viLLS Cell: (360)271-8252 P.O. BOX 829 Email: Skyler@kcbes.com Seabeck, WA 98380 CERTIFIED AHERA ASBESTOS INSPECTION MASON COUNTY November 3rd, 2023 261 E Gray Avenue Shelton, WA Apr a. n t w.. Prepared for: Cathy Moreno 261 E Gray Avenue Shelton, WA 1 TABLE OF CONTENTS 001. Regulatory Compliance.................................... 002. Asbestos Definition......................................... 003. Sampling Protocol........................................... 004. Survey Methodology/Limitations.......................... 005. Site Specifications........................................... 006. Summary...................................................... Attachments which may be included: * Site location maps * Photos * Notification forms * Lab analysis * Field reports * Chain of Custody forms * Certifications * Print outs * Miscellaneous information 2 001. Regulatory Compliance This inspection satisfies the current regulation WAC 296-62-07707 that requires building owners to conduct an inspection before any repair, remodel, or demolition can be performed where asbestos may be disturbed (Chapter 49-17 RCW) and... Olympic Region Clean Air Agency (ORCAA) Regulations, Article 14 of the Asbestos Control Standards Section 14.05 Notification Requirement and Fees "It shall be unlawful for any person to cause or allow work on an asbestos project or demolition unless owner or the operator has obtained written approval from the control officer as follows: (1) A written "Application to Perform an Asbestos Project" or An application to Perform a Demolition; shall be submitted on Agency-provided forms by the owner or operator for approval by the Control Officer before any work on an asbestos project or demolition begins. It shall be unlawful for any person to cause or allow any false or misrepresenting information on either form. (2) The written application shall be accompanied by the appropriate Application fee and a certification that an asbestos survey has been conducted. (3) The written application for a demolition shall also include a Certification that there are no known asbestos-containing materials remaining in the area of the demolition. (4) The duration of an asbestos project or demolition shall not exceed one year beyond the original starting date that is commensurate with the amount of work involved. (5) A copy of the approved application and asbestos survey shall be available For inspection at the asbestos project or demolition site. (6) Upon completion of an asbestos project or demolition, a written "Notice Of Completion" shall be filed with the Control Officer. (7) Submission of an"Application to Perform an Asbestos Project" shall be Prima facie evidence that the asbestos project involves ACM. (8) Application for multiple asbestos projects may be filed on one form, if Specific criteria are met(see ORCAA website for details). Notification is required for demolitions involving structures with a projected roof area greater than 120 square feet, even if no ACM is present. Friable, asbestos-containing material need not be removed from a component if the component can be removed, stored, or transported for reuse without disturbing or damaging the asbestos. 3 It shall be unlawful for any person to cause or allow the burning of any facility for fire training without removing all asbestos-containing materials prior to burning. This includes both friable and nonfriable ACM. ----------------------------------------------------------------------------------------------------- Section 4.05 Procedures for Asbestos Projects. Training Requirements It shall be unlawful for any person to cause or allow any work on an asbestos project unless it is performed by persons trained and certified in accordance with the standards established by the Washington State Department of Labor and Industries, the federal Occupational Safety& Health Administration (OSHA), or the United States Environmental Protection Agency (whichever agency has jurisdiction) and whose certification is current. " This certification requirement does not apply to asbestos projects conducted in an owner-occupied, single-family residence performed by the resident owner of the dwelling. AHERA (Asbestos Hazard Emergency Response Act)regulation requires this inspection to include the identification of Friable and Non-Friable ACM in (1) Surfacing Materials, (2) Thermal System Insulation, and (3)Miscellaneous Materials: to delineate homogeneous areas and to sample or "Presume" all materials located. Friable ACM is thought to release fibers into the air more readily, however, many types of Non-Friable ACM can become airborne if disturbed. Additionally, the condition of the material will be graded and the potential for future damage assessed. The number of samples required is specified in the AHERA Rule (40 CFR 763.86) as follows: Surfacing Materials: (SM) 3 samples per homogeneous area of less than 1000 square feet, 5 samples for greater than 1000 but less than 5000 square feet, 7 samples for greater than 5000 square feet. Thermal System Insulation: (TSI) 3 samples from each homogeneous area that is not"Assumed"to be asbestos, 1 sample per each patched area and as determined by the inspector for T's, elbows, or valves. Miscellaneous Materials: (MM) Sample amounts determined sufficient by the inspector. 4 Friable asbestos is a material that can be crumbled, pulverized, or reduced to powder by hand pressure. Non-Friable asbestos can become Friable by sanding, grinding, sawing, or other mechanically induced means. EPA(Environmental Protection Agency) regulates asbestos above 1%, as determined using the method specified in Appendix A, Subpart F, 40 CFR (Code of Federal Regulations) Part 763, Section 1,by Polarized Light Microscopy (PLM). These Washington State agencies regulate asbestos in these counties: • Puget Sound Clean Air Agency(PSCAA)King,Kitsap,Pierce,Snohomish • Olympic Regional Clean Air Agency(ORCAA)Jefferson,Clallam,Mason,Thurston,Pacific,Grays Harbor • Southwest Clean Air Agency(SWCAA)Lewis,Clark,Wahkiakum,Cowlitz,Skamania • Yakima County Clean Air Authority(YCCAA)Yakima • Northwest Air Pollution Authority(NAPA)Whatcom,Skagit,Island • Douglas County Clean Air Commission • Grant County Clean Air Authority • Tri Counties Air Pollution Control Authority,Benton,Walla Walla,Franklin • Spokane County Air Pollution Control Authority(SCAPCA) Spokane • Washington Department of Ecology,(DOE)Stevens,Ferry,Okanogan,San Juan,Chelan,Kittitas,Klickitat, Columbia,Garfield,Asotin,Adams,Lincoln,Pend Oreille A fee must be paid, and the Notice of Intent filed, and be submitted prior to renovation or demolition of a building. There is a required waiting period after filing a notification before work can begin. (Mandatory 10 days for all demolition's) Calendar or working day wait is stipulated by each regulatory agency's policy. Further information regarding compliance may be obtained at our office. It is unlawful for the owner or the owner's agent to remove asbestos more than 10 linear feet or 48 square feet per year,per structure, unless the building is an owner- occupied, single family private residence. Washington State law requires asbestos that is left in place, be in good repair and maintained at regular intervals. Maintenance should be documented. References: WAC 296-62-077 Asbestos, Tremolite, Anthophlylite &Actinolite WAC 296-65-001 Asbestos Removal& Encapsulation NESHAP Asbestos Regulations 40 CFR 61 Sub Part M PSCCA Regulation III Article 4 AHERA Model Accreditation Plan 1 AHERA Final Rule 40CFR 763 OSHA 29 CFR Parts 1910 US EPA Guidance for Controlling Friable ACM in Buildings 5 US EPA ACM in School Buildings, A Guidance Document Part 1&2 US EPA Asbestos Waste Management Guidance (Office of Solid Waste) US EPA Reporting&Recordkeeping Requirements for Waste Disposal 11-90 US EPA Asbestos in the Home, A Homeowners Guide 6-88 United States Environmental Protection Agency; The Asbestos Informer All federally recognized Tribal Lands are not under the jurisdiction of a local air pollution control agency but must report to the US EPA when undertaking asbestos abatement. 6 002. Asbestos Definition "Asbestos" includes Chrysotile, Amosite, Crocidolite, Tremolite asbestos, Anthrophylite asbestos,Actinolite asbestos, and any of these minerals that have been chemically treated and/or altered. Chrysotile is the most commonly used type of asbestos in North America, known as "white asbestos," the only mineral in the serpentine group of asbestos minerals. The word"asbestos" (Greek- not extinguishable)was first recorded in the first century AD, although the substance was known as early as the second century BC. 75% of the world's asbestos is mined in Quebec. Exposure to asbestos fibers can cause asbestosis, various cancers and the deadly mesothelioma which is an inoperable cancer of the chest and abdominal linings. Because there is no known safe level of exposure to asbestos, all exposure should be avoided. Asbestos was used in the United States in over 3600 different building materials, and while it is possible to suspect that a material contains asbestos, actual determination can only be made by instrumental analysis. Sample List of Suspect Asbestos Containing Materials • Cement Siding/Wallboard/Cement asbestos pipes • Window putty • Vinyl Floor Tile/Vinyl Wall Coverings • Vinyl Sheet Flooringibacking and adhesives • Vermiculite attic insulation • Construction Mastics/Joint Compounds/Spackling/Caulking/Putty • Acoustical and Decorative Plaster • Textured Paints and Coatings • Ceiling Tiles and Lay-in Panels/popcorn ceiling texture • Spray-on Insulation/Duct&Boiler Insulation • Blown-in Insulation/Wiring Insulation • Fireproofing Materials/Cooling Towers/Base Flashing • Taping Compounds/Chalkboards/Roofing Shingles • Packing Materials(Walls/Floors) • Gaskets/DrywalURoofing Felt • Laboratory Hoods/Gloves/Tabletops • Fire Blankets/Fire Curtains/Fire Doors • Heating&Electrical Ducts/Pipe Insulation 7 003. Sampling Protocol This survey addresses Friable and Non-friable suspect asbestos containing materials to meet NESHAP 40 CFR 61 (National Emissions Standards for Hazardous Air Pollutants) requirements for renovation and/or demolition activities. When suspect ACM is observed our technicians are trained and proficient in gathering samples by approved industry standards. All samples are then analyzed by an independent EPA approved NVLAP/NIST/AIHA accredited lab that participates in the PAT program according to 29 CFR 1910.1001, 0)(8)(ii) (A&B). The samples are analyzed using PLM with dispersion staining to estimate the percentage of asbestos composition by volume. Samples in which less than 1%of asbestos mineral is detected are designated as "None Detected" (ND) or"No Asbestos Detected" (NAD). Random samples are gathered of each homogeneous suspect ACM identified during a visual search. A series of samples are gathered (according to the 3-5-7 AHERA Rule) and are read at the lab for a positive result. If positive, no other samples are read of that material; if the sample is negative of asbestos content, the other samples are studied. All samples gathered must be reported negative for the material to be considered "None Detected." The laboratory analysis of all bulk sampling is included in this report and intended to be an integral part of the inspection data. Guidelines require laboratories reading asbestos samples to read all materials which are included in the submitted sample (tile, mastics, vinyl's, adhesives, leveling compounds, etc.) Because we frequently submit a "layered" sample, we may not sample mastics/adhesives separately as we feel this would be redundant and cause confusion in the interpretation for our clients and result in costlier lab fees. Therefore,the number of samples gathered will not always result in the same number of sample results received from the lab. Not all laboratories are qualified to analyze asbestos. The lab must be NVLAP certified, participating in the PAT Program of the Federal government. 8 004. Survey Methodology/Limitations Site reconnaissance was conducted by a Certified AHERA Building Inspector, in accordance with 40 CFR Part 763 Appendix C, who is familiar with the probable uses and locations of suspected Asbestos Containing Building Materials (ACBM). In addition to a visual walk through, effort is expended to disclose prior uses of the facility, age, and characteristics of construction, and other information which helps determine the potential presence of suspected ACBM. This inspection report is the written opinion of a qualified Certified AHERA Building Inspector and is based on conditions visible at the time of the site visit. This report does not constitute a warranty of any kind. Although extensive searches are conducted, there remains a remote possibility that asbestos in some form may lie undetected within the structure; under a floor, inside a duct, behind a wall, or buried in the ground. No degree of demolition was authorized or performed. Some printed materials may be included in this report strictly for educational purposes. The estimated dimensions quoted in this report are approximate estimates for location awareness of the materials and are not intended to be accurate for bidding. The Abatement Contractor should check all measurements by site visit. No portion of this report should be removed from its entirety. This report should remain on file for future reference regarding this structure. In older structures, it should be noted for personal safety that most window putty did contain asbestos, and that in the process of removing the putty to repair a pane, some individual contamination would most likely occur. Such windows should be removed with the glass intact and disposed of as a unit. When flooring is considered suspect of asbestos content, the mastic should always be treated as suspect as well, and should never be chipped, sanded, or scraped until tested to determine if asbestos is present. All questions pertaining to this report should be directed to our office for immediate response. Field notes are included in this report for their interpretive value. Photo's if taken are included for identification. Sample readings resulting in less than one percent (<1%) will not be recorded as asbestos because this amount in unregulated, therefore not considered asbestos (ACM). 9 <1%asbestos containing materials have their own set of requirements by Washington State Code (W4Q. See WAC 296-62-07712-2,4&5 for requirements. Our services have been executed in accordance with generally accepted practices within the limitations of scope, schedule, and budget; no other conditions are expressed or implied. This report does not expire as long as all repairs and remodeling activities after the inspection has been performed are conducted using new materials (not inventoried or used) certified asbestos free; and this action is carefully documented. Because materials are being imported into the United States from China, Canada, Russia, India, and others, which can contain asbestos, all suspect materials must be tested to ascertain whether or not asbestos fibers are present. There no longer is a"cut off'date from the year that the U.S. stopped the manufacturing of ACM for residential use that we can rely on. This document is protected by the Copyright Act of 1979 under Title 17 of the United States Code. Under no circumstances can this report be used unless it has been financially compensated for,nor can it be re-printed without express authorization from this firm. 10 005. Site Specification: This Certified AHERA Building Inspection has been authorized by the owner, Cathy Moreno at 261 E Gray Avenue in Shelton, WA The site investigation was performed on November Yd, 2023, of this single- family home. It has a newer metal roof,wood siding over metal siding. It is planned for demolition. (5) samples were collected on site of materials that were suspect of containing asbestos fibers: - Wall and Ceiling Texture - Sheet Vinyl - Drywall with Joint Compound Suspect materials are collected wet and sealed into 2mil poly lab pouches and were shipped by Priority Mail to our preferred asbestos specific NVLAP laboratory for analysis using Polarized Light Microscopy. "Suspect Material" is defined as any building material that has ever been documented as containing asbestos fibers or materials that closely resemble those that have. The base amount of asbestos that is regulated is more than one percent. This report was prepared for the exclusive use of Cathy Moreno and her agents or representatives for specific application to this site. If new information is developed through excavations,borings or other studies, this inspector should be retained to re-evaluate the conclusions of this report and provide amendments as needed. 11 006. Summary: The local Clean Air Agencies require a 10 day wait prior to asbestos abatement of a commercial or other than owner-occupied structures; and require the 14 day wait for all demolitions. A demolition permit must be purchased from ORCAA whether or not asbestos was identified attached to your structure. It is required to file your Notice of Intent with Olympic Region Clean Air Agency online at wwworcaa.org and you may call them for more information at 360.539.7610. Payment of the Notice of Intent will be accepted by credit/debit card. We suggest you retain this document for as long as you own this property (or hold a contract to work on it) to verify your compliance with the asbestos standards in place at this time. If there are any questions, please feel free to contact this inspector: Skyler Taylor, Certified AHERA Building Inspector#BI-NEs-08-21-14-01 12 KCB ENVIRONMENTAL SERVICES P.O. Box 829—Seabeck, WA 98380 360.271.8252 COMPENDIUM OF LOCATED ASBESTOS-CONTAINING MATERIALS 261 E Gray Avenue Shelton, WA After due diligence was exercised in the investigation of this single- family home, there were no materials identified to contain asbestos. Skyler Taylor, Certified AHERA Building Inspector#BI-NES-08-21-14-01 13 FIELD REPORTS - LABORATORY FINDINGS K C B Environmental Services 14 1VIROFIELD REPORT Page _Lof I N KCBEnvironmental Services PROJECT NAME:EMEHT L P.O. Box 829 INSPECTOR: Skyler Taylor#BI/R-NES-08-13-15-01 Seabeck, WA 98380 Site Address: & l - Phone: (360) 830-5022 Mobile: (360) 271-8252 Email: Skyler@kcbes.com SIGNATURE DATE:1I DESCRIPTION: I 1Iz� ha221u, W 1 I&001�3:CQ CONTRACTOR: SAMPLE FUNCTIONAL HOMO AHERA MATERIAL FRIABLE MATERIAL CONDITION POTENTIAL REASON MATERIAL OTHER COMMENTS IDENTIFICATION SPACE AREA CAT TYPE YES/NO AMOUNT G/D/SD DAMAGE DAMAGE COLOR LOCATION -7 0C� 7) #- 'nn,, vsrJ A� 3 T3-Yw��L �r 1,\v,,��- 2 2.0 c.�I *FUD=Friable Upon Demolition- SM=Surfacing Material- MM=Miscellaneous Material -TS1=Thermal System Insulation -SV=Sheet Vinyl-VT=Vinyl Tile-CT= Ceiling the 0 4 4 E VIRONMEN L CHAIN OF CUSTODY WCATHER Ram I"i i x�w!w"1Aj[-.3mx I REQUESTED SERVICES ww W w EMLaK.Com jdli T------- NonCulturah4o: culluffin MufluALtie�' Andmuti�,SAS Other Rk.,il,psts Marlton,NJ:3()I)()I IrIty —, )m Dr 1, SW A.Marton,NI 4�WA f866)871-1984 !;Wwv.. T I"�p ov .............. Pap kvut),c Phoenix,AZ: ".5f]I West Knmtwn Dive, vlvocniA.AZ 1150�1 o" -J800)6614802 SSF,CA 6r,- ShnmIML Ste an I uinr:#—�o GA<440MO '(866)88H-6653 10 'CA CONTACT INFORMATION 819%cut,wk,k,WA 9q-140 V,.f1wal Inv) :I-Is I 4 TURN AROUND TIME CODES-(TAT) PROJECT INFORMATION a sm Ierk*mvec,;41t.I�pw jj()II area b I, lav,pwase T -mert us gn advance of p .,Pekwd afiatysis neadla PQ mmw)w wil Total TAT NOTES I VolumolArea ��'j IT�mv Pi day,Tamp,RH,0L 7SAMPLE 110 DESCRIPTION C'4 (as -7 "ifr -— -------------- 4-1 - -——------------ SAMPLE-TYPE Coms RELiNQUISHFn BY I)ATE&TIMF RECEIVEL)BY DATE 9 1 IME 3 e icp T� 7;,n:t, 0 13C BKA','aul, ttv- SW -f A' ST 4 12,7, SASS xjflac*,,Air t'iample, ; SO (Aisl y sibmitting INN GI Kull cl Gumody,yLu apr( to be Gopwiqfit r',2019 Fiimfirtb fKab F&K Doe,# ENI(;S-F-1192. New K'k ReVised W N-0 9 Pale, 1 Of 1 tip. e u rof i ns E YIRONMENT L Built Environment Testing Ea.,,:., Report for: Skyler Taylor KCB Environmental Services 9916 NW Pioneer Road Seabeck, WA 98380 Eurofins EPK Built Environment Testing, LLC Regarding: Project: Cathy Moreno; 261 E Gray EML ID: 3443583 Approved by: Dates of Analysis: Asbestos PLM: 11-09-2023 0 - � t ;. , Approved Signatory Marisa Braziel Service SOPs:Asbestos PLM (EPA 40CFR App E to Sub E of Part 763& EPA METHOD 600/R-93-116, SOP EM-AS-S-1267) NVLAP Lab Code 600266-0 All samples were received in acceptable condition unless noted in the Report Comments portion in the body of the report.The results relate only to the samples as received and tested.The results include an inherent uncertainty of measurement associated with estimating percentages by polarized light microscopy. Measurement uncertainty data for sample results with>1%asbestos concentration can be provided when requested. Eurofins EPK Built Environment Testing, LLC("the Company"),a member of the Eurofins Built Environment Testing group of companies,shall have no liability to the client or the client's customer with respect to decisions or recommendations made,actions taken or courses of conduct implemented by either the client or the client's customer as a result of or based upon the Test Results.In no event shall the Company be liable to the client with respect to the Test Results except for the Company's own willful misconduct or gross negligence nor shall the Company be liable for incidental or consequential damages or lost profits or revenues to the fullest extent such liability may be disclaimed by law,even if the Company has been advised of the possibility of such damages,lost profits or lost revenues. In no event shall the Company's liability with respect to the Test Results exceed the amount paid to the Company by the client therefor. Eurofins EPK Built Environment Testing,LLC EMLab ID: 3443583, Page 1 of 2 Eurofins EPK Built Environment Testing, LLC 19515 North Creek Pkwy N,#100, Bothell, WA 98011 (800) 651-4802 www.eurofinsus.com/Built Client: KCB Environmental Services Date of Sampling: 11-04-2023 CIO: Skyler Taylor Date of Receipt: 11-06-2023 Re: Cathy Moreno; 261 E Gray Date of Report: 11-09-2023 ASBESTOS PLM REPORT Total Samples Submitted: 5 Total Samples Analyzed: 5 Total Samples with Laver Asbestos Content> 1%: 0 Location: 1 261 Gray,Sheet Vinyl Lab ID-Version$: 16773330-1 Sample Layers Asbestos Content Tan Sheet Flooring with Fibrous Backing ND Green/Black Mastic ND Composite Non-Asbestos Content: 15%Cellulose Sample Composite Homogeneity: Moderate Location: 2 261 Gray,Drywall Lab ID-Version$: 16773331-1 Sample Layers Asbestos Content White Drywall with Brown Paper ND Composite Non-Asbestos Content: 10%Cellulose Sample Composite Homogeneity: Good Location: 3 261 Gray,Texture Lab ID-Version$: 16773332-I Sample Layers Asbestos Content White Texture with Paint ND Sample Composite Homogeneity: Good Location: 4 261 Gray,Texture Lab ID-Version$: 16773333-1 Sample Layers Asbestos Content White Texture with Paint ND Composite Non-Asbestos Content: 2%Cellulose Sample Composite Homogeneity: Good Location: 5 261 Gray,Texture Lab ID-Version$: 16773334-1 Sample Layers Asbestos Content White Texture with Paint ND Composite Non-Asbestos Content: 2%Cellulose Sample Composite Homogeneity: Good The test report shall not be reproduced except in full,without written approval of the laboratory.The 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.The Company reserves the right to dispose of all samples after a period of thirty(30)days,according to all state and federal guidelines,unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually.ND means no fibers were detected.When detected,the minimum detection and reporting limit is less than 1%unless point counting is performed.Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. $A"Version"indicated by-"x"after the Lab ID#with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of"x". Eurofins EPK Built Environment Testing,LLC EMLab ID:3443583,Page 2 of 2 r' - � T. .e„ a � BUILDING INSPECTOR REFRESHER CERTIFICATE ,a This is to certify that ' 3 S� has attended and satisfactorily completed all requirements to maintain accreditation as a -1 ' an AHERA Building Inspector in accordance with the Toxic Substance Control Act Title (Section 206) and 40 CFR 763. , , f. r � - Accreditation No. BI/R-NES-10-20-23-08 � Course Date: October 20th, 2023 - Valid through: October 20' 2024 NOW Environmental Services, Inc. . ` 34004 — 9' Avenue South, Suite # 12 Federal Way, Washington 98003 �- (253) 927-5233 s 31�c jf r '',. ';� � '> \Y�� ''�';''"�� ti'>,`:+r�...,;k,rcot Pam''' �tibri t+m,.,-'SR"sc'S''+'e'� ""-�,,�,�� ,,*^7?ry•„„..,xP�flw-•`•F/ ��fiu�'�'.,"-'rt"r`.='-% v': � \ � � �`--�.u*�9`fi.-xS•�s� �?�s��3`�-u'-;.j ' -._ " _ ti„ti. - t "h, ,�yl +.' '. v. ,.r a. ;� ` z `�:�,,,,,� \`'----.�• —�� ham`.��'_ .,'�