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1111 W 14th St - Building
PREPARED 12/17/07 10 21 50 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 12/17/07 ADDRESS 1111 W 14TH ST SUBDIV TENANT NBA PA SCHOOL DISTRICT CONTRACTOR RJ SERVICES PHONE (360) 457 1420 OWNER PA SCHOOL DIST PHONE (360) 457 0949 PARCEL 06 30 00 0 3 9785 0000 APPL NUMBER 07 00000295 DEMOLITION PERMIT DEMO 00 DEMOLITION REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 12/17/07 JLL BLDG FINAL t, December 14 2007 9 59 14 AM 1pangrle LINDA P (TO FINAL AN OLD PERMIT) BLDG FINAL DEMO OF MONSON HOUSE (1500 SFR GARAGE) COMMENTS AND NOTES Application Number Application pin number Property Address ASSESSOR PARCEL NUMBER Tenant nbr name Application type description Subdivision Name Property Use Property Zoning Application valuation Owner PA SCHOOL DIST 2912 S PEABODY PORT ANGELES (360) 457 0949 Construction Type Occupancy Type Permit Additional desc Permit pin number Permit Fee Issue Date Expiration Date Qty Unit Charge Per Fee summary Charged Permit Fee Total Plan Check Total Grand Total CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 WA 983637035 50 00 00 50 00 Signature of Contractor or Authorized Agent 07 00000295 329110 1111 W 14TH ST 06 30 00 0 3 9785 0000 PA SCHOOL DISTRICT DEMOLITION PUBLIC BUILDINGS PARKS 1000 BASE FEE T \Policies \1102 15 building pennit inspection record05 wpd [1/4/2005] Contractor RJ SERVICES 514 IRVING JACOBS RD PORT ANGELES WA PORT ANGELES (360) 457 1420 Structure Information 000 000 TYPE V NON RATED SINGLE FAM CONGREGATES DEMOLITION DEMO 1500 SFR 97717 50 00 Plan Check Fee 3/21/07 Valuation 9/17/07 Paid Credited 50 00 00 00 00 50 00 00 Date 3/21/07 WA 98362 Due 00 00 00 00 1000 Extension 50 00 "S a, Separate Permits are required for electrical work, SEPA, Shoreline ESA, utilities private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned fora period of 180 days after the work as commenced or if required inspections have not been requested within 180 days from the last inspection I hereby certify that l have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction n NIV\is Date Signature of Owner (if owner milder) 2l -07 Date E t nn CALL 417 -4815 FOR BUILDING INSPECTIONS. CALL 417-473 FOR ELECTRICAL INSPECTIONS CALL 417 -4807 FOR PUBLIC WORKS UTILITIES PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAHFUL TO COVER, INSULATE OR CONCEAL 4NI' WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN A CONSPICUOUS LOCATION KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. FOUNDATION: FOOTINGS SHEAR WALLS WALLS FOUNDATION DRAINAGE DOWN SPOUTS PIERS POST HOLES (POLE BLDGS.) PLUM RING UNDER FLOOR SLAB ROUGH -IN WATER LINE (METER TO BLDG) GAS LINE BACK FLOW WATER AIR SEAL WALLS CEILING FRAMING JOISTS GIRDERS SHEAR WALL/HOLD DOWNS WALLS ROOF CEILING DPYWALL (INTERIOR BRACED PANEL ONLY) T -BAR INSULATION SLAB WALL FLOOR CEILING MECHANICAL ROUGH -IN HEAT PUMP /FURNACE /DUCTS GAS LINE WOOD STOVE PELLET CHIMNEY INSPECTION TYPE DATE MANUFACTURED HOMES FOOTING SLAB BLOCKING &HOLD DOWNS SKIRTING PLANNING DEPT SEPARATE PERMIT ll's PARKING /LIGHTING LANDSCAPING RESIDENTIAL ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW/ ENGINEERING 417 -4807 FIRE 417 -4653 PLANNING DEPT 417 -4750 I I BUILDING 417 -4815 T- \Pn1i c \1 1 07 1 5 hnilrline nennit insnection record05.wnd 11/4/20051 BUILDING PERMIT INSPECTION RECOJ.D ACCEPTED YES NO I FINAL DATE ACCEPTED BY. FINAL SEPA. ESA. SHORELINE: FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY /USE DATE YES NO COMMERCIAL DATE I ACCEPTED 1 YES I NO 417 -4735 ELECTRICAL LIGHT DEPT CONSTRUCTION R.W PW ENGINEERING FIRE DEPT PLANNING DEPT BUILDING COMMENTS DATE ACCEPTED BY. I I 112 1'l -67 JIB_ Applicant or Agent: J Ovvmer or� Or s". •Q. \0—.g S \-eboA 1s Address. \2 S Architect/Engmeer• Contractor R Address: PROJECT ADDRESS 1\ Lia LEGAL DESCRIPTION Lot: CLALLAM COUNTY PARCEL NUMBER. TYPE OF WORK. Residential Multi- family New Constr Re roof Stove Addition l ove Garage Commercial 0 Remodel 9 Deck Repair Sign Other BRIEF DESCRIPTION OF THE PROJECT 0-L_ •••te �.s ,—.J- COMMERC/RESillENTIAL. Occupancy Group: p' BUILDING PERMIT APPLICATION Fill out COMPLETELY and in INK. Your application and site plan MUST BE COMPLETE to be accepted for review If you have any questions, call PERMITS (360) 417 -4815 FAX(360)417 -4711 L. l vvv, 0..m L.v,S Phone: Phone Phone: Exp City Off- 1 h,A-t_A —J State License Block. No. of Stones: Lot Size: Existing Sq Ft. Total lot coverage PLANNING USE ONLY ESA/Wetland(s) Yes No SEPA Checklist required? Yes No Other Subdivision. SIZE/VALUATION SF /SF SF /SF SF /SF TOTAL VALUATION o-p J b. Occupant Load. Construction Type: Proposed Sq Ft. TOTAL Sq Ft. FOR OFFICIAL SE 011L1' Date Rec. /0 7 Permit 0 7 9-9 Date Approved: Date Issued: Zip R83 kc. 2_ S -11 2Q Phone: u l IL( Z b Zip S 83cZ ZONING APPROVALS PLAN BLDG DPWU FIRE. OTAFR VALUATION OF CONSTRUCTION In all cases, a valuation amount must be entered by the applicant. This figure will be reviewed and may be revised by the Building Division to comply with current fee schedules. Contact the Permit Coordmator at 417 -4815 for assistance. PLAN CHECK FEE IF a plan check fee is due it must be submitted at the time the building permit application and construction plans are submitted. All other permit fees are due at the time of permit issuance. EXPIRATION OF PLAN REVIEW If no permit is issued within 180 days of the date of apphcation, the application will expire. The Building Official can extend the time for action by the applicant up to 180 days upon written request by the apphcant (see Section R105.3.2 of the International Building/Residential Code, 2003). No application can be extended more than once. I hereby certify that I have read and examined this application and know the same to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required not the City's, and that I must obtain such permits prior to work. TA FORMS Applicant: <,L��. Date: 3 1 2 -1 l Z.i o'7 pORT' Marchl2, 2007 W A S H I N G T O N U S A Public Works Utilities Department Port Angeles School District 121 Attn. Chris Baker 2912 South Peabody Street Port Angeles, WA 98362 wal- a 7-v8 RE Port Angeles Transfer Station Waste Disposal Application, WDA 07 -08, Building material at 111 West 14t Street, Port Angeles, WA We have received your application for disposal ofbuilding demolition debns from the referenced site and reviewed the testing results. Based on the testing results the debns appears to be acceptable for disposal at the transfer station. A copy of your approved application is attached. This approved application must be shown to the landfill scale attendant at the time of disposal. Wood matenal is to be disposed of at another source Please be advised that this disposal application is only for the matenals and quantities listed in the application. Matenals not listed or in excess of the quantities noted may require separate applications and approval. Please call if you have questions. Very truly yours, Gary W Kenworthy P.E City Engineer Deputy Director of Engmeenng Services GWK:tf Encl. WDA 07 -08 Copy Claudia Stromski Bldg Division N:\PWKS \ENGINEER \WDAPPLIC`07 -08 WPD FILE: Landfill Solid Waste Disposal Applications Phone 360- 417 -4805 Fax. 360 -417 -4542 Website www cityofpa.us Email publicworks@cityofpa.us 321 East Fifth Street P 0 Box 1150 Port Angeles WA 98362 -0217 pORTg To City of Port Angeles City Engineer 321 E Fifth Street P O Box 1150 Port Angeles Washington 98362 NOTE. All questions must be answered for waste to be approved. 1 Generator Information Company Name 7 s Mailing Address Z- 2 S o v Contact: Phone Project Name Project Location. S 2. Other Contacts (if applicable) Consulting Firm Contact: Phone Contractor Name Contact: Phone Laboratory Contact. Phone 3�d s^ '1 1I 31.p �1 CZ 5 cz- 2.r, L4 a 9 270 o City of Port Angeles Landfill Waste Disposal Application PORT ANGELES LANDFILL WASTE DISPOSAL APPLICATION i NM-u ✓r o. n r, �a n 1 1 2— t 2- (.3 WOE -o Phone (360) 417 -4803 FAX. (360) 417 -4709 ��..�1...�-....G J0... p,1 21 °may L 3L,Z Page 1 3 Source of Waste Check the appropriate box below and briefly describe the project, process and /or cleanup that will or has produced the waste requiring disposal Include the gasoline service station number (if applicable) CERCLA/MTCA Remediation Independent Remedial Action Unused Chemical Product Spill Y. Other Source 1 v D lJ U' n. 4..QJ Cn.4 0-. r v•••• rq 1 �-C �-Cs Y fir"'\ S -0.... 4 oJ' -tea Soil Concrete /Asphalt Preserved Wood Coal Ash Wood Ash NOTE Total must equal 100% 5 Waste Material Contaminants (check all that apply) Unknown City of Port Angeles Landfill Waste Disposal Application Agency Contact. UST Removal 4 Waste Material Composition (check all that apply and include percent of total) Foundry Slag Dredge Sediments `,i. Debris Other (list) Gasoline Metals Solvents Heating Oil Unused Motor Oil Used Motor Oil /Waste Oil `1 Other c c eo c� Other Petroleum Product NOTE. Supply any MSDS information with application if available o •J Ok Diesel PCBs Page 2 6 Estimated Quantity of Waste for Disposal Other 2...0 Cubic yards Drums NOTE. Estimated quantity for disposal must be within 20% of the quantity actually disposed (10% for projects over 7 500 tons or 5 000 cubic yards 7 Frequency of Disposal One time Monthly 8 Waste Sampling Proper characterization of the waste for disposal requires the collection of representative samples The methods and equipment necessary for obtaining representative samples of a waste and the frequency of sampling will vary with the type and form of the waste Check the appropriate box and briefly describe how and where the waste was sampled Include site maps with sampling locations if possible Number of COMPOSITE samples number of discrete samples per composite Number of DISCRETE samples Z`\ 2 +l L\■- Lsr:o NOTE 1 Unless prior approval has been granted by Port Angeles the following frequency will be used 0 25 25 100 101 500 501 1000 1001 2000 >2000 G or 4--^ w cubic yards cubic yards cubic yards cubic yards cubic yards cubic yards City of Port Angeles Landfill Waste Disposal Application 2.0 Tons (estimate both) Tons (estimate both) Annual Other 'L 1 composite sample 3 composite samples 5 composite samples 7 composite samples 10 composite samples 10 plus one sample for each cubic yards sampling additional 500 NOTE 2. One composite sample shall contain a minimum of three /maximum of five discrete samples Page 3 9 Waste Analysis The Dangerous Waste Regulations (WAC 173 -303) shall be utilized to determine the appropriate analytical requirements for waste characterization Ecology Publication #91 -30 (Revised April 1994) `Guidance for Remediation of Petroleum Contaminated Soiis shall also be used to characterize petroleum contaminated soils from UST releases Submit all laboratory analytical results QA/QC data, and Chain of Custody sheets along with this application (NOTE. The laboratory must be accredited by the Washington State Department of Ecology a) List all analytical test methods used L vY� 0/N 41 :0..a 1. n o b) Provide a narrative as to why the above analytical methods were selected L ,.-l� NOTE. Additional sheets attached X YES NO 10 Soil Classification *FOR PETROLEUM CONTAMINATED SOILS ONLY Based on the analytical data and Ecology Publication #91 30 the soil classification is (check one) Class 1 Class 2 Calculated Hazard Index 11 Dangerous Waste Affidavit: City of Port Angeles Landfill Waste Disposal Application Class 3 Class 4 Based on a review of the analytical test results site history and the applicable regulations this waste is classified as (check one) Neither Dangerous Waste (DW) nor Extremely Hazardous Waste (EHVV) Dangerous Waste (DW) and Waste Code Extremely Hazardous Waste (EHW) and Waste Code Page 4 12. Certification We THE UNDERSIGNED certify that this application is true to the best of our knowledge All information provided is correct and the enclosed analytical results represent the proposed waste material to the best of our abilities Waste Generator Printed Name 11 4 Q. Company q 1 Date Date zno� oaf :Ppr't..At g0Ee ::Approval: :rig ir�ee N: \POLICY P \1000 SW11009 01 WPD :Approval: Ex piration.: pate: City of Port Angeles Landfill Waste Disposal Application Page 5 f Figure C.3 ProblemWasteDiosaiAccepjance Process NMI 111•1 Generator contacts City of Port Angeles or CCEHD' requesting to dispose of problem wastes at the PALF• City sends an approval letter to the generator. Ycs Upon receipt of the waste at the landfill, the gate attendant verifies that the quantity received is within 20% of the quantity teportcd in the WDA (within l0% for >7500 tons or 5000 cy Yes CCEEID or City of Port Angeles S forwards the generator a copy of the PALF WDA' (Attachment A to Waste Acceptance Policy) *CCEHD Ctailarrr Counth Environmental Health Division No Generator completes and submits to City the WDA including laboratory analytical results and quality control information. City of Port Angeles Engineer, or designated representative signs WDA and forwards a copy to CCEHD for their review and authorization. —a► Yes PALF• Port Angeles Landfill WDA. Waste Disposal Application City of Port Angeles, City Eaginecr or designated dative reviews WDA for completeness and accuracy City notifies generator in writing of reason for disapproval and forwards copy to CCEHD Generator may S resubmit WDA after addressing City and or CCEHD concerns. Ken Morgan Consulting March 12 2007 Mr Chris Baker Port Angeles School District #121 2912 South Peabody Street Port Angeles WA 98362 Re LEAD TESTING FOR MONSON HOUSE 1111 WEST 14 STREET. PORT ANGELES. WASHINGTON Dear Mr Baker On Friday October 2006 an inspection for lead was conducted on the structures located at 1111 West 14 Street in Port Angeles The two structures at the site consist of a single -story single family residence and a detached two car garage with a loft. The only portion of the garage that was finished was the loft. The inspection of the interior of the garage did not reveal any finishes that historically have contained lead The inspection of the exterior of the garage and the single family residence revealed that both of the paint colors used on the exterior of the house and the garage should be sampled and analyzed for lead content. Since different paint colors were used on the house and the garage two paint samples would have to be collected from the house together with the garage and analyzed for lead. All of the paint samples to be collected from the painted wood surfaces would be 1 509 South Liberty Street Port Angeles, WA 98362 collected by scraping the painted surface down to the base wood so as to collect a paint sample that was representative of all the layer of paint on the wood substrate while minimizing any wood fibers that were collected in the paint sample The two paint samples collected from the exterior of the house were both collected from the trim of the house The first paint sample was collected from the window and door trim and was labeled as sample number SS -1 The second paint sample was collected from the white fascia boards on the house and was labeled SS -2. The exterior of the garage was painted yellow with brown trim. A sample of the yellow paint was collected from the exterior of the garage and labeled as paint sample number SS -3 The brown paint sample collected from the exterior of the garage was labeled as paint sample number SS-4 The inspection of the interior of the house revealed two painted surfaces that have historically contained lead. The first of these two surfaces to be sampled was the interior door and window tnm. The tan colored paint sample collected from the interior door and window trim was labeled as paint sample number SS- 5 The second interior painted surface to be sampled was the white kitchen cabinets and the paint sample collected from the kitchen cabinets was labeled sample number SS-6 When the collection and labeling of the six paint samples had been completed, the paint samples were packaged and shipped together with the chain -of- custody form to TestAmerica for lead analysis The laboratory was instructed via the chain -of- custody form to analyze the paint samples for total lead by EPA Method 60108 If this analysis revealed a total lead content of 50 parts per million (ppm) or greater the laboratory was then instructed to perform a toxic characteristic leaching procedure (TCLP) extraction on the paint sample by EPA Method 1311 and to analyze the extract for lead via EPA Method 6010B On Friday October 27 2006 the analytical results associated with the six paint samples collected from the site were received from TestAmerica These analytical results indicated that the only paint sample that contained less than 50 ppm of total lead was the paint sample collected from the kitchen cabinets The test results did not reveal the TCLP results for the five paint samples that contained more than 50 ppm of total lead The following business day Monday, October 30 2006 I contacted Ms. Kate Haney at TestAmenca to determine the status of the TCLP results associated with the five paint samples that contained more than 50 ppm of total lead. Ms Haney stated that she would check with the chemist for this project to determine the status of the TCLP test results 2 On Wednesday November 1 2006 Ms Haney from TestAmerica informed me that the project chemist failed to notice the TCLP testing requirement on the chain -of- custody form for samples containing 50 ppm or more of total lead Due to the amount of time that had elapsed from the date the paint samples had been collected, a new set of paint samples would now have to be collected. The following day Thursday November 2 2006 an additional set of the same paint samples that had been collected on Friday October 6 2006 were collected from the site with the exception that a sixth paint sample was collected from the blue paint on the siding of the house Onginally it had been assumed that the window and door trim on the house were painted with the same paint that was on the siding of the house but now it appeared that the paint on the siding of the house was slightly different than the paint on the window and door tnm so an additional paint sample was collected from the siding on the house and was labeled paint sample SS-6A. An additional paint sample was not collected from the kitchen cabinets because the original paint sample collected from the kitchen cabinet did not contain any detectable amount of lead. The letter A was added as a suffix to the second set of paint samples to distinguish them from the first set of paint samples After the second set of paint samples had been collected and labeled as sample numbers SS -1A through SS-6A, the six paint samples were packaged and shipped together with the chain -of- custody form to TestAmerica for lead analysis The laboratory was instructed via the chain -of- custody form to perform a TCLP extraction on each of the six paint samples by EPA Method 1311 and then to analyze the extract for lead by EPA Method 6010B The analytical results associated with the second set of six paint samples were received from TestAmerica on Thursday November 16 2006 These test results indicated that the lead content of the paint on the fascia boards of the house together with the paint on the interior door and window trim of the house was below the level of concern. The paint on the exterior door and window tnm and the paint on the siding of both the house and the garage would have to be classified as a dangerous waste due to the high lead content. Following the receipt of the analytical results a cost estimate was developed for the removal of the siding and trim from both the house and the detached two -car garage together with the trucking the material to Arlington Oregon for disposal at Waste Management s chemical waste landfill near Arlington Oregon Once the cost estimate had been developed, a meeting was scheduled between Mr Roger Wheeler the demolition contractor Mr Scott Brodhun the Director of Facilities /Technology /Maintenance for Port Angeles School District #121 and I During the meeting the two options for demolition of the structure at 1111 West 14 Street in Port Angeles were discussed. The first option discussed was the removal of the siding and tnm from both the house and the garage and 3 transporting the lead contaminated material to Arlington Oregon for disposal at Waste Management's chemical waste landfill The second option discussed was the burning of the house together with the garage by the Port Angeles Fire Department as a training exercise The treatment of lead contaminated wood by burning is a viable option because it meets the Washington State Department of Ecology's criteria of waste reduction and reduces the lead contamination to acceptable levels for disposal as solid waste On Tuesday March 6 2007 I was informed that the house at 1111 West 14 Street would be burned by the Port Angeles Fire Department. The detached two car garage would not be bumed, but rather the siding and trim from the garage would be removed and placed in the house for the fire training exercise After the fire training exercise the remains of the house together with the garage, if it is successfully saved during the fire training exercise will be transported to the City of Port Angeles landfill for disposal. The Training Fire Request and the Notice of Demolition Permit have been approved by the Olympic Region Clean Air Agency A copy of this report together with the completed Port Angeles Landfill Waste Disposal Application have been submitted to the City of Port Angeles for approval Copies of the Training Fire Request, the Notice of Demolition Permit, the Port Angeles Landfill Waste Disposal Application and the analytical results associated with this project are enclosed If you have any questions regarding the information in this letter please contact me at your convenience Sincerely Enclosures 4 Date: 10/24/05 Northwest Asbestos Consultants 406 Reed St. Port Townsend, WA 98368 360 385 -0584 northwestasbestosconsultants @cablespeed com lob Location. 1111 W 14th St. Port Angeles, WA 98363 Owner. Contacts: Subject: Demolition Chris Baker- M&O Port Angeles School Dist. 2 912 S. Peabody St. Port Angeles, WA 98362 Zenovic and Associates, Inc. Tracy Gudgel, P.E. 519 S. Peabody St. Port Angeles, WA 98362 Inspector: Bob Witheridge AHERA Building inspector Management Planner WAMOA 0042 -05 Expires 10/12/06 Scope o ork 1) Good faith inspection for asbestos containing building materials (ACBM) 2) Survey, sample and record suspect materials. 3) Report to Tracy Gudgel of Zenovic and Associates, Inc. with results of testing by Clayton Services. 4) Copies for Tracy Gudgel, owner, Clallam County Permit Center, Olympic Region Clean Air Agency and on site for demolition. Inspection Report The inspection started with a visual survey looking for Asbestos Containing Building Material (ACBM) Sample results are as follows: Sample #1. Kitchen and dining rooms. Floor vinyl with mastic. White Sample #2.,. East bedroom 9 "x9" floor tile with mastic. Under carpet. Pink and white. Sample #3. Popcorn ceiling. East bedroom only Sample North bedroom off deck. Floor vinyl with mastic. Tan and cream. Sample #SL Laundry room floor vinyl with mastic. Tan and brown. Sample #6. Laundry room and north bedroom cove base with mastic. Sample L Pantry storage room. Top layer of floor vinyl. White with blue. Sample #8. Pantry storage room. Bottom layer 12"x 12" floor tile. Brown pebble pattern. Sample #9: Bathroom 12 "x 12" floor tile with mastic. Brown shades. Sample #10: Attic and wall insulation. Charcoal colored rock wool. Sample #11. Sheetrock walls. Homogeneous to home. Sample #12. Sheetrock mud at seams and around skylight. Kitchen Sample was sent to lab See results. To Clayton Services Date: 10/13/05 JQh Location. 1111 W 14th St. Port Angeles, WA 98363 Owner: Contacts: Sample #1_, Sample #2. Sample #3. Sample #4. Sample #5. Sample #6, Sample #7 Samnle #8. Sample #9: Samnle #10: Sample #11. Sample #12. Inspector. A r.3 1 u 15 U LI JAMYLL L)A I A Northwest Asbestos Consultants 406 Reed St. Port Townsend, WA 98368 360 385 -0584 northwestasbestosconsultants@cablespeed.com Chris Baker- M &O Port Angeles School Dist. 2912 S. Peabody St. Port Angeles, WA 98362 Kitchen and dining rooms. Floor vinyl with mastic. White East bedroom 9 "x9" floor tile with mastic. Under carpet. Pink and white. Popcorn ceiling East bedroom only North bedroom off deck. Floor vinyl with mastic Tan and cream. Laundry room floor vinyl with mastic. Tan and brown. Laundry room and north bedroom cove base with mastic. Pantry storage room. Top layer of floor vinyl. White with blue. Pantry storage room. Bottom layer 12 "x 12" floor tile. Brown pebble pattern. Bathroom 12 "x 12" floor tile with mastic. Brown shades. Attic and wall insulation. Charcoal colored rock wool. Sheetrock walls. Homogeneous to home. Sheetrock mud at seams and around skylight. Kitchen Please call with test results when completed. S attachment. k.) Thank you, Zenovic and Associates, Inc. Tracy Gudgel, P.E. 519 S. Peabody St. Port Angeles, WA 98362 Bob Witheridge AHERA Building Inspector Management Planner WAMOA 0042 -05 Expires 10/12/06 XL/11V CROUP SERVICES X76 B. hAlribui I0. k. Suva to Suds. WA NM 7i3aJt4 licit Name: Nordtwest Asbestos Consultants Location: 1111 W 14th Bt Port Angeles, WA 98362 waft 10292.1 SOtJR j Floor Vigyt and Mastic CATION; Kliebto .ad Warms rooms LAMED WV* watk Wee Jaeais backiq calf rldilup „rshdua lattnam (2 1w�8 �k 4292,2A. 9"X9" Moor '1'I1e LOCATION; Fast Sedraecs MATMIAL DES Ptak ml whits 00 whir whge twItlue MATERIAL, rs9attPTION: Mack a spiraltic material COMPANY Northwest Asbestos Ooknts NVLA? LA* CODE 01011O114 ]Y� Ness: Aruodltcd Laboratory LAYER 2 13LTS: AMPLE Cx LASI 410292.2A Mesdc Na a Detected 1..0 c }.TION: East ssdrsem RECEIVED BY Tins Moffett DATE: 10/l712005 UL Layers F1omog tired for Analysis No Asbestos Detected AMSTOS TAE ZEMIST M(0. 0~8 WNW. aahrq jir A distio f ere yam. Asbestos Contab thrg Material (ACM) ASBESTOS-TYPE Maga Cbryeotf k 2 p..Vb ere %I MIR leriortty: Regular Fromm Rt 900.75 Number of Smol 12 Bo aL s� U �i ertdge PO /Job# war galfigUMOS Cellulose Sysnlietle ggligLIMMIAlea rifler Mader vinyiRler sad Benda LAYER= SAMPLE: NESHAP and AHERA regulation require layers be siolyzed and reported separately. LAYU 1 isizgal onsumm PlaPt 7U Algralme Vi Missed Minder [+!der Btador CYTHElt /Man CsUulose Syc MAO' c amsdhid by 111TatvLAr.Asolinro.hjWiLAP oet Was .r,. ►.vw h. sogl imItiYa .1111.4re..wMIKA EPA HW. Auras midagbildellinb tow t.d is.etiaro ssegf r.rao www3ndos. Sle woos lifts memo, liowleeMae tiEhni*Auld ram", M mhos ImtliNdes4 r6iaihrfeslsWhoa" Ted aseiteMtselwl .e+w}lmde gimlet wahnoedltSeolks seklloa. Tow rkapadhlytaaisle*NlL d+.:6oet was aawtbtar btted.7tissipenagl rri ra!MOj►a1 tSa o0IplO/P.Sinks Sow Ras tfgat9nA.w.aiCoodidtu=beam w. es. Quagusi,.. lTo wwnbAlrrdAeAap lyiReuitrame mvm.fthettio.46 Ano et bogie IworrweDsMIMIkdm ArMM n..41.0111 eweste IOU telUllO M 'Nee S6 15 5 50 30 20 75 3 10 2 Asphalt Ma &Nader 38 SAMPLED BY. Bab Wig DATE: 10/1312005 ANALYZED BY Jude Cu vn DATE: 10/21/2005 .i k1Y UJlI Mir GROUP SERVICES ee84 brats war se: Soh 140 3ede. WA NISI �lisnt Name: Northwest Asbestos Consents ob Location: 1111 W 14th St. Port Angeles, WA 98362 t (3 LAB t 402423 Popcorn Celiblg Bart Bodr•oaa LAYERED *Sake pale as white ararmstaprodir s 3i: 40292.4 SOUP.CE; Floor Vigil with Mastic MICalcali North Bedruoat ORDadt M DG MPTIO l: LAYERED Feflow mil 1410 WWI with ttilfteJ 4a* is backing axd talkie SAMPLE JP: (s IA0 it 48292.5 SOURS, Floor Vinyl with Mastic .112CAUSa Laandry Rodin MATgaIAL DP.SCISIPT04= LAYERED (*whiz aisd Jaw vinyl wick shtwkits jesvis map vl gall reads NVLAP LAN CODE SIN IQ%-o Now AcQeditet Laboratory SAMPLED BYI Bob Wilt ge DATE; 1Qt13/2O05 COMPANY Northwest Asbestos Consultants RECEIVED BY TunMoaott DATE 10/17/2005 jo lS cciinkde La licampaized fot Analysis Asbestos C nbigMaterial (Ai, As8 STOS TYPE gERC T T 2 Proja# s= Nusahtr of &unpi t: Canute Bob Witheridge PORobt t QMELMAriglak Flues Wader Paier =UMW Layers Hasangasitad A d s Cos gMaferfrl (ACM) osEEMEnn 1' Chrysotiie 12 r New Usable s; wpm�raitbzJ imaridoai snsrrrss. Layers lameasifnad far Analysis No Asbestos Detected Tag MOM r Nolo rhriWs b aye esst/sr fit badmiatel aaa{tlie IZIBBR MATERIALS 9� MrB Binder Way' Pill= and Binder SZEURELPZEZ Collolcoe C &Binder Vinyl Far Ind Bfr+der DRAFT Reaalar B 400.75 11 TiNXIBisioLeldISLIZIWAIEDDZUDERerv cops .wnH.rbyltYriIAAP. AbstOodatIONLAIP ant INN Mime i _r IiprnrLAr Army aatr sarm. AY edtiusglu IPA lirratt aaaasb lab mad FN S 11I. A*swacemthdwi*dmmia law ad tgt+fweeyr12‘ ...ititzetat. Oattra Watt tiew0d.rewebade. osAbawddw4 camas adopt Wan latliadalid4Wid Owen laidt144 Yerwtlisitpatdatarewlp aisaiudb imam izDelft Tat m u m er yaw mu b. iabbit PLM. visci ssserteersli__ bitra4m4 TYil Monsk6aet late.10AA1 11:a t5 clear 3u' imiraIMP Ateart wnwiwt o,akcorm :2lluwo4t. Adadit AAA Adgktior wee AL Cluadluera40 A wit matt of album lt &Fad Y est v a.o Iowa awl is i mss A+io had bw drama *Ali IU1st'LA4t~ 5 75 20 3' 5 53 30 3' IS OTC MATERIALS 54 55 ANALYZED BY Juda c=ingt DATE: 10/2112005 GROUP SERVICES GROUP SERVICES 4106 L Mwg idi wcy So. Sae 140 Steak WA 98134 (206) -734 X23 40292.6A 3URCE, Cove Base DCATION; Laundry Room and North Bedroom ERIAL DE,SCRIP'r1ON; fawn vinyl .MPLE (6 1B g; 40291613 JURCE. Mastic )CATION: Laundry Room and North Bedroom A TER (A1. DESCRIPTION on and brown Lwasric k.MPLE C7 iR 40292.7 DURCE. Floor Vinyl D_ATIOIV. Pantry/Storage Room Top Layer ATERIAL DESCRIPTION: LAYERED lue and white vinyl with gray fibrous backing ad off-white residue Now Note: J� NVLAP LAB CODE 0101106 -0 Accredited Laboratory ent Name: Northwest Asbestos Consultants Contact: Bob Witheridge Location: 1111 W 14th St. Port Angeles, WA 98362 PO /rob#. LAYERED SAMPLE NESRAP And ALIERA regnlattons requite layers be analyzed and reported separately 4MPLE LAYER 1 RESULTS. OTHER FIBERS C 6 r No Asbestos Detected t tSBESTUS TYPE PERCENT LAYER 2 RESULTS. No Asbestos Detected ASBESTOS TYPE PERCENT RESULTS_, Layers Homogenized for Analysis No Asbestos Detected ASBESTOS TYPE PERCENT 1 Nolen Unable to sepoi Ie regime/Grind/virtual analysis. Priority- Project Number of Samples: OTHER MATERIALS Vinyl Filler and Binder OTHER FIBERS Cellulose Filler Binder OTHER FIBERS Cellulose Synthetic OTHER MATERIALS Filler Binder Vinyl Filler and Binder DRAFT Ytegular B 400.75 12 COMPANY Northwest Asbestos Coltsultents ECEIVED BY Tim Moffett DATE. 10/17/2005 TrlJcv Perkins ar other NVLAP Anernved gienatnry �laywu is ocawuted by NISrANv1 AaaediIaiao by NV .AP dace oat indiaN ettdoesetsoet pq N vl.AP army taw t_u_ spew AU tak Hngdes tut aosyad la aeegress= wah atabal 6PAl00a,M4 -a 20 (Decmebat 19;2) Aadyrec ste avta.dtcdted *Po* boa owl btm laboroury epdstity pr juseu for erifiemiae Plc paws odes meted sb,.e ire Wed me t:olt1eusd •1141 ;intatar by .,heat* Wlm mi6calae by Plot Oos 6 indeued Ten wag teemed Mats only t0 toe AaPbx tttrbeaiksd by et mem m oaymo. Tract intoccet or estrum meld rei fitly bemired b7 7514. Mackie 'main,=Wu mom 4e resamed. 11 ii OA em ba ceprodacad catcp la ba mare". without Clow Gem, Services exemi de &nor Rats: Ceeywdte, A,emite zed Cm:W Wta "Arm= owed ta tie Qudhative..01. meows be reported .1T �vwfitc and Aw°tophylUee robs= OeaiitYw t+02. Cloped eireA1 A'ace eatovs& or mamtm b 10 dcIm 4 u ose to tut Bea tkoli bt dvc glide tma Moos noe ac 'Tate 100 OTHER MATERIALS 10 90 20 3 47 30 AMPLED BY Bob Witberidge DATE. 10/13/2005 ANALYZED BY Jude Cummings DATE. 10/21/2005 Lae 40292.6 ijJRCg; 12"X1.2" Floor's QCATlON: Pantry/Stange Room BOUM Layer TTON; LAYERED Brows aid y tow "kg with akar okay sesterist Wal (9 LOA 4O292.9A 12 rT MaTIM1At.. Olkita sad a IAMPLE (9 Wit 40292.9B Mostly LOCATION: Bathroom MAIIttrAL DESc J lord: W. and Omni brink *mods/ MIA" LAS CODS /1Ot 206 Acerb Ltboratiory p l uaywn k I OW CROUP SERVICES Ins a )4 i W4 Sr. idrc 140 teat~ ww Rt14 tm%1 ieut Name: Northwest Asbestos Consultants b Locution, 1111 W ill St. Port Angeles, WA 91362 1 Pfs, SAM Lay= Btaaobt:oixed for Aallyt:t Asbestos Containing Material (ACM) AZIESIMME eitrysotilt 2 Ness Um&tempos* Nadat*Isarderta LAYERED SAMPLE: MESHAP oul A ZRA monk requite layers be aulysed and reported separatcIy ma LAM �su.,?r� I Ccitukoe Asbestos GoatabdagMl PERCIEIT Chrytotilo 2 OTC MUM 0 30 Viryt Mar aid »i 67 Mac LAY)2 &a te o ge#os Detected riiNalrr Log ff: Projects: Neither afSamp Bob Wlther#dge PO/dobli: 4 gnitatIM Wham* J OligaillEga r Aillegaz Vinyl Fillet and Binder tier &Hinder Wollasionita RAer Blades DRAFT mow. a .es disc 4 1asrw Mt Iae.aadla ky WIL1P Mr rep ham* 1 b /NW orsat aint. 11000Y. +t8 iattwp• ttar�!>dttwe0na. wh �w erA QM ibu 19.1), mabisof easidrdod ooze HIM udInn relay Wawa lNPse d+.disea 7l. WWII vim Inmtr1N.w Wed r* aiimrado.i c almly bq•we.ww+m..mcamobr ?aim Comwr4 ao..s sr...m at.. sly Saw moils Shaba brie dmasNom Nemo siabli shad 4104. t A e r c r o n i bulb emu i t f t W O D L TJdi<>put /bat tot 6o brxibal io lb arblo, Mir• s a w i n g .o Saar lkwmogyr", Ammo rr}aeeiseaaw p,,10 q .111 ball.. 11rdi0tlw Obi amembisim mace QM 'o` •dw+1i A 1iwbo y b&ud wtor la on Ms hod is Omo ark mma PAVAN Lama la Ali mow We*mbia yes r Sb 30 62 5 1 2 98 SAMPLED BY Bob Wtt eriga DATE. 10/13/2005 ANALYZED BY. Jude Cummings DATE: 10I21/20Q9 COMPANY Northwest Asbestos Cots RECEIVED BY Tim Moffett DATE: 10/17/2005 k,itty GROUP R0 UP SERVI NvLAP LAB CODE #101106-0 C R U P SCES Accredited Laboratory 4676 6 Matphd way So. Suitt 140 Soak. wA *611 (206) 163.7364 Lent Name: Northwest Asbestos Consultants Location: 1111 W 14th St. Port Angeles, WA 98362 AMPLE (10 40292.10 MRCP. Rock Wool OCATTQl:. Attic and Wail Insulation iA'TERIAL Dp.SCRIPTTON: HOMOGENEOUS %say fibrous loosely onmpressed material AMPLE (1i ADA 40292.11A OURCE. Sheetrock °CATION. Walls f ATERIAL DESCRIPTION f'kde paint on white lumpy compressed powder nd twblte paper a� (11 AB 40292.11B OURC,E_ Sheetrock .00ATION. Walls IATERIAL DESCRIPTION: ran paper on while compressed powder Now Note: LAYER2 RESULTS. Note: RESULTS. No Asbestos Detected ASBESTOS TYPE PERCENT No Asbestos Detected ASBESTOS TYPE PERCENT No Asbestos Detected ASBESTOS TYPE PERCENT Lug 1.r Priority. Project #1 Number of Samples: Contact: Bob Witheridge PO /Job#k OTHER. FIBERS Cellulose Mineral Wool with Emil LAYERED SAMPLE. NESHAP and ARERA regulations require layers ba analyzed and reported separately LAYER 1 RESULTS. OTHER. FIBERS Ccilulosa OTHER MATERIALS Misccltaneous P2Idc1CS OTHER MATERIALS Filler Binder Paint OTHER FIBERS Cellulose Glass Fiber OTHER MATERIALS Filler Binder COMPANY Northwest Asbestos Consultants ;E,CEIVED By Tim Moffett DATE. 10/17/2005 Tnev Petkin4 or Ober liVLAP Artamved sii nit wy await ie 0 4,d try esT/NVGI3 Aco 4iaioo by NVLAP dew eat kdkase to keeemnei by NvI.AT dr nay aeber garasinee Ivy ell bulk =Rift tine wtdymd ie =era= wbll TMVd grA1000tuA• 3.00 Cuceunixt i maims ate qpe- tbadrod Waugh beat dad fele saalil amm pteiaar fir rerirtetlida. The P4oaat vile. r0e0od Hors are bred A alarmed viand 41.;6+4 by vebane nnlra vuinw b him Camtias is i uguted Tai ranat tWerted rdite only io die samba !Ambled by die dine m Cake, Tact Tan of =bowl cook poctibty be teiocd b PJ.AM, deader; Mia°ve eaule =et bc sueroeaCd 116 rrpmc than not bc rcWwWccd aaoapt bn itl ald rgty, witboot Claytem OM, genius on. duos tart Cleryeear, AraOF d IC a treo4idobu o•bawm Qualiwi.e A�, Qua a e. ria ACtlnol+r an rmbopivf na aK+ame Qaaliaeri` .03 QwMrbauve -OS A franc amW T fir rlems it de!'atad de net eo Ova fibre Nod in Heed tilde owuaa. Asixolut Wed le tbtf =mat will 6 rrpmeed to "NW DRAFT 'yV �.Jr Regular B 900.75 12 93 ro 5 2 25 55 20 25 3 12 ;A iLED BY Bob Witheridge DATE. 10/13/2005 ANALYZED BY 7ude Cuaunings DATE. 10/21/2005 l y U NvLAP LAB CODE #101106-0 GROUP 5 E R V 1 C E S Accredlted Laboratory sdSe Mogio l Ws; 50. smote 140 Smile, WA9104 (20 965 -7164 tent Name. Northwest Asbestos Consultants Location. 1111 W 14th St. Port Angeles, WA 98362 PO/Job# LAYERED SAMPLE. NESHAP and AMEBA regulations require layers be analyzed and reported separately AMPLE (12 LAYER 1 RESULTS. OTHER FIBERS 911 40292.12A Cellulose 25 OURCE. Sheetrock Mud No Asbestos Detected OCATION: Kitchen Around Skylight ASBESTOS TYPE PERCENT WERJAL DESCRIPTION: i'lrite paint on white humpy cos pressed pooder 'ad white paper AMPLE (12 AB 40292.12B OURCE: Sheetrock Mud .00ATION. Kitchen Around Skylight MATERIAL DESCRIPTION: Kau paper on white comprised powder Now LAYER. 2 RRESULTS. i Nat= No Asbestos Detected ASBESTOS TYPE PERCENT Priority- Regular B Project Si- 900.75 Number of Samples: 12 COBtactBob Witheridge ,uv% rr. OTHER MATERIALS Puler Binder 60 Paint 15 OTHER FIBERS 1 Cellulose Glass Fiber RECEIVED BY Tim Moffett DATE. 10/17/2005 DRAFT rediled by bas Th VtAI man byWV14p mew indicate ts0a *at by NYL►t er 410 4110 y. AU Perkins or other N�/I eeez AvrxovCd Similarity cu r°, %nee clivey M4-1z -020 (Deavaber 1982. Aalyse, ere er�d t kcd dim* Later and mils d A!! b o s era man ia i enbe breed a method escnmes b' ootwno ke'mrimm a,' by read Cdwttl v n iuSexed TIM rWhe rsponed 4 ��c l a@�w f d e e kes iao r m v rtga maned abort m Ee�ed oa ri.uY wo mr4Aat ue�iv. iawlu Anna be Leeson red This ?wed eh4u not be reprvdnood maw to hs en Maples Maples Gro u p Sc the ekes li Cl t T ae bins+) embalms ca Bad yCtei k award by T[2d o MCbD7R *3 t ete G roff Scrim paariNlyl. tea- Auto- (bryaflb nn rand la dam muds n►b t,,A,.orne aed «orj+iatiee eebrm Qwd dit: t o10 t w be 2 /Trpeolhe, Acsinolna and AaAOplyWec mites= Qwrnotka 01, Qwntiocvr 03 A M+ O= a ill setae de err riat4 M tee to nee fb Aida *wind is th:e armee wilt be maned ere ?nee Trr rr. r AP 22 3 OTHER MATERIALS Filler Binder 75 SAMPLED BY Bob Witeridge DATE. 10/13/2005 ANALYZED BY Jude Cummings DATE. 10/21/2005 COMPANY Northwest Asbestos Consultants Smv of Inspection. This survey includes all areas of inspection with the report results from Clayton Environmental Testing Labs. sample #L Kitchen and dining rooms. Floor vinyl with mastic. White No asbestos detected. �2.111o2 1e #2. East bedroom 9 "x9" floor tile with mastic Under carpet. Pink and white. 2% Chrysotile asbestos. Approx. 224 sq ft. Sample #3. Popcorn ceiling. East bedroom only 2% Chrysotile asbestos. Approx. 224 sq ft. Sample ##4. North bedroom off deck. Floor vinyl with mastic. Tan and cream. 12% Chrysotile asbestos. Approx. 143 sq ft. Laundry room floor vinyl with mastic. Tan and brown. No asbestos detected. Sample Sample #6. .Sample #.Z.. Sample #8. Sample #9 Sample #10: Sample #11. Sample #12. Laundry room and north bedroom cove base with mastic. No asbestos detected. Pantry storage room. Top layer of floor vinyl. White with blue. No asbestos detected. Pantry storage room. Bottom layer 12"x 12" floor tile. Brown pebble pattern. 2% Chrysotile asbestos. Approx. 81 sq ft. Bathroom 12"x 12" floor tile with mastic. Brown shades. No asbestos detected. Attic and wall insulation. Charcoal colored rock wool. No asbestos detected. Sheetrock walls. Homogeneous to home. No asbestos detected. Sheetrock mud at seams and around skylight. Kitchen No asbestos detected. All asbestos containing building materials with a reading of 1% or greater is to be removed by a certified abatement contractor which follows the rules of the EPA and governed by Olympic Region Clean Air Agency During building demolition or remodeling, it is possible that additional suspect asbestos containing building material (ACBM) may be found with in a wall, floor, ceiling or other areas not accessible at the time of the survey Should such suspect material be discovered an AHERA certified inspector will have to sample and test the material to prove it is of non asbestos. Northwest Asbestos Consultants is not responsible for identification of hidden materials that are not identifiable with reasonable diligence. After the facility is completely cleaned out a walk through and inspection is required by the original AHERA building inspector (NW Asbestos) after abatement, then a copy of the letter certifying that abatement has been completed needs to be received by the Clallam County Permit Center and Olympic Region Clean Air Agency Thank you, Bob Witheridge, E.F.M. 4 tS Instructor rikk' terV \P.V.M.Cnr`A .”1:: Certificate of Completion This is to certify that Bob A. Witheridge has satisfactonly completed 4 hours of refresher training as an Asbestos Bui ding nspector /t/ 7)7.4 EPA Provider Cert. Number 1085 kagsr r.s91 50 1 to tom* ititb tbe trattium requtrement5 of Tikea Title 131 40 ejfil 763 (zme3az) Certificate Number WAMOA-00421018144 ARGUS n SAFETY TRAINING INDUSTRIAL HYGIENE 4,eis NWI- 11 Argus Pacific Inc 1900 W Nickerson Suite 315 Seattle Washington 98119 (206) 285 3373 fax (206) 285 3927 VA Oct 12. 2005 Date(s) of Training Exam Score NA Expiration Date Oct 12, 2006 "k- 4...11,, k ■}1.21J, V.1,1 41 1.40, W. WA., WI !AN 4 1 /1 IAire Hart AtIL:44 I .1011 \Akty nIFIIP 7ft AX ANtirg- 41. lb. Itt 0 .0 4°. I Jr '3107/2007 12 25 3602493475 07/24/2006 15 05 3504171467 07/24/2006 15 00 FAX 3140 4D1 6308 87/24/2096 14 10 3602493475 ARULABaikiing tweeter Neooe: I B teironnssieel )Nation dataltrotor: C.. Anherters Project Ittlemotatiott 1,. e/enpe Aanttfa S500 A est Trove 1 1. LI Psbrstos Remo) Znear 3latma r s. u Denateitian pew' Property (*nu s 2ylailit+R Addresar ,Z, S .odes a_ C Arbor/op Cdwlreetgr: IiP &5 Environmental, c. Atichesx P.o. 110; 312 C r o SI:tr. D. s1Me�� ua t:n Addeestax Surma or No. of Stteett,es: bat'lPsraumeed: 1 et Screamer, r Ka, a3 SIR++o�tes: tame Me bast if 11 1001 Oonatity to be,Reft oved: 2205gvall Pee I Thernd SI Insubtioo: 1 L I Boe1rrlpattm to ki L d Dart Su:faaio*Matl. I W Palau 6.1 Flaet4 Mise. Mat'1 TLI [einem Bet I U Cement PIP+ I Pfrimiiir Mxt'I AsbeetosiDernelition Proje t Cmrgttrime 1. ul tieneial D.relltne Asbestos Rentoas1 Pmitter liovAe feet nr yea IlAn l 1 square ZJ~( 1. LI y0 -259 rmnr feet or 11 159 mete feet 5. 42 0 1? 999 linear f e a t or 1 6 0 4 9 9 9 9 4 1 0 3 1 P 6.1,1-1090 P.999 linear keel. or 5,000 193fee 9 sgpare fe 7. U 10.1100+ linear feet Of S smart f tt t. Uri Fit (Limited retoovaL addiriaual aermitz. contact 9. Prc+iesx 10.W Aracpaitncnta too fee fit P' ana ameotimaatl oAC4A 1 2910 8 Li.it d Lane NW Oinopis WA 1 5C2 Monet (.34;e an-M.4 Fir. PM -011-083 LL'34' rcpt -44"drArtIff TO PliM141.11,-LsiOsitrt PRfl1RGT Phone: 1.50) Date s '+q�coaooca�d: Eps ?walk 3/0 1 3 II NO,A(tAch Culver Cerodieotiu4No. II LSp;IRatloaDot Wi' Z r 1M/ Oo Matt .1 1 V 7'ralstag Pitt iList Fste Depi as drmnlition completer Worm Date Ordered psmaritina (,Aoch coot- of C>R'deo VanarJ+r s.c..rfo.,e �^^••�trna mern.- vo*.,Or+pe I. I de. 4as6r .tetffl- ten the Istonnenen outwitted ie die onrtf sboa a.f .aCNeerAd dab P.a.mr rd dde '"'s 4 -c. yt da sited i ii to t{. kid .t IMF laverMdJta Bosnia dui aeterASp, 1 .h.0 net as fo Of 3 BM, N*F tt.rimed dotes -c' 4' f oleter velem et &m ates a to boil', mob) the eppaacibrc wai;a�gp�m r/ a+aa edatxaL A.�1�ld b)1 r i i^ t„t r S /t- a4 u hrOba4h altCdes t,.ppIcant 11 Aims Math I 2.9esdinv I4„ Aat►are AcArrr me emar l ORCAA CK. Nn c•.; DATE r 7 -3LI KDS ENVIRONMENTAL ICS ENV 1Rt31'U NTAL. f I� tatioi' a 1 LI Maintenance ¢enC 17. 1..1 Ckbrr Cite I Coniractor t7vt Dean Wi ;atl 1 P1an: 13380 1249 -5540 43.915 .63 1 Ptas ©$,Q_ 1 24g-3475 L444* 4 PAGE 02 PAGE 01 @j 00I PAGE el Date Appi oataun ltecdued RED JUL 2 4 ZDO A r- 0a MCA Firun& Wk. Daya>' II W Th P !jr Su wIII au ellbcstos 31 be removed tn Li Feet I Rrolect eomr teflcd',Ei Yer �+lo 6.1 ripe los I over, Teamed Ccrekr Rasflng Man I On cr f f Vot tiost_Wsinerjernvd jor 10 Wor iacc Nes IO WorldniDays 10 Worts 10 JO W� Ppm to teat of Ne iv Tear Priorliocce Cam AA Prior Nt:te I C 1=11E12W FPPP_ I 15 425 I00 i500 $L000 1500 125 MAP 7 -2007 07 00P FROM Date: 8/9/06 Owner. Contacts cc Northwest Asbestos Consultants 406 Reed St. Port Townsend, WA 98368 360 -385 -0584 northwestasbestosconsultants@cablespeed.com lob Location: 1111 W 14th St. Port Angeles, WA 98363 Chris Baker- M &O Port Angeles School Dist. 2912 S. Peabody St. Port Angeles, WA 98362 Zenovic and Associates, Inc. Tracy Gudgel, P.E. 519 S. Peabody St. Port Angeles, WA 98362 Olympic Region Clean Air Agency KD&S Environmental Clallam County Permit Center Zenovic and Associates, Inc. TO 13604571729 P 1 Subject: Regards to re- inspection, The purpose of re- inspection after ACBM was removed by the abatement contractor KD &S Environmental on 8/8/06 This area that was noted on 10/13/05 inspection report has been abated and all areas were left clean. I find this building ready for demolition as according to the regulations of Olympic Region Clean Air Agency and EPA guidelines. Inspector: Bob Witheridge EPA -AHERA Building Inspector Management Planner WAMOA- 0042 10270601 Expires- 10/27/07 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. A written application for a demolition shall include a certification that there is no known asbestos containing material remaining in the area of the structure. Project Site Address: 1111 West 14th Street County. Clallam City• Port Angeles State WA Zip 98363 Starting Date March 242007 Completion Date March 24,2007 *(There is a 10 working day advance notification period from receipt of permit application) Property Owner Port Angeles School District Number 121 Telephone 360452 -0267 F ax. 360-452-0267 Mailing Address. 2912 South Peabody Street City. Port Angeles State WA Zip 98362 Demolition Contractor Mailing Address: City State Zip Contact Person. Telephone: Fax: YES NO X Demolition by Wrecking or Dismantling? ($25 00 fee) check #5 nonrefundable Training Fire Demolition? (If yes, attach fire department request for training fire) X Renovation, Alteration, Remodeling, Maintenance, or other Construction? Asbestos found or suspected* An ORCAA "Notice of Intent to Remove or Encapsulate Asbestos" form and appropriate fee must be submitted prior to any asbestos removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation 1 Article 14 for additional requirements that may apply Asbestos Survey Completed by AHERA Certified Inspector Northwest Asbestos Consultants Certification WAMOA- 00421018144 This approved permit must be available at the job site F COMMON \Forms \asbestos\DemoPerm it. doc Rev 10/22/02 Olympic Region Clean Air Agency 2940 -B Limited Lane NW Olympia, WA 98502 (360) 586 -1044 or 1- 800 -422 -5623 Fax (360) 491 -6308 www ORCAA.org Notification of Demolition Permit Enclose S25 Processing Fee State License 7 .DEMO Ap proved 3/x/0 by �Cr�ct 1 Certification of the Asbestos Survey must accompany this form J( 6 E O RC L% A Attach Notification of Demolition Permit 1PPLI(:_1NT N 1 \CE /TI I L E. Port Angeles School District Number 121 1PPLI(" ANT /FIRE PROTECTION k(7 ENC. City of Port Angeles Fire Department 1PPLI( NT \DDRE ti 2912 South Peabody Street TR 1NN(. -\DDRESS. 1111 'hest 14th street PROPOSED TRAININC3 D E. March 24.2007 The following items are conditions that must be met prior to the ignition of fire fighter training fires Please complete the checklist below and provide documentation where necessary N LOCATION OF FIRE is not in an area dedared to be in an air pollution episode or any stage of impaired air quality N /N 1 N N 0 N N NOTICE OF FIRE TRAINING EXERCISE provided to adjoining property owners and additional persons as necessary ALL STRUCTURES to be set on fire are identified, and all structures on same parcel not to be set on fire are identified (pkaseprovide details). ASBESTOS INSPEC I ION conducted (please provide written documentation). ASBESTOS detected? ASBESTOS NOTIFICATION and removal completed please submit copy of notification). MERCURY- CONTAINING THERMOSTATS AND SWITCHES identified, propedy removed and disposed of in a safe manner. (Contact your local County Solid Waste Department for more information) MATERIALS NON ESSENTIAL TO TRAINING removed, including, but not limited to composition roofing (AFTER asbestos inspection), carpet, linoleum, furniture, and floor tile. If you have any questions about this checklist, please call the Olympic Region Clean Air Agency at (360) 586-1044 or (800) 422 5623 Signature Date -kpplication Received (J 2940 B Limited Lane NW Olympia, WA 98502 Phone: (360) 586-1044 FAX (360) 491 -6308 www.orcaa.org Permit Requirements pproved -Asbestos Permit Disapproved Permit \SB( )1 -keno. I e Only Reviewed by iMac24: Usersxlannelson :Doctmients:transfer docs:Tr imng Fire.doc Created on 5/15/06 10:06 AM by Steve Rybolt Training Fire Request 3161 ---eL% Date Review date Demolition Permit FAX'd date: Permit _DEM i Survey es No r e tJ merica October 25 2006 AI "T red r r^oP!'",.A Ken Morgan Ken Morgan Consulting 509 S. Liberty Street Port Angeles, WA 98362 RE Stevens School SEATTLE, WA 11720 NORTH CREEK PKWY N, SUITE 400 BOTHELL, WA 98011 -8244 PH: (425) 420.9200 FAX: (425) 420.9210 Enclosed are the results of analyses for samples received by the laboratory on 10/09/06 11 40 The following list is a summary of the Work Orders contained m this report, generated on 10/25/06 10 If you have any questions concerning this report, please feel free to contact me. TestArnerica Seattle, WA 1. f Kate Haney Project Manager Work Order Proiect ProiectNumber BPJ0172 Stevens School 10106 www testamericainc com The remits t this report apply to the oamplea analyzed accordance wtth the sham of custody document This analytical report nest be produced entirety Page 1 of 5 'es ti Ken Morgan Consulting 509 S. Liberty Street Port Angeles, WA 98362 Sample ID SS -1 SS -2 SS -3 SS -4 SS -5 SS -6 TestAmerica Seattle, WA .P.AIvT CA( T' 111( CC'PPCPAT O' %(u t c Kate Haney, Project Manager Project Name: Project Number Project Manager. Stevens School 10106 Ken Morgan ANALYTICAL REPORT FOR SAMPLES Laboratory ID BPJ0172 -0 l BPJ0172 -02 BPJ0172 -03 BPJO 172-04 BPJ0I72 -05 BPJ0172 -06 Matrix Other dry Other dry Other dry Other dry Other dry Other dry www testamericainc com SEATTLE, WA 11720 NORTH CREEK PKWY N, SUITE 400 BOTHELL, WA 9E1011-8244 P14: (425) 420.9200 FAX. (425) 420.9210 Date Sampled 10/06/06 12:00 10/06/06 12 :00 10/06/06 12 :00 10/06/06 12:00 10/06/06 12:00 10/06/06 12:00 Report Created: 10/25/06 10:00 Date Received 10/09/06 11 40 10/09/06 11.40 10/09/06 11 40 10/09/06 11.40 10/09/06 11 40 10/09/06 11 40 The resuhs this report apply the samples analysed accordance wit the chain of docranat. This analytical report rant be reprodd ed itr ernnery. Page 2 or 5 TesU merica Ken Morgan Consulting 509 S. Liberty Street Port Angeles, WA 98362 Ar Ai''T.rAt TF SEATTLE, WA 11720 NORTH CREEK PKWY N, SUITE 400 BOTHELL. WA 98011 -8244 PH: (425) 420.9200 FAX: (425) 420.9210 Project Name: Stevens School Project Number 10106 Report Created. Project Manager Ken Morgan 10/25/06 10:00 Total Metals by EPA 6000/7000 Series Methods TestAmenca Seattle, WA 1 Analyte Method Rauh MDL MRL Units 1)0 Batch Prepared Analyzed Notes BPJ0172 -01 (SS-1) Other dry Sampled: 10/06/06 12:00 1111 Lead EPA 6010B 24160 1020 mg/kg wet lOx 6J12044 10/12/0614:33 10/18/0613:22 BPJ0172 (SS-2) Other dry Sampled: 10/06/06 12:00 Lead EPA 60108 1990 1020 mg/kg wet IOx 6712044 10/12/06 1433 10/18/06 13:28 BPJ0172 -03 (SS-3) Other dry Sampled: 10/06/06 12:00 Lead EPA 6010B 24100 1050 10 8 1 k8 wet 10x 6712044 10/12/0614:33 10/18/06 13:34 BPJO172 -04 (SS-4) Other dry Sampled: 10/06/06 12:00 Lead EPA 6010E 15800 1010 mg/kg wet 10x 6J12044 10/12/06 14:33 10/18/06 13:40 BPJ0172 -05 (SS-5) Other dry Sampled: 10/06416 12:00 Lead EPA6010B 2210 227 mg/kgwet Ix 6712044 10/12/0614:33 10/18/06 14:12 BPJ0172 -06 (SS-6) Other dry Sampled: 10/06/0612:00 Lead EPA 6010B ND 147 mg/kg wet Ix 6112044 10/12/06 14:33 10/18/06 14:17 TestAmenca Seattle WA 7 Kate Haney Project Manager www testamericainc com 71r reary tat report apply the aka analyzed accordance with the than of moody document T(ir analytical report mart be reproduced t entirety Page 3of5 r bs iI A merica. AC.AI'+T C.4( TF' 1 Jr cC`PPr.aAT'ON Lead Ken Morgan Consulting Project Name: Stevens Scholl 509 S. Liberty Street Project Number 10106 Port Angeles, WA 98362 Project Manager Ken Morgan QC Batch: 6J12044 Anatyte Blank (6J12044 -BLK1) LCS (6J12044 -BSI) Lead LCS Dup (6J12044 -BSD1) Lead TestAmerica Seattle, WA Cat-) (zety Kate Haney, Project Manager SEATTLE, WA 11720 NORTH CREEK PKWY N, SUITE 400 BOTHELL, WA 98011 -8244 PH: (425) 420.9200 FAX: (425) 420.9210 Total Metals by EPA 6000/7000 Series Methods Laboratory Quality Control Results TestAmerica Seattle, WA Paint Chip Preparation Method: EPA 30508 www testamericainc corn Report Created: 10/25/06 10:00 Method Result MDL MRL Units Di SOUTce Spike x x Result At REC (Limits) (Lions) Analyzed Notes E......, ..L 10(12/06 14:33 EPA 6010B ND 95.2 og/kg wet Ix 10/18/06 12:59 E. ........1 10112/0614:33 EPA 60100 281 98.0 mg/kg wet Ix 245 11501 (70 -130) 10/18/06 13:05 E 10/12/06 14:33 EPA 601013 278 100 mg/kg wet Ix 250 111% (70-130) 1.0705 (20) 10/18/06 13:11 The nradts is this report apply to the .sastudas analyzed ix accordance with the chain of custody document Thu amoytied report .tote be reprochmed t its entirety. Page 4 of 5 es J America A,,AI''T CAI TT 11 i! rnaPr)RAP.Ori SEATTLE. WA 11720 NORTH CREEK PKWY N. SUITE 400 BOTHELL WA 96011 -8244 PH: (425) 420.9200 FAX. (425) 420.9210 Ken Morgan Consulting Project Name: Stevens School 509 S. Liberty Street Project Number 10106 Report Created: Port Angeles, WA 98362 Project Manager. Ken Morgan 10/25/06 10:00 Notes and Definitions Report Specific Notes: None Laboratory Reporting Conventions: DET Analyte DETECTED at or above the Reporting Limit Qualitative Analyses only ND Analyte NOT DETECTED at or above the reporting limit (MDL or MRL, as appmpriate)- NR/NA Not Reported Not Available dry Sample results reported on a Dry Weight Basis. Resutts and Reporting Limits have been corrected for Percent Dry Weight wet Sample results and reporting limits reported on a Wet Weight Basis (as received). Results with neither 'wet' nor 'dry' are reported on a Wet Weight Basis. RPD RELATIVE PERCENT DIFFERENCE (RPDs calculated using Results, not Percent Recoveries). MRL METHOD REPORTING LIMIT Reporting Level at, or above, the lowest level standard of the Calibration Table. MDL* METHOD DETECTION LIMIT Reporting Level at, or above, the statistically derived limit based on 40CFR, Part 136, Appendix B. *MDLs are listed on the report only if the data has been evaluated below the MRL. Results between the MDL and MRL are reported as Estimated Results. Dil Dilutions are calculated based on deviations from the standard dilution performed for an analysts, and may not represent the dilution found on the analytical raw data. Reporting Reporting limits (MDLs and MRLs) are adjusted based on variations in sample preparation amounts, analytical dilutions and Limits percent solids, where applicable. Electronic Electronic Signature added in accordance with TestAmerica's Electronic Reporting and Electronic Signatures Policy Signature Application of electronic signature indicates that the report has been reviewed and approved for release by the laboratory Electronic signature is intended to be the legally binding equivalent of a traditionally handwritten signature. TestAmerica Seattle, WA a A) ci!_ Kate Haney Project Manager w w w t e s to m e r i c a i n c c o m lb tenths dui 177001 apply io the samples aealyced accordance with the chain of malady dacuwen Ties analytical report newt be reproduced entirety. Page 5 of 5 NCA CLIENT 1s& REPORT TO: ADDRESS, S-0 S PHONE: 4, 4 'I T r\- 1"1 PROJECT NAME. tt aa• 3 S o_1 t 1 PROJECT NUMBF,RQ 1 0 La SAMPLED BY CLIENT SAMPLE IDENTIFICATION 1 SS 2 SS Z 3 SS 3 4 SS 5 s,s -,r 6 S S •lo 7 8 9 10 RELEASED BY PRINT NAME: RELEASED BY. PRINT NAME: COC REV 09/04 CHAIN OF CUSTODY REPORT INVO1C TO: Inn o� r S 44-.1 4. (3. 8133(4 2 ADDITIONAL REMARKS: 1 ohs) aka r SAMPLING DATEITIME JO n� AA—cry M. O ezg0s. FIRM: P.O. NUMBER: PRESERV ATIYE 11720 North Creek Pkwy N Sabo 400, Botdtell, WA 900114244 11922 E let Ave, Spoke s, WA 99206.3302 9405 SW Nimbus Ave. Beevetwq OR 97001 -7143 20332 &opens An Ste F1, Bead, OR 91101.3712 2000 W Intanee{ooal Alcpott Rd Ste ALO, Mc6an/e, AK 995024119 1 1 1 1 I 1 1 1 1 DATE: REQUESTED ANALYSES RECEIVED BY. FIRM: TB4E, PRINT NAME: S DATE: I V I v RECEIVED BY (a* lava Wert Osier h at) Ye.1 n I OMB I pespo 1 r l r 1 TIME 1.4 p0 P 'IN-...PRINT NAME cvoete weaver Plithr MATRDC 9 OF LOCATION NCA (W S, 0) CONT COMMENTS WO ID FIRM: \3 425- 4239200 FAX 4304210 509- 9144)00 FAX 9144290 503 9064700 FAX 9064210 541 31343 10 FAX 3$2.158* 907 5434200 FAX 5634210 TURNAROUND REQUEST r Mims Dale 0 0 0 TIME: DATE: m DATE: t 0 0q 0 ll 46 TIME: Tom: o�ti•I PAGE OF estt meriea November 13 2006 Ken Morgan Ken Morgan Consulting 509 S Liberty Street Port Angeles, WA 98362 RE Stevens School Enclosed are the results of analyses for samples received by the laboratory on 11/03/06 09 :25 The followmg hst is a summary of the Work Orders contained m this report, generated on 11/13/06 16 47 If you have any questions concerning this report, please feel free to contact me. TcstAmenca Seattle, WA Kate Haney Project Manager A..A∎ (At F! tN C_ PP.)0ATION Work Order Protect ProiectNumber BPK0096 Stevens School 10106 www tastemericainc coin SEATTLE. WA 11720 NORTH CREEK PKWY N. SUITE 400 BOTHHl. WA 98011 -8244 PH: (425) 420.9200 FAX (425) 420.9210 rh ',mar tlaa repo, apply to the sampler analyzed accordance with the churn oft -moody document Ms analytical report new be reproduced its entirety. Page 1 of 5 Testi \.merica Ken Morgan Consulting 509 S. Liberty Street Port Angeles, WA 98362 Sample ED SS-IA SS -2A SS -3A SS -4A SS -5A SS -6A TestAmerica Seattle, WA AP.AI CAl TF.' CCPPQPATION CGL («t Kate Haney Project Manager Project Name: Project Number. Project Manager. Stevens Scholl 10106 Ken Morgan ANALYTICAL REPORT FOR SAMPLES Laboratory ID BPK0096-01 BPK0096 -02 BPK0096-03 BPK0096 -04 BPK0096 -05 BPK0096 -06 Matrix Other dry Other dry Other dry Other dry Other dry Other dry www testamericainc com SEATTLE. WA 11720 NORTH CREEK PKWY N, SUITE 400 BOTHELL, WA 98011 -8244 P11: (425) 420.9200 FAX: (425) 420.9210 Date Sampled 11/02/06 16.00 11/02/06 16:00 11/02/06 16:00 11/02/06 16 11/02/06 16:00 11/02/06 16:00 Report Created: 11/13/06 16 Date Received 11/03/06 09:25 11/03/06 09:25 11/03/06 09:25 11/03/06 09:25 11/03/06 09:25 11/03/06 09:25 The malts OM sport apply to the ramp/ .r analysed n accordance with the chain a/custody duunent This analytical report lout be produced emirety. Page 2 of 5 i estAmerica ANA,'Y AL TE`TIt'ZG CG`l PCRATION! Ken Morgan Consulting Project Name: Stevens Scholl 509 S. Liberty Street Project Number 10106 Report Created: Port Angeles, WA 98362 Project Manager Ken Morgan 11/13/06 16:47 TestAmerica Seattle, WA Cda S LILt Kate Haney, Project Manager TCLP Metals by EPA 1311 /6000 /7000 Series Methods TestAmenca Seattle, WA SEATTLE WA 11720 NORTH CREEK PKWY N, SUITE 400 BOTHE L WA 980 11 -8 244 MI: (425) 420.9200 FAX: (425) 420.9210 I Analyte Method Result MDL AML Units Da Batch Prepared Analyzed Notes JJJ 1 BPK0096 -01 (SS -1A) Other dry Sampled: 11/02/0616:00 Lead EPA 6010B 27.9 0.100 rag/1 lx 61(09051 11 15 11/10/06 16:59 BPK0096 -02 (SS -2A) Other dry Sampled: 11/02/0616:00 Lead EPA 601013 2.64 0.100 mg/1 Ix 6K09051 11/09/06 15:34 11/10/06 17:05 BPK0096-03 (SS -3A) Other dry Sampled: 11/02/06 16:00 Lead EPA 6010B 27.5 0.100 mg/1 lx 61(09051 11/09/0615.34 11 /10/0616.53 BPK0096 -04 (SS -4A) Other dry Sampled: 11/02/16 16:00 Lead EPA 6010B 35.0 0.100 mg/1 Ix 61(09051 11/09/0615:34 11/10/06 17:12 BPK0096 -05 (SS -5A) Other dry Sampled: 11/02/06 16:00 Lead EPA 60108 0,900 0.100 mgll Ix 61(09051 11/09/06 15:34 11/10/06 17:31 BPK0096 -06 (SS 6A) Other dry Sampled: 11/02/06 16:00 Lead EPA6010B 39.7 0.100 mg/1 Ix 61(09051 11 15 11/10/0617:37 www testamericainc corn TL mans r this report apply ro the mucks analyzed m accordance wnh the chain of cleanly doc.w.raL Thu analytical report went be reproduced to entirety. Page 3 of 5 r estii,merica At At +7 (Al TF ")Nf CCPPOPATION Lead Ken Morgan Consulting Project Name: Stevens School 509 S. Liberty Street Project Number 10106 Report Created: Port Angeles, WA 98362 Project Manager Ken Morgan 11/13/06 16.47 QC Batch: 6109051 Analyte Blank (61(09051 BLK1) Blank (6K09051 -BLK2) Lead LCS (6K09051 -BS1) Lead Du plicate (6K09051 -DUP1) Lead Matrix Spike (61(09051 -MS1) QC Sorrcr: BPKt076O3 Laract.d 11/09106 15:34 Lead EPA6010B 874 0.100 mg/1 Ix 27.5 50.0 120% (80 -120) 11/10/06 16:34 TcstAmerica Seattle, WA zLu Kate Haney. Project Manager SEATTLE, WA 1 1220 NORTH CREEK PKWY N, 51117E 400 BOFHEaL WA 90011 -8244 P11: (425) 420.9200 FAX: (425) 420.9210 TCLP Metals by EPA 1311 /6000/7000 Series Methods Laboratory Quality Control Results TestAmerica Seattle, WA TCLP Preparation Method: EPA 3010A TCLP Method Result MDL MRL Units Di Source Spike (Limits) 4 (posits) Analyzed Notes Result Ault REC RFD E.._ .....k 1110911615:34 EPA60108 ND 0.100 mg/1 Ix 11/10/0616:15 Extractet 11/0910615:34 EPA 60106 ND 0.100 mg/1 Ix 11/10/06 16:21 Eaoracteat 11/0910615:34 EPA6010B 58.4 0.100 mg/1. Ix 50.0 1175'. (80 -120) 11/10/06 16:27 QC Source: BPK0096 -4(1 L.._ t /1/07106 15c34 EPA 6010B 26.4 0.100 mg/1 lx 275 4.0895 (20) 11/10/06 16:46 W W W to s to m e r iC a i rt C C o m 174...ndtr in liar rayon onto thr samples analyzed in orcordaner with the chain afnntody =own= 7 artaytrd. port sow e.. .l:. 1tnu. rtsarty. Page 4 of 5 r estti merica A., AI ri rAl TF "IrZG C ^rPORAT:OPi Ken Morgan Consulting P Name: Stevens School 509 S. Liberty Street Project Number 10106 Report Created: Port Angeles, WA 98362 Project M ---s- Ken Morgan 11/13/0616.47 Notes and Definitions Report Specific Notes: None Laboratory Reporting Conventions: DET Analyte DETECTED at or above the Reporting Limit Qualitative Analyses only ND Analyte NOT DETECTED at or above the reporting limit (MDL or MRL, as appropriate). SEATTLE, WA 11720 NORTH CREEK PKWY N, SUITE 400 BOTHELL,. WA 98011 -8244 PH: (425) 420.9200 FAX. (425) 420.9210 NR/NA Not Reported Not Available dry Sample results reported on a Dry Weight Basis. Results and Reportmg Limits have been corrected for Percent Dry Weight. wet Sample results and reporting limits reported on a Wet Weight Basis (as received). Results with neither 'wet' nor dry' are reported on a Wet Weight Basis. RPD RELATIVE PERCENT DIFFERENCE (RPDs calculated using Results, not Percent Recoveries). MRL METHOD REPORTING LIMIT Reporting Level at, or above, the lowest level standard of the Calibration Table. MDL* METHOD Dh1hCTION LIMIT Reporting Level at, or above, the statistically derived limit based on 40CFR, Part 136, Appendix B. 'MDLs are listed on the report only if the data has been evaluated below the MRL Results between the MDL and MRL are reported as Estimated Results. Dil Dilutions are calculated based on deviations from the standard dilution performed for an analysis, and may not represent the dilution found on the analytical raw data. Reporting Reporting limits (MDLs and MRLs) are adjusted based on variations in sample preparation amounts, analytical dilutions and Limits percent solids, where applicable. Electronic Electronic Signature added in accordance with TestAmerica's Electronic Reporting and Electronic Signatures Policy. Signature Application of electronic signature indicates that the report has been reviewed and approved for release by the laboratory Electronic signature is intended to be the legally binding equivalent of a traditionally handwritten signature. TestAmerica Seattle, WA 1 L t Z L '4 Kate Haney, Project Manager w w w t e s t a m e r i c a i n c c o m The rendtr t Nil report apply the samples analyzed in accordance with the chain of woody document. This analytical report twit be reproduced entirety. Page 5of5 CHAIN OF CUSTODY REPORT NCA CLIENT Y1(\ G Y REPORT TO: k ADDRESS. c`L PHONE: 3 L Ci `-1S' 9 PROJECT NAME. S� PROJECT NUMBER. 1C �C•�r. SAMPLED BY 10 CLIENT SAMPLE IDENTIFICATION PRINT NAME: J RELEASED BY PRINT NAME: RELEASED BY ADDITIONAL REMARKS. 1 2 kAX. SAMPLING DATE/TIME SS 1 1a 1 2 1 2 S 5 z J: 3 S' S 3 4 S 5 SS- c 6 8 7 8 9 x v X FIRM. FIRM. eve INVOICE TO: IP O. NUMBER. PRESERVATIVE 11111 REQUESTED ANALYSES DATE: 047, 1 4 TIME. 5-i t DATE: TIME. 11720 North Creek Pkwy N Suite 400, Bothell, WA 98011 -8244 11922 E 1st Ave, Spokane, WA 99206 -5302 9405 SW Nimbus Ave, Beaverton, OR 97008-7145 20332 Empire Ave, Ste Fl Bend, OR 97701 5712 2000 W International Airport Rd Ste AI0, Anchorage, AK 99502 1119 RECEIVED BY /cam. f3/c: n kin.540 PRINT NAME: RECEIVED BY PRINT NAME: work order$( -P2 o6/ TURNAROUND REQUEST In Business Days Organic Inorganic Analyses U ©o ©u Petroleum Hydrocarbon Analyses sm. 425 -420 -9200 509- 924 -9200 503- 906 -9200 541 383 -9310 907 563 -9200 OTHER I gay TA FAX 420 -9210 FAX 924 -9290 FAX 906 -9210 FAX 382 -7588 FAX 563 -9210 MATRIX OF LOCATION (W S, 0) CONT COMMENTS FIRM. FIRM. TIME: TEMP. (7 0 u NCA WO ED D3 DATE: 7 /7-3/06 TIME. l• /�y,) DATE: . CITY OF PORT ANGELES LIGHT DEPARTMENT 321 E. Fifth Street Port Angeles, WA 98362 (206) 457-0411 PERMIT NO. )/t z c: s;~~y DATE ELECTRICAL PERMIT Installed By: /l1~ o READY FOR INSPECTION License Number: o WILL CALL FOR INSPECTION Phone: Site Address: Owner/Business: Phone: Owner/Business Address: Sq. Ft. ELECTRIC HEAT o BASEBOARD KW _ o FURNACE KW _ o HEAT PUMP KW_ ~ FAN/WALL KW ~ o RESIDENTIAL o COMMERCIAL o NEW CONSTRUCTION ~ REMODEL o ADD/ALTER CIRCUITS ~ SERVICE UPGRADE/REPAIR o TEMPORARY SERVICE o RISER ~ OVERHEAD SERVICE o UNDERGROUND)3,~VICE VOLTAGE: /.2iJ~p ~1 r/J 03 r/J' SERVICE SIZE ~ AMPS FEEDER SIZE AMPS Details/Description: I;vs.4// c;2I)O ~ s:o~ f--- W~e ~ . W.S. No. SERVICE SIZE CAPACITY: o O.K. 0 NOT O.K. ACTION REQUIRED: 0 CHANGE TRANSFORMER o INSTALL SERVICE POLE DATE ENGR. o OVERHEAD SERVICE APPROVED o CHANGE SERVICE WIRE o OTHER o Ditch Inspection O.K. )RRough-in/cover O.K. '\Zt O.K. to connect service ~~Final O.K. Installer: G ~ New Meters - Site Address: ., III! . Notify Port Angeles City Light by Street Address and Permit Number when ready for inspection. Work must not be covered before inspection and O.K. for covering has been given by the electrical inspector in writing on either the Wiring Report or on the Building_Permit. PHONE 457-0411, EXT. 224. ./:1., NO OCCUPANCY OR USE ESTABLISHED UNDER THIS PERMIT If' '-~ ~~~ $ ~~V Electfical Il1spect~r Permit Fee WHITE - File by address PINK - Top: Eng, Bottom, Customer GREEN - Top: Meter Dept., Bottom: City Hall OLYMPICPRINTEASINC "