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HomeMy WebLinkAbout125 E 3rd St - BuildingPREPARED 5/28/10 8 41 19 INSPECTION TICKET PAGE 3 CITY OF PORT ANGELES INSPECTOR JAMES LIERLY DATE 5/28/10 ADDRESS 125 E 3RD ST SUBDIV TENANT NBR STRAIT VIEW CREDIT UNION CONTRACTOR MORRISON EXCAVATING INC PHONE (360) 452 7179 OWNER STRAIT VIEW CREDIT UNION PHONE PARCEL 06 30 00 0 0 5465 0000 APPL NUMBER 10 00000461 DEMOLITION PERMIT DEMO 00 DEMOLITION REQUESTED INSP DESCRIPTION TYP /SQ COMPLETED RESULT RESULTS /COMMENTS BL99 01 5/28/10 BLDG FINAL May 27 2010 2 53 39 PM 1pangrle DAN 460 0776 BUILDING FINAL DEMOLISHED THE HOUSE COMMENTS AND NOTES r Application Number 10 00000461 Date 5/27/10 Application pin number 631527 Property Address 125 E 3RD ST ASSESSOR PARCEL NUMBER 06 30 00 0 0 5465 0000 Tenant nbr name STRAIT VIEW CREDIT UNION Application type description DEMOLITION Subdivision Name Property Use Property Zoning COMMUNITY SHOPPING DISTR Application valuation 0 Application desc DEMOLISH THE HOME Owner Contractor STRAIT VIEW CREDIT UNION MORRISON EXCAVATING INC PO BOX 339 P 0 BOX 3051 PORT ANGELES WA 983620054 PORT ANGELES WA 98362 (360) 452 7179 Structure Information 000 000 DEMO THE HOUSE Permit DEMOLITION Additional desc DEMOLISH THE HOUSE Permit pin number 165068 Permit Fee 50 00 Plan Check Fee 00 Issue Date 5/27/10 Valuation 0 Expiration Date 11/23/10 Qty Unit Charge Per Extension BASE FEE 50 00 Special Notes and Comments The Fire Department has reviewed the project application and has no comments May 25 2010 10 36 26 AM sroberds May 26 2010 10 47 25 AM rlarson Permit application received in planning on 5 10 10 received in electrical engineering on 5 11 10 field review on 5 12 10 reveled house had already been demolished Applicant should be advised that primary power lines have been installed under buildings in Port Angeles in the past and some are still in use and energized today Demoing buildings without proper review can be dangerous and potentially life threatening May 27 2010 2 15 27 PM 1pangrle PER ROGER VESS CAP THE SEWER AT THE PROPERTY LINE Other Fees Fee summary Permit Fee Total Plan Check Total T:FormsBuilding DivisionBuilding Permit CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES WA 98362 Charged 50 00 STATE SURCHARGE 4 50 Paid Credited Due 50 00 00 00 00 00 00 00 Fk 5 Z lo 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 has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I 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 0 c�c istruction. 5- 044) v� -M Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION. Slab Wall Floor Ceiling MECHANICAL. Heat Pump Fumace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES. Footing Slab Blocking Hold Downs Skirting T:Forms /Building Division /Building Permit PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 4815 Electrical Inspections 417 4735 Public Works Utilities 417 4831 Backflow Prevention Inspections 417 4886 Inspection Type Date Accepted By PLANNING DEPT Separate Permit #s SEPA. Parking Lighting ESA. Landscaping 1 SHORELINE. Comments FINAL Date Accepted by FINAL Date Accepted by FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Electrical 417 -4735 Construction R W PW Engineering 417 -4831 Fire 417 -4653 Planning 417 -4750 Building 417 -4815 Date Accepted By CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY ECONOMIC DEVELOPMENT BUILDING DIVISION 321 EAST 5TH STREET PORT ANGELES, WA 98362 Application Number Application pin number Other Fee Total Grand Total T:Forms/Building Division/Building Permit 4 50 54 50 10 00000461 631527 4 50 54 50 00 00 Page 2 Date 5/27/10 0 0 00 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 for a period of 180 days after the work has commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I 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. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) BUILDING PERMIT INSPECTION RECORD PLEASE PROVIDE A MINIMUM 24 -HOUR NOTICE FOR INSPECTIONS Building Inspections 417 -4815 Electrical Inspections 417 -4735 Public Works Utilities 417 -4831 Backflow Prevention Inspections 417 -4886 IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED POST PERMIT IN CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. Inspection Type Date Accepted By Comments FOUNDATION Footings Stemwall Foundation Drainage Downspouts Piers Post Holes (Pole Bldgs.) PLUMBING Under Floor Slab Rough -In Water Line (Meter to Bldg) Gas Line Back Flow Water AIR SEAL. Walls Ceiling FRAMING Joists Girders Under Floor Shear Wall Hold Downs Walls Roof Ceiling Drywall (Interior Braced Panel Only) T -Bar INSULATION Slab Wall Floor Ceiling MECHANICAL. Heat Pump Fumace FAU Ducts Rough -In Gas Line Wood Stove Pellet Chimney Commercial Hood Ducts MANUFACTURED HOMES Footing Slab Blocking Hold Downs Skirting FINAL Date Accepted by FINAL Date Accepted by N 4- PLANNING DEPT Separate Permit #s SEPA. Parking Lighting 1 ESA. Landscaping I SHORELINE. FINAL INSPECTIONS REQUIRED PRIOR TO OCCUPANCY/ USE Inspection Type Date Accepted By d Electrical 417 -4735 Construction R.W PW Engineering 417 -4831 Fire 417 -4653 C Planning 417 -4750 il3 Building 417 -4815 j j Lb 31-- -1 0 T /Building Division /Building Permit 4 Floor Areas Project Type Brief Des Check all that apply New Construction Addition Remodel Repair Demolition Re -roof Heat System Other Basement 1 Floor 2 Floor 3rd Floor Garage Carport Covered Porch Deck Shed Other l Total footprint of structures s Site Coverage the amount of impervious surfac and other impervious surfaces (see PAMC 17 9 Max. height of proposed structures Will a lawn sprinkler system be installed Will a fire sprinkler system be installed. Date 5 10^10 Print Name T Forms /Building Division /Building permit application BUILDING PERMIT APPLICATION Print in ink CITY OF PORT ANGELES Attn Building Permit Technician 321 E Fifth St. Port Angeles WA 98362 (360) 417 -4815 fax (360) 417 -4711 Applicant t PP DA-A., Owner St a, Dui 82,4 1 "N Property Owner's Address ,Q o k) 5;, /NCOf v S? Contractor PO22fso/ -I Contractor's Address pv 13, 3©5 License fllo/212 e To 7( PROJECT ADDRESS �RD Parcel Number cription. Residential Multi- family Commercial Industrial xY►o ��`s l', 4 h o us-e L ►2-1 Id 1 4 a kh l5 P-kl r ____A► s p a ced. ®fi wee- 1ira.h er Sd c1 House gge other tear off re -roof lay over one layer Heat pump wood burning stove gas fireplace pellet stove other Existing (sq. ft.) Proposed (sa. ft.) A 413 6 ,A. Expires 35 for exemptions) PA ccupancy group O upant load Cons uction typ Signature 7' For City Use Only Date Received 5— I o— ID_ Permit 10 y ate Approved Pho e �6� V6.0 Phone P,4. Phone 9/q /9c)k) E -mail floRai.$o,c ex&P,474 28.714 Lot Zoning TOTAL VALUATION of size sq ft. Lot cove age parcel including structures paved drivewa sidewalks patios e coverage I have read and completed 'this application and know it 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, and to obtain permits prior t working on projects 36 0 C /5) 7/7 per sq ft. •edrooms of fu •aths of half ba k 'r tir ct +on Mans ire plans, saecifi building officat n of .exnxs fn said or from preventing reuridvffeh..in Clallam County Assessor Treasurer Property Details 56113 STRAIT -VIEW CREDI Page 1 of 8 Clallam County Assessor Treasurer Property Search Results 56113 STRAIT VIEW CREDIT UNION for Year 2010 2011 Property Account Property ID 56113 Legal Description. LOT 16 BL 54 Geographic ID 0630000054650000 Agent Code. Type. Real Tax Area. 0010 PA 121 PORT ST CNTY H2 L Land Use Code 11 Open Space: N DFL N Historic Property* N Remodel Property' N Multi Family Redevelopment: N Location Address. 125 E THIRD ST Mapsco PORT ANGELES Neighborhood: Cycle 5 Comm Map ID' Neighborhood CD• 20953140 Owner Name. STRAIT VIEW CREDIT UNION Owner ID 54662 Mailing Address: PO BOX 339 Ownership* 100 0000000000% PORT ANGELES WA 98362 -0054 Taxes and Assessments Due Property Tax Information as of 05/10/2010 Amount Due if Paid on. M. Exemptions: First Second Half Half Statement Base Base Base Arr Year ID Taxing Jurisdiction Due Due Penalty Interest Paid Du 2010 39170 ST SCH STATE SCHOOL $196 37 $196 37 $0 00 $0 00 $196 37 $1 2010 39170 CC -GEN COUNTY $104 51 $104 49 $0 00 $0 00 $104 51 $1 2010 39170 PORT PORT $14 69 $14 69 $0 00 $0 00 $14 69 2010 39170 PORT ANG PORT ANGELES $241 95 $241 95 $0 00 $0 00 $241 95 $2 2010 39170 SD #121 SCHOOL DISTRICT #121 $254 36 $254 34 $0 00 $0 00 $254 36 $2 2010 39170 NTH OLY LIB NORTH OLYMPIC LIBRARY $30 36 $30 37 $0 00 $0 00 $30 36 2010 39170 HOSP #2 HOSPITAL #2 $42.87 $42.87 $0 00 $0 00 $42.87 2010 39170 WSMET PK DIST WILLIAM SHORE MET PARK DIST $13 64 $13 64 $0 00 $0 00 $13 64 2010 39170 CITY STORMWATER CITY STORMWATER $36 40 $36 41 $0 00 $0 00 $36 40 2010 39170 WEED_CONTROL WEED CONTROL $0 82 $0 81 $0 00 $0 00 $0 82 2010 39170 TOTAL. $935.97 $935.94 $0.00 $0.00 $935.97 $9 2009 561132008 ST SCH STATE SCHOOL $229 17 $229 17 $0 00 $000 $458 34 2009 561132008 CC -GEN COUNTY $115 98 $115 98 $0 00 $0 00 $231 96 2009 561132008 PORT PORT $16 43 $16 43 $0 00 $0 00 $32 86 2009 561132008 PORT ANG PORT ANGELES $254 39 $254 40 $0 00 $0 00 $508 79 2009 561132008 SD #121 SCHOOL DISTRICT #121 $283 40 $283 39 $0 00 $0 00 $566 79 2009 561132008 NTH OLY LIB NORTH OLYMPIC LIBRARY $33 70 $33 70 $0 00 $0 00 $67 40 2009 561132008 HOSP #2 HOSPITAL #2 $47 56 $47 57 $0 00 $0 00 $95 13 2009 561132008 CITY STORMWATER CITY STORMWATER $36 41 $36 40 $0 00 $0 00 $72.81 http. /vpn.clallam.net.8084 /propertyaccess /Property aspx ?cid =0 &year= 2010 &prop_id =56 5/10/2010 l93 April 12 2010 Morrison Excavation 408 Scnbner Road Port Angeles WA 98362 ORT,,;N W A S H I N G T O N U S A Public Works Utilities Department COPY RE. Port Angeles Landfill Transfer Waste Disposal Application WDA 10 -10• for 125 E Third Street, Port Angeles WA 98362 We have received your application for disposal of building demolition debris from the referenced site and reviewed the testing results. Based on the testing results the debris 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 transfer station scale attendant at the time of disposal Please be advised that this disposal application is only for the matenals and quantities listed in the application. Materials not listed or in excess of the quantities noted may require separate applications and approval. Please call 417 -4812 if you have questions Sincerely Stephen Sperr P.E. City Engineer Encl. WDA 10-10 Cop T ansfer Station Waste Connections \,tPWKS\E \GINEER\Wask Disposal \pplications\2010 Applications \10 -10 1'5 E 'rd St \WDA 10 -10 1 F. ,rd Street. 'pd Phone 360 -417 -4800 Fax 360 -417 -4542 Website wwi cityofpa.us Email pubiicworks @crtyofpa us 321 East Ffth Street P 0 Box 1 150 Port Angeles WA 98362 -0217 Gv`A •cGG1/ Y ,L, •1�. April 12, 2010 Roger Vess City of Port Angeles 321 E. 5 St PO Box 1150 Port Angeles, WA 98362 Dear Mr Vess. C Andy Brastad, Director of Environmental Hcatth P -S.LF File. Corr. ponden. File Clailam County Department of Health and Human Services 0 Z Environmental Health Services .223 East 4 Street, Suite #14 Port Angeles. WA 98362 3015 "9 .S. Telephone 360- 417 2258. FAX 360 -417 2313 HtimA 4 RE. PALF Waste Disposal Application WDA 10 -10 Based on the chemical test results submitted by Zenovic and Associates, Clallam County Environmental Health Services (CCEHS) concurs with the disposal of 25 yd'! 30 tons of home demolition debris from 125 East 3 Street in Port Angeles to the Port Angeles Transfer Station If you have any questions, please contact me at 360 -417- 2347 orJgarcelon @co clallam.wa.us Sincerely Jennifer Garcelon, MPH, RS Environmental Health Specialist III To: City of Port Angeles, City Engineer 321 E. Fifth Street P Q Box 1150 Port Angeles, Washington 98362 NOTE. 1 Generator Information. Mailing Address: t" Contact: Phone. Project Name: Project Location: 2. Other Contacts (if applicable) Consulting Firm: Contact Phone Contractor Name: Contact: Phone. Laboratory Contact: Phone. PORT ANGELES LANDFILL WASTE DISPOSAL APPLICATION Lay tit i'G t Atigete. r' any ,lama and Utilities Dept. All questions must be answered for wasteitekbeeajiproved. Company Name: S T A t t.J CA tm Gc s LAD 0/2fl tScrr -49776 l 1-/ t n..DD /9,5 7 r2.iw f-. A.Sg6 T o c 7/7. 72, ,A.rt.)c 494 it t 6/24 T7`AtJV/ U., i. 2" j (WC) Pliione: (00)4f 'sFAX. 060Y417 709 J kf 36Z �tl A,A,K S City of Port Angeles Landfill Waste Disposal Application Page 1 of 5 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 Agency Contact: Independent Remedial Action UST Removal Unused Chemical Product Spill 7 Other Source. l 5 h /5 17�/Ula I s T icy c t 2 S tJ l CAS rr s L./ lc r 4 Waste Material Composition. (check ail that apply and include percent of total) NOTE. Total must equal 104% 5. Waste Material Contaminants. (check all that apply) NOTE. Soil Concrete/Asphalt Preserved Wood Coal Ash Wood Ash Gasoline Solvents Unused Motor Oil Other T. ST.T) Unknown lo Supply any MSDS information with application, if available. City of Port Angeles Landfill Waste Disposal Application Foundry Slag Dredge Sediments Debris Other (list) Metals Heating Oil Used Motor OiUWaste Oil Other Petroleum Product Ok Diesel PCBs Page 2 of 5 6. iEstimated Quantity of Waste for Disposal: (1. 5 Cubic yards Tons (estimate both) Drums Tons (estimate both) Other NOTE: Estimated quantity for disposal must be within 20% of the quantity actually disposed. (10% for projects over 7,500 tons or 5,040 cubic yards.) 7 Frequency of Disposal: 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 1 2) ki tr�� 5f3Et2155 3 6nu'-) g YZ Aw. A L 1 e(4) /\J[ NOTE 1 NOTE 2. One time Monthly 0 -25 25 100 101 500 501 -1000 1001- 2000 >2000 cubic yards cubic yards cubic yards cubic yards cubic yards cubic yards City of Port Angeles Landfill Waste Disposal Application �t_f/ 5 f IjL G.G Annual Other Unless prior approval has been granted by Port Angeles, the following sampling frequency will be used. 1 composite sample 3 composite samples 5 composite samples 7 composite samples 10 composite samples 10 plus one sample for each additional 500 cubic yards One composite sample shall contain a minimum of three /maximum of five discrete samples. Page 3 of 5 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 Soils" 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 b) Provide a narrative as to why the above analytical methods were selected: Tc.-) i u se A Tai S �c c_TO Td.5/2 L.IA S r /s i A14 J i v �iQ22 /Ys .o C NOTE. Additional sheets attached 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 Class 3 Class 4 Calculated Hazard Index 11 Dangerous Waste Affidavit: Based on a review of the analytical test results, site history and the applicable regulations, this waste is classed as: (check one) Neither Dangerous Waste (DW) nor Extremely Hazardous Waste (EHW) Dangerous Waste (DW) and Waste Code. Extremely Hazardous Waste (EHW) and Waste Code. City of Port Angeles Landfill Waste Disposal Application Page 4 of 5 12. Special Notes for Asbestos Disposal 1 Certification All asbestos containing materials (with the exception of roofing material in good condition that is not peeling, cracking, or crumbling with petroleum based binder that still exhibits plasticity to prevent the release of asbestos fibers) must: be tightly wrapped or bagged in 6 mil plastic with no excess air in the packaging not exceed 50 pounds per bundle be labeled as asbestos with required information regarding its origin be transported with a manifest in the vehicle arrive at the transfer station only by appointment with Brian Tate of Waste Connections so that the material can be deposited in a lock box (his cell number is 360 912 7080). 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 was material to the best of our abilities. Vyaafe"Generator Sign attire DLO OAAC, �C Printed Name Company Date City of Port Angeles itOr City Engineer 4A3 Date (/O rya z S /U L- Approval Expiration Date N:IPWKS\ENGtNEER \Waste Disposal Appticafknslwaste disposal application- 2008 version.wpd City of Port Angeles Landfill Waste Disposal Application Page 5 of 5 NVL Laboratories. Inc. 4708 Aurora Ave N, Seattle, WA 98103 Tel: 206.547.0100 Emerg- Pager 206.344 1878 1.888.NVL.LABS (685.5227) Client Zenovic Associates, Inc. Street U 1 G Port Angeles Project Manager 4 _jga. Project Location L•S ;1,•, r_ kt j. s Phone: (360) 417 -0501 Fax: (360) 417 -0514 10 Asbestos Air 1 PCM (NIOSH 7400) TEM (NIOSH 7402) CJ TEM (AHERA) 0 TEM (EPA Level 11) 0 Other 10 Asbestos Bulk I PLM (EPA1800IR- 931116) 0 PLM (EPA Point Count) 0 PLM (EPA Gravimetry) 0 TEM Bulk METALS 0 Total Metals TCLP Other Types 0 Fiberglass of Analysis 0 Silica Condition of Package: Good 1 Seq. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Lab ID Print Below Sampled by I e Relinquished by l Received by I Analyzed by I Results Called by f Results Faxed by Dot. Limit Matrix O• ppm (AAS) Air Filter 0 p (GFAA) Drinking water U Dust/wipe Soil Nuisance Dust Rotometer Calibration 0 Other (Specify) 0 Respirable Dust Mold/Fungus 0 Damaged (no spillage) Severe damage (spillage) Client Sample Number Comments 'F. Pt Sion Below CHAIN of CUSTODY SAMPLE LOG o Paint Chips Paint Chips (Area) Waste Water NVL Batch Number Client Job Number Total Samples Turn Around Time Email address RCRA Metals Arsenic (As) O Barium (Ba) o Cadmium (Cd) Chromium (Cr) L A t 6 5 1 Hr 0 24 -Hrs 4 Days C1 2 -Hrs 0 2 Days 0 5 Days O 4 Hrs R-3 Days 6 to 10 Days Please=call for TAT less than 24 Hrs 2 r. All 8 0 Lead (Pb) Mercury (Hg) Selenium (Se) Silver (A9) Company Date 4 r 't. c- 7,4 c I c''; cj 7 )C1 t( ;,t s1 Y I Special Instructions Unless requested in writing. alt samples will be disposed of two (2) weeks after analysis. Other Metals U Ali 3 Copper (Cu) Nickel (Ni) Zinc (Zn) AIR Time 1 ?c 1 r c{%ll NVL Laboratories, Inc 4708 Aurora Ave. N Seattle, WA 98103 Tel: 206.547 0100 Fax: 206.634 1936 www nvllabs.com Attention. Mr Scott Headrick Project Location. 125 East 3rd St. Port Angeles Lab ID Client: Zenovic Associates Inc. Address 301 E. 6th St. Suite 1 Port Angeles, WA 98362 30021583 10078 -A Client Sample Analysis Report Sampled by Client Analyzed by Brittany Vogel Date Analyzed 04/02/2010 mg/ L Milligrams per liter ppm parts per million Note Method QC results are acceptable unless stated otherwise Unless otherwise indicated, the condition of all samples was Bench Run No 30- 0401 -09 RL mg/ L 0 5 AIHA IH 101861 WA DOE C1765 Toxicity Characteristic Leaching Procedure Lead (Pb) Results in mg /L 08 acceptable at time of receipt. DRAFT AIHA en ACCREDITED LABORATORY Batch 3003853 00 Matrix: Bulk Method EPA 1311/70006 Client Project* 10078 Date Received: 04/01/2010 Samples Received 1 Samples Analyzed: 1 Results in ppm 08 RL Reporting Limit Below the reporting Limit Page 1 of 1