HomeMy WebLinkAboutApplication.pdfDemolition Notice Application Form Information and Instructions: 1. To determine the proper amount for the application fee, multiply the length of the building (lineal feet) by the width
of the building (lineal feet). Divide the total by 1000, round the result !!Q to the next whole number and multiply this number by 5$. This is the square footage fee. Add the square
footage fee to the base fee of $50 and submit the total amount to the Division along with the demolition notice application form. Ex: 40ft. x 52ft. = 2080 square feet; 2080/1000 = 2.08
(round up to 3); 3 x $5 = $15 (square footage fee) $15 + $50 (base fee) = $65 total application fee. 2. In the event that only a load-bearing member is demolished, the square footage
fee is calculated the same way as in "number 1". However, you only need to calculate the actual footprint of the load-bearing member. 3. All spaces must be filled in on the application.
If the information is not applicable, please write N/A. Incomplete information may result in a delay in processing the application, which may delay your project. 4. We must have proposed
start and end dates for the demolition. 5. There is a 10 working-day advance notification requirement for permit applications. Day 1 is the 1st business day following the postmark or
hand-delivery date. (Working Day means Monday through Friday and including holidays that falls on any of the days Monday through Friday.) If a demolition follows a permitted or noticed
asbestos abatement project within 10 business days of the completion of the abatement project, the 10 working-day advance notification requirement will be waived. 6. The Colorado-certified
asbestos inspector must sign the form in blue ink. (Original signature must be submitted.) The building owner or the contractor must also sign the application certifying that all refrigerants
and luminous signs have been properly removed from the site. 7. If the notice must be modified after the application has been submitted, notify the Asbestos Unit by fax at 303-782-0278
or e-mail at asbestos@state.co.us by the end of the next regular State business day following the modification. Project modifications include discovery of unidentified asbestos-containing
materials, changes in scope of work or the scheduled work dates. Please use the PermiUNotice Modification Form. 8. Recycling of materials, such as concrete or wood, that are bonded or
contaminated with asbestos-containing material (ACM), such as floor tile or mastic, is NOT permitted. 9. Demolition of a building that has non-friable asbestos-containing materials remaining
must be completed without causing the asbestos-containing materials to become friable. Burning a building with any asbestos-containing materials is PROHIBITED. Concrete floors covered
with floor tile shall be removed in as large sections as possible. Operations such as crushing, pneumatic jacking, etc. of materials containing asbestos are not permitted. 10. All provisions
of laws and ordinances governing this type of work shall be complied with whether specified herein or not. Demolition permits or approval notices appearing to give authority to violate
or override the provisions of any other laws or ordinances shall be invalid. Furthermore, demolition permits or approval notices issued in error or based upon incorrect information supplied
to the Division shall also be invalid.
.. I 8 c .S! ." "0 E 2l '. .. .. sl~ .. 0 e 4IE_ .r::Ia;c ~O::8 Submil fOOD !OJ Permit COordinator DEMOLITION NOTIFICATION APPLICATION FORM c~~::hQa~~P~n~i.~~~nt APPLICATION FEE MUST
ACCOMPANY THIS FORM APCD-IE·Sl INCOMPLETE APPLICATIONS WILL BE RETURNED 4300 c .. rry Creek Olive SoUlll (Notice will bemailedtothedemOlitiOncontra.ctoru.nless~peci~o.tL.ep)oenv ...
co 80246·1530 '-'t...' Phone: 303-6e2"~100 -Fee: $50 + $S per 1000 ft' of area to be demolished $ . Fax: ••• ·782·.27" (S. . InstrucUDn #1 on reverse side) L _A_sb_es_to_s@_j_st_ate_,o_o_.\I$_
___. ...l Project Ma~iI sr. I I r Cell pnone #. n.._ .. 10M \ n nrh','\J\ p (<::\10) 31q -'IDl..'f ~ c ,g 'g E Building Name: 1-IcxAse. 57tl"'< d~ r-e I cenify thatthe Certified Asbestos
Building Inspector nas infonned me Method/Means of Demolition; aMut any remainIng asbestos-<lOntainil'lg materials In trut facility to be demolished, ~ . V ~ WIBCki 0 Burning t D Implosion
0 MoVing 0 Othet, s~eeify: '\ I £nnt Name; l ~ ~ 1(;.. • K.\"\CLU<: ~ Bumlng reqYiles additional il.lthor1~iltiOIl-Plea,e call {303} 692 .. 3100 and ask 1 ~L""dj{fill~1 17";0'",'n]·O
BdU, .lrd,ng,f/l D).,,~""m "t.4 U -' t to speak to "Ills open BUMlng Permit Coordinator With my signature below, I certify that I posses!:'turre~t AHlORA accreditation and state of Colorado
certification as I' an Asbestos Building Inspector. I also certify that I have thoroughly Inspected the facility to be demOlished, as listed in the Demolition Site block above, sampled
all suspect materials, had all samples analyzed for the presence· of asbestos by a NVLAP-accredited laboratory, and have· determined that no Regulated ACM exists anywhere in the facility.·
J also certify that I have Informed the owner/operator of the facility or the demolition contractor that any asbestos-containing material allowed to stay in the facility must remain
non-friable during demolition. Specify type(s) of ACM remaining, below: (check appropriate box(es»): o Vinyl asbestos floor tile (VAT) 0 VAT mastic 0 Tar/asphalt impregnated roofing
0 Asphaltic pipe coatings o Spray-applied tar coatings 0 Caulking 0 Glazin 0 Other, specify: Signatl,lre; On Blue rnkJ.t\'( -~ f'rinted ~",me: 7l... A /' j , \J~ --"4Jias r;. L-.f()Se
.......... I V8rif>:~~~all refrigerants...t~m air conditioning/refrigeration appliances have been properly recovered in accordance With AQCC Regulation No. 15 (for information on CFC
requirements call 692·31 00), I further verifY ~a.t all luminous exit signs (containing radioactive material) haVe been .. ~ disposed 01 in accordance with 6 CCR 1007·1 subpaI13.6.4.3
(lor inlormalion on luminous eXit sign requirements call 303-692-3320). i ~ IU CHECK THE APPROPRIATE; BOX; J ~~~ ~~~.~B=u~_'n~g~ __ e_r _ ~~I~~~rtc~on_~_ad_or ____ ~I~D~r.rnh~.~ru.=~
________ ~~I~_ ,, :-~/r~lt}l~d~'fL/l~~~------~' S~turs: .\ 1n/I fill -PJtn~........ \/ondM ' THIS BOX IS FOR CDPHE USE ONLY: Po.!maIl< or Hand Oelivory Oate: "I I I '" Approved By: 'OW
I COdO: (0"lnltlol-310 0 Iransfer-380 FnIrnoIPayment&#: 3R1D/Jjrno Permit II: I Record II .1 Date I.sued: < Regulated asbestos-contalning ,:,"aterials means (a) f~jable asbesto~-conl~ini~g
mate.rial. (b) Category! oor'lfrlable ACM that .has become friabler(c) Category I nonfriabie ACM Ihal woll b. or has been ,ub)octod 10 sanding, gnndIng, cultlng, or abradIng or (d) Category
II nDnlnable ACM that h~a.llig" probability of becoming or has beCOMe crumbled, pulverized, or reduced to poWder by 1t'l8 forces expectecl to act on the material in the courserof >.
~ • demolilion or renovation operations regulated by this regulation. Note; ASbestos-containA~~~i~M'ust be properly,l l\\\\~ '\ abated/removed prior to dem.lttion. .. ! "V V I::LJ {<
~ Il ~,.\ .. "._.""". DATE 1I/1~~/3.CDPHE_Br,J"... D ... ",nol,,~ --) .. t/t:~6·d 88Eb6ES6tLt: Ol dSS NOIlnllOd ~I~:WO"j 02:bt Et02-2t-~ON
ON ... bye~tVte e~sl::J'" Final Clearance Air Monitoring Services Date: October 25, 2013 Project: Abatement of ACM texture and sheet vinyl flooring prior to building demolition at 8432
CR 320, Rifle, Colorado. Contractor: Edge Environmental Services, Aurora, Colorado Air Monitoring Description: Phase Con provided final clearance air monitoring services at the project
site listed above on October 25, 2013. Air samples were situated inside the enclosure so as to be representative of the entire work space. Air samples were obtained utilizing· aggressive
sampling methods to aid in ensuring that any fibrous material left in the enclosure would be entrained in the air during the sampling period. Abatement Description: Abatement of ACM
texture and sheet vinyl flooring prior to building demolition. Comments and Recommendations: PCM analysis of the final clearance air samples revealed airborne fiber levels inside the
containment area(s) to be less than the Colorado State Maximum Allowable Asbestos Level (MAAL) and the EPA clearance level of 0.010 fibers per cubic centimeter of air; therefore, the
are be re-occupied under non-abatement conditions . . Close do State Air Monitoring Specialist #2930 593 19 3/4 Road Grand Junction, CO 81507 Office: 970-260-3341 pceconsultants@qwestoffice.net
ON ... bveatltie eas1::J ... PCM LABORATORY ANALYSIS Client: Gary Knaus Rifle, Colorado Project: 8432 CR 320 Rifle, Colorado OSHA Reference Method -NIOSH 7400 Sampling Date: 10/25/13
Technician/Analyst: D. Close CDPHE Technician ID: 2930 Abatement Contractor: Edge Environmental Services, Aurora, Colorado Description of Work: Abatement of ACM texture and sheet vinyl
flooring prior to Building demolition. SAMPLE SAMPLE DESCRIPTION AIR VOLUME 10 01 Final C.learance Sample -Living Room 595 L 02 Final Clearance Sample -Rear Hall 595 L 03 Final Clearance
Sample -Dining Room 595 L 04 Final Clearance Sample -Back Bedroom 595 L 05 Final Clearance Sample -Master Bedroom 595 L 06 Blank .---.-07 Blank .-----* Colorado State Clearance Level
is 0.010 f/cc of air Technician/Analyst: ----P.~'----------------593 19 3/4 Road Grand Junction, CO 81507 fiberslfields flee 4.0/100 <0.006 flee 4.5/100 <0.006 F/ee 5.0/100 <0.006 Flec
5.0/100 <0.006 Flce 6.0/100 <0.006 Flee NONE DETECTED NONE DETECTED Office: 970-260-3341 pceconsultants@qwestoffice.net
STATE OF COLORADO Expires on: 1218/2013 ~ ""iiuiorlzed APeD Representative • This certlftcate Is valid olil)' with the possessil>h of a current Dlvli//JiI:approveitralnlng course certlftcatlon
In the dlsclpllnespee/fled above.
Rick Ormsby From: Sent: To: Subject: Attachments: Douglas Close [pceconsultants@qwestoffice.net] Tuesday, October 29,201311:14 AM greatwesternhomes@bresnan.net Asbestos clearance report
and invoice: Gary Knaus Invoice 8432 CR 320-Clearance-1 0-2013.pdf; Report-8432 CR 320-Clearance-1 0-2013.pdf Invoice-8432 CR Report-8432 CR 320-Clearance-... 320-Clearance-1... for
Gary Knaus. Thank you. Doug Close Tracy: Please see asbestos final air clearance report and invoice Copies, along with signed demolition permit application, follow by mail. Phase Con
Environmental Consultants, LLC 970-260-3341 1
N Asbestos Building Materials Inspection Services Client: Gary Knaus, 8432 CR 320, Rifle, CO 81650 Project Site: 8432 CR 320 (house structure only), Rifle, Colorado Inspection Date:
September 24,2013 Phase Con Project #: 13-09-24D 593 19 3/4 Road Grand Junction, CO 81507 Office: 970-260-3341 pceconsultants@qwestoffice.net
8432 CR 320 (house structure only), Rifle, Colorado Sampling Description Phase Con provided asbestos building inspection services at 8432 CR 320 in Rifle, Colorado on September 24, 2013.
The inspection was performed by Mr. Douglas Close, a Colorado State and EPA Asbestos Building Inspector/Management Planner. The scope of work included only the house structure on the
property. The house is scheduled for demolition in the near future. The scope of this inspection was limited to sampling and analysis of materials which were suspect for asbestos content,
readily accessible, and present in or on the building only. Suspect materials within the scope of work were sampled and analyzed as per Colorado State Regulation #8. Discussion & Recommendations
The building possessed the following Asbestos Containing Materials (ACMs) which are regulated by the State of Colorado, the EPA and . OSHA during building demolition, and must be properlv
removed from the unit by a licensed Colorado State asbestos abatement contractor prior to achieving an inspector sign-off on the CDPHE demolition permit application: • Wallboard Texture
-present in the rear office room (walls & ceiling), the adjoining hallway ceiling, the master bedroom walls and ceiling and the living room walls & ceiling (the balance of the house
did not possess asbestos in the wallboard texture ... this Includes the dining room, the bathrooms, the kitchen, the upper level and the rear entry area). Estimated 1500 square feet
of this ACM present. • Sheet Vinyl Flooring (yellow in color) -present in the bedroom hallway bathroom beneath carpeting. There is an estimated 50 square feet of this ACM present. •
Sheet Vinyl Flooring (yellow in color) -present In the east bathroom and rear entry hallway as the bottom layer of sheet vinyl flooring. There is an estimated 150 square feet of this
ACM present. • Cement Asbestos Board Siding Shingles -these siding shingles are present beneath the metal siding. It is assumed that this ACM is present beneath all of the metal siding,
but this cannot be verified without destructive removal of significant portions of the metal siding materials. If this ACM is present beneath all of
the metal siding there Is an estimated 2000 square feet of this ACM present on the house. The State of Colorado requires that the client retain a licensed Colorado State asbestos abatement
contractor (General Abatement Certificate, or GAC, holder) to properly remove and dispose of these ACMs. The homeowner is prohibited from removing these ACMs by themselves prior to demolition
due to the quantity of ACM exceeding the State trigger level of 160 square feet. The homeowner cannot optout of these requirements. Following complete removal of these ACMs, Phase Con
must return to the site to verify that these ACMs are completely removed from the house after which the certified inspector can sign the demolition permit application. Achievement of
this signature necessitates removal of £ll of the ACMs. There cannot be small pieces, debris or dust present from the ACMs or the inspector cannot sign the demolition permit application.
Removal of these ACMs by non-certified personnel and/or by a nonGAC holder could result in significant asbestos exposure to personnel, an accompanying health hazard, potential contamination
of significant areas of the building, and failure to achieve the Inspector sign-off on the demolition permit. Further information on the asbestos regulation can be found on the CDPHE
web site or by contacting the CDPHE at 303-692-3100. The joint compound present in association with the upper level wallboard wall and ceiling systems was found to contain 3% asbestos.
The State of Colorado and the EPA consider the wall system as a whole in determining total asbestos content. To be considered an ACM by the State and the EPA a material must contain>
1 % asbestos. As the wallboard wall/ceiling system as a whole (consists of wallboard sheets which do not contain asbestos and asbestos containing joint compound present at the seams
and screw holes only) contains < = 1 % asbestos this material is not considered an ACM and Is not required to be removed prior to demolition.
If any previously unknown or undiscovered materials are found during demolition activities which are suspect for asbestos content then these materials should be tested for potential
asbestos content prior to continuing any further demolition work. Disclaimer This inspection was performed using non-invasive sampling techniques. This report does not imply, or guarantee
that every material on the property, or in the property building, which may potentially have asbestos as a component has been identified and/or sampled. A guarantee that all asbestos
materials have been identified and/or sampled would require cost-prohibitive and destructive sampling protocols. Furthermore, identified asbestos containing materials may be in areas
which are inaccessible or hidden due to their application during the construction process and their subsequent enclosure or covering with building and finish materials. Areas behind
walls, inside chases, or other hidden, covered or enclosed areas were not included within the scope of this inspection, as destructive techniques would have been required to access these
areas. These areas should be inspected whenever renovation or demolition activities are scheduled which may disturb the materials within or beneath these barriers. 'Overspray' or excess
materials from the installation or application process of asbestos containing materials is common, should be expected in the vicinity of installed asbestos containing materials, and
is often present either covered by other building materials or in hidden or unexpected locations. This inspection cannot determine the presence of these materials and their locations
and therefore the determination of these locations and material quantities is outside of the scope of this inspection. Bulk material samples are obtained in accordance with applicable
regulations, Industry standard techniques and analyzed by a NVLAP accredited laboratory; however, due to the asbestos content fluctuations which may occur in a building material due
to the application and/or initial mixing process no guarantee can be made as to an 'exact' percentage asbestos content (this Includes 'no asbestos detected' and 'trace' contents) which
represents the entirety of the material (asbestos content fluctuations can and will occur throughout a building material). Abatement cost estimates and material quantity estimates are
approximate only (due to the hidden nature of many of the materials),
and are provided only as a general guideline to the client. More than one licensed Colorado State asbestos abatement contractor should be consulted to determine actual abatement costs
of the ACBMs described above. Actual material quantities can only be determined by complete removal of covering materials. Please call us with any questions which you may have concerning
this report a r rec mendations. Thank you. ou sA. Close C rado State and EPA Certified Asbestos Building spector/Management Planner #2930
Sample Description Table
Sample # C-Ol C-02 C-03 C-04 C-05 C-06 C-07 C-08 C-09 C-l0 C-11 C-12 C-13 C-14 C-15 8432 CR 320, Rifle, Colorado Asbestos Sample Description and Location Tables Sample Descriptions and
Locations Textured Wallboard -Rear Office Room & Adjoining Hallway Ceiling Textured Wallboard -Rear Office Room & Adjoining Hallway Ceiling Textured Wallboard -Rear Office Room& Adjoining
Hallway Ceiling Textured Wallboard -Master Bedroom Textured Wallboard -Master Bedroom Textured Wallboard -Master Bedroom Textured Wallboard -Living Room Textured Wallboard -Living Room
Textured Wallboard -Living Room Textured Wallboard -Walls of Hallway Adjacent to Upper Stairway Textured Wallboard -Walls of Hallway Adjacent to Upper Stairway Textured Wallboard -Walls
of Hallway Adjacent to Upper Stairway Textured Wallboard & Joint Compound -Upper Level Textured Wallboard -Upper Level Textured Wallboard -Upper Level ===========================
Sample # C-16 C-17 C-18 C-19 8432 CR 320, Rifle, Colorado Asbestos Sample Description and Location Tables Sample Descriptions and Locations Sheet Vinyl Flooring -Yellow -Beneath Carpeting
-Bedroom Hallway Bathroom Sheet Vinyl Flooring -White -Top Layer of Flooring In the Rear Entry Hallway and Bathroom Sheet Vinyl Flooring -Yellow -Bottom Layer of Flooring in the Rear
Entry Hallway and Bathrm Cement Asbestos Board Siding Shingles -Present Beneath the Metal Siding Materials ================================
· Laboratory Analysis Results
CllLabs Dedicated to Qualll!! Crisp Analytical, L.L.C. 1929 Old Denton Road Carrollton, TX 75006 Phone 972-242-2754 Fax 972-242-2798 CA Labs, L.L.C. 12232 Industrlpfax, Suite 32 Baton
Rouge, LA 70809 Phone 225-751-5632 Fax 225-751·5634 Materials Characterization -Bulk Asbestos Analysis Laboratory Analysis Report· Polarized Ught Phase Con Environmental 593 19 3/4 Road
Grand Junction, CO 61507 Analysis and Method Attn: Doug Close Customer Project: 8432 CR 320 Reference #: CBR13092939 Date: 9/25/2013 Summary of polarizing light microscopy (PLM I Slereomicroscopy
bulk asbestos analysis) using the methods described In 40CFR Part 763 Appendix E to Subpart E (Interim and EPA 600 I R-93 J 116 (Improved). The sample is firstvJewed with the aid of
stereom)cfoscoPY. Numerous liquid sllde preparations are created for analysis under the polarized microscope 'Mlere identifications and quantifications are prefOrmed. Calibrated liquid
refractlva oils are used as liquid moullng medium. These oils are used for Identification (dispersion staining). A calibrated visual estimation is reported, should any asbestiform minerai
be present. Other techniques such as acid washing are used In conjugation with refractive oils for detection of smaller quantities of asbestos. All asbestos percentages are based on
calibrated visual estimation traceable to NIST standards for regulated of asbestos. Traceability to measurement and calibratron is achieved by using known amounts end types of asbestos
from standards where analyst and laboratory accuracy are measured. A13 little as 0.001 % asbestos can be detected In favorable samples, INhl1e detection in unfavorable samples may approach
the Discussion Vermiculite containing samples may have trace amounts of actlnolile-Iremolite, where nol found be PLM should be analyzed using TEM methods and lor water separation techniques.
Suspecled aclinolilelvenniculite presence will be Indicated through the sample comment section of this report. Fibrous talc containing samples may aven contain a related asbestos fiber
knO'Ml as anthophyllite. Under certain conditions the same fiber may actually contain both talc and anthophyllite (a phenomenon called Intergrowth). Again, TEM detection methods are
recommended. CA labs PLM report comments will denote suspected amounts of asbestiform anthophyllite with talc, ..mere further analysis Is recommended. Some samples (floor tiles, surfaclngs,
etc.) may contain fibers too smaU10 be delectable by PLM analysis and should be analyzed by TEM bulk protocols. A ~trace asbestos" VJilt be reported If the analyst observes far less
than 1% asbestos. CA labs defines "traca asbestos· as a few fibers detected by the analyst In several preparatIons and will Indicate as such under these circumstances. QuantificatIon
of <1% Will actually be reported as <=1% (allowable variance close to 1% is hIgh). Such results are ideal for point counting, and the technique is mandatory for friable samples (NESHAP,
Nov. 1990 and clarification letter 8 May 1991) under 1% percent asbestos and the "trace asbestosM. In order to make all Initial PLM reports issued from CA Labs NESHAP compliant, all
<1 'Yo asbestos results (except floor tiles) will be point counted at no additional charge. Qualifications CA labs Is accredited by the National Voluntary Accreditation Program (NVLAP)
for selected test methods for airborne fiber analysis (TEM), and for bulk asbestos fiber analysis (PLM). All analysts have a college degree In a natural science (geology, biotoQy, or
envlronmenlalsclence) or are recognized by a state professional board in one these disciplines .Extenslve In·house trainIng programs are used to augment education baCkground of tha analyst.
The group leader of polarized light has received supplemental McCrone Research training for asbestos identification. This report is not covered by the scope of AIHA acoredltation. Analysis
performed at CA Lebs, LLC 122321nduslriplex, Suite 32 Baton Rouge, LA 70809. Baton Rouge NVLAP Lab Code 200772·0 TEMIPLM LDEQ Page 1 of 10 TDH30·0370
CALabs Dedicated to Qualiw Crisp Analytical, L.L.C. 1929 Old Denton Road Carrollton, TX 75006 Phone 972-242-2754 Fax 972-242-2798 CA Labs, L.L. C. 12232 Indusfriplex, Suite 32 Baton
Rouge, LA 70809 Phone 225-751-5632 Fax 225-751-5634 OveNiew of Project Sample Material Containing Asbestos Customer Project: Sample # C-01 C-Q2 C-Q3 C-Q4 C-05 C-06 C-Q7 8432 CR 320 Layer
Analysts Physical Description of # Subsample Asbestos type I calibrated visual estimate percent 1-1 white sUlfaced white compound 2% Chrysotlle 1-2 white compound (beneath tape) <1%
Chrysotlle 1-1 white surfaced white compound 2'1" Chrrsotl/e 1-1 white surfaced white compound 2% Chrysotlle H white surfaced whIte compound 2<''' Chrysotile 1-1 white surfaced white
compound 2% Chrysotlle 1-1 white surfaced white compound 2% Chrysotlle 1-1 white surfaced white compound 2% ChrysotJ/e Baton Rouge NVLAP Lab Code 200772-0 TEM/PLM LDEQ OloS$'ry of ibbrerlatlom
(_ubi/s/os fJbe~ .nd nol)-flbrou, minerals): ca -carbonal$ gypsum ·gypsum bl.bi-lder or· organic rna· matrix m/.mlca vII-vermiculite ot·other pa·pe~~e qu. quartz Ig -fiberglass mw· ml-1eraf
wool wo -'Mllla8~ni!e Ia·tafe ay • syntheUc ce-cellulose br-brueite ka. kaorlll (clay) CALab. ProJect#: CBR13092939 Us! of Affected Building Material Types white surfaced white compound
white compound (beneath tape) white linoleum tan surfaced gray transite TOH 30-0370 pa. palygorsk~e (dsy) Thls repo~ relates tO!h1l items tested. ThisrepoJ11B not to ba used by the wstomerto
clelm productC<lrtl!lcallon, approval or endorsement byNVLAP. NIST, AlHA LAP, LLC, or anyolheragency of the fe<!eral governmenl This repoJ1 may not be reproduced except In full without
written perrnlsslonfi"om CA Labs. These resutl$ are submittEPd pulSuarrt to CA Labs' current terms and AaTe,oondlt.k>n of sale, Includilg the company's standard WBlTlInly lind Imllatlons
of ~abifil)' provisions and no responslblrrtyOf~abllly is lISSumed for !he manner In which the results ale used or I-1lerpreled. Unless IIOliflad In IWiUng to return the samples covered
by\hls report, CA Labs will store thll samples for a period ofnlnel)'(90) days beforlldl!lcardlng. A sl1lpplngor handling fee may be assessed forthe return of any S81lll\eS. Page 2 of
10
CllLabs Dedicated to Quality C·08 C-09 C·13 C·16 C-18 C·19 Crisp Analytical, L.L. C. 1929 Old Denton Road Carrollton. TX 75006 Phone 972-242-2754 Fax 972-242-2798 CA Labs, L.L. C. 12232
fnduslripfex, Suite 32 Baton Rouge, LA 70809 Phone 225-751-5632 Fax 225-751-5634 Overview of Proiect Sample Material Containing Asbestos ,., ,., ,., '·2 '·2 ,., whIte surfaced white
compound white surfaced white compound white surfaced white compound white linoleum white finoleum tan surfaced gray transite calibrated estimate percent 3% Chrysotile 3% Chrysotfle
3% Chrysotlle 35% Chrysotile 35% Chrysotile 18% Chrysotlle Baton Rouge NVLAP Lab Code 200772·0 TEM/PLM LDEQ TDH 30-0370 GIOIIIHI)' of abbreviations (notI-asbesros 6ben and non-tfbrous
mlnefi//s): CII -C3lb<>nete IIYPsum -gypsum bl-binder or-organk: rna· matrix mi. mica ve-vermk:ulite ol-oiller pe·penKe qu-q\lartz rv -fiberglass mw-mnllralwoo/\\Q • woHas~olta la·talc
By-synthetic C:II_ OIIIIuloae br-brucite ka _ kaolin (clay) pIII-pBttgorskle (day) This r&pOrt IIllates 10 111& Items tested. This IIlportls nOI 10 ~e used bylhe wstomer 10 dalrn product
certlllcatlon, approval or end()($8menl ~yNVlAP, NIST, AIHA LAP, LLC, 0( anY0lher agency of !he federal government This report may nalbs reproduced except In full wiIhavt wriIlaIl permission
ft"orn CALabs. These reaulls are submlll9d pursuMt to CA Lebs' current lenns and sale, oondilkm ofsailt.lncludtng the company's standard wam'lnty and Rmilaliona of iabRlty prOVisions
end no responsl~mtyor~abitilyJs assumed for the manner In IIotllch the results are used 04' Inlerpre!ed. Un~ notified In writing Iorelum thB samples COl/Elred by this report, CA Labs
oMll atoll' the samples fO( a period of nine I)' (90)days before dise1lrdlng. A shipping or lIa(ldllng fea maybe assessed for Ihe relum of anylarr(lles Page 3 of 10
CA Labs, L.L.C. CIlLabs Dedicated to Quality Crisp Analytical, L.L.C. 1929 Old Denton Road Carrollton, 7X 75006 Phone 972-242-2754 +-12232 Indus/rip/ex, Suite 32 Baton Rouge, LA 70809
Phone 225-751--5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Atb1: Doug Close Phase Con Environmental 593 19 3/4 Road Grand
Junction, CO 81507 Customer Project: CA Labs Project #; CBR13092939 Date: Samples Received: 912512013 912512013 Phone # Fax # 970-241-6480 970-241-6584 8432 CR 320 Turnaround Time: 4
hrs Date Of Sampling: N/A Sample # C-01 C-02 C-03 Comm layer ent # 1-1 1-2 1-3 1-1 1-2 1-1 1-2 Analysis Physical Description of Subsampie white surfaced white compound white compound
(beneath tape) white drywall with paper white surfaced white compound white drywall with paper white surfaced white compound white drywall with paper Homer geneo us (YIN) n y n n n n
n Asbestos type I calibrated visual estimate percent 2% Chrysotlle <1% Chrysotlle None Detected 2% Chrysotite None Detected 2% Chrysotlle None Detected Bafon Rouge NVLAP Lab Code 200772-0
TEMIPLM LDEQ Purchase Order #: Non-asbestos fiber type I percent 8%ce 8% ce 8%ce TDH30-0370 An~lysis Method: Inlarlm {40CFR Part 763 Appendix E to Subpart E)flmproved (EPMOO I R-931116)
Preparation Malhod: HCL add waShing for carbonate based samples, chemical reduction lor organically bound components, oil inmorslon lor ldentHlcalion 01 QsbestoG types by dispersion
attaining f beckellM malhod. ca -carbonala mi· mica Ig. fiboorgTa86 ee -celiumt gwsum -gwsum VII -vetmlculftEI mw-minerai wool br-brue/le bi -binder ot -other WD' woliastinUa ka -kaolin
(clay) Non-fibrous type I percent 98% bl,mi,ca 100% mi,ca 92% qU,gy 98% bi,ml,ca 92%qu,gy 98% bi,ml,ca 92% qU,9Y or-organic pe-perlite ta-talo pa -pa1ygOrS~1le (clay) Approved Signatories:
rna -matriX qu -quartz sr -1I~lt1ellc M' . '.-.-....,.,,..,..-...-..., Alicia Stretz Analyst 1. Fre [)¥I1!1V<1 Slgni!leant flJetdom~. -",~d percanlogu refIocl ~f$CIlI>ea 2. fire Dlmtge
"" l'gnrioant liber dam"ll"s err-.g librouo p"'""nlagat 3. Adholh In _110<0 vMI VOIIlIIoJlte ~.Uoy9root IInOlyzed -allacMd lo~ j)OOI[hIel ...... Md c:onca"*"'lb'lb..,opecIed 5.NOIe~""'~to~.
Senior Analyst Alicia Stretz II.AnChop/l)oIlc "mocIallOo"lwlh fl>'ous Talc 1.~..,spectedlMmolllorl>ul\:llOgmatarlal. laboratory Director Chris Williams 8. F~ notb kfwater sepsration
on vermIcUlie forpossl>o ..... lysis by lIMlhe<II1elllod 9. <1% Re",hpWlloountedpnsilMo 10. TEM "M'ysis IOW&"Ied Page 4 of 10
CIlLabs Dedicated to Quality Crisp Analytical, L.L.C. 1929 Old Denton Road Carrollton, TX 75006 Phone 972-242-2754 CA Labs, L.L.C. 12232 Industrlplex, Suite 32 Baton Rouge, LA 70809
Phona 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform MaterIals Characterization customer Info: Attn: Doug Close Customer Project: CA Labs project #: Phase
Con Environmental CBR13092939 593 19 314 Road Grand Junction, CO 61507 Date: Samples Received: 912512013 912512013 Phone # Fax # 970·241-6480 97()'241-6584 8432 CR 320 Turnaround Time:
4 hrs Date Of Sampling: N/A Sample # Co04 Co05 C·06 Co07 Comm Layer ent # 1-1 '·2 ,., '·2 I·' '·2 Analysts Physical DescrlptiQf1 of Subsample white surfaced white compound white drywall
with paper white surfaced white compound white drrwafl with paper white surfaced white compound white drywafl with papar Homo--Asbestos type I geneo calibrated visual ". (YIN) n n n
n n n estimate percent 2% Chrysotlle None Detected 2% Chrysotlle None Detected 2% C~rysotile None Detected 1·1 white surfaced white compound n 2% Chrysotlle Baton Rougo NVlAP Lab Code
200772-0 TEMIPLM LDEQ Purchase Order #: Non·asbestos fiber type I percent 8%ce 8%ce 8%ce TDH 30-0370 Analysis Method: Inhtrlm (4OCFR Part 763Appaod« E \0 Subpart E)/Improved (EPA~OO
fR·931116) Preparation Method; HCL acid washing bcarbon~te band !l3mpies, chemical reduction Iororganlcallybouocl COmPOn~\s, 011 Immersion lor identiflca!ioo of asbestos typea by disparslon
attaIning I becke fJ'le method. ca -catbonata mI-mica fg _ fiberglass ce . cenutose vc -vcnnicufrte rnw • minerai WOOl br· brucltft ot-olhar wo· wollastini\a Ita_ kaolin (clay) Non-fibrous
type I percent 98% bl,mi,ca 92% gu,gy 98% bi,mi,ca 92% gu,gy 98% bl,ml,ca 92% gu,gy 98% bi,ml,ca gypsum. gypsum bj -binder or·org~nte rna· matrix pe· perlil6 tB .lete pl'I-l"'iygorskna
(clay) qu -quam. sy-s)fllhetlc Approved Signatories: Alicia Stretz Analysl I. Fte o..-nago, oi{lri'loall! tiber d.." •• repo~ed petcenlAg!9 re/1eCt .... I_d-. 2. FI"d oamego M olgroNloaOl
_d""" errll<l!r'Ij tJ:I<cm peruntoge. 3.~tl_lbn"'~Verm""'I" 4.~noI aoalyzed -attached'" p!8YIow pooIIWo IayorMd cooIamlllaHon laMJspecIed 5.NotOflClll9/lOOOlflie",analyl8 Senior Analyst
Alicia Siretz 6.Anlqlh).ifI<o n.B5OCIalbnwlt.fbrous Tale 1.CtInIom_~fto:natPlerbtJlldlngma!.rIaI. Laboratory Director Chris Williams 8. F_bIo """......., 1or .... lor Hpen.1fQn on \OIImkuI"\;l
lor"",,",ilQ ona",," I7i MoIhor lII&II>ocI 9. ~1% R ..... poWcoUTII.dpoa/llYo 10.TEt.I.....tysts!llg96S1ed Page 5 of 10
CA Labs, L.L.C. CALabs Dedicated to Qu.lI~ Crisp Analytical, L.L.C. 1929 Old 06nton Road Carroflton, 7X 75006 Phone 972-242-2754 +-12232 Industrlplax, Sulta 32 Baton Rouge, LA 70809
Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestlform Materials Characterization Customer Info: Attn: Doug Close Customer Project: CA Labs Project #: Phase
Con Environmental CBR13092939 593 19 3/4 Road Grand Junction, CO 81507 Date: Samples Received: 9/25/2013 9/25/2013 Phone # Fax # 970·241·6480 970-241·6584 8432 CR 320 Turnaround Time:
4hrs Date Of Sampling: N/A Sample # C-08 C-09 C-10 Comm Layer ent # 1-2 1-1 1·2 1-1 1-2 1-1 1-2 Analysts PhysIcal Description of Subsamp1e white drywall with paper white swiaced white
compound white drywall wfth paper white surfaced white compound white drywalf with paper white surfaced white compound white drywalf with paper Homogeneo us (YIN) n n n n n n Asbestos
type J calibrated vlsua] estimate percent None Detected 3% Chrysotlle None Detected 3% Chrysotlle None Detected None Detected n None Detected Baron Rouge NVLAP Lab Goda 200772-0 TEM/PLM
LDEQ Purchase Order #: Non-asbestos fiber type I percent S%ce B%ce 8%C9 8%ce TDH 30~370 Analysis Method: Inlel'Vn (40CFR Part 763 Appendix E to SUbpart E)flmplovltd (EPMlOO I R-931116)
PreparatiOn Method: HCL acid wsshing for carbonale based samp"'s, chemical reduction lor organically bound compoMenlS, OllimmersJon for ca • carbol!ale gypsUm· gypellm bl· bOOsf klentlftcalloo
of asbaslos types by dispersion attaining I becke Rne malOOd. ml-mlca fg. fiberglass OEI-cellulose va • V9rmlcu~le mw -mln8t11t WJOI br -brucna OI-<lthOf IYG ·mnQstilHo ka-kaolin (clay)
Non-fibrous type I percent 92% gu,gy 97% bI,mi,ca 92% gu,gy 97% bf,mi,ca 92%qu,gy 100% bi,mf,ca 92% qU,9Y or· organic ma·matllx ~. purliia Ie .Ioia pa_ palygorsHtI (day) qu· qUBrIl $'J.
synlhBOO Approved Signatories: Alicia S1retz Analyst 1. FIrI o,magollgNfh:an!!bet damttgl· .opttr\tId ptrcenI.,. rel!oc\ u.....",red fOots 2. Fie 0Nnage M&bn_ ibof dam",," effllC*'l
ibrttm per~llI_ 3.A_In"""c/.!tIlon~Verml~, 4.Lay8r""' .... lyUd ·'_lopm\otl8pos1lve ............. oontaml!w.lIonltltJOflt'cl«l ~.NoIallO\lghoatll9lotoanoly.!a 8, ~ ,,"HOdallotlwlh FitInUs
Talc Senior Analyst Alicia Stretz 1. Colnlatn .... ,.". .... pec:Iodtom ollw lull<fng malt>llela Laboratory Director Chris Williams & Fa ... """nom for wale' Mlpartllloo on -.nIcUle
lor poGSbl:) '1lEII)M by.r"tOIher molhod g. < 1" RlISOJIpoh1C011rtodpoo!tMo 10. TE'-!"",1ysIa0U'JllBA"'" Page 6 of 10
CllLabs Dedicated to Quality Crisp Analytical, L.L.C. 1929 Old Danton Road Carrollton, TX 75006 Phone 972·242·2754 CA Labs, L.L.C. 12232 Industrip/ax, Suite 32 Baton Rouge, LA 70809
Phone 22(j..751~632 Fax 972·242·2798 Fax 225·751·5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Doug Close Customer Project: CA Labs Project #: Phase
Con Environmental CBR13092939 593 19 3/4 Road Grand Junction, CO 81507 Date: Samples Received: 9/25/2013 9/2512013 Phone # Fax # 970-241-6480 970-241-6584 6432 CR 320 Turnaround Time:
4hrs Date Of Sampling: N/A Sample # C-11 C-12 C-13 C-14 Comm Layer ent # 1-1 1-2 1-1 1-2 1-1 1-2 1-1 Analysts Physical Description of Subsample white surfaced white compound white drywall
with paper white surfaced whIte compound white drywall with paper white surfaced white compound white drywall with paper whit~ surfacing Homo-Asbestos type I genae calibrated visual
us estimate percent (YIN) n None Detected n None Detected n None Detected n None Detected n 3% Chrysotile n None Detected y None Detected Baton Rouge NVLAP Lab Code 200772-0 TEMIPLM
LDEQ Purchase Order #: Non·asbestos fiber type I percent BO/o ce B%ce B%ce TDH 30-0370 Analysis Method: Interim (4OCFR Part 763 Appendix E toSubpartE)!lmproved (EPA.eOOI R-93/116) Preparalion
Method: HCL aeld ~Ing fclcarbonate based samplu, chamieel reduction fororg.anlcalybound COI'Ilpooanls, on immerabnfor ca • carbonate gypsum 0 ijW&UI\1 bi· binder Olentiliealbn of asbestos
Iypes bydlsperslon at1Blnlflg I be<:ke Il1a method. mI-mIea tgo fiberglass ce _ cellulose VI'II_ v"hl"lll:uUle fllIV-mineral.....,oI br-brucl)'" ol-olher 1'11:>. woIlastinile ka _ kaolin
(Glay) Non-fibrous type I percent 100% bl,mi,ca 92% gU,9Y 100% bi,mi,ca 92% qU,9Y 97% bl,mi,ca 92% gU,9Y 100% gU,bl or-organic rna ma!ri~ pEl -pemle Ia -laic pa -palygorski.e (clay)
3Y· ~yntheUe Approved Signatories: quo qu!lr1Z Allcla Stretz Analyst 1. Fr9 OM\Eql .. O_thrd ........ l\I!lOrIod ~ ftI/Ie<lIlII'IIIlIerodflbers 2. Fn OIlWg8 no IIgrIican111>ef dOlYl3g8$
.ffectll1l /JIfIl<IS pen::$l'll8Qru1 3. AeJm4lo n asooobllon wlIh VormbJiI. 4. Leyo' rd.~ . alladlod 10 pre"*':>us Pfl$III>'e Ioyor jrrld oonIamna1iorl1s ""lIpOoied 5. NOIllnOUgh sample
I~ 1II18lf!:e e.~I1.na..o.;;a1iorlwllhfllrolJ'T.1o Senior Analyst AlicIa Stratz 1. Cortam!rl8llon "'"""""'" from oIhtU 1ru'Id-'"tl ml>l ..... is Laboratory DIrector Chris Williams S.
FIMIf8t:I& IIOINrl:l1ar wale, -",1Ion on I'ImI'IICUlte lor pOtsbIa AnaiyBIs by AlI01!Iormeihod 9. < 11'; R.....,~lXIIrIIodpooitMl 10. reid _lysis ouggosl&d Page 7 of 10
CllLabs CA Labs, L.L.C. Dedicated to Quality Crisp Analytical, L.L.C. 1929 Ofd Denton Road Carrollton, 1)( 75006 Phone 972·242·2754 12232 Industrlplex, Suite 32 Baton Rouge. LA 70809
Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Doug Close Phase Con Environmental 593 19 314 Road Grand
Junction, CO 81507 customer Project: CA Labs Project #: CBR 13092939 Date: samples Received: 9/25/2013 9/25/2013 Phone # Fax # 970·241-8480 971).241·6584 8432 CR 320 Turnaround Time:
4 hr. Date Of Sampling: N/A Sample # C·15 C·16 C·17 Comrn layer enl # '·2 ,., '·2 4 ,., '·2 4 ,-3 ,., Analysts Physical Description of Subsample white drywall with paper blue surfacing
white drywafl with paper yellow mastIc white/ino/eum yeflowmastic white/inoieum Homo-Asbestos type I genae calibrated visual us estimate percent (YIN) n None Detected y None Detected
n None Detected y 35% Chrysotlle y None Detected Baton Rouge NVLAP Lab Coda 200772-0 TEMIPLM LOEQ Purchase Order #: Non-asbestos fiber type I percent B%ce 8%ce 5%fg 35%00 TDH30-0370
Analysis Method: Interim (40CFR Part 763Appandlx E to Subpart E) /Improved (EPA-600 IR-931116) Preparation Method; HCL add wa!l/llog for carbonate based samples, chemical reduction for
t>rgBnlcany bound oomponenls, ojIlmlJ'Mll5lDn for klenU1!I;aUon ri asbestos types bydispef$/on attaln~ I becke line meihod. ca • carbonate mI-mica fg _ fiberglass ce· cellutcse gypsum
-gypsum ve -vermcuijte mw -mkleral wool br -brucite bi -binder ot.other wo-,I'odlutloile ka -kaolin (clay) Non-fibrous type I percent 92% gu,gy 100% gu,bi 92% gu,gy 65% gU,ca 6O%gu,ca
or· organic pe-perlite Ia -talc pa-palygorsUe (day) Approved Signatories: ma-malrb( qu_qUBrtz ffj_aynthallc Alicia Strelz Analyst 1. Ra Damage slgrhaillfblt dNMgo -"'I""1ed peo:entages_
..... 1Ieted fot>erJ 2. Fn 0",,"-00 sIgNfIconl ft>erdom",," 6!I&elin;J Ii>Iout pen:erjago. 3. AtlIoom. h aosodolbn WHh Vermb.Jlle 4.lIysfnollroolyald • a/IQc .... d to ~ po ....... le)'er
MII<X>IItamhitlon kru!pOCled 5. Not eOOll\lh .. ",pro to .""Iyz. 8.~h_lbf1wtt1!FhwtT.k: Senior Analyst Alicia Stretz 1. C¢nIamhallon suspec!.d ftan OIhGr buidq. materlel. Laboralory
Director Chris Williams 8. F~. oce.-..m r<lr ...... , sepanollon on WIIIIlburn.."". po..JbIo .... Iyob by II/'QIJw rnolhoc! 9. <1% Re!IUlpoht~~ 10. TEM .... 1'* "'W"st&cI Page 8 of 10
CA Labs, L.L.C. CALabs Dedicated to Quality Crisp Analytical, L.L. C. 1929 Old Denton Road Carrollton, TX 75006 Phone 972-242-2754 +-12232 Industripfax, Suite 32 Baton Rouge, LA 70809
Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Doug Close Customer Project: CA Labs Project #: Phase
Con Environmental CBR13092939 593 19 314 Road Grand Junction, CO 81507 Date: Samples ReceIved: 912512013 912512013 Phone # Fax # 970-241-6480 970-241-6584 8432 CR 320 Turnaround Time:
4hrs Date Of Sampling: N/A Sample # C-18 C-19 Comm Layer enl # 5 '·2 4 ,-, '·2 ,., Analysts PhYsical Description of SubsampJe yellow mastic yellow mastic white linoleum tan surfaced
gray transffe Homo-. Asbestos type I genaa calibrated visual us estimate percent (YIN) y 35% ChiYsotlle n 18% Chrrsotlle Baton Rouge NVLAP Lab Code 200772-0 TEMIPLM LDEQ Purchase Order
#: Non-asbeslos fiber type I percent TDH 30-0370 Anal)l$ls Method: Inlerim (4OCFR Part 763 Appendix E to SlIbpartEJ/lmpro'led (EPMlOO IR·93/116) Preparalion ~elhod: HCL add washing klrcarbonele
based samplos, chemical radllCllon forOfgflnlcallybound cnmponants. 011 immefSlon for IdllOtifieatkJn of a!!beam types bydbperslon atlaining I becke rille melhad. ca • carbonale ml-mica
19 -fiberglass ce -cellulose gypsum _ gypsum ve-v9rm!cutrt.. mw-mlnara!wool Dr-brock .. bI-binder oj·other we -""lIJastkllte ka. kaol"lfl (clay) Non-fibrous type I percent 65% gU,ca
82% bl'Qu,ca or-organic pe -pS!lllB Ia • laic pa. palygor&k~B (day) APproved Signatories: ma. matrix qu -QUam sy. synlhetic: Alicia Stretz Analyst 1. R9 Dlrnago &IQrifIoaJllI'bo, dam"ll'"
.. ported perconlageo refIBcI 1.Ml1eted __ 2. f'ra Do""'9" 110 o~ fibordo"'agel elfoctk"lg IIwu.o p"'con!1IgM 3. J\dl"KIIito In asooo;;IiIlIon y,ih Vermlaik (.lAye< not .... ~ _ AIt9dIed
10 prG\ious paSD • ." kI)w and COfltamhalbn Is""spec;!&d &.N(IIofWll.\1/lUl\ljll<llOaoaI)'lG 6.~ ... ;.,.,..tbow'hl'llMu.Ta/e Senior Analyst Alicia Siretz 1. ConIarnlnotlon MP"c!&d fran
"""',Widing ma\l!rW. Laboratory Director Chris Williams 8. fwmroblo _1Wb for wltlr8epeMlon on -.rkuIlolorpooslble analyol!. by aootlwmoflDd D. <I'll R,",*pohtCCIIJrUdposlllloe 10. TEI.4'rIIIIy$aJtI90
01ed Page 9 of 10
C.IlLabs Dedicated to Quality Crisp Analytical, L.L. C. 1929 Old Denton Road Carrollton, 1)( 75006 Phone 972'242~2754 Fax 972-242-2798 CA Labs, L.L.C. 12232 fndustrlplex, Suite 32 Baton
Rouge, LA 70809 Phone 225-751-5632 Fax 225-751-5634 Polarized Light Asbestiform Materials Point Count Laboratory Analysis Report. Point Count Analysis and Method Point counting was performed
on a polarized light microscope with a calibrated reticle according to the revised NESHAP method of November 20, 1990 (Federal Register, V.55, N.224, 11120190). Origionai asbestos content
of bulk materials was determined using procedures outlined in the interim method (40 CFR part 763, Appendix E to subpart E) and AHERA method (EPA-6001R-93/116). Samples were prepared
using HCL acid washing for carbonate based samples, chemical reduction for organically bound components, oil immersion for identification of asbestos types by dispersion staining I becke
line method. Qualifications CA Labs is accredited by the National Voluntary Accreditation Program (NVLAP) for selected test methods for airborne fiber analysis (TEM), and for bulk asbestos
fiber analysis (pLM). All analysts have a college degree in a natural science (geology, biology, or envirorunental science) or are recognized by a state professional board in one of
these disciplines. Extensive in-house training programs are used to augment education background of the analyst. The group leader of polarized light has received supplemental McCrone
Research training for asbestos identification. This report is not covered by the scope ofNVLAP or AJHA accreditation. Analysis performed at CA Labs, LLC 12232 Industriplex, Suite 32
Baton Rouge, LA 70809. Customer Info: Attn: Doug Close Phase Con Environmental 593 19 3/4 Road Grand Junction, CO 81507 Phone # Fax # Sample # C·Ol 970·241·6480 970·241·6584 Layer Analysts
Physical 2 # Description of Subsample white compound (beneath tape) y Homo-geneous (YIN) Customer ProJect: 8432 CR 320 Turnaround Time: 4 hrs Point Counted % I Asbestos Type Trace Chrysome
Beton Rouge NVLAP Lab Code 200772-0 TEMJPLM LDEQ CA Labs Project #: CBR13092939 Date: Samples Received; Date Of Sampling: N/A Purchase Order #: TOH 30-0370 9/2512013 9/25/2013 This report
relates to the ftems te"ted. This report Is not to be used by the customer to clelm productcerti/icalion, approval or endorsement byNVlAP, NISTor anyolhera~nC)'orthe federal governmenl
This report may not be reproduced axcepl In ruHwithout written permission from CA LabS. These results eAl Gubmitted purnuanl to CA Labs' current !arms and sala. condftion ofsala. "eluding
the COff'98ny's standard warranty and Imilatioos ofllibillty provlsbns and no respon~bliltyoriiabilityis assumed !of Ills manner In which the results are used or Inteqlrelad. UnleSS
notified in writing to return the samples covered by this report, CA Labs wla store the Silmples lor s psriod ofnlnely (90) days before discaldlng. A shtpplng orhandling fee may be assessed
/orIlla return ofany samples. AIlela Stratz. Analysl Page 10 of 10 Senior Analyst AlicIa Stretz Approved SIgnatories: Laboratory Director ChrlsWmlams
Certificates
STATE OF COLORADO Expires on: 12/5/2013 ~-<:::. .AUthorlzed APeD ~epresentative • This certificate Is valid only with the possession of a curtenl DI'1!lon,approved traIning COUrse certification
In the dIscipline specified above. . " . ':
Phase Con Environmental Consultants, LLC 593 19 3/4 Road Grand Junction, CO 81507 BILL TO Gary Knaus 8432 CR 320 Rifle, CO 81650 DESCRIPTION Asbestos Building Inspection Services -House
Structure Only, 8432 CR 320, Rifle, Colorado --9/24/13: TAX ID # 26-2007377. Please remit to above address. Terms are Net 30 days. Thank you. Invoice DATE INVOICE # . 9/26/2013 5636
AMOUNT 575.00 Total $575.00
the metal siding there is an estimated 2000 square feet of this ACM present on the house. The State of Colorado requires that the client retain a licensed Colorado State asbestos abatement
contractor (General Abatement Certificate, or GAC, holder) to properly remove and dispose of these ACMs. The homeowner is prohibited from removing these ACMs by themselves prior to demolition
due to the quantity of ACM exceeding the State trigger level of 160 square feet. The homeowner cannot optout of these requirements. Following complete removal of these ACMs, Phase Con
must return to the site to verify that these ACMs are completely removed from the house after which the certified inspector can sign the demolition permit application. Achievement of
this Signature necessitates removal of gjl of the ACMs. There cannot be small pieces, debris or dust present from the ACMs or the inspector cannot sign the demolition permit application.
Removal of these ACMs by non-certified personnel and/or by a nonGAC holder could result in significant asbestos exposure to personnel, an accompanying health hazard, potential contamination
of significant areas of the building, and failure to achieve the inspector Sign-off on the demolition permit. Further information on the asbestos regulation can be found on the CDPHE
web site or by contacting the CDPHE at 303-692-3100. The joint compound present in association with the upper level wallboard wall and ceiling systems was found to contain 3% asbestos.
The State of Colorado and the EPA consider the wall system as a whole in determining total asbestos content. To be considered an ACM by the State and the EPA a material must contain>
1 % asbestos, As the wallboard wall/ceiling system as a whole (consists of wallboard sheets which do not contain asbestos and asbestos containing joint compound present at the seams
and screw holes only) contains < = 1 % asbestos this material is not considered an ACM and is not required to be removed prior to demolition.
c:E" Gar/wId County Community Development Department 108 8'" Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-countv.com Mailing Architect: !,~ _"':""':~{N..J..~!..:"::.\...
. _____________ Phone:, _______-,-_ Mailing Address: N •P f~ Engineer: k\ I 8:~, Mailing Address: Phone: ( _ ), ______ _ Manufactured Home Installer:_Nl->'-fI-l(\-"-_______ Phone: _______
_ Mailing Address: ___________________________ _ Assessor's Parcel Number: .&;..L.L/.-i"lJL£JA.,L-"UU' _____ ~ _ Lot Block Owner's Valuation of Work: $ 2! COO . CO Property Size (Sq.Ft
or Acres): • eA Sq.Ft of Building:· I 0 00 tl Height: I '-{ , # of Floors:-==1=-__ _
NOTICE , " Authority. This application for a Building Permit must be signed by the Owner of the property, described above, or an authorized agent. If the signature below is not that
of the Owner, a separate letter of authority, signed by the Owner, must be provided with this Application. legal Access. A Building Permit cannot be issued without proof of legal and
adequate access to the property for purposes of inspections by the Building Division. Other Permits. Multiple separate permits may be required: (1) State Electrical Permit, (2) County
ISDS Permit, (3) another permit required for use on the property identified above, e.g. State or County Highway/Road Access or a State Wastewater Discharge Pe rmit. Void Permit. A Building
Perm it becomes null and void if the work authorized is not commenced within 180 days of the date of issuance and if work is suspended or abandoned for a period of 180 days after commencement.
CERTIFICATION I I hereby certify that I have read this Application and that the information contained above is true and correct. I understand that the Building Division accepts the Application,
along with the plans and specifications and other data submitted by me or on my behalf (submittals), based upon my certification as to accuracy. Assuming completeness of the submitta
ls and approval of this Application, a Building Permit will be issued granting permission to me, as Owner, to construct the structure{s) and faci lities detailed on the su bmittals reviewed
by t he Building Divi sion. In consideration of the issuance of the Building Permit, I agree that I and my agents will comply with provisions of any federal, state or loca l law regulating
the work and the Garfield County Building Code, ISDS regulations and applicable land use regu lations (County Regulation(s)). I acknowledge that the Building Permit may be suspended
or revoked, upon notice from the County, if the location, construction or use of the stru ctu re(s) and facility{i es), described above, are not in compliance with County Regulation(s)
or any other applicable law. I hereby grant permission to the Bu ilding Division to enter the property, described above, to inspect the work. I further acknowledge that t he issuance
of the Building Permit does not prevent the Building Official from: (1) requiring the correction of errors in the submittals, if any, discovered after issuance; or (2) stopping construction
or use of the structure(s) or facility(ies) if such is in violation of County Regulation(s) or any other applicable law, Review of this Application, including submittals, and inspections
of the work by the Building Division do not constitute an acceptance of responsi bility or liability by the County of errors, omiss ions or discrepancies. As the Owner, I acknowledge
that responsibility for compliance with federal, state and local laws and County Regulations rest with me and my authorized agents, including without limitation my architect designer,
engineer and/or builder. I hereby acknowledge that I have read and understand the Notice and Certification above as well as have provided the required information which is correct and
accurate to the best of my knowledge. Gfr0,.4 to MM>~ . ~ ---,-1l£f'o/l'f-',liC..L3 __ _ propertYdwner Print and Sig~ Date OFFICIAL USE ONLY Special Condition s: Adjusted Valuation:
Plan Check Fee: Permit Fee: Manu home Fee: Mise Fees: \'J/~ $2SfP--~~OO Fees Paid: Balance Due: BPNo: iJ';5.09-f;O. ~O 1m. (lAc:{) IS~~JA 1_\/6\ -<.JV..J I Setbacks: oce Group: Const
Type: Zoning: R 4· ~~/~ /0?~7 BUILDING I PLANNING DIVISION: Signed Approval d'.te 7 ~a.. \\. \~ .\~