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5024 Cemetery Rd_BLD035467_2025
INSPECTION REPORT 4`titN G 1'O Permit No.: 'S4� -7 Lot #: Address: - s • Contractor: _ r u r 9s, ,S4 Owner: IN Date: -7- t i - 03 APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION - 24 hour notice required. )r v Inspector: G'S Date: -7- {t t-c S. TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in 'Final r)C , C ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT N G?'O Permit No.: Gq6 1 Lot#: Address: 50 z-y e—` ,mot cl -w4- Z Contractor: as C� e.0Pa 7 _ Owner: IN Date: APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION -24 hour notice required. Inspector: — - l/ ^-03 TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in 'Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: s City of Arlington Building Dept PUBLIC WORKS CHECKLIST PERMIT # �� " ( � 7 DATE LEGAL Plat Lot Tax ID# NAME 12 Js- ADDRESS at / BUILDING USE FP-- # of BUILDING UNITS CID Existing Required Signature Date Water Meter Fire Hydrant Side Sewer Permit Monitoring Manhole Cross-Connection Control Sewer: Off site On site Water: Off site On site Pretreatment Discharge Permit Water/Sewer Fees Date received Date Yellow returned Date Pink returned Department Of Community Development • 238 North Olympic Avenue Arlington, WA 98223 360-403-3431 To: Lee Hinds,My-Ed Construction From: Scott Black, Building Inspector Date: June 6, 2003 Re: Building Permit# 03-5467,Demolition of Residence at 5024 Cemetery Rd. Your demolition permit has been approved subject to the following conditions: Prior to demolition or burning of the structure: 1. All asbestos is to be removed and documentation submitted to the building department showing removal and disposal by an accredited agency. 2. Contact Earl Anderson of the Water Department at 360-403-3506 to discuss and inspect the disconnecting of the existing water service. 3. Contact Virgil Renfroe of the Wastewater Department at 360-403-3516 to discuss and arrange and inspection of the septic system to verify it has been properly decommissioned. Provide documentation of proper disposal of debris prior to calling for final inspection. Prior to issuance of a building permit for a new structure the demolition permit needs to be finaled. Any new construction will be required to connect to the City's sewer system. Please call Scott Black for any questions pertaining to building issues at 360-403-3437. Please call Reta Shepard for any questions pertaining to utility issues at 360-403-3526. r /7 r City of Arlington Building Depr' PUBLIC W�E,Wgj!UCKLIST SUN U 5 PERMIT # D3 _!-ll� 7 2�03 IVATE r� of AR,INGTG LEGAL / ` 3 f 051& Plat r Lot Tax ID# NAME CA 141 1'1) ADDRESS 'Too / r� T BUILDING USE � , = # of BUILDING UNITS Existing Required Signature Date Water Meter Fire Hydrant Side Sewer Permit Monitoring Manhole Cross-Connection Control l V Sewer: Off site On site Water: Off site On site Pretreatment Discharge Permit Water/Sewer Fees R E C E Date received D JUN 5 2 �a-' 003 to Yellow returned Utilities Div. Date Pink returned �d �� 9�) 1XV._t�5b ��-3 City of . • DepartmentUtilities Memo To: Lee Hinds, MY-Ed Construction From: Reta Shepard, Utilities Specialist CC: David Anderson, Building Official Date: June 5, 2003 Re: Utility Review, Building Permit#03-5467 - 5014 Cemetery Road Your house demolition documents submitted with Building permit #03-5467 have been reviewed for compliance with Utility Division regulations. To receive approval for home demolition from the Water and Wastewater Departments, you will need to complete the items listed below: Water Department 1. Prior to beginning work, contact Earl Anderson of the Water Department at 360403-3506 to discuss with him what is required for disconnecting the existing service. Wastewater Department 1. Contact Virgil Renfroe of the Wastewater Department at 360-435-3516 to discuss and arrange an inspection of the septic system to verify it has been properly decommissioned. 2. Any new construction will be required to connect to the City's sewer system. I can be contacted at 403-3526 to answer any other questions. • Page 1 A. A. Services, Inc. Invoice P.O. Box 3278 Arlington, WA 98223-3278 DATE INVOICE# PH(360)435-6682 FAX(360)435-7246 6/2/2003 #03-40-1 BILL TO �' PROJECT SITE Lee Hinds Arlington Demo 6020 - 79th Place NE 5024 Cemetery Road Marysville, WA 98270 Arlington, WA P.O./CONTRACT TERMS DUE DATE CONTACT Verbal Net 15 6/17/2003 Lee Hinds#425-334-3487 DESCRIPTION QTY RATE AMOUNT Asbestos Abatement Services for the removal and 1 300.00 300.00T disposal of VAT prior to demolition. Note: Customer filed his own Puget Sound Clean Air Agency Notices. 3101 - Arlington Sales Tax 8.50% 25.50 D � It's been a pleasure working with you! Total $325.50 A late charge of 1 1/2%per month,calculated from invoice date,will be charged on all past due accounts plus collection and/or Attorneys Fees. •JUN-11-2003 06 :20 AM WITTMAN 360 387 6430 P. 01 :R AAS y A. A. Services, Inc. P.O. Box 3278 . Arlington,WA 9rA23-3273 Telephone: 3604354U2 •Four 360433-TV4 Juno 11,2003 Mr.Lee Hinds 6020—79'x Plaoe NE Maryville,WA "270 Re: Asbestos Abatement at 5024 Cemetery Read,Arlington,WA Dear Mr.ffux s, This letter is to conf nu chat asbeatoa abaten=t of VAT was perfonned par your request prior to remodel and/or demolition by others as Hand above The work was completed on June 2"d. 2003. Please call meat(360)433-6692 if you have any further quesdws. Thank y'on fbr your business. Slnoerely, AAS,INC. /J aidrltl T.D. Alskog Company Invoice 30511 223RD AVE. NE ARLINGTON, WA DATE INVOICE# 98223 6/30/2003 1790 BILL TO MY- ED CONSTRUCTION LEE HINDS P.O. BOX 1012 EVERETT, WA. 98206 TERMS JOB LOCATION JOB NAME j Due on receipt Arlington CEMETARY RD. DESCRIPTION HRS/QTY RATE AMOUNT 06-30-03 EXCAVATOR/LOAD TRUCKS WITH CONCRETE 3 98.50 295.50T BASEMENT TRUCKING SOLO CONCRETE TO DUMP SITE 3 70.00 210.00 I TONS DUMP FEES CONCRETE 44.4 6.75 299.70T 3100 not in RTA 7.60% 45.24 I t l I i l k Thank you for your business. Total $850.44 City 60 1 Utilities of • • Department Memo To: Lee Hinds, MY-Ed Construction From: Reta Shepard, Utilities Specialist CC: David Anderson, Building Official Date: June 5, 2003 Re: Utility Review, Building Permit#03-5467 - 5014 Cemetery Road Your house demolition documents submitted with Building permit #03-5467 have been reviewed for compliance with Utility Division regulations. To receive approval for home demolition from the Water and Wastewater Departments,you will need to complete the items listed below: Water Department 1. Prior to beginning work, contact Earl Anderson of the Water Department at 360-403-3506 to discuss with him what is required for disconnecting the existing service. Wastewater Department 1. Contact Virgil Renfroe of the Wastewater Department at 360-435-3516 to discuss and arrange an inspection of the septic system to verify it has been properly decommissioned. 2. Any new construction will be required to connect to the City's sewer system. I can be contacted at 403-3526 to answer any other questions. • Page 1 5024 Cemetery Road,Arlington,WA '5XI07 Project#2003-190 3_ 5.0 FINDINGS Inventory of Suspect Asbestos-Containing Materials _ JJAf Sample Material Location JAsbestos Area ble Number Description (%) I 1 t es/no 2003-190 1: grey vinyl floor at back entrance to main ` 1: ND ""'4 V ruin -1-1 tile unit 2: yellow mastic 2: ND 2003-190 1: green linoleum north bedroom in main unit 1: ND • -2-1 2: fibrous backing 2: ND 2003-190 1: green linoleum north bedroom in main unit 1: ND -2-2 2: fibrous backing 2: ND 2003-190 1: white vinyl floor dining area of main unit 1: 2 160 1: no -3-1 the 2: yellow mastic 2: ND 3: grey vinyl floor 3: 3 3: no the _ 4: black mastic 4: ND 2003-190 1: white vinyl floor dining area of main unit 1: 2 -3-2 the 2: yellow mastic 2: ND 3: grey vinyl floor 3: 3 i the 4: black mastic 4: ND 2003-190 1: wood patterned kitchen of main unit 1: ND -4-1 vinyl floor the 2: yellow mastic 2: ND 2003-190 1: wood patterned kitchen of main unit 1: ND -4-2 vinyl floor the 2: yellow mastic 2: ND_ 2003-190 1: brown splash kitchen of main unit 1: ND -5-1 guard mastic 2: gypsum 2: ND wallboard 2003-190 textured painted ceiling of main unit <1* 385 no -6-1 finish 2003-190 textured painted ceiling of smaller unit ' ND -6-2 finish 2003-190 textured painted ceiling of smaller unit ND -6-3 finish 2003-190 1: linoleum bedroom of smaller unit 1; ND -7-1 2: fibrous back'n 2: ND - 2003-190 1: linoleum bedroom of smaller unit 1; ND -7-2 2: fibrous backing 2: ND *Please refer to the following section for information materials containing les than 1% Asbestos. ND-None Detected I NVL Laboratories, Inc., Page 5 4708 Aurora Avenue North,Seattle,WA 98103 Ph (206)547-0100 - Fx(206)63471936 5024 Cemetery Road,Arlington,WA Project#2003-190 17. Asbestos—continued 1 Sample Material Location Asbestos Area Friable Number Description '(yes/no) 2003-190 sheet vinyl kitchen of smaller unit _ ND 2003-190 loose fibrous attic crawl space ND -9-1 thermal insulation 2003-190 loose fibrous attic crawl space ND -9-2 thermal insulation 2003-190 loose fibrous attic crawl space ND F_ -9-3 thermal insulation 2003-190 1: rolled asphalt rooftop 1: ND -10-1 roofing F � 2: roofing felt 2: ND 2003-190 1: rolled asphalt rooftop 1: ND _ -10-2 roofing 2: roofing felt 2: ND 2003-190 asphalt roof rooftop ND -11-1 _ sealant ND - None Detected I _ _ Any suspect material(s) not identified above should not be disturbed, and tested immediately. The suspect material must be treated as asbestos containing until testing proves otherwise. I _ I , 7 i .l NVL Laboratories, Inc., Page 6 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206)547-0100 • Fx(206)634-1936 i 5024 Cemetery Road,Arlington,WA Project#2003-190 6.0 CONCLUSIONS AND RECOMMENDATIONS ASBESTOS The following summarizes the homogeneous Asbestos-Containing Materials (ACM) and Presumed Asbestos-Containing Materials (PACM) identified at the duplex located at 5024 Cemetery Road, Arlington, WA on April 22, 2003. i 1. Vinyl floor tile: (material number 2003-190-3) There is approximately 160 ftz of asbestos-containing vinyl floor tile in the dining area of the main unit. 2. Painted texture on ceiling: (material number 2003-190-6) There is approximately 385 ftz of asbestos-containing painted texture on the ceiling in the living room of the main unit. This material contains less than 1% asbestos. Please refer to the end of this section for information on materials containing less than 1% asbestos. f If discovered, all ACM's that will be disturbed as a natural part of renovation/demolition and are required to be removed and disposed of in accordance with Washington State Regulations. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on-site supervision of a Certified Asbestos Supervisor. Further, NVL suggests that an AHERA inspector review this —J property after abatement to ensure all ACM has been removed by the contractor. Hidden wall and ceiling cavities that are not accessible during the time of surveying can sometimes conceal ACM. Thus, NVL recommends that an AHERA inspector/project manager be on site at the time of renovation/demolition to ensure that any potentially asbestos- containing materials uncovered during the process of renovation/demolition be dealt with properly. Approximations of quantities are reported as an added service to our clients. These quantities are approximations and should be verified by the client. I _ J NVL Laboratories, Inc., Page 7 4708 Aurora Avenue North,Seattle,WA 98103 Ph (206)547-0100 • Fx(206)634-1936 f CITY OF ARLINGTON, WASHINGTON --- BUII 'ZING DEPARTMENT No building construction shall be commenced until permit holder INSPECTION RECORD SHALL or his agent has posted this Inspection Record Card in a REMAIN AT JOB SITE conspicuous place on the premises. OWNER: CONTRACTOR: -";_• JOB ADDRESS: O ! LL,tit �;�-� PLAT NAME LOT# NATURE of WORK: NEW CONSTRUCTION USE of BUILDING: c/�i� -- SFR _ PERMIT No Ci -7 DATE ISSUED: - r Is TYPE GROUP INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB DEPARTMEN INSPECTION DATE INSPECTOR'S SIGNATURE FOOTING BUILDING FOUNDATION (360)435-0674 UNDERFL00 Press#1 SHEAR W L PL ING(grounc••vork) G PING(groun. vork) ROUGH UMBING ROUGH GA IRNG ROUGH HEATIN 3 VENTIL-..ION FRAMING INSULATION WALLBOARD STORM DRAINAG= ENGINEERING GRA tN (360)435-0674 Y _54s#Z GENERAL SERVICES (360)4350674 = Y I.• Pra3ss F3 - UTILITIES >:�;t,� 5��2- •�r �rw�.� rp-C?-Oj '� (360)435-0674 C(7-- .3C)-C_j l(_ (� Sewer Press#5 ST OW Water press#6 W (TER-SE-RVICE-tN-ST- --)N (360)435-0674 FINAL INSPECTION Press#1 All sections must be signed ca prior t final inspection C I T1f OF ARL I MC3-rU I CO I'll STRU(--T I C)M PERM I T PE Ft I T P4C) _ GD3-546 -7 Orner: HINDS, LEE PO BOX 1012 EVERETT 98206 Value of Work: $0. 00 Tax ID: 310516-001-015-00 Phone: 388-9611 Describe Work: BURN AND DEMOLISH EXISTING RESIDENCE Proposed Use: VACANT LAND Legal Description: Job Address: 5024 CEMETERY ROAD Contractor's Name Type Address License* MY ED CONSTRUCTION GEN PO BOX 1012 MYEDCI0558T TOTALS Fee Permit Fee $100. 00 State fee $4. 50 SIGNATU TOTAL FEE. . . . . . . . . . . . . . . . . $104. 50 I HEREBC-ERTIF�Y HAT I HAVE READ AND EXAMINED THIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KNO THE SAME TO BE TRUE AND COR- RE ALL PROWDT OFS AND TOTAL DUE. . . . . . . . . . . . . . . . . $104. 50 OR I ANCE GYPE OF WO K WIL EWHETHER C FfE%�A1`"' RECEIPT # UIL INGO N ) i g T:_,'!'I Q1 _'23 12 J5 +ir = IGE:T So!_('•i] r=IP Ei:L''r:i P.3/4 r c vt C SO[�1D CLFA\'AIR AQE4 CY r — ]l0 l:rion Street,Suite sr Dare Recaired Seettie,WA 93101-2038 tvww.nscleanainorg 1 -4gency use oily :NOTICE OF LATENT .tgency Us:Only . Yroieei'f�ne; i (] ;F'iable AchneMc D tnoval , 2- ❑ Friab.e Asj►g os R oval&Demolition ,; 3. ❑ Derno, tton�Iv,_ 1 Property Owner: / c C Phone: L:atli. Address: Q O 2 City: !�f/'"yv Stzte �l.�Gt.- Li �O C. A4besros P ` rracr.rn carts:ro hf.vzNtir,r Contractor- Mailin Add,-ess! — .�� Contractor ' Phone: Job No.: Airh 0— ( /C-k Zi �— Fax: D. Site Address: O / Site "G City: Z 4 h i . Manager: Local Phone: I j F• Asbestos Sur vev or No.of 1at'1 Presumed Structures: Date of 4s stos . Was Friable Asbestos Identified? s: Sun a Yes o t f AHER-A Building / p Was Noti iable Asbestos Identif"K, ❑fires LINa ' Ins?ector: p Certification#: 60 Attach a copy of the survey unless jriabie asbestos I Fat .Date: p is identified Sr::?liEq 4 Syr. a required before ail de�te1+':ton�raj�ts F. Demolition Star, Information: Date: ��j-e _ O No, of 1. Training Fire(List Fire Dept,) t Structures: 2. ❑ Ordered Deniol;tion!attach cc of O:der? lrr ert 6':m .'LOn conrractvr't Demolit On erriirtg adr'ress on back. Contt'actor: Will ncnfriabl:asbestos be Ieft in place during demo? Yes iva es,list' and qty. G. Friable Asbestos Protect Information: Start llatc: Fork Days: vt T VA' '1'h r sa u S Comoletion Date: Hour;: Total Ory to he Removed: Litlear ft Will all friable asbestos Ye. List We(*of material to be removed: S uare Ft materials be removed? ❑ :�o H. AsbestosJDemolition Project Categories: —� 1. Single-Family Residence: Notifrcatlon period Project DemaHtior. A. Q.Asbestos Removal Project Only Fee Surchnha�e B.'%Demolition Project(t^ith or without asbestos removel project) A.Prior Notice A. $25 *(Asbestos removal can be ir.u un notification:demolition must wait 10 da s) 13 10 Days" B. I50 Vote:Ifthe single fantPly residence is owned b one snrLt y f who has been or will oe using the residence as their domicile,(he above boxes 1.4 or eB me•he checked. A sin le anti! residence does not include rental rn e ,multi- ainif•unit or an neiared-use Other Detn�lidons Witb No Asbestos Removal Pro'ec: _ Friable Asbestos prole other than Sin le FamJ 1 Residence): I Q Da s _ 200 �t 3. > 10-25S linear feet or?43. 159 s ware feet of asbestos Asbestos Demo Y. 260- 999 Iinear feet or 160-4,999 s uare feet of asbestos Prior Notice 10 Da s $ISO gd0 1, 1,000-9,999 linear feet or 5 000-49,999 s ua:c feet of asbestos 10 Da $300 $1 CO �6 >10,000 linear feet or--,SO,Oi)0 stare feet of asbestos l0 Da $7e0 �2�C Emergency Asbestos Pro)ect or Erergency Demolition Project 10 Da $Z 0(.N) 'Siny.le-hmiy Residences are exemptfrom niffsency fee;ttoWcver, , Frior Notice Twice Project Fee 7 I tt owner rra st provide a written enersenav request) [. ]ecrtify that t}.e i romaro coraained i^this r.,t fica:ion&supP]emental daca is,to the best of ny know3ccige.accurate&eomplCe. Agency Use Only Ste re Re9rerentin ate Revtewe d By jget S:-ur,d Crean AtrAgency Form No.. 66-160,ReYiayd 3iO3;TS RECEIVED JUN 0 4 2003 ��� 3 CITY OFARLINGMN 30 N d3 11 When Recorded Return To: 21 RECEIVED 1z - Lee E. Hinds P.EveOrett�WA 98206 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIII JUN U 4 2003 r 200304250082 3 PGS 04-25-2003 10:09am $21 .()bTY OF ARLINGTON �0 SNOHOMISH COUNTY. WASHINGTON g o• AH TRUSTEE'S DEED The GRANTOR, Kathleen Kim Coghlan, as present Trustee under that Deed of Trust, as hereinafter particularly described, in consideration of the premises and payment, recited below, hereby grants and conveys, without warranty, to: Lee E. Hinds, GRANTEE, that real property, situated in the County of Snohomish, State of Washington, described as follows: Lot 3 of City of Arlington Short Plat No. MN-00-037-SP recorded under Recording Number 200111155004, being a portion of the Northeast quarter of Section 16, Township 31 North, Range 5 East, W.M. in Snohomish County, Washington. (which is more commonly known 5024 Cemetery Road, Arlington, Washington 98223) Tax Parcel No.: 310516-001-015-00 RECITALS: l. This Conveyance is made pursuant to the powers, including the power of sale, conferred upon said Trustee by that certain Deed of Trust between the Harold E. Smith and Polly A. Smith, husband and wife, and Christopher D. Smith and Kellyanne M. Smith, husband and wife, as Grantors, Stewart Title, as Trustee, to secure an obligation in favor of North County Bank, as Beneficiary, dated December 29, 2000, recorded January 11, 2001 under Auditor's File No 200101110362 records of Snohomish County, Washington. 2. Said Deed of Trust was executed to secure, together with other undertakings, the payment of a promissory note in the sum of$225,000.00, with interest thereon, according to the terms thereof, in favor of North County Bank and to secure any other sums of money which might become due and payable under the terms of said Deed of Trust. 3. The described Deed of Trust provides that the real property conveyed therein is not used principally for agricultural or farming purposes. - i - 4. Default having occurred in the obligations secured and/or covenants of the Grantor as set forth in "Notice of Trustee's Sale" described below, which by the terms of the Deed of Trust made operative the power to sell, the thirty day advance "Notice of Default" was transmitted to the Grantor, or his successor in interest, and a copy of said Notice was posted or served in accordance with law. 5. North County Bank, being then the holder of the indebtedness secured by said Deed of Trust, delivered to said Trustee a written request directing said Trustee to sell the described property in accordance with the law and the terms of said Deed of Trust. 6. The defaults specified in the "Notice of Default" not having been cured, the Trustee, in compliance with the terms of said Deed of Trust, executed and on December 27, 2002 recorded in the office of the Auditor of Snohomish County, Washington, a " Notice of Trustee's Sale" of said property under Auditor's Recording No. 200212270665. 7. The Trustee, in its aforesaid " Notice of Trustee's Sale," fixed the place of sale as the entrance to the Snohomish County Superior Courthouse, 3000 Rockefeller, Everett, Washington 98201, a public place, on March 28, 2003 at 10:00 o'clock a.m., and in accordance with law, caused copies of the statutory "Notice of Trustee's Sale" to be transmitted by mail to all persons entitled thereto and either posted or served prior to ninety days before the sale and caused a copy of said "Notice of Trustee's Sale" to be published between the thirty-second and twenty-eighth day before the date of sale, and once between the eleventh and seventh day before the date of sale; and further, included with this Notice, which was transmitted or served to or upon the Grantor or his successor in interest, a "Notice of Foreclosure" in substantially the statutory form, to which copies of the Grantor's Note and Deed of Trust were attached. 8. During foreclosure, no action was pending on an obligation secured by said Deed of Trust. 9. All legal requirements and all provisions of said Deed of Trust have been complied with, as to acts to be performed and notices to be given, as provided in Chapter 61.24 RCW. 10. The defaults specified in the "Notice of Trustee's Sale" not having been cured eleven days prior to the date of Trustee's Sale and said obligation secured by said Deed of Trust remaining unpaid, on March 28, 2003, the date of sale, which was not less than 190 days from the date of default in the obligation secured, the Trustee then and there sold at public auction to said Grantee, the highest bidder therefore, the property hereinabove described, for the sum of$ 94,000.00 (Cash). DATED this 7 --- day of April, 2003. ha hleen Kim Co_l lai , Trustee STATE OF WASHINGTON ) ) ss. COUNTY OF KING ) On this day personally appeared before 1ne Kathleen Kim Coghlan, to me known to be the individual described in and who executed the within and foregoing instrument, and acknowledged that she signed the same as her free and voluntary act and deed for the usq and purposes therein mentioned. GIVEN under my hand and official seal this day of ,2003. Notary Public State of Washington DARLAMARSHALL PrintName: My Appointment Expires Jun 3, 2004 NOTARY PUBLIC in and for the State of Washington, residing in King County. My commission expires: 4L (� N:\cl ients\1 7103\21 1\Trustee's Deed.doc CITY OF ARLINGTON CONSTRUCTION PERMIT ] El COMBINATION ❑COMBINATION ❑ BUILDING O ❑ PLUMBING ElSIGN PERMIT NO. UttnLR, /MAIL ADDRESS CITY ZFP PHONE AACHITLCT UK UESIGNLR MAIL AOURESS CITY ZIP F'I40NE GLNLKAL CUN(RAL'iOR MAIL ADDRESS ell / /. CITY ZIP PHONE LIC NSE Il btLTIIANI n UNTKACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 1 g - FLLIM11ING CONTRACTOR MAIL ADDRESS ` E cll CITY ZIP PHONE LICENSE/ CLAS)OF WORK ❑NLW [:]ADDITION ❑ALTERATION ❑REPAIR ODEMOLITION ❑BUILDING RELOCATION VALUAT ION Of WORK S ULSLR18E WORK P U USt U USE OF BUILDING _,;;1 e c e I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- LLGAL ULSCKIP f IUN Of PROPLKTY SHOWN BELOW OR ATTACH FOUR COPIES) TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOI 3 BLUCK • OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO 65� - �6 - i - VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION.PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. IUD AUURI SS SIGNATURE OFCONT CTOR OR AUTHORIZED NT DATE Zz ; _ (OFFICE USE ONLY) PLUMBING N1 CHANICAL NO. I TYPE OF FIXTURE FEE NO. I TYPE OF EQUIPMENT FEE %VATER CLOSET (TOILLI) AIR COND.UNITS-H.P.EA. BA III I UB REFRIGERATION UNITS-H.P.EA. LAVAIORY(WASH BASIN) BOILERS-H.P.EA Sfi()WL'R GAS FIRED A.C.UNITS-TONNAGE EA. KI ICIIEN SINK& UISP. FORCED AIR SYSTEMS-B.T.U. MEA U1514WASHE'R WALL HEATERS-B.T.U. M LAUNDRY 1 RAY UNI1 HEATERS-B.T.U. M CLOIIILS WASI(LR EVAPORAI IVE COOLERS WATER IIEATLR CLOIHESDR.YERS URINAL VLNTILATICN FAN DRINKING FUUN IAIN RANGE HOOD COMMERCIAL 1'LUOR DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOT DRAINS•- RAINLEAUERS METAL FIREPLACE&CHIMNEY SINK (SERVICE - BAR.E TC.) WATER HEATER GAS PIPING SUB TOTAL 3 SUBTOTAL f PERMIT ! PERMIT f TOTAL FEE f TOTAL FEE f SIULY.IRUSLIunCK SfKLLlSL10ACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEL FEE RECEIPT NO. USI /UNI LOI AKLA VACANT SITE ❑YES !E[a:]NO]� FEES VALUATION FEE I YPL Of CONS1. OCCUPANCY GROUP NO.OF DWELLPLAN CHECKING VG SILL OI ULUG• NO.Of STUHILS MAX.000.LOAD BU'WING f PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE PENALTY U.D.C. SEC.]0)1+1 WATER/SEWER FEES RECEIVED TOTAL PERMIT VAUDATION J UN 0 4 2003 WHEN PROPERLY VALIDATED TIN THIS SPACEI THIS IS YOUR PERMIT&RECEIPT PAID CRp BY CITY OF ARLINGTON r'r1•P':''f'!;^r'l F� Arr I Io^n1,,T 'nr-pr:iI'rr n •.r mn ri—T P,-11 r".11.r "I".1 n..r ,'ATCHBASIN v�_" 'r ■ c . • V•98.87' h 8 u � -96.97' EXISTING MANHOLE : :=95.52' RIM ELEV.=99.78' !=95.62' FLOW LINE=85.42' EXISTING CATCHBASIN -- --- — — — — RIM ELEV.=99.60' 8` S.INV.ELEV.=96.50' - - - -FM- - - - -FM- -FM- - -FM- - - - - -FM- - - E.INV.ELEV.=96.30' 12 ) W.I � 8` NV.ELEV.=96.15' lualr D D D - �� i W W W v � w �- - - - -FM- - - - �T 04' 23" E ` 530.58 S— G`W�\ G G rn� b \ ��-G ----off CONC. WALK CURB CL T CURB CUT CONC. WALK 7' 82.10' m 93.10' EXISTING INLET i 25.02'i LA >10.11' RIM ELEV.=99.59' INLET :/C9 " % po N o INV. ELEV.=96.69' .=98.76' FND. 1/2 B&C � �o r' -97.06' r___1?4Ej .Ls-js2 �--- - - ---�-� r--- ------------------- EX. PUMP HOUSE O WELL TO BE I 1 DECOMMISSIONED 1 IN ACCORDANCE OTW/WAC 173-160-381- i i II I I I 1 .556 SO. FT. 1 - I I 1 I %/ ofiEC I°'V v 25' To BE REMOVED I "'i `f E AC I V -- x ,4r . CESS FRO NEW ROA 1 � ? ; I CITY OF A I' N LOT 1 1 12.549 SO. FT. 0 TO BE C7 N I i ; REMOVED I C791 L cn 1 I I I ` �_ ------------�------- � 10 66 �- -42.09,-- �-_ ---'- 50.97J ,1 (n 1 51.74 ____ 11 _20_ N86'36' 8"E _S 89_42 20 E R° } r SETBACK FOR To BE i to DAD 1 �� HOUSE TO BE REMOVED i C m 1 I 5 MIN. HOUSE � B.S 2Q'.B.L- r' � ( I . � I ,` I I LOT ►i 3 w 21.111 SO, FTC(TOTAL) 15.478 SO,*T. (NET) 163105-1006-002 )` 0o I I JUDITH MCKINTOSH 5024 CEMETERY ROAD I AR INGTON, WA. I � I 1 ----------5----89,- --42;f- ----- - --------- _ _ i I S.L. #13 20` - 185.r----------------- '-25.00*- 5 t I 5' B.S.B.L. I `TO E REMO OR -----t--i m '-25.00'-� I Vl N x I (TYP. SIDE) I LOCATED 1 � W o - I 10' B.S.B.I --------- It ` J I �- ,__(TYP; RLAR) I --- _ - \ I I $ LOT 15.539 SO. FT. I (TYP. SI-- DE) f` 1 I r" I - L------------- -- ----- S 89' 42' 20 E - ----- - 1 :a 210.00' LOT 6 --1c, cool n.,.. ...._ _ _ / 1 I )T 0 _ SUN0 - C/�, 4 Asbestos Survey 5024 Cemetery Road Arlington, WA www.nvllabs.com ZARDO ATERIALS TRAINING IN I L A & B S HAZARDOUS MATERIALS SERVICES Asbestos Survey 5024 Cemetery Road Arlington, WA Date Prepared April 28, 2003 Prepared for: Lee Hinds My-Ed Construction, Inc. PO Box 1012 Everett, WA 98206 Prepared By: John Terrill Building Inspector Cert.#: 1004060 Expiration Date: February 4, 2004 Date Inspected: April 22, 2003 Project#: 2003-190 i i i i i i i i i i i i i i i i i _i l 1 TABLE OF CONTENTS Subject Page J 9 1.0 SCOPE OF WORK 1 1 2.0 SURVEY METHOD 2 3.0 LABORATORY INFORMATION 3 l 4.0 BUILDING DESCRIPTION 4 5.0 FINDINGS 5-6 1 6.0 CONCLUSIONS AND RECOMMENDATIONS 7-8 7.0 LIMITATIONS OF SURVEY 9 APPENDICES Sample Locations (Map) A Laboratory Results B AHERA Certifications & Laboratory Qualifications C . 1 J J 5024 Cemetery Road,Arlington,WA Project#2003-190 1.0 SCOPE OF WORK An investigative survey for asbestos containing materials (ACM) was conducted on a residential structure located at 5024 Cemetery Road, Arlington, WA. John Terrill conducted the inspection on April 22, 2003, an AHERA certified building inspector. This inspection was performed at the request of Lee Hinds of My-Ed Construction, Inc. The purpose of this inspection was to identify asbestos containing materials that would be impacted by the planned demolition of this structure. The asbestos survey section is written to comply with the AHERA asbestos sampling procedure as stated in 40 CFR 763.86. This protocol is required for all asbestos surveys prior to a building demolition under the Puget Sound Clean Air Agency, (PSCAA), Regulation III, Article IV, revised July 13, 2000. The asbestos survey also satisfies the "Good Faith" asbestos inspection requirements as stated in Washington Administrative Code (WAC) 296-62-07221(2), "identification". As stated in this regulation, the owner of a structure scheduled to be renovation/demolished must provide a contractor with a written report of the asbestos containing materials to be disturbed during renovation/demolition. The National Emission Standards for Hazardous Air Pollutants (NESHAP), 40 CFR Part 61 requires a survey by an accredited asbestos inspector prior to demolition of a structure. A floor sketch indicating sampling locations has been included in Appendix A. NVL Laboratories, Inc., Page 1 4708 Aurora Avenue North, Seattle,WA 98103 Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington, WA Project#2003-190 2. 0 SURVEY METHOD Asbestos Survey Method A walk-through inspection of all accessible areas of this structure was performed to identify potential asbestos-containing materials. The walk-through inspection included a review of the internal and external aspects of this structure. The locations and types of potential asbestos containing materials were noted. Sufficient bulk samples of building materials (vinyl floor tile, roofing, wall materials, etc.)were obtained of each material to satisfy the requirements of the Asbestos Hazard Emergency Response Act (AHERA) rules and regulations. These samples were placed into plastic sample bags, numbered and recorded. Homogeneous Materials Homogeneous materials are defined as an area of Asbestos-Containing Material (ACM) or Presumed Asbestos-Containing Material (PACM) which appears similar throughout in terms of color, texture, and date of material application. The report listing for homogenous materials will appear as follows: Sample Material Location Asbestos Area Friable iNumber Descri tion % ft._') (yes/no 'ob#-01-01 white floor tile kitchen 'ob#-01-02 white floor tile kitchen ob#-01-03 1white floor the I kitchen Under L & I Guidelines, a minimum of three negative analysis of a single suspect homogeneous asbestos containing material is required to prove a negative result for surfacing materials and thermal system insulation. NVL Laboratories, Inc., Page 2 4708 Aurora Avenue North, Seattle, WA 98103 Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington,WA Project#2003-190 3.0 LABORATORY INFORMATION Laboratory Analysis —Asbestos Samples are analyzed in our laboratory using polarized light microscopy (PLM) with dispersion staining. If samples are not homogeneous, then subsamples of the components were analyzed separately. All Bulk samples are analyzed using EPA Method 600/R-93/116 with the following measurement uncertainties for reported % Asbestos (1%=0-3%, 5%=>1-9%, 10%=5-15%, 20%=10-30%, 50%=40-60%). For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled Layer: 1, Layer: 2, etc.). The asbestos concentration in the sample is determined by visual estimation. Laboratory Accreditation Professional accreditations for NVL Laboratories, Inc., include the following: NVL Laboratories, Inc., is currently accredited by the National Institute of Standards and Technology (NIST) under the National Volunteer Laboratory Accreditation Program (NVLAP) program for bulk asbestos fiber analysis. NVLAP Lab Code 102063-0. NVL Laboratories, Inc., is approved by the American Industrial Hygiene Association (AIHA) Asbestos Analysts Registry (AAR) program for airborne asbestos fiber analysis. Counter ID 7412. NVL Laboratories, Inc., is currently accredited by the American Industrial Hygiene Association (AIHA) under the Industrial Hygiene Laboratory Accreditation Program (IHLAP). The IHLAP program is designed specifically for laboratories involved in analyzing samples to evaluate workplace exposure. Certification Number 563. NVL Laboratories, Inc., Page 3 4708 Aurora Avenue North, Seattle,WA 98103 Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington,WA Project#2003-190 4.0 BUILDING DESCRIPTION General Building type: This is a single story, wood framed, duplex. Primary external components: The primary external component is wood siding. Type of foundation: The structure rests on a concrete slab and/or soil. Roofing materials: Roofing is rolled asphalt and asphalt sealants. Window types: Windows are aluminum framed, without glazing compounds. Flooring: Flooring is primarily wood. There is some sheet vinyl, linoleum, and vinyl tile in the kitchens, bathrooms and bedrooms. Thermal systems w/insulation types: Heating is primarily from a wood stove supplemented by electric baseboard heaters. Finishing: The walls and ceilings are primarily fir boards with some textured gypsum wallboard in places. NVL Laboratories, Inc., Page 4 4708 Aurora Avenue North, Seattle,WA 98103 Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington,WA Project#2003-190 5.0 FINDINGS Inventory of Suspect Asbestos-Containing Materials Sample Material Location Asbestos Area Friable Number Description %/% ft2 es/no 2003-190 1: grey vinyl floor at back entrance to main 1: ND -1-1 the unit 2: yellow mastic 2: ND 2003-190 1: green linoleum north bedroom in main unit 1: ND -2-1 2: fibrous backing 2: ND 2003-190 1: green linoleum north bedroom in main unit 1: ND -2-2 2: fibrous backing 2: ND 2003-190 1: white vinyl floor dining area of main unit 1: 2 160 1: no -3-1 tile 2: yellow mastic 2: ND 3: grey vinyl floor 3: 3 3: no tile 4: black mastic 4: ND 2003-190 1: white vinyl floor dining area of main unit 1: 2 -3-2 the 2: yellow mastic 2: ND 3: grey vinyl floor 3: 3 the 4: black mastic 4: ND 2003-190 1: wood patterned kitchen of main unit 1: ND 1 -4-1 vinyl floor tile 2: yellow mastic 2: ND 2003-190 1: wood patterned kitchen of main unit 1: ND -4-2 vinyl floor tile 2: yellow mastic 2: ND ' 2003-190 1: brown splash kitchen of main unit 1: ND -5-1 guard mastic 2: gypsum 2: ND wallboard 2003-190 textured painted ceiling of main unit <1* 385 no -6-1 finish 2003-190 textured painted ceiling of smaller unit ND -6-2 finish 2003-190 textured painted ceiling of smaller unit ND -6-3 finish 2003-190 1: linoleum bedroom of smaller unit 1; ND -7-1 2: fibrous backing 2: ND 2003-190 1: linoleum - bedroom of smaller unit 1; ND -7-2 2: fibrous backing 2: ND * Please refer to the following section for information materials containing les than 1%Asbestos. ND- None Detected NVL Laboratories, Inc., Page 5 4708 Aurora Avenue North,Seattle, WA 98103 Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington,WA Project#2003-190 Asbestos—continued Sample Material Location Asbestos Area Friable Number Description % ftZ es/no 2003-190 sheet vinyl kitchen of smaller unit ND I -8-1 2003-190 loose fibrous attic crawl space ND -9-1 thermal insulation 2003-190 loose fibrous attic crawl space ND -9-2 thermal insulation 2003-190 loose fibrous attic crawl space ND -9-3 thermal insulation 1 2003-190 1: rolled asphalt rooftop 1: ND l -10-1 roofing 2: roofing felt 2: ND 1 2003-1 00 1: rolled asphalt rooftop 1: ND -10-2 roofing 2: roofing felt 2: ND 2003-190 asphalt roof rooftop ND l -11-1 sealant ND - None Detected 1 Any suspect material(s) not identified above should not be disturbed, and tested immediately. The suspect material must be treated as asbestos containing until testing proves otherwise. 1 _ l . l _ 1 _ 1 _.J NVL Laboratories, Inc., Page 6 4708 Aurora Avenue North, Seattle,WA 98103 `� Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington, WA Project#2003-190 6.0 CONCLUSIONS AND RECOMMENDATIONS ASBESTOS The following summarizes the homogeneous Asbestos-Containing Materials (ACM) and Presumed Asbestos-Containing Materials (PACM) identified at the duplex located at 5024 Cemetery Road, Arlington, WA on April 22, 2003. 1. Vinyl floor tile: (material number 2003-190-3) There is approximately 160 ft2 of asbestos-containing vinyl floor tile in the dining area of the main unit. 2. Painted texture on ceiling: (material number 2003-190-6) There is approximately 385 ft2 of asbestos-containing painted texture on the ceiling in the living room of the main unit. This material contains less than 1% asbestos. Please refer to the end of this section for information on materials containing less than 1% asbestos. If discovered, all ACM's that will be disturbed as a natural part of renovation/demolition and are required to be removed and disposed of in accordance with Washington State Regulations. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on-site supervision of a Certified Asbestos Supervisor. Further, NVL suggests that an AHERA inspector review this property after abatement to ensure all ACM has been removed by the contractor. Hidden wall and ceiling cavities that are not accessible during the time of surveying can sometimes conceal ACM. Thus, NVL recommends that an AHERA inspector/project manager be on site at the time of renovation/demolition to ensure that any potentially asbestos- containing materials uncovered during the process of renovation/demolition be dealt with properly. Approximations of quantities are reported as an added service to our clients. These quantities are approximations and should be verified by the client. NVL Laboratories, Inc., Page 7 4708 Aurora Avenue North, Seattle,WA 98103 Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington,WA Project#2003-190 Materials Containing 1% Asbestos or Less The OSHA asbestos standard(s) regulate occupational exposure to asbestos, including asbestos containing material (ACM). Please see (a) Scope and Application and (b) Definitions for"Asbestos" and "Asbestos Containing Material," for the General Industry, Construction and Shipyard asbestos standards. In the OSHA Construction Standard, work involving materials containing 1% or less asbestos would be considered unclassified. Unclassified asbestos operations cover employees likely to be exposed in excess of the permissible exposure limit (PELs), and who are performing operations not covered by Class I through IV. For construction work involving unclassified asbestos the applicable requirement will include; an exposure assessment, use of vacuum cleaners equipped with HEPA filters, use of wet methods and prompt cleanup of debris, use of respirators and protective clothing, training and record keeping. Further, If a negative exposure assessment cannot be made, air monitoring would be required Ias part of the exposure assessment. I I l I l J .1 _1 NVL Laboratories, Inc., Page 8 4708 Aurora Avenue North, Seattle,WA 98103 `� Ph (206)547-0100 • Fx(206)634-1936 5024 Cemetery Road,Arlington,WA Project#2003-190 7.0 LIMITATIONS OF SURVEY The sole purpose of this survey report is to document asbestos-containing materials discovered in the survey of suspect materials by NVL Laboratories personnel at the duplex located at 5024 Cemetery Road, Arlington, WA on April 22, 2003. This site visit consisted of a thorough visual walk-through of the building for the purpose of viewing and sampling potential ACMs. As hazardous material surveys are non-comprehensive by nature, NVL Laboratories, Inc., cannot be held liable for materials which require destructive means to access, materials which are hidden from sight (e.g. materials hidden behind walls), materials which cannot be found due to their obscure nature, or which otherwise cannot be discovered with reasonable diligence. This document is the sole property of NVL Laboratories and the property owner, or his agent, authorizing this survey. Inspected by: Q� 9/ �- John Terrill AHERA Building Inspector AHERA Certification No.: 1004060 AHERA Certification Expires on: February 4, 2004 NVL Laboratories, Inc., Page 9 4708 Aurora Avenue North, Seattle,WA 98103 Ph (206)547-0100 • Fx(206)634-1936 i i i i i i �v. Z NM rr� I _ N � fr � d -� c,-2 g v N C'' ~J I� �-IZJ V C^ C^ i i i i i i i i i i i i i i i i i �I�da NVL Laboratories, Inc. � 4708 Aurora Ave. N., Seattle, WA 98103 #102063 Te1: 206.547www. bs.com6.634.1936 Bulk Asbestos Fibers Analysis www.nvllabs.com By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 2305329.00 Address: 4708 Aurora Ave. North Client Project #:2003-190 Seattle, WA 98103 6516 Samples Received: 21 Attention: Mr. John Terrill Samples Analyzed: 21 Project Location: 5024 Cemetary Road, Arlington, WA Method: EPA/600R-93/116 Lab ID : 23035087 Client Sample #:2003-190-1-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: Gray vinyl material with gray plastic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder, Binder/filler Cellulose 1% None Detected ND Layer 2 of 2 Description: Yellow mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 7% None Detected ND Lab ID : 23035088 Client Sample #:2003-190-2-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: Green vinyl material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Binder/filler, Mastic/binder Cellulose 65% None Detected ND Lab ID : 23035089 Client Sample #:2003-190-2-2 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: Green vinyl material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Binder/filler, Mastic/binder Cellulose 65% None Detected ND Lab ID : 23035090 Client Sample #:2003-190-3-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 4 Description: Gray vinyl tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% Chrysotile 2% Layer 2 of 4 Description: Yellow mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 4% None Detected ND Sampled by: Client Analyzed by: Wei Long Tai Date:04/24/2003 Reviewed by: Nick Ly Date:04/24/2003 Nick _y, ,nical_9i a or Note:If samples are not homogeneous,then subsamples of the components were analyzed separately.All bulk samples are analyzed using EPA 600/R-93/116 Method with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%,10%=5-15%,20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full,without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 1 of 5 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 #102063 Te1: 206.547www. bs.com6.634.1936 Bulk Asbestos Fibers Analysis www.nvllabs.com By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 2305329.00 Address: 4708 Aurora Ave. North Client Project #:2003-190 Seattle, WA 98103 6516 Samples Received: 21 Attention: Mr. John Terrill Samples Analyzed: 21 Project Location: 5024 Cemetary Road, Arlington, WA Method: EPA/600R-93/116 Layer 3 of 4 Description: Gray vinyl tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% Chrysotile 3% Layer 4 of 4 Description: Black mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 7% None Detected ND Lab ID : 23035091 Client Sample #:2003-190-3-2 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 4 Description: Gray vinyl tile Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% Chrysotile 2% Layer 2 of 4 Description: Yellow mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 4% None Detected ND Layer 3 of 4 Description: Gray vinyl the Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% Chrysotile 3% Layer 4 of 4 Description: Black mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 7% None Detected ND Lab ID : 23035092 Client Sample #:2003-190-4-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: White vinyl tile with yellow plastic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder, Binder/filler Cellulose 2% None Detected ND Layer 2 of 2 Description: Yellow mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 4% None Detected ND Lab ID : 23035093 Client Sample #:2003-190-4-2 Location: 5024 Cemetary Road, Arlington, WA Sampled by: Client j Analyzed by: Wei Long Tai Date:04/24/2003 Reviewed by: Nick Ly Date:04/24/2003 Nick E nic� or Note:If samples are not homogeneous,then subsamples of the components were analyzed separately.All bulk samples are analyzed using EPA 600/R-93/116 Method with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%,10%=5-15%,20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full,without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 2 of 5 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 #102063 Te1: 206.547www. bs.com6.634.1936 Bulk Asbestos Fibers Analysis www.nvllabs.com By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 2305329.00 Address: 4708 Aurora Ave. North Client Project #:2003-190 Seattle, WA 98103 6516 Samples Received: 21 Attention: Mr. John Terrill Samples Analyzed: 21 Project Location: 5024 Cemetary Road, Arlington, WA Method: EPA/600R-93/116 Layer 1 of 2 Description: White vinyl tile with yellow plastic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder, Binder/filler Cellulose 2% None Detected ND Layer 2 of 2 Description: Yellow mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 4% None Detected ND Lab ID : 23035094 Client Sample #:2003-190-5-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: Brown mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Mastic/binder Cellulose 2% None Detected ND Layer 2 of 2 Description: White chalky material with paper Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Gypsum/binder, Binder/filler Cellulose 27% None Detected ND Lab ID : 23035095 Client Sample #:2003-190-6-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: White compacted powdery material with paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Paint Cellulose 3% Chrysotile <1% Lab ID : 23035096 Client Sample #:2003-190-6-2 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: White compacted powdery material with paint and paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Paint Cellulose 3% None Detected ND Lab ID : 23035097 Client Sample #:2003-190-6-3 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: White compacted powdery material with paint and paint Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler, Paint Cellulose 3% None Detected ND Lab ID : 23035098 Client Sample #:2003-190-7-1 Location: 5024 Cemetary Road, Arlington, WA Sampled by: Client Analyzed by: Wei Long Tai Date:04/24/2003 _ Reviewed by: Nick Ly Date:04/24/2003 Nic eh ' or Note:If samples are not homogeneous,then subsamples of the components were analyzed separately.All bulk samples are analyzed using EPA 600/R-931116 Method with the following measurement uncertainties for the reported%Asbestos(1%a=0-3%,5%=1-9%,10%=5-15%,20%=10-30%,50%=40-60%).This report relates only to the iterns tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full,without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 3 of 5 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 #102063 Te1: 206.547www. bs.com6.634.1936 Bulk Asbestos Fibers Analysis www.nvllabs.com By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 2305329.00 Address: 4708 Aurora Ave. North Client Project #:2003-190 Seattle, WA 98103 6516 Samples Received: 21 Attention: Mr. John Terrill Samples Analyzed: 21 Project Location: 5024 Cemetary Road, Arlington, WA Method: EPA/600R-93/116 Layer 1 of 2 Description: Yellow/tan patterned vinyl material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt with mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Binder/filler, Mastic/binder Cellulose 65% None Detected ND Lab ID : 23035099 Client Sample #:2003-190-7-2 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: Yellow/tan patterned vinyl material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder Cellulose 1% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt with mastic Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Binder/filler, Mastic/binder Cellulose 65% None Detected ND Lab ID : 23035100 Client Sample #:2003-190-8-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: Gray vinyl material with plastic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder, Binder/filler Cellulose 1% None Detected ND Lab lD : 23035101 Client Sample #:2003-190-8-2 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: Gray vinyl material with plastic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Vinyl/binder, Binder/filler Cellulose 1% None Detected ND Lab ID : 23035102 Client Sample #:2003-190-9-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: Yellow/black/white fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler Glass fibers 80% None Detected ND Lab ID : 23035103 Client Sample #:2003-190-9-2 Location: 5024 Cemetary Road, Arlington, WA Sampled by: Client Analyzed by: Wei Long Tai Date:04/24/2003 " Reviewed by: Nick Ly Date:04/24/2003 Nic ech ' ector Note:If samples are not homogeneous,then subsamples of the components were analyzed separately.All bulk samples are analyzed using EPA 600/R-93/116 Method with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%. 10%=5-15%,20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full,without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. �— Page 4of5 NVL Laboratories, Inc. 4708 Aurora Ave. N., Seattle, WA 98103 #102063 Te1: 206.547www. bs.com6.634.1936 Bulk Asbestos Fibers Analysis www.nvllabs.com By Polarized Light Microscopy Client: NVL Field Services Division Batch #: 2305329.00 Address: 4708 Aurora Ave. North Client Project #:2003-190 Seattle, WA 98103 6516 Samples Received: 21 Attention: Mr. John Terrill Samples Analyzed: 21 Project Location: 5024 Cemetary Road, Arlington, WA Method: EPA/600R-93/116 Layer 1 of 1 Description: Yellow/black/white fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler Glass fibers 80% None Detected ND Lab ID : 23035104 Client Sample #:2003-190-9-3 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: Yellow/black/white fibrous material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Binder/Filler Glass fibers 80% None Detected ND Lab ID : 23035105 Client Sample #:2003-190-10-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: Black asphaltic fibrous material with granules Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Sand Glass fibers 27% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Binder/filler Cellulose 65% None Detected ND Lab ID : 23035106 Client Sample #:2003-190-10-2 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 2 Description: Black asphaltic fibrous material with granules Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Sand Glass fibers 27% None Detected ND Layer 2 of 2 Description: Black asphaltic fibrous felt Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder, Binder/filler Cellulose 65% None Detected ND Lab ID : 23035107 Client Sample #:2003-190-11-1 Location: 5024 Cemetary Road, Arlington, WA Layer 1 of 1 Description: Black asphaltic material Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: % Asphalt/binder Cellulose 17% None Detected ND Sampled by: Client Analyzed by: Wei Long Tai Date:04/24/2003 _ Reviewed by: Nick Ly Date:04/24/2003 Nick hnica trector Note:If samples are not homogeneous,then subsamples of the components were analyzed separately.All bulk samples are analyzed using EPA 600/R-93/116 Method with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%,20%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is limited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full,without written approval of NVL Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government. Page 5 of 5 NVL Laboratories, Inc. CHAIN of CUSTODY 4708 Aurora Ave N, Seattle, WA 98103 BATCH I D el: 206.547.0100 Emerg.Pager: 206.344.1878 SAMPLE LOG ax: 206.634.1936 1.888.NVL.LABS (685.5227) 2305329.00 Client NVL Laboratories, Inc. NVL Batch Number Street 4708 Aurora Ave N Client Job Number 2003-ls 190 Seattle, WA. 98103 2 -- - - Total Samples Project Manager J.4 Turn Around Time ❑ 1-Hr ❑24-Hrs ❑4 Days Project Location __ -S_0'Z d- 6--vn I (�)� ❑2-Hrs 2 Days ❑5 Days El4-Hrs 93Days ❑6 to 10 Days Please call for TAT less than 24 Hrs Email address Phone: (425) 776-1119 Fax: (425) 776-5680 Cell: (206) 949-9647 Home: ❑Asbestos Air ❑ PCM (NIOSH 7400) ❑TEM(NIOSH 7402) ❑TEM(AHERA) ❑TEM (EPA Level II) ❑Other )Asbestos Bulk I VPLM (EPA/600/R-93/116) ❑ PLM (EPA Point Count) ❑PLM (EPA Gravimetry) ❑TEM Bulk ❑ Mold/Fungus 10MoldAir ❑Mold Bulk ❑Rotom_eter Calibration METALS Det. Limit Matrix RCRA Metals ❑ All 8 Other El Total Metals ❑ ppm(AAS) El Air Filter El Paint Chips El Arsenic (As) El Lead (Pb) ❑ All 3Metals ❑TCLP ❑ ppb(GFAA) ❑ Drinking water ❑ Paint Chips (Area) ❑ Barium(Ba) ❑ Mercury(Hg) ❑Copper(Cu) ❑Dust/wipe ❑Waste Water ❑Cadmium(Cd) ❑Selenium(Se) 0 Nickel(Ni) ❑ Soil ❑ Chromium(Cr) ❑Silver(Ag) 0 Zinc(Zn) ❑Other Types ❑Fiberglass ❑ Nuisance Dust ❑ Other(Specify) 1 of Analysis ❑ Silica ❑ Respirable Dust J Condition of Package:-❑ Good ❑ Damaged(no spillage) ❑ Severe damage(spillage) lSeq. # Lab ID Client Sample Number Comments I A/R 1 -1Dv3-i5© - 1 - t ✓ lv. 1 4,(t Cn�fcv. 2 2- 1 Ii 3 -2 4 3 3 L12 5 Z I6 4- 1 uT 7 8 5_- I mow$ r•Hs� s 14s �•� l9 - I ce,1 - _'t wg L 10 L 4 Z 1 11 L YZ 2 12 13 14 ' I Ui� I T► �, �- 2 15 Print Below Sian Below Company Date Time Sampled by 3'I /Vu — Q 2z u Relinquished by 4 Z 2 � )217U Received by Z �j Analyzed by, Results Called by Results F d by — i Special Instructions: Unless reque d in writing, all samples will be disposed of two (2) weeks after a lysis. NVL Laboratories Inc. CHAIN of CUSTODY BATCH ID 4708 Aurora Ave N, Seattle, WA 98103 Tel: 206.547.0100 Emerg.Pager: 206.344.1878 SAMPLE LOG 2305329 .00 206.634.1936 1.888.NVL.LABS (685.5227) Client NVL Laboratories, Inc. NVL Batch Number Street 4708 Aurora Ave N Client Job Number 2003-176 Seattle. WA. 98103 Total Samples Project Manager_ Turn Around Time ❑ 1-Hr ❑24-Hrs ❑4 Days Project Location _ ❑2-Hrs ❑2 Days ❑5 Days ❑4-Hrs ❑3 Days ❑6 to 10 Days Please call for TAT less than 24 Hrs Email address Phone: (425) 776-1119 Fax: (425) 776-5680 Cell: (206) 949-9647 Home: ❑Asbestos Air ❑ PCM(NIOSH 7400) ❑TEM(NIOSH 7402) ❑TEM(AHERA) ❑TEM (EPA Level II) []Other ❑Asbestos Bulk I❑ PLM (EPA/600/R-93/116) ❑ PLM (EPA Point Count) ❑ PLM (EPA Gravimetry) ❑TEM Bulk ❑ Mold/Fungus ❑ Mold Air ❑ Mold Bulk 1i ❑ Rotometer Calibration METALS Det. Limit Matrix RCRA Metals ❑ All 8 Other Metals ❑Total Metals ❑ ppm(AAS) ❑Air Filter ❑ Paint Chips ❑Arsenic (As) ❑ Lead(Pb) ❑ All 3 ❑TCLP ❑ ppb(GFAA) ❑Drinking water ❑ Paint Chips (Area) ❑ Barium(Ba) ❑Mercury(Hg) ❑Copper(Cu) ❑ Dust/wipe ❑Waste Water ❑ Cadmium(Cd) ❑ Selenium(Se) ®Nickel(Ni) ❑Soil ❑Chromium(Cr) ❑Silver(Ag) Zinc(Zn) [El Other Types ❑ Fiberglass ❑ Nuisance Dust ❑Other(Specify) i of Analysis ❑ Silica ❑ Respirable Dust Condition of Package:❑ Good ❑ Damaged (no spillage) ❑Severe damage (spillage) Seq. # Lab ID Client Sample Number Comments AIR 1 -Loo 3 -- 190 - 4L L 2 -2 3 -3 4 jf - 5 -2 6 7 8 9 10 11 12 13 14 15 Print Below Si n Below COMDany Date Time Sampled by Relinquished by Received by tLUZLAJ V V Z V Analyzed by Results Called by Results Faxed by Special Instructions: Unless requested in writing, all samples will be disposed of two (2) weeks after analysis. i i i i i i i i i i i FIX., %4 1 y-,Ltrc j4 Ey C) C-4 C4 CIO ;4 cis CN4 a. F--j C) 3-m 0 't u A o cz 0 Lr) 00 N co CD PACIFIC bJD '1A N z Lur) 4EP 4-j C) C) C) ON zzi 0 Q) ......... ........................................... q 6 O t O a 0 *C9 N ooO o v (,4 O O N .O Op Ln �4 uu p U) - o LSO v L � bA " � u i C 2 � O p c S = a c Q a v Q b Z Q N r� C LL- L -C m — = Q) ZZ QW � v _ a) ,� M � V >. EO � o ?: pq N +.� M bo U C o Z o `I_j N C N W 4- a L � � U O � Q e- Ln � N � O O U O w O - O o O O ° U O d Q J National Institute National Voluntary of Standards and Technology Laboratory Accreditation Program 0'r OF co) ISO/IEC 17025:1999 ISO 9002:1994 Scope of Accreditation a Fp StA E f P� Page: 1 of 1 BULK ASBESTOS FIBER ANALYSIS NVLAP LAB CODE 102063-0 NVL LABORATORIES,INC. 4708 Aurora Avenue N. Seattle, WA 98103 Mr. Nghiep Vi Ly Phone: 206-547-0100 Fax: 206-634-1936 E-Mail: munaf@nvllabs.com LJRL: http://www.nvllabs.com NVLAP Code Designation 18/A01 EPA-600/M4-82-020: Interim Method for the Determination of Asbestos in Bulk Insulation Samples September 30, 2003 Effective through For the National Institute of Standards and Technology _. NVLAP-01 S(Ofi-01) - -- -- -- 1 l 1 ,I .1 J 1 J . j J J J