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5822 CEMETERY RD_BLD20080097_2026
f 14�WWI E /a � to BLD-BuildingPermit Ver 2008A' 1 P oYty_ --77 . —L1 XI �rllJli;r 4BLD20080097 ry,. owner:JOPAL PROPERTIES-RENGEN,GLEN Status:JAPPLIED r address:15822 CEMETERY RD,ARLINGTON post date: 4/10/2008 data screens:I Select Screen. zj functions_I Select Permit Function... J i REVIEWS Sock Add Rea3ew Remove Review j Print JClow Address •,�tcoaadminll . ® Description + �W®�®I Filew`S�,�end Folder Tas& 1014 P-Public Works I LTAYLOR 4122/2009 0 Y N A Make anew foldel 1016 P-Public Works 11 LRUPERT 4/W2008 0 Y N ASSM _ Publish this Polder Web 1026 P-Utilities Fees RSHEPARD 4/22/2008 0 Y N View previous ver 2000 C-Building I CYOUNG 4/22/2008 0 Y N ASSON 2008 C-Community Development I BFECHT 4IM008 0 Y N ASSON Other Places 2014 C-Planning I YPAGE 4/22/Y008 0 Y N ASSGN u My Documents My Computer kj My Network Place Detads Scan We Folder — `Oone 91-0560 COMPLETE BLD-1 1/1/1900 SPRINKLER 5916 195TH ST 97-2629 COMPLETE BLD-1 9/1911997,MISC 5916 195TH ST - Local ft tranet 00% Senior Center Expansion Rev, m' 04-15-2008 Site Plan 4.4,08 c- ' ✓� � Lc:AcrcbatDacu!wunt 1.i705KF3 *Sta+rt 9 Internet Ex... - Jj Inbox•Mcrosoft...I -J RE:So Un Yanq.., I ORE:So un Yaw... I J Scan I �.04-11-2008(6).p... ( a J® 11:12 AM Tuesday,Apr 15,2008 11:12 AM Demolition application — 5822 Cemetery Rd. Need asbestos abatement report indicating the proper removal of all ACM's. 611S i�1 7 1 1 a A%& - ❑ J r ct ia, Microsoftr BLD-Building Permit Ver.2008A Priority: Normal . ##BLD20080097 y owner: OPAL PROPERTIES-RENGEN,GLEN status.JAPPLIED e address:15822 CEMETERY RD,ARLINGTON post date: 4/10/2008 data screens:I Select Screen. fur�fjpRS_ Select Permit Function... J Fie Edt Ytm+ Fan V EEWS Address t]j�Coaadminll AddRrarinr I E!T.Rwd. Print Cl. — File and folder Taslo 1014 P-Public Works I LTAYLOR 4i221200£ 0 Y N ASSIGN Make anew folder 1016 P-Public Works II LRUPERT 4I2212008 0 Y N ASSIcx Publish this folder rs `► J Web 1026 P-Utilities Fees RSHEPARD 4/22/2008 0 Y N ASsrGri , x view previous ver 2t100 C-Budding I CYOUNG 4/22/2008 0 Y N ASS 2008 C-Community Development I 8FECHT 4122/2008 0 Y N ASSIGN Other Places 2014 C-Planning I YPAGE 4/22/2008 0 Y N ASSIGN My Documents t My Computer My Network Place Details Scan File Folder Done 7 r—i r—1--I I��Local urt.ar,et 100°h - 91-0560 COMPLETE EILD-1 1/1/1900 SPRINKLER 5916 195TH ST 97-2629 COMPLETE BLDA 9/19/1997 M#SC 5916 195TH ST -- — --- (--F r--f `—(—�� «al int,ranet +,i00% - Senior Center Expansion Rev. 04-15-2008 Site Plan 4,4.08 0 Adobe JdE:f Ot}:;i C'CiEa.iil'. Yl: Jdok e�lo,e Act t�:3«t I:!ocu'r,::nc �^�� i;1tJ5 KEG 'Start " 3 Internet Ex-7- a Inbox-h4aosoft...I J RE:So U.Yang... I __�j RE:So U.Yang... I �L)Scan I � 94•t!-2008(5).p... I I«__j O 11:12 AM Tuesday,Apr 15,2008 11:12 AM Inspection for the Presence of Asbestos Containing Building Materials July 10, 2007 House Located at 5822 Cemetery Road Arlington, Washington This inspection report must be on-site during all phases of abatement/demolition of the structures. The Knebel Company,Inc. 9122 169°i Avenue NE Granite Falls,WA 98252 (360)`691-5910 RECEIVED APR 112008 COA PERMIT CENTER OFFICE 5822 Cemetery Road Arlington; Washington INTRODUCTION An inspection for the presence of asbestos containing building materials was conducted on July 10, 2007, in the house located at 5822 Cemetery Road in Arlington, WA. This inspection is to identify asbestos containing materials that will affect the proposed demolition of the structure. Chris Gangle from Pacific Road& Bridge Company requested the asbestos inspection. Dan Shelly and Sara Knebel, AHERA certified building inspectors from The Kriebel Company,Inc. conducted this asbestos inspection. Seattle Asbestos Test, LLC analyzed the suspect bulk asbestos samples. The following report contains material descriptions, sample locations, assessment of asbestos containing building materials,laboratory results and accreditation, and inspector certification. AHERA Building Inspector: Dan Shelly t Inspector Number: 07-1252 Expiration Date:May 10, 2008 Signatur � LIMITATIONS OF SURVEY The sole purpose of this inspection report is to document the asbestos containing materials discovered during the inspection and sampling of suspect materials by The Knebel Company, in the house located at 5822 Cemetery Road in Arlington, WA. In strict accordance with NESHAPS regulations, this site visit consisted of a thorough visual walk through of the structure for the purpose of viewing and sampling potential asbestos containing materials. As inspections are non-comprehensive by nature, The Knebel Company, 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. Due to - electrical shock hazard, none of the wiring was sampled. This survey does not include documentation for other hazardous materials that may exist on site, including: lead, soil contamination due to underground storage tanks, etc. Certain friable materials in this inspection were found to contain less than 10%asbestos using the analysis method specified in Appendix E, subpart E,40 CFR part 763, section 1, Polarized Light Microscopy. EPA recommends(NESHAPS, 40CFR, Part 61, 61.141) that-samples of friable asbestos materials containing less than 10 %be analyzed using the point count method of analysis. "Friable asbestos material means any material containing more than 1 percent asbestos as determined using the method specified in Appendix E, subpart E, 40 CFR part 763, section 1, Polarized Light Microscopy, that, when dry, can be crumbled, pulverized, or reduced to powder by hand pressure. If the asbestos content is less than 10 percent as determined by a method other than point counting by polarized light microscopy(PLM),-verify the asbestos content by point counting using PLM." - WAC 296-62-07703 Definitions—Asbestos-containing materials(ACM) means any material containing more than 1%asbestos. N r � is JI ( IT ( 1•' t�`�rTJr�;k�,y tt4���,u�4i.��"�,{t�l��Nt' - - ' Alf `K�1yt'rZj/�' ""�1r�tx i + r xpa t L 1'1 ,t,= a � � mA 4fi ASBESTOS SUMMARY with RECCOMMENDATIONS (Recommendation comments are not to be used as contract document directives.) 5822 Cemetery Road in Arlineton,WA. House: This is a one-story wood framed building constructed on a concrete foundation. There is an attached garage of the same construction. The house has wood siding, an attic crawl space, and the roof is covered with multiple layers of composition roofing shingles. The primary source of heat is electric baseboard heaters. ASBESTOS: Spray applied ceiling texture (popcorn type with glitter) (homogenous material#01)was sampled from the ceiling in the mud room(room between the house and the garage). This material was found to contain 4% chrysotile asbestos. MATERIAL AREAS AMOUNT ASSESSMENT DAMAGE Spray applied Mud room 86 square Friable : Minimal ceiling texture feet o corntype) Gray 9" x 9"floor tile with pink and blue dot pattern,and tan mastic (homogenous material# 13) was sampled from the floor in the kitchen hallway. The floor file was found to contain 2% chrysotile asbestos. The tan mastic was found to contain no detectable asbestos. MATERIAL AREAS AMOUNT ASSESSMENT DAMAGE Gray 9" x 9" Kitchen hallway 88 square Non-friable Minimal floor tile with feet pink and blue dot pattern Gray 9" x 9"floor tile with brown and black streak pattern over black mastic and black paper(homogenous material# 14) was sampled from the floor in the central bedroom under carpet. The floor tile was found to contain 2% chrysotile asbestos. The mastic and paper were found to contain no detectable asbestos. MATERIAL AREAS AMOUNT ASSESSMENT DAMAGE Gray 9" x 9" Central bedroom 68 square Non-friable minimal floor tile with feet brown and black streak attern 9" x 9" mosaic pattern floor tile with black mastic (homogenous material# 16) was sampled from the floor in the northeast bedroom under the carpet. The floor tile was found to contain 2% chrysotile asbestos. The black mastic was found to contain 3% chrysotile asbestos. MATERIAL AREAS AMOUNT ASSESSMENT DAMAGE 9" x 9" mosaic NE bedroom 158 square Non-friable minimal pattern floor the feet with black mastic Green sheet vinyl flooring and mastic(homogenous material# 18) was sampled in the south bathroom. This material was found to contain 50% chrysotile asbestos. MATERIAL AREAS AMOUNT ASSESSMENT DAMAGE Green sheet South bathroom 1 20 square Friable minimal vinyl flooring feet and mastic Materials sampled by The Knebel Comnanv Inc.. and found to contain LESS THAN 1% ASBESTOS: • (Homogenous Material#07)Trowel on ceiling texture, swirl pattern was collected in the kitchen area. This material was found to contain 2%chrysotile asbestos. Point count analysis of this material found it to contain less than 1% asbestos. (see point count laboratory results) • (Homogenous Material#09)Trowel on wall/ceiling texture, knock down pattern, over gypsum wallboard was collected in the living room and hallway area. This material was found to contain 2%chrysotile asbestos. Point count analysis of this material found it to contain less than 1%asbestos. (see point count laboratory results) t Materials sampled by The Knebel Company Inc.,and found to be NON-ASBESTOS CONTAINING MATERIALS. • (Homogenous Material# 02) Spray applied wall/ceiling texture over gypsum wallboard • (Homogenous Material# 03) 12"x 12" nailed in ceiling file • (Homogenous Material# 04) White leveling compound and yellow carpet mastic • (Homogenous Material# 05) Spray applied ceiling texture (popcorn type in bedroom) • (Homogenous Material# 06) 12"x 12" ceiling tile with even holed.pattern (nailed in) • (Homogenous Material # 08)Gray/brown blown-in attic insulation • (Homogenous Material# 10) White leveling compound over yellow carpet mastic over gray slate type material • (Homogenous Material# 11) White leveling compound over brown sheet vinyl flooring with burlap backing over black mastic • (Homogenous Material # 12) White sheet vinyl flooring with blue square pattern and mastic, over white leveling compound,:over pressboard, over black fibrous paper • (Homogenous Material# 15) 12" x 12" gray and brown floor file and black mastic over wood,over black paper • (Homogenous Material# 17) White and tan sheet vinyl flooring and mastic • (Homogenous Material# 19) Silver paper, black mastic, and pink fiberglass insulation • (Homogenous Material# 20) White building caulking • (Homogenous Material# 21)Black vapor barrier paper • (Homogenous Material# 22)Multiple layers of composition roofing shingle with black tar over black roofing paper • (Homogenous Material#23) Red brick with gray mortar and white sealant • (Homogenous Material#24) Brown mastic Recommendations: General — Any suspect asbestos containing materials discovered during the demolition project, that have not been sampled,:should not be disturbed until an assessment of the suspect material can be made. All asbestos-containing materials that will be disturbed by the demolition, should be removed by a certified asbestos abatement contractor, using methods as outlined in: 1. EPA 40 CFR Part 763,Asbestos-Containing Materials in Schools. 2. EPA 40 CFR part 61, National Emission Standards for Hazardous Emission Standards for Hazardous Air Pollutants;Asbestos NESHAP Revision;Final Rule 3. Department of Labor and Industries,Asbestos,Tremolite, Anthophyllite, and Actinolite WAC 296-62-077 through 296-62-07761. 4. Department of Labor and Industries Safety Standards for Asbestos Removal and Encapsulation WAC 296-65-001 through 050. --- -- 5. Department of Labor and Industries,Respiratory Protection, WAC 296-62-071 through- 07121. - 6. Department of Labor and Industries WISHA Regional Directive WRD2310 April 30, 1997 7. All current regulations of Washington State Department of Transportation. 8. Puget Sound Clean Air Agency 9. 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Bulk Asbestos Report 7Job#: 5822 TKC Job#: 0707-1849 Customer ID: 363 e: Pacific Road&Bridge Company : P 0 Box 3393 City: Arlington State: WA Zip Code: 98223- Contact Name: Chris Gangle Homogeneous Material# 01 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-01-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: mud room Material Description:Spray applied ceiling texture(popcorn type) Sample Locabon: Collected from the northwest comer from the ceiling in the mud room. Comments: Asbestos Content 4% Asbestos Type Chrysotile Approx Amt of material: 86 Unit: Square Feet Homogeneous Material # 01 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-01-02 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: mud'room Material Description:Spray applied ceiling texture(popcom type) Sample Locadon Collected from the southeast corner of the ceiling in the mud room. Comments* This sample was not analyzed but assumed to contain asbestos. Asbestos Content 4% Asbestos Type Chrysotile Approx Amt of material: 86 Unit: Square Feet Reviewed By: Page 2 of 13 Bulk Asbestos Report Continued Homogeneous Material # 01 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-01-03 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: mud room Material Description:Spray applied ceiling texture (popcorn tvpe) Sample Location Collected from the middle of the ceiling in the mud room, east side. Comments: This sample was not analyzed but assumed to contain asbestos. Asbestos Content 4% Asbestos Type Chrysotile Approx Amt of material: 86 Unit: Square Feet Homogeneous Material # 02 Collected:By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-02-01 Analyzed�By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: family room Material Description:Spray applied wall/ceiling texture over gypsum wallboard Sample Location: Collected from the southwest corner of the family room, west wall. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material# 02 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-02-02 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: laundry room Material Description:Spray applied wall/ceiling texture over gypsum wallboard Sample Location: Collected from the east wall in the laundry room. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By: Page 3 of 13 Bulk Asbestos Report Continued Homogeneous Material # 02 Collected By: Dan Shelly Date Collected: 7/1 012 0 0 7 Sample ID#: 5822-02-03 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: east/west hallway Material Description:Spray applied wall/ceiling texture over gypsum wallboard Sample Location: Collected from the west end of the east-west hallway from the ceiling, Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 02 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-02-04 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: central bedroom Material Description: Spray applied wall/ceiling texture over gypsum wallboard Sample Location: Collected from the small central bedroom, west wall, 2'from the north wall. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 02 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-02-05 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: family room Material Description:Spray applied wall/ceiling texture over gypsum wallboard Sample Location: Collected from the far east wall, 1' from the south wall. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By: Page 4 of 13 Bulk Asbestos Report Continued Homogeneous Material # 03 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-03-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: SE bedroom Material Description:12" x 12" nailed in ceiling tile Sample Location: Collected from the ceiling in the southeast bedroom, just outside entry to bathroom. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 04 Collected By: Dan Shelly Date Collected: 7/102007 Sample ID#: 5822-04-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: family room Material Description:White leveling compound and yellow carpet mastic Sample t_ocadon: Collected from the southwest corner of the family room, under carpeting. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 05 Collected By: Dan Shelly Date Collected: 7/102007 Sample ID#: 5822.05-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: NE bedroom Material Description:Spray applied ceiling texture (popcorn type) Sample Location: Collected from the southwest corner of the ceiling in the NE bedroom Comments- Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By: '� � Page 5 of 13 Bulk Asbestos Report Continued Homogeneous Material # 05 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-05-02 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: NE bedroom Material Description:Spray applied ceiling texture (popcorn type) Sample Location Collected from the northeast corner of the ceiling in the northeast bedroom. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 05 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-05-03 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: NE bedroom Material Description:Spray applied ceiling texture (popcom type) Sample Location: Collected from the center of the ceiling in the northeast bedroom Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 06 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-06-01 Analyzed By: Seattle Asbestos Test,LL_ Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: north-south hallway Material Description:1.2" x 12" ceiling tile with even holed pattem (nailed in) Sample Locanon: Collected from the ceiling in the north-south hallway, outside entry to central bedroom. Comments. Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By: /Z •' Page 6 of 13 Bulk Asbestos: Report Continued Homogeneous Material # 07 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-07-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: kitchen Material Description:Trowel on ceiling texture swirl pattern Sample Location: Collected from the southwest corner of the ceiling in the kitchen Comments: This material was found to contain 2% chrysotile asbestos. Point count analysis of this material was found to contain less than 1% asbestos Asbestos Content < 1% Asbestos Type Chrysotile Approx Amt of material: Unit: Homogeneous Material# 07 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-07-02 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: kitchen Material Description:Trowel on ceiling texture, swirl pattem Sample Location: Collected from the northeast corner of the kitchen from ceiling. Comments' This material was found to contain 2% chrysotile asbestos. Point count analysis of this material was found to contain less than 1% asbestos Asbestos Content < 1'/0 Asbestos Type chrysotile Approx Amt of material: Unit: Homogeneous Material# 07 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID #: 5822-07-03 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: hallway Material Description:Trowel on ceiling texture, swirl pattern Sample Locaeon: Collected from the hallway, 3'west of the east entry by kitchen Comments: This material was found to contain 2%'chrysotile asbestos. Point count analysis of this material was found to contain less than 1% asbestos Asbestos Content < 1% Asbestos Type Chrysotile Approx Amt of material: Unit: i Reviewed By:_' ""� Page 7 of 13 Bulk Asbestos Report Continued Homogeneous Material # 08 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-08-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/1412007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: attic Material Description:Gray/brown blown-in attic insulation sample Location Collected from the attic crawl space. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 08 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-08-02 Analyzed:By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: attic Material Description:Gray/brown blown-in attic insulation Sample Location: Collected from the attic crawl space. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material# 08 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-08-03 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: attic Material Description:Gray/brown blown-in attic insulation Sample Location Collected from the attic crawl space. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By: -� Page 8 of 13 Bulk Asbestos Report Continued Homogeneous Material# 09I ected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-09-01 lyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: living room Material Description:Trawl on surfacing material (knock down type) over gypsum wallboard Sample Location Collected from the southwest corner of the wall in the living room. Comments: This material was found to contain 2% chrysotile asbestos. Point count analysis of this material was found to contain less than 1% asbestos Asbestos Content < 1% Asbestos Type Chrysotile Approx Amt of material: Unit: Homogeneous Material # 09 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-09-02 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14I2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: hallway Material Description:Trawl on surfacing material (knock down type) over gypsum wallboard Samole_`ocation• Collected from the south wall by entry to north/south hallway Comments: This material was found to contain 2% chrysotile asbestos. Point count analysis of this material was found to contain less than 1% asbestos Asbestos Content < 1% Asbestos Type Chrysotile Approx Amt of material: Unit: Homogeneous Material # 09 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-09-03 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: living room Material Description:Trawl on surfacing material (knock down type) over gypsum wallboard sample Location Collected from the northeast corner in the living room. Comments: This material was found to contain 2% chrysotile asbestos. Point count analysis of this material was found to contain less than 1% asbestos Asbestos Content < 1% Asbestos Type Chrysotile Approx Amt of material: Unit: Reviewed By: Page 9 of 13 Bulk Asbestos Report Continued Homogeneous Material # 10 Collected By: Dan Shelly Date Collected: 7/102007 Sample ID#: 5822-10-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: living room Material Description:White leveling compound over yellow carpet mastic over gray slate type material Samoie Location Collected from the living room floor next to doorway between kitchen and living room. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 11 Collected By: Dan Shelly Date Collected: 7/102007 Sample ID#: 5822-11-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: living room Material Description:White leveling compound over brown sheet vinyl flooring with burlap backing over black mastic Sample Location Collected from the living room floor just east of entry doorway. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 12 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-12-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: kitchen Material Description:White sheet vinyl flooring with blue square pattem and mastic over white leveling compound, over pressboard over black fibrous paper Sample Location Collected from the kitchen floor by doorway to entry to living room. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By: / Page 10 of 13 Bulk Asbestos Report Continued Homogeneous Material # 13 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID #: 5822-13-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: kitchen hall Material Description:Gray 9" x 9"floor file with pink and blue dot pattem and tan mastic Sample Location Collected from the hallway floorjust outside entry to kitchen Comments: The floor tile was found to contain2% chrysotile asbestos. The tan mastic was found to contain no detectable asbestos. Asbestos Content 2% Asbestos Type Chrysotile Approx Amt of material: 88 Unit: Square Feet Homogeneous Material # 14 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-14-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: central bedroom Material Description: Gray 9" x 9"floor tile with brown and black streak pattern over black mastic and black paper Sample Location: Collected from the northwest corner of the floor in the central bedroom, under carpet. Comments: The floor tile was found to contain 2% chrysotile asbestos. The mastic and paper were found to contain no detectable asbestos. Asbestos Content 2% Asbestos Type Chrysotile Approx Amt of material: 68 Unit: Square Feet Homogeneous Material # 15 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-15-01 Analyzed By: Seattle Asbestos Test, LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: N bathroom Material Description: 12" x 12" gray and brown floor tile and black mastic over wood over black paper sample Location Collected from the center of the floor in the north bathroom. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By Page 11 of 13 Bulk Asbestos Report Continued Homogeneous Material # 16 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-16-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: NE bedroom Material Description:9" x 9" mosaic pattern floor tile with black mastic Sample Locanon Collected from the northeast corner of the room under carpet. commenrs: The floor tile was found to contain 2% chrysotile asbestos. The black mastic was found to contain 3% chrysotile asbestos. Asbestos Content 2% &3% Asbestos Type Chrysotile Approx Amt of material: 158 Unit: Square Feet Homogeneous Material # 17 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-17-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: laundry room Material Description:White and tan sheet vinyl flooring and mastic Sample Location Collected from the southwest corner of the floor in the laundry room. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 18 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-18-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: S bathroom Material Description:Green sheet vinyl flooring and mastic Sample Locabon: Collected from the center of the floor in the south bathroom. Comments: Asbestos Content 50% Asbestos Type Chrysotile Approx Amt of material: 20 Unit: Square Feet Reviewed By: Page 12 of 13 Bulk Asbestos Report Continued Homogeneous Material # 19 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-19-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: living room Material Description:Silver paper, black mastic and pink fiberglass insulation Sample Location Collected from the east side of the house behind wood siding. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 20 Collected:By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-20-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington. Building: house Floor: 1 Room: EXTERIOR Material Description:White building caulking Sample Location Collected from the exterior of the house, west side,just outside entry to kitchen Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 21 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-21-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: EXTERIOR Material Description:Black vapor barrier paper Sample Location Collected from the east side of they house behind the wood siding. Comments. Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Reviewed By: Page 13 of 13 Bulk Asbestos Report Continued Homogeneous Material # 22 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-22-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: roof Material Description:Multiple layers of composition roofing shingle with black tar over black roofing Pape Sample Location: Collected from the west side of the roof over the kitchen area. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: Homogeneous Material # 23 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-23-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: family room Material Description:Red brick with gray mortar and white sealant Sample Location: Collected from the front of the fire place in the family room. Comments: Asbestos Content ND Asbestos Type None-detected Approx Amt of material: Unit: - --- -- Homogeneous Material # 24 Collected By: Dan Shelly Date Collected: 7/10/2007 Sample ID#: 5822-24-01 Analyzed By: Seattle Asbestos Test,LL Date Analyzed: 7/14/2007 Building Name: 5822 Cemetery Road Arlington,Washington Building: house Floor: 1 Room: N bathroom Material Description:Brown mastic - Sample Location: Collected from the east wall in the north-bathroom behind shower,wall covering.- Comments: Asbestos Content ND Asbestos-Type-None-detected Approx Amt of material: Reviewed By: /. � v��)ijr y it � 'A•i ��,�'y`'11s d•'�i�''�4."s1)`)r � j .0 r r,� 1• • i R� r, r., .f Page 1 of 5 SEATTLE ASBESTOS TESL', LLC NVLAF AcowlHatim 19711 )rdbcr Lake Rnod,5utoo L1,Lynnwood,WA.98C36:'1'el 425.6 73.98%Fax:425,673SM Lab(',o*:W)78j webutc:hap:/?www%c.itMbCgM. -nail: ad'n:nL1s4g1tl,a�yb—_4t+rt t.- ANALYTICAL LABORATORY REPORT PLM by Method EPA/600/R-93/115 Client;'The Knebel Company, Inc. Client,Job;#: %922 Address,9122 169(h.Ave NE Labulalory Satoh#' 200791058 Gralnita falls, WA 982452 mate ReaanmoJ: 71",2I2007 Samples ReceMw d: 38 Date Analyzed: 7114I007 Adention:Ivlr. fear, Shelly Samples Analyzed: 36 Pmjoct:-552.2 Continnstion CYont Sample l ' Aubmtox Non-Fibrous Non.asbeatos Lab ID � In Layer Dascrltation 1%1 Fibers Components % Fibsrs � l White Solt lumpy Synthetic foam, FiSer, 2007205 727 ' 5822 4)1.?1 1 4 iChryectnae � 3 ellulose materitll i I Bi nder 2007205728 1 58Z?-01-02 amc1 a not analyzed� ? — -- — -- �- _--__-____!_-- ------ -- ---i I , 7007205729 5822•01-0: j !sample nct analyzed 200720573E 5822-02.01 1 j�dh to powdery p Notts i,Sinder/Ifler, Paint 4 ellulose ater r:t with paint j' I �Whi a rnalky 'wane inder/niler ' -', materal with pa �25�(.,e;►iulosea F __...._. _....—.�. ._ _...1-_._..... paw �detoctM�y�asurrdbincJer —' (� White powdety i TMwe I r^ '^ 1 !2�.:C7205731 5822-(1%-(�1M1 I I d ;gxiier,nAs:r, Paint E nllulose j materal with paint I 2 rh!ta chalky lone n-•jelsr/filler _ ,material with paper a etedw -ypsum/binder 24_�tubse t _ _ __ 2�CG'120s732 ' 5122-02-" 1 'lt�ilite powdafy --�—It+lettu �il-deNt�it® , Pan __ '1 I. I materiai with paint �>t*dr it �.:ellulose i i i ,White chalky one finder/filler Z — —_�natorial with paper a!rbeeted- 'ypsuln,'boxie+r 22" Cellulose l Ahitea chalky ky I Ncear lair-der/filler, Point, i j 29C7205733 l 5822-02-04 1 °matenel with paper ,,, f 35�Celluloss 1 a I � detected ypsum/binder i t Viand paint +7l"0'l2{16;?�4 5�522-02 U5 1 lI Mite powdefy I!GGar10 �material with paint idatected Binder/�Nar, Paintl 5 lc:eiiuiose t � _.�....;+,Mnitr,anatky ._�.Nana f3i;iderltillar 25 ,ellulos+a 0 atenal with papera detected GypsumJbinder l 2G(i71Ua7:i:+ 1 3922 1 .--—'1^ T an fior��u8 rnratLe'ial � �y,a "'—"___.. .—.. ..... I_ ^ — If3�ndor/fi!irr, Paint — 85 Icelluhose Analyzed by. Wailony Tai Reviewed--*: Steva (Fanyao)Zhang, President Page 2 of 5 $EATTLE ASBESTOS TEST, LLC biVLAPA=edltabw 14111 Scribe Lake Road.Suter D•LynnwoiKL WA 98036,Tel:425 673 9850,Fu:42.S 673 98 L6 Lzb Code;2007664 Wubmtc:ntsp;;�uww awtcicx4roswua st com, E-mail;admi, 5CW1Mb4,%WW.com ANALYTICAL LABORATORY REPORT PLtd by Method EPA;'600/R-93/11?' Client:The Knebal Company, Ina, Client Job#: 582.2 Address.912. 169th Ave NE LaboraWry 8ateh#; 200791058 Grande Fails,WA 98252 Date Received: 7!12r2007 Samples Received: 38 Date Analyzed: 7114/2007 AttenbonWr. Dan Shelly Samples Analyzed: 35 Projeyct:6822 Continnstlon -_--- Client Sample +4cclosstos V`lVan.Flbroe7y- LablDWan-aabwtos i0 Layer t>escription %' ponents � Mom — >=lbefs Components bite powdery I2007?.05736 !822-04-01 1 ateria]with paint NOn° Dirlderifi!{er, Paint, 5 �ellUlose d mrastic ;MastirJbindrr 12007205737 5822-05-01 ! 1 hate so,,`t lumpy IN'ono -� Syyn tic foam, Fille , I F--- material with paint #elected �inder, paint 14 Celiulaee f2007205738 5822-05.02 Nhite soft lumpy no (Synthetic toaam, Filler, 1 Material with part etscted (Binder, paint 1 Cellulose White soft lump one 15yrithetic Loam, Filer, ' 2007205739 5822-05.03 1 — C Il� u!Ase teriai with paint bt+eCLed Hinder, paint 42 ti 2 ��22 06-01 1 an fibrous Twteial � Ncme I 007205740 - ttt paint �i°tkUd IlFlller. Paint 90;Cellulose 12,107205741 5822-07-01 1 -fan Wwde ry 2 •Chrysodle 19inderMller, paint ' 7 'lwCe�llulose c material with paint --- l !2007205742 5822-07-02 an powdery 12 Chrysott�nderlfiller, pain! 17 edlulese III _ — - .� material with paint. - _ .._ -1. ._ _J 2007205743 5822-07-03 I an rKr*dery 2 1 hrysodie mderMiler, paint 7 eliulose etmial with;paint l 407206744 S822-0"1 1 Gray fibrous material None Binder/filler 90 Cellulose _—__� —i----- - 2007205745 6822.09.02 1 Gray fibrous matenal'i Non* 'Binder/flller 52 elVose i l acted I2007205746 S8224)8-03 1 C7my ftrous material IN � �Bincier/filter [90 !Cellulose 2007205747 i 58=-08-J1 1 1Ter powdery ysvtile inrder/f411pr, Paint 4 hC�elluiosa i jmarer''3t with paint + hits chalky na ,:i+nderMNerwse 2material wi,h ^iraperoGosd ,Uypsumlt>rircder . Analyzed by: Weilong 1'al RevaaWed by; Steve (Fanyae)hang, President page 3 of 5 SEATTLE ASSESTOS TEST, LLC 4711 SRiber iaht'(;+ed,:Iuur.1),1"r'wr.w(WA vxn.,,W.Tc1:425 VISLIN.Fax:4z? .573 3!I� y'1LAP Accedit,W= +Yeossw:hdP:lr�vww saergeari�ttoswxr.w� F mul:� >rsntlaet aom Lab Owe:N!07 8_f) ANAVMCAL LABORATORY REPORT PLht by Wthod EPi1 IMAYR-93/11.3 Cllenr'fhe Knebe,(:Ompny, love. wddr9".9122 199th Ave NE Client.lots#: 5822 Granite Fvwos, WA 98252 t mots WY Sak,h#_ 2100791088 Uste J "lived: 7112;2007 9r>;mples Received; 38 Attermon.her D,ys Stteily Date Aeialyzed: 7/14/2007 Project 58a,,Con-hnns zi i Samp*s Analyzed 3e Lab 10 Client Sample Laysr Description '���' Nan-l"9broas —_.._-- I 1�b R� °G INon-ast►erstosl �_.--1;1 rs _I .comments (!�°I Fibom t 2007205748 � 582244102U 1 NVhttel potvdtiry [2 _ 'matsral! with paint �tlrysiatlls Pridercttller, Paint 5 Cellulose t i ! Z �VVhi:Ochitlky � iorr� _ �8mertfrNr;r "—f Imateriai with Paper ?19etursr tetf Pypsumibinder j 2.007205 749 + M 24-g4)3 1 IV1/hite Dowd' -- Imaterial With faint 2hr�rrcor.;lu �i1rJ(ieeN,}91101, Paint 6 Cellulr�se y y White c,tmalkx' btO06 _ atertal rv� ,,a Binclra,•O!iJ!er 'iri ►7E'. 4*h .Nd +y12SUr�/hinder 24 Ce31Vrjlosa i �2007205750 S>322-i�;Fi h 'Gray hard DNttJs IFlonee — ntaMral I 'dstv�cKed Siltnerl?+Iwr Non8I.W..ected elluw(TI�SIiC I !None Nti]41eGti7rl(SCf�- ( �Cl1Ul()EP� Yeitow soft material ;i ifft white%brittle I ` dewvt� BirtC;erffittgr '2 ICeitulose I 2007205751 582[-1',�y 1 L Hram�st lino>eum �Yane l I �rriatttrial _ * ,Linoleumibinde;r Y l;,'r;ellul(�se_ �IBR+rcta6 2 ;aniblacic fitxous none IQ�,dt�rfller. �------- _� -material wrIt,maanc � detects iNaeti+✓roinder 65�Cellulosa gi1-1,-Ut I rAletr, , �lllhi!t3 Sheet viltyl ;Vnyltbmde-r ; N x�trestnd I I orte tiatec�ted i _._.-►Gray fibratts meti�rfAl �. —.__... .. __..___-_` — _ ._._.._�___—_ J3irlCer/flJler, ivMrith mastic: b�rcterci 3sticlbind�r B7�C;e�ilulow! Sigclf fiarous INono atanai_. cad 1rldfainerfllrr 95 eltulose 120077.05'153 rows We? Z tlrysuale old M(neral 4 talYLeci by. Weilan.l Tai ROvltwAV,'a by: Steve(Funyao)Zhang, President Page 4 of G SEATTLE ASBESTOS TEST, LLC NVLAP AccrediWon 19711 Scriber LAkt Road,Ute D.Lgaiwood, WA 9$ 36:T d,425.673.9850,Fax:425 673,9810 Lab Cade:20076U Wsbsire:hup:Nwwwirluleaalxatetb,�s!cxrn. E-mail:aimij-4 .eahticaxhe�uxtcacwm ANALYTICAL LABORATORY REPORT PLM by Meftd EPA/600/R-93/116 Client:The Kriebel Company, Inc. Client Job#f: 58Z2 Address-.9122 169th Ave NE Laboratory Batch* 200791058 Granite Fells, WA 98252 Date Received: 711212007 Samples Received: 38 Date Analyzed: 7/14/2007 Attention:Mr. Gan Shelly SamplesAnaWed: 36 Project 5822 Cantinnebon ------------- Client Sample — I. � Asbestos � h1cm-Fibrous I lNon-asbastoo LL ID ID- LsYse .• Deeeniptioty '�! Fibers Cornpons�nts I�O F lbers --+- 2 Yellow mastic Nwtseted IMastic;'binder 7 Cellulose 2007205754 8822-14-01 1 IGray/fed tile- 2 hrysotile �rnyl/Onder, Mineral 13 }Cellulose 1 rains 1 2 Black fibrous None �Mastic/bmder, 65 ICeliuiase atenal with mastic tested IBinder/f!ler I2007205755 5822-15-01 ' 1 r an tie Mona rnyllbrnCor, Mineral , 2 ICeilufose — letecta! rains 2!slack fi.bmus , Ong Mastiribinder, material with mastic dese ,ad der/filler 65 Bin Cellulose 200,205758 5822-18-01 7 �E3sigefile 2 �:hrysotlie Ninyilbinder, 11�ineral 4 Cellulose rains , 2 Black mafte 1 3 hrys"Il. ''""'' joinder, - 7 Cellulose I t1,07205757 5822-17.01—r1 White sheet vinyl None nyb'binrfer None detected �—_-�I--�--___mat I detected C ,►C'raiy fibrous erial I � orris Binder/filler, ----- r ' r with mastic �_ sbectsd sl:WJ inder 70 eilulosa ---- ,---•-- II------ Norse .� t 1Groen sheet vinyl detected iryUbinder one detected 2007206758 5822-1�1 ! I z i5a Ciuysoti ray fibrous material Binder/filler, r . •th mastic ... ! ly �Aast�•�binder 35 eliuke I 2007205759 6822.19.01 I 1 ISilver paper None BinderMller Nona detected i r [Tan pap±rmth #ted Biaid$rifiller, 5 r ellulose L-- —T� 2 [Tan ,asbcJbinder Analyzed by: Weilong Tai Revis>w.e8 by: Steve(Fanyao)Zhang, President r r.ra page 5 of 5 SlEATME ASSESTOS TEST, LLC 97i I StTtben take ftcsw'4 Juilr t) Lynuwtxxt 14 4 98tlab,+±ri 125.677,RIB,P�.:42i.673.98!(! NVLA.PA=wIIl tlon W"A"r tl P"'*NWW-"Wlg l9A`J�rO!l� (;OIYL. E•mut*a Li(. wb;uc,uar Lab L'�dp; _tk7'68s swae�t.tum ANALYTICAL LABORATORY RSPORT PL.M by Method ENA/640/R_g3r116 Client:The Knebel CUmpany, Inc AddA*96:9122 16M Avo NE C>lerei Job : 5822 Granite Fatly, WA g6252 Laboratory fiatCrt:Ir 200731058 Date R"rjaa: '111Z"_)Ov7 Samples Receives.;. 38 Atention:Mr. Dan SlteUy Date A111911YIOU.' 7114.12007 projd&5822 Contrin,>suon Sample$Analy j:d: 36 I fah ID Cti�r�It io-; w I `— — — —� ! 0 I i aYerl S s+crltrtlal � ' Won-ii:ibr*U6 ,� Non-eerb+� Components Fibers ! 3 iYeOow fibrous apq - t Venal � inderKllef _ r t�ekect.d 96 i�.•,{8ss fit5ara I2C072Q:y76p 5r1�?2•�?tl-f71 1 White soft Malaria-' f3inder'rftilar 1 t 1 I--_ _ 1rtr:tt�c•� 2 cellulose 12007205761 5822,24-tl.; Mack Qsphwtic _-i._ !._..__.____ { 1INaweie Sender/t;flur, ff r+o+rs rratariai — + ;eetOctod a L'binder I7ft .8iluias8 f ' slack asph3itic. 100r'2QW`lG2 5822-21-U1 Mo!1atbbindor, Sand, ! Y matc�risf writh.,and th mastic irtd IP 'Glass Glass fibers 'i"Spnedfic tisti�Il wilri sand ( 114eteC't61f pralt/binder, Sand 125 r7iass fi:ers Black as�jjdU- aorta Nspnall�binder, i ibrow ;datwted sinciwiTiliar 5�%elluiga& j 1200 7 205 7 53 C 5_6_2•2---2-3--_--0--1G..<.x_r-e.ts oy n-b-ar l-t N' o�n—,ctlFa e_to_n_i tejdetnoctede maerial inder/filter r?renge bhttls lNone detec_t3 —d 007'4087641 rmistiC i i141.a5tir:Jhinnlr.< 2 eliutoesP ' Analyzed by, Wellung 1-31 RevWw"d by: Steve(Fanyao).Zt;ang, President CHAIN OF CUSTODY ;,,:Uik Asbastcs 'lest 706 212. V.r Lu J-1 77� L.LE z L=10 J6 SO -A&AQ 4WW Ava c Grit ........... AA.0 0-ft ., _ __ .•vim. CHAIN OF CUSTODY Buik �sbertos Test run ArOu,3d �+ume-.:,3i 5arnples_3—F—c?itnt ?Jan .. . ,ent None: Stare: WA. Zia' F-Inat: 'm eisoc�j•�nxcgaco r roj�czocac:Ur. " t? Proj�cr Wtana�er, a.� Shci(v -•_�� Sax--pi-- rcL,,igr.d Severe Da=ge(Sotflage) �CQ� 3r1i f.,i: w SAy,(PL: Lao ZD j ( ui.11iltStL 1 2 r._41Z Sig rtaiure ComONnv `taste D�.r (iuir Zeus Ct:cisCc by "e!ivrrma by I i /•sue•--•� f �-- ' JI -10-CWVI LJ•.i0 r,7VCC SEATTLE ASBESTOS TEST, LLC Page 1 of 6 ANAL"CAL LABORATORY REPORT NVLAP ACCREDITATION LA9 CODE:2M7W PLM by Point Count(400) Client:The KneW Company,Inc. Client Job* 5822 Address:9122169M Ave NE, Laboratory Batch* 200791097 Ganite Fags,WA 98252 Date Received: 7/16/2007 Samples Received: 6 Date Analyzed: 7/1612007 Attentlon:Mr.Dan Shelly Samples Anal: 6 Pr�1ect:5t122 ConlnnsW Client Project#: NIA Sample l"uested for Pant Count 6822-07-01 Prmi Previously Analyzed by:Seattle Asbestos Test, LLC Previous Batch#:200791 D58 Previous Lacs ID:2007205741 Previous Description:Tan powdery matertal with paint Layer That Contained Asbestos:1 AsbestoS Type Found:Chrysodis Asbestos Percentage Found:2% Point C4yQt LPrggg%h mf Naw Lab ID: 2007206037 _ Asbestos Points Non-Asbestos Points Total Points Counted! Slide 1 �'— 1.� 49 — 54 —� _ Slide 2 �— 0 i 50 - 50 Slide 3 0� 50 50 1 - -- Slide 4 T—�-1 49 50 Slide 5 0 so 50 Slide 6 _ 0 50 Slide 7 0 50 50 SIKSe 8 0 50 50 Total - --2 - 398 _ 400 --- Point Count L—Mary R3Q Hits Type of Asbestos:Cn•.rysotlle Percentage of Asbestos:0.50% Sample Description:Tan prrw/dery material with paint An.alyzea by: Weilong Tai Reviewed by:Steve(Fanyao) Zhang, President SEATTLE,ASBESTOS T ST, Lt_C Page 2 of 6 ANAL:YT' AL LABO"TORY REPORT NVLAP ACCREDTATION iAO CODE:200766.0 PLM by Point Count(4GO) 0 ent the KneW r4 , parry, inc, Client,iaa 5522 Address:912216 th Ne NE, Laomatcry nstctr#: T0791097 Granile Faila,WA 96262 Case R&miwoi: 711&2007 Sumpms Received: 6 Oste Ar lyzr*.l, 7113/22007 Attention:Mr.Oan Shesy Samples Andyzoa: 6 I qod:5922 Cunrtinns8an Client Prgwt 0: WA Rampla RaqU&V&2d for Paint Cauggt 6822.07.02 Previousiy Analyzed by:Se.ittle Asbestos'Test, LLC P�-dvioas Batch*200791058 Previous Lab ID:2007205742 PrevKwi Description:Tan powdery material with paint layer That Contained Asbestos:l Asbestos. Type Found:Chrysotile •4.sbestas Perrceniage found:2% fti0t L.gunt.AnabdiCalkimoodum Now Lab 113: 7'007206039 i A beslas Points Non-Asbestos PoirntsiTotsf Poi1ts Counted' t -- _.50 50 __._.. ------- Slide? 0 30 50 I Slide 3 1 _ 40 50 i Slide 4 0 —_ _50 50,Slide3 _ r_�=_... r 50 50 Slide 7 ----..0 a0 50 Slideb a r1 +- 50 - - - 60 TaWl _ _ - _..._-•--399� 400 — Point C:aunt 5 + $ 11g 'rype of Asbestos:Chrysotiie Pereentage of Asbeatas:i0.259A i5arr:!:f+�Dewrmflor:''an powcaryr material with paint analyzed try: rWeiieng T-ai Reviewed try: Steve(fenyao)Deng, President - - h'HGE4 SEATfLE ASSESTbS TEST, LLC. Page 3 of 5 ANAL"CAL LABOWORY REPORT NVLAP ACCREDITATION LAe CCOE:200788 0 PLM by Paint Count(400) Client The KneW Company,Inc. Client.loh* 5822 Address:912216Bth Ave NE, Laboratory satctl#: 200791097 Granite Falls,WA 98252 Dace Received: 71181zU07 Samples Reoeived: 6 Date Analyzed: 7116 007 Atteri,ion:Mr.Dan Sheily Samples Anslyxed: 6 Pruject:5822 Condnnstion Client Pro)ed#: N/A ill_ urastse�r Point aWlt 5822-07-03 Pnvia��,�n—ja ytira! into r��gII Previously Analyzed by:Seattle Asbestos Test, LL.0 Previous Batch S:200791058 Previous Lab ID:2007205743 PreVM3 Descriptiom Tan powdery material with paint Layer That Contained Asbestos:I Asbestos'type Found,Chrysot;le Asbestos Percentages Found;2% Point Count An tvttr l r+MC&dLjWS. Now Lab bo: 2007206039 AsbYeWs Polnes Non-Asbestos PoIntslTotat Points Counte�f� Slade 1 - - -- 0 1 50 50 -' _Slide 2 — --1 ---- — 49 50 _ Slide 3 _ 0 50 50 --� _Slide 4 1 _ 49 $0 >bide 5 0 _ 50 - Sude 6 0 50 50 - -J I Suds 7 —'G _ —M--- 50 ---- —— 54 Toni 2 400 _..� Plaint Count SLjnWajy ReaLil We of Asbestos:Chrysotlie Percen0;s of Asbestos:0.60% Sample Clescrbptlon:Tan Powdery material withh pant Analyzed by: V1leilong Tai reviewed by: Steve(Fanyao)Zhgtng, President SEATTLE ASBESTOS TEST, LLC Page 4 of 6 ANALY'nC L LABORATORY REPORT NVLAPACCREDTATION LAB CODE:2007W PLI I by Point Court(400) Clieft The Kh9bei Gimany, Inc. Client„ob* 6822 Address;9122166ih Arr+NE, LaWrak"Batch* 200791097 Granite Fags,WA SK52 Date R@LAY d: /1612007 Samples Rived: 6 Date Analyzed-. "I"',W007 Attention,Mr, Can ShWy Samples,du aNed; 6 Pr ject:5822 Caiiinnsdw Client Project: NIA Ssimp.�Requestedix Point Cmagt 5822-09-01 —Nylous ArtaNbcxi Informatign Previously Analyzed by:Seattle Asbestos Test, LLC Previous Batch*200791068 Previous,Lab I0:2007205747 Previous Description:Tan powdery material with paint Layer That Contained Asbestos,I Asbestos Type Found,('hrysntle Asbestos Percentage Found:2% Point CoIjInt AnabdkMi ProcedjM Now Lab ID. 2007206040 r-----y _ Asbestoe Points Non--Asbestos Points Total Polnft Counted Slide 1 0 50 _ _50 Slide 2 0 50 _ 50 -- _Slide 3 — 0 50 50 — Slidr 4 0 50 54 -fide 5 - 0 50 50 - SIIcie 6 0 50 11:0 Slide 7 1 49-- ----50 Slide 8 1 _ 49 -5U � I_ Tartu 2 398 -- 400 Poi r Cants Ovum ally Rasatts Type of Asbestos:Chtysotlie Perrentage of Asbestos.,0,5'0•7e Samp4 Description:Tan powdery material with paint Analyzea by: Weilang Tai Reviewed by: Steve(Fanyao) Zhang, President r hlaCD SEATTLE ASBESTOS TEST, ;LC Page 5 Cf 3 ANALYTICAL LABORATORY REPORT NVIAP ACCREDITATION PUM by Point Count(400) IA9 CODE:2007WO 048111;The Krrobsl Carnpany,Inc. Client ebb)f 5BU Addrem:9122181h Ave NE,Gra Laboratory o 20073/097 �!lE Fads,WA 98252 Date Received: 7116/2007 SaMPM Received: 6 Attention:Mr.Dan Shelly Date Analyzed: 7/15/2007 G s Analyzed: 6 r'�siect:5821 Continnstsosy Client Project 0: NIA S�,t11�IsLi�BQ.tt for r�ofnt���t 51122-09-02 Previously analyzed by'.Seattle Asbestos Test, LLC Previous Batch A200791058 Previous Lab I0:2007d05743 Prfwious DeecAptien:White powdery, atertal with palm Layer That Contained Asbestos:1 Asbestos Type Found:C,1 rys9otile Asbestos Percentage Pound;2% eiZltlL�S2W>llZAo LFe � New Lab to-. 2=206041 �laebsatoaa Points Noe-A4bsatosa Points Tote!>a�inta Caa,nied! � Slide?_ 0-- 50 --50 _ 1 49 50 S1. .3 0 50_.. Skde 4 — 0 50 _ �" 50 50 ! --JO __ 50 - - l--_ 49 - - 50 -ro _Slide E _ — 0 50 50 50 2 Podrtt Cuurst 6unnq�pt�� Type of Asbesbas:Chrysotile Percentage of Asbestos:0.50% SzVnPle iUescription:White powdery nnateii;il with paint Analyzod by:Weilong Tai Reviewed ny: Steve 0 anyao)Zhang, President SEAT711 E A.S8ESTCS TEST, LLC Paga t;of S ANALYTICAL LABORATORY REPORT NVL4P P,"XREDFATION LAS CODE:;20076N PLtdl by Point.Count(400} Cl"t:The ILiebe;Company,Inc, Client Job#: 5822 adorers:91221 t tt Ave`JE, Laboratory Batch#: 20079169'' Gi aoite Fads,WA 98252 irate Reoeived: 71161200 SmVlea RaoeiwW: 6 Oats Analyzed: 711612QC 7 rtenton:Mr,Dan Shelly Sample,Analyzed; 6 Prgoct:5822 C�xhnnslion MentPr t#: NIA. sampt )rpoinlrwowni 5822-OM3 ftftis>!nA 1 dira1 f-rammugn Previously Analyzed by:Saat:tle,asbestos'Te-st, LLG Previous Batch 4:200791058 Previous Lab lt):2007205749 Previous Descripdon:White povkery ma dal with paint Layer That Contained Asbestos:9 Asbeeras Type Found:Chrisotile Asbestos Pmer+.tage Foun;:2% EQiU:qQUQL na1yUca!Procm&= Now Lab 10: 200720W42 Aubmtot Poinim Non-Asbestoo Polrfs Total Points Gounterd . . 50 =_._ 50 _ j— Slide 2 _r— 0 50 50 Slide 3 i 1 _ 49 .50 Slice 4 50 ;Aide 5 Q —� 50 r _ 60 j 0 50 50 Sees 7 t 49 _— 'SC 0 50 50 _Total._.._. _ L---- _..L�-� 39H -- --- 400 �SfillYlL��ri23lnt 0urrvmary_�,ttetu�tg Type of Asbestos Chrysotile Peroentage of Asbastas:0.50% Sample Dem ri3Ouf I.White powdery rrsale.rIuI with paint Anarvzcr b-w7 Weilong Tai Reviewed by:Steve(FanNrjo)Zhang, president CHAIN OF CUSTODY Guik Asbe'stcs-Test `4=6er of 3=pics ss: C%;�Y' Utuge Fails State: '60',69, zio: lul L�'Jj ttC, —; JC=()n IN tr Dan 5heily ('4153!97479� Damaged Severe Damage(SpI]ap'l SAMPLE Lao U) Aare IN IL A cumplolly N141ne t Date T ilt .......... 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On, Sheily f.{L:,;97��� �1i1♦1�7ie UULtLurja: C.:and Oa:¢1:� �^ �rve'Ca UilSftr'YzC($plllagC) SEQ= IA.MFf c TJD 51424PL C,UICI.:SM:! {iR t i l V r 1 ♦C,3mlp Vrrr value j )��lC ^• :111f ]�YT'�1l1;'�5' �_•..-.�w:�:� �^i G—� '•�' 'jr�,�,'. �1:'r/.,•' /�t!''��� ��d Q/�' - �rmocusnn ay Ggtrrwren.lovIL vrwj • Psr�e of i It T - i{ ' , T tI ,,, 1• }. _ ... 1, ' 1 ♦ 'I I} . yt '�! � S 1'. , f•. .•,. rj ff. 1.yif=�_l. 0 0 �o O a.z INI tio m o 0o Z 3 CQ a 0 O pia J fL cc N d' 00 M O CO I o $, c � I o o i o I cat CO � o O C G v 0 o I _p c 0 o .Oi a (L!7 O 7 a CQ O C 4-1 c 1 O � C (d G N CT) o ., m N L A00 Q LO o I ni o 0 co o o� of J� co 0 0 o o z 5o 0 0 0 N u� N o 0 0 ., z :z � � Zrn 00 LLJ m v W N � `103 �c i 0 Q W tj N -S G !.- ! 11.1� •✓l1.�)!! t.l:l /,•�r.k_>7 to )!•i�il�l._!I•! I , Lo t O o Ln i = a - c LLI �— C7 o W `z v © J r V i r� 1 —' i it __ :� •> .,. now -- t .w 71 ri - I N JUN-18-2008 04:22 PM <AAS> <AIIState> 13604357246 P. 1 P.0,Box 3278 Mown,WA 96223 PH: 380.436 8862 FAX:3W436-7246 ftx To: From; Phorm DOW Re; car 0 Urgent q For Review 0 Please Comment O Piss"RsPiy D Please Recycle DXn �4 i " CITY OF ARLINGTON 238 N.OLYMPIC AVE.-ARLINGTON,WA.98223 PHONE:(360)403-3421 Permit#: BLD20080097 BUILDING ' Project Address: 5822 CEMETERY RD, ARLINGTON Parcel No: 31051500200800 PROPERTY OWNER APPLICANT CONTRACTOR OPAL PROPERTIES OPAL PROPERTIES PACIFIC ROADS&BRIDGE PO BOX 3554 PO BOX 3554 PO BOX 3554 ARLINGTON,WA 98223 ARLINGTON,WA 98223 ARLINGTON,WA 98223 Phone:425 754-2248 Phone:425 754-2248 LICENSE#: EXP: Email: Email: PLUMBING O' MECHANICAL CONTRACTOR Lic#: ExQ Lic#: L;, i DESCRIPTION DEMOLITION OF EXISTING RESIDENCE ATTACHED GARAGE. WATER SERVICE TO THIS SITE VALUATION: $0 PERMIT TYPE:Residential PERMIT GROUP:Demolition NUMBER OF STORIES:0 TYPE OF CONSTRUCTION: NUMBER OF DWELLING UNITS:0 OCCUPANT GROUP: CODE:2006 OCCUPANT LOAD: BASEMENT:0 1ST FLOOR:0 2ND FLOOR:0 BASEMENT:0 1ST FLOOR:0 2ND FLOOR:0 3RD FLOOR:0 GARAGE:0 DECK:0 OTHER:0 13RD FLOOR:0 GARAGE:0 DECK:0 OTHER:0 FRONT1REARSETBACK REQUIRED: PROPOSED: REQUIRED: PROPOSED: RE UIRED: PROPOSED: HEIGHT ALLOWED:O PROPOSED:O I REQUIRED: PROPOSED: SETBACK NOTES: PERMITAPPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY,NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. SfTriatur6 Print Name Date eleased B Dat ATTENTION �M_zs_ IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.UBC 109/IBC 110/IRC 110. ARCHIVE APPLICANT ASSESSOR OTHER BLD20080097 CONDITIONS • None Description Fee Amount Paid Balance Due C-Building Permit Fee $100.00 ($100.00) $0.00 C-Plumbing Permit Fee $0.00 $0.00 $0.00 C-Mechanical Permit Fee $0.00 $0.00 $0.00 C-State Building Code Surcharge $4.50 ($4.50) $0.00 Total Due: $104.50 ($104.50) $0.00 INSPECTIONS THIS PERMIT AUTHORIZES ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY.ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. CALL FOR INSPECTIONS BUILDING/ENGINEERING/PARKS/UTILITIES/FINAL(360)435-0674 FIRE(360)403-3607 When calling for an inspection please leave the following information: Permit Number,Job Site Address,Type of Inspection l being requested,Contact Name and Phone Number,Date Prefereed,and whether you prefer morning or afternoon. • None Snohomish County, WA Assessor Parcel Data Page 1 of 2 no h o m s h Online Government Information Services County W Washington K R E A L * Property Information County Home Assessor Home Treasurer Home Information on which Department to contact Please view Disclaimer If you have questions,comments or suggestions,please Contact Us. Date/Time:4/10/2008 11:27:37 AM Answers to Frequently Asked Questions about Parcel Data(opens as new window) Return to Property Information Entry page Parcel Number 31051500200800 Prev Parcel Reference 15310520080009 jJ View NVlap of this parcel (opens as new window)11 General Information Taxpayer Name 11 Address (contact the Treasurer if you have questions) OPAL PROPERTIES LLC 11 PO BOX 3554 - - - ARLINGTON, WA 98223 If the above mailing address is incorrect and you want to make a change,see the information on Name and Address Changes Owner Name 11 Address (contact the Assessor if you have questions) OPAL PROPERTIES LLC 11 PO BOX 3554 - - -ARLINGTON, WA 98223 If the above name and address is incorrect due to a recent sale,please see the information on Name and Address Changes After a Sale Street(Situs)Address (contact the Assessor if you have questions) 5822 CEMETERY RD - - - ARLINGTON, WA 98223-7781 Parcel Legal Description SEC 15 TWP 31 RGE 05 RT-1413-1)BEG NE COR SE1/4 NW1/4 TH S 111.8FT TO S LN CO RD TPB TH S 30OFT TH W 175FT TH N 232FT M/L TO S LN CO RD TH NELY ALG S LN SD CO RD 188FT M/L TO TPB SUBJ ESE PUD Go to top of page Treasurer's Tax Information Taxes For answers to questions about Taxes, please contact the Treasurer's office (opens as new window) 2008 Taxes for this parcel $2,267.98 (Taxes may include Surface Water Management and/or State Forest Fire Patrol fees. LID charges,if any, are not included.) To obtain a duplicate tax statement, either download our Tax_$tatement_Request form or call 425-388-3366 to request it by phone. Go to top of page e Assessor's Property Data Characteristics and Value Data below are for 2008 tax year. RECEI—Y`'G® Please contact the Treasurer's office for answers to questions about Taxes(opens as n"Wigdow)rlrj!j For questions ONLY about property characteristics or property values(NOT taxes), COA PERMIT CENTER please contact the assessor's Office Property Values do not reflect adjustments made due to an exemption, such as a senior or disabled persons Values exemption. 616 20"m�I7 http://web5.co.snohomish.wa.us/propsys/asr-tr-propinq/PrpIngO2-ParcelData.asp?PN=310... 4/10/2008 Snohomish County, WA Assessor Parcel Data Page 2 of 2 Reductions for exemptions are made on the property tax bill. Tax Year 2008 Market Land $227,600 Market Improvement $41,5001 Market Total $269,100 Go to top of page Valuation, Payment, and Property Tax History View History(opens as new window) Go to top of page Property Characteristics Tax Code Area(TCA) 00110 View Taxing Districts for this Parcel(opens as new window) use Code 111 Single Family Residence-Detached Size Basis ACRE Size 1.11 (Size may include undivided interest in common tracts and road parcels) Go to top of page Property Structures Type Yr.Built Structure Description Dwelling 1943 1 Story SFR View Structure_Data(opens as new window) Go to top of page Property Sales since 7/31/1999 Explanation of Sales Information(opens as new window) Sales data is based solely upon excise affidavits processed by the Assessor. Transfer Receipt Sales Excise Deed Grantor(Seller) Grantee(Buyer) Other Date Date Price Number Type Parcels 10/11/2007 10/11/2007 $0 215040 QC GUTSCHMIDT PENNY LEE RENGEN GLENN A No 10/11/2007 10/11/2007 $0 215041 QC RENGEN GLENN A OPAL PROPERTIES LLC No Go to top of page Property Maps Township/Range/Section/Quarter,links to maps Neighborhood 5203002 Explanation of Nei.gh_borhood_Cod.e(opens as new window) Township 31 Range 05 Section 15 Quarter NW Find parcel maps for this Township/Range/Section View X1a1) of this parcel (opens as new window) RECEIVED APR 10 Z008 COA PERMIT CENTER http://web5.co.snohomish.wa.us/propsys/asr-tr-propinq/PrpIng02-ParcelData.asp?PN=310... 4/10/2008 Snohornish County Online Property Inforniation-Microsoft Internet Explorer proyided by Lity of Arlinaton (1 J ^ ' PJ httpo/*.eo.sndwmish.wa.us/mepslp►ope►tylvWmr.htm7PIRA-31051s00202600&ADDR:31051500202600 X Live search s Fie Edt vbw Favorites Tools Hea 14 4�1 *Snohomish County:mime Property Information- - - 1�1 + 7 Page - Tools Snohomish Snohomish County Assessor's Office CountyLY�, Snohomish County Online Proper Information Washington I , 1 Assessor Home County Home Privacy Statement Disclaimer Contact Cs Frequently Asked Questions UO � JrOSI504f00700 Vk-W it-cent sates oorn In Zoom W move Mop FtAl VAMv Refresh Map Print Map J105150010tT00 00)J63000tMi00 SeCee1 a C' _+ ► " 31os1eootooeoo 31os��oo2oosoo 3105f5 200800 M,"1 0pot Aerial Photo 2001 007I8J00001000 r r. r 7 00:0��00 :K- Oti7.a3000tio7oo r+ ,. , drag to rediraw at a larger scale Done Start L--j W » )f Inbox-Microsoft...I --I RE:Emmlirq:HI... I J Stormwater and... I My Pictures I *Snohomish Count...I Snohomish Cow- lee%i�J 11 A0 AM RECEIVED APR 10 2008 COA PERMIT CENTER &b 2UU 9 0 UC Thursday,Apr 10,2008 11:40 AM I JUN-18-2008 04:22 PM <AAS> <AIIState> 13604357246 P. 2 A.A. Services, Inc Attu:Robin—Pacific Road&Bridge 4/17/2008 Re: Asbestos abatement at 5822 Cemetery Rd.Arlington,WA 98223 This letter is to confirm that the asbestos containing materials have been removed per local regulatory agencies, All proper notifications were filed,as required,with PSCAA&Department of Labor&Industries to perform asbestos abatement prior to remodel and/or demolition by others as listed above, Asbestos containing materials were removed per quantities and locations listed on survey. Removal was completed April 17,2008. Please call me at(360)629-io64 if you have any further questions. Thank you for your business, Sincerely, Scot'Sampso"l Scott Sampson OFFICE COPY President P O Box 3278 phone:(360)629-xo64 Arlington,WA 98223 Fax:(360)435-7246 DEMOLITIOt PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington,WA 98223 • Phone (360)403 3551 FAX(360)403 3447 THIS APPLICATION MUST BE ACCOMPANIED TWO(2)SETS OF FULLY DIMENISIONED PLOT PLANS AND SITE CLEAN-UP PLAN, TWO(2) COPIES OF AN ASBESTOS ABATEMENT REPORT COMPLETED BY AN APPROVED AGENCY. Type of Permit: (check one) Residential ( )Commercial --> 97 �C`�"r tzp Parcel ID#: Project Address. Lot#: Subdivision: Valuation: d G.Kzrye 7O5<s RI 1 Building Area (Sq Ft) No.of floors: y ` Number of Buildings: (�PA-t Pr,L�� Phone Number: Owner: >, �� State: �-� Zip Code: Z Address: ?o gyX 3 `� City: f ` c S C�AQ Phone Number: Contact Person: 3�a \ - L� 120 E-mail: � Cell Phone: �4ZS 7S 4 -22 4b' Fax: BOO) ��-3 c State: e"� 4 Zip Code: Address: Jc�`- �``c-��ny City: Scope of Work: 5'rvf, c-T Z` Contractor: IL��� f � Z7�(�c Phone Number: Address: 8`Z Y City: State: Z ��� Zip Code: 4ZZ3 Contractor's License Number: Expiration: I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- described pr p rt ill be in accordance with the laws, rules and regulations of the Stat of Washington. Applicants Signature Date RECEIVED Print Applicants Name APR 10 2008 COA PERMIT CENTER FOR STAFF USE ONLY �00 14 0 Amount Received Receipt# Date Received Permit# Accepted By 3107 dwa WEB Forms-14 Page 1 of 1