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HomeMy WebLinkAbout20101 67th Ave Ne_BLD830_2026 Z_ vo CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address: 20015 67th Avenue Permit#: 830 Parcel#: 31051400200700 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Gayteway Business Park, LLC Name:Chris Gayte Name: Decker Enterprises,Inc. Address:P.O. Box 1727 Address:PO Box 1727 Address: 11402 Kelly Road NE City, State Zip:Bellevue,WA 98009 City, State Zip:Bellevue,WA 98009 City, State Zip:Carnation,WA 98014 Phone: Phone:206-240-9739 Phone:425-788-1874 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City, State,Zip: City, State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Demolition CODE YEAR: 2012 STORIES: CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: 6 OCC LOAD: PERMIT APPROVAL A 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. 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. IBC1 10/IRC1 10. SALES' X NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return Ring a d c d C4ty of Arl' tun #�333�I l. VteSignature Print Name ale Released By CONDITIONS THIS PERMIT AUTHORIZE 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. PERMIT FEES Date Description Fee Amount 11/2/2015 Demolition Fee $100.00 11/2/2015 State Building Code Surcharge Fee $4.50 Total Due: $104.50 Total Payment: $104.50 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING (360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon Launa Peterson From: Asbestos Program <Asbestos@ pscleanair.org> Sent: Friday, November 20, 2015 3:50 PM To: Launa Peterson Subject: RE: Notification Case#201504477 Importance: High If each building has a different/individual address, then yes, you need to file a notification for each individual site. Thank you for your inquiry. From: Launa Peterson [mailto:lpeterson@arlingtonwa.gov] Sent: Thursday, November 19, 2015 2:39 PM To: Asbestos Program Cc: Marc Hayes Subject: Notification Case #201504477 Notification Case#20150447. 1 appears the asbestos survey was for 13 buildings. Per No. 3 of the approval "(3) 1 understand one Notification must be filed for each structure..." My question is; does this notification cover all 13 buildings or only 1? Thank you for advising me in this matter. Launa Peterson, CPTJ City of Arlington 360-403-3551 1 Ipeterson@arlingtonwa.gov 18204 591h Avenue NE, Arlington, WA 98223 (located inside the Airport Office Building) Launa Peterson From: Chris Gayte <cjgayte@yahoo.com> Sent: Tuesday, November 03, 2015 8:49 AM To: Launa Peterson Cc: brent@nicholsondev.com; Amy Rusko; Marc Hayes Subject: Re: Demolition Permit Laura I am out of town until tomorrow...There's one tax parcel number and only one notice is needed... If it were separate parcel numbers I agree, but since the buildings were all tested under one parcel we should be good Thanks Chris Gayte Sent from my iPhone On Nov 3, 2015, at 10:41 AM, Launa Peterson<Ipeterson@arlingtonwa.gov>wrote: Brent and Chris, Per the Puget Sound Clean Air Agency; One notification must be filed for each structure to be removed. We have received one of the six notifications required.The permit will not be issued until the remaining five notifications have been received. Please contact me if you have any questions or concerns. Thank you, <image003.jpg> Launa Peterson, CPTJ City of Arlington 360-403-3551 1 Ipeterson@arlingtonwa.gov 18204 591h Avenue NE, Arlington, WA 98223 (located inside the Airport Office Building) Launa Peterson From: Launa Peterson Sent: Tuesday, November 03, 2015 8:41 AM To: 'brent@nicholsondev.com'; 'Chris Gayte' Cc: Amy Rusko; Marc Hayes Subject: Demolition Permit Brent and Chris, Per the Puget Sound Clean Air Agency; One notification must be filed for each structure to be removed.We have received one of the six notifications required. The permit will not be issued until the remaining five notifications have been received. Please contact me if you have any questions or concerns. Thank you, Launa Peterson, CPT I City of Arlington 360-403-3551 1 Ipeterson@arlingtonwa.gov 18204 591h Avenue NE,Arlington, WA 98223 (located inside the Airport Office Building) Permit Information Date 11/2/2015 Permit Number 830 Project Name Gayteway Business Park Applicant Name Chris Gayte Applicant Address PO Box 1727 City, State,Zip Bellevue,WA 98009 Contact Chris Gayte Phone 206-240-9739 Email cjgayte@yahoo.com Permit Type Demolition Site Address 20016 67th Avenue Valuation 0.00 Status Ready to Issue Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Demo Metal Buildings Assigned To Amy Rusko Property . . Owner Parcel#:31051400200700 Gayteway Business Park,LLC Gayteway Business Park, LLC P.O.Box 1727 20015 67TH AVE NE Bellevue,WA 98009 Fees Fee Description . - Demolition Fee 322.10.00.001 $100.00 State Buildinq Code Surchar a Fee 386.00.01.00 $4.50 Total Payments Date Paid By Amount Description Payment Type Accepted By 11/2/2015 Brent Nicholson 5104.5 cash I_ai,na Peterson Total0- 50 Amount Outstanding: ,0 00 Uploaded FileUpload File DEMOLITION PERMIT APPLICATION Department of Community& Economic Development City of Arlington •.18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551 THIS APPLICATION MUST BE ACCOMPANIED WITH A COPY OF THE ASBESTOS/DEMOLITION NOTIFICATION FROM PUGET SOUND CLEAN AIR AGENCY, TWO(2)COPIES OF AN ASBESTOS SURVEY REPORT AND ABATEMENT REPORT (if applicable)COMPLETED BY AN APPROVED AGENCY. Type of Permit:(check one) ❑ Residential ® Commercial Industrial Project Address © � ` LA— Parcel ID#: Lot#: Subdivision: Valuation Building Arre1a�(Sq Ft) No. off floors: Number of Buildings Owner: �'� yTc.�J� �� A 5�k�SS l' J" ,e LL�� Phone Number: Address n- ` City: State: Zip Code q Contact Person: �--1/1 u'i� Qx C _9_ Phone Number. f 2.� �2 -3 Cell Phone: 11 9- 0,Ct E-mail Address: City: State: Zip Code:_ Contractor: Phone Number: Address: City State: Zip Code: Contractor's License Number: Expiration: Scope of Work: I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above- described pro rty will be in accordance with the laws, rules and regulations of the Stat of Washington. pplicalnts Signature Date Print Applicants Name Y30FOR STAFF USE ONLY Permit# Accepte By Amount Received Receipt# bath Iko6ft t-ypruveu r ralt mmon Page 1 oI 1 I L pscIeanair.org Pu"Sow►d�-k,,,•'[-Agency Notification Case #: 201504477 This page must be printed.A printout of the notification,all amendments to the notification,and the asbestos survey shall be available for Inspection at all times at the asbestos project or demolition site(Reg III,4.03(a)(6)). Fee Amount Paid $65.00 Credit Card Transaction #ASOF094811AA Transaction Date ., 10/20/15 IC G)a;J 5 Owner's Name Aayteway Business park LLC Phone (206) 240-9739 Project Street Address 20015 671th eve no city arlington ZIP 98223 Contact Person chrin gayte Phone (206)240-9739 Mailing Address pobox 1727 bellevue,WA 98009 This project includes a demolition. Demolition Start Date 11/01/16 Completion Date 12/01/13 Demolition will be completed by a demolition contractor Demo Contractor Property Owner Contractor Job# Contact Phone Mailing Address (1)I certify that the Information I have provided Is to the best of my knowledge true and accurate. (2)I understand that I must file an Amendment to this Notification If: • The type of project has changed.The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History Loa Out If you have questlonsr contact us at asbestosopscleanair.org or 206.689.4058, https://secum.pscleanair_org/Asbestos/ApprovecLaspx 1 0120/20 1 5 Environmental Specialties 4227 S Meridian, STE C,#625 •Puyallup, WA 98373 •(253)683-1144 Asbestos Inspection NW Hardwoods Mill 20015 67th Ave NE Arlington, WA Owner NW Hardwoods 3316 Fuhrman Ave E, Ste 200 Seattle, VYA 98102 Consultant Environmental Specialties 4227 S Meridian, Ste C, #625 Puyallup, WA 98373 Reviewed by AS Es Introduction On April 16, 2013 Environmental Specialties inspected 13 structures that make up the NW Hardwoods NO site for asbestos materials. A previous inspection covered the kilns (now demolished) and central storage shed. The kilns have been demolished. The storage shed is still in place. This is a large hardwood mill facility made up of 14 structures that are presently vacant. A leased facility adjacent to the truck shop is in addition and was not inspected. This inspection report includes data that describes the type of materials found, their quantities, where appropriate and their asbestos content. The report can also be used as a planning aid for all construction, maintenance, abatement and demolition work associated with the structure. Facilities Description This mill site consists of 14 structures. 13 were inspected for this Survey of Asbestos Materials. The central storage shed next to the original kilns (now demolished) was inspected along with the kilns during 2012. The buildings are: Office, Boiler, Kiln office, Kiln Shed, Planer Building, Mill Building, Truck Storage, Mill Modular 2,New Mill, Scale Office,and Truck Shop with fuel station. The Site Office and Scale Office are wood structures. The Site office is combined with a modular building from the 1970's. Generally all structures date from 1980. The Kiln office is a wood frame building with a steel exterior. The scale house is also a conventional wood frame building on a concrete slab foundation. Mill buildings and the Boiler building have steel or wood post and beam framing with a steel skin. Wood is generally used to line the offices although there is a small amount of gypsum wallboard in the mill buildings. The truck shop is a steel building built on a concrete slab foundation. Floors in the mills are either concrete or asphalt paving. The offices, lunchrooms and saw filing rooms have wood floors. Offices have electric unit heaters agd the main working areas are unheated. A significant quantity of machinery has been removed. Inspection & Sampling Procedures Northwest Air Pollution Agency and Labor&Industries regulations require an inspection of all buildings for the presence of asbestos containing materials prior to renovation and/or demolition. Asbestos containing materials are defined as those building materials containing one percent or more of asbestos as verified by laboratory analysis. Reviewed by.lf.S Es Asbestos containing materials are sub-divided into three types: surfacing materials, thermal system insulation, and miscellaneous materials. Surfacing materials are defined as those materials that are sprayed-on, troweled-on or otherwise applied to surfaces including, but not limited to, acoustical plaster on ceilings, paints, fireproofing materials on structural members, or other materials on surfaces for decorative purposes. Thermal system insulation indicates material applied to pipes, fittings, boilers, tanks, ducts, or other structural components to prevent heat loss or gain. All other materials are considered to be miscellaneous materials. All surfacing materials, thermal system insulation and flooring installed in structures prior to 1980 are presumed to contain asbestos unless proven otherwise by a licensed building inspector.Tb.=number of samples collected depends on the type of material and its quantity. In order to prove that suspect or presumed surfacing materials do not contain asbestos at least three samples of each homogeneous area are required. Five samples are required for areas greater than 1000 square feet and seven are required for areas greater than 5000 square feet. Thermal system insulation requires at least three samples be collected. One sample of each suspect miscellaneous material must also be collected. Each sample was collected and placed into a separate, sealed, plastic bag. They were then individually numbered. When possible,samples were collected from areas or materials that were previously damaged. Sampling equipment was decontaminated after each sample was collected. Once collected, the samples were delivered to an accredited laboratory, accompanied by a chain of custody describing each sample. The samples were then analyzed using Polarized Light Microscopy (PLM) Stain Dispersion technique in accordance with EPA Method 600/R-93/116. Additional treatment and tests may have been used as required to define a sample's composition. Non-Asbestos Containing Materials, The following materials have been shown by a laboratory to be non-asbestos. Material Type Location Quantity Description Gyp Wallboard Office& 3000 Gypsum wallboard, offices,kiln office, Kiln office sc ift planer electrical office Exterior SidingOffice& 4000 Cement Board,Hardie Siding Modular sq/ft Roofmg Office s00 Two levels, asphalt&rubber roofing Floor Tile Modular 2 200 sq/ft 12x12,Dark and light vinyl composition tiles Reviewed byJLS 1 1 Es Floor Tile Planer 300 sq/ft 12x12 cream, lunchroom Lunchroom Sheet Vinyl Office Bldg 40 sq/ft Black patterned,upstairs Sheet Vinyl Office Bldg 40 sq/lt Black heavy entry vinyl Sheet Vinyl Office Bldg 30 sq/ft Tan top layer,upstairs kitchen Sheet Vinyl Office Bldg 30 sq/ft Black bottom layer,upstairs kitchen Sheet Vinyl Office Bldg 10 sq/ft Yellow,old modular attached utility room Sheet Vinyl Planer 40 sq/ft Lunchroom restroom Lunchroom Planer Sheet Vinyl Shipping 30 sq/ft Upstairs office Office Sheet Vinyl File Room 40 sq/ft Office floor covering Asbestos Containing Materials No asbestos materials were found d71--9 this inspection. Conclusion No asbestos materials were found during this inspection. The boiler and piping materials were sampled and found to not contain asbestos in an earlier inspection targeting the kilns. This inspection was conducted December 6, 2012. It contains information useful to this inspection. If additional suspect materials are found during renovation or demolition another inspection by a certified inspector is recommended. Northwest Air Pollution Control Agency and Washington WISHA asbestos regulations require that all asbestos containing materials be properly handled during demolition and renovation and that a survey of the asbestos containing materials be provided to all contractors and posted at the site to prevent potential accidental asbestos exposure. Revieived by JLS aim S Inspector Endorsement Inspector: Certified AHERA Building Inspector, SP-AP Inspector#141111 Attachments: Laboratory Analysis r® Reviewed byJLS K -a m o O C O O 3 m tJ 3 .. o 0 w ,rD�� o a lu D r1 ca rD 00 3 N � V O V1 rD n rD CEI LANos ASBESTOS LABORATORY REPORT Prepared for CMSI - Environmental Specialties PROJECT: NW Hardwoods -200015 67th Ave. NE, Arlington, WA CEI LAB CODE: A13-4192 DATE ANALYZED: 04/21/13 DATE REPORTED: 04/22/13 TOTAL SAMPLES ANALYZED: 20 # SAMPLES >1% ASBESTOS: TEL: 866-481 -1412 www.ceitabs.com Asbestos Report Summary C: EI '- By: POLARIZING LIGHT MICROSCOPY L/��S PROJECT: NW Hardwoods - 200015 67th Ave. NE, CEI LAB CODE: Ala-4192 Arlington, WA METHOD: EPA 600/ R93/ 116 and EPA 600/ M4-82/020 ASBESTOS Client ID Layer Lab ID Color Sample Description % I A1454136 White Wallboard None Detected 2 A1454137 White Wallboard None Detected 3 A1454138 White Wallboard None Detected 4 A1454139 White,Black Sheet Vinyl None Detected ^^ 5 A1454140 Black Sheet Vinyl None Detected 6 Al454141 Tan Sheet Vinyl None Detected 7 A1454142 Black Sheet Vinyl None Detected 8 A1454143 Yellow Sheet Vinyl None Detected 9 A1454144 White Siding None Detected 10 - - - - Layer 1- A1454145 - - - -_Silver- - - - - Coating- -- - -None Detected - - - - - - - - - - - Layer 2 A1454145 Black Roofing None Detected T 11 A1454146 White Wallboard None Detected 12 A1454147 White Wallboard None Detected 13 A1454148A Cream Tile None Detected A1454148B Clear Mastic None Detected 14 Al454149 Grey Sheet Vinyl None Detected 15 A1454150 White Sheet Vinyl None Detected 16 A1454151 Beige f, Sheet Vinyl None Detected 17 A1454152 White Wallboard None Detected 18 A1454153 Grey Sheet Vinyl None Detected 19 A1454154A Grey Tile None Detected A1454154B Clear Mastic None Detected 20 A1454155A Cream Tile None Detected A1454155B Yellow Mastic None Detected Page 1 of 1 - ASBESTOS BULK ANALYSIS EI «s_4.� By: POLARIZING LIGHT MICROSCOPY J�L135 Client: CMSI -Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 -'� Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods -200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 1 Wallboard Heterogeneous 20% Cellulose 70% Gypsum None Detected A1454136 White 5% Paint Fibrous 5% Binder Bound 2 Wallboard Heterogeneous 20% Cellulose 70% Gypsum None Detected A1454137 White 5% Paint Fibrous 5% Binder Bound 3 Wallboard Heterogeneous 20% Cellulose 75% Gypsum None Detected Al454138 White 5% Paint Fibrous Bound 4 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454139 White,Black 25% Binder Fibrous Bound 5 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454140 Black 25% Binder Fibrous Bound 6 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454141 Tan 5% Fiberglass 20% Binder Fibrous Bound 7 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454142 Black 25% Binder Fibrous Bound 8 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454143 Yellow 20% Synthetic Fiber 5% Mastic Fibrous Bound Page 1 of 5 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY LADS Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods- 200015 67th Ave, NE,Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD F lient ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS ab ID Description Attributes Fibrous Non-Fibrous % 9 Siding Heterogeneous 25% Cellulose 75% Binder None Detected A1454144 White Fibrous Bound 10 Coating Heterogeneous 100% Paint None Detected Layer 1 Silver A1454145 Non-fibrous Bound - - - --- --- - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Layer 2 Roofing Heterogeneous 25% Synthetic Fiber 75% Tar None Detected A1454145 Black Fibrous Bound 11 Wallboard Heterogeneous 85% Calc Carb None Detected A1454146 White 15% Silicates Non-fibrous <1% Mica Bound 12 Wallboard Heterogeneous 20% Cellulose 80% Gypsum None Detected A1454147 White <1% Fiberglass Non-fibrous Bound 13 Tile Heterogeneous 100% Vinyl None Detected A1454148A Cream Non-fibrous Bound A1454148B Mastic Heterogeneous 100% Mastic None Detected Clear Non-fibrous Bound a 14 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454149 Grey 30% Binder Fibrous Bound Page 2 of 5 r ASBESTOS BULK ANALYSIS CEIBy: POLARIZING LIGHT MICROSCOPY LAC35 Client: CMSI - Environmental Specialties CEI Lab Code: A13A192 4227 South Meridian, Suite C#625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods -200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 15 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454150 White 25% Binder Fibrous Bound 16 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454151 Beige 5% Fiberglass 25% Binder Fibrous Bound 17 Wallboard Heterogeneous 20% Cellulose 80% Gypsum None Detected A1454152 White Non-fibrous Bound 18 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454153 Grey 5% Fiberglass 25% Binder Fibrous Bound 19 Tile Heterogeneous 100% Vinyl None Detected A1454154A Grey Non-fibrous Bound A1454154B Mastic Heterogeneous 100% Mastic None Detected Clear Non-fibrous Bound 20 Tile Heterogeneous 100% Vinyl None Detected A 1454155A Cream Non-fibrous Bound A1454165B Mastic Heterogeneous - 100% Mastic None Detected Yellow Non-fibrous Bound Page 3 of 5 ASBESTOS BULK ANALYSIS CEI ­ By: POLARIZING LIGHT MICROSCOPY L/�C35 Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods -200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % Page 4of5 a E I LEGEND: Non-Anth = Non-Asbestiform Anthophylite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate METHOD: EPA 600/ R93 1116 and EPA 600/ M4-82 1020 The detection limit for the method is <1% by visual estimation and 0.25% by 400 point counts or 0.1% by 1,000 point counts. Due to the limitations of the EPA 600 Method, nonfriable organically bound materials (NOBs) such as vinyl floor tiles can be difficult to analyze via polarizing light microscopy (PLM). EPA recommends that all NOBs analyzed by PLM, and found not to contain asbestos, be further analyzed by Transmission Electron Microscopy(TEM). Please note that PLM analysis of dust and soil samples for asbestos is not covered under NVLAP accreditation. This report may not be reproduced, except in full, without written approval by CEI LABS. CEI LABS makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U. S. Government. ANALYST: APPROVED BY: lG� Gl Greg Ruff Tianbao Bai, Ph.D. Laboratory Director y m V A NVLAP Lab Cade 101768.0 CEI Labs,107 New Edition Court,Cary,NC 27511,Phone:(866)481-1412 Page 5 of 5 CHAIN OF CUSTODY CELASS L-48USEONLY: 107 New Edition Court.Cary.NC 27511 CEI Lab Code: Tel:866-481-1412; Fax:919-481-1442 CEI Lab I.D.Rance: Jy$y/JYO• l�Sy COMPANY CONTACT INFORMATION Cam an Client 4: a ° Address: P yallup.M. 98373 Job Contact: '- cam lG�•� =- Email: -f Project Name: �7 c ^ =� Fax: Project ID#: �C C C , f � c 1 r� P-0.#: TURN AROUND TIME ASBESTOS METHOD 4 HR` 8 HR` 24 FIR 2 DAY 3 DAY 5 DAY PLM BULK EPA 600 ❑ ❑ ❑ ❑ ❑ PLM POINT COUNT(400) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM POINT COUNT(1000) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM GRAVIMETRIC EPA 600 ❑ ❑ ❑ ❑ ❑ PLM GRAY w POINT COUNT EPA 600 ❑ ❑ ❑ ❑ PCM AIR NIOSH 7400 ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR AHERA C ' ❑ ❑ ❑ ❑ ❑ TEM AIR EPA Level II ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR NIOSH 7402 ❑ ❑ ❑ ❑ ❑ TEPA BULK CHATFIELD �_E ❑ ❑ ❑ ❑ ❑ TEM DUST WIPE ASTM D6480-05 ❑ ❑ ❑ ❑ TEM DUST MICROVAC ASTM D5755-03 ❑ ❑ ❑ ❑ ❑ ❑ TEM QUALITATIVE CEI LABS ❑ ❑ ❑ ❑ ❑ OTHER: ❑ ❑ ❑ ❑ ❑ ❑ LEAD PAINT METHOD _ 4 HR` a HR• 24 HR 2 DAY 3 DAY s DAY LEAD PAINT EPA SW846 7000B ❑ ❑ ❑ LEAD WIPE EPA SW846 7000B ❑ ❑ LEAD SOIL EPA SW846 7000B ❑ ❑ LEAD AIR NIOSH 7082 ❑ ❑ ❑ ED REMARKS: Accept Samples Reject Samples elin uis ed By: D teMme Re i e ;B DatefrIme —� 7 /3 �f`G"crJ/ Ll-l i rz `Call to confirm RUSH analysis. Samples will be disposed of 30 days' r analysis VERSION CCOC.0112.1i2.L0 Customer COC Page 1 aeifl�i�egc lelemnorivn3-i2fl�i� 2SiI4� e18.2 nalbheM SSSt, 97980 AW,qulls p9 - y; r = SAMPLING FORM CEL"AC3S COMPANY CONTACT INFORMATION Company: w5 x r S Job Contact: Z Project Name: r�0 — Pro ect ID#: © ' Tel: VOLUME! SAMPLE ID# DESCRIPTION LOCATION .AREA" :COMMENTS` � LLG4J K � F w GZL 77 e/ i Cv i cp 7 ull� I > U fC Z 4, G vvorh ) U G r e !eC Av, ft�L� I e- lac ' f mkf tj I z XIZ �1r -BoAab lie , Page —7— of ?i VERSION CCOC.0112M2.LD Customer COC Page 2 v pscleanair.org PwgvtSotmd:-= Agency Notification Case #: 201504477 This page must be printed.A printout of the notification,all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site(Reg III,4.03(a)(6)). Fee Amount Paid $63.00 Credit Card Transaction#ASOFD94811AA Transaction Date 20/15 /6 Owner's Name Osyteway 6usineas park LLC Phone (206) 240-9739 Project Street Address 20015 67th eve ne City arlington ZIP 98223 Contact Person chris gayte Phone (206) 240-9739 Malting Address pobox 1727 bellevue, WA 98009 This project includes a demolition. Demolition Start Date 11/01/15 Completion Date 12/01/15 Demolition will be completed by a demolition contractor Demo Contractor Property Owner Contractor Job # Contact Phone Mailing Address (1)I certify that the Information I have provided Is to the best of my knowledge true and accurate. (2)I understand that I must file an Amendment to this Notification It: • The type of project has changed.The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category, • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure, The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Ci-oaip Anot-htir batiti" ign View Mistory Loa Out If you have questions, contact us at asbestos@pscleanalr.org or 206.689.4058. https://secure.pscleanair_org/Asbestos/Approved.aspx 10/20/2015 Environmental Specialties 4227 S Meridian, STE C,#625 •Puyallup,WA 98373 •(253)683-1144 Asbestos Inspection NW Hardwoods Mill 20015 67th Ave NE Arlington, WA Owner NW Hardwoods 3316 Fuhrman Ave E, Ste 200 Seattle, VYA 98102 Consultant Environmental Specialties 4227 S Meridian, Ste C, #625 Puyallup, WA 98373 Reviewed by AS y Es Introduction On April 16, 2013 Environmental Specialties inspected 13 structures that make up the NW Hardwoods Mill site for asbestos materials. A previous inspection covered the kilns (now demolished) and central storage shed. The kihis have been demolished. The storage shed is still in place. This is a large hardwood mill facility made up of 14 structures that are presently vacant. A leased facility adjacent to the truck shop is in addition and was not inspected. This inspection report includes data that describes the type of materials found, their quantities, where appropriate and their asbestos content. The report can also be used as a planning aid for all construction, maintenance, abatement and demolition work associated with the structure. Facilities Description This mill site consists of 14 structures. 13 were inspected for this Survey of Asbestos Materials. The central storage shed next to the original kilns (now demolished) was inspected along with the kilns during 2012. The buildings are: Office, Boiler, Kiln office, Kiln Shed, Planer Building, Mill Building, Truck Storage, Mill Modular 2, New Mill, Scale Office, and Truck Shop with fuel station. The Site Office and Scale Office are wood structures. The Site office is combined with a modular building from the 1970's. Generally all structures date from 1980. The Kiln office is a wood frame building with a steel exterior. The scale house is also a conventional wood frame building on a concrete slab foundation. Mill buildings and the Boiler building have steel or wood post and beam framing with a steel skin. Wood is generally used to line the offices although there is a small amount of gypsum wallboard in the mill buildings. The truck shop is a steel building built on a concrete slab foundation. Floors in the mills are either concrete or asphalt paving. The offices, lunchrooms and saw filing rooms have wood floors. Offices have electric unit heaters Vd the main working areas are unheated. A significant quantity of machinery has been'removed. Inspection & Sampling Procedures Northwest Air Pollution Agency and Labor&hidustries regulations require an inspection of all buildings for the presence of asbestos containing materials prior to renovation and/or demolition. Asbestos containing materials are defined as those building materials containing one percent or more of asbestos as verified by laboratory analysis. Reviewed by.II.S 0S Asbestos containing materials are sub-divided into three types: surfacing materials, thermal system insulation, and niscellaneous materials. Surfacing materials are defined as those materials that are sprayed-on, troweled-on or otherwise applied to surfaces including, but not limited to, acoustical plaster on ceilings, paints, fireproofing materials on structural members, or other materials on surfaces for decorative purposes. Thermal system insulation indicates material applied to pipes, fittings, boilers, tanks, ducts, or other structural components to prevent heat loss or gain. All other materials are considered to be miscellaneous materials. Ain surfacing materials, thennal system insulation mid flooring installed in structures prior to 1980 are presumed to contain asbestos unless proven otherwise by a licensed building inspector. Tl� number of samples collected depends on the type of material and its quantity. In order to prove that suspect or presumed surfacing materials do not contain asbestos at least three samples of each homogeneous area are required. Five samples are required for areas greater than 1000 square feet and seven are required for areas greater than 5000 square feet. Thermal system insulation requires at least three samples be collected. One sample of each suspect miscellaneous material must also be collected. Each sample was collected and Placed into a separate, sealed, plastic bag. They were then individually numbered. When possible, samples were collected from areas or materials that were previously damaged. Sampling equipment was decontaminated after each sample was collected. Once collected, the samples were delivered to an accredited laboratory, accompanied by a chain of custody &sctibuig each sample. The samples were then analyzed using Polarized d 6001R-93/116. Additional treatment and tests may have been used as required to define a sample's composition. Non-Asbestos Containing Materials_., The following materials have been shown by a laboratory to be non-asbestos. Material Type Location Quantity Description Gyp Wallboard Office& 3000 Gypsum wallboard, offices, kihi office, Kiln office s /ft planer electrical office Office& 4000 Cement Board, Hardie Siding Exterior Siding Modular s /ft 0 Roofing Office s 300 0 Two levels, asphalt& rubber roofing 12x12, Dark and light vinyl Floor Tile Modular 2 200 sq/ft composition tiles Reviewed by AS S Floor Tile Planer 300 sq/ft 12xl2 cream, lunchroom Lunchroom Sheet Vinyl Office Bldg 40 sq/ft Black patterned,upstairs Sheet Vinyl Office Bldg 40 sq/ft� Black heavy entry vinyl Sheet Vinyl Office Bldg 30 sq/ft Tan top layer,upstairs kitchen Sheet Vinyl Office Bldg 30 sq/ft Black bottom layer,upstairs kitchen Sheet Vinyl Office Bldg 10 sq/ft Yellow,old modular attached utility room Sheet Vinyl Planer 40 sq/ft Lunchroom restroom Lunchroom Planer Sheet Vinyl Shipping 30 sq/ft Upstairs office Office Sheet Vinyl File Room 40 sq/ft Office floor covering Asbestos Containing Materials No asbestos materials were found during this inspection. Conclusion No asbestos materials were found during this inspection. The boiler and piping materials were sampled and found to not contain asbestos in an earlier inspection targeting the kilns. This inspection was conducted December 6, 2012• It contains information useful to this inspection. If additional suspect materials are found during renovation or demolition another inspection by a certified inspector is recommended. Northwest Air Pollution Control Agency and Washington WISHA asbestos regulations require that all asbestos containing materials be properly handled during demolition and renovation and that a survey of the asbestos containing materials be provided to all contractors and posted at the site to prevent potential accidental asbestos exposure. Re viewed by JLS ES Inspector Endorsement Inspector: Certified AHERA Building Inspector, SP-AP Inspector#141111 Attaclunents: Laboratory Analysis _40 Reviewed by AS i -0 m o p C = O O X M ff<D IN 3 U rD 7 W r�r O a 7 — O- D °,-r' kD m 00 3 N v � W Ln fD C fD V) rc I CEI LAID5 ASBESTOS LABORATORY REPORT Prepared for CMSI - Environmental Specialties PROJECT: NW Hardwoods - 200015 67th Ave. NE, Arlington, WA CEI LAB CODE: Al3-4192 DATE ANALYZED: 04/21/13 UA 1 L Kti`U [I CU: U+44i k.5 TOTAL SAMPLES ANALYZED: 20 # SAMPLES >1% ASBESTOS: TEL: 866-481 -1412 www.ceilabs.com 1 Asbestos Report Summary C: E1 LA13S By: POLARIZING LIGHT MICROSCOPY PROJECT: NW Hardwoods - 200015 67th Ave. NE, CEI LAB CODE: A13-4192 Arlington, WA METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82! 020 ASBESTOS Client ID Layer Lab ID Color Sample Description % I A1454136 White Wallboard None Detected 2 A1454137 White Wallboard None Detected 3 A1454138 White Wallboard None Detected 4 A1454139 White,Black Sheet Vinyl None Detected 5 A1454140 Black Sheet Vinyl None Detected 6 A1454141 Tan Sheet Vinyl None Detected 7 A1454142 Black Sheet Vinyl None Detected 8 A1454143 Yellow Sheet Vinyl None Detected 9 A1454144 White Siding None Detected 10 Layer 1 A1454145 Silver _ __ Coating_ __ __ _____ _ _ _None Detected _ - - - Layer 2 A1454145 Black Roofing None Detected 11 A1454146 White Wallboard None Detected 12 A1454147 White Wallboard None Detected 13 A1454148A Cream Tile None Detected A1454148B Clear Mastic None Detected 14 A1454149 Grey Sheet Vinyl None Detected 15 A1454150 White Sheet Vinyl None Detected 16 A1454151 Beige ® . Sheet Vinyl None Detected 17 A1454152 White Wallboard None Detected - 18 A1454153 Grey Sheet Vinyl None Detected 19 A1454154A Grey Tile None Detected A1454154B J Clear Mastic None Detected 20 A1454155A Cream Tile None Detected A1454155B Yellow Mastic None Detected Page 1 of 1 ASBESTOS BULK ANALYSIS EI -, By: POLARIZING LIGHT MICROSCOPY LAC35 Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project:-NW Hardwoods - 200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD F ent ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS ID Description Attributes Fibrous Non-Fibrous % 1 Wallboard Heterogeneous 20% Cellulose 70% Gypsum None Detected A1454136 White 5% Paint Fibrous 50S Binder Bound 2 Wallboard Heterogeneous 20% Cellulose 70% Gypsum None Detected A1454137 White 5% Paint Fibrous 5% Binder Bound 3 Wallboard Heterogeneous 20% Cellulose 75% Gypsum None Detected A1454138 White 5% Paint Fibrous Bound 4 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl Nune Detected A4AF,41'4h White_Black 25% Binder Fibrous Bound 5 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454140 Black 25% Binder Fibrous Bound 6 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454141 Tan 5% Fiberglass 20% Binder Fibrous Bound 7 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454142 Black 25% Binder Fibrous Bound 8 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454143 Yellow 20% Synthetic Fiber 5% Mastic Fibrous Bound Page 1 of 5 ASBESTOS BULK ANALYSIS C: EI - By: POLARIZING LIGHT MICROSCOPY LADS Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C #625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods - 200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 9 Siding Heterogeneous 25% Cellulose 75% Binder None Detected A1454144 White Fibrous Bound 10 Coating Heterogeneous 100% Paint None Detected Layer 1 Silver A1454145 Non-fibrous Bound • - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - . - - - - - - - - Layer 2 Roofing Heterogeneous 25% Synthetic Fiber 75% Tar None Detected A1454145 Black Fibrous Bound 11 Wallboard Heterogeneous 85% Calc Carb None Detected A1454146 White 15% Silicates Non-fibrous <1% Mica Bound 12 Wallboard Heterogeneous 20% Cellulose 80% Gypsum None Detected A1454147 White <1% Fiberglass Non-fibrous Bound 13 Tile Heterogeneous 100% Vinyl None Detected Al454148A Cream Non-fibrous Bound A1454148B Mastic Heterogeneous 100% Mastic None Detected Clear Non-fibrous Bound 14 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454149 Grey 30% Binder Fibrous Bound Page 2 of 5 U ASBESTOS BULK ANALYSIS CEI By: POLARIZING LIGHT MICROSCOPY L_/�EiS Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C #625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods - 200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous 15 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454150 While 25% Binder Fibrous Bound 16 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454151 Beige 5% Fiberglass 25% Binder Fibrous Bound 17 Wallboard Heterogeneous 20% Cellulose 80% Gypsum None Detected A1454152 White Non-fibrous Bound 18 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected �. . . Fibrous Bound 19 Tile Heleiuyeneous 100% Vinyl None Detected A1454154A Grey Non-fibrous Bound A1454154B Mastic Heterogeneous 100% Mastic None Detected Clear Non-fibrous Bound 20 Tile Heterogeneous 100% Vinyl None Detected A1454155A Cream Non-fibrous Bound A1454155B Mastic Heterogeneous 100% Mastic None Detected Yellow Non-fibrous Bound Page 3 of 5 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY CEILA' 13S Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods - 200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD FClient ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % Page 4 of 5 CEI LASS LEGEND: Non-Anth = Non-Asbestiform Anthophylite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate METHOD: EPA 600 1 R93 1 116 and EPA 600/ M4-82/020 The detection limit for the method is <1% by visual estimation and 0.25% by 400 point counts or 0.1% by 1,000 point counts. Due to the limitations of the EPA 600 Method, nonfriable organically bound materials (NOBs) such as vinyl floor tiles can be difficult to analyze via polarizing light microscopy (PLM). EPA recommends that all NOBs analyzed by PLM, and found not to contain asbestos, be further analyzed by Transmission Electron Microscopy (TEM). Please note that PLM analysis of dust and soil samples for asbestos is not covered under NVLAP accreditation. This report may not be reproduced, except in full, without written approval by CEI LABS. CEI LABS makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U. S. Government. ANALYST: APPROVED BY: //..✓ Greg Ruff Tionboo Bai, Ph.D. Laboratory Director R: mV4NVLAP Lab Co0 CEI Labs,107 New Edition Court,Cary,NC 27511,Phone:(866)481-1412 Page 5 of 5 CHAIN OF CUSTODY CEILAIDS LAB USE ONL Y: 107 New Edition Court. Cary.NC 2751 I CEI Lab Code: ��- 9•� �v Tel:866-481-1412: Fax:919-481-1442 ICEI Lab I.D.Range: /CAS A ILKV t S COMPANY CONTACT INFORMATION - VIC011111attil Specialties Company: Client 0: } Address. Puyallup,WA 98373 Job Contact: =- Email: t �'� Tel: Pro ect Name: [-o Z y Fax: Project ID#: P.O. L', TURN AROUND TIME ASBESTOS METHOD 4 HR' 8 HR' 24 HR 2 DAY 3 DAY 5 DAY PLM BULK EPA 600 ❑ ❑ i ❑ ❑ ❑ PLM POINT COUNT(400) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM POINT COUNT(1000) EPA 600 ❑ _❑ ❑ ❑ ❑ ❑ PLM GRAVIMETRIC EPA 600 � '�; .,i, ❑ ❑ ❑ ❑ ❑ PLM GRAV w POINT COUNT EPA 600 ❑ ❑ ❑ ❑ PCM AIR NIOSH 7.400 ❑ ❑ ❑ ❑ ❑ 0 TEM AIR AHERA ❑ ❑ ❑ ❑ ❑ TEM AIR EPA Level II ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR NIOSH 7,102 ❑ ❑ ❑ ❑ ❑ ❑ TEM BULK CHATFIELD i ` ' ❑ ❑ ❑ ❑ ❑ TEM DUST WIPE ASTM D6480.05 ❑ ❑ ❑ ❑ ❑ ❑ TEM DUST MICROVAC ASTM D5755-03 ❑ _ ❑ ❑ ❑ ❑ ❑ TEM QUALITATIVE CEI LABS ❑ ❑ ❑ ❑ 171 OTHER: ❑ ❑ ❑ ❑ ❑ LEAD PAINT METHOD 4 HR` 8 HR' 24 HR 2 DAY 3 DAY 5 DAY LEAD PAINT EPA SW846 70006 ❑ _ ❑ ❑ LAD WIPE i EPA SW846 7000B "• ❑ ❑ ❑ LEAD SOIL EPA SW846 70006 Fi. __ ❑ ❑ ❑ 1 ❑ ❑ ❑ LEAD AIR NIOSH 7062 _ •'�„ I •'� � � OTHER: r ❑ REMARKS: Accept Samples Reject Samples Relinquished By: D teffime Re i e : Date/Ti ;B me *Call to confirm RUSH analysis. Samples will be disposed of 30 days'VfWe analysts VERSION CCOC.0112.1r2.1-0 Customer COC Page 1 voillsi3ege lsfemno0vn948M:D ISO*0 918 .8 nalbhom UP, CUB®AAN,qullmVu9_ fi/T {= SAMPLING FORM C C ILT:�as COMPANY'G.ONTACT INFORMATION Company: Job Conlact7 Project Name: Project ID Tel: VOLUME/ SAMPLE ID# DkSCRIPTIONJ LOCATION AREA-: `COMMENTS cy jee f � va Cv r 11 IlutTil u u Plac1L G�'�6 J .6o7Yise e JIzf r e ,G /H 1C 13 ow, r&L46 I v [c }� `lo . l V Page of ?� VERSION CCOC.0112.2/2.LD Customer COC Page 2 ' DEMOLITION PERMIT APPLICATION Department of Community& Economic Development City of Arlington •.18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551 THIS APPLICATION MUST BE ACCOMPANIED WITH A COPY OF THE ASBESTOS/DEMOLITION NOTIFICATION FROM PUGET SOUND CLEAN AIR AGENCY, TWO(2)COPIES OF AN ASBESTOS SURVEY REPORT AND ABATEMENT REPORT (if applicable)COMPLETED BY AN APPROVED AGENCY. Type of Permit:(check one)) 1 I ❑ Residential ® Commercial ❑ Industrial Project Address: © y ` 6 /4 Parcel ID#: Lot#: Subdivision: Valuation: Building Area(Sq Ft) No. of floors �l Number of Buildings: Owner: �2yT"-��/� � ��SS Z Phone Number: Address: n \ City: State: Zip Code p� Contact Person: l--U1 t✓'t 00'a Ct`t Q Phone Number: y� J cm Cell Phone: � ((� /% 7 U E-mail: Address: City: State: Zip Code Contractor: Phone Number: Address: City: State: Zip Code Contractor's License Number: Expiration: Scope of Work: I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- described pro rty will be in accordance with the laws, rules and regulations of the Stat of Washington. Y- zr�� � pplicants Signature Date °_)c7 Print Applicants Name FOR STAFF USE ONLY Recei ved NO Permit# Accepte By Amount Received Receipt# afd Fqoc&44,� CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 \` PHONE; (360) 403-3551 BUILDING PERMIT Address: 20015 67th Avenue Permit#: 830 Parcel#: 3 105 1400200700 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Gayteway Business Park,LLC Name:Chris Gayte Name:Decker Enterprises,Inc. Address: P.O. Box 1727 Address:PO Box 1727 Address: 11402 Kelly Road NE City, State Zip:Bellevue,WA 98009 City,State Zip:Bellevue,WA 98009 City, State Zip:Carnation,WA 98014 Phone: Phone:206-240-9739 Phone:425-788-1874 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City, State, Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION s PERMIT TYPE: Demolition CODE YEAR: 2012 STORIES: CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: 6 OCC LOAD: PERMIT APPROV 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. 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. IBC110/IRC1 10. SALES VAX NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return ['or a d ups d C4ty of Ari' ton#. 1,0 1. Signature Print Name ate Released By DI to CONDITIONS THIS PERMIT AUTHORIZS 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. PERMIT FEES Date Description Fee Amount 11/2/2015 Demolition Fee $100.00 11/2/2015 State Building Code Surcharge Fee $4.50 Total Due: $104.50 Total Payment: $104.50 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address: 20015 67th Avenue Permit#: 830 Parcel#: 3 105 1400200700 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:Gayteway Business Park,LLC Name: Chris Gayte Name:Decker Enterprises,Inc. Address:P.O. Box 1727 Address:PO Box 1727 Address: 11402 Kelly Road NE City, State Zip:Bellevue,WA 98009 City,State Zip:Bellevue,WA 98009 City, State Zip:Carnation,WA 98014 Phone: Phone:206-240-9739 Phone:425-788-1874 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City, State,Zip: City, State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Demolition CODE YEAR: 2012 STORIES: CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: 6 OCC LOAD: ' PERMIT APPROVAL, WIT 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. 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. IBC110/IRC1 I0. SALES TAX NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sates tax return form and coded City of Arlington#3101. Signature Print Name Date Released By DAe CONDITIONS THIS PERMIT AUTHORIZS 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. PERMIT FEES Date Description Fee Amount 11/2/2015 Demolition Fee $100.00 11/2/2015 State Building Code Surcharge Fee $4.50 Total Due: $104.50 Total Payment: $104.50 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING (360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon mypiuveu J raitsaVUVu rl rage I OI I v pscIeanair.©rg Pyget Sound Agerwy Notification Case #: 201504477 This page must be printed.A printout of the notification,all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site(Reg III,4.03(a)(6)). Fee Amount Paid $65.00 Credit Card Transaction # ASOFD94811AA Transaction Date 2 - /(5 Owner's Name Gayteway Business park LLC Phone (206) 240-9739 Project Street Address 20015 67th ave ne City arlington ZIP 98223 Contact Person chris gayte Phone (206) 240-9739 Mailing Address pobox 1727 bellevue, WA 98009 This project includes a demolition. Demolition Start Date 11/01/15 Completion Date 12/01/15 Demolition will be completed by a demolition contractor Demo Contractor Property Owner Contractor Job T Contact Phone Mailing Address (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2)I understand that I must file an Amendment to this Notification If: • The type of project has changed.The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Qaai®&r,os he,-.Pdotificatdon VIFw#fiasco Loa Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058, https:Hsecure.pseleanair.org/Asbestos/Approved.aspx 10/20/2015 Environmental Specialties 0 4227 S Meridian, STE C,#625 •Puyallup,WA 98373 •(253)683-1144 Asbestos Inspection NW Hardwoods Mill 20015 67th Ave NE Arlington, WA Owner NW Hardwoods 3316 Fuhrman Ave E, Ste 200 Seattle, N'YA 98102 Consultant Environmental Specialties r 4227 S Meridian, Ste C, #625 Puyallup, WA 98373 Reviewed by AS S Introduction On April 16, 2013 Environmental Specialties inspected 13 structures that make up the NW Hardwoods Mill site for asbestos materials. A previous inspection covered the kilns (now demolished) and central storage shed. The kilns have been demolished. The storage shed is still in place. This is a large hardwood mill facility made up of 14 structures that are presently vacant. A leased facility adjacent to the truck shop is in addition and was not inspected. This inspection report includes data that describes the type of materials found, their quantities, where appropriate and their asbestos content. The report can also be used as a planning aid for all construction, maintenance, abatement and demolition work associated with the structure. Facilities Description This mill site consists of 14 structures. 13 were inspected for this Survey of Asbestos Materials. The central storage shed next to the original kilns (now demolished) was inspected along with the kilns during 2012. The buildings are: Office, Boiler, Kiln office, Kiln Shed, Planer Building, Mill Building, Truck Storage, Mill Modular 2, New Mill, Scale Office,and Truck Shop with fuel station. The Site Office and Scale Office are wood structures. The Site office is combined with a modular building from the 1970's. Generally all structures date from 1980. The Kiln office is a wood frame building with a steel exterior. The scale house is also a conventional wood frame building on a concrete slab foundation. Mill buildings and the Boiler building have steel or wood post and beam framing with a steel skin. Wood is generally used to line the offices although there is a small amount of gypsum wallboard in the mill buildings. The truck shop is a steel building built on a concrete slab foundation. Floors in the mills are either concrete or asphalt paving. The offices, lunchrooms and saw filing rooms have wood floors. Offices have electric unit heaters Vd the main working areas are unheated. A significant quantity of machinery has been removed. Inspection & Sampling Procedures Northwest Air Pollution Agency and Labor&Industries regulations require an inspection of all buildings for the presence of asbestos containing materials prior to renovation and/or demolition. Asbestos containing materials are defined as those building materials containing one percent or more of asbestos as verified by laboratory analysis. Reviewed by✓LS Es Asbestos containing materials are sub-divided into three types: surfacing materials, thermal system insulation, and miscellaneous materials. Surfacing materials are defined as those materials that are sprayed-on, troweled-on or otherwise applied to surfaces including, but not limited to, acoustical plaster on ceilings, paints, fireproofing materials on structural members,or other materials on surfaces for decorative purposes. Thermal system insulation indicates material applied to pipes, fittings, boilers, tanks, ducts, or other structural components to prevent heat loss or gain. All other materials are considered to be miscellaneous materials. All surfacing materials, thermal system insulation and flooring installed in structures prior to 1980 are presumed to contain asbestos unless proven otherwise by a licensed building inspector.T_b number of samples collected depends on the type of material and its quantity. In order to prove that suspect or presumed surfacing materials do not contain asbestos at least three samples of each homogeneous area are required. Five samples are required for areas greater than 1000 square feet and seven are required for areas greater than 5000 square feet. Thermal system insulation requires at least three samples be collected. One sample of each suspect miscellaneous material must also be collected. Each sample was collected and placed into a separate, sealed, plastic bag. They were then individually numbered. When possible, samples were collected from areas or materials that were previously damaged. Sampling equipment was decontaminated after each sample was collected. Once collected, the samples were delivered to an accredited laboratory, accompanied by a chain of custody describing each sample. The samples were then analyzed using Polarized Light Microscopy (PLM) Stain Dispersion technique in accordance with EPA Method 600/R-93/116. Additional treatment and tests may have been used as required to define a sample's composition. Non-Asbestos Containing Materials, , The following materials have been shown by a laboratory to be non-asbestos. Material Type Location Quantity Description Gyp Wallboard Office& 3000 Gypsum wallboard,offices,kiln office, Kiln office /ft planer electrical office Exterior SidingOffice& 4000 Cement Board,Hardie Siding Modular s /ft Roofing Office 3000 s /ft Two levels,asphalt& rubber roofing 12xl2,Dark and light vinyl Floor Tile Modular 2 200 sq/ft composition tiles Reviewed by AS Es Floor Tile Planer 300 sq/ft 12x12 cream, lunchroom Lunchroom Sheet Vinyl Office Bldg 40 sq/ft Black patterned,upstairs Sheet Vinyl Office Bldg 40 sq/11 Black heavy entry vinyl Sheet Vinyl Office Bldg 30 sq/ft Tan top layer,upstairs kitchen Sheet Vinyl Office Bldg 30 sq/ft Black bottom layer,upstairs kitchen Sheet Vinyl Office Bldg 10 sq/ft fellow,old modular attached utility room Sheet Vinyl Planer 40 sq/ft Lunchroom restroom Lunchroom Planer Sheet Vinyl Shipping 30 sq/ft Upstairs office Office Sheet Vinyl File Room 40 sq/ft Office floor covering Asbestos Containing Materials No asbestos materials were found duri5g this inspection. Conclusion No asbestos materials were found during this inspection. The boiler and piping materials were sampled and found to not contain asbestos in an earlier inspection targeting the kilns. This inspection was conducted December 6, 2012_ It contains information useful to this inspection. If additional suspect materials are found during renovation or demolition another inspection by a certified inspector is recommended. Northwest Air Pollution Control Agency and Washington WISHA asbestos regulations require that all asbestos containing materials be properly handled during demolition and renovation and that a survey of the asbestos containing materials be provided to all contractors and posted at the site to prevent potential accidental asbestos exposure. Reviewed by JLS ES Inspector Endorsement IZ4 4 F. Inspector: Certified AHERA Building Inspector, SP-AP Inspector#141111 Attachments: Laboratory Analysis Reviewed by AS o p c W �• 0 0 rt X --s < rlJ 3 , o fD � w 0 Q, s D co 3 N ro li :0 w rt L) (D G_ n (D N r-C E I L/k1 3S ASBESTOS LABORATORY REPORT Prepared for CMSI - Environmental Specialties PROJECT: NW Hardwoods - 200015 67th Ave. NE, Arlington, WA CEI LAB CODE: Al3-4192 DATE ANALYZED: 04/21/13 DATE REPORTED: 04/22/13 TOTAL SAMPLES ANALYZED: 20 # SAMPLES >1% ASBESTOS: TEL: 866-481 -1412 www.ceilabs.com Asbestos Report Summary CEIBy: POLARIZING LIGHT MICROSCOPY LAQS PROJECT: NW Hardwoods - 200015 67th Ave. NE, CEI LAB CODE: A13-4192 Arlinqton, WA METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 1 020 ASBESTOS Client ID Layer Lab ID Color Sample Description % 1 A1454136 White Wallboard None Detected 2 A1454137 White Wallboard None Detected 3 A1454138 White Wallboard None Detected 4 A1454139 White,Black Sheet Vinyl None Detected 5 A1454140 Black Sheet Vinyl None Detected 6 A1454141 Tan Sheet Vinyl None Detected 7 A1454142 Black Sheet Vinyl None Detected 8 A1454143 Yellow Sheet Vinyl None Detected 9 A1454144 White Siding None Detected 10 Layer 1 A1454145 Silver Coating None Detected r _ _ - - Layer 2 A1454145 Black Roofing None Detected 11 A1454146 White Wallboard None Detected 12 A1454147 White Wallboard None Detected 13 A1454148A Cream Tile None Detected A1454148B Clear Mastic None Detected 14 A1454149 Grey Sheet Vinyl None Detected 15 A1454150 White Sheet Vinyl None Detected 16 A1454151 Beige 6 . Sheet Vinyl None Detected 17 A1454152 White Wallboard None Detected 18 A1454153 Grey Sheet Vinyl None Detected 19 A1454154A Grey Tile None Detected A1454154B Clear Mastic None Detected 20 A1454155A Cream Tile None Detected A1454155B Yellow Mastic None Detected Page 1 of 1 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY L/-�C35 Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 `' Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods -200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 1 Wallboard Heterogeneous 20% Cellulose 70% Gypsum None Detected A1454136 White 5% Paint Fibrous 5% Binder Bound 2 Wallboard Heterogeneous 20% Cellulose 70% Gypsum None Detected A1454137 White 5% Paint Fibrous 5% Binder Bound 3 Wallboard Heterogeneous 20% Cellulose 75% Gypsum None Detected A1454138 White 5% Paint Fibrous Bound 4 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454139 White,Black 25% Binder Fibrous Bound 5 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454140 Black 25% Binder Fibrous Bound 6 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454141 Tan 5%n Fiberglass 20% Binder Fibrous Bound 7 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454142 Black 25% Binder Fibrous Bound 8 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454143 Yellow 20% Synthetic Fiber 5% Mastic Fibrous Bound Page 1 of 5 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY L/�C35 Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods -200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % g Siding Heterogeneous 25% Cellulose 75% Binder None Detected A1454144 White Fibrous Bound 10 Coating Heterogeneous 100% Paint None Detected Layer 1 Silver Al 454145 Non-fibrous . Bound - - - - - - - - - - - - - - - - --- - - - - - - -- --- - - - - - - - ---- - - - - - - - - - - - - - - - - - - - - - - - - " Layer 2 Roofing Heterogeneous 25% Synthetic Fiber 75% Tar None Detected A1454145 Black Fibrous Bound 11 Wallboard Heterogeneous 85% Calc Carb None Detected A1454146 White 15% Silicates Non-fibrous <1% Mica Bound 12 Wallboard Heterogeneous 20% Cellulose 80% Gypsum None Detected A1454147 White <1% Fiberglass Non-fibrous Bound 13 Tile Heterogeneous 100% Vinyl None Detected A1454148A Cream Non-fibrous Bound A1454148B Mastic Heterogeneous 100% Mastic None Detected Clear Non-fibrous Bound " 14 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454149 Grey 30% Binder Fibrous Bound Page 2 of 5 v ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY L/�f�5 Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C#625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Bate Reported: 04-22-13 Project: NW Hardwoods -200015 67th Ave. NE, Arlington, WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 15 Sheet Vinyl Heterogeneous 25% Cellulose 50% Vinyl None Detected A1454150 White 25% Binder Fibrous -`� Bound 16 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454151 Beige 5% Fiberglass 25% Binder Fibrous Bound 17 Wallboard Heterogeneous 20% Cellulose 80% Gypsum None Detected A1454152 White Non-fibrous Bound 18 Sheet Vinyl Heterogeneous 20% Cellulose 50% Vinyl None Detected A1454153 Grey 5% Fiberglass 25% Binder Fibrous Bound 19 Tile Heterogeneous 100% Vinyl None Detected A1454154A Grey Non-fibrous Bound A1454154B Mastic Heterogeneous 100% Mastic None Detected Clear Non-fibrous y Bound Y0 Tile Heterogeneous 100% Vinyl None Detected A1454155A Cream Non-fibrous Bound A1454155B Mastic Heterogeneous 100% Mastic None Detected Yellow Non-fibrous Bound Page 3 of 5 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY L/�.C3S Client: CMSI - Environmental Specialties CEI Lab Code: A13-4192 4227 South Meridian, Suite C #625 Date Received: 04-19-13 Puyallup, WA 98373 Date Analyzed: 04-21-13 Date Reported: 04-22-13 Project: NW Hardwoods - 200015 67th Ave. NE, Arlington. WA ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % Page 4 of 5 r E L/�.C35 LEGEND: Non-Anth = Non-Asbestiform Anthophylite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate METHOD: EPA 600 / R93/ 116 and EPA 600 I M4-82/020 The detection limit for the method is <1% by visual estimation and 0.25% by 400 point counts or 0.1% by 1,000 point counts. Due to the limitations of the EPA 600 Method, nonfriable organically bound materials (NOBs) such as vinyl floor tiles can be difficult to analyze via polarizing light microscopy (PLM). EPA recommends that all NOBs analyzed by PLM, and found not to contain asbestos, be further analyzed by Transmission Electron Microscopy(TEM). Please note that PLM analysis of dust and soil samples for asbestos is not covered under NVLAP accreditation. This report may not be reproduced, except in full, without written approval by CEI LABS. CEI LABS makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U. S. Government. /�dLo ANALYST: �k 4 APPROVED BY: l�""" Greg Ruff Tianbao Bai, Ph.D. 9 Laboratory Director r4v A NVLAP Lab Code 101768 0 CEI Labs,107 New Edition Court.Cary,NC 27511,Phone:(866)481-1412 Page 5 of 5 CHAIN OF CUSTODY CEIL/kIBS LAB USE ONLY. 107 New Edition Court.Cary.NC 27511 - CEI Lab Code: Tel:866.461-1412: Fax:919-481-1442 CEI Lab I.D.Range: /1/S ly COMPANY CONTACT INFORMATION %,M01-ClIvIrOnmetall Specialties Company: Client#: Address: P allu WA 98373 Job Contact: > =- Email: t Tel: : �.� ell 9 Pro ect Name: T �' cr=C r Fax: Project ID#: l 7 f Ll 'v�% rY P.O.#: (u ' x}z+ TURN AROUND TIME ASBESTOS METHOD 4 HR' 8 HR` 24 HR 2 DAY 3 DAY 5 DAY PLM BULK EPA 600 ❑ ❑ ❑ ❑ ❑ PLM POINT COUNT(400) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM POINT COUNT(1000) EPA 600 ❑ ❑ ❑ ❑ ❑ ❑ PLM GRAVIMETRIC EPA 600 ❑ ❑ ❑ 0 ❑ PLM GRAV w POINT COUNT EPA 600 ❑ ❑ ❑ ❑ ❑ PCM AIR NIOSH 7400 ❑ ❑ ❑ ❑ 0 TEM AIR AHERA Qfl C7 ❑ ❑ ❑ ❑ TEM AIR EPA Level II ❑ ❑ ❑ ❑ ❑ ❑ TEM AIR NIOSH 7402 ❑ ❑ ❑ ❑ ❑ TEM HULK CHATFIELD ❑ ❑ ❑ ❑ ❑ TEM DUST WIPE ASTM D6480.05 ❑ ❑ ❑ ❑ ❑ ❑ TEM DUST MICROVAC ASTM D5755.03 ❑ ❑ ❑ ❑ ❑ TEM QUALITATIVE CEI LABS ❑ ❑ ❑ ❑ ❑ OTHER: ❑ ❑ ❑ ❑ ❑ ❑ LEAD PAINT METHOD 4 HR' 8 HR' 24 HR 2 DAY 3 DAY 5 DAY LEAD PAINT EPA SW846 7000E ❑ ❑ LEAD WIPE EPA SW846 70006 ❑ LEAD SOIL EPA SW846 7000E _ ❑ ❑ LEAD AIR NIOSH 7082 C(1 ❑ ❑ ❑ ti ❑ ❑OTHER: ❑" - � •- - REMARKS: Accept Samples Reject Samples Relinquished By: D te/Time Re iye4rBy. DatelTI ( 011 "Call to confirm RUSH analysis. Samples will be disposed of 30 dayvgWr analysis VERSION CCOC.0112.lt2.LD Customer COC Page 1 aei3isiasgc Isisrr�roiivr��J-i2t�i:i �Sc�. a s!E .2 �slbtg9� SSS� M88 AW,qu11rYu9 _ SAMPLING FORM C � I LAQS COMPANY CONTACT INFORMATION Company: nIl(5j- Job Contact: � - Project Name: Project ID#: aZ ^ Tel: VOLUME/ SAMPLE ID# DESCRIPTION)LOCATION AREA COMMENTS u76 �oG' S c ems. C yu J �e �c rJ�uclL Tu� -�o S� 0-6 h rco r -2!C z tr I — `Y" f IL— (D 8 Or�Q Page --2— of VERSION CCOC.01122/2.LD Customer COC Page 2 Permit#: 830 Permit Date: 11/02/15 Permit Type: DEMOLITION Project Name: Gayteway Business Park Applicant Name: Chris Gayte Applicant Address: PO Box 1727 Applicant, City, State, Zip: Bellevue,WA 98009 Contact: Chris Gayte Phone: 206-240-9739 Email: cjgayte@yahoo.com Scope of Work: Demo Metal Buildings Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 12/16/2015 Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 399 Other 31051400200700 20101 67TH AVE NE Park,,LLC way Business Miscellaneous P Manufacturing NEC Contractors Contractor Primary Contact Phone Address Contractor Type License License# USVET,LLC Chris Nicholls 425-788-1874 18101 Butler CONSTRUCTION Labor&Industries USVETL*894RB Road CONTRACTOR Fees Fee Description Notes Amount Demolition $100.00 State Surcharge- 1st DU Residential- 1st Unit $4.50 Total $104.50 Attached Letters Date Letter Description 11/02/2015 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 11/02/2015 Brent Nicholson cash Launa Black $104.50 Outstanding Balance $0.00 Notes Date Note Created By: 12/10/2015 USVET needs to pay for business license prior to issuing permit. Launa Black 12/07/2015 Emailed permit to Chris Gayte for signature Launa Black 11/19/2015 Emailed Puget Sound Clean Air Agency for clarification.1p Launa Black Uploaded Files Date File Name 12/16/2015 1398098-830 Issued Permit.pdf 11/02/2015 1347929-830 Application.pdf 11/02/2015 1347351-ArlingtonAsbestos survey_.pdf