HomeMy WebLinkAbout19221 59th Avenue NE_BLD2191_2026 CITY OF ARLINGTON
238 N. OLYMPIC AVE -ARLINGTON, WA. 98223
4P PHONE; (360) 403-3551
BUILDING PERMIT
Address:19221 59th Avenue NE Permit#:2191
Parcel#:31051500401200 Valuation:0.00
OWNER APPLICANT CONTRACTOR
Name:City of Arlington Name:2BRND,LLC Name:Reese Construction,Co.
Address: 18204 59th Drive NE Address:]9132 59th Drive NE Address:P.O.Box 1531
City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:Marysville,WA 98270
Phone: Phone:425-870-8259 Phone:
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: 2015
STORIES: CONST.TYPE:
DWELLING UNITS: 0 OCC GROUP:
BUILDINGS: 1 OCC LOAD:
PERMIT APPROVAL
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/IRCI10.
ALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form
od ity of Arlington#3101.
Signature Print Name Date Released By ate
CONDITIONS
Any traffic control measures will need to be approved. Keep dust down and road clean. Call for final
inspection.
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
9/25/2018 Demolition Fee $100.00
9/25/2018 Processing/Technology Fee $25.00
9/25/2018 State Building Code Surcharge Fee $6.50
Total Due: $131.50
Total Payment: $0.00
Balance Due: $131.50
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
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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 BYAN APPROVED AGENCY.
Type of Permit:(check one) 0 Residential El Commercial FV7' Industrial
Project Address:19211-&: 19221 59TH AVE NE Parcel ID#: Lot 77 at Arlington Airport
Lot#: Subdivision: Valuation: 94,000
Building Area(Sq Ft)100:9, 13000 No. of floors: 1 Number of Buildings:2
Owner: 2BRND LLC Phone Number: 425-870-8259
19132 59TH DR NE ARLINGTON WA 98223
Address: City: State: Zip Code:
Contact Person:Brent Barker Phone Number: 425-870-8259
Cell Phone: 425-870-8259 E-mail: barkergmw@gmail.com
Address: 1502 Lakeshore Drive C; Lake Stevens 98258
City: State: WA Zip Code:
Contractor: Reece Construction Co. Phone Number: 360-659-9600
Address: PO Box 1531 City: Marysville State: WA Zip Code: 98270
Contractor's License Number-REECECC852C7 Expiration-2/27/2019
Scope of Work:
Demolish 2 existing buildings and remove debris. Remove concrete and asphalt around
buildings.
I hereby certify that the above information is correct and that the construction on; and the occupancy and the use of the above-
de ibed pr ty will be in accordance with the laws, rules and regulations of the Stat of Washington.
l — \2 -yb
Applicants Signature Date
Print Applicants Name
FOR STAFF USE ONLY received
rrn .r t] onjo
Perm I Accepted B Amount Received Receipt 4 DY&kec&t\f6dr-"'"
- A
Inspection for the Presence of
Asbestos Containing Building Materials
April 11, 2018
Machine Shop/Warehouse
Located at
1922159th Avenue NE
Arlington, Washington
This inspection report must be on-site during all phases of
abatement/demolition/renovation of the structures.
The Knebel Company,Inc.
91221691h Avenue NE Received
Granite Falls,WA 98252
(360)691-5910 S E P 12 7 0 1 8
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TABLE, OF CONTENTS
SECTION 1. INTRODUCTION
SECTION 2. SAMPLE SUMMARY ASBESTOS
SECTION 3. ASBESTOS HOMOGENOUS MATERIALS LIST
SECTION 4. ASBESTOS BULK SAMPLE DATA REPORT
SECTION 5. ASBESTOS LABORATORY ANALYSIS REPORT
SECTION 6. SAMPLE LOCATION DRAWING
SECTION 7. CERTIFICATIONS & ACCREDITATION'S
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SECTION 1
INTRODUCTION
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19221 59th Avenue NE
Arlington,Washington
INTRODUCTION
A inspection for the presence of asbestos containing building materials was conducted on April
11,2018, in the machine shop/warehouse, located at 19221 59th Avenue NE in Arlington,WA.
This inspection is to identify asbestos containing materials that will affect the proposed
demolition of the structure.Brent Barker from Global Machine Works,Inc.,requested the
asbestos inspection. Dan Shelly, an AHERA certified building inspector from The Knebel
Company, Inc., conducted this asbestos inspection. Samples were analyzed by NVL Laboratories,
Inc.,which is a NVLAP certified laboratory.The following report contains material descriptions,
sample locations, assessment of asbestos containing building materials,laboratory results,
accreditation, and inspector certification.
AHERA Building Inspector: Dan Shelly
Inspector Accreditation Number: 166572
Expiration Date: March 28,2019
Signaturew
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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 Machine Shop/Warehouse located at 19221 59th Avenue NE in Arlington,WA.
In strict accordance with NESHAPS regulations,this site visit consisted of a thorough visual walk
through of the buildings 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.
This survey does not include documentation for other hazardous materials that may exist on site,
including: lead,PCB,biohazards,chemicals,soil contamination due to underground storage
tanks, etc.
All sample analysis reported here-in were analyzed using analysis method specified in Appendix
E,subpart E,40 CFR part 763,section 1,Polarized Light Microscopy.
"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.
WAC 296-62-07703 Definitions—Asbestos-containing materials (ACM)means any material
containing more than 1% asbestos.
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SECTION 2
INSPECTION SUMMARY
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ASBESTOS SAMPLE SUMMARY
Machine Shop/Warehouse located at 19221 59th Avenue NE Arlington WA
This is a two story metal framed structure constructed on a concrete slab. The interior walls of
the building are gypsum wallboard and/or wood.Floors are covered with carpeting in the office
areas. In the bay areas the floor is concrete. The primary source of heat is a electric baseboard
heaters. The attic space is insulated with fiberglass insulation. The exterior is covered with metal
siding and the roof is also metal.
Materials sampled by The Knebel Company Inc and found to be ASBESTOS 7
CONTAINING MATERIALS in 2018.
None of the samples collected during the inspection were found to contain any detectable
asbestos.
Materials sampled by The Knebel Company Inc and found to be NON ASBESTOS
CONTAINING MATERIALS in 2018.
• (Homogenous Material#01) Spray applied wall texture over gypsum wallboard
• (Homogenous Material#02)Brown carpet mastic
• (Homogenous Material#03)White vinyl cloth,over mastic,over black fiberglass insulation
• (Homogenous Material#04)Gypsum wallboard with mudded and tape seams
• (Homogenous Material#05)2'x 4'suspended ceiling tile with gouge pattern
• (Homogenous Material#06)2'x 4'suspended ceiling tile with pinhole pattern,over
adhesive,over fiberglass insulation
• (Homogenous Material#07)Brown/black window weather stripping
Recommendations:General—Any suspect asbestos containing materials discovered during the
demolition/renovation 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/renovation 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,
and WRD23.35 Demolition of Buildings with ACM.January 31,2001
7. All current regulations of Washington State Department of Transportation.
8. Puget Sound Clean Air Agency
9. All regulations of the landfill where asbestos materials are deposited.
10. 29CFR 1926,Safety and Health Regulations for Construction
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SECTION 3
ASBESTOS HOMOGENOUS
MATERIALS LIST
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SECTION 4
ASBESTOS BULK DATA REPORT
The Knebel Company, Inc.
Bulk Asbestos Report
Job# 19221 TKC Job#: Customer ID: 480
Company Name: Global Machine Works,Inc.
Billing Address: 19130 59th Drive NE
City Arlington State: WA Zip Code 98223- Contact Name: Brent Barker
Homogeneous Material# 01 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-01-01 Analyzed By: NVL Laboratories,Inc. Date Analyzed: 4/18/2018
Building Name: 19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: Office
Material Description Spray applied wall texture over avpsum wallboard
Sample Location Collected from the middle of the west wall in the main office.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
Homogeneous Material# 01 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-01-02 Analyzed By: NVL Laboratories, Inc. Date Analyzed: 4/18/2018
Building Name:19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: Office
Material Description Spray applied wall texture over avpsum wallboard
Sample Location Collected from the middle of the north wall in the main office.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
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Page 2 of 4 Bulk Asbestos Report Continued
Homogeneous Material# 01 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-01-03 Analyzed By: NVL Laboratories,Inc. Date Analyzed: 4/18/2018
Building Name:19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: Office
Material Description Spray applied wall texture over gypsum wallboard
Sample Location Collected from the middle of the South wall in the main office.
Con,men�s:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
Homogeneous Material# 02 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-02-01 Analyzed By: NVL Laboratories, Inc. Date Analyzed: 4/18/2018
Building Name:19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: Office
Material Description Brown carpet mastic
Sample Location Collected from the middle of the main office, under carpeting.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
Homogeneous Material# 03 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-03-01 Analyzed By: NVL Laboratories, Inc. Date Analyzed: 4/18/2018
Building Name: 19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: North bay
Material Description White vinyl cloth,over mastic over black fiberglass insulation
Sample Location Collected from the ceiling in the north bay, northwest corner of the ceiling.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
I
Page 3 of 4 Bulk Asbestos Report Continued
Homogeneous Material# 04 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-04-01 Analyzed By: NVL Laboratories,Inc. Date Analyzed: 4/18/2018
Building Name:19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: Tool room
Material Description Gypsum wallboard with mudded and tape seams
Sample Location Collected from the middle of the north wall in the tool room.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
Homogeneous Material# 04 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-04-02 Analyzed By: NVL Laboratories, Inc. Date Analyzed: 4/18/2018
Building Name:19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: S restroom
Material Description GVpsum wallboard with mudded and tape seams
Sample Location Collected from the middle of the north wall in the south restroom.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
Homogeneous Material# 04 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-04-03 Analyzed By: NVL Laboratories, Inc. Date Analyzed: 4/18/2018
Building Name: 19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 1
Room: N restroom
Material Description Gypsum wallboard with mudded and tape seams
Sample Location Collected from the middle of the north wall in the north restroom.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
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Page 4 of 4 Bulk Asbestos Report Continued
Homogeneous Material# 05 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-05-01 Analyzed By: NVL Laboratories, Inc Date Analyzed: 4/18/2018
Building Name: 19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 2
Room: Break room
Material Description 2' x 4'suspended ceiling the with gouge pattern
Sample Location Collected from the ceiling in the second floor storage room, on the west side of the
building.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
Homogeneous Material# 06 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-06-01 Analyzed By: NVL Laboratories,Inc. Date Analyzed: 4/18/2018
Building Name:19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 2
Room: Break room
Material Description 2'x 4'suspended ceiling the with pinhole pattern over adhesive over fiberglass
insulation
Sample Location Collected from the ceiling in the second floor break room, on the east side of the
building.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
Homogeneous Material# 07 Collected By: Dan Shelly Date Collected: 4/11/2018
Sample ID#: 19221-07-01 Analyzed By: NVL Laboratories, Inc. Date Analyzed: 4/18/2018
Building Name:19221 59th Avenue NE,Arlington,Washington Building: Machine shop Floor: 2
Room: Break room
Material Description Brown/black window weather stripping
Sample Location Collected from the east window in the break room on the second floor, east side of
the building.
Comments:
Asbestos Content ND Asbestos Type None-detected
Approx Amt of material Unit:
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SECTION 5
ASBESTOS LABORATORY
_ ANALYSIS .
�a t
April 19, 2018
L A B S
Dan Shelly INDUSTRIAL
The Knebel Company, Inc. H Y G I E N E
S
9122 169th Ave. NE E R V I C E S
Laboratory I Management I Training
Granite Falls, WA 98252
RE: Bulk Asbestos Fiber Analysis; NVL Batch#1806868.00
Client Project: 19221
Location: 19221 59th Ave NE Arlington
Dear Mr. Shelly,
Enclosed please find test results for the 11 sample(s) submitted to our laboratory for analysis on
4/12/2018.
Examination of these samples was conducted for the presence of identifiable asbestos fibers using
polarized light microscopy (PLM) with dispersion staining in accordance with both EPA 6001M4-82-020,
Interim Method for the Determination of Asbestos in Bulk Insulation Samples and EPA 600/R-93/116
Method for the Determination of Asbestos in Bulk Building Materials.
For samples containing more than one separable layer of materials, the report will include findings for
each layer (labeled Layer 1 and Layer 2, etc. for each individual layer). The asbestos concentration in
the sample is determined by calibrated visual estimation.
For those samples with asbestos concentrations between 1 and 10 percent based on visual estimation,
the EPA recommends a procedure known as point counting (NESHAPS, 40 CFR Part 61). Point
counting is a statistically more accurate means of quantification for samples with low concentrations of
asbestos.
The detection limit for the calibrated visual estimation is <1%, 400 point counts is 0.25% and 1000 point
counts is 0.1%
Samples are archived for two weeks following analysis. Samples that are not retrieved by the client are
discarded after two weeks.
Thank you for using our laboratory services. Please do not hesitate to call if there is anything further we
can assist you with.
Sincerely,
:-7
Nick Ly, Technical Director
LssE.NVL.LABs Enc.: Sample Results MW�Af NVL Lab
oratories, Inc.
1,888.( 85.5227) Lab Code:102W3-0 4708 Aurora Ave N, Seattle, WA 99103
www rMlabs.com p 2%547.0100 1 f 206.6:34.1936
page 1 of 7
NVt Laboratories, Inc.
4708 Aurora Ave 14,Seattle,WA 98!03 II I S�
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p 206.547.0100 1 f 206,634,1936 I www nvllabs corn L A R S
Bulk Asbestos Fibers Analysis
y Polarized Light Microscopy
Client: The Knebel Company, Inc. Batch #: 1806868.00
Address: 9122 169th Ave. NE Client Project#: 19221
Granite Falls, WA 98252 Date Received: 4/12/2018
Samples Received: 11
Attention: Mr. Dan Shelly Samples Analyzed: 11
Project Location: 19221 59th Ave NE Arlington Method: EPA/600/R-93/116
& EPA/600/M4-82-020
Lab ID: 18036226 Client Sample#: 19221-01-01
Location: 19221 59th Ave NE Arlington
Layer 1 of 2 Description: White compacted powdery material with paint
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Calcareous binder, Calcareous particles, Paint Cellulose <1% None Detected ND
Layer 2 of 2 Description: White chalky material with paper
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Gypsum/Binder, Fine particles Cellulose 19% None Detected ND
Glass fibers 2%
Lab ID: 18036227 Client Sample#: 19221-01-02
Location: 19221 59th Ave NE Arlington
Layer 1 of 2 Description: White compacted powdery material with paint
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Calcareous binder, Calcareous particles, Paint Cellulose <1% None Detected ND
Layer 2 of 2 Description: White chalky material with paper
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Gypsum/Binder, Fine particles Cellulose 15% None Detected ND
Glass fibers 3%
Lab ID: 18036228 Client Sample M 19221-01-03
Location: 19221 59th Ave NE Arlington
Layer 1 of 2 Description: White compacted powdery material with paint
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Calcareous binder, Calcareous particles, Paint Cellulose 2% None Detected ND
Sampled by: Client ?
pr►
Analyzed by: William Minor Date:04/18/2018
Reviewed by: Nick Ly Date:04/19/2018 Nick Ly, Technical Director
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA
600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%, 5%=1-9%, 10%=5-15%,
'10%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is
mited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL
Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government
page 2 of 7
NVL Laboratories, Inc. ���
4708 Aurora Ave N,Seattle.WA 98103
p 206.5-17.0100 I f 206.634,1936 I www.nvllabs com L A 8 5
Bulk Asbestos Fibers Analysis
y Polarized Light Microscopy
Client: The Kriebel Company, Inc. Batch M 1806868.00
Address: 9122 169th Ave. NE Client Project#: 19221
Granite Falls, WA 98252 Date Received: 4/12/2018
Samples Received: 11
Attention: Mr. Dan Shelly Samples Analyzed: 11
Project Location: 19221 59th Ave NE Arlington Method: EPA/600/R-93/116
& EPA/600/M4-82-020
Layer 2 of 2 Description: White chalky material with paper
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Gypsum/Binder, Fine grains Cellulose 18% None Detected ND
Glass fibers 4%
Lab ID: 18036229 Client Sample#: 19221-02-01
Location: 19221 59th Ave NE Arlington
Layer 1 of 1 Description: Multicolored debris
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Adhesive/Binder, Mastic/Binder, Paint Cellulose 4% None Detected ND
Fine grains, Fine particles, Calcareous particles Synthetic fibers <1%
Mineral grains, Metallic flakes, Metal Glass fibers <1%
Wood flakes Hair <1%
Lab ID: 18036230 Client Sample#: 19221-03-01
Location: 19221 59th Ave NE Arlington
Layer 1 of 2 Description: Tan vinyl
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Vinyl/Binder None Detected ND None Detected ND
Layer 2 of 2 Description: Brown fibrous material
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Carbonaceous material Glass fibers 98% None Detected ND
Cellulose <1%
Lab ID: 18036231 Client Sample#: 19221-04-01
Location: 19221 59th Ave NE Arlington
Sampled by: Client
Analyzed by: William Minor Date:04/18/2018
Reviewed by: Nick Ly Date:04/19/2018 Nick Ly, Technical Director
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA
600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%.
?0%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is
mited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL
Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government
page 3 of 7
NVL Laboratories, Inc.
51708 Aurora Ave N,Seattle.WA 98103
p)_06.547,0100 1 I206.634,1936 I www,wllabs rom
L A E
Bulk Asbestos Fibers Analysis
By Polarized Light Microscopy
Client: The Knebel Company, Inc. Batch #: 1806868.00
Address: 9122 169th Ave. NE Client Project#: 19221
Granite Falls, WA 98252 Date Received:4/12/2018
Samples Received: 11
Attention: Mr. Dan Shelly Samples Analyzed: 11
Project Location: 19221 59th Ave NE Arlington Method: EPA/600/R-93/116
&EPA/600/M4-82-020
Layer 1 of 3 Description: White compacted powdery material with paint
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Calcareous binder, Calcareous particles, Paint Cellulose 2% None Detected ND
Layer 2 of 3 Description: White chalky material with paper
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Gypsum/Binder, Fine grains Cellulose 21% None Detected ND
Glass fibers 5%
Layer 3 of 3 Description: White compacted powdery material
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Calcareous binder, Calcareous particles, Fine particles Cellulose 2% None Detected ND
'-ab ID: 18036232 Client Sample#: 19221-04-02
Location: 19221 59th Ave NE Arlington
Layer 1 of 1 Description: White chalky material with paper and paint
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Gypsum/Binder, Fine particles Cellulose 29% None Detected ND
Lab ID: 18036233 Client Sample M 19221-04-03
Location: 19221 59th Ave NE Arlington
Layer 1 of 2 Description: White compacted powdery material with paint
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Calcareous binder, Calcareous particles, Paint Cellulose <1% None Detected ND
Layer 2 of 2 Description: White chalky material with paper
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Gypsum/Binder, Fine particles Cellulose 30% None Detected ND
Glass fibers 2%
Sampled by: Client
Analyzed by: William Minor Date:04/18/2018
Reviewed by: Nick Ly Date:04/19/2018 Nick Ly, Technical Director
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA
600/R-93/116 and 600/M4-82-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%,5%=1-9%, 10%=5-15%,
?0%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is
.mited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL
Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government
page 4 of 7
NVL Laboratories, Inc.
4708 Aurora Ave N,Seattle,WA 98103
p 206.5417.0100 1 f 206.634,1936 1 www.nvllabs rom L A 8 S
Bulk Asbestos Fibers Analysis
y Polarized Light Microscopy
Client: The Knebel Company, Inc. Batch M 1806868.00
Address: 9122 169th Ave. NE Client Project#: 19221
Granite Falls, WA 98252 Date Received: 4/12/2018
Samples Received: 11
Attention: Mr. Dan Shelly Samples Analyzed: 11
Project Location: 19221 59th Ave NE Arlington Method: EPA/600/R-931116
& EPA/600/M4-82-020
Lab ID: 18036234 Client Sample M 19221-05-01
Location: 19221 59th Ave NE Arlington
Layer 1 of 1 Description: Tan compressed fibrous material with paint
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Adhesive/Binder, Paint, Glass debris Cellulose 38% None Detected ND
Glass shots&debris, Perlite, Fine particles Glass fibers 16%
Lab ID: 18036235 Client Sample M 19221-06-01
Location: 19221 59th Ave NE Arlington
Layer 1 of 1 Description: Yellow fibrous material with plastic
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Plastic Glass fibers 98% None Detected ND
Lab ID: 18036236 Client Sample M 19221-07-01
Location: 19221 59th Ave NE Arlington
Layer 1 of 1 Description: Black rubbery material
Non-Fibrous Materials: Other Fibrous Materials:% Asbestos Type: %
Binder/Filler Glass fibers <1% None Detected ND
Cellulose <1%
Sampled by: Client
Analyzed by: William Minor Date:04/18/2018
Reviewed by: Nick Ly Date:04/19/2018 Nick Ly, Technical Director
10
Note: If samples are not homogeneous, then subsamples of the components were analyzed separately. All bulk samples are analyzed using both EPA
600/R-93/116 and 600/M4-62-020 Methods with the following measurement uncertainties for the reported%Asbestos(1%=0-3%, 5%=1-9%, 10%=5-15%,
?0%=10-30%,50%=40-60%).This report relates only to the items tested. If sample was not collected by NVL personnel,then the accuracy of the results is
mited by the methodology and acuity of the sample collector. This report shall not be reproduced except in full, without written approval of NVL
Laboratories,Inc. It shall not be used to claim product endorsement by NVLAP or any other agency of the US Government
page 5 of 7
NVL Laboratories, Inc. ASBESTOS LABORATORY SERVICES N
1708 Aoiora Ave N,Seattle,VVA 98103 'N I .
r,206.. 1Z0100 I f 206,634,1936 I www.nvllabs.com L A B S
Company The Knebel Company, Inc, NVL Batch Number 1806868.00
Address 9.122 169.th Ave.NE TAT 5 Days AH No
G.rani.te.Falls,WA 9.82.5.2 Rush TAT
Project Manager Mr...Dan Shelly Due Date 4/19./2.0.18. Time. 8'.0.0 AM.
Phone .(.3.6.0.)6.91.-.59.1.0. — Email knebelco@ix.netcom.com �
Cell .(4.2.5)3..19-7.4.2.9 ._.__. Fax
Project Name/Number: .1,922.1- Project Location: 19221 59.th.Ave.NE.Arling.ton _
Subcategory PLM Bulk _
Item Code ASB-.02 EPA 60.0/R-9.3-116 Asbestos by PLM <bulk>
Total Number of Samples _µ_11— Rush Samples
Lab ID Sample ID Description AIR
1 18036226 19221-01-01 A
2 18036227 19221-01-02 A
3 18036228 19221-01-03 A
4 18036229 19221-02-01 A
5 118036230 19221-03-01 A
6 18036231 19221-04-01 A
7 18036232 19221-04-02 A
8 18036233 19221-04-03 A
9 18036234 19221-05-01 A
10 18036235 19221-06-01 A
11 118036236 19221-07-01 A
Print Name Signature Company Date Time
Sampled by Client
Relinquished by I Drop Box
Office Use Only Print Name Signature Company Date Time
Received by I Michael Jenkins NVL 4/12/18 0800
Analyzed by William Minor NVL 4/18/18 _
Results Called by
❑Faxed ❑Emailed
,- - —Special _ --
Instructions:
DFie:4112/2018
Tni?e:9:20 AM
Entered By:Michael Jenkins
page 6 of 7
1806868
Ir4`�I Tum Around Tuna
ASBESTOS 01 How 0,24 Moves W4:
1. A 0 S 02ldours o 2 Days
11N9?W9ttril
CHAIN OF CUSTODY 04Hours 03D.ys 0I00,&Ys
" y 0i s E R:E please,Oil#or TAT less than 24 Howl
$f 9 V I C 9$
cpR,pmy The Knebel Co.. Ine PrgKtM9anag.r Dan Shelly
Address 9122 169th Avenue NE tell t 4215M) 319. 7429
Granite Falls, WA 98252 E„W kneb91W1M1x netcom-com -
Phone 360.691-5910 t 360 ) 691. 5088
9h�Itist Narnr/Mwrber �� project 4oeat3on
O PCM Alr(NIOSH 7400) 0 TEM MSH 7402) 0 TEM MERA) C1 TEM(EPA level R Modi6
PLM PA 6DOM-93116) 0 EPA 400 Points(600/R-93-116) Q, EPA 1000Polnts(60WR-93-116)
O PI M+Gravimetry(600/R-93-116) 0 Asbestos In Vemticulte(EPA 600/R-04/004) 0 Asbestos In SedlmeM(EPA 1900 Points)
C9 Asbestmklabie/Non-f"ble(EPA 600/R-93/116) Ct Other
Reporting Instructions
a Coll l ) a fox � i - )(Email
Total plumber of Samples _
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a g At✓ora Aaa t4,$, altlas WA#1ds I j;20&$47.010 I 11oli.634.19" www.nV'gW,wm
page 7 of 7
SECTION 6
SAMPLE LOCATION
DRAWINGS
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SECTION 7
CERTIFICATION and
ACCREDITATION
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Laboratory Accreditation Program '
SCOPE OF ACCREDITATION TO ISOIIEC 17025:2005
NVL Laboratories, Inc.
4702 Aurora Avenue N.
Same,WA 98103
Mr.Nghiep Vi Ly
Phone:206-347.0100 Fau:206-634-1936
FA mil,niak.1@nyllabs,com
htipJ/+www.nvitabs.com
ASBESTOS FIBER ANALYSIS NVLAP LAB CODE 102063-0
Bulls Asbestos Analysis
imp-* D WL &n
11(A01 EPA 6 W41-tUN:InWin iHe&W fltwThe Wanninstfim of Arbesuws in Milk liuuiation Swnplet
I9AA03 EPA 600VRAU116.Med od for the 1]MerminMior Of Ashnicn in®nlllc Bwil&pg Mink
A rd*Nst�vst on Volunta L borat Accreditatlon PAvra if
FffecUw 2015 OP-25 thv-oWh 2016.0"0 Pam 1 of 1
DEMOLITION
VA. ' 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 BYAN APPROVED AGENCY.
Type of Permit:(check one) ❑ Residential ❑ Commercial ❑✓ Industrial
Project Address:192I1-:& 19221 59TH AVE NE Parcel ID #: Lot 77 at Arlinqton Airport
Lot#: Subdivision. Valuation: 94,000
Building Area (Sq Ft)3�5f10 13000 No. of floors: 1 Number of Buildings:2
Owner: 2BRND LLC Phone Number: 425-870-8259
19132 59TH DR NE ARLINGTON 98223
WA
Address: City: State: Zip Code:
Contact Person:Brent Barker Phone Number: 425-870-8259
Cell Phone: 425-870-8259 E-mail: barkergmw@gmail.com
Address: 1502 Lakeshore Drive City: Lake Stevens State: WA zip Cade: 98;258
Contractor:Reece Construction Co. Phone Number: 360-659-9600
Address: PO Box 1531 City: Marysville State: WA Zip Code: 98270
Contractor's License Number:REECECC852C7 Expiration:2/27/2019
Scope of Work:
Demolish 2 existing buildings and remove debris. Remove concrete and asphalt around
buildings.
I hereby certify that the above information is correct and that the construction on; and the occupancy and the use of the above
de ibed pr ty will be in accordance with the laws, rules and regulations of the Stat of Washington.
- \1 -\�
Applicants Signature Date
Print Applicants Name
FOR STAFF USE ONLY
e
Permit# Accepted By Amount Received Receipt# e d D i '
CITY OF ARLINGTON
238 N. OLYMPIC AVE - ARLINGTON, WA. 98223
PHONE; (360) 403-3551
BUILDING PERMIT
Address:19221 59th Avenue NE Permit#:2191
Parcel#:31051500401200 Valuation:0.00
OWNER APPLICANT CONTRACTOR
Name:City of Arlington Name:2BRND,LLC Name:Reese Construction,Co.
Address: 18204 59th Drive NE Address:19132 59th Drive NE Address:P.O.Box 1531
City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:Marysville,WA 98270
Phone: Phone:425-870-8259 Phone:
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: 2015
STORIES: CONST.TYPE:
DWELLING UNITS: 0 OCC GROUP:
BUILDINGS: I OCC LOAD:
PERMIT APPROVAL
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/IRC110.
SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form
od iry of Arlington#3101.
Z"l-\ .S—�IzP3
Signature Print Name Date Released By e
CONDITIONS
Any traffic control measures will need to be approved. Keep dust down and road clean. Call for final
inspection.
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
9/25/2018 Demolition Fee $100.00
9/25/2018 Processing/Technology Fee $25.00
9/25/2018 State Building Code Surcharge Fee $6.50
Total Due: $131.50
Total Payment: $0.00
Balance Due: $131.50
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
Permit#: 2191
Permit Date: 09/25/18
Permit Type: DEMOLITION
Project Name: 2BRND, LLC
Applicant Name: 2BRND, LLC
Applicant Address: 19132 59th Drive NE
Applicant, City, State, Zip: Arlington,WA 98223
Contact: Brent Barker
Phone: 425-870-8259
Email: barkergmw@gmail.com
Scope of Work:
Valuation: 0.00
Square Feet: 0
Number of Stories: 0
Construction Type:
Occupancy Group:
ID Code:
Permit Issued: 09/27/2018
Permit Expires:
Form Permit Type:
Status: LASERFICHE
Assigned To: Launa Black
Property
Parcel# Address Legal Description Owner Name Owner Phone Zoning
31051500401200 19221 59th Avenue NE City of Arlington
Contractors
Contractor Primary Contact Phone Address Contractor Type License License#
Reese Construction,Co. P.O.Box 1531 CONSTRUCTION Labor&REECECC852C7
CONTRACTOR Industries
Fees
Fee Description Notes Amount
Demolition $100.00
Processing/Technology $25.00
State Surcharge- 1st DU Residential- 1st Unit $6.50
Total $131.50
Attached Letters
Date Letter Description
09/25/2018 Building Permit
Payments
Date Paid By Description Payment Type Accepted By Amount
09/27/2018 2BRND,LLC check#5079 Kristin Foster $131.50
Outstanding Balance $0.00
Uploaded Files
Date File Name
09/27/2018 3988398-2191 Issued Permit.pdf
09/25/2018 3979085-2191 Apnlication.pdf