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HomeMy WebLinkAbout346 S COBB ST_BLD2431_2026 GITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 ` PHONE; (360) 403-3551 BUILDING PERMIT Address:PO Box 663 Permit#:2431 Parcel#:00411701301002 Valuation:35000.00 OWNER APPLICANT CONTRACTOR Name:ROBERTS DAVID&JANE Name:Rengen Earthworks Inc. Name:Rengen Earthworks,Inc. Address:PO BOX 3157 Address:PO Box 663 Address:PO Box 663 City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:425-299-6699 Phone:425-299-6699 LIC:PENGEEI820QT EXP: 11/30/2020 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: OCC GROUP: BUILDINGS: 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. IBCI10/IRCI I0. 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 and cod d City of Arlington#3101. n Gn Signature Print Namt -FfCf Oak Released By Date CONDITIONS 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 2/28/2019 Demolition Fee $100.00 2/28/2019 Processing/Technology Fee $25.00 2/28/2019 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 Information Date 2/27/2019 Permit Number 2431 Project Name Demo 346 S.Cobb St Applicant Name Rengen Earthworks Inc. Applicant Address PO Box 663 City,State,Zip Arlington,WA 98223 Contact Nathan Rengen Phone 425-299-6699 Email n.rengenearthworksinc@gmail.com Permit Type Demolition Site Address PO Box 663 Valuation 35000.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Demo Number of Stories 0 Proposed Use Assigned To Raelynn Jones Property Parcel Address Legal Owner Owner Phone Zoning 00411701301002 1346 S COBB ST ROBERTS DAVID&JANE 111 Single Family Residence-Detached Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# Rengen Earthworks.Inc. INathan Rengen [425-299-6699 i.ren enearthworksinc mail.com CONTRACTOR _&I ]RENGEEI820QT Review Date Type I Descri lion Tar et Date I Completed Date Assigned To I Status 2/27/2019 Pernolition I I I IBuildin n Review Fees Fee Description Notes Amount Demolition Fee 322.10.00.00 $100.00 Processing/Technology Fee 341.43.00.02 $25.00 State Building Code Surchar a Fee 386.00.01.00 $6.50 Total $131.50 Notes Date Note 2/27/2019 Applicant waiting ft 'get Sound Clean Air reports.See application for so )f work Uploaded Files Upload File Date File Uploaded B 2/27/2019 10:18:13 AM 2431 As esto Survekpdf Jones,Rael nn 2/27/2019 10:18:13 AM 2431 Ap licati n.pdf Jones,Rael nn }C DEMOLITION PERMIT APPLICATION �1 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: 346 S. Cobb St - Parcel ID#: 00411701301002 Lot#_ . Subdivision: Valuation: A��, coo Building Area(Sq Ft) 2100 No. of floors: 1 - Number of Buildings:3 Owner: Dave And Jane Roberts Phone Number: 411-5- 311 - 13ZI Po Box 3157 Arlington WA 98223 Address: City: State: Zip Code: Contact Person:N atha n Rengen Phone Number: 425-299-6699 Cell Phone: 425-299-6699 E-mail: N.rengenearthworksinc@gmial.com Address: Po Box 663 City:Arlington y 9 -State: WA — Zip Code: 98223 Contractor: Rengen Earthworks INC Phone Number: 425-299-6699 Address. Po Box 663 City:Arlington State: WA Zip Code: 98223 Contractor's License Number:RENGEE1820QT Expiration:11/30/2020 Scope of Work: To demolish and remove the old manufactured home along with 2 sheds. The manufactured home has had an asbestos survey preformed on it and an abatement contractor Will be out to remove the asbestos. This project will need to be done in phases, due to the fact that the manufactured home has a structure/roof built over the top of it. The structure/roof will need to be removed in order to access the manufactured home roof Mere the asbestos is. I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above- described operty will be in accordance with the laws, rules and regulations of the Stat of Washington. zlz71 I!J Applicants Signature tDath06%01f�l ?_,,OnVAC� Print Applicants me FOR STAFF USE ONLY FEB 2 7 2019 Permit# p By Amount Received Receipt# Date Received 1429Ave.D.4187,Snohomish,WA 98290 425-489-4040:c 206-914-5500;f 775-665-0420 L!rn•.rt x({rfC.tl,c'ojR:{�fJ.([rr{�i.4hi�ln.�crn�gi ASBESTOS SURVEYADDENDUM#1 TO BE ATTACHED AND INCL UDED WITH SURVEY#B2181215 Single Wide Manufactured Home A Additions ca'� 346 S. Cobb Ave.,Arlinwon, WA 98223 Page 1 of 1 +3Attachments January 21,2019 ADI B2181215 David Roberts POB 3157 Arlington,WA 98223 360-435-3559; 425-388-1321 dm teroberts(a)msn.com On December 13,2018,Asbesto-Test personnel conducted an Asbestos survey(per U.S.E.P.A./A.H.E.R.A.guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State)of the single wide manufactured home and additions 346 S.Cobb Ave..Arlinglon,Snohomish County, Washington 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. ON January 7,2019,per client request,sampling retains were submitted to an outside laboratory for"Point Cont performed by EPA 600/R-93/116 Method with Gravimetric Reduction and 400 Point Count". • sample 1&1-mastic: There was no asbestos detected in the floor tile and mastic(plate flooring)throughout. The anomaly between the two labs is likely due to the difference in the analytical protocol,and/or non-homogeneity of the samples. • Sample 3: There was 2.7 Chrysotile asbestos detected in the off-white floor tile from the laundry room.(designated as 3%in the original asbestos survey report). • Sample 6&9: There was no asbestos detected in the wall or ceiling tile mastics,again,the anomaly between the two labs is likely due to the difference in the analytical protocol,and/or non-homogeneity of the samples.Fibrous material was detected after their gravimetric reduction. • Sample 10: There was 5.8%chrysotile asbestos detected in the"silver seal"roofing sealant material(designated as 2%in the original asbestos survey report). �f1ELK,EOyjmnmental.tnc:BULK SAMPLES EPA Method 600IR-931116 The analysis includes testing of bulk building materials for asbestos by performing a visual estimation using the EPA Method 600/R-931116.This method is the most widely used method for estimating asbestos is bulk building materials and works well for most sample types.However,it might require the more detailed method of point counting for accurate estimation of asbestos in samples with low asbestos concentration.This method is also not applicable for samples containing large amounts of fine fibers below the resolution of the PLM (<0.3 microns). PLM Gravimeldc(Chalfied orNYSNOB)The analysis includes a detailed and very labor-intensive testing of bulk building materials for its organic components,inorganic acid-soluble and Insoluble components.Analysis of sample can be performed by either PLM or TEM depending on the size of the fibers expected in the sample.Currently the New York State Department of Public Health Laboratory Method 198.6"Polarized Light Microscopy Method for the ldentlncation and Quantacation of Asbestos in Non-Friable Organically Bound Samples"is the preferred method. EPA Point Count-400 Points The analysis Includes testing of bulk building materials for asbestos by performing 400 point counts(EPA 600/R- 931116).This is a detailed and more labor-intensive technique for estimating asbestos In a building material and Is less subjective than a visual estimate.While the visual estimation of asbestos in a building material works well for most samples,this methodology can be very important when low asbestos concentration In a building material is suspected or detected.This methodology,which has a detection limit of 0.25"/o,increases the accuracy and precision of the asbestos concentration determined in a sample and Is widely used to comply with NESHAP regulations which require point counting on samples with low concentrations of asbestos. ArLynn Hammond,Pres.,BSc. Asbesto-Test,Inc. Analytical Chemist,A1HA proficient Inspector,certified A.H.E.R.A. accred.#168598(Expires July 18,2019) to FrEPA EMSL Analytical, Inc. EMSL Order: 511900162 3317 3rd Ave S,Suite D 2nd floor,Seattle,WA 98134 CustomerlD: 32ATST78 Phone/Fax (206)269-6310/(206)900-8789 CUstomerPO: seatlle;rtli Con? ProjectlD: Attn: ArLynn Hammond Phone: (425)489-4040 Asbesto-Test Fax (775)665-0420 1429 Avenue D Received: 01/071191:00 PM Suite 187 Analysis Date: 1/21/2019 Snohomish, WA 98290 Collected: Project 346 S Cobb Ave,Arlington B2181215 Test Report: Polarized Light Microscopy (PLM) - Point Count Performed by EPA 600/R- 93/116 Method with Gravimetric Reduction and 400 Point Count (%)Matrix NON-ASBESTOS NON-ASBESTOS ASBESTOS SAMPLE ID DESCRIPTION APPEARANCE Organic Acid % Fibrous % NON-FIBROUS %TYPES 1 Floor tile,It bm; Brown 57.0 31.1 11.9 Non-fibrous(other) None Detected 511900162-000i black back(test: Non-Fibrous the& Homogeneous mastic/backing) 1-Mastic Floor tile,It bm; Black 71.9 13.5 14.5 Non-fibrous(other) None Detected 51 1900 162-000 1A black back(test: Non-Fibrous file& Homogeneous mastic/backing) 3 Floor tile,tan;It Tan 24.5 38.5 34.4 Non-fibrous(other) 2.7 Chrysotile 511900162-0002 bm mastic(test: Non-Fibrous file only) Homogeneous 6 Mastic-on Brown 38.1 12.5 49.5 Non-fibrous(other) None Detected 511900162-0003 drywall(test: Non-Fibrous mastic only) Homogeneous 9 Mastic-on ac. Brown 58.2 5.6 <0.4 Fibrous(other) 36.2 Non-fibrous(other) None Detected 5119MI62-0004 Ceiling file(test: Non-Fibrous mastic only) Homogeneous 10 Silverseal- Silver 42.8 7.7 43.7 Non-fibrous(other) 5.8 Chrysotile 511900162-0005 rooftop Non-Fibrous Homogeneous Analyst(s) C7" Jason Stuhr(6) Lauren Kerber,Laboratory Manager or other approved signatory Disclaimers:Some samples may contain asbestos fibers present in dimensions below PLM resolution limits The limit of detection as stated in the method is 0 25% EMSL Analytical Inc suggests that samples reported as<025%or none detected undergo additional analysis via TEM. The above lest report relates only to the Items tested This report may not be reproduced,except in full,without written approval by EMSL Anslyfical Inc. This report must not be used to claim product endorsement by NVLAP or any agency of the United States Govemment EMSL Analytical Inc. bears no responsibility for sample collection activities,analytical method limitations,or the accuracy of results when requested to separate layer samples.EMSL Analytical Inc liability is limited to the cost of sample analysis The test results contained within this report meet the requirements of NELAC unless otherwise noted.Samples received in good condition unless otherwise noted.Unless requested by the client,building materials manufactured with multiple layers(i a linoleum,wallboard,etc)are reported as a single sample Samples analyzed by EMSL Analytical,Inc Seattle,WA Initial report from 01/21/2019 13:14:48 Test Report PLMPCGrav-7.26.0 Printed:1/21/2019 1:14:48 PM THIS IS THE LAST PAGE OF THE REPORT. l E OrderID: 511900162 Asbestos Bulk Building Material EMSL ANALYt(CAL, INC. �UStOd 200 ROUTE 130 NORTH Y CINNAMINSON,N.)08077 RESIDENTIAL Iber(Lab Use Only):LIGHT COMMERCIAL,,::: LEAD(Pb)CERTIFIED PHONE:(800)220-3675 AF HREDABLE RA 1t 01 6 FAX:(856)786 5974 INSPECTIONS EMSL-Bill to: El Same ❑Different If Bel to Is Different note Instructions In Comments•• A S B E STO-TEST I N C Third Patty Billing requires written authorization from third party 1429AVE D.PMB#187 - SNOHOMISH,WA 98290 Zip/Postal Code: Country: i PHONE (425)489-4040 ARLYNN HAMMOND Telephone#: SEATTLE(206)323-5117 ANALYTICAL CHEMISTIPRES. --- AHERA CERTIFIED INSPECTOR I CELL (206)914-5500 I Fax#_: Purchase Order: . arlynn@asbestotest.can - E FAX (775)665-0420 www.asbestotesc.com Please Provide Results: ❑ Fax ❑Email U.S.-State Samples Taken: CT Samples: Commercialffaxable ResldentialiTax Exempt Turnaround Time TAT Options*-Please Check 3 Hour I ❑6 Hour -24 Hour ❑48 Hour 72 Hour 96 Hour 1 Week I [-i 2 Week NSor TEMAir3 hr through 6 hr,please call ahead to schedule.'T here is a premium charge for 3 Hour TEM AHERA or EPA Level It TAT. You will be asked to sign an authorization form for this service. Analysis completed in accordance with EMSL's Terms and Conditions located in the Anulytpl Price Guide. FILM-Bulk(reporting Iimill TEM-Bulk ❑PLM EPA 600/1193/116(<1%) _ _ ❑TEM EPA NOB-EPA 600/R-931116 Section 2.6.5.1 ❑PLM EPA;NOB(<1%) _ ❑NY FLAP Method 198.4(TEM) Point COUnt 400(<0.250/6)❑1000(<0.1%) ❑Chatfield Protocol(semi-quantitative) Point CountwlGraVirrietr(c❑400 j 1000<0.25% ❑ (<0.1% f( ) El %by Mass-EPA 600/R-93/116 Section 2.5.5.2 I NIOSH 9002(<1%) ❑TEM Qualitative via Filtration Prep Technique ❑ NY ELAP Method 198.1 (friable in NY) ❑TEM Qualitative via Drop Mount Prep Technique ❑ NY ELAP Method 198.6 NOB(non-friable-NY) _ Other ❑ OSHA ID-191 Modified _ ❑ ❑ Standard Addition Method Check For Positive Stop-Clearly Identify Homogenous Group I Date Sampled: Samplers Name: Samplers Signature: Sample# HA# Sample Location Material Description t _E1 aor bt L,} &n lwc. 3 �► as L 'Grr• ;)tr On 1 e. . Get1 n S S��G 4YJ i 1 Client Sam le#(a): �p . [! rt tlr•� i�v`-`�N� �� a� Total#of Samples: Zi Relinquished(Client): Date: Time: Received(Lab): , Date: I Time: Comments/Specidl IristrijWdris:Q CarftWd Mwmrf-Ati Av COG-M-11MM2 Page 1 of pages ' Pacge 1 Of 2 OrderID: 511900162 � '� '� g o 0 1 � 4/ 6 2 Baum, Rudy From: ARLYNN HAMMO_ND ASBESTO TEST INC <Asbestotest@msn.cbm> Sent: Monday,January' 07,201912.58TM To: Baum, Rudy Cc: D.J. Roberts Subject: point count testing Hello Rudy, Thank you for talking with me today.Yes,the client is requesting a 2 week turn around on the 5 samples submitted today. Please test the title and backing separately in sample#1(linoleum floor tile-brown surface with tar back) ' For all samples,please use procedure:PLM EPA NOB-EPA/600/R-93/116 400 Point Count w th Gravimetric Prep I understand the total sample number will be 6,with the mastic/backing being analyzed separate)f in sample#1 per your counsel. Thank youl -ArLynn ArLynn Hammond, BSc., Pres., AHERA arlynn@asbestotestxom Asbesto-Test, Inc. 1429 Ave. D. #187 Snohomish, WA 98290 ph 425-489-4040; 206-914-5500 f 775-665-0420 www.asbestotest.com (NOME-7 This email message is for the sole use of the intended recipients)and may contain conlirieiWal and privileged Irrfori ration.Any unauthorized review, use,disclosure,or distribution is prohibited.If you are not the intended recipient,please contact the sender by reply email an destroy ail copies of the original message.) l - O 1 I I I Pace 2 Of 2 I Asbesto-Test, Inc. 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040 www,osbestotcst.com;!n/oCwosbestotesr.com ASBESTOS SURVEY Siazle Wide Manufactured Home& Additions(a) 346 S. Cobb Ave..Arli"On, WA 98223 Page 1 of 9 December 29,2018 B2181215 David Roberts POB 3157 Arlington,WA 98223 360-435-3559 ;425-388-1321 dm ierobertsWmisn.com On December 13,2018,Asbesto-Test personnel conducted an Asbestos survey(per U.S.E.P.A./A.H.E.R.A.guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State)of the single wide manufactured home and additions(a),346 S. Cobb Ave..Arlington,Snohomish County, Washington 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The structure is a single wide manufactured home with additions built on.The siding is metal and wood. The siding vapor barrier materials were sampled.There is composition roofing over the original manufactured home metal roofing. The composition roofing materials were sampled.The silver-coat on the metal roof of the original manufactured home was sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is drywall and wood. The misc.mastic materials were sampled.The vinyl and tile flooring materials with relating mastics and backings were also sampled. The masonry tile and mortar/mastic materials were sampled. INSULATION: The insulation was sampled. continue to page 2 f;CiF-{ Page 2 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Sinzle Wide Manufactured Home& Additions(� 346 S. Cobb Ave.,Arlington, WA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation is not of the type to be ACM. HEATING AND VENTILATION SYSTEM:There is an electric forced air furnace in the structure.There was no relating suspect ACM located. Note:It was not possible to dismantle the furnace and ducting to locate and/or evaluate any additional suspect ACM that may be concealed, inside the unit, or associated in hidden areas. It is our opinion any further handling of the furnace system should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect asbestos containing materials should be considered to be ACM(Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Any TSI that may be present inside or outside the furnace and/or ducting system including but not limited to all gaskets,joint compounds,sealants,and/or insulations, are PACM unless tested otherwise by laboratory analysis. • The gas stove insulated chimney sections and the loose lay insulated chimney sections in the wood shed are PACM. MISC: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY:None. #of structures included in survey: one single wide manufactured home with additions Requested by:David Roberts ®' William R Hutson 11 4 here of rfirpslrrr t•ain nq ae an Ah[till fi-d`q:r rrrr ISCA Tale 11 49 CI*R 763 IANFRA) William R.Hutson 11 Inspector,Certified A.H.E.R.A. Accred.# 165106 exp.Jan. 17,2019 continue to page 3 BBB CD 1429 Ave.0.#187,Snohomish,WA 98190 425-489-4040;f 775-665-0420 u'lv n}o.hesturest-om;inLos�osbtestolcst.c'om i Page 3 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Single Wide Manufactured Home& Additions n 346 S. Cobb Ave..Arlington, WA 98223 THE ASBESTOS CONTAINING MATERIALS LISTED M"NON-FRIABLE"REMAIN NON-FRIABLE(NOT EASILY AIRBORNE)UNTIL FORCES EXPECTED TO ACT ON THE MATERIAL WILL RENDER THE ACM AS FRIABLE(EASILY AIRBORNE).SUCH FORCES INCLUDE,BUT ARE NOT LIMITED TO,EQUPMENT USED IN THE DEMOUTON PROCESS,WEATHER INCIDENTS,AND OTHER DAMAGES THAT RENDER THE ACM FROM NON-FRIABLE TO FRIABLE ANY AND ALL MATERIALS IDENTIFIED AS ACM OR PACM IN THIS REPORT(AND/OR ADDITIONAL MATERIALS ASSOCIATED WITH THE STRUCTURE THAT MAY BE DISCOVERED AND LATER IDENTIFIED AS ACM OR PACM),MUST BE PROFESSIONALLY ABATED PRIOR TO DEMOUTIOM ASSESSMENT AND QUANTIFICATION OF ACM FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE DETERMINED BY ON SITE EVALUATION. F 5Aiv7r' 4t,.i:" is=.. ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL NOTE:THE METAL INSULATED CHIMNEY SYSTEM (ATTACHED TO GAS STOVE AND PARTS LOOSE LAY IN SHED)IS PACM 1.0 LINOLEUM FLOOR TILE yes H chrysotile//2% non-fibrous materials, NON-FRIABLE ACM "PLATE"FLOORING—BOTTOM LAYER THROUGHOUT MOST AREAS BENEATH MASONRY TILE SURFACE IN PLACES ON ORIGINAL PLYWOOD SUB-FLOORING COLOR:BROWN-NOTE:THE ASBESTOS IN THE HARD TILE SURFACE MATERIAL 2.0 mastic/backing NAD adhesive,cellulose,tar beneath previous sample listed 3.0 FLOOR TILE yes H chrysotile//3% non-fibrous materials TILE IS NON-FRIABLE ACM LAUNDRY ROOM—COLOR:OFF WHITE 4.0 backing material NAD tar,cellulose beneath previous sample listed 5.0 red brick NAD non-fibrous materials on lower walls of gas stove nook 6.0 BLACK MASTIC yes//chrysotile H 2% adhesive,cellulose NON-FRIABLE ACM ON SHEETROCK HOLDING RED BRICK ON LOWER WALLS OF GAS STOVE NOOK APPROX.70 SQ.FT. 7.0 CAB PANELS yes H chrysotile H 18% non-fibrous materials Concrete Asbestos Board ACM FRIABLE FOR DEMOLITION PURPOSES 2 PANELS ON WALLS OF GAS STOVE NOOK-APPROX.15 SQ. FT. continue to page 4 9 CD 1419 Ave.0.#187,Snohomish,WA 98290 425-489-4040,•f 775-665-0420 ww v nshesta(ev_ony infv�,L_q-4tesfutea(_cum Page 4 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Siniie Wide Manufactured Home& Additions 346 S. Cobb Ave.,Ariinyon, WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 8.0 acoustic ceiling tile NAD cellulose,paint living room 8.1 acoustic ceiling tile NAD cellulose,paint hall,2 bedrooms(different pattern) 8.2 acoustic ceiling tile NAD cellulose,paint kitchen above dropped ceiling&end bedroom closet(different pattern) 9.0 BLACK MASTIC yes H chrysotile//2% adhesive,cellulose NON-FRIABLE ACM HOLDING ALL ACOUSTIC CEILING TILE IN PREVIOUS SAMPLES APPROX.650 SQ. FT. 10.0 SILVER SEAL yes H chrysotile//2% non-fibrous materials, FRIABLE ACM cellulose ROOFING SEALANT ON SURFACE OF ORIGINAL METAL ROOF APPROX.4$0 SQ. FT. NOTE:THERE IS A TAB PITCHED ROOF BUILT OVER THE TOP OF THE ORIGINAL MANUFACTURED HOME METAL ROOF. NOTE:ANY ADDITIONAL COLORS OR KINDS OF VINYL FLOORING AND/OR TILE WITH ANY RELATING MASTICS/BACKINGS THAT WERE NOT DISCOVERED IN THIS SURVEY AND MAY LATER BE LOCATED IN THIS STRUCTURE ARE ALSO PRESUMED TO CONTAIN ASBESTOS UNLESS TESTED OTHERWISE BY LABORATORY ANALYSIS THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES 11.0 masonry tile NAD non-fibrous materials kitchen,living room/dining room,hall,bathroom,bedrooms,bathroom,laundry room color:white&gray 11.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 12.0 masonry tile NAD non-fibrous materials kitchen countertop&backsplash-color:blue 12.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 13.0 mastic NAD adhesive,cellulose kitchen holding pink laminate under the masonry 14.0 vapor barrier NAD tar,cellulose bathroom under plywood continue to page 5 1391181 ® AF68 d_T 1429Ave.D.#187,Snohomish,WA 98290 425-089-4040,'f 775-665-0420 www.nsbesrotest.com;i�nausbtestorest.ron Page 5 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Single Wide Manufactured Home& Additions 346 S. Cobb Ave.,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 15.0 masonry tile NAD non-fibrous materials in gas stove nook off living room—color:red 15.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 16.0 masonry tile NAD non-fibrous materials one wall of living room—color:white 16.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 17.0 mastic NAD adhesive,cellulose kitchen holding pressboard paneling to wood paneling 18.0 drywall/taping compound/paint NAD non-fibrous materials, kitchen ceiling composite cellulose,gypsum 18.1 drywall/taping compound/paint NAD non-fibrous materials, gas stove nook composite cellulose,gypsum 18.2 drywall/taping compound/paint NAD non-fibrous materials, bathroom composite cellulose,gypsum 18.3 drywall/taping compound/paint NAD non-fibrous materials, laundry composite cellulose,gypsum 18.4 drywall/taping compound/paint NAD non-fibrous materials, room between bedroom&garage composite cellulose,gypsum 19.0 mastic NAD adhesive,cellulose bathroom holding white laminate on countertop 20.0 textured paint NAD non-fibrous materials, laundry sample 1 cellulose,paint 20.1 textured paint NAD non-fibrous materials, laundry sample 2 cellulose,paint 20.2 textured paint NAD non-fibrous materials, laundry sample 3 cellulose,paint continue to page 6 1 BBB Ak38 CD 1429 Ave.0.#187,Snohomish,WA 98290 425-489-4040,•f 775-665-0420 mymo$bes(afest cow 11k)�asb,�es of st_l.f.Dn1 Page 6 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Single Wide MonyLactured Nome& Addition. (a% 346 S. Cobb Ave.,Arlington, IVA 98223 COMMON AREAS: 21.0 insulation NAD fiberglass,cellulose,foil kitchen above drop ceiling foil faced 21.1 insulation NAD cellulose,fiberglass original&addition walls paper faced 22.0 vapor barrier NAD cellulose,foil material beneath metal siding 23.0 composition roofing NAD cellulose,tar, pitched roof non-fibrous materials 24.0 vapor barrier NAD cellulose,tar,fiberglass beneath previous sample 25.0 mastic NAD cellulose,adhesive holding composition roofing 26.0 hard caulking NAD non-fibrous materials on particle board backing loose lay in shed at south side of garage color:black continue to page 7 BBB FH3A 49 ® � T 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040,•f 775-665-0420 www.osbr y«;1nr��%�u>b(u�rotest.com Page 7 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Sinxle Wide Manu%actured Home c& Additions(a 346 S. Cobb Ave.,Arlingron, {VA 98223 jr rW. am , .s F� S �► - •�, -°mix `... _ - continue to page 8 BBB. area ®I CID 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.osbesiotest-cony inlo�au�bt�}�otest.rom Page 8 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Sink* {fide Manufactured Home do Additions 346 S. Cobb Ave.,Arlington, Wit 98223 r 1 I ` ` t 1-� r O_ contlnue to page 9 BB COO . ® C�D 1429 Ave.0.#187,Snohomish,WA 98290 425-489-4040,f 775-665-0420 ,ww_asbestorestcom:i�attasr.com r Page 9 of 9 December 29,2018 B218121 S Asbesto-Test,Inc. 425-489-4040 Single Wide Manufactured Home& Additions 346 S. Cobb Ave.,Adinyon, WA 98223 Interior FeatUt-US Unit Information IieaGng htformation Room Infornication Bathroom bifornrltioti Firewace hiforanation • . ,- :: .It 1 • Fto , i Bt,dii)oin lnforniation Parkin;=;i Garage.Taxes 1 Assessments Parkin;;;Garagc Infoaniation I Assessor Information • f,t : i.. . . . . . Samples taken are listed with their corresponding analyses.If asbestos is detected,those samples containing asbestos are listed first and noted with the initials"ACM". Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials,as prescribed by A.H.E.R.A.guideline. If,during demolition or renovation,any additional suspect asbestos containing materials are located[may include but not limited to: sheet vinyl flooring,tile flooring,wall or ceiling texturings or points,concrete siding or skirting,cement pipes,cement wallboard, electrical cloth,electrical wiring insulation,thermal paper,wallboard,joint compounds,vinyl wall coverings,spackling compounds,or any other suspect TSI(Thermal System Insulation)],those materials are presumed Asbestos Containing Materials unless determined to be non-asbestos by laboratory analysis. Asbesto-Test,Inc.does not guarantee approximations of quantities of ACM,which may be listed with the analyses.It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material(i.e.square or linear foot etc.),or by on site assessment. Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance in renovation or demolition. PLM(polarized light microscopy)has been known to miss asbestos in small percentages of some samples,which contain asbestos, thus negative PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM(scanning electron microscope)or TEM(transmitting electron microscope),to insure analytical accuracy when asbestos is reported in small percentages Analytical test method:USEPAWWR93111611(PLMI,WAC296-62-07753 App.J **One percent Is the USEPA regulatory limit for asbestos in bulk samples. key-, "FRIABLE"signifies Easily Airborne" ACM signfes Asbestos Containing Material" PACM slgnfes"Presumed Asbestos Containing Material" CAB signifies Concrete Asbestos Board" < signifies"less than" a31 signfies'Thermal System Insulation" HVAC signifies Heating Ventilating Air-Conditioning" NAD signifies"No Asbestos Detected" END OF REPORT ArLynn Hammond, Pres., BSc. Analytical Chemist,AIHA proficient Inspector, certified A.H.E.R.A. accred.#168598 (Expires July 18,2019) CE:) 1429Ave.0.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.osbestot st.com•inL,�osbtestot�%l.cprn NNW Home Espafiol I Contact Aft A-/Index I [IcIp Nily I'm Labor i Industries Safety&Health O Claims&Insurance o Workplace Rights 8 Trades& c Washington State Department of " Labor & Industries RENGEN EARTHWORKS INC Owner or tradesperson PO BOX 663 ARLINGTON,WA 98223 Principals 425-299-6699 RENGEN,NATHAN AARON,PRESIDENT SNOHOMISH County ■ RENGEN,LYNSEYLEEANNE,TREASURER Doing business as RENGEN EARTHWORKS INC WA UBI No. Business type 604 318 265 Corporation Governing persons LYNSEY RENGEN NATHAN RENGEN; License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. RENGEE1820QT Effective—expiration 11/30/2018-11/30/2020 Bond Western Surety Co $12,000.00 Bond account no. 63858367 Received by L&I Effective date 12/05/2018 12/04/2018 Expiration date Until Canceled Bond history Insurance Nautilus Ins Co $1,000,000.00 Policy no. NN995615 Received by L&I Effective date 11/30/2018 11/21/2018 Expiration date 11/21/2019 Savin......gs ......... No savings accounts during the previous 6 year period. Lawsuits against the bond or savings ' No lawsuits against the bond or savings ac arts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is closed. 670,683-00 Doing business as RENGEN EARTHWORKS INC Estimated workers reported N/A L&I account contact T3/KENT ANDERSON(360)902-6963-Email:ANDN235@lni.wa.gov Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health No inspections during the previous 6 year period. �1Y.isitington" w us improve 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: 346 S, Cobb St Parcel ID#: 00411701301002 Lot#: Subdivision: Valuation: �� �� Building Area(Sq Ft) 2100 No. of floors: 1 Number of Buildings:3 Owner: Dave And Jane Roberts Phone Number: 424- 311 - 117-1 Po Box 3157 Arlington WA 98223 Address: City: State: Zip Code: Contact Person Nathan Rengen Phone Number: 425-299-6699 Cell Phone: 425-299-6699 E-mail: N.rengenearthvvorksinc@gmial.com Address: Po Box 663 City:Ar_l111910 State:W_ Zip Code: 98223 Contractor: Rengen Earthworks INC 425-299-6699 Phone Number: Address: Po Box 663 City: Arlington State: WA Zip Code: 98223 Contractor's License Number RENGEE1820QT Expiration:11/30/2020 Scope of Work: To demolish and remove the old manufactured home along with 2 sheds. The manufactured home has had an asbestos survey preformed on it and an abatement contractor will be out to remove the asbestos. This project will need to be done in phases, due to the fact that the manufactured home has a structure/roof built over the top of it. The structure/roof will need to be removed in order to access the manufactured home roof where the asbestos is. I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above- described r, operty will be in accordance with the laws, rules and regulations of the Stat of Washington _ 2/z? 1 I17 Applicants Signature � t Date ��'�nar,—�rticrar� Print Applicants t6me FOR STAFF USE ONLY alb 24 51 FEB 2 7 2019 Permit# p By Amount Received Receipt# Date Received J 1429Ave,D.#187,Snohomish,WA 98290 425-489-4040;c 206-914-5500;f 775-665-0420 uy H•.a.�'/rt�sfofust-cm);frrl}7n!({�;�dShtlFlorCal.CgBl ASBESTOS SURVEYADDENDUM#1 TO BE ATTACHED AND INCLUDED WITH SURVEY#B2181215 Single Wide Manu%aclured Hoare& Additions Ca), 346 S. Cobh Ave.,Arlington, WA 98223 Page 1 of 1 +3Attaehments January 21,2019 ADI-B2181215 David Roberts POB 3157 Arlington,WA 98223 360-435-3559; 425-388-1321 d m igrobe rts(a7nisn.com On December 13,2018,Asbesto-Test personnel conducted an Asbestos survey(per U.S.E.P.AJA.H.E.R.A.guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State)of the sinrle wide manufactured home and additions(a)346 S.Cobb Ave,ArlinPlon,Snohomish County, 111ashinElon 98223.This survey purpose is to identify asbestos containing materials,prior to demolition. ON January 7,2019,per client request,sampling retains were submitted to an outside laboratory for"Point Cont performed by EPA 600/R-93/116 Method with Gravimetric Reduction and 400 Point Count". • sample 1&1-mastic: There was no asbestos detected in the floor tile and mastic(plate flooring)throughout. The anomaly between the two labs is likely due to the difference in the analytical protocol,and/or non-homogeneity of the samples. • Sample 3: There was 2.7 Chrysotile asbestos detected in the off-white floor tile from the laundry room.(designated as 3%in the original asbestos survey report). • Sample 6&9: There was no asbestos detected in the wall or ceiling tile mastics,again,the anomaly between the two labs is likely due to the difference in the analytical protocol,and/or non-homogeneity of the samples.Fibrous material was detected after their gravimetric reduction. • Sample 10: There was 5.8%chrysotile asbestos detected in the"silver seal'roofing sealant material(designated as 2%in the original asbestos survey report). Per TEM Environmental.Inc.BULK SAMPLES EPA Method 600IR-931116 The analysis includes testing of bulk building materials for asbestos by performing a visual estimation using the EPA Method 600/R-931116.This method Is the most widely used method for estimating asbestos Is bulk building materials and works well for most sample types.However,it might require the more detailed method of point counting for accurate estimation of asbestos in samples with low asbestos concentration.This method is also not applicable for samples containing large amounts of fine fibers below the resolution of the PLM (<0.3 microns). PLM Gravimetric(Chatfield orNYSNOB)The analysis includes a detailed and very labor-intensive testing of bulk building materials for its organic components,Inorganic acid-soluble and insoluble components.Analysis of sample can be performed by either PLM or TEM depending on the size of the fibers expected In the sample.Currently the New York State Department of Public Health Laboratory Method 198.6"Polarized Light Microscopy Method for the Identification and Quantification of Asbestos In Non-Friable Organically Bound Samples"is the preferred method. EPA Point Count-400 Points The analysis includes testing of bulk building materials for asbestos by performing 400 point counts(EPA 600IR- 931116).This is a detailed and more labor-intensive technique for estimating asbestos in a building material and Is less subjective than a visual estimate. While the visual estimation of asbestos In a building material works well for most samples,this methodology can be very important when low asbestos concentration in a building material is suspected or detected.This methodology,which has a detection limit of 0.25°/n,increases the accuracy and precision of the asbestos concentration determined in a sample and is widely used to comply with NESHAP regulations which require point counting on samples with low concentrations ofasbestos. ArLynn Hammond,Pres.,BSc. Asbesto-Test,Inc. Analytical Chemist,AIHA proficient Inspector,certified A.H.E.R.A. accred.#168598(Expires July 18,2019) 1311 1 EMSL Analytical, Inc. EMSL Order: 511900162 3317 3rd Ave S,Suxe D 2nd floor,Seattle,WA 98134 CiustomerlD: 32ATST78 Phone/Fax (206)269-6310/(206)900-8789 CUstomerPO: ...... sealtielablMemsl,corn ProjectlD: Ann: ArLynn Hammond Phone: (425)489-4040 Asbesto-Test Fax: (775)665-0420 1429 Avenue D Received: 01/07/19 1:00 PM Suite 187 Analysis Date: 1/21/2019 Snohomish, WA 98290 Collected: Project 346 S Cobb Ave,Arlington B2181215 Test Report: Polarized Light Microscopy (PLM) - Point Count Performed by EPA 600/R- 93/116 Method with Gravimetric Reduction and 400 Point Count (%)Matrix NON-ASBESTOS NON-ASBESTOS ASBESTOS SAMPLE ID DESCRIPTION APPEARANCE Organic Acid % Fibrous % NON-FIBROUS %TYPES 1 Floor tile,it brn; Brown 57.0 31.1 11.9 Non-fibrous(other) None Detected 511900162-0001 black back(test: Non-Fibrous tile& Homogeneous mastic/backing) 1-Mastic Floor tile,It brn; Black 71.9 13.5 14.5 Non-fibrous(other) None Detected 511900162-0001A black back(test: Non-Fibrous file& Homogeneous masticibacking) 3 Floor tile,tan;It Tan 24.5 38.5 34.4 Non-fibrous(other) 2.7 Chrysotile 511900162-0002 brn mastic(test: Non-Fibrous file only) Homogeneous 6 Mastic-on Brown 38.1 12.5 49.5 Non-fibrous(other) None Detected 511900162-0003 drywall(test: Non-Fibrous mastic only) Homogeneous 9 Mastic-on ac. Brown 58.2 5.6 <0.4 Fibrous(other) 36.2 Non-fibrous(other) None Detected 511900162-0004 Ceiling file(test: Non-Fibrous mastic only) Homogeneous 10 Silverseal- Silver 42.8 7.7 43.7 Non-fibrous(other) 5.8 Chrysolile 511900162-0005 rooftop Non-Fibrous Homogeneous Analyst(s) ��_Vk � Jason Stuhr(6) Lauren Kerber,Laboratory Manager or other approved signatory Disclaimers:Some samples may contain asbestos fibers present In dimensions below PLM resolution limits The limit of detection as stated in the method is 0 25%. EMSL Analytical Inc suggests that samples reported as<0 25%or none detected undergo additional analysis As TEM. The above test report relates only to the items tested This report may not be reproduced,except in full,without written approval by EMSL Analytical Inc..This report must not be used to claim product endorsement by NVLAP or any agency of the United Stales Government EMSL Analytical Inc bears no responsibility for sample collection activities,analytical method limitations,or the accuracy of results when requested to separate layer samples EMSL Analytical Inc liability is limited to the cost of sample analysis The lest results contained within this report meet the requirements of NELAC unless otherwise noted Samples received in good condition unless otherwise noted Unless requested by the client,building materials manufactured with multiple layers(i a linoleum,wallboard,etc)are reported as a single sample Samples analyzed by EIVISL Analytical,Inc Seattle,WA Initial report from 0l/21/2019 13:14:48 Test Report PLMPCGrav-7.26.0 Printed:1/21/2019 1:14:48 PM THIS IS THE LAST PAGE OF THE REPORT. OrderID: 511900162 Asbestos Bulk Building Material EMSL ANALYTICAL, INC. !t>- Use Only):�UStOd i 200 ROUTE 13O NORTH RESIDENTIAL y CiNNAMINSON,NJ 08077 LIGHT COMMERCIAL LFaD(Pb)CERTIFIED lber(LabPHONE:(800)220-3675 AFFOR ��� 01 6 2 FAX:(856)786-5974 INSPECTIONS Pi EMSL-Bill to: Same F1 Different ( If Bill to Is DIfferent note instructions in Comments•• ASBE STQ —TEST m C Third Party Billing requires written authorization from third)party ( 1429 AVE D,PMB#107 - SNOHOMISH.WA 98290 Zip/Postal Code:_ Country: f PHONE (425)4894040 ARLYNN HAMMOND Telephone#: SEATTLE(206)523-S 117 ANALYTICAL CHEMISTIPRES. i CELL (206)914-SSOti AHERA CERTIFIED INSPECTOR , Fax#: I Purchase Order: ; I E FAX (775)665 0420 arlynn@asbestotest.com 1 --- •• www.asbestorestcom Please Provide Results: ❑ Fax ❑Email U.S:State Samples Taken: Taxable 0 Residential/Tax Exempt Turnaround Time TA Options*—Please Check 3 Hour El 6 Hour 24 Hour. I ❑48 Hour 72 Hour I C1 96 Hour ❑ 1 Week 2 Week For TEM Air3 hr through 6 hr,please calf ahead to schedule"7here is a premium charge for 3 Hour TEM AHERA or EPA Level It TAT. You will be asked to sign an authorization form forthis service:Analysis completed in accordance with EMSL s Terms and Conditions located in the Analytical Price Guide. PLM-Bulk(recortine limit) TEM—Bulk ❑PLM_E_PA 600/R-93/116(<1%) _ _ ❑TEM EPA NOB—EPA 600/R-93/116 Section 2.5.5.1 ' ❑PLM EPAINOB(<196) _ ❑NY ELAP Method 198.4(TEM) Point Count 400(<0.25%)❑1000(<0.19/6) ❑Chatfield Protocol(semi-quantitative) _ Point Countw/Gravimetrlc[_�400(<0.25%)❑1000(<0.1%)_ ❑TEM%by Mass—EPA 600/R-93/116 Section 2.5.5.2 _D NIOSH 9002(51%) ElTEM Qualitative via Filtration Prep Technique ❑ NY ELAP Method 198.1 (friable in NY) v ❑TEM Qualitd"via Drop Mount Prep Technique ❑ NY ELAP Method 198.6 NOB(non-friable-NY) Other ❑ OSHA ID-191 Modified ❑ ❑ Standard Addition Method ❑Check For Positive Stop—Clearly Identi Homogenous Grou Date Sam fed: Samplers Name: Samplers Signature: Sample# HA# Sample Location Material Description 3 r . ✓�I L '�eST• I �t 041 � a5fi L enn ae . GeJl Sr AWA, G Client Sample#(s): L U Tt U� �7V�-�+ �� e� Total#of Samples: i Relinquished(Client: Date: Time: Received(Lab): Date: I Time: Comments/Specidllns u Ions: cownum mmn ms-Asbestos Coo-Re-11rAM12 Page 1 of pages ' Page 1 Of 2 I OrderID: 511900162 O 01 ! I 62 Baum, Rudy From: ARLYNN HAMMOND ASBESTO TEST INC <Asbestotest@msn.c7 Sent: Monday,January' 07,2019 12:5&TM To: Baum, Rudy Cc: D.J. Roberts Subject: point count testing Hello Rudy, Thank you for talking with me today.Yes,the client is requesting a 2 week turn around on the 5 samples submitted today. Please test the the and backing separately in sample#1(linoleum floor the-brown surfac a with tar back) For all samples,please use procedure :PLM EPA NOB- EPA/600/R-93/116 400 Point Count w th Gravimetric Prep I understand the total sample number will be 6,with the mastic/backing being analyzed separate) in sample#1 per your counsel. Thank you! I -ArLynn ArLynn Hammond, BSc., Pres., AHERA ar(vnn(d)asbestotest.com Asbesto-Test, Inc.- - 1429 Ave. D. #187 Snohomish, WA 98290 ph 425-489-4040; 206-914-5500 f 775-665-0420 www.asbestot!gst.com (NOTICE:This email message Is for the sole use of the intended recipients)and may contain confidential and privilegedinforii ation.Any unauthorized review, use,disclosure,or distribution is prohibited.If you are not the intended recipient,please contact tire sender by reply email ano destroy all copies of the original message.) y1 ��,,,� •ti 1 ter_ - 0 I I 1 I 1 1 i Paqe 2 Of 2 A-T Asbesto-Test, Inc. 1429 Ave.0.#187,Snohomish,WA 98290 425-489-4040 wwW,0$be5r0te5f tgm;infn�tiosbe5toreSt./Om ASBESTOS SURVEY Sinzle Wide Manufactured Home& Additions(a., 346 S. Cobb Ave.,Arlin1,ton, WA 98223 Page 1 of 9 December 29,2018 B2181215 David Roberts POB 3157 Arlington,WA 98223 360-435-3559; 425-388-1321 d m iuroberts�a)msn.com On December 13,2018,Asbesto-Test personnel conducted an Asbestos survey(per U.S.E.P.A./A.H.E.R.A.guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State)of the single wide manufactured home and additions(�346 S. Cobb Ave..Arlin��ton,Snohomish County, Washington 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The structure is a single wide manufactured home with additions built on.The siding is metal and wood. The siding vapor barrier materials were sampled. There is composition roofing over the original manufactured home metal roofing. The composition roofing materials were sampled.The silver-coat on the metal roof of the original manufactured home was sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is drywall and wood. The misc.mastic materials were sampled.The vinyl and tile flooring materials with relating mastics and backings were also sampled. The masonry tile and mortar/mastic materials were sampled. INSULATION: The insulation was sampled. continue to page 2 Page 2 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Single Wide Manufactured Home& Additions 346 S. Cobb Ave.,AHinton, WA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation is not of the type to be ACM. HEATING AND VENTILATION SYSTEM:There is an electric forced air furnace in the structure. There was no relating suspect ACM located. Note:It was not possible to dismantle the furnace and ducting to locate and/or evaluate any additional suspect ACM that may be concealed, inside the unit, or associated in hidden areas. It is our opinion any further handling of the furnace system should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect asbestos containing materials should be considered to be ACM(Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Any TSI that may be present inside or outside the furnace and/or ducting system including but not limited to all gaskets,joint compounds,sealants,and/or insulations,are PACM unless tested otherwise by laboratory analysis. • The gas stove insulated chimney sections and the loose lay insulated chimney sections in the wood shed are PACK MISC: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY:None. #of structures included in survey: one single wide manufactured home with additions Requested by:David Roberts William R Hutson 11 A nx,rs r..!r.!-�.per Pao!rd a�an SSCA Tdl.li 40 CFA 761 IAHEFIA)c / t William R.Hutson 11 Inspector,Certified A.H.E.R.A. Accred.# 165106 exp.Jan. 17,2019 continue to page 3 BWB � A-T 1429Ave.0.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.osbestotest.rom;in/oftsbtestotestcom Page 3 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 $Wjzk Wide Manufactured Nome& Additions n 346 S. Cobb Ave..Arlington, WA 98223 THE ASBESTOS CONTAINING MATERIALS LISTED AS"NON-FRIABLE"REMAIN NON-FRIABLE(NOT EASILY AIRBORNE)UNTIL FORCES EXPECTED TO ACT ON THE MATERIAL WILL RENDER THE ACM AS FRIABLE(EASILY AIRBORNE).SUCH FORCES INCLUDE,BUT ARE NOT LIMITED TO,EQUPMENT USED IN THE DEMOUTON PROCESS,WEATHER INCIDENTS,AND OTHER DAMAGES THAT RENDER THE ACM FROM NON-FRIABLE TO FRIABLE ANY AND ALL MATERIALS IDENTIFIED AS ACM OR PACM IN THIS REPORT(AND/OR ADDITIONAL MATERIALS ASSOCIATED WITH THE STRUCTURE THAT MAY BE DISCOVERED AND LATER IDENTIFIED AS ACM OR PACM),MUST BE PROFESSIONALLY ABATED PRIOR TO DEMOLITION.ASSESSMENT AND QUANTIFICATION OF ACM FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE DETERMINED BY ON SITE EVALUATION. ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL NOTE:THE METAL INSULATED CHIMNEY SYSTEM(ATTACHED TO GAS STOVE AND PARTS LOOSE LAY IN SHED)IS PACM 1.0 LINOLEUM FLOOR TILE yes H chrysotile H 2% non-fibrous materials, NON-FRIABLE ACM "PLATE" FLOORING—BOTTOM LAYER THROUGHOUT MOST AREAS BENEATH MASONRY TILE SURFACE IN PLACES ON ORIGINAL PLYWOOD SUB-FLOORING COLOR:BROWN-NOTE:THE ASBESTOS IN THE HARD TILE SURFACE MATERIAL 2.0 mastic/backing NAD adhesive,cellulose,tar beneath previous sample listed 3.0 FLOOR TILE yes H chrysotile//3% non-fibrous materials TILE IS NON-FRIABLE ACM LAUNDRY ROOM—COLOR:OFF WHITE 4.0 backing material NAD tar,cellulose beneath previous sample listed 5.0 red brick NAD non-fibrous materials on lower walls of gas stove nook 6.0 BLACK MASTIC yes H chrysotile//2% adhesive,cellulose NON-FRIABLE ACM ON SHEETROCK HOLDING RED BRICK ON LOWER WALLS OF GAS STOVE NOOK APPROX.70 SQ. FT. 7.0 CAB PANELS yes H chrysotile//18% non-fibrous materials Concrete Asbestos Board ACM FRIABLE FOR DEMOLITION PURPOSES 2 PANELS ON WALLS OF GAS STOVE NOOK-APPROX. 15 SQ. FT. continue to page 4 CD 1419 Ave.D.#187,Snohomish,WA 98290 425-489-4040,•f 77S-665-0420 www.osbestotest c4mi;mi mu,w5Ltestotestxom Page 4 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Single Wide Manufactured Monte& Additions Cal 346 S. Cobb Ave..Arlinalon, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 8.0 acoustic ceiling tile NAD cellulose,paint living room 8.1 acoustic ceiling tile NAD cellulose,paint hall,2 bedrooms(different pattern) 8.2 acoustic ceiling tile NAD cellulose,paint kitchen above dropped ceiling&end bedroom closet(different pattern) 9.0 BLACK MASTIC yes H chrysotile//2% adhesive,cellulose NON-FRIABLE ACM HOLDING ALL ACOUSTIC CEILING TILE IN PREVIOUS SAMPLES APPROX.650 SQ. FT. 10.0 SILVER SEAL yes H chrysotile H 2% non-fibrous materials, FRIABLE ACM cellulose ROOFING SEALANT ON SURFACE OF ORIGINAL METAL ROOF APPROX.450 SQ. FT. NOTE:THERE IS A TAB PITCHED ROOF BUILT OVER THE TOP OF THE ORIGINAL MANUFACTURED HOME METAL ROOF. NOTE:ANY ADDITIONAL COLORS OR KINDS OF VINYL FLOORING AND/OR TILE WITH ANY RELATING MASTICS/BACKINGS THAT WERE NOT DISCOVERED IN THIS SURVEY AND MAY LATER BE LOCATED IN THIS STRUCTURE ARE ALSO PRESUMED TO CONTAIN ASBESTOS UNLESS TESTED OTHERWISE BY LABORATORY ANALYSIS THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES 11.0 masonry tile NAD non-fibrous materials kitchen,living room/dining room,hall,bathroom,bedrooms,bathroom,laundry room color:white&gray 11.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 12.0 masonry tile NAD non-fibrous materials kitchen countertop&backsplash-color:blue 12.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 13.0 mastic NAD adhesive,cellulose kitchen holding pink laminate under the masonry 14.0 vapor barrier NAD tar,cellulose bathroom under plywood continue to page 5 ® e_r 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.psbesiotest.corn;in/o(pnshr•stntast.cnrn Page S of 9 December 29,2018 B218121 S Asbesto-Test,Inc. 425-489-4040 Sinele Wide Manufactured Home& Additions a) 346 S. Cobb Ave.,Arlineton, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 15.0 masonry tile NAD non-fibrous materials in gas stove nook off living room—color:red 15.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 16.0 masonry tile NAD non-fibrous materials one wall of living room—color:white 16.1 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 17.0 mastic NAD adhesive,cellulose kitchen holding pressboard paneling to wood paneling 18.0 drywall/taping compound/paint NAD non-fibrous materials, kitchen ceiling composite cellulose,gypsum 18.1 drywall/taping compound/paint NAD non-fibrous materials, gas stove nook composite cellulose,gypsum 18.2 drywall/taping compound/paint NAD non-fibrous materials, bathroom composite cellulose,gypsum 18.3 drywall/taping compound/paint NAD non-fibrous materials, laundry composite cellulose,gypsum 18.4 drywall/taping compound/paint NAD non-fibrous materials, room between bedroom&garage composite cellulose,gypsum 19.0 mastic NAD adhesive,cellulose bathroom holding white laminate on countertop 20.0 textured paint NAD non-fibrous materials, laundry sample 1 cellulose,paint 20.1 textured paint NAD non-fibrous materials, laundry sample 2 cellulose,paint 20.2 textured paint NAD non-fibrous materials, laundry sample 3 cellulose,paint continue to page 6 X AeMlk ® CI_D KW 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040,•f 775-665-0420 WWw.asbe5to tem.Co 'LnLiz@osbtesto[eFLcom Page 6 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Sin—We Wide Manufactured Home& Additions Cu. 346 S. Cobb Ave.,Arlington, WA 98223 COMMON AREAS: 21.0 insulation NAD fiberglass,cellulose,foil kitchen above drop ceiling foil faced 21.1 insulation NAD cellulose,fiberglass original&addition walls paper faced 22.0 vapor barrier NAD cellulose,foil material beneath metal siding 23.0 composition roofing NAD cellulose,tar, pitched roof non-fibrous materials 24.0 vapor barrier NAD cellulose,tar,fiberglass beneath previous sample 25.0 mastic NAD cellulose,adhesive holding composition roofing 26.0 hard caulking NAD non-fibrous materials on particle board backing loose lay in shed at south side of garage color:black continue to page 7 _1 B B _ .s=ErJ 1429 Ave.D,#187,Snohomish,WA 98290 425-489-4040,f 775-665-0420 Www.nsbestolyg.Com;Ofo osbrestoteyxorn Page 7 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Single Wide Manufactured Home A Additions Ca 346 S. Cobb Ave.,Arlington, WA 98223 i • r continue to page 8 BB yes ® 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.osbesrotestrom;lla@oshtcsmresr.rom Page 8 of 9 December 29,2018 B2181215 Asbesto-Test,Inc.425-489-4040 Single Wide Manufactured Home& Additions OW 346,S Cobb Ave.,Arlington, WA 98223 u A d f r Ow v i v .r continue to page 9 1 ��A d_T 1429Ave.D.#197,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www,nsbestotastcrLm,•in q-@osbtesrotest.com Page 9 of 9 December 29,2018 B2181215 Asbesto-Test,Inc. 425-489-4040 Single Wide Manufactured Home& Additions n, 346 S. Cobb Ave.,Arlington, WA 98223 Interior Features Unit Information Heating Information • - -�il::•1±..::1 1I:..+lT';Pr:�u�r,•u,^sir Room Information Bathroom information Fireplacelnformation 1= .s:lir• • Fi >!,.. Ty i;,:Sin Bedroom Information Parking/Garage,Taxes i Assessments Parking/Garage Information • Prim.uY C.u;ugt•Tyt1r•./lllar.hcrr Assessor Information • Pummy G.u.o' Sq Ft 286 'y;•t;: L r,L_,uri+1 i r v king Tyjw:G+law. Samples taken are listed with their corresponding analyses.If asbestos is detected,those samples containing asbestos are listed first and noted with the initials ACM". Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials,as prescribed by A.H.E.R.A.guideline. if,during demolition or renovation,any additional suspect asbestos containing materials ore located[may include but not limited to: sheet vinyl flooring,tile flooring,wall or ceiling texturings or paints,concrete siding or skirting,cement pipes,cement wallboard, electrical cloth,electrical wiring insulation,thermal paper,wallboard,joint compounds,vinyl wall coverings,spackling compounds,or any other suspect TSI(Thermal System Insulation)],those materials are presumed Asbestos Containing Materials unless determined to be non-asbestos by laboratory analysis. Asbesto-Test Inc.does not guarantee approximations of quantities of ACM,which may be listed with the analyses.It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material(i.e.square or linear foot etc.),or by on site assessment. Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance in renovation or demolition. PLM(polarized light microscopy)has been known to miss asbestos in small percentages of some samples,which contain asbestos, thus negative PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM(scanning electron microscope)or TEM(transmitting electron microscope),to insure analytical accuracy when asbestos is reported in small percentages Analytical test method;USEPA 600/R93/116"(PLM);WAC296-62-07753App.J ••One percent is the USEPA regulatory limit for asbestos in bulk samples. kke FRIABLE"signifies'Easily Airborne" ACM signfies Asbestos Containing Material" PACM signifies"Presumed Asbestos Containing Materiar CAB signifies Concrete Asbestos Board" < signifies"less than" TSI signfes"Thermal System Insulation" HVAC signifies'Heating Ventilating Air-Conditioning" NAD slgnfies"No Asbestos Detected" END OF REPORT ArLynn Hammond, Pres., BSc. Analytical Chemist,AIHA proficient Inspector,certified A.H.E.R.A. accred.#168598(Expires July 18,2019) 'ii.1:, .r 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.gsc,s _r_,:_tom In o@nsbtestotestrom I CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:346 S.Cobb Avenue Permit#:2431 Parcel#:00411701301002 Valuation:35000.00 OWNER APPLICANT CONTRACTOR Name:ROBERTS DAVID&.JANE Name:Rengen Earthworks Inc. Name:Rengen Earthworks,Inc. Address:PO BOX 3157 Address:PO Box 663 Address:PO Box 663 City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:425-299-6699 Phone:425-299-6699 LIC:RENGEE1820QT EXP: 11/30/2020 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: OCC GROUP: BUILDINGS: 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 and cod4i City of Arlington#3101. n Gn l� Signature Print Nam 1phef fbatc Released By Datc CONDITIONS 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 2/28/2019 Demolition Fee $100.00 2/28/2019 Processing/Technology Fee $25.00 2/28/2019 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 Date: 03/27/2026 Permit#: 2431 Permit Date: 02/27/2019 Review Date: 03/27/2019 Permit Type: DEMOLITION Review Type: DEMOLITION Target Date: Scheduled 00:00 Time: Completed 03/27/2019 Date: Description: Sewer must be capped prior to demolition and a COA sewer inspector must be on-site to document all work. Inspection line #360-403-3508 JL Review Status: Assigned To: PW-SEW-REV Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 00411701301002 ROBERTS DAVID &JANE ROBERTS DAVID & JANE PO BOX 3157 346 S COBB ST ARLINGTON, WA 98223 Zoning: I I 1 Single Family Residence - DetachedLot: Block: Permit#: 2431 Permit Date: 02/27/19 Permit Type: DEMOLITION Project Name: Roberts Applicant Name: Rengen Earthworks Inc. Applicant Address: PO Box 663 Applicant, City, State, Zip: Arlington,WA 98223 Contact: Nathan Rengen Phone: 425-299-6699 Email: n.rengenearthworksinc@gmail.com Scope of Work: Valuation: 35000.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 03/01/2019 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Raelynn Jones Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00411701301002 346 S COBB ST ROBERTS DAVID 111 Single Family &JANE Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# Rengen Earthworks,Inc. Nathan Rengen 425-299-6699 PO Box 663 CONSTRUCTION L&I RENGEEI820QT CONTRACTOR Plan Reviews Date Review Type Description Assigned To Review Status 02/27/2019 DEMOLITION BUILDING 03/27/2019 DEMOLITION Sewer must be capped prior to demolition and a COA PW-SEW-REV sewer inspector must be on-site to document all work. Inspection line#360-403-3508 JL Fees Fee Description Notes Amount Demolition $100.00 Processing/Technology $25.00 State Surcharge- 1 st DU Residential-1 st Unit $6.50 Total $131.50 Attached Letters Date Letter Description 02/28/2019 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 03/01/2019 D.Roberts Check#13644 Kristin Foster $131.50 Outstanding Balance $0.00 Notes Date Note Created By: 02/27/2019 Applicant waiting for Puget Sound Clean Air reports.See application for scope of work Raelynn Jones Uploaded Files Date File Name 03/04/2019 4578908-1691 Signed pgrmit.pdf 03/04/2019 4576586-2431 Issued Permit.pdf 02/27/2019 4560770-2431 Application.pdf 02/27/2019 4560771-2431 Asbestos Survey-.pdf