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Home My WebLink About8821 172ND ST NE_BLD1175_2026 AMB We Do Abatement dba K&T We Do Dirt P.O. Box 3123 Arlington, WA 98223 360-657-0390 Office 360-657-0391 Fax Contractor's License#KTWEDTW917PA Asbestos Contractor Certification # 1522 CERTIFICATE OF COMPLETION For Asbestos Project 10/25/2016 On 10/25/2016 asbestos abatement services were completed at: 8805 172nd St. NE Arlington, WA 98223 AM We Do Abatement job#2011692 Be assured that all activities as set forth in our proposal of 9/20/2016 were completed, and were conducted in accordance with all currently applicable regional, state, and federal environmental regulations. Air monitoring required by regulation was performed. Clearance air sampling verified that the air was clean by current regional, state, and national standards. Regulated waste was deposited in an approved facility. Asbestos liability insurance and a contractor's surety bond were in effect during our operations. Please feel free to contact us at (360) 657-0390 between 8:00am and 5:00pm Monday through Friday if you have any further questions or need additional documentation. 10/19i2016 Approved Transaction r pscIeanair.org Puget Sound':.co(4n,'air Agency Notification Case #: 201605135 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)), Fee Amount Paid $170.00 Credit Card Transaction # AQIFDDOIAE31 Transaction Date 10/19/16 Owner's Name Arlington Crossroads, LLC Phone (360) 659-0404 Project Street Address 8801 172nd St NE City Arlington Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 113 square feet Project Start Date 10/20/16 Completion Date 10/24/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Derno Contractor Arlington Crossroads, LLC Contractor Job # Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed, (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notifiyation WSW History Log Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. https://secure,pscleanair,org/Asbestos/Approved.aspx 1/1 10/19/2016 Approved Transaction pscleanair.org Puri t Sound`v ,w,A:.Agency Notification Case #: 201605136 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $315.00 Credit Card Transaction # AUIFEE075D9E Transaction Date 10/19/16 Owner's Name Arlington Crossroads, LLC Phone (360) 659-0404 Project Street Address 8821 172nd St NE City ARLINGTON Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 920 square feet Project Start Date 10/20/16 Completion Date 10/24/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Demo Contractor Arlington Crossroads, LLC Contractor Job # Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History Loci Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. littpsY/se(,ure.pscleanair.org/Asbestm/Apprc)ved.aspx 1/1 1 012 512 01 6 Notification Details psc lean air.org Puget Sound Clean Air Agency View Account History Create Amendment 201605136-3 Notification Details for Case #: 201605136-2 Fee Amount $20.00 Transaction Date 10/24/16 Owner's Name Arlington Crossroads, LLC Phone (360) 659-0404 Project Street Address 8821 172nd St NE City ARLINGTON Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 920 square feet Project Start Date 10/20/16 Completion Date 10/26/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Demo Contractor Arlington Crossroads, LLC Contractor Job # Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. Note: Notifications cannot be amended after the completion date. https://secure.pscleanair.org/Asbestos/LoginAccounUNotificationDetcil.aspx 1/1 10/19/2016 Approved Transaction pscIeanair.org Pu(JK Sound :.t->in A,, Agency Notification Case #: 201605137 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $315.00 Credit Card Transaction # ALIFDE9DCCAA Transaction Date 10/19/16 Owner's Name Arlington Crossroads, LLC Phone (360) 659-0404 Project Street Address 8805 172nd St NE City ARLINGTON Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 920 square feet Project Start Date 10/20/16 Completion Date 10/24/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Demo Contractor Arlington Crossroads, LLC Contractor Job # Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The prolect's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View Higo y Loa Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. https:/Isecure.pscleanair.org/Asbeslos/Approved.aspx 1/1 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;r� residential ❑ Commercial ❑ Industrial Project Address: 112,P) col N6 Parcel ID#: OCR Lot#: Subdivision: Valuation: 25 �� Building Area(Sq Ft) l"J` No.of floors: ' Number of Buildings: Owner: _�Tll m ` �4/� SO n Phone Number: Address: Q j 1 /� City: State: Zip Code: Contact Person:_ )6 e✓ 'T` /Ulm n/`z5:4 / JPhone Number: Vr2 5 —3 !�� 3— V 2 Z Cell Phone: E-mail: r [ / P_-�) O�nGZ! / , G a.,- i Address: 3g 7,21 54 4f �� City-Ae- State: Zip Code: Contractor: fig a, i v�� L� � jCG-G UG h Number: r/ Address: 11 City: —State: Zip Code: Contractors License Number: eft/ LT (Q -t� ✓ Expiration Scope of Work: hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above- described property will be in accordance with the laws, rules and regulations of the Stat of Washington. Applicants Signature Date A)tp_�/-),C'4 Print Applicants Name �OR STAFF USE ONLY Recelvea OCT 14 2016 Permit# ep ed gy Amount Received Receipt# Date Received (Asbesto-Test, Inc. 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040 www.asbestotest.com infonaasbestotest.com ASBESTOS SURVEY Coffee Stand only (a 8801 or 8805172nd St. NE,Arlington, WA 98223 Page 1 of 7 September 7, 2016 PAT2160904 Arlington Crossroads,LLC P.O.Box 5616 Everett,WA 98206 attn: James Thompson 360-659-0404 arlingtoncrossroadsllc(&gmail.com On August 30,2016,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 coffee stand only(a,8801 or 8805172°d St.NE, 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 wood frame on a post and beam foundation. The siding is wood. The roofing is composition. The composition roofing materials were sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood. There are multiple layers of vinyl and tile flooring in this structure. They are intermixed and throughout. Samples were taken per homogenous material. The Misc. mastic materials were sampled. INSULATION: There was no suspect ACM located. continue to page 2 S .yEPA , BB NAT-4 11-1 Page 2 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only A 8801 or 8805172"d St.NE,Arlington, WA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation did not appear to be the kind to be ACM. The power may have been"on"at the time of the inspection,thus sampling was not safe. Any suspect electrical wiring insulation or any suspect TSI(Thermal System Insulation)found in, around, or behind any located fuse or breaker boxes should be considered to be ACM (Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM: There is a wood stove in the coffee stand. There was no relating suspect ACM visually located. There was no additional heating source found. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY:None. #of structures included in survey: one coffee stand Requested by: James Thompson 19M W N.&.St q 315 Snore.WA 98119 _ ]06.185.3313 T �n This certifes 6.- Christopher L.Patterwn lu v h—My mn,gleted hours of refresher wining as an A,b—..Building Inspector mtryles v/1/rJl T5U Tidc li I10 CM 763(ARCM) Clus Date Nry I ]01 PA Y.a.W Cmifiweg1p95 figi�Nry l& 7]01 Christopher Patterson Inspector, certified A.H.E.R.A. Accred.#157289 EXP.May 18,2017 continue to page 3 _1 BBBC �3�• A T 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info@asbtestotest.com Page 3 of 7 September 7, 2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only Ca 8801 or 8805172nd St.NE,Arlington, WA 98223 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 PALM),must be professionally abated prior to demolition. SAMPLES#5,#7,#9,#10, #12,#16 ARE ASBESTOS CONTAINING MATERIALS ANALYSIS ID ASBESTOS//TYPEHOUANTITY OTHER MATERIAL NOTE:THERE ARE MULTIPLE LAYERS OF FLOOR TILE AND/OR VINYL FLOORING THAT OVERLAP EACH OTHER. ASSESSMENT AND QUANTIFICATION OF ACM FLOORING MATERIALS, FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL, SHOULD BE DETERMINED BY ON SITE EVALUATION. 1.0 sheet vinyl flooring NAD non-fibrous materials, surface entry&half way to counters in main area color:tan cellulose,fiberglass 2.0 mastic NAD adhesive beneath previous sample listed 3.0 sheet vinyl flooring NAD non-fibrous materials, 2nd layer entry&half way to counters foam (beneath previous sample listed)-color:yellowish brown 4.0 mastic NAD adhesive beneath previous sample listed 5.0 FLOOR TILE yes//chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM 3rd layer ENTRY& HALF WAY TO COUNTERS —BENEATH PREVIOUS SAMPLE LISTED-COLOR: LIGHT GRAYISH TAN 6.0 mastic NAD adhesive beneath previous sample listed 7.0 FLOOR TILE yes H chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM 4th layer- ENTRY& HALF WAY TO COUNTERS(BOTTOM LAYER) BENEATH PREVIOUS SAMPLE LISTED— COLOR: BROWN &TAN ROCK PATTERN 8.0 mastic NAD cellulose,adhesive beneath previous sample listed continue to page 4 13. BBB CD 11.1 T11 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 www.asbestotest.com;info(7,asbtestotest.com Page 4 of 7 September 7, 2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only Ca 8801 or 8805172nd St.NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPEHOUANTITY OTHER MATERIAL 9.0 SHEET VINYL FLOORING yes//chrysotile//38% non-fibrous materials, FRIABLE ACM cellulose WOOD STOVE AREA SURFACE—COLOR: BROWN &YELLOW NOTE:THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. THE MASTIC IS ALSO ACM AS IT CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING MATERIAL. 10.0 FLOOR TILE yes//chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM 2ND LAYER-WOOD STOVE AREA—BENEATH PREVIOUS SAMPLE—COLOR: CREAM 11.0 mastic NAD cellulose,adhesive beneath previous sample listed 12.0 FLOOR TILE yes H chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM ENTRY TO WOOD STOVE AREA BOTTOM LAYER—COLOR: BROWN 13.0 mastic NAD cellulose,adhesive beneath previous sample listed 14.0 the flooring NAD non-fibrous materials restroom surface layer—color: cream 15.0 mastic NAD adhesive beneath previous sample listed 16.0 SHEET VINYL FLOORING yes H chrysotile//38% non-fibrous materials, FRIABLE ACM cellulose RESTROOM 2ND(BOTTOM) LAYER—COLOR: LIGHT BROWN & DARK BROWN NOTE:THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. THE MASTIC IS ALSO ACM AS IT CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING MATERIAL.-ON PRESSBOARD QUANTITIES OF ASBESTOS CONTAINING MATERIAL(FOR ABATEMENT ASSESSMENT AND/OR PRICING FOR REMOVAL)SHOULD BE DETERMINED BY ON SITE EVALUATION. 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 continue to page 5 _1 BBB3.y- CD 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 www.asbestotest.com;info(7,asbtestotest.com Page 5 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only A 8801 or 8805172"d St.NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES 17.0 mastic NAD adhesive,cellulose holding laminate on countertops 18.0 masonry tile NAD non-fibrous materials around wood stove 19.0 mortar/mastic NAD adhesive,cellulose, holding previous sample listed non-fibrous materials 20.0 sheet vinyl flooring NAD non-fibrous materials, floor surface layer @ back half of coffee prep area near counters cellulose,fiberglass color: off white speck 21.0 mastic NAD adhesive beneath previous sample listed 22.0 the flooring NAD non-fibrous materials bottom layer @ entry to shop&entry half way to counter area—color: gray 23.0 mastic NAD adhesive beneath previous sample listed 24.0 floor leveling NAD non-fibrous materials, bottom layer @ entry to wood stove area fiberglass COMMON AREAS: 25.0 composition roofing NAD cellulose,tar, non-fibrous materials 26.0 vapor barrier NAD cellulose,tar beneath composition roofing 27.0 mastic NAD cellulose,adhesive holding composition roofing continue to page 6 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info@asbtestotest.com Page 6 of 7 September 7, 2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only Ca 8801 or 8805172nd St.NE,Arlington, WA 98223 � I r COFFEE STAND continue to page 7 1 aaaa BBB 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com:info@asbtestotest.com Page 7 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only A 8801 or 8805172"d St.NE,Arlington, WA 98223 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 byA.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 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);WAC296-61-07753 App.J **One percent is the USEPA regulatory limit for asbestos in bulk samples. Kev: 'FRIABLE"signifies"Easily Airborne" ACM signifies"Asbestos Containing Material" PALM signifies"Presumed Asbestos Containing Material" CAB signifies"Concrete Asbestos Board" < signifies"less than" T51 signifies'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.#158283 (Expires July 27, 2017) 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com:info@asbtestotest.com (Asbesto-Test, Inc. 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040 www.asbestotest.com infonaasbestotest.com ASBESTOS SURVEY double-wide mobile(beneath the canopy) & barn only A 8821172nd St. NE,Arlington. WA 98223 Page 1 of 7 September S, 2016 PAT2160810 Arlington Crossroads,LLC P.O.Box 5616 Everett,WA 98206 attn: James Thompson 360-659-0404 arlinl!toncrossroadsllc(&i!mail.com On August 30,2016,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 double-wide mobile(beneath the canopy) & barn only (a)8821172nd St. NE,Arlington,Snohomish County, Washington 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The mobile home is a double wide beneath a wood frame canopy. The mobile is wood frame with metal roofing and siding. There is"silver seal"roofing over the mobile. There is composition roofing over the canopy. These roofing materials were sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood and drywall. The drywall is not taped. The drywall was sampled. The vinyl and tile flooring materials were sampled per each located homogenous area. The textured paint was sampled from the hall&living room walls. The misc. mastic materials were sampled. INSULATION: The insulation was sampled. continue to page 2 S .yEPA BB IIAT-4 11-I Page 2 of 7 September 5, 2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy) & barn only (a,8821172nd St. NE,Arlington, WA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation is not of the kind 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. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: The barn is adjacent to the house. The structure is wood frame with a composition roof. The roofing materials were sampled. The insulation was also sampled. #of structures included in survey: one double wide manufactured home with canopy and adjacent barn. Requested by: James Thompson 19W W N.&—k.315 S.—WA%.19 !mil 2.6 US.3313 This c.mfies that—� Christopher L Pam— has satah—nly—pl—d hurt of nfrnh-Brain,as- Mbestas Building Inspeaar mnplea iit�h,TSCA Tide II t 40 CFR 763(AHERA) (:arti s i9 B�hwiaCv 'fi oupl0a Cub,pDire=i Ma ay:8.3016 K 2 ] Christopher Patterson Inspector, certified A.H.E.R.A. Accred.#157289 EXP.May 18, 2017 continue to page 3 B A93 n ® CE) 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;infonaasbtestotest.com Page 3 of 7 September 5, 2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy) & barn only (a,8821172nd St. NE,Arlington, WA 98223 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,AS LISTED QUANTITIES ARE NOT GUARANTEED AND ARE AN APPROXIMATION ONLY. SAMPLE#1 IS ASBESTOS CONTAINING MATERIAL ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 1.0 SILVER SEAL ROOFING yes//chrysotile//2% non-fibrous materials, SILVER SEAL MATERIAL IS FRIABLE ACM cellulose ON TOP OF MOBILE HOME METAL ROOF UNDER CANOPY THE MOBILE ROOFING AREA WAS NOT TOTALLY ACCESSIBLE BECAUSE OF THE CANOPY. QUANTITIES OF ASBESTOS CONTAINING MATERIAL(FOR ABATEMENT ASSESSMENT AND/OR PRICING FOR REMOVAL)SHOULD BE DETERMINED BY ON SITE EVALUATION. 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 2.0 sheet vinyl flooring NAD non-fibrous materials, plate vinyl throughout—color:tan pebble cellulose,fiberglass 3.0 mastic NAD adhesive beneath previous sample listed 4.0 the flooring NAD non-fibrous materials hall closetcolor: cream 5.0 mastic NAD adhesive beneath previous sample listed 6.0 sheet vinyl flooring NAD non-fibrous materials, master bathroom—color: off white/light gray cellulose,fiberglass 7.0 mastic NAD adhesive beneath previous sample listed continue to page 4 BBB ED ® CD 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 www.asbestotest.com;info(7,asbtestotest.com Page 4 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy) & barn only �a 8821172nd St. NE,Arlington. WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 8.0 sheet vinyl flooring NAD non-fibrous materials, hall bathroom—color: light brown cellulose,fiberglass 9.0 mastic NAD adhesive beneath previous sample listed 10.0 mastic NAD adhesive,cellulose bathroom holding laminate on countertop 11.0 sheet vinyl flooring NAD non-fibrous materials, kitchen—color:tan cellulose,fiberglass 12.0 mastic NAD adhesive beneath previous sample listed 13.0 sheet vinyl flooring NAD non-fibrous materials, kitchen 2nI layer—color: light brown cellulose,fiberglass 14.0 mastic NAD adhesive beneath previous sample listed 15.0 drywall NAD non-fibrous materials bathroom not taped cellulose,fiberglass, 16.0 drywall NAD non-fibrous materials hall sample 1-not taped cellulose,fiberglass, 17.0 drywall NAD non-fibrous materials hall sample 2—not taped cellulose,fiberglass, 18.0 textured paint material NAD paint,cellulose, living room&hallway sample I non-fibrous materials 18.1 textured paint material NAD paint,cellulose, living room&hallway sample 2 non-fibrous materials 18.2 textured paint material NAD paint,cellulose, living room&hallway sample 3 non-fibrous materials 19.0 mastic NAD adhesive,cellulose kitchen holding laminate on countertop 20.0 acoustic ceiling wall panels NAD cellulose 21.0 insulation NAD fiberglass,cellulose color: cream continue to page 5 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info@asbtestotest.com Page 5 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy) & barn only �a 8821172nd St. NE,Arlington. WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 22.0 mastic NAD adhesive,cellulose holding laminate on island 23.0 masonry tile NAD non-fibrous materials kitchen backsplash 24.0 mortar/mastic NAD adhesive,cellulose, holding previous sample listed non-fibrous materials 25.0 composition roofing NAD cellulose,tar, on canopy built up over mobile non-fibrous materials 26.0 vapor barrier NAD cellulose,tar beneath composition roofing BARN: 27.0 composition roofing NAD cellulose,tar, non-fibrous materials 28.0 vapor barrier NAD cellulose,tar beneath composition roofing 29.0 mastic NAD cellulose,adhesive holding composition roofing 30.0 insulation NAD fiberglass,cellulose color: cream continue to page 6 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info@asbtestotest.com Page 6 of 7 September 5, 2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy) & barn only (a 8821172nd St. NE,Arlington, WA 98223 %4P 64 BARN MOBILE HOME UNDER CANOPY continue to page 7 1 aaaa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com:info@asbtestotest.com Page 7 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy) & barn only �a 8821172nd St. NE*Arlington* WA 98223 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 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);WAC 296-62-07753 App.l **One percent is the USEPA regulatory limit for asbestos in bulk samples. Kev: "FRIABLE"signifies"Easily Airborne" ACM signifies"Asbestos Containing Material" PALM signifies"Presumed Asbestos Containing Material" CAB signifies"Concrete Asbestos Board" < signifies"less than" TSI signifies"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.#158283 (Expires July 27, 2017) 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com:info@asbtestotest.com (Asbesto-Test, Inc. 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040 www.asbestotest.com infonaasbestotest.com ASBESTOS SURVEY House& Garaze only (a 8801 and/or 8805172nd St.NE,Arlington, WA 98223 Page 1 of 7 September 7, 2016 PAT2160901 Arlington Crossroads,LLC P.O.Box 5616 Everett,WA 98206 attn: James Thompson 360-659-0404 arlingtoncrossroadsllc(&gmail.com On August 30,2016,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 house&garage only A,8801 and/or 8805172nd St.NE, Arlington,Snohomish County, Washington 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The house is one story wood frame on a post and beam foundation. The siding is wood. The siding vapor barrier materials were sampled. The roofing is composition. The composition roofing materials were also sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood and drywall. The drywall/taping materials were sampled. The misc. mastic materials were sampled. The linoleum and vinyl flooring materials were sampled. The acoustic ceiling tile were sampled. There is some polymer sealant on the floor in the hallway at the bathroom door. This material was also sampled. INSULATION: The insulation was sampled. continue to page 2 S .yEPA BB IIAT-4 11-I Page 2 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garage only A 8801 and/or 8805172nd St.NE,Arlington, WA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation did not appear to be the kind to be ACM. The power may have been"on"at the time of the inspection,thus sampling was not safe. Any suspect electrical wiring insulation or any suspect TSI(Thermal System Insulation)found in, around, or behind any located fuse or breaker boxes should be considered to be ACM (Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM: There is a wood stove in the house. There was no relating suspect ACM visually located. There was no additional heating source found. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: The garage is adjacent to the house. The garage has CAB (concrete asbestos board) siding. The siding materials were sampled. The vapor barrier was sampled from beneath the CAB siding. The CMU block and mortar materials were sampled from the interior wall. #of structures included in survey: one house& one garage Requested by: James Thompson I IN W..kvwn S.q 315 10619 WA 98119 (�j ]061g5.]])3 This ce fi.d- ..�.... Christopher L.patt—n has alafi.cnM co pl..d 1 boon W nhuh"oa ft.s a Asbestos Building Imk— conpet Mnn IN TSCA Thk II/10 CM 763(AHERA) bC 11 ISIlg9 Cba l& MI I%1016 p�hwCo.GtiAooglW3 fig-.Y.q May 2111] Christopher Patterson Inspector, certified A.H.E.R.A. Accred.#157289 EXP.May 18,2017 continue to page 3 1 a9aa BBB CD 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info@asbtestotest.com Page 3 of 7 September 7, 2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Gara,-e only (a 8801 and/or 8805172nd St. NE,Arlin,-ton, WA 98223 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,AS LISTED QUANTITIES ARE NOT GUARANTEED AND ARE AN APPROXIMATION ONLY. SAMPLE#1 IS ASBESTOS CONTAINING MATERIAL ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 1.0 CAB EXTERIOR SIDING yes//chrysotile// 18% non-fibrous materials Concrete Asbestos Board ACM FRIABLE FOR DEMOLITION PURPOSES ON GARAGE-APPROX. 500 SQ. FT. 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 2.0 sheet vinyl flooring NAD non-fibrous materials, house entry color: tan cellulose,fiberglass 3.0 mastic NAD adhesive beneath previous sample listed 4.0 linoleum flooring NAD non-fibrous materials, beneath previous sample listed cellulose,tar also throughout 1 bedroom&living room under carpet color: cream&rust 5.0 mastic/backing NAD cellulose,tar beneath previous sample listed 6.0 acoustic ceiling tile NAD cellulose,paint living room-stapled up 6.1 acoustic ceiling tile NAD cellulose,paint kitchen-stapled up 7.0 mastic NAD adhesive,cellulose kitchen holding laminate on countertop continue to page 4 13.=; BBB CD 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 www.asbestotest.com;info(7,asbtestotest.com Page 4 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garage only A 8801 and/or 8805172nd St.NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 8.0 sheet vinyl flooring NAD non-fibrous materials, bathroom floor—color:tan cellulose,fiberglass 9.0 flooring sealant NAD polymers, in hallway bathroom @ doorway-color: off white non-fibrous materials 10.0 sheet vinyl flooring NAD non-fibrous materials, back entry on wood—color: cream cellulose,fiberglass 11.0 mastic NAD adhesive beneath previous sample listed 12.0 drywall NAD non-fibrous materials bathroom sample I cellulose,fiberglass, paint,(gypsum) 12.1 drywall taping compounds NAD non-fibrous materials, SAMPLED PER AHERA GUIDELINE cellulose,fiberglass 13.0 drywall NAD non-fibrous materials bathroom sample 2 cellulose,fiberglass, paint,(gypsum) 13.1 drywall taping compounds NAD non-fibrous materials, SAMPLED PER AHERA GUIDELINE cellulose,fiberglass 14.0 drywall NAD non-fibrous materials bathroom sample 3 cellulose,fiberglass, paint,(gypsum) 14.1 drywall taping compounds NAD non-fibrous materials, SAMPLED PER AHERA GUIDELINE cellulose,fiberglass COMMON AREAS: 15.0 composition roofing NAD cellulose,tar, non-fibrous materials 16.0 vapor barrier NAD cellulose,tar beneath composition roofing 17.0 mastic NAD cellulose,adhesive holding composition roofing 18.0 vapor barrier NAD cellulose,tar material beneath siding exterior 19.0 insulation NAD cellulose blown cellulose—color:gray continue to page 5 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info@asbtestotest.com Page 5 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garage only Cad,8801 and/or 8805172nd St.NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL GARAGE: 20.0 composition roofing NAD cellulose,tar, non-fibrous materials 21.0 vapor barrier NAD cellulose,tar beneath composition roofing 22.0 mastic NAD cellulose,adhesive holding composition roofing 23.0 vapor barrier NAD cellulose,tar material beneath siding exterior 24.0 CMU block interior wall NAD non-fibrous materials 25.0 mortar NAD non-fibrous materials holding previous sample 1 25.1 mortar NAD non-fibrous materials holding previous sample 2 25.2 mortar NAD non-fibrous materials holding previous sample 3 continue to page 6 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com;info@asbtestotest.com Page 6 of 7 September 7, 2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Gara,-e only (a 8801 and/or 8805172nd St. NE,Arlin,-ton, WA 98223 li 'r 1 -+y ,rs j ♦ �3 HOUSE GARAGE continue to page 7 1 �aa BBB 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com info@asbtestotest.com t st.com Page 7 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garage only Cad,8801 and/or 8805172nd St.NE,Arlington, WA 98223 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 byA.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 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);WAC296-61-07753 App.J **One percent is the USEPA regulatory limit for asbestos in bulk samples. Kev: 'FRIABLE"signifies"Easily Airborne" ACM signifies"Asbestos Containing Material" PALM signifies"Presumed Asbestos Containing Material" CAB signifies"Concrete Asbestos Board" < signifies"less than" T51 signifies'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.#158283 (Expires July 27, 2017) 1 a9aa BBB 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 www.asbestotest.com:info@asbtestotest.com CITY OF ARLINGTON 1� % 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:8821 172nd Street NE Permit#: 1175 Parcel#:31052400300500 Valuation:25000.00 OWNER APPLICANT CONTRACTOR Name:THOMPSON JAMES R Name:Robert Nemnich Name:Mr.Haulking Recycling and Excavating Address:P O BOX 5616 Address:39729 SR 530 Address:39729 SR 530 NE City,State Zip:EVERETT,WA 98206 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:425-343-4241 Phone:425-343-4241 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: 5 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. IBCI 10/IRCI 10. 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 co -d Ciry of Arlin #3101. Signature Print Name Date Released By tc CONDITIONS Approved as submitted. 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 10/26/2016 Demolition Fee $100 00 10/26/2016 Demolition Fee $100.00 10/26/2016 Demolition Fee $100.00 10/26/2016 Demolition Fee $100.00 10/26/2016 Demolition Fee $100 00 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 Total Due: $522.50 Total Payment: $0 00 Balance Due: $522.50 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 CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT _ Address:8821 172nd Street NE Permit#•1175 Parcel#:31052400300500 Valuation:25000.00 OWNER APPLICANT CONTRACTOR Name:THOMPSON JAMES R Name:Robert Nemnich Name:Mr.Haulking Recycling and Excavating Address:P O BOX 5616 Address:39729 SR 530 Address:39729 SR 530 NE City,State Zip:EVERETT,WA 98206 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:425-343-4241 Phone:425-343-4241 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: 5 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. 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 codged City of Arlin #3101. Signature Print Name Date Released By tc CONDITIONS Approved as submitted. 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 10/26/2016 Demolition Fee $100.00 10/26/2016 Demolition Fee $100.00 10/26/2016 Demolition Fee $100 00 10/26/2016 Demolition Fee $100.00 10/26/2016 Demolition Fee $100.00 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 10/26/2016 State Building Code Surcharge Fee $4.50 Total Due: $522.50 Total Payment: $0 00 Balance Due: $522.50 CALL FOR INSPECTIONS III IILDI\G(3611)4113-3417 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 10/14/2016 Permit Number 1175 Project Name Thompson Property Applicant Name Robert Nemnich Applicant Address 39729 SR 530 City, State,Zip Arlington,WA 98223 Contact Robert Nemnich Phone 425-343-4241 Email mrhalking@gmail.com Permit Type Demolition Site Address 8821 172nd Street NE Valuation 25000.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Demo of 5 buildings Assigned To Kristin Foster Property Information Owner Information Parcel#:31052400300500 THOMPSON JAMES R THOMPSON JAMES R P O BOX 5616 8821 172ND ST NE EVERETT,WA 98206 Contractors Contractor Name Primary Phone Email Contractor License License# Contact Type Mr.Haulking Recycling and Robert 425-343- Labor and Excavating Nemnich 4241 mrhalking@gmaiLcom CONTRACTOR (Industries MRHAUHR9216J Review Date T e Description I Target Date Completed Date Assigned To Status 10/14/2016 Demolition 10/31/2016 Kevin Olander 11n Review Fees Fee Description Notes Amount Demolition Fee 322.10.00.Oq $100.00 Demolition Fed322.10.00.00 $100.0 Demolition Fe 322.10.00.0 $100.0 Demolition Fe 322.10.00.0( $100.0 Demolition Fe 322.10.00.0 $100.00 State Building Code Surcharge Feel 386.00.01.0 $4.50 State Building Code Surcharge Fe M 386.00.01.0 $4.5 State Building Code Surcharge Feel 386.00 01.00 $4.5 State Building Code Surcharge Feel 386.00 01.00 $4.50 State BuildingCode Surcharge Fe 386.00.01.00 $4.5 Total $522.5 Notes Date Note 10/14/2016 Waiting for abatement report.KF Uploaded Files Upload File , Date File Uploaded B 10/14/2016 4:16:29 PM 1175_Asbestos Survey Double Wide and Barn.p df Foster,Kristin 10/14/2016 4:16:29 PM 1 175_Asbestos Survey Coffee_Stand. df Foster,Kristin 10/14/2016 4:16:29 PM 11'5 Asbestos SLJrvey House and Gara e.pdf Foster,Kristin 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�q residential ❑ Commercial ❑ Industrial "U ��2N� e2C N� Project Address: Parcel ID#: 2s Lot#: Subdivision: Valuation: Building Area(Sq Ft) T No. of floors: I Number of Buildings: Owner: LT �M 161n 1,o Ser4 Phone Number: Address City:: State: Zip Code: Contact Person: f,-,o k-e'e / f3rr� /��s JPhone Number: '42 57 —3/ 2— Cell Phone: E-mail: 1 Address: 317,21 54 �f S�Q �� City— State: Zip Code: Contractor: t'Y7.-14a k',Z.,. ��, ,_,l` O'ZxCrG L-"'�hW Number: Address: 11 City: !� State: Zip Code: Contractors License Number: ')_Expiration: Scope of Work: )9d r--b I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above- described property will be in accordance with the laws, rules and regulations of the Stat of Washington. // //Applicants Signature Date oil Pti" '1 X)ewnniC'i Print Applicants Name OR STAFF USE ONLY Receivea 4� OCT 14 2016 Permit# ep ed y Amount Received Receipt# Date Received .". 1 1 1 ' . : , 1 • �� ' I _ � 1 r * _ 1 i Aa 1 _ ,.. _y_ 1 �11 ' 1 \' A � � 1 10/14/2016 MR HALILKING RECYCLING&EXCAVA r I'Search L&I :A %lu�li•;< Ilri�t SaPf-,iy&Health C;?ai ns &Insurance �1Vork{Aare Rights Tradr-s 8 Licensing Aft Washington State Department of " Labor & Industries MR HAULKING RECYCLING & EXCAVA Owner or tradesperson 39729 STATE ROUTE 530 NE ARLI Principals ARLINGTON,WA 98223 425-343-4241 NEMNICH, ROBERT,OWNER SNOHOMISH County Doing business as MR HAULKING RECYCLING&EXCAVA WA UBI No. Business type 602 384 849 Individual Governing persons JESSICA MARI E NEMNICH ROBERT H NEMNICH; License Verity 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. MRHAUHR921 BJ Effective—expiration 01/11/2008—01/11/2018 Bond American Contractors Indem CO $12,000.00 Bond account no. 100233154 Received by L&I Effective date 10/11/2013 10/11/2013 Expiration date Until Canceled Bond history Insurance Ohio Security Ins Co $1,000,000.00 Policy no. BKS53618145 Received by L&I Effective date 02/16/2016 03/27/2014 Expiration date 03/2712017 Insurance history Savinos No savings accounts during the previous 6 year period. Lawsuits against the bond or savings Help us Improve https://secure.Ini.wa.gov/verify/Detaii.aspx?UBI=602384849&LIC=M RHAU H R921 BJ&SAW= 112 i 10/14/2016 MR HAULKING RECYCLING&EXCAVA No lawsuits against the bond or savings acco,'^during the previous 6 year period. L&1 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 Infraction no. NBATI00876 Satisfied Issue date RCW/WAC 07/09/2012 18.27.200 RCW Violation city Violation amount Arlington $500.00 Type of violation CONSTRUCTION INFRACTION Description Advertising,offering to do work,submitting a bid or performing work outside a registered specialty.Company was installing/had installed plumbing waste and storm water collection piping when registered as a specialty contractor-for Excavation,Grading and Land Clearing. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. This company has multiple workers'comp accounts. Active accounts L&I Account ID Account is current. 064,692-01 Doing business as MR HAUL KING RECYCLING Estimated workers reported Quarter 2 of Year 2016"Less than 1 Workers" L&I account representative TO/KRISTI LINN(360)902-0620-Email:LINB235@lni.wa.gov Track this contractor A Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington Stale Dept,of Labor&Industries.Use of this site is subject to the laws of the state of Washington 1�ielp+ts improve https://secure.1 ni.wa.gov/verify/Detai I.aspx?U BI=602384849&LIC=M R HAU H R921 BJ&SAW= 212 L �� AMB We Do Abatement dba K&T We Do Dirt P.O. Box 3123 Arlington, WA 98223 360-657-0390 Office 360-657-0391 Fax Contractor's License#KTWEDTW917PA Asbestos Contractor Certification # 1522 CERTIFICATE OF COMPLETION For Asbestos Project 10/25/2016 On 10/25/2016 asbestos abatement services were completed at: 8805 172nd St. NE Arlington, WA 98223 AM We Do Abatement job#2011692 Be assured that all activities as set forth in our proposal of 9/20/2016 were completed, and were conducted in accordance with all currently applicable regional, state, and federal environmental regulations. Air monitoring required by regulation was performed. Clearance air sampling verified that the air was clean by current regional, state, and national standards. Regulated waste was deposited in an approved facility. Asbestos liability insurance and a contractor's surety bond were in effect during our operations. Please feel free to contact us at (360) 657-0390 between 8:00am and 5:00pm Monday through Friday if you have any further questions or need additional documentation. 1 10/19i2016 Approved Transaction pscIeanair.org P t Soond i: r Agency Notification Case #: 201605135 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)), Fee Amount Paid $170.00 Credit Card Transaction # AQlFDDOIAE31 Transaction Date 10/19/16 Owner's Narne Arlington Crossroads, LLC Phone (360) 659-0404 Project: Street Address 8801 172nd St NE City Arlington Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 113 square feet Project Start Date 10/20/16 Completion Date 10/24/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Demo Contractor Arlington Crossroads, LLC Contractor Job it Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: The type of project has changed. The project types are asbestos and demolition, • The quantity of friable asbestos to be removed meets a larger project category. The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Crtxa.t Another Notification View History Log Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. littiDs://secure.pseleanair.or.q/Asbestos/Approved,aspx 1/1 I� I - � I IOh9/2016 Approved Transaction pscIeanair,org Pi�s1 t Stsrsncd C=aar:A>r Agency Notification Case #: 201605136 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $315.00 Credit Card Transaction # AUIFEE075D9E Transaction Date 10/19/16 Owner's Name Arlington Crossroads, LLC Phone (360) 659-0404 Project Street Address 8821 172nd St NE City ARLINGTON Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 920 square feet Project Start Date 10/20/16 Completion Date 10/24/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Demo Contractor Arlington Crossroads, LLC Contractor Job it Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 1-his is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History t o Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. hlfps ilsecure.pscleanair.org/Asbestos/Approved.aspx 1/1 i 10/25/2016 Notification Details pscleanair.org Puget Sound Clcan Air Agency View Account History Create Amendment 201605136-3 Notification Details for Case #: 201605136-2 Fee Amount $20.00 Transaction Date 10/24/16 Owner's Name Arlington Crossroads, LLC Phone (360) 659-0404 Project Street Address 8821 172nd St NE City ARLINGTON Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 920 square feet Project Start Date 10/20/16 Completion Date 10/26/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Demo Contractor Arlington Crossroads, LLC Contractor Job # Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. Note: Notifications cannot be amended after the completion date. https://secure.pscleanair.org/Asbestos/LoginAccount/NotificationDetaii.aspx 1/1 i� 10/19/2016 Approved Transaction pscleanair,org Pugfet Sound :osln -r-Agency Notification Case #: 201605137 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site(Reg III, 4.03(a)(6)). Fee Amount Paid $315.00 Credit Card Transaction -# ALIFDE9DCCAA Transaction Date 10/19/16 Owner's Name Arlington Crossroads, LLC Phone (360) 659-0404 Project Street Address 8805 172nd St NE City ARLINGTON Zip 98223 Contact Person James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 EVERETT, WA 98206 This project includes asbestos removal. Project Size linear feet / 920 square feet Project Start Date 10/20/16 Completion Date 10/24/16 Asbestos will be removed by a licensed asbestos abatement contractor Contractor AMB We Do Abatement Contractor Job # Contact Kimberly Baar Phone (360) 657-0390 Mailing Address PO BOX 3123 Arlington, WA 98223 This project includes a demolition. Demolition Start Date 10/25/16 Completion Date 04/25/17 Demolition will be completed by a demolition contractor Demo Contractor Arlington Crossroads, LLC Contractor Job # Contact James Thompson Phone (360) 659-0404 Mailing Address PO BOX 5616 Everett, WA 98206 This is an emergency project. The emergency reason: The project must proceed to avoid imposing an unreasonable burden. 11) 1 certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History Loa Out If you have questions, contact us at asbestos@pscleanair.org or 206.689,4058. https:i/secure.psrleanair.org/Asbestos/Approved.aspx 1/I i i A-T Asbesto-Test, Inc. 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040 wunttaabtcetrur.+tconr.ur i r{"da hrstnlact cruu ASBESTOS SURVEY double-wide mobile(beneath the canopy) & barn only (a)8821172id St. NE.Arlington, WA 98223 Page 1 of 7 September 5,2016 PAT2160810 Arlington Crossroads,LLC P.O.Box 5616 Everett,WA 98206 attn: James Thompson 360-659-0404 a rlingtoncrossroadsllc(a)zmail.com On August 30,2016,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 lire double-wide mobile(beneath the canopy) & barn only k%8821 172d St. NE,Arlington,Snohomish County, Washington 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The mobile home is a double wide beneath a wood frame canopy. The mobile is wood frame with metal roofing and siding.There is"silver seal"roofing over the mobile.There is composition roofing over the canopy. These roofing materials were sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood and drywall.The drywall is not taped. The drywall was sampled.The vinyl and tile flooring materials were sampled per each located homogenous area.The textured paint was sampled from the hall&living room walls. The mist.mastic materials were sampled. INSULATION: The insulation was sampled. continue to page 2 8138 sew "Al i Page 2 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy)& barn only (&882117rd St.NE,Arlington, OVA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation is not of the kind 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. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: The barn is adjacent to the house.The structure is wood frame with a composition roof.The roofing materials were sampled.The insulation was also sampled. #of structures included in survey:one double wide manufactured home with canopy and adjacent barn. Requested by: James Thompson 19d � TM«1� Chrhtopher L.Put- , „w6,c6ey mn,la,d s l.ouR A,ba SWIdl,x Ip,p, , cari1plIo1 twtl6 TSC1 T4,11140 CM 761(ARCM) Qr D—Mry&1016 IO.IOn Christopher Patterson Inspector,certified A.H.E.R.A. Accred.#157289 EXP.May 18,2017 continue to page 3 CD 1429 Ave.D 9187,Snohomish,WA 98290 425-489-4040;f775-665-0420 n•u•66.nsbrevmestrnnl;In i((i�mhlLsn 11Lg.cfNn Page 3 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy)& barn only ��8821 172"d St NE,Arlington, WA 98223 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,AS LISTED QUANTITIES ARE NOT GUARANTEED AND ARE AN APPROXIMATION ONLY. SAMPLE#1 IS ASBESTOS CONTAINING MATERIAL ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 1.0 SILVER SEAL ROOFING yes//chrysotile H 2% non-fibrous materials, SILVER SEAL MATERIAL IS FRIABLE ACM cellulose ON TOP OF MOBILE HOME METAL ROOF UNDER CANOPY THE MOBILE ROOFING AREA WAS NOT TOTALLY ACCESSIBLE BECAUSE OF THE CANOPY. QUANTITIES OF ASBESTOS CONTAINING MATERIAL(FOR ABATEMENT ASSESSMENT AND/OR PRICING FOR REMOVAL)SHOULD BE DETERMINED BY ON SITE EVALUATION. 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 2.0 sheet vinyl flooring NAD non-fibrous materials, plate vinyl throughout—color:tan pebble cellulose,fiberglass 3.0 mastic NAD adhesive beneath previous sample listed 4.0 the flooring NAD non-fibrous materials hall closet—color:cream 5.0 mastic NAD adhesive beneath previous sample listed 6.0 sheet vinyl flooring NAD non-fibrous materials, master bathroom—color:off white/light gray cellulose,fiberglass 7.0 mastic NAD adhesive beneath previous sample listed continue to page 4 Bea a_•r 1429Ave.D.8187,Snohomish,WA 98290 425-489-4040;f775-665-0420 uv w oshrsirmw earn;ar n nhnhtrsrn�ev�.cow Page 4 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy)& barn only (&8821172'St. NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 8.0 sheet vinyl flooring NAD non-fibrous materials, hall bathroom—color:light brown cellulose,fiberglass 9.0 mastic NAD adhesive beneath previous sample listed 10.0 mastic NAD adhesive,cellulose bathroom holding laminate on countertop 11.0 sheet vinyl flooring NAD non-fibrous materials, kitchen—color:tan cellulose,fiberglass 12.0 mastic NAD adhesive beneath previous sample listed 13.0 sheet vinyl flooring NAD non-fibrous materials, kitchen 2n1 layer—color:light brown cellulose,fiberglass 14.0 mastic NAD adhesive beneath previous sample listed 15.0 drywall NAD non-fibrous materials bathroom not taped cellulose,fiberglass, 16.0 drywall NAD non-fibrous materials hall sample 1-not taped cellulose,fiberglass, 17.0 drywall NAD non-fibrous materials hall sample 2—not taped cellulose,fiberglass, 18.0 textured paint material NAD paint,cellulose, living room&hallway sample 1 non-fibrous materials 18.1 textured paint material NAD paint,cellulose, living room&hallway sample 2 non-fibrous materials 18.2 textured paint material NAD paint,cellulose, living room&hallway sample 3 non-fibrous materials 19.0 mastic NAD adhesive,cellulose kitchen holding laminate on countertop 20.0 acoustic ceiling wall panels NAD cellulose 21.0 insulation NAD fiberglass,cellulose color:cream continue to page 5 B BB AM8 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 n•u•utarhaslalasi.�Y�m:nrMCakcsbresio�rs�.rom Page 5 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy)& barn only (a),8821172id St.NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 22.0 mastic NAD adhesive,cellulose holding laminate on island 23.0 masonry tile NAD non-fibrous materials kitchen backsplash 24.0 mortar/mastic NAD adhesive,cellulose, holding previous sample listed non-fibrous materials 25.0 composition roofing NAD cellulose,tar, on canopy built up over mobile non-fibrous materials 26.0 vapor barrier NAD cellulose,tar beneath composition roofing BARN: 27.0 composition roofing NAD cellulose,tar, non-fibrous materials 28.0 vapor barrier NAD cellulose,tar beneath composition roofing 29.0 mastic NAD cellulose,adhesive holding composition roofing 30.0 insulation NAD fiberglass,cellulose color:cream continue to page 6 d_T 1429Ave.D. 9187,Snohomish,WA 98290 425-489-4040;f775-665-0420 uovuutshcrtolec(,con{;m o/u_t�.�GttlYloferl.annl Page 6 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-wide mobile(beneath the canopy)& barn only na 8821172nd St.NE,Arlington, WA 98223 L .ti \4 40 7V } M BARN MOBILE HOME UNDER CANOPY continue to page 7 40 r'- BBB 1429 Ave.D.9187,Snohomish,WA 98290 425-489-4040;f775-665-0420 trlru:usbrslotestcnrn;0 of�xh—clesta" Page 7 of 7 September 5,2016 PAT2160810 Asbesto-Test,Inc. 425-489-4040 double-►vide mobile(beneath the canopy)& barn only L 8821 172nd St. NE,Arlinivon, WA 98223 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,the 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 WWR93/116"(PLM);WAC 296-62-07753 App J —One percent is the USEPA regulatory limit for asbestos in bulk samples Kev: "FRIABLE'signifies"Easily Airborne" ACM signifies Asbestos Containing Material" PACM signifies"PresumedAsbestos Containing Material" CAB signifies Concrete Asbestos Board" < signifies"less than" TSI signifies"Thermal System Insulation" HVAC signifies"Heating Ventilating Air-Conditioning" HAD slgnfies'No Asbestos Detected` END OF REPORT ArLynn Hammond, Pres., BSc. Analytical Chemist,AIHA proficient Inspector,certified A.H.E.R.A. accred.#158283(Expires July 27,2017) BBB av�a ® CD . 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 um'sr,[ahoslol�sLcrMl;in hQarh[aslDlesf.cylH I I (:ADsbesto-Test, 1429 Ave.D.9187,Snohomish,WA 98290 425-489-4040 1191r115OV' S',P1P1tl[LCllnl;Nr it t s Slnl�iCl,Mm ASBESTOS SURVEY House& GaraPe one A 8801 and/or 8805172"d St.NE,Arlington, WA 98223 Page I of 7 September 7,2016 PAT2160901 Arlington Crossroads,LLC P.O.Box 5616 Everett,WA 98206 attn: James Thompson 360-659-0404 arlingtoncrossroadsllc(agmail.com On August 30,2016,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 house& garage only(a),8801 and/or 8805172nd St. NE, Arlin--ton,Snohomish County, Washineton 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The house is one story wood frame on a post and beam foundation.The siding is wood.The siding vapor barrier materials were sampled.The roofing is composition.The composition roofing materials were also sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood and drywall. The drywall/taping materials were sampled.The misc.mastic materials were sampled.The linoleum and vinyl flooring materials were sampled.The acoustic ceiling tile were sampled.There is some polymer sealant on the floor in the hallway at the bathroom door.This material was also sampled. INSULATION: The insulation was sampled. continue to page 2 oEPA, Bf3B 9 3------I NAT-46033 Page 2 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Carare only (a�8801 and/or 8805172"6t St. NE,Arlin—vton, 1*A 98223 ELECTRICAL SYSTEM: The electrical wiring insulation did not appear to be the kind to be ACM.The power may have been"on"at the time of the inspection,thus sampling was not safe. Any suspect electrical wiring insulation or any suspect TSI(Thermal System Insulation)found in, around, or behind any located fuse or breaker boxes should be considered to be ACM (Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM:There is a wood stove in the house. There was no relating suspect ACM visually located.There was no additional heating source found. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: The garage is adjacent to the house.The garage has CAB (concrete asbestos board)siding. The siding materials were sampled.The vapor barrier was sampled from beneath the CAB siding. The CMU block and mortar materials were sampled from the interior wall. #of structures included in survey:one house& one garage Requested by: James Thompson r.. wnseus n to66w IM — Chr,.mPh-L.P.tw— h.aua—.0 ,c—*.d 6 neon el rrbnher—�,a.. A.b—.8WWI.a Ilnp— canplw111wth TEA rN II 140 CAR 763(M40A) 6w.� 1?.—w'a]016 WrlaaTlr Christopher Patterson Inspector,certified A.H.E.R.A. Accred.#157289 EXP.May 18,2017 continue to page 3 40BSE CD 1429 Ave.D.4187,Snohomish, WA 98290 425-489-4040;f775-665-0420 P'II'14dtf slotey.con);mljo uq rrrhticfcNu.xl.c""! Page 3 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garage onh, 0)8801 and/or 8805172"`'St. NE,Arlington. WA 98223 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,AS LISTED QUANTITIES ARE NOT GUARANTEED AND ARE AN APPROXIMATION ONLY. SAMPLE#1 ISASBESTOS CONTAINING MATERIAL ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 1.0 CAB EXTERIOR SIDING yes//chrysotile//18% non-fibrous materials Concrete Asbestos Board ACM FRIABLE FOR DEMOLITION PURPOSES ON GARAGE-APPROX.500 SQ. FT. 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 2.0 sheet vinyl flooring NAD non-fibrous materials, house entry—color:tan cellulose,fiberglass 3.0 mastic NAD adhesive beneath previous sample listed 4.0 linoleum flooring NAD non-fibrous materials, beneath previous sample listed cellulose,tar also throughout 1 bedroom&living room under carpet—color:cream&rust 5.0 mastic/backing NAD cellulose,tar beneath previous sample listed 6.0 acoustic ceiling tile NAD cellulose,paint living room-stapled up 6.1 acoustic ceiling tile NAD cellulose,paint kitchen-stapled up 7.0 mastic NAD adhesive,cellulose kitchen holding laminate on countertop continue to page 4 FSC�Ci , e_r , 1429Ave.D.4187,Snohomish,WA 98290 425-489-4040;f775-665-0420 w1ru..asbest"Irmyarn;1tJi�(a�asbtaxlotesrenw Page 4 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Gara—ve only (a)8801 and/or 880517Td St.NE.Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 8.0 sheet vinyl flooring NAD non-fibrous materials, bathroom floor—color:tan cellulose,fiberglass 9.0 flooring sealant NAD polymers, in hallway bathroom @ doorway-color:off white non-fibrous materials 10.0 sheet vinyl flooring NAD non-fibrous materials, back entry on wood—color:cream cellulose,fiberglass 11.0 mastic NAD adhesive beneath previous sample listed 12.0 drywall NAD non-fibrous materials bathroom sample 1 cellulose,fiberglass, paint,(gypsum) 12.1 drywall taping compounds NAD non-fibrous materials, SAMPLED PER AHERA GUIDELINE cellulose,fiberglass 13.0 drywall NAD non-fibrous materials bathroom sample 2 cellulose,fiberglass, paint,(gypsum) 13.1 drywall taping compounds NAD non-fibrous materials, SAMPLED PER AHERA GUIDELINE cellulose,fiberglass 14.0 drywall NAD non-fibrous materials bathroom sample 3 cellulose,fiberglass, paint,(gypsum) 14.1 drywall taping compounds NAD non-fibrous materials, SAMPLED PER AHERA GUIDELINE cellulose,fiberglass COMMON AREAS: 15.0 composition roofing NAD cellulose,tar, non-fibrous materials 16.0 vapor barrier NAD cellulose,tar beneath composition roofing 17.0 mastic NAD cellulose,adhesive holding composition roofing 18.0 vapor barrier NAD cellulose,tar material beneath siding exterior 19.0 insulation NAD cellulose blown cellulose—color:gray continue to page 5 BBB a_r /429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 �rrrnxrshrsrorrcc cam;nr o rposhtr.curh•sr.tarn Page 5 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garage only (a' 8801 antUor 8805 172"`'St. NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE1/OUANTITY OTHER MATERIAL GARAGE: 20.0 composition roofing NAD cellulose,tar, non-fibrous materials 21.0 vapor barrier NAD cellulose,tar beneath composition roofing 22.0 mastic NAD cellulose,adhesive holding composition roofing 23.0 vapor barrier NAD cellulose,tar material beneath siding exterior 24.0 CMU block interior wall NAD non-fibrous materials 25.0 mortar NAD non-fibrous materials holding previous sample 1 25.1 mortar NAD non-fibrous materials holding previous sample 2 25.2 mortar NAD non-fibrous materials holding previous sample 3 continue to page 6 1 B ESEMW CD 1429 Ave.D.9187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 uw�r.rtrbcrineestcvm;m/o aLk{rhlex�orrstco� Page 6 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garare only (a)8801 and/or 8805172nd.St.NE,Arlington, WA 98223 `r T I I s� e HOUSE GARAGE continue to page 7 B � CD /429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 wiv Ot a.the alert,cam;11 fP*.0(alakit.4YJln Page 7 of 7 September 7,2016 PAT2160901 Asbesto-Test,Inc. 425-489-4040 House& Garaee only (a)8801 and/or 8805172nd St.NE.Arlington, {VA 9822.3 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 byA.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,the 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/Dr 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);WAC296-62-0 7 753 App.1 "One percent is the USEPA regulatory limit for asbestos in bulk samples. Kev: "FRIABLE'signifies"Easily Airborne" ACM signifies Asbestos Containing Material" PACM signifies Presumed Asbestos Containing Material" CAB signifies Concrete Asbestos Board" < signifies"less than" TSI signifies'thermal System Insulation" HVAC signifies Pleating 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.#158283(Expires July 27, 2017) B R EB ra9�a' A.T I429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 uvvv oAhesiolekt_coin;�nfn(a`u.�hnnn+tect<um I� I �. I I A-T Asbesto-Test, Inc. 1429Ave.D.9187,Snohomish,WA 98290 425-489-4040 rvpm•.aebrsfalKsl,egfn:rq&(@gehrsmlerf.cone ASBESTOS SURVEY Coffee Stand only 0)8801 or 8805172nd St.NE,Arlington, WA 98223 Page 1 of 7 September 7,2016 PAT2160904 Arlington Crossroads,LLC P.O.Box 5616 Everett,WA 98206 attn:James Thompson 360-659-0404 a rlinQtoncrossroadsllc(a)gm ail.com On August 30,2016,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 coffee stand only r 8801 or 8805172"d St NE, Arlington.Snohomish County. Washington 98223. This survey purpose is to identify asbestos containing materials,prior to demolition. NARRATIVE OF FINDLNIGS BASIC CONSTRUCTION: The structure is wood frame on a post and beam foundation.The siding is wood.The roofing is composition.The composition roofing materials were sampled. INTERIOR CONSTRUCTION, FINISHES, AN FLOORINGS: The interior construction is wood.There are multiple layers of vinyl and tile flooring in this structure. They are intermixed and throughout. Samples were taken per homogenous material.The Misc.mastic materials were sampled. INSULATION: There was no suspect ACM located. continue to page 2 T BBB Page 2 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Co1Tee Stand Only (u 8801 or 8805 172""S!. NE,Arlington, UA 98223 ELECTRICAL SYSTEM: The electrical wiring insulation did not appear to be the kind to be ACM. The power may have been"on"at the time of the inspection,thus sampling was not safe. Any suspect electrical wiring insulation or any suspect TSI(Thermal System Insulation)found in, around, or behind any located fuse or breaker boxes should be considered to be ACM (Asbestos Containing Material), unless determined otherwise by laboratory analysis. HEATING AND VENTILATION SYSTEM: There is a wood stove in the coffee stand. There was no relating suspect ACM visually located. There was no additional heating source found. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY:None. #of structures included in survey:one coffee stand Requested by: James Thompson W 9B WAI19 IM Q Iaf)III Thle cenilin llnu Chrihmpher L.Pam— AA-BWIdl."'�Pp r conplrn ai TSCA Tldc h I�CM 76)(AHEM) M Oer My Illhle n.r...ww.oe+ l.a�ra,mm� Christopher Patterson Inspector,certified A.H.E.R.A. Accred.#157289 EXP.May 18,2017 continue to page 3 BBB CZ) 1429 Ave.D.9187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 II'119r..ashc tmar.[w!!t;aifof&gs1no1a1e.y4Cmn Page 3 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Co/lee Stand Only (a)8801 or 8805172od St.NE,Arlington, WA 98223 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. SAMPLES#5.#7.dt9#10, #12,#16 AREASBESTOS CONTAINING MATERIALS ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL NOTE:THERE ARE MULTIPLE LAYERS OF FLOOR TILE AND/OR VINYL FLOORING THAT OVERLAP EACH OTHER. ASSESSMENT AND QUANTIFICATION OF ACM FLOORING MATERIALS, FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE DETERMINED BY ON SITE EVALUATION 1.0 sheet vinyl flooring NAD non-fibrous materials, surface entry&half way to counters—in main area—color:tan cellulose,fiberglass 2.0 mastic NAD adhesive beneath previous sample listed 3.0 sheet vinyl flooring NAD non-fibrous materials, 2,d layer entry&half way to counters foam —(beneath previous sample listed)-color:yellowish brown 4.0 mastic NAD adhesive beneath previous sample listed 5.0 FLOOR TILE yes H chrysotile H 2% non-fibrous materials TILE IS NON-FRIABLE ACM V layer ENTRY&HALF WAY TO COUNTERS —BENEATH PREVIOUS SAMPLE LISTED-COLOR:LIGHT GRAYISH TAN 6.0 mastic NAD adhesive beneath previous sample listed 7.0 FLOOR TILE yes H chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM 41h layer-ENTRY& HALF WAY TO COUNTERS(BOTTOM LAYER) BENEATH PREVIOUS SAMPLE LISTED— COLOR:BROWN &TAN ROCK PATTERN 8.0 mastic NAD cellulose,adhesive beneath previous sample listed continue to page 4 141*0 BBB ® CT uo.... 1429Ave.D.#187,Snohomish, WA 98290 425-489-4040;f 775-665-0420 e—triv hrsrarestcom;it ogZnsbfestdiertcm» Page 4 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 CoM,e Stand Only (a.8801 or 8805 172""St.NE,Arlington, WA 98223 ANALYSIS ID ASBESTOS//TYPE//OUANTITY OTHER MATERIAL 9.0 SHEET VINYL FLOORING yes//chrysotile//38% non-fibrous materials, FRIABLE ACM cellulose WOOD STOVE AREA SURFACE—COLOR:BROWN&YELLOW NOTE:THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. THE MASTIC IS ALSO ACM AS IT CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING MATERIAL. 10.0 FLOOR TILE yes H chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM 2ND LAYER-WOOD STOVE AREA—BENEATH PREVIOUS SAMPLE—COLOR:CREAM 11.0 mastic NAD cellulose,adhesive beneath previous sample listed 12.0 FLOOR TILE yes H chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM ENTRY TO WOOD STOVE AREA BOTTOM LAYER—COLOR:BROWN 13.0 mastic NAD cellulose,adhesive beneath previous sample listed 14.0 the flooring NAD non-fibrous materials restroom surface layer—color:cream 15.0 mastic NAD adhesive beneath previous sample listed 16.0 SHEET VINYL FLOORING yes//chrysotile//38% non-fibrous materials, FRIABLE ACM cellulose RESTROOM 2ND(BOTTOM)LAYER—COLOR:LIGHT BROWN&DARK BROWN NOTE:THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. THE MASTIC IS ALSO ACM AS IT CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING MATERIAL.-ON PRESSBOARD QUANTITIES OF ASBESTOS CONTAINING MATERIAL(FOR ABATEMENT ASSESSMENT AND/OR PRICING FOR REMOVAL)SHOULD BE DETERMINED BY ON SITE EVALUATION. 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 continue to page 5 EtBE: CD 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 11'II.11'.(tihP.Ml0/CfLCBN1;Nt hfCSfMpd'l.CWN Page S of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only (a),8801 or 8805172"d St.NE.Arlin ton. WA 98223 ANALYSIS ID ASBESTOSHTYPE//QUANTITY OTHER MATERIAL THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES 17.0 mastic NAD adhesive,cellulose holding laminate on countertops 18.0 masonry tile NAD non-fibrous materials around wood stove 19.0 mortar/mastic NAD adhesive,cellulose, holding previous sample listed non-fibrous materials 20.0 sheet vinyl flooring NAD non-fibrous materials, floor surface layer @ back half of coffee prep area near counters cellulose,fiberglass color:off white speck 21.0 mastic NAD adhesive beneath previous sample listed 22.0 the flooring NAD non-fibrous materials bottom layer @ entry to shop&entry half way to counter area—color:gray 23.0 mastic NAD adhesive beneath previous sample listed 24.0 floor leveling NAD non-fibrous materials, bottom layer @ entry to wood stove area fiberglass COMMON AREAS: 25.0 composition roofing NAD cellulose,tar, non-fibrous materials 26.0 vapor barrier NAD cellulose,tar beneath composition roofing 27.0 mastic NAD cellulose,adhesive holding composition roofing continue to page 6 BBB I 'g 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 nmx•.ashdst"rtscrgm;n�r� achierroirrs.cnnr Page 6 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425 489-4040 Coffee Stand Only (a 8801 or 8805 172""SG NE,Arlinkim, PPA 98223 1 1 tiy� 1 77- nfim .a . r la COFFEE STAND continue to page 7 1 BBB TAW 1429Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 �rvrseasbrsrorrvr.cwn;uru{a�nrbrestufustcaxr Page 7 of 7 September 7,2016 PAT2160904 Asbesto-Test,Inc. 425-489-4040 Coffee Stand Only k 8801 or 8805172"`'St.NE,Arlington, WA 98223 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,the 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"IPLM);WAC 29 6-62-0 7 75 3 App.! **One percent is the USEPA regulatory limit for asbestos in bulk samples. Nev: FRIABLE'signifies"Easily Airborne" ACM signifies Asbestos Containing Material' PACM signifies"Presumed Asbestos Containing Material" CAB signifies Concrete Asbestos Board" < signifies"less than" TSI signifies"Thermal System Insulation" HVAC signifies Pleating 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.#158283(Expires July 27,2017) �s is r� nos CD 1429Ave.D.0187,Snohomish,WA 98290 425-489-4040;f775-665-0420 u*lrlv..arhrxlote_q.rrmt;{n ii ce arh�rrtutrse cvmt i i I Permit#: 1175 Permit Date: 10/14/16 Permit Type: DEMOLITION Project Nam e Thom fson Property Applicant Nam a Robert Nem rich Applicant Address: 39729 SR 530 Applicant, City, State, Zip: Arlington,WA98223 Contact: Robert Nem rich Phone: 425-343-4241 Em al: m ihalking@gm al.com Scope of Work: Dem oof 5 buildings Valuation: 25000.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 10/26/2016 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address L egal Description O wner Nam e Cvner Phone Zoning 31052400300500 8 821 172ND ST NE THOMPSON 113 3 Single Fam iy JAM ES R Residences Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# Mr Haulking Recycling Robert Nem rich 4 25-343-4241 39729 SR 530 NE CONSTRUCTION UBI 602 384 849 and Excavating CONTRACTOR Mr Haulking Recycling Robert Nem. CONSTRUCTION Labor and MRHAUHR921BJ and Excavating rich 4 25-343-4241 39729 SR 530 NE CONTRACTOR Industries Plan Reviews Date R eview Type D escription A ssigned To R eview Status 10/14/2016 D EMOLITION B UILDING Fees Fee D escription N otes A m cunt Dem dition $100.00 Dem dition $100.00 Dem dition $100.00 Dem dition $100.00 Dem dition $100.00 State Surcharge- 1 st DU R esidential- 1 st Unit $4.50 State Surcharge- 1st DU R esidential-1st Unit $4.50 State Surcharge- 1 st DU R esidential- 1 st Unit $4.50 State Surcharge- 1st DU R esidential-1st Unit $4.50 State Surcharge- 1 st DU R esidential- 1 st Unit $4.50 Total $522.50 Attached Letters Date Letter D escription 10/26/2016 Building Perm i Paym sits Date Paid By D escription P aym dit Type A ccepted By A m amt 10/26/2016 Robert Nem rich 6 2032431 c c $522.50 O itstanding Balance $0.00 Notes Date Note C reated By: 10/26/2016 Received abatem mt reports.KF K ristin Foster 10/14/2016 Waiting for abatem mt report.KF K ristin Foster Uploaded Files Date File Nam e 10/26/2016 1914942-1175 Issued Perm i.pdf 10/26/2016 1913736-1175 Application.pdf 10/26/2016 1913734-1175 Abatem ait Reports.pdf 10/14/2016 1893975-1175 Asbestos Survey df House and Garage.p 10/14/2016 1893976-1175 Asbestos Survey Coffee Stand.pdf 10/14/2016 1893977-1175 Asbestos Survey Double Wide and Barn.pdf