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HomeMy WebLinkAbout135 S FRENCH AVE_03554_2026 INSPECTION REPORT ¢*,1N G" Permit No.: Lot #: Address: 1 ,115 -5 I<9-t-v CIH Z Contractor: 6 s o jN G0 Owner: ✓�-S o Date: //- 7 - 03 *APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION -24 hour notice required. 5599 Inspector: Date: ___C11 4 TYPE OF INSPECTION REQUESTED( ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: C ITV OF' A FP.L I NCCTON C O N S T R U C T I O N P E R M I T PE RM I T NO_ a 03-5544 Owner: ARLINGTON SCHOOL DIST 315 N FRENCH AV ARLINGTON 98223 Value of Work: $29, 000. 00 Tax ID: 31051100102000 Phone: 360-435-2156 Describe Mork: DEMO PORTABLE Proposed Use: PORTABLE CLASSROOM Legal Description: Job Address: 135 S FRENCH AVE Contractor's Ma)i.e Type Address License# WM DICKSON CO GEN 3315 SOUTH PINE STREET WMDICC*108J7 TOTALS Fee Permi00. 00 State tfee e $1$4. 50 Qm �,����AVE SIGNATUREC TOTAL FEE. . . . . . . . . . . . . . . . . $164. 50 I HEREBY CERTIFY THAT READ AND AMINED THIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $6. 00 KNO I E SAME TO BE TRUE AND COR- REC A L PR OVISIO G OF LAWS AND TOTAL DUE. . . . . . . . . . . . . . . . . $104. 56 OR NA CES GOVERN G T IS TYPE OF WO WILL E CO P IED ITH WHETHER SP I IED R R DATE RECEIPT # � BUY NG F' ICIAL �� - ARLINGTON VENDOR COPY BI AND M0 ' SCHOOL DISTRI T NO. 16 IN LL VOICE TO I ME315 N. FRENCH • ARLINGTON, WA 98223 r (360) 435-2156 . FAX (360) 435-0752 Cap Fund Purchase Order No. 70352;1 Date : 08/14/2003 Page : 1 of 1 P.O. No . 70352 Vendor No. 3360 PLEASE READ ALL INSTRUCTIONS PRIOR TO SENDING ORDER CITY OF ARLINGTON I. PURCHASE ORDER NUMBER MUST APPEAR ON ALL 238 N OLYMPIC INVOICES, SHIPPING DOCUMENTS AND PACKAGES. ARLINGTON WA 98223 2. PACKING SLIP MUST BE INCLUDED WITH EACH SHIPMENT 3. SHIPPING CHARGES SHALL BE PREPAID AND CHARGED ON Ship To : ASD#16 SUPT. OFFICE INVOICE. 1000 315 N. FRENCH 4. INVOICE PARTIAL AND COMPETE SHIPMENTS IMMEDIATELY, ARLINGTON WA 98223 Mark For : WARREN CLEARLY MARK IF PARTIAL ORDER. Purchase Order No . 70352 5. SHIP VIA U.P.S. OR CHEAPEST MEANS. Quant Unto Unit Total Ite }.I Ordere Me Description -- - Cost- _--------Cost - - - - - -- --- --------------- ------ - ---- --------- -- 1 * 1 DEMOLITION PERMIT FOR 1 , 254 . 5000 1 , 254 . 50 PORTABLES LOCATED AT OLD HIGH SCHOOL SITE . THIS IS AN APPROXIMATE AMOUNT . REC IVE� 413G 4 Z003 CITY OF FtLINGTON NOTICE TO VENDOR: AS PART OF THIS CONTRACT OF SALE BETWEEN * - Tax not Computed on Item ARLINGTON SCHOOL DISTRICT NO.16 AND THE VENDOR;IT IS SPECIFICALLY page Sub-Tot 1254 . 50 AGREED THAT PAYMENT FOR ALL GOODS AND SERVICES SATISFACTORILY PO Sub-Total 1254 . 50 RENDERED, SHALL BE MAILED TO THE VENDOR OR MADE AVAILABLE TO Add' l . 00 THE VENDOR WITHIN SIXTY (60) DAYS OF RECEIPT OF GOODS AND SERV- ICES OR A PROPERLY COMPLETED INVOICE, WHICHEVER IS LATER. PO Total 1254 . 0 THE ARLINGTON SCHOOL DISTRICT REQUIRES MSDS (MATERIAL SAFETY DATA SHEETS) BE INCLUDED WITH ALL APPLICABLE ITEMS PURCHASED. Item No Account Code Encumbered 1 28-19-22-709-1-28- 1254 . 50 11 .61)rZJ4d4e)_ ISC L APOVAL AN AFFIRMATIVE ACTION EQUAL OPPORTUNITY EMPLOYER DATE I CITY OF AR L I N G TO N Invoice No. 03-DEMO 238 N. Olympic Ave. %mawaW Arlington, WA 98223 360-403-3431 fax 360-435-3906 INVOICE — Customer Name ASD#16 _ _ Date 8/18/2003 Address 315 N Frenc 315 N French Order No. City Arlington State WA ZIP 98223 PO 70352 Phone (360)435-3176 FOB QTY Description Item TOTAL 1 Demo permit Ws 03-5545--03-5555 $1,254.50 $1,254.50 PO Number 70352 Payment Details SubTotal $1,254.50 O Cash O Check O Credit Card TOTAL $1,264.50 Name CC# Please send payment Attention Expires Building Department DATE IA510 No. 231516 RECEIVED FROM Ast •t T DOLLARS U0FOR RENT Q FOR ACCOUNT QCASH wFRO TO PAYMENT CHECK MONEY BAL. DUE J7��q QORDER BY 1182 Arlington School District No. 16 CAP FUND REMITTANCE ADVICE PAYEE CITY OF ARLINGTON VEND NO 003360 DATE 08/22/03 VCHR NO 319 WARR NO 819 INVOICE NO DATE PO NET AMOUNT 'I D 4 3� 5 �---�0��52 �\ 0 D OT A.L 5 4. 0 7r~� D D PLEASE DETACH AT THIS PERFORATION BEFORE DEPOSITING CAP FUND Arlington School District No. 16 Arlington, Washington 98223 19-2 1250WARRANT NO. 819 PERCENT INTEREST PER ANNUM ALLOWED HEREON FROM DATE REGISTERED UNTIL CALLED. WARRANT NO. 819 DATE08/22/2003 447667 rONE THOUSAND TWO HUNDRED FIFTY,-.;FOUR AND 50/100 DOLLARS PAY TO THE ' ORDER OF: #r4 `1 s 2 54.5 0 CITY OF A R L I N GT O W VOID SIX MONTHS FROM DATE OF ISSUE 238 N OLYMPIC ARLINGTON WA 98223 pg DANP CASH TO THE TREASURER OF WARRANT ✓ '`- SNOHOMISH COUNTY ��//�/]�. EA$�Q EVERETT,WASHINGTON BOAT. SECRE RY 1190044766711' i: L250000241: 9390 238110 ASBESTOS HAZARD CLOSEOUT SUBMITTALS FOR ARLINGTON HIGH SCHOOL ARLINGTON, WA RECEIVED SEP 2 9 2003 CITY 0FARLINGTON WM. DICKSON CO. 3315 SOUTH PINE STREET TACOMA, WA. 98409 PHONE (253) 472-4489 FAX (253) 472-4521 TABLE OF CONTENTS 1. DAILY REPORTS 2. EMPLOYEE CERTIFICATIONS 3. AIR MONITORING 4. WASTE MANIFESTS 5. NOTICES OF INTENT DAILY REPORT - PAGE 2 PROJECT - /) r WvL.C; fa/- k ,­,` 1-, S C kCC, 1 DATE - 9-I �- 0 3 (0 06 '5� :, f S r INJURY - (LIST ANY INJURY THAT OCCURRED, OR ENTER "NONE") NAME SOCIAL SECURITY NUMBER TYPE OF INJURY CLAIMS OR CHANGES - (Describe what, where, which, why, who, & how; refer to specifications and contract drawings if applicable) PROGRESS REPORT - d` � he ch O vci f re �uvc; 1 Cow (0ce•� � cc� � �.o C � ea1�ti� e.� ,nonce 0L e 4- a✓l.. C `-e.v-� C i,e ct!-s.i h C 1L r Ln/h V-\, +"" PG�,; uSteiS fC 5e zc s wFle- IS C wr•�4- o e „ P `"Pc 1 b b � --F CD f"'� o O CD P. Co cp CD a � � dd CD c � O y � O n � � a O Z O s' � n � s � n c' P. CD a. b N DAILY REPORT - PAGE 2 PROJECT- (1�Lf f�i�,l� DATE - "�c� 6r 3 INJURY - (LIST ANY INJURY THAT OCCURRED, OR ENTER "NONE") NAME ISOCIAL SECURITY"NUMBER TYPE OF INJURY CLAIMS OR CHANGES - (Describe what, where, which, why, who, & how; refer to specifications and contract drawings if applicable) PROGRESS REPORT - /le,d � e'u e f� G r✓� t. i"� I , 7��...J f[, 1il/ '�r 4�G�e� j r l' L ' �-, 5 1— :� / f�^, C i'r�j • .�r t.. �3. �Lr j>`,L� r>Ca ' �!'(" �� 1�i �27,, %iit� .�;`/•4 es /_j u A C'1/;� .$ C�L'�c=y �•Z(1 t4-400,� n G, h FOR THE CONSTRUCTION INDUSTRY © SAFETY MEETING OUTLINES PO Box 700, Frankfort, IL 60423 815-464-0200 Vol. 26 No. 33 Week of 8/18/2003 Company Name L2' � A4 l-Z G'�oI> Name ' ' / ,'✓ Date `�r ' INSPECTIONS AND WALKDOWNS Inspections and walkdowns play an important part in en- When inspectors come to a jobsite, they will also be on th suring the safety of the construction process. The local lookout for unsafe acts and practices. Are your work prac building inspector can perform an inspection to make sure tices up to snuff? They may compliment you for doing . the project is being built to code. Quality control inspec- good job or challenge you for not following safe practices tions take place to make sure work is being completed ac- The inspector might also ask to look at the tools, cords cording to plans and specifications. Safety inspections and and equipment you are using. Always be cooperative, hon walkdowns can be conducted by project management, an est, and polite. Follow any suggestions given by the in owner, or by walkdown teams consisting of supervisors, spector to correct the hazards found during the inspection foremen, and craft workers. OSHA inspects workplaces for You may have to take immediate corrective measures t;- violations of safety standards. The process of inspection fix problems identified during the inspection. Don't argu( provides an opportunity to evaluate and identify safe prac- with the inspector. If you have questions or are unsur( tices, effective processes, and areas that need improve- about any part of the safety inspection, ask the inspecto ment. There are many different ways to complete these or talk to your supervisor once the inspection is completed inspections. The purpose of safety inspections is to identify and re Inspectors may check on personal protective equipment, move any hazards that pose a threat to you and your co fall protection, electrical and environmental compliance, workers. If safety is a part of your daily routine and you hazardous chemicals, trenching and excavation, ladders, have participated in the required safety training, you scaffolding, confined spaces, lockout/tagout procedures, should have nothing to worry about when an inspection oc• cranes, heavy equipment, signs, signals, barricades, per- curs. If the person conducting the inspection asks yot. mits, steel erection, GFCls, pre-task plans, and posting of questions about safety procedures or emergency plans emergency phone numbers. Would an inspector find prob- you'll be able to impress him with your knowledge and un- lems in your work area? derstanding. You should think about safety every day, whether there's an inspection or not. SAFETY REMINDER Safety is expected — even when your jobsite its not being inspected! Special Topics For Your Project 4/�.^(.'�." U'� Employee Safety Recommendations Reviewed MSDS# Subject Meeting Attended By ,�� -� Supervisor's Signature DAILY REPORT - PAGE 2 PROJECT — DATE - "� INJURY- (LIST ANY INJURY THAT OCCURRED, OR ENTER "NONE") NAME ISOCIAL SECURITY'NUMBER ITYPE OF INJURY CLAIMS OR CHANGES - (Describe what, where, which, why, who, & how; refer to specifications and contract drawings if applicable) PROGRESS REPORT - �,i G t� �/ /�.,4✓ i �, � S�,c?� �'i:✓•S�e cl 1 v�a �� s "d°,�°i r�s �O � c' .S U e-, u G.-✓J IP4i11;5 �e j cb i ] q 1 cy J' OF W c,14 (—,A-- fie- Gri✓d t^, v P'd' W, + l 'c_ fie- �* f- 7r`c 2 c,-� .. l� L �'l �C-•• Phi/'� L,� ( r c: .�_,r-l�� �f�✓� Pam% r� �.�� DAILY REPORT - PAGE 2 PROJECT ( VAL, ��J L� DATE - '2 INJURY- (LIST ANY INJURY THAT OCCURRED, OR ENTER "NONE.") NAME ISOCIAL SECURITY-NUMBER ITYPE OF INJURY CLAIMS OR CHANGES - (Describe what, where, which,why, who, & how; refer to specifications and contract drawings if applicable) PROGRESS REPORT - $r✓G �� ej l j"l n��/ U r G�7 � �J�-✓�l� �/ r` er- �✓r t DAILY REPORT -.PAGE 2 I /PROJECT , , Tl , , a DATE - INJURY ��- �Z--➢ � ? INJURY - (LIST ANY INJURY THAT OCCURRED, OR ENTER "NONE") NAME ISOCIAL SECURITY-NUMBER TYPE OF INJURY CLAIMS OR CHANGES - (Describe what, where, which, why, who, & how; refer to specifications and contract drawings if applicable). PROGRESS REPORT - WvA Ic,or zf t 1 t 't j G c Vl e. li✓G.S ���. ,�)�/ ! �Io ✓"i'��L�/-�I �%`In G�i /40, �� '.���ft ,✓ r r f 'xj Lc,rJi. l C� Le_ CERTIFIED AS PROVIDED BY LAW AS ASBESTOS SUPERVISOR CERTIFICATE NUMBER: 2003019650A EXPIRATION DATE: 10/22/2003 ay DENATALE, JESS A 3102S8THST TACOMA,,WA 98405 Issued by 1) PAWrM ANDENDUSTIUES encr6 I-P/ �NAMEccupat(orial Medical f ADDRESS .-� r G� Id , � � + � ZIP �$�(u s OClinic of Tacoma S.S.# S 5- �`�- qy�t�' BIRTHDATE q- GO 1 4703 Pacific Hwy.E.•Tacoma,WA 98424 DATE OCT ZOO2 pHON NUMB 3 d °r° ( (253)922-9570•FAX 922.9587 n email: omctacoma@aol.com NAME OF COMPANY �— PRE-PLACEMENT REPORT RESPIRATORY COMPLIANCE LETTER MAL FINDINGS: ❑PENDING X-RAYAND/OR LAB RESULTS (For Respiratory Compliance Exam) VNo significant findings which require job modification. TO WHOM IT MAY CONCERN: ❑ Job modification recommended: This letter is in accordance with Federal(CFR 29, 1910.134 ❑ Job modification mandatory: (10))and WA State(296-62-07109 WAC) regulations which states that employees should not be assigned jobs which ❑ Bending/Stooping/Twisting may require the use of a respirator unless they have been medically cleared to use such equipment. ❑ Lifting The medical status of the employee named above has been ❑ Standing/Walking evaluated and the individual ❑ Sitting is qualified to use any and all types of respirators. ❑ Kneeling _ ❑ No work unprotected heights, with or about dangerous ❑ is qualified to use only these specified types of respirators: machinery, operation of commercial motor vehicle. - - - - — ❑ Other limitations ❑ is NOT qualified to use a respirator. ❑ requires a respirator which allows for wearing of corrective Comments: lenses. M.D. M.D. TYPE OF EXAM: FORMA ABNORMAL(EXPLANATION&RECOMMENDATIONS) �OT ❑ HISTORY AND PHYSICAL ESCLASS ❑ RESPIRATORY COMPLIANCE ❑ BACK ASSESSMENT ❑ LAB: AME ❑ CBC ❑ ❑ SMA ❑ fi15b ' ❑ OOD LEAD ❑ �.} REPORTEr ZPP ❑ RPR OCT 2 8 200 ❑ BLOOD ALCOHOL ❑ --",5� ❑ NIDA DS(TYPE ) ❑ TO s-B ' •--- ❑ NON NIDA DS(TYPE )❑ ❑ CHOLINESTERASES ❑ ❑ OTHER ❑ ❑ OTHER ❑ , S: 1)VIEW CHEST ❑ )VIEW CHEST ❑ ❑ OTHER ❑ SPECIAL PROCEDURES: ❑ G ❑. ULMONARY FUNCTION AUDIO ❑ TB TINE ❑ ❑ OTHER ❑ ❑ OTHER _ __ ❑ ❑ OTHER ❑ WHEN PHYSICAL IS MAILED,PRINT DATE AND INITIALS TO VERIFY IT WAS MAILED DATE MAILED: SENT BY: oa SE2VICES QUANTITATIVE RESPIRATOR FIT TEST REPORT TSI PORTACOUNT MODEL 8010 PORTACOUNT SERIAL NO. 411 AND SERIAL NO. 117953 EMPLOYEE TEST DATE j-ate NAME TFRS ilFTimATT NEXT TEST DUE 1-304 EMPLOYER RESPIRATOR NAME_ nTl'K0— ('O MAKE NORTH ML PD/CF ADDRESS__ U5 q P7 iF ST MODEL 85781 CITY 09 TC�/ 21 375 FIT FACTOR _19 2 TEST RESULTS TO BE KEPT IN EMPLOYEE'S FILE P• JORGENSEN (253) 272-6728 PO BOX 7659 r T A /I„I,, ,,, , n . ,, _ CERTIFIED AS PROVIDED BYLAW AS ASBESTOS WORKER CERTIFICATE NUMBER: 2004019834A EXPIRATION DATE: 04/09/2004 GENTRY, ALLAN L PO BOX 1902 EATONVILLE, WA.98328 Signature / Issued by DEPART ; " f f3f} AND INDUSTRIES 1 ' J 0 ccupational Medical Clinic of 4703 Pacific Highway East•Tacoma,Washington 98424•(253)922-9570•FAX 922-9587•email:omctacoma@ac Medical Clearance was examined at this facility and had required medical testing performed on this date '� Z 2003 © Pre Placement Report []Pending x-ray/ lab results or review prior medical records No significant findings which require job modifications. ❑ odifications recommended ❑ lob mo i i i mandated by Federal/State regulations ❑ Bending/Stooping Ling ❑ Lilting ❑ Standing/Walking ❑ Sitting ❑ No work at unprotected heights,with or about dangerous finery, operation of commercial motor vehicle. Respiratory Clearance 1.WMay[]May not use of a respirator. 2.ti�boes Not[]Does have limitations with regard use of a respirator. [J Requires a respirator which allows for wear of corrective lenses. []Other 3. The employee as []Has not been given and/or sent a report of his examination. 4. Future periodic medical evaluations should be conducted: Wpursuant to applicable Federal or State statues(WAC 296-62-07109, "All respirator user's medical status should be evaluated annually.") [] Hazmat Clearance 1. []Does Not[] Does have a medical condition which contraindicates exposure or places the individual at increased risk of health from exposure to: Asbestos o r ea(- . ' f, hies 2. The employee[J Has[] Has not been informed of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure. 3. The employee[]Has[] Has not been given and/or sent a report of his examination DOT Clearance CF []Meets ards in 49 R 391.41; qualifies for 2 year certificate, expires [] Weann ective lenses [J Wearing hearing aid []Skill performance Evaluation(SPE)Certifichte [] Accompanied by waiver/exemption []Driving within an exempt intracity zone [] ed by operation of 49 CFR 391.64 []Does not meet standards []Meets standards, but periodic evaluation required due driver qualified only for: [] 3 montlis [] 6 months [] 1 year [ ] ' [] Temporarily disqualified due to(condition or medication):._ Return to medical examiners office for follow up on Nick W. Uraga, M.D. Stephen D. -ewell,PA-C Op YI,* •O SL�tvzcrs QUANTITATIVE RESPIRATOR FIT TEST REPORT TSI PORTACOUNT MODEL 8010 PORTACOUNT SERIAL NO. 411 AND SERIAL NO. 117953 EMPLOYEE TEST DATE 5_11E_0, _ NAME. ALL AN UNTgy NEXT TEST DUE 5-1 n4 EMPLOYER RESPIRATOR NAME WM DICKSON--CD MAKE—N RT1i _-M� D/CF ADDRESS_3315 S pTNF SZ' MODEL R5781 CITY TACO A WA 99409 TC# 91 r'.375 FIT FACTOR 1 , 700 : 1 TEST RESULTS TO BE KEPT IN EMPLOYEE'S FILE EQII&. JORGENSEN� P. (253) 272-6728 PO BOX 7659 TAfl II,, ,,, ,, , _ _ CERTIFIED AS PROVIDED BY LAW AS ASBEST09 SUPERVISOR CERTIFICATE NUMBER: 2003022976A EXPIRATION DATE: 08/05/2003 LUTHER, CHRIS B 2407 N ORCHARD TACOMA, WA 98406 _ issued by DEPARTMENT OF LABOR AND (NDUSITRJ:ES CATHOLIC HEALTH INITIATIVES lI f! F nciscan Health System Port Clinic OCCUPATIONAL HEALTH Luther, Chris (Patient) 08/23/2002 SSN : 531-48-0784 DOB: 03/05/1947 Case: 15931 MRN: William Dickson Co Recommendations: (Medically qualified to perform his/her job duties without limitation ( ) Medically qualified to perform his/her job duties with the following restrictions: ( ) Provisionally medically qualified to perform his/her job duties, pending: ( ) Not medically qualified until: ( ) Not medically qualified to perform his/her job duties for the following reasons: ` Respirator Fitness: ( his person is fit to wear any respirator or SCBA . ( ) This person is fit to wear any type of respirator.without restriction, except SCBA which may be used for egress only ( ) This person is fit to wear only positive pressure respirators. ( ) Corrective lenses required for full-face respirator. ( ) This person is not fit to wear a respirator. Respirator clearance expires on (date) Findings (if applicable): ( Does Not ( ) Does have detected medical conditions which would place the employee at increased risk of material impairment of the employee's health. Has been informed of medical conditions which may relate to further occupational ccupatlonal exposures, including but not limited to the increased risk of lung cancer due to the combined effects of smoking and asbestos exposure I have 4een advised If the examination results and understan the ecommendations made to me. PATIENT IGNATURE DATE PROVIDE I 1 OE S NATURE DATE Drug and Alcohol Testing: I have reviewed the laboratory results identified by this form in accordance with applicable Federal requirements. My final determination is: ( ) Negative ( ) Negative, however dilute { ) No test, specimen failed testing requirements ( ) Positive: Substance _ _ _ ( ) Adulterated: Substance ( ) Non-contact Positive: Substance ( ) Evidential Breath Alcohol ( ) Negative ( ) Positive MEDICAL REVIEW OFFICER SIGNATURE DATE PC-600060 (11/14/01) 00 00 SERVICES QUANTITATIVE RESPIRATOR FIT TEST REPORT TSI PORTACOUNT MODEL 8010 PORTACOUNT SERIAL NO. 411 AND SERIAL NO. 117953 EMPLOYEE TEST DATE 9-10-02 NAME CHRIS LUTHER NEXT TEST DUE 9-10-03 EMPLOYER RESPIRATOR NAME WM DICKSON CO MAKE NORTH ML PD/CF ADDRESS 3315 S PINE ST MODEL 85781 CITY TACOMA WA 98409 TO 21C375 FIT FACTOR 28,100:1 TEST RESULTS TO BE KEPT IN EMPLOYEE'S FILE F. WV. JORGENSEN (253) 272-6728 ��"�"� " - PO BOX 7659 ,,... . NOWICKI & ASSOCIATES, INC. ' ASBESTOS AIR MONITORING ANALYSIS REPORT Lab Number: 30845 Project: Arlington SD — 600 E 1st Street Page: 1 of 2 Client: Wm. Dickson Company Date Sampled: 8-18-03 Date Analyzed: 8-20-03 Submitted By: Jess Denatale Date: 8-20-03 Received By: PAG Sample Description Type Time Start Flow Fiber # Of A, PA Time End Rate Per Fiber/CC Sample PO, P, C Total Time Total Fields Portable#5 S: 8:00 R: 12.0 Um 1 Floor Tile PA E: 9:40 56/100 0.022 T: 100 min V: 1200 L Allan Gentry S: 9:45 R: 2.0 Um 2 Portable#5 P E: 10:15 19/100 0.155 Floor Tile T: 30 min V: 60 L Portable#5 S: 9:45 R: 5.0 L/m 3 Floor Tile at decon A E: 11:30 Bad Filter N/A T: 105 min V: 525 L Allan Gentry S: 10:17 R: 2.0 Um 4 Portable#5 P E: 12:30 57/100 0.105 Floor Tile T: 133 min V: 266 L Portable#7 S: 11:35 R: 12.0 Um 5 Tile& mastic PA E: 12:45 8/100 0.003 Black sink insulation T: 100 min V: 1200 L CLEARANCE S: 12:50 R: 12.0 Um 6 Portable#5 C E: 2:30 15/100 0.006 Floor Tile T: 100 min V: 1200 L (A) Area Sample (PA) Pre Abatement (PO) Post Abatement (P) Personal (C) Clearance Comments: Analyst: Phase Contrast Microscopy(PCM): NIOSH Analytical Method 7400, A Rules Minimum Detection Limit: 2 FIBERS/100 FIELDS Lower Quanititaion Limit(LQL): 10 FIBERS/100 FIELDS Proficiency In Analytical Testing (PAT) PROGRAM ID NUMBER: 98003001 33516 91h Avenue South, Bldg #6 0 Federal Way, WA 98003 0 (253) 927-5233 0 (253) 924-0323 FAX NOWICKI & ASSOCIATES, INC. ASBESTOS AIR MONITORING ANALYSIS REPORT Lab Number: 30845 Project: Arlington SD — 600 E 15t Street Page: 2 of 2 Client: Wm. Dickson Company Date Sampled: 8-18-03 Date Analyzed: 8-20-03 Submitted By: Jess Denatale Date: 8-20-03 Received By: PAG Sample Description Type Time Start Flow Fiber # Of A, PA Time End Rate Per Fiber/CC Sample PO, P, C Total Time Total Fields Portable#7 S: 2:35 R: 5.0 L/m 7 Black sink insulation A E: 3:25 16/100 0.031 Tile&mastic T: 50 min V: 250 L Portable#7 S: 2:35 R: 2.0 L/m 8 Chris Luther P E: 3:25 101/100 0.494 Black sink insulation Tile&mastic T: 50 min V: 100 L CLERANCE S: 3:30 R: 12.0 Um 9 Portable#7 LC E: 5:10 3/100 0.001 Black sink insulation Tile&mastic T: 100 min V: 1200 L Music Room P S: 4:00 R: 2.0 L/m 10 Pipe fitting STEL E: 4:30 4/100 0.032 Allan Gentry T: 30 min V: 60 L S: R: 11 BLANK E: 0/100 N/A T: V: S: R: E: - - - -- T: V: (A) Area Sample (PA) Pre Abatement (PO) Post Abatement (P) Personal (C) Clearance Comments: Analyst: Phase Contrast Microscopy (PCM): NIOSH Analytical Method 7400, A Rules Minimum Detection Limit: 2 FIBERS/100 FIELDS Lower Quanititaion Limit (LQL): 10 FIBERS/100 FIELDS Proficiency In Analytical Testing (PAT) PROGRAM ID NUMBER: 98003001 33516 91h Avenue South, Bldg #6 0 Federal Way, WA 98003 (253) 927-5233 (253) 924-0323 FAX U U M w O F- ,� � a o z '^ i1w U i- :>: w - z (i v 6i w -j w' Q "5 p U 0 f'(1 Z (n CO) (J z > _ � 0 0 0 O o 0 w ¢ 0LL UJ co LLJ = z z O ``' Q Ck: Q w ` , h- � f LIJ al��' � � J0 I J D �: 4 fl�, a H 0 o ZO t1J a �' 4 Q �° (� �i '1 UO o � p a z 0 ;E UU ~ p '- � z �- U z s t U of� W co Q � � f s � Q a Mqr � s s U t z 'o z '7 (— w fn J Q SZ. c vl O O �" O U O Z O Z W Z w w w J , - n c� � Lr+ J M � U w d Uo � f J o 5' UJ � � - '� ram �' P) v� C6z 0 0 o Uz a O01 F- S ' - ,- Q �, c� c, VL �p L Q 8 V O( W H 3 z u a �++ -• O a 0 (q r � U o 0 OQw Y �J w0 ¢ �d cn u u QZ Or , H ai W O 0 O Z r `� {1 � r J W =O w Y w O � 1, H z U W � o a O + W LZ \ Ir f c — O0 � w w or ar J o r .i ,� aJ n a U -i I w ad 0 Lj U w '� a �/ f — ° w a _. 'b � t U U ''O � u } (9 Cn w U i-- LL Q O D }}a_. � d c) w c) --� w Q Z o -1 I- w w J UI-- 0Q - , `E < w ~ > ¢ w v5 Q 2 = ZCO w � � �" ~ G) w = Z O a ¢ U as = = O a Z Z Q Q Z ( 0 Op � � � Eo � � c � � 0 C) "T w w Q F- c c0 ELa) rn as Z Q � Q Q � n U zLU w O UIS U) ow C _ N — z N z co J m U EM mLO Z Q � ("1 'rl 4�� ¢ ma � � Q � chF- N Q U) Z w � R—� e wa wFZ w 41 w ~ z W w J I Q 0 UJ '� Z wp w > � tz O ao w -j W m wmW9 = z z Z = z z O o F- � Q O O � � a a O 6 La �j Z Dado 0 O uq- � oZZOW n. � Q 00 � � UU 0 F- z F � W � p a no jc g £ fro , (0) W co cn y, I o f �i w Z o w o J 0Zf-- z LY WwQ � � h a a � � aWoz � OQ � U � � 0 � N` C, - oN � z d U Co F= I- H o 0 o z 66 ?/ DO u u O n S � U .v o O ¢ J o LL ZW > C' aca 0L � ( � 0 F- Z rI � o _ F- 40 > o w � w + O L � Z NN s � z LL w LL Lz -J m � Q q� f _ J � U U Q Q. <C co �r� v. f � C d U LL � a a Q Q Z Z QQl- C)< W O y u_. l- F- :E Co N-. Q Y O C { Q Q wUHQ a 0 0 co ` z0 w LLJ <tz o � � � _ � J U !- OQ ,od � ¢ W = Z a o j LIJ W (n -iW U) = z0a ¢ U J a_ z ' O a z F�-- ,D z a CO 0 U orn w law J Z c c rn N aQ � ^� Q Q C2 �..0 wLU _✓. U_ j � N U U 0zw Z (L CQ U) :3 9 U Q O — U a w w(rj U (Y.) f-- u Q Z �J _, q m a U Q Q m 6 U U.S. EPA WASTE SHIPMENT RECORD FOR REGULATED ASBESTOS WASTE MATERIAL R.Q.Hazardous substance: Solid N.O.S.(asbestos): ORM-E NA-9188 This form is prepared in accordance with 40 C.F.R.61.150(d)(NESHAPs) GENERATOR W7ork Site Name:Arlington HS Portables Owner's Name:Arlington School District Location: 600 East 1"Street—Arlington, WA County: Snohomish j Mailing Address: 315 North French Street Arlington, WA 2 Operator's Name/address: Wm. Dickson Co. Contact: Jason Roosa Address: 3315 South Pine Street, Tacoma, WA 98409 Operator's Phone: (253)472-4489 3 Waste Disposal Site (WDS)DESTINATION: Name: Columbia Ridge Landfill c/o Waste Mgmt. - Seattle WDS Phone: (541)454-3318 Mailing address: 18177 Cedar Springs Lane,Arlington, OR WDS Address/location: Same as above 4 Name and address of responsible agency(Local,District,or EPA Office where demolition/renovation notification was sent): Puget Sound Clean Air Agency, 110 Union Street, Suite 500—Seattle,WA 98101 Description of waste materials 6. Containers 7.Total Quantity 5 Number Type (cubic yards) Flooring,Ducting End Dump 5 CY Special handling instructions and additional information: 8 Wetted,labeled, and double-bagged as per all current laws and regulations. OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignme are fully and accurately described above by proper 9 shipping name and are classified,packed,marked and labeled,and are in all resp is in proper c dition for transport by highway according to applicable international and government regulations.(Obtain signature in Item 0 efore taki old sheet for receipt) Jason Roos - : <' ��- , Printed/typed Name Title Signature Date(MM/DD/YY) TRANSPORTER Transporter 1 (Acknowledgement of receipt of materials) 10 Name:Wm.Dickson Co. Ad r^ s: 3315 Sou Pine S eet, Tacoma,WA 98409 Truck Driver - OL I Printed/typed Name Title Signature Date(MM/DD/YY) 11 Transporter 2(Acknowledgement of receipt of materials) Name:Union Pacific Railroad(UPRR) Address: 402 South Dawson Street, Seattle, WA 98108 -_ Printed/typed Name h, Title (i i._ Signature, ` —/ Date( M/DD/YY) WASTE DISPOSAL SITE 12 Discrepancy indication space: Optional Disposal Location Index X Y Depth 13 WASTE DISPOSAL SITE CERTIFICATION:I hereby certify that the above named in have been accepted and to the best of my kndwicdge,the foregoing is true and accurate and complete except as note in-Item 12. Printed/typed Name ' Title Signature Date(MNl/DD/VY) 07/25/2003 13:27 2534724521 r-Hur_ CJlr L1 Agency Lase No. PUGET SOUI"D CLEAN,AIR AGENCY Date P-cowed 110 Union Street,Suito 500 ;,': Seattle;WA 98101.2038 —. . www'pscicanair.org �.J1_ e �0+.7 Agency Use Only NOTICE OF INTENT r i 4. Agency Use Only . Pro i ect Tyne: 1. ❑ rable A bestos Rcmoval 2. OlEriable bcstos cmoval emolition 3. ❑ De olition Only B. Property Owner: Arlington School District Phone: 360-435-1270 Mailing Address: 315 N. French St. City: Arlington State WA Zip: 98223 C. Asbestos PLcASL'vN1N1 CL 4RLY,/H[S WILL RE rVUR RETURN M114ING L.1,,, Contractor: Wm. Dickson Co. Owncr/CEO: Wm B. Dickson Contractor Mailin Address; 3315 South Pine Street Phone: 253-472-4489 Job No.: City: Tacoma State: WA Zip- 98409 Fax: 253-472-4521. 0301E j D. Site Address: 600 E. 1"St. rn rLLle- b` City:Arlin ton 7i Site 9R_23 Manager: Tom Wa117- Local Phone:360-435-1270 E. WAsbestos Survey or No. of Date of Asbcstos Was Friable Asbestos Identified? Yes No ❑ at'l Preoumed Structures:lO(Portables) Sure :07/7 6/01 Was Non-friable Asbestos Identified? QXes 0No AHERA Building Certification#972189 Anach a cony of the survey unless friable asbestos Inspector:Tom Waltz Exp.Date:04/04/04 &identified. An AHMU Survey Lr rrrpiircd before all demolirion project F. Demolition Start No.of 1. LJ Training Firc(List Fire Dept.) Information: Date:08/22/03 Structures:10 1 2. ❑ Ordered Demolition attach capy of Order Demolition Insert demolition confractor:r)nailing nddreTs on back. Will non-friable asbestos be left in place during demo? Yte No Contractor: Wm.Dickson Company If yes,list type and qty.Built up roofing ±2,500 G. Friable Asbcstos Work Days: M T W Th F Sa Su Project Information: Start Date: 08/04/03 Completion Date: 09/04/03 Hours: 7:00 AM -3:30 PNt Will all friable asbestos Qycs Total . to be Removed: Linear Ft. Square Ft. 60 materials be removed? ❑No List e(s) of material to be removed:Gasket Materials H. A.abestos/Demolition Project Categories: Notification Period Project Demolition 1. Single-Family Residence: Fee Surcharye A_ ❑ Asbestos Removal Project Only A.Prior Notice A. $25 B. ❑ Demolition Projcct(with or without asbestos removal project) B. 10 Days* B. $50 *'Asbestos removal can be b upon notification• demolition must wait 10 days) Note:If the sin.gie family residence is owned by one fancily who has been or will be using the residence as their donne/le.the above bores 1A or 1B may he checked. A single family residence dots not include rental properV, multi-family units, or aLnX mixed-rise buildin•e. 2. All Other Demolitions With No Asbestos Removal Project .10 Days S200 Friable Asbestos Projects other than Single FamUy Residence): Asbestos Demo 3. Z ? 10-259 linear feet or z 48 - 159 square feet of Asbcstos Prior Notice 10 Da vs S50 4. LJ 260-999 linear feet or 160-4,999 square feet of asbestos 10 Days I S300 S I M 5. 1,000-9,999 linear feet or 5,000-49,999 square feet of asbestos 10 Days 1 $750 $250 6. > 10,000 linear feet or>50,000 square feet of asbestos 10 Days S2,000 $1,000 7. O Emergency Asbestos Project or ❑ Emergency Demolition Projcct Prior Notice Twicc Project Fee Single-Famil Residences an:c,,cm,,from corer enc feet however, ro owners must wovide o wrilten emir,rncy"equal Z. I crC Y that the infom, ripn conwined in this notification&supplcmcntat data is.m the best of my knowledge,accurate&complete. Agepcy,LIse Only (\ C �) Wm. Dickson Co. 07/25/03 7 r Se rtfi/re Reprerenring Ilan Re imved B A� Puget Sound Clcan Air Agency Form No.: 66-160(Revised 3103)TS Labor and Industries NOTICE OF Industrial Hygiene Compliance ASBESTOS ABATEMENT m (Regional addresses and phone numbers on page 2) 4PROJECT THIS NOTICE MUST BE RECEIVED NO LATER THAN 10 CALENDAR DAYS PRIOR TO THE START DATE COMPLETE ALL APPLICABLE BOXES—INCOMPLETE OR ILLEGIBLE NOTICES WILL NOT BE ACCEPTED MAIL OR FAX TO THE REGIONAL OFFICE—CIRCLE CHANGES ON AMENDED NOTICES Notice date: 07 /25/03 Initial ✓❑Amended❑ Site Work Hours Su Mo Tu We Th Fr Sa t . 8 1 /03 On Hold❑ Off Hold❑ 7:00 am am X -X X X to Completion:000 /•� /Q`3 Emergency❑ 5:30 pm pm Project Dates and Work Hours must be Exact RACTOR PROPERTY O"ER Company Name Name Wm.Dickson Company Arlington School District Contractor Certification Number Owner's Agent WDIC *108J7 Tom Waltz Signattire lh,-./ Company Arlington School District Printed ame Address Donald Sims 315 N.French St. Phone Number City State ZIP+4 253-472-4489 Arlington WA 98223 Job Site C.A.S. Phone number Ken Menshing 360-435-1270 JOB SITE FACILITY Address Type 600 E. 1st St. Portables Building Name Room Age Size Arlington High School Portables(10 EA) ±30 ±500 City ❑ Arlington WA Remodel ❑✓ Demolition ZIP+4 County 98223 Snohomish ❑Repair ❑Maintenance QUANTITY OF ASBESTOS TO BE: ❑✓ REMOVED ❑ENCAPSULATED Quantity 3100 square feet ❑✓ Indoors ✓❑ Outdoors ❑ Fireproofing ❑ Boiler insulation CONTkOL MEASURES ❑ Popcorn ceiling ❑ Duct paper ❑ Neg.pres.enclosure ❑ Wrap&cut ❑ CAB Q VAT ❑ Glove bag ❑✓ Wet methods ❑ Sheet vinyl ❑✓ Roofing ❑ Mini enclosure ✓❑ HEPA vacuum ❑ Asbestos paper ❑✓ Other Gaskets ❑ Critical barriers ✓❑ Manual methods Quantity linear feet ❑ Other ❑ Other ❑ Mag.pipe insulation ❑Cement asbestos pipe RESPIRATORY PROTECTION ❑ Air cell pipe insulation ❑Mudded pipe ins. Q %mask APR ❑ Type C continuous flow ❑ Ducting/duct insulation ❑ Duct tape ❑ Full face APR ❑ Type C pressure demand ❑ Other ❑ Other El PAPR ❑ Other F413-025-000 notice of asbestos abatement project 11-01 For clean copies go to http://www.Ini.wa.gov/forms/ Arlington Arfiny:un SCHOOL DISTRICT ASBESTOS MANAGEMENT PLAN Public Schools Asbestos Survey Portable Classroo #1 Ag Portable Arlington School District '! Inspection Date: 7-16-01 Client: Arlington School District 315 N French Ave Arlington, WA Facilities Description - This portable is one large classroom. This building shares common design elements and finishes as all of the portables under type A in the Arlington School District. Therefore the samples from one portable to another(with the same letter type) should be the same homogeneous area. This portable was remodeled during the late 80's.with a GWB- wallboard system. The portable is const�acted*itlrwood framing,,')a 1;I.1 idiiZg,4an GWB wallboard. The portable is heated,wi,ti octtic-heat. The'_rogf is_4.1pitched fr ed roof with athree-tab roofing system. This building: Cilizes a post and concrete pad �I system for the foundation. . INSPECTION RESULTS DAT E AHERA, Puget Sound Air Pollution Con 1 Agency'and Labor& Industries (WISHA) regulations require an inspection of all bui dings for t6' presence of asbestos-containing materials prior to renovation and demoliti .. .Asbestos containing materials are defined as those building materials containing one percent or more of asbestos as verified by laboratory analysis. All building materials built prior to 1980 are assumed to contain asbestos unless proven otherwise by a licensed building inspector. Asbestos containing materials are sub-divided into three types: surfacing materials, thermal system insulation, and miscellaneous materials. Surfacing materials are divided as those materials that are sprayed-on, troweled-on or otherwise applied to surfaces including, but not limited to, acoustical plaster on ceiling,paints, fireproofing materials on structural members or other materials on surfaces for decorative purposes. Thermal system insulation means material applied to pipes, fittings,boilers, tanks, ducts, or other structural components to prevent heat loss or gain. All other materials are considered to be miscellaneous materials. "Keeping Arlinglon,School Dislrid's Building's safer" Page 11 of 68 08iO4I2073 15: 22 2534724521 FACE 01/0" WM. DICKSON CO. GENERAL CONTRACTORS FAX TRANSMITTAL TO: Af?LINGTON SCHOOL DISTRICT DATE: AUG:15T'4. 200S ATTN: Tom WALTZ FAX#: r 4 5• 406 PHONE#- FROM: D N I RE: ARLINGTON HIGH SCHOOL POP T ABLE DEMOLITION TOTAL PAGES BEING TRANSMITTED (INCLUDING TRANSMITTAL): IF ALL PAGES ARE NOT RECEIVED, PLEASE CALL(253)4724489. COMMENTS: Tom: Here copies of the PSCAA and Department of Labor and Industries Permits that you requested. Let me kno f ou tijMd an thin else. Don Sims h t,,'� TRANSMITTED: FOR APPROVAL FOR REVIEW AND COMMENT X AS, REQUESTED FOR YOUR INFORMATION URGENT! PLEASE DELIVER TO RECIPIENT IMMEDIATELY. IF CHECKED, ORIGINALS TO FOLLOW VIA US MAIL. 33 1 5 SOUTW PINT S7RErZT ' TACOMA,WA 9e4Q9 (253)472-4489 ` FAx(253)472-4521 EMAIL WMDICKSQN@WMdICKSCN,NET LICENSE No.:WNIDICC'106J7 RECEIVED AUG 0 4 2003 CIT`( OF ARLINGTON 0?,04/2dd3 15: 22 2E34724521 per e2 6_ Labor and Industries Tndustrial Hygiene Compliance NOTICE OF (Regional addresses and phone ASBESTOS ABATEMENT numbers on page 2) 0 PROAiTT THIS NOTICE MUST BE RECEIVED NO LATER THAN 10 CALENDAR DAYS PRIOR TO TIIE START DATE COMPLETE ALL APPLICABLE BOXES—NCONb1PL.ETE OR TLLEGIBLE NOTICES NVILL NOT BE ACCEy, D MAIL OR FAX TO THE REGIONAL OFFICE—CIRCLE C1i004GES ON AMENDED NOTICES Notice date: 07 /25/03 I Initial Q Amended[] Site Work Hours Su Mo Te We TIi Fr 5a Start datc: a8 /11 /0 On HoId❑ CffHold❑ 7:00 am am X X ;C X to 1 Cot npletior,: 0q /11/ 03 Emergency❑ 5:30 pm pm Project Dates and Work Hours must be exact CONTRACTOR PROPERTY OWNER Company Name Name RWm.Dickson Company Arlington School District Contractor Certification Number owner;Agent WDtC l08J7 Torn Walt? Signat Company Arlington Schaal District Printed N am-- Address Donald Slnu 315 N.French St. Phone Num"cr City Sta:e ZIP+4 253-472-4489 Arlin ton WA 98223 101;Site C.A.S. Phone number Ken Xcnshing 360435-1270 JOB SITE FACILITY Address Type 600 E.13t SL Portablcs Building Name Room Age Sizc Arlin on High School Portables Q0 EA,) *30 �500 city Arlin ton WA []Remodel 0 Demolition ZIP+4 County 98223 Snohumish ❑Repair ❑Maintenance QUANTITY OF ASBESTOS TO BE: m Rrsmo m ❑ENCAPSULATED Quantity 3100 square fcci [Z Indoors 0 Outdoors ❑ Fireproofing ❑ ,Boller ingulatior. CONTROL ME,ASYJRES ❑ Popcom ceiling [] Duct pager [] Neg.pres. enclosure ❑ Wrap&cut ❑ CAB Q VAT ❑ Glove bag ❑✓ Wet methods ❑ Shcct vinyl []I Roofmg [l Mini encloswre 0 HEPA vacuum ❑ Asbestos paper ❑ OtherjGaske—_ 0 Critical barriers ✓❑ Manual methods Quantity linear feet [] Other ❑ Othcr Q Mag.pipe insulation ❑Cement asbootos pipe RESPIRATORY PROTECTION ❑ Air cell pipe insulation; Q Mudded pipe ins. 0 Va mask APR ❑ Type C continuous flow ❑ Ducting/duct insulation ❑ Duct tape ❑ Full race APR ❑ Type C pressure demand ❑ Other ❑ Other 0 PA-PR I ❑ Other F4I3-025-000 nctice of asbestos abatement proicet 11-01 For clean topics go to http://,,vww,lni.wa.gov/form;,/ 0-13/04/20T3 15:22 25347245-21 PAGE 03/03 A8e;CY(.:Ma'No. ruciz I SOUND CLE.,a-N AIR AGENCY I 10 Union ion cc-,Suite Soo U 573 www.pseleanair.org F NOTICE O MENT JUL 25 2003 ACENty V$*OnOP au 1910 AgI1cstqiJRgnovaJ-!&JDemqliljpn B. Property Ownar: Ariing',Q;)School District Phone: 3 60-435-1270 Mailing Addfcss: 315 N.Frer.ch St Ct�: Arhnron— State WA �Zir: 9822.3 COnlyIetar: WTr,, is on Co. Owns-/CEO: WM B.Dickson 3315South pine Srr--er Conncror '" "J' Phone:2"-472-44,19 b cjty. Tacoma State. WA 0 I -[ZIP! 98409 Fi�c 253-4?2-4521 L003 16 D. Site Addrea: 600 E. In St. 0 12 Jo F Li-JA-,n' 9 8" Sift -- Manage: Tom Waltz Local Pb(Me:360-415-1270 E. Cl — No.of Date 1 of Asbestos W-&s`Frizblc Asbestos ldcTrtified? -Sr Yts"0—No hdAsbcVwq Survcy or -Xist'l Frgnmp.-d 1 5 q-t-qeE19P-crabJ_t-zA _3MLe3C 0,7116MI Was Non-Mable Asbc2tas Idendfled7 ElYzs DNo AHERA Building Certification#972189 Attach a copy of agswvey unleisfri grble ab g1log baycctur Tom Waltz F=.Datc:04/04/04 An/MZAV Zstrwv Is rcqktred �apv aff demolition prVietz F. Demadolt Stan No.of 1.U Trad:d=Fire,(List Fire Dept.) I Information; - I Data: 08122103 2.0 Crclp-red Demolition(attach c of Order) Dcw"01 Will non-6iible asbeMsbalcl-kin place during de Yes LJNo *Mz.]Dickson Ctrs an lf yM List type a44 qty.Bafltmp molixg:tZ.5 00 G. Friable Asbesm Work Days: M T W 71 F Sa Su Project Inforuntion. I Start Date: 08/0443 Cmletiom Date- 09/04103 Hours: 7:00 AM 4!30 n1 Will all friable aabc3tas ZYCS Total Qty.to be Rermved: Linear Ft Square Ft 60 rnaterlals be=QYQd? otio List i)qc(s)ormam-rial to be rcmoved:0askctN1AtcnaJs H. A-tbe4iordDemolition Project C2tegorW: jNot_' Cation Period Project Demolition 1. Single-Farnily Residence: Fee SgLcharr A.71 Asbestos Remov-al Project Only A.Prior N*ti=c A. S25 B,C3 Demolition Projcct(with or without asbestos removal project) B.10 DMY$* B. s5a *(Asbesto5 removal can be;in RFou notificaLon,demolition mmt wait 10 dzLV31 - 1 Arfthlf siMglfffftgy rCSidfiffeff it 0-4a by ogee fancily who has berm or w1J7 be using the rodmcc as their d,00defle,IfiLd above boxes 1A or IB may be checkg4 J Single faml7y residence does mot include rental v wulti- i!�Lv units,Qr a rope mired-rise buitding. 2. Ll All Other Dmohdom with No Asbestos Removal roject 10 Days S200 Friable Aabc5tas 11'rojecti(other thso Sin le FRn*Wy F."Idencel: AsbaRtog Demo 3. E ? 10-259' 550 linear feet or 2!48-159 squire fret of Asbestos Mot Notice 10 D2Y-s � 4. IJ 760-9.99 linear feet or 160-4,999 sqtm-e fee,of asbestos 10 Day.: 33 5. 1,000-9,999 linear foot or 5,OW-49,999 squart flam of asbestos 10 Da yt - $250 6. U �10,000 lhmar feet or>50,000 55uare feet of a4xvm 10 Dlys $2,000 311000 7. 0 E==Z=c-f Agw"p"act of U T1-==8=cY Demolition P'mJcct Pries Notice Twice Freject Fee (single-F=R-j Residertcm rr ciaTv-trnm,crwz:cy prorxTty MMCR rru;t fwide A %r;tb&r effwccr--Y r==K) fm ft th f ion C"Ined In this n0rication&sumkM=M1 dift 1&V tie bat Of MY kfl*wl2dLw,ac"Tom"o I=' Age 1S*only/'U —07a$/03 --5�LM�an�C Rcorwe-Nixf - _yfowegf kW'l Pupal Souvid Clem Alr.qeficy Form No.. 66.160(RcviwJ 31031 TS Linda Friddle From: Karen Latimer[klatimer@email.ci.adington.wa.us] Sent: Friday, August 08, 2003 7:52 AM To: Linda Friddle Subject: high school portables Linda, We do not have water or sewer to the high school portables that are being removed. Thank you for sending me the info to review. Karen Latimer Utilities Manager klatimer@ci.arlington.wa.us 360-403-3505 1 Linda Friddle From: Linda Friddle [Ifriddle&i.arlington.wa.us] Sent: Wednesday, August 06, 2003 4:02 PM To: Karen Latimer Subject: RE: asd-portables on 1st Thank you Karen--I will send you a copy of the site plan--the application doesn't have much information on it. -----Original Message----- From: Karen Latimer [mailto:klatimer@email.ci.arlington.wa.us] Sent: Wednesday, August 06, 2003 3:12 PM To: Linda Friddle Subject: RE: asd-portables on 1st I should probably look at them. There is one service off of First for the science trailer -- I want to make sure they're not removing this one too, and we have one service on French, but they're not supposed to be connected to it. You don't need to send the white/yellow/pink checklist form -- just make me copies of the application and I'll look at those. Thank you. Karen Latimer Utilities Manager klatimer@ci.arlington.wa.us 360-403-3505 -----Original Message----- From: Linda Friddle [mailto:1friddle@ email.ci.arlington.wa.us] Sent: Wednesday, August 06, 2003 11:07 AM To: Karen Latimer Cc: Reta Shepard Subject: asd-portables on lst Karen, The School District has submitted 12 demo permits for the portables on first st.--It is my understanding they do not have any utilities to them--do you need to review the applications or are we good to go. 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PORTA SAW 2981 RMGRRYY 3 R • BLE cOIKtpE RAYP w commit fAgE ID tau •,� 0 MASS CRASS ` �CSPHAa) OCCK ' TS Y.))�fApt SOW1 7w a ASPHALT W• O 0 11 Ol£FHµG RCY.ib..Al •X•177.g7p !J1 E 0 O t-16).07 &AIDING TD � ��1 1 LASS MIGRCI[DOMILK 1'• �, '��y`y Ca1AM lNK OKRNANG [:171 'P1f r�• GRASS .G �G `~~•• �Z: CRASS ` ' RO 1 R' CO"°RE4 wij � �\ r nn E' MASS PAL01NC 01CRHANO D 1 µRR �PP r_ D ��unu T.F..17s.. \♦ �r- 1Pi� � t C-,70.SJ � lO 65 ;•, O '• KI�O O EONMEa � BIRLDRac RMiI .0 =, n tWt. i UPI OR Fl t^ p BO.ADI.NC 00 C NC 1)CORETE m g i vJ 1`�16)' CB 1395 Q 17B.B A:H_171 5) 1 kY.,>,A OV0R1Aq O / C-t7p.0� IOt 1{21 f0 a IC.,6P?07 1P�-i 01OINAHO OKRNA1q • MA55 t J 4 IFULDAC I � CONCRETE � `BELL Ra�LE o UTILITY POLE Q SHRUB ourb UTTUTY POLENNDERCFtOUNO POWER NO �YORKSHEET CATCNBA,4N ¢ UMITY POLE/IGHT POLE TREE-CONIFER W4Ei� ��DRAIN TREE-DECIDUOUS IOWmVfr u¢SaOwl AQ COY6RT S[7 APIW[M 0®LOCA1Ur6 .p STORM E MArAtotE F umstt NE RISPOLE ER ORTIERS40 LPES Awr Nun. w aslRuat¢or o+,tRsw a Ez"""SE0 PROJECT ARLINGTON MIDDLE SCHOOL FLOWUNEROOF DEWN o TELEPHONE RISER STUMP G CA slPrla IrS 9VAM'oer7 Iqt fvRPOrr ro fADr Ata C"wrIL ® TELEPHONE BOOTH YARD UGNT Y T.ly R[lTRSitla6,9[7+O7rSTAaa AAD OCCIRMIW,wrCaa YAr VIOULIG rm[ O��ablc ��oT ofP »K".m LGRORr/ 00pP[rrr Au xwYr[AsocYrs Ao[,G901CNIA)RS TYPE: TOPOGRAPHY CM/�� m .AJNCRON EX , PLOTTED BY: JIM DATE:01/09/03 BOCtAR(♦/{THEE POST { uCNT POLE IOn.0Y1Y a Amwoom;PO b%wATY Loc Afa"KM c[1 rr ry707w 74TFR ET17t/POwfR BOX POST DA cD-04 4"7Ptaue,we!Garww. COMPERED BY: AP DATE:01/09/03 WA7 NY VALVE SON ta4iQ„E PST --C— UNDERGROUND GAS LINE WATER VALVE A —BP— STORM OOl1ND POREN �- 1� rQF=^~IURITY r[AnA%0 SOW"RfP*CWO R)dAK rLa7WII DRAWING NAME: S2930TOP-OWC �'•v- SIGN DOUBLE POST —m— STORM YSEI LOCCII �p LOCATEDAPVWX 0.7W M ANY W WON wWtW=AIDN PRaW n XiRX6RRON VALVE CgA —SS— SAMTNtY SEINER 11 10u7m Ow 7K T]lL An WOPCxpuw UrRm6 sroPH.v[ $GALL{ CAS METER HANDICAP SYMBOL —IB-- WATER L'CA Y q r eE°n L•15e on[x7. AQER PC K-BUILT 4jCC*CS AO vnv7y P07ADM/p CAS VALVE c MAIL BOX -•B7— TELEPHONE �l °"'o mRtp Wcrr AS-Buu COIOMOW. PAD MOUNTED TRANSFORAIER BOULDER + SURVEY CONTROL POINT ax ro il[Osr morwµr L.raFOL[aHnAQ or IY7p lA`L A[OORO 20 TO O 20 AO J09 No.S2930 FIELD BOON 559 PG. 61 GAS METER C3'= ROCKERY YAPS PAO.'CCD Br Mr cm,PC M[W«a[A0&-0.AA c.T,-.m POWER VAULT !��Of Tart AINS FOCTII YLLi THE E> 77 acwrT 01 7)t wv..Yr �� SHEET 1 OF 7