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Permit D16-0291 - BALZARINI RESIDENCE - DEMOLITION
BALZARINI DEMOUTION 12611 37 AVE S D16-0291 Parcel No: Address: City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Inspection Request Line: 206-438-9350 Web site: http://www.TukwilaWA.gov 7345600810 12611 37TH AVE S Project Name: BALZARINI DEMOLITION DEVELOPMENT PERMIT Permit Number: D16-0291 Issue Date: 11/17/2016 Permit Expires On: 5/16/2017 Owner: Name: Address: Contact Person: Name: TOCHERJAMES LIONEL+BRUCKER 3535 S 126TH ST, TUKWILA, WA, 98168 MIKE HIMPLE Address: 419 AVE E , SNOHOMISH, WA, 98290 Contractor: Name: HIMPLE DRYWALL Address: 419 AVE E , SNOHOMISH, WA, 98290 License No: HIMPLD*887DB Lender: Name: TOM BALZARINI Address: 1204 N 10TH PL ATP 2515 , RENTON, WA, 98057 Phone: (425) 508-2039 Phone: (425) 508-2039 Expiration Date: 3/27/2018 DESCRIPTION OF WORK: DEMO EXISTING HOUSE ON PROPERTY Project Valuation: $15,000.00 Type of Fire Protection: Sprinklers: Fire Alarm: Type of Construction: VB Electrical Service Provided by: TUKWILA Fees Collected: $657.82 Occupancy per IBC: R-3 Water District: 125 Sewer District: VALLEY VIEW Current Codes adopted by the City of Tukwila: International Building Code Edition: International Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: International Fuel Gas Code: 2015 2015 2015 2015 2015 National Electrical Code: WA Cities Electrical Code: WAC 296-46B: WA State Energy Code: 2014 2014 2014 2015 Public Works Activities: Channelization/Striping: Curb Cut/Access/Sidewalk: Fire Loop Hydrant: Flood Control Zone: Hauling/Oversize Load: Land Altering: Landscape Irrigation: Sanitary Side Sewer: Sewer Main Extension: Storm Drainage: Street Use: Water Main Extension: Water Meter: Volumes: Cut: 0 Fill: 0 Number: 0 No Permit Center Authorized Signature:kild W I"1V Date: ' 1 I hearby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this development permit and agree to the conditions attached to this permit. Signature: Print Name: M1,44,4,1_ Date: i/— (7`/C This permit shall become null and void if the work is not commenced within 180 days for the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. PERMIT CONDITIONS: 1: ***BUILDING PERMIT CONDITIONS*** 2: All permits, inspection record card and approved construction documents shall be kept at the site of work and shall be open to inspection by the Building Inspector until final inspection approval is granted. 3: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of this requirement. 4: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206-431-3670). 5: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 6: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL** 0101 PRE -CONSTRUCTION CITY OF TUK. . A Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Building Permit No. 1 V - C?' Project No. Date Application Accepted: Date Application Expires: 0 (0 - 7 (For office use only) CONSTRUCTION PERMIT APPLICATION Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. **Please Print** SITE LOCATION Site Address: / Z6 11 3 7 Ait-:— 5 7UK(.ji Suite Number: Floor: Tenant Name: 7() pi BA L2_4(Z King Co Assessor's Tax No.:7 314 s (Q 0 $( 2 PROPERTY OWNER Company Name: /41 -1 /(4f CC' Poky WALL Name: f t, I (` f 1 L4 d0 L/ Name=- -(-yz AA f-/74 /L i N / Phone;,. j6<`603,_ ,03I Fax: ate_,_ Address: I g„�rl., 0 _, tc, 77L 4/r i5 City: `1-< ,74 Tr_1dl) State: I 1 j Zip: / b Zip? CONTACT PERSON - person receiving all project communication Company Name: /41 -1 /(4f CC' Poky WALL Name: f t, I (` f 1 L4 d0 L/ CityAJO H -ON is tis , State: ton Zip:?CB Phone;,. j6<`603,_ ,03I Fax: ate_,_ AddressJ: 4/ i 9 _ 4t' 04.7, e Tukwila Business License No.: ` 3 ? ` OZFax: `� L l c(� City: ci Jb i4-0 AA 1 S!� State: Zip? (3 Phone:x : �/ZvS� SAX-�3 Email: K 0 t WL Q 140.7744.11_ , cv 01 GENERAL CONTRACTOR INFORMATION Company Name: /41 -1 /(4f CC' Poky WALL Address:ZJ f7v ^ ',,- E CityAJO H -ON is tis , State: ton Zip:?CB Phone;,. j6<`603,_ ,03I Fax: ate_,_ Contr Reg No.41 MP I'D 7 D �j Date: 3- 2 -.i -,g, Tukwila Business License No.: H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 hh New Tenant: ❑ Yes af.. No ARCHITECT OF RECORD Company Name: n 4. ,0 Dcs i .. Architect Name:pso i,�'J UJ i /..V g4iti Address: xi L5ii,A vo— City: C.vrfas&— State:, - /� Zip:p�, / Phone: r[2 - 25 Z 7:1,4 `Tpn Email: D ` 1%l� _S 14/ 4 iciUr7Vl/ i 1 ,c ENGINEER OF RECORD Company Name: 51) a'kn rr 1 Engineer Name: ' 42_r L 0 `�g-/ Address: 2-o a 7 ` -ate a r`J tii, 72„, !Le__ State:L Zip City: C'ut u...., ,_ Phone:.2 ` 3 ? ` OZFax: `� L l c(� Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Nam --m 3.4-L? 42 i v / Address: 204/ , AI -10"x+ PL 47)-25-k City kiTn a/ State: 14 ZiplccQ S ., Page 1 of 4 BUILDING PERMIT INFORMATI - 206-431-3670 Valuation ,.rn,.oject (contractor's bid rice): Q I.=bed 0SExisting Building Valuation: $ �� dpi Describe the scope of work (please provide detailed information): Ai4- 77& -ono &:5 k57 -t641 'Sc-- .0., p& -A -r`1 Will there be new rack storage? ❑ ....Yes No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Will there be a change in use? 0 Yes FIRE PROTECTION/HAZARDOUS MATERIALS: 0 Sprinklers 0 Automatic Fire Alarm Compact: Handicap: 0 No If "yes", explain: None 0 Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes 0 No If `yes', attach list of materials and storage locations on a separate 8-1/2"x 11 "paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM 0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 bh Page 2 of 4 Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1St Floor ?Sb St T 2nd Floor 3rd Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Will there be a change in use? 0 Yes FIRE PROTECTION/HAZARDOUS MATERIALS: 0 Sprinklers 0 Automatic Fire Alarm Compact: Handicap: 0 No If "yes", explain: None 0 Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes 0 No If `yes', attach list of materials and storage locations on a separate 8-1/2"x 11 "paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM 0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 bh Page 2 of 4 PUBLIC WORKS PERMIT INFC "ATION — 206-433-0179 Scope of Work (please provide detailed information): er District Tukwila .. Water Availability Provi Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Sewer District ❑ .. Tukwila 0 .. Sewer Use Certificate ater District # 125 ,Valley View ❑ ...Sewer Availability Provided 0... Highline 0... Renton ❑... Renton ❑... Seattle Septic System: 0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. Submitted with Application (mark boxes which apply): ❑ .. Civil Plans (Maximum Paper Size — 22" x 34") ❑ .. Technical Information Report (Storm Drainage) ❑ .. Bond 0...Insurance ❑... Easement(s) Proposed Activities (mark boxes that apply): DI.. Right-of-way Use - Nonprofit for less than 72 hours ❑ .. Right-of-way Use - No Disturbance ❑ .. Construction/Excavation/Fill - Right-of-way 0 Non Right-of-way ❑ 0 .. Total Cut ❑ .. Total Fill cubic yards cubic yards ❑ .. Sanitary Side Sewer ❑ .. Cap or Remove Utilities ❑ .. Frontage Improvements ❑ .. Traffic Control ❑ .. Backflow Prevention - Fire Protection Irrigation Domestic Water EL ❑. ❑. ❑. ❑... Geotechnical Report 0...Maintenance Agreement(s) ❑ .. Traffic Impact Analysis ❑ .. Hold Harmless — (SAO) ❑ .. Hold Harmless — (ROW) 0... Right-of-way Use - Profit for less than 72 hours 0... Right-of-way Use — Potential Disturbance ❑... Work in Flood Zone ❑ ... Storm Drainage .. Abandon Septic Tank .. Curb Cut .. Pavement Cut .. Looped Fire Line >> ❑ .. Permanent Water Meter Size (1) ❑ .. Temporary Water Meter Size (1) ❑ .. Water Only Meter Size ❑ .. Sewer Main Extension Public ❑ .. Water Main Extension Public 0 0 0...Grease Interceptor ❑ ... Channelization 0... Trench Excavation 0... Utility Undergrounding WO # (2) >> WO # (3) WO # (2) >> WO # (3) WO # ❑ .. Deduct Water Meter Size Private ❑ Private 0 >> WO # >> WO # FINANCE INFORMATION Fire Line Size at Property Line ❑ .. Water ❑ .. Sewer ❑ .. Sewage Treatment Monthly Service Billing to: Name: Mailing Address: Number of Public Fire Hydrant(s) Day Telephone: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:\ApplicationsWorms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 hh Page 3 of 4 PERMIT APPLICATION NOTES Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition). I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTHORIZED AGENT: // Signatur:' , ,r--.411 1.. Date: Date: 9 — iC Print Name: M t G�1q.c airue111- Jo__ Day Telephone: 4/2.5 —,s6? — 3 Mailing Address: 9/ — /ur 510 c.) 40M,s µ— i u -S it 7821 [) City H: Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 bb State Zip Page 4 of 4 1 Cash Register Receipt City of Tukwila Receipt Number R9876 DESCRIPTIONS PermitTRAK I ACCOUNT QUANTITY PAID $408.02 D16-0291 Address: 12611 37TH AVE S Apn: 7345600810 $408.02 DEVELOPMENT $388.80 PERMIT FEE R000.322.100.00.00 0.00 $384.30 WASHINGTON STATE SURCHARGE 6640.237.114 0.00 $4.50 TECHNOLOGY FEE $19.22 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R9876 R000.322.900.04.00 0.00 $19.22 $408.02 Date Paid: Thursday, November 17, 2016 Paid By: MICHAEL HIMPLE Pay Method: CHECK 1142 Printed: Thursday, November 17, 2016 1:18 PM 1 of 1 ISYSTEMS Cash Register Receipt City of Tukwila DESCRIPTIONS ACCOUNT QUANTITY PAID PermitTRAK $249.80 D16-0291 Address: 12611 37TH AVE 5 Apn: 7345600810 $249.80 DEVELOPMENT $249.80 PLAN CHECK FEE TOTAL FEES PAID BY RECEIPT: R9723 R000.345.830.00.00 0.00 $249.80 $249.80 Date Paid: Tuesday, October 25, 2016 Paid By: MICHAEL HIMPLE JR Pay Method: CHECK 1136 Printed: Tuesday, October 25, 2016 11:33 AM 1 of 1 CANWSYSTEMS INSPECTION RECORD Retain a copy with permit INS TION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 DIG -02,e/ Project: �I t?.,t/2 /,U! 0 T e of Inspection: X11 Lb) �r6 � 9 /4, Address: /26// 37174,LF C Date Called: Special Instructions: Date Want d: 12iS' I' p.m. Request r: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: AAA,. Date: REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Pro' ct: 15.�tL2A l n)1 1)E141,0 T of Inspec . n: ��� ' Ccti SeleGIC5n0Ail Address: I26i 1 377H ✓ S Date Called: Special Instructions: Date Wanted: a m. Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: A Inspector:A Date: j 09h REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. FILE COPY Permit No. 11(t)- n 2-,c ? Plan review approval is subject to errors and omissions. Approval of construction documents does not authorize the violation of any adopted code or ordinance. Receipt of approved Field Copy and conditiops is acknowiedgJu. Date: fI-l7 /k City of Tukwila BUILD NG DIVISION C.. , 3/86 F'ERM11 FOR: lechanical % Iectrical I Dumbing as Piping r�fy of Tukwila etilZ_DWG DIVISION GRAPHIC SCALE 40 BO •(zxFEET ) `.1 inch. = 20 ft.. REVISIONS No changes shall be rrnde to the scope of work without prior approval of Tukwila Building Division NOTE: Rev;sians will require a new plan submittal and may include additional plan review fees. 2 SHED TO BE 176 o (' 5 C4 E0 13.0' NEW LOT LIN S88'40'55E -5'BSBL 110.02 • OfO NI o chi LO NI �zl EXISTING HOUSE LOT 2 7,909 sf t 0.18 acres ± EXISTING SHED 5'BSBL SHED TO BE '171-'1. 0LA. 5t'_'7 12.8' 110.02' N 88'40'55"W c)4(6TI �.�-N e .A DEtrta.- 15rcE . " = yon 2-Ct OITA 71‘NV5 % TI-Ntel,jALLkb1(a- u - /4/ RECEIVE ''E.VIEWED FOR CE COi''iPLIARNCE APPROVED I SOV 0 7 2016 20' I'i#y of Tukwila1 i ry d.l_tJII�4G DIVIS?ON ; SURVEY FOR: OWNER(S): THOMAS J BALZARINI ADDRESS: PHONE: 3535 S, 126TH ST. Tukwild, WA 98168 LI I Y/5T3, I t/LIN: OCT 2 5 2016 TUKWILA PUBLIC WORKS RECEIVED TY OF TUKWILA OCT 2 5 2016 ERMIT CENTER PUBLIC WORKS PERMIT INF. .NATION — 206-433-0179 Scope of Work (please provide detailed information): Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District ❑ .. Tukwila • 0 ...Water District #125 0 .. Water Availability Provided Sewer District • 0 .. Tukwila ❑ .. Sewer Use Certificate ❑...ValleyView ❑ :..Sewer Availability Provided ❑ ... Highline ❑ ... Renton 0... Renton ' 0... Seattle Septic System: 0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. Submitted with Application (mark boxes which apply): ❑ .. Civil Plans (Maximum Paper Size — 22" x 34") ❑ .. Technical Information Report (Storm Drainage) ❑ .. Bond 0...Insurance 0... Easement(s) Proposed Activities (mark boxes that apply): 0 .. Right-of-way Use - Nonprofit for less than 72 hours ❑ .. Right-of-way Use - No Disturbance 0 .. Construction/Excavation/Fill - Right-of-way 0 Non Right-of-way El ❑ .. Total Cut ❑ .. Total Fill cubic yards cubic yards 0 .. Sanitary Side Sewer ❑ .. Cap or Remove Utilities 0 .. Frontage Improvements 0 .. Traffic Control 0 .. Backflow Prevention - Fire Protection Irrigation Domestic Water ❑• ❑• ❑• ❑• 0... Geotechnical Report 0...Maintenance Agreement(s) ❑ .. Traffic Impact Analysis El.. Hold Harmless — (SAO) ❑ .. Hold Harmless — (ROW) 0...Right-of-way Use - Profit for less than 72 hours 0... Right-of-way Use — Potential Disturbance 0... Work in Flood Zone 0... Storm Drainage .. Abandon Septic Tank .. Curb Cut .. Pavement Cut .. Looped Fire Line ❑ .. Permanent Water Meter Size (1) " WO # ❑ .. Temporary Water Meter Size (1) " WO # ❑ .. Water Only Meter Size WO # 0 .. Sewer Main Extension Public 0 Private ❑ .. Water Main Extension Public 0 Private ❑ ... Grease Interceptor ❑ ... Channelization 0... Trench Excavation 0... Utility Undergrounding (2) " WO # (3) " WO # (2) " WO # (3) " WO # ❑ .. Deduct Water Meter Size FINANCE INFORMATION Fire Line Size at Property Line 0 .. Water ❑ .. Sewer ❑ .. Sewage Treatment Monthly Service Billing to: Name: Mailing Address: Number of Public Fire Hydrant(s) Day Telephone: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 hh Page 3 of 4 PERMIT APPLICATION NOTES — Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition). I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUT R Signature: Print Name: Mailing Address: Date: Day Telephone: H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 hh Stade i Zip Page 4 of 4 ASBESTOS SURVEY REPORT REVIEWED FOR CODE COMPLIANCE APPROVED NOV 0 7 2016 City of Tukwila BUILDING DIVISION Himple Drywall 12611 37th Ave S Tukwila WA 98168 Submitted To: Michael Himple 12611 37th Ave S Tukwila WA 98168 425-508-2039 R8mike@hotmail.com Job Number: 1603008 Job Name: Himple Drywall Inspection Conducted On: 3/31/16 Report Written By: Josh O'Neil Prepared by: Josh O'Neil Environmental Issues and Solutions, Inc. 11625 Center Rd Ste C Everett WA 98204 josh@environmentalias.com 425-249-2502 RECEIVED OCT 252016 TUKWILA PUBLIC WORKS RECEIVED CITY OF TUKWILA OCT 2 5 2016 PERMIT CENTER TABLE OF CONTENTS 1. Project Summary 2. Executive Summary 3. Collection and Examination Procedures 4. Conclusions and Recommendations 5. Limitations 6. Site Sketch 7. Site Photographs Attachments: Raw lab data. Chain of Custody. Inspector's AHERA Building Inspector Certification. 1. Project Summary Project Type: Asbestos Sampling Project Name: Himple Drywall Project Address: 12611 37th Ave S Tukwila WA 98168 Client: Himple Drywall On Site Contact: Michael Himple AHERA Building Inspector: Josh O'Neil Inspection Date: 3/31/16 Report Date: 4/5/16 2. Executive Summary Michael Himple of Himple Drywall hired Environmental Issues and Solutions, Inc. to conduct Asbestos Sampling of 12611 37th Ave S Tukwila WA 98168 on 3/31/16. A thorough visual inspection was made of the property in the areas directed by Michael Himple. Bulk samples were collected at the time of the inspection of all PACM (Potentially Asbestos Containing Materials) unless noted below. These samples are then sent to a National Institute of Standards and Technology (NIST) National Voluntary Laboratory Accreditation Program (NVLAP) accredited laboratory for analysis. Below is a list of all items found to contain 1% or greater amounts of Asbestos. Sample ID Description Sample Type Location(s) in the structure Total Quantity Percent of Asbestos MT -02-01 Window Glazing Kitchen Si B Kitchen 100 In. ft. 2% Chrysotile MT -03-01 Sheetrock Living Room B Living Room 2,500 sq. ft. <1% Chrysotile All other materials tested were found to contain 1% or less Asbestos content therefore they are considered Non -Asbestos Containing Materials. NOTE: Items between 0-1% may still require special handling requirements. Check with your local governing body. THE INSPECTION WAS LIMITED TO JUST THE FOLLOWING MATERIALS PER MICHAEL HIMPLE REQUEST. OTHER PACM MAY BE PRESENT AND IS ASSUMED TO CONTAIN ASBESTOS UNTIL PROPERLY COLLECTED AND ANALYZED. Below is a list of the items tested. The Client is aware that additional tested may be needed in the future. Sample ID Description Sample Type Location(s) in the structure Total Quantity Percent of Asbestos MT -01-01 Vinyl Living Room B Living Room 166 sq. ft. ND MT -01-02 Vinyl Living Room B Living Room 166 sq. ft. ND MT -01-03 Vinyl Entry B Entry 9 sq. ft. ND MT -01-04 Vinyl Entry B Entry 9 sq. ft. ND MT -01-05 Vinyl Kitchen B Kitchen 190 sq. ft. ND MT -01-06 Vinyl Kitchen B Kitchen 190 sq. ft. ND MT -01-07 Vinyl Bathroom B Bathroom 30 sq. ft. ND MT -01-08 Vinyl Bathroom B Bathroom 30 sq. ft. ND MT -01-09 Vinyl Bedroom One B Bedroom One 120 sq. ft. ND MT -01-10 Vinyl Bedroom Two B Bedroom Two 150 sq. ft. ND MT -01-11 Vinyl Laundry Room B Laundry 28 sq. ft. ND MT -01-12 Vinyl Laundry Room B Laundry 28 sq. ft. ND MT -02-01 Window Glazing Kitchen Si B Kitchen 100 In. ft. 2% Chrysotile MT -02-02 Window Glazing Kitchen Fr B Kitchen 100 In. ft. ND MT -03-01 Sheetrock Living Room B Living Room 2,500 sq. ft. <1% Chrysotile MT -03-02 Sheetrock Kitchen B Kitchen 2,500 sq. ft. ND MT -03-03 Sheetrock Bedroom Two B Bedroom Two 2,500 sq. ft. ND MT -04-01 Vapor Barrier/Insulation B Crawler Under Kitchen 800 sq. ft. ND MT -04-02 Vapor Barrier/Insulation B Crawler Under Hallway 800 sq. ft. ND MT -05-01 Brick And Mortar B Roof 1,300 sq. ft. ND MT -05-02 Brick And Mortar B Roof 1,300 sq. ft. ND MT -06-01 Roofing B Roof 120 sq. ft. ND MT -06-02 Roofing B Roof 120 sq. ft. ND 3. Collection and Examination Procedures Using destructive investigative techniques samples of Potentially Asbestos Containing Materials were collected and placed in Zip -Lock © bags. This prevents cross contamination of samples and allows for individual analysis of each sample at the laboratory. Each individual sample is then labeled and photographed for documentation purposes. Once all samples have been collected they are logged onto a Chain of Custody form. They are then shipped, usually via overnight shipping, to a National Institute of Standards and Technology (NIST) National Voluntary Laboratory Accreditation Program (NVLAP) accredited laboratory for analysis. Environmental Issues and Solutions, Inc. did not sample any part, component or system which presented a hazard to the inspector to include, but not limited to active electrical systems, heating systems or areas that are unsafe to access. The analysis is typically conducted via Polarized Light Microscopy (PLM). This type of analysis meets the requirement of most clients for asbestos testing. The final product yields not only the amount of asbestos but the type of fibers present in each sample. The detection limit of PLM is 1%. If the client requires Transmission Electron Microscopy (TEM), which allows for detection of levels much less than 1% contact Environmental Issues and Solutions, Inc. within one week (seven days) of receiving this report. Additional costs will apply if TEM testing is requested. 4. Conclusions and Recommendations Asbestos Containing Material (ACM) was discovered during the inspection process. It has been identified in this report (see section 2). Proper procedures must be followed in accordance with all Local, State, and Federal Laws pertaining to Asbestos when disturbing this material. Typically a licensed abatement contractor must perform the removal of all ACM. Remember in most cases if the materials are not disturbed then no special precautions need to be taken. The Puget Sound Clean Air Agency has a list of Asbestos Abatement Companies if the materials found to be ACM are to be disturbed. www.pscleanair.org All materials that were determined to be Non -Detected (ND) do NOT require any special handling. Follow their individual manufacture's recommendations for disturbing and or handling. Again if you don't bother it, it won't bother you. If ACM is undisturbed it possesses very little risk to humans. In the State of Washington upon selling your home any known ACM must be disclosed. If you choose to not remove the ACM please include this report with the sale of your home and provide us written permission to discuss this report with the buyer of your home. 5. Limitations The inspection and report was completed for Himple Drywall. Use of any part of this report or test results by any other parties will be that parties sole risk and Environmental Issues and Solutions, Inc. disclaims liability for any such use or reliance by third parties. No warranties, implied or expressed in this report are made to any third party. The observations made during the inspection are considered sufficient to determine the presence of asbestos in the materials tested. Due to limitations such as access to all materials of the structure Environmental Issues and Solutions, Inc. will warrant that these observations are true and correct based on generally accepted industry standards for asbestos testing. Environmental Issues and Solutions, Inc. does not guarantee that all potentially asbestos containing materials on the subject property were identified and tested. This report is limited to the samples taken at the noted locations. Additional sampling may be needed to further identify other potentially asbestos containing materials. Thank you for choosing Environmental Issues and Solutions, Inc. for your Asbestos Sampling and Surveying. Please do not hesitate to contact us, if for any reason, you have questions related to this report. Written by, Josh O'Neil AHERA Building Inspector 153906 Certification expires November 10th 2016 6. SITE SKETCH Not to scale Living Room Bedroom _2_�__I 7. Site Photographs EMLab P&K A TestAmerica Company Report for: Mr. Josh O'Neil Environmental Issues and Solutions, Inc 11625 Center Road Suite C Everett, WA 98204 Regarding: Project: 1603008; Asbestos EML ID: 1517755 Approved by: Dates of Analysis: Asbestos PLM: 04-05-2016 Approved Signatory Diane Green Service SOPs: Asbestos PLM (EPA Methods 600/R-93/116 & 600/M4-82-020, SOP EM -AS -S-1267) All samples were received in acceptable condition unless noted in the Report Comments portion in the body of the report. The results relate only to the items tested. The results include an inherent uncertainty of measurement associated with estimating percentages by polarized light microscopy. Measurement uncertainty data for sample results with >1% asbestos concentration can be provided when requested. EMLab P&K ("the Company") shall have no liability to the client or the client's customer with respect to decisions or recommendations made, actions taken or courses of conduct implemented by either the client or the client's customer as a result of or based upon the Test Results. In no event shall the Company be liable to the client with respect to the Test Results except for the Company's own willful misconduct or gross negligence nor shall the Company be liable for incidental or consequential damages or lost profits or revenues to the fullest extent such liability may be disclaimed by law, even if the Company has been advised of the possibility of such damages, lost profits or lost revenues. In no event shall the Company's liability with respect to the Test Results exceed the amount paid to the Company by the client therefor. EMLab P&K, LLC EMLab ID: 1517755, Page 1 of 4 ATTACHMENTS Chain of Custody Laboratory Data Certifications EMLab P&K 8304 Clairemont Mesa Blvd, Suite 103, San Diego, CA 92111 (866) 888-6653 Fax (623) 780-7695 www.emlab.com Date of Sampling: 03-31-2016 Date of Receipt: 04-01-2016 Date of Report: 04-05-2016 Client: Environmental Issues and Solutions, Inc C/O: Mr. Josh O'Neil Re: 1603008; Asbestos ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116 Total Samples Submitted: 11 Total Samples Analyzed: 11 Total Samples with Layer Asbestos Content > 1%: 0 Location: MT-O1-Ol, Vinyl living room Lab ID -Version$: 7022803-1 Sample Layers Asbestos Content Green Sheet Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 75% Cellulose ND Sample Composite Homogeneity: Poor ND Location: MT -O1-02, Vinyl living room Lab ID -Version$: 7022804-1 Sample Layers Asbestos Content Green Sheet Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 75% Cellulose ND Sample Composite Homogeneity: Poor ND Location: MT -01-03, Vinyl entry Lab ID -Version$: 7022805-1 Sample Layers Asbestos Content White Floor Tile ND Semi -Transparent Mastic ND Green Sheet Flooring with Tar Paper ND Brown Wood 45% Cellulose ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Poor Location: MT -O1-04, Vinyl entry Lab ID -Version$: 7022806-1 Sample Layers Asbestos Content White Floor Tile ND Semi -Transparent Mastic ND Green Sheet Flooring with Tar Paper ND Composite Non -Asbestos Content: 45% Cellulose Sample Composite Homogeneity: Poor The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government. EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When detected, the minimum detection and reporting limit is less than 1% unless point counting is performed. Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. t A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". EMLab P&K, LLC EMLab ID: 1517755, Page 2 of 4 EMLab P&K 8304 Clairemont Mesa Blvd, Suite 103, San Diego, CA 92111 (866) 888-6653 Fax (623) 780-7695 www.emlab.com Client: Environmental Issues and Solutions, Inc Date of Sampling: 03-31-2016 C/O: Mr. Josh O'Neil Date of Receipt: 04-01-2016 Re: 1603008; Asbestos Date of Report: 04-05-2016 ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116 Location: MT -O1-05, Vinyl kitchen Lab ID -Version$: 7022807-1 Sample Layers Asbestos Content White Floor Tile ND Semi -Transparent Mastic ND Off -White Sheet Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Poor Location: MT -O1-06, Vinyl kitchen Lab ID -Version$: 7022808-1 Sample Layers Asbestos Content White Floor Tile ND Semi -Transparent Mastic ND Off -White Sheet Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Poor Location: MT-Ol-07, Vinyl bathroom Lab ID -Version$: 7022809-1 Sample Layers Asbestos Content White Sheet Flooring with Fibrous Backing ND Semi -Transparent Mastic ND Brown Wood ND Black Tar Paper ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Poor Location: MT -O1-08, Vinyl bathroom Lab ID -Version$: 7022810-1 Sample Layers Asbestos Content White Sheet Flooring with Fibrous Backing ND Semi -Transparent Mastic ND Brown Wood ND Black Tar Paper ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Poor The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal govemment. EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When detected, the minimum detection and reporting limit is less than 1% unless point counting is performed. Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. $ A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". EMLab P&K, LLC EMLab ID: 1517755, Page 3 of 4 EMLab P&K 8304 Clairemont Mesa Blvd, Suite 103, San Diego, CA 92111 (866) 888-6653 Fax (623) 780-7695 www.emlab.com Date of Sampling: 03-31-2016 Date of Receipt: 04-01-2016 Date of Report: 04-05-2016 Client: Environmental Issues and Solutions, Inc C/O: Mr. Josh O'Neil Re: 1603008; Asbestos ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116 Location: MT -O1-09, Vinyl bedroom one Lab ID -Version$: 7022811-1 Sample Layers Asbestos Content Blue Sheet Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 70% Cellulose ND Sample Composite Homogeneity: Poor _ Location: MT -O1-10, Vinyl bedroom two Lab ID -Version$: 7022812-1 Sample Layers Asbestos Content Blue Sheet Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 70% Cellulose ND Sample Composite Homogeneity: Poor _ Location: MT -O1-11, Vinyl laundry room Lab ID -Version$: 7022813-1 Sample Layers Asbestos Content Gray Floor Tile ND Semi -Transparent Mastic ND White Sheet Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Poor The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government. EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When detected, the minimum detection and reporting limit is less than 1% unless point counting is performed. Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. I A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". EMLab P&K, LLC EMLab ID: 1517755, Page 4 of 4 Report for: EMLab P&K A TestAmerica Company Mr. Josh O'Neil Environmental Issues and Solutions, Inc 11625 Center Road Suite C Everett, WA 98204 Regarding: Project: 1603008; Asbestos EML ID: 1517760 Approved by: Q Approved Signatory Diane Green Dates of Analysis: Asbestos PLM: 04-05-2016 Service SOPs: Asbestos PLM (EPA Methods 600/R-93/116 & 600/M4-82-020, SOP EM -AS -S-1267) All samples were received in acceptable condition unless noted in the Report Comments portion in the body of the report. The results relate only to the items tested. The results include an inherent uncertainty of measurement associated with estimating percentages by polarized light microscopy. Measurement uncertainty data for sample results with >1 % asbestos concentration can be provided when requested. EMLab P&K ("the Company") shall have no liability to the client or the client's customer with respect to decisions or recommendations made, actions taken or courses of conduct implemented by either the client or the client's customer as a result of or based upon the Test Results. In no event shall the Company be liable to the client with respect to the Test Results except for the Company's own willful misconduct or gross negligence nor shall the Company be liable for incidental or consequential damages or lost profits or revenues to the fullest extent such liability may be disclaimed by law, even if the Company has been advised of the possibility of such damages, lost profits or lost revenues. In no event shall the Company's liability with respect to the Test Results exceed the amount paid to the Company by the client therefor. EMLab P&K, LLC EMLab ID: 1517760, Page 1 of 4 EMLab P&K 8304 Clairemont Mesa Blvd, Suite 103, San Diego, CA 92111 (866) 888-6653 Fax (623) 780-7695 www.emlab.com Date of Sampling: 03-31-2016 Date of Receipt: 04-01-2016 Date of Report: 04-05-2016 Client: Environmental Issues and Solutions, Inc C/O: Mr. Josh O'Neil Re: 1603008; Asbestos ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116 Total Samples Submitted: 12 Total Samples Analyzed: 12 Total Samples with Layer Asbestos Content > 1%: 2 Location: MT -O1-12, Vinyl laundry room Lab ID -Version$: 7022783-1 Sample Layers Asbestos Content White Floor Tile ND Semi -Transparent Mastic Good ND White Flooring with Tar Paper ND Brown Wood ND Composite Non -Asbestos Content: 50% Cellulose Sample Composite Homogeneity: Poor Location: MT -02-01, Window glazing kitchen si Lab 1D -Version$: 7022784-1 Sample Layers Asbestos Content Gray Window Glazing 2% Chrysotile Sample Composite Homogeneity: Good ND Location: MT -02-02, Window glazing kitchen fr Lab 1D -Version$: 7022785-1 Sample Layers Asbestos Content Beige Window Glazing ND Sample Composite Homogeneity: Good ND Location: MT -03-01, Sheetrock living room Lab ID -Version$: 7022786-1 Sample Layers Asbestos Content Beige Compound 2% Chrysotile Cream Tape ND Beige Joint Compound 2% Chrysotile White Drywall with Brown Paper ND Composite Asbestos Fibrous Content: < 1% Asbestos Composite Non -Asbestos Content: 15% Cellulose Sample Composite Homogeneity: Poor Comments: Composite asbestos content provided is only for Drywall/Joint compound. Composite content provided does not follow the guidelines set forth by NVLAP. This analysis was performed by following the NESHAP guidelines. The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government. EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When detected, the minimum detection and reporting limit is less than 1% unless point counting is performed. Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. $ A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". EMLab P&K, LLC EMLab ID: 1517760, Page 2 of 4 EMLab P&K 8304 Clairemont Mesa Blvd, Suite 103, San Diego, CA 92111 (866) 888-6653 Fax (623) 780-7695 www.emlab.com Date of Sampling: 03-31-2016 Date of Receipt: 04-01-2016 Date of Report: 04-05-2016 Client: Environmental Issues and Solutions, Inc C/O: Mr. Josh O'Neil Re: 1603008; Asbestos ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116 Location: MT -03-02, Sheetrock kitchen Lab ID -Version$: 7022787-1 Sample Layers Asbestos Content White Drywall with Brown Paper and Paint ND Composite Non -Asbestos Content: 10% Cellulose ND Sample Composite Homogeneity: Moderate Location: MT -03-03, Sheetrock bedroom two Lab ID -Version$: 7022788-1 Sample Layers Asbestos Content White Drywall with Brown Paper and Paint ND Brown Wood 70% Cellulose ND Composite Non -Asbestos Content: 40% Cellulose Sample Composite Homogeneity: Moderate Location: MT -04-01, Vapor barrier/ insulation Lab ID -Version$: 7022789-1 Sample Layers Asbestos Content Brown Vapor Barrier with Black Mastic -Like Material ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Good Location: MT -04-02, Vapor barrier/ insulation Lab ID -Version$: 7022790-1 Sample Layers Asbestos Content Brown Vapor Barrier with Black Mastic -Like Material ND Composite Non -Asbestos Content: 70% Cellulose Sample Composite Homogeneity: Good The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government. EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When detected, the minimum detection and reporting limit is less than 1% unless point counting is performed. Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. I A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". EMLab P&K, LLC EMLab ID: 1517760, Page 3 of 4 EMLab P&K 8304 Clairemont Mesa Blvd, Suite 103, San Diego, CA 92111 (866) 888-6653 Fax (623) 780-7695 www.emlab.com Date of Sampling: 03-31-2016 Date of Receipt: 04-01-2016 Date of Report: 04-05-2016 Client: Environmental Issues and Solutions, Inc C/O: Mr. Josh O'Neil Re: 1603008; Asbestos ASBESTOS PLM REPORT: EPA -600/M4-82-020 & EPA METHOD 600/R-93-116 Location: MT -05-01, Brick and mortar Lab ID -Version$: 7022791-1 Sample Layers Asbestos Content Gray Mortar ND Sample Composite Homogeneity: Good ND Location: MT -05-02, Brick and mortar Lab ID -Version$: 7022792-1 Sample Layers Asbestos Content Gray Mortar ND Red Brick ND Sample Composite Homogeneity: Good Location: MT -06-01, Roofing Lab ID -Version$: 7022793-1 Sample Layers Asbestos Content Black Roofing Shingle ND Black Tar Paper ND Composite Non -Asbestos Content: 40% Glass Fibers 20% Cellulose Sample Composite Homogeneity: Good Location: MT -06-02, Roofing Lab m -Version$: 7022794-1 Sample Layers Asbestos Content Black Roofmg Shingle with Red Pebble ND Black Roofmg Shingle ND Composite Non -Asbestos Content: 40% Cellulose 40% Glass Fibers Sample Composite Homogeneity: Good The test report shall not be reproduced except in full, without written approval of the laboratory. The report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the federal government. EMLab P&K reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Inhomogeneous samples are separated into homogeneous subsamples and analyzed individually. ND means no fibers were detected. When detected, the minimum detection and reporting limit is less than 1% unless point counting is performed. Floor tile samples may contain large amounts of interference material and it is recommended that the sample be analyzed by gravimetric point count analysis to lower the detection limit and to aid in asbestos identification. I A "Version" indicated by -"x" after the Lab ID# with a value greater than 1 indicates a sample with amended data. The revision number is reflected by the value of "x". EMLab P&K, LLC EMLab ID: 1517760, Page 4 of 4 1900 W Nickerson St, # 315 Seattle, WA 98119 206.285.3373 ARGUS II AI TRAINING•CONSUI.TING nlrmrnrnn oonrnirr This certifies that Josh C. O'Neil has satisfactorily completed 4 hours of refresher training as an Asbestos Building Inspector complies with TSCA Title II / 40 CFR 763 (AHERA) `mom (3 ciA, Instructor EPA Provider Certificate # 1085 Certificate # 153906 Class Date: Nov 11, 2015 Expires: Nov 10, 2016 lkIIftiIf II Irl I I U )1517755 m n tke4 anb, arra; rgn"que45 l ust $oil, Con[P[etes _ ram min Ji 0 nom IN *seoloodshed Q It • C7 Q ! 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CI 0 0 Q slefyaa dwimot—muni El 0 0 ID 1 0 0.0 0 �7a1�jpo N AROUND TIME CODES (TAT) 21 tp ppppjjjj • 01!*■ t W i . . t 15. ki I fg 'ene-t 1 m CHAIN OF CUSTODY EM Lab P. 8,1( www.EmLabpttoorri A TestAmerica Company New Jersey: 3900 Lino* Wee EA Sub A, Maddca, NJ 0053' (868) 871.4%L Phoenix, AZ: 15V West Knudsen dire, Rosati, AZ 8.527 * (eqp) 6S1 -4S02 . San Bruoq, CA: 9150 Bayhlf D iue,#1O0, San Bruno, GA 94966` (866) 8884663 CONTACT INFORMATION • x x s g.1 z o: - a a e P e°(0 v e PROJECT INFORMATION 1 w To . o o -; Gd ",1 co m co at m co m m coJ g c4 MT.i 3 ;Vinyl Entry. : Vinyl Entry` T-01-05 . Vinyi Kitchen• _ MT -03.-0G ,Vinyl Kitchen MT -01-O7 :Vinyl Bathroom IViT-01-0S IVinyi Bathroom - - - IyIT-01-D5, !Vinyl Bedroom One Environmental Issues and Solutions • I SMA Sk1mpls FD Description MT -01-01 IVinyt Living Room 1 MT -02-02 'Vinyl Living Room _.T � b $, I D m m m 4 8 �co _ ii C d � Qs3 fD Sp i. r d CO 03 8 1 w m 0 O 0 0 1 0 0.0 0 0 ■ 000 0 ■ 1:30 00 000'00 ■ ■■■■ Drioo© 00000 00❑:0{ 000,00 000100 000❑❑ 00000 00 0 LTJ ■ 1 0 00 00000 000❑0 00000 00000 L0 GO Oa: ❑00 000 00.0:00 00DD0 000130 00,000 00.0:00 V ti 41 ' oa Q OS COCO 09 0 CO as 0 0 W 1 v a A 10072 Peal a 194; 0 g Q a m 5 • g CD -o 11-4 Rog- Spam TrapAnaIis Spore Trap Anolyss - Outer parities DYectMieroscopicExam (Quaflfalira) Quantitative Spore Count Most Exam 1 •Nadia SEaiasa Fu4gi (Genus D +Asti, spp.) 2 Media SElrtare Fungi (Ganes ID +Asp. am) 3•144/110 Stake NV Menus ID+Asp. app.) CufwiaMeAir Fungi (Genus ID+Asp, spp.) Gram &Consols(CullurMble Air & &shoe lautoria) Logone&aato Rid Califon,, is cat(Pr Ater .4 a a A 2 0 O 0 0 0 0 ❑'0 ❑ 0 0 0 0 0 0 0 0 00 00 O 0 0 0 Womanise FOIraean Sspectfg attaniar MPPI Bacteria (specify weals* 4nanUfray-Sewee Screen �] AsbesfosAssIys{s-PCMMesons Mar Must (NOSH 74{fO Asbestos Anal * - PLM TEPA method GODS/ 413-11 ) 0 PCR (specfify te9tjc Levet a 0 D Cly A,Li ❑ 0 p • • -, ` vl I PROJECT INFORMATION• M ._ CONTACT INFORMATION CHAD( OF CUSTODY oEMLab P& • www.EMLabPK.Corn A T9stAm$r'sca Cprrtpny • Hew Arm; 3D04 Lincoln Drive Eat Sufic A, Marlton, NJ G$b53+(BM 871•1984 Pink AZ: 1501 West novel aril*, Phoenix, A2 B5027 " (8dG) 651.if02 ' San primp, CA: 1150 Bay'<+io Woe, MO, San Brunn, CA 94666' *OM 8888663 • j , i • 1 - _.;) ; via; • •r E ' Samplae �r JCO — . or , s. ni 0 CB ru • IN W CO173 W CO'W ] WA o'03 CO 03 in in -a 2 a • 3 a Z • wa j$m�iy g a v c61 �•-� (1 STD g • +r c� 3 t�` + 11 • P D ifs —.. 1 5 I 1 • , [revel . i1 'w $ g 1 ; ' d * li C] ng • I I -•.81.23 _ : • .Illi i ik��= c Q P no ❑ ff # p. p.g5m g . 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Q O R' CJ 0 ■ 0 • .O PCR kw* tem).• 0 0 01111:1-0001101a • LEAD SURVEY REPORT Himple Drywall 12611 37th Ave S Tukwila WA 98168 Submitted To: Michael Himple 12611 37th Ave S Tukwila WA 98168 425-508-2039 R8mike@hotmail.com Job Number: 1603008 Job Name: Himple Drywall Inspection Conducted On: 3/31/16 Report Written By: Josh O'Neil Prepared by: Josh O'Neil Environmental Issues and Solutions, Inc. 11625 Center Rd Ste C Everett WA 98204 josh@environmentalias.com 425-249-2502 TABLE OF CONTENTS 1. Project Summary 2. Executive Summary 3. Collection and Examination Procedures 4. Conclusions and Recommendations 5. Limitations Attachments: Raw lab data. Chain of Custody. Inspector's Lead Based Paint Certification. 1. Project Summary Project Type: TCLP (Lead Leaching) Project Name: Himple Drywall Project Address: 12611 37th Ave S Tukwila WA 98168 Client: Himple Drywall On Site Contact: Michael Himple AHERA Building Inspector: Josh O'Neil Inspection Date: 3/31/16 Report Date: 4/12/16 2. Executive Summary Himple Drywall hired Environmental Issues and Solutions, Inc. to conduct Lead Based Paint Sampling of 12611 37th Ave S Tukwila WA 98168 on 3/31/16 for a Lead Leaching Test. A thorough visual inspection was made of the property in the areas (all accessible) directed by Michael Himple. Bulk samples were collected at the time of the inspection of a representative sampling of what would be demolished and end up in the landfill. These samples are then sent to a National Institute of Standards and Technology (NIST) National Voluntary Laboratory Accreditation Program (NVLAP) accredited laboratory for analysis. Lead Based Paint Leaching Results ND (None Detected) 3. Collection and Examination Procedures Using destructive investigative techniques, a representative sampling of what would be demolished and end up in the landfill were collected. Materials were collected and placed in Zip -Lock © bags. This prevents cross contamination of samples and allows for individual analysis of each sample at the laboratory. Each individual sample bag is then labeled and photographed for documentation purposes. Once all samples have been collected they are logged onto a Chain of Custody form. They are then shipped, usually via overnight shipping, to a National Institute of Standards and Technology (NIST) National Voluntary Laboratory Accreditation Program (NVLAP) accredited laboratory for analysis. Environmental Issues and Solutions, Inc. did not sample any part, component or system which presented a hazard to the inspector to include, but not limited to active electrical systems, heating systems or areas that are unsafe to access. The analysis is typically conducted via a leaching process in which chemicals are added to release the lead, and then the amount of lead is measured. This type of analysis meets the requirement of most waste streams for lead based paint testing. The final product yields a ND or amount of lead. 4. Conclusions and Recommendations No Lead Based Paint was discovered during the inspection process. All materials that were tested were determined to be Non -Detected (ND) and do NOT require any special handling. Follow their individual manufacture's recommendations for disturbing and or handling. 5. Limitations The inspection and report was completed for Himple Drywall. Use of any part of this report or test results by any other parties will be that parties sole risk and Environmental Issues and Solutions, Inc. disclaims liability for any such use or reliance by third parties. No warranties, implied or expressed in this report are made to any third party. The observations made during the inspection are considered sufficient to determine the presence of Lead Based Paint in the materials tested. Due to limitations such as access to all materials of the structure Environmental Issues and Solutions, Inc. will warrant that these observations are true and correct based on generally accepted industry standards for Lead Based Paint Testing. Environmental Issues and Solutions, Inc. does not guarantee that all Lead Based Paint containing materials on the subject property were identified and tested. This report is limited to the samples taken at the noted locations. Again, a representative sampling was taken of the structure both inside and out. Thank you for choosing Environmental Issues and Solutions, Inc. for your Lead Based Paint Sampling and Surveying. Please do not hesitate to contact us, if for any reason, you have questions related to this report. Written by, Josh O'Neil Lead Based Paint Risk Assessor Certification expires December 19th, 2016 ATTACHMENTS Chain of Custody Laboratory Data Certifications a Ica g .Q 0 O ❑ s g ❑1*© 0 ❑ z 1 '1"P'197d1 1 9II4:6-wM9 pavddj - slsleuy sosgs. No 0 l • WOK MOM} limn 1 nutomeWm-saks3 e V ❑ iiiiros duos -.Amiguent} 0 0 4tuglueruc djroeds) etnpaeg NM 0 ;acslueStalpedsj mac elentufet.4 OVUOSIVAMSEUGO NO, 8 WOOD1 1 eimrp CIPMDe r { sue9ee MPS IN ln311Pfri g ule18 oiatg bddd Why+snue8}!fiend{Nerkituyln3 tdd9 viae+ ai sem} eO S 2IPevr.E {Tilt *p+ CII alrnn} IBund mire mewl (trig Ise, QI srus9} IUnd =PS c41)81/11. • fragginintOugyaidoommiriloalICI sel!ed Jaglp- BMS asleuy ern mot -!Bung 0 0000000 0000000 0 a IL] 0 ce W 0 0 U m 3 4 E SEandab (DEFAULT) ay a A jm I ! . z � 5 A db W CI rd U d Z Z f ti 497 id 0 0 CD CD 0 7 1 0 0 ❑ 0 0 m 03 m ri if O g OFT w 1- 06 w 3/31/1B 1600 r a) sep re PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D16-0291 DATE: 10/25/16 PROJECT NAME: BALZARINI DEMOLITION SITE ADDRESS: 1261137 AVE S X Original Plan Submittal Response to Correction Letter # Revision # before Permit Issued Revision # after Permit Issued DEPARTMENTS: c Building Division Public Works A -M N//4- 0/4 Ire -6)--70 Fire Prevention Planning Division CI Structural ❑ Permit Coordinator C:1 PRELIMINARY REVIEW: Not Applicable ri (no approval/review required) DATE: 10/27/16 Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved ❑ Approved with Conditions Corrections Required Denied (corrections entered in Reviews) (ie: Zoning Issues) DUE DATE: 11/24/16 Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: 12/18/2013 Himple Drywall Hoare Espanol Contact. Search L&I Page 1 of 2 CH A-7, Index Help Mv L&I Safety & Health Claims & Insurance Workplace Rights Trades & Licensing Washington State Department of Labor & Industries Himple Drywall Owner or tradesperson Himple Jr, Michael Roy Principals Himple Jr, Michael Roy, OWNER WA UBI No. 603 186 290 419 Ave E SNOHOMISH, WA 98290 425-508-2039 SNOHOMISH County Business type Individual License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor License specialties GENERAL License no, HIMPLD*887DB Effective — expiration 03/02/2012— 03/27/2018 Bond Wesco Insurance Co Bond account no. 46WB044696 Active. Meets current requirements. $12,000.00 Received by L&I Effective date 03/01/2016 02/24/2016 Expiration date Until Canceled Bond history Insurance Contractors Bonding & Insuranc Policy no. C11SJ8533 $1,000,000.00 Received by L&I Effective date 02/24/2016 02/24/2016 Expiration date 02/24/2017 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. 1 � Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603186290&LIC=HIMPLD*887DB&SAW= 11/14/2016