07 - 630A4-22-700 Appx D-Asbestos Inspection Report.pdf

INSPECTION FOR ASBESTOS-CONTAINING MATERIALS

Performed at:

VA Medical Center Brooklyn Campus 800 Poly Place, Brooklyn, NY 11209

Buildings 1, 2, 4, 14 and 15 Athenica Project #24-114-1183

Performed for:

Spees Design Build 23830 Pacific Hwy S, Suite 203, Kent, WA 98032

Attn: Jonathan Greb Cell: 253-670-1236, Email: JonG@speesdb.com

Prepared by:

Athenica Environmental Services, Inc.

31-33 31st Street, Astoria, NY 11106

Tel: (718) 784-7490

Report Date:

JANUARY 15th, 2025

TABLE OF CONTENTS

1.0 BACKGROUND

2.0 SCOPE OF WORK

3.0 SUMMARY OF INSPECTION RESULTS

4.0 INSPECTION RESULTS

5.0 REPORT CERTIFICATIONS

APPENDICES

6.0 APPENDIX A: Analytical Results, Chain-of-Custody Forms and Certificates of Laboratory Analysis

7.0 APPENDIX B: Personnel Certificates

8.0 APPENDIX C: Consulting Company License

9.0 APPENDIX D: Laboratory Accreditation

10.0 APPENDIX E: Project Documents

Inspection for Asbestos-Containing Materials at

800 Poly Place, Brooklyn, NY 11209 - Buildings 1, 2, 4, 14 and 15

Athenica Project #24-114-1183 1

1.0 BACKGROUND

Athenica Environmental Services, Inc. has conducted an asbestos survey for the presence of asbestos-containing materials (ACM) at the following building:

Address: VA Medical Center Brooklyn Campus

800 Poly Place, Brooklyn, NY 11209 Buildings 1, 2, 4, 14 and 15

The Project Managers/ Inspectors/ Investigator responsible for this project were:

Name NYC DEP Investigator Cert # NYS DOL License Inspector Cert #

Juraj Bardiovsky 150557 - Exp.: 10/14/2025 23-6T9CT-SHAB - Exp.: 10/2024

Artour Martirossian

146717 - Exp.: 07/07/2025 23-6T6XF-SHAB - Exp.: 07/2025

Matthew Taylor - 23-61EUK-SHAB - Exp.: 07/2024

Site Visits: August 27th, 2024, August 28th, 2024 Report Date: January 15th, 2025

2.0 SCOPE OF WORK

The scope of the inspection was to inspect and sample suspect asbestos containing materials in all locations as outlined on the Project Drawings/ Scope of Work:

EHRM Infrastructure Upgrades – Project 630Q4-22-700 (Date 06/10/2024)

Field Procedures:

Guidelines used for the inspection were established by the Environmental Protection Agency (EPA) in the Guidance for Controlling Asbestos Containing Materials in Buildings, Office of Pesticides and Toxic Substances, DOC # 560/5-85-024, and 40 CFR Part 763, Asbestos Hazard Emergency Response Act

(AHERA).

Field information was organized as per the AHERA concept of homogenous area (HA). That is, suspect ACM with similar age, appearance, and texture was grouped together, sampled and assessed for condition.

The survey consisted of checking and inspecting the building for evidence of ACM. The survey has two components:

▪ Inspecting materials throughout all locations

▪ Sampling for laboratory confirmation that asbestos is present.

For the purpose of the inspection, suspect ACM materials have been grouped into three categories:

▪ Surfacing Materials, e.g.: wall plaster, ceiling plaster and other materials.

▪ Thermal System Insulation, e.g.: pipe insulation, boiler insulation, duct insulation and other materials.

▪ Other Miscellaneous Materials, e.g.: floor and ceiling tiles, mastic/glue and other materials.

Analysis Methodology:

Bulk samples were analyzed using Non-Organically Bound Polarized Light Microscopy (PLM-NOB) and Transmission Electron Microscopy (TEM-NOB) by Laboratory Testing Services, Inc. Laboratory Testing Services, Inc. laboratory is accredited by the New York State Department of Health under their Environmental Laboratory Approval Program (ELAP ID # 10955) and by the National Institute of Standards and Technology (NIST) under their National Voluntary Laboratory Accreditation Program (NVLAP Laboratory ID 101958).

Athenica Project #24-114-1183 2

3.0 SUMMARY OF INSPECTION RESULTS

The asbestos inspection involved a thorough visual examination of all areas affected by planned project and sampling of all suspect materials. Asbestos-containing materials were identified during this asbestos inspection. The following is a summary of materials which are identified as ACM, ACM-Contaminated or Assumed ACM and may/ may not be disturbed during this project:

Locations Material ACM Result Quantity of ACM

BUILDING 1

Level 00B – Room B302 Corrugated Pipe Insulation ACM 30 LF

Fire Door Insulation Assumed ACM Not Impacted

Level 00B – Room B106A Fire Door Insulation Assumed ACM Not Impacted

Level 00G – Room G140 12x12 Floor Tiles - Yellow/ Gold/ Mastic/ Glue

ACM/ ACM

Contaminated

185 SF

Fire Door Insulation Assumed ACM 24 SF

Level 00G – Room G100B

Spray-on Fireproofing Assumed ACM

Not Impacted 12x12 Floor Tiles White w/ Speckles/ Mastic Assumed ACM

12x12 Floor Tiles Light Grey w/ Beige Speckles/ Mastic Assumed ACM

12x12 Light Grey w White Speckles/ Mastic Assumed ACM

Level 001 – Room 1-503 and Closet in Room 1-503

12x12 Floor Tiles/ Glue Assumed ACM Scheduled to be removed under an unrelated project.

ACM Pipe Insulation Assumed ACM

12x12 Floor Tiles Beige w/ Brown Speckles Assumed ACM

Glue under 12x12 Floor Tiles Beige w/ Brown Speckles Assumed ACM

Level 001 – Room 1-102B

Faux Wood Linoleum ACM/ ACM Contaminated

185 SF

Floor Tiles/ Glue/ Dash Patch under Linoleum

Fire Door Insulation Assumed ACM 24 SF

Level 002 – 2-108A Fire Door Insulation Assumed ACM 24 SF

Level 002 – 2-108A Closet

9x9 Floor Tiles ACM

25 SF

Mastic under 9x9 Floor Tiles ACM

Fire Door Insulation Assumed ACM 24 SF

Level 002 – Room 2-300

Remnant Tar on Quarry Tiles ACM 130 SF

Waterproofing Membrane under Quarry Tiles Assumed ACM Not Impacted

Fire Door Insulation Assumed ACM 24 SF

Level 003 – Room 3-300 Fire Door Insulation Assumed ACM 24 SF

Level 003 – Room 3-115A

12x12 Floor Tiles - Taupe w/ Lines

ACM

Contaminated 387 SF

Mastic under 12x12 Floor Tiles - Taupe w/ Lines ACM

Fire Door Insulation Assumed ACM 24 SF

Level 003 – Hallway by Room 3-115A

12x12 Floor Tiles - Off White w/ Lines ACM

10 SF

Mastic under 12x12 Floor Tiles – Off White w/ Lines ACM

Level 004 – Room 4-118

Faux Wood Linoleum

ACM

Contaminated 185 SF

Floor Tiles/ Glue/ Dash Patch under Linoleum ACM

Fire Door Insulation Assumed ACM 24 SF

Level 004 – Room 4-138A Bathroom Foyer

12x12 Floor Tiles – Off White w/ Spots ACM

183 SF

Mastic under 12x12 Floor Tiles - Off White w/ Spots ACM

Fire Door Insulation Assumed ACM Not Impacted

Level 004 – Room 4-139 Concealed Insulation on Hot/ Cold Water/ Supply &

Plumbing Lines Assumed ACM 60 LF

Athenica Project #24-114-1183 3

Locations Material ACM Result Quantity of ACM

Level 005 – Open Lounge Area 5-108

12x12 Floor Tiles – Light Grey w/ Spots ACM

12 SF

Mastic under 12x12 Floor Tiles – Light Grey w/ Spots ACM

Level 007 – Room 7-108

Bottom Layer of Floor Tiles under 12x12 Floor Tiles ACM

186 SF

Mastic under Bottom Layer of Floor Tiles ACM

12x12 Floor Tiles Beige w/ Brown Speckles

ACM

Contaminated

Glue under 12x12 Floor Tiles Beige w/ Brown Speckles

ACM

Contaminated

Fire Door Insulation Assumed ACM 24 SF

Level 008 – Room 8-110 Fire Door Insulation Assumed ACM Not Impacted

Level 009 – Room 9-111 Fire Door Insulation Assumed ACM 24 SF

Level 010 – Room 10-111

12x12 Floor Tiles Light Grey w/ Blue Lines ACM

341 SF

Glue under 12x12 Floor Tiles Light Grey w/ Blue Lines

ACM

Contaminated

Acoustical Ceiling Plaster ACM 341 SF

Fire Door Insulation Assumed ACM 24 SF

Level 011 – Room 11-108 Fire Door Insulation Assumed ACM 24 SF

Level 012 – Room 12-115 Fire Door Insulation Assumed ACM 24 SF

Level 012 – Hallway by Room 12-115

12x12 Floor Tiles Light Grey w/ Blue Lines ACM

8 SF

Glue under 12x12 Floor Tiles Light Grey w/ Blue Lines ACM

Level 013 – Room 13-112 Fire Door Insulation Assumed ACM 24 SF

Level 014 – Room 14-108 Fire Door Insulation Assumed ACM 24 SF

Level 015 – Room 15-228 Fire Door Insulation Assumed ACM 24 SF

Level 016 – Room 16-112, Hallway by Room 16-112

12x12 Floor Tiles Light Grey w/ Blue Lines ACM

162 SF

Glue under 12x12 Floor Tiles Light Grey w/ Blue Lines

ACM

Contaminated

Fire Door Insulation Assumed ACM 24 SF

BUILDING 2

4th Floor – Room 421

Carpet ACM

170 SF Floor Tiles under Carpet

ACM

Contaminated

Glue under Floor Tiles under Carpet

ACM

Contaminated

BUILDING 4

Level 00G – Room G20

Bottom Layer Floor Tiles ACM

308 SF Mastic under Bottom Layer of Floor Tiles ACM

12x12 Floor Tiles (White w/ Blue Lines)/ Glue ACM

Fire Door Insulation Assumed ACM 24 SF

Notes:

1. Due to the variations of floor tiles found and locations with multiple layers of tiles, we would recommend to exercise caution when working with floor tiles/ flooring materials throughout Building

1. Should additional flooring materials be found which were not observed during our surveys, work shall stop not to disturb these tiles and additional testing would be recommended.

2. All fire doors were assumed to contain asbestos insulation and should be tested prior to disposal.

Testing requires destructive measures and may void warranty and effectiveness of fire protection.

In the event that suspect ACM materials are encountered during the renovation project and are to be disturbed by the proposed construction work, all work must stop. The suspect ACM materials should be tested and abated properly.

4.0 INSPECTION RESULTS

Line

HA

No.

Location Material No. of Samples

Inspection Results

Affected ACM Quantity Notes/Comments

SF LF

1. 1.

Interior – Throughout (Areas in Scope Only)

Wall Plaster - Brown Coat 7 Non-ACM - -

Wall and ceiling plaster samples were collected from rooms in scope for this project only and do not represent entire building.

2. 2. Wall Plaster - White Coat 7 Non-ACM - -

3. 3. Ceiling Plaster - Brown Coat 3 Non-ACM - -

4. 4. Ceiling Plaster - White Coat 3 Non-ACM - -

5. 5. Sheetrock Walls 2 Non-ACM - -

6. 6. Sheetrock Wall Joint Compound 3 Non-ACM - -

7. 7. Sheetrock Ceilings 2 Non-ACM - -

8. 8. Sheetrock Ceilings Joint Compound 3 Non-ACM - -

9. 9. CMU Mortar 3 Non-ACM - -

10. 10. Spray-on Fireproofing (Tan/ Beige) 3 Non-ACM - - Spray-on fireproofing was found in one location only.

11. 11. Corrugated Pipe Insulation 3 ACM - - See individual locations for ACM Quantities.

12. 12. Glazed Block Mortar 5 Non-ACM - -

13. 13. Quarry Tile Setting Bed 4 Non-ACM - -

14. 14. Quarry Tile Grout 4 Non-ACM - -

15. 15. Ceiling Tiles – Fissured Texture 2 Non-ACM - -

16. 16. Ceiling Tiles – Rough Texture 2 Non-ACM - -

17. 17. Ceiling Tiles – Smooth Texture 2 Non-ACM - -

18. 18. Ceiling Tiles – Square Grid Texture 2 Non-ACM - -

19. 19. Baseboards – Black 2 Non-ACM - -

20. 20. Baseboard Glue – Black Baseboards 2 Non-ACM - -

21. 21. Baseboards – Green 2 Non-ACM - -

22. 22. Baseboard Glue – Green Baseboards 2 Non-ACM - -

23. 23. Baseboards – Red 2 Non-ACM - -

24. 24. Baseboard Glue – Red Baseboards 2 Non-ACM - -

25. 25. Baseboards – Brown 2 Non-ACM - -

26. 26. Baseboard Glue – Brown Baseboards 2 Non-ACM - -

27. 27. Baseboards – Beige 2 Non-ACM - -

28. 28. Baseboard Glue – Beige Baseboards 2 Non-ACM - -

29. 29. Fire Door Insulation (Various Types) - Assumed ACM - - See individual locations for ACM Quantities.

30. 13

Level 00B – Room B302

Quarry Tile Setting Bed - Non-ACM - -

31. 14. Quarry Tile Grout - Non-ACM - -

32. 9. CMU Mortar - Non-ACM - -

33. 12. Glazed Block Mortar - Non-ACM - -

34. 11. Corrugated Pipe Insulation - ACM - 30 May be impacted by space renovation.

35. 30. Remnant Mastic on Wall 2 Non-ACM - -

36. 29 Fire Door Insulation - Assumed ACM - - Fire doors not impacted by the scope of work.

37. 31

Level 00B – Room B106A

12x12 Floor Tiles Beige w/ Brown Speckles - Non-ACM - -

38. 32 Glue under 12x12 Floor Tiles Beige w/ Brown Speckles - Non-ACM - -

39. 12. Glazed Block Mortar - Non-ACM - -

40. 5. Sheetrock Walls - Non-ACM - -

41. 6. Sheetrock Walls Joint Compound - Non-ACM - -

42. 29. Fire Door Insulation - Assumed ACM - - Fire doors not impacted by the scope of work.

43. 5.

Level 00G – Room G140

Sheetrock Walls - Non-ACM - -

44. 6. Sheetrock Walls Joint Compound - Non-ACM - -

45. 15. Ceiling Tiles – Fissured Texture - Non-ACM - -

46. 29. Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

Line

HA

No.

Location Material No. of Samples

Inspection Results

Affected ACM Quantity Notes/Comments

SF LF

47. 33.

Level 00G – Room G140

12x12 Floor Tiles - Yellow/ Gold 2 ACM 185 - May be impacted by space renovation.

48. 34. Glue under Yellow/ Gold 12x12 Floor Tiles 2 ACM Contaminated

49. 5.

Level 00G – Room G100B

Sheetrock Walls - Non-ACM - -

50. 6. Sheetrock Walls Joint Compound - Non-ACM - -

51. 95. Spray-on Fireproofing (Grey) - Assumed ACM - -

Per walkthrough, no work will be performed in this space.

52. 35. 12x12 Floor Tiles White w/ Speckles - Assumed ACM - -

53. 36. 12x12 Floor Tiles Light Grey w/ Beige Speckles - Assumed ACM - -

54. 87. 12x12 Light Grey w/ White Speckles - Assumed ACM - -

55. 29. Fire Door Insulation - Assumed ACM - - Fire doors not impacted by the scope of work.

56. 37.

Level 001 – Room 1-503

12x12 Floor Tiles/ Glue - Assumed ACM - -

Scheduled to be removed under an unrelated project.

57. 11. ACM Pipe Insulation - ACM - -

58. 38. 12x12 Floor Tiles Beige w/ Brown Speckles - Assumed ACM - -

59. 39.

Glue under 12x12 Floor Tiles Beige w/ Brown Speckles

- Assumed ACM - -

60. 11.

Level 001 – Room 1-502 (Closet in Room 1-503)

ACM Pipe Insulation - ACM - -

61. 40.

Level 001 – Room 1-102B

Faux Wood Linoleum 1 ACM Contaminated 185 - May be impacted by space renovation.

62. 41. Floor Tiles/ Glue/ Dash Patch under Linoleum 3 ACM

63. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

64. 42.

Level 002 – 2-108A

12x12 Floor Tiles Light Blue 2 Non-ACM - -

65. 43. Glue under 12x12 Floor Tiles Light Blue 2 Non-ACM - -

66. 44. 12x12 Floor Tiles Blue 2 Non-ACM - -

67. 45. Glue under 12x12 Floor Tiles Blue 2 Non-ACM - -

68. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

69. 46.

Level 002 – 2-108A Closet

9x9 Floor Tiles 2 ACM 25 - May be impacted by space renovation.

70. 47. Mastic under 9x9 Floor Tiles 2 ACM

71. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

72. 48.

Level 002 – Room 2-300

Remnant Tar on Quarry Tiles 2 ACM 130 - May be impacted by space renovation.

73. 13. Quarry Tile Setting Bed 4 Non-ACM - -

74. 14. Quarry Tile Grout 4 Non-ACM - -

75. 49. Waterproofing Membrane under Quarry Tiles - Assumed ACM - - Should not be impacted by space renovation.

76. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

77. 50.

Level 003 – Room 3-115A

12x12 Floor Tiles - Taupe w/ Lines 2 ACM Contaminated 387 - May be impacted by space renovation.

78. 51. Mastic under 12x12 Floor Tiles - Taupe w/ Lines 2 ACM

79. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

80. 52. Level 003 – Hallway by Room 3-115A

12x12 Floor Tiles - Off White w/ Lines 2 ACM 10 - Should not be impacted by space renovation.

81. 53. Mastic under 12x12 Floor Tiles – Off White w/ Lines 2 ACM

82. 54.

Level 003 – Room 3-300

12x12 Floor Tiles Beige w/ Brown Speckles - Non-ACM - -

83. 55. Glue under 12x12 Floor Tiles Beige w/ Brown Speckles - Non-ACM - -

84. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

85. 40.

Level 004 – Room 4-118

Faux Wood Linoleum 1 ACM Contaminated 185 - May be impacted by space renovation.

86. 41. Floor Tiles/ Glue/ Dash Patch under Linoleum 3 ACM

87. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

88. 56.

Level 004 – Room 4-138A

Bathroom Foyer

12x12 Floor Tiles – Off White w/ Spots 2 ACM 183 - May be impacted by space renovation.

89. 57. Mastic under 12x12 Floor Tiles - Off White w/ Spots 2 ACM

90. 29 Fire Door Insulation - Assumed ACM - - Should not be impacted by space renovation.

91. 58.

Level 004 – Room 4-138A Bathroom

Ceramic Wall Tile Grout 2 Non-ACM -

92. 59. Ceramic Wall Tile Thinset 2 Non-ACM -

93. 60. Ceramic Wall Tile Setting Bed 2 Non-ACM -

94. 96. Waterproofing Below Ceramic Tiles - Assumed ACM - Should not be impacted by space renovation.

Line

HA

No.

Location Material No. of Samples

Inspection Results

Affected ACM Quantity Notes/Comments

SF LF

95. 38.

Level 004 – Room 4-139

12x12 Floor Tiles Beige w/ Brown Speckles - Non-ACM - -

96. 39. Glue under 12x12 Floor Tiles Beige w/ Brown Speckles - Non-ACM - -

97. - Sink/ Exposed Sink Pipe - Non-Suspect - -

98. 97.

Concealed Insulation on Hot/ Cold Water/ Supply & Plumbing Lines

- Assumed ACM - 60 May be impacted by space renovation.

99. 61.

Level 005 – Open Lounge Area 5-108

12x12 Floor Tiles – Light Grey w/ Spots 2 ACM 12 - May be impacted by space renovation.

100. 62. Mastic under 12x12 Floor Tiles – Light Grey w/ Spots 2 ACM

101. 63. 12x12 Floor Tiles Light Beige w/ Pink/ Green Speckles - Non-ACM - -

102. 64. Glue under 12x12 Floor Tiles Beige w/ Brown Speckles - Non-ACM - -

103. 65.

Level 006 – Hallway Area by 6-107

12x12 Floor Tiles Light Beige w/ Pink/ Green Speckles - Non-ACM - -

104. 66.

Glue under 12x12 Floor Tiles Light Beige w/ Pink/ Green Speckles

- Non-ACM

105. 67.

Level 007 – Room 7-108

Bottom Layer of Floor Tiles under 12x12 Floor Tiles 2

ACM

Contaminated

186 - May be impacted by space renovation.

106. 68. Mastic under Bottom Layer of Floor Tiles 2 ACM

107. 69. 12x12 Floor Tiles Beige w/ Brown Speckles - ACM Contaminated

108. 70.

Glue under 12x12 Floor Tiles Beige w/ Brown Speckles

- ACM Contaminated

109. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

110. 38.

Level 008 – Rooms 8-110 and 8-111A

12x12 Floor Tiles Beige w/ Brown Speckles 2 Non-ACM - -

111. 39. Glue under 12x12 Floor Tiles Beige w/ Brown Speckles 2 Non-ACM - -

112. 29 Fire Door Insulation - Assumed ACM - - Should not be impacted by space renovation.

113. 73.

Level 009 – Room 9-111

12x12 Floor Tiles Light Brown 2 Non-ACM - -

114. 74. Glue under 12x12 Floor Tiles Light Brown 2 Non-ACM - -

115. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

116. 38. Level 009 – Hallway by Room 9-111

12x12 Floor Tiles Beige w/ Brown Speckles 2 Non-ACM - -

117. 39. Glue under 12x12 Floor Tiles Beige w/ Brown Speckles 2 Non-ACM - -

118. 75.

Level 010 – Room 10-111

12x12 Floor Tiles Light Grey w/ Blue Lines 1 ACM 341 -

May be impacted by space renovation. 119. 76. Glue under 12x12 Floor Tiles Light Grey w/ Blue Lines 1 Non-ACM

120. 77. Acoustical Ceiling Plaster 3 ACM 341 -

121. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

122. 78.

Level 011 – Room 11-108

12x12 Floor Tiles Beige w/ Brown Speckles 2 Non-ACM -

123. 79. Glue under 12x12 Floor Tiles Beige w/ Brown Speckles 2 Non-ACM -

124. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

125. 80. Level 011 – Hallway by Room 11-108

Mastic under 12x12 Floor Tiles - Pink 1 Non-ACM - -

126. 81. 12x12 Floor Tiles - Pink 1 Non-ACM - -

127. 82.

Level 012 – Room 12-115

12x12 Floor Tiles Light Beige w/ Pink/ Green Speckles 2 Non-ACM - -

128. 83. Glue under 12x12 Floor Tiles Pink/ Green Speckles 2 Non-ACM - -

129. 84. Floor Patch under 12x12 Floor Tiles 2 Non-ACM - -

130. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

131. 85 Level 012 – Hallway by Room 12-115

12x12 Floor Tiles Light Grey w/ Blue Lines 2 ACM 8 -

At door way – may be impacted by renovations. 132. 86 Glue under 12x12 Floor Tiles Light Grey w/ Blue Lines 2 ACM

133. 87.

Level 013 – Room 13-112

12x12 Floor Tiles Light Beige w/ Lines 1 Non-ACM - -

134. 88. Glue under 12x12 Floor Tiles Light Beige w/ Lines 1 Non-ACM - -

135. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

136. 89.

Level 014 – Room 14-108

12x12 Floor Tiles Light Green - Non-ACM - -

137. 90. Glue under 12x12 Floor Tiles Light Green 1 Non-ACM - -

138. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

Line

HA

No.

Location Material No. of Samples

Inspection Results

Affected ACM Quantity Notes/Comments

SF LF

139. 91.

Level 014 – Room 14-099

Ceramic Wall Tile Grout 2 Non-ACM - -

140. 92. Ceramic Wall Tile Thinset 2 Non-ACM - -

141. 88. Glue under 12x12 Floor Tiles Light Beige w/ Lines 2 Non-ACM - -

142. 93. 12x12 Floor Tiles Orange 2 Non-ACM - -

143. 94.

Level 014 – Room 14-099

12x12 Floor Tiles Light Blue 2 Non-ACM - -

144. 87. 12x12 Floor Tiles Light Beige w/ Lines 1 Non-ACM - -

145. 80. Level 014 – Hallway by Room 14-108

Mastic under 12x12 Floor Tiles Pink 1 Non-ACM - -

146. 81. 12x12 Floor Tiles Pink 1 Non-ACM - -

147. 91.

Level 015 – Room 15-228

12x12 Floor Tiles Light Green 2 Non-ACM - -

148. 92. Glue under 12x12 Floor Tiles Light Green 2 Non-ACM - -

149. 93. 12x12 Floor Tiles Beige 2 Non-ACM - -

150. 94. Glue under 12x12 Floor Tiles Beige 2 Non-ACM - -

151. 95. Ceiling Sheetrock Glue 2 Non-ACM - -

152. 29 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

153. 85. Level 016 – Room 16-112, Hallway by Room 16-112

12x12 Floor Tiles Light Grey w/ Blue Lines 1 ACM 162 - May be impacted by space renovation.

154. 86. Glue under 12x12 Floor Tiles Light Grey w/ Blue Lines 1 ACM Contaminated

155. 29 Level 016 – Room 16-112 Fire Door Insulation - Assumed ACM 24 - May be impacted by space renovation.

BUILDING 2

156. 2-1

Interior – Throughout (Areas in Scope Only)

Wall Plaster - Brown Coat 5 Non-ACM - -

157. 2-2 Wall Plaster - White Coat 5 Non-ACM - -

158. 2-3 Ceiling Plaster – White Coat on Concrete Deck Only 3 Non-ACM - -

159. 2-4 Concrete Deck - Non-Suspect -

160. 2-5 Acoustical Ceiling Plaster 3 Non-ACM - -

161. 2-6 Sheetrock Walls 2 Non-ACM - -

162. 2-7 Sheetrock Wall Joint Compound 3 Non-ACM - -

163. 2-8 Sheetrock Ceilings 2 Non-ACM - -

164. 2-9 Sheetrock Ceilings Joint Compound 3 Non-ACM - -

165. 2-10 Baseboards - Green 2 Non-ACM - -

166. 2-11 Baseboard Glue – Green Baseboards 2 Non-ACM - -

167. 2-12

1st Floor – Room 123

Bottom Layer Floor Tiles 2 Non-ACM - -

168. 2-13 Glue under Bottom Layer Floor Tiles 2 Non-ACM - -

169. 2-14 Top Layer 12x12 Floor Tiles Beige w/ Spots 2 Non-ACM - -

170. 2-15 Glue under Top Layer 12x12 Floor Tiles Beige w/ Spots 2 Non-ACM - -

171. 2-16 2nd Floor – Room 221 No Work - - - - Per walkthrough, no work will be performed.

172. 2-17 3rd Floor – Room 321 No Work - - - -

173. 2-18 Carpet - ACM Contaminated

174. 2-19 4th Floor – Room 421 Floor Tiles under Carpet 2 ACM 170

175. 2-20 Glue under Floor Tiles under Carpet 2 ACM

BUILDING 4

176. 4-1

Level 00G – Room G20

CMU Mortar 3 Non-ACM - -

177. 4-2 White Paint on CMU 2 Non-ACM - -

178. 4-3 Bottom Layer Floor Tiles 2 ACM

179. 4-4 Mastic under Bottom Layer of Floor Tiles 2 ACM 308

180. 4-5 12x12 Floor Tiles (White w/ Blue Lines)/ Glue 2 ACM

181. 4-6 Horsehair Insulation - Non-Suspect - -

182. 4-7 Horsehair Insulation Wrap 3 Non-ACM - -

183. 4-8 Fiberglass Insulation Mastic 2 Non-ACM - -

184. 4-9 Fire Door Insulation - Assumed ACM 24 -

Line

HA

No.

Location Material No. of Samples

Inspection Results

Affected ACM Quantity Notes/Comments

SF LF

BUILDING 14

185. 14-1

1st Floor – Room 131A

Sheetrock Walls 2 Non-ACM - -

186. 14-2 Sheetrock Wall Joint Compound 3 Non-ACM - -

187. 14-3 Baseboard – Black 2 Non-ACM - -

188. 14-4 Baseboard Glue – Black Baseboards 2 Non-ACM - -

189. 14-5 12x12 Floor Tiles Beige 2 Non-ACM - -

190. 14-6 1st Floor – Room 131A

Glue under 12x12 Floor Tiles Beige 2 Non-ACM - -

191. 14-7 Ceiling Tiles - Fissured 2 Non-ACM - -

BUILDING 15

192. 15-1

Interior – Throughout (Areas in Scope Only)

Sheetrock Walls 2 Non-ACM - -

193. 15-2 Sheetrock Wall Joint Compound 3 Non-ACM - -

194. 15-3 CMU Mortar 3 Non-ACM - -

195. 15-4 Wall Paper 2 Non-ACM - -

196. 15-5 Wall Paper Glue 2 Non-ACM - -

197. 15-6 Baseboard – Beige 2 Non-ACM - -

198. 15-7 Baseboard Glue – Beige Baseboards 2 Non-ACM - -

199. 15-8 Spray-on Fireproofing 3 Non-ACM - -

200. 15-9 Ceiling Tiles - Fissured 2 Non-ACM - -

201. 15-10

Interior – Throughout (Areas in Scope Only)

12x12 Floor Tiles (Pink w/ Spots) 2 Non-ACM - -

202. 15-11 Mastic under 12x12 Floor Tiles (Pink w/ Spots) 2 Non-ACM - -

203. 15-12 12x12 Floor Tiles - Beige w/ Brown Spots 2 Non-ACM - -

204. 15-13 Mastic under 12x12 Floor Tiles - Beige w/ Brown Spots 2 Non-ACM - -

205. 15-14 Faux Wood Linoleum 2 Non-ACM - -

206. 15-15 Faux Wood Linoleum Glue 2 Non-ACM - -

TOTAL AFFECTED ACM QUANTITY

Notes:

1. Due to the variations of floor tiles and locations with multiple layers of tiles, we would recommend to exercise caution when working with floor tiles throughout Building 1. Should additional flooring materials be found which were not observed during our surveys, work shall stop not to disturb these tiles and additional testing would be recommended.

2. Any materials not listed or addressed in above table must be assumed to be Asbestos-Containing Materials. Should any additional concealed materials be found during construction, work shall stop, and the VA Hospital Representatives shall be notified.

3. Any material reported non-ACM but in direct contact with assumed or confirmed ACM must be treated as ACM-Contaminated. Any substrate/component with adhered ACM material should be treated as ACM Contaminated.

5.0 REPORT CERTIFICATIONS

Athenica Environmental Services, Inc. certifies that the information contained herein is based on the physical and visual inspections conducted by Athenica and data collected during the inspection survey.

Juraj Bardiovsky NYSDOL Asbestos Inspector/ NYC DEP Asbestos Investigator

Matthew Taylor NYSDOL Asbestos Inspector/ QA/QC

APPENDIX A

6.0 Analytical Results, Chain-of-Custody Forms

and Certificates of Laboratory Analysis

APPENDIX B:

7.0 Personnel Certificates

APPENDIX C:

8.0 Consulting Company License

DIVISION OF SAFETY & HEALTH LICENSE AND CERTIFICATE UNIT, STATE OFFICE CAMPUS, BLDG. 12, ALBANY, NY 12226 ASBESTOS HANDLING LICENSE Athenica Environmental Services Inc.

31-33 31 Street, 2nd Floor, Astoria, NY, 11106

This license has been issued in accordance with applicable provisions of Article 30 of the Labor Law of New York State and of the New York State Codes, Rules and Regulations (12 NYCRR Part 56). It is subject to suspension or revocation for a (1) serious violation of state, federal or local laws with regard to the conduct of an asbestos project, or (2) demonstrated lack of responsibility in the conduct of any job involving asbestos or asbestos material.

This license is valid only for the contractor named above and this license or a photocopy must be prominently displayed at the asbestos project worksite. This license verifies that all persons employed by the licensee on an asbestos project in New York State have been issued an Asbestos Certificate, appropriate for the type of work they perform, by the New York State Department of Labor.

Amy Phillips, Director For the Commissioner of Labor

SH 432 (12/21)

License Number:

License Class:

Date of Issue:

Expiration Date:

Duly Authorized Representative:

29663

RESTRICTED

06/03/2024 07/31/2025 Maria Dongaris

APPENDIX D

9.0 Laboratory Accreditation

Expired Certificates:

68641 SW ELAP

68642 AI ELAP

LAB ID: 10955

MR. EMANUEL DIMITRAKAS

LABORATORY TESTING SERVICES INC

40-20 22ND ST

LONG ISLAND CITY, NY 11101 Certificate Expiration Date:

April 01, 2025

Dear Mr. Dimitrakas, July 18, 2024

Sincerely, Director, Environmental Laboratory Approval Program Amy J. Steuerwald, Ph.D.

Enclosed are revised certificate(s) of approval issued to your environmental laboratory for the current permit year. The certificate(s) supersede(s) any previously issued one(s) and are in effect through the expiration date listed. Please carefully examine the certificate(s) to insure that the categories, subcategories, analytes, and methods for which your laboratory is approved are correct. In addition, verify that your laboratory's name, address, lead technical director, and identification number are accurate.

Pursuant to NYCRR Subpart 55-2.2, original certificates must be posted conspicuously in the laboratory and copies shall be made available to any client of the laboratory upon request.

Pursuant to NYCRR Subpart 55-2.6, any misrepresentation of the fields of accreditation (category - method -analyte) for which your laboratory is approved may result in denial, suspension, or revocation of your certification. Any use of the Environmental Laboratory Approval Program (ELAP) or National Environmental Laboratory Accreditation Program (NELAP) name, reference to the laboratory's approval status, and/or using the NELAP logo in any catalogs, advertising, business solicitations, proposals, quotations, laboratory analytical reports, or other materials must include the laboratory's ELAP identification number and distinguish between testing for which the laboratory is approved and testing for which the laboratory is not approved.

If the changes to your certificate are due to insufficient proficiency tests and/or proficiency test failures, your laboratory must investigate the root cause for any insufficient and/or unsatisfactory proficiency tests and keep this on file for review during an onsite assessment. Also, the laboratory must provide a corrective action report to ELAP within 30 calendar days of a request by the program.

If you have any questions, please contact us at the Environmental Laboratory Approval Program, Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany NY, 12237; by phone at (518) 485-5570; by facsimile at (518) 485-5568; and by email at elap@health.ny.gov.

LONG ISLAND CITY, NY 11101

AppCat Analyte Name Method Name Comments Date

AI Lab Address Changed 07/18/2024

SW Lab Address Changed 07/18/2024

LAB ID: 10955

MR. EMANUEL DIMITRAKAS

LABORATORY TESTING SERVICES INC

40-20 22ND ST

July 18, 2024

A revised certificate has been generated because of the change(s) listed below.

If your laboratory has applied for a change in the laboratory's location and/or technical director, the approved change(s) will be reflected on the certificate.

If the changes to your certification are due to insufficient proficiency tests and/or proficiency test failures, your laboratory must investigate the root cause for any insufficient and/or unsatisfactory proficiency tests and keep this on file for review during an onsite assessment.

Also, the laboratory must provide a corrective action report to ELAP within 30 calendar days of a request by the program.

In addition, your laboratory must investigate and document the root cause for any insufficient and/or unsatisfactory proficiency tests. If your lab lost accreditation due to two PT failures, you must submit the corrective action response to ELAP for review before accreditation will be re-instated.

Dear Mr. Dimitrakas, is hereby APPROVED as an Environmental Laboratory for the category

ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE

All approved subcategories and/or analytes are listed below:

CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE

Issued in accordance with and pursuant to section 502 Public Health Law of New York State

MR. EMANUEL DIMITRAKAS

LABORATORY TESTING SERVICES INC

40-20 22ND ST

LONG ISLAND CITY, NY 11101

NY Lab Id No: 10955

NEW YORK STATE DEPARTMENT OF HEALTH

WADSWORTH CENTER

Expires Issued

Revised

12:01 AM April 01, 2025 April 01, 2024 July 18, 2024

Miscellaneous Asbestos in Friable Material Item 198.1 of Manual

EPA 600/M4/82/020

Asbestos in Non-Friable Material-PLM Item 198.6 of Manual (NOB by PLM)

Asbestos in Non-Friable Material-TEM Item 198.4 of Manual

Asbestos-Vermiculite-Containing MaterialItem 198.8 of Manual

Lead in Dust Wipes EPA 7000B

Lead in Paint EPA 7000B

ASTM D3335-85A

Sample Preparation Methods

ASTM E-1644-17

Serial No.: 69489 Property of the New York State Department of Health. Certificates are valid only at the address shown and must be conspicuously posted by the laboratory. Continued accreditation depends on the laboratory's successful ongoing participation in the Program. Consumers may verify a laboratory's accreditation status online at https://apps.health.ny.gov/pubdoh/applinks/wc/elappublicweb/, by phone (518) 485-5570 or by email to elap@health.ny.gov.

is hereby APPROVED as an Environmental Laboratory for the category

ENVIRONMENTAL ANALYSES AIR AND EMISSIONS

All approved subcategories and/or analytes are listed below:

CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE

Issued in accordance with and pursuant to section 502 Public Health Law of New York State

MR. EMANUEL DIMITRAKAS

LABORATORY TESTING SERVICES INC

40-20 22ND ST

LONG ISLAND CITY, NY 11101

NY Lab Id No: 10955

NEW YORK STATE DEPARTMENT OF HEALTH

WADSWORTH CENTER

Expires Issued

Revised

12:01 AM April 01, 2025 April 01, 2024 July 18, 2024

Metals I Lead, Total NIOSH 7082

Miscellaneous Asbestos 40 CFR 763 APX A No. III

Fibers NIOSH 7400 A RULES

Serial No.: 69490 Property of the New York State Department of Health. Certificates are valid only at the address shown and must be conspicuously posted by the laboratory. Continued accreditation depends on the laboratory's successful ongoing participation in the Program. Consumers may verify a laboratory's accreditation status online at https://apps.health.ny.gov/pubdoh/applinks/wc/elappublicweb/, by phone (518) 485-5570 or by email to elap@health.ny.gov.

APPENDIX E

10.0 Project Documents