A06_HazMat_Survey_Inspection_Sheets_and_Reports_0002.pdf
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- Asbestos Abatement at Glacier National Park
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| Sol_140P1424R0011_Amd_0003.pdf | ||
| B09_Updated_Bid_Schedule_0003.docx | DOCX document | |
| B09_Hazmat_B536_Two_Medicine_0003.pdf | ||
| A04_Statement_of_Work_0002.docx | DOCX document | |
| B03_WD_WY20240013_0002.pdf | ||
| A06_Site_Photos_29_pages_0002.pdf | ||
| A06_As-Built_Drawings_0002.pdf | ||
| Sol_140P1424R0011_Amd_0002.pdf | ||
| B08_140P1424R0011_0002.pdf | ||
| A06_Site_Photos_29_pages_0001.pdf | ||
| A04_Statement_of_Work_0001.docx | DOCX document | |
| B03_WD_WY20240013_0001.pdf | ||
| A06_As-Built_Drawings_0001.pdf | ||
| Sol_140P1424R0011_Amd_0001.pdf | ||
| A06_HazMat_Survey_Inspection_Sheets_and_Reports_0001.pdf |
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Glacier National Park
HAZARDOUS MATERIALS INSPECTION COVER SHEET
Building Title 1085 TWO-MED TRI-PLEX
Park Location TWO MEDICINE
Building No. 1085 FMSS Location No. 8189
PREPARATION FOR SURVEY
lfr_çheck each HAZMAT suspected in this building then elaborate on where these may be located:
I/I Asbestos Containing Materials: Flooring,Drywall,Rooling,Concrete, Caulking
ElI Lead-based Paint: INTERIOR TRIM (WHITE) EXTERIOR DOOR JAMB (YELLOW)
F~i Rodents (Hantavirus): _________________________________________________________________________
F~i Mold:ri Other:
2. Check and identify existing HAZMAT records; Identify what was found and where; If none go to paragraph 4
[7] Local Records search conducted on 10/20/20 by GERLAD GILHAM Found Y (YIN) ri TIC Records search conducted on by Found (Y/N)
3. If records were found is an updated survey needed to record past rehab or renovation?
If YES, then proceed to paragraph 4; If NO, skip to paragraph 6 and file this form with the record
CONDUCT THE SURVEY
4. Identify material was surveyed, date of survey and name of surveyor; (attach HAZMAT Form 2 & floor plan) ASBESTOS Survey done; conducted on 10/20/20 by GERALD GILHAM
LEAD Survey done; conducted on 10/20/20 by GERALD GILHAM done; conducted on by_______________________________________ done; conducted on by_______________________________________ done; conducted on by_______________________________________
5. From survey send samples for HAZMAT testing (attach HAZMAT Form 3) and complete the HAZMAT Laboratory Testing Checklist (attach HAZMAT Form 4):
~ # of ACM samples sent: 10/20120 Lab: RESERVOIRS ENVIROMENTAL INC.
3 . 10/20)20 RESERVOIRS ENVIROMENTAL INC.of Paint samples sent:_____ Lab:
of Mold samples sent:_____ Lab:
6. As a result of the survey:
is negative for HAZMAT / HAZMAT confirmed through testing (forms attached)
C This is an updated survey to correct the record (forms attached as needed)
~. C Records are adequate and no update survey is needed
Signature Validation:
(Certified Inspector)
Printed name of inspector GERALD GILHAM
Inspector’s MT License Number MTA-5354 Expires on 4/25/21
HAZMAT Form I
HAZMAT SURVEY FORM BY MATERIAL
Note: Use one form per suspect hazardous material found in the building
Building#: 1085 Building Description: TWO MED TRIPLEX
Homogeneous area number: F3.1A Type of Material: Surfacing®TSlOMisc.O
Homogeneous Material Description: TILE AND ADHESIVE
Functional Space Description: THROUGH OUT ENTIRE BUILDING
Friable: YesLjNo~Condition of material: GOOD (ENCAPSULATED)
Extentofdamage: None~D~ <1O%Ø >1O%(3 <25%~flJ >25%Q
Type of damage: Deterioration0 WaterO Physical® Dry RotO RodentO
Potential for significant damage: Yes D No 171 Describe: ___________________
Est’d Quantity of material: Square feet 1600
Pipe: Size_______ Footage ___________ Size _________Footage ___________
Size _______Footage ___________ Size Footage ___________
Type of Substrate (for surfacing materials): CONCRETE
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility D D Contact by general public D D Contact by building occupants D D 121 Activity near the material D D Possibility of vibration damage D D Possibilityofwaterdamage D D Possibility of air erosion D D 121 Possibility of vandalism D D [~] Comments:
Signature of Inspector: Date: 10/28/20
HAZMAT Form 2
Note: Use one form per suspect hazardous material found in the building
Building #: 1085 Building Description: TWO MED TRI PLEX
Homogeneous area number: El .A-B Type of Material: SurfacingGTSlOMisc.O
Homogeneous Material Description: RUBBER BASE AND GLUE
Functional Space Description: FOUND IN LAUNDY ROOM
Friable: YesLjNo~Condition of material: FAIR
Extentofdamage: NoneC <1O%Ø >1O%(3 c25%(D >25%O Type of damage: Deterioration0 WaterO Physical® Dry RotC RodentO
Potential for significant damage: Yes D No ______ Describe: ___________________
Est’d Quantity of material: Square feet 100 LINEAL FT
Pipe: Size________ Footage ___________ Size __________Footage ___________
Size _______Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): DRYWALL
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility D i71 D Contact by general public D D Contact by building occupants D i~1 D Activity near the material D 121 D Possibility of vibration damage D D Possibility of water damage D D Possibility of air erosion D D Possibility of vandalism D D I~1 Comments:
Signature of Inspec Date: 10/28/20
Note: Use one form per suspect hazardous material found in the building
Building U: 1085 Building Description: TWO MED TRI PLEX
Homogeneous area number: MI. 1 A-F Type of Material: Surfacing€kSlOMisc.O
Homogeneous Material Description: SHEETROCK/JOINT/TAPE
Functional Space Description: INTERIOR WALLS AND CEILING
Friable: YesLk’Jo~Condition of material: GOOD
Extent ofdamage: None® <1O%C >1O%Q <25%(~ >25%Q
Type of damage: Deterioration0 WaterO PhysicalO Dry RotC Rodent C Potential for significant damage: Yes D No RI Describe: ___________________
Est’d Quantity of material: Square feet 2000
Pipe: Size_______ Footage ___________ Size __________Footage ___________
Size _______Footage __________ Size _________Footage __________
Type of Substrate (for surfacing materials): WOOD FRAMING
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility El EZI El Contact by general public El El RI Contact by building occupants El El Activity near the material El El Possibility of vibration damage El El Possibility of water damage El El 17l Possibility of air erosion El El Possibility of vandalism El 171 El Comments:
Signature of Inspec or: ,. ~. Date: 10/28/20
Note: Use one form per suspect hazardous material found in the building
Building#: 1085 Building Description: TWO MED TRIPLEX
Homogeneous area number: M5.1AE Type of Material: Surfacing®TSIOMi5c.O
Homogeneous Material Description: EXTERIOR SIDING
Functional Space Description: SIDING ON EXTERIOR WALLS
Friable: YesLjNo~Condition of material: GOOD
Extentofdamage: NoneQ <1O%® >1O%rJ <25%cflj >25%(J~
Type of damage: Deterioration0 WaterO Physical® Dry Rot~D Rodent 0 Potential for significant damage: Yes D No ______ Describe: ___________________
Est’d Quantity of material: Square feet 2000
Pipe: Size_______ Footage ___________ Size __________Footage ___________
Size Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): WOOD FRAMING
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility El El Contact by general public El El Contact by building occupants El 171 El Activity near the material El 171 El Possibility of vibration damage El El 171 Possibilityofwaterdamage El El Possibility of air erosion El 121 El Possibility of vandalism El El Comments:
Signature of Inspector: ~1i-~-4~~ 3’1t~t~3_k) Date: 10/28/20
I-IAZMAT Form 2
Note: Use one form per suspect hazardous material found in the building
Building#: 1085 Building Description: TWO MED TRI PLEX
Homogeneous area number: Ri .1AE Type of Material: Surfacing®TSlOMisc.O
Homogeneous Material Description: ROOF SHINGLES
Functional Space Description: SHINGLES COVERING THE EXTERIOR ROOF
Friable: YesLINo~Condition of material: POOR
Extentofdamage: None~Z~ <1O%Q >1O%E~ c25%~~ >25%~~
Type of damage: Deterioration0 WaterO Physical® Dry RotO Rodent 0 Potential for significant damage: Yes _______No El Describe: WIND DAMAGED
SHINGLES CAN CAUSE MORE SHINGLES TO BE DAMAGED OR BLOWN OFF.
Est’d Quantity of material: Square feet 20000
Pipe: Size_______ Footage ___________ Size __________Footage ___________
Size _______Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): TARPAPER AND PLYWOOD
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility El El 171 Contact by general public El El 171 Contact by building occupants El El 171 Activity nearthe material El I~1 Possibility of vibration damage El El Possibility of water damage El El Possibility of air erosion El El Possibility of vandalism El El Comments:
Note: Use one form per suspect hazardous material found in the building
Building U: 1085 Building Description: TWO MED TRI PLEX
Homogeneous area number: R5.IAE Type of Material: SurfacingGrSlOMisc.O
Homogeneous Material Description: TAR PAPER
Functional Space Description: PAPER FOUND UNDER SHINGLES
Friable: YesLINo~Condition of material: GOOD
Extentofdamage: None® <10%O >10%CJ <25%C3 >25%Q
Type of damage: Deterioration0 WaterO PhysicalO Dry RotQ RodentO
Potential for significant damage: Yes LI No ______ Describe: ___________________
Est’d Quantity of material: Square feet 2000
Pipe: Size_______ Footage ___________ Size __________Footage ___________
Size ________Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): PLYWOOD
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility El El Contact by general public El El Contact by building occupants El El Activity nearthe material El El [7] Possibility of vibration damage LI El Possibility of water damage El EEl Possibility of air erosion El El 171 Possibilityof vandalism El El Comments:
Signature of Inspec Date: 10/28/20
Note: Use one form per suspect hazardous material found in the building
Building#: 1085 Building Description: TViIO MED TRI PLEX
Homogeneous area number: CRT.1A-E Type of Material: Surfacing®TSlOMisc.O
Homogeneous Material Description: CONCRETE SLABS
Functional Space Description: FLOOR SLAB
Friable: YesLjNo~Condition of material: GOOD
Extentofdamage: None® <1O%C >1O%1~ <25%C3
Type of damage: Deterioration0 WaterO PhysicalO Dry Rot~D RodentQ
Potential for significant damage: Yes D No RI Describe: ___________________
Est’d Quantity of material: Square feet 2000
Pipe: Size_______ Footage ___________ Size __________Footage ___________
Size _______Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): GRAVEL
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility El El RI Contact by general public El El RI Contact by building occupants El El 171 Activity near the material El El RI Possibility of vibration damage El El RI Possibility of water damage El El RI Possibility of air erosion El El 171 Possibility of vandalism El El 171 Comments:
gnature of Inspector: Date: 10/28/20
Note: Use one form per suspect hazardous material found in the building
Building#: 1085 Building Description: TWO TRI PLEX
Homogeneous area number: CRT.2A-E Type of Material: Surfacing®TSlOMisc.O
Homogeneous Material Description: FOUNDATION WALL
Functional Space Description: EXTERIOR CONCRETE FOUNDATION WALL
Friable: YesLjNo~Condition of material: GOOD
Extentofdamage: None® <1O%Q >1O%~~ c25%(D
Type of damage: Deterioration0 WaterC PhysicalO Dry RotO RodentO
Potential for significant damage: Yes D No D Describe: ___________________
Est’d Quantity of material: Square feet 800
Pipe: Size_______ Footage ___________ Size __________Footage ___________
Size _______Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): GRAVEL
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility D D Contact by general public D D 121 Contact by building occupants El El Activity near the material El El [~] Possibility of vibration damage El El 121 Possibility of water damage El El R~i Possibility of air erosion El El I~i Possibility of vandalism El El I~71 Comments:
Signature of Inspector: - - -A ..Aa.~_ Date: 10/28/20
Note: Use one form per suspect hazardous material found in the building
Building 4: 1085 Building Description: TWO MED TRI PLEX
Homogeneous area number: Wi .1AE Type of Material: Surfacing®TSICMisc.O
Homogeneous Material Description: EXT. CAULKING
Functional Space Description: EXT. WINDOWS DOORS AND SIDING
Friable: YesLjNoWCondition of material: FAIR
Extentofdamage: NoneQ <1O%Ø >1O%rJ <25%Q >25%r~
Type of damage: Deterioration0 WaterO Physical® Dry RotO Rodent 0 Potential for significant damage: Yes D No E71 Describe: ___________________
Est’d Quantity of material: Square feet 600 LN FT
Pipe: Size_______ Footage ___________ Size _________Footage ___________
Size _______Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): SIDING, DOOR AND WINDOW TRIM
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility D D Contact by general public D D Contact by building occupants D D Activity nearthe material D D Possibility of vibration damage D D Possibility of water damage D D Possibility of air erosion D Possibility of vandalism D D Comments:
Note: Use one form per suspect hazardous material found in the building
Building#: 1085 Building Description: TWO MED TRI PLEX
Homogeneous area number: P1-3 Type of Material: Surfacing®TSlOMisc.O
Homogeneous Material Description: PAINT
Functional Space Description: EXT DOOR JAMB, INT. TRIM
Friable: YesLk4o~Condition of material: GOOD
Extentofdamage: None® <1O%C >1O%E~ c25%C3 >25%CJ
Type of damage: Deterioration0 WaterO PhysicalO Dry Rot~D Rodent 0 Potential for significant damage: Yes Li No ______ Describe: ___________________
Est’d Quantity of material: Square feet 800 LN FT
Pipe: Size________ Footage ___________ Size __________Footage ___________
Size _______Footage ___________ Size __________Footage ___________
Type of Substrate (for surfacing materials): WOOD
RATE EACH OF THE FOLLOWING RISKS High Moderate Low
Accessibility Li [El [7] Contact by general public Li Li Contact by building occupants Li Li Activity near the material Li 171 Li Possibility of vibration damage Li Li 171 Possibility of water damage Li Li 171 Possibility of air erosion Li Li Possibility of vandalism Li Li Comments:
Signature of Inspector: }~~te: 10/28/20
Peso sEnsi,tnmenlal. Inc Effecflvooclobero9. 2020 poser~o,nEnwonmenIaI0AMen,jaI 0~QA0O~Lsb~.s.r,&s Env~onni.nl~ QAManu&.pdf flEl LAB Re e oirs E vim en I. I c.
October 27, 2020 Subcontractor Number:
Laboratory Report: RES 476722-2 Project #IP.O. #: None Given Project Description: 1085 Two-Med Tri-plex
John Lucke Glacier National Park 64 Grinnell Dr.
West Glacier MT 59936
Dear John, Reservoirs Environmental, Inc. is an analytical laboratory accredited for the analysis of Industrial Hygiene and Environmental matrices by the American Industrial Hygiene Association, Lab ID 101533 - Accreditation Certificate #480. The laboratory is currently proficient in both IRPAT & ELPAT programs respectively.
Reservoirs has analyzed the following sample(s) using Atomic Absorption Spectroscopy (AAS) / Inductively Coupled Plasma - Mass Spectrometry (ICP-MS) per your request. Reported sample results were not blank corrected. The analysis has been completed in general accordance with the appropriate methodology as stated in the analysis table. Results have been sent to your office.
RES 476722-2 is the job number assigned to this study. This report is considered highly confidential and the sole property of the customer. Reservoirs Environmental, Inc. will not discuss any part of this study with personnel other than those of the client. The results described in this report only apply to the samples analyzed.
This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of the U.S. Government. This report shall not be reproduced except in full, without written approval from Reservoirs Environmental, Inc. Samples will be disposed of after sixty days unless longer storage is requested.
If you have any questions about this report, please feel free to call 303-964-1986.
Sincerely, by Jeff Green
Robin Kiover Vice President
(3031984-1086 8608 Logan 0,. Su,Ie 100. Denver.C080216 Www.reOab.com lses(PESI-ENV Page I o12 hIIp*J(ci,,nls.reiIab.co,n
R.ueuuuils Enwonmenlal, Inc Rosenvoff, Envi,onmenlat QA Manual
Elledine Oclobar 09,2020 O;tOAOC1Lub~enernoils Envilonmenlal CA Manual pdl
TABLE: I ANALYSIS: LEAD IN PAINT
RESERVOIRS ENVIRONMENTAL, INC
NVLAP Lab Code 101896-0
AIHA Certificate of Accreditation #480 LAB ID 101533
* P3: Sample contained insufficient sample volume to accurately quantify for EPA method 3050B.
qualitative only.
RES Job Number: RES 476722-2 Client: Glacier National Park Client Project/RO.: None Given Client Project Description: 1085 Two-Med Tri-plex Date Samples Received:
Analysis Type:
Turnaround: Standard Date Samples Analyzed: October 27, 2020
October 26, 2020
REI CHEMISTRY SOP I IJSEPA SW846 3050B17420-M
NA u Not Analyzed NR = Not ReceIved NO a None Detected BAS u Below Analytical Sensitivity SRI a Below Reporting Limit
Client Reporting LEAD ID Number Limit CONCENTRATION
P1 0.026 1.2 P2 0.016 2.9 P3 0.051 4.0
Therefore, results should be considered as
* Unless otherwise noted all quality control samples performed within specifications established by the laboratory
5801 Logan SI, Sate 100. O,nver.C0a0216 Page2ot2
Jeff anven
Analyst/Data QA w,Av,re8ahcom hit), fldienls .reilab.com
(303)968.1 986 (gob) RESI-ENV
Reservoirs Environmental. I~. Effective October 9. 2020 Reservoirs Environmental QA Manual Q:~OAQCMab~eservoirs Environmental QA Manual.,pdf
RESERVOIRS ENVIRONMENTAL INC.
NVLAP Lab Code 101896.0
TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number: RES 476722-1 Client: Glacier National Park Client Project Number! P.O. None Given Client Project Description: 1085 Two-Med Tri-plex Date Samples Received: October 26, 2020 Method: EPA 6001R-931116 - Short Report, Bulk Turnaround: Standard Date Samples Analyzed: November 03, 2020 - November 04, 2020
NDNone Detected TR=Trace, <1% Visual Estimate Trem/Act=Tremoljte/Actinolite
Client L Asbestàs Content Non Non- Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components
E Description Estimate Components R (%) (%) (%) (%)
F3.1A A Black mastic 10 ND 0 100 B Gray/multi-colored tile 90 Chrysotile 5 0 95
F3.1B A Black mastic 7 ND 0 100 B Gray/multi-colored tile 93 Chrysotile 5 0 95
F3.1C A Black mastic 15 ND 0 100 B Gray/multi-colored tile 85 Chrysotile 6 0 94
El .A A Brown adhesive 3 Chrysotile 3 0 97 B Tan cove base 97 ND 0 100
E1.B A Brown adhesive 4 Chrysotile 3 0 97 B Tan cove base 96 ND 0 100
TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%.
P: 303-954-1986 5801 Logan Street. Suite 100. Denver CO 80216 l-866-RESI.ENV F 3034774275 wv.w.rellab.com
Page 1 o16
Rese.voiis Environmental. Inc. Effective October 9, 2020 Reseivoirs Environmental QA Manual Q:~QAQCtab\Reseivoirs Environmental OA ManuaLpdl
RESERVOIRS ENVIRONMENTAL INC.
NVLAP Lab Code 1018964
TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number:
Client:
RES 476722-1
Glacier National Park
Client Project Number! P.O.: None Given Client Project Description: 1085 Two-Med Tri-plex Date Samples Received: October 26, 2020 Method: EPA 600/R-931116 - Short Report, Bulk Turnaround: Standard Date Samples Analyzed: November 03, 2020 - November 04, 2020
NDNone Detected TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite
Client L Asbestos Content Non Non- Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components
E Description Estimate Components R (%) (%) (%) (%)
M1.1A A White paint S ND 0 100 B White tape 13 ND 95 5 C Tan joint compound 22 Chrysotile 3 0 97 D Tan compound 25 Chrysotile 3 0 97 E Tan/white drywall 35 ND 75 25
M1.1B A Tan compound 6 Chrysotile 2 0 98 . BTanpaint 9 ND 0 100
C White/tan drywall 85 ND 45 55 M1.1C A Tan compound 4 Chrysotile 2 0 98
B Tan pant 6 ND 0 100 C White/tan drywall 90 ND 35 65
TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%.
P 303-964-1986 5801 Logan Street Suite 100. Denver CO 80216 1-866-RESI-ENV F 303-4774275 vwm.reilab.con.
Reservoirs Environmental. Inc. Effective October 9.2020 Reservoirs Environmental OA Manual O:\OAOC~Lab\Reservoirs Environmental QA Manual..pdf
RESERVOIRS ENVIRONMENTAL INC.
NVLAP Lab Code 101896-0
TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number: RES 476722-1 Client: Glacier National Park Client Project Number/ P.O.: None Given Client Project Description: 1085 Two-Med Tri-plex Date Samples Received: October 26, 2020 Method: EPA 6001R-931116 - Short Report, Bulk Turnaround: Standard Date Samples Analyzed: November 03, 2020 - November 04, 2020
ND=None Detected TR=Trace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite
Client L Asbestos Content Non Non- Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components
E Description Estimate Components R (%) (°h) (%) (%)
M1.1D A Off white compound 20 Chrysotile 3 0 97 BTanpaper 20 ND 95 5 C White tape 30 ND 95 5 D Off white joint compound 30 Chrysotile 3 0 97
M1.1E A White/multi-colored paint 5 ND 0 100 B Off white joint compound 8 Chrysotile 3 0 97 C White tape 10 ND 95 5 D Off white compound 12 Chrysotile 3 0 97 E White/tan drywall 65 ND 30 70
M5.1A A Gray fibrous material w/ brown paint 100 ND 60 40 M5.1B A White caulk w/ brown paint 20 ND 0 100
B Gray fibrous material w/ brown paint 80 ND 65 35
M5.1C A Gray fibrous material w/ brown paint IOU ND 60 40
TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%.
P: 303-964-1986 5801 Logan Street. suite ix. Denver. co 80216 l-866-RESI-CNV F- 3034774275 wew.reilab.conn
Page 3 ol 6
Reseivoirs EnvIronmental. Inc. Effective October 9.2020 Reservoits Environmental QA Manual 0 ~OAOC\Lab’Reseivoirs Environmental QA Manuat..pdl
RESERVOIRS ENVIRONMENTAL INC.
NVLAP Lab Code 101896-0
TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number: RES 476722-1 Client: Glacier National Park Client Project Number/ P.O.: None Given Client Project Description: 1085 Two-Med Tri-plex Date Samples Received: October 26, 2020 Method: EPA 6001R-931116 - Short Report, Bulk Tumaround: Standard Date Samples Analyzed: November 03, 2020 - November 04, 2020
NDNone Detected TR=Trace, <1% Visual Estimate TremtAct=Tremolite/Actinolite
Client L Asbestos Content Non Non- Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components
E Description Estimate Components R (%) (°h) (%) (%)
M5.1D A White caulk w/ brown paint 8 ND 0 100 B Gray fibrous material w/ brown paint 92 ND 65 35
M5.IE A White caulk w/ brown paint 8 ND 0 100 B Gray fibrous material w/ brown paint 92 ND 65 35
R1.1A A Dark red/multi-colored shingle 100 ND 15 85 R1.1B A Gray/multi-colored shingle 100 ND 15 85 R1.1C A Dark red/multi-colored shingle 100 ND 15 85 R1.1D A Dark red/multi-colored shingle 100 ND 15 85 RilE A Dark red/multi-colored shingle 100 ND 15 85 R5.1A A Black felt 100 ND 70 30 R5.1B A Black felt 100 ND 70 30 R5.1C A Black felt 100 ND 70 30
R5.1D A Black felt 100 ND 70 30 R5.1E A Blackfelt 100 ND 70 30
TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%.
P: 303-964-1986 5801 Logan So-eel. Suite 100. Denver. co 80216 1-866-RESI-ENV F 303.4773275 ~wAq.reltab,con, Page 4 ol 6
Reservoirs Environmental OP Manual Q:tOAOCU.abReseivoirs Environmental OA Mar,ual..pdf Reservoirs Environmenlal, Inc. Effective October 9.2020
RESERVOIRS ENVIRONMENTAL INC.
NVLAP Lab Code 101896.0
PERCENTAGE COMPOSITION BY VOLUME
RES 476722-1
Glacier National Park None Given 1085 Two-Med Tri-plex October 26, 2020 EPA 6001R-93/116 - Short Report, Bulk Standard November 03, 2020 - November 04, 2020
TABLE: PLM BULK ANALYSIS,
RES Job Number:
Client:
Client Project Number! P.O.:
Client Project Description:
Date Samples Received:
Method:
Turnaround:
Date Samples Analyzed:
NDNone Detected TRTrace, <1% Visual Estimate Trem/Act=Tremolite/Actinolite
Client L Asbestos Content Non Non- Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components
E Description Estimate Components R (%) (%) (%) (%)
CRT.1A A Gray/multi-colored granular cementitious material wI off 100 ND 0 100 white paint
CRT.1B A Gray/multi-colored granular cementitious material w/ off 100 ND 0 100 white paint
CRT.1C A Gray/multi-colored granular cementitious material w/ off 100 ND 0 100 white paint
CRT.1D A Gray/multi-colored granular cementitious material w/ off 100 ND 0 100 white paint
CRT.1 E A Gray/multi-colored granular cementitious material w/ off 100 ND 0 100 white paint
CRT.2A A Gray/multi-colored granular cementitious material w/ gray 100 ND 0 100 paint
CRT.2B A Gray/multi-colored granular cementitious material 100 ND 0 100 CRT.2C A Gray/multi-colored granular cementitious material 100 ND 0 100
TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%.
P 303-964-1986 F 3034774275
1-866-RESI-ENV
‘wm,reilab.com
5801 Logan Street. suite 100, Denver 0080216
Page 5 ol 6
Reservoirs Environmental, Inc. Effective October 9. 2020 Reservoirs Environmental QA Manual Q:tQA0C\LabV~ese,voirs Environmental OP Manual..pdf
RESERVOIRS ENVIRONMENTAL INC.
NVLAP Lab Code 101896-0
TABLE: PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME
RES Job Number:
Client:
RES 476722-1
Glacier National Park
Client Project Number! P.O.: None Given Client Project Description: 1085 Two-Med Tri-plex Date Samples Received: October 26, 2020 Method: EPA 600!R-93!116 - Short Report, Bulk Turnaround: Standard Date Samples Analyzed: November 03, 2020 - November 04, 2020
NDNone Detected TRTrace, <1% Visual Estimate Trem/Act=TremolitefActinolite
Client L Asbestos Content Non Non- Sample A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components
E Description Estimate Components R (%) (%) (%) (%)
CRT.2D A Gray/multi-colored granular cementitious material w/ gray 100 ND 0 100 paint
CRT.2E A Gray/multi-colored granular cementitious material w/ gray 100 ND 0 100 paint
W1.1A A White caulk w! brown paint 100 ND 0 100 W1.1B A White caulk w! brown paint IOU ND 0 100 W1.1C A White caulk w/ brown paint 100 ND 0 100 W1.1D A White caulkw/brown paint 100 ND 0 100 W1.1E A Whitecaulkw/brownpaint 100 ND 0 100
TEM Analysis recommended for organically bound material (i.e. floor tile) if PLM results are <1%.
Ryan Shaling - 1
Analyst Analyst I Data QA
P: 303-964-1986 5801 Logan Skeet, suite lao, Denver co 80216 1466-RESI-EN\/ F 303-477-4275 www.reltsb.com
Page 5 ol 6
0, war.
303)964.1988 5601109609). Su4 l00.Oeove,.C080216 (866)RESI-EIW Page2ct2 h(lpsJ/dienIs.reilab.con
•,-‘ EMNumber rst~UieOtty~.
..4t ~g~:
flese,-t.-ojrs En lvirnrnn-,entaj Inc..
5~l Loçin St Dcayvt CO b0208 . P0. 30Z %41)te ‘.a 303-477.4775 • Tot Ha. a.e PESt
Pager 30340)-Zn
INVOICE TO: (IF DIFFERENT)
CONTACT INFORMATION:
caMaro Myron Haa,yR.nw L_
Glacier National Park J’.~’°” Glacier National Park Cat~w Iv.tuciie
64 GrinneIl Dr. 3T6) 132-1772 t*ais ATTN Jo’-., Lucke ‘~ (406) 732.7118
Iflfl’ ATTN J01~ ucke Far — . -— a, PC Box 128 c West Glacier MT 59936 CttØ.gw (406) 250-3394
West Glacier MT 59936 re’a øaaa Dfln,b tine. Mthnx
John_Lucke~npsgov qa0 Ot,an~c~n ices mc -~ in-pta.
VALID MATRIX CODES LAB NOTES:
ASBESTOS LABORATORY HOURS: weekdays: lam ~ir = A Bulk ~B PHIl I PCM I TEM _Q RUSH (Same Day) fi PRIORITY (Nexi Day) tLST4NDARD P lRushPCMs2hr,iubqnGh,.) Sons WipeW CHEMISTRY LABORATORY HOURS: Weekdays: Sam -5pm SW F MetaI(sl i ~ jJ. RUSH LI 24 IV ~3 SDaY IkZWWOTer OWl Waste Waler a%~
RCRASIMeftISSWCIdIn9 flRUSHflsdayflloday 0 o=~~ —~ —
Fume Scan/TCLP organic, fl24hr fl3dayfls Day __________
“ASTM El 792 a~povaro .e macta oi~MICROBIOLOGY LABORATORY HOURS: Weekdays: 9am. -.
E.coIiOtS7:H7CoIIfo,,ll,saure~ _24hr _2Day _S-SDay Salmonella, Listen,, Ecoll, APC. Y & IA _48 Hr _3$ Day ____________
Mold — RUSH Z4Hr4SHr3Oaysoay ~ 1wnsround 10.... ns.b~g, a Iabcato.y m(only loWect to oboniory votwnq ~ era not psan Addelaiji ..a w
•pgty ‘at ftsrt’cws wak.nd. and hobdays
Special Instructions: POINT COUNT ALL TRACES “ ‘~ I____ ________
___________________________________ 3,‘UClierttsamplelDnumber (San eIDsslm,q.,~) —~ GG £JjlHo/2o,2of 1O:oOam x — ___ ___ __ ______ ~ F3.1A(Vfl&GLUE) — 01 i Iio/2o/2o( 10:00am
_________ x — ______ ______
2 PS lB ~VFT&GLUE) ____________ ________________ — GO x — _______ ______1 10120/20 10:00 am 2 F3.1C(VFT&cJwE) --
10120/20j 10:00 am
— x
4 EIA (RUBBER BASE&GLUE) ________- — Go 1 10/20/20 10:00 am
S E1.B(RUBBERBASE&GLUE) ______ — GO 1 f1o/20/20j 10:00am
______ x — ___________ ______
6 M1.1A (SHEETROCIcJJOINTffAPE) x GO r3.J 1 10120120 10:00 am —-
~ M1.1B (SHEETROCKJJOINTnAPE) — GO 8 H1io~/2oI 10:00 an?
M1.lc (SHEETROCICJJOINTIrAPE) X ~Tfio~o~o~ 10:00am
1 10120/201 10:00amx — _______ ______ ! Ml.1D(SHEEROClCJJOINTR-A~E) — GG 10 M1.1E (SHEETROCKJJOI~aP.PE) —
___________________________ x — ____ _______ ______ Nun*e of swØes received: o OF 43 (Add&r,aI sample, shall be flted on atached long (0cm)
NOTe. RE, — sn4-z. .ioonw.g sa’,wbata.ad.im.~nt.~...e~ — rot be na.anba — anon or aninions a. t bate... ~saig Won a.. flsCCtnCy a, eøg0.& 440 By ~i— O.att.te,y ‘*P’fleMthie .7W taM ~án*.c, am. (oao,e,o ..~la. — ‘aqo.Oed ~a. Wi&.tadon 44. Cham 04 Custody ..t cant.0aa an .n~.wag once. .gan,,s p.yiraM in ci NET loday., Iatn ,ey eta pysrani Nm. tray eta toe 03% fl,aat4 a’leaed
I Relinquishecs By: ‘~t.~.tL.e.’ ~-t~ac’~E rubomto~ Use Only f~eceaved By DatelT,me ResiAts ICoq,tact Phone Eamil Fax Date in
Icontaci Phone Email Fax Date Vane
HAZMAT Form Mi
Date Ccdlecied -e
Tk,,e Collected ~on wp
Due Date _____________
Due Time_________
Job # 1085 TVEQ Med Tn-pin
Page at ~
DateFTane 10/20/20
Came, Initials Contact
Initials Coniact Phone Email Fax f~çne Emaa Fax
10:00 am Sample Condition. On Ice Sealed Intact
Ten~(F9 _____ YesINl> YOSINQ Ye.INo
Date TaTie India, Date The Initals
7-2011_version I
CONTACT INFORMATION:Cilme.,, Glacier National Park
I’°” Glacier National Park John Locke I0~ MIH~Rurw,ee~ AUN: John Locke
~ ATTN:john tunic ~ (406) 732-7715 (406) 732.7772 64 Grinnell Dr
~ P.O. Box 128 Va West Glacier MT 59936 West Glacier MT 59935 Crepe9.. 406)250-3fl4
Peo~..o N.~n’b.c ar.d’o. P0 0 Fuel Dam Drtnnelq tree ad.es, ~ IOISIWOMCDTRI.PLEX John_Lucke@nps.gov ASBESTOS LABORATORY HOURS: Weekdays: 7am - 7pm REQUESTED ANAlYSIS VALID MATRIX CODES LAB NOTES:
PLM I PCM I TEM ~a RUSH (Same Day)fi PRIORIn (Next Day) rn.STANDARD Air A Bulk B
(Rush PCM Zhr FEM • 6hr.) Dust 0 Paint P CHEMISTRY LABORATORY HOURS: Weekdays: Sam - 5pm Soil S Wipe W Metal(s) I Dust fl RUSH fl 24 tv ~3-5 Day Swab = SW F Food
•‘Pllor flOliticItlOn is
RCRAS!MetalsaWelcjing flRUSHflSdayflIoday r.q.Ar.dIOCRUSH 0 4 C g DruId,9 Waler: OW Waste Wale, •FUmCSCnITCL.p ~ 5 0-Other
.-0-Organics ja24hr. D.3dayflsoay ~ & ~ ASTMEifl2sroflth.ip.m~or,r.
MICRO8IOLOGy LABORATORY HOURS: Weekdays: Sam. 6pm a ° -aE.coliOlST:117,coljfonnssaureus ~~~_2Day I Satmonella,tj,teria.EcollApc VIM ....._3-5 Day g. 8 o ~ Mold -‘ 3 m ~ —.o ~ (3 ~
Twnaroww time. estateisha bberna.y pnonty sttjstt to laboralor~ vcltgme and... nor ~‘asrlnw4d AcitiUrna ieee ~ Uia —
•v$oratnrhotnwwid.sp.,~.oj~.~.- • c~ ~ ~w 8~~f..50•~ E~1 Date Tune
C EM Number Speclannslrucuons COUNT ALL TRACES - • ~ r ~ cclIe~xed Collected {LaboatoryUseO~
— 4< 4 ~ “ a m a 0 tOW..i<w Utfl)~u . aQlientsampleaonumber (San~lelDsbnj~,,) a — to a 0 2 a a MICROBIOLOGY ~ I .. miedaw Iaercap i M5 1A (SIDING) X - - GG j3 1 10/20/20 10:00 am
2 M5 1B(SIDNG) X GO 1 10120120 10:00am
~ M51C(SIDING) )( GO 1 10120/20 10:00am 4 M&1D(SIDING) X GO $3~ 1 10120/20 10:00am
~ MS.IE (SIDING) X GO
1 10120/20 10:00 am
S RIM (SHINGLES) X - — GG
1 10120/20 10:00 am
.1. Rt.1B(SHINGLES) X GO
~ GG~____
I 10I20J20~ 10:00 am
JJJflTh~~~oio:00am ! R1.1C (SHINGLES) x} I - - — Jj GG
2. R1JD (SHINGLES) X 1 10/20/201 I0:OOam 10 RilE (SHINGLES) I I I ~f j GG ~ 1T~oQoJ 10:00am Nunta 04 sanip4es received 200€ 43 (Adddtnal samples shall be hated on attad,ed cog form,)
ICTE. PCI ~d snfl~zs florr~g .aI3tn bind 0, flfolflaten mind ‘mid — mel be moptaid. For wo.s 4’ omel~ a ~loialans ,nib~ brett lie umoctacy of aegIiM date By svw,g de,tcre,et..,y It,fl5t. Sgt.es eta .I4bneSami of the Fo0O.0Ig ISaçln fir It~.iflied amelyte em udaled en meDia.. of Culle4 11i ce.s~J,,aea&ca .g.nnl via. pi~n0N lanai NET 30 4ev., Sean II corçty vie, payliwit ten’s Y 1l* thi I 5% InoiSdy nm.ni .o.d’.~e
Relinquished By: )-~ ~ ~-&_ti~iitE~--.~,. ~ 10/20/20 10.00 am Srecond4ioe, On be Sealed Inact Laboratory Use Only T~ (Fl _____ Yes! No Yes! No Yes I No Received By DaIeITlme Carrier Reajis contact Phone Email Fax Date mite Iniads Contaa Phone Email Fax Date Time IMiafl
Contact Phone Email Fax Dale Ye,,. Inibais Gonad Phone Email Fax Date Tn tr~bds
Due Date Due Time flesertojrs Er,~tal Inc..
6101 Logan St One. CO F0215 . P?1 ta ZaliM . Faa 3CJS4774fl5 . dl Pie
Pager: 3O1-SOS.209e
INVOICE TO: (IF DIFFERENT)
Job #1065 TWO MED TRI-PLEX
Page &~Q
UAZMAT Form 3I~ 7-2011_version 1
S
C-, I.
£<Iw
Due Date ___________
Due Time ____________ flesert-ojrs Er, ,-‘ironrns’ntal Inc..
SbDltoaln& Denver C~≥l6.Pn )O3%LI~S6.Fa~333.477.42?5VThiiFme SeSRESJ.50V
Page, : 301.50$-flu
INVOICE to: (IF DIFFERENT) CONTACT INFORMATION:
ASBESTOS LABORATORY HOURS: Weekdays: 7am - 7pm
Glacier National Park Caravan, Glacier National Park Coitaci JoM bt*t Myron Hasty Rw,c.
“ ATTN:joM Lijcko ATTN Jcin Locke ~‘ (406) 132.7718 Jpbw (406)7327772
64 Gdnnell Dr. P0 Box 126 c..
West Glacier MT 59936 West Glade, MT 59936 Ceki~er (4~)25O-33S4 Poqec M,itee ~oa P0 I Paw Ova. Ovewneic (filM
PidDtww~oMMcaicn TVQMEDTRIPtEX John_Lucke~nps.gov flM (PCM /TEM JJ RUSH (Same Day) fl PRIORITY (Next Day) .E.STANDARD
________ (Rush PCM • Slit. ThM = 6hr.)
CHEMISTRY LABORATORY HOURS: Weekdays: Sam - 5pm
Job # IO8STWO MED TRI.PtE~
Page S ol,~E
Metal(s) I Dust fi RUSH fl24 iw .a3-5 Day PHw noaltlcauon I.RCRAS IMetaI, S Welding C.RLJSH .0.5 dayfllo day nqdn.dtorRuSH
Fume Scant TCLP Organic, sa 24 hr .1]. 3 day .125 Day MICROBIOLOGY LABORATORY HOURS: Weekdays: 9am -6pm E.coli 0157:H7, collfomn. Saureus _24 hr _2 Day _3-5 Day Sabnonella, Listen., E.coIi, APC, yaM 4$ Hf. _3.5 Day Mold _RUSH_24Hr4SHr3Day5Day ‘~Tiwnarrww urn.. emNnh a iaboe.loq pslonty SIJ*a to Iabcnta.y voOw.. anon not goanlead, Add10on.I sea apply Ion altwtaoun wnlmnds .,.d ht4aayar
SPecial lnstruc~ons: POINT COUNT ALL TRACES
“I
K r
I I I a
U Lu -
-C, ≥E ad I-
C
! 6
0-
-Cr a, S a U
IL
C
U, I Lu t1 U r a a-x Client sample ID number (Sample ID, ntst be unique)
1 R5.1A(ROOFING TAR PAPER)
! R&IB(ROOFING TAR PAPER)
3 R5.1C(ROOFING TAR PAPER)
4 R5.1D(ROOFING TAR PAPER)
~ R5.1E(ROOFING TAR PAPER)
S CRT.IA (CONCRETE FLOOR
~ CRT.1B (CONCRETE FLOOR
B CRT.1C(CONCRETE FLOOR
2. CRT.1D(CONCRETE FLOOR
10 CRT.1 E (CONCRETE FLOOR
x x x
VAliD MATRIX CODES LAB NOTES:
AiraA{ ButicaB —
Dust= D Paint= P —~
SO1=S
SwabzSW FaFood
Drfrakng Waler Owl Waste Waie, 1W ~ ODThet 0 “ASTMEI792 appoyied v.ipe media cft(”
~ I —-r --
S —~0 t1
~ -~ a;
~ >~ EMNilnibir
!~ Coed Collectedm~ ‘nociry Maiw,i~ - —
GO 1 10/20/20 10:00 am
GG 1 10/20/20 10:00am
GO S 1 10120/20 10:00am
GO — ji 10120120 10:00 am
~ a 1 10/20/20 10:00am
~ Ps .1110/20120 10:00am GG J~ 1 10/20/20 10:00am
GO 3 1 10120120 io!ãoam GO ~ 1 10/20/20 10:00 am
9~ — S..! 10/20/20 10:00am x x x x x x
Ncmter of san~es received 300F43 (Additional sanfles shaH be hated on attached long lonit.)
NOTE. REt — eo$yoe n~nieg wias —— — mte.ninc.i swed nd ad not be mpo..de let anon et effusion, a caIa~ia. Inulaig Not, lii elaconcy Cl et~.M — By 19ie9 di.nuce.a10an1 apomean. a—el taM eth,tn,n out,. btn.ng tMi~b, — raqa.a.d anl~. a; aucavad on tie Chat. of Custody thae ceaouaje~ a-nt. eus p.rraM lenin — NET 30 day. I’ Stan 10 conway..t payn.nc N.mn ny .na~ a. 1.5% rnonflp ma...’ lad..’9.
Relinquished By: )\~As~) 5Ca.~~tzztz>— Datefrrne 10/20/20 10:00 am SaCondd,on Ot,Ice sealed Intact Laboratery Use Only Temp (F9 _____ Yes (No Yes / No Yea! No Received Br Date(Tune Corner RentAls Contact Phone EznsiI Fax Date Time Initials Contact Phone Email Fax Date ThTie Initials
Contact Phone Email Fax Date Time ln*itaI. Contact Phone Emad Fax Dale Tn Initals
FIA1MAl Form 3h 7-20 1 1_~ension 1 awr Glacier National Park Ce,,ny Glacier National Park JoMtu~e Coaa
A4&*n ATIN: Julvi Luck; Ao$n, ATTN kiu, lucke ~ 1406) 732-7711 ~ (406) 732-7172
64 Grinnell Dr. P0 Box 128 West Glacier MT 59936 West Glacier MT 59936 .t,.rC (406) 250-3394 ~*.ga (406) 345-3125 cied Ndfltn a,d~e P0 C fl-a ~
~IOESTwOMEDTRI-PtEx John_Lucke~rips.gov ASBESTOS LABORATORY HOURS: Weekdays: 7am - 7pm
PLM I POM (FEM Jj RUSH (Same Day) fi PRIORITY (Next Day) .EISTANDARO (Rush PCM = 2hr, ThM = Shr.)
CHEMISTRY LABORATORY HOURS: Weekdays: Sam - 5pm Metal(s) I Dust fi RUSH fl 24 hr Es-s Day
P,lornollfLcaUonb RCRA 8 (Metals S Welding fl RUSH fi 5 day fib day r.qUr.d toe RUSH Fume Scans TCLP Organics £124 hr fl. 3 day j]5 Day MICROBIOLOGY LABORATORY HOURS: Weekdays: 9am -6pm E.coll 01 57:H7, Cothoons. S.aureus _24 hr __2 Day _3-5 Day
Salmonella, Listeda. E.coll APC, Y & M _48 Hi _3-5 Day Mold — RUSH __24 Hr_46 Hr _3 Day __5 Day
T.nn.*’oijnd time. nitebSti a IaacnWay plenty sutjoct to laaorato.-y ‘diane end ai fiat guaranteed Additional fast apply toe alIitOcwa aedeands and holidays
Speciallnstn.ctlons: POINT COUNT ALL TRACES
Client sample ID number (SasrØe IDs rnus* be unique) i CRT. 2A (FOUNDATION)
2 CRT. 2B (FOUNDATION)
~ CRT. 2C (FOUNDATION)
~ CRT. 2D (FOUNDATiON)
~ CRT. 2E (FOUNDATION)
6 WI 1A ( EXT. CAULK)
~ WI IB(EXT. CAULK)
I WI 1C( EXT. CAULK)
g WilD (EXT. CAULK)
10 Wl.1E (EXT. CAULK)
DustD I PaintP — — S0IISL_ Wipe W —
Swab~SW I PeFood De*.lcñg Water = DW Wave Water
0 = Othee ASTM E1792 ac7ovsd wipe flea fl
.2 o’ t 0 0
~ F EMNurnba
~ ~ t~jCo~ted C~:ed ltOrtt€L .~_a ~ is) .iw&iwpy ~
GG 1 10120/20 10:00am
99 11012020) 10-00 am GG /3 1 10(20/201 10:00am
GG )~ 1 10120120 10:00am
06 Q 1 10120120 10:00am
~ ~ 10120/201 10:00am GG 511 10/20120 10:00am
GG 10:00am
Go It~ 1 10(20/20) 10:00am
99 IOu 10/20/20) 10:00am Number of samples recelnd 40 a’ 43 (Additional sartoes shaH be ~sted on attached long bent)
NOTE PSI — enalyr. sicoeriap saawi based upea adnawe ia~vad ~~11015. tnponi~. loins or onman a cateas rn9wg hors C.. vacancy ci oñ1eia data By ai5fl dihaWcee~any epeslaitafree syaa, v.a sutaeada at Ce hOltkMrç SaITçIsa for r.qsed.d saa*n at fd.d — ese caa, 4 Caaooy ens cenftta an ,flflcM lanai .~aa,wr4 aeti PaVea Ian ci NET 30 d.~ sin to Ceatat ad. p*Øv.aI Sn Isey slId Isa I 5% Ii.eethly line s.d.aig.
Due Date _____________
Due Time ___________ _______ flesereoIrs Ent-ironrnental Inc..
S~1 LogafIStOenwer C0b0216.Pt 30398t-IBaSFa’fl4 42 Fewe ~dPE
P.goi: 303420U
INVOICE TO: IIF DIFFERENTi CONTACT INFORMATION:
Job #_1085 IWO MED TRI PLEX
Page t’/of≤
VALIDMATRIX CODES
C
I
AirsA BuihaB
LAB NOTES:
a
ZOcit I
I a =1a
-L a it r Ia a, a
I 5- Id
5, a a a U a
X x x X x x x X
X x
Relinquished By: Y,_L_a._JtJ .~Y’L.~*ZZ5tt7~~ DaIWTkne 10120120 10:00 am Sample Condition On Ice Sealed h,tact Laboratory Use Only Ten~ (F9 _____ YesINo Yes/No Yes/No Received By Daletrlme Canter Rescits Contact Phone Email Fax Dab rape Intials Contact Phone Eria0 Fax Dale Thne InItials
Contact Phone Email Fax Date Tine Irtitsals Contact Phone EmaIl Fax Date Tn Initials
HA/MAT Form Mi 7-201 1_version 1
Due Date:___________ Due Time:
a’v Glacier National Pait AUN: John LU&t
64 Gdnnell Dr.
West Glacier MT 59936
Pa.~.O Ita,iã.r a~M, PQt
Dnc’cte.tacaar ,~s iwo MED Ti~.PtEJ(
ASBESTOS LABORATORY HOURS: Weekd : 7am -7 m PUll PCM I TEM RUSH (Sans Day) PRIORITY (Next Day) - STANDARD
(Rush PCM 21w, TEM Lhr.)
CHEMISTRY LABORATORY HOURS; Weflda : 8dm - 5pm MetaHs)IDust RUSt-I 24 It. -‘ 3.5 Day RCRA8IMetaI&Welding Q RUSH fl 5 day flio day
Organics fi 241w fi 3 day Jfl5 Day
MICROBIOLOGY LABORATORY HOURS: Weekda : Sam-S E.cdff 0157*17, CoIlfoms, Saunas _24 hr _2 Day _3-5 Day Salmonella, Listeda, E.coIi, APt, V 8 M ._.48 Hr _3-5 Day Mold _RUSH_24Hr._.48Hr_3Day_5Oay
Ito.. uM.h. I. .Iacy Many. Mt4KI to hb0r~ty vein and no 451 wsannte.d. AddIonaI ran .0911101 w .ndhodaya.”
ReIin uished B Laboratory Use Only Received B~ Rnfl _
Job It ‘°~ TWO MED TRI.PtEX
Page tCof S•’
• ~ao flesen-’oirs Inc..
S~I Lo~t& ~,ar CG~18. Ri ~
Pagt : 303409a1a INVOICE TO: IF DIFFEREN CONTACT INFORMATiON:
~ Glacier National Park Ludie c0,~.0- Mymn Many Rtq,ner
ATTN: John tat)., ~‘°“ (406)732-7718 fl.O~ (4%) 732-7772 P.O. Box 126 Faa.
West Glacier MT 59936 Cttt.ow14%1~
— Data D*ratle Emal
John_LUcke@nps.gov
‘Pdor noufiatlon Is ‘aqiind for RUSH
LAB NOTES:REQUESTED ANALYSIS VALID MATRIX CODES
Alr=A Bulk B DijstD Palr4=P SoilS W =W
S,vthtSW FFood I>tkkig Wator = OW Waste Water~ 0
~ U, I.,3w O0uw
~ 0 ASTMEtlt2wovadwp.maocjr
-‘I~
~ I
! z6 ~ ~ U.
if ° . I~’ .s~u~c~u ~-‘
~ -~~I ~.. -Lt t~.~*~:!
g~~4_ -—
I~ o~ Og
1 4< •~w~<wt3wj>- ~ E— ~ ° CoIleded ar 03 a i-,n a a ~ MICROBCLOGY a Wm*&fl utanMt
X (56 1 10120/20 10:00am
X GG 1 10120/20 10:00am
X GG 1 10120120 10.00 am
Special Instnjctions; POINT COUNT ALL TRACES
Cllentsam lelDnumber ( ID’srmsstbe )
1 P1 (EXT.000R JAMB YELLOW)
2 P2 (INTERIOR DOOR TRIM)
3 P3 (INTERIOR TRIM)
S
S
- EM Number (tflUn0*)
Nunter cc samples seceived 43 ~ 43 (Additional sanwles abet be Ested on cuadied long tonn.)
NOT!. REI ad wfl ,sowaq wt~n ban — ...L...L,. ..o.ind — ad aca — re.pab flns nacq. a. ~Ia.a torn a.. E.anflov at IIQW.at — Bysö*i, d.a*O’Teiy ,.p,.witfla ~ that totanflo., at to. swapb. far saad at itod — O~ atcedady thai teaia a” - ‘-~ —.4 ‘MI’ pe)qanfl at NET 30 dntfn to ao.r* .4e1 9e4an1 bins ney awe a.. 14% rnoet~ k,tan4 aa.d,a.w
Canter Pita,. Easil F~c Date This W~eIs Canted Phone Email Fax Tins Phone Entail Far Date This h~aIs Canted Phone Entail Fax Date Thi.
DaWfli..: 10120120 10:00 am San—Ic Con&.ion On Ice Sealed Intect
Temp (P) YesINo Yea/No Yes/No
HAZMAT Form 3b 7-2011_vetsiori 1
GLACIER NATIONAL PARK
HAZMAT CHAIN OF CUSTODY RECORD
Glacier National Park Billing Information: Project Name 1085 TWO MED TRI-PLEX 64 Grinnell Dr. Contact Name, Address & Phone: Project No:
West Glacier, MT59936 John Lucke Results MAIL YES orNO S PHONE: 406-888-7901 Hudson Bay District Office FAX FAX: 4/f,$3g.7°$~ 73 Hudson Bay Rd. Unit 1 PHONE (406)732-7718
Browning, Mt 59417
CLIENT ANALYSIS REQUIRED TURNAROUND
Reservoirs Environmental Inc. Circle One:
5801 Logan Street RUSH 0 Same Day 0 Denver,CO.80216 24HR 0 Other:
z 2 ~ 3-SDM 0
— z o ~ (-I
SAMPLE ft SAMPLE DESCRIPTION DATE/TIME ~i REMARKS RESULTS
F3.1A VFT&GLUE 10/20/20 1 ~ C] C]
F3.1B VFT&GLUE 10(20/20 1 / 0 0
F3.l~ VET & GLUE 10/20/20 1 / 0 Cl EtA RUBBERBASE&GLUE 10/20/20 1 1 C] C]
E1.B RUBBER BASE & GLUE 10/20)20 1 [2] III C]
MIAA SHEETROCK JOINTTAPE 10/20)20 1 ~ C] C]
killS SHEETROCKJOINTTAPE 10/20/20 1 [2] C] Mt.IC SHEETROCKJOINTTAPE 10/20)20 1 [2] C] C MIlD SHEETROCKJOINTTAPE 10/20/20 1 1 C] C] MilE SHEETR0cK,J0INTTAPE 10)20/20 1 C] C] C] M5.IA SIDING 10/20(20 i [2] C C]
M5.1B SIDING 10/20/20 1 C] C] C
M5.1C SIDING 10/20/20 1 [2] C] C]
M5.ID SIDING 10/20/20 1 [2] C] C]
M5.IE SIDING 10/20120 I C]
REI.EASED BY: DEUVERY RECEIVED BY: COMPANY/AGENCY OR DATE / TIME
(si nature) METHOD (si ature) AFFIUATION RECEIVED SAMPLE CONDITION
%OIl(~ tOw
AZMATFonn3a
Glacier National Park Billing Information: Project Name. 1085 TWO MED TRI-PLEX 64 GrinneIl Dr. Contact Name, Address & Phone: Project No:
West Glacier, MI 59936 John Lucke Results MAIL YES or NO YES PHONE: 406-888-7901 Hudson Bay District Office FAX FAX: 4c~~~-7~55 73 Hudson Bay Rd. Unit 1 PHONE (406)732.7718
Browning, Mt 59417
CUENT ANALYSIS REQUIRED TURNAROUND
Reservoirs Environmental Inc. a Circle One:
5801 Logan Street RUSH 0 Same Day 0 Denver, CO. 80216 r I—~ 24 HR 0 Other:
L1.j •~ Z z 2 ~ 3-5DAYØ
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SAMPLE# SAMPLE DESCRIPTION DATE/TIME ~ ~. t~
~ REMARKS RESULTS
RI.1A SHINGLES 1 El OJEJ Rl.lB SHINGLES I I~UI~DIEEI
R1.1C SHINGLES 1 L~DI~JL~I
RI ID SHINGLES 1 PFADEEJI~1
RIlE SHINGLES 1 !~DEE1I~I
R5.IA ROOFINGTARPAPER ~ I~EJI~I
R5.1B ROOFING TAR PAPER I LET C] C]
R5.1C ROOFING TAR PAPER I ~ 0 0
R5.1D ROOFING TAR PAPER i [2] 0 0
R5IE ROOFINGTARPAPER 1 C]0 0
CRT.IA CONCRETE SLAB FLOOR 1 ~ 0 C]
CRT.lB CONCRETE SLAB FLOOR 1 0 0 0
CRTIC CONCRETE SLAB FLOOR 1 00 0
CRT.1 D CONCRETE SLAB FLOOR 1 [2] C] [I]
CRT.IE CONCRETE SLAB FLOOR 1 El] C] C]
RELEASED BY: DEUVERY RECEIVED BY: COMPANY/AGENCY OR DATE / TIME
(signature) METHOD signature) AFFILIATION RECEIVED SAMPLE CONDITION
HAZMAT Form 3a
Glacier National Park Billing Information: Project Name: 1085 TWO MED TRI-PLEX 64 Grinnell Dr. Contact Name, Address & Phone: Project No.
West Glacier, MT 59936 John Lucke Results: MAIL YES or NO ES PHONE: 406-888-7901 Hudson Bay District Office FAX FAX: 406-888-7886 73 Hudson Bay Rd. Unit 1 PHONE (406)732-7718
Browning, Mt 59417
CLIENT — ANALY~S REQUIRED TURNAROUND
Reservoirs Environmental Inc. S Circle One:
5801 Logan Street RUSH 0 Same Day 0 Denver, CO. 80216 24HR 0 Other:
a 2 < 3-SDAYØ ~ a a
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SAMPLE if SAMPLE DESCRIPTION DATE/TIME ~ n REMARKS RESULTS CRT 24 FOUNDATION 10/20120-lOAM I ~ C C CRT 28 FOUNDATION 10/20120-lOAM 1 ~ C] C CRt2C FOUNDATION 10120/20-lOAM 1 0 0 CRT.20 FOUNDATION 10/20/20-lOAM ~ c:j c CRT.2E FOUNDATION 10/20120-lOAM [2] 0 0 Wl.1A EXT CAULK 10/20/20-lOAM 1 [2] C] [II WI_la EXT. CAULK 10/ 0/20-iOWA I ~ C] El] W1IC EXT. CAULK 10(20/20-lOAM 1 ~ C] C WIlD EXt CAULK 10/20/20-lOAM 1 [2] C C] WIlE EXt CAULK 10/20/20-lOAM 1 [~ C] C]
P1 EXT. DOOR JAMB YELLOW 10/20/20-lOAM i 0 0 [2] P2 INTERIOR DOOR TRIM 10/20/20-lOAM 1 C] C El] P3 INTERIOR TRIM 10/20.20-lOAM 1 C C [2]
CcJ 0
RELEASED BY: DEU VERY RECEIVED BY: COMPANWAGENCYOR DATE/TIME
(signature) METHOD (signature) AFFIUATION RECEIVED SAMPLE CONDITION
~L1&>vct~ HAZMAT Form 3a
HAZMAT Laboratory Testing Checklist
- TWO MED TRI PLEX HAZMAT TWO MEDICINEProjectTitle: PMIS#: Location:
Date: 10128120 FMSS Location #: 8189
Description of HAZMAT Work:
Date samplestaken: 10/20/20 Sampler: GERALD GILHAM Note: Attach Chain of Custody Record (HAZMAT Form 3)
Type, material and quantity of samples taken: ROOFING,FLOORING,DRYWALL ,PAINT,CAULKING CEMENT,SIDING
Laboratory analyzing samples: REI Date sent to lab: 10120/20 Date results returned: 11/5/20
Do results indicate asbestos containing material > 1.0%? Yes171 (identify type below) NojJI (no asbestos hazard exists)
Check type of asbestos detected: Tremolite: % content: __________ Actinolite: % content: __________
Anthophyllite: % content: __________ Chrysotile: • % content: 2-6% Amosite: % content: ___________ Crocidolite: % content: ___________
Location where asbestos sampling results were filed: SHAREPOINT Filer: _____________________________
2. Lead:
Datesampletaken: 10/20/20 Sampler: GERALD GILHAM Methodofsamplingdone: LEAD CHECK SWABS Location of samples taken in building: INTERIOR TRIM AND EXTERIOR DOOR JAMB
Laboratory analyzing samples: REI Date sent to lab: 10/20/20 Date results returned: 10/26/20
Do results indicate lead >0.5% by weight? Yes~ No11 (no lead hazard exists)
Location where lead sampling results were fi ed: SHAREPOINT Filer: _____________________________
3. Hantavirus Potential:
Is there sign of rodent infestation? YesU No~
Location(s) in building where signs were noted:
4. Mold:
Is there sign of mold? YesU No1~
Describe evidence in detail:
Locations) in building where signs were noted:
HAZMAT Form 4
| 1.4 Hazmat B353 Polebridge |
| 1.4 Hazmat B535 Two Medicine |
| 1.4 Hazmat B1019 St Mary |
| 1.4 Hazmat B1020 St Mary |
| 1.4 Hazmat B1022 St Mary |
| 1.4 Hazmat B1085 Two Medicine |
| 1.4 Hazmat B1133 St Mary |
File details come from the government source that posted it. Updated .