Atch 25 AMEND_3 _ Limited HazMat Report.pdf

Limited Hazardous Materials Survey Report James H. Quillen VAMC Building 35 Theatre Restoration Lamont Street and Veterans Way Johnson City, Tennessee 37604 VA Project No. 621-24-103

July 24, 2024 | Terracon Project No. KF247037 Prepared for:

Limited Hazardous Materials Survey Report JHQ VAMC – Building 35 Theatre Restoration ■ Johnson City, Tennessee July 24, 2024 ■ Terracon Project No. KF247037

Facilities | Environmental | Geotechnical | Materials i

Table of Contents

1.0 Introduction

2.0 Previous Report Review

3.0 Building Description

4.0 Asbestos Survey

4.1 Regulatory Overview

4.2 Visual Assessment

4.3 Physical Assessment

4.4 Sample Collection

4.5 Sample Analysis

4.6 Findings

4.7 Conclusions and Recommendations

5.0 Lead Paint Survey

5.1 Regulatory Overview

5.2 Analysis via Paint Chip Sampling

5.3 Findings and Recommendations

6.0 Limited Mold Assessment

6.1 Assessment Methodology and Observations

6.2 Surface Mold Sampling

6.3 Conclusions and Recommendations

7.0 General Comments

List of Tables 1 – Asbestos Results Sample Summary 2 – Lead-In-Paint Sample Summary (Paint Chip)

List of Appendices

A – Photo Documentation

B – Laboratory Reports Asbestos Analytical Laboratory Data Lead Paint Analytical Laboratory Data Microbiological Analytical Laboratory Data

C – Inspector’s Credential

Facilities | Environmental | Geotechnical | Materials 1

LIMITED HAZARDOUS MATERIALS SURVEY REPORT

JAMES H. QUILLEN VETERANS ADMINISTRATION MEDICAL CENTER

BUILDING 35 THEATRE RESTORATION

LAMONT STREET AND VETERANS WAY

JOHNSON CITY, TENNESSEE 37684

VA PROJECT NO. 621-24-103

Terracon Project No. KF247037 Survey Date: July 2, 2024

1.0 Introduction

Terracon Consultants, Inc. (Terracon) conducted a limited hazardous materials survey on July 2, 2024 as part of the Restoration of the Theatre Building 35 project on the James H. Quillen VAMC campus in Johnson City, Tennessee. The survey was conducted in general accordance with Terracon Proposal No. PKF247037, dated March 25, 2024. It is our understanding that restoration activities are planned to bring the building into current code standards and repair/restore the building.

2.0 Previous Report Review

The following survey reports that included Building 35 were provided by the Client for Terracon’s review:

Asbestos Survey Report, prepared by Terracon Consultants, Inc., dated February 3, 2023.

Lead-Containing Paint Screening Report, prepared by Terracon Consultants, Inc., dated February 3, 2023.

The above reports included limited surveys of Buildings 3, 5, 8, 13, 15, 17, 19, 20, 34, 35, 36, 37, 39, 40, 41, 42, 43, 44, 45, 46, 47, 53, 69, 77, 108, and 116. It is assumed that the reader has access to copies of the full reports for additional reference, if necessary.

The Asbestos Survey Report stated that fire doors throughout Building 35 were assumed to contain asbestos. The Lead-Containing Paint Screening Report identified lead-based and lead-containing paints and glazing on walls, ceilings, windows, doors, handrails, and stair components throughout Building 35. The paint schemes covered a wide variety of colors on various substrates including wood, metal, concrete, brick, plaster, and ceramic tile.

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3.0 Building Description

Building 35 is an approximately 16,600 square foot, two-story structure constructed of wooden timber framing with a brick veneer. The building was found to have an attic space throughout and a dugout crawlspace under the auditorium and partial basement under the stage. The building was originally utilized as live theatre space but is currently used to house part of the facility engineering group. Floors are predominantly hardwood flooring with limited areas of carpet or ceramic tile. Walls were found to be painted plaster over wooden lath, exposed brick, or ceramic wall tile over plaster and metal lath. The ceiling in the auditorium space was composed of painted plaster while the stage area was open to attic space and roof deck. Limited piping was observed throughout the interior and was insulated with fiberglass with a suspect mastic over it. Several commercial heating, ventilation, and air conditioning (HVAC) units were found in the basement space with metal ductwork wrapped in mastic covered fiberglass insulation. Roofing was predominantly slate over tongue and groove wooden decking, with a flat roof covered by a rubber membrane and polyisocyanurate insulation over the auditorium and backstage spaces.

4.0 Asbestos Survey

The asbestos survey was conducted by Mr. Stephen N. Ellis, a Tennessee Department of Environment and Conservation (TDEC) Asbestos Building Inspector (License No. A-I-591148- 134091). A copy of Mr. Ellis’ license is provided in Appendix C. The survey was conducted on July 2, 2024 in general accordance with the sampling protocols established by US Environmental Protection Agency (EPA) Regulation 40 Code of Federal Regulations (CFR), Part 763, Subpart E, known as the Asbestos Hazard Emergency Response Act (AHERA). EPA regulation 40 CFR 61, Subpart M, National Emission Standards for Hazardous Air Pollutants (NESHAP), prohibits the release of asbestos fibers to the atmosphere during renovation/demolition activities. NESHAP requires that asbestos-containing materials (ACM) be identified, classified, and quantified prior to planned disturbances or demolition activities.

A summary of survey activities is provided below.

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4.1 Regulatory Overview

The asbestos NESHAP (40 CFR Part 61) regulates asbestos fiber emissions and asbestos waste disposal practices. It also requires the identification and classification of existing asbestos containing building materials prior to demolition or renovation activity. Under NESHAP, asbestos-containing building materials are classified as either friable, Category I non-friable or Category II non-friable ACM. Friable materials are those that, when dry, may be crumbled, pulverized or reduced to powder by hand pressure. Category I non-friable ACM includes packings, gaskets, resilient floor coverings and asphalt roofing products.

Category II non-friable ACM are any materials other than Category I materials that contain more than 1% asbestos.

Friable ACM and Category I and Category II non-friable ACM which is in poor condition and has become friable or which will be subjected to drilling, sanding, grinding, cutting or abrading and which could be crushed or pulverized during anticipated renovation or demolition activities are considered regulated ACM (RACM). RACM must be removed prior to renovation or demolition activities. If the amount of RACM exceeds 260 linear feet of pipe insulation or more than 160 square feet in other building components, the owner or operator must provide the Tennessee Department of Environment and Conservation – Division of Air Pollution Control (TDEC-APC) with written notification of planned removal activities at least 10 working days prior to the commencement of asbestos abatement activities. Removal of RACM should be conducted by an accredited and appropriately licensed asbestos abatement contractor.

The OSHA Asbestos standard for the construction industry (29 CFR 1910.1101) regulates workplace exposure to asbestos. The OSHA standard requires that employee exposure to airborne asbestos fibers be maintained below 1 fiber per cubic centimeter (f/cc) for a 30-minute excursion limit and 0.1 f/cc for an 8-hour permissible exposure limit. The OSHA standard classifies construction and maintenance activities, which could disturb ACM, and specifies work practices and precautions which employers must follow when engaging in each class of regulated work.

According to US EPA and OSHA regulations, an ACM is considered any material or product containing more than one percent (>1%) asbestos. Per the US EPA, a material with asbestos content ranging from <1% to 10% by PLM, must be analyzed by point count method or must be presumed asbestos-containing. Materials confirmed to be <%1 asbestos by point count analysis are considered by OSHA to be materials of concern. OSHA’s concern is that a material, when disturbed, may emit fiber concentrations greater than 1 f/cc for a 30-minute excursion limit and 0.1 f/cc for an 8-hour permissible exposure limit. Therefore, the renovation / demolition contractor is required to comply with OSHA worker protection regulations during any disturbance or removal of these materials.

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4.2 Visual Assessment

Our survey activities began with visual observation of the interior and exterior of the subject structure to identify apparent homogeneous areas of suspect ACM. A homogeneous area consists of building materials, which appear similar throughout in terms of color, texture and apparent date of application. Building materials which were not identified as concrete, glass, wood, masonry, metal or rubber were considered suspect ACM.

With respect to previously identified ACM, Terracon reviewed those materials and compared the current conditions and quantities with those reported in the February 2023 survey report.

No significant differences were observed.

4.3 Physical Assessment

A physical assessment of each homogeneous area was conducted to assess the friability and condition of the materials. A friable material is defined by the EPA as a material which can be crumbled, pulverized, or reduced to powder by hand pressure when dry. Friability was assessed by physically touching suspect materials.

4.4 Sample Collection

Based on the results of the visual observations, bulk samples of suspect ACM were collected in random locations within a given homogeneous area, in general accordance with the sampling protocols outlined in EPA Regulation 40 CFR 763 Subpart E, Section 763.86 (AHERA).

Samples were collected using wet methods, as applicable, to reduce the potential for fiber release. Samples were placed in sealable containers and labeled with unique sample numbers using an indelible marker. The selection of sample locations and frequency of sampling was based on Terracon’s observations and the assumption that like materials in the same homogeneous area were similar in content.

Terracon collected a total of 27 bulk samples from nine (9) separate homogenous areas. A summary of the samples collected from suspect ACM during the survey is presented in Table 1.

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4.5 Sample Analysis

Bulk samples were submitted using chain-of-custody procedures to Scientific Analytical Institute, Inc. (SAI) of Greensboro, North Carolina. SAI is accredited for bulk asbestos analysis under the National Voluntary Laboratory Accreditation Program (NVLAP, Accreditation No. #200664-0). Asbestos analysis was performed by polarized light microscopy (PLM) with dispersion staining techniques per EPA Method 600/R-93/116. The percentage of asbestos, where applicable, was determined by microscopical visual estimation.

4.6 Findings

The following materials were identified by laboratory analysis to contain asbestos:

Insulation (60% chrysotile) in stage fire doors;

Glazing compound (2% chrysotile) on wooden windows throughout;

Wiring jacket (50% chrysotile) on stage lights throughout;

Residual mastic/flashing (30% chrysotile) on the roof entry door; and, Silver/black coating (4% chrysotile) on the roof ventilator, plumbing vents, and along the wall of the stage attic.

The following materials were not safely accessible to sample at the time of our survey and, therefore, were assumed to contain >1% asbestos:

Emergency fire curtain above the stage; and, Felt paper under slate roofing.

The following materials were assumed to contain asbestos in the February 2023 asbestos survey report:

Fire door insulation (assumed) on fire doors throughout the building.

Table 1 summarizes the results of the visual observations, estimated quantities, and laboratory analyses. A copy of the asbestos laboratory analytical report is included in Appendix B.

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4.7 Conclusions and Recommendations

The following steps should be taken for the removal of ACMs prior to impact by renovation or demolition activities:

1. Notify TDEC-DAPC officials of the impending abatement project electronically at Asbestos.NESHAP.Program@tn.gov or (written) at the following address:

State of Tennessee Department of Environment and Conservation Division of Air Pollution Control Davy Crockett Tower 500 James Robertson Parkway Nashville, Tennessee 37243

2. Remove the ACM from the building before any activity begins that would break up, dislodge, or similarly disturb the material.

3. The ACM waste must be manifested and disposed at an appropriately classified landfill that is certified to accept RACM and non-RACM wastes.

A Tennessee-accredited asbestos abatement firm should be contracted to perform the ACM removal prior to impact by renovation/demolition activities. The work should be performed in compliance with federal, state and local guidelines. It should be noted that suspect materials, other than those identified during this survey may exist within the structure.

Should suspect ACM other than those which were identified during this or prior surveys be discovered during renovation/demolition activities, those materials should be assumed to be asbestos-containing until the results from sampling and analysis can be used to demonstrate otherwise.

5.0 Lead Paint Survey

5.1 Regulatory Overview

Lead is regulated by the Occupational Health and Safety Administration (OSHA), EPA, and the State of Tennessee. Lead-containing paints may present a lead dust hazard during renovation/demolition activities. Personnel performing renovation/demolition activities that may disturb painted components with concentrations of lead above the designated analytical detection limit should comply with all current OSHA regulations in order to minimize employee exposure. OSHA regulates construction activities that disturb lead-containing material regardless of the concentration. Currently, any proposed renovation/demolition is mailto:Asbestos.NESHAP.Program@tn.gov

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Facilities | Environmental | Geotechnical | Materials 7 subject to the OSHA regulation (29 CFR 1926.62 – Lead Exposure in Construction). Lead-based paint is defined as greater than or equal to 0.5 percent by weight and/or greater than or equal to 1.0 milligram per centimeter squared (mg/cm2).

For the purpose of the OSHA lead standard, lead includes metallic lead, inorganic lead compounds, and organic lead soaps. A synopsis of the OSHA regulations (29 CFR 1926.62) and the applicability are described below.

The OSHA Lead Standard for Construction (29 CFR 1926.62) applies to construction work where an employee may be occupationally exposed to lead. Work related to construction, alteration, or repair (including painting and decorating) is included. The lead-in-construction standard applies to any detectable concentration of lead in paint, as even small concentrations of lead can result in unacceptable employee exposures depending upon on the method of removal and other workplace conditions. Under this standard, construction includes, but is not limited to, the following:

Demolition or salvage of structures where lead or materials containing lead are present;

Removal or encapsulation of materials containing lead;

New construction, alteration, repair, or renovation of structures, substrates, or portions containing lead, or materials containing lead;

Installation of products containing lead;

Lead contamination/emergency clean-up;

Transportation, disposal, storage, or containment of lead or materials containing lead on the site or location at which construction activities are performed; and, Maintenance operations associated with construction activities described above.

The Resource Conservation and Recovery Act (RCRA) regulates management of hazardous wastes which may include lead-containing materials. Under RCRA, lead-containing wastes are considered a characteristic hazardous waste if laboratory analytical results exceed 5 milligrams per liter (mg/L) when analyzed by the Toxicity Characteristic Leaching Procedure (TCLP). Specific regulatory requirements apply to the transport, treatment, storage, or disposal of hazardous wastes.

The above overview is not intended to be inclusive of all potentially pertinent regulatory information. The relevant OSHA, EPA and State of Tennessee standards should be consulted prior to undertaking activities involving the demolition, renovation, or maintenance of surfaces coated with lead-containing paint (LCP) or materials that contain lead.

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5.2 Analysis via Paint Chip Sampling

The LBP sampling was conducted by collecting random paint chip samples to assist the Veterans Administration and/or its contractor(s) with determining potential engineering controls or other means to ensure OSHA compliance during the upcoming project.

The paint samples were collected down to the surface substrate to include underlying paints in the analysis. The random paint chip samples were selected based on current paint schemes and may not be inclusive of old paint systems covered with newer coatings. The paint chip samples were submitted to an American Industrial Hygiene Association Laboratory Approval Program (AIHA LAP)-accredited laboratory (SAI) for analysis of lead by inductively-coupled plasma (ICP) analysis using EPA Method No. SW-846 3050B.

5.3 Findings and Recommendations

Twelve paint chip samples were collected from various painted components and submitted for laboratory analysis. Lead was detected in all samples analyzed. The reported lead concentrations in 10 of the samples were above 0.5% by weight and are considered lead-based paints. The two remaining paint samples (PC-3 and PC-10) were below 0.5% by weight and are not considered to be lead-based but are still considered lead-containing paints. The lead-based paints identified during this survey are:

White paint on metal door and frame on the roof access door from the stage attic;

Silver paint on metal ventilator on the flat roof;

White paint on metal fire doors on the stage;

White paint on plaster walls in the stage back hallway;

White paint on wooden baseboard in the stage 2nd floor back hallway;

White paint on wooden beadboard ceiling in the orchestra pit;

Brown paint on metal fire door frame in the orchestra pit;

Gray paint on wooden stair riser in the stage stairwell;

Peach paint on plaster walls in the auditorium men’s restroom storage space; and, White paint on wooden door and frame on the exterior balcony fire escape.

Table 2 provides a summary of the results. Copies of the laboratory data report and chain-of-custody form are included in Appendix B.

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In addition to the paint chip samples collected above, a number of other coatings in Building 35 were evaluated as part of a prior scope of work. Specifically, the following paints were identified to contain lead by x-ray fluorescence or laboratory analysis of paint chip samples:

Off-white paint on plaster walls;

Off-white glazing on ceramic wall tiles;

Off-white paint on concrete pole;

White paint on wooden door frames;

White paint on wooden baseboards;

White paint on wooden doors;

White paint on metal stair rails;

White paint on wooden window frames;

White paint on wooden window casings;

Off-white paint on plaster ceiling;

Gray paint on wooden stairs;

Brown paint on sliding metal doors;

White paint on wooden stair railing;

Brown paint on wooden door frames;

White paint on wooden stair well;

White paint on exterior wooden door frames;

White paint on exterior wooden doors;

Brown paint on exterior metal handrails;

White paint on exterior wooden window frames;

Black/brown paint on exterior metal handrails;

Gray paint on wooden stair trim/railing;

White paint on wooden floors;

White paint on brick walls;

Black paint on metal window frames; and, White paint on wooden doors.

Regulatory agencies, such as the US EPA, TDEC, and the Consumer Products Safety Commission (CPSC) have designated levels of lead in paint, below which they consider the paint to be non-lead containing. The missions of these agencies differ from OSHA's, and for that reason, OSHA cannot recognize these levels as safe under workplace situations. The OSHA lead-in-construction standard was intended to apply to detectable concentrations of lead in paint, as even small concentrations of lead can result in unacceptable employee exposures depending upon the method of removal and other workplace conditions.

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OSHA does not consider methods that rely solely on the analysis of bulk materials or surface content of lead (or other toxic material) to be acceptable for safely predicting employee exposure to airborne contaminants. Without air monitoring results or without the benefit of historical or objective data (including air sampling which clearly demonstrates that the employee cannot be exposed above the action level during any process, operation, or activity) the analysis of bulk or surface samples cannot be used to determine employee airborne exposure. Building materials, equipment, and components identified in this report as being coated with lead-containing paint/primer should be properly evaluated to determine if the paint system should be abated by qualified and properly equipped personnel under the OSHA Lead Construction Standard, found at 29 CFR 1926.62. A full copy of the OSHA lead standard for construction industry may be found at OSHA’s website (www.osha.gov) and should be referenced for specific information.

With regard to disposal of painted waste, LBP-coated materials may generally be disposed at a construction and demolition (C&D) landfill provided that the paint remains intact on the substrate. Paint that is delaminated or paint waste that will be generated as a result of renovation/demolition activities must undergo a hazardous waste determination by collecting one or more representative samples of the waste material for laboratory analysis. The specific laboratory test methods necessary may be prescribed by the prospective disposal facility but should, at a minimum, include lead analysis via TCLP.

6.0 Limited Mold Assessment

6.1 Assessment Methodology and Observations

The limited mold assessment was performed by visually evaluating the interior of the building (including the attic, basement, and crawlspace) for the presence of apparent water damage and/or the presence of apparent mold. The following conditions were noted:

Room 107 Window Frame: Suspect mold growth was noted on the window frame and adjacent wall in Room 107.

Room 35-8 Ceiling: Visible water damage, physical damage, and suspect mold growth was noted on the plaster ceiling in Room 35-8.

Crawlspace Floor Joist: Visible water damage and suspect mold growth was noted on the wooden floor joist members in the northeast corner in crawlspace adjacent to the mechanical room/basement.

http://www.osha.gov/

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6.2 Surface Mold Sampling

Terracon collected three swab samples and submitted the samples to SAI for analysis via optical microscopy. Table A-1 below presents a summary of the results. The laboratory analytical report is in Appendix B.

Table A-1 Swab Sample Results Summary

Sample ID and Location Fungi Seen/Identified

Mold Growth Rating**

General Impression

SW-1

Room 107

Window Frame

Cladosporium

Hyphal Fragments

Indicates fungal growth

SW-2

Room 35-8

Ceiling No Spores Detected N/A

Does not indicate fungal growth

SW-3

Crawlspace Floor

Joist

Aspergillus/Penicillium Like

Hyphal Fragments

Indicates fungal growth

** 1 – Trace (1-10 spores) 2 – Light (11-100 spores) 3 – Abundant (101-300 spores) 4 – Loaded (>300 spores)

6.3 Conclusions and Recommendations

Based on the swab sampling results, Terracon has concluded the following:

Active mold growth is present on the window frame in Room 107.

Mold is not present in the sampled area of the ceiling in Room 35-8.

Active mold growth is present on the floor joist in the crawlspace.

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Based on the above conclusions, the following recommendations are given:

Identify and repair sources of water intrusion or leaks in various areas of the building, specifically in backstage areas where visible water damage and mold growth are occurring.

Remove and replace damaged plaster in Room 107. Clean or repair (if necessary) the window frame in this room as well.

Clean or repair (if necessary) the water damaged wooden floor joists and adjacent wooden members in the crawlspace. Cleaning should be conducted using trained workers that have experience with projects of similar scope and complexity.

Fungal remediation should follow ANSI/IICRC S520 Standard and Reference Guide for Profession Mold Remediation (latest edition).

7.0 General Comments

This survey was conducted in a manner consistent with the level of care and skill ordinarily exercised by members of the profession currently practicing under similar conditions in the same locale. The results, findings, conclusions, and recommendations expressed in this report are based on conditions observed during our survey, as described herein. The information contained in this report is relevant to the date on which this survey was performed and may not be representative of conditions at a later date.

This report has been prepared on behalf of and exclusively for use by FFE, Inc. for specific application to their project as discussed. Terracon does not warrant the work of regulatory agencies, laboratories or other third parties supplying information, which may have been used in the preparation of this report. No warranty, express or implied is made.

This report is not a bidding document. Contractors or consultants reviewing this report must draw their own conclusions regarding further investigation or remediation deemed necessary.

TABLES

AA-1 PLM

AA-2 NA

AA-3 NA

AB-1 PLM

AB-2 NA

AB-3 NA

AC-1 PLM

AC-2 NA

AC-3 NA

AD-1 PLM

AD-2 PLM

AD-3 PLM

AE-1 PLM

AE-2 PLM

AE-3 PLM

RFA-1 PLM

RFA-2 NA

RFA-3 NA

RFB-1 PLM

RFB-2 PLM

RFB-3 PLM

RFC-1 PLM

RFC-2 NA

RFC-3 NA

RFD-1 PLM

RFD-2 PLM

RFD-3 PLM

Notes:

Termination Strip on Wall of

Stage Attic

N/A

Sample Location(s)

Stage Back Wall and

Orchestra Pit

Backstage, 2nd Floor

Backstage, and Balcony

Foyer

2nd Floor Backstage

Restrooms at Rear of

Auditorium

Exterior Front, Exterior Right

Side, and Exterior Left Side

N/A

Roof Entry Door

Roof Entry Door

LPD 340 LF

N/A N/A

N/A N/A

NAD

Exterior Wooden Door

Frames White Caulking AE Miscellaneous Non-Friable Good

LF

4% Chrysotile

Roof Ventilator, Plumbing

Vents, and along Wall of

Stage Attic

Silver/Black Roof Coating RFC Miscellaneous Friable Significantly

Damaged

PSD 180 SF

NAD Roof Entry Door White Caulking RFB Miscellaneous Friable Damaged PD 12

Roof Ventilator and

Plumbing Vents

SF

30% Chrysotile Roof Entry Door Residual Roof

Mastic/Flashing RFA Miscellaneous Friable

Significantly

Damaged

PSD <1 SF

Assumed to Contain

Asbestos Stage Emergency Fire Curtain AF Miscellaneous Friable Good LPD 750

LF

NAD

Restrooms at Rear of

Auditorium

Felt Paper under Plaster and

Metal Lath AD Miscellaneous Non-Friable Good LPD 850 SF

50% Chrysotile Stored Stage Lights** Wiring Jacket AC TSI Friable Good LPD 18

Friable Significantly

Damaged

PSD 320 SF

60% Chrysotile Stage Fire Doors* Fire Door Insulation AA TSI Friable Good LPD 170

NA - Not Analyzed

NAD - No Asbestos Detected

PLM - Polarized Light Microscopy

LF

Termination Strip on Wall of

Stage Attic Black Roof Caulking RFD Miscellaneous Good

Slate Roof Felt Paper under Slate RFE Miscellaneous Category I

Non-Friable Good LPD 5,770 SF

1) Quantities listed above are estimates to be used for inspection purposes only and should be field-verified for all other uses.

2) Asbestos-containing materials containing >1% asbestos or materials assumed to contain asbestos are bolded.

* - Fire doors were assumed to contain asbestos as part of a previous survey, labeled as HA-20.

** - We were unable to assess all stage lighting used in the building, it should be assumed that all wiring associated with the stage lighting is asbestos-containing.

TSI - Thermal System Insulation LPD - Low potential for disturbance

PD - Potential for disturbance

PSD - Potential of significant disturbance

SF - square feet

LF - linear feet

CF - cubic feet

Good LPDNAD

Assumed to Contain

Asbestos

TABLE 1

ASBESTOS RESULTS SAMPLE SUMMARY

LAMONT STREET AND VETERANS WAY

JOHNSON CITY, TENNESSEE

Sample

Number

Analysis

Method

Estimated

Quantity Material Location

TERRACON PROJECT NO. KF247037

Material Description Homogeneous

Area Classification

Current

Condition

Potential for

Disturbance

Friable /

Non-Friable Analytical Results

JHQ VAMC - BUILDING 35 THEATRE RESTORATION

SF

2% Chrysotile Wood Windows

Throughout Glazing Compound AB Miscellaneous

Sample

ID No.

Area Substrate Component Color

Lead

Concentration

PC-1

Roof Access Door from

Stage Attic Metal Door and Frame White 18

PC-2 Flat Roof Metal Roof Ventilator Silver 27

PC-3 Stage Walkways Wood Window Black 0.42

PC-5 Stage Metal Fire Door White 8.4

PC-6 Stage Back Hallway Plaster Wall White 1.1

PC-7

Stage 2nd Floor Back

Hallway Wood Baseboard White 1.7

PC-8 Orchestra Pit Wood Beadboard Ceiling White 4.3

PC-9 Orchestra Pit Metal Fire Door Frame Brown 17

PC-10 Basement Mechanical Room Brick Wall White 0.055

PC-11 Stage Stairwell Wood Stair Riser Gray 35

PC-12

Auditorium Men's Restroom

Storage Space Plaster Wall Peach 8.6

PC-13

Exterior Balcony

Fire Escape Wood Door and Frame White 22

Notes:

1) Values above the analytical method detection limit are indicated in bold type

2) Values equal to or greater than 0.5 percent are bolded and shaded

TABLE 2

LEAD IN PAINT SAMPLE SUMMARY (PAINT CHIP)

JHQ VAMC - BUILDING 35 THEATRE RESTORATION

JOHNSON CITY, TENNESSEE

TERRACON PROJECT NO. KF247037

LAMONT STREET AND VETERANS WAY

APPENDICES

APPENDIX A

Photo Documentation

Hazardous Materials Survey Report

Photos Taken: July 2, 2024 ■ Terracon Project No. KF247037

Facilities | Environmental | Geotechnical | Materials 1

Photo 1: General view of the front of Building 35. Photo 2: General view of the rear of Building 35.

Photo 3: General view of the right side of Building 35. Photo 4: General view of the left side of Building 35.

Facilities | Environmental | Geotechnical | Materials 2

Photo 5: General view of the former stage area. Photo 6: General view of the auditorium.

Photo 7: General view of the orchestra pit. Photo 8: General view of the men’s restroom at the rear of the auditorium. Typical of both restrooms.

Facilities | Environmental | Geotechnical | Materials 3

Photo 9: General view of the projection booth. Photo 10: General view of the attic space above the auditorium.

Photo 11: General view of the mechanical room under the stage. Photo 12: Genera view of the crawlspace under the auditorium.

Facilities | Environmental | Geotechnical | Materials 4

Photo 13: General view of the flat roof over the auditorium. Photo 14: General view of the slate roof over various areas of the building.

Photo 15: View of insulation (HA-AA) inside the stage fire doors.

Contains asbestos.

Photo 16: View of glazing compound (HA-AB) on the wooden windows.

Contains asbestos.

Facilities | Environmental | Geotechnical | Materials 5

Photo 17: View of wiring jacket (HA-AG) on stored lights in the 2nd floor space behind the stage. Contains asbestos.

Photo 18: View of felt paper under plaster and metal lath (HA-AD) on the walls of the auditorium restrooms.

Photo 19: View of white caulking (HA-AE) around wooden door frames on the exterior of the building.

Photo 20: View of an emergency fire curtain (HA-AF) above the stage.

Assumed to contain asbestos.

Facilities | Environmental | Geotechnical | Materials 6

Photo 21: View residual roof mastic/flashing (HA-RFA) on the roof entry door from the stage attic. Contains asbestos.

Photo 22: View of white caulking (HA-RFB) around the roof entry door from the stage attic.

Photo 23: View of silver/black coating (HA-RFC) on the roof ventilator, plumbing vents, and along the stage attic wall. Contains asbestos.

Photo 24: View of black roof coating (HA-RFD) on the termination strip on the wall of the stage attic.

Facilities | Environmental | Geotechnical | Materials 7

Photo 25: View of white paint on the metal roof access door from the stage attic. Sample PC-1 collected here.

Photo 26: View of silver paint on the metal roof ventilator. Sample PC-2 collected here.

Photo 27: View of black paint on wooden windows in the stage mezzanine area. Sample PC-3 collected here.

Photo 28: View of white paint on metal fire door in the stage area.

Sample PC-5 collected here.

Facilities | Environmental | Geotechnical | Materials 8

Photo 29: View of white paint on plaster walls in the stage back hallway.

Sample PC-6 collected here.

Photo 30: View of white paint on wooden baseboard in the stage 2nd floor back hallway. Sample PC-7 collected here.

Photo 31: View of white paint on wooden beadboard in the orchestra pit. Sample PC-8 collected here.

Photo 32: View of brown paint on metal fire door frame in the orchestra pit. Sample PC-9 collected here.

Facilities | Environmental | Geotechnical | Materials 9

Photo 33: View of white paint on brick walls in the mechanical room under the stage. Sample PC-10 collected here.

Photo 34: View of gray paint on wooden stair riser in the stage stairwell.

Sample PC-11 collected here.

Photo 35: View of peach paint on plaster walls in the auditorium men’s room storage space. Sample PC-12 collected here.

Photo 36: View of white paint on wooden door and frame on the exterior balcony fire escape. Sample PC-13 collected here.

Facilities | Environmental | Geotechnical | Materials 10

Photo 37: View of previous water damage on wooden framing at the roof hatch access.

Photo 38: View of water damaged plaster ceiling and wall in Room 35-8.

Photo 39: Additional view of water damaged plaster ceiling and wall in Room 35-8.

Photo 40: View of suspect mold growth on wooden window frame in Room 107. Sample SW-1 collected from here.

Facilities | Environmental | Geotechnical | Materials 11

Photo 41: View of suspect mold growth on plaster ceiling in Room 35-8.

Sample SW-2 collected from here.

Photo 42: View of suspect mold growth on wooden floor joist in the dugout crawlspace under the stage. Sample SW-3 collected from here.

APPENDIX B

Laboratory Reports and Chain-of-Custody Forms

Bulk Asbestos Analysis By Polarized Light Microscopy EPA Method: 600/R-93/116 and

40 CFR, Part 763, Subpart E, App.E

Lab Order ID:Attn: 10056100Customer: Terracon 7 Glenn Bridge Road Suite G Arden , NC 28704

Analysis:

Date Received:

George Flores Stephen Ellis

PLM

07/08/2024

Project: VAMC Mtn Home Bldg 35 KF247037 - Task

Date Reported: 07/11/2024

Sample ID

Lab Sample ID

Description

Lab Notes Asbestos

Fibrous Components

Non-Fibrous Components Treatment

Attributes

AA-1

10056100_0001

Fire Door Insulation

60% Chrysotile 40% Other

Fibrous

Dissolved

Gray

Homogeneous

AA-2

10056100_0002

Fire Door Insulation

Not Analyzed

AA-3

10056100_0003

Fire Door Insulation

Not Analyzed

AB-1

10056100_0004

Window Glazing Compound

2% Chrysotile 98% Other

Non-Fibrous

Dissolved

White, Tan

Homogeneous

AB-2

10056100_0005

Window Glazing Compound

Not Analyzed

AB-3

10056100_0006

Window Glazing Compound

Not Analyzed

AC-1

10056100_0007

Stage Lighting Wiring Jacket

50% Chrysotile 50% Other

Fibrous

Dissolved

Gray, White

Homogeneous

AC-2

10056100_0008

Stage Lighting Wiring Jacket

Not Analyzed

Disclaimer: Due to the nature of the EPA 600 method, asbestos may not be detected in samples containing low levels of asbestos. We strongly recommend that analysis of floor tiles, vermiculite, and/or heterogenous soil samples be conducted by TEM for confirmation of "None Detected" by PLM. This report relates only to the samples tested and may not be reproduced, except in full, without the written approval of SAI. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. government. Analytical uncertainty available upon request. Scientific Analytical Institute participates in the NVLAP Proficiency Testing program.

Unless otherwise noted blank sample correction was not performed. Estimated MDL is 0.1%.

Kiersten Smith (27)

Analyst Approved Signatory

Page 1 of 4P-F-002 r15 1/15/2028 Scientific Analytical Institute, Inc. 4604 Dundas Dr. Greensboro, NC 27407 (336) 292-3888

EPA Method: 600/R-93/116 and

40 CFR, Part 763, Subpart E, App.E

Lab Order ID:Attn: 10056100Customer: Terracon 7 Glenn Bridge Road Suite G Arden , NC 28704

Analysis:

Date Received:

George Flores Stephen Ellis

PLM

07/08/2024

Project: VAMC Mtn Home Bldg 35 KF247037 - Task

Date Reported: 07/11/2024

Sample ID

Lab Sample ID

Description

Lab Notes Asbestos

Fibrous Components

Non-Fibrous Components Treatment

Attributes

AC-3

10056100_0009

Stage Lighting Wiring Jacket

Not Analyzed

AD-1

10056100_0010

Felt Paper

None Detected 10% Cellulose 90% Other

Fibrous

Ashed

Black

Homogeneous

AD-2

10056100_0011

Felt Paper

None Detected 10% Cellulose 90% Other

Fibrous

Ashed

Black

Homogeneous

AD-3

10056100_0012

Felt Paper

None Detected 10% Cellulose 90% Other

Fibrous

Ashed

Black

Homogeneous

AE-1

10056100_0013

White Door/Window Caulking

None Detected 5% Cellulose 95% Other

Non-Fibrous

Ashed

White

Homogeneous

AE-2

10056100_0014

White Door/Window Caulking

None Detected 5% Cellulose 95% Other

Non-Fibrous

Ashed

White

Homogeneous

AE-3

10056100_0015

White Door/Window Caulking

None Detected 5% Cellulose 95% Other

Non-Fibrous

Ashed

White

Homogeneous

RFA-1

10056100_0016

Residual Roof Mastic/Flashing

30% Chrysotile 70% Other

Non-Fibrous

Ashed

Black

Homogeneous

Disclaimer: Due to the nature of the EPA 600 method, asbestos may not be detected in samples containing low levels of asbestos. We strongly recommend that analysis of floor tiles, vermiculite, and/or heterogenous soil samples be conducted by TEM for confirmation of "None Detected" by PLM. This report relates only to the samples tested and may not be reproduced, except in full, without the written approval of SAI. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. government. Analytical uncertainty available upon request. Scientific Analytical Institute participates in the NVLAP Proficiency Testing program.

Unless otherwise noted blank sample correction was not performed. Estimated MDL is 0.1%.

Kiersten Smith (27)

Page 2 of 4P-F-002 r15 1/15/2028 Scientific Analytical Institute, Inc. 4604 Dundas Dr. Greensboro, NC 27407 (336) 292-3888

EPA Method: 600/R-93/116 and

40 CFR, Part 763, Subpart E, App.E

Lab Order ID:Attn: 10056100Customer: Terracon 7 Glenn Bridge Road Suite G Arden , NC 28704

Analysis:

Date Received:

George Flores Stephen Ellis

PLM

07/08/2024

Project: VAMC Mtn Home Bldg 35 KF247037 - Task

Date Reported: 07/11/2024

Sample ID

Lab Sample ID

Description

Lab Notes Asbestos

Fibrous Components

Non-Fibrous Components Treatment

Attributes

RFA-2

10056100_0017

Residual Roof Mastic/Flashing

Not Analyzed

RFA-3

10056100_0018

Residual Roof Mastic/Flashing

Not Analyzed

RFB-1

10056100_0019

White Door Caulking

None Detected 5% Cellulose 95% Other

Non-Fibrous

Ashed

White

Homogeneous

RFB-2

10056100_0020

White Door Caulking

None Detected 5% Cellulose 95% Other

Non-Fibrous

Ashed

White

Homogeneous

RFB-3

10056100_0021

White Door Caulking

None Detected 5% Cellulose 95% Other

Non-Fibrous

Ashed

White

Homogeneous

RFC-1

10056100_0022

Silver/Black Roof Coating

4% Chrysotile 96% Other

Non-Fibrous

Ashed

Black, Silver

Homogeneous

RFC-2

10056100_0023

Silver/Black Roof Coating

Not Analyzed

RFC-3

10056100_0024

Silver/Black Roof Coating

Not Analyzed

Disclaimer: Due to the nature of the EPA 600 method, asbestos may not be detected in samples containing low levels of asbestos. We strongly recommend that analysis of floor tiles, vermiculite, and/or heterogenous soil samples be conducted by TEM for confirmation of "None Detected" by PLM. This report relates only to the samples tested and may not be reproduced, except in full, without the written approval of SAI. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. government. Analytical uncertainty available upon request. Scientific Analytical Institute participates in the NVLAP Proficiency Testing program.

Unless otherwise noted blank sample correction was not performed. Estimated MDL is 0.1%.

Kiersten Smith (27)

Page 3 of 4P-F-002 r15 1/15/2028 Scientific Analytical Institute, Inc. 4604 Dundas Dr. Greensboro, NC 27407 (336) 292-3888

EPA Method: 600/R-93/116 and

40 CFR, Part 763, Subpart E, App.E

Lab Order ID:Attn: 10056100Customer: Terracon 7 Glenn Bridge Road Suite G Arden , NC 28704

Analysis:

Date Received:

George Flores Stephen Ellis

PLM

07/08/2024

Project: VAMC Mtn Home Bldg 35 KF247037 - Task

Date Reported: 07/11/2024

Sample ID

Lab Sample ID

Description

Lab Notes Asbestos

Fibrous Components

Non-Fibrous Components Treatment

Attributes

RFD-1

10056100_0025

Black Roof Caulking

None Detected 100% Other

Non-Fibrous

Ashed

Black

Homogeneous

RFD-2

10056100_0026

Black Roof Caulking

None Detected 100% Other

Non-Fibrous

Ashed

Black

Homogeneous

RFD-3

10056100_0027

Black Roof Caulking

None Detected 100% Other

Non-Fibrous

Ashed

Black

Homogeneous

Disclaimer: Due to the nature of the EPA 600 method, asbestos may not be detected in samples containing low levels of asbestos. We strongly recommend that analysis of floor tiles, vermiculite, and/or heterogenous soil samples be conducted by TEM for confirmation of "None Detected" by PLM. This report relates only to the samples tested and may not be reproduced, except in full, without the written approval of SAI. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. government. Analytical uncertainty available upon request. Scientific Analytical Institute participates in the NVLAP Proficiency Testing program.

Unless otherwise noted blank sample correction was not performed. Estimated MDL is 0.1%.

Kiersten Smith (27)

Page 4 of 4P-F-002 r15 1/15/2028 Scientific Analytical Institute, Inc. 4604 Dundas Dr. Greensboro, NC 27407 (336) 292-3888

Client:

Contact:

Address:

Phone:

Fax:

Email:

Project:

Client Notes:

P.O.#.

Date Submitted:

*Instructions:

Use Column "B" for your contact info

Terracon Asheville Stephen Ellis 7 Glenn Bridge Rd, Ste A, Arden NC 28t04 423--426-2164 To See an Example Click the ..

step hen. ellis@terracon.com george.flores2@terracon.com VAMC Mtn Home Bldg 35 KF247037 - Task 1 Positive Stop bottom Example Tab.

Enter samples between "<<" and ">>" Begin Samples with • "<< "above the first sample and end with a ">>" below the Int sample.

Only Enter your data on the first sheet "Sheet1"

Note: Data 1 and Data 2 are optional 7/2/2024 O:OOI fields that do not show up on the official nalysls: IPLM TumAroundTlme: 3 Day_ TAT report, however they will be included in the electronic data returned to you to facilitate y0ur reintearation of the report data.

1Lmpte Number

AA-1

AA-2

AA-3

AB-1

AB-2

Data 1

Small Sample Small Sample Small Sample

Sample Description

Fire Door Insulation Fire Door Insulation Fire Door Insulation l {JOc;lQ, i oo

Sclentlflc Analytical Institute

4604 Dundas Drive Greensboro, NC 27407 Phone: 336.292.3888

Fax: 336.292.33.13 Emal/: lab@sallab.com

Oati2

PLM

PLM

PLM

PLM

PLM

PLM AB-3

AC-1

AC-2

AC-3

AD-1

Small Sample Small Sample Small Sample

Window Glazing Compound Window Glazing Compound Window Glazing Compound Stage Lightin~ Wiring Jacket Stage Lighting Wiring Jacket Stage Lighting Wiring Jacket Felt Paper

I PLM

, . ·,t

AD-2

AD-3

AE-1

AE-2

AE-3

RFA-1

RFA-2

RFA-3

~ > . / l,,f-1-Lf

Felt Paper Felt Paper White Door/Window Caulking

White Door/Window Caulking White Door/Window Caulking Residual Roof Mastic/Flashing Residual Roof Mastic/Flashing Residual Roof Mastic/Flashing

PLM

PLM

PLM

PLM

PLM

PLM

PLM

PLM

PLM

PLM

PLM

~hl--1 \S'

Accepted r-v:.l

Rejected [l

Received By ta:~~

RFB-1

RFB-2

RFB-3

RFC-1

RFC-2

RFC-3

RFD-1

RFD-2

RFD-3

Relinquished By

White Door Caulking White Door Caulking White Door Caulking Silver/Black Roof Coating Silver/Black Roof Coating Silver/Black Roof Coating Black Roof Caulking Black Roof Caulking Black Roof Caulking

PLM

PLM

PLM

PLM

PLM

PLM

PLM

PLM

PLM

l tJbVJ (al 6b

Received By

Analysis for Metals Concentration in Paint Chips by Inductively-Coupled Plasma (ICP)

EPA SW-846 3050B

Lab Order ID:Attn: 10056104Customer: Terracon 7 Glenn Bridge Road Suite G Arden , NC 28704

Analysis:

Date Received:

Stephen Ellis

IPP

07/08/2024

Project: VAMC Mtn. Home bldg 35 Date Reported: 07/11/2024

Sample ID

Lab Sample ID

Description

Lab Notes

Concentration (ppm)

Concentration (% by Weight)

Mass (g) Reporting Limit

(ppm) Element

PC-1

10056104_0001

White paint on Mt door

0.1339 Pb 1.9 180000 18

PC-2

10056104_0002

Silver paint on Mt roof rentilation

0.1173 Pb 2.1 270000 27

PC-3

10056104_0003

Black paint on wd window

0.1091 Pb 2.3 4200 0.42

PC-5

10056104_0004

White paint on Mt fire door

0.0939 Pb 2.7 84000 8.4

PC-6

10056104_0005

White paint on pl wall

0.1174 Pb 2.1 11000 1.1

PC-7

10056104_0006

White paint on wd baseboard

0.0799 Pb 3.1 17000 1.7

PC-8

10056104_0007

White paint on wd baseboard

0.1092 Pb 2.3 43000 4.3

PC-9

10056104_0008

Brown paint on Mt fire door

0.1775 Pb 1.4 170000 17

Disclaimer: This report relates only to the samples tested and may not be reproduced, except in full, without the written approval of SAI. Scientific Analytical Institute participates in the AIHA ELPAT program. ELPAT Laboratory ID: 173190. SAI is AIHA ELLAP accredited for Pb only for paint samples. Unless otherwise noted blank sample correction was not performed on analytical results. Reporting limits stated above. Analytical uncertainty available upon request.

Athena Summa (12)

Page 1 of 2I-F-020 r1 2/28/2027 Scientific Analytical Institute, Inc. 4604 Dundas Dr. Greensboro, NC 27407 (336) 292-3888

Analysis for Metals Concentration in Paint Chips by Inductively-Coupled Plasma (ICP)

EPA SW-846 3050B

Lab Order ID:Attn: 10056104Customer: Terracon 7 Glenn Bridge Road Suite G Arden , NC 28704

Analysis:

Date Received:

Stephen Ellis

IPP

07/08/2024

Project: VAMC Mtn. Home bldg 35 Date Reported: 07/11/2024

Sample ID

Lab Sample ID

Description

Lab Notes

Concentration (ppm)

Concentration (% by Weight)

Mass (g) Reporting Limit

(ppm) Element

PC-10

10056104_0009

White paint on br wall

0.0461 Pb 5.4 550 0.055

PC-11

10056104_0010

Gray paint on wd stair risen

0.1292 Pb 1.9 350000 35

PC-12

10056104_0011

Peach paint on Pl wall

0.12 Pb 2.1 86000 8.6

PC-13

10056104_0012

White paint on wd window

0.175 Pb 1.4 220000 22

Disclaimer: This report relates only to the samples tested and may not be reproduced, except in full, without the written approval of SAI. Scientific Analytical Institute participates in the AIHA ELPAT program. ELPAT Laboratory ID: 173190. SAI is AIHA ELLAP accredited for Pb only for paint samples. Unless otherwise noted blank sample correction was not performed on analytical results. Reporting limits stated above. Analytical uncertainty available upon request.

Athena Summa (12)

Page 2 of 2I-F-020 r1 2/28/2027 Scientific Analytical Institute, Inc. 4604 Dundas Dr. Greensboro, NC 27407 (336) 292-3888

Scientific Analytical Institute 4604 Dundas Dr. Greensboro, NC 27407

Phone: 336.292.3888 Fax: 336.292.3313 www.sailab.com lab@sailab.com

Lab Use Only LabOrderID: lC>O~&I04 Client Code: -------

Contact Information

Address:

Contact:

Paint Chips by Flame AA

(PBP)

Wipe by Flame AA 0

B

Sample ID#

. _i:-_n">n J;Vl), ") /AMf\''1

L

·J.en'/k, l?t/_ _J_./--e A tj1(Jf

1,1.,Wt.(

Other D

,,'i., Address:

Contact:

Phone • :

Fax0:

Email

Turn Around Times 3 Hours • 72 Hours

6 Hours • 96 Hours

12 Hours • 120 Hours

24 Hours • 144+ Hours

48 Hours • Volume/ Area Comments

Total Number of Samples /]

Dateffime

P<aao f nf f ff

Direct Exam: Swab Analysis

SAI Method B-SOP-005

Customer:

Analysis:

Date Received:

Date Reported:

Stephen Ellis

Date Amended:

10056102Lab Order ID:Attn:Terracon 7 Glenn Bridge Road Suite G Arden , NC 28704

DES

07/08/2024

Project: VAMC Mtn. home bldg 35 07/10/2024

07/12/2024

Description

Lab Notes

Lab Sample ID

Sample ID

IDENTIFICATION

Aspergillus/Penicillium-like Cladosporium

Pollen Debris

Fruiting Bodies Hyphal Fragments

No Spores Detected

SW-1 SW-2 SW-3

10056102_0001 10056102_0002 10056102_0003

Rm 107 window fr Rm 35-8 ceiling Crawlspace floor j

Disclaimer: This report relates only to the samples tested and may not be reproduced, except in full, without the written approval of SAI. Unless otherwise noted blank sample correction was not performed on analytical results. Scientific Analytical Institute participates in the AIHA EMPAT program for fungi.

EMPAT Laboratory ID: 173190. Reporting Limit equals Analytical Sensitivity. Analytical Sensitivity equals 1 spore or structure.

LEGEND: 1=Trace (1-10 Spores); 2=Light (11-100 spores); 3=Abundant (101-300); 4=Loaded (>300 spores)

Palmer Hines (3) Approved SignatoryAnalyst

B-F-015 r17 2/28/2027 Scientific Analytical Institute, Inc. 4604 Dundas Dr. Greensboro, NC 27407 (336) 292-3888 Page 1 of 1

Address:

BUiin

Contact:

Address:

Scientific Analytical Institute 4604 Dundas Dr. Greensboro, NC 27407

Phone: 336.292.3888 Fax: 336.292.331.3 www.saflab.com /ab@sailab.com

Contact: JI l,e11 E/l.5 Phone 0 :

Email

' ( c:JJ/Y)

Turn Around Times 90Min. • 48 Hours • 3 Hours • 72 Hours

6 Hours • 96 Hours • 12 Hours • 120 Hours D 24 Hours • 144+Hours D

Microbiology Test Types Spore Trap - Slit Impact, • ie, AOC/Allergenco (STA)

Spore Trap Other, ie. Micro-5 • (STO)

Direct Exam Tape (DET) • Direct Exam Swab (DES)

Direct Exam Bul.\c (DEB) • ngal Culture Swab (FCS) •

Bacteria Culture Air (BCA) • Bacteria Culture Bulle (BCB) • Bacteria Culture Swab (BCS) • Biolog (BLG) •

PO Number: K r- 7_ 4 7-o 31- Drinking Water (BCC) • (Coliform/E.coli)

Project Name/Number: Vl~/\/1 (_ fVl.fh . f,( 0 ty1(l 13/Jc. '?.5' Other: •

Sample ID# Description/Locatioa Volume/ Area ;;__ Comments

SW-I KW\ ti I V1 V/"iv-..Jo.,, ~;,,.e s W-l.. RIA.. 1~-~ (.e,1,',,c ~ w,,3 ( ir,,._ I cr1r., P ~v JD i<..+

I

& . rifl .._.. .. ...... cu LJ . -

Rejected I I

Total # of Samples _j__ dby Date/Time Received by Date/Time

Page JF-019 %~

APPENDIX C

Inspector…