Asbestos Report Jun 19 2019.pdf
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- Y1DZ--Expand MRI Suite Project 541-CSI-103
- Solicitation number
- 36C25020B0043
About this file
This notice provides details for an upcoming solicitation to expand an MRI suite at a VA medical center. The Department of Veterans Affairs seeks to add a third 3T MRI unit to the north of the existing MRI suite at the Louis Stokes VA Medical Center in Cleveland, Ohio. The project scope includes associated site work, landscaping, sidewalks, and renovations to connecting areas. The pre-solicitation notice specifies a 100% set-aside for Service-Disabled Veteran-Owned Small Businesses. The estimated period of performance is 548 calendar days. The solicitation documents will be posted to SAM.gov on or around June 5, 2020, with proposals due approximately 30 days later. The assigned NAICS code is 236220 with a small business size standard of $39.5 million. The contractor will be required to perform a minimum of 15% of construction work. Bonds, licenses, and a site visit are also addressed.
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STEPHEN J. SEBESTA & ASSOC., INC.
ENVIRONMENTAL HEALTH ENGINEERS
30628 DETROIT ROAD, NO. 258, WESTLAKE, OHIO 44145 TELEPHONE (216) 781-0060 sjs@sjs-inc.com
June 19, 2019
Perspectus Arcitecture 13212 Shaker Square Cleveland, Ohio 44120
Attention:
Project:
Mr. Tim Huffman, AIA, NCARB, Director Operations (216-752-1800)
Report of asbestos sampling of suspected asbestos-containing materials which may be disturbed during renovations related to the Expand MRI Suite Project (VA Project No. 541-CSI-103) at the Louis Stokes VA Medical Center located at 10701 East Boulevard in the City of Cleveland, Ohio (16691)
Dear Mr. Huffman;
On May 30, 2019, Stephen J. Sebesta and Associates, Inc. collected samples of suspected asbestos-containing materials which may be disturbed during renovations related to the Expand MRI Suite Project (VA Project No. 541-CSI-103) at the Louis Stokes VA Medical Center located at 10701 East Boulevard in the City of Cleveland, Ohio. This letter provides a summary of the samples collected and laboratory results.
The building is an approximately 18,052 sq ft single story building with a basement constructed around 2011. The renovations involve the addition of a new building to the north of the existing Radiology Phase 1 Building and renovations to the first floor of the existing Radiology Phase 1 MRI area.
No asbestos-containing materials were identified in the Radiology Phase 1 Addition on the January 17, 2015 survey. The exterior of he building was not inspected also not included on the 2015 survey.
The proposed renovation includes the demolition of the north stairwell on the first floor and basement (BB501 and 1B501), first floor waiting room (1B534), first floor storage rooms (1B535 and 1B536) as well as the north curtain wall and partial demolition of the brick wall on the north facade to create a new entryway into the existing building.
METHODOLOGY
The sampling was conducted in accordance with the USEPA guidelines recommended for public and private elementary and high schools to meet the requirements of the Asbestos Hazard Emergency Response Act (AHERA) of 1986 and the National Emission Standards for Hazardous Air Pollutants (NESHAP) requirements for the repair and demolition of buildings containing asbestos-containing materials (ACM).
Based on the age of construction, physical appearance, location, systems where located and other factors, flooring materials were identified as homogeneous asbestos-containing materials.
Samples of the suspect homogeneous Materials were sampled and analyzed for asbestos by a NVLAP accredited laboratory in accordance with AHERA requirements.
Samples were collected in 6 mil zip-lock polyethylene bags and the sample number as well as other related information, was marked on the sample bag label. W here feasible, sample numbers were also marked adjacent to the field sample location. All sample bags were placed in a second 6 mil polyethylene bag and submitted to the laboratory for analysis along with a chain-of-custody form.
Attachment No. 1 contains an Asbestos Bulk Sample Log showing a summary of the analysis of bulk samples. Attachment 2 contains copies of the Environmental Hazards Services (EHS) bulk sample laboratory reports for the bulk asbestos samples collected. Attachment No. 3 contains photographs of the sample locations. Attachment 4 contains a copy of the previous survey report of the Radiology Phase 1 Addition entitled, “Asbestos Survey Report, Radiology Phase 1 Addition” prepared by Stephen J. Sebesta & Assoc., Inc. and dated January 17, 2015.
ATTACHMENT NO. 1
Bulk Sample Log
SUMMARY OF BULK SAMPLE ANALYSES
FROM THE NORTH EXTERIOR WALL OF THE
RADIOLOGY PHASE 1 ADDITION AT THE
LOUIS STOKES VA MEDICAL CENTER LOCATED AT
10701 EAST BOULEVARD, CLEVELAND, OHIO 44106
JOB NO. 16681
SAMPLE
NUMBER
SAMPLE
DESCRIPTION
SAMPLE LOCATION
ASBESTOS-
CONTAINING
FRIABLE
% ASBESTOS
PLM Point Count
16691-1 Gray caulk in expansion joint, exterior
Radiology Phase 1, Exterior North Facade
No N/A NAD -
16691-2 Gray caulk in expansion joint, exterior
Radiology Phase 1, Exterior North Facade
No N/A NAD -
16691-3 Back waterproofing tar, exterior
Radiology Phase 1, Exterior North Facade
No N/A NAD -
16691-4 Back waterproofing tar, exterior
Radiology Phase 1, Exterior North Facade
No N/A NAD -
NOTES: (1) NAD means no asbestos detected
(2) N/A means Not Applicable
(3) PLM means Polarized Light Microscopy (Percentages are based on visual estimation)
ATTACHMENT NO. 2
Environmental Hazards Services Laboratory Report for
Bulk Asbestos Samples
Asbestos Bulk Analysis Report
Client:
Report Number:
Project/Test Address:
Client Number:
Reported Date:
Received Date:
Analyzed Date:
Stephen J. Sebesta & Assoc. 06/03/2019
36-3130
06/07/2019
19-06-00220
7469 Whitepine Rd
Telephone: 800.347.4010
Richmond, VA 23237
Environmental Hazards Services, L.L.C.
16691; VA MRI Addition
Laboratory Results Fax Number:
29931 Shadow Creek Lane West Lake OH, 44145
06/06/2019
Layer Type AsbestosClient Sample Number
Other Materials
Lab Gross DescriptionLab Sample Number
Gray Adhesive;
Homogeneous
19-06-00220-001 16691-1 100% Non-FibrousNAD
Gray Adhesive;
Homogeneous
19-06-00220-002 16691-2 100% Non-FibrousNAD
Black Rubbery Tar like;
Homogeneous
19-06-00220-003 16691-3 100% Non-FibrousNAD
Black Rubbery Tar like;
Homogeneous
19-06-00220-004 16691-4 100% Non-FibrousNAD
1 of 2Page
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 19-06-00220
16691; VA MRI Addition
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample Number
Tasha Eaddy
1% Asbestos
Analyst:
Reporting Limit:
Method:
QC Blank:
QC Sample:
Sami Hosn
EPA Method 600/R-93/116, EPA Method 600/M4-82-020
QA/QC Clerk
Reviewed By Authorized Signatory:
34-M22014-3
SRM 1866 Fiberglass
NAD = no asbestos detectedLEGEND:
The condition of the samples analyzed was acceptable upon receipt per laboratory protocol unless otherwise noted on this report. Each distinct component in an inhomogeneous sample was analyzed separately and reported as a composite. Results represent the analysis of samples submitted by the client. Sample location, description, area, volume, etc., was provided by the client. This report cannot be used by the client to claim product endorsement by NVLAP or any agency of the U.S. Government. This report shall not be reproduced except in full, without the written consent of the
Environmental Hazards Service, L.L.C. California Certification #2319 NY ELAP #11714 NVLAP #101882-0 VELAP 460172. All information concerning sampling location, date, and time can be found on Chain-of-Custody. Environmental Hazards Services, L.L.C. does not perform any sample collection.
Environmental Hazards Services, L.L.C. recommends reanalysis by point count (for more accurate quantification) or Transmission Electron Microscopy
(TEM), (for enhanced detection capabilities) for materials regulated by EPA NESHAP (National Emission Standards for Hazardous Air Pollutants) and found to contain less than ten percent (<10%) asbestos by polarized light microscopy (PLM). Both services are available for an additional fee.
400 Point Count Analysis, where noted, performed per EPA Method 600/R-93/116 with a Reporting Limit of 0.25%.
* All California samples analyzed by Polarized Light Microscopy, EPA Method 600/M4-82-020, Dec. 1982.
2 of 2Page
Sami Hosn
Analyst Signature Page
Richmond, VA 23237
Telephone: 800.347.4010
Environmental Hazards Services, L.L.C.
06/07/2019
Received Date:
29931 Shadow Creek Lane West Lake OH, 44145
Client:
06/06/2019
19-06-00220
Stephen J. Sebesta & Assoc. 06/03/2019
Report Number:
Reported Date:
Analyzed Date:
36-3130Client Number:
16691; VA MRI AdditionProject/Test Address:
7469 Whitepine Rd
Analyst(s)
ATTACHMENT NO. 3
Photographs
Photo VAMRI-1, Looking southwest at north façade of Radiology Phase 1 Addition
Photo VAMRI-2, Looking west at north façade of Radiology Phase 1 Addition
Photo VAMRI-3, Non asbestos-containing exterior building caulking, North façade of Radiology Phase 1 Addition
Photo VAMRI-4, Non asbestos-containing exterior waterproofing tar, North Façade of Radiology Phase 1 Addition, (Sample Nos. 16681-3 and 16681-4)
Photo VAMRI-5, Non asbestos-containing exterior waterproofing tar, North Façade of Radiology Phase 1 Addition, (Sample Nos. 16681-3 and 16681-4)
Photo VAMRI-6, Looking southwest at
Photo VAMRI-7, Looking southwest at
Photo VAMRI-8, Non asbestos-containing exterior building caulking, North façade of Radiology Phase 1 Addition (Sample No. 16681-1)
Photo VAMRI-9, Non asbestos-containing exterior building caulking, North façade of Radiology Phase 1 Addition (Sample No. 16681-2)
Photo VAMRI-10, Non asbestos-containing exterior waterproofing tar, North façade of Radiology Phase 1 Addition, (Sample Nos. 16681-3 and 16681-4)
ATTACHMENT 4
Copy of “Asbestos Survey Report, Radiology Phase 1 Addition” prepared By Stephen J. Sebesta & Assoc., Inc. and dated January 17, 2015.
S u m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv e y
A re a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P ip
J o in ts
C o n d it io n N o te s
B a se m e n t
B
-B c o rr id o r
R
P -1
F
T N
A D n /a
L a m in a te f lo o ri n g t su sp e c t
B a se m e n t
A B
-B b o n e d e n si ty -1
R P
-2
D
W (N
A D n /a
B a se m e n t
G B
-B b o n e d e n si ty
D
W M
(N A
D n /a
B a se m e n t
C B
-B b o n e d e n si ty
C
T (N
A D n /a x2 t e xt u re d
B a se m e n t
E B
-B b o n e d e n si ty
S
F (N
A D n /a x2
B a se m e n t
B B
-B b o n e d e n si ty
R P
-2
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P (N
A D n /a
B a se m e n t
F B
-B b o n e d e n si ty -1
R P
-1
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B U
N A
D n /a w h it e
B a se m e n t
I B
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R P
-1
W
T N
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A B
-B
X -r a y
R
P -1
D
W (N
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C B
-B
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R
P -1
C
T (N
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X -r a y
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(N A
D n /a x2
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A B
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D W
(N A
D n /a
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C B
-B c o rr id o r
C T
(N A
D n /a x2 t e xt u re d
B a se m e n t
E B
-B c o rr id o r
R
P -8
S F
(N A
D n /a x2
B a se m e n t
A B
-B in te rv ie w
D
W (N
A D n /a
B a se m e n t
D B
-B in te rv ie w -1
R P
-1
C
T N
A D n /a x4 t e xt u re d
B a se m e n t
G B
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C
S T
(N A
D n /a
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G B
-B in te rv ie w -1
R P
-1
C
S T
N A
D n /a
G re y b e lo w c a rp e t
B a se m e n t
A B
-B
U lt ra so u n d
D W
(N A
D n /a
B a se m e n t
C B
-B
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C T
(N A
D n /a x2 t e xt u re d
B a se m e n t
E B
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U lt ra so u n d
S F
(N A
D n /a x2
B a se m e n t
F B
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U (N
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(N A
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U lt ra so u n d
D W
(N A
D n /a
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C T
(N A
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B a se m e n t
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U lt ra so u n d
S F
(N A
D n /a x2
B a se m e n t
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-B
U lt ra so u n d
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R P
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D M
N A
D n /a
G re y b e rp e t
B a se m e n t
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P -1
S
B U
(N A
D n /a w h it e
B a se m e n t
B B
-B
U lt ra so u n d
-1
R P
-1
F
P N
A D n /a
S p ra y-o n
B a se m e n t
A B
-B B re st ro o m
R
P -1
D
W (N
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B -B
(N A
D n /a
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-B
U lt ra so u n d
D W
(N A
D n /a
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U lt ra so u n d
-1
R P
-2
C
T N
A D n /a x2 t e xt u d m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P in ts
C o n d it io n N o te s
B a se m e n t
E B
-B
U lt ra so u n d
S F
(N A
D n /a x2
B a se m e n t
D B
-B
U lt ra so u n d
-1
R P
-1
D M
N A
D n /a
G re y b e rp e t
B a se m e n t
F B
-B
U lt ra so u n d
S B
U (N
A D n /a w h it e
B a se m e n t
B B
-B
U lt ra so u n d
-1
R P
-3
F P
N A
D n /a
S p ra y-o n
B a se m e n t
A B
-B B re st ro o m
D W
(N A
D n /a
B a se m e n t
A B
-B st o ra g e
D W
(N A
D n /a
B a se m e n t
C B
-B st o ra g e
C T
(N A
D n /a x2 t e xt u re d
B a se m e n t
E B
-B st o ra g e
S F
(N A
D n /a x2
B a se m e n t
A B
-B
U lt ra so u n d
R
P -7
D W
(N A
D n /a
B a se m e n t
C B
-B
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C T
(N A
D n /a x2 t e xt u re d
B a se m e n t
E B
-B
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S F
(N A
D n /a x2
B a se m e n t
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D M
(N A
D n /a
G re y b e rp e t
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F B
-B
U lt ra so u n d
-1
R P
-4
S B
U N
A D n /a w h it e
B a se m e n t
B B
-B
U lt ra so u n d
-1
R P
-6
F P
N A
D n /a
S p ra y-o n
B a se m e n t
A B
-B B re st ro o m
D W
(N A
D n /a
B a se m e n t
A B
-B B re st ro o m
-1
R P
-5
D W
M N
A D n /a
B a se m e n t
A B
-B c o rr id o r
D W
(N A
D n /a
B a se m e n t
C B
-B c o rr id o r
-1
R P
-2
C
T N
A D n /a x2 t e xt u re d
B a se m e n t
G B
-B c o rr id o r
C S
T (N
A D n /a
B a se m e n t
G B
-B c o rr id o r
-1
R P
-3
F
M N
A D n /a g re y
B a se m e n t
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D W
(N A
D n /a
B a se m e n t
D B
-B st a ff l o u n g e
-1
R P
-2
C
T N
A D n /a x4 t e xt u re d
B a se m e n t
E B
-B st a ff l o u n g e
S F
(N A
D n /a x2
B a se m e n t
H B
-B st a ff l o u n g e
-1
R P
-2
F
S N
A D n /a re d
B a se m e n t
B B
-B st a ff l o u n g e
-1
R P
-2
F
P N
A D n /a
S p ra y-o n
B a se m e n t
A B
-B st o ra g e
D W
(N A
D n /a
B a se m e n t
D B
-B st o ra g e
C T
(N A
D n /a x4 t e xt u re d
B a se m e n t
E B
-B st o ra g e
S F
(N A
D n /a x2
B a se m e n t
B B
-B st o ra g e
R
P -2
F
P (N
A D n /a
B a se m e n t
A B
-B
M ic ro -r e c e iv in g
D W
(N A
D n /a
B a se m e n t
D B
-B
M ic ro -r e c e iv in g
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(N A
D n /a x4 t e xt u re d
B a se m e n t
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-B
M ic ro -r e c e iv in g
S F
(N A
D n /a x2
B a se m e n t
E B
-B
M ic ro -r e c e iv in g
S F
M (N
A D n /a b e lo w s h e e t flo r m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P in ts
C o n d it io n N o te s
B a se m e n t
E B
-B
M ic ro -r e c e iv in g
-1 a
R P
-2
S
F N
A D n /a
B a se m e n t
E B
-B
M ic ro -r e c e iv in g
-1 b
S
F M
N A
D n /a
B a se m e n t
A B
-B re st ro o m
D W
(N A
D n /a
B a se m e n t
A B
-B re st ro o m
-1
R P
-2
D
W M
N A
D n /a
B a se m e n t
C B
-B re st ro o m
C T
(N A
D n /a x2 t e xt u re d
B a se m e n t
A B
-B o ff ic e
D
W (N
A D n /a
B a se m e n t
D B
-B o ff ic e
C
T (N
A D n /a x4 t e xt u re d
B a se m e n t
G B
-B o ff ic e
C
S T
(N A
D n /a
B a se m e n t
A B
-B re st ro o m
D W
(N A
D n /a
B a se m e n t
C B
-B re st ro o m
C T
(N A
D n /a x2 t e xt u re d
B a se m e n t
A B
-B o ff ic e
D
W (N
A D n /a
B a se m e n t
D B
-B o ff ic e
C
T (N
A D n /a x4 t e xt u re d
B a se m e n t
G B
-B o ff ic e
C
S T
(N A
D n /a
B a se m e n t
A B
-B o ff ic e
D
W (N
A D n /a
B a se m e n t
D B
-B o ff ic e
C
T (N
A D n /a x4 t e xt u re d
B a se m e n t
G B
-B o ff ic e
C
S T
(N A
D n /a
B a se m e n t
B B
-B o ff ic e -1
R P
-2
F
P N
A D n /a
S p ra y-o n
B a se m e n t
A B
-B o ff ic e
D
W (N
A D n /a
B a se m e n t
D B
-B o ff ic e
C
T (N
A D n /a x4 t e xt u re d
B a se m e n t
G B
-B o ff ic e
C
S T
(N A
D n /a
B a se m e n t
A B
-B o ff ic e
D
W (N
A D n /a
B a se m e n t
D B
-B o ff ic e
C
T (N
A D n /a x4 t e xt u re d
B a se m e n t
G B
-B o ff ic e
C
S T
(N A
D n /a
B a se m e n t
A B
-B o ff ic e
D
W (N
A D n /a
B a se m e n t
D B
-B o ff ic e
C
T (N
A D n /a x4 t e xt u re d
B a se m e n t
G B
-B o ff ic e
C
S T
(N A
D n /a
B a se m e n t
H B
-B st a ir
F S
(N A
D n /a re d
B a se m e n t
B B
-B st a ir
R
P -3
F
P (N
A D n /a
S p ra y-o n
F ir s t F lo o r
C -B ve st ib u le
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
B -B ve st ib u le
-1
R P
-3
F
P N
A D n /a
S p ra y-o n
F ir s t F lo o r
A -B re c e p ti o n
D W
(N A
D n /a
F ir s t F lo o r
A -B re c e p ti o n
-1
R P
-3
D
W M
N A
D n /a
F ir s t F lo o r
G -B re c e p ti o n
C S
T (N
A D n /a
F ir s t F lo o r
B -B re c e p ti o n
-1
R P
-3
F
P N
A D n /a
S p ra y-m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P in ts
C o n d it io n N o te s
F ir s t F lo o r
C -B re st ro o m
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
B -B re st ro o m
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
A -B c o rr id o r
D W
(N A
D n /a
F ir s t F lo o r
C -B c o rr id o r
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
J -B c o rr id o r
-1
R P
-3
F
S N
A D n /a w h it e
F ir s t F lo o r
B -B c o rr id o r
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
E -B c o rr id o r
F T
(N A
D n /a x2
F ir s t F lo o r
A -B st o ra g e
D W
(N A
D n /a
F ir s t F lo o r
C -B st o ra g e
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
H -B st o ra g e
F S
(N A
D n /a re d
F ir s t F lo o r
B -B st o ra g e
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
E -B st o ra g e
F T
(N A
D n /a x2
F ir s t F lo o r
A -B o ff ic e
D
W (N
A D n /a
F ir s t F lo o r
C -B o ff ic e
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
G -B o ff ic e
C
S T
(N A
D n /a
F ir s t F lo o r
H -B o ff ic e -1
R P
-3
F
S N
A D n /a re d
F ir s t F lo o r
B -B o ff ic e
F
P (N
A D n /a
S p ra y-o n
F ir s t F lo o r
A -B c o n su lt r o o m
D W
(N A
D n /a
F ir s t F lo o r
C -B c o n su lt r o o m
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
G -B c o n su lt r o o m
C S
T (N
A D n /a
F ir s t F lo o r
D -B c o n su lt r o o m
-1
R P
-3
D
M N
A D n /a g re y
F ir s t F lo o r
H -B c o n su lt r o o m
F S
(N A
D n /a re d
F ir s t F lo o r
B -B c o n su lt r o o m
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
A -B re c e p ti o n
D W
(N A
D n /a
F ir s t F lo o r
C -B re c e p ti o n
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
G -B re c e p ti o n
C S
T (N
A D n /a
F ir s t F lo o r
H -B re c e p ti o n
F S
(N A
D n /a re d
F ir s t F lo o r
B -B re c e p ti o n
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
A -B o ff ic e
D
W (N
A D n /a
F ir s t F lo o r
C -B o ff ic e
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
G -B o ff ic e
C
S T
(N A
D n /a
F ir s t F lo o r
D -B o ff ic e
D
M N
A D n /a g re y
F ir s t F lo o r
H -B o ff ic e
F
S (N
A D n /a re d
F ir s t F lo o r
B -B o ff ic e
F
P (N
A D n /a
S p ra y-m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P in ts
C o n d it io n N o te s
F ir s t F lo o r
A -B st a ff l o u n g e
D W
(N A
D n /a
F ir s t F lo o r
A -B st a ff l o u n g e
-1
R P
-3
D
W M
N A
D n /a
F ir s t F lo o r
C -B st a ff l o u n g e
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
H -B st a ff l o u n g e
F S
(N A
D n /a re d
F ir s t F lo o r
B -B st a ff l o u n g e
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
E -B st a ff l o u n g e
F T
(N A
D n /a x2
F ir s t F lo o r
A -B re st ro o m
D W
(N A
D n /a
F ir s t F lo o r
C -B re st ro o m
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
-B re st ro o m
F T
(N A
D n /a x2 c e ra m ic
F ir s t F lo o r
A -B st o ra g e
D W
(N A
D n /a
F ir s t F lo o r
C -B st o ra g e
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
H -B st o ra g e
F S
(N A
D n /a re d
F ir s t F lo o r
B -B st o ra g e
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
E -B st o ra g e
F T
(N A
D n /a x2
F ir s t F lo o r
A -B re st ro o m
D W
(N A
D n /a
F ir s t F lo o r
C -B re st ro o m
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
-B re st ro o m
F T
(N A
D n /a x2 c e ra m ic
F ir s t F lo o r
A -B c le a n u ti lit y
D
W (N
A D n /a
F ir s t F lo o r
C -B c le a n u ti lit y -1
R P
-4
C
T N
A D n /a x2 t e xt u re d
F ir s t F lo o r
H -B c le a n u ti lit y
R P
-3
F
S (N
A D n /a re d
F ir s t F lo o r
E -B c le a n u ti lit y
F
T (N
A D n /a x2
F ir s t F lo o r
A -B o ve rf lo w s to ra g e
D W
(N A
D n /a
F ir s t F lo o r
C -B o ve rf lo w s to ra g e
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
H -B o ve rf lo w s to ra g e
F S
(N A
D n /a re d
F ir s t F lo o r
B -B o ve rf lo w s to ra g e
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
-B o ve rf lo w s to ra g e
F T
(N A
D n /a x2 c e ra m ic
F ir s t F lo o r
A -B o ff ic e
D
W (N
A D n /a
F ir s t F lo o r
C -B o ff ic e
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
G -B o ff ic e
C
S T
(N A
D n /a
F ir s t F lo o r
H -B o ff ic e
F
S (N
A D n /a re d
F ir s t F lo o r
B -B o ff ic e
F
P (N
A D n /a
S p ra y-o n
F ir s t F lo o r
K -B o ff ic e -1
R P
-4
W
C N
A D n /a
F ir s t F lo o r
A -B e le c tr ic a l c lo se t
D W
(N A
D n /a
F ir s t F lo o r
H -B e le c tr ic a l c lo se t
F S
(N A
D n /a m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P in ts
C o n d it io n N o te s
F ir s t F lo o r
E -B e le c tr ic a l c lo se t
F T
(N A
D n /a x2
F ir s t F lo o r
H -B c lo se t
F S
(N A
D n /a
F ir s t F lo o r
A -B c o rr id o r
D W
(N A
D n /a
F ir s t F lo o r
C -B c o rr id o r
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
H -B c o rr id o r
F S
(N A
D n /a re d
F ir s t F lo o r
B -B c o rr id o r
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
E -B c o rr id o r
F T
(N A
D n /a x2
F ir s t F lo o r
-B m e c h a n ic a l
F T
(N A
D n /a ra is e d c o m p u te r flo o r
F ir s t F lo o r
L -B
M R
I
F
T (N
A D n /a vi n yl
F ir s t F lo o r
C -B
M R
I
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
A -B
M R
I
D
W (N
A D n /a
F ir s t F lo o r
D -B
M R
I
D
M (N
A D n /a
F ir s t F lo o r
-B
M R
I c h a n g in g r m c a rp e t
(N A
D n /a
F ir s t F lo o r
C -B
M R
I c h a n g in g r m
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
A -B
M R
I c h a n g in g r m
D
W (N
A D n /a
F ir s t F lo o r
B -B
M R
I c h a n g in g r m
F
P (N
A D n /a
F ir s t F lo o r
A -B w a it in g a re a
D W
(N A
D n /a
F ir s t F lo o r
C -B w a it in g a re a
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
G -B w a it in g a re a
C S
T (N
A D n /a
F ir s t F lo o r
L -B w a it in g a re a
-1
C
A N
A D n /a w h it e
F ir s t F lo o r
H -B w a it in g a re a
-1
R P
-4
F
S N
A D n /a re d
F ir s t F lo o r
B -B w a it in g a re a
-1
R P
-4
F
P N
A D n /a
S p ra y-o n
F ir s t F lo o r
A -B st o ra g e
D W
(N A
D n /a
F ir s t F lo o r
C -B st o ra g e
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
G -B st o ra g e
C S
T (N
A D n /a
F ir s t F lo o r
H -B st o ra g e
F S
(N A
D n /a re d
F ir s t F lo o r
B -B st o ra g e
F P
(N A
D n /a
S p ra y-o n
F ir s t F lo o r
A -B
D
W (N
A D n /a
F ir s t F lo o r
C -B
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
G -B
C
S T
(N A
D n /a
F ir s t F lo o r
-B
M R
I c h a n g in g r m c a rp e t
(N A
D n /a
F ir s t F lo o r
C -B
M R
I c h a n g in g r m
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
A -B
M R
I c h a n g in g r m
D
W (N
A D n /a
F ir s t F lo o r
B -B
M R
I c h a n g in g r m
F
P (N
A D
/a m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P in ts
C o n d it io n N o te s
F ir s t F lo o r
L -B
M R
I
F
T (N
A D n /a vi n yl
F ir s t F lo o r
C -B
M R
I
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
A -B
M R
I
D
W (N
A D n /a
F ir s t F lo o r
D -B
M R
I
D
M (N
A D n /a
F ir s t F lo o r
-B m e c h a n ic a l
F T
(N A
D n /a ra is e d c o m p u te r flo o r
F ir s t F lo o r
-B
M R
I c a rp e t
(N A
D n /a
F ir s t F lo o r
C -B
M R
I
C
T (N
A D n /a x2 t e xt u re d
F ir s t F lo o r
A -B
M R
I
D
W (N
A D n /a
F ir s t F lo o r
B -B
M R
I
F
P (N
A D n /a
F ir s t F lo o r
A -B w a it in g a re a
D W
(N A
D n /a
F ir s t F lo o r
A -B w a it in g a re a
-1
R P
-4
D
W M
N A
D n /a
F ir s t F lo o r
C -B w a it in g a re a
C T
(N A
D n /a x2 t e xt u re d
F ir s t F lo o r
G -B w a it in g a re a
C S
T (N
A D n /a
F ir s t F lo o r
H -B w a it in g a re a
F S
(N A
D n /a re d
F ir s t F lo o r
B -B w a it in g a re a
-1
R P
-4
F
P N
A D n /a
S p ra y-o n
F ir s t F lo o r
A -B c lo se t
D W
(N A
D n /a
F ir s t F lo o r
G -B c lo se t
C S
T (N
A D n /a
P e n th o u se
B
-5 m e c h a n ic a l p e n th o u se
R
P -5
(N A
D n /a
F ib e rg la ss p ip e a ct i n su la ti o n n o t su sp e ct
P e n th o u se
A B
-5 m e c h a n ic a l p e n th o u se
D W
(N A
D n /a
P e n th o u se
A B
-5 m e c h a n ic a l p e n th o u se
-2
R P
-5
D
W M
N A
D n /a
P e n th o u se
D B
-5 m e c h a n ic a l p e n th o u se
-2
R P
-5
D
M N
A D n /a g re y
P e n th o u se
D B
-5 m e c h a n ic a l p e n th o u se
-2
D
M N
A D n /a w h it e
P e n th o u se
H B
-5 m e c h a n ic a l p e n th o u se
-2
R P
-5
F
S N
A D n /a re d
P e n th o u se
B B
-5 m e c h a n ic a l p e n th o u se
-2
-2
-2
R P
-4
R P
-5
R P
-5
F
P
N A
D N
A D
N A
D n /a
S p ra y-o n
P e n th o u se
D -B e le c tr ic a l p e n th o u se
-2
R P
-4
D
M N
A D n /a g re y
P e n th o u se
H -B e le c tr ic a l p e n th o u se
-2
F
S (N
A D n /a re d
P e n th o u se
B -B e le c tr ic a l p e n th o u se
-2
-2
-2
R P
-4
R P
-4
F
P N
A D
N
A D n /a
S p ra y-o n
T
O T
A L m m a ry o f
D a ta
L o u is
S to k e s V
A M e d ic a l
C e n te r, R a d io lo g y P h a s e
A d d it io n
P a g e o f
F lo o r
N o
A re a
H o m o g e n o u s A re a
S u rv a /R o o m N o
A re a u s e
S a m p le
N o
P h o to N o
S u s p e c t
M a te ri a l
A s b e s to s s q ft ln ft
N o
P in ts
C o n d it io n N o te s
N o te s:
F P
C T
C e ili n g T ile
C S
T C a rp e t M a s tic
F T
F lo o r
T ile
D W
D ry w a ll
C A
C a u lk in g
S F
S h e e t F lo o ri n g
S B
U S in k
B a s e U n d e rc o a tin g
D M
D u c t M a s tic
D W
M D ry w a ll
M u d
S F
M S h e e t
F lo o r
M a st ic
W T
W a te rp ro o fi n g T a r
W C
W in d o w
C a u lk in g
F M
F lo o r
M a st ic
F S
F ir e st o p p in g
F ir e p ro o fi n g
(1
/a i s n o t a p p lic a b le
(2
N
D i s
N o A sb e st o s
D e te c te d
(3 m p le r e su lt s sh o w n i n p a re n th e se s in d ic a te t h e p e rc e n ta g e o f a sb e st o s w a s d e te rm in e d b y a s a m p le o f th e h o m o g e n e o u s m a te ri a l fr o m a n o th e r lo c a ti o n
S U
M M
A R
Y O
F D
A T
A K
E Y
G R
O U
P C
T H
E R
M A
L S
Y S
T E
M I
N S
U L A
T
IO
N M
IS
C
E L L A
N E
O U
S M
A T
E R
IA
L S
S U
R F
A C
IN
G
M A
T E
R
IA
L S
G R
O U
P B
G R
O U
P
FROM THE LOUIS STOKES VA MEDICAL CENTER
LOCATED AT 10701 EAST BOULEVARD, CLEVELAND, OHIO 44106
THE RADIOLOGY PHASE 1 ADDITION
JOB NO. 19341
SAMPLE
NUMBER
SAMPLE
DESCRIPTION
SAMPLE LOCATION
ASBESTOS-
CONTAINING
FRIABLE
% ASBESTOS
PLM Point Count
19341-120 2'x2' ceiling tile, textured
Radiology, P-1, Basement, B-B526 Ultrasound 3
No N/A NAD -
19341-121 Gray duct mastic Radiology, P-1, Basement, B-B526 Ultrasound 3
No N/A NAD -
19341-122 Sprayed-on fireproofing
Radiology, P-1, Basement, B-B526 Ultrasound 3
No N/A NAD -
19341-123 W hite sink base undercoating
Radiology, P-1, Basement, B-B528 Ultrasound 4
No N/A NAD -
19341-124 Drywall and mud, wall Radiology, P-1, Basement, B-B528 Ultrasound 4 restroom
No N/A NAD -
19341-125 Sprayed-on fireproofing
Radiology, P-1, Basement, B-B528 Ultrasound 4
No N/A NAD -
19341-126 Gray duct mastic Radiology, P-1, Basement, B-B524 Ultrasound 2
No N/A NAD -
19341-127 Sprayed-on fireproofing
Radiology, P-1, Basement, B-B524 Ultrasound 2
No N/A NAD -
19341-128 2'x4' textured ceiling tile
Radiology, P-1, Basement, B-B521 Interview
No N/A NAD -
19341-129 Gray floor mastic below carpeting
Radiology, P-1, Basement, B-B521 Interview
No N/A NAD -
19341-130 W hite sink base undercoating
Radiology, P-1, Basement, B-B511 Bone density
No N/A NAD -
19341-131 W aterproofing tar on wall above ceiling
Radiology, P-1, Basement, B-B511 Bone density
No N/A NAD -
19341-132 Drywall and mud wall Radiology, P-1, Basement, B-B511 Bone density
No N/A NAD -
19341-133 Red fire stopping Radiology, P-1, Basement, B-B553 Staff lounge
No N/A NAD -
19341-134 2'x4' textured ceiling tile
Radiology, P-1, Basement, B-B553 Staff Lounge
No N/A NAD -
19341-135 Sprayed-on fireproofing
Radiology, P-1, Basement, B-B553 Staff lounge
No N/A NAD -
19341-136 2'x2' ceiling tile, textured
Radiology, P-1, Basement, Corridor by B- B554
No N/A NAD -
FROM THE LOUIS STOKES VA MEDICAL CENTER
LOCATED AT 10701 EAST BOULEVARD, CLEVELAND, OHIO 44106
THE RADIOLOGY PHASE 1 ADDITION
JOB NO. 19341
SAMPLE
NUMBER
SAMPLE
DESCRIPTION
SAMPLE LOCATION
ASBESTOS-
CONTAINING
FRIABLE
% ASBESTOS
PLM Point Count
19341-137 Drywall and mud Radiology, P-1, Basement, W omen’s restroom, staff
No N/A NAD -
19341-138 Sprayed-on fireproofing, column
Radiology, P-1, Basement, B-B616 office
No N/A NAD -
19341-139a 1'x2' sheet flooring, tan marble
Radiology, P-1, Basement, B-B611 Micro receiving
No N/A NAD -
19341-139b Mastic below 1'x2' sheet flooring, tan marble
Radiology, P-1, Basement, B-B611 Micro receiving
No N/A NAD -
19341-140 Gray floor mastic Radiology, P-1, Basement, Corridor by B- B611
No N/A NAD -
19341-141 Sprayed-on fireproofing
Radiology, P-1, 1 floor, 1-st
B511 Reception No N/A NAD -
19341-142 Drywall and mud Radiology, P-1, 1 floor, 1-st
B511 No N/A NAD -
19341-143 sprayed-on fireproofing
Radiology, P-1, 1 floor,st
Vestibule, radiology No N/A NAD -
19341-144 Red fire stopping Radiology, P-1, 1 floor, 1-st
B515 office No N/A NAD -
19341-145 Gray duct mastic Radiology, P-1, 1 floor, 1-st
B516 Reading consult room
No N/A NAD -
19341-146 W hite caulking/fire stopping
Radiology, P-1, 1 floor,st corridor outside 1-B517 No N/A NAD -
19341-147 Drywall and mud, wall Radiology, P-1, 1 floor, 1-st
B519 staff lounge No N/A NAD -
19341-148 2'x2' ceiling tile, textured
Radiology, P-1, 1 floor, 1-st
B523 Clean utility No N/A NAD -
19341-149 Sprayed-on fireproofing
Radiology, P-1, 1 floor, 1-st
B534 waiting area No N/A NAD -
19341-150 Red Fire stopping Radiology, P-1, 1 floor, 1-st
B534 waiting area No N/A NAD -
19341-151 W hite caulking Radiology, P-1, 1 floor, 1-st
B534 waiting area No N/A NAD -
19341-152 Sprayed-on fireproofing
Radiology, P-1, 1 floor, 1-st
B541 waiting area No N/A NAD -
19341-153 Drywall and mud Radiology, P-1, 1 floor, 1-st
B541 waiting area No N/A NAD -
19341-154 Gray window caulk Radiology, P-1, 1 floor,st
Near 1-B525 No N/A NAD -
FROM THE LOUIS STOKES VA MEDICAL CENTER
LOCATED AT 10701 EAST BOULEVARD, CLEVELAND, OHIO 44106
THE RADIOLOGY PHASE 1 ADDITION
JOB NO. 19341
SAMPLE
NUMBER
SAMPLE
DESCRIPTION
SAMPLE LOCATION
ASBESTOS-
CONTAINING
FRIABLE
% ASBESTOS
PLM Point Count
19341-155 Gray window caulk Radiology, P-1, 1 floor, 1-st
B511 reception waiting area
No N/A NAD -
19341-241 Sprayed-on fireproofing
Radiology P1 Penthouse, Electrical
No N/A NAD -
19341-242 Sprayed-on fireproofing
Radiology P1 Penthouse, Electrical
No N/A NAD -
19341-243 Sprayed-on fireproofing
Radiology P1 Penthouse, Electrical
No N/A NAD -
19341-244 Firestopping Radiology P1 Penthouse, Electrical
No N/A NAD -
19341-245 Gray duct mastic Radiology P1 Penthouse, Electrical
No N/A NAD -
19341-246 Sprayed-on fireproofing
Radiology P1 Penthouse, Mechanical, 2B-501
No N/A NAD -
19341-247 Drywall and mud Radiology P1 Penthouse, Mechanical, 2B-501
No N/A NAD -
19341-248 Sprayed-on fireproofing
Radiology P1 Penthouse, Mechanical, 2B-501
No N/A NAD -
19341-249 Red firestopping Radiology P1 Penthouse, Mechanical, 2B-501
No N/A NAD -
19341-250 Gray duct mastic Radiology P1 Penthouse, Mechanical, 2B-501
No N/A NAD -
19341-251 W hite duct mastic Radiology P1 Penthouse, Mechanical, 2B-501
No N/A NAD -
19341-252 Sprayed-on fireproofing
Radiology P1 Penthouse, Mechanical, 2B-501
No N/A NAD -
NOTES: (1) NAD means no asbestos detected
(2) N/A means Not Applicable
(3) PLM means Polarized Light Microscopy (Percentages are based on visual estimation)
(4) Samples containing less than 1% asbestos are not considered asbestos-containing by USEPA but
OSHA requires special handling of these materials.
(5) Category 1 non-friable asbestos-containing material
(6) Category 2 non-friable asbestos-containing material
Client:
Report Number:
Project/Test Address:
Client Number:
Reported Date:
Received Date:
Analyzed Date:
Stephen J. Sebesta & Assoc. 12/01/2014
36-3130
12/04/2014
14-12-00078
7469 Whitepine Rd
Telephone: 800.347.4010
Richmond, VA 23237
Environmental Hazards Services, L.L.C.
19341; VAMC Wade Park Radiology P-1
Laboratory Results Fax Number:
216-781-0024
30628 Detroit Road #258 Westlake OH, 44145
12/03/2014
Layer Type AsbestosClient Sample Number
Other Materials
Lab Gross DescriptionLab Sample Number
Gray Fibrous; White Paint-Like;
Inhomogeneous
14-12-00078-001 19341-120 5% Cellulose 80% Fibrous Glass 15% Non-Fibrous
NAD
Gray Pliable;
Homogeneous
14-12-00078-002 19341-121 3% Cellulose 97% Non-Fibrous
NAD
Brown Powder; Fibrous;
Homogeneous
14-12-00078-003 19341-122 25% Cellulose 2% Fibrous Glass 73% Non-Fibrous
NAD
Gray Granular;
Homogeneous
14-12-00078-004 19341-123 2% Cellulose 98% Non-Fibrous
NAD
White Chalky; Brown Fibrous; Inhomogeneous
14-12-00078-005 19341-124 25% Cellulose 75% Non-Fibrous
NAD
1 of 6Page
Beige Powder; Fibrous;
Homogeneous
14-12-00078-006 19341-125 25% Cellulose 5% Fibrous Glass 70% Non-Fibrous
NAD
Gray Pliable;
Homogeneous
14-12-00078-007 19341-126 2% Cellulose 98% Non-Fibrous
NAD
Beige Powder; Fibrous;
Homogeneous
14-12-00078-008 19341-127 25% Cellulose 75% Non-Fibrous
NAD
Gray Fibrous; White Paint-Like;
Inhomogeneous
14-12-00078-009 19341-128 5% Cellulose 80% Fibrous Glass 15% Non-Fibrous
NAD
Gray Granular;
Homogeneous
14-12-00078-010 19341-129 5% Cellulose 95% Non-Fibrous
NAD
Gray Granular;
Homogeneous
14-12-00078-011 19341-130 5% Cellulose 95% Non-Fibrous
NAD
Black Tar-Like; Brown Powder; Inhomogeneous
14-12-00078-012 19341-131 15% Cellulose 5% Fibrous Glass 80% Non-Fibrous
NAD
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 14-12-00078
19341; VAMC Wade Park Radiology P-1
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample Number
2 of 6Page
White Chalky;
Brown/White Fibrous;
White Granular; White Paint-Like;
Inhomogeneous
14-12-00078-013 19341-132 25% Cellulose 75% Non-Fibrous
NAD
Red Pliable;
Homogeneous
14-12-00078-014 19341-133 2% Cellulose 18% Fibrous Glass 80% Non-Fibrous
NAD
Gray Fibrous; White Paint-Like;
Inhomogeneous
14-12-00078-015 19341-134 5% Cellulose 80% Fibrous Glass 15% Non-Fibrous
NAD
Beige Powder; Fibrous;
Homogeneous
14-12-00078-016 19341-135 25% Cellulose 5% Fibrous Glass 70% Non-Fibrous
NAD
Gray Fibrous; White Paint-Like;
Inhomogeneous
14-12-00078-017 19341-136 5% Cellulose 80% Fibrous Glass 15% Non-Fibrous
NAD
White Chalky;
Brown/White Fibrous;
White Granular; White Paint-Like;
Inhomogeneous
14-12-00078-018 19341-137 25% Cellulose 75% Non-Fibrous
NAD
Beige Powder; Fibrous;
Homogeneous
14-12-00078-019 19341-138 25% Cellulose 5% Fibrous Glass 70% Non-Fibrous
NAD
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 14-12-00078
19341; VAMC Wade Park Radiology P-1
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample
3 of 6Page
Gray/Beige Vinyl-Like;
Inhomogeneous
14-12-00078-020A 19341-139 100% Non-FibrousLinoleum NAD
Yellow Adhesive;
Homogeneous
14-12-00078-020B 19341-139 2% Cellulose 98% Non-Fibrous
Mastic NAD
Gray Pliable; Brown Powder; Inhomogeneous
14-12-00078-021 19341-140 5% Cellulose 95% Non-Fibrous
NAD
Beige Powder; Fibrous;
Homogeneous
14-12-00078-022 19341-141 25% Cellulose 5% Fibrous Glass 70% Non-Fibrous
NAD
White Chalky; Brown Fibrous; White Granular;
White Paint-Like;
Inhomogeneous
14-12-00078-023 19341-142 25% Cellulose 75% Non-Fibrous
NAD
Gray Powder; Fibrous;
Homogeneous
14-12-00078-024 19341-143 20% Cellulose 2% Fibrous Glass 78% Non-Fibrous
NAD
Red Pliable;
Homogeneous
14-12-00078-025 19341-144 5% Cellulose 10% Fibrous Glass 85% Non-Fibrous
NAD
Gray Pliable;
Homogeneous
14-12-00078-026 19341-145 5% Cellulose 95% Non-Fibrous
NAD
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 14-12-00078
19341; VAMC Wade Park Radiology P-1
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample
4 of 6Page
White Pliable; Red Paint-Like;
Inhomogeneous
14-12-00078-027 19341-146 2% Cellulose 98% Non-Fibrous
NAD
White Chalky; Brown Fibrous; Inhomogeneous
14-12-00078-028 19341-147 25% Cellulose 75% Non-Fibrous
NAD
Gray Fibrous; White Paint-Like;
Inhomogeneous
14-12-00078-029 19341-148 50% Cellulose 35% Fibrous Glass 5% Synthetic 10% Non-Fibrous
NAD
Brown Powder; Fibrous;
Homogeneous
14-12-00078-030 19341-149 25% Cellulose 75% Non-Fibrous
NAD
White Pliable; Red Paint-Like;
Inhomogeneous
14-12-00078-031 19341-150 2% Cellulose 98% Non-Fibrous
NAD
White Pliable;
Homogeneous
14-12-00078-032 19341-151 100% Non-FibrousNAD
Beige Powder; Fibrous;
Homogeneous
14-12-00078-033 19341-152 25% Cellulose 75% Non-Fibrous
NAD
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 14-12-00078
19341; VAMC Wade Park Radiology P-1
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample
5 of 6Page
White Chalky; Brown Fibrous; White Granular;
Inhomogeneous
14-12-00078-034 19341-153 25% Cellulose 75% Non-Fibrous
NAD
Gray Rubbery;
Homogeneous
14-12-00078-035 19341-154 2% Cellulose 98% Non-Fibrous
NAD
Gray Rubbery;
Homogeneous
14-12-00078-036 19341-155 2% Cellulose 98% Non-Fibrous
NAD
Tasha Eaddy
1% Asbestos
Analyst:
Reporting Limit:
Method:
QC Blank:
QC Sample:
Timothy Harris
EPA Method 600/R-93/116, EPA Method 600/M4-82-020
QA/QC Clerk
Reviewed By Authorized Signatory:
80-M22013-3
SRM 1866 Fiberglass
NAD = no asbestos detectedLEGEND:
The condition of the samples analyzed was acceptable upon receipt per laboratory protocol unless otherwise noted on this report. Each distinct component in an inhomogeneous sample was analyzed separately and reported as a composite. Results represent the analysis of samples submitted by the client. Sample location, description, area, volume, etc., was provided by the client. This report cannot be used by the client to claim product endorsement by NVLAP or any agency of the U.S. Government. This report shall not be reproduced except in full, without the written consent of the
Environmental Hazards Service, L.L.C. California Certification #2319 NY ELAP #11714 NVLAP #101882-0. All information concerning sampling location, date, and time can be found on Chain-of-Custody. Environmental Hazards Services, L.L.C. does not perform any sample collection.
Environmental Hazards Services, L.L.C. recommends reanalysis by point count (for more accurate quantification) or Transmission Electron Microscopy
(TEM), (for enhanced detection capabilities) for materials regulated by EPA NESHAP (National Emission Standards for Hazardous Air Pollutants) and found to contain less than ten percent (<10%) asbestos by polarized light microscopy (PLM). Both services are available for an additional fee.
400 Point Count Analysis, where noted, performed per EPA Method 600/R-93/116 with a Reporting Limit of 0.25%.
* All California samples analyzed by Polarized Light Microscopy, EPA Method 600/M4-82-020, Dec. 1982.
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 14-12-00078
19341; VAMC Wade Park Radiology P-1
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample
6 of 6Page
Timothy Harris
Richmond, VA 23237
Telephone: 800.347.4010
Environmental Hazards Services, L.L.C.
12/04/2014
Received Date:
30628 Detroit Road #258 Westlake OH, 44145
Client:
12/03/2014
14-12-00078
Stephen J. Sebesta & Assoc. 12/01/2014
Report Number:
Reported Date:
Analyzed Date:
36-3130Client Number:
19341; VAMC Wade Park Radiology P-1Project/Test Address:
7469 Whitepine Rd
Client:
Report Number:
Project/Test Address:
Client Number:
Reported Date:
Received Date:
Analyzed Date:
Stephen J. Sebesta & Assoc. 12/09/2014
36-3130
12/15/2014
14-12-01090
7469 Whitepine Rd
Telephone: 800.347.4010
Richmond, VA 23237
Environmental Hazards Services, L.L.C.
19341; VAMC Radiology P1 Penthouse
Laboratory Results Fax Number:
216-781-0024
30628 Detroit Road #258 Westlake OH, 44145
12/12/2014
Layer Type AsbestosClient Sample Number
Other Materials
Lab Gross DescriptionLab Sample Number
Beige Fibrous; Gray Cementitious;
Inhomogeneous
14-12-01090-001 19341-241 35% Cellulose 65% Non-Fibrous
-- NAD
Beige Fibrous;
Homogeneous
14-12-01090-002 19341-242 45% Cellulose 55% Non-Fibrous
-- NAD
Beige Fibrous; Gray Cementitious;
Inhomogeneous
14-12-01090-003 19341-243 35% Cellulose 65% Non-Fibrous
-- NAD
Red Pliable;
Homogeneous
14-12-01090-004 19341-244 7% Cellulose 93% Non-Fibrous
-- NAD
Gray Pliable to Brittle;
Beige-Gray Pliable;
Inhomogeneous
14-12-01090-005 19341-245 10% Cellulose 2% Synthetic 88% Non-Fibrous
-- NAD
1 of 3Page
Beige Fibrous;
Homogeneous
14-12-01090-006 19341-246 45% Cellulose 55% Non-Fibrous
-- NAD
Off-White/White Brittle;
Tan/Pale Beige Fibrous;
Inhomogeneous
14-12-01090-007 19341-247 15% Cellulose 7% Fibrous Glass 78% Non-Fibrous
-- NAD
Beige Fibrous;
Homogeneous
14-12-01090-008 19341-248 45% Cellulose 55% Non-Fibrous
-- NAD
Pale Red Pliable;
Homogeneous
14-12-01090-009 19341-249 3% Cellulose 97% Non-Fibrous
-- NAD
Gray Pliable;
Homogeneous
14-12-01090-010 19341-250 4% Cellulose 96% Non-Fibrous
-- NAD
Off-White Pliable;
Homogeneous
14-12-01090-011 19341-251 8% Cellulose 92% Non-Fibrous
-- NAD
Beige Fibrous;
Homogeneous
14-12-01090-012 19341-252 45% Cellulose 55% Non-Fibrous
-- NAD
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 14-12-01090
19341; VAMC Radiology P1 Penthouse
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample
2 of 3Page
Environmental Hazards Services, L.L.C
Project/Test Address:
Client Number: Report Number:36-3130 14-12-01090
19341; VAMC Radiology P1 Penthouse
Other Materials
AsbestosLab Sample Number
Layer Type Lab Gross DescriptionClient Sample Number
Howard Varner
1% Asbestos
Analyst:
Reporting Limit:
Method:
QC Blank:
QC Sample:
Mark Case
EPA Method 600/R-93/116, EPA Method 600/M4-82-020
General Manager
Reviewed By Authorized Signatory:
72-M22010-3
SRM 1866 Fiberglass
NAD = no asbestos detectedLEGEND:
The condition of the samples analyzed was acceptable upon receipt per laboratory protocol unless otherwise noted on this report. Each distinct component in an inhomogeneous sample was analyzed separately and reported as a composite. Results represent the analysis of samples submitted by the client. Sample location, description, area, volume, etc., was provided by the client. This report cannot be used by the client to claim product endorsement by NVLAP or any agency of the U.S. Government. This report shall not be reproduced except in full, without the written consent of the
Environmental Hazards Service, L.L.C. California Certification #2319 NY ELAP #11714 NVLAP #101882-0. All information concerning sampling location, date, and time can be found on Chain-of-Custody. Environmental Hazards Services, L.L.C. does not perform any sample collection.
Environmental Hazards Services, L.L.C. recommends reanalysis by point count (for more accurate quantification) or Transmission Electron Microscopy
(TEM), (for enhanced detection capabilities) for materials regulated by EPA NESHAP (National Emission Standards for Hazardous Air Pollutants) and found to contain less than ten percent (<10%) asbestos by polarized light microscopy (PLM). Both services are available for an additional fee.
400 Point Count Analysis, where noted, performed per EPA Method 600/R-93/116 with a Reporting Limit of 0.25%.
* All California samples analyzed by Polarized Light Microscopy, EPA Method 600/M4-82-020, Dec. 1982.
3 of 3Page
Mark Case
Richmond, VA 23237
Telephone: 800.347.4010
Environmental Hazards Services, L.L.C.
12/15/2014
Received Date:
30628 Detroit Road #258 Westlake OH, 44145
Client:
12/12/2014
14-12-01090
Stephen J. Sebesta & Assoc. 12/09/2014
Report Number:
Reported Date:
Analyzed Date:
36-3130Client Number:
19341; VAMC Radiology P1 PenthouseProject/Test Address:
7469 Whitepine Rd
Photo RP1-1, Non-Asbestos-containing (ACM) duct sealant Radiology, Phase 1, Basement, B-B526 Ultrasound 3
(Sample No. 19314-121)
Photo RP1-2, Non-Asbestos-containing ceiling tile, Radiology, Phase 1, Basement, B-B526 Ultrasound 3 (Sample No. 19341-120)
Photo RP1-3 Non-Asbestos-containing fireproofing, Radiology, Phase 1, Basement, B-B526 Ultrasound 3, (Sample No. 19314-122)
Photo RP1-4, Non-Asbestos-containing sink base undercoating Radiology, Phase 1, Basement, B-B528 Ultrasound 4, (Sample No. 19314-123)
Photo RP1-5, Non-Asbestos-containing drywall and mud, Radiology, Phase 1, Basement, B-B528 Ultrasound 4 restroom, (Sample No. 19314-124)
Photo RP1-6, Above ceiling, Non-ACM fireproofing. Radiology, Phase 1, Basement, B-B528 Ultrasound 4, (Sample No. 19341-125)
Photo RP1-7 Non-ACM fiberglass pipe insulation, drywall and fire stop-ping above Basement ceiling, Radiology
Photo RP1-8, Non-Asbestos-containing laminate flooring, Radiology, Basement
Photo RP1-9, Non-Asbestos-containing duct sealant, Basement, B-B524 Ultrasound 2(Sample No. 19341-126)
Photo RP1-10, Non-ACM fireproofing Radiology Phase 1, Basement, B-B524 Ultrasound 2(Sample No. 19341-127)
Photo RP1-11, Non-Asbestos-containing Sink base undercoating and flooring, Radiology, Basement exam room
Photo RP1-12, Non-Asbestos-containing Flooring, Radiology, Phase 1, Basement bathroom
Photo RP1-13, Non-Asbestos-containing ceiling tile, Radiology, Phase 1, Basement
Photo RP1-14, Non-Asbestos-containing Drywall walls, Photo RP1-15, Non-ACM ceiling tile, Radiology, Phase 1, Basement, B-B521 Interview (Sample No. 19341-128)
Photo RP1-16, Non-asbestos-containing floor mastic, Basement, B-B521 Interview, Radiology, Phase 1(Sample No.19341-129)
Photo RP1-17, Non-Asbestos-containing sink base undercoating, Basement, B-B511 Bone density, Radiology, Phase 1
(Sample No. 19341-130)
Photo RP1-18, Non-asbestos-containing laminate flooring, Photo RP1-19, Non-Asbestos-containing black waterproofing tar, Radiology, Phase 1, Basement, B-B511 Bone density (Sample No. 19341-131)
Photo RP1-20, Non-Asbestos-containing fireproofing, Photo RP1-21, Non-Asbestos-containing drywall and mud, Radiology, Phase 1, Basement, B-B511 Bone density (Sample No. 19341-132)
Photo RP1-22, Non-ACM red fire stopping, Basement, B-B553 Staff lounge, Radiology, Phase 1 (Sample No. 19341-133)
Photo RP1-23, Non-Asbestos-containing ceiling tile, Radiology, Phase 1 Basement, B-B553 Staff Lounge (Sample No. 19341-134)
Photo RP1-24, Non-asbestos-containing fireproofing, Radiology, Phase 1, Basement, B-B553 Staff lounge (Sample No. 19341-135)
Photo RP1-25, Non-asbestos-containing fireproofing, Radiology, Phase 1 basement
Photo RP1-26, Non-asbestos-containing ceiling tile, Radiology, Phase 1, Basement, Corridor by B-B554 (Sample No. 19341-136)
Photo RP1-27, Non-asbestos-containing Drywall and mud, Radiology, Phase 1, Basement, Women’s restroom, staff (Sample No. 19341-137)
Photo RP1-28, Non-asbestos-containing sprayed-on fireproofing Basement, B-B616 office, Radiology, Phase 1 (Sample No. 19341-138)
Photo RP1-29, Non-Asbestos-containing covebase and mastic, Radiology, Phase 1, Basement, B-B611 Micro receiving (Sample No. 19341-139)
Photo RP1-30, Non-asbestos-containing carpet mastic, Radiology Phase 1, Basement, Corridor by B-B611 (Sample No. 19341-140)
Photo RP1-31, Non-ACM fireproofing and red fire stopping, Radiology, Phase 1
Photo RP1-32, Non-ACM fireproofing, 1st floor, 1-B511 Reception
Radiology, Phase 1 (Sample No. 19341-141)
Photo RP1-33, Non-asbestos-containing Drywall ceiling, Radiology, Phase 1, 1st floor, 1-B511 (Sample No. 19341-142)
Photo RP1-34, Non-Asbestos-containing fireproofing, Radiology, Phase 1, 1st floor, Vestibule, radiology (Sample No. 19341-143)
Photo RP1-35, Non-asbestos-containing fire stopping, Radiology, Phase 1, 1st floor, 1-B515 office (Sample No. 19341-144)
Photo LC36, Non-ACM duct sealant, Radiology, Phase 1, 1st floor, 1-B516 Reading consult room (Sample No. 19341-145)
Photo RP1-37, Non-Asbestos-containing white fire stopping caulk Radiology, Phase 1, 1st floor, corridor outside 1-B517 (Sample No. 19341-146)
Photo RP1-38, Non-asbestos-containing Drywall and mud, Radiology, Phase 1, 1st floor, 1-B519 staff lounge (Sample No. 19341-147)
Photo RP1-39, Non-Asbestos-containing ceiling tile and fire stopping Radiology, Phase 1, 1st floor
Photo RP1-40, Non-Asbestos-containing ceiling tile, Radiology, Phase 1, 1st floor, 1-B523 Clean utility (Sample No. 19341-148)
Photo RP1-41, Non-Asbestos-containing fireproofing, Radiology, Phase 1, 1st floor, 1-B534 waiting area (Sample No. 19341-149)
Photo RP1-42, Non-ACM red fire stopping, (Sample No. 19341-150) and Non-ACM drywall and mud, Radiology, Phase 1, 1st floor, 1-B534 waiting area (Sample No. 19341-151)
Photo RP1-43, Non-Asbestos-containing Drywall and mud, Radiology, Phase 1, 1st floor, 1-B541 waiting area (Sample No. 19341-153)
Photo RP1-44, Non-Asbestos-containing fireproofing, Radiology, Phase 1, 1st floor, 1-B541 waiting area (Sample No. 19341-152)
Photo RP1-45, Non-Asbestos-containing window caulk, Radiology, Phase 1, 1st floor, Near 1-B525 (Sample No. 19341-154)
Photo RP1-46, Non-ACM fireproofing Radiology, Phase 1, Penthouse, Electrical Room (Sample No. 19341-242)
Photo RP1-47, Non-Asbestos-containing fireproofing, Radiology, Phase 1, Penthouse, Electrical (Sample No. 19341-243)
Photo RP1-48, Non-ACM fire stopping, Radiology, Phase 1, Penthouse, Electrical (Sample No. 19341-245)
Photo RP1-49, Non-asbestos-containing fireproofing, Radiology, Phase 1, Penthouse, Mechanical, 2B-501 (Sample No. 19341-246)
Photo RP1-50, Non-ACM fire stopping (Sample No. 19341-249) and Non-ACM fireproofing, Radiology, Phase 1, Penthouse, Mechanical, 2B-501 (Sample No. 19341-248)
Photo RP1-51, Non-asbestos-containing drywall and mud, Radiology, Phase 1, Penthouse, Mechanical, 2B-501 (Sample No. 19341-247)
Photo RP1-52, Non-asbestos-containing fiberglass and PVC pipe insulation, Radiology, Phase 1 Penthouse, Mechanical
Photo RP1-53, Non-asbestos-containing duct sealant, Radiology, Phase 1, Penthouse, Mechanical, 2B-501 (Sample No. 19341-250)
Photo RP1-54, Non-asbestos-containing fireproofing, Radiology, Phase 1, Penthouse, Mechanical, 2B-501(Sample No. 19341-252)
Photo RP1-55, Radiology P1 penthouse
ATTACHMENT 5
Ohio Asbestos Certification for Asbestos Inspector
| 19341.Radiology spreadsheet (2).pdf |
| Sheet1 |
File details come from the government source that posted it. Updated .