Ft Wayne VA Chapel - Asbestos Report.pdf

Asbestos Inspection Report VA Project: Remodel Fort Wayne Chapel

VA Project No.: 610A4-22-203

VA Northern Indiana Healthcare System

Fort Wayne Campus

2121 Lake Avenue

Fort Wayne, Indiana 46805

April 10, 2023 | Report Number: N1227129

Prepared for:

FFE, INC

Cincinnati, Ohio 45242

611 Lunken Park Drive Cincinnati, OH 45226

P (513) 321-5816 F (513) 321-0294

Terracon.com

Facilities | Environmental | Geotechnical | Materials

April 10, 2023

FFE, Inc.

4445 Lake Forest Drive, Suite 600 Cincinnati, Ohio 45242

Attn: Mr. Clint Weekley President T: (513) 519-5999 E: clint.weekley@ffe-serv.com

Re: Asbestos Inspection Report VA Project: Remodel Fort Wayne Chapel VA Project No. 610A4-22-203 VA Northern Indiana Health Care System Fort Wayne Campus 2121 Lake Avenue Fort Wayne, Indiana 46805 Terracon Project No. N1227129

Dear Mr. Weekley:

Terracon Consultants, Inc. (Terracon) is pleased to submit the attached report for the above-referenced site to FFE, Inc. (Client). The purpose of this report is to present the results of an asbestos inspection which was performed on March 28, 2023 regarding the project titled “Remodel Fort Wayne Chapel.” We understand that this inspection was requested for the purpose of a future planned renovation of the chapel located at the VA Northern Indiana Health Care System, Fort Wayne campus.

Materials containing asbestos were identified as a result of the inspection. Please refer to the attached report for further detail.

Terracon appreciates the opportunity to provide this service to FFE, Inc. If you have any questions regarding this report, please contact the undersigned at 513-321-5816.

Sincerely, Terracon Consultants, Inc.

Lem Weyer Josh Vogel Field Scientist Group Manager https://na3.documents.adobe.com/verifier?tx=CBJCHBCAABAAEkFXNoC2mFDIQpXRWUi7X4MA-auhAGs_ https://na3.documents.adobe.com/verifier?tx=CBJCHBCAABAAEkFXNoC2mFDIQpXRWUi7X4MA-auhAGs_

Remodel Fort Wayne Chapel | 2121 Lake Ave., Fort Wayne, IN

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials

TABLE OF CONTENTS

1.0 INTRODUCTION

1.1 Project Objective

1.2 Reliance

2.0 Project DESCRIPTION

3.0 FIELD ACTIVITIES

3.1 Visual Assessment

3.2 Physical Assessment

3.3 Sample Collection

3.4 Sample Analysis

4.0 REGULATORY OVERVIEW

5.0 FINDINGS AND RECOMMENDATIONS

6.0 LIMITATIONS/GENERAL COMMENTS

APPENDICES

APPENDIX A IDENTIFIED ASBESTOS-CONTAINING MATERIALS BY HOMOGENEOUS AREA (HA)

APPENDIX B ASBESTOS INSPECTION SAMPLE & RESULTS SUMMARY

APPENDIX C ASBESTOS ANALYTICAL LABORATORY REPORT

APPENDIX D LICENSES AND CERTIFICATIONS

APPENDIX E SAMPLE LOCATION AND ACM LOCATION DIAGRAM

APPENDIX F PHOTO LOG

Facilities | Environmental | Geotechnical | Materials

ASBESTOS INSPECTION REPORT

VA Project: Remodel Fort Wayne Chapel

VA Project No.: 610A4-22-203 VA Northern Indiana Health Care System-Fort Wayne Campus

2121 Lake Avenue Fort Wayne, Indiana

Terracon Project No. N1227129 April 10, 2023

1.0 INTRODUCTION

Terracon Consultants, Inc. (Terracon) conducted an asbestos inspection which was limited to the boundaries of the VA project titled “Remodel Fort Wayne Chapel” at the VA Northern Indiana Health Care System, Fort Wayne Campus. The inspection was performed at the site on March 28, 2023 by a United States Environmental Protection Agency (USEPA)-accredited and Indiana Department of Environmental Management (IDEM) licensed asbestos inspector.

Accessible building components within the renovation areas were inspected. Homogeneous areas of accessible suspect asbestos-containing materials (ACM) were visually identified and documented. Although reasonable effort was made to inspect for accessible suspect materials, additional suspect but un-sampled materials could be located in walls, in voids, or in other concealed areas. Bulk samples from suspect ACM were collected in general accordance with the sampling protocols outlined in USEPA 40 Code of Federal Regulations (CFR) Part 763, Subpart E, known as the Asbestos Hazard Emergency Response Act (AHERA). Collected bulk samples were delivered to an accredited laboratory for analysis by polarized light microscopy (PLM).

1.1 Project Objective

We understand that this inspection was requested for the purpose of a future planned renovation regarding the VA project titled “Remodel Fort Wayne Chapel” at the VA Northern Indiana Health Care System, Fort Wayne Campus. Asbestos inspections are required prior to renovation and demolition activities to satisfy requirements of the USEPA 40 CFR Part 61, Subpart M, the National Emission Standards for Hazardous Air Pollutants (NESHAP) regulation (as well as the state NESHAP equivalent).

1.2 Reliance

This report is for the exclusive use of FFE, Inc. (Client) for the project being discussed.

Reliance by any other party on this report is prohibited without written authorization of Terracon and the Client. Reliance on this report by the Client and all authorized parties will

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials 2 be subject to the terms, conditions, and limitations stated in the proposal and the agreement between Terracon and FFE, Inc.

2.0 PROJECT DESCRIPTION

The subject renovation area is located on the first floor of Building 1 at the Fort Wayne, Indiana VA campus (Rooms 193, 194, 194A, and 194B). The renovation space is approximately 1,400 square foot of interior floor space. The interior walls and ceilings consist of plaster. The floors of the chapel are carpeted, and the office and storage closet have vinyl floor tile. As previously noted, this inspection was limited to the boundaries of the VA project titled “Remodel Fort Wayne Chapel.”

3.0 FIELD ACTIVITIES

The interior inspection was conducted by Mr. Lem Weyer, who is a USEPA-accredited and IDEM-licensed asbestos inspector. A copy of Mr. Weyer’s Indiana asbestos credential is attached as Appendix D. The inspection was conducted in general accordance with the sample collection protocols established in USEPA 40 CFR Part 763, Subpart E, Section 763.86, AHERA. A summary of inspection activities is provided below.

3.1 Visual Assessment

Inspection activities were initiated with visual observation of the accessible interior areas of the subject renovation space to identify homogeneous areas of accessible suspect ACM. A homogeneous area (HA) consists of building materials that appear similar throughout in terms of color and texture with consideration given to the date of application.

This inspection did not include knocking holes in walls and removing coverings to look for potentially concealed materials. Additionally, electrical equipment, electrical lines, and active equipment were not included in this inspection as such item present a safety hazard to the inspector.

3.2 Physical Assessment

A physical assessment of each HA of suspect ACM was conducted to assess the friability and condition of the materials. A friable material is defined by the USEPA 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.

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials 3

3.3 Sample Collection

Based on results of the visual observation, bulk samples from interior suspect ACM were collected in general accordance with USEPA AHERA sampling protocols. Samples of suspect materials were collected from randomly selected locations in each homogeneous area. Bulk 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 were based on Terracon’s observations and the assumption that like materials in the same area are homogeneous in content.

With respect to this interior inspection, Terracon collected a total of 31 bulk samples from nine (9) homogeneous areas of suspect ACM. A summary table of samples collected from homogenous areas of suspect ACM is included in Appendix B. Sample locations and ACM locations are shown on a diagram included in Appendix E.

3.4 Sample Analysis

Collected bulk samples were submitted under chain of custody to Eurofins CEI, Inc. of Cary, North Carolina for analysis by polarized light microscopy (PLM) with dispersion staining techniques per USEPA methodology 600/R-93/116. The percentage of asbestos by PLM, where applicable, was determined by microscopic visual estimation using PLM. When applicable for friable material samples determined by PLM to have a low asbestos content (<5%), the additional point count (PC) method (400 points) was utilized. Eurofins CEI Inc.

is accredited for bulk asbestos analysis under the National Voluntary Laboratory Accreditation Program (NVLAP), accreditation number 101768-0.

The laboratory analytical report is included in Appendix C. Results are also summarized in the sample summary table included in Appendix B.

4.0 REGULATORY OVERVIEW

The federal asbestos NESHAP (40 CFR Part 61, Subpart M) regulates asbestos fiber emissions and asbestos waste disposal practices. The asbestos NESHAP regulation also requires the identification and classification of existing ACM according to friability prior to demolition or renovation activity. Friable ACM is a material containing more than 1% asbestos that, when dry, can be crumbled, pulverized, or reduced to powder by hand pressure. All friable ACM is considered regulated asbestos containing material (RACM).

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials 4

The asbestos NESHAP regulation classifies material subject to demolition or renovation as either RACM, Category I non-friable ACM, or Category II non-friable ACM. RACM includes all friable ACM (pre-disturbance), along with Category I non-friable ACM that becomes friable (during disturbance), and Category I non-friable ACM subject to sanding, grinding, cutting, or abrading, or Category II non-friable ACM with a high probability of becoming crumbled, pulverized, or reduced to powder by forces expected to act on the material during disturbance. Category I non-friable ACM are exclusively asbestos-containing packings, gaskets, resilient floor coverings, and asphalt roofing products that contain more than 1% asbestos. Category II non-friable ACM are all other non-friable materials (other than Category I non-friable ACM) that contain more than 1% asbestos. Category II non-friable ACM generally includes (but is not limited to) cementitious material such as: cement pipes, cement siding (Transite™), cement panels, glazing, mortar, and grouts.

IDEM implements the asbestos NESHAP regulation as adopted by reference at Indiana Administrative Code Title 326. The owner or operator must provide IDEM with written notification at least 10 working days prior to the commencement of asbestos abatement activities that will disturb RACM in amounts greater than or equal to 160 square feet, 260 linear feet (of pipe insulation) or 35 cubic feet, and prior to demolition projects (even if no ACM is being removed or if no ACM was identified present).

The Indiana Department of Labor enforces the federal Occupational Safety and Health Administration (USOSHA) asbestos standard for construction (29 CFR 1926.1101) regulates workplace exposure to asbestos. The USOSHA standard requires that employee exposure to airborne asbestos must not exceed 0.1 fibers per cubic centimeter of air (0.1 f/cc) as an eight-hour time weighted average (TWA) and not exceed 1.0 fibers per cubic centimeter of air (1.0 f/cc) over a 30-minute time period known as an excursion limit (EL). The TWA and EL are known as USOSHA’s asbestos permissible exposure limits (PELs). The USOSHA 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.

5.0 FINDINGS AND RECOMMENDATIONS

Based on the analytical results for samples collected from the renovation area, the material listed below was identified to contain asbestos.

ACM

Description

Material Location(s)

% & Type Asbestos

Condition/ Friability

EPA NESHAP

Category

Estimated Quantity*

Layered Cardboard Pipe Insulation with Tar Paper Layer

Above Plaster Ceilings and within

Pipe Chases of Renovation Area

2% Chrysotile

Regulated Asbestos- Containing Material

(RACM)

Good/Friable ~ 150 Linear Feet (LF)

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials 5

ACM

Description

Material Location(s)

% & Type Asbestos

Condition/ Friability

EPA NESHAP

Category

Estimated Quantity*

White Fittings

Associated with Layered Cardboard

Pipe Insulation above Plaster

Ceilings and within Pipe Chases throughout the Renovation Area

65% Chrysotile RACM Good/Friable ~ 16 LF or

16 Fittings

12”x12” White with Brown

Streak Floor Tile and Black Mastic

Office and Storage Closet of

Renovation Area

Floor Tile:

5%

Chrysotile, Mastic: 2% Chrysotile

Category I Non-Friable

Good/Non- Friable

~ 200 Square Feet

*Estimated quantities listed above are based on a cursory field evaluation, and actual quantities may vary significantly, especially if ACMs are concealed/hidden or located in inaccessible areas that could not be evaluated as part of this inspection. This is not a bidding document and contractors would be responsible for drawing their own conclusions on quantities present.

The above table is reiterated in Appendix A. A bulk sample and analytical results summary table is included in Appendix B, the laboratory analytical report is included in Appendix C, approximate sample locations and ACM locations are shown on a diagram included in Appendix E, and an example photo of the identified ACM is included in Appendix F.

6.0 LIMITATIONS/GENERAL COMMENTS

As previously noted, this inspection was limited to the client provide areas within the renovation project titled “Remodel Fort Wayne Chapel.” Additional suspect materials may exist outside the scope of work. Because the structure was occupied at the time of our inspection, Terracon did not perform sampling which required demolition or destructive activities such as knocking large holes in walls, sampling ceramic flooring materials, dismantling of equipment or removal of protective coverings. Reasonable efforts to access suspect materials within known areas of restricted access (e.g., crawl spaces) were made;

however, confined spaces or areas which may pose a health or safety risk to Terracon personnel were not sampled.

This asbestos inspection 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 interior inspection of the building. The information contained in this report is relevant to the date on which this inspection 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

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials 6 application to their project as discussed. This report is not a bidding document.

Contractors or consultants reviewing this report must draw their own conclusions regarding quantities, further investigation or remediation deemed necessary.

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.

APPENDIX A

VA Project: Remodel Fort Wayne Chapel VA Project No.: 610A4-22-203

VA Northern Indiana Health Care System-Fort Wayne Campus 2121 Lake Avenue

Fort Wayne, Indiana Terracon Project No. N1227129

April 10, 2023

IDENTIFIED ASBESTOS-CONTAINING MATERIALS BY HOMOGENEOUS AREA (HA)

HA

No’s.

ACM Description Material Location % and Type

Asbestos

EPA NESHAP

Classification

Condition/ Friability

Estimated Quantity*

Layered Cardboard Pipe

Insulation with Tar Paper Layer

Above Plaster Ceilings and within Pipe Chases of Renovation Area 2% Chrysotile Regulated Asbestos-

Containing Material (RACM) Good/Friable ~ 150 Linear Feet

05 White Fittings

Associated with Layered Cardboard Pipe

Insulation above Plaster Ceilings and within Pipe Chases throughout the

Renovation Area

65% Chrysotile RACM Good/Friable ~ 16 LF or 16 Fittings

12”x12” White with

Brown Streak Floor Tile and Black Mastic

Office and Storage Closet of Renovation

Area

Floor Tile: 5% Chrysotile, Mastic: 2% Chrysotile Category I Non-Friable Good/Non-

Friable ~ 200

Square Feet

See Appendix B for a summary of samples collected with respective analytical results, Appendix C for the laboratory analytical report, Appendix E for a sample location and ACM location diagram, and Appendix F for a photo example of the above-listed material.

*Estimated quantities listed above are based on a cursory field evaluation, and actual quantities may vary significantly, especially if ACMs are hidden and/or present in inaccessible areas not evaluated as part of this inspection. This is not a bidding document and contractors would be responsible for drawing their own conclusions regarding quantities present.

APPENDIX B

VA Project: Remodel Fort Wayne Chapel VA Project No.: 610A4-22-203

VA Northern Indiana Health Care System-Fort Wayne Campus 2121 Lake Avenue

Fort Wayne, Indiana Terracon Project No. N1227129

April 10, 2023

ASBESTOS INSPECTION SAMPLE & RESULTS SUMMARY

Sample #

Sample Material Description

Sample Location HA Location(s) Results (% / Type of

Asbestos)HA #

SEQ.

Plaster Walls: Base Coat and Finish Coat

Northeast Corner of Storage Closet

Throughout Renovation Area

Base Coat: None Detected (ND), Finished Coat: ND

Southeast Corner of Storage Closet

Base Coat: ND, Finished Coat: ND

Southeast Corner of Storage Closet

Base Coat: ND, Finished Coat: ND

Northeast Corner

Office Base Coat: ND, Finished Coat: ND

Southwest Corner of Office Base Coat: ND, Finished Coat: ND

Plaster Ceilings: Base Coat and Finish Coat

At Access Hatch in Southeast Corner of Alter Area

Throughout Renovation Area

Base Coat: ND, Finished Coat: ND

At Access Hatch in Southeast Corner of Alter Area

Base Coat: ND, Finished Coat: ND

Southwest Corner of Storage Closet

Base Coat: ND, Finished Coat: ND

At Access Hatch in Northeast Corner of Office

Base Coat: ND, Finished Coat: ND

At Access Hatch in Northeast Corner of Office

Base Coat: ND, Finished Coat: ND

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials

Sample # Sample Material

Description Sample Location HA Location(s) Results (% / Type of

Asbestos)HA #

SEQ.

Yellow Carpet Mastic

Northwest Corner of Chapel

Throughout Chapel

ND

Northeast Corner of Chapel

ND

South side of the

Alter

ND

Layered Cardboard Pipe Insulation with Tar Paper

Layer

At Access Hatch in Southeast

Corner of Alter Above Plaster Ceilings and within Pipe Chases of

Renovation Area

Pipe Insulation: 1.5% Chrysotile by Point Count

At Access Hatch in Southeast Corner of Alter

Pipe Insulation: 2% Chrysotile

At Access Hatch in Northeast Corner of Office

Pipe Insulation: 2% Chrysotile, Tar Paper: ND

White Fittings

At Access Hatch in Southeast

Corner of Alter

Associated with Layered

Cardboard Pipe Insulation above Plaster Ceilings and within Pipe

Chases throughout the

Renovation Area

65% Chrysotile

At Access Hatch in Southeast Corner of Alter

65% Chrysotile

At Access Hatch in Southeast Corner of Alter

65% Chrysotile

12”x12” White with Brown Streak Floor Tile and Black

Mastic

Northeast Corner of Storage Closet

Office and Storage Closet of Renovation

Area

Floor Tile: 5% Chrysotile, Mastic: 2% Chrysotile

Northeast Corner of Storage Closet

Floor Tile: 5% Chrysotile, Mastic: 2% Chrysotile

Northeast Corner of Office Floor Tile: 5% Chrysotile, Mastic: 2% Chrysotile

23 Brown/Tan Vinyl Sheet Flooring with

Yellow Mastic

Middle East Side Throughout Congregation Area of Chapel (Under Carpet)

Flooring: ND, Mastic: ND

24 Northeast Corner Flooring: ND, Mastic: ND

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials

Sample # Sample Material

Description Sample Location HA Location(s) Results (% / Type of

Asbestos)HA #

SEQ.

25 Northwest Corner Flooring: ND, Mastic: ND

Gray Duct Mastic

Southeast Corner of Storage Closet

Associated with Duct Work in

Storage Closet of Renovation Area

ND

27 At HVAC Unit ND

28 At HVAC Unit ND

Black Tar Pipe Wrap

At HVAC Unit

Associated with Pipes going to HVAC Unit in

Storage Closet

ND

30 At HVAC Unit ND

31 At HVAC Unit ND

Inspector Signature: _____________________________ Lem Weyer

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials

APPENDIX C

ASBESTOS ANALYTICAL LABORATORY DATA

April 7, 2023

Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

CLIENT PROJECT: Ft. Wayne VAMC - Chapel, N1227129

CEI LAB CODE: B237172

Dear Customer:

Enclosed are asbestos analysis results for PLM Bulk samples received at our laboratory on March 31, 2023. The samples were analyzed for asbestos using polarizing light microscopy (PLM) per the EPA 600 Method.

Sample results containing >1% asbestos are considered asbestos-containing materials (ACMs) per EPA regulatory requirements. The detection limit for the EPA 600 Method is <1% asbestos by weight as determined by visual estimation.

Thank you for your business and we look forward to continuing good relations.

730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Tianbao Bai, Ph.D., CIH Laboratory Director

Kind Regards, ASBESTOS ANALYTICAL REPORT

By: Polarized Light Microscopy

Prepared for

Terracon Consultants, Inc.

CLIENT PROJECT:

LAB CODE:

TEST METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020

REPORT DATE:

TOTAL SAMPLES ANALYZED:

# SAMPLES >1% ASBESTOS:

Ft. Wayne VAMC - Chapel, N1227129

04/07/23

B237172

730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Asbestos Report Summary By: POLARIZING LIGHT MICROSCOPY

PROJECT: Ft. Wayne VAMC - Chapel, N1227129 LAB CODE: B237172

Client ID Lab ID Color Sample Description

ASBESTOS

%Layer

METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020

01-01 Layer 1 B237172.01 White Plaster Finish Coat None Detected01-01

Layer 2 B237172.01 Gray Plaster Base Coat None Detected

01-02 Layer 1 B237172.02 White Plaster Finish Coat None Detected01-02

Layer 2 B237172.02 Gray Plaster Base Coat None Detected

01-03 Layer 1 B237172.03 White Plaster Finish Coat None Detected01-03

Layer 2 B237172.03 Gray Plaster Base Coat None Detected

01-04 Layer 1 B237172.04 White Plaster Finish Coat None Detected01-04

Layer 2 B237172.04 Gray Plaster Base Coat None Detected

01-05 Layer 1 B237172.05 White Plaster Finish Coat None Detected01-05

Layer 2 B237172.05 Gray Plaster Base Coat None Detected

02-06 Layer 1 B237172.06 White Plaster Finish Coat None Detected02-06

Layer 2 B237172.06 Gray Plaster Base Coat None Detected

02-07 Layer 1 B237172.07 White Plaster Finish Coat None Detected02-07

Layer 2 B237172.07 Gray Plaster Base Coat None Detected

02-08 Layer 1 B237172.08 White Plaster Finish Coat None Detected02-08

Layer 2 B237172.08 Gray Plaster Base Coat None Detected

02-09 Layer 1 B237172.09 White Plaster Finish Coat None Detected02-09

Layer 2 B237172.09 Gray Plaster Base Coat None Detected

02-10 Layer 1 B237172.10 White Plaster Finish Coat None Detected02-10

Layer 2 B237172.10 Gray Plaster Base Coat None Detected

03-11 B237172.11 Yellow Carpet Mastic None Detected03-11

03-12 B237172.12 Yellow Carpet Mastic None Detected03-12

03-13 B237172.13 Yellow Carpet Mastic None Detected03-13

04-14 B237172.14A Brown Pipe Insulation Chrysotile04-14 2% B237172.14B Pipe Insulation (point Count) Chrysotile 1.5%

04-15 B237172.15A Brown Pipe Insulation Chrysotile04-15 2% B237172.15B Sample Not Analyzed per COC

04-16 Layer 1 B237172.16A Brown Pipe Insulation Chrysotile04-16 2% Layer 2 B237172.16A Black Tarpaper None Detected

B237172.16B Sample Not Analyzed per COC

05-17 B237172.17 White Fittings Chrysotile05-17 65%

Page 1 of 2730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Asbestos Report Summary

PROJECT: Ft. Wayne VAMC - Chapel, N1227129 LAB CODE: B237172

Client ID Lab ID Color Sample Description

ASBESTOS

%Layer

METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020

05-18 B237172.18 White Fittings Chrysotile05-18 65% 05-19 B237172.19 White Fittings Chrysotile05-19 65% 06-20 B237172.20A White Floor Tile Chrysotile06-20 5%

B237172.20B Black Mastic Chrysotile 2% 06-21 B237172.21A White Floor Tile Chrysotile06-21 5%

B237172.21B Black Mastic Chrysotile 2% 06-22 B237172.22A White Floor Tile Chrysotile06-22 5%

B237172.22B Black Mastic Chrysotile 2% 07-23 B237172.23A Tan Flooring None Detected07-23

B237172.23B Yellow Mastic None Detected

B237172.23C Brown Flooring None Detected

B237172.23D Yellow Mastic None Detected

07-24 B237172.24A Tan Flooring None Detected07-24

B237172.24B Yellow Mastic None Detected

07-25 B237172.25A Brown Flooring None Detected07-25

B237172.25B Yellow Mastic None Detected

08-26 B237172.26 Gray Duct Mastic None Detected08-26

08-27 B237172.27 Gray Duct Mastic None Detected08-27

08-28 B237172.28 Gray Duct Mastic None Detected08-28

09-29 B237172.29 Black Pipe Wrap None Detected09-29

09-30 B237172.30 Black Pipe Wrap None Detected09-30

09-31 B237172.31 Black Pipe Wrap None Detected09-31

Page 2 of 2730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

ASBESTOS BULK ANALYSIS

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

White 01-01

B237172.01

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.01 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 01-02

B237172.02

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.02 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 01-03

B237172.03

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.03 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 01-04

B237172.04

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Page 1 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

Gray Plaster Base Coat

B237172.04 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 01-05

B237172.05

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.05 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 02-06

B237172.06

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.06 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 02-07

B237172.07

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.07 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

Page 2 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

White 02-08

B237172.08

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.08 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 02-09

B237172.09

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.09 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

White 02-10

B237172.10

Heterogeneous

Non-fibrous Bound

65% 35% <1%

Binder Silicates Paint

None Detected Layer 1

Plaster Finish Coat

Gray Plaster Base Coat

B237172.10 <1%Heterogeneous

Non-fibrous Bound

65% 35%

Cellulose Silicates Binder

None DetectedLayer 2

Yellow Carpet Mastic03-11

B237172.11 Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Page 3 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

Yellow Carpet Mastic03-12

B237172.12 Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Yellow Carpet Mastic03-13

B237172.13 Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Brown Pipe Insulation04-14

B237172.14A 98%Heterogeneous

Fibrous Loosely Bound

No tarpaper present.

Cellulose 2% Chrysotile

Pipe Insulation (point Count)

B237172.14B

(7 asbestos points / 400 total) x 100.=1.5%

1.5% Chrysotile

Brown Pipe Insulation04-15

B237172.15A 98%Heterogeneous

Fibrous Loosely Bound

No tarpaper present.

Cellulose 2% Chrysotile

Sample Not Analyzed per COC

B237172.15B

Brown 04-16

B237172.16A

98%Heterogeneous

Fibrous Loosely Bound

Cellulose 2% Chrysotile Layer 1

Pipe Insulation

Black Tarpaper

B237172.16A 60%Heterogeneous

Fibrous Bound

40%Cellulose Tar None DetectedLayer 2

Page 4 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

Sample Not Analyzed per COC

B237172.16B

White Fittings05-17

B237172.17 35%Heterogeneous

Fibrous Loosely Bound

Cellulose 65% Chrysotile

White Fittings05-18

B237172.18 35%Heterogeneous

Fibrous Loosely Bound

Cellulose 65% Chrysotile

White Fittings05-19

B237172.19 35%Heterogeneous

Fibrous Loosely Bound

Cellulose 65% Chrysotile

White Floor Tile06-20

B237172.20A Heterogeneous

Fibrous Bound

95% Vinyl 5% Chrysotile

Black MasticB237172.20B Homogeneous

Non-fibrous Bound

98% Tar 2% Chrysotile

White Floor Tile06-21

B237172.21A Heterogeneous

Fibrous Bound

95% Vinyl 5% Chrysotile

Black MasticB237172.21B Homogeneous

Non-fibrous Bound

98% Tar 2% Chrysotile

Page 5 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

White Floor Tile06-22

B237172.22A Heterogeneous

Fibrous Bound

95% Vinyl 5% Chrysotile

Black MasticB237172.22B Homogeneous

Non-fibrous Bound

98% Tar 2% Chrysotile

Tan Flooring07-23

B237172.23A 10%Heterogeneous

Non-fibrous Bound

90%Cellulose Vinyl None Detected

Yellow MasticB237172.23B Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Brown FlooringB237172.23C 10%Heterogeneous

Non-fibrous Bound

90%Cellulose Vinyl None Detected

Yellow MasticB237172.23D Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Tan Flooring07-24

B237172.24A 10%Heterogeneous

Non-fibrous Bound

90%Cellulose Vinyl None Detected

Page 6 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

Yellow MasticB237172.24B Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Brown Flooring07-25

B237172.25A 10%Heterogeneous

Non-fibrous Bound

90%Cellulose Vinyl None Detected

Yellow MasticB237172.25B Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Gray Duct Mastic08-26

B237172.26 Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Gray Duct Mastic08-27

B237172.27 Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Gray Duct Mastic08-28

B237172.28 Homogeneous

Non-fibrous Bound

100% Mastic None Detected

Black Pipe Wrap09-29

B237172.29 10%Homogeneous

Fibrous Bound

70% 20%

Cellulose Tar Binder

None Detected

Page 7 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

Lab Code: B237172 Date Received: 03-31-23 Date Analyzed: 04-06-23 Date Reported: 04-07-23

Client ID Lab ID

Lab Attributes

Lab Description

ASBESTOS

ASBESTOS BULK PLM, EPA 600 METHOD

NON-ASBESTOS COMPONENTS

Non-Fibrous

Client: Terracon Consultants, Inc.

611 Lunken Park Drive Cincinnati, OH 45226

Project: Ft. Wayne VAMC - Chapel, N1227129

Fibrous

Black Pipe Wrap09-30

B237172.30 10%Homogeneous

Fibrous Bound

70% 20%

Cellulose Tar Binder

None Detected

Black Pipe Wrap09-31

B237172.31 10%Homogeneous

Fibrous Bound

70% 20%

Cellulose Tar Binder

None Detected

Page 8 of 9730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

LEGEND: Non-Anth = Non-Asbestiform Anthophyllite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate

METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020

REPORTING LIMIT: <1% by visual estimation

REPORTING LIMIT FOR POINT COUNTS: 0.25% by 400 Points or 0.1% by 1,000 Points

REGULATORY LIMIT: >1% by weight

Due to the limitations of the EPA 600 method, nonfriable organically bound materials (NOBs) such as vinyl floor tiles can be difficult to analyze via polarized light microscopy (PLM). EPA recommends that all NOBs analyzed by PLM, and found not to contain asbestos, be further analyzed by Transmission Electron Microscopy (TEM). Please note that PLM analysis of dust and soil samples for asbestos is not covered under NVLAP accreditation. Estimated measurement of uncertainty is available on request.

This report relates only to the samples tested or analyzed and may not be reproduced, except in full, without written approval by Eurofins CEI. Eurofins CEI makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results.

Interpretation of the analytical results is the sole responsibility of the client. Samples were received in acceptable condition unless otherwise noted. This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. Government.

Information provided by customer includes customer sample ID and sample description.

ANALYST: APPROVED BY:

Tianbao Bai, Ph.D., CIH Laboratory Director

Regan Kerns

730 SE Maynard Road • Cary, NC 27511 • 919.481.1413

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials

APPENDIX D

LICENSES AND CERTIFICATIONS

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials

APPENDIX E

SAMPLE LOCATION & ACM LOCATION DIAGRAM

Project No. N1227129

Consulting Engineers and Scientists

611 Lunken Park Drive Cincinnati, Ohio 45226

PH. (513) 321-05816

FAX (513) 321-0294

Sample Location and ACM Location Drawing Exhibit Inspection Date: March 28, 2023 VA Project: Remodel Fort Wayne Chapel

VA Project No.: 610A4-22-203 VA Northern Indiana Health Care System

2121 Lake Avenue Fort Wayne, Indiana 46805

Project Manager: Lem Weyer

APR: Josh Vogel

11 12

Asbestos-Containing 12”x12” White with Brown Streak Floor Tile and Black Mastic (HA 06)

Asbestos-Containing Layered Cardboard Pipe Insulation and

Associated Mudded Fittings (HAs 04 & 05)

April 10, 2023 | Terracon Report No. N1227129

Facilities | Environmental | Geotechnical | Materials

APPENDIX F

PHOTO LOG

Photo #1- HA 04: Asbestos-Containing Layered Cardboard Pipe Insulation

Photo #2- HA 05: Asbestos-Containing Pipe Fittings

Photo #3- HA 06: Asbestos-Containing 12”x12” White with Brown Streak Floor Tile and Black Mastic