Hazardous Material Documents.pdf

Correct HVAC Systems in Procedure Rooms, JC

Project Number: 657-21-115JC

31 JAN 2023

Hazardous Material Documents

U.S Department of Veterans Affairs VA St. Louis Health Care System

John Cochran Division St. Louis, MO

“For Official Use Only”

SCI ENGINEERING, INC.

EARTH • SCIENCE • SOLUTIONS

GEOTECHNICAL

ENVIRONMENTAL NATURAL

RESOURCES CULTURAL

RESOURCES

CONSTRUCTION SERVICES

January 27, 2023

Arlo Wieczorek

Romanyk Consulting Corp.

3308 Preston Road, Suite 350-164

Plano, Texas 75093

RE: Asbestos Survey Activities

VISN 15 – Project 657-21-115JC

Correct Heating, Ventilation, and Air Conditioning Systems

And Procedure Rooms

St. Louis, MO VAMC

St. Louis, Missouri SCI No. 2017-0502.20 Task 009

Dear Arlo Wieczorek:

INTRODUCTION

SCI Engineering, Inc. (SCI) is pleased to submit this report of the analytical test results for samples of suspect asbestos-containing materials (ACMs) collected during the survey performed on September 26 and

September 27, 2022. The survey was conducted by Brian Lieb, Missouri-Licensed Asbestos Inspector.

A copy of Brian’s asbestos inspector license is enclosed.

The purpose of this survey was to identify ACMs in accessible areas of the structure at the St. Louis VA

Health Care Center in St. Louis, Missouri which may be impacted by proposed upgrade of selected

HVAC systems. This survey is intended to satisfy the requirements for the asbestos National Emission

Standard for Hazardous Air Pollutant for demolition and renovation as well as for Occupational Safety and Health Administration (OSHA) compliance.

LIMITATIONS

SCI's asbestos survey entailed visually assessing accessible areas only. If any other suspect asbestos materials are discovered during demolition or renovation, please contact SCI, and we will make arrangements for assessment of these materials. Areas behind walls, under subfloors and above fixed ceilings are considered non-accessible.

During the course of performing the survey of the structure, SCI was instructed by VA staff to not collect the following samples:

• Tan speckled sheet flooring in Room B124,

• Tan and blue speckled sheet flooring and tan ceramic wall tile, and the drywall system in Room

E128 and E129,

• Light tan ceramic wall tile in Room A165 and A164, 130 Point West Boulevard, St. Charles, Missouri 63301 ■ 636-949-8200 www.sciengineering.com

Romanyk Consulting Corp. 2 January 27, 2023

• Gray speckled sheet flooring in Room D220 and D219,

• White flecked sheet flooring in Room B503,

• Tan speckled sheet flooring in Room C510 and C511A,

• Tan ceramic wall tile and wallboard in Room C615 and C615A, and

• Wallboard, composite flooring and white ceramic wall tile in Room A663, A663A and A663B.

Additionally, due to the height of the material and/or current improvements above the ceiling, SCI was unable to sample the following materials:

• Tan HVAC duct tape in Room E128 and E129,

• Gray HVAC sealant in Room B503, and

• Gray HVAC sealant in Room C510 and C511A.

Additionally, COVID patients were located in Rooms A707, A720 and A757. The following materials were observed but could not be sampled.

• 12-inch by 12-inch black flecked floor tile,

• White ceramic wall tile,

• Black cove base,

• Gray HVAC sealant, and

• 12-inch by 12-inch gray flecked floor tile.

Because SCI was unable to collect a sample of these materials, they must be assumed asbestos-containing until analytical results prove otherwise. SCI recommends that if any of these materials are impacted by the proposed renovations, that they are sampled prior to renovation activities. SCI was able to access all other materials which are anticipated to be impacted by the renovation activities.

Additionally, patients were located in Rooms A658, A658A, and A658B during SCI’s survey, therefore, SCI was unable to collect any samples in these rooms. However, Rooms A663, A663A, and A663B were located next to Rooms A658, A658A, and A658B and appeared to be constructed/renovated at the same time. Visual observations determined that these rooms were homogenous.

ASBESTOS SURVEY

One hundred four samples were collected from the on-site structure. From these 104 samples, 207 layers were analyzed by Polarized Light Microscopy (PLM). Of the 207 layers analyzed, 2 were found to contain asbestos. Analytical test results and chain-of-custody documentation are enclosed. Additionally, several materials were assumed to be asbestos containing and are listed in the table below. The results of the analysis of all samples as well as the assumed ACM materials are summarized in Table 1.

Romanyk Consulting Corp. 3 January 27, 2023

Table 1 - Summary of Analytical Test Results

Sample

Number Material Location Material Description

Approx.

Quantity Result Category

115-1A

Floor 01- Room

A165 and A164

Tan Speckled Sheet

Flooring (on concrete)

450 sf

None Detected in Sheet Flooring or Adhesive

-- 115-1B

None Detected in Sheet Flooring or Adhesive

115-1C None Detected in Sheet Flooring

115-2A

Drywall System

1,900 sf

None Detected in Joint

Compound, Tape and Drywall

-- 115-2B

Compound, Tape and Drywall

115-2C None Detected in Joint

Compound, Tape and Drywall

115-3A Floor 01 – Room

Hallway

2’ x 2’ White Drywall

Ceiling Tile (drop-in)

100 sf

None Detected

-- 115-3B None Detected

115-3C None Detected

115-4A

Gray Duct Sealant

150 sf

-- 115-4B None Detected

115-4C None Detected

115-5A Floor 01 – Room

B124

Red Fire Caulk

25 sf

-- 115-5B None Detected

115-5C None Detected

115-6A

360 sf

None Detected in Tape, Joint

Compound or Drywall

-- 115-6B

None Detected in Tape, Joint

Compound or Drywall

115-6C None Detected in Tape, Joint

Compound or Drywall

115-7A

Plaster System

None Detected in Texture or

Plaster

-- 115-7B None Detected in Texture or

Plaster

115-7C None Detected in Texture or

Plaster

115-8A

2’ x 4’ White Drywall

225 sf

-- 115-8B None Detected

115-8C None Detected

115-9A

B124 (Hallway)

Old Fiberglass Lag

Cloth

40 lf

-- 115-9B None Detected

115-9C None Detected sf - square feet lf - linear feet

Romanyk Consulting Corp. 4 January 27, 2023

Table 1 - Summary of Analytical Test Results (continued)

Material Location Material Description

Approx.

Quantity

115-10A

D220 and D219

1,500 sf

-- 115-10B

Compound, Tape and Drywall

115-10C None Detected in Joint

Compound, Tape and Drywall

115-11A

Gray HVAC Sealant

(above ceiling)

35 sf

-- 115-11B None Detected

115-11C None Detected

115-12A

25 sf

-- 115-12B None Detected

115-12C None Detected

115-13A

2’ x 4’ White Ceiling

Tile (with pinholes, drop-in)

400 sf

-- 115-13B None Detected

115-13C None Detected

115-14A

Floor 05 – Room

C510 and C511A

-- 115-14B

Compound, Tape and Drywall

115-14C None Detected in Joint

Compound, Tape and Drywall

115-15A

B503

Plaster System

600 sf

None Detected in Plaster

-- 115-15B None Detected in Plaster

115-15C None Detected in Plaster

115-16A

2’ x 2’ White Drywall

400 sf

-- 115-16B None Detected

115-16C None Detected

115-17A

Grayish Green HVAC

Sealant

75 sf

-- 115-17B None Detected

115-17C None Detected

115-18A

None Detected in Caulk

-- 115-18B None Detected in Caulk

115-18C None Detected in Caulk

115-19 Floor 05 – Room

B503 TSI (above ceiling) 35 lf

2% Amosite and 27% Chrysotile in TSI; None Detected in Wrap Friable

Romanyk Consulting Corp. 5 January 27, 2023

Material Location Material Description

Approx.

Quantity Result Category

115-20 Floor 05 – Room

B503

Mudded Elbow

(above ceiling) 25 ea.

20% Amosite and 6% Chrysotile in Elbow; None Detected in Mud Friable

115-21A

600 sf

Compound, Tape, and Drywall

-- 115-21B

Compound, Tape, and Drywall

115-21C None Detected in Joint

115-22A

Floor 06 – Room

C615 and C615A

18” x 18” Tan

Speckled Floor Tile

(on 25abc)

None Detected in Floor Tile or

Adhesive

-- 115-22B

Adhesive

115-22C None Detected in Floor Tile or

115-23A

6” Gray Cove Base

76 lf

None Detected in Cove Base or

-- 115-23B

Adhesive

115-23C None Detected in Cove Base or

Adhesive

115-24A

2’ x 4’ White Drywall

-- 115-24B None Detected

115-24C None Detected

115-25A

12” x 12” Light

Brown Speckled Floor

Tile (under 22abc, on concrete)

None Detected in Floor Tile, Orange or Green Adhesive, or

Concrete

115-25B

None Detected in Floor Tile, Orange or Green Adhesive, or

Concrete

115-25C None Detected in Floor Tile or

Tan or Black Adhesive

115-26A

-- 115-26B

Compound, Tape, and Drywall

115-26C None Detected in Joint

Compound, Tape, and Drywall

115-27A

45 sf

-- 115-27B None Detected

115-27C None Detected

Romanyk Consulting Corp. 6 January 27, 2023

Material Location Material Description

Approx.

Quantity

115-28A

Floor 08 – Room

A663, A663B, A358, A658B

12” x 12” Gray

Streaked Floor Tile

(on concrete)

350 sf

-- 115-28B

Adhesive

115-28C None Detected in Caulk, Floor Tile

115-29A

Floor 08 – Room

A663, A663B, A358, A658B

6” Black Cove Base

120 lf

-- 115-29B

Adhesive

115-29C None Detected in Cove Base or

115-30A

A663, A663A, A663B, A658, A658A, A658B

3,000 sf

None Detected in Plaster or

Drywall

-- 115-30B

None Detected in Plaster or

Drywall

115-30C None Detected in Joint Compound or Drywall

115-31A

A663, A663A, Tan Duct Tape (on seams)

170 sf

None Detected in Duct or

115-31B

None Detected in Duct or

Adhesive

115-31C None Detected

115-32A Floor 06 – Room

A663, A663A, -- 115-32B None Detected

115-32C None Detected

115-33A

A663A, A658A

2’ x 2’ White Ceiling

Tile (with pinholes and gouge, drop-in)

50 sf

-- 115-33B None Detected

115-33C None Detected

115-34A Floor 07 – Room

A707

2’ x 2’ White Ceiling

Tile (with pinholes and gouge, drop-in)

-- 115-34B None Detected

115-34C None Detected

115-35A

A707

None Detected in Joint Compound, Tape, or Drywall

-- 115-35B

Tape, or Drywall

115-35C

Tape, or Drywall

Romanyk Consulting Corp. 7 January 27, 2023

NCII - Non-Friable Category II Material

Material Location Material Description

Approx.

Quantity Result Category

115-36A

Floor 01 – Room

E128 and E129 Hallway

2’ x 4’ White Ceiling

Tile (with pinholes and wormtracks, drop-in)

150 sf

-- 115-36B None Detected

115-36C None Detected

115-37 Floor 01 – Room

B124

Tan Speckled Sheet

Flooring 200 sf Assumed NCI

115-38

E128 and E129

Tan and Blue

Speckled Sheet

Flooring

200 sf

Assumed

NCI

115-39 Floor 01 – Room

E128 and E129 Tan HVAC Duct Tape 50 lf Assumed Friable

115-40 Floor 01 – Room

E128 and E129

Tan Ceramic Wall

Tile 40 sf Assumed NCII

115-41 Floor 01 – Room

E128 and E129 Drywall System 2,000 sf Assumed Friable

115-42 Floor 01 – Room

A165 and A164

Light Tan Ceramic

Wall Tile 40 sf Assumed NCII

115-43 Floor 02 – Room

D220 and D219

Gray Speckled Sheet

Flooring 200 sf Assumed NCI

115-44 Floor 05 – Room

B503 Gray HVAC Sealant 10 lf Assumed NCII

115-45 Floor 05 – Room

B503

White Flecked Sheet

Flooring 200 sf Assumed NCI

115-46 Floor 05 – Room

C510 and C511A Gray HVAC Sealant 10 lf Assumed NCII

115-47 Floor 05 – Room

C510 and C511A

Tan Speckled Sheet

Flooring 200 sf Assumed NCI

115-48 Floor 06 – Room

C615 and C615A

Tan Ceramic Wall

Tile 40 sf Assumed NCII

115-49 Floor 06 – Room

C615 and C615A Wallboard 75 sf Assumed NCII

115-50 Floor 06 – Room

A663B Wallboard 75 sf Assumed NCII

115-51 Floor 06 – Room

A663B Composite Flooring 100 sf Assumed NCII

115-52 Floor 06 – Room

A663 and A658

White Ceramic Wall

Tile 40 sf Assumed NCII

115-53 Floor 07 – Room

A707 and A720

12”x12” Black

Flecked Floor Tile 400 sf Assumed NCI

NCI – Non-Friable Category I material

Romanyk Consulting Corp. 8 January 27, 2023

Material Location Material Description

Approx.

Quantity

115-54

A707, A720, and

A757

White Ceramic Wall

Tile

120 sf

NCII

115-55

A707, A720, and

A757

Black Cove Base

115-56

A707, A720, and

A757

30 lf

115-57 Floor 07 – Room

A757

12”x12” Gray Flecked

Floor Tile 200 sf Assumed NCI

NCI – Non-Friable Category I material

NCII - Non-Friable Category II Material

DEMOLITION/RENOVATION

According to the St. Louis County Department of Health (SLCDOH), any friable or potentially friable

ACM in excess of 16 linear feet or 10 square feet is classified as a regulated ACM (RACM) and must be removed prior to demolition or renovation which would significantly damage the material.

The following friable materials were identified:

• Room B503, TSI,

• Room B503, mudded elbow,

• Room E128 and E129, tan HVAC duct tape, and

• Room E128 and E129, drywall system.

These materials are considered friable and exceed the minimum quantity requirements. Therefore, these materials must be abated if they will be impacted by renovation activities.

The following Category II non-friable materials were identified:

• Room E128 and E129, tan ceramic wall tile,

• Room A165 and A164, light tan ceramic wall tile,

• Room B503, gray HVAC sealant,

• Room C510 and C511A, gray HVAC sealant,

• Room C615 and C615A, tan ceramic wall tile, Romanyk Consulting Corp. 9 January 27, 2023

• Room C615 and C615A, wallboard,

• Room A663B, wallboard,

• Room A663B, composite flooring,

• Room A663 and A658, white ceramic wall tile,

• Room A707, A720, and A757, white ceramic wall tile,

• Room A707, A720, and A757, black cove base, and

• Room A707, A720, and A757, gray HVAC sealant.

According to the rule outlined above, the non-friable Category II materials mentioned above are not, by definition, RACMs. However, these materials must be abated if they will be impacted by renovation activities.

The following Category I non-friable materials were identified:

• Room B124, tan speckled sheet flooring,

• Room E128 and E129, tan and blue speckled sheet flooring,

• Room D220 and D219, gray speckled sheet flooring,

• Room B503, white flecked sheet flooring,

• Room C510 and C511A, tan speckled sheet flooring,

• Room A707 and A720, 12-inch by 12-inch black flecked floor tile, and

• Room A757, 12-inch by 12-inch gray flecked floor tile.

The Category I non-friable materials outlined above would not typically require removal. However, these materials must be abated if they will be impacted by renovation activities.

The Occupational Safety & Health Administration also has regulations (29 CFR Parts 1910 et al, Occupational Exposure to Asbestos, August 10, 1994) regarding removal of asbestos-containing materials which must be followed.

REPORTING

Attached is SLCDOH Notification of Demolition and Renovation form, which has been filled out to the extent possible by SCI. The remaining information must be completed by you.

This report, as well as the completed EPA Notification of Demolition and Renovation form, must be submitted to the SLCDOH, Kathrina Donnegan, SLCDOH, 111 South Meramec, Clayton, Missouri, 63105.

Scott Thraen

Romanyk Consulting Corp.

10 January 27, 2023

SCI ENGINEERING, INC.

It should be noted that following submittal of the notification form, there is a 10-day waiting period before demolition, renovation, or abatement activities can begin.

If this report is to be used for bidding purposes for asbestos abatement, SCI recommends the contractor visit the site to verify all conditions and quantities.

SCI appreciates the opportunity to be of service to you on this project. Please contact us if you have any questions or comments regarding the information provided.

Respectfully, Brian L. Lieb Glen A. Grissom

Missouri State Certified Asbestos Inspector Senior Scientist

Certificate Number 7011011722MOIR16703

Jessica B. Keeven, CHMM

Senior Scientist

BLL/GAG/JBK/rah

Enclosures

Asbestos NESHAP Notification of Demolition and Renovation

Analytical Test Results and Chain of Custody

Asbestos Inspector Certificate

2017 PROJECTS\2017-0502 VISN 15 MATOC-Romanyk\T009-STLVA Correct HVAC-Procedure Rooms 115JC\ACM\HVAC Procedure Rms 115JC - ACM Report.doc user Rectangle

X

St Louis VAMC

915 N. Grand Boulevard

St. Louis MO

Procedure rooms

Medical Center

VOL. RACM OFF FACILITY COMPONENT (CUBIC FEET)

VIII. SCHEDULED DATES DEMO/RENOVATION (MM/DD/YY)

START: COMPLETE:

IX. SCHEDULED DATES ASBESTOS REMOVAL (MM/DD/YY) WEEKDAYS WORK HOURS WEEKEND WORK HOURS

START: COMPLETE:

X. DESCRIPTION OF PLANNED DEMOLITION OR RENOVATION WORK, AND METHOD(S) TO BE USED

XI. DESCRIPTION OF WORK PRACTICES AND ENGINEERING CONTROLS TO BE USED TO PREVENT EMISSIONS OF ASBESTOS AT THE DEMOLITION AND RENOVATION

SITE.

XII. WASTE TRANSPORTER

ADDRESS

CITY STATE ZIP CODE

CONTACT PERSON TELEPHONE NUMBER

XIII. WASTE DISPOSAL SITE

NAME

LOCATION

CITY STATE ZIP CODE

TELEPHONE NUMBER

XIV. IF DEMOLITION ORDERED BY A GOVERNMENT AGENCY, PLEASE IDENTIFY THE AGENCY BELOW

NAME TITLE

AUTHORITY

DATE OF ORDER (MM/DD/YY) INCLUDE A COPY OF THE ORDER. DATE ORDERED TO BEGIN (MM/DD/YY)

XV. FOR EMERGENCY RENOVATIONS

A. DATE AND HOUR OF EMERGENCY (MM/DD/YY)

B. DESCRIPTION OF THE SUDDEN, UNEXPECTED EVENT

C. EXPLANATION OF HOW THE EVENT CAUSED UNSAFE CONDITIONS OR WOULD CAUSE EQUIPMENT DAMAGE OR AN UNREASONABLE FINANCIAL BURDEN

XVI. DESCRIPTION OF PROCEDURES TO BE FOLLOWED IN THE EVENT THAT UNEXPECTED ASBESTOS IS FOUND OR PREVIOUSLY NONFRIABLE ASBESTOS MATERIAL

BECOMES CRUMBLED, PULVERIZED, OR REDUCED TO POWDER.

XVII. I certify that an individual trained in the provisions of this regulation (40 CFR Part 61, Subpart M) will be on-site during the demolition or renovation and evidence that the required training has been accomplished by this person will be available for inspection during normal business hours (required 1 year after promulgation).

SIGNATURE OF OWNER/OPERATOR DATE

XVIII. I Certify that the above information is correct.

SIGNATURE OF OWNER/OPERATOR DATE

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Initial report from: 10/05/2022 16:56:31

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 1 of 13

Attention: Glen A Grissom Phone: (314) 581-7570

SCI Engineering, Inc. Fax: (636) 949-8269

130 Point West Blvd. Received Date: 09/28/2022 9:32 AM

Saint Charles, MO 63301 Analysis Date: 10/04/2022 - 10/05/2022

Collected Date:

Project: 2017-0502.20 T009 VISN 15 MATOC-Romanyk-HVAC Procedure Rooms 115JC

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

Light Microscopy

Non-Asbestos Asbestos

Sample Description Appearance % Fibrous % Non-Fibrous % Type

115-1A-Sheet Flooring

392210529-0001

115-1A-Adhesive

392210529-0001A

115-1B-Sheet Flooring

392210529-0002

115-1B-Adhesive

392210529-0002A

115-1 C-Sheet Flooring

392210529-0003

115-1C-Adhesive

392210529-0003A

115-2 A-Joint Compound

392210529-0004

115-2A-Tape

392210529-0004A

115-2A-Joint Compound

392210529-0004B

115-2A-DW

392210529-0004C

115-2B-Joint Compound

392210529-0005

115-2B-Tape

392210529-0005A

115-2B-Joint Compound

392210529-0005B

115-2B-DW

392210529-0005C

115-2C-Joint Compound

392210529-0006

115-2C-Tape

392210529-0006A

Tan

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Heterogeneous

Gray

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

100% Cellulose

17% Cellulose

14% Glass

18% Cellulose

15% Glass

100% Non-fibrous (Other)

27% Perlite

73% Non-fibrous (Other)

69% Non-fibrous (Other)

67% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 2 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

Non-Asbestos Asbestos

115-2C-Joint Compound

392210529-0006B

115-2C-DW

392210529-0006C

115-3A

392210529-0007

115-3B

392210529-0008

115-3C

392210529-0009

115-4A

392210529-0010

115-4B

392210529-0011

115-4C

392210529-0012

115-5A

392210529-0013

115-5B

392210529-0014

115-5C

392210529-0015

115-6A-Tape

392210529-0016

115-6A-Joint Compound

392210529-0016A

115-6A-DW

392210529-0016B

115-6B-Tape

392210529-0017

115-6B-Joint Compound

392210529-0017A

115-6B-DW

392210529-0017B

115-6C-Tape

392210529-0018

115-6C-Joint Compound

392210529-0018A

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

White

Non-Fibrous

25% Cellulose

5% Glass

29% Cellulose

38% Min. Wool

26% Cellulose

35% Min. Wool

30% Cellulose

40% Min. Wool

70% Non-fibrous (Other)

29% Perlite

4% Non-fibrous (Other)

26% Perlite

13% Non-fibrous (Other)

20% Perlite

10% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 3 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-6C-DW

392210529-0018B

115-7A-Texture

392210529-0019

115-7A-Plaster

392210529-0019A

115-7A-Plaster

392210529-0019B

115-7B-Texture

392210529-0020

115-7B-Plaster

392210529-0020A

115-7B-Plaster

392210529-0020B

115-7C-Texture

392210529-0021

115-7C-Plaster

392210529-0021A

115-7C-Plaster

392210529-0021B

115-8A

392210529-0022

115-8B

392210529-0023

115-8C

392210529-0024

115-9A

392210529-0025

115-9B

392210529-0026

115-9C

392210529-0027

115-10A-Joint

Compound

392210529-0028

115-10A-Tape

392210529-0028A

Various

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

Various

Fibrous

Homogeneous

Various

Fibrous

Homogeneous

White

Gray

Homogeneous

15% Cellulose

8% Glass

89% Glass

86% Glass

85% Glass

80% Non-fibrous (Other)

14% Quartz

86% Non-fibrous (Other)

19% Quartz

81% Non-fibrous (Other)

11% Quartz

89% Non-fibrous (Other)

16% Quartz

84% Non-fibrous (Other)

10% Quartz

90% Non-fibrous (Other)

15% Quartz

85% Non-fibrous (Other)

74% Non-fibrous (Other)

11% Non-fibrous (Other)

14% Non-fibrous (Other)

15% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 4 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-10A-Joint

392210529-0028B

115-10A-DW

392210529-0028C

115-10B-Joint

392210529-0029

115-10B-Tape

392210529-0029A

115-10B-Joint

392210529-0029B

115-10B-DW

392210529-0029C

115-10C-Joint

392210529-0030

115-10C-Tape

392210529-0030A

115-10C-Joint

392210529-0030B

115-10C-DW

392210529-0030C

115-11A

392210529-0031

115-11B

392210529-0032

115-11C

392210529-0033

115-12A

392210529-0034

115-12B

392210529-0035

115-12C

392210529-0036

115-13A

392210529-0037

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

White

15% Cellulose

29% Glass

26% Glass

20% Glass

27% Cellulose

36% Min. Wool

71% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 5 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-13B

392210529-0038

115-13C

392210529-0039

115-14A-Joint

392210529-0040

115-14A-Tape

392210529-0040A

115-14A-Joint

392210529-0040B

115-14A-DW

392210529-0040C

115-14B-Joint

392210529-0041

115-14B-Tape

392210529-0041A

115-14B-Joint

392210529-0041B

115-14B-DW

392210529-0041C

115-14C-Tape

392210529-0042

115-14C-Joint

392210529-0042A

115-14C-DW

392210529-0042B

115-15A-Plaster

392210529-0043

115-15A-Plaster

392210529-0043A

115-15B-Plaster

392210529-0044

115-15B-Plaster

392210529-0044A

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

Gray

Fibrous

Homogeneous

White

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

28% Cellulose

37% Min. Wool

19% Cellulose

16% Cellulose

6% Cellulose

28% Perlite

7% Non-fibrous (Other)

20% Perlite

81% Non-fibrous (Other)

84% Non-fibrous (Other)

94% Non-fibrous (Other)

17% Quartz

83% Non-fibrous (Other)

18% Quartz

82% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 6 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-15C-Plaster

392210529-0045

115-15C-Plaster

392210529-0045A

115-16A

392210529-0046

115-16B

392210529-0047

115-16C

392210529-0048

115-17A

392210529-0049

115-17B

392210529-0050

115-17C

392210529-0051

115-18A-Caulk

392210529-0052

115-18A-Caulk

392210529-0052A

115-18B-Caulk

392210529-0053

115-18B-Caulk

392210529-0053A

115-18C-Caulk

392210529-0054

115-18C-Caulk

392210529-0054A

115-19-Wrap

392210529-0055

115-19-TSI

392210529-0055A

115-20-Mudded

392210529-0056

115-20-Elbow

392210529-0056A

115-21A-Joint

392210529-0057

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Green

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

Gray

Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Fibrous

Heterogeneous

White

Non-Fibrous

Homogeneous

White

13% Glass

10% Cellulose

27% Glass

28% Glass

10% Glass

100% Fibrous (Other)

66% Fibrous (Other)

66% Non-fibrous (Other)

85% Non-fibrous (Other)

72% Non-fibrous (Other)

90% Non-fibrous (Other)

69% Gypsum

2% Non-fibrous (Other)

34% Non-fibrous (Other)

66% Gypsum

8% Non-fibrous (Other)

2% Amosite

27% Chrysotile

20% Amosite

6% Chrysotile

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 7 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-21A-Tape

392210529-0057A

115-21A-Joint

392210529-0057B

115-21A-DW

392210529-0057C

115-21B-Joint

392210529-0058

115-21B-Tape

392210529-0058A

115-21B-Joint

392210529-0058B

115-21B-DW

392210529-0058C

115-21C-Joint

392210529-0059

115-21C-Tape

392210529-0059A

115-21C-Joint

392210529-0059B

115-21C-DW

392210529-0059C

115-22A-F.T.

392210529-0060

No tan layer present.

115-22A-Adhesive

392210529-0060A

115-22B-F.T.

392210529-0061

115-22B-Adhesive

392210529-0061A

115-22C-F.T.

392210529-0062

Fibrous

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

Various

Orange

Orange

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 8 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-22C-Adhesive

392210529-0062A

115-23A-C.B.

392210529-0063

115-23A-Adhesive

392210529-0063A

115-23B-C.B.

392210529-0064

115-23B-Adhesive

392210529-0064A

115-23C-C.B.

392210529-0065

115-23C-Adhesive

392210529-0065A

115-24A

392210529-0066

115-24B

392210529-0067

115-24C

392210529-0068

115-25A-F.T.

392210529-0069

115-25A-Adhesive

392210529-0069A

115-25A-Adhesive

392210529-0069B

115-25A- Conc

392210529-0069C

115-25B-F.T.

392210529-0070

115-25B-Adhesive

392210529-0070A

115-25B-Adhesive

392210529-0070B

115-25B-Conc

392210529-0070C

115-25C-Adhesive

392210529-0071

Yellow

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Brown

Non-Fibrous

Homogeneous

Orange

Non-Fibrous

Homogeneous

Green

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Brown

Non-Fibrous

Homogeneous

Orange

Non-Fibrous

Homogeneous

Green

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

Tan

12% Cellulose

83% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 9 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-25C-F.T.

392210529-0071A

392210529-0071B

392210529-0071C

115-26A-Joint

392210529-0072

115-26A-Tape

392210529-0072A

115-26A-Joint

392210529-0072B

115-26A-DW

392210529-0072C

115-26B-Joint

392210529-0073

115-26B-Tape

392210529-0073A

115-26B-Joint

392210529-0073B

115-26B-DW

392210529-0073C

115-26C-Joint

392210529-0074

115-26C-Tape

392210529-0074A

115-26C-Joint

392210529-0074B

115-26C-DW

392210529-0074C

115-27A

392210529-0075

115-27B

392210529-0076

Brown

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Black

Non-Fibrous

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

82% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 10 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-27C

392210529-0077

115-28A-F.T.

392210529-0078

115-28A-Adhesive

392210529-0078A

115-28B-F.T.

392210529-0079

115-28B-Adhesive

392210529-0079A

115-28C-Caulk

392210529-0080

115-28C-F.T.

392210529-0080A

115-28C-Adhesive

392210529-0080B

115-29A-Cove Base

392210529-0081

115-29A-Adhesive

392210529-0081A

115-29B-Cove Base

392210529-0082

115-29B-Adhesive

392210529-0082A

115-29C-Cove Base

392210529-0083

115-29C-Adhesive

392210529-0083A

115-30A-Plaster

392210529-0084

115-30A-DW

392210529-0084A

115-30B-Plaster

392210529-0085

115-30B-DW

392210529-0085A

115-30C-Joint

392210529-0086

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Gray

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Black

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Black

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

Black

Non-Fibrous

Homogeneous

Tan

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

Non-Fibrous

Homogeneous

Various

Non-Fibrous

Homogeneous

White

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 11 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-30C-DW

392210529-0086A

115-31A-Duct

392210529-0087

115-31A-Adhesive

392210529-0087A

115-31B-Duct

392210529-0088

115-31B-Adhesive

392210529-0088A

115-31C

392210529-0089

115-32A

392210529-0090

115-32B

392210529-0091

115-32C

392210529-0092

115-33A

392210529-0093

115-33B

392210529-0094

115-33C

392210529-0095

115-34A

392210529-0096

115-34B

392210529-0097

115-34C

392210529-0098

115-35A-Joint

392210529-0099

115-35A-Tape

392210529-0099A

Non-Fibrous

Homogeneous

Gray

Clear

Clear

Red

Homogeneous

Red

Non-Fibrous

Homogeneous

Red

Non-Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

37% Fibrous (Other)

38% Fibrous (Other)

40% Fibrous (Other)

29% Glass

26% Glass

24% Glass

77% Min. Wool

78% Min. Wool

85% Min. Wool

25% Cellulose

63% Non-fibrous (Other)

62% Non-fibrous (Other)

60% Non-fibrous (Other)

76% Non-fibrous (Other)

23% Non-fibrous (Other)

22% Non-fibrous (Other)

25% Perlite

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 12 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized

115-35A-Joint

392210529-0099B

115-35A-DW

392210529-0099C

115-35B-Joint

392210529-0100

115-35B-Tape

392210529-0100A

115-35B-Joint

392210529-0100B

115-35B-DW

392210529-0100C

115-35C-Joint

392210529-0101

115-35C-Tape

392210529-0101A

115-35C-Joint

392210529-0101B

115-35C-DW

392210529-0101C

115-36A

392210529-0102

115-36B

392210529-0103

115-36C

392210529-0104

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Homogeneous

White

Fibrous

Homogeneous

White

Fibrous

Homogeneous

White

77% Non-fibrous (Other)

15% Perlite

ASB_PLM_0008_0001 - 1.78 Printed: 10/5/2022 3:56 PM Page 13 of 13

EMSL Order: 392210529 EMSL Analytical, Inc.

100 Green Park Industrial Court Saint Louis, MO 63123

Tel/Fax: (314) 577-0150 / (314) 776-3313 http://www.EMSL.com / saintlouislab@emsl.com

SCI50 Customer ID:

Customer PO:

Project ID:

Analyst(s)

Donald Schmidt (30)

Sue Ferrario (140)

Sarah Kuper (37)

Jeff Siria, Laboratory Manager or Other Approved Signatory

EMSL maintains liability limited to cost of analysis. Interpretation and use of test results are the responsibility of the client. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. The report reflects the samples as received.

Results are generated from the field sampling data (sampling volumes and areas, locations, etc.) provided by the client on the Chain of Custody. Samples are within quality control criteria and met method specifications unless otherwise noted. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 “Interim Method”) but augmented with procedures outlined in the 1993 (”final”) version of the method. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Unless requested by the client, building materials manufactured with multiple layers (i.e. linoleum, wallboard, etc.) are reported as a single sample. Estimation of uncertainty is available on request.

Samples analyzed by EMSL Analytical, Inc. Saint Louis, MO NVLAP Lab Code 200742-0

BOLA ASBESTO

CHA N OM CUS ODI

130 Point West Boulevard

St. Charles, Missouri 63301 636-949-8200 Fax 636-949-8269 www.sciengineering.com

Company : SCI Engineering, Inc. }Please Provide Resulta Via: O Fax gJ Email D Mail

Street: 130 Point West Boulev6fd (To: Glen Grissom

City/State/Zip: St. Charles, Missouri 63301 )TeIephone #: Fax #: 636-949-8269 Project Name: VJSN IG MATQC•Romanyk - HVAC Procedure Rooms 11SJC Email: qqrissomttZiscienqineerinq.com Project Number: 2017-0502.20 T0O9

Turnaround Tlme (YAT) Options - Please Check One

O 3 Hour O S Hour Q 24 Hour Q 48 HOtar Q 72 Hour O 96 Hour IN Dthers-uaz

PLM Bulk Analysls TEM Bulk Analysls

(N PLM-WPA 600

Q PLM-EPA 600 NOB

Q P1M-Point Count

Q TEM EPA NOB - EPA 600/R-93/116 Sectlon 2.5.5.1

Q Chatfield Protocol (seml-quantltative)

■ Check Box for Stop Positive £ommenW '- 1 e ‹ • •*S ‹ 8 1 e $

' survey was limited to HVAC upgrade areas only per drawings provided to SCI.

Samplers Nae„ Brian Lieb Samplers Slgnature Date Sampled: 9/26 & 9/27/22

Building Use/Description/Featured, Occupied Hospital Age: Slze:

Windows. metal adding; n @ R«f: n/a

HVAC: forced air

SampJe # Material Location Material Description

Condition Comments

115-1ABC Floor 01 - Raam A165 and A164 Tan speckled sheet flóoring 450 sf Good on conc

115-2ABC Floor 01 - Room A165 and A164 DW Sys 1,900 sf

115-3ABC Floor 01 - Room A165 and A164 Hallway 2x2 White D.W.C.T. 100 sf drop in

115-4ABC Floor 01 - Raom A165 and A164 Gray Duct Sealant 150 sf

115-5ABC Floor 01 - Room B124 Red Fire Caulk 25 sf

115-6ABC Floor 01 - Room B124 DW Sys 360 sf

115-7ABC Floor 01 - Room B124 Plaster Sys 360sf

115-8ABC Floor 01 - Room B124 2x4 White D.W.C.T. 225 sf drop-in

115-9ABC Floor 01 - Room B124 (Hallway) Old Fiberglass lag cloth 40 If

Relinquished

O r d e r I D

P a g e f

Sample # Material Location Material Description Approx. Quantity Condition Comments

115-10ABC Floor 02 - Room D220 & D219 DW Sys 1,500 sf Good

115-11ABC Floor 02 - Room D220 & D219 Gray HVAC sealant 35 sf above ceiling

115-12ABC Floor 02 - Room D220 & D219 Red Fire Caulk 25 sf above ceiling

115-13ABC Floor 02 - Room D220 & D219 2x4 White C.T. (w/ pinholes) 400 sf drop-in

115-14ABC Floor 05 -Room C510 & C511A DW Sys 1500 sf

115-15ABC Floor 05 - Room B503 Plaster Sys 600 sf

115-16ABC Floor 05 - Room B503 2x2 white DW C.T. 400 sf drop in

115-17ABC Floor 05 - Room B503 Grayish Green HVAC Sealant 75 sf

115-18ABC Floor 05 - Room B503 Red Fire Caulk 100 sf

115-19 Floor 05 - Room B503 TSI 35 If above ceiling

115-20 Floor 05 - Room B503 Mudded Elbow 25 ea above ceiling

115-21ABC Floor 05 - Room B5O3 DW Sys 600 sf

115-22ABC Floor 06 - Room C615 and C615A 18x18 tan speckled F.T. 360 sf on 25abc

115-23ABC Floor 06 - Room C615 and C615A 6" gray C.B. 76 If

115-24AB@ Floor 06 - Room C615 and C615A 2x4 White DW C.T. 360 sf drop in

115-25ABC Floor 06 - Room C615 and C615A 12x12 light brown speckled F.T. 360 sf under 22ABC, on conc)

115-26ABC Flaor 06 - Room C615 and C615A DW Sys 1500 sf i

115-27ABC Floor 06 - Room C615 and C615A Gray HVAC sealant 45 sf above ceiling

115-28ABC Floor 06 - Room A663, A663B, A658, A658B 12x12 gray streaked F.T. 350 sf on conc

115-29ABC Floor 06 - Room A663, A663B, A65B, A658B 6" black cove base 120 If

115-3OABC

Floor 08 • Room A663, A6 . A663B. A85B, A658A, A6S8B DW Sys 3000 sf r d e r I D

Sample # Material Locatlon Material Description

Condition Comments

115-31ABC Ffocr 06 - Roont A663, A863A, A683B, AB58, ›'\058A, A65BB Tan Duct Tape 170 sf Good (on seams)

115-32ABC F oo 06 Room A883 A683/u A803B, A658, A858A, AsSBB Red Fire Caulk 100 sf

115-33ABC Floor 06 - Room A663A, A658A 2X2 white C.T. (w/ pinholes and gouge) 50 sf drop in

115-34ABC Floor 07 - Room A707 2x2 White C.T. (w/ pinholes and gouge) drop in

115-35ABC Floor 07 - Room A707 DW Sys

115-36ABC Floar 01 - Room E128 and E129 Hallway 2x4 White CT (w/ pinholes and wormtrack•J 1 50 sf drop in r d e r I D

CERTTFICATTDN NUMBER :

7011011722MOIR16703

TH78 CERTIFIES

Brian L Lieb

HAS COMPLETED THE CERTIFICATION

REOtJIREMENT5 FOR

Inspector

APPROVED: 01/24/2022 TRAINING DATE: 01/17/2022

EXPPES: 01/24/2023

Dir of Air PolMion Control Program