36E77619B0012-0004004.pdf

IIHHII

E N V I R O N M E N T A L

ASBESTOS SURVEY REPORT

Bob Stump Veterans Affairs Medical Center Building 107

Prescott, Arizona

Order Number VA649-C10326

April 19, 2012

Prepared for:

Richard Trevino Northern Arizona Veterans Affairs Health Care System

500 North Highway 89 Prescott, Arizona 85723

Prepared by: Reviewed by:

Scott Nordstrom, PE, CSP

AHERA Certified Asbestos Inspector Randy McClure, CSP IHI Project Manager

Project # 11P-A3138

640 EAST WILMINGTON AVE SALT LAKE CITY UT 84106 TELEPHONE: 801-466-2223 FAX: 801-466-9616 E-MAIL: IHI@IHI-ENV.COM

SALT LAKE CITY SAN FRANCISCO PHOENIX DENVER SEATTLE

Executive Summary During January 2011, IHI Environmental conducted a comprehensive asbestos survey of Building 107, at the Bob Stump Veterans Affairs Medical Center in Prescott, Arizona. Mr.

Eric Towles was the Contract Officer Technical Representative for this project. The objective of this inspection was to determine the presence and condition of all accessible asbestos-containing building materials (ACBM) and to recommend response actions for the materials identified.

Hazard Rank Codes – All of the ACBM materials, including those that contain less than 1% but greater than none detected, were assigned a Hazard Rank Code of 1, 2, 3, or 4. A Hazard Rank Code of 1 requires an immediate response action. Materials assigned a Hazard Rank Code 4 are those ACBMs that do not pose a significant health risk and do not require immediate response. Hazard Rank Codes were determined by assessing the material condition, accessibility, and potential for future disturbance. The Executive Summary Table below outlines the recommended response actions and abatement costs that accompany Hazard Rank Codes 1 through 3.

Operations and Maintenance Plan – The VA should implement the Operations and Maintenance Plan provided with this project. This plan assigns responsibility for program management and coordination and institutes a formal system for coordinating building construction or maintenance activities so that asbestos-containing materials are not inadvertently disturbed.

Cost Estimates for Removal – The estimated cost to remove all of the ACBM from this building in a single planned abatement project is $360,000. The Material Removal Unit Cost Estimate (Table 6) in Appendix A outlines the estimated removal costs associated with each of the various homogeneous materials identified during this survey.

The report that follows this Executive Summary should be read in its entirety because it includes detailed information, such as material descriptions and locations, regulatory requirements, and building-specific recommended response actions, contained in other sections and appendices.

Bob Stump VAMC – Building 107 i IHI Environmental Asbestos Survey Report Project # 11P-A3138

Response Actions and Cost Estimates for Asbestos-Containing Building Materials with Hazard Ranks of 1, 2, or 3

Executive Summary

Building No.: 107 (Main Hospital)

Hazard

Rank

Recommended

Response ActionsMaterial Description

Building

No. QuantityBuilding Name

Room

No.

Material

Code

Cost Estimate for

Response Actions

Hazard Rank # 2

Material

Comments

Damaged or significantly damaged ACBM with a low to moderate disturbance potential. These materials require removal, repair, encapsulation and/or enclosure.

(1)

60T03.01 2107 Main Hospital 238 3" Straight Run Insulation ln. ft. Remove damaged insulation and clean any debris or

Remove all ACM pipe insulation

$600 - $3,500One piece of straight run 6-feet long has fallen off and is laying on top of the plaster ceiling (all above the drop ceiling)

8T02.01 2107 Main Hospital 245 3" Pipe Joint Insulation each Remove damaged insulation and clean any debris or

Remove all ACM joint insulation

$150 - $1,2002 elbows are significantly damaged laying on top of the drop ceiling tiles

(center east side of room).

17T02.01 2107 Main Hospital 401 3" Pipe Joint Insulation each Remove/repair damaged insulation and clean any debris or

Remove all ACM joint

$800 - $4,500

130T03.01 2107 Main Hospital 401 3" Straight Run Insulation ln. ft. Remove/repair damaged insulation and clean any debris or Remove all ACM pipe

$300 - $3,000Above ceiling tile grid

2000M16.03 2107 Main Hospital E. Roof Silver Painted Sealant on

HVAC ducting on roof

sq. ft. Remove/repair deteriorated sealant and any debris or Remove all ACM sealant

$850 - $12,000

(1) Material Codes: T - Thermal Systems Insulation; S - Surfacing Material (Sprayed or Troweled-on); M - Miscellaneous Material; F - Miscellaneous Material (Floor Covering)

4/19/2012 Page 1 of 1Printed: Northern Arizona Veterans Affairs Health Care System

TABLE OF CONTENTS

EXECUTIVE SUMMARY

1.0 INTRODUCTION

1.1 Scope of Work

2.0 SURVEY PROCEDURES

2.1 Building Inspection

2.2 Bulk Sampling

2.3 Bulk Sample Analysis

3.0 SURVEY FINDINGS

3.1 ACBM

3.2 Non-ACBM

3.3 Damage and Hazard Assessment

3.3.1 Hazard Rank Codes

3.4 Special Considerations

3.4.1 Roofing Materials

3.5 Inaccessible Areas

4.0 APPLICABLE RULES AND REGULATIONS

4.1 Renovation and Demolition (EPA and OSHA)

5.0 COST ESTIMATES FOR REMOVAL

6.0 PROJECT LIMITATIONS

APPENDICES

Appendix A - Summary Tables

Table 1: Summary of Asbestos-Containing Building Materials (ACBM) Table 2: Summary of Non-ACBM Table 3: Room-by-Room Inspection and Assessment Findings Table 4: Bulk Sample Log Table 5: Homogeneous Materials with Room-by-Room Inspection and Assessment

Findings Table 6: ACBM Removal Cost Estimates

Appendix B: Building Description & Floor Plans Appendix C: Laboratory Analytical Results Appendix D: Inspector Certificates

Bob Stump VAMC – Building 107 TOC-1 IHI Environmental

ABBREVIATIONS AND DEFINITIONS

Asbestos: A group of naturally occurring minerals that separate into fibers. Asbestos fibers are incombustible, are chemically resistant, and are characterized by the properties of thermal and electrical insulation. There are six asbestos minerals used commercially: chrysotile, amosite, crocidolite, tremolite, anthophyllite, and actinolite. This includes any of these minerals that have been chemically treated and/or altered.

Asbestos abatement: Procedures to remove ACBM from buildings with the simultaneous control of the release of asbestos fibers. Additionally, this includes activities focused on the encapsulation, encasement, repair, and enclosure of ACBM.

Asbestos Containing Building Material (ACBM): Surfacing ACBM, TSI ACBM, or miscellaneous ACBM found in or on interior structural members or other parts of a building.

This definition is used in the AHERA regulations for school buildings.

Asbestos abatement contractor: An Arizona-licensed asbestos removal company.

Asbestos-Containing Materials (ACM): The US EPA and OSHA define this as a material containing more than 1% by weight of the regulated asbestos minerals.

Asbestos Coordinator: The designated VA Facilities Service employee is the single contact point for all ACBM issues on the VA campus.

Asbestos Hazard Emergency Response Act (AHERA): The federal Asbestos Hazard Emergency Response Act of 1986 and the Environmental Protection Agency implementing regulations, 40 CFR Part 763, Subpart E - Asbestos-Containing Materials in Schools. The passage of AHERA by Congress led to the promulgation by EPA of two additional regulations:

the Asbestos School Hazard Abatement Reauthorization Act (ASHARA) and the Model Accreditation Plan (MAP), which outlines the requirements for accreditation of inspectors and personnel conducting asbestos activities in schools.

Asbestos inspection: Any activity undertaken to determine the presence or location, or to assess the condition, of asbestos-containing material or suspected asbestos-containing material, whether by visual or physical examination, or by taking samples of the material. This term includes reinspections of the type described in AHERA, 40 CFR 763.85(b), of known or assumed asbestos-containing material which has been previously identified.

Asbestos project: Any activity involving the removal, renovation, repair, demolition, salvage, disposal, cleanup, or other disturbance of regulated asbestos-containing material greater than small scale short duration.

Demolition: The wrecking, salvage, or removal of any load-supporting structural member of a structure together with any related handling operations, or the intentional burning of any structure. This includes the moving of an entire building.

Disturb: To disrupt the matrix of ACM or regulated asbestos-containing material, crumble, or pulverize ACM or regulated asbestos-containing material, or generate visible debris from ACM or regulated asbestos-containing material.

Bob Stump VAMC – Building 107 TOC-2 IHI Environmental

Bob Stump VAMC – Building 107 TOC-3 IHI Environmental

Friable Asbestos-Containing Material: Friable asbestos-containing material refers to materials which are capable of being crumbled, pulverized, or reduced to powder by hand pressure when dry. Friable asbestos-containing materials are usually found on overhead surfaces, including steel beams, pipes, and ceilings. This may also include previously non-friable material which becomes broken or damaged by mechanical force.

Inaccessible: Physically restricted or obstructed area or covered in such a way that detection or removal is prevented or severely hampered.

Miscellaneous ACM: Interior building material on structural components, structural members or fixtures, such as floor and ceiling tiles. This does not include surfacing material or TSI.

Non-friable ACM: Material of greater than 1 percent asbestos into which the fibers have been locked by a bonding agent, coating, binder, or other material in order to prevent the release of fibers during any appropriate use, handling, storage, transportation, or processing.

Non-friable asbestos-containing materials are usually found in the form of roofing, flooring, and siding materials. When previously non-friable asbestos becomes damaged to the extent that when dry it may be crumbled, pulverized or reduced to a powder during the removal, renovation, or demolition process, it should now be categorized as friable material. This material is considered hazardous during removal and disposal procedures.

Operations and Maintenance (O&M) Plan: A plan of safe work practices and procedures intended to maintain ACBM in good condition and minimize asbestos exposure to building occupants and VA employees, while complying with federal, state, and local regulations.

Presumed Asbestos-Containing Material (PACM): Thermal system insulation and surfacing material found in buildings constructed no later than 1980. OSHA requires that building owners identify PACM in their buildings and treat the PACM as asbestos-containing materials (ACM) until the materials are proven not to contain asbestos. Although not defined strictly as PACM, both OSHA standards also require asphalt and vinyl flooring material installed no later than 1980 be "considered" and "treated" as asbestos-containing, until the building owner proves the flooring is not ACM. This includes not only the flooring material, but associated mastics and backings.

Regulated Asbestos-Containing Material (RACM): Friable asbestos material, Category I non-friable ACM that has become friable, Category I non-friable ACM (vinyl asbestos tile, roofing felts, gaskets and packing) that will be or has been subjected to sanding, grinding, cutting, or abrading, or Category II non-friable ACM (asbestos board, transite, and asbestos shingles) that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations regulated by this subpart.

Surfacing material: Material that is sprayed, troweled, or otherwise applied to surfaces (such as acoustical plaster on ceilings and fireproofing materials on structural members, or other materials on surfaces for acoustical, fireproofing, and other purposes).

Thermal System Insulation (TSI): Asbestos-containing material applied to pipes, fittings, boilers, breeching, tanks, ducts, or other interior structural components to prevent heat loss/gain or water condensation.

1.0 INTRODUCTION

In January 2011, IHI Environmental conducted an asbestos survey of Building 107 on the

Bob Stump Veterans Affairs Medical Center (VAMC) campus located at 500 North Highway

89 in Prescott, Arizona. Mr. Eric Towles was the Contract Officer Technical Representative for this project.

1.1 Scope of Work

The objective of this inspection was to determine the presence and condition of all ACBM and to recommend response actions for the materials identified. The scope of work for this inspection was outlined in solicitation VA-258-11-RP-0424.

To accomplish this survey, IHI identified all accessible areas in each building by name, functional space, and room number, and then collected bulk samples of each suspect material according to AHERA sampling protocols and protocols outlined in the VA solicitation.

Tables 3 and 5 (Appendix A) identify the building, functional spaces, rooms, materials, quantities, condition, hazard rank, and any recommended response actions.

2.0 SURVEY PROCEDURES

The asbestos survey was performed using the inspection protocol developed for schools under Asbestos Hazard Emergency Response Act (AHERA). Some deviations in standard sampling protocol were required by the Statement of Work.

2.1 Building Inspection

The building inspections were conducted by EPA-accredited inspectors. Inspections consisted of a detailed visual inspection and assessment of the condition and potential for disturbance of suspect ACBM. The specific components of the inspection and assessment included:

• Room-by-room identification and inspection of materials. Summaries of the suspect materials identified in each building are presented in the Data Tables included in Appendix A.

• An assessment of suspect, known, or assumed ACBM.

• Identification of suspect ACBMs, by material type, with a unique identifier. The material types are thermal system insulation (TSI), surfacing materials, and miscellaneous materials.

Bob Stump VAMC – Building 107 1 IHI Environmental

IHI uses a standardized numbering system to identify homogeneous materials during the survey. Letters T, F, S, or M designate material types as follows:

− Thermal System Insulation (pipe insulation, fittings, etc.): T01 - T10 (example:

T02.2 Hard Pipe Insulation)

− Floor Covering (floor tile, sheet vinyl, mastics and adhesives, floor leveling compounds, cove base, etc.): F01 - F07 (example: F04.4: 9”x9” Floor Tile – Gray)

− Surfacing Materials (texturing and fire-proofing): S01 - S02 − Miscellaneous Materials (roofing, sink undercoating, gypsum board, roofing, etc.): M01 – M17 (example: M10.1: Gray Window Caulk)

2.2 Bulk Sampling

Inspectors collected bulk samples of suspect ACBM and submitted the samples to an accredited laboratory for analysis. Bulk sample numbers are included in Table 4 (Appendix

A: Bulk Sample Log).

• IHI conducted its sampling in a manner that minimized damage to the building, did not leave unsightly marks, and did not create a health hazard for the inspector or building occupants.

• The number of samples collected from each homogeneous area was based on AHERA rules as modified by the requirements from the Statement of Work.

• Friable surfacing materials were sampled using the random sampling scheme given in the EPA publication 560/5-85-030a, titled, “Asbestos in Buildings: Simplified Sampling Scheme for Friable Surfacing Materials.”

• Unique sample numbers were assigned to each sample collected during the inspection. These numbers were entered on the chain-of-custody forms that accompanied the bulk samples to the analytical laboratory.

• Locations of bulk samples and confirmed ACM are identified on the Building Floor Plans (Appendix B).

2.3 Bulk Sample Analysis

Bulk samples were analyzed using polarized light microscopy (PLM) and visual estimation according to the EPA Interim Method for the Determination of Asbestos in Bulk Insulation

Samples, EPA-600/M4-82-020. The quantification of asbestos in a sample is intended to be an estimate only, and the limit of detection for this method is approximately 1% by weight, based on visual estimation.

Bob Stump VAMC – Building 107 2 IHI Environmental

Samples were analyzed by EMLab P&K offices in San Diego and San Bruno, California, and

Phoenix, Arizona. EMLab P&K is accredited under the National Institute of Standards and

Technology, National Voluntary Laboratory Accreditation Program (NIST-NVLAP) for bulk asbestos sample analysis, and is also accredited by the American Industrial Hygiene

Association (AIHA).

EPA’s National Emissions Standards for Hazardous Air Pollutants (NESHAP) and AHERA regulations define ACM as material containing greater than 1% asbestos by weight; materials containing 1% or less asbestos are not considered regulated ACM by the EPA. Further, the

NESHAP regulations state that any sample of friable material found to contain less than 10% asbestos but greater than “none detected,” by the visual estimation method used during PLM analysis, must be assumed to contain greater than 1% asbestos unless confirmed by NESHAP point counting analysis. The Statement of Work (SOW) for this project required that all materials sampled and determined to contain less than 3% asbestos shall be point counted.

The SOW further stipulated that non-friable organically bound materials such as vinyl floor tile, mastic, and roofing materials, containing less than 1% asbestos, shall be confirmed by transmission electron microscopy (TEM).

The laboratory reports are included in Appendix C.

3.0 SURVEY FINDINGS

3.1 ACBM

All ACBM is identified in Tables 1 and 5 (Appendix A). These tables describe the type of material, visual appearance, condition, friability, potential for disturbance, and identify any materials that require immediate actions. Locations of these materials are shown on the

Building Floor Plans (Appendix B).

3.2 Non-ACBM

Suspect materials are identified as non-ACBM if the material contains no detectable asbestos. Tables 2 and 3 (Appendix A) identify the non-ACBM materials.

3.3 Damage and Hazard Assessment

Each ACBM was assessed for damage, accessibility, and the potential for future damage.

This information is presented in Table 3 in Appendix A.

Bob Stump VAMC – Building 107 3 IHI Environmental

3.3.1 Hazard Rank Codes

Hazard Rank Codes were determined by assessing the material condition, accessibility, and potential for future disturbance. ACBM materials, including those that contain less than 1% but greater than none detected, were assigned a Hazard Rank Code 1, 2, 3 or 4. A Hazard

Rank Code of 1 requires some immediate response action. Materials assigned a Hazard Rank

Code 4 do not pose a significant risk and do not require immediate response. The Executive

Summary Table outlines the recommended response actions that accompany Hazard Rank

Codes 1 through 3.

• Hazard Rank Code 1 Materials – These materials are damaged or significantly damaged ACBM with a high fiber release potential. These materials require immediate isolation, removal, repair, encapsulation and/or enclosure by an Arizona-licensed asbestos abatement contractor.

• Hazard Rank Code 2 Materials – These materials are damaged or significantly damaged ACBM with a low to moderate fiber release potential. These materials require removal, repair, encapsulation and/or enclosure by an Arizona-licensed asbestos abatement contractor.

• Hazard Rank Code 3 Materials – These materials are intact (in good condition) but present a high potential for disturbance. These materials may be removed, enclosed, and/or labeled, or they may be managed in place in the Operations and Maintenance Plan. IHI recommends that any intentional contact with ACBM be performed by an Arizona-licensed asbestos abatement contractor.

• Hazard Rank Code 4 Materials – These materials are intact (in good condition), present a low to moderate potential for disturbance and can be managed under the Operations and Maintenance Plan. They should be inspected periodically, however, to ensure they do not deteriorate.

3.4 Special Considerations

Materials with peculiar configurations and materials assumed to be asbestos-containing are identified in Table 3 (Appendix A).

3.4.1 Roofing Materials

Roofing materials were sampled in accordance with the Summary of Work and when it was clear that such sampling would not compromise the integrity of the roof.

The roofing materials on this building were included in this survey.

Bob Stump VAMC – Building 107 4 IHI Environmental

3.5 Inaccessible Areas

Some building structures may have been constructed after the application of ACBM and, therefore, may have obscured these materials from visual examination during this inspection.

Typical scenarios include thermal system insulation inside hardened mechanical chases, floor tile and mastic under walls, and sprayed-on texturing and/or fireproofing behind structural supports or architectural features. Suspect materials that were hidden or inaccessible may not have been characterized by this inspection. Therefore, any material not identified in this report as having been tested should be treated as suspect ACBM until it has been properly sampled.

4.0 APPLICABLE RULES AND REGULATIONS

In Arizona, EPA asbestos regulations are administered by the State of Arizona, Department of Environmental Quality, Air Quality Compliance Section (Asbestos NESHAP Program).

The Arizona Division of Occupational Safety and Health (ADOSH) has adopted the Federal

OSHA regulations.

4.1 Renovation and Demolition (EPA and OSHA)

NESHAP regulations require the removal of friable ACBM and non-friable ACBM that could become friable during demolition activities. Despite EPA rules exempting building materials containing 1% or less asbestos from stringent regulation, OSHA regulations outline specific precautionary work practices when employees work with materials containing any detectable amount of asbestos. Compliance by building owners with the OSHA asbestos regulations may result in response actions not required by the EPA for certain unregulated materials.

5.0 COST ESTIMATES FOR REMOVAL

The estimated cost to remove all of the ACBM from this building is $360,000. This estimate assumes that all of the materials will be removed during a single planned abatement project.

A list of the costs associated with each of the various homogeneous materials identified during this survey is included in Table 6 (Appendix A).

These cost estimates are provided for the use of long-term budgeting and planning only and do not have a level of accuracy sufficient to be used as construction design cost estimates.

Bob Stump VAMC – Building 107 5 IHI Environmental

Bob Stump VAMC – Building 107 6 IHI Environmental

The actual cost of asbestos removal is highly dependent on the size of the project or quantity of materials removed in a single abatement project. The unit costs associated with small-scale emergency projects will typically be significantly greater than the costs associated with larger, planned projects. The removal costs shown in the Material Removal Unit Cost table attempt to capture the range of costs associated with a variety of removal scenarios.

Material replacement and consultant abatement management costs are not included in these estimates.

6.0 PROJECT LIMITATIONS

This project was performed using, as a minimum, practices consistent with standards acceptable within the industry at this time, and a level of diligence typically exercised by

EH&S consultants performing similar services.

The procedures used attempt to establish a balance between the competing goals of limiting investigative and reporting costs and time, and reducing the uncertainty about unknown conditions. Therefore, because the findings of this report were derived from the scope, costs, time and other limitations, the conclusions should not be construed as a guarantee that all universal, toxic and/or hazardous wastes have been identified and fully evaluated.

Furthermore, IHI assumes no responsibility for omissions or errors resulting from inaccurate information, or data, provided by sources outside of IHI or from omissions or errors in public records.

It is emphasized that the final decision on how much risk to accept always remains with the client since IHI is not in a position to fully understand all of the client's needs. Clients with a greater aversion to risk may want to take additional actions while others, with less aversion to risk, may want to take no further action.

Appendix A

Summary Tables

Summary of Asbestos-containing Building Materials

Building No.: 107 (Main Hospital)

Table 1

QuantityHomogeneous Material Description ACM Designation(2)(1)

12" Floor Tile - Yellow with Black Felt Paper (Black Mastic Only) >1% AsbestosF03.01 906 sq. ft.

12" Floor Tile - White with Black Felt Paper (Black Mastic Only) >1% AsbestosF03.02 12447 sq. ft.

12" Floor Tile - Brown with Black Felt Paper (Black Mastic Only) >1% AsbestosF03.03 1154 sq. ft.

12" Floor Tile - Orange with Black Felt Paper (Black Mastic Only) >1% AsbestosF03.04 973 sq. ft.

12" Beige with white streaks over green floor tile with black vapor barrier

(Black Mastic & Black Felt ACM)

>1% AsbestosF03.06 150 sq. ft.

12" light blue with white flecks w/sage mastic (ND by PLM; 0.133%

Chrysotile by TEM)

<= 1% AsbestosF03.09 198 sq. ft.

12" Gray w/Shades of gray flecks w/yellow mastic (ND by PLM; 4.803%

Chrysotile by TEM)

>1% AsbestosF03.17 30 sq. ft.

12" Lt. Yellow w/gray flecks and black mastic (Black Mastic Only) >1% AsbestosF03.19 110 sq. ft.

12" Dark Blue w/white streaks floor tile w/black mastic (Black Mastic

Only)

>1% AsbestosF03.20 1375 sq. ft.

12" White with beige flecks w/black mastic (Black Mastic Only) >1% AsbestosF03.21 200 sq. ft.

12" Off-white to yellow with beige flecks and black mastic (Black Mastic

Only)

>1% AsbestosF03.22 821 sq. ft.

9" Dark Green Floor Tile w/Black Vapor Barrier (Black Mastic Only) >1% AsbestosF04.01 81 sq. ft.

9" Light Green Floor Tile w/Black Vapor Barrier (Green Tile Only) <= 1% AsbestosF04.02 81 sq. ft.

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Table 1

QuantityHomogeneous Material Description ACM Designation(2)(1)

Sealant on Roof Penetrations >1% AsbestosM01.03 383 ln. ft.

Fire Door Core (Metal Door) >1% AsbestosM11.02 3 each

Silver Painted Sealant on HVAC ducting on roof <= 1% AsbestosM16.03 2000 sq. ft.

Round light fixture w/heat shield and wiring (White Fibrous Material Only) >1% AsbestosM16.04 3 each

Ceramic Floor Tile Adhesive - Behind 12" Beige Tiles (Room 211 NOT

SAMPLED - Assumed ACM - Sample Before Disturbance)

>1% AsbestosM19.17 1714 sq. ft.

Exterior Surfacing (Skim Coat with Paint) >1% AsbestosS03.06 45000 sq. ft.

3" Pipe Joint Insulation >1% AsbestosT02.01 336 each

6" Pipe Joint Insulation >1% AsbestosT02.02 8 each

3" Straight Run Insulation >1% AsbestosT03.01 4579 ln. ft.

6" Straight Run Insulation >1% AsbestosT03.02 120 ln. ft.

Vibration Collar >1% AsbestosT04.01 4 each

HVAC Duct Tape >1% AsbestosT10.01 2500 ln. ft.

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Table 1

QuantityHomogeneous Material Description ACM Designation(2)(1)

(1) Material Codes: T - Thermal Systems Insulation; S - Surfacing Material (Sprayed or Troweled-on); M - Miscellaneous Material; F - Miscellaneous Material (Floor Covering)

(2) ACM Designation: >1% Asbestos - Asbestos-containing materials that contain greater than 1% asbestos and are regulated under EPA and State air quality regulations, and have requirements for worker protection under OSHA. <=1% Asbestos - Asbestos-containing materials that contain less than or equal to 1% asbestos and are NOT regulated under EPA or State air quality regulations, but have requirements for worker protection under OSHA.

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Summary of Non-Asbestos-containing Building Materials

Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

410 sq. ft.Tan Speckled Linoleum with Black Mastic None DetectedF01.01

6299 sq. ft.Linoleum Gray with blue and rose specks and yellow mastic None DetectedF01.02

1080 sq. ft.Brown Marbled Linoleum w/yellow mastic None DetectedF01.03

762 sq. ft.Light Beige linoleum w/white and beige flecks None DetectedF01.04

2489 sq. ft.Light wood grain linoleum None DetectedF01.05

480 sq. ft.Linoleum Light Beige w/Dark Beige Flecks self-adhering None DetectedF01.06

100 sq. ft.Linoleum Sage with green specks and yellow mastic None DetectedF01.07

1755 sq. ft.Linoleum Gray with gray specks None DetectedF01.08

425 sq. ft.Linoleum Lt. Blue with blue specks None DetectedF01.09

472 sq. ft.Light purple w/purple and blue specks linoleum None DetectedF01.10

476 sq. ft.Linoleum Lt. Gray with gray specks None DetectedF01.11

150 sq. ft.Linoleum Camouflage None DetectedF01.12

13272 sq. ft.12" Floor Tile - Beige with tan specks and yellow mastic None DetectedF03.05

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Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

5129 sq. ft.12" White with Gray Specks Floor Tile with yellow & residual mastic None DetectedF03.07

181 sq. ft.12" Blue Floor Tile with gray/yellow mastic None DetectedF03.08

1725 sq. ft.12" Dark Brown w/yellow mastic None DetectedF03.10

1677 sq. ft.12" Rust w/yellow mastic None DetectedF03.11

6294 sq. ft.12" Light Beige w/yellow mastic None DetectedF03.12

3166 sq. ft.12" Dark Beige w/yellow mastic None DetectedF03.13

230 sq. ft.12" Light Green w/yellow mastic None DetectedF03.14

42.5 sq. ft.12" Light Purple w/yellow mastic None DetectedF03.15

1187 sq. ft.12" White w/Blue Squigglies w/black mastic None DetectedF03.16

220 sq. ft.12" Chocolate swirl w/gray mastic None DetectedF03.18

130 sq. ft.12' blue with blue flecks w/yellow mastic None DetectedF03.23

30 sq. ft.Black Floor Tile Mastic None DetectedF06.01

350 sq. ft.Upper Flat Roof (ND by TEM) None DetectedM01.01

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Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

6200 sq. ft.Green Asphalt Shingles with Felt (ND by TEM) None DetectedM01.02

67950 sq. ft.Drywall (walls on B, 1, 2W, and 4) None DetectedM03.01

11135 sq. ft.Drywall composite 5th floor None DetectedM03.02

43750 sq. ft.Drywall composite 2E and 3rd floor remodels None DetectedM03.03

2950 sq. ft.Drywall composite 1st floor 107 labs (new construction) None DetectedM03.04

450 sq. ft.Drywall composite new bathroom room 410A None DetectedM03.05

98288 sq. ft.Plaster (walls and/or ceilings) None DetectedM05.01

100 sq. ft.Plaster Light weight patch None DetectedM05.02

5449 sq. ft.12" Ceiling Tile Type I - White Worm Hole Pattern None DetectedM09.01

2145 sq. ft.2' x 4' Ceiling Tile Type II - White some cut down None DetectedM09.02

3185 sq. ft.2' x 4' Ceiling Tile Type III - Wormhole some cut down None DetectedM09.03

8161 sq. ft.2' x 4' Ceiling Tile Type I - White Bumpy with pinholes (some cut down) None DetectedM09.04

681 sq. ft.2' x 4' Ceiling Tile Type IV - White pinhole pattern None DetectedM09.05

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Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

2469 sq. ft.2' x 4' Ceiling Tile Type VII - White w/Contact paper (gray spots - some cut down)

None DetectedM09.06

3953 sq. ft.2' x 4' Ceiling Tile Type V - White Solid None DetectedM09.07

14852 sq. ft.2' X 4' Ceiling Tile - Type VI White small fissures some cut down None DetectedM09.08

790 sq. ft.2' x 2' Ceiling Tile - Type I White Recessed Rough Pinhole None DetectedM09.09

1985 sq. ft.2' x 4' Ceiling Tile White Solid w/Texture paper some cut down None DetectedM09.10

275 sq. ft.12" White Ceiling Tile with holes and tan adhesive None DetectedM09.11

600 sq. ft.12" White Small Fissures Ceiling Tile and brown adhesive None DetectedM09.12

977 sq. ft.2' x 4' Solid White Ceiling Tile with sandpaper finish (some cut down) None DetectedM09.13

75 sq. ft.2' x 2' Ceiling Tile - Type II White Recessed small fissure None DetectedM09.14

19940 sq. ft.2' x 4' Ceiling Tiles - Type I - some cut down (Rooms 200B, 246, & 252) None DetectedM09.M6B1

250 ln. ft.Window Glazing None DetectedM10.01

6 eachFire Door Core (Wooden Door) None DetectedM11.01

13 eachBlack Sink Undercoating None DetectedM15.01

4/19/2012 Page 4 of 10Printed: Northern Arizona Veterans Affairs Health Care System

Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

9 eachBlack Sink Undercoating (New Sinks) None DetectedM15.02

12 eachGray Sink Undercoating None DetectedM15.03

2 eachWhite sink undercoating None DetectedM15.04

1877 sq. ft.Ceiling Tile Adhesive - Brown None DetectedM16.01

4650 sq. ft.Concrete Floor None DetectedM16.02

70 sq. ft.Cork ceiling tile adhesive None DetectedM16.05

650 sq. ft.Front Stairs Concrete None DetectedM16.06

650 sq. ft.Transformer Pad Concrete None DetectedM16.07

25000 sq. ft.Building Concrete None DetectedM16.08

274 sq. ft.Ceramic Floor Tile - Multi-Pattern (Room 256) None DetectedM18.M2D

1235 sq. ft.Ceramic Wall Tile - White 4 x 4 (Rooms 200A & 213) None DetectedM18.M4E

3020 sq. ft.Ceramic Tile Wall Adhesive - behind 4" Beige wall tile None DetectedM19.01

219 sq. ft.Ceramic Tile Floor Adhesive - behind 2" Tan tile None DetectedM19.02

4/19/2012 Page 5 of 10Printed: Northern Arizona Veterans Affairs Health Care System

Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

900 sq. ft.Ceramic Wall Tile Adhesive - Behind 4" Yellow tiles None DetectedM19.03

305 sq. ft.Ceramic Floor Tile Adhesive - under 1" green tiles None DetectedM19.04

1100 sq. ft.Ceramic Wall Tile Adhesive (behind 4" Off-white, Blue and Rose) None DetectedM19.05

535 sq. ft.Ceramic Floor Tile Adhesive (under 2" Off-white, Blue and Rose) None DetectedM19.06

1232 sq. ft.Ceramic Wall Tile Adhesive behind 4" White None DetectedM19.07

300 sq. ft.Ceramic Wall Tile Adhesive - Gray behind 4" green and gray tiles None DetectedM19.08

3240 sq. ft.Ceramic Wall Tile Adhesive - behind 6" beige tiles None DetectedM19.09

687 sq. ft.Ceramic Floor Tile Adhesive - under 1" blue tiles None DetectedM19.10

320 sq. ft.White ceramic tile adhesive behind 4" light brown ceramic tiles None DetectedM19.11

112 sq. ft.Gray adhesive under 1" light brown ceramic tiles None DetectedM19.12

500 sq. ft.White adhesive behind 4" x 6" off-white ceramic tile None DetectedM19.13

370 sq. ft.Gray adhesive under 2" x 1", 2" x 2" off-white, 1" x 1" lt. blue, and 1" x 1" beige ceramic tile

None DetectedM19.14

1550 sq. ft.Gray adhesive under off-white 4" x 4" ceramic wall tile None DetectedM19.15

4/19/2012 Page 6 of 10Printed: Northern Arizona Veterans Affairs Health Care System

Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

1539 sq. ft.White cementitious Adhesive under 2" and/or 6" cream colored ceramic floor tile

None DetectedM19.16

300 sq. ft.Gray adhesive behind new 4" beige ceramic tiles None DetectedM19.18

93 sq. ft.Gray adhesive under new 2" tan ceramic tiles None DetectedM19.19

725 sq. ft.Ceramic Floor Tile Adhesive (Rooms 256, 257, & 258) None DetectedM19.M2C1

1025 sq. ft.Ceramic Wall Tile Adhesive - Brown (Rooms 201, 252, & 256) None DetectedM19.M4F

344 sq. ft.Ceramic Floor Tile Adhesive (Rooms 200B, 256, & 257) None DetectedM19.M4G

790 sq. ft.Ceramic Tile Wall Grout on 4" Beige wall tile None DetectedM20.01

85 sq. ft.Ceramic Tile Floor Grout on 2" Tan tile None DetectedM20.02

235 sq. ft.Ceramic Wall Tile Grout - White on 4" Yellow tiles None DetectedM20.03

161 sq. ft.Ceramic Floor Tile Grout - Gray on 1" green tiles None DetectedM20.04

237 sq. ft.Off-White Ceramic Wall Tile Grout (on 4" Off-white, Blue and Rose) None DetectedM20.05

125 sq. ft.Gray Ceramic Floor Tile Grout (on 2" Off-white, Blue and Rose) None DetectedM20.06

220 sq. ft.Ceramic Wall Tile Grout - 4" White None DetectedM20.07

4/19/2012 Page 7 of 10Printed: Northern Arizona Veterans Affairs Health Care System

Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

20 sq. ft.Ceramic Wall Tile Grout - Tan on 4" green and gray tiles None DetectedM20.08

1520 sq. ft.Ceramic Wall and Floor Tile Grout - Tan on 6" beige wall and 12" Beige floor tiles

None DetectedM20.09

45 sq. ft.Gray grout on new 2" tan ceramic tiles None DetectedM20.10

236 sq. ft.Ceramic Floor Tile Grout - Gray on 1" blue tiles None DetectedM20.11

160 sq. ft.White grout on 4" light brown ceramic tiles None DetectedM20.12

75 sq. ft.Brown grout on 1" lt. brown ceramic tiles None DetectedM20.13

100 sq. ft.White grout on 4" x 6" off-white ceramic tile None DetectedM20.14

165 sq. ft.Gray grout on 2" x 1", 2" x 2" off-white, 1" x 1" lt. blue, and 1" x 1" beige ceramic tile

None DetectedM20.15

850 sq. ft.White grout on off-white 4" x 4"cream colored ceramic wall tile None DetectedM20.16

765 sq. ft.Gray grout on 2" and/or 6" cream colored ceramic floor tile None DetectedM20.17

75 sq. ft.White grout on new 4" beige ceramic tiles None DetectedM20.18

120 sq. ft.Ceramic Floor Tile Grout - Gray (Rooms 256, 257, & 258) None DetectedM20.M2B1

350 sq. ft.Ceramic Wall Tile Grout - White (Rooms 201, 252, & 256) None DetectedM20.M4E

4/19/2012 Page 8 of 10Printed: Northern Arizona Veterans Affairs Health Care System

Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

250 sq. ft.Light Brown Cementitious Fireproofing 5th floor None DetectedS02.01

3480 sq. ft.Sprayed-on Structural Fire Proofing 5th floor None DetectedS02.02

13070 sq. ft.Sprayed on Fireproofing 3rd Floor None DetectedS02.03

1355 sq. ft.Structural Fireproofing 3rd floor East Side None DetectedS02.04

2903 sq. ft.Sprayed on fireproofing gray (soft) None DetectedS02.05

2900 sq. ft.Structural Fireproofing (Rooms 200B, 226, 240, 249 or 250, 261, & 266) None DetectedS02.S7A1

36660 sq. ft.Sprayed-on Wall Texture Floors 1, 2E, 4, & 5 None DetectedS03.01

650 sq. ft.Trowelled on wall texture Type I None DetectedS03.02

1925 sq. ft.Trowelled on wall texture Type II None DetectedS03.03

800 sq. ft.Sprayed-on Wall Texture Type II None DetectedS03.04

350 sq. ft.Trowelled on wall texture Type III None DetectedS03.05

7400 sq. ft.Exterior Stucco/Surfacing None DetectedS03.07

11750 sq. ft.Drywall Texture (Rooms 200B, 252, & 256) None DetectedS03.S4C1

4/19/2012 Page 9 of 10Printed: Northern Arizona Veterans Affairs Health Care System

Table 2

QuantityHomogeneous Material Description ACM Designation(2)(1)

(1) Material Codes: T - Thermal Systems Insulation; S - Surfacing Material (Sprayed or Troweled-on); M - Miscellaneous Material; F - Miscellaneous Material (Floor Covering)

(2) ACM Designation: None Detected - No asbestos was detected and therefore the material is not regulated under EPA, State air quality regulations, or OSHA (for asbestos concerns).

4/19/2012 Page 10 of 10Printed: Northern Arizona Veterans Affairs Health Care System

Room-by-Room Inspection and Assessment Findings

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

000B (Corridor)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 50 sq. ft.

ND None Detected PLM

ND None Detected TEM

F03.14 (12" Light Green w/yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 650 sq. ft.

F03.07 (12" White with

Gray Specks Floor Tile with yellow & residual mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 50 sq. ft.

ND None Detected PLMF03.14 (12" Light Green w/yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 50 sq. ft.

ND None Detected PLMF03.14 (12" Light Green w/yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 5 sq. ft.

ND None Detected PLM

ND None Detected TEM

F03.15 (12" Light Purple w/yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

4/19/2012 Page 1 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

000B (Corridor)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 5 sq. ft.

ND None Detected PLMF03.15 (12" Light Purple w/yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 5 sq. ft.

ND None Detected PLMF03.15 (12" Light Purple w/yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 150 sq. ft.

M09.M6B1 (2' x 4' Ceiling

Tiles - Type I - some cut down (Rooms 200B, 246, & 252))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 600 sq. ft.

ND None Detected PLMM09.08 (2' X 4' Ceiling

Tile - Type VI White small fissures some cut down)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 1800 sq. ft.

ND None Detected PLMM05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 2 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

001 (Female Locker Room)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 275 sq. ft.

F03.07 (12" White with

Gray Specks Floor Tile with yellow & residual mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 400 sq. ft.

M03.01 (Drywall (walls on

B, 1, 2W, and 4))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

001A (Restroom)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 109 sq. ft.

M19.14 (Gray adhesive under 2" x 1", 2" x 2" off-white, 1" x 1" lt. blue, and

1" x 1" beige ceramic tile)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 400 sq. ft.

M05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 3 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

001A (Restroom)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 2 each

M16.04 (Round light fixture w/heat shield and wiring (White Fibrous

Material Only))

>1%

Asbestos

Hazard Assessment Comments:

Sample Comments:

Friable Good No YesPeriodically Moderate 4

Quantity: 40 sq. ft.

M20.15 (Gray grout on 2" x 1", 2" x 2" off-white, 1" x

1" lt. blue, and 1" x 1" beige ceramic tile)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

002A (Storage)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 79 sq. ft.

M09.08 (2' X 4' Ceiling

Tile - Type VI White small fissures some cut down)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 350 sq. ft.

M19.03 (Ceramic Wall

Tile Adhesive - Behind 4"

Yellow tiles)

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 4 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

002A (Storage)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 100 sq. ft.

M20.03 (Ceramic Wall

Tile Grout - White on 4"

Yellow tiles)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 79 sq. ft.

M19.02 (Ceramic Tile

Floor Adhesive - behind 2"

Tan tile)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 300 sq. ft.

M05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 40 sq. ft.

M20.02 (Ceramic Tile

Floor Grout on 2" Tan tile)

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 5 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

002B (Office)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 119 sq. ft.

M09.08 (2' X 4' Ceiling

Tile - Type VI White small fissures some cut down)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 350 sq. ft.

M05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 350 sq. ft.

M03.01 (Drywall (walls on

B, 1, 2W, and 4))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

002C (Office)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 150 sq. ft.

M09.M6B1 (2' x 4' Ceiling

Tiles - Type I - some cut down (Rooms 200B, 246, & 252))

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 6 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

002C (Office)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 400 sq. ft.

M05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 400 sq. ft.

M03.01 (Drywall (walls on

B, 1, 2W, and 4))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 179 sq. ft.

F01.02 (Linoleum Gray with blue and rose specks and yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 30 sq. ft.

M09.08 (2' X 4' Ceiling

Tile - Type VI White small fissures some cut down)

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 7 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

003 (Morgue)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 24 ln. ft.

T03.01 (3" Straight Run

Insulation)

>1%

Asbestos

Hazard Assessment Comments:

Sample Comments:

Friable Good No YesPeriodically Moderate 4

Quantity: 2 each

T02.01 (3" Pipe Joint

Insulation)

>1%

Asbestos

Hazard Assessment Comments:

Sample Comments:

Friable Good No YesPeriodically Moderate 4

Quantity: 148 sq. ft.

M09.M6B1 (2' x 4' Ceiling

Tiles - Type I - some cut down (Rooms 200B, 246, & 252))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 400 sq. ft.

M05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 148 sq. ft.

F03.05 (12" Floor Tile -

Beige with tan specks and yellow mastic)

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 8 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

004 (Unoccupied)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 250 sq. ft.

M05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 30 sq. ft.

Black Mastic 2% Chrysotile PLM

Green Tile < 1%

Felt

Green Tile < 0.25%

Chrysotile PLM

None Detected PLM

Chrysotile Point Count

F04.01 (9" Dark Green

Floor Tile w/Black Vapor

Barrier (Black Mastic

Only))

>1%

Asbestos

Hazard Assessment Comments:

Sample Comments:

Category 1

Non-friable

Good No NoPeriodically Moderate 4

Quantity: 30 sq. ft.

Black Mastic None Detected PLM

Green Tile < 1%

Felt

Chrysotile PLM

None Detected PLM

F04.02 (9" Light Green

Floor Tile w/Black Vapor

Barrier (Green Tile Only))

<= 1%

Asbestos

Hazard Assessment Comments:

Sample Comments:

Category 1

Non-friable

Good No NoPeriodically Moderate 4

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

005 (Restroom)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 50 sq. ft.

M20.01 (Ceramic Tile

Wall Grout on 4" Beige wall tile)

None

Detected

Hazard Assessment Comments:

Sample Comments:

4/19/2012 Page 9 of 603Printed: Northern Arizona Veterans Affairs Health Care System

Table 3

Hazard

RankAccessibility

Disturbance

Potential ACM? Homogeneous Material

Friability

Category

Analytical

Result

Type of

Asbestos

Analytical

Method Condition

Clean/Repair

Needed?

Labeling

Needed?

005 (Restroom)Room #:

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

Quantity: 400 sq. ft.

M05.01 (Plaster (walls and/or ceilings))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 50 sq. ft.

M20.04 (Ceramic Floor

Tile Grout - Gray on 1" green tiles)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 100 sq. ft.

M09.M6B1 (2' x 4' Ceiling

Tiles - Type I - some cut down (Rooms 200B, 246, & 252))

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 100 sq. ft.

M19.04 (Ceramic Floor

Tile Adhesive - under 1" green tiles)

None

Detected

Hazard Assessment Comments:

Sample Comments:

N/A N/A N/A N/AN/A N/A N/A

Quantity: 150 sq. ft.

M19.01 (Ceramic…