R11_-_VA0003ZZ_2016_asbestos_survey_report_(1).pdf

OPERATIONS AND MAINTENANCE INSPECTION REPORT

MARTIN V. BOSTETTER COURTHOUSE (VA0003ZZ)

Prepared for:

General Services Administration

Safety Environment and Fire Protection Branch National Capital Region

301 7th Street, S.W., Room 2080 Washington, DC 20407

Prepared By:

TTL-Arc Environmental, JV LLC

November 25, 2016

Contract No. GS11P-12-DC-C-0008

PDN No. PJ4NA1560 Order No. GS-P-11-15-DC-5007

Reviewed by:

Stacy Kahatapitiya, CHMM, LEED GA Jean Mlynek, CIH, Project Manager Certified Industrial Hygienist

JV

Table of Contents

1.0 INTRODUCTION

2.0 SCOPE AND OBJECTIVES

3.0 LOCATIONS OF ACBM

3.1 Previous Surveys

3.2 Current Survey (2016)

4.0 RECOMMENDATIONS

APPENDICES

APPENDIX A Asbestos-Containing Materials Inventory APPENDIX B Non-Asbestos Containing Materials Inventory APPENDIX C Laboratory Analytical Results APPENDIX D GSA Inspection Forms APPENDIX E Accreditation Information APPENDIX F Site Drawings APPENDIX G Summary of Abatement Actions

Asbestos Operations and Maintenance Inspection Report November 2016 Martin V. Bostetter Courthouse (VA0003ZZ)

1.0 INTRODUCTION

In accordance with our Industrial Hygiene Services contract with the General Services Administration (GSA), TTL-Arc Environmental, JV (TTL-Arc) completed the Asbestos Hazard Emergency Response Act (AHERA) Operations and Maintenance (O&M) inspection of the Martin V. Bostetter Courthouse (Bostetter Courthouse) (VA0003ZZ). The Bostetter Courthouse is located at 200 South Washington Street in Alexandria, Virginia. The purpose of the survey was to assess previously identified asbestos-containing materials (ACMs) and to identify and sample additional suspect ACMs not previously identified.

2.0 SCOPE AND OBJECTIVES

The principle objective of the O&M Survey was to conduct a visual inspection of known asbestos containing building materials (ACBMs) and presumed asbestos containing building materials (PACMs) within the building to verify quantities and conditions. Limited bulk sampling of previously unidentified materials which are suspect to contain asbestos were also conducted as part of the inspection; sampling was prioritized by material type and potential for disturbance. Sampling within the Bostetter Courthouse was limited to 30 samples per the contract.

3.0 LOCATIONS OF ACBM

Multiple surveys and re-inspections have been conducted over the years, with the most recent re-inspection occurring in October 2014. This section summarizes the previous survey data and analytical results made available to TTL-Arc for review. A full inventory of ACMs is provided in Appendix A; a list of sampled suspect materials which were determined to be non-asbestos containing is included in Appendix B. Laboratory analytical results for all samples collected within the building is included in Appendix C. Copies of the GSA asbestos inspections forms are provided in Appendix D.

3.1 Previous Surveys

Previous surveys have identified ACMs within the building in the form of floor tiles, thermal system insulation (TSI), and miscellaneous materials. These materials were verified during the 2016 survey and are listed in Appendix A.

3.2 Current Survey (2016)

TTL-Arc reviewed the 2014 re-inspection report provided by GSA. The areas previously identified as ACMs were inspected to verify the quantity and evaluate the condition of the materials. A visual inspection of accessible portions of the entire building was also conducted to identify and sample materials suspect to be asbestos-containing which were not previously identified; areas which were not accessible at the time of the survey included the following locations:

Suite 200 Judge’s Chamber U.S. Marshall’s Service Court Security

Per the contract language, GSA did not allow samples to be collected in rooms which were occupied. Any suspect ACMs in occupied rooms or inaccessible areas that could not be sampled were classified as Presumed ACMs (PACMs). Unless proven otherwise, PACMs must be treated as asbestos-containing.

The asbestos survey and bulk sample collection was conducted by TTL-Arc’s Asbestos Building Inspector, Mr. Derek Kwon. Mr. Kwon has received asbestos inspector training from a training provider accredited by the U.S. Environmental Protection Agency (USEPA).

3.2.1 Methodology

TTL-Arc conducted the asbestos survey under protocols established by USEPA 40 Code of Federal Regulations (CFR) 763 Asbestos Hazard Emergency Response Act (AHERA) and 40 CFR 61 Subpart M, National Emission Standards for Hazardous Air Pollutants (NESHAP). GSA-established protocols for asbestos bulk sampling were also adhered to during the survey.

Every reasonable attempt was made to locate ACMs present as TSI, surfacing material, or other miscellaneous materials which had not been previously identified. Specifically, TTL-Arc employed the following protocols while performing the survey: flooring materials were penetrated to the subfloor to determine how many layers of flooring were present; wall systems and ceiling systems were evaluated to identify suspect building materials associated with the systems themselves, as well as any accessible cavities; and mechanical insulation systems were evaluated to identify potential suspect insulation.

During the survey, TTL-Arc collected a total of 32 bulk samples of suspect materials from within the building. Several suspect ACMs were presumed to be asbestos-containing until such a time when additional bulk sampling is authorized. The bulk samples were submitted, along with the corresponding chain-of-custody documentation, to EMSL Analytical, Inc. (EMSL) to determine the presence of asbestos in the sampled materials. EMSL is accredited for the analysis of asbestos in bulk materials through the National Voluntary Laboratory Accreditation Program (NVLAP). A total of 43 analyses resulted from the 26 submitted samples based on requirements to analyze discrete layers present within the bulk materials. The bulk samples were analyzed using polarized light microscopy (PLM/Dispersion Staining following the EPA method 600/R-93/116, Method for the Determination of Asbestos in Bulk Building Materials). Based on the United States Environmental Protection Agency's (USEPA’s) definition, a material which contains greater than one percent (1%) asbestos, as determined using the methods specified in Appendix E, Subpart E, 40 CFR Part 763, Section 1, Polarized Light Microscopy (PLM), is considered an ACM and must be handled according to OSHA, USEPA, and Commonwealth of Virginia regulations.

3.2.2 Results

Based on the laboratory analytical results, none of the materials sampled during the current survey were determined to be asbestos-containing by PLM analysis. Additionally, thirteen (13) materials were categorized as PACMs due to conditions preventing these materials from being sampled.

Table 1, below, summarizes previously unidentified suspect materials that were determined to be asbestos-containing by laboratory analysis or assumed to be asbestos-containing during the current survey. A comprehensive list of all previously and newly identified asbestos-containing materials located within the building can be found in Appendix A; a list of materials which were tested and found to not contain asbestos are included in Appendix B.

Table 1: Asbestos-containing Materials Identified During 2016 Survey

HA Material Description Location Quantity Sample Number Result

TZ1

Brown, Grey and Beige Stone

Design Terrazzo

3rd fl. Stairwell/Elevator Lobby, 2nd fl.

Stairwell/Elevator Lobby, Men’s

Restrooms, Women’s Restroom, 3rd fl.

Mech. Room, 1st fl. Security Station, 1st

fl. Hallway, Basement Restroom

3,934 SF N/A PACM

CT1

1’x1’ Ceiling Tile with Fissure and Mastic Daub Courtroom 3 1,302 SF N/A PACM

CT2

2’x2’ Ceiling Tile with Divots and Pinholes Throughout the Building 4,544 SF N/A PACM

SI1 Beige Sink Undercoating 300 Suite Kitchen 1 EA N/A PACM

PL3 Decorative Plaster

3rd fl. Hallway, 2nd fl. Hallway, 2nd fl.

Stairwell Lobby/Elevator Lobby, Lobby outside Rm. 207, 1st fl. Security Station, 1st fl. Hallway, Suite 103 Lunch Room, 1st

fl. Old Courtroom

1,026 SF N/A PACM

FD1 Fire Door

3rd fl. Elevator Lobby, 2nd fl. Elevator Lobby, 1st fl. Elevator Lobby, Basement Telephone Closet, Basement Electrical

Closet, Chiller Room

14 EA N/A PACM

VT1

12”x12” White Floor Tile with Grey Streaks and Associated

Mastic 300 Suite Kitchen 72 SF N/A PACM

VT2

12”x12” White Floor Tile with Multi Different Color Streaks and Associated Mastic Suite 206 Judge’s Chamber Kitchen 221 SF N/A PACM

VT3

12”x12” Beige Mottled Floor Tile and Associated Mastic

Basement Hallway by Holding Cell (Cage Room), Pipe Room, Basement Storage

Room, Basement Back Hallway, Basement Main Hallway, Hallway outside large Storage Room

1,964 SF N/A PACM

Table 1: Asbestos-containing Materials Identified During 2016 Survey

HA Material Description Location Quantity Sample Number Result

VT4

12”x12” Light Grey Floor Tile with Dark Grey Streaks and Associated Mastic

Janitorial Storage Closet 156 SF N/A PACM

VT5

9”x9” Green Floor Tile underneath the carpet

Basement Storage 500 SF N/A PACM

BBM2

4” Red Baseboard and

Associated Mastic

1st fl. Back Office Suite Hallway, Back Office Suite Office 2, Office 3, Clerk

Station, Pipe Room, Basement Storage Room

378 LF N/A PACM

Noise Dampener

Noise Dampener 1st Fl. Old Court Room 800 SF N/A PACM

HA = Homogeneous Area

Asbestos Operations and Maintenance Inspection Report November 2016

4.0 RECOMMENDATIONS

The following recommendations are based on the results of the re-inspection:

All asbestos-containing or PACMs identified within this report should be maintained in good condition through the continuation of the Operations and Maintenance (O&M) Program;

Any damaged and/or significantly damaged ACBM identified during the re-inspection should be removed, enclosed, encapsulated, or repaired (Damaged materials are highlighted in yellow in Table 2); and

Materials which have not been sampled to determine asbestos-content should be treated as PACM and included in the O&M Program.

APPENDIX A

ASBESTOS-CONTAINING MATERIALS

INVENTORY

Table 2: Asbestos-Containing Materials Inventory

HA Sample Number Location Material

Description Quantity Friable Condition Results

Quantity of

Damage

Estimated Abatement

Costs

Recommended Response

Action

DIM1

BC-101614-02A,

BC-101614-02B,

BC-101614-02C

Attic Black Mastic on Duct Insulation

Wrap 159 LF No Damaged

Identified in 2014 Survey 14 LF $391.14 Repair

DIM2 N/A

Attic, 3rd fl. Mech.

Room

Beige Seam Sealant Mastic on Foil Duct

Wrap 82 LF No Damaged

Assumed in 2014 Survey

3 LF $201.72 Repair

DIM3 N/A

Attic, 2nd fl. Mech.

Room

Black Seam Sealant Mastic on Foil Duct

Wrap 30 LF No Damaged

Assumed in 2014 Survey

5 LF $73.80 Repair

DI1 N/A Chiller Room Duct Insulation 52 LF Yes Good Assumed in 2014 Survey

N/A $434.72 O&M

Fit1

BC-101614-04A,

BC-101614-04B,

BC-101614-04C

Attic, 3rd fl. Mech.

Room

Mudded Fitting 5 EA Yes Damaged Identified in 2014 Survey 1 EA $109.75 Remove

PI1 N/A

Attic, 2nd fl. Mech.

Room Cork Pipe Insulation with Black Mastic

235 LF No Good Assumed in 2014 Survey

N/A $1,964.60 O&M

PI2 N/A 3rd fl. Mech. Room Hard Mag Pipe

Insulation 10 LF Yes Good

Assumed in 2014 Survey

N/A $83.60 O&M

Material

Description Quantity Friable Condition Results

Quantity of

Damage

Estimated Abatement

Costs

Recommended Response

Action

PIM1 N/A

Attic, Basement Custodial Office, Pump Room, Hallway by Old

Holding Cell (Cage Room), Pipe Room, Telephone Closet 1, Electrical Closet, B13 Mech. Room, Basement Main Hallway, Chiller

Room, Large Storage Room, Computer

Storage Room, Server Room, Office next to Server Room, Janitorial Storage Closet

White Pipe Seam Sealant Mastic

1,601 LF No Damaged Assumed in 2014 Survey 26 LF $3,938.46 Repair

PIM2 N/A Attic Black Mastic on Pipe

Wrap 64 LF No Good

Assumed in 2014 Survey

N/A $157.44 O&M

PIW1 N/A Attic Paper Pipe Wrap with Foil Backing and Black Mastic

18 LF No Damaged Assumed in 2014 Survey 3 LF $44.28 Repair

VC1

BC-101614-01A,

BC-101614-01B,

BC-101614-01C

Attic Vibration Collar 26 LF No Damaged Identified in 2014 Survey 1 LF $45.00 Repair

Material

Description Quantity Friable Condition Results

Quantity of

Damage

Estimated Abatement

Costs

Recommended Response

Action

TZ1 N/A

3rd fl.

Stairwell/Elevator

Lobby, 2nd fl.

Stairwell/Elevator

Lobby, Men’s Restrooms, Women’s

Restroom, 3rd fl.

Mech. Room, 1st fl.

Security Station, 1st fl.

Hallway, Basement

Restroom

Brown, Grey and Beige Stone Design

Terrazzo 3,934 SF No Good PACM N/A $10,936.52 O&M

CT1 N/A Courtroom 3 1’x1’ Ceiling Tile with Fissure and

Mastic Daub 1,302 SF No Good

PACM N/A $2,343.60 O&M

CT2 N/A

Throughout the

Building

2’x2’ Ceiling Tile with Divots and

Pinholes 4,544 SF No Good PACM N/A $8,179.20 O&M

SI1 N/A 300 Suite Kitchen Beige Sink

Undercoating 1 EA No Good PACM N/A $307.40 O&M

PL3 N/A

3rd fl. Hallway, 2nd fl.

Hallway, 2nd fl.

Stairwell Lobby/Elevator

Lobby, Lobby outside Rm. 207, 1st fl.

Security Station, 1st fl.

Hallway, Suite 103 Lunch Room, 1st fl.

Old Courtroom

Decorative Plaster 1,026 SF No Good PACM N/A $10,218.96 O&M

Material

Description Quantity Friable Condition Results

Quantity of

Damage

Estimated Abatement

Costs

Recommended Response

Action

FD1 N/A

3rd fl. Elevator Lobby, 2nd fl. Elevator Lobby, 1st fl. Elevator Lobby, Basement Telephone

Closet, Basement Electrical Closet, Chiller Room

Fire Door 14 EA No Good PACM N/A $4,303.60 O&M

VT1 N/A 300 Suite Kitchen

12”x12” White Floor Tile with Grey

Streaks and Associated Mastic

72 SF No Good PACM N/A $200.16 O&M

VT2 N/A

Suite 206 Judges’ Chamber Kitchen

12”x12” White Floor Tile with Multi Different Color

Streaks and Associated Mastic

221 SF No Good PACM N/A $614.38 O&M

VT3 N/A

Basement Hallway by Holding Cell (Cage Room), Pipe Room, Basement Storage

Room, Basement Back Hallway, Basement

Main Hallway, Hallway outside large

Storage Room

12”x12” Beige Mottled Floor Tile and Associated Mastic

1,964 SF No Good PACM N/A $5,459.92 O&M

VT4 N/A

Janitorial Storage

Closet

12”x12” Light Grey Floor Tile with Dark

Grey Streaks and Associated Mastic

156 SF No Good PACM N/A $433.68 O&M

VT5 N/A Basement Storage 9”x9” Green Floor Tile underneath the carpet 500 SF No Good PACM N/A $1,390.00 O&M

Material

Description Quantity Friable Condition Results

Quantity of

Damage

Estimated Abatement

Costs

Recommended Response

Action

BBM2 N/A

1st fl. Back Office Suite Hallway, Back Office Suite Office 2, Office3, Clerk Station, Pipe Room, Basement

Storage Room

4” Red Baseboard and Associated

Mastic 378 LF No Good PACM N/A $929.88 O&M

Noise Dampe ner N/A 1st fl. Old Court Room Noise Dampener 800 SF No Good PACM N/A $1,440.00 O&M

Note: Estimated abatement costs are applicable to large scale abatement projects.

Table 3: Estimated Abatement Cost Unit Price Table

RS Means Basis of Abatement Cost

Estimates Cost Per Unit Locality Adjustment

General Conditions Adjustment

Contingency Adjustment

Total Estimated Unit Price

Flooring $2.26 / SF

0.972 1.15 1.1

$2.78 Pipe/Duct Insulation $6.80 / LF $8.36

Pipe Fittings $17.85 / EA $21.95 Caulking $5.35 / LF $6.58

Ceiling Tile / Wall Board $1.46 / SF $1.80 Thermal Insulation $11.40 / SF $14.02 Industry Normal Abatement Cost

Estimates Cost Per Unit Locality Adjustment

General Conditions Adjustment

Contingency Adjustment

Total Estimated Unit Price

Pipe/Duct Mastic $2.00 / LF

0.972 1.15 1.1

$2.46 Baseboard Mastic $2.00 / LF $2.46

Fire Door $250.00 / EA $307.40 Sink Under Coating $250 / EA $307.40 Elevator Brake Pads $20.00 / EA $24.59

Mastic Daubs $2.00 / SF $2.46 Vibration Dampener Cloth $15.00 / EA $18.44

Transite Materials $2.75 / SF $3.38

APPENDIX B

PREVIOUSLY SAMPLED, NON-ASBESTOS

CONTAINING MATERIALS

Table 4: Previously Sampled Non-Asbestos Containing Materials

Homogenous

Area Material Sample Location Color Results Sample Date

BC-101614 Black AHU Wrap Mastic Sealant AHU in Attic Black None Detected 10/16/2014

PL1 Plaster Wall 3rd fl. Mech. Room, 2nd Fl. Mech., 3rd fl. Restroom, 2nd fl. Restroom White None Detected 6/20/2016

PL2 Plaster Ceiling 3rd fl. Mech. Room, 2nd fl. Mech.

Room White None Detected 6/20/2016

CT3

2’x4’ Ceiling Tile with Pinholes and

Fissures

103 Suite Lunch Room, Suite 103

Storage Room, Basement Back

Storage

White None Detected 6/20/2016

BBM1

4” Black Baseboard and Associated

Mastic Rm. 203, 202, 203 Black None Detected 6/20/2016

CM1 Yellow Carpet Mastic

Office Next to Server Room, Computer Storage Room, Server

Room

Yellow None Detected 6/20/2016

APPENDIX C

LABORATORY ANALYTICAL RESULTS FOR

2016 SURVEY

EMSL Analytical, Inc.

10768 Baltimore Avenue Beltsville, MD 20705

Tel/Fax: (301) 937-5700 / (301) 937-5701 http://www.EMSL.com / beltsvillelab@emsl.com

191606873EMSL Order:

Customer ID: ARCE78

Customer PO:

Project ID:

Attention: Phone:Stacy Kahatapitiya (443) 864-7464

Fax:Arc Environmental (410) 962-1065

Received Date:1311 Haubert Street 06/24/2016 1:10 PM

Analysis Date:Baltimore, MD 21230 06/27/2016

Collected Date: 06/20/2016

Project: MARTIN V BOSTTETOR

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

Light Microscopy

Sample Description Appearance % Fibrous % Non-Fibrous

Non-Asbestos Asbestos

% Type

PL1-1-Skim Coat

191606873-0001

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER WALL

PL1-1-Rough Coat

191606873-0001A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

18%

Cellulose2%Tan/Various

Fibrous

Homogeneous

PLASTER WALL

PL1-2-Skim Coat

191606873-0002

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER WALL

PL1-2-Rough Coat

191606873-0002A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

16%

Cellulose4%Tan/Various

Fibrous

Homogeneous

PLASTER WALL

PL1-3-Skim Coat

191606873-0003

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER WALL

PL1-3-Rough Coat

191606873-0003A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

16%

Cellulose4%Tan/Various

Fibrous

Homogeneous

PLASTER WALL

PL1-4-Skim Coat

191606873-0004

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER WALL

PL1-4-Rough Coat

191606873-0004A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

17%

Cellulose3%Tan/Various

Fibrous

Homogeneous

PLASTER WALL

PL1-5-Skim Coat

191606873-0005

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER WALL

PL1-5-Rough Coat

191606873-0005A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

18%

Cellulose2%Tan/Various

Fibrous

Homogeneous

PLASTER WALL

PL1-6-Skim Coat

191606873-0006

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER WALL

PL1-6-Rough Coat

191606873-0006A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

17%

Cellulose3%Tan/Various

Fibrous

Homogeneous

PLASTER WALL

PL1-7-Skim Coat

191606873-0007

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER WALL

PL1-7-Rough Coat

191606873-0007A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

16%

Cellulose4%Tan/Various

Fibrous

Homogeneous

PLASTER WALL

PL2-8-Skim Coat

191606873-0008

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER CEILING

PL2-8-Rough Coat

191606873-0008A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

17%

Cellulose3%Tan/Various

Fibrous

Homogeneous

PLASTER CEILING

Initial Report From: 06/28/2016 10:46:44

Page 1 of 3ASB_PLM_0008 - 1.71 Printed: 6/28/2016 10:46 AM

Tel/Fax: (301) 937-5700 / (301) 937-5701 http://www.EMSL.com / beltsvillelab@emsl.com

191606873EMSL Order:

Customer ID: ARCE78

Customer PO:

Project ID:

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

Light Microscopy

Sample Description Appearance % Fibrous % Non-Fibrous

Non-Asbestos Asbestos

% Type

PL2-9-Skim Coat

191606873-0009

Insufficient MaterialPLASTER CEILING

PL2-9-Rough Coat

191606873-0009A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

17%

Cellulose3%Tan/Various

Fibrous

Homogeneous

PLASTER CEILING

PL2-10-Skim Coat

191606873-0010

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER CEILING

PL2-10-Rough Coat

191606873-0010A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

16%

Cellulose4%Tan/Various

Fibrous

Homogeneous

PLASTER CEILING

PL2-11-Skim Coat

191606873-0011

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER CEILING

PL2-11-Rough Coat

191606873-0011A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

18%

Cellulose2%Tan/Various

Fibrous

Homogeneous

PLASTER CEILING

PL2-12-Skim Coat

191606873-0012

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER CEILING

PL2-12-Rough Coat

191606873-0012A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

17%

Cellulose3%Tan/Various

Fibrous

Homogeneous

PLASTER CEILING

PL2-13-Skim Coat

191606873-0013

Insufficient MaterialPLASTER CEILING

PL2-13-Rough Coat

191606873-0013A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

16%

Cellulose4%Tan/Various

Fibrous

Homogeneous

PLASTER CEILING

PL2-14-Skim Coat

191606873-0014

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

5%

45%

50%

White

Non-Fibrous

Homogeneous

PLASTER CEILING

PL2-14-Rough Coat

191606873-0014A

None DetectedQuartz

Ca Carbonate

Non-fibrous (Other)

60%

20%

17%

Cellulose3%Tan/Various

Fibrous

Homogeneous

PLASTER CEILING

CT3-15

191606873-0015

None DetectedPerlite

Non-fibrous (Other)

35%

10%

Cellulose

Min. Wool

30%

25%

Gray/White

Fibrous

Heterogeneous

2X4 FISSURED &

PINHOLE CEILING

TILE

CT3-16

191606873-0016

None DetectedPerlite

Non-fibrous (Other)

35%

10%

Cellulose

Min. Wool

30%

25%

Gray/White

Fibrous

Heterogeneous

2X4 FISSURED &

PINHOLE CEILING

TILE

CT3-17

191606873-0017

None DetectedPerlite

Non-fibrous (Other)

35%

10%

Cellulose

Min. Wool

30%

25%

Gray/White

Fibrous

Heterogeneous

2X4 FISSURED &

PINHOLE CEILING

TILE

DM1-18

191606873-0018

None DetectedCa Carbonate

Non-fibrous (Other)

30%

70%

Gray

Non-Fibrous

Homogeneous

DUCT SEAM

SEALANT ON BARE

METAL DUCT

DM1-19

191606873-0019

None DetectedCa Carbonate

Non-fibrous (Other)

30%

70%

Gray

Non-Fibrous

Homogeneous

DUCT SEAM

SEALANT ON BARE

METAL DUCT

DM1-20

191606873-0020

None DetectedCa Carbonate

Non-fibrous (Other)

30%

70%

Gray

Non-Fibrous

Homogeneous

DUCT SEAM

SEALANT ON BARE

METAL DUCT

BBM1-21-Cove Base

191606873-0021

None DetectedCa Carbonate

Non-fibrous (Other)

45%

55%

Gray/Black

Non-Fibrous

Heterogeneous

4" BLK.

BASEBOARD &

MASTIC

Page 2 of 3ASB_PLM_0008 - 1.71 Printed: 6/28/2016 10:46 AM

Tel/Fax: (301) 937-5700 / (301) 937-5701 http://www.EMSL.com / beltsvillelab@emsl.com

191606873EMSL Order:

Customer ID: ARCE78

Customer PO:

Project ID:

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

Light Microscopy

Sample Description Appearance % Fibrous % Non-Fibrous

Non-Asbestos Asbestos

% Type

BBM1-21-Mastic

191606873-0021A

None DetectedNon-fibrous (Other)100%Brown/Yellow

Non-Fibrous

Heterogeneous

4" BLK.

BASEBOARD &

MASTIC

BBM1-22-Cove Base

191606873-0022

None DetectedCa Carbonate

Non-fibrous (Other)

45%

55%

Gray/Black

Non-Fibrous

Heterogeneous

4" BLK.

BASEBOARD &

MASTIC

BBM1-22-Mastic

191606873-0022A

None DetectedNon-fibrous (Other)100%Brown/Yellow

Non-Fibrous

Heterogeneous

4" BLK.

BASEBOARD &

MASTIC

BBM1-23-Cove Base

191606873-0023

None DetectedCa Carbonate

Non-fibrous (Other)

45%

55%

Gray/Black

Non-Fibrous

Heterogeneous

4" BLK.

BASEBOARD &

MASTIC

BBM1-23-Mastic

191606873-0023A

None DetectedNon-fibrous (Other)100%Brown/Yellow

Non-Fibrous

Heterogeneous

4" BLK.

BASEBOARD &

MASTIC

CM1-27

191606873-0024

None DetectedNon-fibrous (Other)100%Yellow

Non-Fibrous

Homogeneous

CARPET MASTIC

CM1-28

191606873-0025

None DetectedNon-fibrous (Other)100%Yellow

Non-Fibrous

Homogeneous

CARPET MASTIC

CM1-29

191606873-0026

None DetectedNon-fibrous (Other)100%Yellow

Non-Fibrous

Homogeneous

CARPET MASTIC

Analyst(s)

William Chrobak (41) Joe Centifonti, Laboratory Manager or Other Approved Signatory

EMSL maintains liability limited to cost of analysis . This report relates only to the samples reported 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. Interpretation and use of test results are the responsibility of the client. 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. Samples received in good condition unless otherwise noted. Estimated accuracy, precision and uncertainty data available upon request. Unless requested by the client, building materials manufactured with multiple layers (i.e. linoleum, wallboard, etc.) are reported as a single sample. Reporting limit is 1%

Samples analyzed by EMSL Analytical, Inc. Beltsville, MD NVLAP Lab Code 200293-0

Page 3 of 3ASB_PLM_0008 - 1.71 Printed: 6/28/2016 10:46 AM

OrderID: 191606873

OrderID: 191606873

APPENDIX D

GSA INSPECTION FORMS

Asbestos Assessment Data Form

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): _159 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______DIM1__________________

(Assign HSA Number)

HSA DESCRIPTION: __Black Mastic on Duct Insulation Wrap _______

LOCATION(S) OF HSA IN BLDG: ____Attic ___

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _X Minor __ Medium

_X Miscellaneous Material _ None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____1_____

Sample Number Sample Location Result

(Include percent and type of asbestos in result, e.g. 50% Chrysotile)

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and definitions.

BC‐101614‐02A Attic 6% Chrysotile

BC‐101614‐02B Attic Not Analyzed, Positive Stop

BC‐101614‐02C Attic Not Analyzed, Positive Stop

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): _82 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______DIM2__________________

(Assign HSA Number)

HSA DESCRIPTION: __Beige Seam Sealant Mastic on Foil Duct Wrap _______

LOCATION(S) OF HSA IN BLDG: ____Attic, 3rd Fl. Mech. Room ___

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _X Minor __ Medium

_X Miscellaneous Material _ None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____1_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): _30 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______DIM3__________________

(Assign HSA Number)

HSA DESCRIPTION: __Black Seam Sealant Mastic on Foil Duct Wrap _______

LOCATION(S) OF HSA IN BLDG: ____Attic, 2nd Fl. Mech. Room ___

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _X Minor __ Medium

_X Miscellaneous Material _ None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____1_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): _52 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______DI1 _________________

(Assign HSA Number)

HSA DESCRIPTION: _Duct Insulation _ _______

LOCATION(S) OF HSA IN BLDG: ____Chiller Room ___

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

X Thermal Systems Insulation _ Minor __ Medium

_ Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_X High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_ Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): _5 EA__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______Fit1__________________

(Assign HSA Number)

HSA DESCRIPTION: __Mudded Fitting _______

LOCATION(S) OF HSA IN BLDG: ____Attic, 3rd Fl. Mech. Room ___

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material _X Significant _ High

X Thermal Systems Insulation _ Minor __ Medium

_ Miscellaneous Material _ None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_X High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_ Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____1_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

BC‐101614‐04A Attic 20% Chrysotile

BC‐101614‐04B Attic Not Analyzed, Positive Stop

BC‐101614‐04C Attic Not Analyzed, Positive Stop

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): _235 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______PI1__________________

(Assign HSA Number)

HSA DESCRIPTION: _Cork Pipe Insulation with Black Mastic _______

LOCATION(S) OF HSA IN BLDG: ____Attic, 2nd Fl. Mech. Room ___

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material _ Significant _ High

X Thermal Systems Insulation _ Minor __ Medium

_ Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): _10 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______PI2__________________

(Assign HSA Number)

HSA DESCRIPTION: __Mudded Pipe Insulation _______

LOCATION(S) OF HSA IN BLDG: ___3rd Fl. Mech. Room ___

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material _ Significant _ High

X Thermal Systems Insulation _ Minor __ Medium

_ Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_X High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_ Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 1,601 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______PIM1__________________

(Assign HSA Number)

HSA DESCRIPTION: __White Pipe Seam Sealant Mastic _______

LOCATION(S) OF HSA IN BLDG: __Attic, Basement Custodial Office, Pump Room, Hallway by Old Holding Cell (Cage Room), Pipe

Room, Telephone Closet 1, Electrical Closet, B13 Mech. Room, Basement Main Hallway, Chiller Room, Large Storage Room, Computer Storage Room, Server Room, Office next to Server Room, Janitorial Storage Closet __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _X Minor __ Medium

_X Miscellaneous Material _ None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_______

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 64 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______PIM2__________________

(Assign HSA Number)

HSA DESCRIPTION: __Black Mastic on Pipe Wrap _______

LOCATION(S) OF HSA IN BLDG: __Attic __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 18 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______PIW1_________________

(Assign HSA Number)

HSA DESCRIPTION: __Paper Pipe Wrap with Foil Backing and Black Mastic _______

LOCATION(S) OF HSA IN BLDG: __Attic __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 26 LF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______VC1_________________

(Assign HSA Number)

HSA DESCRIPTION: __Canvas Vibration Collar _______

LOCATION(S) OF HSA IN BLDG: __Attic __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _X Minor __ Medium

_X Miscellaneous Material _ None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _ High _X High __ High

__ Medium __ Medium _ Medium __ Medium

_X Low _X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

BC‐101614‐01A Attic 60% Chrysotile

BC‐101614‐01B Attic Not Analyzed, Positive Stop

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 3,934 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______TZ1_______________

(Assign HSA Number)

HSA DESCRIPTION: __Brown, Grey and Beige Stone Design Terrazzo ______

LOCATION(S) OF HSA IN BLDG: __ 3rd fl. Stairwell/Elevator Lobby, 2nd fl. Stairwell/Elevator Lobby, Men’s Restrooms, Women’s

Restroom, 3rd fl. Mech. Room, 1st fl. Security Station, 1st fl. Hallway, Basement Restroom __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _X High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _ Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

__ High _X High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 1,302 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______CT1______________

(Assign HSA Number)

HSA DESCRIPTION: __1’x1’ Ceiling Tile with Fissure and Associated Mastic Daub ______

LOCATION(S) OF HSA IN BLDG: __ Courtroom 3 __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_X High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_ Low _ X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 4,544 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______CT2______________

(Assign HSA Number)

HSA DESCRIPTION: __2’x2’ Ceiling Tile with Pinholes and Divots ______

LOCATION(S) OF HSA IN BLDG: _ Throughout the Building __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_X High _X High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_ Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 1 EA__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______SI1______________

(Assign HSA Number)

HSA DESCRIPTION: __Beige Sink Undercoating ______

LOCATION(S) OF HSA IN BLDG: _ 300 Suite Kitchen __

(Include Functional Space)

HSA Category Damage Accessibility

__ Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _ High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _ X Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 1,026 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______PL3______________

(Assign HSA Number)

HSA DESCRIPTION: __Decorative Plaster ______

LOCATION(S) OF HSA IN BLDG: _ 3rd fl. Hallway, 2nd fl. Hallway, 2nd fl. Stairwell Lobby/Elevator Lobby, Lobby outside Rm. 207, 1st

fl. Security Station, 1st fl. Hallway, Suite 103 Lunch Room, 1st fl. Old Courtroom __

(Include Functional Space)

HSA Category Damage Accessibility

_X Surfacing Material __ Significant _ High

_ Thermal Systems Insulation _ Minor __ Medium

_ Miscellaneous Material _X None _X Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _X High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 14 EA__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______FD1____________

(Assign HSA Number)

HSA DESCRIPTION: __Fire Door ______

LOCATION(S) OF HSA IN BLDG: _ 3rd fl. Elevator Lobby, 2nd fl. Elevator Lobby, 1st fl. Elevator Lobby, Basement Telephone

Closet, Basement Electrical Closet, Chiller Room __

(Include Functional Space)

HSA Category Damage Accessibility

_ Surfacing Material __ Significant _X High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _ Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _X High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 72 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______VT1____________

(Assign HSA Number)

HSA DESCRIPTION: _12”x12” White Floor Tile with Grey Streaks and Associated Mastic ______

LOCATION(S) OF HSA IN BLDG: _ 300 Suite Kitchen __

(Include Functional Space)

HSA Category Damage Accessibility

_ Surfacing Material __ Significant _X High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _ Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _X High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 221 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______VT2____________

(Assign HSA Number)

HSA DESCRIPTION: _12”x12” White Floor Tile with Multi Color Streaks and Associated Mastic ______

LOCATION(S) OF HSA IN BLDG: _ Suite 206 Judges’ Chamber Kitchen __

(Include Functional Space)

HSA Category Damage Accessibility

_ Surfacing Material __ Significant _X High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _ Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _X High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 1,964 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______VT3____________

(Assign HSA Number)

HSA DESCRIPTION: _12”x12” Beige Mottled Floor Tile and Associated Mastic ______

LOCATION(S) OF HSA IN BLDG: _ Basement Hallway by Holding Cell (Cage Room), Pipe Room, Basement Storage Room, Basement Back Hallway, Basement Main Hallway, Hallway outside large Storage Room __

(Include Functional Space)

HSA Category Damage Accessibility

_ Surfacing Material __ Significant _X High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _ Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _X High __ High __ High

__ Medium __ Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 156 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______VT4____________

(Assign HSA Number)

HSA DESCRIPTION: _12”x12” Light Grey Floor Tile with Dark Grey Streaks and Associated Mastic __

LOCATION(S) OF HSA IN BLDG: _ Janitorial Storage Closet __

(Include Functional Space)

HSA Category Damage Accessibility

_ Surfacing Material __ Significant _X High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _ Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _ High __ High __ High

__ Medium _X Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 500 SF__

ASBESTOS INSPECTOR: __Derek Kwon ______________________________________________________________

HOMOGENOUS SAMPLING AREA #: ______VT5____________

(Assign HSA Number)

HSA DESCRIPTION: _9”x9” Green Floor Tile and Associated Mastic under the carpet ______

LOCATION(S) OF HSA IN BLDG: _ Basement Storage Room __

(Include Functional Space)

HSA Category Damage Accessibility

_ Surfacing Material __ Significant _X High

_ Thermal Systems Insulation _ Minor __ Medium

_X Miscellaneous Material _X None _ Low

Air Plenum __

(Y or N)

Friability Traffic Vibration Potential for Air Erosion

_ High _ High __ High __ High

__ Medium _X Medium _X Medium __ Medium

_X Low _ Low __ Low _X Low

Comments:_________________________________________________________________________________________

AHERA Classification (see instructions): ____5_____

NOTE: Use one form per homogeneous sampling area. Consult 40 CFR Part 763 for sampling and analytical protocols and

Bldg. Name: _Martin V Bostetter Courthouse_ ASSESSMENT DATE: _6/20/2016_____

Address: _200 South Washington St. Alexandria, VA_

GSA BLDG. NO.: _VA0003ZZ_______ AMOUNTS (S.F./L.F./CU.F.): 378 LF__

ASBES…