48-Doc 00 73 00 07 - Appendix C - ACM Survey Rpt final.pdf
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- Attached to
- 1121 Horsham Road Demolition (26-01054)
- Solicitation number
- US.258594
- Issued by
- Pennsylvania
About this file
This is an Asbestos-Containing Materials (ACM) Survey Report prepared by Criterion Laboratories, Inc. for Horsham Township in Ambler, Pennsylvania. The survey was conducted to identify and document asbestos-containing materials within a residential building located at 1121 Horsham Road prior to planned demolition, as required by EPA's National Emission Standard for Hazardous Air Pollutants (NESHAP) regulation and OSHA's Construction Standard for Asbestos. The inspection was performed on September 9, 2026, by EPA-accredited building inspector Alexis Richards, who collected a total of nineteen (19) bulk samples from the building for analysis.
The laboratory analysis, conducted using Polarized Light Microscopy (PLM) methodology, found no asbestos-containing materials in any of the samples collected, with the threshold for classification set at greater than one percent (>1%) asbestos content. The report, dated September 16, 2026, includes certificates of analysis for all bulk samples, certifications for Criterion employees, and documentation of sampling methodology. The report recommends that if suspect materials are exposed during the demolition process at 1121 Horsham Road, Criterion Laboratories should be contacted for reassessment. The survey documentation is intended to comply with EPA, OSHA, and State of Pennsylvania regulations governing asbestos.
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Text version
400 Street Road, Bensalem, PA 19020 / 215-244-1300 / Fax 215-244-4349 www.criterionlabs.com
At:
1121 Horsham Road Ambler, PA 19002
For:
Jean Weiss Horsham Township 1025 Horsham Road Horsham, PA 19044
Prepared By:
Eric Wysocki Senior Project Manager
Report Date:
September 16, 2026
Project Number:
263505
Date of Project:
September 9, 2026
ASBESTOS-
CONTAINING
MATERIALS
SURVEY
Field Services
Lab
Training
Asbestos Bulk Sampling & Analysis Horsham Township Criterion Laboratories, Inc.
TABLE OF CONTENTS
Section Number
1.0 Narratives
2.0 Laboratory Results
3.0 Suspect Materials Testing Negative for Asbestos Content
4.0 Sampling Methodology
5.0 Certifications
1.0 NARRATIVE
1.0 NARRATIVES
1.1 Purpose:
Criterion Laboratories, Inc. (Criterion) was retained by Jean Weiss of Horsham Township to perform a survey for asbestos containing materials of the building located at 1121 Horsham Road in Ambler, PA.
The purpose of the sampling was to identify and document asbestos-containing materials (ACM) within the building prior to planned demolition. The EPA’s National Emission Standard for Hazardous Air Pollutants (NESHAP) regulation requires that buildings scheduled for renovations/demolition have an inspection identifying asbestos materials.
OSHA’s Construction Standard for Asbestos (29 CFR 1926.1101) requires that building materials installed prior to 1981 be inspected for asbestos or they must be classified as presumed asbestos-containing materials (PACM).
1.2 Personnel:
Ms. Alexis Richards of Criterion performed the sampling on September 9, 2026. Ms.
Richards is an EPA-accredited building inspector licensed by the State of Pennsylvania.
1.3 Discussion and Survey Results:
A total of nineteen (19) samples were collected from the building. All samples were analyzed by Polarized Light Microscopy (PLM), which classifies a material as asbestos-containing if it contains greater than one percent (>1%).
No asbestos was detected in any of the samples by PLM analysis.
Those materials that were observed, sampled, submitted for analysis and found not to be asbestos-containing materials are identified in Section 3.0 of this report.
1.4 Disclaimer:
Information contained herein was obtained by means of onsite observations, bulk sampling and analytical data. Conclusions will be based upon the data obtained. This is not to imply that the data gathered is all the information that exists which may be pertinent to the site. Any areas inaccessible to the inspection team due to reasons beyond the control of Criterion (i.e., hidden pipe chases, behind hard walls, above hard ceilings, secured spaces, etc.) will not be included in this inspection.
1.5 Conclusions and Recommendations:
No asbestos-containing materials were identified at 1121 Horsham Road in Ambler, PA.
If suspect materials are exposed during demolition, call Criterion to re-assess.
Section 2.0, Laboratory Results, contains certificates of analyses for all bulk samples collected and analyzed.
Section 5.0, Certifications, lists asbestos accreditation for all Criterion employees who worked on this project.
This report is intended to strictly comply with EPA, OSHA and State of Pennsylvania regulations governing asbestos. This report should be referenced prior to disturbing any materials that may contain asbestos.
Criterion appreciates the opportunity to provide you with this Asbestos Bulk Sampling & Analysis Report. Should you have any questions, please do not hesitate to call me at
(215) 244-1300, extension 1030.
Eric Wysocki
Senior Project Manager
2.0 LABORATORY RESULTS
Results of Polarized Light Microscopy
Client Horsham Township Site Address 1121 Horsham Road, Ambler, PA 19002 Sample Date 9/9/2026
Project # 263505 Sample Received Date 9/10/2026
Collected By Criterion Laboratories, Inc. Analyzed By Caragiulo, Cory Sample Analysis Date(s) 9/11/2026
Report Date: 9/14/2026 400 Street Road, Bensalem, PA 19020 / 215-244-1300 / Fax 215-244-4349 / www.criterionlabs.com Rev. 10_<11_20180216
Sample Number Non-Asbestos Asbestos Material Description Appearance Layer Fibrous - % Non-Fibrous % Asbestos Type Percent Location
263505-02-002-01-01 Gray Plaster 1 Cellulose - 2% 98% None Detected --- Wall plaster Original front entrance - 1st floor 263505-02-002-01-01 White Skim 2 None Detected 100% None Detected --- Wall plaster Original front entrance - 1st floor 263505-02-002-01-01 White Drywall 3 Cellulose - 10% 90% None Detected --- Wall plaster Original front entrance - 1st floor 263505-02-002-01-02 Gray Plaster 1 Cellulose - 2% 98% None Detected --- Wall plaster Original front entrance- 1st floor 263505-02-002-01-02 White Skim 2 None Detected 100% None Detected --- Wall plaster Original front entrance- 1st floor 263505-02-002-01-03 Gray Plaster 1 Cellulose - 2% 98% None Detected --- Wall plaster Original front office - 2nd floor 263505-02-002-01-03 White Skim 2 None Detected 100% None Detected --- Wall plaster Original front office - 2nd floor 263505-02-002-01-04 Gray Plaster 1 None Detected 100% None Detected --- Wall plaster Original hallway outside of restroom - 2nd floor 263505-02-002-01-04 White Skim 2 None Detected 100% None Detected --- Wall plaster Original hallway outside of restroom - 2nd floor 263505-02-002-01-05 Gray Plaster 1 None Detected 100% None Detected --- Wall plaster Room behind wood oven office - 2nd floor
Client Horsham Township Site Address 1121 Horsham Road, Ambler, PA 19002 Sample Date 9/9/2026
Project # 263505 Sample Received Date 9/10/2026
Collected By Criterion Laboratories, Inc. Analyzed By Caragiulo, Cory Sample Analysis Date(s) 9/11/2026
Report Date: 9/14/2026 400 Street Road, Bensalem, PA 19020 / 215-244-1300 / Fax 215-244-4349 / www.criterionlabs.com Rev. 10_<11_20180216
Sample Number Non-Asbestos Asbestos Material Description Appearance Layer Fibrous - % Non-Fibrous % Asbestos Type Percent Location
263505-02-002-01-05 White Skim 2 None Detected 100% None Detected --- Wall plaster Room behind wood oven office - 2nd floor 263505-02-002-01-05 White Drywall 3 None Detected 100% None Detected --- Wall plaster Room behind wood oven office - 2nd floor 263505-02-002-01-06 Gray Ceiling Tile 1 Cellulose - 50%
Fiber Glass - 30% 20% None Detected ---
2x4 Ceiling tile Main office - 1st floor 263505-02-002-01-07 White Ceiling Tile 1 Cellulose - 90% 10% None Detected --- 2x2 Ceiling tile (type 1) Original room left of entrance - 1st floor 263505-02-002-01-08 White Ceiling Tile 1 Cellulose - 50%
Fiber Glass - 30% 20% None Detected ---
2x2 Ceiling tile (type 2) Original room left of entrance - 1st floor 263505-02-002-01-09 White Sheetrock 1 None Detected 100% None Detected --- Sheetrock/joint compound Side entrance by ramp - 1st floor 263505-02-002-01-09 White Joint Compound 2 None Detected 100% None Detected --- Sheetrock/joint compound Side entrance by ramp - 1st floor 263505-02-002-01-10 White Sheetrock1 1 Cellulose - 10% 90% None Detected --- Sheetrock/joint compound Main office - 1st floor 263505-02-002-01-11 White Sheetrock 1 Cellulose - 10% 90% None Detected --- Sheetrock/joint compound Front office with wood oven - 2nd floor 263505-02-002-01-11 White Joint Compound 2 None Detected 100% None Detected --- Sheetrock/joint compound Front office with wood oven - 2nd floor
Client Horsham Township Site Address 1121 Horsham Road, Ambler, PA 19002 Sample Date 9/9/2026
Project # 263505 Sample Received Date 9/10/2026
Collected By Criterion Laboratories, Inc. Analyzed By Caragiulo, Cory Sample Analysis Date(s) 9/11/2026
Report Date: 9/14/2026 400 Street Road, Bensalem, PA 19020 / 215-244-1300 / Fax 215-244-4349 / www.criterionlabs.com Rev. 10_<11_20180216
Sample Number Non-Asbestos Asbestos Material Description Appearance Layer Fibrous - % Non-Fibrous % Asbestos Type Percent Location
263505-02-002-01-12 White Sheetrock 1 Cellulose - 10% 90% None Detected --- Sheetrock/joint compound Rear room with patio - 2nd floor 263505-02-002-01-12 White Joint Compound
2 None Detected 100% None Detected ---
Sheetrock/joint compound Rear room with patio - 2nd floor 263505-02-002-01-13 White Sheetrock 1 Cellulose - 10% 90% None Detected --- Sheetrock/joint compound Right office - 3rd floor 263505-02-002-01-13 White Joint Compound 2 None Detected 100% None Detected --- Sheetrock/joint compound Right office - 3rd floor 263505-02-002-01-14 Yellow Insulation 1 Fiber Glass - 90% 10% None Detected --- Boiler insulation Original basement 263505-02-002-01-15 Tan Linoleum 1 Cellulose - 60% 40% None Detected --- Linoleum, marbled & yellow mastic Throughout 1st floor 263505-02-002-01-15 Yellow Mastic 2 None Detected 100% None Detected --- Linoleum, marbled & yellow mastic Throughout 1st floor 263505-02-002-01-16 White Linoleum 1 None Detected 100% None Detected --- Linoleum, white Original restroom - 2nd floor 263505-02-002-01-17 Tan Floor Tile 1 None Detected 100% None Detected --- Tan 12x12 Newer restroom - 2nd floor 263505-02-002-01-18 Black Shingle 1 Fiber Glass - 10% 90% None Detected --- Roofing shingle Roof
Client Horsham Township Site Address 1121 Horsham Road, Ambler, PA 19002 Sample Date 9/9/2026
Project # 263505 Sample Received Date 9/10/2026
Collected By Criterion Laboratories, Inc. Analyzed By Caragiulo, Cory Sample Analysis Date(s) 9/11/2026
Report Date: 9/14/2026 400 Street Road, Bensalem, PA 19020 / 215-244-1300 / Fax 215-244-4349 / www.criterionlabs.com Rev. 10_<11_20180216
Sample Number Non-Asbestos Asbestos Material Description Appearance Layer Fibrous - % Non-Fibrous % Asbestos Type Percent Location
263505-02-002-01-18 Black Tar 2 None Detected 100% None Detected --- Roofing shingle Roof 263505-02-002-01-19 Black Shingle 1 Fiber Glass - 10% 90% None Detected --- Roofing shingle Roof 263505-02-002-01-19 Black Tar 2 None Detected 100% None Detected --- Roofing shingle Roof
Sample Count 19 1 - No Joint Compound 2 - Insufficient Sample Provided
Criterion Laboratories, Inc. bears no responsibility for sample collection activities of non-Criterion personnel. Results apply to sample(s) as received. This report relates only to the samples reported above, and when reproduced, must be in its entirety. Estimated accuracy, precision and uncertainty data available on 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%. QC data associated with this sample set is within acceptable limits. Samples were received in good condition, unless otherwise noted.
Note: If your project number ends with an “R”, it is a revised report and replaces the original document in full. The above results represent the analysis of bulk sample(s) by Criterion Laboratories, Inc. according to EPA 40 CFR Part 763 Appendix E to Subpart E - Polarized Light Microscopy and EPA 600/R- 93/116. The concentration of asbestos is determined by visual estimation.
Renee Battiste, Quality Manager
Criterion Laboratories, Inc. (ID 100424) is accredited by the AIHA Laboratory Accreditation Programs (AIHA LAP), LLC in the IHLAP; EMLAP and ELLAP accreditation programs for Polarized Light Microscopy (PLM), Phase Contrast Microscopy (PCM); Air-Direct Examination; and Airborne Dust, Paint, Settled Dust by Wipe and Soil for Fields of Testing as documented by the Scope of Accreditation Certificate and associated Scope. Additionally, Criterion Laboratories, Inc. is certified by the Center for Disease Control (CDC) Environmental Legionella Isolation Techniques Evaluation (ELITE) Program for the determination of Legionella in water by culture and holds accreditation from the National Voluntary Laboratory Accreditation Program (NVLAP ID 102046-0) for the determination of asbestos in bulk samples by Polarized Light Microscopy (PLM). This test report must not be used to claim product endorsement by NVLAP, NIST, AIHA or any agency of the US Government. Unless specifically listed as above, these test results are not covered under AIHA LAP, LLC, 100424 accreditation.
THIS IS THE LAST PAGE OF THE REPORT
Chain of Custody
14-Sep-2026 Criterion Laboratories, Inc.
Rev. 12_<11_20170228
Matrix Bulk/Building Material Other Analyte Asbestos Other Analysis Type PLM Other Container Bag Other Project 263505 Client Horsham Township Site Address 1121 Horsham Road, Ambler, PA 19002
Location Turnaround 48 Hour Field Tech Alexis Richards Sample Notes Chain of Custody Notes
Additional Analytes
Sample Number Location Material Description
Received Condition Date Notes
263505-02-002-01-01 Original front entrance - 1st floor
Wall plaster Good 9/10/2026
263505-02-002-01-02 Original front entrance- 1st floor
Wall plaster Good 9/10/2026
263505-02-002-01-03 Original front office - 2nd floor
Wall plaster Good 9/10/2026
263505-02-002-01-04 Original hallway outside of restroom - 2nd floor
Wall plaster Good 9/10/2026
263505-02-002-01-05 Room behind wood oven office - 2nd floor
Wall plaster Good 9/10/2026
263505-02-002-01-06 Main office - 1st floor 2x4 Ceiling tile Good 9/10/2026 263505-02-002-01-07 Original room left of entrance - 1st floor 2x2 Ceiling tile (type 1)
Good 9/10/2026
263505-02-002-01-08 Original room left of entrance - 1st floor
2x2 Ceiling tile (type 2)
Good 9/10/2026
263505-02-002-01-09 Side entrance by ramp - 1st floor
Sheetrock/joint compound
Good 9/10/2026
263505-02-002-01-10 Main office - 1st floor Sheetrock/joint compound
Good 9/10/2026
263505-02-002-01-11 Front office with wood oven - 2nd floor
Sheetrock/joint compound
Good 9/10/2026
263505-02-002-01-12 Rear room with patio
- 2nd floor
Sheetrock/joint compound
Good 9/10/2026
263505-02-002-01-13 Right office - 3rd floor
Sheetrock/joint compound
Good 9/10/2026
263505-02-002-01-14 Original basement Boiler insulation Good 9/10/2026 263505-02-002-01-15 Throughout 1st floor Linoleum, marbled & yellow mastic Good 9/10/2026
Chain of Custody
14-Sep-2026 Criterion Laboratories, Inc.
Rev. 12_<11_20170228
263505-02-002-01-16 Original restroom - 2nd floor
Linoleum, white Good 9/10/2026
263505-02-002-01-17 Newer restroom - 2nd floor
Tan 12x12 Good 9/10/2026
263505-02-002-01-18 Roof Roofing shingle Good 9/10/2026 263505-02-002-01-19 Roof Roofing shingle Good 9/10/2026
Sample Count 19
Handling Chain Type Handled By Date Time Notes Report Results To Eric Wysocki 9/9/2026 Send Reports To Horsham Township 9/9/2026 Samples Taken By Alexis Richards 9/9/2026 10:00 Transported By Alexis Richards 9/10/2026 10:30 Relinquished By Alexis Richards 9/10/2026 11:15 Received By Lauren Mitchell 9/10/2026 11:20 Analyzed By Cory Caragiulo 9/11/2026 09:55 Reviewed By Isabella Patel 9/14/2026 15:08
3.0 SUSPECT MATERIALS TESTING NEGATIVE
FOR ASBESTOS CONTENT
3.0 Suspect Materials Testing Negative for Asbestos Content
The following materials were observed, sampled, submitted for analysis and found not to be asbestos-containing materials. For more specific information concerning the location of these materials, see Section 2.0 of this report.
Wall Plaster 2’ x 4’ Lay-in Ceiling Tile 2’ x 2’ Ceiling Tile Drywall/Joint Compound Boiler Insulation Marbled Linoleum/Yellow Mastic White Linoleum/Yellow Mastic Tan 12” x 12” Floor Tile Black Roof Shingle
4.0 SAMPLING METHODOLOGY
4.0 Sampling Methodology
Bulk samples of suspected asbestos-containing material (ACM) were collected in accordance with guidelines set forth by the Environmental Protection Agency (EPA) and the National Institute for Occupational Safety and Health (NIOSH). The procedures for obtaining a bulk sample of suspected ACM are:
1. "Functional Spaces" in the Property were identified. A Functional Space is a spatially distinct unit within a building, which contains identifiable populations of building occupants (i.e. corridor, office space, mechanical area, etc.).
2. The total amount and location of each type of suspected ACM was tabulated.
3. The types of suspected ACM were then grouped as homogeneous materials. Each homogeneous material is defined as being uniform in texture and appearance. Based on these parameters, each homogeneous material was assigned a specific identification number as listed below.
Homogeneous Material I.D. #Reference List
Surfacing
0100 to 0199 - Sprayed-On 0200 to 0299 - Troweled-On 0300 to 0399 - Blown-In 0400 to 0499 - Other Surfacing 1900 to 1999 - Plaster Walls and Ceilings
Thermal
0500 to 0599 - Lagging 0600 to 0699 - Breeching 0700 to 0799 - Duct Insulation 0800 to 0899 - Tank Insulation 0900 to 0999 - Block Pipe Insulation 1000 to 1099 - Joints associated with Block Pipe Insulation 1100 to 1199 - Corrugated/Air Cell Pipe Insulation 1200 to 1299 - Joints associated with Corrugated Pipe Insulation 1300 to 1399 - Compressed Pipe Insulation 1400 to 1499 - Joints associated with Compressed Pipe Insulation 1500 to 1599 - Joints associated with Fibrous Glass Pipe Insulation 1600 to 1699 - Other Thermal
4.0 Sampling Methodology (Continued)
Miscellaneous
1700 to 1799 - Lay-In Ceiling Tiles 1800 to 1899 - Spline Ceiling Tiles 2000 to 2099 - Floor Tiles 2100 to 2199 - Drywall 2200 to 2299 - Linoleum 2300 to 2399 - Transite 2400 to 2499 - Expansion Joints 2500 to 2599 - Mastic Floor Tiles 2600 to 2699 - Other Miscellaneous 2700 to 2799 - Mastic Linoleum
4. A sampling scheme was devised based upon the amounts and locations of the different homogeneous materials in order to obtain representative samples.
5. Trained personnel using an appropriate sampling tool and a leak-tight, labeled sample container took the actual bulk samples. The sampling was conducted in areas of the building that are not readily visible to the building occupants. These areas included above lay-in ceiling tiles and beneath cabinets and desks, etc.
6. The personnel employed proper decontamination procedures to prevent contamination of the building environment and possible exposure to themselves and others.
7. Each location of suspicious asbestos-containing material (ACM) was documented on the
Asbestos Bulk Sample Log. This documentation included the location of suspicious materials, type of material located, square footage of suspicious ACM, as well as the square footage of damaged suspicious ACM. All bulk samples taken were documented on the Sample Log form and a Chain of Custody form. Each was completed for all samples taken by the inspector and handler.
8. The samples were then taken to the laboratory for analysis. The Certificates of Analysis and Chain of Custody relative to each sample are included in this report.
9. The inspector assessed the condition of the suspicious ACM using the eight EPA factors.
10. On the Asbestos Bulk Sample Log, “NS” in the Sample # box means “not sampled”.
This homogeneous material was sampled elsewhere or assumed to contain asbestos. The purpose of the “NS” listing is to quantify the material for its inclusion in the Asbestos Inventory should similar material sampled elsewhere test positive for asbestos.
5.0 CERTIFICATIONS
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