Asbestos Survey Bldg 200.pdf

ASBESTOS SURVEY

At

SACATON SERVICE UNIT

Building #200 - Outpatient Clinic

For

Phoenix Area Indian Health Service Two Renaissance Square

40 N. Central Avenue Phoenix, AZ 85004

By

U.S. Public Health Service Federal Occupational Health

2201 Sixth Avenue, M/S Rx-21 Seattle, Washington 98121-2500

(206) 615-2441

February 2003

TABLE OF CONTENTS

Section Title Page No.

1.0 Introduction

2.0 Description of Inspected Area .................................................................................. I

3. 0 Survey Procedures

4.0 Findings

5.0 Liability Limitations

Appendices

1 Bulk Sample Log and Location of Functional Spaces

2 Laboratory Results

3 Certifications

1.0 INTRODUCTION

Area Wide Asbestos Building Inspection Indian Health Service Facilities

Sacaton Service Unit Building #200 - Outpatient Clinic

Sacaton, Arizona

As requested by the Phoenix Area Indian Health Services, bulk sampling of suspect asbestos-containing building materials was conducted in Building #200, Outpatient Clinic, located at the Sacaton Service Unit, Sacaton, Arizona, on August 14, 2002. Bulk samples of suspect asbestos-containing materials (ACMs) were collected throughout the interior and exterior of the building.

Mr. James Marshall, representing Federal Occupational Health (FOH), performed the asbestos inspection of the subject property. Mr. Marshall holds current Asbestos Hazard Emergency Response Act (AHERA) accreditation as an Asbestos Building Inspector. Sampling of suspect asbestos-containing materials was conducted using procedures similar to the Environmental Protection Agency (EPA) AHERA regulations, 40 CFR 763. The Federal Occupational Health EH Environmental Laboratory in Denver, Colorado, performed the laboratory analysis of the asbestos samples.

Laboratory analysis indicates that no asbestos-containing materials were found in Building #200, Outpatient Clinic.

2.0 DESCRIPTION OF INSPECTED AREA

This inspection focused on the entire interior and exterior of the building. The building is single story with a stucco exterior built slab-on grade. The roof consists of a rolled roofing system.

Suspect building materials identified and sampled in the subject property included the following: various floor tiles and associated mastics, various gypsum drywall materials, covebase adhesive, acoustical ceiling tiles and associated mastic, exterior stucco, and roofing materials.

3.0 SURVEY PROCEDURES

Each room was assigned unique functional space numbers. Each functional space was visually inspected for suspect asbestos-containing materials. Materials were mapped and quantified on maps provided by the IHS or on hand made maps of the existing floor plan.

Each suspect ACM was designated as a distinct homogeneous area, which is a single material, uniform in texture and appearance, installed at one time, and unlikely to consist of more than one type or formulation of material. The inspector touched each suspect material in order to determine friability.

A sufficient number of samples were collected of each material to satisfy the Occupational Safety and Health Administration (OSHA) and the National Emission Standard for Hazardous Air Pollutants (NESHAP) regulations for the determination of asbestos content. A total of 59 samples were collected from Building #200.

Each sample was assigned a unique sample identification number and assessed for damage and friability classifications. The samples, with Chain of Custody documentation were delivered to FOH EH Environmental Laboratory for analysis.

The FOH EH Environmental Laboratory is accredited under the National Voluntary Laboratory Accreditation Program (NVLAP) for bulk-asbestos sample analysis conducted by the National Institute of Standards and Technology.

A description of the samples taken, location, and summary of laboratory results are located in Appendix I.

The asbestos laboratory reports are included as Appendix 2.

4.0 FINDINGS

Results of the asbestos inspection are as follows:

Sacaton Service Unit Building #200-Outpatient Clinic Results

HA# Material Functional Space ACM Condition Quantity IA 12"xl2" Beige 1, 3-6, 9, 13-15, 17, 18 No Good 4,019 sf

Floor Tile & Mastic

1B l Z"x 12" Pink 11 No Good 150 sf Floor Tile &

Mastic 2A Joint Compound 1, 5, 6, 8, 9-14, 17, 18 No Good 4,180 sf 2B Gypsum Drywall 1, 5, 6, 8, 9-14, 17, 18 No Good 4,180 sf

2C Drywall 1, 5, 6, 8, 9-14, 17, 18 No Good 4,180 sf Texturing

2D Gypsum Drywall 2, 7, 8, 15, 16 No Good 2,091 sf

2E Joint Compound 2, 7, 8, 15, 16 No Good 2,091 sf

2F Drywall 2, 7, 8, 15, 16 No Good 2,091 sf Texturing (Heavy)

2G Exterior Stucco Exterior No Good 5,690 sf

3A 2'x4' Ceiling 1, 3-6 No Good 2,742 sf Tile

3B Unfinished 1, 3-6 No Good 2,742 sf Drywall Ceiling

3C Drywall Tape & 1, 3-6 No Good 2,742 sf Joint Compound

3D 1 'xl' Ceiling 1, 3-6 No Good 2,742 sf Tiles

3E l 'xl' Ceiling 1, 3-6 No Good 2,742 sf Tile Mastic

7A Covebase Mastic 1-15, 17, 18 No Good 405 sf

8A Rolled Roofing Roof No Good 5,500 sf

8B Penetration Roof No Good 50 sf Mastic

Laboratory analysis of the bulk samples collected from the Sacaton Service Unit Building #200, Outpatient Clinic~ indicates that no asbestos-containing materials were found.

5.0 LIABILITY LIMITATIONS

This asbestos inspection was performed using procedures and a level of diligence typically exercised by professional consultants performing similar services.

Asbestos-containing material (ACM) can be present in a structure, but not identified using normal, non destructive, investigative procedures.

No survey can completely eliminate uncertainty regarding the presence of ACM. FOH's level of diligence and investigative procedures are intended to reduce, but not eliminate, potential uncertainty regarding the presence of ACM. The procedures used for this survey attempt to establish a balance between the competing goals of limiting investigative costs, time, and building damage, and reducing the uncertainty about unknown conditions.

Therefore, the determinations in this report should not be construed as a guarantee that all ACM present in the subject property has been included in this report. This report presents FOH's professional determinations, which are dependent upon information obtained during the performance of the consulting services. FOH assumes no responsibility for omissions or errors resulting from inaccurate information provided by sources outside of FOH.

No warranty or guarantee, expressed or implied, is made regarding the findings, conclusions, or recommendations contained in this report. The limitations presented above supersede the requirements on provisions of all other contracts on scope of work, implied or otherwise, except those stated or acknowledged herein.

Refer to the report for laboratory results of the inspection. The Table in Appendix 1 lists the bulk samples that were collected from homogeneous areas of suspect ACM. The laboratory results are included in Appendix 2.

APPENDIX 1

Bulk Sample Log

Location of Functional Spaces

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Indian Health Service Sacaton Service Unit

Building #200 - Outpatient Clinic Functional Space Locations

Asbestos Containing Materials Inspection

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Figure No.

Project No.

02P-3514

Client: FOHIIHS

IHI Environmental

Bulk Sample Log Service Unit: SACATON Project No.: 02P-3514

Building No.: .2 0 0 ----------------- Material: ( I ) F /6 or 6 Number

Sample Designation: 6 4 C - 2 00 - l HA& Sample Material

HANo. No. Description

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Expires: 12/5/02

Type {TS!. Misc. Surf)

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Sample Location Functional Origin Feet Feet Quant

Space Corner N/S E/W Ht. Surface (s.f.)

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Training Provider: The Asbestos Institute, Phoenix, Arizon2

Phone: (602)864-6564

4527 ~onh 16th Street, Suite 105, Phoenix. Arizona g5016

Telephone: (602) 776-0300 far (602) 776-0301

Lab Result

Client FOH/IHS

Bulk Sample Log

Service Unit: SACATON Project No.: 02P-3514

BuildingNo.:_:;)__cJ.....;:Oo:;;..._ __________ _ Material: ~u:l) \A/ct// s C I 0;Z ) Sample Designation: C'A-C-200 - :;l__ Sample Location

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Inspector: James Marshall

Inspector Sig. ~~~ CY/.::½lf ~e /

AHERA Cert. No.: C8003

Expires: 12/5/02

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Training Provider: The Asbestos Institute, Phoenix, Arizon2

Phone: (602) 864-6564

4527 North 16th Street, Suite 105, Phoenix. Arizona 85016

Telephone: (602} 776-0300 Fax: {602) 776-0301

IID Environmental Bulk Sample Log

Service Unit: SACATON Project No.: 02P-3514 , Client: FOH/IHS

Building No.: Do o Material: (cl ) ~ /j __ R ~ \ Number W \::.:: 'D - J

Sample Designation: <:-A ,--,__ -:, c-? C} ,_ _,-,_ ; '- L, d--- Sample Location t:t l J s

HA& Sample Material Type Functional Origin Feet Feet Quant HA No. No. Description {TSI, Misc.Sud) Space Corner N/S FJW Ht. Surface (s.f.)

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Iospector: ___ J_a_m_e_s_M_a_r_sh_a_U _________ _ Date: d I I y/c) z Inspector Sig. __ aJ...1....,U--P...::;.-1/(__,....) ...._/7......,,......;/l:;_.!./!,.,_(t:......;'=>:::....,:~l'-"' t'--",J,- 1 R ..... /_' -------

AHERA Cert. No.: C8003 ---------- Expires: 12/5/02

Training Provider: The Asbestos Institute, Phoenix, Arizona

Phone: (602) 864-6564

4521 North 16th Street, Suite 105, Phoenix, Arizona 85016

Telephone: (602) 776-0300 Fax: (602) 776-0JOi

Client: FOH/IHS

Bulk ~ample Log Service Unit: SACATON Project No.: 02P-3514

Building No.: __._r-2 ...... · ,_().__Q.,,.___ __________ _ Material: ( 3 > Ce Z Li' "'J s Numbei

Sample Designation: S k -c&c> - 3 Sample Location HA& Sample Material Type Functional Origin Feet Feet Quant

HANo. No. Description (TSI. Misc, Surf) Space Corner N/S F1W Ht. Surface (s.f)

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Inspector: ___ Ja_m_e_s _M_a_rs_ha_ll __ ___,... _____ _

Inspector Sig. -.,L..c--'/ 7::;._·' _·0--z_,.....__:;.ft...;..,1,..__/___.l(_l t; ...... r_i_w_L.;;_·'.· /_/ _____ _ ( - 0

AHERA Cert. No.:

Expires:

C8003 --------- Training Provider: The Asbestos Institute, Phoenix, Arizona

Phone: (602) 864-6564 12/5/02

4527 North 16th Street, Suite 105, Phoenix. Arizona 85016

Telephone: (602) 776-0300 Fax: (602) 776-0301

IHI Environmental. PAGE 1

PHYSICAL ASSESSMENT SHEET OF FRIABLE ACM

t.3UILDING NAME & NO. 5ACA TC]\} - 1) (6 ) q. (✓ 0 () .I

PROJECT NO. U d p ~ 3 5- / Lj

FUNCTIONAL SPACES: ) , 3 - 0 -,.-. .....;;:;._ __________________________ _

HOMOGENEOUS AREA: NUMBER 3 A

TYPE OF MATERIAL: SURFACING __ TSI MISCELLANEOUS _2_

LOCATION OF HOMOGENEOUS AREA WITHIN THE FUNCTIONAL SPACE: _(...;a.f'__,;1....i.)_,.;;1_\,.._,. ti ....... d.;:;;..~-------

FUNCTrONAL SPACE(S) WITH DAMAGED MATERIAL: _____ )'....,__,._\f) ...... f'l....:.....:;;;.l:.: ______________ _

EXTENT OF DAMAGE: LOCALIZED: <25%_ >25% __

SOURCE OF DAMAGE:

PHYSICAL CONT ACT

DETERIORATION/AGE __

VANDALISM

DELAMINATION

DISTRIBUTED: <10%_ >10%_

WATER

FLAKING

AIR EROSION

FIRE

DESCRIPTION OF DAMAGE. __ ~_\f_J_. ________________________ _

OVERALLDAMAGECATEGORY: UNDAMAGED __ DAMAGED_ SIGNIFICANTLY DAMAGED __

POTENTIAL FOR DAMAGE:

POTENTIAL FOR CONTACT: HIGH __ _ MODERATE __ LOW Y

I i I JUSTIFICATION: / rr' ( 1 ',_.,,,, 5 ~ 8 - I{/ l-u Ci ?-1--

EFFECT/INFLUENCE OF VIBRATION: HIGH ___ _ MODERATE,_ __

JUSTIFICATION: __________________________ _

POTENTIAL FOR AIR EROSION: HIGH___ MODERATE. ___ LOW V

JUSTIFICATION: _______________________ / ___ _

OVERALL POTENTIAL FOR DAMAGE:

POTENTIAL FOR SIGNIFICANT POTENTIAL FOR LOW POTENTIAL FOR

DAMAGE/DISTURBANCE__ DAMAGE/DISTURBANCE __ DAMAGE/DISTURBANCE~

I - , JUSTIFICATION: F t'c; /, (-fr'[ /v1q S •_..;..._;_~_.;__.a,....;....:;;_;_--i-)--=-------------------

NESHAP CATEGORY:

NAME OF INSPECTOR:

\CCREDITATION NUMBER: EPA ACCREDITED

P010/ALHAMBRA.PA

Client: FOH/IHS

Building No.: ,200

IHI Environmental

Bulk Sample Log Service Unit: SACATON Project No.: 0ZP-3514

~ ;A:c- iao- -:t-- Material: { + ) ).) r\-'r'e/lo YJ eoJ S

Number Sample Designation: Sample Location

HA& Sample Material Type Functional Origin Feet Feet Quant HANo. No. Description (1SI. Misc. Surf) Space Corner NIS PJW Ht. Surface (s.f.)

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Inspector: ___ Ja_m_es_M_a_rs_h_al_l _________ _ /J I ,J rJ./ Inspector Sig. _ ___,,,,...~-/ ,,;""-"-·1'.'..-...::l~h----7"'~ ._'/,1_½_~,._;:;1vvLr_;;_;;•::;__,, _______ _

AHERA Cert. No.: / (_.C8003 ---------- Expires: l 2/5/02

Training Provider: The Asbestos Institute, Phoenix, Arizona

Phone: (602) 864-6564

4527 ,orth 16th Street. Suite I 05, Phoenix. Arizona 850!6

Telephone: {602} 776-0300 Fax: (602) 776-0301

Client: FOH!IHS

Bulk Sample Log

Service Unit: SACA TON Project No.: 02P-3514 Building No.: ___ c:2P)Z) __ ,....,.........., __ I"'. _______________ _ Material: { 3") id-mfs

Number · Sample Designation: SAc-;;:?~r)-- I Sample Location

HA& Sample Material Type Functional Origin Feet Quant HANo. No. Description (TS!, Misc, Sun) Space Comer NIS Ht. Surface (s.f.)

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Inspector Sig. __ <1-r-L--=~---'1/-_,.~,'--c-;__,,;;~:¼-~_'/1_0.__._}/_...;''L/:..=...._A ______ _

AHERA Cert. No.: / ° C8003 --------- Expires: l 2/5/02

Training Provider: The Asbestos Institute, Phoenix, Arizona

Phone: (602) 864-6564

4527 North 16th Street. Suite IOS, Phoenix. Arizona 85016

Telephone: {602} 776-0300 Fax: (602) 776-030!

APPENDIX2

Laboratory Results

DEPARTMENT OF HEALTH & HUMAN SERVICES

October 9, 2002

Wayne Mohler Federal Occupational Health 2201 - Sixth Ave. M/S RX-21 Seattle, WA 98121

Dear Mr. Mohler:

Program Support Center

Federal Occupational Health Service PO Box 25145, Bldg 41, Ent E-1, Rm 190 Denver Federal Center Denver Co 80225-0145

LGN B0385994

Enclosed are the results of the analysis of 76 bulk materials from IRS SAC 200, submitted to the Division of Federal Occupational Health (DFOH) National Environmental Reference Laboratory (NERL) Asbestos/Fine Particle Analytical Division in Denver, Colorado, for asbestos analysis.

These samples were received at NERL on August 21, 2002. The methods used for this evaluation involve stereo- and polarized-light microscopy (PLM} in compliance with guidelines established by EPA in its Method For The Determination Of Asbestos In Bulk Building Materials (EPA-600/R-93-

116) . The DFOH laboratory services are currently accredited for bulk asbestos analysis_ by the National Voluntary Laboratory Accreditation Program {NVLAP) of the National Institute of Standards and Technology (NIST) . This report may not be used to claim product endorsement by

NVLAP or other U.S. Government agency. our NVLAP 1aboratory code number is 101593-0.

The results given, which pertain only to the materials submitted for testing, are listed in Table 1. Details of this report will not be issued to any person or agency not associated with you or IHS. The EPA method guidelines were developed for use in evaluating friable materials. Point-count reanalysis of materials is recommended to confirm trace or low-percentage PLM results. If you have questions regarding the content of this report, analytical procedures or methods, asbestos evaluation or abatement, please contact DFOH at(303) 236-3455 ext. 500, or NERL directly at (303} 236-9984/9985.

YST //~

IJ

Gaddis

LABORATORY DIRECTOR

~ --:;;.?/4flL Bruce Hills, MS Certified Industrial Hygienist

TABLE 1

DIVISION OF FEDERAL OCCUPATIONAL HEALTH

NERL/AFPAD POLARIZED LIGHT MICROSCOPY (PLM) BRANCH

LGN: B0385994

PROJECT I.D.: IHS SAC 200

REPORT DATE: October 9, 2002

NVLAP LAB CODE: 101593-0

--------Estimated% Composition-----------

SAMPLE

NUMBER

ASBESTOS

PRESENT?

SAC-200-lAl-lA: NO Floor Tile: tan, homogeneous, nonfriable, nonfibrous

SAC-200-lAl-lB: NO Mastic: yellow, homogeneous, nonfriable, nonfibrous

SAC-200-1A2-2A: NO

Floor Tile: tan, homogeneous, nonfriable, nonfibrous

SAC-200-1A2-2B: NO

Mastic: yellow, homogeneous, nonfriable, nonfibrous

SAC-200-1A3-3A: NO

Floor Tile: tan, homogeneous, nonfriable, nonfibrous

SAC-200-1A3-3B: NO

Mastic: yellow, homogeneous, nonfriable, nonfibrous

SAC-200-1Bl-4A: NO Floor Tile: pink, homogeneous, nonfriable, nonfibrous

SAC-200-1Bl-4B: NO Mastic: yellow, homogeneous, nonfriable, nonfibrous

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected None 0

·None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

SAMPLE

NUMBER

ASBESTOS

PRESENT?

SAC-200-1B2-5A: NO

Floor Tile: pink, homogeneous, nonfriable, nonfibrous

SAC-200-1B2-5B: NO

Mastic: yellow, homogeneous, nonfriable, nonfibrous

SAC-200-1B3-6A: NO

Floor Tile: pink, homogeneous, nonfriable, nonfibrous

SAC-200-1B3-6B: NO

Mastic: yellow, homogeneous, nonfriable, nonfibrous

SAC-200-2Al-7: NO Compound: white, homogeneous,· friable, nonfibrous

SAC-200-2A2-8: NO

Compound: white, homogeneous, friable, nonfibrous

SAC-200-2A3-9: NO

Compound: white, homogeneous, friable, nonfibrous

SAC-200-2Bl-10: NO Drywall: white, homogeneous, friable, nonfibrous

SAC-200-2B2-ll: NO Drywall: white, homogeneous, friable, nonfibrous

SAC-200-2B3-12: NO

Drywall.: white, homogeneous, friable, nonfibrous

TABLE l

(CONTINUED)

NVLAP Lab Code 101593-0

--------Estimated% Composition-----------

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected Fibrous Glass 1 0

None Detected Fibrous Glass 1 0

None Detected Fibrous Glass 1 0

NUMBER

ASBESTOS

PRESENT?

SAC-200-2C1-13: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2C2-14: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2C3-15: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2C4-16: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2C5-17: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2C6-18: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2C7-19: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2D1-20: NO

Drywall: pink, homogeneous, friable, nonfibrous

SAC-200-2O2-21: NO

Drywall: pink, homogeneous, friable, nonfibrous

SAC-200-2O3-22: NO

Drywall: pink, homogeneous, friable, nonfibrous

TABLE 1

(CONTINUED)

NVLAP Lab Code 101593-0

--------Estimated% Composition-----------

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

·None Detected

None

None

None

None

None

None

None

Cellulose 3 Fibrous Glass 1

Cellulose 3 Fibrous Glass 1

Cellulose 3 Fibrous Glass 1

NUMBER

ASBESTOS

PRESENT?

SAC-200-2El-23: NO Compound: white, homogeneous, friable, nonfibrous

SAC-200-2E2-24: NO

Compound: white, homogeneous, friable, nonfibrous

SAC-200-2E3-25: NO

Compound: white, homogeneous, friable, nonfibrous

SAC-200-2F1-26: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2F2-27: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2F3-28: NO

Texture: white, homogeneous, friable, nonfibrous

SAC-200-2Gl-29: NO Stucco: pink, homogeneous, nonfriable, nonfibrous

SAC-200-2G2-30A: NO

Stucco: pink, homogeneous, nonfriable, nonfibrous

SAC-200-2G2-30B: NO

Stucco: gray, homogeneous, nonfriable, nonfibrous

SAC-200-2G3-31A: NO

stucco: pink, homogeneous, nonfriable, nonfibrous

TABLE 1

(CONTINUED)

NVLAP Lab Code 101593-0

--------Estimated% Composition-----------

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

NUMBER

ASBESTOS

PRESENT?

SAC-200-2G3-31B: NO

Stucco: gray, homogeneous, nonfriable, nonfibrous

SAC-200-2G4-32: NO

Stucco: gray, homogeneous, nonfriable, nonfibrous

SAC-200-2G5-33A: NO

Stucco: pink, homogeneous, nonfriable, nonfibrous

SAC-200-2G5-33B: NO

Stucco: gray, homogeneous, nonfriable, nonfibrous

SAC-200-2G6-34A: NO

Stucco: pink, homogeneous,· nonfriable, nonfibrous

SAC-200-2G6-34B: NO

Stucco: gray, homogeneous, nonfriable, nonfibrous

SAC-200-2G7-35A: NO

Stucco: pink, homogeneous, nonfriable, nonfibrous

SAC-200-2G7-35B: NO

Stucco: gray, homogeneous, nonfriable, nonfibrous

SAC-200-3Al-36: NO Ceiling Tile: white/gray, heterogeneous, friable, fibrous

SAC-200-3A2-37: NO

Ceiling Tile: white/gray, heterogeneous, friable, fibrous

TABLE 1

(CONTINUED)

NVLAP Lab Code 101593-0

--------Estimated% Composition----------

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected Cellulose 40 0 Fibrous Glass 30

None Detected Cellulose 40 0 Fibrous Glass 30

NUMBER

ASBESTOS

PRESENT?

SAC-200-3A3-38: NO

Ceiling Tile: white/gray, heterogeneous, friable, fibrous

SAC-200-3Bl-39: NO Drywall.: pink, homogeneous, friable, nonfibrous

SAC-200-3B2-40: NO

Drywall: pink, homogeneous, friable, nonfibrous

SAC-200-3B3-41: NO

Drywall: pink, homogeneous, friable, nonfibrous

SAC-200-3Cl-42: NO Compound: white, homogeneous, friable, nonfibrous

SAC-200-3C2-43: NO

Compound: white, homogeneous, friable, nonfibrous

SAC-200-3C3-44: NO

Compound: white, homogeneous, friable, nonfibrous

SAC-200-3D1-45: NO

Ceiling Tile: white/gray, heterogeneous, friable, fibrous

SAC-200-3D2-46: NO

Ceiling Tile: white/gray, heterogeneous, friable, fibrous

SAC-200-3D3-47: NO

Ceiling Til.e: white/gray, heterogeneous, friable, fibrous

TABLE 1

(CONTINUED)

NVLAP Lab Code 101593-0

--------Estimated% Composition-----------

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

None Detected

Cellulose 40 0 Fibrous Glass 30

Cellulose 2 Fibrous Glass 1

Cellulose 2 Fibrous Glass 1

Cellulose 2 Fibrous Glass 1

· None

None

None

Fibrous Glass 70 0

Fibrous Glass 70 0

Fibrous Glass 70 0

NUMBER

ASBESTOS

PRESENT?

SAC-200-3El-48: NO Mastic: brown, homogeneous, nonfriable, nonfibrous

SAC-200-3E2-49: NO

Mastic: brown, homogeneous, nonfriable, nonfibrous

SAC-200-3E3-50: NO

Mastic: brown, homogeneous, nonfriable, nonfibrous

SAC-200-7Al-51: NO Mastic: white, homogeneous, nonfriable, nonfibrous

SAC-200-7A2-52: NO

Mastic: white, homogeneous, nonfriable, nonfibrous

SAC-200-7A3-53: NO

Mastic: white, homogeneous, nonfriable, nonfibrous

SAC-200-8Al-54A: NO Shingle: gray/black, heterogeneous, nonfriable, fibrous

SAC-200-8Al-54B: NO Roofing: black, heterogeneous, nonfriable, fibrous

SAC-200-BA2-55A: NO

Shingle: gray/black, heterogeneous, nonfriable, fibrous

SAC-200-8A2-55B: NO

Roofing: black, heterogeneous, nonfriable, fibrous

TABLE 1

(CONTINUED)

NVLAP Lab Code 101593-0

--------Estimated% Composition-----------

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected None 0

None Detected Fibrous Glass 30 0

None Detected Fibrous Glass 20 0

None Detected Fibrous Glass 30 0

None Detected Fibrous Glass 20 0

NUMBER

ASBESTOS

PRESENT?

SAC-200-8A3-56A: NO

Shingle: gray/black, heterogeneous, nonfriable, fibrous

SAC-200-8A3-56B: NO

Roofing: black, heterogeneous, nonfriable, fibrous

SAC-200-8Bl-57A: NO Paint: silver, homogeneous, nonfriable, nonfibrous

SAC-200-8Bl-57B: NO Tar: black, homogeneous, nonfriable, fibrous

SAC-200-8B2-58A: NO

Paint: silver, homogeneous, nonfriable, nonfibrous

SAC-200-8B2-58B: NO

Tar: black, homogeneous, nonfriable, fibrous

SAC-200-8B3-59A: NO

Paint: silver, homogeneous, nonfriable, nonfibrous

SAC-200-8B3-59B: NO

Tar: black, homogeneous, nonfriable, fibrous

TABLE 1

(CONTINUED)

NVLAP Lab Code 101593-0

--------Estimated% Composition----------

ASBESTIFORM OTHER FIBROUS TOTAL%

MINERAL FIBERS CONSTITUENTS ASBESTOS

None Detected Fibrous Glass 30 0

None Detected Fibrous Glass 20 0

None Detected None 0

None Detected Cellulose 20 0

None Detected None 0

None Detected Cellulose 20 0

None Detected Cellulose 20 0

• S. Public Health S U.S. Public Health Service (U.S. Postal

<~;:~~~,:: :::;:_¥2~rr;::T~{"- -(FED-EX) g Address) For Lab Use Only ederal Occupationa. .th Federal Occupational Health Project#:

OH EH Environmental Laboratory FOH EH Environmental Laboratory uilding 41, Room 190, E-1, Denver Federal Center P.O. Box 25145

Due Date:

1enver, Colorado 80225 hone: (303) 236-9984 Fax: (303) 236-3440 :lient Information:

ederal Occupational Health 1ddress: 2201 5th

Avenue, RX-21 :ity: Seattle State: WA Zip Code: 98121 'hone: (206) 615-2441 ax: (206) 615-2446 OH Area Office: San Francisco, CA OH POC: Wayne Mohler

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IHI Environmental 4527 North 15th Street Phoenix, AZ 85016

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SPA/Contract No.: 232-98-0014 :ederal Occupational Health To: Delivery Order: SF02-09 ,ddress: 2201 6 th Avenue, RX-21 IHI Environmental :ity: Seattle State: WA Zip Code: 98121 4527 North 16th Street 1hone: (206) 615-2441 Phoenix, AZ 85016 :ax: (206) 615-2446 OH Area Office: San Francisco, CA Phone: (602) 776-0300 Fax: (602) 776-0301 ·oH POC: Wavne Mohler

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:.eceived by: , Date:

-· .,,._., Rush.

) ... , \ er) • Routine: Pagel.fat

;omments:

APPENDIX3

Certifications

THE ~SBESTOSINSTITUTE

' I ! i' • . . . . ·. . s -'· (' .. , .. , -: ' ' - -, . . -- x, e.. , J s / r. · _ __ 1 .• _

C . f. th ~ . . h... ~ . 1 ,r,,.rr· . . -.. ert1 ies at .,. · ·· y: .·· . · .. ·.'-1 • ·.• , , .1

J3fn#s Michael )\1arsBa ( tJ//

1¼.,lf' f \ ,_.,...,-....(..,,~ / ~/ ,~ .,JJ#I > / \ . • I' i <. J cP'I' (/) y /

·-I ' I u IJ~ERA i-____ .. \·" ,/ . -_: '-•~§uilMih~ Inspect t---~

·. , · Delember 3-S, 4, · OJ ..

and successfully passed the competenc)/4 exam. ,/, ,._

• . . i l ,I'"· .,_ I • • l i .,, ,, ,, i I Date\9f Exarriination: Dece'mber 5, 200 I

,r, ~} .,_ Date of Expii;a(q9' ,'Djc'6m~c:r S, 2002

~ ~ / Ct (:•i• r·, 11•\1,<J /)i/1/ r -.A·(~ n r 11• .. , ~ . li(!.:1•-51: J&.,cz.. •

THE AsnEsTos INSTITUTE 8102 North 23rd A venue

Suite A Phoenix, AZ 85021-4904

602-864-6564

Appr9veolnstructor

This tmi11i111: meets nil m11lirrm1r11t.\' for n.fhestos nccreditarinn 111uler TSCA 7it/e II.

C 8003