S02 - Building 2 Hazard Report.pdf

LIMITED PRE-RENOVATION

ASBESTOS INSPECTION REPORT

RENOVATE BUILDING 2 FOR MENTAL HEALTH RRTP BEDS

VA PROJECT NO #676-322

SITE:

TOMAH VA MEDICAL CENTER

500 EAST VETERANS STREET

TOMAH, WISCONSIN

PREPARED FOR:

RUSSELL DREWRY AIA

ASSOCIATE VICE PRESIDENT

HGA ARCHITECTS AND ENGINEERS

333 EAST ERIE STREET, MILWAUKEE, WI 53202

PREPARED BY:

PROJECT REFERENCE #2794

MARCH 2011

This document contains confidential information which is the sole and exclusive property of Sigma Environmental Services, Inc. and CLIENT. This document shall not be duplicated in any manner except in full without the express written consent of Sigma Environmental

Services, Inc.

Copyright, SIGMA ENVIRONMENTAL SERVICES, INC.

TABLE OF CONTENTS

Page

1. INTRODUCTION

2. BACKGROUND

3. ASBESTOS SAMPLE COLLECTION AND ANALYSIS PROCEDURES

4. SUMMARY OF RESULTS

5. RECOMMENDATIONS

6. QUALIFICATIONS OF REPORT

7. STATE AND LOCAL REPORTING REQUIREMENTS

Tables

1 Summary of Building Materials (Sorted by Building and Material Code)

2 Summary of Building Materials (Sorted by Building and Material Code and Room)

3 Summary of Building Materials (Sorted by Building and Room)

4 Summary of Asbestos-Containing Building Materials (Sorted by Building and Material Code)

5 Bulk Material Sample Summary (Sorted by Building and Sample Number)

6 Bulk Material Sample Summary (Sorted by Building and Material Code)

Figures

1 Basement and First Floor Plan Layout

2 Second Floor and Roof Plan Layout

Appendices

A. Credentials – Wisconsin Certified Asbestos Inspectors

B. Certificate of Analysis

C. Photo Documentation

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1. INTRODUCTION

HGA Architects and Engineers (HGA) retained Sigma Environmental Services, Inc.

(Sigma) to perform a limited pre-renovation asbestos inspection in Building 2 as part of the Mental Health RRTP Beds project. The inspection activities described in Sigma’s proposal dated November 22, 2010 were limited to the Veterans Affairs Medical Center

(VA) Building 2 located in Tomah, Wisconsin and included visual observation, material sampling and laboratory analysis of suspect asbestos-containing building materials

(ACBM).

State of Wisconsin certified asbestos inspectors, Mr. Dale Armbruster (AII-156285) and

Mr. Tom McCoy (AII-117261), performed the limited pre-renovation asbestos inspection between February 8 and 10, 2011. Appendix A provides a copy of Mr.

Armbruster’s and Mr. McCoy’s asbestos inspection certification cards. This limited pre-renovation asbestos inspection was performed in substantial compliance with the

United States Environmental Protection Agency’s (USEPA) National Emission Standards for Hazardous Air Pollutants (NESHAP) asbestos regulations (40 CFR 61, Subpart M) and the Wisconsin Department of Natural Resources (WDNR) Control of Asbestos

Emissions (WAC Chapter NR 447) inspection and sampling requirements with the exception of items and/or areas listed in the Qualifications of Report section.

Building 2 was vacant at the date and time of this inspection. Floor plans indicating the existing floor layout were provided to Sigma prior to the assessment.

2. BACKGROUND

Pre-renovation asbestos inspections are required by the USEPA NESHAP regulations provided in 40 CFR 61 and the WDNR Control of Asbestos Emissions defined in

Chapter NR 447. The VA is required to perform a thorough asbestos inspection of the affected facility or part of the facility where the renovation operation will occur prior to the commencement of the renovation.

3. ASBESTOS SAMPLE COLLECTION AND ANALYSIS PROCEDURES

Between February 8 and 10, 2011, Sigma visually inspected building materials and obtained representative samples from each identified homogeneous material of suspect

ACBM with the exception of items listed in the Qualifications of Report section. The samples were submitted under chain of custody to International Asbestos Testing

Laboratories, Inc. (IATL) in Mount Laurel, New Jersey for asbestos analysis. IATL is a

National Voluntary Laboratory Accreditation Program (NVLAP) and American Industrial

Hygiene Association (AIHA) approved laboratory. Samples were analyzed using

Polarized Light Microscopy (PLM) coupled with Dispersion Staining as outlined in the

USEPA’s, “Method for the Determination of Asbestos in Bulk Building Material (EPA-

600/R93/116)”. Samples identified using PLM analysis with less than 10 percent asbestos content were point counted in accordance with EPA-600/R-93/116.

4. SUMMARY OF RESULTS

ACBM was identified within the limits of renovation as defined in the figures.

Homogenous materials defined as ATC or POS in the tables were either assumed to contain asbestos or determined to contain greater than one percent asbestos fiber

N:\HGA\2794 - Tomah Mental Health\Asbestos\Asb Rpt v2011-3-16.doc 2 concentration estimated visually by PLM analysis and are therefore classified as ACBM

(WDNR definition). Materials determined to contain less than one percent asbestos by

PLM point count analysis are identified with the designation “- (<1% Asbestos by PC)” in the material description and are defined as ATC. While these materials are not regulated by the USEPA or WDNR, OSHA does regulate these materials. Finally, materials determined not to contain asbestos are defined as NEG.

Tables 1 through 6 provide the inspection material inventory, analytical results, and summary of materials identified or assumed to be ACBM. Figures 1 and 2 provide the floor plans. A copy of the asbestos Certificate of Analysis is provided in Appendix B.

Photo documentation of each sample is provided in Appendix C.

5. RECOMMENDATIONS

The USEPA, WDNR, and Occupational Safety and Health Act (OSHA) regulate activities involving asbestos. The following provides a brief summary of the requirements specific to asbestos.

USEPA and WDNR

The NESHAP regulations authorized under the Clean Air Act and administered by the

USEPA and the WDNR cover a wide variety of substances, including asbestos. NESHAP defines ACBM that must be removed prior to demolition and/or renovation and those

ACBMs that can remain.

Friable

Friable asbestos material is defined as a material containing more than one percent asbestos that when dry, can be crumbled, pulverized, or reduced to powder by hand pressure.

Category I

Non-friable Category I ACM is generally defined as packings, gaskets, resilient floor covering, and asphalt roofing containing more than one percent asbestos that when dry cannot be crumbled, pulverized, or reduced to powder by hand pressure.

Category II

Non-friable Category II ACBM is defined as any material, excluding Category I non-friable ACM, containing more than one percent asbestos that when dry cannot be crumbled, pulverized, or reduced to powder by hand pressure.

RACM: NESHAP defines Regulated Asbestos Containing Material (RACM) as:

- Friable asbestos material; or

- Category I nonfriable ACM that has become friable; or

- Category I nonfriable ACM that will be or has been subject to sanding, grinding, cutting or abrading; or

- Category II nonfriable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations

With limited exceptions, Section NR 447.08 of the Wisconsin Administrative code generally requires that all RACM be removed from a facility being demolished or

N:\HGA\2794 - Tomah Mental Health\Asbestos\Asb Rpt v2011-3-16.doc 3 renovated before any activity that would break up, dislodge, or similarly disturb the material or preclude access to the material for subsequent removal.

Chapter NR 447 also has specific requirements that pertain to the disposal of wastes containing asbestos.

In addition to the requirements stated above, a trained individual knowledgeable with the requirements of 40 CFR Part 61, Subpart M must be onsite during demolition and/or renovation activities and be available during normal business hours. If any ACBM material becomes damaged or rendered friable during demolition and/or renovation, proper abatement measures must be immediately initiated by appropriately trained

State of Wisconsin certified abatement personnel.

Sigma recommends that the VA review the summary of identified or assumed ACBM provided in Table 4 and the narrative above in order to determine which materials require removal prior to renovation activities.

OSHA

OSHA regulates employee exposure to hazardous conditions. 29 Code of Federal

Regulations (CFR) 1926 regulates employee exposure to hazardous substances in the construction industry. 29 CFR 1926.1101 regulates activities which may impact materials containing asbestos. OSHA defines asbestos as chrysotile, amosite, crocidolite, tremolite asbestos, anthophyllite asbestos, actinolite asbestos, and any of these minerals that has been chemically treated and/or altered. While materials determined to contain asbestos at less than one percent are not classified as ACBM and are therefore not regulated by the USEPA and WDNR, OSHA does regulate activities involving these materials.

Sigma recommends that the VA be aware of the OSHA requirements for activities involving materials containing asbestos. Additional recommendations are provided in the Qualifications of Report section provided below.

6. QUALIFICATIONS OF REPORT

The findings and recommendations included herein are based on information obtained during the site visit and from previous experience. The limitations of the report and recommended actions are as follows:

1. The material condition assessment reflects conditions at the date and time of the inspection. Material conditions may change due to age, use, maintenance, and other building conditions.

It is recommended that the ACBM material condition be assessed immediately prior to initiating renovation and/or demolition activities.

2. An assessment/inspection of non-building components including but not limited to office equipment, beds, chairs, desks, tables, cabinets, kitchen and other appliances, wall hangings, and other equipment and materials used or stored by the former/current occupant was not conducted.

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It is recommended that these items be managed in accordance with all local, state, and federal rules and regulations.

3. Homogeneous material samples were collected from reasonably accessible areas only. Destructive investigation methods were not employed to identify additional materials not readily visible. During abatement, demolition, renovation, and/or further inspection, a potential exists for encountering asbestos and/or other hazardous materials not previously identified to become revealed.

It is recommended that there is one individual on-site during abatement and demolition that is designated as a “Competent Person”. At a minimum, this individual shall be a State of Wisconsin certified asbestos supervisor familiar with applicable asbestos and hazardous material related regulations; have the experience to recognize potential work crew and environmental exposures;

institute proper personal protective equipment and personnel monitoring as necessary; have the authority to stop work; and meet training requirements established by the State of Wisconsin. Discovery of suspect asbestos and/or other hazardous materials should be reported immediately to the Owner so that appropriate measures can be implemented. Further sampling of newly discovered materials may be required to confirm the presence of ACBM within walls and other areas that were not visible or reasonably accessible during the asbestos inspection.

4. Estimated quantities of ACBM should be considered a preliminary estimate of square footage, linear footage, or individual units for each identified ACBM.

Accurate pricing for abating identified ACBMs will be best realized following the bidding of abatement activities to qualified contractors.

It is recommended that quantities of identified ACBMs be field verified by the abatement contractors bidding on the abatement activities.

5. In accordance with the terms of the November 22, 2010 proposal or observed conditions, the following floors, materials, building systems and/or areas were not evaluated for the presence of asbestos:

• The building electrical system(s) was not evaluated or sampled for the presence of asbestos as it was energized at the time of the inspection;

• The building heating system(s) was not evaluated or sampled for the presence of asbestos as it was energized at the time of the inspection;

• The main facility roofing system was not inspected for the presence of asbestos. The roof over the boiler room was inspected and evaluated for the presence of asbestos; and

• Non-building components including but not limited to office equipment, beds, chairs, desks, tables, cabinets, kitchen and other appliances, wall hangings, and other equipment and materials used or stored by the former/current occupant were not evaluated for the presence of asbestos.

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These areas and building systems should be assumed to contain materials having greater than one percent asbestos or be further evaluated prior to conducting renovation and/or demolition activities.

6. Materials determined to contain less than one percent asbestos using PLM point count analysis are not regulated by the USEPA or WDNR. However, OSHA still regulates activities involving materials containing any asbestos. These materials are designated as ATC and are identified as “(<1% Asbestos by PC)” in this report.

It has been our experience that removal of materials with asbestos is best performed by certified asbestos workers using appropriate means and methods.

7. STATE AND LOCAL REPORTING REQUIREMENTS

The WDNR and the Department of Health Services (DHS) require notification (WDNR

Form 4500-113 and WDHS Form F00041) prior to asbestos abatement or demolition projects. The City of Tomah should be consulted for applicability of additional local ordinances, codes, and permits.

TABLES

The inspection results are summarized in the following tables.

Table 1 – Summary of Building Materials (Sorted by Building and Material Code) provides the material code, material description, asbestos classification

(positive, negative, contains asbestos at less than one percent and is assumed to contain asbestos (ATC)), and estimated quantity for each positive or ATC ACBM.

Table 2 – Summary of Building Materials (Sorted by Building and Material Code and

Room) provides a comprehensive summary of all building materials identified and includes the material code, material description, room number, estimated quantity for each positive or ATC ACBM, asbestos classification (positive, negative, ATC), and category (Category I, Category II, or Friable) and condition (Fair, Good, or Poor) for each positive or ATC ACBM.

Table 3 – Summary of Building Materials (Sorted by Building and Room) provides a comprehensive summary of all building materials identified on a room by room basis and includes the material code, material description, estimated quantity for each positive or ATC ACBM, asbestos classification

(positive, negative, ATC), and category (Category I, Category II, or Friable) and condition (Fair, Good, or Poor) for each positive or ATC ACBM.

Table 4 – Summary of Asbestos-Containing Building Materials (Sorted by Building and

Material Code) provides a summary of all positive and ATC ACBM and includes the material code, material description, category (Category I, Category II, or Friable), room number(s), asbestos classification (positive, ATC), estimated quantity, and condition (Fair, Good, Poor).

Table 5 – Bulk Material Sample Summary (Sorted by Building and Sample Number) provides a summary of bulk material samples in numerical order and includes the sample number, material code, material description, sample comments, building, sample location, and asbestos content (percentage, not detected

(NEG), not analyzed (NA), point counted (PC)).

Table 6 – Bulk Material Sample Summary (Sorted by Building and Material Code) provides a summary of bulk material samples in alphabetical order and includes the building, material code, material description, sample comments, sample number, sample location, and asbestos content (percentage, not detected (NEG), not analyzed (NA), point counted (PC)).

TABLE 1

SUMMARY OF BUILDING MATERIALS

Sorted by Building and Material Code

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Material DescriptionMaterial Code Estimated QtyACM

INACCESSIBLEINA

8" BRICK MORTARMB8M NEG

CAULK - LIGHT GRAYMC-1 NEG

CAULK - WHITEMC-2 NEG

CAULK - BROWNMC-3 97 lfPOS

CAULK - EXTERIOR WHITE MC-4 1245 lfPOS

CAULK - TAN EXTERIOR MC-5 NEG

CAULK - BLACK EXTERIOR (<1% ASBESTOS BY PC)MC-6 15 lfATC

CAULK - EXTERIORMC-7 5 lfPOS

CAULK - EXTERIOR LIGHT GRAYMC-8 NEG

CAULK - BLACK EXTERIOR SOFTMC-9 NEG

CONCRETE BLOCK MORTARMCBM NEG

ROOF CAP MASTIC MCM 30 sfPOS

CERAMIC TILE & MASTIC - 2X2: TAN BROWN BLACK MCTM-1 NEG

CERAMIC TILE & MASTIC - 4X4: YELLOWMCTM-2 NEG

CERAMIC TILE & MASTIC - 2X4: BLACKMCTM-3 NEG

CERAMIC TILE & MASTIC - 1X1: LT. GRAYMCTM-4 NEG

CERAMIC TILE & MASTIC - 3X6: WHITEMCTM-5 NEG

CERAMIC TILE & MASTIC - 1X2: WHITEMCTM-6 NEG

CERAMIC TILE & MASTIC - 3X6: GREENMCTM-8 NEG

CERAMIC TILE & MASTIC - 4X4: WHITE WITH GOLD

SPECS

MCTM-9 NEG

DUCT SEALANTMDS NEG

DRYWALL MDW NEG

DRYWALL AND JOINT COMPOUND - DRYWALL AND

JOINT COMPOUND

MDWC-1 NEG

ELEVATOR SYSTEM - CAR, MECHANICAL AND

ELECTRICAL SYSTEMS

MES 1 EATC

FIRE BRICK - REDMFB-1 NEG

FIRE BRICK MORTAR-GRAYMFBM NEG

HEATING SYSTEM - FORCED AIR UNITMHS 3 EATC

MASTIC - BLACKMM NEG

BLACK MASTIC - 6-INCH BASEBOARDMM1 NEG

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Notes:

sf = Square Feet ATC = Assumed to contain asbestos lf = Linear Feet NEG = Asbestos content less than or equal to one percent E = Each POS = Asbestos content greater than one percent

TABLE 1

Sorted by Building and Material Code

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Material DescriptionMaterial Code Estimated QtyACM

MORTAR PATCH WHITE MMP-1 NEG

MORTAR PATCH PINKMMP-2 NEG

MORTAR PATCH GREY (<1% ASBESTOS BY PC)MMP-3 48 sfATC

WINDOW PANE GLAZING - WHITEMPG-1 4670 lfPOS

PYROBAR WHITE MPRB NEG

BUILT- UP ROOF - ABOVE BOILER ROOMMRB-1 NEG

MAIN BUILDING ROOF SYSTEMMRS 1 EATC

SINK LINING - GRAYMSC-1 NEG

TERRAZZO FLOOR - BLACK CREAM YELLOW REDMTF-1 NEG

TERRAZZO FLOOR - BLACK AND WHITE MTF-2 NEG

TOILET WAX RINGMTWR 18 EATC

WATER PROOFINGMWP NEG

PLASTER - WHITE SPI-1 NEG

0-5" AIRCELL PIPE INSULATIONTA5 23 lfPOS

0-5" FITTING ON AIRCELL PIPE INSULATIONTA5F 2 EPOS

PIPE WRAPTPW NEG

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Notes:

sf = Square Feet ATC = Assumed to contain asbestos

TABLE 2

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

INACCESSIBLEINA ELEVATOR

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

8" BRICK MORTAR NEGMB8M 00B11

8" BRICK MORTAR NEGMB8M 00B13

8" BRICK MORTAR NEGMB8M 00B5

8" BRICK MORTAR NEGMB8M 00B6

8" BRICK MORTAR NEGMB8M 00B7

8" BRICK MORTAR NEGMB8M 00B8

8" BRICK MORTAR NEGMB8M 0116

8" BRICK MORTAR NEGMB8M 0118

8" BRICK MORTAR NEGMB8M 0120

8" BRICK MORTAR NEGMB8M 0121

8" BRICK MORTAR NEGMB8M 0122

8" BRICK MORTAR NEGMB8M 0126

8" BRICK MORTAR NEGMB8M 0131

8" BRICK MORTAR NEGMB8M 0137

8" BRICK MORTAR NEGMB8M 0225

8" BRICK MORTAR NEGMB8M 0234

8" BRICK MORTAR NEGMB8M 0236

8" BRICK MORTAR NEGMB8M 0301

8" BRICK MORTAR NEGMB8M 0302

8" BRICK MORTAR NEGMB8M 0303

8" BRICK MORTAR NEGMB8M EXTERIOR S

8" BRICK MORTAR NEGMB8M HW-2

8" BRICK MORTAR NEGMB8M HW-2

Page 1 of 18Sigma Environmental Services, Inc.3/16/2011

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Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - LIGHT GRAY NEGMC-1 00B1

CAULK - LIGHT GRAY NEGMC-1 00B11

CAULK - LIGHT GRAY NEGMC-1 00B2

CAULK - LIGHT GRAY NEGMC-1 00B3

CAULK - LIGHT GRAY NEGMC-1 0101

CAULK - LIGHT GRAY NEGMC-1 0118

CAULK - LIGHT GRAY NEGMC-1 0136

CAULK - LIGHT GRAY NEGMC-1 0137

CAULK - LIGHT GRAY NEGMC-1 0200

CAULK - LIGHT GRAY NEGMC-1 0201

CAULK - LIGHT GRAY NEGMC-1 0208

CAULK - LIGHT GRAY NEGMC-1 0211

CAULK - LIGHT GRAY NEGMC-1 0212

CAULK - LIGHT GRAY NEGMC-1 0213

CAULK - LIGHT GRAY NEGMC-1 0215

CAULK - LIGHT GRAY NEGMC-1 0216

CAULK - LIGHT GRAY NEGMC-1 0219

CAULK - LIGHT GRAY NEGMC-1 0221

CAULK - LIGHT GRAY NEGMC-1 0223

CAULK - LIGHT GRAY NEGMC-1 0224

CAULK - LIGHT GRAY NEGMC-1 0226

CAULK - LIGHT GRAY NEGMC-1 0227

CAULK - LIGHT GRAY NEGMC-1 0228

CAULK - LIGHT GRAY NEGMC-1 0229

CAULK - LIGHT GRAY NEGMC-1 0232

CAULK - LIGHT GRAY NEGMC-1 0233

CAULK - LIGHT GRAY NEGMC-1 0234

CAULK - LIGHT GRAY NEGMC-1 0235

CAULK - LIGHT GRAY NEGMC-1 0236

CAULK - LIGHT GRAY NEGMC-1 HW-3

CAULK - LIGHT GRAY NEGMC-1 SW-1

CAULK - LIGHT GRAY NEGMC-1 SW-2

Page 2 of 18Sigma Environmental Services, Inc.3/16/2011

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Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

CAULK - LIGHT GRAY NEGMC-1 SW-3

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - WHITE NEGMC-2 00B5

CAULK - WHITE NEGMC-2 0107

CAULK - WHITE NEGMC-2 0112

CAULK - WHITE NEGMC-2 0118

CAULK - WHITE NEGMC-2 0120

CAULK - WHITE NEGMC-2 0201

CAULK - WHITE NEGMC-2 0208

CAULK - WHITE NEGMC-2 0211

CAULK - WHITE NEGMC-2 0221

CAULK - WHITE NEGMC-2 0224

CAULK - WHITE NEGMC-2 0227

CAULK - WHITE NEGMC-2 0235

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - BROWN 2 lf POSMC-3 FairCategory I0235

CAULK - BROWN 30 lf POSMC-3 GoodCategory I0301

CAULK - BROWN 25 lf POSMC-3 GoodCategory I0302

CAULK - BROWN 40 lf POSMC-3 GoodCategory I0303

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - EXTERIOR WHITE 110 lf POSMC-4 FairCategory IEXTERIOR E

CAULK - EXTERIOR WHITE 435 lf POSMC-4 FairCategory IEXTERIOR N

CAULK - EXTERIOR WHITE 300 lf POSMC-4 FairCategory IEXTERIOR S

CAULK - EXTERIOR WHITE 200 lf POSMC-4 FairCategory IEXTERIOR W

CAULK - EXTERIOR WHITE 200 lf POSMC-4 EXTERIOR W

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - TAN EXTERIOR NEGMC-5 BIOLER RM ROOF

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - BLACK EXTERIOR (<1%

ASBESTOS BY PC)

15 lf ATCMC-6 GoodCategory IBIOLER RM ROOF

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Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - EXTERIOR 5 lf POSMC-7 FairCategory IBIOLER RM ROOF

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - EXTERIOR LIGHT GRAY NEGMC-8 BIOLER RM ROOF

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - BLACK EXTERIOR SOFT NEGMC-9 BIOLER RM ROOF

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CONCRETE BLOCK MORTAR NEGMCBM 00B12

CONCRETE BLOCK MORTAR NEGMCBM 00B13

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

ROOF CAP MASTIC 30 sf POSMCM GoodCategory IIBIOLER RM ROOF

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 2X2: TAN

BROWN BLACK

NEGMCTM-1 0107

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 4X4: YELLOW NEGMCTM-2 0107

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 2X4: BLACK NEGMCTM-3 0107

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Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0108

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0112

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0116

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0121

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0123

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0125

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0129

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0135

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0136

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0201

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0211

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0219

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0224

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0226

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0229

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0233

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4 0235

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Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0108

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0112

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0116

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0121

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0123

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0125

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0129

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0135

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0136

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0201

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0211

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0219

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0224

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0226

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0229

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0233

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5 0235

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 1X2: WHITE NEGMCTM-6 0227

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 3X6: GREEN NEGMCTM-8 0227

CERAMIC TILE & MASTIC - 3X6: GREEN NEGMCTM-8 0228

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 4X4: WHITE

WITH GOLD SPECS

NEGMCTM-9 0229

Page 6 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

DUCT SEALANT NEGMDS 00B10

DUCT SEALANT NEGMDS 00B12

DUCT SEALANT NEGMDS 00B13

DUCT SEALANT NEGMDS 00B6

DUCT SEALANT NEGMDS 00B9

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

DRYWALL NEGMDW 00B10

DRYWALL NEGMDW 00B11

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

DRYWALL AND JOINT COMPOUND -

DRYWALL AND JOINT COMPOUND

NEGMDWC-1 00B12

DRYWALL AND JOINT COMPOUND -

DRYWALL AND JOINT COMPOUND

NEGMDWC-1 00B13

DRYWALL AND JOINT COMPOUND -

DRYWALL AND JOINT COMPOUND

NEGMDWC-1 00B2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

ELEVATOR SYSTEM - CAR, MECHANICAL

AND ELECTRICAL SYSTEMS

1 E ATCMES Category IIELEVATOR

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

FIRE BRICK - RED NEGMFB-1 00B13

FIRE BRICK - RED NEGMFB-1 00B6

FIRE BRICK - RED NEGMFB-1 00B7

FIRE BRICK - RED NEGMFB-1 0118

FIRE BRICK - RED NEGMFB-1 0120

FIRE BRICK - RED NEGMFB-1 0131

FIRE BRICK - RED NEGMFB-1 0200

FIRE BRICK - RED NEGMFB-1 0211

FIRE BRICK - RED NEGMFB-1 0212

FIRE BRICK - RED NEGMFB-1 0213

FIRE BRICK - RED NEGMFB-1 0236

FIRE BRICK - RED NEGMFB-1 HW-2

Page 7 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

FIRE BRICK MORTAR-GRAY NEGMFBM 0101

FIRE BRICK MORTAR-GRAY NEGMFBM 0126

FIRE BRICK MORTAR-GRAY NEGMFBM 0137

FIRE BRICK MORTAR-GRAY NEGMFBM 0225

FIRE BRICK MORTAR-GRAY NEGMFBM 0234

FIRE BRICK MORTAR-GRAY NEGMFBM 0301

FIRE BRICK MORTAR-GRAY NEGMFBM 0302

FIRE BRICK MORTAR-GRAY NEGMFBM 0303

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

HEATING SYSTEM - FORCED AIR UNIT 3 E ATCMHS GoodCategory II00B6

Page 8 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

MASTIC - BLACK NEGMM 0103

MASTIC - BLACK NEGMM 0108

MASTIC - BLACK NEGMM 0112

MASTIC - BLACK NEGMM 0114

MASTIC - BLACK NEGMM 0116

MASTIC - BLACK NEGMM 0118

MASTIC - BLACK NEGMM 0120

MASTIC - BLACK NEGMM 0124

MASTIC - BLACK NEGMM 0129

MASTIC - BLACK NEGMM 0131

MASTIC - BLACK NEGMM 0208

MASTIC - BLACK NEGMM 0211

MASTIC - BLACK NEGMM 0213

MASTIC - BLACK NEGMM 0215

MASTIC - BLACK NEGMM 0216

MASTIC - BLACK NEGMM 0217

MASTIC - BLACK NEGMM 0221

MASTIC - BLACK NEGMM 0223

MASTIC - BLACK NEGMM 0232

MASTIC - BLACK NEGMM 0234

MASTIC - BLACK NEGMM HW-2

MASTIC - BLACK NEGMM HW-3

Page 9 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 00B5

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 00B7

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 00B8

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0103

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0107

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0112

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0114

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0116

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0118

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0119A

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0120

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0123

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0124

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0129

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0131

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0208

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0211

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0213

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0215

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0216

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0217

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0219

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0221

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0223

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0226

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0227

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0228

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0229

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0232

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 0234

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 HW-1

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 HW-2

Page 10 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1 HW-3

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH WHITE NEGMMP-1 00B10

MORTAR PATCH WHITE NEGMMP-1 00B11

MORTAR PATCH WHITE NEGMMP-1 00B12

MORTAR PATCH WHITE NEGMMP-1 00B6

MORTAR PATCH WHITE NEGMMP-1 00B8

MORTAR PATCH WHITE NEGMMP-1 0303

MORTAR PATCH WHITE NEGMMP-1 HW-1

MORTAR PATCH WHITE NEGMMP-1 SW-1

MORTAR PATCH WHITE NEGMMP-1 SW-3

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH PINK NEGMMP-2 00B10

MORTAR PATCH PINK NEGMMP-2 00B12

MORTAR PATCH PINK NEGMMP-2 00B6

MORTAR PATCH PINK NEGMMP-2 00B7

MORTAR PATCH PINK NEGMMP-2 00B8

MORTAR PATCH PINK NEGMMP-2 00B9

MORTAR PATCH PINK NEGMMP-2 0303

MORTAR PATCH PINK NEGMMP-2 HW-1

MORTAR PATCH PINK NEGMMP-2 SW-1

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH GREY (<1% ASBESTOS

BY PC)

22 sf ATCMMP-3 FairCategory II00B11

MORTAR PATCH GREY (<1% ASBESTOS

BY PC)

20 sf ATCMMP-3 FairCategory II00B6

MORTAR PATCH GREY (<1% ASBESTOS

BY PC)

3 sf ATCMMP-3 GoodCategory II00B7

MORTAR PATCH GREY (<1% ASBESTOS

BY PC)

3 sf ATCMMP-3 FairCategory II00B9

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

WINDOW PANE GLAZING - WHITE 2600 lf POSMPG-1 PoorCategory IEXTERIOR N

WINDOW PANE GLAZING - WHITE 2070 lf POSMPG-1 PoorCategory IEXTERIOR S

Page 11 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

PYROBAR WHITE NEGMPRB 00B5

PYROBAR WHITE NEGMPRB 0112

PYROBAR WHITE NEGMPRB 0114

PYROBAR WHITE NEGMPRB 0215

PYROBAR WHITE NEGMPRB 0224

PYROBAR WHITE NEGMPRB 0225

PYROBAR WHITE NEGMPRB 0236

PYROBAR WHITE NEGMPRB 0302

PYROBAR WHITE NEGMPRB HW-2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

BUILT- UP ROOF - ABOVE BOILER ROOM NEGMRB-1 BIOLER RM ROOF

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

MAIN BUILDING ROOF SYSTEM 1 E ATCMRS Category I0ROOF

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

SINK LINING - GRAY NEGMSC-1 00B10

SINK LINING - GRAY NEGMSC-1 00B11

Page 12 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 00B1

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 00B10

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 00B11

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 00B13

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 00B2

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 00B9

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 0107

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 0122

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 0126

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 0212

TERRAZZO FLOOR - BLACK CREAM

YELLOW RED

NEGMTF-1 0225

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

TERRAZZO FLOOR - BLACK AND WHITE NEGMTF-2 00B9

Page 13 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

TOILET WAX RING 1 E ATCMTWR Category I0107

TOILET WAX RING 1 E ATCMTWR Category I0108

TOILET WAX RING 1 E ATCMTWR Category I0112

TOILET WAX RING 1 E ATCMTWR Category I0116

TOILET WAX RING 1 E ATCMTWR Category I0121

TOILET WAX RING 1 E ATCMTWR Category I0125

TOILET WAX RING 1 E ATCMTWR Category I0129

TOILET WAX RING 1 E ATCMTWR Category I0135

TOILET WAX RING 1 E ATCMTWR Category I0136

TOILET WAX RING 1 E ATCMTWR Category I0201

TOILET WAX RING 1 E ATCMTWR Category I0211

TOILET WAX RING 2 E ATCMTWR Category I0219

TOILET WAX RING 1 E ATCMTWR Category I0224

TOILET WAX RING 1 E ATCMTWR Category I0229

TOILET WAX RING 2 E ATCMTWR Category I0233

TOILET WAX RING 1 E ATCMTWR Category I0235

Page 14 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

WATER PROOFING NEGMWP 00B1

WATER PROOFING NEGMWP 00B10

WATER PROOFING NEGMWP 00B11

WATER PROOFING NEGMWP 00B13

WATER PROOFING NEGMWP 00B2

WATER PROOFING NEGMWP 00B3

WATER PROOFING NEGMWP 00B7

WATER PROOFING NEGMWP 00B8

WATER PROOFING NEGMWP 0107

WATER PROOFING NEGMWP 0116

WATER PROOFING NEGMWP 0120

WATER PROOFING NEGMWP 0121

WATER PROOFING NEGMWP 0131

WATER PROOFING NEGMWP 0200

WATER PROOFING NEGMWP 0225

Page 15 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

PLASTER - WHITE NEGSPI-1 00B1

PLASTER - WHITE NEGSPI-1 00B10

PLASTER - WHITE NEGSPI-1 00B11

PLASTER - WHITE NEGSPI-1 00B12

PLASTER - WHITE NEGSPI-1 00B13

PLASTER - WHITE NEGSPI-1 00B2

PLASTER - WHITE NEGSPI-1 00B3

PLASTER - WHITE NEGSPI-1 00B4

PLASTER - WHITE NEGSPI-1 00B5

PLASTER - WHITE NEGSPI-1 00B6

PLASTER - WHITE NEGSPI-1 00B7

PLASTER - WHITE NEGSPI-1 00B8

PLASTER - WHITE NEGSPI-1 00B9

PLASTER - WHITE NEGSPI-1 0101

PLASTER - WHITE NEGSPI-1 0103

PLASTER - WHITE NEGSPI-1 0107

PLASTER - WHITE NEGSPI-1 0108

PLASTER - WHITE NEGSPI-1 0112

PLASTER - WHITE NEGSPI-1 0114

PLASTER - WHITE NEGSPI-1 0116

PLASTER - WHITE NEGSPI-1 0118

PLASTER - WHITE NEGSPI-1 0119A

PLASTER - WHITE NEGSPI-1 0120

PLASTER - WHITE NEGSPI-1 0121

PLASTER - WHITE NEGSPI-1 0122

PLASTER - WHITE NEGSPI-1 0123

PLASTER - WHITE NEGSPI-1 0124

PLASTER - WHITE NEGSPI-1 0125

PLASTER - WHITE NEGSPI-1 0126

PLASTER - WHITE NEGSPI-1 0129

PLASTER - WHITE NEGSPI-1 0131

PLASTER - WHITE NEGSPI-1 0133

Page 16 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

PLASTER - WHITE NEGSPI-1 0135

PLASTER - WHITE NEGSPI-1 0136

PLASTER - WHITE NEGSPI-1 0137

PLASTER - WHITE NEGSPI-1 0200

PLASTER - WHITE NEGSPI-1 0201

PLASTER - WHITE NEGSPI-1 0208

PLASTER - WHITE NEGSPI-1 0211

PLASTER - WHITE NEGSPI-1 0212

PLASTER - WHITE NEGSPI-1 0213

PLASTER - WHITE NEGSPI-1 0215

PLASTER - WHITE NEGSPI-1 0216

PLASTER - WHITE NEGSPI-1 0217

PLASTER - WHITE NEGSPI-1 0219

PLASTER - WHITE NEGSPI-1 0219

PLASTER - WHITE NEGSPI-1 0221

PLASTER - WHITE NEGSPI-1 0222A

PLASTER - WHITE NEGSPI-1 0223

PLASTER - WHITE NEGSPI-1 0224

PLASTER - WHITE NEGSPI-1 0225

PLASTER - WHITE NEGSPI-1 0226

PLASTER - WHITE NEGSPI-1 0227

PLASTER - WHITE NEGSPI-1 0228

PLASTER - WHITE NEGSPI-1 0229

PLASTER - WHITE NEGSPI-1 0232

PLASTER - WHITE NEGSPI-1 0233

PLASTER - WHITE NEGSPI-1 0234

PLASTER - WHITE NEGSPI-1 0235

PLASTER - WHITE NEGSPI-1 0236

PLASTER - WHITE NEGSPI-1 0303

PLASTER - WHITE NEGSPI-1 HW-1

PLASTER - WHITE NEGSPI-1 HW-2

PLASTER - WHITE NEGSPI-1 HW-3

PLASTER - WHITE NEGSPI-1 SW-1

PLASTER - WHITE NEGSPI-1 SW-2

Page 17 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Material Code and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

PLASTER - WHITE NEGSPI-1 SW-3

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

0-5" AIRCELL PIPE INSULATION 10 lf POSTA5 FairFriable0122

0-5" AIRCELL PIPE INSULATION 10 lf POSTA5 FairFriable0126

0-5" AIRCELL PIPE INSULATION 3 lf POSTA5 FairFriable0129

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

0-5" FITTING ON AIRCELL PIPE

INSULATION

2 E POSTA5F FairFriable0129

RoomMaterial Description Estimated Qty ACMMaterial Code ConditionCategory

PIPE WRAP NEGTPW 0121

Page 18 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

TABLE 3

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 00B1

Material Description Estimated Qty ACMMaterial Code ConditionCategory

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

WATER PROOFING NEGMWP

PLASTER - WHITE NEGSPI-1

CAULK - LIGHT GRAY NEGMC-1

Room: 00B10

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH PINK NEGMMP-2

WATER PROOFING NEGMWP

SINK LINING - GRAY NEGMSC-1

PLASTER - WHITE NEGSPI-1

MORTAR PATCH WHITE NEGMMP-1

DRYWALL NEGMDW

DUCT SEALANT NEGMDS

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

Room: 00B11

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH GREY (<1% ASBESTOS BY PC) 22 sf ATCMMP-3 FairCategory II

PLASTER - WHITE NEGSPI-1

WATER PROOFING NEGMWP

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

SINK LINING - GRAY NEGMSC-1

MORTAR PATCH WHITE NEGMMP-1

DRYWALL NEGMDW

8" BRICK MORTAR NEGMB8M

CAULK - LIGHT GRAY NEGMC-1

Page 1 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 00B12

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH PINK NEGMMP-2

DUCT SEALANT NEGMDS

PLASTER - WHITE NEGSPI-1

DRYWALL AND JOINT COMPOUND - DRYWALL AND

JOINT COMPOUND

NEGMDWC-1

CONCRETE BLOCK MORTAR NEGMCBM

MORTAR PATCH WHITE NEGMMP-1

Room: 00B13

Material Description Estimated Qty ACMMaterial Code ConditionCategory

PLASTER - WHITE NEGSPI-1

8" BRICK MORTAR NEGMB8M

CONCRETE BLOCK MORTAR NEGMCBM

DUCT SEALANT NEGMDS

DRYWALL AND JOINT COMPOUND - DRYWALL AND

JOINT COMPOUND

NEGMDWC-1

FIRE BRICK - RED NEGMFB-1

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

WATER PROOFING NEGMWP

Room: 00B2

Material Description Estimated Qty ACMMaterial Code ConditionCategory

PLASTER - WHITE NEGSPI-1

WATER PROOFING NEGMWP

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

CAULK - LIGHT GRAY NEGMC-1

DRYWALL AND JOINT COMPOUND - DRYWALL AND

JOINT COMPOUND

NEGMDWC-1

Room: 00B3

Material Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - LIGHT GRAY NEGMC-1

WATER PROOFING NEGMWP

PLASTER - WHITE NEGSPI-1

Page 2 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 00B4

Material Description Estimated Qty ACMMaterial Code ConditionCategory

PLASTER - WHITE NEGSPI-1

Room: 00B5

Material Description Estimated Qty ACMMaterial Code ConditionCategory

PLASTER - WHITE NEGSPI-1

CAULK - WHITE NEGMC-2

8" BRICK MORTAR NEGMB8M

PYROBAR WHITE NEGMPRB

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

Room: 00B6

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH GREY (<1% ASBESTOS BY PC) 20 sf ATCMMP-3 FairCategory II

HEATING SYSTEM - FORCED AIR UNIT 3 E ATCMHS GoodCategory II

PLASTER - WHITE NEGSPI-1

MORTAR PATCH PINK NEGMMP-2

MORTAR PATCH WHITE NEGMMP-1

FIRE BRICK - RED NEGMFB-1

DUCT SEALANT NEGMDS

8" BRICK MORTAR NEGMB8M

Room: 00B7

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH GREY (<1% ASBESTOS BY PC) 3 sf ATCMMP-3 GoodCategory II

FIRE BRICK - RED NEGMFB-1

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

MORTAR PATCH PINK NEGMMP-2

WATER PROOFING NEGMWP

PLASTER - WHITE NEGSPI-1

8" BRICK MORTAR NEGMB8M

Page 3 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 00B8

Material Description Estimated Qty ACMMaterial Code ConditionCategory

WATER PROOFING NEGMWP

MORTAR PATCH PINK NEGMMP-2

PLASTER - WHITE NEGSPI-1

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

8" BRICK MORTAR NEGMB8M

MORTAR PATCH WHITE NEGMMP-1

Room: 00B9

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MORTAR PATCH GREY (<1% ASBESTOS BY PC) 3 sf ATCMMP-3 FairCategory II

DUCT SEALANT NEGMDS

MORTAR PATCH PINK NEGMMP-2

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

TERRAZZO FLOOR - BLACK AND WHITE NEGMTF-2

PLASTER - WHITE NEGSPI-1

Room: 0101

Material Description Estimated Qty ACMMaterial Code ConditionCategory

CAULK - LIGHT GRAY NEGMC-1

FIRE BRICK MORTAR-GRAY NEGMFBM

PLASTER - WHITE NEGSPI-1

Room: 0103

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MASTIC - BLACK NEGMM

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

PLASTER - WHITE NEGSPI-1

Page 4 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 0107

Material Description Estimated Qty ACMMaterial Code ConditionCategory

TOILET WAX RING 1 E ATCMTWR Category I

PLASTER - WHITE NEGSPI-1

CAULK - WHITE NEGMC-2

CERAMIC TILE & MASTIC - 2X2: TAN BROWN BLACK NEGMCTM-1

CERAMIC TILE & MASTIC - 4X4: YELLOW NEGMCTM-2

CERAMIC TILE & MASTIC - 2X4: BLACK NEGMCTM-3

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

WATER PROOFING NEGMWP

Room: 0108

Material Description Estimated Qty ACMMaterial Code ConditionCategory

TOILET WAX RING 1 E ATCMTWR Category I

PLASTER - WHITE NEGSPI-1

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4

MASTIC - BLACK NEGMM

Room: 0112

Material Description Estimated Qty ACMMaterial Code ConditionCategory

TOILET WAX RING 1 E ATCMTWR Category I

PYROBAR WHITE NEGMPRB

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

MASTIC - BLACK NEGMM

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4

CAULK - WHITE NEGMC-2

PLASTER - WHITE NEGSPI-1

Room: 0114

Material Description Estimated Qty ACMMaterial Code ConditionCategory

MASTIC - BLACK NEGMM

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

PYROBAR WHITE NEGMPRB

PLASTER - WHITE NEGSPI-1

Page 5 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 0116

Material Description Estimated Qty ACMMaterial Code ConditionCategory

TOILET WAX RING 1 E ATCMTWR Category I

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

WATER PROOFING NEGMWP

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5

8" BRICK MORTAR NEGMB8M

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4

PLASTER - WHITE NEGSPI-1

MASTIC - BLACK NEGMM

Room: 0118

Material Description Estimated Qty ACMMaterial Code ConditionCategory

PLASTER - WHITE NEGSPI-1

8" BRICK MORTAR NEGMB8M

CAULK - LIGHT GRAY NEGMC-1

CAULK - WHITE NEGMC-2

FIRE BRICK - RED NEGMFB-1

MASTIC - BLACK NEGMM

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

Room: 0119A

Material Description Estimated Qty ACMMaterial Code ConditionCategory

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

PLASTER - WHITE NEGSPI-1

Room: 0120

Material Description Estimated Qty ACMMaterial Code ConditionCategory

8" BRICK MORTAR NEGMB8M

CAULK - WHITE NEGMC-2

FIRE BRICK - RED NEGMFB-1

MASTIC - BLACK NEGMM

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

WATER PROOFING NEGMWP

PLASTER - WHITE NEGSPI-1

Page 6 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 0121

Material Description Estimated Qty ACMMaterial Code ConditionCategory

TOILET WAX RING 1 E ATCMTWR Category I

PIPE WRAP NEGTPW

PLASTER - WHITE NEGSPI-1

WATER PROOFING NEGMWP

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4

8" BRICK MORTAR NEGMB8M

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5

Room: 0122

Material Description Estimated Qty ACMMaterial Code ConditionCategory

0-5" AIRCELL PIPE INSULATION 10 lf POSTA5 FairFriable

8" BRICK MORTAR NEGMB8M

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

PLASTER - WHITE NEGSPI-1

Room: 0123

Material Description Estimated Qty ACMMaterial Code ConditionCategory

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

PLASTER - WHITE NEGSPI-1

Room: 0124

Material Description Estimated Qty ACMMaterial Code ConditionCategory

BLACK MASTIC - 6-INCH BASEBOARD NEGMM1

PLASTER - WHITE NEGSPI-1

MASTIC - BLACK NEGMM

Room: 0125

Material Description Estimated Qty ACMMaterial Code ConditionCategory

TOILET WAX RING 1 E ATCMTWR Category I

CERAMIC TILE & MASTIC - 3X6: WHITE NEGMCTM-5

PLASTER - WHITE NEGSPI-1

CERAMIC TILE & MASTIC - 1X1: LT. GRAY NEGMCTM-4

Page 7 of 18Sigma Environmental Services, Inc.3/16/2011

Printed On:

Notes:

f = Square Feet ATC = Assumed to contain asbestos

Sorted by Building and Room

HGA

BUILDING 2 - MENTAL HEALTH RRTP BEDS VA #676-322

VA MEDICAL CENTER - TOMAH, WI

Project Reference #: 2794

Building: 2

Room: 0126

Material Description Estimated Qty ACMMaterial Code ConditionCategory

0-5" AIRCELL PIPE INSULATION 10 lf POSTA5 FairFriable

8" BRICK MORTAR NEGMB8M

FIRE BRICK MORTAR-GRAY NEGMFBM

TERRAZZO FLOOR - BLACK CREAM YELLOW RED NEGMTF-1

PLASTER - WHITE NEGSPI-1

Room: 0129

Material Description Estimated Qty ACMMaterial Code ConditionCategory

0-5" AIRCELL PIPE INSULATION 3 lf POSTA5 FairFriable

0-5" FITTING ON AIRCELL PIPE INSULATION 2 E…