ATCH 7. Attachment to 02 82 00 Hazardous Materials Survey Technical Memo 212 South Douglas.pdf

Hazardous Materials Report Residential Property

HAZMAT Building Surveys Middle Logan Creek Contract: W9128F-18-D-0054 Flood Risk Management Project Task Order No. W9128F2F0124 Randolph, NE

Date: 09 August, 2021

To: United States Army Corps of Engineers – Omaha District

CENWO USACE

1616 Capital Avenue Omaha Nebraska 68102-4901

Attention: Sarah Miller and Brandon Sellers

From: Troy Pfertsh

Subject: HAZMAT Building Surveys Middle Logan Creek Flood Risk Management Project, Randolph Nebraska.

Sustainment and Restoration Services LLC (SRS), and our contractor, Atlas Technical, has prepared this Hazardous Materials (HAZMAT) Survey Technical Memorandum detailing the findings and conclusions from the survey which was conducted for the property located at 212 South Douglas Street, Randolph Nebraska.

INTRODUCTION

SRS and our contractor ATC performed the survey of the Residential property located at 212 S Douglas Street, Randolph, Nebraska. The survey evaluated for the type, location and quantity of asbestos containing materials (ACM), lead base paint (LBP), polychlorinated biphenyl (PCB) building materials, and other hazardous materials that may be present on the property.

The property inspected contained a single-story structure with basement constructed in the early to mid-1900’s. The structure is constructed with a brick and concrete foundation and wood framed interior with asphalt shingled roof and wood siding. Interior finishes include plaster on wood lathe and updated gypsum wall panels (drywall). Flooring materials include wood flooring covered with carpet and vinyl floor tile with associated mastic. Asbestos pipe insulation is located in the basement for the HVAC system. The basement is unfinished. There are multiple outbuildings on the property including a garage, multiple sheds and a pole barn with a metal roof. There is a significant quantity of yard waste including old tires, mechanical parts, wood scraps, general trash, and salvaged vehicles.

Asbestos Testing

A total of eighty-three bulk samples (83) of suspect ACMs were collected from the building. Based on the PLM results, the following building materials analyzed were found to contain asbestos concentrations greater than one percent (>1%).

• Samples 016, 017, 018, 019, and 020. Wall and Ceiling Plaster, 2-3% Chrysotile, located throughout the main house (~3,200 SF).

• Samples 027, 028, and 029. 9” x 9” Floor Tile with Black Adhesive, 2%-3% Chrysotile in the Floor Tile only (associated adhesive is <1% Chrysotile). Floor Tile is located in the main bathroom (40 SF).

• Samples 030, 031, and 032. Window Glazing, 2% Chrysotile, located on the main porch windows (20 LF).

• Samples 033, 034, and 035. Door Window Glazing, 2% Chrysotile, located on the window of main porch door (10 FL).

• Samples 036, 037, and 038. Pipe Insulation (Air Cell), 30% Chrysotile, located in the basement (20 LF).

• Samples 038, 040, and 041. Pipe Insulation Wrap (on joints), 40% Chrysotile, located in the basement (50 LF).

• Samples 057, 058, and 059. Roof Flashing, 0-2% Chrysotile, located on around roof penetrations (20 SF).

The following list of building materials analyzed were found to contain asbestos concentrations less than one percent (<1%):

Building Materials Less than 1%

• Samples 045, 046, and 046. Door Window Glazing, located on the breezeway door exterior.

• Samples 027, 028, and 029. Adhesive for floor tile, located in the main bathroom.

Lead Testing A total of seven (7) paint chip samples were collected for analysis of lead in representative painted surface coatings. Lead was detected in all seven samples submitted with five (5) samples reported to be above 0.5% lead by weight. Laboratory analysis was completed using Flame AAS, method SW 846 3050B/7000B. A complete list of results is included in section 3.0.

PCB Testing A total of two (2) paint chip samples were collected for analysis for PCBs. Interior paint was found to contain 3 parts per million (ppm) total PCBs and the exterior paint was found non-detect for PCBs. A complete description of the results is included in Section 4.0.

Hazardous Waste & Universal Waste Survey An inventory of the household hazardous waste identified on the property was developed during the assessment. Based on the inventory generated during the inspection of the property, multiple household hazardous wastes are present and must be removed and disposed of properly according to all local, state, and federal guidelines.

The materials identified included chemicals, compounds and gases (both organic and inorganic) that may exist in the interior and exterior of the structure. Examples identified at the property include, but are not limited to: cleaning supplies, paints, solvents, hydrocarbon-based materials, chlorofluorocarbon (CFC) refrigerants, and propane. The inventory also included fluorescent, mercury capsule thermostats; and polychlorinated biphenyls (PCB)–containing ballasts. A complete inventory is provided in Section 5.0.

Technical Memorandum

ATTACHEMENT 1

ATC Assessment results 212 South Douglas Street

11117 Mockingbird Drive

Omaha, NE 68137

July 27, 2021

HAZARDOUS MATERIALS REPORT

Residential Building 212 South Douglas Street

Randolph, Nebraska 68771

ATC PROJECT NO. 204BS04057

Prepared for:

Sustainment & Restoration Services, LLC

1033 North Mayfair Road, Suite 201

Milwaukee, WI 53226

Prepared by:

ATLAS TECHNICAL

July 27, 2021

James R. Griffin Sustainment & Restoration Services, LLC 1033 North Mayfair Road, Suite 201 Milwaukee, WI 53226

Re: Hazardous Materials Survey Report

212 South Douglas Street

ATC Project Number 204BS04057

Dear Mr. Griffin:

ATC Group Services LLC (ATC) has completed the hazardous materials survey of the referenced building. Our findings and conclusions are included herein.

We appreciate the opportunity to be of service to you on this project. If you have questions or comments regarding the information presented in this report, please contact us at (402) 697-9747.

Sincerely, ATC Group Services LLC

Tony Colby Johnny Thor Sr. Project Manager Environmental Scientist ATC Group Services LLC ATC Group Services LLC Email: tony.colby@oneatlas.com Email: johnny.thor@oneatlas.com mailto:tony.colby@oneatlas.com mailto:johnny.thor@oneatlas.com

This Page Intentionally Left Blank

TABLE OF CONTENTS

LETTER OF TRANSMITTAL ........................................................................................................... i

1.0 BUILDING DESCRIPTION

2.0 ASBESTOS SAMPLING AND RESULTS

3.0 LEAD PAINT CHIP SAMPLING AND RESULTS

4.0 PCB SAMPLING AND RESULTS

5.0 HAZARDOUS AND UNIVERSAL WASTE INVENTORY

6.0 LIMITATIONS

LIST OF TABLES

Table 2.1 Asbestos Bulk Sample Results Table 3.1 Lead Based Paint Sample Results Table 4.1 PCB Sample Results Table 5.1 Universal and Hazardous Waste Inventory

APPENDICES

Appendix A Certifications and Licenses Appendix B PLM Laboratory Analysis Report & Chain of Custody Appendix C Lead Paint Laboratory Analysis Report & Chain of Custody Appendix D PCB Laboratory Analysis Report & Chain of Custody Appendix E Sample & Material Location Sketches Appendix F Project Photographs

INTRODUCTION

ATC performed a hazardous materials survey of the Residential Property located at 212 S. Douglas Street, Randolph, Nebraska. The purpose of this survey and report is to assist Sustainment & Restoration Services, LLC with regulatory compliance in preparation of demolition of the property.

1.0 BUILDING DESCRIPTION

The property inspected contained a single-story structure with a basement constructed in the early to mid-1900’s. The structure is constructed with a brick and concrete foundation and wood framed interior with asphalt shingled roof and wood siding. Interior finish include plaster on wood lathe and some updated gypsum wall board (drywall). Flooring materials include wood flooring covered with carpet and vinyl floor tile with associated mastic. Asbestos pipe insulation is located in the basement for the HVAC system. The basement is unfinished. There are multiple outbuildings on the property including a garage, multiple sheds and a pole barn with a metal roof. There is a significant quantity of yard waste including old tires, mechanical parts, wood scraps, general trash, and salvaged vehicles.

2.0 ASBESTOS SAMPLING AND RESULTS

Tony Colby and Johnny Thor of ATC conducted the survey on July 8, 2021. Copies of their accreditation certificates and licenses are provided in Appendix A. Bulk sample analysis was performed by EMSL Analytical Inc. located in Cinnaminson, New Jersey. Bulk samples were analyzed by PLM / Dispersion Staining (DS) using the USEPA's Test Method: Method for the Determination of Asbestos in Building Materials (EPA 600/R-93/116). The laboratory is accredited under the National Institute of Standards and Technology's (NIST) National Voluntary Laboratory Accreditation Program (NVLAP Lab Code 101048-0). The laboratory analysis report and chain-of-custody forms are provided in Appendix B. Sample locations sketches are included in Appendix E and photographs are included in Appendix F. A complete list of all samples collected is provided in Table 2.1.

The following building materials analyzed were found to contain asbestos concentrations greater than one percent (>1%).

• Samples 016, 017, 018, 019, and 020. Wall and Ceiling Plaster, 2-3% Chrysotile, located throughout the Residential Property Building (~3,200 SF).

• Samples 027, 028, and 029. 9” x 9” Floor Tile with Black Adhesive, 2%-3% Chrysotile in the Floor Tile only (associated adhesive is <1% Chrysotile). Floor Tile is located in the main bathroom (40 SF).

• Samples 030, 031, and 032. Window Glazing, 2% Chrysotile, located on the main porch windows (20 LF).

• Samples 033, 034, and 035. Door Window Glazing, 2% Chrysotile, located on the window of main porch door (10 FL).

• Samples 036, 037, and 038. Pipe Insulation (Air Cell), 30% Chrysotile, located in the basement (20 LF).

• Samples 038, 040, and 041. Pipe Insulation Wrap (on joints), 40% Chrysotile, located in the basement (50 LF).

• Samples 057, 058, and 059. Roof Flashing, 0-2% Chrysotile, located on around roof penetrations (20 SF).

The following list of building materials analyzed were found to contain asbestos concentrations less than one percent (<1%)

Building Materials Less than 1%

• Samples 045, 046, and 046. Door Window Glazing, located on the breezeway door exterior.

• Samples 027, 028, and 029. Adhesive for floor tile, located in the main bathroom.

A total of eighty-three bulk samples (83) of suspect ACMs were collected from the building. Table

2.1 presents a summary of laboratory analysis and condition assessments of the sampled suspect ACMs.

Table 2.1: SUSPECT ASBESTOS BUILDING MATERIALS

Sample Number

Material Description

Material Location

% ACM Estimated

Quantity

001-003

Drywall & Joint Compound

Throughout House

ND

500 SF

004-006

12” x 12” Floor Tile with Clear Adhesive

Kitchen

ND

200 SF

007-009 Red Sheet Flooring Living Room ND 60 SF

010-012 Tan Sheet Flooring Living Room ND 10 SF

013-015 2’ x 4’ Ceiling Tile Living Room, Laundry Room, Hallway ND 900 SF

016-020 Plaster Throughout House 2%-3% Chrysotile 3,200 sf

021-023 Fiber Board Bathroom ND 160 SF

024-026 Multi-Color Sheet Flooring Hallway ND 100 SF

027-029

9” x 9” Floor Tile with

Black Adhesive

Bathroom

2%-3% Chrysotile (Floor

Tile)

<1% Chrysotile

40 SF

030-032 Window Glazing Porch Windows 2% Chrysotile 20 LF

033-035 Door Window Glazing Front Door Window 2% Chrysotile 10 LF

036-038 TSI - Air Cell Basement 30% Chrysotile 20 LF

Table 2.1: SUSPECT ASBESTOS BUILDING MATERIALS

Sample Number

Material Description

Material Location

% ACM Estimated

Quantity

039-041 TSI - Pipe Wrap Basement 40% Chrysotile 50 LF

042-044 12” x 12” Floor Tile with Brown Adhesive Breezeway ND 180 SF

045-047 Door Window Glazing Breezeway Door <1% Chrysotile 10 LF

048-050 Exterior Window Glazing Breezeway Windows ND 80 LF

051-053 Insulation Basement, Wood Burning Stove ND 10 SF

054-056 Felt Paper (Siding) Beneath Vinyl Siding ND 200 SF

057-059 Flashing Roof Penetrations <1% - 3% Chrysotile 20 SF

060-062 Grey Roof Shingle Roof ND 1,000 SF

063-065 Brown Roof Shingle Roof ND 600 SF

066-068 Felt Paper (Roof) Roof ND 150 SF

069-071 Grey Roof Shingle Roof, Large Shed ND 150 SF

072-074 Silver Roof Shingle (Bottom Layer) Roof, Small Shed ND 100 SF

075-077 Red Roof Shingle (Top Layer) Roof, Small Shed ND 100 SF

078-080 Grey Roof Shingle (Top Layer) Roof, Hay Storage Barn ND 400 SF

081-083 Red Roof Shingle (Bottom

Layer) Roof, Hay Storage Barn ND 400 SF

Notes:

ACM = Asbestos-Containing Material (>1% Chrysotile) NA = Not Applicable ND = None Detected SF = Square Feet LF = Linear Feet

Additional ACM may be present at the site in inaccessible or concealed spaces. These spaces include, but are not limited to, pipe chases, spaces between wall/ceiling/door/floor cavities, interior of mechanical components such as boiler cavities, interior ducts, beneath foundation pads, etc.

Unidentified suspect materials should be treated as assumed ACM in accordance with 40 CFR 763.

Quantity provided in Table 2.1 is estimated by the inspector based on visible ACM. Additional pipe insulation may be hidden within call chases or cavities.

3.0 LEAD PAINT CHIP SAMPLING AND RESULTS

EMSL Analytical, Inc. located in Cinnaminson, New Jersey, conducted analysis on the paint chip samples to determine lead concentrations. The American Industrial Hygiene Association (AIHA) Laboratory Accreditation Program accredits EMSL for lead paint analysis. The laboratory report detailing the findings is provided in Appendix B.

Mr. Tony Colby performed the sampling of the Residential Property on July 8, 2021. Seven (7) paint chips were collected from the Residential Property that may be impacted by renovation or demolition work.

A material is considered by the US EPA to be lead-based paint (LBP) if analysis indicates more than 0.5% by weight of lead in paint (or 1.0 mg\cm2 or 5,000 ppm). A material is considered lead-containing paint (LCP) if lead is present in any concentration above the laboratory limit of detection

(LOD).

The complete list of the results of the lead survey are presented in Table 3.1 below:

Table 3.1: Lead Paint Survey Results

Sample # Color Sample Location Structure / Member Substrate Concentration % by Weight

01 White Interior Wall Plaster 0.015% 02 Tan Interior Window Casing Wood 0.32% 03 White Interior Doors Door Wood 0.81% 04 White Interior Doors Door Frame Wood 0.87% 05 Tan Exterior (front) Porch Ceiling Wood 13% 06 White Exterior Siding Wood 17% 07 Brown Exterior (side) Porch Trim Wood 18%

* Sample result below the detectable reporting limit.

Detection limit is <0.0008%

4.0 PCB SAMPLING AND RESULTS

Samples for PCBs were collected using hand tools (i.e. utility knife, screwdriver, hammer, pliers, chisel, etc.) that were decontaminated or discarded after one-time usage (i.e. utility blades) and delivered to Con-Test Analytical Laboratory of East Longmeadow, Massachusetts under standard chain of custody (COC) procedures. Samples were extracted using US EPA Method 3540C (Soxhlet extraction) and analyzed for PCBs using US EPA Method 8082. The laboratory analysis report and chain-of-custody forms are provided in Appendix D. A summary of the data is provided in Table 4.1 below. Sample locations sketches are included in Appendix E. Sample location photographs are included with the asbestos photographs in Appendix F.

Table 4.1: PCB Sealant Survey Summary

Sample ID

Sample Material

Material Location Total PCBs

PPM (RL)

PCB Type

(Concentration)

Paint

Interior

0.74 1.9

(RL = 0.43)

Aroclor-1248 Aroclor-1254

Paint

Exterior Non-Detect

(RL = 0.45)

N/A

Notes N/A = Not Applicable RL = Laboratory Reporting Limit

5.0 HAZARDOUS AND UNIVERSAL WASTE INVENTORY

A summary of the miscellaneous hazardous and universal waste inventory is presented in the table below. The items identified below were accessible; labels were missing and some assumptions were made at the judgment of the inspector. Additional containers are presumed to be hidden or covered over piles of tires, debris and overgrowth. All universal waste and hazardous materials are to be taken from the property prior to demolition for proper recycling (if not re-used by the Owner) and disposal.

Table 5.1 Hazardous & Universal Waste Inventory

Item Approximate Quantity Field Notes

Thermostat ampules (mercury) 1 House: living room wall

Coolers / refrigerants (CFCs) 1 House: kitchen

HVAC unit (CFCs) 1 Exterior: west side of house

Light ballast (PCBs) 16 Garage & 1 loose in shed

4’ Fluorescent lights (mercury) 30 Garage

Roof patch, 5 gallon 1 Shed: exterior

Drywall mud buckets, 5 gallon 3 Shed & house

Latex or Oil-Based Paint, 1 gallon containers 10 Basement, garage/sheds.

Many labels are missing.

Various household cleaners (Windex, Clorox, Armor All, etc.) 10+ Throughout garage & house; partially used/empty, many labels missing.

Lacquer paint thinner, 1 gallon 2 Garage

Motor oil, 1 quart 7 Garage: partially empty

Coolant (auto), 1 gallon 2 Garage: partially empty

Gas container, 5 gallon 2 Garage & shed: empty

Abandoned lawn mowers, oil & gas

2 Abandoned around property (lawn boy push & riding style)

Abandoned snow blower, potential oil & gas 1 Pole barn

Abandoned vehicles, potential fuel, oil, fluids

2 trucks 1 tractor Pole barn, abandoned vehicles

Generator with potential oil/gas fuel 1 Shed, abandoned

Trailer with hydraulic pump 1 Abandoned by shed, may contain hydraulic fluid in pump.

Empty 55 Gallon Drums 4 Unreadable labels, appear empty.

Located sheds & around yard.

Golf Cart Battery (lead-acid style) 1 Abandoned in shed, limited access

Table 5.1 Hazardous & Universal Waste Inventory

Item Approximate Quantity Field Notes

Butane camping fuel (grill style) 4 Garage: Appears empty

Propane tanks (grill style) 3 Garage: Appears empty

Propane tank, large 2 Outside on lawn, disconnected & appears empty

Tires 50+ Scattered around property

6.0 LIMITATIONS

This report is intended for the sole use of Sustainment & Restoration Services, LLC. The scope of services performed in execution of this evaluation may not be appropriate to satisfy the needs of other users, and use or re-use of this document or the findings, conclusions, or recommendations is at the risk of said user. ATC’s selection of sample locations and frequency of sampling was based on ATC’s observations and the assumption that like materials in the same area are homogeneous in content. Unsampled suspect asbestos materials should be treated as assumed ACM in accordance with 40 CFR 763.

For paint and PCB sampling, ATC’s selection of sample locations and frequency of sampling was based on the inspector’s assumption that like materials in the same area are homogeneous in content. Materials that could not be visually identified on the surface were not inspected and would not be noted in this report.

This report is not intended to serve as a bidding document or as a project specification document.

Actual site conditions may change over time and quantities are general estimates and should be field verified prior to making cost assumptions. The scope of services performed in execution of this evaluation may not be appropriate to satisfy the needs of other users, and use or reuse of this document or the findings or conclusions herein is at the risk of said user. Although reasonable efforts have been made to identify suspect hazardous materials in the areas identified, the limits of the scope of work and inspection technique used is inherently limited in the sense that only full demolition procedures will reveal all building materials of a structure.

Our professional services have been performed, our findings obtained, and our conclusions and recommendations prepared in accordance with customary principles and practices in the fields of environmental science and engineering. This statement is in lieu of other statements either expressed or implied. This report does not warrant against future operations or conditions, nor does it warrant against operations or conditions present of a type or at a location not investigated. The results, findings and conclusions expressed in this report are based only on conditions that were observed during ATC's inspection of the Site.

APPENDIX A

ATC Certifications and Licenses

State of Nebraska Department of Health and Human Services

Division of Public Health

Tony J Colby

Asbestos Inspector

License #: 740 Status: Active

Expiration: 08/11/2021

Tony J Colby

Lead Abatement Risk Assessor

License #: 219

Expiration: 06/11/2022

Johnny Vong Thor

Asbestos Inspector

License #: 1317

Expiration: 05/22/2023

APPENDIX B

PLM Laboratory Analysis Report & Chain of Custody

EMSL Order: 042117015 EMSL Analytical, Inc.

200 Route 130 North Cinnaminson, NJ 08077

Tel/Fax: (800) 220-3675 / (856) 786-5974 http://www.EMSL.com / cinnasblab@EMSL.com

ATC55 Customer ID:

Customer PO:

Project ID:

Attention: Tim Jacobsen Phone: (402) 320-8396 ATC Group Services LLC Fax: (402) 597-8532 11117 Mockingbird Drive Received Date: 07/13/2021 8:40 AM Omaha, NE 68137 Analysis Date: 07/15/2021 - 07/21/2021

Project: 204BS04057 - 212 Douglas St

Collected Date: 07/08/2021

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

Non-Asbestos Asbestos Sample Description Appearance % Fibrous % Non-Fibrous % Type

001-Drywall

042117015-0001

1- Joint Compound

042117015-0001A

002-Drywall

042117015-0002

2- Joint Compound

042117015-0002A

003-Drywall

042117015-0003

3- Joint Compound

042117015-0003A

4- Floor Tile

042117015-0004

004-Adhesive

042117015-0004A

5- Floor Tile

042117015-0005

005-Adhesive

042117015-0005A

6- Floor Tile

042117015-0006

006-Adhesive

042117015-0006A

042117015-0007

042117015-0008

042117015-0009

042117015-0010

Kitchen - Drywall

Kitchen - Joint Compound

Kitchen - Drywall

Kitchen - Joint

Laundry Room - Drywall

Laundry Room - Joint

Kitchen - 12x12 Floor Tile

Kitchen - Clear Adhesive

Living Room - Red Sheet Flooring

Living Room - Tan

Brown/White Fibrous Heterogeneous

White Non-Fibrous Homogeneous

Brown/White Fibrous Heterogeneous

White Non-Fibrous Homogeneous

Brown/White Fibrous Homogeneous

White Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

Clear Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

Clear Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

Clear Non-Fibrous Homogeneous

Red/Black Fibrous Heterogeneous

Red/Black Non-Fibrous Heterogeneous

Red/Black Fibrous Homogeneous

Tan/Black Fibrous Heterogeneous

10% Cellulose

2% Synthetic

15% Cellulose

30% Cellulose

90% Non-fibrous (Other)

98% Non-fibrous (Other)

100% Non-fibrous (Other)

85% Non-fibrous (Other)

70% Non-fibrous (Other)

None Detected

ASB_PLM_0008_0001 - 1.78 Printed: 7/21/2021 9:07 PM Page 1 of 6

Initial report from: 07/21/2021 21:07:39 http://www.emsl.com/ mailto:cinnasblab@EMSL.com

Tel/Fax: (800) 220-3675 / (856) 786-5974 http://www.EMSL.com / cinnasblab@EMSL.com

ATC55 Customer ID:

Customer PO:

Project ID:

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

Non-Asbestos Asbestos

042117015-0011

042117015-0012

042117015-0013

042117015-0014

042117015-0015

016-Base Coat

042117015-0016

016-Skim Coat

042117015-0016A

042117015-0017

018-Base Coat

042117015-0018

18- Skim Coat

042117015-0018A

19- Base Coat

042117015-0019

19- Skim Coat

042117015-0019A

20- Base Coat

042117015-0020

020-Skim Coat

042117015-0020A

042117015-0021

042117015-0022

042117015-0023

042117015-0024

042117015-0025

Living Room - 2x4 Ceiling Tile

Kitchen - Plaster

Plaster

Bedroom - Plaster

Bedroom - Plaster

Bathroom Wall - Fiber Board

Hallway - Multi-color

Tan/Black Non-Fibrous Homogeneous

Tan/Black Fibrous Homogeneous

White Fibrous Homogeneous

White Fibrous Homogeneous

White Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Brown Fibrous Homogeneous

Brown Fibrous Homogeneous

Brown Fibrous Homogeneous

Brown/Black Fibrous Heterogeneous

Brown/Black Fibrous

80% Min. Wool

90% Cellulose

60% Cellulose

90% Cellulose

20% Non-fibrous (Other)

97% Non-fibrous (Other)

10% Non-fibrous (Other)

40% Non-fibrous (Other)

10% Non-fibrous (Other)

2% Chrysotile

3% Chrysotile

ASB_PLM_0008_0001 - 1.78 Printed: 7/21/2021 9:07 PM Page 2 of 6

Tel/Fax: (800) 220-3675 / (856) 786-5974 http://www.EMSL.com / cinnasblab@EMSL.com

ATC55 Customer ID:

Customer PO:

Project ID:

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

042117015-0026

27- Floor Tile

042117015-0027

027-Adhesive

042117015-0027A

28- Floor Tile

042117015-0028

028-Adhesive

042117015-0028A

29- Floor Tile

042117015-0029

029-Adhesive

042117015-0029A

042117015-0030

042117015-0031

042117015-0032

042117015-0033

042117015-0034

042117015-0035

042117015-0036

042117015-0037

042117015-0038

042117015-0039

042117015-0040

042117015-0041

Bathroom - 9x9 Floor

Bathroom - Black

Porch Windows - Window Glazing

Front Door Window - Door Window Glazing

Basement - TSI - Air Cell

Basement - Pipe Wrap

Brown/Black Fibrous Homogeneous

Gray Non-Fibrous Homogeneous

Black Non-Fibrous Homogeneous

Gray Non-Fibrous Homogeneous

Black Non-Fibrous Homogeneous

Gray Non-Fibrous Homogeneous

Black Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Fibrous Homogeneous

White Fibrous Homogeneous

White Fibrous Homogeneous

White Fibrous Homogeneous

White Fibrous Homogeneous

White Fibrous Homogeneous

50% Cellulose

40% Cellulose

30% Chrysotile

40% Chrysotile

ASB_PLM_0008_0001 - 1.78 Printed: 7/21/2021 9:07 PM Page 3 of 6

Tel/Fax: (800) 220-3675 / (856) 786-5974 http://www.EMSL.com / cinnasblab@EMSL.com

ATC55 Customer ID:

Customer PO:

Project ID:

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

42- Floor Tile

042117015-0042

042-Adhesive

042117015-0042A

43- Floor Tile

042117015-0043

043-Adhesive

042117015-0043A

44- Floor Tile

042117015-0044

044-Adhesive

042117015-0044A

042117015-0045

042117015-0046

042117015-0047

042117015-0048

042117015-0049

042117015-0050

042117015-0051

042117015-0052

042117015-0053

042117015-0054

042117015-0055

042117015-0056

042117015-0057

Breezeway - 12x12 Floor Tile

Breezeway - Brown

Breezeway Door -

Breezeway Window - Exterior - Window Glazing

Breezeway Window - Exterior - Window Glazing

Breezeway Window - Exterior - Window Glazing

Basement - Wood Burning Stove - Insulation

Basement - Wood Burning Stove - Insulation

Basement - Wood Burning Stove - Insulation

Beneath Vinyl Siding - Felt Paper - Siding

Roof - Penetrations - Flashing

White Non-Fibrous Homogeneous

Brown Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Brown Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Brown Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Tan Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

White Non-Fibrous Homogeneous

Tan/White Non-Fibrous Homogeneous

Brown Non-Fibrous Homogeneous

Brown Non-Fibrous Homogeneous

Brown Non-Fibrous Homogeneous

Black Fibrous Homogeneous

Black Fibrous Homogeneous

Black Fibrous Homogeneous

Black Non-Fibrous

65% Cellulose

35% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 7/21/2021 9:07 PM Page 4 of 6

Tel/Fax: (800) 220-3675 / (856) 786-5974 http://www.EMSL.com / cinnasblab@EMSL.com

ATC55 Customer ID:

Customer PO:

Project ID:

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

042117015-0058

042117015-0059

042117015-0060

042117015-0061

042117015-0062

042117015-0063

042117015-0064

042117015-0065

042117015-0066

042117015-0067

042117015-0068

042117015-0069

042117015-0070

042117015-0071

042117015-0072

042117015-0073

042117015-0074

042117015-0075

Roof - Grey Roof Shingle

Roof - Brown Roof

Roof - Felt Paper - Roof

Large Shed - Roof - Roof Shingle - Large Shed

Large Shed - Roof - Roof Shingle - Large Shed

Large Shed - Roof - Roof Shingle - Large Shed

Small Shed - Roof - Bottom Layer - Silver Roof Shingle - Small Shed

Small Shed - Roof - Bottom Layer - Silver Roof Shingle - Small Shed

Small Shed - Roof - Bottom Layer - Silver Roof Shingle - Small Shed

Small Shed - Roof - Top Layer - Red Roof Shingle - Small Shed

Black Non-Fibrous Homogeneous

Black Fibrous Homogeneous

Gray Fibrous Homogeneous

Black Fibrous Homogeneous

Gray/Black Fibrous Homogeneous

Brown Fibrous Homogeneous

Brown Fibrous Homogeneous

Brown/Black Fibrous Homogeneous

Black Fibrous Homogeneous

Black Fibrous Homogeneous

Black Fibrous Homogeneous

Black Fibrous Homogeneous

Black Fibrous Homogeneous

Gray/Black Fibrous Homogeneous

Silver Fibrous

Silver

Black/Silver

Red/Black

7% Cellulose

7% Cellulose

3% Glass

20% Glass

20% Glass

25% Glass

6% Cellulose

10% Glass

93% Non-fibrous (Other)

91% Non-fibrous (Other)

80% Non-fibrous (Other)

82% Non-fibrous (Other)

80% Non-fibrous (Other)

50% Non-fibrous (Other)

50% Non-fibrous (Other)

75% Non-fibrous (Other)

2% Mica 88% Non-fibrous (Other)

2% Mica 92% Non-fibrous (Other)

ASB_PLM_0008_0001 - 1.78 Printed: 7/21/2021 9:07 PM Page 5 of 6

Tel/Fax: (800) 220-3675 / (856) 786-5974 http://www.EMSL.com / cinnasblab@EMSL.com

ATC55 Customer ID:

Customer PO:

Project ID:

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

042117015-0076

042117015-0077

042117015-0078

042117015-0079

042117015-0080

042117015-0081

042117015-0082

042117015-0083

Small Shed - Roof - Top Layer - Red Roof Shingle - Small Shed

Small Shed - Roof - Top Layer - Red Roof Shingle - Small Shed

Hay Storage Barn - Roof - Top Layer - Grey Roof Shingle - Barn

Hay Storage Barn - Roof - Top Layer - Grey Roof Shingle - Barn

Hay Storage Barn - Roof - Top Layer - Grey Roof Shingle - Barn

Hay Storage Barn - Roof - Bottom Layer - Red Roof Shingle - Barn

Hay Storage Barn - Roof - Bottom Layer - Red Roof Shingle - Barn

Hay Storage Barn - Roof - Bottom Layer - Red Roof Shingle - Barn

Red/Black Fibrous Homogeneous

Red/Various/Black Fibrous Homogeneous

Gray

Gray

Gray/Black

25% Cellulose

25% Glass

25% Cellulose

Analyst(s)

Brian Kibelstis (64) Nancy Stalter (22) Paige Havener (13)

Samantha Rundstrom, Laboratory Manager or Other Approved Signatory

ASB_PLM_0008_0001 - 1.78 Printed: 7/21/2021 9:07 PM Page 6 of 6

EMSL maintains liability limited to cost of analysis. Interpretation and use of test results are the responsibility of the client. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. The report reflects the samples as received.

Results are generated from the field sampling data (sampling volumes and areas, locations, etc.) provided by the client on the Chain of Custody. Samples are within quality control criteria and met method specifications unless otherwise noted. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-82-020 “Interim Method”) but augmented with procedures outlined in the 1993 (”final”) version of the method. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Unless requested by the client, building materials manufactured with multiple layers (i.e. linoleum, wallboard, etc.) are reported as a single sample. Estimation of uncertainty is available on request.

Samples analyzed by EMSL Analytical, Inc. Cinnaminson, NJ NVLAP Lab Code 101048-0, AIHA-LAP, LLC-IHLAP Lab 100194, NJ DEP 03036, PA ID# 68-00367, LA #04127

OrderID: 042117015

APPENDIX C

Lead Paint Laboratory Analysis Report & Chain of Custody

EMSL Analytical, Inc.

200 Route 130 North, Cinnaminson, NJ 08077 Phone/Fax: (856) 303-2500 / (856) 786-5974 http://www.EMSL.com cinnaminsonleadlab@emsl.com

EMSL Order:

CustomerID:

CustomerPO:

ProjectID:

202105422

ATC55

Omaha, NE 68137 Collected:

Project: 204BS04057 212 Douglas St.

Attn: Tim Jacobsen Phone: (402) 697-9747 ATC Group Services LLC Fax: (402) 597-8532

11117 Mockingbird Drive Received:

07/12/21 10:00 AM

7/8/2021

Test Report: Lead in Paint Chips by Flame AAS (SW 846 3050B/7000B)*

Client SampleDescription Collected Analyzed Weight RDL Lead Concentration

01 7/8/2021 7/15/2021 0.2495 g 0.0080 % wt 0.015 % wt 202105422-0001 Site: interior walls, plaster - white paint

02 7/8/2021 7/15/2021 0.2574 g 0.0080 % wt 0.32 % wt 202105422-0002 Site: interior window casing wood - tan paint

03 7/8/2021 7/15/2021 0.2512 g 0.040 % wt 0.81 % wt 202105422-0003 Site: interior door - wood - white paint

04 7/8/2021 7/15/2021 0.2556 g 0.040 % wt 0.87 % wt 202105422-0004 Site: interior droor frame - wood - white - paint

05 7/8/2021 7/15/2021 0.2569 g 1.6 % wt 13 % wt 202105422-0005 Site: porch - enclosed ceiling - wood tan paint

06 7/8/2021 7/15/2021 0.2541 g 1.6 % wt 17 % wt 202105422-0006 Site: exterior siding wood white paint

07 7/8/2021 7/15/2021 0.2507 g 1.6 % wt 18 % wt 202105422-0007 Site: exterior side porch wood brown paint

The sample duplicate RPD for samples -0001 through -0007 fell outside control limits. All other QC results met criteria.

Phillip Worby, Lead Laboratory Manager or other approved signatory

Test Report PB w/RDL-2.0.0.0 Printed: 7/19/2021 5:56:23 PM Page 1 of 1

EMSL maintains liability limited to cost of analysis. Interpretation and use of test results are the responsibility of the client. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. The report reflects the samples as received.

Results are generated from the field sampling data (sampling volumes and areas, locations, etc.) provided by the client on the Chain of Custody. Samples are within quality control criteria and met method specifications unless otherwise noted.

Analysis following Lead in Paint by EMSL SOP/Determination of Environmental Lead by FLAA. Reporting limit is 0.008% wt based on the minimum sample weight per our SOP. "<" (less than) result signifies the analyte was not detected at or above the reporting limit. Measurement of uncertainty is available upon request. Definitions of modifications are available upon request.

Samples analyzed by EMSL Analytical, Inc. Cinnaminson, NJ NELAP Certifications: NJ 03036, NY 10872, PA 68-00367, AIHA-LAP, LLC ELLAP 100194, A2LA 2845.01

Initial report from 07/19/2021 17:56:23 mailto:cinnaminsonleadlab@emsl.com

OrderID: 202105422

OrderID: 202105422

APPENDIX D

PCB Laboratory Analysis & Chain of Custody

39 Spruce Street * East Longmeadow, MA 01028 * FAX 413/525-6405 * TEL. 413/525-2332

July 19, 2021

Tim Jacobsen ATC Group Services LLC - Nebraska

Project Location: 212 Douglas St, Randolph, NE Client Job Number:

Project Number: 204BS04057 Laboratory Work Order Number: 21G0555

Enclosed are results of analyses for samples received by the laboratory on July 27, 2021. If you have any questions concerning this report, please feel free to contact me.

Sincerely, Kaitlyn A. Feliciano Project Manager

Table of Contents Sample Summary 3

Case Narrative 4

Sample Results 5

21G0555-01 5

21G0555-02 6

Sample Preparation Information 7

QC Data 8

Polychlorinated Biphenyls with 3540 Soxhlet Extraction 8

B286088 8

Dual Column RPD Report 9

Flag/Qualifier Summary 12

Certifications 13

Chain of Custody/Sample Receipt 14

ATC Group Services LLC - Nebraska

ATTN: Tim Jacobsen

PURCHASE ORDER NUMBER:

REPORT DATE: 7/19/2021

PROJECT NUMBER: 204BS04057

ANALYTICAL SUMMARY

WORK ORDER NUMBER: 21G0555

The results of analyses performed on the following samples submitted to CON-TEST, a Pace Analytical Laboratory, are found in this report.

PROJECT LOCATION: 212 Douglas St, Randolph, NE

FIELD SAMPLE # LAB ID: MATRIX

SAMPLE DESCRIPTION

TEST

SUB LAB

1- Paint Interior, walls, doors 21G0555-01 Paint SW-846 8082A

2- Paint Exterior siding 21G0555-02 Paint SW-846 8082A

CASE NARRATIVE SUMMARY

All reported results are within defined laboratory quality control objectives unless listed below or otherwise qualified in this report.

The results of analyses reported only relate to samples submitted to Con-Test, a Pace Analytical Laboratory, for testing.

I certify that the analyses listed above, unless specifically listed as subcontracted, if any, were performed under my direction according to the approved methodologies listed in this document, and that based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is, to the best of my knowledge and belief, accurate and complete.

Lisa A. Worthington Technical Representative

Date Received: 7/13/2021

Sample Description: Work Order: 21G0555

Field Sample #: 01-Paint Interior, walls, doors

Sample ID: 21G0555-01

Sampled: 7/8/2021 00:00

Sample Matrix: Paint Polychlorinated Biphenyls with 3540 Soxhlet Extraction

Analyte

Results

RL

Units

Dilution

Flag/Qual

Method

Date Prepared

Date/Time Analyzed

Analyst

Aroclor-1016 [1] ND 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1221 [1] ND 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1232 [1] ND 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1242 [1] ND 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1248 [2] 0.74 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1254 [1] 1.9 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1260 [1] ND 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1262 [1] ND 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Aroclor-1268 [1] ND 0.43 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:42 JMB

Surrogates % Recovery Recovery Limits Flag/Qual Decachlorobiphenyl [1] 56.4 Decachlorobiphenyl [2] 46.8 Tetrachloro-m-xylene [1] 65.5 Tetrachloro-m-xylene [2] 56.7

30-150 30-150 30-150 30-150

7/18/21 16:42 7/18/21 16:42 7/18/21 16:42 7/18/21 16:42

Date Received: 7/13/2021

Sample Description: Work Order: 21G0555

Field Sample #: 02-Paint Exterior siding

Sample ID: 21G0555-02

Sampled: 7/8/2021 00:00

Sample Matrix: Paint Polychlorinated Biphenyls with 3540 Soxhlet Extraction

Results

RL

Dilution

Flag/Qual

Method

Prepared

Date/Time Analyzed

Analyst

Aroclor-1016 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1221 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1232 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1242 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1248 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1254 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1260 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1262 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Aroclor-1268 [1] ND 0.45 mg/Kg 1 SW-846 8082A 7/15/21 7/18/21 16:59 JMB

Surrogates % Recovery Recovery Limits Flag/Qual Decachlorobiphenyl [1] 95.4 Decachlorobiphenyl [2] 79.1 Tetrachloro-m-xylene [1] 86.1 Tetrachloro-m-xylene [2] 74.0

30-150 30-150 30-150 30-150

7/18/21 16:59 7/18/21 16:59 7/18/21 16:59 7/18/21 16:59

Sample Extraction Data

Prep Method: SW-846 3540C Analytical Method: SW-846 8082A

Lab Number [Field IDJ Batch Initial [gJ Final [mLJ Date

21G0555-01 [01-Paint Interior, walls, doors] 21G0555-02 [02-Paint Exterior siding]

B286088 B286088

0.235 10.0

0.222 10.0

07/15/21 07/15/21

QUALITY CONTROL

Polychlorinated Biphenyls with 3540 Soxhlet Extraction - Quality Control

Result Reporting

Limit

Spike Level

Source Result

%REC

%REC

Limits

RPD

RPD

Limit

Notes

Batch B286088 - SW-846 3540C

Blank (B286088-BLK1) Prepared: 07/15/21 Analyzed: 07/18/21 Aroclor-1016 ND 0.35 mg/Kg Aroclor-1016 [2C] ND 0.35 mg/Kg Aroclor-1221 ND 0.35 mg/Kg Aroclor-1221 [2C] ND 0.35 mg/Kg Aroclor-1232 ND 0.35 mg/Kg Aroclor-1232 [2C] ND 0.35 mg/Kg Aroclor-1242 ND 0.35 mg/Kg Aroclor-1242 [2C] ND 0.35 mg/Kg Aroclor-1248 ND 0.35 mg/Kg Aroclor-1248 [2C] ND 0.35 mg/Kg Aroclor-1254 ND 0.35 mg/Kg Aroclor-1254 [2C] ND 0.35 mg/Kg Aroclor-1260 ND 0.35 mg/Kg Aroclor-1260 [2C] ND 0.35 mg/Kg Aroclor-1262 ND 0.35 mg/Kg Aroclor-1262 [2C] ND 0.35 mg/Kg Aroclor-1268 ND 0.35 mg/Kg Aroclor-1268 [2C] ND 0.35 mg/Kg Surrogate: Decachlorobiphenyl 6.44 mg/Kg 6.91 93.2 30-150 Surrogate: Decachlorobiphenyl [2C] 5.39 mg/Kg 6.91 77.9 30-150 Surrogate: Tetrachloro-m-xylene 6.24 mg/Kg 6.91 90.3 30-150 Surrogate: Tetrachloro-m-xylene [2C] 5.41 mg/Kg 6.91 78.2 30-150

LCS (B286088-BS1) Prepared: 07/15/21 Analyzed: 07/18/21

Aroclor-1016 1.8 0.45 mg/Kg 2.25 79.3 40-140 Aroclor-1016 [2C] 1.6 0.45 mg/Kg 2.25 70.7 40-140 Aroclor-1260 1.6 0.45 mg/Kg 2.25 69.1 40-140 Aroclor-1260 [2C] 1.3 0.45 mg/Kg 2.25 59.2 40-140

Surrogate: Decachlorobiphenyl 6.33 mg/Kg 9.02 70.2 30-150 Surrogate: Decachlorobiphenyl [2C] 5.30 mg/Kg 9.02 58.8 30-150 Surrogate: Tetrachloro-m-xylene 6.72 mg/Kg 9.02 74.5 30-150 Surrogate: Tetrachloro-m-xylene [2C] 5.73 mg/Kg 9.02 63.6 30-150

LCS Dup (B286088-BSD1) Prepared: 07/15/21 Analyzed: 07/18/21

Aroclor-1016 2.1 0.44 mg/Kg 2.20 97.3 40-140 17.7 30 Aroclor-1016 [2C] 1.9 0.44 mg/Kg 2.20 85.5 40-140 16.4 30 Aroclor-1260 2.0 0.44 mg/Kg 2.20 89.4 40-140 23.0 30 Aroclor-1260 [2C] 1.7 0.44 mg/Kg 2.20 75.7 40-140 21.9 30

Surrogate: Decachlorobiphenyl 8.34 mg/Kg 8.78 95.0 30-150 Surrogate: Decachlorobiphenyl [2C] 6.96 mg/Kg 8.78 79.2 30-150 Surrogate: Tetrachloro-m-xylene 6.50 mg/Kg 8.78 74.0 30-150 Surrogate: Tetrachloro-m-xylene [2C] 5.62 mg/Kg 8.78 64.0 30-150

IDENTIFICATION SUMMARY

FOR SINGLE COMPONENT ANALYTES

SW-846 8082A

Lab Sample ID:

21G0555-01

Date(s) Analyzed:

07/18/2021 07/18/2021

Instrument ID (1): ECD5 Instrument ID (2): ECD5

GC Column (1): ID: (mm) GC Column (2): ID: (mm)

ANALYTE COL RT RT WINDOW CONCENTRATION %RPD

FROM TO

Aroclor-1248 1 0.000 0.000 0.000 0.64 2 0.000 0.000 0.000 0.74 14.5

Aroclor-1254 1 0.000 0.000 0.000 1.9 2 0.000 0.000 0.000 1.6 17.1

01-Paint Interior, walls, doors

LCS

B286088-BS1

Aroclor-1016 1 0.000 0.000 0.000 1.8 2 0.000 0.000 0.000 1.6 11.8

Aroclor-1260 1 0.000 0.000 0.000 1.6 2 0.000 0.000 0.000 1.3 20.7

B286088-BSD1

Aroclor-1016 1 0.000 0.000 0.000 2.1 2 0.000 0.000 0.000 1.9 10.0

Aroclor-1260 1 0.000 0.000 0.000 2.0 2 0.000 0.000 0.000 1.7 16.2

LCS Dup

FLAG/QUALIFIER SUMMARY

* QC result is outside of established limits.

t Wide recovery limits established for difficult compound.

Wide RPD limits established for difficult compound.

# Data exceeded client recommended or regulatory level

ND Not Detected

RL Reporting Limit is at the level of quantitation (LOQ)

DL Detection Limit is the lower limit of detection determined by the MDL study

MCL Maximum Contaminant Level

Percent recoveries and relative percent differences (RPDs) are determined by the software using values in the calculation which have not been rounded.

No results have been blank subtracted unless specified in the case narrative section.

Certified Analyses included in this Report

No certified Analyses included in this Report

Certifications

CERTIFICATIONS

Con-Test, a Pace Environmental Laboratory, operates under the following certifications and accreditations:

Code Description Number Expires

AIHA AIHA-LAP, LLC - ISO17025:2017 100033 03/1/2022

MA Massachusetts DEP M-MA100 06/30/2022

CT Connecticut Department of Publilc Health PH-0165 12/31/2022

NY New York State Department of Health 10899 NELAP 04/1/2022

NH-S New Hampshire Environmental Lab 2516 NELAP 02/5/2022

RI Rhode Island Department of Health LAO00112 12/30/2021

NC North Carolina Div. of Water Quality 652 12/31/2021

NJ New Jersey DEP MA007 NELAP 06/30/2022

FL Florida Department of Health E871027 NELAP 06/30/2022

VT Vermont Department of Health Lead Laboratory LL720741 07/30/2022

ME State of Maine MA00100 06/9/2023

VA Commonwealth of Virginia 460217 12/14/2021

NH-P New Hampshire Environmental Lab 2557 NELAP 09/6/2021

VT-DW Vermont Department of Health Drinking Water VT-255716 06/12/2022

NC-DW North Carolina Department of Health 25703 07/31/2021

PA Commonwealth of Pennsylvania DEP 68-05812 06/30/2022

MI Dept. of Env, Great Lakes, and Energy 9100 09/6/2021 i ffi 2.!t!!. J" Phooe, 413-525-2'3' JI{; oS-S} http://www.contestlabs.com

CHAIN OF CUSTODY RECORD

Doc# 381RevO58 2015

39 Spruce Street

Page-/- of/--

<:ompany Nam,e:

Fax: 413-525-6405 Email: info@contestlabs.com

ATC Grou1.2 Services LL( (NEBRASKA!

East Longmeadow, MA 01028

# of Containers

2 Preservation Code

Phone: 402-697-9747 I xuJ a:

ANALYS IS 1 REQUESTED won.ftfaiiintieiriiC&od1e

Address: 11117 Mockingbird Drive Omaha, NE 68137 I I I I Project Name: · SRS Randolph - 212 Douglas St ::c.

Project Location: 212 Douglas Street, Randolph, Nebraska

Project Number: 2048S04057

Project Manager: Tim Jacobsen Other:

".s'=

N

Con-Test Bid: Enhanced Data Package Required: LJ Invoice Reclpient: Same Email To: tim.jacobsen@atcgs.com Sampled By: Tim Jacobsen Fax To#:

02- Paint Exterior siding 7/8/2021 I 7/8/2021 ca co

0 Lab to Filter

1 Matrix Codes:

GW = Ground Water WW = Waste Water DW = Drinking Water A= Air S = Soil/Solid SL= Sludge 0 = Other {please define)

Comments:

PCBs via USEPA 8082 with Soxhlet Extraction (3540C) Please use the foUowing codes to indicate possible sample concentration

2 Preservation Codes:

I= Iced

H = HCL

M = Methanol N = Nitric Acid S = Sulfuric Acid B = Sodium Bisulfate X = Sodium Hydroxide T = Sodium Thiosulfate O = Other (please define) within the Cone Code column above:

H - High; M - Medium; L • Low; C • Clean; U - Unknown byns ure)

2£.,,\,, dl-1

Program Information 0 MCP Analytical Certlfication Form Required

0 RCP Analysis Certification Form Required

3 Container Codes:

A = Amber Glass G = Glass P = Plastic ST= Sterile V = Vial S = Summa Canister

Relinquished by: (signature) Date/Time:

Received by: (signature) Date/Time:

0 MA State DW Form Required

PWSID # - - - - - - -

NELAC and AIHA-LAP, LLC Accredited

T = Tedlar Bag 0 = Other (please define)

Relinquished by: (signature) Date/Time: TURNAROUND TIME (BUSINESS DAYS) STARTS AT 9:00 AM THE DAY AFTER SAMPLE RECEIPT UNLESS THERE ARE http://www.contestlabs.com/ http://www.contestlabs.com/ mailto:info@contestlabs.com mailto:tim.jacobsen@atcgs.com

!--------------+---------{QUESTIONS ON THIS CHAIN. IF THIS FORM IS NOT FILLED OUT COMPLETELY OR IS JNCORRECT, TURNAROUND TIME Received by: (signature) Date/Time: CANNOT START UNTIL ALL QUESTIONS HAVE BEEN ANSWERED.

PLEASE BE CAREFUL NOT TO CONTAMINATE THIS DOCUMENT

TRACK ANOTHER SHIPMENT

774236914590

ADD NICKNAME

Delivered Tuesday, July 13} 2021 at 10:23 am

DELIVERED

Signed for by: L.RJOS

GET STATUS UPDATES

OBTAIN PROOF OF DELJVERY

FROM

TO

Omaha, NEUS EAST LONGMEADOW, MA US

Travel History

TIME ZONE

Local Scan Time

Tuesday, July 13, 2021

1023AM

EAST LONGMEADOW. MA

Delivered

8:18 AM WINDSOR LOCKS, CT On FedEx vehicle for delivery

804AM WINDSOR LOCKS, CT At local FedEx facility

714AM EAST GRANBY CT Atdestination sort facility

353AM MEMPHIS, TN Departed FedEx location

Monday, July 12, 2021

10:55 PM

MEMPHIS, TN

Arrived at FedEx location

825PM OMAHA.NE Left FedEx origin facility

408PM OMAHA, NE Picked up

306PM Shipment information sent to FedEx

Sulfuric- Perchlorate Ziplock

Login Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False

Statement will bebrought to the attention of the Client - State True or False Client

Received By LL

Time io.2= How were the samples In Cooler No Cooler T On Ice No Ice T received? Direct from Sampling Ambient Melted Ice ----

Were samples within ,.- By Gun# ---- Actual Temp -_:2.._0_', °"------

Temperature? 2-6°C r By Blank# Actual Tem'p -- --------- Was Custody Seal Intact? t:,JA. Were Samples Tampered with?

Was COC Relinquished? T Does Ch in Agree With Samples?

Are there broken/leaking ose caps on any samples? --'----- Is COC in ink/ Legible? I Were samples received within holding time?

Did COC include all Client 1 Analysis T Sampler Name 'T pertinent Information? Project r ID's I Collection Dates/Times j-_ -- Are Sample labels filled out and legible? t

Are there Lab to Filters? r Are there Rushes?

Who was notified?

Who was notified?

Are there Short Holds?

Is there enough Volume?

Is there Headspace where applicable?

Proper Media/Containers Used?

Were trip blanks received?

Do all samples have the proper pH?

r t=

Who was notified?

MS/MSD? r-ls splitting samples required?

OnCOC? -,...

Acid Base

Unp- 1 Liter Amb. 1 Liter Plastic 16 ozAmb.

HCL- 500 ml Amb. 500 ml Plastic 8oz Amb/Clear Meoh- 250 ml Amb. 250 ml Plastic 4oz Amb/Clear Bisulfate- Flashpoint Col./Bacteria 2oz Amb/Clear 01- Other Glass Other Plastic Encore T--hio-su-lf-ate-- ----+---S-O-C -Kit-----------Pl-as-tic-B'a '------- Frozen:

Unp-

HCL-

1 Liter Amb.

500 ml Amb.

1 Liter Plastic 500 ml Plastic

16ozAmb.

8oz Amb/Clear

Meoh- Bisulfate-

DI-

Thiosulfate-

250 mLAmb.

Col./Bacteria Other Plastic

SOC Kit

250 ml Plastic Flashpoint

Other Glass Plastic Ba

4oz Amb/Clear 2oz Amb/Clear

Encore Frozen:

Sulfuric- Perchlorate Ziplock Comments:

}J >.:...,.-p't \- \f"'€

CJ(\ GC. / (r;..J1. ¥--t 1'\tC\

I Have Not Confirmed Sample Container

Numbers With Lab Staff Before Relinquishing Over Samples _

· < t>o.c#21t<t1 vs 2011<<< ·

APPENDIX E

Sample & Material Location Sketches

042, 043

027, 028

048, 049

004, 005

021, 022

045, 046 017 023

010, 011

013 018, 019 024, 025, 007, 008

033, 034

06 020

014, 015 04

Basement Floor Hatch

054, 055

030, 031

02 05

Main Floor

Legend Asbestos Sample Locations

XXX > 1% Asbestos Sample Location

XXX < 1% Asbestos Sample Location

XXX No Asbestos Sample Location

XX Lead Based Paint Sample Location

XX Non-Lead Based Paint Sample Location

N

212 Douglas Avenue Randolph, Nebraska 68771

DWN BY

JVT

SCALE

NONE

Omaha, NE 68137 DATE

7/23/2021

JOB NUMBER

204BS04057

SHEET

1 of 2 Ph. (402) 697-9747

Hay Barn Storage

078, 079

080 081, 082

Car Port

072, 073

075, 076

069, 070

Multiple Sheds

051, 052

063, 064

066, 067

036, 037

038 059 060, 061

039, 040

041 057

Basement

Main House

Property View (Roof)

Legend

Ph. (402) 697-9747

Asbestos Sample Locations Residential Property 212 Douglas Avenue

XXX

XXX

XXX

> 1% Asbestos Sample Location < 1% Asbestos Sample Location No Asbestos Sample Location DWN BY

JVT SCALE

NONE

DATE

7/23/2021

JOB NUMBER

204BS04057

Basement Floor Hatch

Basement Main House

ACM Plaster Located Throughout the House:

Walls and Ceiling

Legend

Ph. (402) 697-9747

Asbestos Sample Locations Residential Property 212 Douglas Avenue Randolph, Nebraska 68771

9 x 9 Floor Tile (ACM) and Black Adhesive (Non-ACM)

Window Glazing (Door and Windows)

TSI - (Air Cell and Pipe Wrap)

DWN BY

JVT

SCALE

NONE

DATE

7/23/2021

JOB NUMBER

204BS04057

APPENDIX F

Photographs

Hazardous Materials Inspection

204BS04057, Randolph, NE 68771 Photos Taken July 7, 2021 ■ ATC Project No. 204BS0405