ABS_DAA_A4_02_99CS.pdf

RAVENNA, ARMY AMMUNITION PIANT

Building Summary Sheet

Form A

Building ID: ''

Building Type (Use):

Number of People/

Percentage of Time:

Area:

Inspection Team (Names):

Drawing Numbers:

Year of Construction:

Total Square

Footage Building:

Floors:

Basements/Crawl Spaces:

Fan/Boiler Rooms:

Samples Taken:

Q.A. Samples Taken:

Survey Date: $" M

SfiR£A<?.C

Of)

Sumnary Data

Type of Construction:

(Check Applicable)

Wood Frame

Masonry

Transite Siding

J ^

Steel Frame

Reinforced Concrete

Consents:

Portion of Building Not Inspected (square feet):

Reason:

B u i l d i n g

M

R A V E N N A A R M Y A M M U N I T I O N P L A N T

B U I L D I N G S U M M A R Y S H E E T

P O E M B

S h e e t

N o o f

S a m p l e

0)4-

0A

D r a w i n g

R e v i s i o n

O c c u p i e d

F l o o r

R o o m

A r e a

M a t e r i a l

T y p e

D e s c r i p t i o n

L o c a t i o n f r a c o if e q

E n c a p s u l a t e d o r

E n c l o s e d

F r i a b l e C o n d i t i o n

B e s t

W o r s t-

Q u a n t i t y

A m o u n t

U n i t P i p e

D i a

C o m m e n t s n>

> o

I

•sL i O

Q> oi

A

RAVENNA ARM* AMOHTION PLANT

RISK ASSESSMENT

FORM C

Building No:

Drawing No:

Date:

/H- Floor No:

Room No:

Evaluator:

FACTOR FOR ASSESSING POTENTIAL FIBER RELEASE

Current CJondition of ACEM

Present Absent

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage

X v Y

Potential far FXiture Disturbance

Damage or Erosion of ACEM

Low

Occupancy

Occupied

High

Proximity of Air Plenum or

Direct Air Stream

Visibility, Accessibility (to building occupants and maintenance personnel), and degree of activity

(air movements, vibration, movement of building occupants)

Change in Building Use

V

V

X

Unoccupied

Current Occupancy t

RAVENNA AKMZ AMMENTTTON PLANT

RISK ASSESSMENT

R3RM C

Building No:

Drawing No:

Date:

Floor No: '

Room No: £X

Evaluator:

FACTOR FCR ASSESSING POTENTIAL FIBER RELEASE

Current Condition of ACEM

Present Absent

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage k V for Future Disturbance

Damage or Erosion of ACEM

Low

Occupancy

Occupied

High

Proximity of Air Plenum or

Direct Air Stream

Visibility, Accessibility (to building occupants and maintenance personnel), and degree of activity

(air movements, vibration, movement of building occupants)

Change in Building Use

V

Unoccupied

Current Occupancy

OO3

OO\

RAVENNA ARMY AMMCNZT1ON PLANT

ASBESTOS BULK SAMPLE CHAIN-HDF-CaSTODY RECCED

FORM E

Laboratory Name:

Date Samples Collected:

Sampler's Name:

Sampler's Signature:

Control Number: I l£)O I Z>

Date Received in Lab: 2E.

Name:

w> U T

Sample Field

Identification No:

/V-4-0O4

Sample Laboratory

Identification No:

■zirmz

Disposition:

Receiver's

Signature:

Samples Disposed of

Delivered to Owner or Agent

Date Received:

EAVENNA AKff H*DtHrCN PLANT

BOLK SAMPLE ANALYSIS

FORM D

Laboratory Name:

ID Number:

T*h Number:

ID Technique:

PiTP^DEaSH Bu\LD\r4£ %- A~4-

P<

4fef 7/ /3 f 3

Gross Sample Description:

Materials Present:

S. Z.

♦Estimated Percent in Sample:

^Asbestos: fJ^ - i>^^ '' r\f-

-4-

Qirysotile

Amosite

Crocidolite

Anthophlyllite

Tremolite/Actinolite

Non-Asbestos Fibers:

Glass Fibers

Mineral Wool

Cellulose

Synthetic Fibers

Other i-r/.

Non-Fibrous Component /v/4

♦Percentage is Visually Estimated

Analysts Comments

Date:

RAVENNA AEMY AMM^tETICN PIANT

BULK SAMPLE ANALYSIS

1X331 D

Laboratory Name:

ID Number:

Lab Number:

ID Technique: Pi

Gross Sample Description:

Materials Present:

•Estimated Percent in Sample:

^Asbestos:/y Or'* '^Clcc^

Non-Fibrous Component/V^

"♦Percentage is Visually Estimated

Analysts Comments

' /C, Crocidolite

Anthophlyllite

Tremolite/Actinolite

Non-Asbestos Fibers:

Mineral Wool

Synthetic Fibers

EAVENNA ARE AWOOHCN PLANT

EOLK SAMPLE ANALYSIS

FCRK D

Number:

ID Technique: Pi

^TfilMl

Gross Sample Description:.

Ls Present: i

♦Estimated Percent in Sample:

Asbestos:

Chrysotile

Tremolite/Actinolite

Cellulose

Synthetic Fibers

Other

♦Percentage is Visually Estimated

Analysts Canments

KAVJENNA AEHZ AWfrOOTICN PLANT

BOLK SAMPLE ANALYSIS

FCKH D

Laboratory Name:

ID Number:

T.^h Number:

ID Technique:

6blc\

Gross Sample

Materials Present:

/V / iption:. UULiU I <5\C(-'

T~u

*Estimated Percent in Sample:

Asbestos:

Chrysotile

Amosite

Crocidolite

Anthophlyllite

TreiDolite/Actinolite

Non-Asbestos Fibers:

Glass Fibers

Mineral Wool

Cellulose

Synthetic Fibers

Other

Non-Fibrous Component

*Percentage is Visually Estimated

Analysts Comments

RAVENNA ARMY AMMDNETICN PLANT

ASBESTOS BULK SAMPLE CHMN-OF-COSTCDY RECORD f -> _, _

FORME

Laboratory Name: PlTTSE^g6.K)

Date Sanples Collected

Saitpler's Name: ^

: 9>lZ(r>( ^ 1

Sampler's Signature:

Control Number:

Date Received in Lab:

name;

/O ' °l/

Signature:

Sc n

Sample Field n , ,, n ft. J Identification No: bufU?)A)6 f IT T

Sample Laboratory

Identification No:

A-4-col

Disposition:

Receiver's

Signature:

,3V A

Samples Disposed of

Delivered to Owner or Agent

„ Date Received:

e o/c

077^

U L K

S A M P L E N O O Z

A R E A S A M P L E D

?j+z:r<* M A T E R I A L

T Y P E W y

S A M P L E D

B Y michael t g r o h

C A H E S

L D G

D R A W I N G

N O

B U L K

S A I V

A R E A S A M P L E D

D A T E

B L D G

N O

J

D R A W I N G

N O

B U L K

S A M P L E

N O i

A R E A S A M P L E D i