ABS_DAA_A4a_02_99CS.pdf

RAVINNA, AFM¥ AMMUNITION PIANT

Building Sunmary Sheet

Farm 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:

ski Sunmary Data bU

Type of Construction:

(Check Applicable)

1/ Wood Frame

Masonry

Transite Siding

Steel Frame

Reinforced Concrete

Comments:

Portion of Building Not Inspected (square feet):

Reason: .

R A V E N N A A R M Y A M M L N T T I C N E L R N T

B U H D I N G

S U M M A R Y S H E E T

F O R M B

B u i l d i n g

S h e e t

N o o f

S a m p l e

0A

D r a w i n g

R e v i s i o n

O c c u p i e d

M O

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

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

E n c l o s e d a

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

Z

Q u a n t i i

A m o u n t

Iftiit P i p e

D i a

C o m m e n t s

RAVENNA ARMY AMMONITION PLANT

RISK ASSESSMENT

FORM C

Building No:

Drawing No: fsrr>.3)

Date: R \7AC\<\ j

FACTOR FOR ASSESSING POTENTIAL FIBER RET.EASE

Current Condition of ACEM j\[Q

Present Absent

Potential for Future Disturbance

Damage or Erosion of ACEM

Low

Occupancy

Occupied

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage

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

Unoccupied

Current Occupancy V3

KAVENNA AEMZ AWMDNITTCN PLANT

BULK SAMPLE ANALYSIS

FCRM D

Laboratory Name:

ID Number:

Lab Number:

ID Technique:

Gross Sample Description:. EXtiXi-

Materials Present: £°°F

•Estimated Percent in Sample:

Asbestos: (P4.—

Chrysotile

Aroosite

Crocidolite

Anthophlyllite

Tremolite/Actinolite

Non-Asbestos Fibers:

Glass Fibers

Mineral Wool

Cellulose

Synthetic Fibers

Other dLu-

Non-Fibrous Component

•Percentage is Visually Estimated

Analysts Comments

Date:

RAVEHNA ARMY AmDNTTTCN PLANT

ASBESTOS BULK SAMPLE CHAIN-OF-CDSTODY RECORD

FCKM E

Control Number:Laboratory Name: P^l PiTrygui?6.h)

Date Samples Collected: //Z4r

Sampler's Name: . 6.R0M

Date Received in Lab:

Name: rV

-/ f

Sampler's Signature: Signature:

Sample Field

Identification No:

? « /\ >i A Sample Laboratory

-F n~H" n Identification No:

Disposition:

I oF e

A

Samples Disposed of

/^-—Deliyered to Owner or Agent

Date Received:

2.©