ABS_GA_SD-3_02_99.pdf

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RAVINNA, AIM* AMUJNTTICN PLANT

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 Buildirsg:

Floors:

Basements/Crawl Spaces:

Fan/Boiler Rooms:

Samples Taken:

Q.A. Samples Taken:

Survey Date:

oil)

Sumnary Data

L

Type of Construction:

(Check Applicable)

Wood Frame

Masonry

Transite Siding

Steel Frame

Reinforced Concrete

Comments:

Portion of Building Not Inspected (square feet):

Reason:

b

R A V E N N A A R M Y i M M G N T E E C N

E L f t N T

B U I L D I N G S L 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 oA

D r a w i n g

53).

jS

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

C c x r P

O o F

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

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

RAVENNA ARMY AMOCETXCN PIANT

RISK ASSESSMENT

POEM C

Building No:

Drawing No:

Date:

SP-3 Floor No:

Room No:

Evaluator: Af

FACTOR FOR ASSESSING POTENTIAL FIBER RELEASE

Current Condition of ACBM A/

Present Absent

Potential far Riture Disturbance

Damage or Erosion of ACEM

Low

Occt^ancy

Occupied

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage

• w/ft

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 / V

Unoccupied

Current Occupancy

Building No:

Drawing No:

Date:

RAVENNA ARM¥ AftMQNTXICN PLANT

RISK ASSESSMENT SHEET

PCRM C

Floor No: fit Room No: -*-

Evaluator:

FACTOR FOR ASSESSING POTENTIAL FIBER RELEASE

Current Condition of ACBM

Present Absent

Potential far 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

M<A

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

ESVENNA AEM¥ AIMDNITICN PLANT

ASBESTOS BGLK SAMPLE OmiN-OF-COSTCOY RECCRD

FCKM E

laboratory Name: P=>)

Date Samples Collected: _1 I

Sampler's Name:

Sampler's Signature:

Control Number: ^ZOOio

Date Received in Tab:

Name:

Signature:

Sample Field

Identification No:

Sample Laboratory

Identification No:

Disposition: Samples Disposed of

Delivered to Owner or Agent

Received: t>\\m

ESVENNA AKM¥ AJM2OTICN ELANT

EOLK SAMPLE ANALYSIS

FCEM D

Laboratory Name:

ID Number:

Lab Number:

ID Technique:

Gross Sample Description:.

Materials Present: Cofr/poS) TiOlO

*Estimated Percent in Sample:

Asbestos: (

Chrysotile

Amosite

Crocidolite

Anthophlyllite

Iremolite/Actinolite

Non-Asbestos Fibers: /0

Glass Fibers

Mineral Wool

Cellulose

Synthetic Fibers

Other

Non-Fibrous Component

*Percentage is Visually Estimated

Analysts Comments

Date: