Bldg SD1A HAZMAT Report.pdf

RAVENNA, ARM¥ AMHJNITION PLRNT

Building Summary Sheet

Farm A

Building ID: _

Building Type (Use): C^-ty

Number of People/

Percentage of Time:

Area:

Inspection Team (Names):

Drawing Numbers:

Survey Date: ^ "U

Taa-k to

(xrtxrtk

1 579(0 -

Year of Construction:

Total Square

Footage Building:

Floors:

Basements/Crawl Spaces:

Fan/Boiler Rooms:

Samples Taken:

Q.A. Samples Taken:

Sunmary Data

Type of Oanstruction:

(Check Applicable)

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 U N I T I O N F I A N T

B U H J 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

Ar S h e e t

N o o f

S a m p l e

O Q oA

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

O U T S

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 m I)

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

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 i m n e n t s

B u i l d i n g

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

F O R M B

S h e e t

N o

S a m p l e

0 A 1"'

D r a w i n g

(5

M

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 j i l

T y p e f a

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 AJMCNTTION PLANT

RISK ASSESSMENT

form c

Building No:

Drawing No: <^CQ,jyT

Data: ftf?8M /

Floor No:

Room No:

Evaluator:

FACTOR FOR ASSESSING POTENTIAL FIBER RELEASE

Current Condition of ACBM f$Q C, \0S2J

Present Absent

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage 9

Potential far Future Disturbance

Damage or Erosion of ACBM

Low

Occupancy

Occupied

QxCurrent Occupancy

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

M

J

Unoccupied i

RAVENNA ARMY AMCNZnCN PIANT

RISK ASSESSMENT

FCKM C

Building No:

Drawing No:

Date:

lit

ISOD <

Floor No:

Room No:

Evaluator:

FACICR FCSR ASSESSING PCTTEWnAL FIBER RELEASE

Current Condition of ACEM

Present Absent

Evidence of deterioration of delamination from underlying surface

Evidence of Physical Damage

Evidence of Water Damage

Potential far Future Disturbance

Damage or Erosion of ACEM

Low

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

High

X

Occupancy

Occupied ITnoccupied

RAVENNA ARM* AMCTCEnCN PLANT

ASBESTOS BULK SAMPLE CHAIN-OF-ajSTCXDY RECCED

FCEME

Laboratory Name:

1: 8/^

Control Number:

Date Samples Collected: ft/^ JV Date Received in Lab: h ' to V

Sampler's Name: ^'CH/y^T- <^RoM . Name: (*.»>zfT\\o»nfs*n

Sampler's Signature: H^^Si^Signature

Field

No: &*&»& Sample Laboratory

SStification No:

Disposition:

Receiver's

Signature:

Samples Disposed of

Delivered to Owner or Agent

Date Received: // ■^-&>' '

HAVENNA ARMY AWCNZEICN PLANT

BULK SAMPLE ANALYSIS

PCKM D

Sb-lA-OOA

3/0/7^ ^0

Laboratory Na^e:

ID Number:

Lab Number:

ID Technique:

Gross Sample Description:. Ho^oyvr, Materials Present: ( Ol ^ lPS,OtATlQO

SO"

•Estimated Percent in Sample:

?jv Asbestos:

Chrysotile

Aroosite

Crocidolite

Anthophlyllite

Tremolite/Actinolite

Non-Asbestos Fibers :

- - ;■•«* •-»■—14 '--jOWfJ.." r''* **°-1M

Glass Fibers

Mineral Wool

Cellulose

Synthetic Fibers

Other

Non-Fibrous Component/V ^

•Percentage is Visually Estimated

Analysts Conments

Date

EAVENNA AKMZ AttOtHTCN PLANT

BULK SAMPLE ANALYSIS

FCRM D

Laboratory Name:

ID Number:

Lab Number:

ID Technique:

%- A

Pt-rA Atai io

Gross Sample Description:

Materials Present:

*Estimated Percent in Sample:

Asbestos:

Chrysotile

Amosite

Crocidolite

Anthophlyllite

Tremolite/Actinolite

$o -StX

Non-Asbestos Fibers: { <f . ^ QZ

Glass Fibers

Mineral Wool

Cellulose

Synthetic Fibers

Other

Non-Fibrous Component >2\'~ 3S 4}

*Percentage is Visually Estimated

Analysts Comments

Date:

CU^ii-

RAVENNA ARMX AMOITTXCN PLANT

ASBESTOS BULK SAMPLE CHMNHDF-CUSTODY RECCKD

FORM E

Laboratory Name: F^l PlTTSi^gtal-)

Date Samples Collected: _i -2^

Sampler's Name: - 61R0H

Sampler's Signature:

Control Number: \^

Date Received in Lab:

Name:

Sample LaboratorySample Field p , n .,» -^ , a Sample Laboratory Identification No: bUU?JAi6 -F.S)-/-/ ft Identification No:

Disposition: Samples Disposed of ivered to Owner or Agent

Received:

T

D R A W I N G

NO.:

j T

]AREA

S A M P L E D I t

M A T E R I A L T Y P E M mm

Jm

I

■ zf 1 a

H

LU

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