notification of demolition southwest clean air agency neas(j.8s10s lsad mold phone (503) 685-9505 i...

Notification #

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NOTIFICATION OF DEMOLITION Southwest Clean Air Agency

11815 NE 99th Street, Suite 1294 Vancouver, WA 98682

Voice: (360) 574-3058 Fax: (360) 576-0925 www.swcleanair.org

(10 dav waitina oeriod from date submitted)

Must include fee

See Consolidated Fee Schedule (Table 11) httQ://www.swcleanair.org/fees/index.asQ

1f3L[Sl(p I

Kd/Y.f)f)) 19'>7 1. TYPE OF NOTIFICATION (ii Original D Revised D Cancelled):

2. TYPE OF OPERATION D Partial Demolition ii Complete Demolition D Ordered Demolition

D Emergency Demolition D Fire Training

~}~ f~,,~ -~I~ Liu\ DEC 1 2 2018 \

SOUTHWES I CLE rN NR ~G[]\J0)'

1=1.~ SWCAA Reviewed fr " /

\ ' 3. FACILITY DESCRIPTION (Example: Residence, Barn, carport) 1 house, 1 mobile home, 1 shop, 1 detached garageV

Commercial Name or Description:

Address:6300 NE 119th St

city: Vancouver State:WA County: c I ark

Present use: Al I Va cant Prioruse:Residency, storage

4. FACILITY INFORMATION

ownerName:StoneRidge Capital, LLC. Mailing Address:2552 NW 12th

City: Camas I State:WA Zip Code:98607

contact:Luke Jolma Phone:360-635-2627

5. NAME AND AHERA CERTIFICATION NUMBER OF ASBESTOS INSPECTOR: Tom Levitt IR -18 - 44278

6. ATTACH A COPY OF THE ASBESTOS INSPECTION REPORT Report must include laboratory name, analyst, sample type, location sample was taken and analytical method used to detect the presence of asbestos materials.

7. ASBESTOS REMOVAL CONTRACTOR (IF APPLICABLE): D No asbestos present, see attached AHERA Report

Name:Rose City Contracting Address: 2 g 7 91 SW Kinsman Rd

City:Wilsonville I State:QR Zip Code:97070

contact:Cheryl Rice Phone: 503-685-9505

I

8. DATES ASBESTOS REMOVAL OCCURRED (mm/dd/yy) Start: 11 /13/18 Complete: 11/13/18 Asbestos Case Number: 18- W 00 .

9. DATES DEMOLITION WILL OCCUR (mm/dd/yy) Start: 12/27/18 Complete: 12/30/18

10. DEMOLITION CONTRACTOR or FIRE DEPARTMENT:

Name:StoneRidge Excavating

AddressA 707 NE Minnehaha St #C305

c ity: Vancouver I State:WA County: c I ark

Contact and Phone# J OS h Bishop 360-450-1642

SWCAA FORM N0.23 REVISED 07/13/2018

11. DESCRIPTION OF PLANNED DEMOLITION WORK, METHOD(S) TO BE USED:

Knock down with Excavator. Load into boxes and dump. 12. FUGITIVE EMISSIONS/DUST FROM DEMOLITION ACTIVITIES MUST BE CONTROLLED/PREVENTED DURING ALL PHASES OF THE PROJECT.

13. IF UNEXPECTED ASBESTOS CONTAINING MATERIAL (ACM) IS FOUND DURING DEMOLITION, STOP WORK, NOTIFY SWCAA AND CONSULT/HIRE A CERTIFIED ASBESTOS ABATEMENT CONTRACTOR.

14. IF DEMOLITION IS ORDERED BY A GOVERNMENT AGENCY, PLEASE IDENTIFY THE AGENCY BELOW:

Name: I Title:

Agency:

Date of Order (mm/dd/yy): I Date Ordered to Begin ( mm/dd/yy ):

15. FOR EMERGENCY DEMOLITIONS: (Contact SWCAA prior to work)

Date and Hour of Emergency (mm/dd/yy) (hh/mm):

Description of the Sudden, Unexpected Event:

EXPLANATION OF HOW THE EVENT CAUSED UNSAFE CONDITIONS OR WOULD CAUSE EQUIPMENT DAMAGE OR AN UNREASONABLE BURDEN: (ATIACH ADDITIONAL PAGE IF NECESSARY)

16. I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT.

~ (J,;.,t_-t(l,<;GrJ =A~ {l -(l ~fb --- (Type or Print Name) '- (Date)

HAVE YOU PERFORMED A HAZARDOUS MATERIALS ASSESSMENT ON THE STRUCTURE? DYES 0 NO

The Washington State Dangerous Waste Regulations (WAC 173-303) require that demolition debris be evaluated to determine if it is dangerous. The evaluation should be completed before demolition to ensure that hazardous constituents are not released to the environment and do not present a risk to human health during or after demolition. These requirements apply to all buildings being demolished and are the responsibility of the property owner. The Washington Department of Ecology's website, https://ecology.wa.gov/Regulations-Permits/Guidancetechnical-assistance/Dangerous-waste-guidance/Common-dangerous-waste/Construction-and-demolition, provides more information about the requirements and about sampling and testing construction materials to determine if they present a risk. For more information please contact a Hazardous Waste Inspector at the Washington Department of Ecology Southwest Regional Office: 360-407-6300.

SWCAA FORM N0.23 REVISED 07/13/2018

AS(J.8S10S lSAD MOLD

Phone (503) 685-9505 I Fax (503) 685-9190

www.rosecitycontracting.com 29791 SW Kinsman Rd.• Wilsonville, OR 97070

ontractina Inc. v

November 16, 2018

Stone Ridge Homes

RE: 621 O and 6300 NE 119th Street Vancouver WA 98686 RCCI Job No. 18-736

Dear Farzan,

Rose City Contracting, Inc. completed the asbestos abatement November 13, 2018 per the estimate# 18-1047 provided dated 10/11/18.

All abatement projects employed by Rose City Contracting, Inc. meet or exceed federal, state and local regulatory requirements. All waste was disposed at a state approved landfil l. Such records are not required for exempt material such as mastic.

Thank you for the opportunity to serve you. If you have any questions, please do not hesitate to call us.

R spectfully Submitted,

~

OR CCB# i0293.2 WA# ROSECC!° 0 63.J9

Abate Tek LLC 37LI SW Stephenson St. Portland Or. 97219 971-275-6423

ABATE TEK LLC

ASBESTOS ASSESMENT AND SURVEY

Prepared for: Ryan Christensen- StoneRidge Homes

Property Address: 6300 NE 119th St. Vancouver WA. 98686

Residence

1.0 INTRODUCTION:

On Monday, September 24th, 2018 Abate Tek LLC of Portland, completed an asbestos inspection and survey of a home slated for demolition located at: 6300 NE l l 9th St. Vancouver WA. 98686. This survey was conducted by Tom Levitt (Certification# IR-18-44278), an accredited AH ERA Asbestos Inspector under 40 CFR, Part 763, Subpart E, and Appendix C. This report presents the asbestos survey methods, findings, and conclusion.

2.0 PURPOSES AND SCOPE:

This survey & assessment is to be done on home slated for demolition.

6300 NE l 19th St. Vancouver WA. 98686

Various local, state, and federal regulations govern the use and management of Asbestos Containing Materials (ACM). The codes are generally focused on preventing airborne emissions of asbestos fibers and addressing public and worker health concerns for exposure to asbestos during demolition or renovation projects. The Environmental Protection Agency (EPA) requires that any material that contains greater than 1% asbestos be handled as an asbestos containing material.

3.0 SUSPECT MATERIALS TESTED FOR ASBESTOS CONTENT:

The number of samples taken for any surfacing, TSI or miscellaneous material is determined by CFR Part 763.86.

In some cases, the inspector can use discretion and take fewer samples of factory manufactured materials such as VCT, ceiling tile, and roofing.

- - - . - ---------- ---

4.0 SUBJECT SITE DESCRIPTION: The subject property site is a family home with basement (Dwell ing). Approx. 2300 Sq. Ft. The structure was (unoccupied) at time of survey.

5.0 SURVEY METHODOLOGY: The scope of services included identification of any suspected ACM within the specific areas that could be impacted by upcoming activities, to bulk sample and analyze those suspect materials and to provide a report of findings. A general walkover examination was initially completed to plan the asbestos survey, identify functional spaces (spatially distinct areas within the work area), and to develop a sampling scheme for homogeneous areas of suspected ACM. The interior finishes were visually inspected for suspect ACM. Bulk

samples were collected in a representative manner by the Inspector based on suspected material contents, as defined by Regulatory codes or guidance's for sampling methods and as applicable to the planned activities .

The samples were placed into airtight plastic bags and hand delivered to LabCor in Portland, Oregon. LabCor Portland, Inc. is a NVLAP accredited laboratory for the analysis of bulk materials using Polarized Light Microscopy (PLM).

6.0 IDENTIFIED ASBESTOS CONTAINING SAMPLES - FINDINGS: A total of twelve (12) samples were taken from interior/exterior of the home. (See Chain of Custody).

The following represents a tabulation of bulk samples, which were found (if any) to contain above 1% asbestos content during the preparation of this survey and the results of their analysis.

Samples that were tested as (Negative) for asbestos are listed as *NAO (No Asbestos Detected).

NR = < 1% Non-Regulated. NR - Non-Regulated materials (<1%} or trace amounts of any asbestos contaminant should be handled using OSHA approved guidelines for wet removal. This is for your safety and the safety of your contractors.

~~~

Sample 001 Plaster Material Living Room No Asbestos Detected

Sample 002 Plaster Material Bedroom East No Asbestos Detected

Sample 003 Plaster Material Bedroom West No Asbestos Detected Sample 004 Insulation Material Attic Area No Asbestos Detected

Sample 005 Ceiling Texture Dining Room No Asbestos Detected

Sample 006 Ceiling Texture Hallway No Asbestos Detected

Sample 007 Ceiling Texture Living Room No Asbestos Detected

Sample 008 Vinyl Flooring Kitchen No Asbestos Detected

Sample 009 Roofing Material Comp. Roof, Front No Asbestos Detected

Sample 010 Ceiling Tiles - Adhesive (Dots) Kitchen Area No Asbestos Detected

Sample 011 Vinyl Flooring Utility Room Next To kitchen 45% (Backing) 90 Sq. Ft. Sample 012 Vinyl Flooring Hall Bathroom 35% (Backing) 42 Sq. Ft.

7.0 RECOMMENDATION: Abate Tek LLC findings after this inspection showed that the samples listed above (011, 012) were tested and found to be (Positive) or greater than >1% asbestos content. Therefore, Abate Tek LLC recommends this material be removed by a licensed abatement contractor.

HV AC tape - wrap was not detected during initial survey but may reside in walls and registers.

This report represents Abate Tek LLC's findings and conclusions based on the scope of services agreed to by the client and within the client's schedule and budget. All findings are based on readily available and reasonably ascertainable information on site conditions at the time of the survey and for the known regulations in affect at that time.

The services provided include professional opinions and judgments based on readily available information, field observations and measurements. This includes analytical reports by an independent laboratory. The specific conditions and limitations of the AH ERA Asbestos Inspector Certification have influenced these results. The bulk samples collected influencing this survey only indicate the presence or absence of the investigated contaminant within the discrete sample units.

Each sample was collected from an area most likely to be affected by the asbestos contaminant and accessible to the inspector. However, affected areas may exist in areas not sampled for potential contaminants and may not be selected for analysis and characterization. Any analytical results included in this report should be considered only as indicators of possible site conditions. Specific statistical significance is influenced by sampling technique and laboratory methodology. Abate Tek LLC recommends that any impact to the identified areas if any in this report be conducted using approved asbestos abatement procedures. These include wet removal methods and engineering controls to capture any asbestos fibers during removal. We further recommend the use of a licensed Asbestos Abatement Contractor.

8.0 LIMITATIONS OF THIS REPORT:

We have prepared this Survey Report to aid in the renovation of this property and reference for potential future remodeling/demolition projects. This report was created for the exclusive use of Ryan Christensen -StoneRidge Homes and Abate Tek LLC. This report applies only to the subject detailed above and shall not be relied upon by any other party without the prior written consent of the inspector that prepared the report.

Abate Tek LLC work is performed in a professional manner with the best interests of our client in mind .

Abate Tek LLC objective is to perform our work with care, exercising the customary thoroughness and competence of professionals in the relevant disciplines; in accordance with the standard for these services at the time and location those services are rendered.

It is important to recognize that even the most comprehensive scope of services may fail to detect environmental liability on a given site.

Therefore, Abate Tek LLC cannot act as insurers and cannot "certify or underwrite" that a site is free of environmental contamination. No expressed or implied representation or warranty is included or intended in our reports. Our work was performed within the limits prescribed by our client, with the customary thoroughness and competence of our profession.

ABATE TEK LLC 3711 SW Stephenson St. Portland OR. 97219 Ph. 971-275-6423

Inspector: Tom Levitt Date: 9 - 27 - 2018

AHERA Inspector# IR-18-4427B

Lat>e9r Lab!Cor Portland Inc Portland ' . In ,, , l) i 4321 SW Corbett Ave,, Ste A

BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http://www,labcorpdx,net

,, : : ' Portland OR 97239 .. : ! ,

..... t Asbestos and Environmental Analysis

Client: Abate Tek LLC

3711 SW Stephenson St Portland , OR 97219

Job Number: 187155

Project Name: Stone Ridge Homes

Project Number: 6300 NE 119th St Vancouver WA

Project Notes:

Client Sample ID: 001

Client Sample Description:

Sample ID: S1

Plaster Material ; Living Room

Asbestos Mineral Fibers

Layer 01

fine compact powder, tan

Layer 02

cementitious material , gray

Layer Percent: Chrysotile Amosite

10 %

90%

Other Fibers Fibrous Mineral

Layer 01 Layer 02

Glass Cellulose Wool Synthetic

Crocidolite

Client Sample ID: 002 Sample ID: S2

Client Sample Description: Plaster Material ; E. Bedroom

Asbestos Mineral Fibers Layer Percent: Chrysotile Amosite Crocidolite

Layer 01


Layer 02


10%

90%


Layer 01

Layer 02


Page 1of7

Other

Other

Report Number: 187155R01 Report Date: 09/2712018

P.O. No: 6300

Date Analyzed: 09/27/2018

Analyst: Stephanie Golden Percent

Asbestos:

Matrix 100%

100%

NAO

NAO


Analyst: Stephanie Golden

Percent Asbestos:

Matrix 100%

100%

NAO

NAO

NVLA.p WJ.? !AB CCY-0 2007.;1.<:1

La&Je9r Lab/Cor Portland Inc Portland ' .

BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http ://www.labcorpdx. net

1· · ·· i) i 4321 SW Corbett Ave ., Ste A J; ' Portland, OR 97239

Asbestos and Environmental Analysis

Client: Abate Tek LLC 3711 SW Stephenson St Portland, OR 97219

Job Number: 187155


Project Number: 6300 NE 119th St Vancouver WA Project Notes:


Client Sample Description :

Sample ID: S3

Plaster Material; W. Bedroom


Layer 01


Layer 02

cementitious material, gray


10 %

90 %


Layer 01

Layer 02


Crocidolite



Sample ID: S4

Insulation ; Attic Area Asbestos Mineral Fibers

Homogeneous

fibrous material, dark brown


100 %

Other Fibers Fibrous Mineral Glass Cellulose Wool Synthetic

100%

Crocidolite

Page 2 of 7

Other

Other

Report Number: 187155R01 Report Date: 09/27/2018

P.O. No: 6300


Analyst:

Date Analyzed:

Analyst:

Stephanie Golden

Percent Asbestos:

Matrix 100 %

100 %

09/27/2018

Stephanie Golden

NAO

NAO

Percent Asbestos:

Matrix 0 %

NAO

NVLA.p ~ J.? LJ.B cc:-E ::o:maJJ

==~ Lab/Cor Portland, Inc. BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http://www.labcorpdx.net

I · · :n 4321 sw Corbett Ave ., Ste A • ~:; · Portland , OR 97239

,.. : ., "' ~ Asbestos and En vironmental Analysis


371 1 SW Stephenson St Portland, OR 97219

Job Number: 187155





Sample ID: S5

Ceiling Texture; Dining Room


Layer 01

fine compact powder, offwhite/tan

Layer 02



10 %

90 %


Layer 01

Layer 02


Crocidolite



Sample ID: S6

Ceiling Texture ; Hallway Asbestos Mineral Fibers

Layer 01


Layer 02



10 %

90 %


Layer 01

Layer 02


Crocidolite

Page 3 of 7

Other

Other


P.O. No: 6300



Percent Asbestos:

Matrix 100 %

100 %

NAO

NAO



Percent Asbestos:

Matrix 100 % 100 %

NAO

NAO

NVlAJ WJ.P UE CCJE ?00'/'.;tJJ

~~d Lab!Cor Portland, Inc. BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http://www. labcorpdx. net

In -~ ~ \ 4321 SW Corbett Ave., Ste A · ."!; ' Portland, OR 97239

: ~- t : Asbestos and Environmental Analysis

Client: Abate Tek LLC 3711 SW Stephenson St Portland, OR 97219

Job Number: 187155



Client Sample ID: 007 Client Sample Description:

Sample ID: S7 Ceiling Texture; Living Room


Layer 01


Layer 02 cementitious material , gray


10%

90%


Layer 01

Layer 02


Crocidolite



Sample ID: SB

Vinyl Flooring; Kitchen Asbestos Mineral Fibers Layer

Layer 01

vinyl , blue/black

Layer 02

mastic, colorless

Other Fibers

Layer 01

Layer 02

Percent: Chrysolile Amosite

90 %

10 %

Fibrous Mineral Glass Cellulose Wool Synthetic

Crocidolite

Page 4 of 7

Other

Other

Report Number: 187155R01

Report Date: 09/27/2018

P.O. No: 6300


Analyst: Stephanie Golden Percent

Asbestos:

Matrix 100% 100 %

NAO

NAO



Percent Asbestos:

Matrix 100 % 100%

NAO

NAO

NVLAJ ~-pill cc:e: :.rom~

=~~ Lab!Cor Portland, Inc. BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http://www.labcorpdx. net

I: ·· · ~n 4321 sw Corbett Ave. , Ste A · • ; · Portland, OR 97239

:. ... : : Asbestos and En vironmental Analysis


3711 SW Stephenson St Portland, OR 97219

Job Number: 187155





Sample ID: S9

Roofing - Comp; Roof, Front


Layer 01

rocky fibrous tar, black

Layer 02

rocky fibrous tar, black

Layer Percent: Chrysotile Amosite Crocidolite

50 %

50 %

Other Fibers Fibrous Mineral Glass Cellulose Wool Synthetic.

Layer 01

Layer 02




Layer 01

compressed fibrous material , tan with paint, off-whi te

Layer 02

brittle mastic, green

35 %

35 %

Sample ID: S10 Ceiling Tile - Dots ; Dining - Kitchen

Layer Percent: Chrysotile Amosite Crocidolite

90 %

10 %

Other Fibers Fibrous Mineral Wool

Layer 01

Layer 02

Glass Cellulose

98 %

Synthetic

Other

Other


Date Analyzed:

Analyst:

P.O. No: 6300

09/27/2018

Stephanie Golden

Percent Asbestos:

Matrix 65 %

65 %

NAO

NAO



Percent Asbestos:

Matrix 2 %

100 %

NAO

NAO

----------------------------- --- - -- -

Page 5 of 7 NVLAJ .WJ..." ue o.::£ L©7.;1.c

=:~ Lab!Cor Portland, Inc. BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http://www.labcorpdx.net

1 . ~h 4321 SW Corbett Ave., Ste A · • : ; · Portland, OR 97239

... ; ' ~ Asbestos and En vironmental Analysis



Job Number: 187155






Sample ID: S11

Vinyl Flooring ; Nook Off Kitchen Layer

Percent : Chrysotile Amosite Crocidolite

Layer 01

vinyl , off-white/brown 25 %

Layer 02

fibrous backing, gray 25 % 45 %

Layer 03

fibrous backing , brown 15 %

Layer 04

foam material, black 35%

Other Fibers Fibrous Mineral Glass Cellulose Wool Synthetic

Layer 01

Layer 02

Layer 03 100 %

Layer 04



Sample ID: S12

Vinyl Flooring ; Bathroom

Asbestos Mineral Fibers Layer Percent: Chrysotile Amosite

Layer 01

vinyl , tan

Layer 02

fibrous backing , gray with mastic, orange

Other Fibers

50 %

50 %

Fibrous Glass Cellulose

35 %

Mineral Wool Synthetic

Crocidolite

Other

Other


Date Analyzed:

Analyst:

Date Analyzed:

Analyst:

P.O. No: 6300

09/27/2018

Stephanie Golden

Percent Asbestos:

Matrix 100 %

55 %

0 %

100 %

09/27/2018

Stephanie Golden

NAO

45%

NAO

NAO

Percent Asbestos:

NAO

35%

Matrix

Layer 01 100 %

Layer 02 65 %

Page 6 of 7 NVLAI 'ji{.J..-::. ill cc:JE x"m.c

==~ Lab!Cor Portland, Inc. 1 .... :p 4321 SW Corbett Ave., Ste A

: ~ ~ 1 Portland, OR 97239 ~ ... f

BULK SAMPLE ASBESTOS ANALYSIS

Asbestos and Environmental Analysis

Phone: (503) 224-5055 http://www.labcorpdx.net




Job Number: 187155 P.O. No: 6300



This laboratory participates in the National Voluntary Laboratory Accreditation Program (NVLAP) . Testing method is per 40 CFR 763 Subpart E, Appendix E, PLM. This report and the data contained therein cannot be used to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the U.S. Government.

• "NAO" is No Asbestos Detected. • Asbestos consists of the following minerals : chrysotile, amosite, crocidolite, tremolite, actinol ite, anthophyllite. • Material binders, such as those found in vinyl floor tiles , may prevent the detection of small diameter asbestos fibers . A gravimetric preparation and point-count is recommended for such samples. • Quantitative analysis by PLM point count or TEM may be recommended for samples testing at <or = to 1 % asbestos. ·The following estimate of error for this method by visual estimation of asbestos percent are as follows: 1 % asbestos: 0-3% error, 5% asbestos : 1-9% error, 10% asbestos: 5-15% error, 20% asbestos : 10-30% error. • This report pertains only to the samples listed on the report. Report considered valid only when signed by analyst.

Reviewed by:

.. ·~ Stephanie Golden Technical Manager

------------------------------ - - - - ----

Page 7 of 7 NVLAJ YN'J.? L4E c.c_"'.E 'm7~~Jj

Chain of Custody Record \S~ lSS r 1/2 Abate Tek LLC

Analytical Protocol: Turnaround: ...,L3Days __ ZDoys 3711 SW Stephenson St.

Info @abatetekllc.com Portland OR. 97219 Contact: Tom Levitt [email protected] Phone - 971-275-6423

_L' · PLM - Visual estimate PLM - Gravimetric PLM - 400 Pt. Count 24Hours

Date: 9-.lc/= / f: Sample No.

Lab Cor Portland 4321 SW Corbett SUite A Portland, OR. ~7239

Job No. ~-ic:c>

Sample Description:

Relinquishe~ Date: 9-...J~. d RecewedB~ _ · Date:Gj-7,4.-JfJ

Internal Lab Use Only:

Location

Time: / · · /0

Time: l i l 0 ff\q

o Final Results Released ------ Invoice Emailed ---------0 By: Email Verbal Reviewed By:

Sq. Ft.

Chain of Custody Record \ 'O"T l SS , ?fl Abate Tek LLC 3711 SW Stephenson St. Info @abatetekllc.com Portland OR. 97219 Contact: Tom Levitt [email protected] Phone - 971-275-6423

Project Address: C:::::.$<=2<' of£

Analytical Protocol: / PLM - Visual estimate

PLM - Gravimetric PLM -400 Pt. Count

Lab Cor Portland 4321 SW Corbett Suite A Portland~ OR. 97239

Tumarou~ _,-_33Days __ 2Days

24Hours

JobNo. 4too

Date: 9 ·«IV·/~ Sample No. Sample Description:

I~_,,.,, ~/, A/v t: ~Ld"""L'-~

ReHnqufflhe~ ReceJVedBy: .... ~ .... ~ ............ ~""""""--......... ~ .... -~--=--

1nternal Lab Use Only:

o Final Results Released ------0 By: Email Verbal

Location

~~-~~ _ ... _, .... -

Date: 9 ... -1o/. /F

Date:q-z4-L&

Invoice Emailed

Time: / -' /6

Time: l < \.0 Ph

------Reviewed By: _____ _

Sq. Ft.

notification of demolition southwest clean air agency neas(j.8s10s lsad mold phone (503) 685-9505 i...

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