BOTH-000244-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000244-2015 Date Issued: Friday, October 28, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000244-2015
has been completed.
Tax Map Number: 226.19-2-33
Location: 16 HONEYSUCKLE LN LN
Owner: Paul Lejuez,Amy Lejuez
Applicant: Howland Construction
This structure may be occupied as a: Demo of SFD and shed
By Order of Town Board
TOWN OF QUEEENNSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
OL Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000244-2015 6P �y5"4
Tax Map No: 226.19-2-33 REVISE
Permission is hereby granted to: Dean Howland
For property located at: 16 HONEYSUCKLE LN LN
in the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other infomtation hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Tvae of Construction
Owner Address: 7 Hickory DR Demolition $0.00
Rye,NY 10580 Total Value 50.00
Contractor or Builders Name/Address Electrical Inspection Agency
Dean Howland
7 IROQUOIS DR DR
Queensbury,NY 12804
Plans&Specifications
Demo of SFD and shed
PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,October 9,2016
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the a/x,2iration date.
Dated at the Town Queens /'Fri y ,2015
SIGNED BY: /V1 for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
tIM
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150483 Application Number: A20150483
Tax Map No: 523400-226-019-0002-033-000-0000
Permission is hereby granted to: PAUL&AMY LEJUEZ
For property located at: 16 HONEYSUCKLE Ln
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: PAUL&AMY LEJUEZ
7 HICKORY Dr Demolition
RYE NY 10580-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
HOWLAND CONSTRUCTION INC.
Plans&Specifications
BP 2015-483
Demolition Residence and Shed
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday, October 09,2016
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the wn Quee ur�; I ctober 09,2015
�YJ
SIGNED BY ' \ for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
Permit#:
DEMOLITION PERMIT APPLICATION 1
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee �� ‘6_
Provide 2 plot plans drawn to scale, showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures
on property and indicate which are to be de , ties
E
Date /0/71 /j- PD
-'— i v 'cation
OCT ,4,s-,y pi-
Tax Map ID 22-6. 19 _/. ..33 ; CU 7 2015 -�
APPLICANT vu)l f1MQ S'oH +'JC v`IVIV ���=QUENfRcw(
Address ? CL ddress _./... LiSuf J?A
L Cctoo N-� t2tY1 � k� (0SBo
Phone Sir - G 68- 3t '5 Phone 375__2J3- Zlo 8'1
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: Phone:
1. Person Responsible for Work eCO Pcu-$t ' _ o Z35 561156112. Where will demolition material be disposed? A� Le . ./�1 it
3. All buildings to be demolished require an Asbestos Survey
4. An_y building substantially damaged by fire must obtain an Asbestos Removal Permit from the Department of Labor
5. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begin
a) Is there any asbestos in the building to be demolished _)C_ Yes ____ No
b) If Yes, our office needs the following information _ x_ Yes ____ No
Name of firm removing the asbestos C 17geco ksrePtert. ka ZG. 235-SCorT
License number of firm 414 - 518.
Indicate where the asbestos material will be disposed if ,4"
6. Structure Information
a) Indicate the structure(s)to be demolished _Residence ___ Garage ___ Business
___ Storage Bldg. ___ Other
b) Size of Structure
c) Number of Stories
d) Foundation Type Pun
e) Foundation
f) Structure(s) 5 //O SF
7. Utilities Information
a) Indicate utilities for this structure___ Gas _2e Electric ___ Propane ___ Public Water ___ Public Sewer
_6_ On-site well water pump in iOv
a) Have you notified the Town Water Department for public water and sewer disconnect? ____ Yes No AJ/A,
b) Have all utilities been disconnected? Yes ____ No se
8. Signature
Print Name: l�&A$. 1-‘01/44,4-GL Date 1(2/7-
Signature: /��-+ -+� i -- Date _/ 171/ --
Town of Queensbury Building& Codes - Demolition Permit - December 2014
OCT 0 7 2015
TOWN OF QUEENSBURY
H ANSON BUILDING&CODES
GEOLOGIC & ENVIRONMENTAL CONSULTANTS
VAN VLEET, LLC
Howland Construction BP 2015-483
September 10,2015 Lejuez
16 Honeysuckle Lane
Mr. Dean Howland Demolition Residence & Shed
Howland Construction
7 Iroquois Street
Lake George,New York 12845
RE: Pre-Demolition Asbestos Survey FILE COPY
16 Honeysuckle Lane
Tax ID#226.19-2-33
Town of Queensbury,New York
Dear Mr. Howland:
Hanson Van Vleet, LLC conducted a pre-demolition asbestos containing material (ACM)
survey at the single story, two bedroom, seasonal camp type residential structure, located at
16 Honeysuckle Lane, in the Town of Queensbury, Warren County, New York (Tax ID:
226.19-2-33. The survey is being conducted to determine if any ACM exists within the
structure, prior to demolition. The owner of record at the time of the survey was Mr. Paul
Lejuez. HVV is a licensed by the New York State Department of Labor under license # 05-
0220 to perform asbestos inspections, sample collection and surveys. Samples of all types of
suspectedected asbestos containing material (SACM) were collected. All samples were collected
by a NYSDOL licensed Class D Inspector, in accordance with 12 NYCRR Part 56 (referred to
as Industrial Code Rule 56) and 29 CFR Part 1910. The sampling was conducted on August
20, 2015. A copy of the NYSDOL Asbestos license is attached to this letter.
This survey was performed to determine the existence of ACM prior to demolition of the
structure. The work included the collection of representative samples of each type of
suspected ACM.
Methods
The asbestos survey was conducted on August 20, 2015. Prior to initiating sampling, an on-
site walk-through inspection of the building was performed in accordance with Subpart 56-
5(e)of 12 NYCRR Part 56. Building plans were not available for review.
Based on the site inspection, sampling of materials was performed to evaluate for suspect
asbestos containing materials (ACM). Bulk samples were collected following standard
sampling procedures. The samples were placed in sealed sample bags and delivered by
Federal Express to EMSL Analytical for analysis under formal chain of custody procedures.
Friable type materials were analyzed by Polarized Light Microscopy (PLM) via the NY State
ELAP 198.1 method. Non-organically bound (NOB) materials were analyzed by PLM via
902 Route 146 (518)371-7940
Clifton Park, New York 12065 Fax(518)371-5885
Pre-Demolition ACM Survey
16 Honeysuckle Road
Town of Queensbury,NY
Page 2 of 4
NYS method 198.6 NOB. If the NYS method 198.6 NOB was inconclusive, the NOB
materials were then analyzed by transient electron microscopy (TEM) via NYS method 198.4
NOB.
INSPECTION RESULTS
The inspection revealed a single story residential structure and shed. The structure was of
wood frame construction on a concrete slab. The Shed was also of wood framed construction.
The date of construction is approximately 1955 according to county records. A site location
map is attached to this letter report.
Interior
Flooring in the building consisted of sheet vinyl flooring in the kitchen and bathroom and
hardwood floors in the bedrooms and front room. The kitchen floor consisted of two layers of
sheet vinyl flooring. Sheet vinyl flooring in the kitchen and bathroom was considered suspect
ACM. Samples were collected of the sheet vinyl flooring and associated mastic in the kitchen
and bathroom.
Walls and ceilings in the building consisted of paperboard. Paperboard is rarely found to be
ACM but, due to the date of construction and large amount of paperboard used in the building
samples of the paperboard were collected and submitted for laboratory analysis. Fiberglass
insulation was observed in the structure, and was not considered suspect ACM. No other
suspected ACM was observed within the structure.
Exterior
The exterior was sided with vinyl siding. The structure had an asphalt shingle roof The
asphalt shingle roof was considered suspect ACM and samples were submitted for laboratory
analysis. The windows were wood framed construction. The window design did not include
any window glazing compounds. No other suspected ACM was observed during the exterior
inspection of the structure.
A small shed was also observed on the property. The shed was of wood framed construction
with an asphalt shingle roof The asphalt shingle roof was sampled for laboratory analysis.No
other suspected ACM was observed during the inspection of the shed on the property.
Asbestos Containing Material Sampling Results
The structure contained very little materials considered suspected ACM. Samples of nine
types of suspected ACM samples were submitted for analysis. Three samples of each type of
material were submitted for analysis. The sample locations and analytical results are
summarized below. The Analytical results and chain of custody are attached to this letter.
Table 1
Asbestos Sampling Locations and Analytical Results
Sample Type of Material Location Result Approximate
No. Quantity
S-lA Asphalt Roof Shingles House Roof ND NA
S-1B Asphalt Roof Shingles House Roof ND NA
S-1 C Asphalt Roof Shingles House Roof ND NA
Pre-Demolition ACM Survey
16 Honeysuckle Road
Town of Queensbury,NY
Page 3 of 4
S-2A Top Layer Sheet Vinyl Kitchen Floor 1.6%Chrysotile =140 Sq Ft
S-2B Leveling Compound W/ Top Layer Sheet Vinyl Floor 5.33%Chrysotile =140 Sq Ft
in Kitchen.
S-2C Top Layer Sheet Vinyl Kitchen Floor NA-Positive Stop =140 Sq Ft
S-3A Top Layer Sheet Vinyl Kitchen Floor 2.5%Chrysotile =140 Sq Ft
Mastic
S-3B Top Layer Sheet Vinyl Kitchen Floor NA-Positive Stop =140 Sq Ft
Mastic
S-3C Top Layer Sheet Vinyl Kitchen Floor NA-Positive Stop =140 Sq Ft
Mastic
S-4A Bottom Layer Sheet Vinyl Kitchen Floor 1.3%Chrysotile =140 Sq Ft
S-4B Bottom Layer Sheet Vinyl Kitchen Floor NA-Positive Stop =140 Sq Ft
S-4C Bottom Layer Sheet Vinyl Kitchen Floor NA-Positive Stop =140 Sq Ft
S-5A Bottom Layer Sheet Vinyl Kitchen Floor NA-Insufficient =140 Sq Ft
Mastic Material
S-5B Bottom Layer Sheet Vinyl Kitchen Floor NA-Insufficient =140 Sq Ft
Mastic Material
S-5C Bottom Layer Sheet Vinyl Kitchen Floor NA-Insufficient =140 Sq Ft
Mastic Material
S-6A Sheet Vinyl Flooring Bathroom ND NA
S-6B Sheet Vinyl Flooring Bathroom ND NA
S-6C Sheet Vinyl Flooring Bathroom ND NA
S-7A Sheet Vinyl Mastic Bathroom ND NA
S-7B Sheet Vinyl Mastic Bathroom ND NA
S-7C Sheet Vinyl Mastic Bathroom ND NA
S-8A Asphalt Shingles Shed Roof ND NA
S-8B Asphalt Shingles Shed Roof ND NA
S-8C Asphalt Shingles Shed Roof ND NA
S-9A Paper Board Walls and Ceilings through house ND NA
S-9B Paper Board Walls and Ceilings through house ND NA
S-9C Paper Board Walls and Ceilings through house ND NA
Conclusions
Testing of all suspect asbestos containing materials was performed pursuant to 12 NYCRR
Part 56, (Code Rule 56). Materials are considered asbestos containing if they contain 1% or
more of asbestos.
The results of the asbestos survey identified asbestos on the interior of the structure. The two
layers of sheet vinyl flooring and associated leveling compound and mastic in the kitchen
were found to contain asbestos.
Recommendations
The two layers of sheet vinyl flooring and associated leveling compound and mastic in the
kitchen were found to contain asbestos. Abatement by a licensed NYSDOL abatement
contractor is required prior to disturbing the materials during the demolition of the structure.
Prior to modification or removal, the asbestos containing vinyl flooring and leveling
compound must be removed by a licensed asbestos contractor, or otherwise in accordance
with 12 NYCRR Part 56 and 29 CFR Part 1910.
Pre-Demolition ACM Survey
16 Honeysuckle Road
Town of Queensbury,NY
Page 4 of 4
If you have any questions regarding this survey, please contact Hanson Van Vleet LLC at
(518) 371-7940.
Very truly yours,
sonIffti
Vleet, LLC
James Gironda
Geologist/Environmental Scientist
NYSDOL Class D Inspector Certificate#07-05263
CC:NYSDOL
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H ANSON WATER SUPPLY &
16 HONEYSUCKLE LANE VANVLEET, LLC ENVIRONMENTAL CONSULTANTS
QUEENSBURY, NEW YORK 902 ROUTE 146 CLIFTON PARK,NEW YORK 12065 (518)371-7940 FAX(518)371-5885
EMSL Analytical, Inc. EMSL Order: 041525562
EIVISL 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
htto://www.EMSL.com cinnasblab(a.EMSL.com ProjectiD:
Attn: James Gironda Phone: (518)371-7940
Hanson Van Vleet, LLC Fax: (518)371-5885
902 Route 146 Received: 08/24/15 9:00 AM
Clifton Park, NY 12065 Analysis Date: 9/9/2015
Collected: 8/20/2015
Project: 16 Honeysuckle Road
Test Report:Asbestos Analysis of Bulk Material
Analyzed Non Asbestos
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID S-1A Description House-Asphalt Roof Shingles
041525562-0001 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Gray 21.5% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9/9/2015 Gray None Detected
Sample ID S-1 B Description House-Asphalt Roof Shingles
041525562-0002 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Gray 22.4% Glass Inconclusive: None Detected
TEM NYS 198.4 NOB 9/9/2015 Gray None Detected
Sample ID S-1C Description House-Asphalt Roof Shingles
041525562-0003 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Gray 10.6% Glass Inconclusive: None Detected
TEM NYS 198.4 NOB 9/9/2015 Gray None Detected
Sample ID S-2A Description Kitchen-Top Layer Sheet Vinyl Floor
041525562-0004 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Gray 1.6% Chrysotile
1.6%Total
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-2B-Floor Tile Description Kitchen-Top Layer Sheet Vinyl Floor
041525562-0005 Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Positive Stop(Not Analyzed)
TEM NYS 198.4 NOB Not Analyzed
Initial Report From 09/09/2015 11:17:17
Test Report 198VCM-7.30.0 Printed:9/9/2015 11:17:17 AM Page 1
• EMSL Analytical, Inc. EMSL Order: 041525562
EMSL 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
htto://www.EMSL.com cinnasblabC6/EMSL.com ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-2B-Leveler Description Kitchen-Top Layer Sheet Vinyl Floor
041525562-0005A Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/8/2015 Brown 94.67%Non-fibrous(other) 5.33% Chrysotile
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-2C Description Kitchen-Top Layer Sheet Vinyl Floor
041525562-0006 Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Positive Stop(Not Analyzed)
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3A-Floor Tile Description Kitchen-Top Layer Sheet Vinyl Mastic
041525562-0007 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Black 3.2% Chrysotile
3.2%Total
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3A-Mastic Description Kitchen-Top Layer Sheet Vinyl Mastic
041525562-0007A Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Yellow Inconclusive: None Detected
TEM NYS 198.4 NOB 9/9/2015 Yellow 2.5%Chrysotile
2.5%Total
Sample ID S-3B-Floor Tile Description Kitchen-Top Layer Sheet Vinyl Mastic
041525562-0008 Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Positive Stop(Not Analyzed)
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3B-Mastic Description Kitchen-Top Layer Sheet Vinyl Mastic
041525562-0008A Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Yellow Inconclusive:None Detected
TEM NYS 198.4 NOB 9/9/2015 Positive Stop(Not Analyzed)
[Initial Report From 09/09/2015 11:17:17
Test Report 198VCM-7.30.0 Printed:9/9/2015 11:17:17 AM Page 2
• EMSL Analytical, Inc. EMSL Order: 041525562
EMSL 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
htto://www.EMSL.com cinnasblab(&,EMSL.com ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-3C-Floor Tile Description Kitchen-Top Layer Sheet Vinyl Mastic
041525562-0009 Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Positive Stop(Not Analyzed)
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3C-Mastic Description Kitchen-Top Layer Sheet Vinyl Mastic
041525562-0009A Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Insufficient Material
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-4A Description Kitchen-Second Layer Sheet Vinyl
041525562-0010 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Brown/Black Inconclusive:<1%Chrysotile
Inconclusive-<1%Total
TEM NYS 198.4 NOB 9/9/2015 Brown/Black 1.3%Chrysotile
1.3%Total
Sample ID S-4B Description Kitchen-Second Layer Sheet Vinyl
041525562-0011 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Brown/Black Inconclusive:<1%Chrysotile
Inconclusive-<1%Total
TEM NYS 198.4 NOB 9/9/2015 Positive Stop(Not Analyzed)
Sample ID S-4C Description Kitchen-Second Layer Sheet Vinyl
041525562-0012 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Brown/Black Inconclusive:<1%Chrysotile
Inconclusive-<1%Total
TEM NYS 198.4 NOB 9/9/2015 Positive Stop(Not Analyzed)
Sample ID S-4A Mastic Description -Second Layer Sheet Vinyl Mastic
041525562-0013 Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Insufficient Material
TEM NYS 198.4 NOB Not Analyzed
[Initial Report From 09/09/2015 11:17:17
Test Report 198VCM-7.30.0 Printed:9/9/2015 11:17:17 AM Page 3
EMSL Analytical, Inc. EMSL Order: 041525562
EMSL 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
htto://www.EMSL.com cinnasblab(a.EMSL.com ProjectiD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-4B Mastic Description -Second Layer Sheet Vinyl Mastic
041525562-0014 Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Insufficient Material
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-4C Mastic Description -Second Layer Sheet Vinyl Mastic
041525562-0015 Homogeneity
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Insufficient Material
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-6A Description Bathroom-Sheet Vinyl Floor
041525562-0016 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9/9/2015 White None Detected
Sample ID S-6B Description Bathroom-Sheet Vinyl Floor
041525562-0017 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9/9/2015 White None Detected
Sample ID S-6C Description Bathroom-Sheet Vinyl Floor
041525562-0018 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 White Inconclusive: None Detected
TEM NYS 198.4 NOB 9/9/2015 White None Detected
Sample ID S-7A Description Bathroom-Sheet Vinyl Mastic
041525562-0019 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 White Inconclusive: None Detected
TEM NYS 198.4 NOB 9/9/2015 White None Detected
[Initial Report From 09/09/2015 11:17:17
Test Report 198VCM-7.30.0 Printed:9/9/2015 11:17:17 AM Pana 4
• EMSL Analytical, Inc. EMSL Order: 041525562
EMSL 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
htto://www.EMSL.com cinnasblab(a?EMSL.com ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-7B Description Bathroom-Sheet Vinyl Mastic
041525562-0020 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9/9/2015 White None Detected
Sample ID S-7C Description Bathroom-Sheet Vinyl Mastic
041525562-0021 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9/9/2015 White <1%Chrysotile
<1%Total
Sample ID S-8A Description Shed-Asphalt Roof Shingles
041525562-0022 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Black 15.2% Glass Inconclusive: None Detected
TEM NYS 198.4 NOB 9/9/2015 Black None Detected
Sample ID S-8B Description Shed-Asphalt Roof Shingles
041525562-0023 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Black 18.1% Glass Inconclusive: None Detected
TEM NYS 198.4 NOB 9/9/2015 Black None Detected
Shingles
Description Shed-Asphalt Roof Shin
Sample ID S-8C p p 9
041525562-0024 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/8/2015 Black 8.2% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9/9/2015 Black None Detected
Sample ID S-9A Description Walls&Ceilings-Paper Board
041525562-0025 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/8/2015 Brown/Black 85.00%Cellulose 15.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Initial Report From 09/09/2015 11:17:17
Test Report 198VCM-7.30.0 Printed:9/9/2015 11:17:17 AM Page 5
EMSL Analytical, Inc. EMSL Order: 041525562
EMSL 200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
http://www.EMSL.com cinnasblab(a,EMSL.com ProjectiD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-9B Description Walls&Ceilings-Paper Board
041525562-0026 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/8/2015 Brown/Blue 80.00%Cellulose 20.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-9C Description Walls&Ceilings-Paper Board
041525562-0027 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/8/2015 Brown 90.00%Cellulose 10.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Analyst(s)
Chelsey Bilhear Samantha Rundstorm
Felix Anusiem
Sandy Burany, Ph.D Benjamin Ellis, Laboratory Manager
or other approved signatory
NOB=Non Friable Organically Bound N/A=Not Applicable VCM=Vermiculite Containing Material
-In New York State,TEM is currently the only method that can be used to determine if NOB materials can be considered or treated as non-asbestos containing.
All samples examined for the presence of vermiculite when analyzed via NYS 198.1.
-NYS Guidelines for Vermiculite containing samples are available at http://www.wadsworth.oro/labcert/elaocert/formsNermiculitelnterimGuidance Rev070913.odf
EMSL maintains liability limited to cost of analysis.This report relates only to the samples reported above and may not be reproduced,except in full,without written approval by EMSL.
EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client.Samples were
received in good condition unless otherwise noted.
This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP,NIST,or any agency of the federal government.This report may contain
data that is not covered by the NVLAP accreditation.
Samples analyzed by EMSL Analytical,Inc.Cinnaminson,NJ NYS ELAP 10872,PA ID#68-00367
Initial Report From 09/09/2015 11:17:17
Test Report 198VCM-7.30.0 Printed:9/9/2015 11:17:17 AM THIS IS THE LAST PAGE OF THE REPORT. Page 6
STATE OF NEW YORK - DEPARTMENT OF LABORN.
i
ASBESTOS CERTIF=ICATE i
JAMES J GIRONDA
CLASS(EXPIRES)
D INSP(11/15)
*.
7° - . --05263
• 48045
MUST BE CARRIED ON ASBESTOS PROJECTS
New York State— Department of,Labor
Division of Safety and Health
License and Certificate Unit
State Campus,Building 12'
Albany,NY 12240
ASBESTOS HANDLING LICENSE
Hanson Van Vleet, LLC FILE NUMBER: 05-0220
LICENSE NUMBER: 28463
902 Route 146 LICENSE CLASS: RESTRICTED
DATE OF ISSUE: 03/09/2015
Clifton Park, NY 12065 EXPIRATION DATE: 03/31/2016
' I
Duly Authorized Representative—D Kirby Vanvleet:
This license has been issued in accordance with applicableprovisions of Article 30 of the Labor Law of New York State and of
the New York State Codes,Rules and Regulations(12NYCRR Part 56). It is subject to suspension or revocation for a(1)
serious violation of state,federal or local las with regard to the conduct of an asbestos project,or(2)demonstrated lack of
responsibility in the conduct of any job involving asbestos or asbestos material:
This license is valid only for the contractor named above and this"license or a photocopy must_be prominently displayed at the
•
asbestos project worksite. This licepse verifies that all persons employed by the licensee on an asbestos project in New York
State have been issued an Asbestos Certificate,appropriate for the type of work they perform,by the New York State
Department of Labor.
Eileen M.Franko, Director
SH 432(8/12) For the Commissioner of Labor
tutor
6
1 A i