DEMO-0175-2021 Office Use Only
DEMOLITION APPLICATION Permit#: benno -01,V5 -ZOZI
Permit Fee:$ 16S
Town of Queensbury
Invoice#:
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.aueensbury.net Flood Zone? Y N Reviewed By:
Demolition Location: Tax Map ID#: ZZ� . �'� — l
**AN ASBESTOS REPORT IS REQUIRED WITH ALL
DEMOLITION APPLICATION SUBX" sl%NTE I
DEMOLITION INFORMATION: F
1. Where will demolition material be disposed? (6--1(11 FAR 3 9 2921
TOVVN OF 01JEENSBURY
2. Type of structure to be demolished: BUILDING& CODES
a. Residence d. Storage Building ❑
b. Garage ❑ Oe Other: 2 6 y -2 (,'J�1v,rocm_ Llr
c. Business ❑
3. What type of utilities are connected to the structure:
a. Gas ❑ f. Well-Water Pump ❑
b. Fuel Oil ❑ g. Public Sewer❑
c. Propane ❑ h. Other
d. Electric❑ i. None 0
e. Public Water❑
4. Have ALL utilities (water, electric, etc.) been disconnected? Yes ® No ❑
ADDITIONAL INFORMATION: J
1. Two inspections may be required: an inspection to determine that utilities are
disconnected, if necessary, and a final inspection, after the structure is removed and the
site is cleaned up and graded.
2. Twenty-four (24) hour notification is required for inspections.
3. Workers' Comp insurance information is required to be submitted with this application.
Declaration: I acknowledge that no structure(s)will be removed from the parcel until the demolition application has
been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a
permit has been issued.
I have read and agree to the above:
PRINT NAME: -a_,,. I-L--,1 f
SIGNATURE /' DATE:
Demolition Application Revised December 2020
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s):
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Primary Owner(s):
Name(s): S�e.ve. C � w
Mailing Address, C/S/Z: /o j,dJ ! ;c��(�,,��r Ay 1 Zoy
Cell Phone: Land Line: 5 i� _ 2 «_ 12,7-3
Email: $AV-ve..o Q,C,,..svi ,
❑Check if all work will be performed by property owner only
• Contractor: (List all additional contractors on the back of this form)
Contact Name(s): 14"IA-k
Contractor Trade: Cie� Cbw�0-41-�
Mailing Address, C/S/Z: '?o VZI�- 16T Q2eec/5' �'Y
Cell Phone: Land Line:
Email:
**Workers' Comp documentation must be submitted with this application**
Contact Person for any questions regarding this project:
Cell Phone: Land Line:
Email: J ��ou�lc�.c�Coy sf�'U Ctdr�: Cam
Demolition Application Revised December 2020
e
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ninc.
ENVIRONMENTAL SERVICES
REPORT OF PRE-DEMOLITION ASBESTOS INSPECTION
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"`° "C *" "sty. '
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Location of Inspection/ 17 Holiday Point Road N 'p y-
Owner: Queensbury, New York CSI L
,r O
Client: Howland Construction, Inc. O :�
PO Box 708 0 O
Lake George, New York 12845 N v
CVN � p
Alpine Project#: 21-26463-A
Material or Area Inspected: West Section of House (Outlined Above)
Asbestos Materials Tested: None
Non-Asbestos Containing
Materials: Drywall &compound,wire insulation,fiberglass insulation
paper, mortar on plywood, stone fagade mortar, shingle
Date(s)of Inspection: February 22, 2021 TOWN OF QUEENSBURY
Report Date: March 1, 2021 BUILDING DEPARTMENT
Based on our limited examination,compliance
Inspection Performed B Alpine Environmental Services Inc. with our comments shall not be construed as
Ins
p Y� p r indicating the plans and specifications are in
438 New Karner Road full
com lSnncee with the Building Codes of
Albany, New York 12205 ;k
Inspector(s): Paul Van Zandt: NYSDOL Cert.#AH95-02581
NYS Department of Labor Certified Asbestos Inspector
TOWN OF QUEENSBURY --
BUILDING & CO ES EPTo
Reviewed B '
Date: 'i, MAR 31 2f
J
TOWN OF QUEENSr',.;b?�'
BUILDING&C}
Main Report Summary-Page 1 of 5
438 New Karner Road Albany,New York 12205 Phone:(518)250-4047
February 2021 17 Holiday Point Road
Queensbury,New York
Scope and Purpose
This report is intended to document the pre-demolition asbestos inspection of the west section
of the building located at 14 Holiday Point Road, Queensbury, New York.
"Asbestos containing materials", as defined by the United States Environmental Protection
Agency (EPA), is any material containing greater than 1% by weight of asbestos. Friable samples
(samples easily crushed/pulverized by hand pressure), were analyzed via Polarized Light
Microscopy (PLM) and Non-Friable samples (samples not easily crushed/pulverized by hand
pressure), were analyzed via Transmission Electron Microscopy (TEM) by EMSL Laboratory of
New York, New York, a New York State Department of Health Approved Laboratory (ELAP
#11506).
Description
The area inspected was limited to the west section of the building. The west section was a
single story wood structure with no basement. The building was constructed in 1970.There was
no heating system in this section of the building. The floors were covered by hardwood. No
vapor barrier was observed under the hardwood. The walls and ceilings were covered with
drywall. The exterior was covered with wood siding and a stone fagade. No suspect vapor
barrier was observed under the siding or stone fagade. The roof was pitched and covered with
shingles.
Limitations
The inspection was limited to the west section of the building scheduled for demolition.
Results of Asbestos Inspection
Bulk samples were collected, as prescribed by US EPA ASHARA protocols for the number and
types of samples. No asbestos containing materials were found at 17 Holiday Point Road in
Queensbury, New York.
The following materials were sampled and determined not to contain asbestos:
Non-Asbestos Locations Sample#s '.
Material
Walls/Ceilings
Drywall &Compound West Demo Section 1-01, 1-02,
2-01, 2-02
Misc.
Wire Insulation West Demo Section 3-01, 3-02
Fiberglass Insulation
West Demo Section 4-01,4-02
Paper
Mortar on Plywood West Demo Section 5-01, 5-02
Main Report Summary-Page 2 of 3
438 New Karner Road,Albany,New York 12205-Phone:(518)250-4047
i
February 2021 17 Holiday Point Road
Queensbury,New York
Non-Asbestos Materials Cont'd
Non-Asbestos -
Material. Locations Sample#s
Exterior
Stone Fagade Mortar Exterior 6-01, 6-02
Roof
Shingle Roof 7-01, 7-02
Conclusion & Recommendations
Any materials not sampled during this inspection should be considered suspect unless sampled
and determined to be non-asbestos. All asbestos containing materials must be abated prior to
the demolition/renovation of any of.the structures unless performed under a variance issued by
the NYS Department of Labor. Disturbance/Abatement of any asbestos containing materials, as
well as necessary air monitoring, must be performed by a NYS DOL licensed contractor, in
accordance with state and federal regulations (NYS DOL ICR 56 and US EPA 40 CFR).
If Alpine Environmental Services can be of further assistance on this matter, please contact Craig
Petreikis at either(518) 250-4047 ext. 313 or craigp@alpineenv.com.
Sincerely,
Alpine Environmental Services, Inc.
Paul Van Zandt
NYS Dept. of Labor Asbestos Inspector
Enclosures: Results, NYSDOL Handling License(s), NYSDOL Handling Certificate(s), NYSDOH ELAP
License(s)
Main Report Summary-Page 3 of 3
438 New Kamer Road,Albany,New York 12205-Phone:(518)250-4047
EMSL Analytical, Inc. EMSL Order: 032102881
307 West 38th Street New York,NY 10018 Customer ID: ALP150
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO:
M http://www.EMSL.com/manhattanlab@emsl.com Project ID:
Attention: Alpine Environmental Services Phone: (518)250-4047
438 New Kamer Road Fax:
Albany, NY 12205 Received Date: 02/24/2021 2:00 PM
Analysis Date: 02/26/2021 -02/28/2021
Collected Date: 02/22/2021
Project: 21-26463-A/17 HOLIDAY PT, CLEVERDALE, NY
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID 1-01 Description WEST DEMO SECTION-DRYWALL
032102861-0001 Homogeneity Homogeneous
PLM NYS 198.1 Friable 02/27/2021 Brown/Beige 15.00%Cellulose 65.00% Gypsum None Detected
8.00%Glass 12.00% Non-fibrous(other)
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID 1-02 Description WEST DEMO SECTION-DRYWALL
032102881-0002 Homogeneity Homogeneous
PLM NYS 198.1 Friable 02/27/2021 Brown/Gray 5.00%Cellulose 40.00% Gypsum None Detected
2.00%Glass 53.00% Non-fibrous(other)
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID 2-01 Description WEST DEMO SECTION-DRYWALL COMPOUND
032102881-0003 Homogeneity Homogeneous
PLM NYS 198.1 Friable 02/27/2021 White 4.00%Cellulose 65.00% Ca Carbonate None Detected
6.00% Mica
25.00% Non-fibrous(other)
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID 2-02 Description WEST DEMO SECTION-DRYWALL COMPOUND
032102881-0004 Homogeneity Homogeneous
PLM NYS 198.1 Friable 02/27/2021 White 62.00% Ca Carbonate None Detected
38.00% Non-fibrous(other)
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID 3-01 Description WEST DEMO SECTION-WIRE INSULATION
032102881-0005 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/26/2021 Beige 100.00% Other Inconclusive:None Detected
Final Residue<1%of original subsample
TEM NYS 198.4 NOB 02/27/2021 Beige 100.00% Other None Detected
Initial report from:02/28/2021 11:38:51
ASB_198x_0009_0001 Printed 2/28/2021 2:24:08PM Page 1 of 4
EMSL Analytical, Inc. EMSL Order: 032102881
-307 West 38th Street New York,NY 10018 Customer ID: ALP150
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO:
M http://www.EMSL.com/manhattanlab@emsl.com Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID 3-02 Description WEST DEMO SECTION-WIRE INSULATION
032102881-0006 Homogeneity Heterogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/26/2021 Black/Beige 8.10%Glass 91.90%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 02/27/2021 Black/Beige 100.00% Other None Detected
Sample ID 4-01 Description WEST DEMO SECTION-FIBERGLASS INSULATION PAPER
032102881-0007 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/28/2021 Brown 1.90%Min.Wool 98.10% Other Inconclusive:None Detected
Sample contained tar
TEM NYS 198.4 NOB 02/28/2021 Brown 100.00%Other None Detected
Sample ID 4-02 Description WEST DEMO SECTION-FIBERGLASS INSULATION PAPER
032102881-0008 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/28/2021 Brown 2.90%Min.Wool 97.10% Other Inconclusive:None Detected
Sample contained tar
TEM NYS 198.4 NOB 02/28/2021 Brown 100.00% Other None Detected
Sample ID 5-01 Description WEST DEMO SECTION LEANING AGAINST WALL-MORTAR ON PLYWOOD
032102881-0009 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/28/2021 Gray 100.60% Other Inconclusive:None Detected
Sample is glue
TEM NYS 198.4 NOB 02/28/2021 Gray 100.00%Other None Detected
Sample ID 5-02 Description WEST DEMO SECTION LEANING AGAINST WALL-MORTAR ON PLYWOOD
032102681-0010 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/28/2021 Gray 100.00% Other Inconclusive:None Detected
Sample is glue
TEM NYS 198.4 NOB 02/28/2021 Gray 100.00% Other None Detected
Sample ID 6-01 Description EXTERIOR-STONE FAgADE MORTAR
032102881-0011 Homogeneity Homogeneous
PLM NYS 198.1 Friable 02/27/2021 Gray 20.00%Ca Carbonate None Detected
30.00% Non-fibrous(other)
50.00%Quartz
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Initial report from:02/28/2021 11:38:51
ASB_198x 0009 0001 Printed 2/28/2021 2:24:08PM Page 2 of 4
EMSL Analytical, Inc. EMSL Order: 032102881
307 West 38th Street New York,NY 10018 Customer ID: ALP150
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO-
http://www.EMSL.com http://www.EMSL.com/manhattanlab@emsl.com Project ID:
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID 6-02 Description EXTERIOR-STONE FAQADE MORTAR
032102861-0012 Homogeneity Homogeneous
PLM NYS 198.1 Friable 02/27/2021 Gray 20.00% Ca Carbonate None Detected
38.00% Non-fibrous(other)
42.00% Quartz
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Initial report from:02/28/2021 11:38:51
ASB_198x 0009 0001 Printed 2/28/2021 2:24:08PM Page 3 of 4
EMSL Analytical, Inc. EMSL Order: 032102881
307 West 38th Street New York,NY 10018 Customer ID: ALP150
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO:
M http://www.EMSL.com/manhattanlab@emsi.com Project ID:
Test Report:Asbestos Analysis of Bulk Material
The samples in this report were submitted to EMSL for analysis by Asbestos Analysis of Bulk Materials via NYS ELAP Approved Methods.The
reference number for these samples is the EMSL Order ID above. Please use this reference number when calling about these samples.
Report Comments:
Sample Receipt Date: .2/24/2021 Sample Receipt Time: 2:00 PM
Analysis Completed Date: 2/27/2021 Analysis Completed Time: 5:11 PM
Analyst(s):
Angelica1 Serrano PLM NYS 198.1 Friable(3) Tiquasha Thompson PLM NYS 198.1 Friable(3)q, 2L� -4
Angelica Serrano PLM NYS 198.6 NOB(6) Hongyan Ran TEM NYS 198.4 NOB(4)
Steven Li TEM NYS 198.4 NOB(2)
Samples reviewed and approved by:
James Hall,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.org/labcertlelapcert/forms/VermiculitelnterimGuidance_Rev070913.pdf 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.New York,NY NYS ELAP 11506.NVLAP Lab Code 101048-9
Initial report from:02/28/2021 11:38:51
ASB_198x_0009_0001 Printed 2/28/2021 2:24:08PM Page 4 of 4
Orein ppit;r ivuu unec8itai services, Inc. '-per (J� '# Phone:(518)250-4047
438 New Kamer Road `� - `'
Albany,NY 12205
CHAIN OF CUSTODY
Client: Alpine Environmental Services, Inc. Project: 17 Holiday Pt, Cleverdale, NY
438 New Kamer Road Project Number: 21-26463-A
Albany,NY 12205 Sampled By: P. Van Zandt
Contact: Paul Van Zandt Date/Time Collected: 02/22/21
Phone/Email: 518 250-4047 paulv(@alpineenv.com Delivery: FedEx 7960 5138 0220
Turnaround Time: 72 Hr
Log No. Sample Sample Location Sample Material Analysis Notes
No. Performed
1-01 West Demo Section Drywall NYS PLM Stop at I"
Positive'
1-02 West Demo Section Drywall 1-01 to 1-02
2-01 West Demo Section Drywall Compound Stop at lst
Positive
2-02 West Demo Section Drywall Compound 2-01 to 2r;02
3-01 West Demo Section Wire Insulation
-Stop atV
r�I,osit��.
r
3-02 West Demo Section Wire Insulation 391 ta'8 02
Fiberglass Stop a-0;`:
4-0I West Demo Section Insulation Paper �sitive-
Fiberglass C
4-02 West Demo Section Insulation Paper 4-090 4-020
West Demo Section Stop at I"
5-01 Leaning Against Wall Mortar on Plywood Positive
West Demo Section
5-02 Leaning Against Wall Mortar on Plywood 5-01 to 5-02
6-01 Exterior Stone Fagade Stop at 15t
Mortar Positive
6-02 Exterior Stone Fagade 6-01 to 6-02
Mortar
Disposition of Samples: Accept Reject Explain
Comments:
Relinquished By: Receiv d By: Date: Time:
Page 1 of 1 y
EMSL Analytical, Inc. EMSL Order: 032102871
307 West 38th Street New York,NY 10018 Customer ID: ALP150
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO:
http://www.EMSL.com/manhattanlab@emsl.com Project ID:
Attention: Alpine Environmental Services Phone: (518)250-4047
438 New Karner Road Fax:
Albany, NY 12205 Received Date: 02/24/2021 2:00 PM
Analysis Date: 02/26/2021 -02/27/2021
Collected Date: 02/22/2021
Project: 21-26463-A/17 HOLIDAY PT, CLEVERDALE, NY
Test Report:Asbestos Analysis of Bulk Material
Non-Asbestos
Analyzed
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID 7-01 Description WEST DEMO SECTION-SHINGLE
032102871-0001 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/26/2021 Black 1.30%Glass 98.70% Other Inconclusive:None Detected
TEM NYS 198.4 NOB 02/27/2021 Black 100.00% Other None Detected
Sample ID 7-02 Description WEST DEMO SECTION-SHINGLE
032102871-0002 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 02/26/2021 Black 2.40%Glass 97.60%Other Inconclusive:None Detected
TEM NYS 198.4 NOB 02/27/2021 Black 100.00% Other None Detected
Initial report from:02/27/2021 05:25:10
ASB_198x_0009 0001 Printed 2/28/2021 10:12:14AM Page 1 of 2
EMSL Analytical, Inc. EMSL Order: 032102871
307 West 38th Street New York,NY 10018 Customer ID: ALP150
Tel/Fax:(212)290-0051/(212)290-0058 Customer PO:
http://www.EMSL.com/manhattanlab@emsi.com Project ID:
Test Report:Asbestos Analysis of Bulk Material
The samples in this report were submitted to EMSL for analysis by Asbestos Analysis of Bulk Materials via NYS ELAP Approved Methods.The
reference number for these samples is the EMSL Order ID above. Please use this reference number when calling about these samples.
Report Comments:
Sample Receipt Date: 2/24/2021 Sample Receipt Time: 2:00 PM
Analysis Completed Date: 2/26/2021 Analysis Completed Time: 8:59 PM
Analyst(s):
Angelica Serrano PLM NYS 198.6 NOB(2) Steven Li TEM NYS 198.4 NOB(2)
Samples reviewed and approved by:
yr. n ✓����
James Hall,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.org/labcertlelapcerttforms/VermiculiteinterimGuidance_Rev070913.pdf 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,N IST,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.New York,NY NYS ELAP 11506,NVLAP Lab Code 101048-9
Initial report from:02/27/2021 05:25:10
ASB_198x_0009_0001 Printed 2/28/2021 10:12:14AM Page 2 of 2
OrderlD'. 032102871 �, r7-,
�..Yu.,.�..,.,�....,�...u.��rvices,Inc. � Phone: 518 250-4047
438 New Kamer Road
Albany,NY 12205
CHAIN OF CUSTODY
Client: Alpine Environmental Services, Inc. Project: 17 Holiday Pt, Cleverdale,NY
438 New Karner Road Project Number: 21-26463-A
Albany,NY 12205 Sampled By: P.Van Zandt
Contact: Paul Van Zandt Date/Time Collected: 02/22/21
Phone/Email: 518 250-4047 paulv@alpineenv.com Delivery: FedEx 7960 5138 0220
Turnaround Time: 72 Hr
Log No. Sample Sample Location Sample Material Analysis Notes
No. Performed
7-01 West Demo Section Shingle NYS Protocol Stop at Positive'
7-02 West Demo Section Shingle 7-01 to 7-02
r
Disposition of Samples: Accept Reject Explain
Comments:
Relinquished By: Receive , y: Date: Time:
•r
Page 1 of 1
r.
STATE,OF NEW YORK-DEPARTMENT OF.LABOR _ t
ASBESTOS CERTIFICATE
PAUL Lk WANZANDT,
CLASS(EXPIRES)
C ATEC(02121:1 D 11'fSP(02j21)
H PM (02121): _
fFRl# 95r0250i .
MUST BE CARRIED ON ASBESTOS PROJECTS
;� HIlNIIItilA61711■ ;,
New=York State `DepartmenVof,Labor,,,,,
Division orSafety and Health w
License and Certificate Unit
State Campus Building 12 _} '
Albany,_N.Y.. 922 00 d `
.ram;r .d'•. r--�"- f i ��e,
X.
ASBESTOS HANDLING LIC'-�ENSE
Alprne Environmental Services Inc. =z== - `t FILE NUMBER' 00-0320 ,
- LICENSE NUMBER:,29095--�-
/438-New<Karner:Rbad ,t LICENSE CLASS: RESTRICTED':,--,� �
DATE OF ISSUE: 07/06/2020
r
r
r 'Alfjany; NYd�12205 G � f u, •7 _ , EXPIRATI�ONIi DATE: 07/31/20211
2 F. � 1 rj�kk` � i �3 �'r ✓3� �.�
ik
.. ekDul Authorized Representative-Craig Petr
l
-,.w�f� f�,,... ,��lj}jfl�``•.��h `` "a ',c. �--.�a r
stfl !vr 'r•:-:.i�'nt1i`.�all , .._.�•�.,"`
L*•, .!r ' r. ,,' 1. ?f " c/if E ;;.• .. 4..j 1 A `^
This lice_nse•has been issued in accordafice with plicahle rovi'si'ons of�Article��,Q'of fhe Labor Law of New Fork State-and of,:i
the New;York Stag.Codes,Rules and''Regu(atio 5 12NY`CRR Part`5.6). rfis subject to susp11:14ension or revocatioAfor a(1) a
,` t \ c /z cl fr! lr. it I = trlkr,+ 5tt d sti
serious violation of state,federal or local laws with regard-to,„the conduct of an:asbestos'project,or(2)demons/trate-d lack-�of r
t t t ; �. 4 1rc w {!�a n4? alfYrr'p 1 ^`-•,,responsibility m the conduct of any job in,�olving asbestos-or,asV.,stos Material: �" f
�-
This >s valid only}for the contractor named'a o,ye and~this license orb a phofocppy_must bejp ommently displayedlat,the
asbestos project worksite�',This�•lice -'e verifies that aWperssoonspemployed:by;,the licensee on an`asbestos,projectw n New York
State have bbenassued an Asbestos Certificate,'appr�rrate foyrthe t'e�.of work-th -perform,by the New York State°
Department of,Labor. ":j, ;w..� — _
a I ~_�
. �
Eileen M.Franko, Director
SH 432(8/12) For the Commissioner of Labor
NEW YORK STATE DEPARTMENT OF HEALTH
WADSWORTH CENTER
Expires 12:01 AM-April 01, 2021
Apr
Issued April 01, 2020
E;t
CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE
Issued in accordance with and pursuant to section 502 Public Health Law of New York-State
MR. JAMES HALL NY Lab Id No: 11506
EMSL ANALYTICAL, INC
307 WEST 38TH STREET
NEW YORK, NY 10018
is hereby APPROVED as an Environmental Laboratory for the category
ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS-WASTE
All approved subcategories and/or analytes are listed below:
Mlscollancous
Asbestos in Friable Material Item 198.1 of Manual
EPA 600/M4/82/020
Asbestos In Non-Friable Material-PLM Item 198.6 of Manual(NOB by PLM)
Asbestos In Non-Friable Material-TEM Item 198.4 of Manual
Asbestos-Vermlculite-Containing Material Item 198.8 of Manual
Serial No,: 61413.
Property of the New York State Department of Health. Certlficatee_are vaiid.only at-the address
shown,must be conspicuously posted,and are printed on secure paper. Continued accreditation depends
on successful ongoing participation In the Program.Consumers are urged to call(518)485-5570 to
verify the-laboratory's accreditation status.
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