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DEMO-0532-2021 v=- Office Use.Oniv 1 DEMOLITION APPLICATION Permit#: \ � Permit Fee:$ Town of Qteensbury Invoice:#: . 742 Bay Road,Queensbury,,NY 12804 P:518-761-8256 www.gueensbury.net Demolition Location: l fe. JCd _ Tax Map.ID#: **AN ASBESTOS REPORT IS RE -QED HALL DEMOLITION APPLICATION .M S 0 CONTACT INFORMATION: JUL 14 2021 _ TOWN OF QUEENSBURY • Applicant: IBUILDING&CODES Name(s); r✓C 'r x�; A&j1 C, Mailing Address, C/S/Z: /0b 10, 2 Z`A, 6� �e / 'V Cell Phone: ale. ..) Z[—.111!57 Land Line: 4S/8-- ) (,,6 .79`? Email', orlei l Dc pSi`�I • Primary Owner(s): Names 1�1G ct.. �' / �e►iin S' C.4 ( )� Mailing Address, C/S/Z: y' Lug tk, Cell Phone:_ 36 / - tlls-' Land Line: _ ) 5R- ��7 Email: c ; iaz lg 5— cli"-f C] Check if all work will be performed by homeowner only • Contractor.: Workers' Comp documentatign must be submitted with this application Contact Name(s):, olid� GG' G �''� --s t�. - � ��- Contractor Trade: Mailing.-Address, C/S/Z: (41,ov �J Cell Phone:_( mod& ) 36 r.- .1 7.S' Land Line: _(�`f� ) 649 W 7 Email: -b^-1-," I /0 Cb "List all additional contractors on the back of this form Contact Person .for. Building & Code,Compliance: t`� ` eiL_ Cell Phone: (.51� ) 30— l/7S� Land Line: ol 9—c Email: ni w e- /0 - z Demolition Application Revised February 2019 • Contractor: Workers' Comp documentation must be submitted with this application .Contact Name(s): Contractor-Trade:. S1< wrk Mailing Address, C/S/Z: (ate l :` ei. T .A4 /� 2% Cell Phone:_( ):..'7� -- 17 3C Land Line: _( ; AY IM--5 Email:: • Contractor: Workers'-Comp documentation must be submitted with-_ this application Contact Name(s): Contractor Trade: Mailing Address, C/S/Z: Cell Phone:_(________) Land Line: Email: • Contractor: Workers' Comp documentation must be submitted with this application Contact Name(s).: . Contractor Trade: Mailing Address, C/S/Z: Cell Phone:_(_), Land Line: _(_� Email: • Contractor:Workers' Comp documentation must be submitted with this application Contact Name(s): _ Contractor Trade: Mailing Address, C/S/Z: Cell Phone:_( ). Land Line: _(�J Email: • Contractor:Workers' Comp documentation must be submitted with this app_ licatiori Contact Name(s): Contractor Trade: Mailing Address,.C/S/Z: Cell Phone:_(_) Land Line: Email: • Contractor_: Workers' Comp documentation must be submitted with this application Contact Name(s): Contractor Trade: Mailing Address,.C/S/Z: Cell.Phone:_( Land Line: _( ) Email: Demolition Applicatidn Revised February,2619 w DEMOLITION INFORMATION: 1. Where will demolition'material be disposed? '?( 2. Type of structure to bg demolished: a. Residence b. Garage c. Business d. Storage Building 3. What type.of utilities are connected to the structure: a. Gas b. Fuel Oil ' c. Propane 76 d. Electric e. Public Water f. Well-Water Pump g. Public Sewer h. Other L None 4. Have ALL utilities been disconnected? Yes No 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 notificatiorvis 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: SIGNATURE: DATE:- Demolition Application Revised February 2019 • . 1 f ■ ,� �� ,AM 19' t_ J J "z 4 r wr- - ���'`��E�l� CC�`i Iiii ,,��yga°. is•1�'.'r Y --, -_ - - - •,. - �' ,� x \� �.,j9r} �°i��,•� f '�tfi^ ^t a�"� s�t✓. t1, 4�. � .F� , z .> S' .4 + a�' +` t r t� r!�crr'✓�,Yl } v}'Y'� '�'+�'��`,s tt r�" r -".y` -�g ---�l%m-e>-"t`r�.rs a_r.,,r>.y`S�'r�-rh,.s..,r'/k�'ir,'�+1 �t.r.r1d.�}a �fi 'SSt� t-. I 1 �s r1 4=�7>�i't'*.r�j x,t•�^rQ'r- !"`Y A k m N�. �� ��-` t 'C.��'r`fy y r� � .s. �.�'+�+fj�„r ���C'� ��fryr s• « ,1 4' r=._�`�x'�j.-.e}a z,������ ��.��>,��s�.,'___�•.�. Low .a.>�` .-S �_'z���+h�rr�'�a$�t'u� � r...-.t;, a, 'i...• u a 5L-}a"r."$-mot -£�""'tiS�, M�t4�;'. �,rNiv 1 • 1 1 ,1 1' • • 1 1 1 /1' • • Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Peter O'Neil,owner,to conduct a Pre-Demolition Asbestos Survey.All methods and procedures employed in this survey were done in accordance with NYSDOL(New York State Department of Labor),OSHA (Occupational Safety and Health Administration),and USEPA(United States Environmental Protection Agency) regulations and protocol. The information contained in this report has been collected in accordance-with existing regulations. If this document is to be utilized for bidding quotations, it cannot be held binding and must be field verified by those contractors submitting bids. PURPOSE The purpose of this survey was to identify,document,and measure specified asbestos-containing materials in this building,which may be disturbed during demolition activities.Samples were collected of suspect accessible asbestos- containing building materials.Should any materials be encountered that are not identified in this report,they should be assumed asbestos containing until a representative number of samples are collected to document these materials as non-asbestos containing. SCOPE OF SERVICES Provide a visual inspection of all accessible building components to determine the presence of suspect materials.The inspector physically assessed, quantified and conducted bulk sampling as required of suspect ACM (Asbestos Containing Materials)which were accessible or exposed.This report represents the locations and quantities of ACM (Asbestos Containing Materials) present as well as all sampled materials that tested negative for the presence of asbestos and their locations. Bulk sample analysis was performed by a participating New York State Department of Health Environmental Approval Program (NYSDOH-ELAP)certified laboratory. SAMPLING METHODOLOGY During the visual inspection process,an inventory of suspect materials similar in appearance and composition was created and grouped into homogeneous sampling areas.A homogeneous area is defined as a surfacing,thermal or miscellaneous material that is uniform in texture,age,and appearance.A representative bulk sampling plan was created in accordance with current USEPA(United States Environmental Protection Agency) requirements and guidelines. Bulk samples were then collected of suspect ACM (Asbestos Containing Materials)to identify the presence of asbestos. There are a number of materials,which rarely contain asbestos and are not specifically addressed in this report.Such materials include but are not limited to,glass, rubber,cinderblock and mortar. LABORATORY METHODOLOGY The friable bulk samples were analyzed by Polarized Light Microscopy(EPA Interim Method:Appendix A to Subpart F 40CFR Part 763) at magnifications ranging from 10x to 400x,and New York State Department of Health ELAP Item Number 198.1(Polarized Light Microscopy Methods for Identifying and Quantitating Asbestos in Bulk Samples).The estimated phase abundances are provided in weight percent and are accurate to within 10 to 15 percent of the amount reported.These methods are sensitive to the detection of asbestos to less than one percent. All non-friable organically bound (vinyl flooring,caulking,etc.) bulk samples were analyzed by New York State Department of Health ELAP Item Number 198.4(Transmission Electron Microscopy Method for Identifying and Page 2 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 Quantitating Asbestos in Non-Friable Organically Bound Bulk Samples). NOB samples were first reduced by the Gravimetric Matrix Reduction Method to determine if greater than one percent of material remained..If greater than one percent of the NOB material remained by weight,the sample was analyzed by Polarized Light Microscopy by New York State Department of Health ELAP Item Number 198.6 to determine if it contained greater than one percent asbestos. In accordance with New York State Department of Health regulations, Polarized Light Microscopy is not consistently reliable in detecting asbestos in non-friable organically bound materials,and in cases of a negative result TEM analysis is performed.This method is sensitive to the detection of asbestos to less than one percent by weight.A material is considered asbestos containing if it contains more than 1%asbestos. NYSDOL and USEPA regulations define asbestos containing material as containing greater than one percent(1%). Materials found to contain asbestos at concentrations of less than one percent(<1%) by weight are classified as containing trace amounts of asbestos. It should be noted,OSHA's definition of"asbestos containing"does not have a one percent(1%)cut-off,therefore,asbestos that is present in percentages less than one percent(< %) continues to be covered by OSHA Construction Standard 29 CFR 1926.1101. HAYES MICROBIAL&EUROFIN CEI- LAB ID# 12048,COMPLETED THE ANALYSIS. WARRANTY The field and laboratory results reported are considered sufficient in detail and scope to determine the presence of accessible and/or exposed asbestos-containing building materials.The findings contained within this report have been gathered in accordance with existing regulations and industry protocol. This survey and analytical methods have been used to provide information regarding the presence of suspect interior asbestos-containing building materials existing at the time of the inspection.This report is limited to the information available from the client at the time it was prepared. It is possible that conditions may exist which could not be identified within the scope of the survey or which were not apparent during the site visit. Page 3 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 Executive Summary Asbestos-Containing Material Field Survey Peter O'Neil 40 Schermerhorn St. Lake George,New York 12845 I. SUMMARY OF FINDINGS On May 23, 2021,an asbestos-containing material (ACM)field survey was conducted at 123 Seelye Road located in Queensbury, New York(Site).The site was inspected to determine the presence of ACM in preparation for renovation. The ACM survey was performed at the request of with . A summary of asbestos-containing materials is provided in the following table. However,this report should be read in its entirety, including detailed information that is contained in other sections and appendices.A total of 43 samples were collected from 20 suspect homogenous materials. The homogenous area 005,which is the mastic on the subfloor in the first floor bathroom, has been deemed as containing Asbesiforms in a concentration of over 1%. It must be removed prior to demolition. Summary Table of Regulated Asbestos-Containing Materials Material Material Id Space Name Material Regulatory Quantity Category Result 005-Floor Tile 005 Bathroom Miscellaneous Greater Than 1% 60sf Mastic Asbestos by Lab (ACM) A table of ACM grouped by homogeneous areas is included in Appendix A of this report.A table presenting those materials sampled which did not contain asbestos can be found in Appendix B of this report.A complete listing of all suspect materials sampled is provided in Appendix C of this report.A Sample Location Diagram is provided in Appendix D of the report.The original laboratory analytical report and chain of custody are located in Appendix E of this report. Page 4 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 Appendix Aa ACM Homogenous Area Table Material Material Space Name Section Name Friability Result Quantity Category Miscellaneous 005-Floor Bathroom First floor Category II Greater Than 60sf Tile Mastic Nonfriable 1%Asbestos by Lab(ACM). Miscellaneous 016-Floor Living Room First floor Category II Less Than or 280sf Tile Mastic Nonfriable Equal to 1% Asbestos by Lab(Trace) Page 5 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 Appendix IB: Tested Negative Homogenous Material Table Material Material Space Name Section Name Friability Result Quantity Category Miscellaneous 020-Furnace Basement Basement Friable Tested N/A Cement (RACM) Negative by Lab(No Asbestos Detected) Miscellaneous 017-Woven Basement Basement Category II Tested N/A Electrical Nonfriable Negative by Wiring Lab(No Asbestos Detected) Miscellaneous 019-Ceramic Bathroom Basement Friable Tested N/A Tile& (RACM) Negative by Adhesive Lab(No Asbestos Detected) Miscellaneous 004-Sealant, Exterior Basement Friable Tested N/A CMU Coating/ (RACM) Negative by Texture Lab(No Asbestos Detected) Miscellaneous 007- Bedroom First floor Category II Tested N/A Insulation, Nonfriable Negative by Batting Lab(No Asbestos Detected) Surfacing 014-Vinyl Bedroom First floor Category II Tested N/A Material flooring and Nonfriable Negative by Adhesive Lab(No Asbestos Detected) Miscellaneous 003-Sealant, Exterior First floor Category II Tested N/A Window Pane Nonfriable Negative by Glazing. Lab(No Asbestos Detected) Miscellaneous 013-Ceramic Kitchen First floor Friable Tested N/A Tile Adhesive (RACM) Negative by Lab(No Asbestos Detected) Page 6 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 Miscellaneous 015- Living Room First floor Friable Tested N/A Fiberboard (RACM) Negative by Lab(No Asbestos Detected) Surfacing 014-Vinyl Living Room First floor Friable Tested N/A Material flooring and (RACM) Negative by Adhesive Lab(No Asbestos Detected) Miscellaneous 018-Woven Living Room Firs_t floor Friable Tested N/A Electrical (RACM) Negative by Wiring Lab(No Asbestos Detected) Miscellaneous 002-Roofing Roof Roof Friable Tested N/A Paper/Felt (RACM) Negative by Lab(No Asbestos Detected) . Miscellaneous 001-Roofing, Roof Roof Category II Tested N/A Composite Nonfriable Negative by Shingle Lab(No Asbestos Detected) Miscellaneous 008-Gypsum Bathroom Second Floor Friable Tested N/A Wallboard (RACM) Negative by Lab(No Asbestos Detected) Miscellaneous 009-Gypsum Bathroom Second Floor Friable Tested N/A Wallboard (RACM) Negative by Joint Lab(No Compound Asbestos Detected) Miscellaneous 010-Gypsum Bathroom Second Floor Friable Tested N/A Wallboard (RACM) Negative by Joint Tape Lab(No (Paper) Asbestos Detected) Miscellaneous 008-Gypsum Bedroom Second Floor Friable Tested N/A Wallboard (RACM) Negative by Lab(No Asbestos Detected) Page 7 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 Miscellaneous . 009-Gypsum Bedroom Second Floor Friable Tested N/A Wallboard (RACM) Negative by Joint Lab(No Compound Asbestos Detected) Miscellaneous 010-Gypsum Bedroom Second Floor Friable Tested N/A Wallboard (RACM) Negative by Joint Tape Lab(No (Paper) Asbestos Detected) Miscellaneous 008-Gypsum Hallway Second Floor Friable- Tested N/A Wallboard (RACM) Negative by Lab(No Asbestos Detected) Miscellaneous 008-Gypsum Master Second Floor Friable Tested N/A Wallboard Bedroom (RACM) Negative by Lab(No Asbestos Detected) Miscellaneous 008-Gypsum Stairwell Second Floor Friable Tested N/A Wallboard (RACM) Negative by Lab(No Asbestos Detected) Miscellaneous 011- Storage Room Second Floor Friable Tested N/A Masonry Brick (RACM) Negative by Lab(No Asbestos Detected) Miscellaneous 006- Storage Room Second Floor Friable Tested N/A Masonry .(RACM) Negative by Mortar Lab(No Asbestos- Detected) Miscellaneous 012- Storage Room Second Floor Friable Tested N/A Masonry I (RACM) Negative by Mortar Lab(No Asbestos Detected) Page 8 of 23 Adirondack Developers and Builders inc.,123 Seelye Road,,Queensbury,New York,12804 Appendix Q All Suspect Materials Sampled Sample ID Space Name Section Name Material Analytical Result Regulatory Result 001A Roof Roof 001-Roofing, 0% Tested Negative Composite by Lab(No Shingle Asbestos Detected) 001B Roof Roof 001-Roofing, 0% Tested Negative Composite by Lab(No Shingle Asbestos Detected) 002A Roof Roof 002-Roofing 0% Tested Negative Paper/Felt by Lab(No Asbestos Detected) 002B Roof Roof 002-Roofing 0% Tested Negative Paper/Felt by Lab(No Asbestos Detected) 003A Exterior First floor 003-Sealant, 0% Tested Negative Window Pane by Lab(No Glazing Asbestos Detected) 003E Exterior First floor 003-Sealant; 0% Tested Negative Window Pane by Lab(No Glazing Asbestos Detected) 004A Exterior Basement 004-Sealant, 0% Tested Negative CMU Coating/ by Lab(No Texture Asbestos Detected). 004E Exterior Basement 004-Sealant, 0% Tested Negative CMU_Coating/ by Lab(No Texture Asbestos Detected) 005A Bathroom First floor 005<Floor Tile 0.88%Chrysotile Less Than or Mastic (Serpentine Equal to 1% group) Asbestos by Lab (Trace) 005B Bathroom First floor 005-Floor Tile 1.5%Chrysotile Greater Than 1% Mastic (Serpentine Asbestos by Lab group) (ACM) Page 9 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 006A Storage Room Second Floor 006-Masonry 0% Tested Negative Mortar by Lab(No Asbestos Detected) 006E Storage Room Second Floor 006-Masonry 0% Tested Negative Mortar by Lab(No Asbestos Detected) 007A Bedroom First floor 007-Insulation, 0% Tested Negative Batting by Lab(No Asbestos Detected) 007B Bedroom First floor 007-Insulation, 0% Tested Negative Batting by Lab(No Asbestos Detected) 008A Stairwell Second Floor 008-Gypsum 0% Tested Negative Wallboard by Lab(No Asbestos Detected) 0086 Master Bedroom Second Floor 008-Gypsum 0% Tested Negative Wallboard by Lab(No Asbestos Detected) 008C Hallway Second Floor 008-Gypsum 0% Tested Negative Wallboard by Lab(No Asbestos Detected) 008D Bathroom Second Floor 008-Gypsum 0% Tested Negative Wallboard by Lab(No Asbestos Detected) 008E Bedroom Second Floor 008-Gypsum 0% Tested Negative Wallboard by Lab(No Asbestos Detected) 009A Bathroom Second Floor 009-Gypsum 0% Tested Negative Wallboard Joint by Lab(No Compound Asbestos Detected) 009B Bedroom Second Floor 009-Gypsum 0% Tested Negative Wallboard.Joint by Lab(No Compound Asbestos Detected) Page 10 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 010A Bathroom Second Floor 010-Gypsum 0% Tested Negative Wallboard Joint by Lab(No Tape(Paper) Asbestos Detected) 0108 Bedroom Second Floor 010-Gypsum 0% Tested Negative Wallboard Joint by Lab(No Tape(Paper) Asbestos Detected) 011A Storage Room Second Floor 011-Masonry 0% Tested Negative Brick by Lab(No Asbestos Detected) 011E Storage Room Second Floor 011-Masonry 0% Tested Negative Brick by Lab(No Asbestos Detected) 012A Storage Room Second Floor 012-Masonry 0% Tested Negative Mortar by Lab(No Asbestos Detected) 012E Storage Room Second Floor 012-Masonry 0% Tested Negative Mortar by Lab(No . Asbestos Detected) 013A Kitchen First floor 013-Ceramic 0% Tested Negative Tile Adhesive by Lab(No Asbestos Detected) 013B Kitchen First floor 013-Ceramic 0% Tested Negative Tile Adhesive by Lab(No Asbestos Detected) 014B Bedroom First floor Multi-layer 0% Tested Negative Parent Material by Lab(No Asbestos Detected) 014C Bedroom First floor 014-Vinyl 0% Tested Negative flooring and by Lab(No Adhesive Asbestos Detected) 015A Living Room First floor 015-Fiberboard 0% Tested Negative by Lab(No Asbestos Detected) Page 11 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 0156 Living Room First floor 015-Fiberboard 0% Tested Negative by Lab(No Asbestos Detected) 016A Living Room First floor 016-Floor Tile 0% Tested Negative Mastic by Lab(No Asbestos Detected) 016E Living Room First floor 016-Floor Tile 0.45%Chrysotile Less Than or Mastic (Serpentine Equal to 1% group) Asbestos by Lab (Trace) 017A Basement 'Basement 017-Woven 0% Tested Negative Electrical Wiring by Lab(No Asbestos Detected) 017B Basement Basement 017-Woven _0% Tested Negative Electrical Wiring by Lab(No Asbestos Detected) 018A Living Room First floor 018-Woven 0% Tested Negative Electrical Wiring by Lab(No Asbestos Detected) 018E Living Room First floor 018-Woven 0% Tested Negative Electrical Wiring by Lab(No Asbestos Detected) 019A Bathroom Basement 019-Ceramic 0% Tested Negative Tile&Adhesive by Lab(No Asbestos Detected) 019E Bathroom Basement 019-Ceramic 0% Tested Negative Tile&Adhesive by Lab(No Asbestos Detected) 02GA Basement Basement 020-Furnace 0% Tested Negative Cement by Lab(No Asbestos Detected) 020B Basement Basement 020-Furnace l)% Tested Negative Cement by Lab(No Asbestos Detected) Page 12 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,QueensbuM New York,12804 Appendix D: Sample Location Maps All Sample Locations for Roof ¢a.iiaq PT ~� 2 S ttZ atU�i RFy + e6i?ni^ ;S , v-rMC?NA ItYA S.t r~+;rreto:-cent 1 baTE .rcc•� T ! t VI lxt ►Iq 4f�} i(;i1,YalEd.j �. +ci i�RK' a'� w �e .. wµRwt ll 1i�. a•i } �•c i iF .3i �1 305t0� 3oAb 4'dw�tia qa .o46 f 4a.t�'a 4:l,a,4A-;g.. ��;M gfjgtLK ' x ;! = Prebr7I ;,q 2-1 -4 rJ Lvu.S"t' or+:c -•- IDilTeI•TY PCi-I. t N` —2!'yr. !:. �3i:J+r.K �} cT iG„p.e:w•Aft"'�...�_+ 'L: _.�._. stas _^? _... 4 3A0 - f lT .. b;�` .!3' ill .. fir R-T N ^'' .•'- � �•I( WA 16 41 J. z 1, Roof-6 A^j-1 rr f; yc.:5✓�. `+.!7s c - .�_:�:R.Y 1 QoSlu SIG TG510 O 1•! ti7 F I O�� 'P'(�-r� Q a ,f ,:y I��' '-��+ `� 1 d: 'G• l•a F �"•-Il �5'lu�S4aa:i' .. F,,,a ai�.%"E Map ID Sample ID Section Name Space Name Material Lab Result Analytical Result 1 001A Roof Roof 001-Roofing, Tested 0% Composite Negative by Shingle 'Lab(No Asbestos Detected) Page 19 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 2 00113 Roof Roof 001-Roofing, Tested 0% Composite Negative by Shingle Lab(No Asbestos Detected) 1 002A Roof Roof 002-Roofing Tested 0% Paper/Felt Negative by Lab(No Asbestos Detected) 2 002B Roof Roof 002-Roofing Tested 0% Paper/Felt Negative by Lab(No Asbestos Detected) Page 14 of 23 Adirondack Developers and Builders Inc.,123 Seelye.Road,Queensbury,New York,12-8O4 All Sample Locations for First floor - 71 1#1 I' 7 1 Y -----�sM.rs �L+ �•i�•1-LrL tL't t U. a:.�.-:ycii... .. :_i•. 1-9-� I'::.�F^�-t..,.--t-:-�••?- c �._�...F.._�—_"'--.-._►-__.. Lt �(�A 9 - Ne T.>lycv o5e.1 ' R 1 �:- sviroii 'i�r.n:p 11 v if IL5 Ii:J,{,. �� 1 1� , AK�•1..eryI�IN.t 14 i,(h^ I --�• 7 r r 11 rT,aY/ .p.�'r- e.�:e.4lil,lh! I;� CJ:•1,..•! It �'� I ..'�___..._f._.._... �i � �i -... • S.(4'•hIL•%G tL11Y y 13 'i'kh•; 1:• {` G,•hY.itt.1^.YES:. + �• 4 ._.._...._._..t 1--:>::..-..... __ -. I.R•IB lKls-u..i LC•f.i.ly __ I' rt- 4 4 • I- 41 7ir 1 P I ItC r „•.:f�pC.Y �0 VO eV • T f Map ID Sample ID Section Name Space Name Material. Lab Result Analytical Result 1 003A First floor Exterior 003 Sealant, Tested 0°l Window Pane Negative by Glazing Lab(No Asbestos Detected) Page 15 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 2 003B First floor Exterior 003-Sealant, Tested 0% Window Pane Negative by Glazing Lab(No Asbestos Detected) 3 005A First floor Bathroom 005-Floor Less Than or 0.88% Tile Mastic Equal to 1% Chrysotile Asbestos by (Serpentine Lab(Trace) group) 4 005B First floor Bathroom 005-Floor Greater Than 1.5% Tile Mastic 1%Asbestos Chrysotile by Lab(ACM) (Serpentine group) 5 007A First floor. Bedroom 007- Tested 0% Insulation, Negative by Batting Lab(No Asbestos Detected) 6 007B First floor Bedroom 007- Tested 0% Insulation, Negative by Batting Lab(No Asbestos Detected) 7 013A First floor Kitchen 013-Ceramic Tested 0% Tile Adhesive Negative by Lab(No Asbestos Detected) 8 013B First floor Kitchen 013-Ceramic Tested 0% Tile Adhesive Negative by Lab(No Asbestos Detected) 10 014B First floor Bedroom Multi-layer Tested 0% Parent Negative by Material Lab(No Asbestos Detected) 9 014C First floor Bedroom 014-Vinyl Tested 0% flooring and Negative by Adhesive Lab(No Asbestos Detected) Page 16 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 11 015A First floor Living Room 015- Tested 0% Fiberboard Negative by Lab(No Asbestos Detected) 12 015B First floor Living Room 015- Tested 0% Fiberboard Negative by Lab(No Asbestos Detected) 13 016A First floor Living Room 016-Floor Tested 0% Tile Mastic Negative by Lab(No Asbestos Detected) 14 016E First floor Living Room 016-Floor Less Than or 0.45% Tile Mastic Equal to 1% Chrysotile Asbestos by (Serpentine Lab(Trace) group) 15 018A First floor Living Room 018-Woven Tested 0% Electrical Negative by Wiring Lab(No Asbestos Detected) 16 018B First floor Living Room 018-Woven Tested 0% Electrical Negative by Wiring Lab(No Asbestos Detected) Page 17 of 23 Adirondack Developers and Builders Inc;,123 Seelye Road,Queensbury,New York,12804 All Sample Locations for Basement � 2 it + 1«1H7i f¢Prt "wav GtI 'Co.0 I L 16r1 { !; 5 J V[.e,![:{{ lam. 4 _• _ ! / ter,,..... r���, t ! ' tl }lE4[If• 417 Y q+( t V r Fyf$•JCGi i�t'. .Ye1lo aop,•r,.— i t 2 4•.LGicch. J iu4pr fayr :rr.a.. (s.cy^` ( f i "'AW Own, i'�Tla'it- hia'•f I t'-f"vial ivt•�C I 1 { �f F�{4. Gt_:.:[•;t t�,�Puaf � ie.a.avA�.Do! I f+ — 71 3 i t ��., � ,�..;,ate, n,t-+:. ;i i -5✓ ? f _ + - LNv'r,9 CzcTtr..� P4•i ,^r Ee"U:;� Map ID Sample ID Section Name Space Name Material Lab Result Analytical Result 1 004A Basement Exterior 004-Sealant, Tested 0% CMU Coating/ Negative by Texture Lab(No Asbestos Detected) Page 18 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 2 004B Basement Exterior 004_Sealant, Tested 0% CMU Coating/ Negative by Texture Lab(No Asbestos Detected) 3 017A Basement Basement 017-Woven Tested 0% Electrical Negative by Wiring Lab(No Asbestos Detected) 4 017B Basement Basement 017-Woven Tested 0% Electrical Negative by Wiring Lab(No Asbestos Detected) 5 019A Basement Bathroom 019-Ceramic Tested 0% Tile& Negative by Adhesive Lab(No Asbestos Detected) 6 019B Basement Bathroom 019-Ceramic Tested 0% Tile& Negative by Adhesive Lab(No Asbestos Detected) 7 020A Basement Basement 020-Furnace Tested 0% Cement Negative by Lab(No Asbestos Detected) 8 020B Basement Basement 020-Furnace Tested 0% Cement Negative by Lab(No Asbestos Detected) Page 19 of 23 Adirondack Developers and Builders Inc.,123Seelye Road,Queensbury,New York,12804 All Sample Locations for Second Floor 'I �xt K•[arT � I�6at lRl+a�.i ..�` y_—a�„ ''--''--'C1'--_ a'•.Tors,D..i;an,e..l ¢4cd Gt'+P,1J i i ,9 wiE+�tai-vcu. tat H V4 e!�ttR;a v<:ac: tIr1G t Ke{� i (FaaG•A+EK 3` 1.`.c+r- eE•... r3 ylnweit t j Si �;� ,`r ay.la'oi io..G V�,o,..a as osL 3aary .°st.a,s.os. PAC, s( 2 i A! n -i • s•.z� -_- •��----- I _ _. .I I Ptr.sTe..:. arri z�:�^I 1 - i A./ V� �;{ �[•C71LR'C7 t'� �..i :(..f('y F. (�-n •J9�, I r- -14 4 J�A�oIVOF T:V _S-.O 7� t:ir ,vF __ � �s •. '� anl,.y 5 s Nor _,.,_�R� :. aJF`iPc'+iGr i. t 1 '4- a-u k Pam!-rr1 i- 1 a.. s :w •�••- q +� �P�•G E Y• cn.. .. —� • N teeor a�ls.i r cs F1 a F I oca P i=-tit i 5•,� �!:- .,1 t E' �•li` (•O aa�i'�� •�f I.rC. Pi,y "�._-T +'S1 Map ID Sample ID Section Name Space Name Material Lab Result Analytical Result 1 006A Second Floor Storage Room 006- Tested 0% Masonry Negative by Mortar Lab(No Asbestos Detected) 1 006B Second Floor Storage Room 006- Tested 0% Masonry Negative by Mortar Lab(No Asbestos Detected) Page ZO of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 2 008A Second Floor Stairwell 008-Gypsum Tested 0% Wallboard Negative by Lab(No Asbestos Detected) 3 00813 Second Floor Master 008-Gypsum Tested 0% Bedroom Wallboard Negative by Lab(No Asbestos Detected) 4 008C Second Floor Hallway 008-Gypsum Tested 0% Wallboard Negative by Lab(No Asbestos Detected) 5 008D Second Floor Bathroom 008-Gypsum Tested 0% Wallboard Negative by Lab(No Asbestos Detected) 6 008E Second Floor Bedroom 008-.Gypsum Tested 0% Wallboard Negative by Lab(No Asbestos Detected) 5 009A Second Floor Bathroom 009-Gypsum Tested 0% Wallboard Negative by Joint Lab(No Compound Asbestos Detected) 6 009B Second Floor Bedroom 009-Gypsum Tested 0% Wallboard Negative by Joint Lab(No Compound Asbestos Detected) 5 010A Second Floor Bathroom 010-Gypsum Tested 0% Wallboard Negative by Joint Tape Lab(No (Paper) Asbestos Detected) 6 0106 Second Floor Bedroom 010-Gypsum Tested 0% Wallboard Negative by Joint Tape Lab(No (Paper) Asbestos Detected) Page 21 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 1 011A Second Floor Storage Room 011- Tested 0% Masonry Brick Negative by Lab(No Asbestos Detected) 1 011B Second Floor Storage Room 011- Tested 0% Masonry Brick Negative by Lab(No Asbestos Detected) 1 012A Second Floor Storage Room 012- Tested 0% Masonry Negative by Mortar Lab(No Asbestos Detected) 1 012B Second Floor Storage Room 012- Tested 0% Masonry Negative by Mortar Lab(No Asbestos Detected) Page 22 of 23 Adirondack Developers and Builders Inc.,123 Seelye Road,Queensbury,New York,12804 Appendix E: Laboratory Report&Chain of Custody Page 23 of 23 581P: FEDEX - IOX So ASOESTOS VAM. 05-28-2021 �I 1 016e 4010 3184 C��A��U #III#I�IIIIIIII#II11#IIIIIIUIIIIIID 21018559 J3T3M Chain of Custody ClearVU Inspections 19 Blackb®fry Lens Project: 10022 Gluet:rtsbury,New York 12804 Site Location: 123 Seelye Rd 123 Seelye Road Queensbury,rNew York 12804 Sampled By: Ryan Wild(ryan@clearw inspections.com) Reporting By: Ryan Wild(ryan@ciearvuinspections.com) Purpose:AHERA Compliance(Mandatory or Voluntary) Laboratory Notes Turn-Around Time Request :!:'.:3v:���??.^F:.:.'-��3cq�:_. n�.sza r�,••".3::7�;...:,.-... ..-.::;xr.+*..�<'.;[v?S'.,r..;L'C_^.xs*'"vrr�....`.+^=.-_s>.:_'sx:�.�?.£: Stop after first positive for each HM 5 Day Samples LYs"µ"G.!a.L"Slr^:.h31�<S+Cl{.•NeLL1.`44.{c«Yc•.'.-._:'T%cv�K iS)�C.`^T11 sample In Material Floor/Section Space Analysis NY ELAP 198.1 & 001A 001 -Roofing,Composite Shingle Roof Roof 198.4 PLM&TEM where applicable NY FLAP 198.1 & 007 B 001 -Roofing,Composite Shingle Roof Roof 198.4 PLM&TEM where applicable NY ELAP 198.1 & 002A 002-Roofing Paper/Felt Roof Roof 198.4 PLM&TEM where applicable NY ELAP 198.1 & 002E 002-Roofing Paper/Felt Roof Roof 198.4 PLM&TEM where applicable NY ELAP 198.1 & 003A 003-Sealant,Window Pane Glazing First floor Exterior 198.4 PLM&TEM where applicable Awv ClearVU Inspections-Chain of Custody For Adirondack Developers and Builders Inc. 123 Seelye Rd-10022 1 of 5 NYELAP 198.1 & 0038 003-Sealant,Window Pane Glazing First floor Exterior 198.4 PLM&TEM where applicable NYELAP 198.1 & 004A 004-Sealant,CMU Coatingfrexture Basement Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 Q 004B 004-Seal6nt,CMU Coating/Texture Basement Exterior 198A PLM&T where applicab NY ELAP 198.' 005A 005-Floor Tile Mastic First floor Bathroom 198A PLM&T where appliicab !�, n NY ELAP 198.' m 005B 005-Floor Tiile Mastic First Boor Bathroom 198A PLM&T where appGca� N x NYELAP 198.- N o 006A 006-'Masonry Mortar Second Floor Storage Room 198.4 PLM&T = U1 where applicaL C3 NYELAP 198.' 006B 006-Masonry Mortar Second Floor Storage Room 198A PLM&T Were applicak NYELAP 198., 007A 007-Insulation,Batting First floor Bedroom 198A PLM&T N where appflcak. N NY ELAN'198. Ln o 007B 007-koulation,Batting First floor Bedroom 198.4 PLM&-1 U1 where applicak NYELAP 198.•. 008A 008-Gypsum Wallboard Second Floor Stairwell 198A PLM&TEM where applicable NY ELAP 198.1 & 008E 008-Gypsum Wallboard Second Floor Master Bedroom 198A PLM&TEM where applicable NYELAP 198.1 & 008C 008-Gypsum Wallboard Second Floor Hallway 198A PLM&TEM where applicable NYELAP 198.1 & 00813 008-Gypsum Wallboard Second Floor Bathroom 198.4 PLM&TEM when;applicable C!learVU Inspections-Ghaln o custody For ron Developers and Eluilder-57—c 123 Saidye Rd-10022 //Oo } , 2 of 5 NY ELAP 198.1 & 008E 006-Gypsum Wallboard Second Floor Bedroom 198A PLM&TEM where applicable NY ELAP 198.1 & 009A 009-Gypsum Wallboard Joint Compound Second Floor Bathroom 198A PLM&TEM where applicable NY ELAP 198.1 & 009B 009-Gypsum Wallboard Joint Compound Second Floor Bedroom 198A PLM&TEM where applicable NYELAP 198.14 010A 010-Gypsum Wallboard Joint Tape{Paper) Second Floor Bathroom 198.4 PLM&TE! where applicable a..e NY ELAP 198.11 010B 010-Gypsum Wallboard Joint Tape(Paper) Second Floor Bedroom 198.4 PLM&TEI H where applicable -;, m NYELAP 198.11 w o 011A 011 -Masonry Brick Second Floor Storage Room 198.4 PLM&TEI w x where applicable NY FLAP 198.1 t RZ 011B 011 -Masonry Brick Second Floor Storage Room 198.4 PLM&TEI where applicable NYELAP 198,16 012A 012-Masonry Mortar Second Floor Storage Room 198A PLM'&TEP where applicable NYELAP 198.1 8 012E 012-Masonry Mortar Second Floor Storage Room 198.4 PLM&TO m c� where applicable � NYELAP 198.1 8 �tr 013A 013-Ceramic Tile Adhesive First floor Kitchen 198.4 PLM&TEI+ where appricable NY ELAP 198.1 & 0138 .013-Ceramic Tile Adhesive First floor Kitchen 198A PLM&TEM. where applicable NYELAP 198.1 & 014E 014-Vinyl flooring and Adhesive First floor Bedroom 198.4 PLM&TEM where applicable NY ELAP 198.1 & 014C 014-Vinyl flooring and Adhesive Firstfloor Bedroom 198A PLM&TEM where applicable AearVU InispeaT6ns-Chain o Custody ForAdirondack Developers and 13WIders Inc. / 123 Seelye Rd-10022 /�l ! - '�'/ 3 of 5 NY FLAP 198.1 & 015A -015-Fiberboard First floor Living Room 198A PLM&TEM where applicable NYELAP 198,1 & 015B 015-Fiberboard First floor Living Room 198.4 PLM&TEM where applicable NY FLAP 198.1 016A 016-Floor Tile Mastic Firstfloor Living Room 198A PLM&11 when;applicabl NYELAP-198.1 •� 0168 016-FloorTile Mastic First floor Living Room 198.4 PLM&Ti s ;a W 9 H where applicabl a.s NYELAP 198.1 =N N a 017A 017-Woven Eiecfdcat Wiring Basement Basement 198.4 PLM&-n =W where applicabl = M X NY ELAP 108.1 = to 0178 017-Woven Electrical Wiring Basement Basement 198:4 PLM&TI where appllcabl NYELAP 198.1 018A 018-Woven Electrical Wiring First floor Living Room 198A PLM&-n where applicabl NY ELAP 198.1 IU 01813 018-Woven Electrical Wiring First floor Living Room 198.4 PLM&TI Fes,, MM m where'applicabi oo —••�■�; art rw�E o NYELAP 198.1 U- 019A 019-Ceramic Tile&Adhesive Basement Bathroom 198A PLM&Til where applicabi NY ELAP 198.1 & 019E 019-Ceramic Tile&Adhesive Basement Ba#mom 198A PLM&TEM where applicable NY ELAP 198.1 & 020A 020-Fum.ce Cement Basement Basement 198A PLM&TEM where applicable NY ELAP 198.1 & 020B 020-Fumace Cement Basement Basement 198A PLM&TEM where applicable VID MICROBIAL CONSULTING #21018559 Analysis Report prepared for We would like to thank you for trusting Hayes Microbial for your analytical needs! We received 43 samples by FedEx in good condition for this project on May 28th,2021. ClearVu Inspections The results in this analysis pertain only to this job,collected on the stated date,and should not be used in the interpretation of any other job.This report may not be duplicated,except in full,without the written I a Blackberm Lane consent of Hayes Microbial Consulting,LLC.. Queensbury,'N Y 12804 Phone: ('518) 832-9213 This laboratory bears no responsibility for sample collection activities,analytical method limitations,or your use of the.test results. Interpretation and use of test results are your responsibility.Any reference to health effects or interpretation of mold levels is strictly the opinion of Hayes Microbial.In no event,shall Hayes Microbial or any of its employees be liable for lost profits or any special,incidental or consequential damages arising out of the use of these-test results. 10022 1231 Seelye Rd. Queensbury,New York 12804 Collected: Received: May 28,2021 Reported: June 8,2021 Steve Hayes,.BSMT(ASCP) Laboratory Director Hayes Microbial Consulting,LLC. ao � T . � Connecticut Department g(PROI _�`�, � of Public Health EPA Laboratory ID:VA01419 Lab ID:#188863 DPH License:#PH-0198 Hayes Microbial Consulting,LLC. .3005 East Boundary Terrace,Suite F.Midlothian,VA.23112 (804)562-3435 contact@hayesmicrobial.com Page:1 of 9 ;yan Wild 10022 #21018559 Aearvu Inspections 123 Seelye Rd. a Blackberry I.Ane Queensbury,New York 12804 tueettebur%NY 12804 Asbestos 198.4 518)832.9213 Subcontracted 1:Eurofin CO-Lab ID#12048 Sample Material Description Weight Organic Acid AcidMaterial% Soluble% Insoluble% Asbestos% 001 A-001-Roofing,Composite Shingle Roof Bulk Material/Black None Detected 001 B-001-Roofing,Composite Shingle Roof Bulk Material/Black None Detected 3;s 002A-002-Roofing Paper/Felt Roof Bulk Material/Black None Detected A- 00211-002-Roofing Paper/Felt Roof Bulk Material/Black None Detected la_ A OOBA-®03-Sealant,Window Pane Glazing First Floor Exterior Bulk Material/White None Detected 003B-003-Sealant,Window Pane Glazing First Floor Exterior Bulk Material/White None Detected 005A-005-Floor riile Mastic First Floor Bathroom Bulk Material/Yellow 0.88%Chrysotile 19` 00&8-000-F1o�orTile Mastic First Floor Bathroom Bulk Material/Yellow 1.5°i°Chrysotile S Collected: Received:May20,2021 Reported:Jun 8,2021 QI� 'YAr E Project Analyst: j Date: Reviewed By: Date: I!"�l v% Darien Williams, /, ��;w,,,0 06-08-2021 Renaldo Drakes, I 06-08-2021 MICROBIALCONSULTING __�_ _.____._�. °""`'�_.--- .�. _..._ .._.... _._.__ _.._.__... ____ _.__.._..._.__... ....___.._._..-. 3005 East Boundary Terrace,Suite F.Midlothian,VA.23112 (804)562-3435 cont c @ha esmicrobial.com Page:2 of 9 Iyan Wild 10022 #21018559 dlealrVu Inspections 123 Seelye Rd. 8 Blackberry Lane Queensbury,New York 12804 lueembury,NY 12804 Asbestos 198.4 518)832-9213 Subcontracted 1:Eurofin CEI-Lab ID#12048 0 Sample Material Description Weight Organic Acid o Acid o Asbestos% Material io Soluble is Insoluble io 006A-006-Masonry►Mortar Second Floor Storage Room Friable None Detected 74k­ 007B-007-Insulation,Batting First Floor Bedroom Bulk Material/Black/... None Detected ;a 013A-013�ramic Tile Adhesive First Floor Kitchen Adhesive/Cream None Detected 0138-018-Ceramic Tile Adhesive First Floor Kitchen Adhesive/Cream None Detected 9= i 0148-414Mnyl Flooring and Adhesive First Floor Bedroom Vinyl Tile/Blue/Cream None Detected q 014B-01 Wnyl Flooring and Adhesive First Floor.Dedroom Adhesive/Yellow None Detected 0148-01+Yinyl Flooring and Adhesive First Floor Bedroom Tar Paper/Black None Detected 0148-01 Vinyl Flooring and Adhesive First Floor Bedroom Adhesive/Yellow None Detected C.oOecteai: -Received:May 28,2021 Reported:Jun 8,2021 H A Project Analyst: /" Date: Reviewed By: Date: Darien Williams, �' 06-08-2021 Renaldo Drakes, 06-08-2021 MICROBIAL.CONSULTING lii.Gua.«a _._._._._gnt 13005 East Boundary Terrace,Suite F.Midlothian,VA.23112 (804)562-3435 @ha esmicrobial.com� _ Page:3 of 9 Ryan wild 10022 #21018559 CleairVu Inspections 123 Seelye Rd. 18 Blackberry Lane Queensbury,New York 12804 leensbury,NY 12804 Asbestos 198.4 :618)$32-9213 Subcontracted 1:Eurofin CEI-Lab ID#12048 Sam Organic Acid Acidple Material Description Weight Material% Soluble% Insoluble% Asbestos% 31'" 014C-014-Vinyl Flooring and Adhesive First Floor Bedroom Vinyl Tile/Blue/Cream None Detected 014 Vinyl Flooring and Adhesive First Floor Bedroom Adhesive/Yellow None Detected 014C-014 Vinyl Flooring and Adhesive First Floor Bedroom Tar Paper/Black None Detected ' 1 r 014C-014 Vinyl Flooring and Adhesive First Floor Bedroom Adhesive/Yellow None Detected 34=' 016A-016-Floor-rile Mastic First Floor Living Room Mastic/Black None Detected 016A-016-Floor Tile Mastic First Fluor Living Room Mastic/Yellow None Detected 0166-.01 f-FloorTile Mastic First Floor Living Room Mastic/Black None Detected 3 s n 016B-016-Floor Tile Mastic First Floor Living Room Mastic/Yellow 0.65%Chrys®tile collected: Received:May 28,2021 Reported:Jun 8,2021 A% yProject Analyst: Date: Reviewed By: Date: hm Darien Williams, %J,'^ 06-08-2021 Renaldo Drakes, I 06-08-2021 MICROBIAL,CONSULTING �- 3005 East Boundary Terrace,Suite F.Midlothian,VA.23112 (804)562-3435 cont @ha esmicrobial.com Page.4 of 9 lyan Wild 10022 #21018559 ,lealrVu Inspections 123 Seelye Rd. 18 Blackberry Lane Queensbury,New York 12804 lueensbur%NY 12804 Asbestos 198.4 518)832.9213 Subcontracted 1:Eurofin CEI-Lab ID#12048 # Sample Material Description Weight Organic Acid Acid Asbestos Rio Material io Soluble% Insoluble o�o s G_ 017A-017-Woven Electrical Wiring-basement Bulk Material/White None Detected f+1 17-Woven Electrical Wiring dement Bulk Material/White None Detected > ` A7 t3A-A18 Woven Electrical Wiring First Floor Living Room Bulk Material/Tan/Bl... None Detected A18-Woven Electrical Wiring First Floor Living Room Bulk Material/Tan/BI... None Detected 4©r 019A-019-Cera3nic"rile Adhesive Basement Bathroom Adhesive/Yellow None Detected <' ouB-A19-ceramic-role Adhesive Basement Bathroom Adhesive/Yellow None Detected A Collected: Received:May 28,2021 Reported:Jun 8,2021 lrl E S Project Analyst: l Date: Reviewed By: Date: 91-offA Darien Williams, f;-' ;��,,,,,,a 06-08-2021 Renaldo Drakes, �� 06-08-2021 MICROBIAL CONSULTING . 3005 East Boundary Terrace,Suite F.Midlothian,VA.23112 (804)562-3435 cont c @ha esmicrobial.com Page:5 of 9 Ryan Wild 10022 #21018559 ClearVu Inspections 123 Seelye Rd. 18131ackberry Lane Queensbury, New York 12804 Jueenabury,NY 12804 Asbestos 198.1 ,518)832-921.3 Subcontracted 7:Eurofin CEI-Lab 1®#12098 0 Sample Material Description Non-Asbestos Fibers Asbestos Fibers 004-Sealant,GMU Coating/Texture Basement Exterior Friable/White None Detected Friable/Gray None Detected $; 004B-004-8ealant,CMU Coating/Texture Basement Exterior Friable/White None Detected _Friable/Gray None Detected �... ^.._._.. }=4 :� 006B-006-Masonry Mortar Second Floor Storage Room Friable/Gray None Detected 007A-007-Inaulation,Batting First Floor Bedroom. Bulk Material/Black 65%Cellulose Fibers None Detected 10%Fberglass 7;5 008A-00"ypsum Wallboard fond Floor Stairwell Friable/White None Detected 0,_,� 0080-00"ypsum Wallboard Second Floor Master Bedroom Friable/White None Detected 17'. 008C-008-Gypsum Wallboard Second Floor Hallway Friable/White None Detected ti 008-Gypsum Wallboard end Floor Bathroom Drywall/White 10%Cellulose Fibers None Detected 903-Gypsum Wallboard Second Floor bedroom Drywall/White 10%Cellulose Fibers None Detected 20 0 009A-009-Gypsum Wallboard Joint Compound Second Floor Bathroom Joint Compound/White None Detected Lab Note:Drywall Material Not Observed. Collected: Received:May 28,2021 Reported:Jun 8,2021 A'%Br LOSE S Project Analyst: Date: Reviewed By: Date: Darien Williams, -08-2021 Renaldo Drakes,liams, t,�_-___.___.__�.__.-- -• •---..._ ___......___..--------_.._.____.___.___._..____.--- �� �..._.__—.------.----.____-- 06-08-2027 MICROBIAL CONSULTING 3005 East Boundary Terrace,Suite F.Midlothian,VA.23112 (804)562-3435 cont 0_ha esmicrobial.com - Panw.6 of 9 Ryan Wild 10022 #21018559 DlASlrVu Inspections 123 Seelye Rd. 18 Blookberry Inane Qaeensbu-ry,New York 12804 Neenebur%NY 12804 Asbestos 198.1 :518)832-0213 Subcontracted 1: Eurofin CEI-Lab ID#12048 # Sample Material Description Non-Asbestos Fibers Asbestos Fibers >,21' 009B-009•Gypsum Wallboard Joint Compound Second Floor Bedroom Joint Compound/White None Detected zT; Lab Note:Drywall Material Not Observed. 010A-010-Gypsum Wallboard Joint Tape(Paper)Second Floor Bathroom Joint Compound-like/White None Detected Lab Note Drywall Material Not Observed. 01 OR-010-Gypsum Wallboard Joint Tape(Paper)Second Floor Bedroom Joint Compound-like/White None Detected Lab Note:Drywall Material Not Observed. -'4- ..i-.r...rw....wn-.u..+......e..�.s...w...u-_..r....,..wn..n...r�+«.....-....._..«.....mw...._..r..r_v.r�.._.r.....r+...«..._..._......._.....-......._........_..._.__.......................�__............._._..._..........�........+w_...s.-.nrr.-+--•...._.�_..�.._w-..-....__.a.__....,.._..... .-._...___....n.._..-._....._.-...............__-_._�.-......-_.-._.......�..+_... ;_ 1-Masonry Brick Second Floor Storage Room Bulk Material/Brown/Red None Detected 25; A11 B-011-Masonry Brick Second Floor Storage Room Bulk Material/Brown/Red None Detected 26;`? 012A-011-Masonry Brick Second Floor Storage Room Bulk Material/Gray None Detected 2 ;= 0726-011-Masonry Brick Second Floor Storage Room Bulk Material/Gray None Detected _._____._.w.--------------_... ._...... 015A-015-'Fiberboard First Floor Living Room Bulk Material/White/Brown None Detected k2w,' 01513-01 5-Fiberboard First Floor Living Room Bulk Material/Brown None Detected Collected: Received:May 28,2021 Reported:Jun 8,2021 A Y BE 's Project Analyst: Date: Reviewed By: Date: 06-08-2021 Renaldo Drakes, Darien Williams, ;��,,r %l•'^� �,;,;.,,,,4 /,J 06-OS-2021 MICROBIAL CONSULTING --- •-.__..._.__.._.-t:w____..__.. _��"__.- _..---.--_. _.--- _.T_.-.._._..__.______.____ ___..___._ _.-..__._ 3005 East Boundary Terrace,Suite F. Midlothian,VA.23112 (804)562-3435 cont c @ha esmicrobial.com Page:7 of 9 Ryan Wild 10022 #21018559 Clenrvu Inspections 123 Seelye Rd. 18 Blackberry Lane Queensbury,New York 12804 Queenebur%NY 12004 Asbestos 198.1 (518)832.9213 Subcontracted 1:Eurofin CEI-Lab 1D##12048 Sample Material Description Non-Asbestos Fibers Asbestos Fibers A' 019A-01 Weramic Tile&Adhesive Basement Bathroom Ceramic/Pink 'None Detected Grout/White None Detected n l 0.198-.019-Ceramic Tile&Adhesive Basement Bathroom Ceramic/Pink None Detected ~lid I Grout/White None Detected 020A-020-Furnace Cement Basement Bulk Material/Gray None Detected 43 ; 02013-020-Furnace Cerraent Baserraent Bulk Material/Gray None Detected Collected: Received:May 28,2021 Reported:Jun 8,2021 �/� Project Analyst: Date: Reviewed By: Date: I10'�4t-1 MICROBIAL CONSULTING Darien`Williams, ,�;� `�-^ha�uwo 06-08-2021 Renaklo Drakes, , , 06-08-2027 .�� 3005 East Boundary Terrace,Suite F Midlothian,VA.23112 (804)562-3435 cont c @ha esmicrobial.com Page:8 of 9 Ryan Wild 10022 #21018559 Clear'Vu Inspections 123 Seelye Rd. is Blackberry Lane Queensbury,New York 12804 Queensbur%NY 12804 Asbestos Analysis Information (618)832.9213 Subcontracted 1:Eurofin CEl-Lab ID#12048 Analysis Details All samples were received in acceptable condition unless otherwise noted on the report.This report must not be used by the client to claim product certification, 1 approval,or endorsement by AIHA,NIST,NVLAP,NY ELAP,or any agency.The results relate only to the items tested.Hayes Microbial Consulting reserves the right to dispose of all samples after a period of'60 days in compliance with state and federal guidelines. PLM Analysis All Polarized Light Microscopy(PLM)results include an inherent uncertainty of measurement associated with estimating percentages by PLM. Materials with interfering matrix,low asbestos content,or small fiber size may require additional analysis via TEM Analysis. S TEM Analysis Analysis by TEM is capable of providing positive identification of asbestos type(s)and semi-quantitation of asbestos content. i i 1 Definitions 'None Detected'-Below the detected reporting limit of 1%unless point counting is performed,then the detected reporting limit is.25%. New York FLAP Per NY.ELAP190.0(NOS),TEM is the only reliable method to declare an NOS material as Non-Asbestos Containing. E Any NY ELAP samples that are subcontracted to another laboratory will display the name and FLAP Lab Identification number in the report page heading of those samples.The original report provided to Hayes Microbial Consulting is available upon request. j I Ilion AIRAF NEw S s MICROBIAL,CONSULTING 3005 East Boundary Terrace,Suite F.Midlothian,VA.23112 (804)562-3435 contact@hayesmicrobial.com Page:9 of t vt.71 t v2 n. 1/a F944 taaavaa�va tayssacac —1.c4=—aw va ..•..—j This form is the official record of successful completion of a New York State accredited asbestos safety training course. Certificate NO.' .�%='fib, e` a here > 'y Name of Trainee (print) NYS Depart.of Motor Vehicles ID(DMV ID)' Signature of Trainee Telephone Number Date of Birth' Address. (Street or PO Box)' t ('Ci ) (State) (Zip Code) } " ..• .::. ,. ...: _..,. .. ..; :.:..�'o,bec�ii�..lefe���i�.:T'ri� Provider's Name Telephone Number Ambient Environmental, Inc. 828 Washington Avenue Address Albany, New York 12203 Course 518-482-070� LOCACI.On: Zip Code AIYS DOII use oirlE Course Title: ❑ Initial ❑ Refresher ❑ DOH Equivalency 2 Training Lan uage: ❑ English❑ Other: Exam Grade/Date- Dates of Training: From: / / To: / " / Expires: I certify that the asbestos safety training course given on the above date complied with both 10 NYCRR Part 73 and TSCA Title 11. was consistent with the curriculum and instructors approved by the New York State Department of Health,and the trainee receivin-this certificate completed the training course and successfully passed the examination. Training Director'- (Print) (Signatuie) S-;.,OENT DOH-2832(10103) 'Optional Information = DOH Equivalency signed by NYS DOH representative only New York State—..pepartment of Labor Division of Safety and Health. License and Certificate'Unit State Campus,Building 12 Albany,NY 12240 ASBESTOS HANDLING LICENSE Creative Spaces II, LLC dba ClearVU inspections ;` FILE NUMBER: 21-282890 LICENSE NUMBER: 282890 18 Blackberry'La.ne . LICENSE CLASS: RESTRICTED DATE OF ISSUE: 01/26/2021 Queensbury, NY 12804 ;EXPIRATION'DATE: 01131/2022 • :3 _' " i ; `API' Duly Authorized Representative—,.Ryan Wild: This license has been.issued in accordarico with applicable provisions of ArEicle;30'of the Labor Law of New York State and of the New York State.Codes,Rules and Regulations(12 NYCRR Part56). 1t is'§ubject to suspension or revocation for a(1) serious violation of state,federal or Local laws with regard;to the conduct of ari.asbestos project,or(2)demonstrated Zack of responsibility in the conduct of any job.involving'asbestos or asbestos material: This license is valid only for the contractor named above aud'tiiis license or'a pliofocopy must be-pibminently displayed at the asbestos project worksite. This license 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 C L E AR V U N S P E C T I O N S 518.832.9213 1 rvan@dearduinspections.com. .1 18 Blackberry Lane,Queensbury,NY 1.2804 Asbestos ClearaTTOWN _ CE _June 18,2021UL 4 2021 Peter O'Neil40 Schermerhorn St. OF QUEEdVSg�RY Lake George, NY 1'2845BUILDING CO®LS 518.361.1175 oneilpe@msn.com The Asbestos Survey performed on May 23,2021 of the building(s)located on 123 Seelye Road, Queensbury,NY,the mastic on the subfloor in the first floor bathroom (homogeneous area 005) was sampled and deemed'to be a regulated asbestos containing material containing greater than 16/oAsbestos.This home is slated for demolition. Since the asbestos survey,the homeowner has removed the asbestos containing material and has thoroughly cleaned the work area(s): In accordance with ICR.56-9.1(d),.56-9.2(e)(2)and ASTM E1368 ClearVU Inspections certifies Ryan Wild has visually inspected the work.area and all surfaces. These surfaces include but are not limited.to pipes, beams,'ledges,walls,ceiling and floor. Ryan Wild,accompanied by the homeowner,observed the contaminated areas-and deems-it to.be complete with no visible dust, debris,or residue apparent on any'surface within the work area. Signed: Ryan Wild ClearVU Inspections Asbestos Handling License-2829.90 Asbestos Building Inspector-879660 Project Monitor&Air.Sampling-883631 I,Peter O'Neil,hereby agree the above information is correct and that I,as the homeowner,am the sole individual who.cleaned the work area. Signed: This form is the official record of successful completion of a New York State accredited asbestos safety training course. Certificate No.8 8 ,6 3 I--!To be completed.by'Trairiee: Name of Trainee(print) NYS Depart. of Motor Vehicles ID(DMV ID)' Signature of Trainee Telephone Number Date of Birth' Address �'-i ,'�.:, •(; �I ��Y. , Street or PO Box). (City) k! (State) 1�1,i (Zip Code) %1 II To be.com leted.b Training`S_ onsor°: Provider's Name Telephone Number Ambient Environmental, Inc. Address Course Albany,New York 12203' 518-482-o704 Location: Zip Code i ? f NYS DON use only Course Title: 1(O*te�� � OVI ( �o Initial, ❑ Refresher ❑ DOH Equivalencyz j Training Language: ®-finglish❑ Other: Exam Grade/Date: Dates of Training: From: To: 7f l_Z1 91�41 Expires: 0 I certify that the asbestos safety training course given on the.above date complied with.both 10 NYCRR Part 73 and TSCA Title H, was consistent with'the curriculum-and instructors approved by the New York State Department of . Health,and the trainee receiving this certificate completed the training course and successfully,passgd the-eza fmination. Training Director2: � X � � (Print) (Signature). .$TUDENT DOH-2832(10/03) 1 Optional Information '- DOH Equivalency signed by NYS DOH representative only FORT ANN TRANSFER STATION 10913 ROUTE 149 FORT ANN, NY 12827 (518) 798-3444 SALE Terminal ID Y,XXXXXXXXXXXXXX Trans ID 000000041967 ' Order ID 210719125404726A3FA Receipt # 210719125404726A3FA Trans Type Purchase Data/Time 2021-07-19 12:54:13 Card Type MasterCard Card Number XXXXXXXXXXXX8282 Entry Legend CHIP READ Entry Method CONTACT Approval Code 02-411B AC E4339F4700541855 ATC OODD AID AOOOOO00041010 AID NAME CAPITAL ONE TVR 0000008000 TSI E800 Rasp CD Z3 TRN REF # MPLFB7N1HO719 Total Amount USD$80.08 Approved - Thank You X _ Cardholder Signature — Buyer agrees to pal total amount above according to cardholder's agrewment with issuer. ****Customer Copy**** Retain this copy for statement verification STATEOPN,EW.YORK-:DE ARTMENTOFiLABOR' BEST, St, ^�C��`�:�`. --"'#= -6.r'%i' •r-/ s:-•�.,s. LN�i'};'".'#,�i.:r.;: - ;' 'RYAWP'WILD CLASS J �r-'S CiATEC(05/22)�D:INSR(05�'22)3�.'r.-' ' ,•; t t n', 7 "'t� �-- x.:�;' ,�'::t.�.:'� •.JP •'.tic cr*�" Sti~_.�' -'y >';;r`i, �'s''je .�i�`• ..d.CERTq.<21=0(a28s>.i:,{ 7,+u.w c,4-`���`�' �?�$'^?_-:.;DMV�7•�73�699619'{� .';vn , ����Y:...,,�..•'.�.�,i..'f••;:y,.�.�'ryyr's�µ':'Y.v}1aJ�'.y�.�/5,..,�{z-,'; .<..'•,��.x,,k_,"j. ,MtJS�BEtCARRIED ON ASBESTOS PROJECTS }k? `�=s.;"• mtuiuinitm"J .?IF'=FOUND'RBTURN r TO::{; 4L.�. 'BAIR;BRO,r - - ';ROOM aT61'f►i8C12LDZFG{12�;'-= a 8GT ';�+67 03�•r �STATS'�OFFICE�C�US t Y -„�!; C'o '"`"ALHANY-,:NY-,122407'- -- -