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DEMO-0657-2022 Office Use Only 4 &- m-o DEMOLITION APPLICATION Permit#:t;�C Permit Fee:$ L�5 7'oivn ofQuccnsbury Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.clueensbury.net Flood Zone? Y /pY ) Reviewed B - 10 Demolition Location.�\ T A IP $ Tax Map ID#:., 1/0 **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? H I Q A hn MI6 LL6 w 2. Type of structure to be demolished: D E C [E 0 / IE a. Residence DC d. Storage Building b. Garage e. other: OCT 2 6 20�Z c. Business 3. What type of utilities are connected to the structure: TO UILD G W N OF U& CODIeS�Y a. Gas f. Well-Water Pump — b. Fuel Oil g. Public Sewer�_ 1� ALL ( v 6 c. Propane h. Other V80i D1SG6NP6GTeb d. Electric i. None e. Public Water 4. Have ALL utilities (water,electric, etc.) been disconnected? Yes No ADDITIONAL INFORMATION: 1. Two inspections are required: an inspection to determine that utilities are disconnected, 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: 6SE H Kc.l SIGNATURE: DATE: 16I L0 2- Demolition Application Revised June 2022 CONTACT INFORMATION: PLEASE'PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): FooT N iLJ-S StXIL0601.S Mailing Address, C/S/Z: 9 MbLkt-tAtMs t0Lr Lkeeps8Lk N`1 fZQ�Y Cell Phone: Qs tF)Ii t-II15 Land Line: Email: Foot U tins&L ►Ll5C&S W-(Q G4mNA t L, (A r1\ • Primary Owner(s): Name(s): 5A MC AS A f P L-t cA+sT Mailing Address, C/S/Z: Cell Phone: Land Line: Email: 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): S A mer AS A P Pt,t �T Contractor Trade: Mailing Address, C/S/Z: Cell Phone: Land Line: Email: **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: 7�0 E LEA(.-d Cell Phone: CS111011 1 -1133 Land Line: Email: 50ol A ILLS bLtt L D 6!6 N`( G G-mA1 L, cA►,n Demolition Application Revised June 2022 : 18 Blackberry Lane k..., L.EARVU' Queensbury, NY 12804 S I �fSPEGTtC7 roan@clearvuinspections.com t°w[ 518.832.9213 FEDCOVE M copy 6 2022 TOWN OF QUEENSBURY BUILDING& CODES Pre-Demolition. Asbestos . Survey TOWN OF QUEENSBURY 0 o O O BUILDING DEPARTMENT BFSed on our limited examination,compliance 3 3 O 0 with our comments shall not be construed as indicating the plans and specifications are in o = O full compliance with the Building Codes of TOWN OF QUEENSBURY 0 r �` New York State. BUILDING & CO S PT. ° Reviewed B : � p0 c Date: `� 2 p rn a M PROJECT NUMBER PREPARED FOR ! co Im 10141 Foothills Builders fD A V 9 mountainside Drive N SITE LOCATION Queensbury, NY 12804 N House&Garage N 80 Main street PREPARED BY Queensnury, New York 12887 Ryan Wild 18 Blackberry Lane Queensbury, New York 12804 'I 1 Foothills Builders,80 Main Street,Queensnury,New York,12887 Executive Summary Asbestos-Containing Material Field Survey House&Garage 80 Main Street Queensnury, New York, 12887 I. SUMMARY OF FINDINGS On August 29, 2022,an asbestos-containing material (ACM)field survey was conducted at 80 Main Street located in Queensnury, New York(Site).The site was inspected to determine the presence of ACM in preparation for demolition; the house was mostly gutted on arrival.The ACM survey was performed at the request of Foothills Builders. 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 61 samples were collected from 25 suspect homogenous materials. Summary Table of Asbestos-Containing Materials Sampie t#�,-„ S ace..Nairie Numerical itesuit Material-Gate o, ¢ :rFria#�ili. NO ASBESTOS DETECTED ***Electrical was on during the survey and electrical insulation was not sampled*** Following the introduction, 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.The original chain of custody & laboratory analytical reports are located in Appendix D of this report. Page 2 of 6 Foothills Builders,80 Main Street,Queensnury,New York,12887 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Foothills Builders to conduct a pre-demolition 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 renovation/demolition/rehabilitation 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. LIMITATIONS&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. Buildings where power is connected, electrical wire sheathing could not and was not sampled. 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 metal,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. Page 3 of 6 Foothills Builders,80 Main Street,Queensnury,New York,12887 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 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(<1%) continues to be covered by OSHA Construction Standard 29 CFR 1926.1101. Eurofins 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 4 of 6 Foothills Builders,80 Main Street,Queensnury,New York,12887 Appendix A: ACM Homogenous Area Table (Material id,-:` ;;,1Vlater�al;::y. -S ace Naive;-,,, SeKtion'Nar�re---w�,,',Friabili' °�` ` '.current Giiridition ;.-.-Resuit:.- .;-:Quanti >:- NO ASBESTOS DETECTED Page 5 of 6 Foothills Builders,80 Main Street,Queensnury,New York,12887 Appendix B:. Chain of Custody&Laboratory Report Page 6 of 6 ......................... .............. ................................................. -2 ,�,Ll �� I 1111111 MEN 11 MORE 111. IER J4Y1 3Y Chain of Custody ClearVU Inspections 18 Blackberry Lane Project: 10141 .Site Location: House&Garage Queensbury,New York 12804 80 Main Street Queensnury,New York,12887 EUROFINS CE19 INC Sampled BY:I Ryan Wild(ryan@clear.vuinspecbons.com): Relpprting-!By,�Ryan Wild,(ryan@clearvuinsr)ections.com) MES ACCEPTED �Purpose: Pre-Dern6lition Laboratory Notes Turn-Ar.o.und rime. Request Stop after first positive fbr.each.HM 2'Day Samples. _ZZ-17. 7 Sample ID Material 'Floor/Section Sp ace Analysis NY ELAP 198.1 & 001A 001. -Gray Stone.Foundation Mortar Garage Garage 198.4 RLM&TEM where applicable WELAP 198.1 001 B' 001 -Gray Stone Foundation Mortar Garage Garage 198A PLM&TEM where applicable NY ELAP 198.1 & 002A. 002,-Gray Masonry Brick Basement Exterior -198.4 PLM&TEM where applica ble NY ELAP 198.1 & 0026 002-Gray Masonry Brick Garage �Garage g 198.4 PLM&TEM where applicable N Y-ELAP 198.1 & 003A 003-Gray Masonry Mortar Basement Exterior 198.4 PLM&TEM where applicable ClearVU Inspections-'Chain of Custody For Foothills builders House&Garage-10141 1 of 3 Sample ID Material Floor/Section Space Analysis NY ELAP 198.1 & 003B 003-Gray Masonry Mortar Basement Exterior 198.4 PLM&TEM where applicable NYELAP 198.1 & 004A 004-Gray Gypsum Wallboard Basement Exterior 198.4 PLM&TEM where applicable NY ELAP 198.1 & 004E 004-Gray Gypsum Wallboard Basement Exterior 198.4 PLM&TEM where applicable NYELAP 198.1 & 005A 005-Red Plaster Basement Exterior 198.4 PLM&TEM J where applicable NYELAP 198.1 & 005B 005-Red Plaster Second floor chimney 198.4 PLM&TEM where applicable NY ELAP 198.1 & 005C 005-Red Plaster Second floor chimney 198A PLM&TEM where applicable NYELAP 198.1 & 006A 006-Gray Woven Electrical Wiring Basement Exterior 198.4 PLM&TEM where applicable 006E 006-Gray Woven Electrical Wiring First floor Kitchen NYELAP 198.1 &198.4 PLM&TEM where applicable NYELAP 198.1 & 007A 007-Brown Vinyl Cove Base&Mastic First floor Kitchen 198.4 PLM&TEM r where applicable NYELAP 198.1 & 008A 008-Green Roofing,Composite Shingle Second floor Attic 198.4 PLM&TEM where applicable NY ELAP 198.1 & 008B 008-Green Roofing,Composite Shingle Second floor Attic 198.4 PLM&TEM where applicable NYELAP 198.1 & 010A 010-Sealant,Window Pane Glazing First floor Family Room 198A PLM&TEM where applicable C1earVU Inspections-Chain of Custody For Foothills Builders House&Garage-10141 2 of 3 i _.._..._..._..._........ ......._._.._..............._...__....................._......_.............._—.-----.._._..__...--------------...._._.— I' Sample ID Material Floor/Section Space Analysis l` WELAP 198.1.& 010E 010-Sealant,Window Pane.Glazing First floor- Living Room 198A PLM&TEM where applicable. 10.14.2022 3PM Sampled By Date Time Received By Date 'Time Received By Date Time Received By Date 'Time 10.1.8.2022 4PM Relinquished BY Date .Time Relinquished By Date Time Relinquished By Date Time �Y Analysis By Date Time i� 1 I ClearVU Inspections-Chain of Custody For Foothills Builders House&Garage-10141 3 of 3 ti�� e u rof i n s I October 21, 2022 ClearVU Inspections 18 Blackberry Lane Queensbury, NY 12804 CLIENT PROJECT: 10141 LAB CODE: N220302 Dear Customer: Enclosed are asbestos analysis results for Asbestos Bulk samples received at our laboratory on October 19, 2022. The samples were analyzed for asbestos using polarizing light microscopy (PLM) and / or transmission electron microscopy (TEM) by New York State ELAP approved methods. Sample results containing >1% asbestos are considered asbestos-containing materials (ACMs) per EPA regulatory requirements. The detection limit varies with the method chosen for the analysis. Eurofins CEI is accredited by the New York State Department of Health (NYSDOH) Environmental Laboratory Approval Program (ELAP), certificate#12048. Kind Regards, � vo Tianbao Bai, Ph.D., CIH Laboratory Director r4vtA TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 eurofins I ASBESTOS ANALYTICAL REPORT By: New York State ELAP Method Prepared for ClearVU Inspections CLIENT PROJECT: 10141 LAB CODE: N220302 TEST METHOD: NYS ELAP METHODS 198.1, 198.4 REPORT DATE: 10/21/22 TOTAL LAYERS ANALYZED: 17 # LAYERS >1% ASBESTOS: 0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Asbestos Report Summary ®� le u rof i n s By: NEW YORK STATE METHOD C ! PROJECT: 10141 LAB CODE: N220302 ASBESTOS BULK, NEW YORK STATE METHODS Client ID`; Lab ID Color - Sample Description Total Asbestos%, 001A N4740 Gray Stone Foundation Mortar No Asbestos Detected.0% 001 B N4741 Gray Stone Foundation Mortar No Asbestos Detected.0% 002A N4742 Green, Gray Masonry Brick No Asbestos Detected.0% 002B N4743 Green, Gray Masonry Brick No Asbestos Detected.0% 003A N4744 Gray Masonry Mortar No Asbestos Detected.0% 003B N4745 Gray Masonry Mortar No Asbestos Detected.0% 004A N4746 White Gypsum Wallboard No Asbestos Detected.0% 004B N4747 White Gypsum Wallboard No Asbestos Detected.0% 005A N4748 Gray Plaster No Asbestos Detected.0% 005E N4749 Gray Plaster No Asbestos Detected.0% 005C N4750 Gray Plaster No Asbestos Detected.0% 006A N4751A Gray Electrical Wiring No Asbestos Detected by 198.4 ---------------------------------- ----- ------ - ---- --------- ---- N4751 B White Electrical Wiring No Asbestos Detected by 198.4 --------------------------------- - - ---- ----- - -- - --- - ----------- N4751 C Black Electrical Wiring No Asbestos Detected by 198.4 006B N4752A Gray Electrical Wiring No Asbestos Detected by 198.4 --------------------------------- ----------- -- - -------- -------- N4752B White Electrical Wiring No Asbestos Detected by 198.4 --------------------------------------------------------------- N4752C Black Electrical Wiring No Asbestos Detected by 198.4 Page 1 of 1 ASBESTOS BULK ANALYSIS li e u rof i n s By: NEW YORK STATE METHOD CI Client: ClearVU Inspections Lab Code: N220302 18 Blackberry Lane Date Received: 10-19-22 Queensbury, NY 12804 Date Analyzed: 10-21-22 Date Reported: 10-21-22 Project: 10141 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description Category Color 001A Stone Foundation Friable Gray Initial Observations: N4740 Mortar Binder 35% Silicates 65% Method: Final Results: 198.1 No Asbestos Detectdabtal Asbestos: No Asbestos Detected.0% 00113 Stone Foundation Friable Gray Initial Observations: N4741 Mortar Binder 35% Silicates 65% Method: Final Results: 198.1 No Asbestos Detect6fttal Asbestos: No Asbestos Detected.0% 002A Masonry Brick Friable Green, Initial Observations: N4742 Gray Paint 5% Binder 20% Silicates 75% Method: Final Results: 198.1 No Asbestos DetectETietal Asbestos: No Asbestos Detected.0% 002B Masonry Brick Friable Green, Initial Observations: N4743 Gray Paint 5% Binder 20% Silicates 75% Method: Final Results: 198.1 No Asbestos Detectr.Tabtal Asbestos: No Asbestos Detected.0% Page 1 of 7 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD Ca Client: ClearVU Inspections Lab Code: N220302 18 Blackberry Lane Date Received: 10-19-22 Queensbury, NY 12804 Date Analyzed: 10-21-22 Date Reported: 10-21-22 Project: 10141 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID Lab Description. Category Color 003A Masonry Mortar Friable Gray Initial Observations: N4744 Binder 40% Silicates 60% Method: Final Results: 198.1 No Asbestos DetectdTabtal Asbestos: No Asbestos Detected.0% 003B Masonry Mortar Friable Gray Initial Observations: N4745 Binder 40% Silicates 60% Method: Final Results: 198.1 No Asbestos Detectd'ibtal Asbestos: No Asbestos Detected.0% 004A Gypsum Friable White Initial Observations: N4746 Wallboard Cellulose 5% Gypsum 95% Method: Final Results: 198.1 No Asbestos Detectelabtal Asbestos: No Asbestos Detected.0% 004B Gypsum Friable White Initial Observations: N4747 Wallboard Cellulose 10% Gypsum 90% Method: Final Results: 198.1 No Asbestos Detect(Tabtal Asbestos: No Asbestos Detected.0% Page 2 of 7 ASBESTOS BULK ANALYSIS e u r®fins By: NEW YORK STATE METHOD I Client: ClearVU Inspections Lab Code: N220302 18 Blackberry Lane Date Received: 10-19-22 Queensbury, NY 12804 Date Analyzed: 10-21-22 Date Reported: 10-21-22 Project: 10141 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ID.. Lab Description Category Color 005A Plaster Friable Gray Initial Observations: N4748 Cellulose 2% Silicates 10% Binder 88% Method: Final Results: 198.1 No Asbestos Detectd'cbtal Asbestos: No Asbestos Detected.0% 005B Plaster Friable Gray Initial Observations: N4749 Cellulose 2% Silicates 10% Binder 88% Method: Final Results: 198.1 No Asbestos Detect(Tabtal Asbestos: No Asbestos Detected.0% 005C Plaster Friable Gray Initial Observations: N4750 Hair <1% Binder 40% Silicates 60% Method: Final Results: 198.1 No Asbestos DetectETabtal Asbestos: No Asbestos Detected.0% 006A 1 NOB Gray Initial Observations: N4751A Electrical Wiring Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 3 of 7 ASBESTOS BULK ANALYSIS e u rof I n s By: NEW YORK STATE METHOD I Client: ClearVU Inspections Lab Code: N220302 18 Blackberry Lane Date Received: 10-19-22 Queensbury, NY 12804 Date Analyzed: 10-21-22 Date Reported: 10-21-22 Project: 10141 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number .Lab ID -Lab Description Category Color --- - -N4751 B 2 NOB White Initial Observations Electrical Wiring Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected --------- ----------- - ----------- - ------ ---------- - - - - -- ----------- N4751C 3 NOB Black Initial Observations: Electrical Wiring Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 006B 1 NOB Gray Initial Observations: N4752A Electrical Wiring Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 4 of 7 1 I ASBESTOS BULK ANALYSIS 4�% e u r®fins By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220302 18 Blackberry Lane Date Received: 10-19-22 Queensbury, NY 12804 Date Analyzed: 10-21-22 Date Reported: 10-21-22 Project: 10141 ASBESTOS BULK, NEW YORK STATE METHODS Client ID -. Layer;Number; Lab Np>,. Lab Description Category Color -N4752B--` 2 -_ -- --NOB - -White -- - - -Initial Observations Electrical Wiring Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected ------------------------------------------- ----------------------• N4752C 3 NOB Black Initial Observations: Electrical Wiring Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 5 of 7 el s� eurofinS CEI LEGEND Non-Anth = Non-Asbestiform Anthophyllite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate NOB = Non-Friable Organically Bound SM-V = Surfacing Material Containing Vermiculite GLOSSARY OF TERMS Inconclusive- No Asbestos Detected PLM is not consistently reliable in detecting asbestos in floor coverings and other NOB materials. Currently, quantitative TEM must be used to determine if this material can be considered or treated as non-asbestos containing. Inconclusive- CR Conflicting Results: Sample yielded 1% or less asbestos as determined by gravimetric reduction and TEM analysis but had protruding fibers identified as asbestos during preliminary examination -further sampling and analysis needed. Inconclusive-Trace (type of asbestos) detected at 1% or less Asbestos identified at 1% or less by the 198.6 method, and 0 asbestos points out of 400 (or more) nonempty points were counted. Further testing by TEM using NYS 198.4 method is required. Trace asbestos detected at less than 1% For methods 198.1 and 198.8, NYSDOH defines trace as samples where 0 asbestos points out of 400 (or more) nonempty points were counted, but did contain asbestos positively identified by PLM. Trace asbestos detected at less than 1% For method 198.4 NYSDOH defines trace as asbestos detected at 1% or less. REGULATORY LIMIT; > 1% by weight 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 6 of 7 eurofins CEI DISCLAIMERS: Reported asbestos content verifiable only as the percentage of asbestos in residue submitted to laboratory. Samples with inconclusive results must not be interpreted as being non-ACM. This report relates only to the samples tested or analyzed and may not be reproduced, except in full, without written approval by Eurofins CEI. Eurofins CEI makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. Interpretation of the analytical results is the sole responsibility of the customer. Samples were received in acceptable condition unless otherwise noted. This report may not be used by the client to claim product endorsement by NVLAP, NYSDOH or any other agency of the U.S. Government. Information provided by customer includes customer sample ID, location, volume and area as well as date and time of sampling. ANALYST(S): reg uff- 19re.1 'ld4 Brunilda Gjoka -9198.4 APPROVED 13) !tio Tianbao Bai, Ph.D., CI Laboratory Director m V TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 7 of 7 ,. .: i µ New,*jrk State L-Depgrtm6 t-o . abor Division o '84gly and lealth License and MtOlcao6nitt State Cus,Building 12 /'a I Albany,,NY,.,_12240 ,. �•. „ ASBESTOS HANDLING LICENSE - - restive Spaces Il, dba ClearVU�lpSpection3s j` F�LE NUMBER: LICENSE NUMBER:`,282890 180Blackberry Lae LICENSE CLASS: RES 1_"RI : • � :a a g� IIN DATE OF ISSUE: 01/28r2'Q22 ' Q eC)`sbury, Y 12804 ,. �. �, EXPIRATION DATE: 01/312023 JiNim- o ',Iy Au ori7e °.Representativw,�4,Ryan'11V�d. �hr"!✓": ^, - _ ;_° ` > #"rj ,a Jj. , e' er ..�. .• '+5{iL;y��t 1 �� II .,.w � "a '+ �. r,P I.•' ..i�'�cr4r..6 , � .S .a { is`3tcen5 li been issued in ac 4 dat}cey ith hbAl rpxi'st*ifz'o ^ Q'bf the Laliar Law of New ,. r t a e rid o 7 � �� .f. t ie New o.R Via Codes,Rules ' t i2egu�at 5 1 N @ 2RPart°5¢)r Itis tx ect to su$ e�►sion or revocat on�or a(1) se io s vio•atio Astate federal�r t cal aWs ark� o.t e c uct`of d esto ro or 2 demo- irate t1 ;s .: pg>�Ti�v jh, � nd ��. rk�54 �P � ( ) p ack reo �ibitiy in thenduct of anya invalvi cos'o asb � rat.y E�,,,.,, "" �"g �s ..--.._...� .• �1 qx tE+1^�Ea isAi�. r•�_'��r�' -Al'Yf� 5k� 9,� ....,,,� t 6 5 f Thi§ icerlse is valid on]),for tjie contraetor_r _`aTi and tisicense oo .p_y_mustepminently displayed at th,e asbestos pro'e �xksite Thi l•cegse veri'ftes tha9I,lIpersons-empl �etiby ttie hcesee on an aslfess project in New Y s��State ha .e een s d an tl.sbestos Certificate;appr,.opri�t�o�fhe�type o v`�axk-they perform,by the,New Yor .�Iat Depart ntoibor. 4,R - __._ - --" t Nx f4 m.f,q, tin R ld° S' • « Amy Phillips,Director SH 432(8/12) For the Commissioner of Labor ✓YSTATE&Nb YORl 'DEPARTMENT OF l ARC}R w ASBESTOS CERTIFICATE. RYAN.:P-,WILD- °CLASS(EXPERES) CATEQ05/23),'D.INSP(05`/ j 1..'. ... .4.pgt��I�:tpp]�ip•Yjf� .j2�yE�"p"9�3aY 428 p� ✓ ..�`�.. :.., _. ... ..��+fYb Y-M. 1 t�J V�:,Y�3.,I.U,to•'• r NIPSTSE CARRIED QN.ASBESTOS''PROJECTS: ._..;��..�.__.�,. ;' '. IIIIIItlll�l•IIt11RH1._..16f_%z . �Illllllf LIIIII lII�lIIIlI I III :I£+' FOUND RETUEM Td: N ETES SRO VYSDOL - L&C UNIT M� ° HAM BRO" ROOM 161A BLJI'LDINt3.12, . e HGT "6:' 03":':-.:_ STATE OET. CAMPUS, AIlZA]4Y- NY 12240: P.�.� �,�,,.., --..�,..roc*.._ _....-P.,^=�r-�'"'"""'�m%-^�,.«s^,Y•+,.•.^.�° RYANt. WILL) o ¢ o s• •doalg 6L ARwwwW s s s N S R E C T t O N S NEW YORK STATE DEPARTMENT OF.HEALTH WADSWORTH CENTER _ Expires 12:01 AM April 01, 2023 ,. Issued April 01, 2022 CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE Issued in accordance with and pursuant to section 502 Public Health Law of New York State DR. TIANBAO BAI NY Lab Id No: 12048 = EUROFINS CEI, INC. -- 730 SE MAYNARD ROAD CARY, NC 27511 is hereby APPROVED as an-Environmental Laboratory in conformance with the National Environmental Laboratory Accreditation Conference Standards(2016) for the category ENVIRONMENTAL ANALYSES POTABLE WATER - All approved analyfes are listed below: Miscellaneous Asbestos _ EPA 100.2 Serial No.: 64945 �fro Property of-the New York State Department of Health. Certificates are valid only at the address shown,must be conspicuously posted,and are printed on secure paper. Continued accreditation depends an successful ongoing participation in the Program. consumers are urged to call{518)485 5570-to verify the'laboratoiy's accreditation status. " - ottxno�' Page 1 of 1 NEW YORK STATE DEPARTMENT OF.'HEALTH: WADSWORTH CENTER Ex keCl 2:01 U AMA ptil'61j��023z=_. s .udd. Apdl 01, 2022 CERTIFICATE OFAPPROVAL FOR LABORATORY SERVICE Issubd In accordince with and pursuant to section 502 Public Health Law of Now VbtkState:4- DR.=TIANBAO BAF NY Lab Id No: 12048 . EUR OFINS CEJ-1 lk d!—, 730 SE MAYNARD ROAD X, NC 27eff an-Environmental 404or*ry for the caftory ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE' All s&rqvdd subcategor1e;_and1bC�_;ana1ytqs are listed below: ..-Miscellaneous Asbestos In Ffi6ble Matedal.- Item 198.1 of Manual Asbe6lds on.MIN Friable Mateifil-PEM -Atem imp of Manual(NOBby PLM)=. Asbestos In Non-Friable Material-TEM Item 198.4 of Manual AsbeiC6i-Vanniculite-Coniil�ntfig Material Item 198.8 of Manual Serial No,-* 64946' Pmpertyof-the New York State Departmera fieittth.-Cerdffcqtea 66 iralld only at the iddmss- be.consplduously posted.-and are pdqW,.o shomi must n secure paper. Continued accreditation.depends nsucqeqdq.c!*o1ng ftdpa n In ft Program:consumers are urged to c#11(51SY485-551n_p e 16 ft .-bors oys C6Q1taVorf_StE1tUS. =6gq 11of 1_