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DEMO-0012-2022 Office Use Only DEMOLITION APPLICATION Permit#: C >M 't1.p 12-Z©ZZ=-.. : J. Permit Fee:$ �� Town of Queen UT Invoice#: . . . 742 Bay Road,:Queensbury;NY 12804 P:518-761-8256 www:ciueensbury.net - Flood Zone? Y; . N Reviewe Cr .-,b 4 202k= n� DemoLhon Location: Tax Map ID:#: °( � ASBESTOS.:REPORT,REPORT IS.1 ;EQUIR, D1VITI3:ALL DEMOLITION APPLICATION, SUBMISSIONS** DEMOLITION.INFORMATION: _ d . 1.: _Where'will.demolitions material be disposed? -2. Type of structure to be demolished:. a. Residence d.Storage Building b ra e. ..Ga .g e.Other: c: . Business I What type of-Utiil.ities are.connectedto the structure: )AN:) 3 20�2 a Gas f.Well-1Nater Pump� .. . ,. b:. Fuel Oil g..Pu_blic Sewer TOWN OF QUEENSBURY c. F rop'ane Q :h. Other - G& CODES BUILDIN d._ Electric is None Q e. .Public Water 0 4. Have ALL utilities (water, electric,etc:) been disconnected? :Yes-0. No N': ADDITIONAL.INFORMATION: Se�✓�r 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) hou.r.notification is.requ r A for inspections:. - 3. Vorkers' Comp insurance.inforrhi tion 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.. have read and agree.to the above: „ PRINT NAME: . SIGNATURE: DATE: -7(0�i. Demolition Application Revised:December 2020 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE; PLEASE I;NCLUD.EAN EMAIL . . Applicant*.... Name(s): o�4LVr- vtiS4(, J�+ l iZk�): . �� 3-7 6 I�y� F4a �, �y Mailing Address,,C/S/Z:. :ps 0e. !r Cell Plione: Land Line: C51��7.y�-®� o y.r C ��>.79�.4.°91:®: . Email: e-t. .6 • Primary.Ow_ner(s)" Name(s): :�. ®'✓l-o Mailing Add ress, C/S/Z:. 9.60 6 0 e Av:e4ve., 15CL5:� C-II.Phone:. Land:Line 1 t;Z03): 041- 02..� 3®:. :Email:. S►v y,Py -tv� �e�e c0wi ❑Check if all work will:be performed by property owner..on1�: Contractor: (List aII addition aLcontraetors on the_ba&ofthis form) ContactName(s): O._(���m:C :GoS � � �'c� �. .�w d .�.��.f -. .Contractor Trade:•'IiX(44' ke o-k Dew;.� Mailing Address, C Cell Phone; Land Line: C l:�> �1 Z- �a°� �.(St 8�79.2-40cl - Email:. P���.�-�.�r,®�►���a���., *Workers' Comp documentation must.be submitted with this application**: Contact:Persorrforany questions:re ardih this ro'ect: w g g p . � � 'D C ���r: CeII Phone: Land Line: C7. Il !LI 2. ®°�/ .. Email:. l', .C, . P Demolition Application Revised December 2020 J0HN TURNER CONSULTING TOWN OF QU . -. Y October28th;2021 Bl9iLDiNG & O fl Reviewed By: ;. .. Attn: John Wypychoski Date: To uvn Fair Tire ®� 460 Coe Avenue East Haven,CT 06512 D E-C V E Re: Asbestos survey': . JAN 3 ZOZz 863 Route 9. Queensbury,'NewYork : TOWN OF . - QUEENSBURY - JTC Project No.21-10-056 BUILDING&CODES Dear Mr:Wypychoski: An urner Consulting, Inc (!TC•) is pleased to present this Pre- emolition Suruey repor ok analysis conducted on Oetober 18t", 2D2�1, at the above referenced site. o asbestos containing ' rfiamal fAW was located on the property. Asbestos bulk. sampling was performed by Mr.Zachary Brockway.*of KAS Inc., a .United States -.Environmental Protection Agency(EPA)certified and New York Licensed Asbestos Inspector. Bulk samples.were. submitted under chain -of custody to SanAir.Technologies Laboratory Iocated'in. .. Powhaian,VA.for analysis by Asbestos Bulk PLM'NY ELAP 198.A,Asbestos Bulk.PLM NOB.NY ELAP 198.6 and Asbestos Bulk TEM NY ELAP 198A as applicable. ; Based on the results.of laboratory analysis; asbestos was detectedin one material collected during the site'visit.`The materials.identified are summarized:in the table below. e State o New or as es,a -Irs a greater hap ne pe cent(I a mmQm asbestos content f r a material to b consid d t b AC he results of this asbestos sam ing with detected asbestos levels below 1°�and analysis are contained in Tabie 1. TABLE 1::ASBESTOS SAMPLING POSITIVE:ANALYSIS RESULTS Sample yV.. � = . -• �,,�,,y Sample�Ngrlp � � = Precept Asbestos(%) Number . 8,. 10A HVAC Roof—Built up roofing, <1% 10B : HVAC Roof-Built up roofing. . <1 Coristruction Engineering&Inspections]Geotechnical I Environmental I Special Inspections&Testing . . www.consultjtc.com. Page 2 of 2 :This asbestos bulksamplingwas.conducted in a manner consistent with.the level ofcare and.skill ordinarily . exercised by.members'of the profession currently practicing under similar conditions.in the same_locale. The results;findings,.and conclusions expressed in the report are based on conditions observed during the limited.asbestos.bulk sampling event. This.report has been prepared on behalf of and exclusively.for use and reliance;by the Town Fair Tire:AC does warrant.the work of regulatory agencies;laboratories or Other third parties supplying information that may have been used in preparation of this report. No warranty,express or implied; is made: JTC.appreciates the opportunity. to-assist Town Fair Tire with this Pre=Demolition. Survey, and looks forward to supporting.your future-industrial hygiene, environmental;and regulatory needs. If you, have any questions;please do not hesitate to contact the undersigned. Sincerely, JOHN TURNER CONSULTING,INC. Benjamin J.Gri as,PG,CG p Matthew Pellerin bireetor,Environmental Consulting Services. Project Manager/Scientist.. 19 Dover Street 19 Dover.Street Dover,NH 03820 Dover,.NH 03820 berieas@consuititc.com matthewPgconsultitc:com Ph:(603).812-1694 Ph: (207)319-0390 ww.w.consultjtc.com - nationalgrid January 5, 2022 Via Email: JWYPY@townfair.com Re: National Grid GSR #: 30473503 Service Address: 863 Route 9, Queensbury This letter is to advise you that the natural gas service line to the above location was physically disconnected on November 24, 2021. The service has been retired, therefore, there is no live gas to the building as of November 24, 2021. If you feel that the location where the service was terminated (as stated above)-will interfere with your planned excavation, please contact us immediately and do not start excavation. New York State law requires anyone planning underground excavation work to notify local utilities by calling "81111, or 800-962-7962. This confirmation letter of disconnect does not relieve the excavator of making this"811"call. Respectfully, E C E 9 V E Pak XWOM D JAN 13 2022 Debi Melsom Gas Connections UNY TOWN OF QUEENSBURY Phone: (518) 603-4015 BUILDING&CODES Email: debra.melsom annationalgrid.com 1125 Broadway,Albany,NY 12204 = Nationalgrid 300 Erie Boulevard West Syracuse,New York 13202 DATE 12/8/2021 RE: Service Removal for Building Demolition. -This letter is to confirm that,per your request,National Grid has confirmed electrical service and meters have been removed from 863 Route 9, Queensbury.The work was processed on work request#30473502. If you have any questions or need further assistance,please feel free to contact us at 800-260-0054. Sincerely, Lydia Styb ESR3 Customer Connections iJNY nationalgrid p E C E 0 dE JAN 132022 11 TOWN OF QUEENSBURY BUILDING&CODES ir Technologies Laboratory The Idefltification S peciallsts Analysis Report prepared for KAS, I nc. Report Date: 10/26/2021 Project Name:863 Route 9 BAN 13 2022 Project#:310215313 TO BUILDING&SENSE, SanAir ID#:21056679 COI)ES INV Lr—J TESTING WLAP LAB CODE 2W87" 296.17-1-34 DEMO-0012-2022 NEWYORK pe t`$!i1@11t Town Fair Tire srnTso, 863 State Rte 9 bPPORTUNITY. Of @Slth Demolition of commercial bldg 10501 Trade Court I North Chesterfield,Virginia 23236 J888.895.117710804.89711771 fax:804.897.00701 IAQ@SanAircom I SanAircom Page 1 of 14 SanAir ID Number 21056679 Sanhi r FINAL REPORT Technologies Laboratory 10/26/2021 4:37:26 PM Name: KAS, Inc. Project Number:310215313 Address: PO Box 787 P.O.Number:John Tumor Consulting Williston,VT 05495 Project Name:863 Route 9 Phone:518-563-9445 Collected Date: 10/18/2021 Received Date: 10/19/2021 10:20:00 AM Dear Zachary Brockway, We at SanAir would like to thank you for the work you recently submitted.The 24 sample(s)were received on Tuesday, October 19,2021 via UPS.The final report(s)is enclosed for the following sample(s): 1A, 1 B,2A,2B,2C, 3A,313, 3C,4A,4B,5A, 5B,5C,6A,6B, 7A,76,7C,8A,8B,9A, 9B, 10A, 10B. These results only pertain to this job and should not be used in the interpretation of any other job.This report is only complete in its entirety. Refer to the listing below of the pages Included in a complete final report. Sincerely, Sandra Sobrino Asbestos&Materials Laboratory Manager SanAir Technologies Laboratory Final Report Includes: -Cover Letter -Analysis Pages -Disclaimers and Additional Information Sample conditions: -24 samples in Good condition. 10501 Trade Ct.,N.Chesterfield,VA 23236 1804.897.1177 1 Fax:804.897.0070 www.SanAir.com IAQ@SanAir.com Page 2 of 14 SanAir ID Number 2,1056679 San& FINAL REPORT Technologies Laboratory 10/26/20214!37:26 PM Name: KAS, Inc. Project Number:310215313 Address: PO Box 787 P.O.Number:John Turner Consulting Williston,VT 05495 Project Name:863 Route 9 Phone•.518-563-9445 Collected Date:10%18/2021 Received Date:10/19/2021 10:20:00 AM Analyst:Roseblock,Mary Asbestos Bulk PLM NY ELAP 198.1 Stereoscopic Components SanAir ID Description Appearance %Fibrous Non-fibrous Asbestos Fibers 2A%21656679=003; White` 1'll0%?Other rNone Detected Foyer.=Joirit:CorriPiiund ,Non=Fifirous_ __ . _... ,. .,.•'>. _ . .-Homogeneous; 28/21056679-004 White 100%Other None Detected Foyer-Joint Compound Non-Fibrous Homogeneous 2C%2,1056679'7005 White.. 1.00%g Other None'Deteefed Foyer,=Joint;Cornbound Non=Fibrous Ho, y .}6 mogeneous::,:. 3A/21056679-006 White 5%Cellulose 95%Other None Detected Foyer-Drywall Non-Fibrous Homogeneous 38%21056679-007 White 59'a Cellulose 957!0 Other None Defected Foyer. Diyivall Non-Fibrous. 3C/21056679-008 White 5%Cellulose 95%Other None Detected Foyer-Drywall Non-Fibrous Homogeneous 5A/21,0566794011. Grey 5%Cellulose 9596 OtFi'er None Defected Kitchen-ON ffid Tile N6n4i6r`ous mogeneous,: ,. - 56/21056679-012 Grey 5%Cellulose 95%Other None Detected Kitchen-Ceiling Tile Non-Fibrous Homogeneous SC/21056679=013 Grey 5%Cellulose. 95%Other None Detected Kitchen-Gei"Tle :Mori-Fibrous Homogeneous 7A/21056679-016 White 99.25%Other 0.75%Chrysotile Dining Room-Textured Ceiling Non-Fibrous Homogeneous Analyst: w6lmt- Approved Signatory: Analysis Date: 10/26/2021 Date: 10/26/2021 Page 3 of 14 SanAir ID Number -21056.679 Sanhit FINAL_REPORT Technologies Laboratory 10126/2021 437:26 PM Name: KAS, Inc. Project Number:310215313 Address: PO Box 787 P.O.Number:John Turner Consulting Williston,VT 05495 Project Name:863 Route 9 Phone: 518-563-9445 Collected Date: 10/18/2021 Received Date: 10/19/2021 10:20:00 AM Analyst:Roseblock,Mary Asbestos Bulk PLM NY ELAP 198.1 Stereoscopic Components . Non-fibrous 76'.21,056679-0t7 White.-/ 100%'`Otlie� .'None Detected Dining;Room-Textured.Ceilirg Non';.'Fibrous - 7C/21056679-01 B White 100%Other None Detected Dining Room-Textured Ceiling Non-Fibrous Homogeneous Analyst: (ewJw0- Approved Signatory: Analysis Date: 10/26/2021 Date: 10/26/2021 10501 Trade Ct.,N.Chesterfield,VA 23236 1804.897.1177 Fax:804.897.0070 1 www.SanAir.com I IAQ@SanAir.com Page 4 of 14 'r SanAir ID Number 21056679 San& FINAL REPORT Technologies Laboratory 10/26/2021 4:37:26 PM Name: KAS, Inc. Project Number:310215313 Address: PO Box 787 P.O.Number:John Turner Consulting Williston,VT 05495 Project Name:863 Route 9 Phone: 518-563-9445 Collected Date:10/18/2021 Received Date:10/19/2021 10:20:00 AM Analyst:Roseblock,Mary Asbestos Bulk PLM NOB NY ELAP 198.6 %Other %Non-Asbestos Asbestos %Total Sample Appearance Material "Fibers Types. Asbes tos 1A on=Fibrous . N _None'Uefected': 21056679.40.1 Homogeneous Yellow Dining Room;Carpet-Mastic 1 B Non-Fibrous 100% None Detected 21056679-002 Homogeneous Yellow Dining Room-Carpet Mastic 4A Non=Fibrous " 100% None.Oetected 21056679-009 Homogeneous Brown Kitchen-..Wal I.Mastic 4B Non-Fibrous 100% None Detected 21056679-010 Homogeneous Brown Kitchen-Wall Mastic ,6A. NonFibrous. 100% None Retecteii 21056679-014 Homogeneous ' ..,.Tan Dining Room-Cove Base Mastic 6B Non-Fibrous 100% None Detected 21056679-015 Homogeneous Tan Dining Room-Cove Base Mastic BA Non-Fibrous 10096 None Detected 21056679-019 Heterogeneous Black Main Pitched Roof-Tar.Paper 8B Non-Fibrous 100% None Detected 21056679-020 Heterogeneous Black Main Pitched Roof-Tar Paper Analyst: %k t-e wu0sp. Approved Signatory: Analysis Date: 10/26/2021 Date: 10/26/2021 10501 Trade Ct.,N.Chesterfield,VA 23236 1804.897.1177 1 Fax:804.897.0070 1 www.SanAir.com I IAQ@SanAir.com Page 5 of 14 1 SanAIr,ID Number SanhC 21056679 i r FINAL REPORT Technologies Laboratory 10/26/20214:37:26 PM Name: KAS, Inc. Project Number:310215313 Address: PO Box 787 P.O.Number:John Turner Consulting Williston,VT 05495 Project Name:863 Route 9 ° Phone:518-563-9445 Collected Date: 10/18/2021 Received Date:10/19/2021 10:20:00 AM Analyst:Roseblock,Mary Asbestos Bulk PLM NOB NY ELAP 198.6 %Other %Non-Asbestos Asbestos %Total Sample Appearance Material Fibers Types Asbestos 9A` �`Fitiro 's` 1Nbrib e ed 21056679-021 Homogeneous; _ Black Ta11.Pifahed Roof=TarHot Mop-pope� . 9B Fibrous 100% None Detected 21056679-022 Homogeneous Black Tall Pitched Roof-Tar Hot Mop Paper 10A Non-Fibrous 100% <1°/u Chryso_tile 41% 21056679-023 Heterogeneous - - ,Black• .: - " HVAC Roof.-_Built-Up Roofing. 10B Non-Fibrous 99.32% <1% Chrysotile <1% 21056679-024 Heterogeneous Black HVAC Roof-Built-up Roofing Total: <1% Analyst: . e k4t"L Approved Signatory: ^&� - Analysis Date: 10/26/2021 Date: 10/26/2021 10501 Trade Ct.,N.Chesterfield,VA 23236 1804.897.1177 1 Fax:804.897.0070 1 www.SanAir.com I IAQ@SanAir.com Page 6 of 14 SanAir ID Number 21056679 San& FINAL REPORT Technologies Laboratory 10/26/2021 4:37:26 PM • Name: KAS, Inc. Project Number:310215313 Address: PO Box 787 P.O.Number:John Turner Consulting Williston,VT 05495 Project Name:863 Route 9 Phone:518-563-9445 Collected Date:10/18/2021 Received Date: 10119/2021 10:20:00 AM Analyst:Tallert,Jonathan Asbestos Bulk TEM NY ELAP 198.4 Appearance %Other %Non-Asbestos Asbestos %Total Sample Y e Non e Detect d' 1A. `Noii=Fibrous: �1OO�o .- 27056679=001 Ho Y geo,y`'ous: e . Diniri ;Room,,.Car,"et, - .9 _P 1B Non-Fibrous 100% None Detected 21056679-002 Homogeneous Yellow Dining Room-Carpet Mastic 4A Nori-Fiibous 100% None Detected. 21056679409 Homogeneous Brown Kitchen Wall Mastic 4B Non-Fibrous 100% None Detected 21056679-010 Homogeneous Brown Kitchen-Wall Mastic 6A Non=Fibrous- 100% None Detected 21056679-014 "Homogeneous Tan Dining,Room-Cove Base Mastic, " 6B Non-Fibrous 100% None Detected 21056679-015 Homogeneous Tan Dining Room-Cove Base Mastic 8A Non-Fibrous 100% None Detected 21056679-019 Heterogeneous Black Main Pitched Roof r Tar Paper 8B Non-Fibrous 100% None Detected 21056679-020 Heterogeneous Black Main Pitched Roof-Tar Paper Analyst: Approved Signatory: 0*919L_ Analysis Date: 10/26/2021 Date: 10/26/2021 10501 Trade Ct.,N.Chesterfield,VA 23236 1 804.897.11771 Fax:804.897.0070 1 www.SanA!r.com I IAQ@SanAir.com Page 7 of 14 SanAlr ID Number Sanh - 21056679 ir FINAL-REPORT Technologies Laboratory 10/26/2021 4:37:26 PM Name: KAS, Inc. Project Number:310215313 Address: PO Box 787 P.O.Number:John Turner Consulting Williston,VT 05495 Project Name:863 Route 9 Phone:518-563-9445 Collected Date:10/18/2021 Received Date:10/19/2021 10:20:00 AM Analyst:Tallert,Jonathan Asbestos Bulk TEM NY ELAP 198.4 %Other %Non-Asbestos Asbestos %Total 'Sample Appearance Material Fibers Types Asbestos .9A- - Fibrous. fiGO% None?elected 105,6679=021 Homogeneous: Black :. .. Tall Pitched Roof=Tar.Hot P Mo,.Pa er. ..P 9B Fibrous 100% None Detected 21056679-022 Homogeneous Black Tall Pitched Roof-Tar Hot Mop Paper 10A Non=Fibrous 166% z1."� Cfrysotile <1% 21056679-023 Heterogeneous H ,.CRoof-Buik-U .Roofin,' To...- 10B Non-Fibrous 100% <1% Chrysotile <1% 21056679-024 Heterogeneous Black HVAC Roof-Built-Up Roofing Total: <1% Analyst: Approved Signatory: Analysis Date: 10/26/2021 Date: 10/26/2021 10501 Trade Ct.,N.Chesterfield,VA 232361804.897.1177 Fax:804.897.00701 www.SanA!r.com I IAQ@SanAir.com Page 8 of 14 Disclaimer • Final reports cannot be reproduced, except in full,without written authorization from SanAir.The accuracy of the results of the analysis is dependent upon the method of sample procurement and information provided by the client.SanAir assumes no responsibility or liability for the manner in which the results are used or interpreted.Samples were received in good condition unless otherwise noted on the report.This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S.government. NY ELAP lab ID 11983 Revision Date 2/20/2012 Page 9 of 14 Disclaimer Final reports cannot be reproduced,except in full,without written authorization from SanAir.The accuracy of the results of the analysis is dependent upon the method of sample procurement and information provided by the client.SanAir assumes no responsibility or liability for the manner in which the results are used or interpreted.Samples were received in good condition unless otherwise noted on the report.This report may not be used by the client to claim product endorsement by NVLAP or any other agency of the U.S. government. Polarized-light microscopy is not consistently reliable in detecting asbestos in floor covering and similar non-friable organically bound materials.Quantitative transmission electron microscopy is currently the only. method that can be used to determine if this material can be considered or treated as non- asbestos containing.Under NY state regulations, None Detected by this method is inconclusive result. NY ELAP lab ID 11983 Revision Date 2/20/2012 Page 10 of 14 Disclaimer Final reports cannot be reproduced, except in full,without written authorization from SanAir.The accuracy of the results of the analysis is dependent upon the method of sample procurement and information provided by the client.SanAir assumes no responsibility or liability for the manner in which the results are used or interpreted.Samples were received in good condition unless otherwise noted on the report.This report may not be used by the client to claim product endorsement by NVLAP,AIHA or any other agency of the U.S. government; and may not be certified by every local,state and federal regulatory agency. Polarized-light microscopy is not consistently reliable in detecting asbestos in floor covering and similar non friable organically bound materials.Quantitative transmission electron microscopy is currently the only method that can be used to determine if this material can be considered or treated as non-asbestos containing. NY ELAP lab ID 11983 Revision Date 2/20/2012 Page 11 of 14 . 4 1551 Oakbridge Dr.STE B sanAkIDNunber Powhatan,VA 23139 Asbestos SanAi r 804.897.1177/888.895.1177 Chain of Custody lr1 ?1 Fall 8N.8".0070 Fo®140,Rev 2,5/18/18 V Technologies Laboratory sanair.com KAS Inc m#. 1D11I�I cajbrZachary Brockway „m=.13 Latour Ave UN=, 60 518-563-9445 s ;Plattsburgh NY 12901 D.coneetad b I IS01 I Fox#. Stateofcolle 6.NY Acco,muv:3605 P.o.xambw. lib h e •ftq I E.,Jwhd@*w-consuft.eom Banc Air Sell "13 KM EPA 60NR 93/116 ABA PCMMGSH 7400 ABIK PLM EPA 6MR 93/116(Quel.) Positive StDP Mr ABA-2 OSHA wi TWA* Vermiculite&soil ABEPA PLM EPA 400 Pont Coma ABTEM TEM AHBRA ABSP FILM CARB 435(LAD<IDA) ABB1K PLM EPA 1000 Point Camt ABATN TEM NOSH 7402 ABSP 1 PLM GARB 435(LOD 0.25%) ABBEN PIM HPANOB** AB72 TEM Leval H ABSP2 PLM CARD 435(LAD 0.1%) ABBCH TEM Chatfidd** Other. Dort ABBTM TEM EPA NOB*• New YorkELAP ABWA TPM Wipe A5TM D-6480 ABQ PIM Qualitati" ABEPA2 NY ELAP 199.1 ABDMV TEM Mictovao ASTM D-5755 *• Avai( a an 24-br.to 5-day TAT ABENY NY EW 198.6 FLU NOB Water ABBNY NY ELAP 198A TEM NOB Matrix Other ABBE I EPA 100.2 Turin Amin 3 HR(4 HR TEM) 6 HR(8HR TEM) 12 H4 1 1 24 HR limes Vas 3 Days 4 Days P65 Days Special Inetrttctton:t Volume Sample Flow Start—stop Sample a7 Sample Identilleation/l ovation or Area Date Rate* Time* Relinquished by Date Time Received by Date Time S�A [ a :R IOCK44, If no tedoldan is provided,then We primary contact for your aoeoant will be selected.Unbxs scheduled,the taraaroond tams for all samples received utter 3 pm EST will be bgEed is the neat bu dness day.Weekend or holiday work mast be selndded ahead of time AM is charged at 158%of Ike 3hr TAT or a nimlmnm eharge of $IS&A courier charge will be applied for same day and onedsy tarmro®d hoes fir oifilte work.SanAir coven Standard Overnight Piedit ddppiry.Sbipmmb bMed to SnAir with a faster shlppiag rate will malt in additional ebrges. Page � of� Page 12 of 14 Page 3 of KAS, INC., P.O. BOX 2787, 13 LATOUR AVENUE, SUITE.204, PLATTSBURGH, N 18) 583-9445 NYS ASBESTOS HANDLING LICENSE 29547 cm __!! -- co - a PROJECT NO.: 3IG�r5 lJ SAMPLER: ZA�hdl l�rockl SIGNATURE: CLIENT: Sb TLUMe( C LOCATION: x's &a cii .S KsS Ntw Yo'rt- SAMPLE TYPE: BULK TURNAROUND TIME: S" Dk-.t � Homogenous Sample Sample Location Building Surface Area HA Identification 1 � s as . 3 v 46 � SA �• • '! sa v L p t128 Cc; v :;t C v v, RELINQUISHED BY: DATE: MADI-RECEIVED BY: Date: RELINQUISHED BY:COMMENTS: DATE: RECEIVED BY; `rA(A Date: �d �� f O ' 1) NEW YORK SAMPLES,USE NYS ASBESTOS BULK SAMPLE PROTOCOLS 2) FOR TILE AND MASTIC SAMPLE MASTIC FIRST AND DO NOT SAMPLE 71LE IF MASTIC POSITIVE 3) STOP AT FIRST POSITIVE FOR EACH HOMOGENEOUS AREA(HA) cue (2105Gro 7o� Page of 3 KAS, INC., P.O. BOX 2787, 13 LATOUR AVENUE, SUITE 204, PLATTSBURGH, N 518) 563-9445 NYS ASBESTOS HANDLING LICENSE 29547 m o. PROJECT NO.: SAMPLER: SIGNATURE: CLIENT: LOCATION: SAMPLE TYPE: BULK TURNAROUND TIME: Homogenous Sample Sample Location Building Surface Area HA Identification ga Vef-CACOI O Qr Q • vIFA J, v • rr 16 • O of f RELINQUISHED BY. DATE: I RECEIVED BY: Date: RELINQUISHED BY: DATE: RECEIVED BY: Date, l COMMENTS: 1) NEW YORK SAMPLES,USE NYS ASBESTOS BULK SAMPLE PROTOCOLS 2) FOR TILE AND MASTIC SAMPLE MASTIC FIRST AND DO NOT SAMPLE TILE IF MASTIC POSITIVE 3) STOP AT FIRST POSITIVE FOR EACH HOMOGENEOUS AREA(HA)