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DEMO-0407-2022 Office Use Only DEMOLITION APPLICATION Permit#: 't� . 0 up Permit Fee: $ FJ ' �O Town ofCLeensbury Invoice#: 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.gueensbury.net Flood Zone? Y N Reviewed By: Demolition Location: 4 Y /2-96 Tax Map ID#: Z- • I a `t17 *AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: oA- i4VUV1 "�rw,n-�� � /tr vq 1. Where will demolition material be disposed? 1 e9 R!�.5 �"l 9 2. Type of structure to be demolished: a. Residence_ d. Storage Building b. Garage +/ e. Other: IE C L u v c. Business U V 3. What type of utilities are connected to the structure: JUN 2 9 2022 a. Gas f. Well-Water Pump TOWN OF QUEENSBURY b. Fuel Oil g. Public Sewer BUILDING & CO c. Propane h. Other 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: �P SIGNATURE: DATE: Z' `1 Zy Demolition Application Revised February 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): -�54,e, 9/1 Mailing Address, C/S/Z: 7� 9 l��J'� L. C: �c >°e _ 7Z �S Cell Phone: Ili - Z 0!g - ,5L&9 Land Line: A Email: ✓rA 0 @ S4�c ao euv1 • Primary Owner(s): Name(s): -�5---y1--0- Gc `J--/,Ptj 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): � ,r© urn ( (��»�'(/1 a►�cQ 1�w G ✓ 2.0 Contractor Trade: Mailing Address, C/S/Z: 2`2 o I T� /Z ' 3? Cell Phone: 51 E; - 1-476,�> --Zr�V,54 Land Line: Email: ,/' o U" z , �� G� "Workers' Comp documenta ion must be submitted with this application" Contact Person for any questions regarding this project: - Cell Phone: 9 1-�' Z-t-90' 54o 0`1 Land Line: Email: C1 ;V fi -! V76? et- 610 Owl Demolition Application Revised February 2022 FILEG - F1'8 Blackberry Lane CLEARVUueensbury, NY 12804 rvan@clearvuinspections.com IiVSAECTt0NS .TOWN OF QJEEi�SB1�ll=Y 1�518.832.9213 BIJILDIh:G & C ODDS P�- ieWe 1='y: Pre-b4a61itio-n - ebstos Survey -:r f `�•�.��f M'••w•: � - �bt-Y<ti� xdp ;� '`tom,'?' "•k, k,as;;` '�''4�Y.,. '"vfl'�" 'iv' '� ¢ya�.t�jv�{d" ;f2c`�3By���• ."'J 'v9 "Y�a"''•�,a';..MCj��t;;,• rYf � r��h� fay TOWN OF QUEENSBURY BUILDING DEPARTMENT Based on our limited exami e with our comments shall not' �asNUMBER PREPARED FOR indicating the plans ands c `ions are in p� Stephen Dempsey full compliance with the BG�ainn Codes of New York State, 3239 State Route 9L co o SITE LOCATION Lake George, NY 12845 0� C 3239 State Route 9L :Z: Lake George, New York 12845 PREPARED BY (10 Ryan Wild C-y� 18 Blackberry Lane p'!) � 239.18-1-49 DEMO-0407-2022 Queensbury, New York 12804 Dempsey, Steve 3239 State Rte 9L Demolition of garage Stephen Dempsey,3239 State Route 9L,Lake George,New York,12845 June 23.2022 Executive Summary Asbestos-Containing'Material Field Survey 3239 State Route 9L Garage due to be demoed,already partially demoed. 3239 State Route 9L Lake George, New York, 12845 I. SUMMARY OF FINDINGS On June 15, 2022,an asbestos-containing material (ACM)field survey was conducted at 3239 State Route 9L located in Lake George, 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 Stephen Dempsey. 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 14 samples were collected from 6 suspect homogenous materials. Summary Table of Asbestos-Containing Materials Sample;tB *;A � "pace";Tdati�e Numerical;-Resuit "Werial"Gategory:, '4fiabili 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 8 Stephen Dempsey,3239 State Route 9L,Lake George,New York,12845 June 23.2022 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Stephen Dempsey 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 8 Stephen Dempsey,3239 State Route 9L,Lake George,New York,12845 June 23.2022 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(<I%) 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 8 • 1 l _\ r_ Stephen Dempsey,3239 State Route 9L,Lake George,New York,12845 June 23.2022 Appendix A: ACM Homogenous Area Table a a# idw .., Ma#eriat=p. "-.Space;Name: Sec#ionNameY;,.,. F�iabili. `" Curren#Condition #tesut#s Quanti"';' ;' There are no homogenous materials for this project that are assumed or have tested positive containing asbestos Page 5 of 8 Stephen Dempsey,3239 State Route 9L,Lake George,New York,12845 June 23.2022 Appendix B: Tested Negative Homogenous Material Table m�su 6aid6ft, " - 1 11 3, Ft MOW! 'WaRnwelill' tibrialO.-O.B. •IRAIPEAW ory .1.,;'m V, "Up"il-I I N• li�- 4 ate 1.go V Miscellaneous 003 003-Concrete Garage Garage Tested Negative by Lab(No Asbestos Detected) Miscellaneous 004 004-Felt Garage Garage Tested Negative by Lab(No Asbestos Detected) Miscellaneous 002 002-Gypsum Wallboard Garage Garage Tested Negative by Lab(No Asbestos Detected) Miscellaneous 001 001-Joint Compound Garage Garage Tested Negative by Lab(No Asbestos w/Tape Detected) Miscellaneous 006 006-Roofing Membrane Roof Garage Tested Negative by Lab(No Asbestos Detected) Miscellaneous 005 005-Roofing,Composite Roof Garage Tested Negative by Lab(No Asbestos Shingle Detected) Page 6 of 8 Stephen Dempsey,3239 State Route 9L,Lake George,New York,12845 June 23.2022 Appendix C: All Suspect Materials Sampled ri R m on,I,,,.­..'.'!I"y"I" a a ' ' - Sam pil e FW105 ':.Result.-F.t; alma to "'I orps "i6t; "IM: RIM ,Name ....... 001A Garage Garage Multi-layer Parent Material OOIA-Joint Garage Garage 001-Joint Compound 0% Tested Negative by Lab(No Compound w/Tape Asbestos Detected) 001A-Tape Garage Garage 001-Joint Compound 0% Tested Negative by Lab(No w/Tape Asbestos Detected) 001B Garage Garage Multi-layer Parent Material OOIB-Joint Garage Garage 001-Joint Compound 0% Tested Negative by Lab(No Compound w/Tape Asbestos Detected) 001E-Tape Garage Garage 001-Joint Compound 0% Tested Negative by Lab(No w/Tape Asbestos Detected) 002A Garage Garage 002-Gypsum Wallboard 0% Tested Negative by Lab(No Asbestos Detected) 002E Garage Garage 002-Gypsum Wallboard 0% Tested Negative by Lab(No Asbestos Detected) 003A Garage Garage 003-Concrete 0% Tested Negative by Lab(No Asbestos Detected) 003E Garage Garage 003-Concrete 0% Tested Negative by Lab(No Asbestos Detected) 004A Garage Garage 004-Felt 0% Tested Negative by Lab(No Asbestos Detected) 004B Garage Garage 004-Felt 0% Tested Negative by Lab(No Asbestos Detected) 005A Roof Garage 005-Roofing,Composite 0% Tested Negative by Lab(No Shingle Asbestos Detected) 005B Roof Garage 005-Roofing,Composite 0% Tested Negative by Lab(No Shingle Asbestos Detected) 006A Roof Garage 006-Roofing Membrane 0% Tested Negative by Lab(No Asbestos Detected) 006B Roof Garage 006-Roofing Membrane 0% Tested Negative by Lab(No Asbestos Detected) Page 7 of 8 Stephen Dempsey,3239 State Route 9L,Lake George,New York,12845 June 23.2022 Appendix D: Chain of Cusody&Laboratory Report Page 8 of 8 �f2,2a�3(0 2°��N�9� II! Ilil !I Illli 1 I it ill! lllil 1 I�I C�E �U 12 MN8G47 srssicases Chain of Custody ClearVV Inspections 18 Blackberry Lane Project:10117 Queensbury,New York 12804 Site Location:3239 State Route 9L 3239 State Route 9L _ Lake George,.NewYork 12845 rcrapt samples T� Sampled By:Ryan Wild(cyan@clearwinspections.com) Reporting By:Ryan Wild(ryan@cleanrttinspections.com) Purpose:Pre-Demolition Laboratory Notes Turn-Around Time Request Gia!'—��3fi7"„1k!TG,'91f�eT.3_r9.3'.;fn—•'CS?�+V'iE11$•44�6k1:tG:"�— flE Stop after first positive for each HM 5 day Samples Sample ID Material Floor/Section Space Analysis NY ELAP 198.1 & 001A 001 -Joint Compound w/Tape Garage Garage 198A PLM&TEM where applicable NY ELAP 198.1 & 001E 001-Joint Compound wrrape Garage Garage 198.4 PLM&TEM where applicable NYELAP 198.1 & 002A 002-Gypsum Wallboard Garage Garage 198A PLM&TEM where applicable NY ELAP 198.1 & 002B 002-Gypsum Wallboard Garage Garage 198.4 PLM&TEM where applicable NY ELAP 198.1& 003A 003-Concrete Garage Garage 198.4 PLM&TEM where applicable CiearVU Inspections-Chain of Custody For Stephen Dempsey 3239 State Route 9L-10117 1 of 3 Sample ID Material Floor/Section Space Analysis NY FLAP 198.1 & 003E 003-Concrete Garage Garage 198.4 PLM&TEM where applicable NYELAP 198.1 & 004A 004-Felt Garage Garage 198.4 PLM&TEM where applicable NY FLAP 198.1 & 004E 004-Felt Garage Garage 198A PLM&TEM where applicable NYELAP 198.1& 005A 005-Roofing,Composite Shingle Garage Roof 198A PLM&TEM where applicable NYELAP 198.1 & 005E 005-Roofing,Composite Shingle Garage Roof 198A PLM&TEM when:applicable NYELAP 198.1 & 006A 006-Roofing Membrane Garage Roof 198.4 PLM&TEM where applicable NY ELAP 198.1 & 006E 006-Roofing Membrane Garage Roof 198.4 PLM&TEM where applicable f CIearVU Inspections-Chain of Custody For Stephen Dempsey 3239 State Route 9L-10117 2 of 3 e, Q. C�, -0 6.15.2022 15:00 Sampled By Date Time Received By Date Time Received By Date Time Received By Date Time UL,.:D 6.15.2022 16:00 _} Relinquished By Date Ttme Relinquished By Date Time Relinquished By Date Time l Analysis By Date Time I I ClearVU Inspections-Chain of Custody For Stephen Dempsey 3239 State Route 9L-10117 3 of 3 tiff e u rof i n s CEI June 23, 2022 ClearVU Inspections 18 Blackberry Lane Queensbury, NY 12804 CLIENT PROJECT: 10117 LAB CODE: N220136 Dear Customer: Enclosed are asbestos analysis results for Asbestos Bulk samples received at our laboratory . on June 16, 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 (AGMs) 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, Tianbao Bai, Ph.D., CIH Laboratory Director NV(A TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 e u rofi n s CI ASBESTOS ANALYTICAL REPORT By: New York State ELAP Method Prepared for ClearVU Inspections CLIENT PROJECT: 10117 LAB CODE: N220136 TEST METHOD: NYS ELAP METHODS 198.1, 198.4 REPORT DATE: 06/23/22 TOTAL LAYERS ANALYZED: 14 # LAYERS >1% ASBESTOS: 0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Asbestos Report Summary ti.v e u rof i n s By: NEW YORK STATE METHOD CEI PROJECT: 10117 LAB CODE: N220136 ASBESTOS BULK, NEW YORK STATE METHODS ":'Clibnt ID";"" ; Lab 10'';', ; Color Sample"Description " Tota1 Asbestos%; 001A N2088A White Joint Compound No Asbestos Detected.0% ------------------------------------- --- ------- ---------------- N2088B Gray,Yellow Tape No Asbestos Detected.0% 001 B N2089A White Joint Compound No Asbestos Detected.0% --------------------------------------------------------------- N2089B Gray,Yellow Tape No Asbestos Detected.0% 002A N2090 White, Brown Gypsum Wallboard No Asbestos Detected.0% 002E N2091 White, Brown Gypsum Wallboard No Asbestos Detected.0% 003A N2092 Gray Concrete No Asbestos Detected.0% 003E N2093 Gray Concrete No Asbestos Detected.0% 004A N2094 Black Felt No Asbestos Detected by 198.4 004B N2095 Black Felt No Asbestos Detected by 198.4 005A N2096 Gray, Red Composite Shingle No Asbestos Detected by 198.4 005E N2097 Gray, Red Composite Shingle No Asbestos Detected by 198.4 006A N2098 Black,White Roof Membrane No Asbestos Detected by 198.4 006B N2099 Beige,White Roof Membrane No Asbestos Detected by 198.4 Page 1 of 1 ASBESTOS BULK ANALYSIS e u rofi n S By: NEW YORK STATE METHOD CI Client: ClearVU Inspections Lab Code: N220136 18 Blackberry Lane Date Received: 06-16-22 Queensbury, NY 12804 Date Analyzed: 06-23-22 Date Reported: 06-23-22 Project: 10117 ASBESTOS BULK, NEW YORK STATE METHODS Client IB'. l ayer'Numlier o Lab I,D Lab,;Desc�iption..".Ca tie.gory Color., 001A 1 Friable White Initial Observations: N2088A Joint Compound Binder 60% Calc Carb 40% Method: Final Results: 198.1 No Asbestos Detectd'obtal Asbestos: No Asbestos Detected.0% ----------------------------------- ------ ------------- -- - --------- N2088B 2 Friable Gray, Initial Observations: Tape Yellow Fiberglass 20% Paint 80% Method: Final Results: 198.1 No Asbestos Detect(TiOtal Asbestos: No Asbestos Detected.0% 001B 1 Friable White Initial Observations: N2089A Joint Compound Binder 60% Calc Carb 40% Method: Final Results: 198.1 No Asbestos DetectEcttal Asbestos: No Asbestos Detected.0% ----------------------------------- - ------ ---- - -- - -- ----- ----- - -- - N2089B 2 Friable Gray, Initial Observations: Tape Yellow Fiberglass 20%. Paint 80% Method: Final Results: 198.1 No Asbestos Detect(Tcbtal Asbestos: No Asbestos Detected.0% Page 1 of 6 ASBESTOS BULK ANALYSIS le u rof i n s By: NEW YORK STATE METHOD CI Client: ClearVU Inspections Lab Code: N220136 18 Blackberry Lane Date Received: 06-16-22 Queensbury, NY 12804 Date Analyzed: 06-23-22 Date Reported: 06-23-22 Project: 10117 ASBESTOS BULK, NEW YORK STATE METHODS kclient=lD'. . -L.aysrNum-ber,`ab iD ' Lab'Des'64 tian,,Category Color 002A Gypsum Friable White, Initial Observations: N2090 Wallboard Brown Cellulose 15% Gypsum 85% Method: Final Results: 198.1 No Asbestos Detect6fttal Asbestos: No Asbestos Detected.0% 002B Gypsum Friable 'White, Initial Observations: N2091 Wallboard Brown Cellulose 15% Gypsum 85% Method: Final Results: 198.1 No Asbestos Detect(Tabtal Asbestos: No Asbestos Detected.0% 003A Concrete Friable Gray Initial Observations: N2092 Silicates 75% Binder 25% Method: Final Results: 198.1 No Asbestos Detectdfttal Asbestos: No Asbestos Detected.0% 003E Concrete Friable Gray Initial Observations: N2093 Silicates 75% Binder 25% Method: Final Results: 198.1 No Asbestos DetectXabtal Asbestos: No Asbestos Detected.0% Page 2 of 6 1 ASBESTOS BULK ANALYSIS 1� e u r®fins By: NEW YORK STATE METHOD C1 Client: ClearVU Inspections Lab Code: N220136 18 Blackberry Lane Date Received: 06-16-22 Queensbury, NY 12804 Date Analyzed:, 06-23-22 Date Reported: 06-23-22 Project: 10117 ASBESTOS BULK, NEW YORK STATE METHODS Client 1D°` :'Layer Nunntier: Lab ID,," `:a:ab Descriptio„n=•,>.Gategorq, Goliir;:;:•:.. 004A Felt NOB Black Initial Observations: N2094 Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 004B Felt NOB Black Initial Observations: N2095 Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 006A Composite NOB Gray, Red Initial Observations: N2096 Shingle Fiberglass 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 3 of 6 1 ASBESTOS BULK ANALYSIS � . e u rof i n s By: NEW YORK STATE METHOD CI Client: ClearVU Inspections Lab Code: N220136 18 Blackberry Lane Date Received: 06-16-22 Queensbury, NY 12804 Date Analyzed: 06-23-22 Date Reported: 06-23-22 Project: 10117 ASBESTOS BULK, NEW YORK STATE METHODS Client ID: Layer,Number l.ab`ID Lab.Description `.Category Golor` . 005B Composite NOB Gray, Red Initial Observations: N2097 Shingle Fiberglass 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 006A Roof Membrane NOB Black, Initial Observations: N2098 White Fiberglass 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 006B Roof Membrane NOB Beige, Initial Observations: N2099 White Fiberglass 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 4 of 6 ti®ti eurofins ICEI 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: > 9% by weight 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 5 of 6 ti®ti 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): Brunilda Gjoka-9198.4 tee a-=. 98.1 APPROVED BN Tianbao Bai, Ph.D., Cl Laboratory Director ?4vt TESTING NVLAP LAB CODE 101768-0- 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 6 of 6 New--York State=`Department-of,Labor , Division of;Sa'iety and Health j t License and Ceitificate;Unit, tt State Campus,Building 12 ° Albany,NY 12240 ASBESTOS HANDLING LICENSE ` .` Creative.Spaces II,•L•LC dba ClearVU`Inspections-� -=FILE NUMBER: ' ' " rLICENSE NUMBER:` I 4L,"—.,�.,;fit``•'' r--�} '^ / ;z5� ' ��"x=' I LICENSE CLASS: RESTRICTED; ' ;18-Bla& erri Lane. 4 �. `DATE OF ISSUE: 01/28%2022 ,•' r "' EXPIRATION DATE: 01/31/2023 Obeehsbury,NY 12804� r._: �':J r�rz.,at, 1 Pf � _ � .a r' �,f�-�4'\;_'1 1'� ..�-•-:,�Tp�_.v.�_''-`4:\i t~_ .+.\ ',' ' • /"f' t ' ?`•;�'I Jy h f_ ,:,r-r"-�.c772 '.7I�,^,i, '^x.`•#� �-^(i`:.—.r�'—•�: i '°,°q'� t 11,fhf',,, rill j Duly�Authorized Representatives, ;Ryani VViId; a- �' 1 ;'; Il �r,,,::ram;,,,... ,\•.,.....; a, 6.: r. , t_ �'-•ir; l;' �". �i�'i',,, � 1,-;r i : This license has been.issued in accordancejwith'appFlicable=provisions of Aitrcle 301'of the Labor Law of New York`•State and of ? the New York State,Codes,Rules and'Regulations:S12.NYCCRR Part 56):`It rs,s'eject to suspension or r ' ocation�for a(1) ; 1 serious violation;of state,federal or local laws with regard�to$:the conduct;of an asliestosiproject,or(2)demonstrat djack of j l responsibility in the conduct of any Job,!in"ol/.ing'asi)estos or asbestos material t This license is.valid only for the contractor named:above and-th icense or'.a photocopy-must_be_promineritly displayed at the asbestos project worksite.`Thi's`license verifies thafall persons-ernploy-ed"by the licensee on an-asbestos project-in New'York r ;, , State have been•issued an Asbestos Certificate;-appropriate for the,,type-of-work they perform,by the New York State'/ .' Department of Labor P p Amy Phillips,Director SH 432(8/12) For the Commissioner of Labor STATE OF NEW YORK-DEPARTMENT OF LABOR, ASBESTOS CERTIFICATE RYAN-P--WILD CLASS(EXPIRES) C ATEC(05/23) D INSP(05/23);;_. r" H PM (05/23): I PD (05/23)'="" CERT# 21,:01428 DMV.7f 173699618', MUST BE CARRIED ON ASBESTOS PROJECTS IIIIIIII I I"II I'll'lllll I III IF FOUND RETURN TO: — EYES BRO NYSDOL - L&C UNIT .°. HAIR BRO, ROOM 161A BUILDING 12 N HGT 6' 03" STATE OFFICE CAMPUS � o —o ALBANY NY 12240 N I RYAN WILD License #160a0085839 . CLEARVU I N S P E C T I O N S J V- ENT OF. A - H : WADSWORTH'CENTER k -12:0 li6qP -1 AM ftfll OtW23-�..P Ssudd..-Apri 01,2022 CERTIFICATE APPROVAL FOR LABORATORY SERVICE Issued In accordiince with and pursuant to section 502 Public.-Health LAw of New York State 'TIA NBA 0 BA - NY Lab Id No:12048.--.. EUROFINS CEf, NC;- _ 730BEWYNARDROAD 7 CAM-M, NC 27eff'- an`-EnvironmeFnta1Laboratory fof the category -SEgSOLIDAND-HA HAZARDOUS ENVIRONMENTAL ANAE-Y Zq WASTE -and All ca apprqyed sub te-godes- loraanalytes are listed beloW. 7 _7 --misdallaneous Asbestos In Fftle Material Item 198.1 of Manual.* --EPA 60b1M4/8W020 Asbeit&s IftN- 66-Friable MateiW-PENI (N­0i3byPLM�-.`?. item 198.6 of Manual Asbestos In Non-Fdable Material-TEM Item 198.4 of Manual 'Asbei6&VermIcuIIte-6nid1nRhg Nhitedal Item 198.8 of Manual Serial No.-!..-64946 P the address== Property New York State D ap["entbf Health- are on(yat j shshown;mustust be.conspIcuously posted;end are printed o L n secure paper. Continued accreditatton depends -_on suc4r?�I.cngolngpa- a n In the Program:consurriers are urged to c&I(510-48"54pp rem 9 tu . - verify the laboraT Ws EFccfedita orf-sta a Page 1 of 1 Z7 W N m 0 �- •`_'. 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