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DEMO-0051-2023
office Use-Only : DEMOLITION APPLICATION : Permit#; ���1b%bb51 -Zo23 Permit Fee:$ Town of Qucensbury: Invoice#: L 742 Bay Road,.Queensbury;NY 12804 P:518-761=8256 ' www.pueensbury.net: Flood Zone? Y. N Reviewed By: AL rr� _ Demolition Location: t � 1 (�. 1 _Taz Map ID#c . AN ASBESTOS:REPORT IS REQUIRED WITKALL' . DEMOLITION APPLICATION: SUBMISSIONS:** DEMOLITION"INFORMATION:. AW 1AJ )h L 1._. Where will.de' olition'rnaterlal be disposed? 2. Type of structure" demolished: D :IE .Q .� a. Res -:d:Storage.Building.: . " b.: :Garage e:Other: FEB. a•7.2023 c. Business. TOWN OF QUEENSSURY 3. What t type . iliti,es:are.connected to the structure: BUILDING&CODES k a._ Gas ;: . :f.Well=Water P b. Fl.uel Oil• g. Public Sewer c.: Propan .. 'h:Othe 11� L7t d.; 'Electric is None. : e. Public Water .4. Have ALL.utilities (water,electric;etc.-).been-disconnected? "Yes" No: ADDITIONAL:IN FORMATION: 1. Two inspecti.onS.are required: -an ins' ecti-on-to determine that utilities are.- disconnected, and afinal: inspection after the structure is removed and the site is Cleaned up.and graded. 2. Twenty=four (24) hour notification is .required1or 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'md.approved by the Town*of Queensbury Building&Code Enforeemerit and Zoning Departments and.a permit has been issued-. have read an agree to the : ove: PRINT NAME: I N SIGNATURE: All DATE: :r J o Demolition Application Revised June 2622 CONTACT.INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL. a Applicant• �-roacpwfl-nl (I Lr-)nc�� M 1111111?� Name(s): LG Mailing Address;C/S/Z: Lk 0. ulla. Cell Phone: Land Line: � i�S- 7� . =q 1 � ?S Email:. . . Primary Owner(s): Names)_ r f Mailing;Address, C/S/ ST J Cell Phone:.:: Land:bne:: � C Check-if:all work will be : erformed b ro ert owner onl o Y p p Y �C Contractor: (List all add itional.contractors o.n the back.of this form) . Coritact Narie(s): Contractor:Trade: . . . Mai.li.ng Add.ress;:C/S/Z Cell Phone* :.. . . . . Land Line: : -mail: **-Workers'.Comp .documentation. must be-submitted.with this application*.*. . /U Contact Person.for any questions regarding this project: _ Cell Rhone: .v — Land Line:. �� j �" ���'��u 3� Email: � ? tDoj . Demolition Application Revised june.2d22 P044 D c Lane +� [9 , NY 12804 CLE' ARVU FEBan c,�I a uins ections.com INSPECTIONS B 1320318k 13 -- TOWN OF QUCENSgURY BUILDING& CODES _ = Pre-Demolition Asbestos rvev_ TOWN Op 01!r'7YSBURY _ BUILDU461,Ei,,RTMENT Based on our limited examination compliance With ou. comments shall not be construed as FILE COPY -indicating the plans and sppecifications are in - fdelw YmpHance with -thee PROJECT NUMBER PREPARED-FOR 10115 Tracey Holdings LLC 280 Corinth Road--- SITE LOCATION Queensbury,Queensbury 12804 Single Family Dwelling Detached garage — �� PREPARED BY 283 Corinth Road Ryan Wild -- - - - - - -Queensbury,New York 12804--.--- - 18 Blackberry Lane---~------ -~ -- - --- Queensbury, New York 12804 TOWN OF QUEENSBURY ; BUILDING & CODEDEPT. Reviewed y: Date: �- ' Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 Executive Summary Asbestos-Containing Material Field Survey Single Family Dwelling&Detached Garage 283 Corinth Road Queensbury, New York, 12804 I. SUMMARY OF FINDINGS • e On June 02,2022,an asbestos-containing material(ACM)field survey was conducted at 283 Corinth Road located in Queensbury, New York_(Site):The_Site was inspected to determine..tlie presence of ACM in preparation for renovation. The ACM survey was performed at the request.of Tracey Holdings LLC. 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 94 samples . were collected from 36 suspect homogenous materials. Summary Table of Asbestos-Containing Materials y; I lC? p Name N Result JCategory Friability Quarttti s 008-Caulk,Window Exterior 25% Miscellaneous Non-Friable 16 Units 1 7 SF 009-Sealant,-Window Pane Glazing Basement Windows 1.3% Miscellaneous, Friable 6 Units I 1 SF 020-Gray Wallpaper* Living Room 4% Miscellaneous_ Non-Friable 400 SF ***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.A photographic log is provided in Appendix D of this report.The original chain of custody&laboratory analytical reports are located in Appendix E of this report. Page 2 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Tracey Holdings LLC 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 pu-rpose 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-shouldobe assumed asbestos containing until a representative number of samples are collected to document these materials as non-asbestos-containing.Return sampling is billed at$350,plus laboratory analysis fees. 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 --_materia Is,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 15 Tracey Holdings LLC,293 Corinth Road,Queensbury,New York,12804 June 16,2022 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(<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(<I%)-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' 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 w y exist which could not be as prepared. It is possible that conditions ma --identified within.the scope of the surveyor which were not apparent during the site visit: Page 4 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 l `June 16,2022 Appendix A: ACM Homogenous Area Table 71dir Ititlate Spa `# . e, ec#ion Fialatiurr+;r►.. t � �.� _ 008 008-Caulk,Window Exterior Interior Unclassified Damaged Greater Than 1% Asbestos by Lab(ACM) 009 009-Sealant, Basement Interior Unclassified Intact Greater Than 1% Window Pane Windows Asbestos by Lab(ACM) Glazing 020 020-Gray Wallpaper Living Room Interior Unclassified Intact Greater Than 1% -Asbestos by Lab(ACM) 036 036-White Sealant, Garage Interior Unclassified Damaged Less Than or Equal to Window Pane 1%Asbestos by Lab Glazing _ (Trace) Page 5 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 Appendix B: Tested Negative Homogenous Material Table i W17 or Id Miscellaneous 001 001-Brown Roofing, Back Porch Exterior Tested Negative by Lab(No Composite Shingle Asbestos Detected) Miscellaneous 002 002-Black Felt Back Porch Exterior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 003 003-Green Roofing, Back Porch Exterior Tested Negative by Lab(No Composite Shingle Asbestos Detected) Miscellaneous 004 004-Green Roofing, Front Porch Exterior Tested Negative by Lab(No Composite Shingle Asbestos Detected) Miscellaneous 005 005-Black Roofing Paper/Felt Front Porch Exterior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 006 006-Masonry Block(CMU) Exterior Interior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 007 007-Masonry Block Mortar Exterior Interior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 010 010-Green Wallpaper southern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous Oil Oil-White Wall Tile&Grout southern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous 012 012-Shower caulk southern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous- .013 013-Joint Compound w/Tape -basement Interior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 013 013-Joint Compound w/Tape Kitchen Interior tested Negative by Lab(No Asbestos Detected) Miscellaneous 013 013-Joint Compound w/Tape northern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous 013 013-Joint Compound w/Tape southern Interior Tested Negative by Lab(No bathroom- - - Asbestos Detected) Miscellaneous 014 014-Gypsum Wallboard basement Interior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 014 014-Gypsum Wallboard Kitchen Interior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 014 014-Gypsum Wallboard southern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous 015 015-Beige Floor Tile southern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous 016 016-Blue Green Floor Tile wl, southern Interior Tested Negative by Lab(No Adhesive bathroom Asbestos Detected) Miscellaneous 017 017-Beige Floor,Sheet Vinyl Laundry Room Interior Tested Negative by Lab(No Paper Backing Asbestos Detected) Surfacing 018 018-Wallpaper southern Interior tested Nedative by Lab(No Material bedroom Asbestos Detected) Miscellaneous 019 019-Wallpaper Living Room Interior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 021 021-Beige Wallpaper Kitchen Interior Tested Negative by Lab(No Asbestos Detected), Miscellaneous 022 022-Red Wallpaper Kitchen Interior Tested Negative by Lab(No Asbestos Detected) Page 6 of 15 i Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 ItAate � iGs■fE }1,.`(3jt F,., ! %i `.; n#, r,, r ii:^x v', IV18t�rrarf' StGI<107! +$}18Ce'NaF17E' i Categ Id r x, +�ss �a Myn ,v; .ra7 ,f:✓s';1'f RR'�":• .KiP:�.'%��':.:'�,�''z �'a'`F �;r,i7'a•.+�•w' Surfacing 023 023-Blue Wallpaper Kitchen A Interior Tested Negative by Lab(No Material Asbestos Detected) Miscellaneous 024 024-Green Vinyl Flooring northern Interior Tested Negative by Lab(No W/Adhesive bathroom Asbestos Detected) Miscellaneous 025, 025-Floor Tile w/Adhesive northern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous 026 026-Wallpaper northern ' Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous 027 027-Beige Wallpaper northern Interior Tested Negative by Lab(No bathroom Asbestos Detected) Miscellaneous 027 027-Beige Wallpaper northern Interior Tested Negative by Lab(No bedroom Asbestos Detected) Miscellaneous ,. 028- 028-Blue Green Wallpaper northern Interior Tested Negative by Lab(No _ bedroom Asbestos Detected) Miscellaneous 029 029-Red Wallpaper northern Interior Tested Negative by Lab(No bedroom Asbestos Detected) Miscellaneous 030 030-Cork Ceiling.Tile Living Room Interior Tested Negative by Lab(No Asbestos Detected) Miscellaneous 031 031-Blue Wallpaper basement Interior- Tested Negative by Lab(No bedroom Asbestos Detected) Miscellaneous 032 032-Red green white basement Interior Tested Negative by Lab(No Wallpaper bedroom. Asbestos Detected) _ Miscellaneous, 034. 034-Red gray..Wallpaper basement Interior. Tested Negative:by Lab(No - bedroom Asbestos Detected) _ Miscellaneous 035 035-Black Roofing Paper/Felt 'Garage Interior Tested Negative by-Lab(No Asbestos Detected) Page 7 of 15 Tracey Holdings LLQ,283 Corinth Road,Queensbury,Ne*w York,12804 June 16,2022 Appendix C: All Suspect Materials Sampled M't' i'vota-R -Oli g- a ry" esuw, a�ez'*N" arne 001A Back Porch Exterior 001-Brown Roofing, 0% Tested Negative by Lab(No Composite Shingle Asbestos Detected) 001E Back Porch Exterior 001-Brown Roofing, 0% Tested Negative by Lab(No Composite Shingle Asbestos Detected) 002A Back Porch Exterior 002-Black Felt 0% Tested Negative by Lab(No - Asbestos Detected) 002B Back Porch Exterior 002-Black Felt 0% Tested Negative by,Lab(No Asbestos Detected) 003A Back Porch Exterior 003-Green Roofing, 0%. tested Negative by Lab(No Composite Shingle Asbestos Detected) 003E ;.!Back Porch Exterior 003-Green Roofing, OW Tested Negative by Lab(No Composite Shingle Asbestos Detected) 004A Front Porch- Exterior 004-Green Roofing, 0% Tested Negative by Lab(No Composite Shingle Asbestos Detected) 004B Front Porch Exterior. 004-Green Roofing, 0% Tested Negative by Lab(No Composite Shingle Asbestos Detected) 005A Front Porch Exterior 005-Black Roofing 0% Tested Negative byLab(No Paper/Pelt Asbestos Detected) 005B Front Porch Exterior= 005-Black Roofing 0% Tested Negative by Lab(No Paper/Felt Asbestos;Detected) 006A Exterior Interior 006-Masonry Block 0% Tested Negative by Lab(No - - -(CMU) Asbestos Detected) 006B Exterior.. . Interior 006-Masonry Block 0% -rested Negative by Lab'(No- (CMU) Asbestos Detected) 007A Exterior Interior 007-Masonry Block 0% Tested Negative by Lab(No Mortar Asbestos Detected) 007E Exterior Interior 007 Masonry Block 0% Tested Negative by Lab(No --Mortar Asbestos=Detectecl) 008A Exterior Interior 008-Caulk,Window 25%Clirysotile Greater Than 1%Asbestos (Serpentine group) by Lab(ACM) 008E Exterior Interior 008-Caulk,Window N/A Assumed Positive(Not Tested by Lab) 009A basement Interior 009-Sealant,Window 1.3%Chrysotile Greater Than 1%Asbestos Pane Glazing (Serpentine group) by Lab(ACM) 009E basement Interior 009-Sealant,Window N/A Assumed Positive(Not Pane Glazing Tested by Lab) 010A southern Interior 010-Green Wallpaper_ 0% Tested Negative by Lab(No _ bathroom Asbestos Detected) 01013 southern Interior 010-Green Wallpaper 0% Tested Negative by Lab(No —bathroom Asbestos Detected) 011A southern Interior Multi-layer Parent bathroom Material 011A-Grodt southern Interior 011-White Wall Tile& 0% Tested Negative by Lab(No bathroom Grout Asbestos Detected) . 011A-Mastic southern Interior 011-White Wall Tile& 0% Tested Negative by Lab(No bathroom Grout Asbestos Detected) 011A-Mud southern Interior 011-White Wall.Tile 0% Tested Negative by Lab(No ---- ---—-1 --- bathroom Grout Asbestos Detected) Page 8 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,3022 "W"ANS Sew te'#R .V41—WA, W-M 's "7, ,4147,; 011A-Tile southern Interior 011-White Wall Tile& 0% Tested Negative by Lab(No bathroom . . I Grout Asbestos Detected) 01113 southern Interior Multi-layer Parent bathroom Material 011B-Grout southern Interior 011-White Wall Tile& 0%Mixed N/A bathroom Grout __O% Tested Negativebyla-b(No Asbestos Detected) 0% Tested Negative by Lab(No Asbestos Detected) 011B-Mastic southern Interior 011-White Wall Tile& 0% Tested Negative by Lab(No bathroom Grout Asbestos Detected) 011B-Mud southern Interior 011-White Wall Tile& 0% Tested Negative by Lab(No bathroom Grout Asbestos Detected) 01113-Tile southern Interior 011-White Wall Tile& 0% Tested Negative by Lab(No bathroom Grout Asbestos Detected) 012A 'southern Interior 012-Shower caulk 0% Tested Negative by Lab(No bathroom Asbestos Detected) 012E southern Interior 012-Shower caulk 0% Tested Negative by Lab(No bathroom Asbestos Detected) 013A southern Interior Multi-layer Parent bathroom Material 013A r Joint southern Interior- 011-White Wall Tile& 0% Tested Negative by Lab(No Compound bathroom- Grout -Asbestos.Detecte d) 013A-Tape southern Interior. T -0137 Joint Compound b% Tested Negative by Lab(No bathroom w/Tape Asbestos Detected) 013E 'basement Interior Multi-layer Parent Material 01313-Joint basement Interior 013-Joint Compound 0% Tested Negative by Lab(No Compound w/Tape Asbestos Detected) ....01313_-Tape basement- Interior— -.013-Joint Compound Tested Negative by-Lab(No w/Tape Asbestos Detected) 013C Kitchen Interior Multi-layer Parent Material 013C-Joint Kitchen Interior 013-Joint Compound 0% Tested Negative by Lab(No Compound w/Tape Asbestos Detected) 013C-Tape Kitchen Interior 013-Joint Compound 0% Tested Negative by Lab(No w/Tape Asbestos Detected) 013D northern Interior Multi-layer Parent bathroom -Material _ 013D-Joint --n&rthern Interior-- --b!3--Joint Compound 0% Tested NegatiV_e by Lab(No Compound bathroom w/Tape ' . Asbestos Detected) _ 013D-Tape northern Interior 013-Joint Compound 0% Tested Negative by Lab(No -_bathJro'o" m- ----Asbestos Detected) 014A southern Interior 014-Gypsum Wallboard 0% Tested Negative by Lab(No bathroom Asbestos Detected) 014E basement Interior 014-Gypsum Wallboard 0% Tested Negative by Lab(No Asbestos Detected) 014C Kitchen Interior 014-Gypsum Wallboard 0% Tested Negative by Lab(No Asbestos Detected) 014D------ Interi&-- -014-z-GypsUm Wallboard -----0%- Tested Negative-by Lab(No- bathroom Asbestos Detected) Page 9 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 at, ce�Name' Sectiart" nMa#eX�al Fllrraifykat=aes_ttlt afY`Resu_lt ' =: M. 015A southern Interior Multi-layer Parent bathroom Material 015A'-Adhesive southern Interior 015-Beige Floor Tile 0% Tested Negative by Lab(.No bathroom ' Asbestos Detected) 015A-Floor Tile southern Interior 015-Beige Floor Tile 0% Tested Negative by Lab(No bathroom. __ __ _ _- _I _-. _. _-.._.__..._ , _ _ _ Asbestos Detected) 015E southern Interior Multi-layer Parent bathroom Material 015E-Adhesive southern Interior 015-Beige Floor Tile 0% Tested Negative by Lab(No bathroom Asbestos Detected) 015B-Floor Tile southern Interior 015-Beige Floor Tile 0% Tested Negative by Lab(No bathroom I Asbestos-Detected) 016A southern Interior Multi-layer Parent bathroom Material 016A-Adhesive southern Interior 016-Blue Green Floor 0% Tested Negative by Lab(No bathroom' Tile w/Adhesive Asbestos Detected) 016A-Floor Tile southern Interior 016-Blue Green Floor 0% Tested Negative by Lab(No bathroom Tile W/Adhesive Asbestos Detected) _ 016B southern Interior Multi-layer Parent _ bathroom Material 016B-Adhesive southern Interior• 016-Blue Green Floor 0%_ Tested Negative by Lab(No bathroom Tile w/Adhesive Asbestos Detected). 016B-Floor Tile southern _. Interior 016_Blue Green Floor 0% Tested Negative by-Lab(No bathroom Tile'w/Adhesive Asbestos Detected) 017A Laundry. Interior 017-Beige Floor,Sheet 0% Tested Negative by Lab(No Room Vinyl Paper Backing Asbestos Detected) 017B Laundry Interior 017-Beige Floor,Sheet 0% Tested Negative by Lab(No Room Vinyl Paper Backing Asbestos Detected) 018A southern Interior 018-Wallpaper 0% Tested Negative by Lab(No --bedroom- Asbestos Detected) _-- 018B southern Interior - 018-Wallpaper 0% Tested Negative by Lab(No -bedroom Asbestos Detected) 019A Living Room Interior 019-Wallpaper 0% Tested Negative by Lab(No Asbestos Detected) 019B Living Room Interior 019-Wallpaper 0% Tested Negative by Lab(No Asbestos Detected) 020A Living Room Interior Multi-layer Parent Material 020A-Mud Living Room Interior 020-Gray Wallpaper 4%Chrysotile Greater Than 1%Asbestos --— - -- - - -- -- -- --- • - --- -- __ __ (Setpentine group) by Lab(ACM)- __- 020A- Living Room Interior 019-Wallpaper 0% Tested Negative by Lab(No Wallpaper Asbestos Detected) 020E - Living Room- Interior- —"•Multi-layer Parent - - - Material 020E-Mud Living Room Interior 020-Gray Wallpaper, N/A Assumed Positive(Not Tested by Lab) 020B- Living Room Interior 020-Gray Wallpaper 0% Tested Negative by Lab(No Wallpaper. Asbestos Detected) 021A Kitchen Interior 021-Beige Wallpaper 0% Tested Negative by Lab(No -- — - ----- -- --- --------- -- ------ ----------- ----- ----- - - ---- - - - - --Asbestos Detected)- Page A of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 ..�,..,'C.. IYf-'�Y,... 49; 63dn {-'..: 5ampter Ne echo -Mit.er7ial'` `carResutt:'> wfot}t ltesti 4 .x"�, a' t !�� # ., .r'r'r.6:�' i:'�,..,.1;.:.L ;,'y;,�'z �?�y�.�,.x,`:•�:rt.:... :�:° .��' ,�� ��'�� P-r t .,as .max 73`d.o��.a%z ..;sG-s'as, �£'i,k^, Y-.. ,/s'A4 :zz,:3n,x„M ..h.. •,.�..'�z, a,:l-., :!. f Nw';i 021E Kitchen Interior 021-Beige Wallpaper 0% Tested Negative by Lab(No Asbestos Detected) 022A Kitchen Interior 022-Red Wallpaper 0% Tested Negative by Lab(No Asbestos Detected) 022B Kitchen Interior 022-Red Wallpaper 0% Tested Negative by Lab(No Asbestos Detected) 023A Kitchen Interior 023-Blue Wallpaper 0% Tested Negative by Lab(No Asbestos Detected) 023B Kitchen Interior 023-Blue Wallpaper 0% Tested Negative by Lab(No Asbestos Detected) 024A northern Interior Multi-layer Parent bathroom Material 024A-Adhesive northern' Interior 024 "Green Vinyl 0% Tested Negative by Lab(No bathroom Flooring W/Adhesive Asbestos Detected) 024A-Vinyl northern Interior 024-Green Vinyl 0% Tested Negative by Lab(No Flooring bathroom Flooring W/Adhesive Asbestos Detected) 024B northern Interior Multi-layer Parent _ bathroom r Material 024B,-Adhesive northern - Interior -- 024-_Green Vinyl 0% Tested Negative by Lab(No bathroom - Flooring W/Adhesive Asbestos Detected) 024E-Vinyl northern Interior 024-Green Vinyl .0% Tested Negative by Lab(No = Flooring bathroom -Flooring W/Adhesive Asbestos Detected) - -025A northern Interior Multi-layer Parent _ _ bathroom Material 025A-Adhesive northern Interior 025-Floor Tile w/ 0% Tested,Negative by Lab(No bathroom Adhesive Asbestos Detected) 025A-Floor Tile northern Interior 025-Floor Tile w/ 0% Tested Negative by Lab(No bathroom Adhesive Asbestos Detected) 025E northern Interior Multi-layer Parent _ bathroom . _.---=Material -. . = m_ -- --.- 025E-Adhesive northern- - Interior 025--Floor Tile w/ 0% Tested Negative by Lab(No bathroom Adhesive Asbestos Detected) 025B-Floor Tile northern Interior' 025-Floor Tile w/ 0% Tested Negative by Lab(No bathroom Adhesive Asbestos Detected) 026A northern Interior. 026-Wallpaper 0% Tested Negative by Lab(No bathroom Asbestos Detected) 026B northern Interior 026-Wallpaper 0% Tested Negative by Lab(No bathroom Asbestos Detected) 027A northern Interior 027-Beige Wallpaper 0% Tested Negative by Lab(No bathroom Asbestos Dettected) 027B northern Interior 027-Beige Wallpaper 0% Tested Negative by Lab(No bathroom Asbestos Detected) --- - 028A - northern —Interior—Y`-028-Blue Green- --- -- -- 0% - -- ---- Tested Negative by Lati(No _- bedroom. Wallpaper Asbestos Detected) 028E northern Interior 028-Blue Green 0% Tested Negative by Lab(No bedroom Wallpaper Asbestos Detected) 029A northern Interior 029-Red Wallpaper 0% Tested Negative by Lab(No bedroom Asbestos Detected) 029B northern Interior 029-Red Wallpaper 0% Tested Negative by Lab(No 6edr66-in--- - -—Asbestos-Detected)---- ----- Page 11 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 n �5:; .y:w. ,r� ,:t;�, xr,�,'l! ,:f;,,,,ffe. a„ ..,-,�F' ;a'=,•f3r' ., z " •. .�'.,h,,, ,.0 ;."f,.,, :,(,,..:',Gai ,.E»'''..✓, w^4s ,/`�. ..i'„ .''✓ / Y' " ram 030A Living Room Interior 030-Cork Ceiling Tile 0% y Tested Negative by Lab(No Asbestos Detected) 030B Living Room Interior 030-Cork Ceiling Tile 0% Tested Negative by Lab(No Asbestos Detected) 031A basement Interior 031-Blue Wallpaper 0% Tested Negative by Lab(No bedroom Asbestos Detected) 031B basement Interior 031-Blue Wallpaper 0% Tested Negative by Lab(No. _ bedroom Asbestos Detected) 032A basement Interior 032-Red green white 0% Tested Negative by Lab(No bedroom Wallpaper Asbestos Detected) 032B basement Interior 032-Red green white 0% Tested Negative by Lab(No bedroom ' Wallpaper Asbestos Detected) 03413, basement,>_ Interior .034.2 Red gray Wallpaper 0% -Tested Negative by Lab(No bedroom Asbestos Detected) 034B basement Interior .034 Red gray Wallpaper 0% Tested Negative by Lab(No bedroom = Asbestos Detected) 035A Garage Interior 035-Black Roofing 0% Tested Negative by Lab(No Paper/Felt Asbestos Detected) _ 035E Garage Interior 035-Black Roofing 0% Tested Negative-by Lab(No Paper/Felt Asbestos Detected) 036A Garage Interior ' 036-White Sealant, 0.24%Chrysotile Less Than or.Equal to 1% - Window Pane Glazing (Serpentine group) Asbestos by Lab(Trace) .036E- Garage Interior 036-White Sealant, 0.46%Chrysotile Less Than or-Equal to-1% Window Pane Glazing (Serpentine group) -Asbestos.by Lab(Trace) - Page 12 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 Appendix D: All Location Photos southern bath'r"oom; lntenor :=T`,'sou#he�n;bed'room,,lnteriorr..' s� in .Room Interior: :Kitchen Interior ' g , northern bathroom, Interior northern-bedroom;Interior' Page 13 of 15 • Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 basement bedroom,' Interior Positive Materials 020-:Gray VVallpa°per;Living Room, Interior 080-Window Caulk E ' Y�. x A• Y 090—Window Pane Glazing Page 14 of 15 Tracey Holdings LLC,283 Corinth Road,Queensbury,New York,12804 June 16,2022 Appendix E: Chain of Cusody&Laboratory Report Page 15 of 15 , a f 22A 12� l � 11111111f 1111111-:Ill�l•11111111111111 CLEAR�u i ! OA71X3 U6PEdilM Chain,of Custody ClearVU Inspections Project: 10115 18 Blackberry Lane Queensbury,New York 12804 Site Location:Single Family Dwelling 283 Corinth Road ! SUROF1Nueensbury,New York 12804 ��9i INCa � Sampled By:Ryan Wild(ryan@clearvuinspections.com) SAMPLES ACCEiTED Reporting By:Ryan Wild.(cyan@dearvuinspections.com) Purpose:Pre-Demolition Laboratory Notes Turn Around Time Request j f Stop after first positive for each HM 5 Day ? i Samples I 1 Sample ID MaterialFloor/Section Space p rNYELAP alysis 001A 001-Brown Roofing,Composite Shingle Exterior Back Porch j as Required 0016 001-Brown Roofing.Composite Shingle . Ext®riotBack Porch ! ELAP as Required 002A 002;Black Felt Exterior'. Back Porch, I NY ELAP as Required 002E 002-Black Feht- Exterior ', Back Porch ! ! NY ELAP as Required 003A 003-Green Roofing,Composite Shingle Exterior Back Porch NY ELAP as Required 003B 003-Green Roofing,Composite Shingle Exterior I Back Porch NYELAP as Required 004A 004-Green Roofing,Composite Shingle Exterior Front Porch NYELAP as Required 004B 004-Green Roofing,Composite Shingle Exterior' Front Porch ; NY ELAP as Required MM 005-Black Roofing Paper/Felt Exterior. Front Porch NYELAP as Required 005E 005-Black Roofing Paper/Felt Facterior Front Porch NY ELAP as Required 006A 006-Masonry Block(CMU) Interior Exterior NY ELAP as Required 006B 006-Masonry Block(CMU) interior I Exterior NY ELAP as Required 007A 007-Masonry Block Mortar Interior i Exterior NY ELAP as.Required ClearVU Inspections-Chain of Custody For Tracey Holdings LLC Single Family Dwelling-10115 I 1 of 4 } Sample ID, Material Floor/Section . Space i i Analysis 007B 007-Masonry Block Mortar Interior Exterior NYELAP as Required I 008A 008-Caulk,Window Interior. i Exterior NYELAP as Required 008E 008-Caulk,Window" Interior Exterior NYELAP as Required 009A 009-Sealant,Window Pane Glazing Interior basement NY ELAP as Required 009B 009-Sealant,Window Pane Glazing Interior basement ; NY ELAP as Required 010A 010-Green Wallpaper' Interior southern bathroom NYELAP as Required 010B 010=Green Wallpaper Interior southern bathroom i NY ELAP as Required 011A 011 -White Wall Tile&Grout Interior southern bathroom NY ELAP as Required 011 B 011 -White Wall Tile&Grout Interior southern bathroom NY ELAP as Required 012A 012-.Shower caulk Interior southern bathroom { NY ELAP as Required 012B' 012-Shower caulk Interior southern bathroom NYELAP as Required 013A 013-Joint Compound w/Tape Interior southern bathroom NY ELAP as Required 013B 013-Joint Compound wRape Interior i basement { NY ELAP as Required . 013C 013,-Joint compound w/Tape Interior Kitchen NY ELAP as Required 013D 013-Joint Compound w/Tape Interior northern bathroom I NY ELAP as Required 014A 014,-Gypsum Wallboard Interior southern bathroom NY ELAP as Required 014E 014-Gypsum Wallboard LIntendor or i basement ' i NY ELAP as Required 014C 014-Gypsum Wallboard L Kitchen NY ELAP as Required 014D 014-Gypsum Wallboard or southern bathroom NY FLAP as Required 015A 015-Beige Floor Tile Interior southern bathroom NY ELAP as Required 015E 015-Beige Floor Tile Interior southern bathroom i NY ELAP as Required 016A 016-Blue Green Floor Tile w/Adhesive Interior southern bathroom NY ELAP as Required 016B 016-Blue Green FloorTile w/Adhesive Interior southern bathroom NYELAP as Required '017A 017-Beige Floor,Sheet Vinyl Paper Backing Interior Laundry Room ! NY ELAP as;Required 017B 017=Beige Floor,Sheet Vinyl Paper Backing, Interior Laundry Room NY FLAP as Required 018A 018-Wallpaper Interior southern bedroom ! NY FLAP as,Required 018E 018-Wallpaper lnterior southern bedroom NY ELAP as,Required 019A 019-Wallpaper ;interior. Living Room { { NYELAP as!Required I ClearVU Inspections-Chain of Custody For Tracey Holdings LLC Single Family Dwelling-10115. ; ! i I 2 of 4 Sample lD Material Floor Section Space Analysis 0196 019-Wallpaper interior Living Room- i i NYELAP as Required 020A 020-Gray Wallpaper.. Interior Living Room ! NY ELAP as Required 0208 020-Gray Wallpaper interior' Living Room NY ELAP as Required- 021A 021-Beige Wallpaper interior, Kitchen NYELAP as Required 021 B 021 -Beige Wallpaper Interior Kitchen i NY ELAP as Required 022A 022-Red Wallpaper Interior Kitchen NY ELAP as Required 022E 022-Red Wallpaper Interior Kitchen NYELAP as Required 023A 023-=Blue Wallpaper Interior Kitchen NY ELAP as Required • 023B 023-Blue Wallpaper Interior Kitchen NYELAP as Required 024A 0247 Green Vinyl Flooring W/Adhesive Interior northern bathroom ;. NYELAP as Required. 024E 024-Green Vinyl Flooring W/Adhesive Interior northern bathroom j NYELAP as Required I 025A 025-Floor Tile w/Adhesive Interior northern bathroom f NYELAP as Required 025E 025-Floor Tile w/Adhesive Interior; northem bathroom i NY FLAP as,Required 026A 026-Wallpaper Interior northern bathroom NY FLAP as Required 026E 026' Wallpaper Interior northern bathroom NYELAP as;Required 027A 027-Beige Wallpaper interior northern bathroom ' NYELAP as.Required 027E 027-Beige Wallpaper Interior northern bathroom j NY ELAP as'Required 028A 028-Blue Green Wallpaper Interior ` northern bedroom ! NY FLAP as Required 028B' 028-Blue Green Wallpaper Interior northern bedroom _ NY ELAP as,Required 029A 029-Red Wallpaper Interior northern bedroom NYELAP as Required 029B 029-Red Wallpaper_ Interior northern bedroom NY ELAP as Required 030A 030-Cork Ceiling Tile Interior Living Room ! NY ELAP as;Required 030B 030-Cork Ceiling Tile Interior Living Room NYELAP as Required 031A 031 -Blue Wallpaper Interior basement bedroom NY ELAP as,Required 031 B 031-Blue Wallpaper Interior basement bedroom j NY ELAP as;Required 032A 032-Red green white Wallpaper Interior basement bedroom f NYELAP as Required 032B 032-Red green white Wallpaper Interior basement bedroom j NY ELAP as;Required 034B 034-Red gray Wallpaper ; interior basement bedroom ( NY ELAP as Required ClearVU Inspections-Chain of Custody For Tracey Holdings,LLC ' 1 Single Family Dwelling-10115 j i 3 of 4 Sample ID Material Floor/Section Space Analysis 0346 034-Red gray Wallpaper Interiorbasement bedroom NY ELAP as Required 035A 035-Black Roofing Paper/Felt Interior, Garage NY ELAP as Required 035B 035-Black'Roofing PapedFelt Interior Garage NY ELAP as Required 036A 036-White Sealant,Window"Pane Glazing Interior Garage NY ELAP as Required 036B 036-White Sealant,Window Pane Glazing Interior Garage NY ELAP as Required • i I i i 6.2.2022 4PM SampleN By Date Time ` 4 I I � 1 Received By Date Time Received By Date Time Received By Date Time P 6.3.2022 3PM 1 f Relinquished By Date Time Relinquished By Date Time Relinquished By Date Time Analysis By Date Time f 4 I i , ClearVU Inspections-Chain of Custody For Tracey Holdings LLC i 4 of 4 Single Family Dwelling-10115 i Young, Erik M. From: CEI-Reporting Sent: Monday,June 6,2022 9:38 AM To: Ryan;CEI-Reporting Subject: 10115,Single Family Dwelling,283 Corinth Road,Queensbury, New York 12804 Good Morning Ryan! We received your New York samples for this project this morning.We have a set of samples labeled 34A and 34B on the bags.On the chain of custody we have two 3413 s listed.We will go ahead and move forward with the 34A and 34B samples so as not to delay your project any.Thank you and have a great day! Sincerely, Erik Young Client Support Specialist Eurofins CEI - --730 SE Maynard Rd Cary, NC 27511 . Phone: (919)481-1413 Fax: (919)48171442 - — COMMUNICATION ALERT: Change of e-mail addresses for all Eurofins-Environment Testing - businesses'in the US effective April 4, 2022 - Please update my e-mail address.in your e-mail directory: Erik.Youne@ET.EurofinsUS.com_ Erik.Young@ET.EurofinsUS.com _www.E:urofinsUS.com/BuiftEnv Follow Usl Facebook i Linkedln 1 . 0, eurofins CEt June 13, 2022 ClearVU Inspections 18 Blackberry,Lane Queensbury, NY 12804 CLIENT PROJECT:- 10115 LAB CODE: N220127 - Dear Customer: Enclosed -are-.asbestos analysis results for Asbestos :Bulk samples, received at our laboratory. _ on.June 6,,2022.'The4 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 CE.I is accredited by the New "York -State Department of Health. " (NYSDOH) Environmental Laboratory Approval Program (ELAP), certificate#12048. Kind Regards, , -_ _._"-_._._TianbaoBai,--P_h.D.,-CIH._-----�.�_--- ---:_ ----- Laboratory Director Hvi TESTING ---. -f---NVLAPLAB.CODE-101768.0 ----- -------------- ------------ -- 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 e u rof i n s CEI ASBESTOS ANALYTICAL REPORT By: New York State .ELAP Method Prepared for ClearVU. lnspectio'ns CLIENT PROJECT: 101-15 LAB CODE: N220127 = _ TEST METHOD: NYS ELAP METHODS 198.1 198A REPORT DATE:- 06/13/22 -TOTAL LAYERS ANALYZED.: 94 __----------# LAYERS >1%ASBESTOS- 3 730 SE Maynard Road.- Cary, NC 27511 • 919.481.1413 r Asbestos Report Summary e u of ins By: NEW YORK STATE METHOD CEI PROJECT: 10115 LAB CODE: N220127 ASBESTOS BULK, NEW YORK STATE METHODS Clien `ID y4 >:Laii.iD:- Cofo :rSam"Ie Desc�i°tiori`r' ,, .:' To#al=Asbesfes'OIQ 001A N1845 Brown, Black Composite Shingle No Asbestos Detected by 198.4 001B N1846 - Brown, Black Composite Shingle No Asbestos Detected by 198.4 002A N1847 Black Felt No Asbestos Detected by 198.4 002B N1848 Black Felt No Asbestos Detected by 198.4 003A N1849 Green, Gray Composite Shingle No Asbestos Detected by 198.4 003B N1850 Green, Gray _ Composite Shingle No Asbestos Detected by 198.4 004A N1851 Green, Black Composite Shingle No Asbestos Detected by 198.4 - 004B N1852 Green, Black Composite Shingle No Asbestos Detected by 198.4 005A- N1853 Black Roofing Paper/Felt No Asbestos Detected by 198.4 _ 005B.= -.,- N1854 Black Roofing Paper/Felt .- - No Asbestos - - Detected by 198.4 006A N1855 Gray Masonry Block(CMU) No Asbestos Detected.0% 006E N1856 Gray Masonry Block(CMU) No Asbestos Detected.0% 007A N1857 Gray Masonry Block Mortar No Asbestos Detected.0% 007B N1858 Gray Masonry Block Mortar No Asbestos Detected.0% 008A N1859 Gray, Brown Caulking __. -. _-_008B-- N1860- - Sample Not Analyzed per COC-_. - -- -_----_ --- 009A N1861 Gray Window Glazing 009B N1862 Sample Not Analyzed per COC 010A N1863 Green Wallpaper No Asbestos Detected by 198.4 010E N1864 Green Wallpaper No Asbestos --- -Detected by 198.4 Page 1 of 5 Asbestos Report Summary tiffe u rof i n s By: NEW YORK STATE METHOD CEI PROJECT: 10115 LAB CODE: N220127 ASBESTOS BULK, NEW YORK STATE METHODS Ci➢eat't Leah!D Co[ rx: ;k ;;fix •.:.:..,; :` y; eSaim Ie Descii}� oi T 'x ."rarRs.• rye;ze, :.?' ,cfi.. .sv!,M xs+. :.M4,,,s<,s. {;-`..�'K:xk.. 011A N1865A Yellow,Clear Wall Tile No Asbestos - Detected.0% _---------- --- ---- ---Tan,White _ --------------------- N186513- Grout No Asbestos Dete6ted.0% N 1865C - _- Clear _-a--Mastic No Asbestos Detected by 198.4 N1865D -_--`White -----Mud --------------------- NoAsbestos -- Detected.0% 011B N1866A Gray,Clear Wall Tile No Asbestos Detected.0% --N1866B ------Tan,White - Grout--------------------- NoAsbestos -- Detected.0% --�- - ^ N1866C --- ' -Clear -_.---Mastic ---------- ---------- No Asbestos Detected by 198.4 - _- N1866D - --White -Mud No Asbestos Detected.0% 012A N1867 White Shower Caulk No Asbestos Detected by 198.4 ---012E-- ---N1868 -----White- ---------Shower Caulk - - -:-- - — ---No Asbestos-- - - Detected by 198.4 013A N1869A White Joint Compound No Asbestos Detected.0% - ---- -- Tan - B ------ ------Tape --------------------- NoAsbestos -- Detected.0% 013B N1870A White Joint Compound No Asbestos Detected.0% ----------- --- Tan Tape No------ ------ --------------------- -- Detected.0% 013C N1871A White Joint Compound No Asbestos Detected.0% ----------- --- Tan------ ------Tape --------------------- No Asbestos -- Detected.0% 013D N1872A White Joint Compound No Asbestos Detected.0% ----------- --- Tan Tape No Asbestos Detected.0% Page 2 of 5 ®.� Asbestos Report Summary e u rof I n s By: NEW YORK STATE METHOD CEI PROJECT: 10115 LAB CODE: N220127 ASBESTOS BULK, NEW YORK STATE METHODS .=;;+� 1;.-b-.2s'.. e`'�� -:t:.tb' -Q'L- - .t�:' - ;,;�.�• i:;µ .::f"ri i ",r;;i-';. - =p"` ,Cl►eiitli�.�,.: La�iID.�.>:r =w;,�;, ,_Co rir,.F_E::; g5am``Ie;'Descr����on:`: � :;� �-�,Tii#al�Asi`testos 014A N1873 Gray Gypsum Wallboard No Asbestos Detected.0% 014B N1874 White, Brown Gypsum Wallboard No Asbestos Detected.0% 014C N1875• White, Brown Gypsum Wallboard No Asbestos Detected.0% 014D N1876 White, Brown Gypsum Wallboard' No Asbestos Detected.0% 015A N1877A Beige Floor Tile No Asbestos Detected by 198.4 .___ - ------ ---- -- -- ----------------- --N1877 Clear Adhesive No Asbestos - Detected by 198.4 015E - N1878A Beige Floor Tile - No'Asbestos Detected by 198.4 - N1878B _ `--`Clear - i Adhesive No Asbestos Detected by 198.4 016A N1879A Blue, Green Floor Tile No Asbestos Detected by 198.4 - - ----------------------- -------- ------------------------- ------ - - - -•----=N1879B- -_- -Brown " - Adhesive No Asbestos - - Detected by 198.4 y 016E N1880A Blue, Green Floor Tile No Asbestos Detected by 198.4 N1880B Brown Adhesive No Asbestos Detected by 198.4 017A N1881 Beige Sheet Vinyl No Asbestos Detected by 198.4 017B N1882 Beige Sheet Vinyl No Asbestos Detected by 198.4 018A N1883 Beige, Floral Wallpaper No Asbestos Detected by.198.4 --- " - 018B N1884 Beige, Floral Wallpaper No Asbestos Detected by 198.4 019A N1885 Beige Wallpaper No Asbestos Detected by 198.4 019B N1886 Beige Wallpaper No Asbestos. Detected by 198.4 Page 3 of 5 Asbestos Report Summary e u rof ins By: NEW YORK STATE METHOD CEI PROJECT: 10115 LAB CODE: N220127 ASBESTOS BULK, NEW YORK STATE METHODS Elie t:FD; ab"@ o r �i K7N'n 1 COl Totat-AsFi00 °lo 020A N1887A Brown Wallpaper No-Asbestos Detected.0% ----------- --- Tan, n Mud -- - ---- - ---------- -- ---- 020B N1888A Brown Wallpaper No Asbestos Detected.0% _--------- 1888B N --------------Sample Not Arialyz ----- ----------------- per 021A N1889 Beige Wallpaper No Asbestos Detected by 198.4 021B N1890 Beige Wallpaper No Asbestos Detected by 198.4 _ 022A N1891 Red Wallpaper No Asbestos Detected by 198.4 022E N1892 Red Wallpaper No Asbestos Detected by 198.4 023A N1893 Blue Wallpaper No Asbestos Detected by 198.4 023B N1894 Blue Wallpaper No Asbestos Detected by 198.4 024A N1895A Green,Black Vinyl Flooring - No Asbestos Detected by 198.4 -------------- ----------------------------------- ------------- N1895B Clear Adhesive No Asbestos Detected by 198.4 024E N1896A Green,Black Vinyl Flooring No Asbestos Detected by 198.4 --------------------------------------------------- ------------ N1896B Clear Adhesive No Asbestos Detected by 198.4 025A -_____-_ N1897A ----. - Gray --Floor Tile __.___NoAsbestos Detected by 198.4 --------------------------------------------------------------- N1897B Tan Adhesive No Asbestos - - - - -- --------------- ---" ---_ -- - - - - - -- �.— _._� --- --- Detected by 198.4 - - 025B N1898A Gray Floor Tile No Asbestos Detected by 198.4 ------------------------------------------------ --------------- N1898B Tan Adhesive No Asbestos Detected by 198.4 026A N1899 Green, Bears Wallpaper No Asbestos - - -- - ------ - - --- - -- --- - - - ------ ---- -Detected by 198.4 ---- --- - Page 4 of 5 Asbestos Report Summary ® eurofins I By: NEW YORK STATE METHOD CEI PROJECT: 10115 LAB CODE: N220127 ASBESTOS BULK, NEW YORK STATE METHODS MP 026B N1900 Green, Bears Wallpaper No Asbestos Detected by 198.4 027A N1901 Beige, Green Wallpaper No Asbestos Detected by 198.4 027B N1902 Beige, Green Wallpaper No Asbestos Detected by 198.4 028A N1903 Green, Dogs Wallpaper No Asbestos Detected by 198.4 028B, N1904. Green, Dogs Wallpaper No Asbestos Detected by 198.4 029A N1905 Red Wallpaper No Asbestos Detected by 198.4 029E N1906 Red Wallpaper No Asbestos- - Detected by 198.4 030A N1907 White,Tan Ceiling Tile No Asbestos Detected by 198.4 030B N1908 White,Tan Ceiling Tile No Asbestos Detected by 198.4 -031A- -N1909 Blue,White Wallpaper No Asbestos - Detected by 198.4 031 B N1910 Blue,White Wallpaper No Asbestos Detected by 198.4 032A N1911 Purple,Green Wallpaper No Asbestos Detected by 198.4 032B N1912 Purple, Green Wallpaper No Asbestos Detected by 198.4 034A N1913 Red,Gray Wallpaper No Asbestos Detected by 198.4 034B N1914 Red, Gray Wallpaper No Asbestos Detected by 198.4 035A N1915 Black Roofing Paper/Felt No Asbestos Detected by 198.4 035E N1916 Black Roofing Paper/Felt No Asbestos Detected by 198.4 036A N1917 White Window Pane Glazing __036B ___N1918_,_ Window Pane Glazing Page 5 of 5 ASBESTOS BULK ANALYSIS 0% e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane - Date Received: 06-06722 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS i33�� y€C'.`.e ^�:Y";a`�f�'^ :�;»a:,• :"C:rr:+.� :.-r:�'�'`�" �..As':,3 ::^^s; ,s��>.t.*^4•;-: ,:•.r.;.:::'.•ys,;1>.%:' a",'Y�i ,,,�. . , - , 3'. :tz�: :,x,..s--„ 1, tst"` ?-`A,, try', .:Y:'u;s°�''^«;J:' r.3, :,r..�:�M:•t,; C►1e'nt IDA 'k�.a""er.hlunber"� -'`i;:.. .AN: `' £'µ ,z1' .•�-' ,e:� ;.#'»_.. �:;?-�.`: ':t> .7:'..,.«`v - �i". S,t�.•, �j jti.',;, -;<"'y..:..�.- ..�..y,ti:5%o-,-�;,":>':1`:' v"s.. "� ,,a,:%{''- m`� ray�„'.z'.o..r 1;1bilD;; s y(111`s[a8SCC1 t1011 ,t'i1tl:FtQ Ctil' :< .. ,..,�l,.a:✓,., 001A Composite . NOB Brown, Initial Observations: N1845 Shingle Black Fiberglass 45% Matrix 55% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 0016 Composite NOB Brown, Initial Observations: N1846 Shingle Black Fiberglass 45% Matrix 55% Method: Final Results: Total Asbestos: No Asbestos Detected b 198 4 - -y ' 198.4 None Detected 002A Felt NOB Black Initial Observations: N1847' Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 1 of 30 ASBESTOS BULK ANALYSIS e u rof i n s' By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS ',.,;, ,,,;y,,, �, ..�'.` ..t. .k ,�r.'va„,i;:c"; '":..y :<..s":.7"3s"�'1A .;t r..✓,;;v,.� ,>;.yr �x, 5?.^ 'ds�"•r'�} s^';; " <s':;,x ,r;.,€,;: ,s%irr `'. € dr„ ,F1@'„';^y�•r, u%";.' ,. ;`'„'z,.x,,,.�n.i'c x„�4k�4� t•�'; w:`'�"� :r.ti� �l4+, s'. �1".,f`:;�',>'•�^�;H?x.,_.rs}w,'w t�' r;,f z,g,: 1.'.'., ..rxr ✓ !>•, ;�," A,;„.�.'..<<.s:; �:s%rl,`,,, r;4r,t•5:; ::r.�.. �£-r'w MG A_.���a;,ns?..'>' .2•�,.;�rn`�`�'.-, s` .�>': ,.K. ,� �-'.`s:` Y-,:�'"'-;<?,�.-..>;7 �, x:. ;. ���; �;�,„�'�,,:;,�,,..,,<. '^"'=4•t,:::r.,t°'�.t, �tp;`.:zcz•.�m'g��s'''�x�._r,a�r; �% „:�.:n- .;,e�,f,;o�( ,.,.'y, ■■ .. {(,Fy�� }� $$ma�yy n �}.,j `/' -,-"<'+• i:1••, xt:'�i:<YwN'�_:_ c,.}.0 .x9.s 4^,ws�> �.3»'✓`..t„'�Y... ��„y,.,d x. :sly*"3,;�t;:s,tt .e:i�iy'ves 002B Felt NOB Black Initial Observations: N1848 Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 003A _ "Composite NOB Green, Initial Observations: N1849 Shingle Gray Fiberglass 45% Matrix 55% Method: Final Results: Total Asbestos: No_Asbestos Detected 198.4 None Detected 003E Composite NOB Green, Initial Observations: N1850 Shingle Gray Fiberglass 45% Matrix 55% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 2 of 30 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearV.0 Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS�BULK,'NEW YORK STATE METHODS k q:�' n f,` xM� Y"�,W;„ ;��*;-:`�,, «;a¢✓'is'�,.; roj•.!.^ ^:.�3 ..pi:,a`^'< >,"E�"�,�,'�;�✓,'�;r`,v f.;>;7•`'4�;,': '�" .��a��'v�r"..t.Y",en4�zk A3.,,?d'y °,;f�'"'�,i`.�„'�,r,"'",agc;�'9£ �'j ..�, �, t � �. ,,hff r>>, .s?'"�rt� ,t�...s 'k ��s S'"^ ^x`'sty:'d;'y;•r'a.iCi `GtietttlD,�, �y R•••���yyy����r'11umfRT ^£;v.. .,drat,^, ,�tx�1 '.�- :.::� ;�i:.;i.": rc�,%rcr'-�r;`.t!: ";a�lZ*".`:��:%s'1.`%'�='•H�r,, �xu=.:'::. SFI�:,: a?..z..r-LC'��• .:L,.M •h..,c-» .r .,Y jr�; ilkµ ,'•�_ r." �� ".z=.:> '?;�';>•.r; �:Cr .a,v s ',.'4;4 '�;: ,.,.,J'_... .a'v'•' ':P�sYca"�-y., ,.w<5z�.5 .;rra7a>y.-,'. .t, :�:� .,a."„'�'�';;,t,.z5';�`�.7*z ..k.•'�F:>'H:;--°^' >-r�qN` ''.��Y.=.�..;„�',..s.:c;7"'.�"L:x:-','.""e.-. 004A Composite NOB Green, Initial Observations: - N1851 Shingle Black Fiberglass 45% Matrix - 55% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 004B Composite° NOB -Green, Initial Observations: N1852 Shingle Black Fiberglass 45% Matrix 55% Method: Final Results: _ Total Asbestos: No Asbestos Detected by 1.98.4 . 198.4 None Detected 005A Roofing Paper/felt NOB Black Initial Observations: N1853 Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected t Page 3 of 30 Y ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 , ASBESTOS BULK, NEW YORK STATE METHODS ;�., rr:r�: ''✓.r s, ,..r:r ir;r .v{v.•s .:.:s: . ,:' �.::r^srv,"a,;;rrs,s•r 4.r; ,;b•":/t,.o;r,;. ;::.�... .r„w,; nn ;,.x'# n„R -.la;?•t`-/�„'4s dk d. z, rt:T'� •,<.,. _ .•:.r;•.. ° iE"a,a• �,..�,F... `si.- ar^„ ?.`i:t=,�i;4„Y�" "'"1i'r.. ¢%{+',{'Xz- :'`..:?:r,; i�7;z. Z.si.;: .v:=' p",s :a; ,,:;W..", •-:,.o� -n r ., ..,.5"'i:�.f...;.,,,,.^•§',.',..r.-'p'Yt_.O l.•k.-zrC" 1`fe 9O'.si!..'y;r., C�'';✓O.t OC,: r•a�.y- . �.b<i<,,te✓R<�;; ::5.. r,:r='.r��s9i.b,'L w:;.•.;y�s:,;,;....''-rcS•:�'T..�v,_f�'.,f�,,..•.Y.,, `rc.,`..{,,i-,.„.•,. ; NP1,;.':,..�xv.Jx,.;-;`✓>3r`a.4 - 00613 Roofing Paper/felt NOB Black Initial Observations: N1854 Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No o Asbestos Detected by 198.4 198.4. None Detected 006A Masonry Block Friable Gray Initial Observations: N1855 (cmu) Cellulose <1% Silicates 60% Binder 40% Method: Final Results: 198.1 No Asbestos Detect�'cbtal Asbestos: -- No Asbestos - - Detected.0% 006B Masonry Block Friable Gray Initial Observations: N1856 (cmu) Cellulose <1% Silicates 60% Binder 40% Method: Final Results: 198.1 No Asbestos DetectETOtal Asbestos: No Asbestos Detected.0% 007A Masonry Block Friable Gray Initial Observations: N1857 Mortar Cellulose <1% Silicates 60% - --- - - - --- - -- --— _------------ - --- ... — ----- -- - - - -- Binder'---- -^-`------40%----- - Method: Final Results: 198.1 No Asbestos DetectrTiabtal Asbestos: No Asbestos Detected.0% Page 4 of 30 ASBESTOS BULK ANALYSIS 1e� e u r®f i n s By: NEW YORK STATE METHOD AEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK,_NEW YORK-STATE METHODS ".•" :• ,,.-v, ,xy-t•, >' ,.• -,,•a§�;":a�ri,r,,,{;ag.,. �;,�:_;sv.'*a. a>;; 4:'d.: '� .,i ntir,,,. ;`�k,,'^. ,��'^i">;� 23.ea .-r�','v;Y.:Bz���ri ;e.�€,.r 4'3'=`. r3.w `!;,�%"�� �' „{u'F'r kd�., �'t°,',,•.'„xr.,:.: , ;, ';`r�,. r '!,"';.rY( ';5. +'`';"�;�;e,r,.'^i�.,.,-K'p;. ;.ta,..;i!...ti'-`i ,,,;�»,v."q,,■ a�,`�jF�,i`,.s�;•"... :";.'.,X`{.'_,�°,e,::;.e.`;i s;3 �� ClientiD,: ;_�'_■((_��{�e�Numb�rok �, d�� �;, ..=,.Jx N _ ��r.flig.,.r .i�,,A's.. �•;k'{:-ry";y&�+`.{.:.. �.1Y.U..{' s;�";���;µ}.,f vm�1,.Yri u.6�:,':�.,iN>n;+-.�. 6=^s.S `" ": -5a,✓.a, rat: -ky. �`J'::w,m€, z .';.�:�':.�Lab,.:�lescr�ption 007B Masonry Block Friable Gray Initial Observations: N1858 Mortar Cellulose <1% Silicates 60% Binder 40% Method: Final Results: 198.1 No Asbestos DetectdTobtal Asbestos: No-Asbestos Detected.0%o 008A -.Caulking NOB Gray, Initial Observations: N 1859 Brown Matrix 75 Method: Final Results: Total .- - - - - _ "-198.4 ". . Chrysotile 25% 008B Sample Not Analyzed per COC N1860 009A Window Glazing NOB Gray Initial Observations: N 1861 Matrix 99% Method: Final Results: 198.4 ---Chrysotile -------- _..___.1.3% --- ----- --- ------- -- ' -- 009B Sample Not Analyzed per COC N1862 Page 5 of 30 ASBESTOS BULK ANALYSIS e u r®fens By: NEW YORK STATE METHOD CEB Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS .t:f',+..- r,. ;'4, �r i � { �►r�.. s A.y);.? j� A W i/!vA r:.n;:..y<d7s, ,s.�''": .Fe*. :`A:r i a',,;y5i%s'y>�, n.'d+'t.s :.�,'``.,'Y s,�tl, �Lf�b„ID' `'�i� .n 1n61 °�eS,Cfl Mf�Ql't,;Ii,�teS O sltililV`'�'^. / "l�l '?fi,: .f� b�'`7"'`';.'.1? '.➢ bn. .N;: 4`:',-">�;n 010A Wallpaper NOB Green Initial Observations: N1863 Cellulose 45% Matrix 55% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 .198.4 None Detected 010B Wallpaper .NOB Green Initial Observations: N1864 Cellulose 45% Matrix 55% Method: Final Results: Total Asbestos: No Asbestos Detected 198.4 None Detected 011A 1 Friable Yellow, Initial Observations: N1865A Wall Tile Clear 100% Method: Final Results: 198.1 No Asbestos DetectETebtal Asbestos: No Asbestos Detected.0% N1865B 2 Friable Tan,White Initial Observations Grout Cellulose <1% Binder 75% Silicates ---"---"--25% ---" -------- ` - Method: Final Results: 198.1 No Asbestos Detectd'ibtal Asbestos: No Asbestos Detected.0% Page 6 of 30 ASBESTOS BULK ANALYSIS tieti e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queehsbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS �.�- r' ... ; ; u'S'.1, „.,v: r4, .� t< h;, ^�i`$"Y"qye; .i::' "<'S; `£�;:. ,,,v.: :.s- ;✓.•:,;'•': ,<r` r .'J--x,..,,P. � er'Numbec. ;�_+,-,-. ....'• Lab�1R��.�r:_��ALabDesciripfpan��C tE'3gory��?,s >.,>�•',:;x°;',,� :�,-,. ��,: �..�,, �- r:',��_,:,.;_ N1865C 3 NOB_ Clear Initial Observations: Mastic Fiberglass 5% Matrix 95% . Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 ^ 198.4 None Detected - ———————————————————————————————————————————————————————————-—-——�• _ N1865D 4 Friable White Initial Observations: Mud Binder 80% Calc Carb 15% Paint 5% -_ - - Method: - Final Results:- 198.1 No Asbestos Detect(Tobtal Asbestos: No Asbestos Detected.0% 011B 1 Friable Gray, Initial Observations: N1866A Wall Tile Clear 100% Method: Final Results: 198.1 No Asbestos Detectffiabtal Asbestos: No Asbestos Detected.0% ----------------------------------------------------------------- N1866B 2 Friable Tan,White Initial Observations: Grout Cellulose <1% Binder 75% - --- -- - -- - ------- Method: Final Results: 198.1 No Asbestos DetectiTibtal Asbestos: No Asbestos Detected.0% Page 7 of 30 ASBESTOS BULK ANALYSIS e u r®f i n s By: NEW YORK STATE METHOD �E! , Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS „;y.' .J:•: _„S:.�S. .yg. ri.y.%vr; 't. '.`fii:.ti�'�:,`Y,.i.:'" .S y.i++ K�':, W"%f'.'y3'.i' '�'.iY=:�'''6,:.. 33tl%.<..5 •';i,,,- <��7uiao .i",r»rr'. e'.^`.'.r'�, ;zv�:.+'.'.a'r,`r ;',J„ �.r,'x ;1"?r .r.,,x� .'Y•:.d;.°�, `pi.: ,➢''?�X,'��' .,Yf,: .?..v :`jxi;:', ;;fug'+`,, �!�"A`" 'x. ;��%.".Y�3�":,' �f..,r", i5f i• .,�o:^.ri iv;6' 2�..`," i. ,`f.'�,{ .'�t.'..t-: $:; ' -N1866C` __: _____-- sClear `_`- _ 3 NOB Initial Observations: Mastic Fiberglass 5% Matrix 95% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected- _ N1866D s 4 Friable a-White _a! s Initial Observations: Mud Binder 80% r Calc Carb 15% Paint 5% -• _--__.. -Method: Final Results:' - 198.1 No Asbestos DetectdTobtal Asbestos: No Asbestos Detected.0% 012A Shower Caulk 'NOB White Initial Observations: N 1867 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 8 of 30 ASBESTOS BULK ANALYSIS �e e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code- N220127. 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS i';#;,,ny :`'K�,` <�•�'.R 5.„ „:d,+.�,,. 3(:, +,`,�i,.'"ii'�•f., ,d"�i." f;{.'>:•�b;xw;; y ,r ;,�::t.�_ '.=�i:";:W:'e�:+`•wni:-t'�`�-R-7 '`Y`., v>`�."sr..;.. e;`X�: _ibo"i� oY C 9y" §:7 .t.d"•< l« - �:IX.,:"r`s„yr` *u't" +._.^v 6a,.::,:�° 012E Shower Caulk NOB White Initial Observations: N 1868 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected - by 198.4 . 198.4 None Detected 013A 1 •Friable White . Initial Observations: N1869A Joint Compound Binder 55% Calc Carb _40% Paint 5% Method: = - -Final Results: - 198.1 No Asbestos Detect(Td)tal Asbestos: No Asbestos Detected.0% -- ----------------------------------- -- =----------------------- N1869B 2 Friable Tan Initial Observations: Tape Cellulose. 100% Method:. Final Results: 198.1 No Asbestos DetectETobtal Asbestos: No Asbestos Detected.0% 013E 1 Friable White Initial Observations: a N1870A Joint Compound Binder 55% Paint 5% Method: Final Results: 198.1 No Asbestos Detectiffiobtal Asbestos: No Asbestos Detected.0% Page 9 of 30 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD AEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS .,.,3., %,.4 w> ,g.n,a ',3f" :'f, ,tY'"•..ws�s', `,r.' - .:a'X% �:,r'•i:- - "<:;'Ysy . K .=:v`. !?f �, ..>„�^ { ,zt, s•'y':.�J;, - !;s„�;'�•::y;:: :,c��".,e„s:;„^ n;j'`-3..,-...'-,.=% ^tvi: ,�?,' ,..>a,L'F; fi' ':a i.n}, s%'•/ s 3%a,. ::NT:T^ :F^„t:'L'.•E -Yr!•'''i 9',Y:.'.,. �.,,,�'»r�ti;. } t g�� a:^h: ,a7;> 'La`li�p�: l:a'-=[?ias+cr� iib. Cafe o -�Giill"i.-,r..'r-.' g:F�4d:^`'�:..:•,> :; '.,;:;•x<...� �;.r��W •.,; �N1870B __ 2 _————_——Friable —Tan__________ _Initial Observations Tape Cellulose 100%' Method: Final Results: 198.1 No Asbestos DetectdTibtal Asbestos: No Asbestos Detected.0% :013C 1 Friable White Initial Observations: N1871A Joint Compound Binder 55% Calc Carb 40% Paint 5% Method: Final Results: 198.1 No Asbestos Detect('obtal Asbestos: No Asbestos Detected.0% N1871B 2 Friable Tan Initial Observations: i Tape Cellulose 100% Method: Final Results: 198.1 No Asbestos DetectUtal Asbestos: No Asbestos Detected.0% 013D 1 Friable . White Initial Observations: N1872A _ --- Joint Compound - - --- - Binder -- - -- --_55% -------- ---- --- Calc Carb 40% Paint 5% Method: Final Results: ^� 198.1 No Asbestos Detecti obtal Asbestos: No Asbestos Detected.0% Page 10 of 30 ASBESTOS BULK ANALYSIS e u r®fins By: NEW YORK STATE METHOD �E! . Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: .06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS .. - - .,a;5'r�'n"+�,.;,=3,,,., ":;;;5:;�>i F3, ,:.v,. _ „'e;.• S1„' ..ce,.,fw" ',•s. .z, b,t; s`.i,�-'€;c:`;��° 'Y�: -,..... :�''., fix` e3. :Gliep ;fp=tl, 5 i�K v�,:,•» t"M,.l Yr :'^F'/ '.;i".'sz.Y Y;'-n;..,tal%II}` >`�. `Lati:Desc�i Yon.. Cate'`o• Colar=�,-�.::� '=:; �.�:-,< :_,: '�: ::a= ,,y,;..•= �.. ------------------------------------------------------------------ N1872B 2 Friable Tan Initial Observations: Tape Cellulose 100% Method: Final Results: 198.1 No Asbestos DetectiTobtal Asbestos: No Asbestos Detected.0% 014A Gypsum Friable Gray - Initial Observations: N1873 Wallboard Gypsum 100%' Method: Final Results: 198.1 No Asbestos Detect4'ebtal Asbestos: No Asbestos Detected.0% 014B Gypsum Friable White, Initial Observations: - N1874 Wallboard Brown- - - ---' --- - o... .. .- ,-- o Cellulose 20/o Gypsum 75/o T Paint 5% Method: Final Results: 198.1 No Asbestos DetectdTobtal Asbestos: No Asbestos Detected.0% 014C Gypsum Friable White, Initial Observations: N1875 Wallboard Brown Cellulose 20% Gypsum 80% ---------- -Method: - - --Final Results: - - - - -- - 198.1 No Asbestos DetectMabtal Asbestos: No Asbestos Detected.0% Page 11 of 30 ASBESTOS BULK ANALYSIS le u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 - Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS "" ,„ rtu^ q.�-.� �W.•.�y,r;t; 7;r.y;n,'—,3,rx:`,* 't,:s 5r-,:'.q,n'n:',C«: -h." >;3". ,.y;,' _-a,:,J':'e''':8,',v .::y.g,;.< ,t��';''v:,'� ' - - a ✓t'F'r �,�f3,"z;%t .d',t;':`�"' *,. -3;, r.,,�j,• vs. s` .,r �, r: „� � >.;ae .z::-,..,r ,w�' r';. .3„e K�F`r ,/�,,: :"3 4; �(«e 'S,. :};"�b.'... !,..}'" h"[��i,a•'i.'6i„u,e.,.. ,,,�;, a..1 ✓ c,3' 4" ;Y.y,,x:, ';'� '''fi�fi`=%7;�l. ^,s;` :',,rtE<, s.f`:,;',;,':..:'.y,,;� nq a'2:.:...::.:.. .'.+• %x.tp, Pile t:ID' La er.Number;; Rn"M':N.'•,fr^2`a '! �A'' -4xrF,v='.sY :�Y ,"�i;4•:'...-" :i ,i�rvR i- r.S r. 014D Gypsum Friable White, Initial Observations: N1876 Wallboard Brown Cellulose .20% Gypsum 75% Paint -5% Method: - Final Results: __ = 198.1 No Asbestos Detectd'cbtal Asbestos: No Asbestos Detected.0% 015A 1 NOB Beige Initial Observations: N1877A Floor Tile Matrix 100% Method: Final Results: - Total Asbestos: No Asbestos Detected by 198.4 None Detected, -----------------------------------------------------------------. N1877B 2 NOB Clear Initial Observations: Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 None Detected 0156 1 NOB Beige Initial Observations: ------_---N1878A---Floor Tile- - -Matrix - -----_—__-100%-' -- -- Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 12 of 30 r ASBESTOS BULK ANALYSIS ti• e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE-METHODS .,✓,:.,.... /�,-".v ;,.r,'�".r;.,.;.:::"',din"k., _ „i'.i .,T,�;:.`.: " — l;lient ID La eNuinber; =sip k%'Descri Lion z. gory-, - ___2____----NOB __Clear --------------- --Initial Observations N1878B Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 - None Detected 016A 1 NOB Blue, Initial Observations: N1879A Floor Tile Green Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected - - - by 198.4 198.4 None Detected ------------------------------------------------------------------ N1879B 2 NOB Brown Initial Observations: Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 13 of 30 ASBESTOS BULK ANALYSIS 1e e u rof i n s By: NEW YORK STATE METHOD CEO Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS .6"W^-'. !'i.. - •;•-i' •�E7:., tag.F j,..�y�,,.�,:y:a e:'Y nT,ei .�y,... _.�„! - — .t;�p.{1 �.�� ��;1+ fix, �„'✓z w.•4E,:r,;..',"",-': a,W'y. .z � �,�' ,t,.,.., pYf ) � �' r rr �c'z P&i ',,:�f��;'�. '.l�! L"•,b ('",R�F`�n�9;' .l,�J, r� ,r: �r";�.,'-��� t.r,.; iv_.. �?,y. .�,. ,� �'?':..t,' .��'' -Cllettt'��ID� ;-vi:a .er.�,NumbeG:;.,� +�,� �'s. �%r.`' ''a' s, `,:r:`<�p �;• �;?'','%'r' ,N„r:t .s,.=..-��a'4`,..;x<.'x, .s.ur,,.,.E:. Lab ii3 :LabDescti" tfon. Cae`ro col �.,. -': 016B 1 NOB Blue, Initial Observations: N1880A Floor Tile Green Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected ^N1880B _ 2________NOB f---- Brown w T Initial Observations Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 017A Sheet Vinyl, NOB Beige Initial Observations: N1881 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 14 of 30 eurofins ASBESTOS BULK ANALYSIS By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS ;,43.,`n;r.,,.Yr-c�.-x:r,,r4;'!.r.;,,�...:<. "^i.iA,z ,.,.�, �,,., •3,3. '�/ak`,. .!."/..�.d#'�dnn: ,:yi;""�s. uw.shxp,�•�,�,-Sit '3,."5 �M.. �. � r;�{�+;:! t ,� ;l„•. t5.. .;:i,': J,f.� sr'.�'' -,.,.e:, .%:5.;,"�: ��..}, ,�.,d, ,g s, .fir-: �'...te• .,va' .t,.:5.�;',n,..pd-.,;fA;;;.�^'a :��s� °��f�:t; Jt� r,..��� :'i::'-�..,,.;:,r:..h�; .,T..,w;,,.3��r+'- ;•,.,."ire ' � , ,:'frsFa,y,; ., .,,.. �.;.;f�a..is�i•�...;:,...,r,.;; .. .:�+�,�;'< �:.,�;"�.t�� "°'�'�'l::t,. s�<<,:�,.�. ,s.•f.' C11ent,ID.' ,11.a ec•,Number.-- :w< �,, 7;:,,-�,,: �' '`;r:4-.,� -j'-:.,l� ';�>.: •O� C1t8�G�. �fllr`w.-..;, s:�:,'%2't"i^`'e.';�' r,��. s. .ram .�pai�k�<_.�,�:.,L.,�b:pe�cnpt�,n;�,.. 9.,ry:,�Cc>. .,�., „�'�ri, �r�... �•�� a..��:.:.>,�.: �,,4:r;:m.•:�: 017B . Sheet Vinyl. NOB Beige Initial Observations: N1882 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 018A Wallpaper NOB Beige, Initial Observations: N1883 Floral Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected — by 198.4. 198.4 None Detected 018E Wallpaper NOB Beige, Initial Observations: N1884 Floral Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 1 Page 15 of 30 �► ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS <Sr'sK,.,;^ ,>„�,rzd .:ia•<:°<i•><i-- ?#e'y ~<�a+,Y:::"l<:, •s': f".#'"!�" ad.7'..;. `ro"'.°%: ;;?5.. .,-s:.:.<,< ,Y',..ft e .,,.•i<rr",,.v;.r •-„b_aa.,r,,„wf ,,•;'.a ..., v N .< ... .yf� r, ,'a;.r• may: R�. 019A Wallpaper. NOB Beige Initial Observations: N 1885 - Matrix 100% Method: Final Results: - Total Asbestos: No Asbestos Detected by 198.4 198.4 J None Detected 019B Wallpaper NOB Beige Initial Observations: N 1886 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected - - - - - - - - by 198.4 . . 198.4 None Detected 020A 1 Friable Brown Initial Observations: N1887A Wallpaper Cellulose go% Paint 10% Method: Final Results: 198.1 No Asbestos DetectETibtal Asbestos: No Asbestos Detected.0% N1887B 2 Friable Tan, Initial Observations Mud Brown Binder 71% Method: Final Results: 198.1 Chrysotile 4.0% Page 16 of 30 ASBESTOS BULK ANALYSIS ti• e-u rof ins ICEI By: NEW YORK STATE METHOD Client: ClearVU Inspections Lab Code: N220127 -18 Blackberry Lane Date Received: 06-06-22- Queensbury, NY 12804 Date Analyzed: 06-13-22 _ Date Reported:' 06-13-22 ; Project: 10115 ASBESTOS-BULK, NEW YORK STATE METHODS . - w^a rim. ;,r-% w�", •r„' ,a.r':�xs<. ,t: .<ry,,,� «.:,�,> '�Yvi"��r;�^z,'... ..�.�;' .. F° x.;wa'r2" ..,2,.,,.-:H.s. .,..,e.._ .,d.: r ,. ,.,.: v Y';, ."S., ""�'sx..y .�,# `•�,+'. "J, �::w X+Ca v, o:+;y.s.n,,. ;`,d,+": .;v";..! �`�i.TM :d .,ye; .'z{... .,�,v>; ='gw; ,,3.i., +.� ,.� `'vd.ry'•„�,,�;:' r,,, ..- '.�,:. .%�I ;ifi -^t" !1'.yT ...,yy,^..�. •2-:r ii i .,e�"',r'N'c.�'ti..'i • �,, r.` ';, �;��`',;N „<„s• :;:i;, :., ."Td.,'.a: „t.v T:w;p xr«:F:iC,:;�^ a. Rai M.,ab.Des D7 I ,�' ; cnp#io1)�� goiy�:Golar-�..;; - 020B 1 Friable .Brown_ Initial Observations: N.1888A- -_Wallpaper Cellulose -90% Paint- 10% Method: Final Results: _ = 198.1 No Asbestos DetectETOtal Asbestos: No Asbestos Detected.0% �N18886 Sample Not Analyzed per COCA__ a ^�- - -- 021A Wallpaper NOB Beige Initial Observations: N1889_ Cellulose 506/o Matrix 50% Method: Final Results: - Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 021 B Wallpaper NOB Beige Initial Observations: N1890 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected 198.4 None Detected Page 17 of 30 ASBESTOS BULK ANALYSIS e u rof I n By: NEW YORK STATE METHOD CE! Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS =.t.,l,+v<''ar' '-;:.;` '✓'%y,'r"",,a�e'- .rr;rnr..,smr'x;tr zs: /�p a ,.�,_ -.'a':(�a.,,,r,<, <ar•`.'� .}5:i l ,v�-^... ; .:1" ;�r. _ ^t,:`�f; �:r?.+ •� ssc 1<:' ,Y>•.r"'�f ^;r t` T. ,LabDesc'� 'ti�tn<��=Ga#e "i ,Dola= =,�=.r•.:_ � r :'��r ��%-��-. �"��=��=�.'�,9. :�. .:�,.. " ,�.:'. 022A Wallpaper NOB Red Initial Observations:_ N1891 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 022E Wallpaper NOB Red Initial-Observations: - N1892 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 023A Wallpaper NOB Blue Initial Observations: N1893 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 18 of 30 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVlJ Inspections. Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 - Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS k ' e:7r ,,y, u,�.'sTis-' a'� ,'..JF'r r -,e";';i.,Jr� •.ti;:s%B:J m!�.��X:'C"^ "ii'. .. "�irm ,;zr.;E:,r,<::a'.. 'f.� Yt°�:,, �a. F.�y:;.xr,�rAva"-`-` .i*�`:p, �J .c, rY: , :w. 4�. 023B Wallpaper NOB Blue Initial Observations: N1894 Cellulose 50% Matrix 50% Method: Final Results: - Total Asbestos: No Asbestos Detected' by 198.4 198.4 None Detected 024A 1 - NOB Green, Initial Observations: N1895A Vinyl Flooring Black Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected - - - by 198.4 _ 198.4 None Detected ----------------------------------------- -=----------------------- N1895B 2 - NOB Clear Initial Observations: Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 19 of 30 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS -'i�" .ji't"r:, :xi'.'1„ =�at`.;1;y ',S+V.�' '`ii:�•dz.,. ^.1. t,::�`°' .;z.�i? .?:l" ,'#t .'h. :,�, y�>. .s� ,:d��;�.,�,.S::i'., ;`ss, g :.'"r�>-s�°:�,.;.•....,.d.�r""9c-'�„:"i'°; y..s - .� .»t- Viz.., >;f• a'ba" ';;�aFt�', ryi{s�sr ,;Is¢� i..i.`i:,,n „t..'`;v,; •.Z�'!;"us:%�•�,. '"}�'." 024E 1 NOB Green, Initial Observations: N1896A Vinyl Flooring Black - Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected _._______ iN1896B 2 o f NOB i !Clear s `a __Initial Observations Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198,4 198.4 None Detected 025A 1 NOB Gray Initial Observations: N1897A Floor Tile Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 20 of 30 ASBESTOS BULK ANALYSIS eur®fins By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 - Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS ID.•",;:�; :La erNumber�'-r ,,:; -'f,�` Wy� �• i:1.. ...}..$i.:'..�"i.:�. .1,., 3C,.x f`-k'I cg-�,"i:' j.q.e::.i!"^e.,~ r -..,. <s.... ,4 d. ,.,ram ;»; .n. ., ., ...�..-.J Y" �•� Cr3:xf.ii.:::a s;.1=a�b:l3+:scri ticm: .Cate'o ;'gCotof;� - T;,, -N1897B s- 2 --------NOB -- Tan ---- --- Initial Observations: - Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 026B 1 - NOB Gray Initial Observations: N1898A Floor Tile Matrix 100% Method: Final Results: - Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected ------------------------------------ ------------------ ------------ N1898B 2 NOB Tan Initial Observations: Adhesive Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 21 of 30 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD GEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13722 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS a„2y s;�:.,-�.�.�1�.�•'�, ,��� r�' ;::.y,...t`r ;i 9, :i;v''.',.,,J�' .a.r. , ✓-.i ��;tiz :,,4"`:1,:;5:a r,":,, ,y_.,.:-. }."","p�`'w.,�,..', y., Clie �:IL><:�� .,L:e erNurrrbec"/.• `r,; �� �, ,3 >r ^+ 026A Wallpaper NOB Green, Initial Observations: N1899 _ Bears Cellulose 50% Matrix 50% Method: Final Results: - - Total'Asbestos:-.No Asbestos Detected by 198.4 = 198.4 None Detected 026B _ Wallpaper NOB Green, Initial Observations: N1900 Bears Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 027A Wallpaper NOB Beige, Initial Observations: N1901 Green Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 22 of 30 ASBESTOS BULK ANALYSIS tie u rof ins By: NEW YORK STATE METHOD AEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS ,;A <-j'v >:t.£,.' '�,, :.i',;r '4 `#''..-uix;1"t<ti�...Y�'Xi`e..r.✓ui ::f ye i�'r` vY.; �f E� yT",y 1, . }• '.{, s3 .fie,"`",t' s,:��''"F;r.`"k, C11erit":ID Z . SM .Lai �A+esc�i Cafe`c 027B Wallpaper NOB Beige, Initial Observations: N1902 Green Cellulose 50% Matrix 50% Method: Final Results: - Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 028A Wallpaper NOB Green, Initial Observations: N1903 Dogs Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected y 198.4 198.4 None Detected 028B Wallpaper -NOB Green, Initial Observations: N1904 Dogs Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected ' by 198.4 198.4 None Detected Page 23 of 30 ti eurofins ASBESTOS BULK ANALYSIS By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS .�;b ,h„ ?;t'x.• �,y> Ned; : '.�-;,, �:h';�,=,, 5,,,.. Cl�ent.ID. i.a er Number.( .:_ r,y- r� ;.yid t"ia _ '�� •.z x�ii;,.,.':- •Z',' sA .:.. §y, .{'- s''I?`',:"r,t,• '.4'• k:%✓` Yfi"�`„ .t~ry-..'y':`.: s,f"£'c,R.`�e'.S.. Lab iDa3 r, a,. : iab escri io :•..,� :.:• a�.,,` : : s 'g= Ws: '. >,,,<,,:; vx,;.- Mew,"< .,:.:,. 029A Wallpaper NOB Red Initial Observations: N1905 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 02913-. Wallpaper NOB Red Initial Observations: N1906 Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected - --' by 198.4 198.4 None Detected 030A Ceiling Tile NOB White,Tan. Initial Observations: N1907 Cellulose 95% Matrix 5% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected e Page 24 of 30 eur®fins ASBESTOS BULK ANALYSIS By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury., NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK, NEW YORK STATE METHODS z;„r: -,.�, ;,.g�n"� yY., :r'r';` i::.a -"�a.;; r,.Z.F;r.,N.;.;�..,z ara..'r `?>vq,`> .r,U::'-,<•;-' Lb o x•j 0�.,, e aix" 0 "L'OI{?I i-"• ': „+Nr; k.. :z!? ,, r.. 030E Ceiling Tile NOB White,Tan Initial Observations: N1908 Cellulose 95% Matrix 5% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 . None Detected 031A Wallpaper NOB. Blue, Initial Observations: N1909 White- Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected y 198.4- - 198.4 t None Detected i 031B Wallpaper NOB Blue, Initial Observations: N1910 White Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 25 of 30 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS-BULK, NEW YORK.STATE METHODS =i+^;: _ �W-'"' 'vr•',- .::n':f:" •l.. =^s„ ..7. ;.z:=`L:S, ty:. ',*�;:;s; .;i�,< ;;1''z°.. - , } ClioriE`113 C:a er.Niutib+e�; LaEi'ID`"� 4• Lab°D�escn tion�='.Cate o Golr.�r- .3'.r �c�-, ry:;; ,f,�:;a :9 - 032A Wallpaper NOB Purple, Initial Observations: _ N1911 Green Cellulose 50%. Matrix.. 50% Method: Final Results: = Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected - 032113 -Wallpaper NOB Purple, Initial Observations: N9912 Green Cellulose 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected 198.4 - 198.4 - None Detected 034A Wallpaper NOB Red,Gray Initial Observations: N1913 Cellulose 50% Matrix- 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 26 of 30 ASBESTOS BULK ANALYSIS lie u rof i n s By: NEW YORK STATE METHOD CEI Client: Clear-VU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS BULK,,NEW YORK STATE,METHODS ?F'•2 icy' q, +.. : r;qt lY�Y. t'ID -.er`Nunillec -4, `,Y ` •,.,,: - yrk �..,�'�., Lati'��D Lab:.t}escr➢ tio�i Cate d a -Cola ?�'_�;=:7-;�_ �=rt;r:µ.�F<":� ¢., " 034B Wallpaper 'NOB Red,Gray Initial Observations: N1914 - Cellulose 5o% Matrix - 50% Method: Final Results- Total Asbestos:-No Asbestos Detected by 198.4 _ 198.4 None Detected 035A Roofing-Paper/felt NOB " Black Initial Observations: N1915 Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No Asbestos Detected 198.4 - None-Detected 035B 'Roofing Papeffelt NOB Black Initial Observations: N1916 Cellulose 70% Matrix 30% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 27 of 30 ®� ASBESTOS BULK ANALYSIS ONti e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220127 18 Blackberry Lane Date Received: 06-06-22 S Queensbury, NY 12804 Date Analyzed: 06-13-22 Date Reported: 06-13-22 Project: 10115 ASBESTOS.BULK,NEW YORK STATE METHODS _ :E' ,..;T+�b?,.'?'"o;,�� .,@;n v� ,s � ,.N -,�:.E» ��;y.. .�,,� �,„✓..,.;,.,,�,.� .�F'..;'H'•�;s'�$�=',r;K.�°': r La .e Num a . , 036A Window Pane NOB White -Initial Observations: N1917 Glazing Matrix 100% Method: Final Results: 198.4 Chrysotile. 0.24%" 036B Window Pane NOB White Initial Observations: N1918 Glazing Matrix 100% Method: Final Results: • �..Fy.n;.v..--�•-•,,;.•�--war-yTM'n?-r,;>.^^V-?�;:^�-,�?-b�'� 'f�atal�Asbestos�"�:� '..�::,"'•{'�� �,-0:46/a 198.4 Chrysotile 0.46% Page 28 of 30 eurofins CEO 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 PLMIs not consistently reliable in detecting asbestos in floor coverings and other NOB Materials. Currently,.quantitative TEM must be used to determirie if this material-can'be considered or treated as nori-asbestos containing. Inconclusive=CR Conflicting Results: Sample:yielded 1%or less asbestos as determined_by gravinjeteic. - 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 4% _ - - -=" For methods 498:1 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 29 of 30 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. Eurofns 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- 98.4 _ - - Kathryn Wescott= 198'.1--j. APPROVED 61 - >- -- - - - -..Tianbao.Bai,_Ph.D., _ Laboratory,birector- TESTING NVLARLAB CODE 10176E-0-- --------- --- .----- -- ---- -�- -- -_.- _� 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 30 of 30 NY22=014-00 REMEDUTIOtd:&DEMOUTOON. -' -• .. : : . wniwwtatauucaa... _ _ .. - 2 -Corinth :ROad " 0 ' CORPORATE:OFFYCE Ssbury, NY:12$04 r=O : _ 0 E84Syiacuse;.NY.1 0�. -�- Plione:3.IS4339045 Ln Fax:3:15:433;9047:'' O� �- e, : .. . . . Co FRS6 Mb" Hat dlir g cease._#28 49 : . a : ER$l V4last 7°ra _:ort Pe mi # A-79 : Actooe�Vase Trans orter Permit.#71-fi1 - . . Gr :peen. - . - 6tid�e`�ndfillPermtW. • :. . . : .-. .: :: � - ' . :. .- lei-h•-SBI•_ - 06635 9 �4 202- - ;. : YS_DOL IUotieiafi®n (2) #26:7$S`fi3$:: Lois.; $upe vo r +Coi�ta nmerlt/Visuai.lnspectiora �. • AWter eo t Personnel l Zmoz. . �u u-t:2C22 GEL;EBRATING: 0 YEARS .Z0ZZ Thank you 'Nqw-Yd&State`=': iv :Departrii ht_o;t:L tior Disi :on of Safely sa Health.• i1 - - Licen's`e'and:Geticate'tfint: - s ;...y 'i 5tate'Ca pus,'Buildfng 12 "'.:,_ I ' .Alban NY�i2240`;:_ ,,: '3,;; ,. ^AS�ESTO: ,I�e4d�DLING'U iCENSE= — ,. ; . . ; E61rofimental Remed ation Seniices Ina :,y;``i s r; =F`1LE NUMBER: °02= 59 r : 04. 'ICENSE NUMB LICEIVSE'CL-ASS FULL.:�`�'`•'-:J,}`,:�'' .'��_.-•.. �'.DATE.o ISSIJ) : '0610 fEa u;_ ter.. 4/2022 st S racirse _NY:: c.,'.. " ,...._. `�. v 13U57 y^ f EXPIRATION;DATE: fl1391202.3 _ 4.. R ;Q}SSA r' `.. -_..fir.. }.''1 1' i•,1 i'1 ;s... : ,`�:°. f,�`- :ram"', -_ _ as�„•.t ---,':.� '•'•�,' :\--:1'� ,r t:=-� . u y,':Authorized`Repeseritafive=Yfirrto#hV''/ ' :�' it .:,f�:�:YY..rS''. i Y, .'1'•1\'�,.w.....�`�A 1. •.7 .!j'l• .I .j 'Z _ Td�is_`license=iias;been;issu ci.in aocdrdance yith:appfsabl ;pr6 isions;of'Aftic e' O bfthe labor Law of Anew- irk'Star;_— _ ,:-,, �1! + {•- !.•.i"_, t +� Yo _ e sand of ',tf e; eav York'State.Codes;;Rules.and=Regu�aEions- 1' :NY'CIt LFart�S� s�Tt-!s sub a io:sus ensiouor.rev _ {k,,• .),: _ ,.J:. 1?. ocafi®nfora: i senousv latioii of state federal oc-loca lain - ��,_ ::� f t ,c:--r�.w.�:;_-_ ,, .,;:._;. , ; ,�.-_)'-::, e. 1, swath regard to the eonduet of an:asbestos project or•.{2)demonstrated tick;6f c i,w nithecbnductofan _pb' ... <Y• , . .. .; P .; tl', involving asbestos.'or."asbesto mater�a �. :ti,t, :r':,- .,'. >;.. . ,.(. ._ �, a- i' - .i;.- ir;.,r.cl•Y.-•�a'f'1.},�. ..` ='a:.�:5 :..,..,n_z..<,�. - `1t .,c.• �i '�''�.. Jam. - �. •`;; Y i '�:RY' •-..��`��� .L ,r- l: ivy :T1119;11CenSe:1S:V 1 =;rT:-�.. ,.,_.:::.a= <•�..,. . - ald"bnlyforttie_'cgntractor:named=aboye:an�?tllls:ilceri§e'or;a: hot�co` ,:mustibe.'rominen -;:. - P wpm r_, tly,dls~la'ed ata�ae':. asliesto§'p m'ect<iy$ksite� -, I lice 'eve" ;pt_1,. ps rifes'tl� Eall"'ersotis;eni It '"etlb" th+elioe ee'i� aiNasbtos T9r-.._ P_3�; .-Y.,.., ro cct=iie=NetiY York:` :Stafe;Have-beesi.lssued`ari'Asb"e5tos Certificate;a'''ro Hate for the e.of work= e :`etfo- j ;pP-_P,. �., .P. Y.P- ,�+.the`NeW�York�'State .Department of L'afor, , , _ Amy:Pliilli}is;'llirector - $H 432. $lit - (, } Foi'ilie`Conilnissionei of-LaWr NEW YORK STATE DEPARTMENT OF ii6MRONIVIENTAL.CONSSRVAMON ' DMSION.OFMATERIAI:S Itll NAGEMENT PAR'q'-064" .. WASTE TRANSPORTER"PERMIT No.7 495 Pirisaant to Aificb 27-,T�Qes 3 end'iS.ol llio F�viroerriental Eonse�valicn Lew end BNYGRR:364 PERMIT ISSUED TO:" PERifAfT TYPE6 ENVIRONMENTAL:REMEDIATION SERVICES;INC: C7- NEW 5857,"FISHER IO ►D: q; RENEWAL . tk§t,SYR4C.USE;NY 13057 ! MOD,IFICATION CQNTACT NAME: . . : . 71MOTKYA,N160zWlECK1 EFFECTNE DATE:, 04131?t2022 :COUNTY ONONDAGA;: EXPIRAT1f3N,DATE:. 4Qt74/2422 TECEPHONE:NO:: . : (31s*3.90A5.- USEPA'lONUMBER: ":AIJTHi3RIZED WASTE TYPES BV EVOMATION FAC1L11Y. - -Tbe.t?epTeetsAuthorizedto.Transg6rttfi6fo,.. ng.WasteType(s)t4"theDsstigat,on"FaciGiyListed _Aesttnattoh Facili : .LocaSon 1�laste 7YPe(s) . Noto, :. :Bath:Sanitarylandfill" Bath N1f. >Nori=HazarQo sJnduslriaUCo►nrrieraaP . Asbestos: . iBsi5t01H1kSLE:. :Evlton N`l Non-"a nercial: " ::Asbestos: . . Bioo ne`,Cntintyt anttfill'" Bingfiaintpg :NY" " ;Nori-ttaiarcioiis ustrib!camrii2rcial CAM1L'CUS:IANDFIIL::" SYRAC1 SE:,NY:. . NoirHazardous:JniaiistrlaVGoirimeiciah- :CWM.t;HEMICAI SERVICES'LC" " ' ." :.MODEL CITY;'NY :Nori�Hazardous'lndustrial/Cornmercfal ' :.Astiesto5 . _- °Petrni "m Co'-m hated Soi- " Deveto mentA on ofttie:North:Gogh- ', odman'.Y.-_ fNorrHazarrious-' - . ._ .. _ try" R .. IndgstrlaltCommerciat "R loaUAt-` k ' "All' 4, ` ntlusMaUCorirrlercial _ _ - Fultpri;Counly.Landfill."-" � :lofirist6wrr :1�1Y` Ndri=tlazar`dou�;lndustilal/Conmeretat-. . ;Asbestos.. "Gansevoort;.Niy Nbi4iizaMb.6'=lgdti-stilaUGommercial : ... •,. -;Asbestos._-•:•.:,:._.--" = -" High AcreS.lNestem F.z ansioh LantlfiA Fai Ort.;:NY:- {VopHaiardoas IntlUstital/Coinmerclal"" - . i4stiestos- - - - - - -.--;- !-,AUTHORIZED WASTE 7YPES",tiY,DESTtNAT10A6;FACILLTY;IfSTih1.�`(oontinued'op":n,:'extpa9e)''`'" ggTg.jBy.accegtancedf _;Isperniit,.the ;erriiitteeagreesthat.th8•petrrilta contieg2nt:upon'stiickooiiipliance`;wilh.Ui&Envuonmeirtal Consen+atton'taw ap'ao$1i16able regulation's,and 1ha:General"Coiidftions.printed on'the.baclt bf"ibis page,' ADDRE,W." " , Netiv Yorrc State Depaitlrient of Fnvironrriental Coriseniaticn .: . .Division of Materials,Mariageitien SteTrari5porterFrogram :625 Br`oedyiray,.9tti,FlQor Albany NY�2233-7251 AUTHORI.ZEO'SIGNATURE: :�a .Date:"- / urn$feverosg,a ,��;« . - PAGE 4"OF-3_ - k 1 NEW YORK STATE DEPARTMENT OF ENVIRGNMENTAL.CONSERVATION -DMSION OF MATERIALS MANAGEMENT . WASTE-TRANSPORTER PERMIT MU419 . ` . PutaveedloAR=N27:T1tlei3indibd,.ihoEmfror6neMdCaMnvh�onLiri indtiM'GRR364 . - VERMIT ISSUED TO: : -.FORM , TYPEi ., .. . : . 14CTION WASTE SERVICES;LLC'.: . :1.NEW : 3396.RIVER ROAD : . . ENEWAL -.RENSSELAER;M-12144: MODIFICATION . CONTACT r1AlAE:. : OIANE RICH:WOLFE :EFFECTIVE OATEI MOM: "CO. . - UNTY:- -.-'. . ;REN33EU►ER . .�fPIRATiON.DATE:. . 01l0?11033 . .• •. - :TELEPHONE N0: . " ;: : :(S16)T8&67Z® U9 EPA ID MJMBER: -AUTHORIZED WAS1E TYPES BY pESTINATION FACIU Y: :. : . Tlie Pennhtee Auttwrtiid to'IFeruport tbo FoflovrGip wean 7yFe(d)io'tlia DesUnatiorl F�cNfty irolod DeiGiiapotiFiclUty:. aoutton: .': Wiil ,Typ (•) Note.. �.�+r.I�)S1NM�. : . ' .- :Aroeny NY .No,♦rHasieidoue lgduiiblaUCantmergiaf . ' - - .• P.elrolBtimCoi►lemuaat01•sop . .: . .' : Aubiim LandAN No T Auburn.NY Nan�tieierdoui U►doatrtaUCortrmeida! . �lgbeitos.' • . : P.�troleumContamineted8a9-_ - ' -- -- " � - .'., -'AYeL'endhf::. . . . ' .:BDD_I►WIe�PIY: .•...'..Norl�Here(douiLlOiutrieUCofi111.ereiel . . . : � :.•.---: : : : .- . . .. 8 e Courilji LeildlEq elrgha_ndon adlr ' - :NolNieia atehalu 60don iri aw. _ :P.Loteii►ncon`firifnBtgdSo9. = ". . -. ci<_.einoiip`Co %Saiilfaiyliiidp►I�. ;CHeeiueD;�NY tTanaiei�hdoi�ir�p�l�Comntei�cbl _ • , • 4®tiolotnrl Cciifaii�li Sol: ,4 - '.CoicNo lt'):SWMF. . .goto�lea+fY.. ' ..t�ori�Hruerdaiia fnllCdrtu"rieiddf� . . . ' - .: '. - - . E8ML o1 thaw Yolk. FoilEdwotd,;Ntf :.P.etioteum Cti�ett2natid 8oU ::. Fulton.CountyleedNl S' own,NY- 3Jon�tia2erdoDliil6prtallC4infnOrt1 ohnel. .QnunRtdpeROF:.;r•�:°'-,,..-• :' -- ;.Qea:®Yoorf-:Ntr :� •.`NoiHipi�irdOutlrWuitrl�llConu�idU•>'-: - '�:. •. :._ _. � ;.- .:'. : .. . - . •, •.=: . -: •!'AUTHORIZFO WASTE:TYPES BY DESTINATION tTAC1LRYL1ST1Np'( 11GrilNdorltteldpay.)••• . • : :. NOTE:By aiaoepWdee ottatle PotM4 ttio P6rmtues Mptroa tiietlho_permlt la:eonUn�onl!upokokiet oompIIdrioq xnlh fho Envlronmonlal.: - . _Coea®iyatlo+i laay ail epplEeeNe ftidaUopi;a id 11io_fthen i Com ttone pftted wt tha bnek:ot Wi pdgo.. :ADDRESS:' _ Eavtmaunao NeuvYcrtcst®teDitpmrimentol. '� - - telCoi►seivetton. Divklon elMatiitalo Megapemont=.Wegto 7ronapottaFPro�ragi 125 Broedwey;ft Floor. Albany.NY 12238-Mi aly7aya�wbW.tkew_ - AUTHORIZEOSIGNATUR' Laura St6yens'e.��m�nmiaceoo�Datoi PAGE.10F3- NEW 7 ORK S3'ATE 73EPAI3TIYlEN�';f)f+�NVIROIV�;i:EN1'AI:C®1�SERVATY®N F�cflfty m�C ID 5-9146-0D018 . . PEA�T der:gee nvirbaif 3e $i i- oia5�rvatio .i,aw Ia PenlitIasurla:': : .Faci #y Waste Management Green Itidga RDh LAC " . GREEN.:RIUGE RDF : Peers<Rd: FE `ERS R13&KOBOR:RU . : Garisevoor;.NY 121331, . . 4 AIVSEv.O r NY:I2�31 : 0*06+2t4I- ..• ac3 H+'ac$tty,Pira~Ial.Rs"'eenee Poii# : EY{7!'1E 0T -'ioNORT HUMBEINDI 0C1 SARAT�ci it ts; 3:205 N ' V1 2I: '4- . - _Latit3aiie; 43°i2!tl8fi��.: ai��t�d� .:73°36_'235!!'.:,. ' - : : • Ag#boiaeii,Aaalvl i donstnotan and o ;"ratioii_of :mianici'a1 solid r as#s: 'S. iandf : opera#ion.ofap iridu§trial waste(laper,sIa3dge Iandl in acooi'da3Yce with f'i NYCRR Part=' b0-and tlie.. a#ta0 ed.pe:•lnit Conditions The maxtmitin�trasfc`acc3 ptaiice:late fflr Ai T. iaridfilfs.is a cu3riuiative of :275,000:toiis;per'caleriiar year:.T'he approved design ca 'aci` ,9.a§' Ienet.in 1?art 36a:2 =14 is 500 . : .. •t©iis:per:dux. Ttie municilal solid tivas#�cansol:da�ed.iandfili�s aitIoi7zeclto"accept;.i`izuriicipal.soiid• ' yeas e,dewl3te ed and stabii xed;sewaga sludge,: psi $iu ge-frori ' i0Tiiicti:Raper and Iiv nQ.Paper: mills,:caiioil, lei I P, demolition de rls' iaivafi g sbestos; i i-leazerd+ous cQntaniiiiated sells,acid, :iridustr�al waste ion a oasis.b,-case lzasis tie tii ior•�wfiteri De; .,z. t a rovi3l Tlie tndt strt' l:vas e landfill Is atidio&i'd to opce t "e: 'a;_ ::<:..:,t' _ F.-p40 r gud� .froiri l e`F ch:;Paper'arid Iivin Pa r,m�[ls:`TI Is;_is:a 4rnEi _ .t . for e,ouelaYIieroPlser6 _ ' see`solld t tvasi:.maaageinent'periill#,c4ritioii:4; (c):' orl 0ohdd W&#o,Mainageiine�g.' - Feriiiit'I'D 5 414& 00100010 .. : Effect lve Date,3122/2021 Expiation:Date.3 U203'I 4. - , • : .sce-pPine0:0f this.emAlt;tI3e.Ike vi tfee;agraps.l at Ap1 'p a3 eta:afi icit.: : coplans�rah�Ii �� ,;nIiplalic4bIe:e°� 3�#is�n ,:A:�r1..� Iod �ao�is_i �I�adcd as: a: off'alms Pel�nit Administrator:BETH A MAGEE,:Depdty. Perinh Admi IniAtit--6t, : Addiess;= NYSDEC,k? gion.5 Wa reiisbtieg Sub�Gfelce : 23�.Go1f.Caursa aid . . tivairelisiil3rg;NY I23$5 C'eV 7z,:jiAOs;YJuiGNnLaT'}i.1J, �. ,., ` C(......--.C� -.:.�JtifN�rlp:e.'dany�.r,inL1.. < - : 72 �L Autho.l�7 ed Sigo'at 31'@:. :c,r.:oua:musmaaKn Dot@_ / .. f . • Pe aseprint:artype.:(FOOdesignedforuseonelite(i2-pitch)typf�� tdOM•19AP14ftD0US GerEra erg PJ+srr?r 2 page 1 of 3.Em:rrencyRas Phone` .: d.)hsto Tracking Number. . 1P�ASTE RIJINIFEST 3 i)-•d -r,cr Q 2. ' ,,I q_i 1 5:Gener�torsi'I�.�irardAta7yfg4ddress Gen_i�lrfsSiteA�dress(d �ftt.Ihavt 9a ss) ' f ;t't1:.�, •��} :�''j�'l'.:1' 4c. d:`?!:...) Crj Y�•'a N an :_ „„yz •:: : eg 4'. •y? 1�_s ..�Y. 7«L.°ld 2 � (�C?3��.31L�S iZC1. 9 ,S LIi�$71 i�.3L'r y P ..iIY ' i.4:•`'�S*z at;`'•S• .� '!t[l^..?• —7f�i Generator's Ptiere: 7 c;,U.� .. -us.EParD:n,nrjer • _, ComparrylVarre.: . �:.. � .. - ' US:EPAID A'rirnbet.. :. " .. 8.De:�gna�.ed FaeiG!}�N2ra�SitlrAdEress ;,,. _ _ • -- - - . 7 . U.S:EPAIDHumber, :1vF•.�'«'ca Fai�t}rs Fhorie:. .. , - p�+, ( s Proper5hppsgtaeme FlazardGass IDNumbD :10.Gci►tenm :: : 91:Ta�(I, i2 Ufa atxi Pang Graip Cd?ny�? nQ 2' ._.: 19: Gt�IERAtOR'SCERI'IF7CATtON:''-Icy.�y�ea�a�e�'ia:sd�ir�eda3aveyatitisrr�rd'�s4acnotsuD;�ttt�fe•3Er�tr�>tta5ci�sfoi.n:par>±n�Pri�erd�wrJoftt�r��rs41'as!8,::..; - _ Garedatas` aW4PdnMffyprtietrie - - Sg�hua !•sDnth Day ":Ye=.r 15.IMemauDrial.ShiFfnts` M. E#pwt- J t Pafi t¢.U.S. � (ro U.S,' Pai of�nlrylexi4 z 7rasrspDrteisren5tuie(faicaportioiJy} Da'wkayingU.S us - !6�rd�sFoRrAcntdejeoto(t;ece'�totA`,ateriaJs: ' �" 3rdnspa ;rlPrinS: iyAedNaae:f Sgnauie.;,•' t�knln : ...Day, Yrar dran:pofLr2P hMl.ypW Name, 9,: i t, * .. pay �. Year - 17a;t)saepaarylnaca"cn Spar e ❑QDanGt%. �i}p=. . OR^_sidce '. . �pat�IR_;ei-66 :Dff.^IRejati!'a7 . Mas?esl R:teen:e tlm%er, 17b.Ntefaate Feely(of Ggrer&Q.- U.S'EPA 1D Nr mti40 ��- Faa'i'sFacre; i� Ns.Vgasmc of A4 mate FeCr;y(o:Gen:r:ar) A'eniti "Gay .. Year to.D_.`r nt_ FscliCrcercr.C+;er.•t.Ce S:aS�c.rec:.cteTatefiaGe��iia�tiy;}oinaC'v5ie7lp'$SG[t'd ill CrntIra rri::cd:7yFEda:nrre � S:�r.lice _ _ • � �. • g158 ,i �`-- j 1148te Management .Green Rid' a LP wiass nrinive►eEnnEivr' eters Rd Original Gansevooxt:, NY; 12831 'Picket# 166635 Ph (518)' fU-7.141 Cusr'o:ror.Name ACTIONWAS-kk_ACTTON -WAS7%4 SFIiV. Carraer Action Was le ACTION W]CSTE Ticker.Date 09:/1!1/2022 Paymont. Type C=edit 1lccount:_ 09 Vehicle$ Manual"TickeL'i Container. . Volume. Hauling 1'icket# Driver Route' . 5t'ate Waste Code .. . . . . Dh cck�, 115n:g .# 00.00003: Manifest 'VC1991 •ben EPA ID DestibAtion Profile 118.671NX. (FRIABLE',AgutTOS) Grid Genezator I90-11G'J'ION67A5'PLM."M M ACTION'WASTE SERVICE;. LC Time In. 09/1�1%20T.2 .11: 'Inbound Scalo Operator' Inbound SU "605115 Gross 50280 lb Out 09%11/7.027. 1I: Qukbouiid 'faro Comments sn 9-60511;5Nc�t 39580. lb _ Ton 30600 lb 5.:30 prdduct UOM, . 1. nt• .1�sb1Fi= :. - ------ -- ---- --Lax-=- _Amou ' iab]a-'Pons-A 100 :30' _-- Or 5: • Tons RFN' . i -Ta:k total . Driver's Signature: Total:Ticket a . jU-1 * Asbestos Project Notification Project-Reference.Numbers-26788618' : et TYPe:.Amended Status::Notifcation Received Notifica`on .-P . . - •,-, _ .N.otificat ion'Receivedr7/92/2 ayrnent-Status' Paid.in full. : Numbefbiariiendrr_ients:.,�..- 02 2 Notification Entered By:.'Enyironmentat Remediation- S erv�ces..Inc: . - Cc4iteaci6 vinfo:rmation:. • FEIN:02D5359.i32 :-. -_ ' .: .-. - :: : . . : , .. `. .- - Erivirorimental RemediatioriServIces,:Inc.. Rliailing Addr"es-s. : . 5857 Fisher-Road _ East Syracu$s NY.13057.: fteegtos--,Lid66s6Nuriiber 284.49. ®uly;Aut�®rized Rep�esertative : _ . Timothyaietlziwlecki;._Orer - P,hgr e,Nurrjber 31.0 43M045 : ... Pfcs ect'9nfolrmation -Project';fa Dat '81112022r Project End.Raie; 8111120 Z . . _ : . <.ro'ect�LocationCoun• '-:Warren` :: •-= : .: :. _-._:..: .,. - . •: 1N®irtte�Iroiim-'nnsation :-.. �.-.'. . . :.. . :. . .. . :. .: . .. .- :: : -- • Worker:Compensation,policy!#��VVCA2t}1?9Q3t.-'14 -:WCExemption Certifcate#:: : : Number of your.employees you•expectao i7eon ptojecf;•4. Will tenipbrary wooers be used? t�0 if es .name oftem ora ..a`end Building Name',Single'Family Room'or Location: Address Line 1: 283 Corinth Rd • Address Lin®•2: bib yTown or Village: Queenseury: State: New York : Zi ':Code: 12804 660dini Intormatioh Current:Use::Residential:- 1 family. Fr'lor Use::Resld6hWl- 'I family Approximate Year Built: 1950 Sizo(sqft)v 00 Is this fee.OXpmpt projedh N ;Reason: Euiittin Rg resentative/Site:Contact. _. Name::Jeri Trace Phone Nu"bey::518=793-9688 .: E:mail Address; Ce1[kbiie Number: Phase®stalls .. Phase.#: P.fiase:$tart Date Phase:,Eridbate PFiase•Location Phase:Sco e Sub-ddhtr` dtof Details. . - Name. :. . :: Asbestos:License�Number: Ni ii, e* ood/Shift Work-Detaft' Shift.ADumtier : Work Days',(Sat--.S'un):: : From To: MTWTF : �:O:D AM. . 03 .30 pM 07 : . Pa': "fma'=:lA 6IMn W. 6tkls.belri�'.Performetl Firsf_Nme: .Jerry Lasl';Nanie: Tracey. Organization:. Tracey Road,Equpment' Apt:)Suit@? NY. :. . . •, . _ i Rd28 ;CAtld 128040ornt Atldre"ss.Line 2: `Coiin4ry: . United.States City Town or'Village?__.: .Queensbury Frpvjnce Cflntract'aollarAmdunf ,for whom Goo-f=riti (None:. VAO1,! te:lnf6rm'ation . P�ocaa�uras artcl T a of E ui' inept and Ve¢�tliat9® S st ems.irlsad. - Negativeairfiltration units;waterfiltraboi-system;half:face-respirator;.full.face respirator;:PAPR,Manometer;: Airless,S ra ers HEPA Vacuum'and remote.itecon;if hiicessa ..BUildin berriolition' a of a ui meni. AWP;®ect Mortit(jr h `Firm- —A - Name:.. .. sb esios.License NOMber Paratligm.Environmental LW1305t9 lLaiboret� Petrtoxrin- Anal sis ELA.P Re" lstratioii Number: • Name:� . _ Paradigm ltlt55 !Yoe ®ff Asbestos Work Pipe Related: No Siding: No Clean up: No Ve&sel.covecing: No Caulkinglmastic Yes. Spray-on 1hdUlation: No . Roofing/flashing:. No, :VAT: No: Demolition:. No Demolition•Ref#: Other-sOeci -Wall Pa er Waste Transporter . . . Name:::EnVironmental'Remediation SeNice' s,Inc ;NYS DEC;or EPAPermit Number;7A-795 Phone.Number: 13154339045 Apt I uite:: Addeess'Line:1;;5857..Fisfier Rd Address Llne_2.' City Town or Village-•.East Syracuse . .. Province:." State:.NY. ..Zip:Code;-'13Q57 ' ... .- _-Count`-::�llnited:States• Landfill Name:,':Green:Ridge ; Phone.NUni k 180*307- 6. : . ;Apt:fSuife ss Line 1;;424-Pete.;Addre., City_Town'or"Villagei:Gai§eJoort . . •Stafe;;NY .. Zip°Code:'':12831 .' 'Count <UriitedStates. . Y -e.ai�d ►th att of.As�iest6-,tainin ll�aterial:. - _ - Friable linear.feet: 0 Fr ablesguaferfeet` 0' - Non4riablellinear feet:' -0.: N h4ftble s agre-feet 'A08 F06 T Total�linear feet:q.0: otdks uare feet;.408:0. Total Fee:.400.0 Pei®j�ct Fee_Sch-eduie. If•th6.hotificatiori was'submitted prior to 4/7/09- the actual:project feeds one half of the amount shown on the'fee schedule' : .. Lin 34 Feet: -Fee S Ware_Feet:_ 0=259 feet:' :$0. .0.-.159,feet:' $0. 26.0.-'-429 feet:: $200 160'459:feei: -: $200. 4.30=824 feet: $400 : . .260=499 feet: $400 825-- 1649.feet; $1.000 500-_999 feet:- $1000 1650:or more.feet: - $2000 1000 or more feet:. $2000. Rerr9airB�s - - . _ 283 C r h th Rd:: aJPER1/ . ; '.:A .�- 8�®.G: . Quee �sbury, NY. 12304: _ :SURE LOCATION::- f ;C (SPECIFIC FLOgRVSWG:} SH IFT � 1; -- 2 .. 3 . ASBESTOS;4C1'1ClIT1ES'.1NERE_'CONDUGTED,TODAY iclac�E,oNEi: . : :NO;' . ENERAL 1N,E"R CONDITIONS. .G • TEMP WIND PRECIPITATION. +spec jTe t,Criticaf 4arriers " : :. LIST V15UAL:INSPECT}ON tO'GATIONS:. • CFi'°eck"Negat ONE.: ve;Ai.�.`MaC Ines . I7,Issues addres ed;corrective.sctiawtakenJrecdrdeb;.., . Mariorrie#er Reaidings; START OF SNIFT'ENSURE:Wofk area.pe'rimeter.is fapped,off;Maiard,postings are at all entrarica?s;.tIVAC is off,isolated'oi positively pressurized;' _., .. Floots;are'polyed"rubber;zed;",Walls;arepotyed,DC7RING SHIFT,-ENSl7RE:,Wo kern:a're:protectedfromelectrrcal-dangers;All,eguiptrieritis.GFCI. protected,Asbestos maEerial is worked'vvet,Waste bags are properly wetted;seated,tiagged and Iabeled;3liowers are_avallable and working. properly with en0ughsoap/towels;:All personnel'are properly decontaminati ng,Waste water is propetly f ltered.(Rer'hdustrial tone Rvie se sevition Dais 3 N.O_EATING,_DRINKING OR ttLL PHONE USE:IN REGULATED AREAS:END.OFSHIFrr ENSURE work areaa: clean: . '- :''TIME�`.' - - : .. .. .. ._ :.: --. .•.BESPEQFIC;AS.`r0llliHERE,WORK`ISBEING.PERFORRAEt):__,-..: .: DETAILALLHEALTH.&SAFE7YISSUES;:EINPLOYEE,CLIENT;VENDORINiERACTIONS / (Q w g•. - :.... s. , G .� r _ - ;r'9ci 0 d0ERVlS0R_'sji3WATUkE _ :6THER PROJECT W ES: . . .: . ASBESTOS SUPERVISOR DA1IY.LOG AND RESPONSIBILITIES(V2), Z83'Coinh,Rd. :U.PERV:IS NO n Z. SUPERVI . LOCATION: Queensbury, NY.12:804 .. {SPECIfICfLOOR% mirk, .) DAT ASBESTOS AC711%ITiES WEFiE'CONDUCTED:TODAYlcieci r oNEj: ES' NO GENERAL WEATHER ONp17i0NS:: RECORD TIMES TEMP, 51VIIND PRECIPJTATION START,SAFETY FIRST FSHIFT Dnspectf Test Critical Bariers LIST VISUAC INSPECTION LOCATIONS: • .0 ecl�Negative Air Machines - - : :13 NONE 17tssues,addressed;_correctiveactiontaken/recorded•_ AA „ : 1. :ZZ :(,1a ,� -' • .IVlalri6ltyi"eter.Rea'dings START OF SHIFT ENSURE:Work area�pe imeter Is tapped.pff,Hazard,posYirigs are;at alientrances;HVAC,'Is off,isolated qr.pos tidely pressurized; Floors are polyed/rubbe'rued;lNaltS`.aie'polyed:DURING SHIFT ENSURE Vorkersaie protected from electrical dangers,All eyuiprnent is'GF.CI teo— : pratected;,Asbestos`inateiiat isyvorked Wet'Vttaste bags�'re propei{y vuetYed;sealer!,bagged and labeled,Showers are 2yai12ble and working " ir k. 0. proper!ywith:enough`soapJtowels;'All.�iersonnelare:prope�lydecontaminatirig;_1Nante`WateHsproperlyfilteredtRet:isid�siriatcoaeauteS6.Re ton h,' Date3/i2/o7):NO EATING;ORINKiNG OR;CELL PHONE USE:'IN,REGULATED AREAS END;OFSHIFT—ENSURE wo�karea_fs clean.'" .SE SPECIFIC:AS TO WNERE,WORKAISB NG PERFQRMED' ' - &SAFETY ISSUES;EMPLOYEE;:CLIENT,+VENDOR INTERACi'l.ONS: "..: ---- .DETAIL AlLf1EALTH.- � . a..' s79Q .S G`CrbJ'1.: (;v 45 > zq- ` -or c= S_.esr� w a2•-o.aa SUPERVISOR SIGNATURE:: • '' OTHER PROJECT 140TES: ASBESTOSSUPERVISORD ILY"LOG AND'RESPONSIBILITIES.IV2) ERSl::C ,NT INEVI�E�NT'ENTi�Y EEX1T LQ . PAGE. , l OF . 1.2-b3 CorinthRde CONTAlN1VI�NTLO.CATiON : PATE:: w' GsfSpecflCfloorjButfdtng Q`' •f 20' ? �• ' �:s . meens .0 p: Y.1zso4' 'm I :SHIFT''. 2nd J. 3rd M" =1'U TFl F SA SU. ' PR{NT FIRST ANb:LAST NAME SI6IVATURE_ SS#: . AC W Y . RESPIRATOR, IN OUT. IN OUT. ,pAfL:' 1 .. !} ;g (' ram Z. 000* � � ..:�•" .ram`: ::��` _ -��' .(�:' ri; .d:: d a. 7. . sr ' 11. 12• -ATTENTION•-in:accordance with'ICttr56.-1 3(a)RegulalrediAbaf�me6ig'WeY.kA'rea',Entry;and:Exit P ocetlures: All persons ENTERING intoAhis,regdiated abatement;work`ai ea or:;ericlosu�e=MU57:: o ' J . Sign tills Entry/Exit log., . . 1. , a. eadaridkiefamiliarvuith o'steel:reguCatians,-:persdnal. rotection;cequirerr:eats:,ndudingregu•lat+rd::aliatement.work'area,entry"/,exit.procedures.,and':emergency R . . p. procedures.ByOgnirrg this"!og'you ad6wledge,that=iFrese Have been rev�eweaftand are understood: . . . o Proceed first•toahe cleari room in'the;decorttarninatlon;urilt;removestreet`clothi,ng.tore.tem's:W o.cke�s;.and puf.on;personal p,rotect'ive egtiipmentappropriatefor the abatement.work area,including,appropriate"respiraitory,protect(ori anti`pcofective_ClOthing::. :. All ersonsE)(IT.ING:fromthit,re �uiates" bitementwuo"rkarea`orenribsare.wil{'c[oso'-throughathe,personai'.decontamination;unit'brahrough`appcopriate:'airlockwherra p g rerrmofe'deconfamination;.unit is:utiiized;except'in;cases:of:emergency when.other means;o#escape maybe used:All:decontamination pr.Qceduresmust:befoilowed in accordance-with j ;ERSI Containment Entry-Exit Log 5-2018 2 1 Corinth.Rd . SUPERVI.S R DAILY 108.: . S R; LOCATION.: �tiT.::, wart L Q GI�SYJB.flI"-3Iy 1V ! �'ZQ,V` .. �' i!1 'tif.4 {SP.ECIFICFLOOR/BLDG.?'' DATE:: Mori, : . M: •TU. .. , N: . F. .":SA'.-SU . SH FT. 2 3 :ASBESTOS:ACTIVITIES WERE.CONDUCTEDTODAY+ciRci�oivEj: „ES: '.. ,f�i0 ., •''. _ GEN ERAI:W EATHER`CO NDff10NS:: RECORD,TIMESSHIFTSTTEiVIP :. WIND: PRECIPITATION. A a p 7r>Ispect/Test Co caf Barriers _.. l0 iir " E' LIST VISij a 1NS>'ECT(ON LOCA7i0NSi._ �'i: Tpp �. C '`tk.Negative:AirMactiines o'-NONE - .; _ . . . . AA o • •Issues addiessed;•cprrectiveactton.takenJrecorded .� ^-,- anometerrRe dingS _ START.OF SHIFT=ENSIDRE:_Work`aiea. erimeter is to ed off:Hezartl post(ngs are ata ll'eritrances HVAC'is off i3olated or positively pres3uriied Floorsare polyed/ri►bberszed;;Walls are.po4yed;DURING SHIFl=fNSURE Workers are.protetted:from electrical dangers;A11 egnipment,is Ud p�otected,•Astiestos riiaterial.KWorked WO';lNaste 6ags'afeproperly wetted,sealed;'baggetl°and labeled;:5howeis:a"re,availa6le and:worfc ng`' Po"eil vNitff:enou h:soa tosvzls A(I e�sonnel'ae:''"ro erl dec6ntar inatin';Waste.yvat6Pis eo erl"filtered'f4e,n WialCode4e56Reiiisioe: - 6aie3/ yw).NO.EATING;DRINKING;OR!pt"AONE USA IN REGUW7ED`AREAS:ENS'OFSHIETF=ENSURE'W&k'area,-is dear... :. 'TIMES• '- ' -- - - _ ;BE-SPEgFICAS'3T0'1NNEREWORK;IS:BEII�G'PERF-ORMED' : - - - - t&SAFETY ISSUES". ..p f.,. ' -DE7AllALL HEALTH:' ' ;.EMP40YEE;'CilEN7;VENDORJNTERA@7IONS.:. . UO/ nn, • -lV- ., • v�. _;�' - •- . - .. . . , - - _ --• fig' ' - - _ - . - �: ;gip .( ro g."S' " l fli t�'U�• / i�'7 s�P�mxi" - SUPER:VISOR.SIrNATLBRE:: . . ®'G-FIEfZ PROJECT NOTES.' �AS$E-STOS SUPERVISOR DAILY LOG AND.RESRONSIBILITIES{V2) _ L k— 1 t ERSI CONTAINM; ENTRY/EXIT 283 Corinh.:�Zd. „ - : •.'. . _ PAGE: if OF 3.�= , n . DATE:. cTAIN 60,0 Qtie 804. 2LU g SHIFT..' Ind" ,'*d'. M TU TH: `F. SA' :SU PRINT FIRST'AND:LAST NAME:' SIGNATURE ' . SSIt 2 . .:%AGTIVtTY , ."RESPIRATOR:. .' :`!N' ' . OUT. tN" - OUT. h 3 MWit M�. �s r is 20. , '.11: E 13. ;ATTENT1DfV-In acc0 eihce_with'ICR'S,6'-8 3(a�.Regulated:Abatement-Wgrk Aiea:Entry and Eiiit`:Procedures: AI(pe�sons ENTERING into this:regulated;abatementWdik'ar'earo�:enedture:MUST: r. a'Sign.this Entry/Exit Log. o.Read:ap'0 be,bmiiiar wItKposted regulations,;personal'protection�equireritents v ,eeve:i.raicrtfuddir :re u laed: wert' /exitproeures° nry emergency proedures:8y signing thislogyou acmowledge:,thgjthese. v . aro_understaod: o:Proceed first,•to the`ciean rod I'ti:the ddcdht6Wratidh t nit,:remove street.datliiiigstore",items4h lockers;aiid. ut;on: ersona', ' r - p p f.protective,equipmen. ppropriate foe.ttie.abatement.work brea;=including.a'ppropriate respirafgry2,prot##1on°and-p":rotective'.clotliing.: A1Lpersons;E)(iTING from:this..regulated'abatement..work;area;ar enclosure will do so throw h the_ erso" I;; : p- nal decontaminationuriitartliraugh appropriatea'irlock•wken a -remote:decontamination unit'is:.utiliaed,except in cases',ofcemergencji When:other means,of escape:may be.ased:,All:decontamination:procedures'must b f accordance.with'.56-8i3(a)(Z): :I a followed In.' ER51 Containment EngY.Ex►t'LoB 5-2018' . Via.�i'�t�le,T/'�[�- .: : : � •®... . . N 2.20-4 283 .C®rithd: �L SUPERVIS R D 1�LY.L .: Ai.V. . Sl1P. V SQRi; 9:Q{.ATlON . ;�yi:;s:. .r?E?� . Queens i >rYy lV a•• �2 .4 V Q . {SPECI JCFLOOR/BCDG.} DATE.� SHIFTt ) . 2 � 3 - • ASBESTQ :-ACTIVITIES_WERE CONDUCTED TODA.Y_:(ciaciE;oNE)c. ES` : Na.:; :. GENERAL WEATIiER-CONDlTI0TV5: ,� ! • e ifMP; WIND`SAFETYFIRSt - PREC. IPITATION ' STARTSHIFT ® . lnspect%Test Critical;I3.aPrie"rs: ;, p 11S f VISUAL INSPECTION LOCATIONS:- .Cheek IVegatiue:Aii•:IUlachiiies O NorvE r. . `10 OIs"suesaddiessed;.co'rtective.acfioniaken%reco�detl; sa.1•: !�1. YS 1:, 9 �. :1lllanotiieter._Readngs 5MRT OF:SHIFT=ENSUREb:Work area.periitieter`Is3apped off;NazaYd:pos#ings are;a4 all entrances 'HVAC is`o iiolated"grpos `ydy.' ressurized;. Floors aie polyed/rvbberized;.Wal1sare:polyed:DURING.SHIFT ENSURE Workerd are protected from:electrical dangers;All equipment is;GfCl - protected;Asbestos:inaterial:is:woi&ed inlet;Waste`bags'a�e properlyiwetfed;sealed;.ba isd'a>id latieled;56owe�a:a�e'availa6le.and workir) : p�ope'rly.ivith enough'soapJfouiels,q11 personnel are.p�operty decor i#hinating;Waste_nrate�.is;properly:flltered cast.=Maustr�al'coae autea6 Revs ion. , Date3/?i/o7I NO'EATiNS,.DRINKING OR'CELL PH0Nt,USE IN-REGULATE AREAS 1~ND OF SHIP I`L`ENSURE work area Is clean. - CIFIC,AS TO,INHERE WORKIS tEIf4G%PtRIi.0FtMED DETAII'ALL HEALTH&5AFE3lf ISSUES;iMPLOYEE;CLIENT;VENDORINTERACTIONS ( lC�. tR �� ;Syr4. lig c GC j . . VN AC ko 01 : .��.. LA SUPERVISOR S1GNATURE:.. : . - OTHER PROJEC'1':f�1OTESs. • ASBESTOS SUPERVISOR DAILY L06 AND,RES0.'0N5IBIlITIES 1V2)- : R TNMENTNTRY/EXIT LOG :SCaVAE PAGE OF Z83 COr1Ylt�l_ Cl:. CONTAlIV6UlEfN1''LOCAYIONi (i►k i�o s sit DATES PRO Ueens'b0 b ICY'd'ZQ.Cj4 itstSpedfic:FlooiJBu!!ding, 'Vi `t�y.l Q. � �:. ��a z s1 . Q � PRC., . _. 5HIFC ; ::. , ;1st ind,. .. 3rd iVl. 'LU. U11' T SA Sl1', . PRINT'FIRST AND LAST NAME; ' SIGNATURE 55# A0VI.TY` RESPIRATOR.' ITV :PUT.' 1611' OUT. :0.. a 7. 11: 13.•. ATTENTION.-.In.accord'ancein►itf�1C1fS6=8:3(a)Regulated'Abatemerit'WorlrArea'•Entry,ared ExitP'rocedures: All persons ENT.ERI�IGinto this;,regutated abotement,wortt area-or'ericlosure MUST: *'.Sign this.Entry)Exit gg:. Read end',be familiar'with.posted regerlations.personal'protedidn requiferinents;including'regolated'abatement:worlcarea;entry/exit procedures and emergency. rocedures.B sf nin4-thss Io you dtkrtosrvled a thatahese have been revreweil•anal'are;urtderstoad: . o-proceedlirst:to the clean room in the decoritaritirfation'ulilt;:rernov.+e street:clothing;rstore'items:'in_lockers,and put on:personal:protective equipment appropriatefor. the abatement worh area;including appropriate.respiratoryprotetio'ri'`and;protective'ctathiog..`,' EI(ITINGfrom:4his're ulated`abatemerit t;vcfk area:or enclosurewil do:so`th'rougH:tile'-personal:decontamination'unit or through appropriate a'irlock'when:'a All-persons g • r.. "-r remote decontamination unit'is utilized;except`in cases of emergenry,wlieti ofher meadsof escape;'may: e•used.Altdecontamination procedures multi be followed in: accordanCewith ER51ContainmentEntry:ExitLog5.2018 ' ITT° "2205 : 283 Corinth R -IJPERVIS.OR DAILY LOG uee Q resburli, Y 12�04 suP �l :. _ LOCATI ON; (SPE. CIFICFLOOR/BLDG.)U•�' c.•c.� .Lt " MTTU •-- W.: ' .. - " SHIET 2 3: ASBESTOS.AC�IVITIES_WERE CONDUCTED OpAY(clRc `o Ej:, NO SU GENERAL WEATHER CONDITIONS: ,r •• :TEMP 4N1N1) PREGPITATION" • Inspect%hest Cris celBarr ers _ - LIST,VISUAL INSPECTION LOCATIONS: [heck D_issuesadtlressed:correctiveaaion'taken%recorded:: : _:: "l,;(�lt/!'1.: . ' ::,1,. ",,1:.!9/y, . . ;tn.:_• 'Manometer Readi�igs:' r-G'r oZ '-:�b it START Y URE�:Woik'a'rea erimeter)s'fa"ed"off Hazard`ostin "are aE'allentrances;HVACisoff;isolateloY oshivel ressu'rizeii OFpHIFI=ENS P PP . Ps YP Floors-are of edJrubberized;•Walls DURING SHIFT ENSUREt.Workers arg toter;ted from electripl dangers;Alpl equipnienYis GFCI �Y p ".:protected;Asbestos materia�.is'ivorlied wet--,Waste;bags are properly wetted;sealed,'.bagged and abeled;,Stiowers ar-eavailable and working properly-,w no4ghsoap%towels,Allpersonnefareproperlydeconaritinating;:lNast2wa2erlsprope�iyfiltered:�kefindustiialcodeRuies�ae4ision,...,•.. p�te3/i�jo7)rN0'EATING;DRINKiNGOR'CEitPHONE.,USE.INREGU(A'FEOAREA5 END'©PNFFl•-ENSUREworkareaisdean. TiMFS :' _ DETAI44 4 HEALTH&Sl4FETYiSSIJESREMP„1,0YEE; ENT O INTERAf.TI®NS rti► .:a %�:. f:t: a:J o. /gyp /t •- - - .. _ _ 9 (+ ii - ''�.' � .tic• 1h' �+. _- - .E�':.' - - - 4�(!`Gs .�•'4Ai�.-• - .. q; G C "w .ter.. ` ;►/1 is . . .: - •mot "�n.4 -� :. .. 4, u SUPERVISOR SIGNA-WRE _ !2. OTHER PROJECT.NOTES; A7 ' - ASBESTOSSUPERVISOR DAILY LOG AND RESPONSIBILITIES(V2) th Rd. . .. ®Ai.I'.LvY: LOGOIl S283. C � UPERS®R SUPERVI L OAk4�0^ EQueensbu�, ISPCGAIFTICIFO10N0:R/.B•L�Di�Sti:s) :roSo_vrm..4�+'�Y�.DATE: X,J .- z.: SHlFi: 2 3 . � _M.- Tu. ��-:l ;ASKSTOS;ACTIVITIES..WEREZDNDU.CTED.TODAY.IciRct oniE) .;,E :.` NO_. GEh1ERACWEATHERCONDITIONS:: • • oil I I lyl I TEMP WIND. PRECIPITATION' li�spect/Te`st:Cratical:Barriers: LIST VISUAL INSPECTION LOCA710NS:-- • Oheues"addre�ssedecoArrlecti�ae�action�keii recoPde'tl .:NONE - : - .. .Mariom�ter Reading s;. Z' START-OF SHIFT=ENSUREr.lfl/ork_area perimeter is tapped:off;Hazard•postings are'at;all:enirarices;HVAC Is off;isolated or,positively pi essuriied; Fioors.are polyed%rubberizeii;lNalls k� -polyed.DURIWG SHIFT ENSURE,Workers are protected from electrical dangers,Atl equipment is"GFCI,: -- p`r"ote"cte 3;�Asbesios.rrmaterial.is worked r+iet;lNasfe'bags:are properly.wetted;'sealed:b'aggedand 1a4e1eil;Slioinie�s:are.availabje and working , prope�lywiifienoughsoap/towels;Allpersorinelarep�operlydecohtammatirigj'WasteWate7f5:p[OpellyfiltefEd-(Ref.;MduStr�dlCOdeRule56'Revlsicn oate,'37ai/o7I N0,EATING;DRINKING OR CELL PWONE USE IN REGU,IATEVAREA5.END OF SHIFT'tkE URE-work aree 5s clean :'. DETAIEIL1 HEALTH&5 ETXSSUES E P10YEE,aENTjNDOREINTERACTIONS '.. •. ;cam, ,. .SUPERVISOR-SIGNATURES OTHER PROJECT NOTES: . _ .. ASBESTbS-SUPERVISOR DAILY LOG:AfiID RESP0N5181U71E5(V2)• �`'�v Y f(yW i.,; � } � ' i�' 3 fM°fm1 f f•+�"'- tom•.. �i' S T"'; 3,:.»�yt1,r,• !^�,:: �,�{i�l,�y�4xu'�, �" .'4�1. �ip •'Jw '} ii'l x, } •-{.Y 7 ! C k sr t r yr t 3 } }J { i t t I I fr, t T }• �. a tt I " 17,1 p�C.„4 itt�� '�a J�i t � !a �e�a�� a N ,f i �' F i ~��F•t •yra*-�„r ,�ir��� y}'r'M�t !4`%{• •trj4i}r{,���+,1�,:;r 4, y! t, ,sI �.. • .&� T..-.�=c. �r 3'aV t'S�d; 't .• ;f t ��k"I I } I i ,fs.; '*�t,� CF .. P. .l Ohl" ?�t .'-.�.' Si•,� �i+y �,,,k`:+,�.y r } `fin! tc+��• r r1t F ��}}�, k . E� t w� N_'1 •t'lii�.' s? 'y,r� gr^�,?''r,Gy"'•. 'S•` t`iy,r3' '{ # '�7 t fy1 i; g a. rim 3 r� R rw ice,. i I , »� ti +�"4r-,- 'c ^�'"S'`�j"'c` �. � 'i',t�"ks �7 ~a ^Yii � ,rsf•S 4 .i�i . ' F�• l h l4 r tt5 '" i' M ns:•f_ `ij k. Tf p� .'y4'S y „r. .-7LI .•'.'j�, s�' 4 •a IZ 0 f. ' �'N-+C.-�t!, l•.'x,r - Wit` i ' _ " :3. { I �.• •'f a 7�� f�Y.e.�k��E" .:,xg1.F?rr.:.•r.;, kC. 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Su `=lied Air Res y uro P.r. r :Cartritj"e Res irti6 .. 15 P Self`aConta?ned: xeadtingl�pparatus - PQtvered Air-Purifying:Respirator. (PAPR) : fIES i[8ATO C�;A;9ShFICAT.IOtN. .. = :C.LASS ] N+D`I S TR1CT10N:, N 1t 51'1tt 4TQR.USE.AS DESCR1k Ev ATT—IMC.bp" .. CAL,EXAM; -. .- - , CL �S 2 IBES lit�11,'li'® SIRE Lift H1Mij .S Jt S�'R1CTIQNS;dCSCR_1B_ : _ 3 .S�li'i'➢-t.1�5;TVIITVU:TE:•1tl�C_ 011 1�'�• - - '= 0 MlPIl1TE. USE"V�ITII 1S;MtNUTC RCGQVi:fiY El .4rIL;ASS 3 No RCSP.ERA7OR Use RECOMv1ENDED.Ti-li.s TltvlE.; Cemttients:. . •. I'roviderSignsate>tec: Dade:. • l':r�r: 3 :i�!° l �;• i?:= (�l+iililicci �a:itrrn�ttl iit`:1;1.,r�ti',; 1 i,+.•-.i_lat; lei i::+•,•i h:l.?+t~1t . :.\ ctq)), rzf!lti •liu•ttt t1i�i,:1 h� i<<.irS;, Illy.vrt;z?li>>Lt;. - �� v�r®nmen��l ��i�nedia�ion Services; inc: FIT T�S'T. �P R7` F.OR IR PUR1FYINO�RESPIRATQRS :(EXPIRES f.-YEAR FROM.TEST:DA7o EMPLOYEE NAME.(Prirotj: �; dal:; t. : .i 1f t. LAST 4 Digits o€$SN: :.. - DATE: FIT TEST.MET Hbt `USED: Qualitative-lritarZt=Smoke. RE$PIRAT4R'Tl(PE 1i2`PACE APR FULL.f4C ApF77 _ 'POVVEREQ`A RESPIRATQR$F�iAND:. RESPIRATOR - .SPIRAT4RSIZE:: :L :. R e�p7rator:T�atriing Record . - fVOT10E Yo[r=sigriature:will attest tlii t yo,u recatved and-untlerstari tl:'the:faitow ng.re*rat or.training:' :9nformatrort which both OSNA and.ERSi 1'equire as part o 'the.Respiratory Protection Program: - Explanatiorl in-misusing oF,inter-changing pars.:': irx (araMori_,"dj iriliaiib'bf this-iYiake.arid ri�odei.of fes'-.1�ator. : p. How to properly;ac!}ust aril hear iesp�rafor ExplanaEion of essential.caie:and ma'intef iih6i.af wwrespirato_r. How`to properlyin`spect;:clean&iiisinfect:respirator.. : Explanationtor ttie purpose of tiie.rimedical evaluation How:to conduct faaepiece to face seal cfieeks 1?iE'ri fitted to leave work area.#o irirash t�ahc#slfac . s.n"eaoted' Novi to!cFiangefiite�s/cartrtlges:: .; Cliarige`fillers.;ir(rhen:b'r',eathln$res)stanceincreases.: Explanatror that APRs only filter the air _ Fit Testing`is rgquired`to be ctimpteted anrivally ECKTEd PEOWo MOD Breathe i11grrnq, .. -:. . _ .. . Y . _�:, � :�.:-: .-� ::: �: . . ...: : : . .. .:�. Grimace (1-5 seconds)•:: : - - Maus:Head Up:arid.Down- 13ehd,at., A19t: _ Move.Head Slde to:Sid® Brea fie`D.e_eply , ;Run;in Place: : : Talk °ss$.Resuits: .- Pass_. Fail_: C.orrrrnetits: 4 Eras ia'ee Name Si natureA .' t' . . . : Tested BY.(Printiag), Ohl�e : ._ �. - : (Signature): : " . 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(::; t�:ct c:: . : 1D# - -D_ B. ;le>�- . .Employ cr_ "5 2. - Date Type:of E:xani:f-1: Pr6l6a'sefliw []Aitimal/Periodic El Exit. .[1 Dili,-r: After conducting a physical:eveltiatioi:.onahc at�o'te nAmed individual including a: : ;Ite ieav of hiss w past-medical histoty ❑BrRead.X-"Ray;Date:i S}iiroinetry E ;apiritora. sbestosiQi estioiu`taiee �1 Glicst;`C=I :ty,:Date: :WaZmati:.l hale de tenniiied.that he/siie.l:as no detcclable niedical:coiiditioiis tliat_1you d.place (iiiilher at risk of` . tcril;;liealtli impainiieiit`froiii ezposureao ti�azmsit"in accrdancc�� th_OSI l,A. 191.0,120i.=11ny necessary restrictions are : . lasted.below:: ;As6e"stos I itave:dcleriitifined thin,helslie ha i�o defect:3lile:niedical-.co�iditiotisahai.ivo`Id_place.lini/her,ai rill:of " tiiafeiial:liealiltiiitpainncit::from cxpasureao asbestos m accordance ie;ith:aSHi1 1910 1.0 1 and OSHA.1926 1 iQ1:. Anti "_ " iaecessaiy restiictii�ns:a`re.lisiei.b�lo�y. - � . .?lie l lijsic l.6 'Mi slio vsXno signs of.asbestosis. T'hc ctii'10 ee,liasai'ecii'i.nfotii eii;b tlie. `li spe6an ort'cdical: roa�ider:ii•o.Tkin under ilesu ervision,ofa{icetaseiJ 'til ysiciait of tltc..°resylts of.tlie meci cAFe ahiiii ditions'_a'elate-t to sbestos ealio$ure tha¢re dices turtlier'ehplanatlon.ortceatment 71ie emphi�see itas teen ifciiedai =>iliczpli}sicinn:o#`th mcicased i cs�of.lung ci{ncer nttriliiitabic to the combined eff'ect;of sit 0.j �nil.asbeslns c�pgsiiee.: i'cr►odic:iiieilicfil a t�itiii►afioitviigs�econiiiiencle l He/sfie'liias. io:lifit ations.-oii tl�e tise:�f'-personaI-:pro# dive eduip#iienf. PPE) ;i le%she;is'also �1 SICAiJ V aril:itic�fical# uatif ieii to;iee r.the.fohowin' t ;es_otru '¢ra or"roteciioai in acco'idanctw" ' ���iEi�OSl :r1";191�13�asiiiiClii�ed 6etoiti�; ,- .. - - I filter Res::iratar:(Diist.11ask. Sii" #i-d;A r:;I it�ator. p ) pp P_ Cartridge;l espirale?r : : self.-'CoiitaiffiM , rcatl ingApparatus !'ci�yered.A.r-[?' fj+in�;`:Usp tat0r li ESl'1RA`g 01 CLASS1-F1 - T1i01�1. GIE�ASS f NO"RESTRiCTIQN ON RL'Si'IRATOK US:t 15:f7ESC.1tIpEL3�A"f`.'f11�;9E OF THE Al - WAL CXXA - CLASS:2 'REST'IIBA'H'OR: S)C'H WITEM AS RESTRiC.TIONS:DESC1 ME: 0 A }-FOUR VSE WITi-1 151 ku'--rE RFCOVERT' :. . 30'NiINUTC;USIJ WITi[ IS :MINUTE R'ECQVERY. ❑ CG 5S 3"-=NO REST?IRATU R USE RFC01Vl_i4fri*iDD:T IS.-TIti1C_:- - - - - Cottiments: . prob�itler Signt�t I'M � � 1" � Date. 1);i�+�" t4l' # I"�t1i:i' 12 �ii<<lili�.l tilcil�i,i�i�t.lin .1,i�c�lu:.l lai-;at. c(I'm (IC111is lVIA1 lint fie Ili%ctl in Ilt� emploven. ErivirQnmOntal.Rem.edW! 'n.derv_ ices; Inc: . FIT:Tf EST REPORT. (E.-PIR9 I YEAR OR T DATE] . EMPLOYEE NAME(Print); LAST:4 Digits of SSN:: �/- DATE: .. , FIT TEST-METHOD USED Qualit fi• . ... . . . :. . awe.• luitant Smoke .... ..., .. :RESPIRATOR=Ty 1/2'FACE :: .• .:. :FULL FACE ESPIRATOR`BND: RESPIRp►1`OR-MODEL:. . ,RESPIRA'I'OR_SIZE : . . >• :S:: . M R®s jratoe•.Traoinit�g.Rod,or _ a nature tiefow attests,.ttiat you received:and.understand:th OTICE:�Your sig �nformationwhict _ otii-OSHA anrJ ERSI ui- a following respirator training r q re.as part ofahe:Respi�af�ry Protection.Progeam Ei Pp ggat pn q:inisus n - �:>y. 9.or inter-changing parts : . : .. Ex ianation :_ _:._,, . :. :. . afovirto.' ro erl :adust;andwearr `: :- p. gf,lirr�itaGonsofalfs-make,and,model :: p :p y 1_ _. _. es iretor.. of respirator. .p . ::Expianaton of essential•care and ma(ntenance of'tiiis respirator _`How'to p opedy inspect;'clean.4,d sihi&t respirator : .,Exptanatiai foc flie,'ry u "se of ` :..:How to contluct tacepTeceto face seal'checks= :. : _ p.rPO the medicai'evaluation . :'How.'to ' o lea`v"eriuork:area to Pemi[tted:t , change filter kartrtd es iara h H'ands/faci3`as pee led . Explanation th�tAPRs only.filterahe air. n s... ,: Cha ga hlfers when;tireatFing resistance increases ` . Fit 1'estfrig:is regpire�,to tie completed:annually :: HECK TES'6' :PERFOIlIAED Breathe NonnaU .. ,. . Y . . Grimace : M `_oye Heatl:Up antl:Do Move,HeadSide�to Side n fiend.of Waist ,�/ Run:1n:Place. Breathe;Deeply . . . • �:. .�Talk;.. : :� • �.. : : . : _ Fit Test Results: p .. . ass . . a • Corrrrnents:. . - � . . . . • . . Empi-Pa Name{Signaturd Required) Tested®y(Printed)°:_ rr . . L _ Si nature . Foim Revised 03-05:2015 STATE OF NEW YORK:-DEPARTMENT OF E:480R - ASBESTOS.CEf TIFICATF.: EDDlE L LEONARD CLA55{EXPIRES) .: .`SU PRO 1 J22) : . . :. J��iUST-B C ED RI : "Oh1:1SBESTOS RRO.IECTS •. �.;�. :�. . . .. E`. rlilt. .. �i.lt9lifdlBi!lIHI : ._ :: .: . . ,��:': . = : : � � - � _ .�:. � = 11�11�11111�:I�:Ia111111�I1IlIf -: ��•- : : � �:�. :: _:: � :. :� :�:� ::: �BLK . . : . 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TSGA TilPc Il;ivns.coiisistcnt with ih'q ceimculum.and iitsliuc(ors appravcd'liy:lPie.Nci�wYoik$fate'.Dcpaiinicrit nf'- __ 13callhd aiid the tXmil' irccivlf,19:yt�(i"'cid.icptc;corfi Idid Wlrainmg rotirsc.acaycf�su" cs fully sss_rcP'IhC cxammatian. yr �6'f�jBlltb UItY'CtOta: 4J"),�! r �c�gi� r S - . y :~:+.• (Print) ti� igniitura): iIE: QP� r >: 11=2832(1Qo3) . :�(3iitionaP Priforirintion j'VQWFgii okficy iisA,d by ldY;•5'QMDH_rcpreRm.2li►l only rt 7 ..ay .. - :�' •N• '^:.f:`.d2 �a - �L q' crt .+�Su.^N.^ - t�hlaJ - L'v. OSHA t�'fill u.S.DM�?�tmentol labor',' "". . OccumiWhi$31ety po Heanh{cbiirtuslrat orl _ .. -. ¢}1DVr pcct,alicml Safety and HCallh •EddU Leona ' - NIS WccCS51UGy=noelod a.{ {So in= Trainuig Cait Consiruct on Safe g.Ffealttl., j�Boa i ' : (Pali) `(Tianeil _ �CCUPATIO.NAL MEDICIADEw AZrti1i17'AND.ASBhSTOS RESPIJ?ATOR AfFDICAL .U1t$IFit,4TION. : rtiployer 5: : Date 9% oir �^-- •-. Type of EMatn: (] .Prc/Basclinc Annudltpdeiodic ❑.EAt Oihcr: Aftcrconduccingaphysical evAluationon Ili ctiliovo named individual incluiiinpn:. �6Acw oFhislher past°medical 1t�stdry []:13-RcAd:X-Rity,Dote; ff [] Sp rometry l ewratlSr:!Asties,a Questionum, (]Chcs�X=Ray;Date: (] Othci :I7; al� t �t%.I lial�c determined�liat he/she hA no detectalilc mcilicalccandigions,that.�vauld-place:hiin/ltcr at risk of . .,.. ..�:-.ter:.•.- -,= �- inAtetiailieallh,iiiipatmient=froi»eXliosuretghttzmot naccordanceivitli`OSHA.1�9.10)i" Anytiece ,aryrestnctiiinsarc - .. l'istel`ielow ``Asbestot�, :f sivc. lctermineii`liuthe/sho:h 'n�deteclttt l triedical:ciintli(ionsahatwould_ `lacerhiinih6t aiAik;of . aterial:h"eali Impaiemeni.fr'om: xposurc.ao;askgstos_in accordance witfi0.5tiA.::91.Os1.00:1 and. SH 1`i'92f.11:Q.1. Any`: -- necessary rest�tct". w lisidd ii%lo'tiv: p Y• r • L�f .Ttic It .s�ca).cxam slioivs ria.sipts:of.asbrsiosis: Tli•`'e to":eel's�bee--inforn., b"" lie: li sicianor.�iiedical. 'rnvide �uoskin uniluc:thesu` 'rvisionofo licensed. . �D,p: cti mr.:Y.s a - n. Y, -.P�.,y-. - -1�. s 'Width''li""re`ulis' fihcinedicotexiuninatio anda i:n c 9icnicoiidit a' reiatedactiaslcstas,ei; #hatre t -•s. ptiy, cian ft c S:. o n. y tag pp . .. 9. re u"h'"`cii lanabon or"regiment: Tfic c`� `io cc l us ices ii tonnai;i tiic:.ti sici�aii of the inci acca risk of.<iji`"cancc : ati iti ifabic:to ttie�cotttpiiieil e(Y'@ct-ufsin king And usl stos a ajiofiare. Periodic ri'Aedical eXamintttion tvas iccommended c/stic hus lid lirniiafions.on tiic use ofliorsonal.p-rotcct ve-c ipinca-t:(3�6'E). rr/she ts,als®:physically and medically`quulitied to wear ehe foiiow.ing;tyjie_ti mFrespirator p 616t tioii III:'' iiidancc " .-" with OSHA 19,i 0 14•as outlined belO-W. - . FitcrRespiator,{l)iistMaSk) [] Siipplied,AirRespi�ator (� Cartridge RcSpirator . C7 Sclf Ciiritaaned BreathinS<Apparatt* ifyin�Resjii�Ator �i PR) RESPIRATOR LASS>VICA'TION, Mj LkSS:1 :NO RRSTRICTION ON:R'990111ATOR LISE AS DESCRIBED AT TIME;OF THE. [� CI LASS-2 R�St'1RATOR,USC I INATED;AS Rr-.STRIC,TI..OW.S DEgeRIBC: = ; []; 4.HOUR USE WITH 151v1.lNUTE RECOVER'.: M1IVUTC USE:WITH 1 S Ml 11T RECOVE11Y .Cti;ASS3°`NO-RirSPIRATOR USE -OlV1MENDED-THiS TIME:-.= domtite'Fitt: Inravldca Sl�natte¢'e: bate: �! . Pau 1 0 .I i .�r�U' ! ' (,':�:'1a1:,: :: �i.r:;+tl,'Itt �.�: ;.I+...I��� t I;t= \Lt1. 1i�^.t•.ic1 6.1 '16 ii irti+•. ��j fl 1• :•'"it7 fitrl.i 1:.' .'t .':i 1.s 011 dl V Il-� nvirolnra�ental:.R�li�e o�ir>I �t� s9 Inic: FIT. TEST RPORT (EXPIRES 9 :YEAR FROIVL TEST OATS) . EmpLOYEE NAME;(Print); LAST 4 Digi1s;of PsNi. DATE:. a fIT-TEST. = : Qualitative. Iraita it.5inohe . RESPIRATOR;:TYPEDILL.FACE: : - ::IPAPR:. :: : : .RESPIRATOR BRAN:; RESPIRATOR MODEL:: 1 PIRATOR,SIZE:;:- :S . Respirator Toaining._Recoa NOTICE 'Your�stgnature:below:attests that;;qu received end uri a,s06hd#he'follovuin`"_res i afor fcairiin"g. [ri€ogn.p rorr:virii ch;fjoth OSNA_and ERSI retju rejas part of the Resi iratoryM6?rofiectior➢ P,rog"ram: : : :: -Explanation ri rnsusingor nterweliatigirig:pans;_:: ; Ex{lariat#on of`lirr7ita.'tioiis:of'this'rnal<eEand`:iriodel'of re's'ry"'irator. ow. properiy adJust and wearrespirator= Xp�a�na#ion.of essential:careratid; iairitenadce-of.this_.fespirator F#ovr,ta propertv''iri'spect;;.clean&itsinfecE respirator: c tanatori•forKose:of-t#ie`medical:evatiiatiori,':A Hovuto:condiic#=facepiece to face'seal chgcks Peritted:to reauer otk`area:#owasli:handsltaeeas neetl cl%angefiilters/cartridges GFirlge;fifiersihen;b�athi�g_"resistance°%ncieases e Explar►abon that APRs only flter;tlie aid Eot'!`asting rs required to be;c9mplr~ted:annually : . CHE CK PT,S:.PERFQRi4�ED ,: : :. , .. _ : . .• :: : . ; - _. . -,: ' :: ; ::- : , :__. eatheNorrriall': . ...., ace:: . Y. G.l Irti. `MoveHead,U ;arid Davuri _ .v; . _..e,.a:; :. . f%:fiAove Head:Sitli: to Side. .'Br ithe:Deeply, _ -1=1t Vest'Resdls; : _.:_.. :::•y: ,._Pas :: :: E1 -- _ --_ -- .:.-._� - _- : Conrraents:.:.: .. . . : l5ni Iti ee !Name Si nature Re ��.. -.. 'tested S Printed}:- Si nature �- . . � ( ( g ) J .Form Revised 03 05-2015 : iSliakcr Roa1.d.790,Wateri�lie A R:A :D.`lG. M L1�_1�a���,N�� York�21a `',5 '782 1466;(plionc) E N'V I R 0 N M E-N TA, ;S.E'R V I-C E S. www:iiaradib%menv:cciiii. . t _ : esa a reEiiir17 ed for: Tracey load Equipment :Alli:a : _ :Ne--"M i'rk: 1 Z205 ®; Y - �o - . (ierforined-liy .:. ;.. - . _ Parad'igm:EnviibnM6rital.LI C: . �. 790:Watervliet=Slaker'Road �R+ ow La h New'Xork 12:110: orined at;, 283 Corirtl Queesliu New`York 122804 Liviiig-:;Room Wallpaper:Removals. Ta th Wed'riesdgv Au ust 3.. Thursda.�� Au' , _ Paf,,A fn:Joli #22.OdO5A : 190 WatciilietShakci.Roaii e liafl3ani Ncit�Yoik:L?1.10• PARA D-I G Nf' 516-782 1466{phone) �Mr. E N V I ke-h',M E,:N:S'A:L; L_L•.G: aaaaaa:naradiLmend.com.. Phase-Conirmf Wcroscopy.(PCM);Airborne Fiber-Analysis' NIOS 74g0 Metliocf;I ue 3.,,Jiue'14;20,1-9,'Coiiiitit�g Rules t'A" CI{crit:' Glient Priiject Numbco'- Sampled 6yi raccy:R_oad.Egtiipnicnt Getirgc.5oinetifroli%Pa I'naject 1)es��iptiorii. Paradigtii,]oti Number: Satiipl{n�Ch isci Luring RoonrWalllaper Rcnio�� l 22.2200A. Uackgiotind'(iB Pro et i l ocztiont : • Hate&imr{cai. Da4e lle chh M at A r !, 283:Coiinth It'oadi, i>ccns�tiry,Ncw,Y�ik 12804'. _ Wcilncsil�y;Augusr3;;2022' 'Wed,'ne 8ay,;August3;`202.2.: : Clictit Natrict ClicntCtiniaeii: Date Analyzetjt Date'Rtiporiedr:. Iv1c.Biidiiy:Ki yiteiiy fil crii;ciiiin�i iici�Ti��1.�oi;i..: TIiifr6o ;y;:A:—st 4,•2022, Tlit rsday;Aili6t 4:2p�Z ; i.. o . !~ _ . . . mple:Dcsce�iption.� � , Number Numbcr �;3 s. r .G.8 a._G. Az l 2.380, ltisidr lr!iirk Area-:L{vh Riicini .puili -onw:,. 12.00: 60.0 : 120;0 12iT39 l6A1c_Wotk AreseLWiiir :Ciiritet 12.66, . 6-.o 732.0 A010 18:4.71 -.. 3, 9382:• 'lit ice WiA Atea.-Lh inig Raxmt-=Grntrr.• 12,00': .61.0 - ' 732i0 .(M4 <7.(i06 '4 9.383; .liislde\Y+,rkAiia, Li�{tir,fiiliitu, Eat:Gi,rnr_r 12;OD b'lA 732.0 0013 -i4.841 . S . . . ':.2383:., Inside.1C�urk Atr1 'l ieintl Rtiimr s'NiittlYGunier �. 2 1,00'-. :61.0 73_p. . li:(+04 7.643 . :: : �385: Qitt{dc Wtiik Arra Friani Pt�rcli, 1?.00' 61.0 732.0 0.014 .-.26.1 l5 . 7 . . ;9386, Put"si&W6ik'Ari•a--Kit.l{i•6 Oilcr:' L2:00 61.0 .. 732;0. : h.�07 1'1;T3'9 - =a 8 -= -,_-938.7,-= 0imlide:NviitkAft%,"kiieliei.•:1C+ea- - 9 9388 Qut:iilr'.W,iik'Arra, Rack Ptrrcb:. 12.00�'� 61.0 Y 732.0 <0.{!04 <7.006 0. 9382 . Oirt'side it ork Arra''.•From tif'tlir H �'12:00' ' '63.0 756.0 j0.903 <7:M6 ' F131 . .9.300. FieldBla{ik .•NAI NA . NA NA 47.M6 Fb-. 4,9391 . Field Bl tnl . .. 'NAj. NA' NA 'NA A nalyzcd 1 j- Dater. " Appiovcd byi Daicr Mi.Mack DC ARioiini Ne iri-Analysi - :.8/4/2022: (� , ��8%4/202Z - - Analyzetl by WY DORE'IAA,'#13138`. : \1r:Mark Dc:Aunttiin Perc{n Trchuical Laliura[i?t3.Diraxtnr. -. Divlainu•t:All Air Simple..ate Citllri'tdl end'.•Cnali:iyl iit.i)rt�.rdancr u•iili•the`\IOSH•T�I(Yl A•,Cotmiinp Rtilr�,XlrtL,i;L M�ie nror Ili56f7ucr'Gunia.4 Ntirrt�ntpyal`C11)•rinaly�;u using KIOS!124M.%d inrpna ofbnaly�ic f it 6brr counting•T3,u urdhn l(c nt pstxrilic li+r ihr anxt}>i.of a{rMnte 5.1 cFust lil ets.Ilrc anilttical tewlu pre coral in thi rrjimt and t1sc IaM.iaisuy pnir,ilures'wca are rtdtsjderol a+he iecuiate and reliahI rm 111i•rati,ple+analt..I.314c rcjxm,nwiy'not hc•rii+n h;fc,- 0tliout ilve aatitt&D!ppun-31 6(-hradig111'Etia9iomiKntal:LLC. (PAILADIGNt1;ni l diem only in full:All inily.is i pedtin,hising in Otyutpiu'Cll-:O,$licitvco{e,{$\1 E1,IG97).'KA'-N,u Applirablr,'!Ir 6 note that t3ital IGna"rain iie`nvrertr,l ni aintt a i+riuiaq•.6ld'r2tiuu:'F16ct cinu Li dutAk the IM-13M{ihei/utiid rmiiF shall Ge feixnial al Laainj,'giratrr dun.'optinul a5riil.ilit}an,l ac_being'pi rlvblti hiii i:'Siria _ ____- PARAUIGNt di,l pot adlrctthe ali.rrmrnti,ned minpl, the t'crilL�bilih of die rridtris Iimltrd to the rrponril lihrrf/nun'.: Rcliiive Stanilard'Dn!atkw:A.._'p r NISO11 140 A Q ting Fulyd Mrtlux)r,Pr11:ADIC'M c'ti,luirnl tdtrr ,rtruGnairil lalw.iatu;y_[nmrtntmtit pred'inn; m-cC,lntuuntri_5,w s 0 331. Mhn0?i0(asy'01i1x - ixt , ) : (0630.2 3). VO Watten•liet-Shaker Road • . Latham,New lark I 110 PARADIGM. 515.7$2:1466(l,llune) : E N V I R.Q N ht E N 7 A L, C L C ww%V;tmrad'ikmenv.com A'slsestos Air Sampling...hah-Atof..Custody/,snwph" ACCOrd 'Client Name: .4mpling Phise. Uate of Sainlile CoUccti in: Projcrt.11 .cription: ' T'vIv o,,f�Ahitcmcnt:r Paradignt Joh7i lu�mhcn �•; / f/! a✓V 1 pCj�el' lL�!'iQ(/cvf �!���G/4 �.-- _ �Z • LLOOA Project,ddreia: / Hotantcter.lf)Number. Cisetcc tot 1CumE r: }h Rd, Qveens ? aGaaG�o + Client Citntacr Name:, i:lirnt Conr.;r.t 'honcf[nialli Rotatmrcr(`alibratinn ttit»I)Mender-S1(}[(4"N 1MINC librated00.0 .22 ltotantetcr Calibration Cood'Ihrougtr p`).O�w2. Sampling Flog Hate(Uti•rs/Nfinute) 9'ime(24 Hour Format) AI3 f f a' L ItiLll �amplc 1 Duratiou 1D lU (total " i Initial Final Otr off minutes) ' �13so TwA= its e l :+ �13�• �: Iz�-S-�/'v; /'cart=,c�.t't CcVvei- ii q,38fo 2' Center' t---LQ-3.•krYcA_Ct-ems:- ( 1 1 i /C3-5 1230� 64 _ 64 i - 1 3�0 1 AU Air;�auiple are Collected and:tnall.e:l-irt_Arconlaucc Hith NP.141 MV(A Rules)Me-thuds. lk6tei=sitRiine this doctnrtrnt,.%•a rifr that the mn'tcnt wu arraigning is correct. FBI 5.imple lucariuns sketch, identifying all project air sample location- aud,'or Print: -- ~-- Dal`: related notes: 11 - — _ - - x r Sign: ( Tittle: Date• • -� C``r�j Il 4 � `� ' r Sign: Tttuc Prinr,' Ua-n, :r � �"�4i�1 CvL�ihun, �•3��� rk 1- as ti FIfe-.ave nary 09.01:21 790,Waieivlie'tShakci'Roaa • . o latliain;'Ne►v:Yoik 1Z1.10. P.A. •P ] .l.!i l 518:Z8Z�1466{phone) £ h L'Ial O-k Wl it t A_ L L L ainvw.i%lradi-menv:com; Fiber:Count Bench;Sheet . P ataii�gm'Environinental;�LI'C.Jo}iNitmber I :222:2O0 ; Field`1D Lab ID' a Whole . ime Analysis. . I a1f Fibers Total:Flets. ;Total:Fields... . .. . -- •,. Nuinkiec; Number . ..5.,... _: .. - .Fibers=� •.H . . - . carted'..: . + I Coiiimpleted: ; - 'S 93.84 . . 38 t 8 938 - -- - -••-_-k._.--.._:.gin. -- - - — - - -- - - _ - �-- - - - -- - - - - ---- - l0: 9389 1.-i. 9390Ito 931.1 ' 5amplea:Prcpped by:, -I}gEe.I'rapped�., : � SanSp Analv:ed 6Yi. ��. � - � -�'.llatOc��l� ... - • An4 sis'pedorined•using an Olympus Cli-2`Microscope;($N 4A0289) •late;and Time Printede ". • 3 of 1 790 Wiiii.%i etSbkcrloid. - • , W L•tdiaiii, +•.1ork.1Z110 -PAR A--D.-I;,..', :,_'�� I 518:782.14GG(pliti ic). E N.VIR.O,N"ME:.NTA*I' LIC. w��n:niradiginenvxop Pha ntrast:Microscopy,(PCIVi)Airborne:Fiber-Analysis, �-- -se Co._. NIOSH 7400 Metlio Ivtie:3;,.J`uiie.14;;2019,:_Coiliiting'Rtile.4"A" Client:I?rojcct'Ntimbcit: &irnplcd:6): Triccy:Road I;quipitictii: ,Geoi64.Sd:.nc 6iv6f*di9pi I'ioject Uciaiiptioni. '.'. Pari3igm Juli'IVtimliczi: - Samplipg Ph"". ng;Rooill Waly ahci:-, oita%'''L 2202A' Abaichicrif;(IIB) . Prdject;Locttii,ri"r :. DitcSaA ledi Datc,Racctvcd_atLa v 283 Coiinth ltoa l;Qiiccnslitiry;Nciv Yolk i'2804:::: Wcdi3esday,August 3'.;i022: .Wednesday;August-5;202,2.: Clictit Niliic:• Client Ciiniaitr_ D tc'AnalyzcdI Da ic Reportedi hk iiiicdi rrac Toail.cniii:.'. Tlit7r:il i Au�ihr 4,�0��` `Titui&da ,Ai tint 4,�0,,I e:iWdd Keitiied s`i Y - g : 22'. o ° M� Simple LAB ID F r �... w L' " Sample Description . ' gO �. a. • Numbcr. .Number �' c 6. . =: ir•' e,= . h- 9400: u'itltin:l0".iif Pasiitial i)if1111:. 3 2:7• 314.0 1095:5 0:016 :44.586 3 19401, icitlitn:10'i f Critical Birrier•1. :3:?T _ 334.0 1092 (i.hti7. 19:108 w-itldn 10'iifdrieia:A 6ariirr2 :3.27; 328.0 .I072.6 i(►.(�b 17.834 i. Ouisiilr Buililitit 3,271 '33.10 1082.4 <(i:(M3 <7.(�136 404. , yiiiliiii 10:_1Sfr�r�.lif ;�UNAiii r ; . 3:?7�• ". 329.Q : 1075.8 . ':(i.M 4 : . 11.465 G 9.405 :tiiihinap`of VJ i3rr Divrin :: : 3?7� 327.IJ lOG9.3 <Q.(?(i3 `<7.M6 FI31 : 9306 F1r11i_BlMik• NA. Nr1i r . .. NA IVA <7:M6 FI33' 9.407-' Firlti=Bl;mk= );!A:=Np - .- I3�1 ,. <7.(Kt6' -.. . . Aiialyted by:. ' Data . ;. rlppegved liyi Elate. 1vii..;<iark Dc.Aniorini Percirii'-Ailaly i 8/4/2022 (J"! ` C uQck XiGL- 8 4/2022' Allal):ed by NY 5614 EPAP k 1 T138 : atlicT Dirirtiir- ' \1r:&lark De Amurint Prrrin•Tcchtticnl labor D 41iinwii All AiiSanij+le+are GilleciM d-nd Ari 1h.d iii RIOS1114MA Ciiiiritinlr Ridr+'\lelluel:[leie nn(e'tlwt Phi e'Cnntiiy\licnwi,pp(1 C\!)rinalysit u.<ing' NIOSI 17 jM is a incan uf'auihxis lair,lil4r rnunting.Thi<uactI` i t%PI xprrifie for iho-analyx ;d oidr,nu 2Av.Ii.<fibers.Ilrc anallttcal results pmeMnl_in dais rei,n atul the L,hntatyap pgarnlures tnnl.are,eari&1err,l ti+he scavate and relial•le,li+t the saria;,lc<nnili:nl.-T1d<.rrjwrt i+uy not he telinialtaal Widumt the written Slipri+ial ql Paradigni Ei+iininurcnul•�bl.C: (PaR4DIClgprnflhen imlp in full All pnali�u is:lx•tlnminl b4ing an Olyinpus CH-26 MRT'I 2ui,i'(SN 1El logh.'NA'-Kit'Appli6filr.Plc c ni+te that Canal5liac riles are cnriidnl .. _. .. s aitira liiivaaty calif+raiiaui.'Filtii ca+untsvniu6le'1he.IOIi_13M lihei/nmi':tanpe'slull be riI mel a Iradn�,-greater than gptiirul tariahilitr-_itid!aa [It1j'-peolaldy_Li>yil'Since i'X&OP) N1 dial nut rullrri dw alprcmrntionnl sa1111,1<.11u',eriti.ANlity.ul the rniilts i linritnl ti+ilie.nyn+rtetl liter./ipnY.. ___ PulatircSt_indird Da',•fatit0_A pgr N'IISOH 7aM.4_G+untin_g Ruln,Mittitaxl,PAR:1I)[G\i G r,ylpi,cd w iapixt otiuiurd-lahiim,lairy,ititircotnttcr prcclsiyin:IntrKIountcr•S 20 tilxrs*P.349:_r 1.50.flxrx--6.131:51 IN hl eis-0.250 la.i4(16.30.22)... -Page l OUL _ 790 WaterviietShaker Read. (ltham,1\'CW YOTk 12110 PA RA D I G 518_782.1460(plume) ?. ENVIRONMENTAL . L L,C- ayarl atadis�nyenV.Com � f Asbestos Air Sa1i,lilinh Chain cif Ctlstod'y/S1n,ple Record Client Namci -$anirIing P has e+ Daie of Sample Ccllectiona Project Den.riptio t t Tyre of A(atemcna 1sandigm�ott'NumGerr ZZ. ZZ LA Project Address. V Rotante er )Number: Casiitte Lot`umber`; t Client Contact,r,'at»ca Client Contact PhoiteJEnuil: Rotantcier Calibration:Bios Defender 510-I1(SIN 117216)Calibrated 06.0122 t /�_ Itbt unccrr Calibration Cot d nlrough.-"09.0+ .22 Flow Rate(L me.,81ioute) flare(24 Ile+ur Formate mrling LAB FIELD Sample Duration, Ill II) I)mAption/lAx2tion (total" Initial Final On (UCf Irt�iutee) �K ,�� �� _ r �V � ���'al" JJ✓ i G 23 3Z-9 c)406 B 1` All Air Samples Are Collected and Analyzed in Accordance with NIOSH 7400(A-Rt6s)Methods. lWore sighing this documunt,yerify drat the content you are signing is corrvm FB2 Sample locations sketch; ldcntihjrg all lidject air~sampla.locations and4ar Y1int: v1e Dat s .� related notes: ell, Sig •i `� " �... C = Tin* � -- - - - Print: i I,atr: An v . Sr+c:vut 1 U i ,� )i?�-;ra:-!Tarr..^•7.:t1.7i - 790--WcMict-Shhkir Road `.Iatliami;New,Yoik I2110 . . -PAR �' 5.18:7.82:146b:(phon4 - ' M'E M1 1 �l L L C1+.1Ca(11LR-eRV.com PCM Filer.Count Bench.Sheet p . nta1;.LLG Jo1 Nu'. mlier Paradigm Etivirotuite 22.4' .=2 • :T%tnc :_ , . . .. . . . •_ _,,Time: a; Field ID. Lab ID'.. Atial Whole " - Ysu; E Fili'cts, ToCia labors 'I'otal•Fietds-; ;pnal sis . . a Number: 'Nuttiber carted' : i •.Cdinpkted.. .. l`• •440Q. _ LL = r T a jo I � � Samples Prcppcd by, . I?zePPed: DSio, -� - -- -- ---- -- - - a—AQ8104-/2Z P • .cd byi.. . .". . Sam'le3' nU— DatcAnaly:cd= j -A galy�js performed.using,an Olympus:CH 2 N ic=oscopr($N 4AU?89). Date and Tune Priatedr. l'of-1. 790 W'tenliet•SliaherRoad. PARADIGM P:A Izthaiii;'Nt i�%York 12190 •� �. D I 0 '1��A 1 518:782:1466(plioiie) E nf'Va R O.N M_E N T A L; L l.0. ������:naradigmrnd.comr :. Phase Co>itrast:Microscopy'':(PCM}:Air�orne;.Fibei Analysis' NIOSH 7400,IVIeEliod I �tie:3;']ui e',14; ?019,:Couiiring Riilcs Client: . . Giieni_hr�cei-Niimtieh Sampled:bti�' Tracey;Ro3d.Eijiliptncnt.-. :POrge:Sonnenfroli/Paraiiier%i Jiib`Nttmli@ii_ - Stirprli- phi6ei . _'Lving:Rootii WallEiaper.R'egioiilc- 22220UA Clciratice(IIC). Dais Sainplcde'.'. Dato:Receivcii'at L16i' '. --U3 Corinth R'nad;QuccnA) -y,Nc Y6rk'1.284. T7iursilay'Aug jsq 4i 202Z: Thursday;Au 2022' Client Na'tner Clieni°Cuniactt- - I}ate�Anilinretlr Uate'Retiartcdi,. Mr:Biiddy.Keiiiiedy, bkennedyAtracevroaii:com:: ThiirsdSy-A*si.4,`202 ,•, •'Tliu sday;Ausurr:4,'2022. :Sample I:AB ID Number .Number S.imji[e.Dercription' 1'. 9432 In,iili,\C�iirk.A'ica._East 1019i - 950.0 `. 1528:5 :(r02 ' 243i. •lirgi,lc,\3'..irh•Air1:..Craftvr 10.191 150.0 i528:5 <(►.(102 <7.006 3 -9434.• Iti itiv,WorkArea=South 10.19 150.0 '_1528:5• 0.M2 S 28Q 3 9435,z .Iti:idc Wiiil'A'--,,N6rtli 10:19.1 15?:0 "1548.9 i<t`.(Kt2 <'T.cKt6 5 9436: In'sidr:'\r4irk Arra=\Crri 10;19.; 150:0 : 1528:5 ;��it?3 12.1P2 G '•'9437 vin<idr W�itk Arra=Ea<r 10.19 i :12'3:0 1?53:4 0.(?C�3 - 7 :9438' -Out3iiiv Wiirk Airi-.)SWrth, 10.19.1" 12j:0 ., 1253:4 _.. 8 >9439' Oittadr\r�iiik Arra;Gciirrr:'. :,- -- - IO:f91 t122.0 .' ,1243? -- :<L•:(K►2 <7aM6 " 9 .•9440 Outaile Work.Area Soutlm•v:r: 10.191. t23.0 125.3.4 'OR2 <7,Q(to , .10 9441 " OutA&)York Area?\Wr3i 10.19,1 120:0 1723.8 di.0Ol TiiiJ'Blatik. N.A 1\A.. NA : . N�ti <7.f`& :r[32 943. Fllrl Blank NAi. NIA- _ NA : .;NA <7:(M6 Anal".r.rl 6: Dates: .1 ror,cd b s -: — -- Daisy —- — - - Y-' Y PP. 1'_ Mr.Mark DcAirioiiiii Pcicira-.AlialyYt 8/472022 Anahir�l by'K DOH ELAP 12C38 ark Dr.Amuiinrl'vr sin-Tglinicil Lillurauirybirecri�r Divliinlcn All Air Simples arc CollertA.Anti Anairmi in Accord anci with the?\IOS1!79M'A Cuuniinp Rules Mril—I_Plea-+e ncwte thm Plisse Q+nlia<t micittvdpr(PCM 1Anklys6 ruing MOSH 74M'a ntf3rV o+lar+iliri f ii I;I rr 7otintinp.Tit-tltitlw ii rii5 i{iciflc'f?aihc pnilp{<irtiidvrne>InnnN filYd;TlK anahtic5l result{sir arils t in th6 tc{x-'k and the Lih+nt:+ry' j+i.+rrolurn-uial orr rtro.i&ml_td hr arcidSte'and rrliaW'fr tlt•iamplrx anal}:a.l.Th6 ri{yirt`nnr riot he-irj+iitluml.witlurot-thi ittinen appnnil of 1'aiitligut"Einiioniurdtal;"LLC: IRARaDIGDII and i wit oy.in(nll.All analpio is pi•if iriind tizl ip an Oliw{;u Cll:(1.Mimi+.iupr:(SN IE11G97l,-ITA:_ Ni+t Applii�l+ir-Plr a note that final Quw fairs ore cortrttnl. a>at[el a ptinury•.CaliLratlOn.FtiYr ftR1nL,ix141tiC IhC 1M-13M fibrT/ntlllr ran):i(lull IV, rrpotpod adminc'oraier thart ilpthnal vjriallthry-inil a+l+eiriq'pibhahly hia<i•:L' ReLthr Star, art.:Dawiptiiina:f-'prr,NISQ11 74M A-G+unting"Rul."WtltM.P.AR.aDiG\1 it rrqulritl.to rr{itirt;r-liniateil_lalti tatury iriteriountet pn t:ti6roautci Cou1. S .(1'til.irs-O.i95�?1-SPfilx•r�'0_ii1:51.1(1(r:fil+rt.:'f1.?>Olas�+f(1(iaP121. page Vof.i t PARADIGM 790,WnlervlietSha-cr Road Latham,New York 1211'0 5.18.782.1466(phone), ENVIRONMENTAL, L L[, i���w.t. adit!tnenv.cumt t ,i Asbestos,Air Sanipling('pain-of=Cwtody/Sample R&oed r: Client'Namet Sampling Pbmes I)ate.of Sample Collectior-a t Project 1)�<rriptions f)Ix of.rlhatement: Paradigm job lit mben ' q, ��. FAN a\ >��� Lyi 22• ZZCraA Project.Address: Rotaatcter ID N'timVer. Ci�cttc'IartNumhcri IA ZS Client Contact Name; Client Contact 1'Ir- rellimai _ Rsnartieter.C•alll,ration:lliosDetendci 510.11(SN 11721b).Calihratcd06.03.22 _ - S { ? ct Z.f'� 1Lotanutcr Calibratittq Good 7}rrouglu t59,43 22 Flory Ratite Wter's,AMinutcl Tiine d4lliour Forn-6t) Sampling LAB FIELD Sample Durannn [I) If) 1)rxrip[ion/l�rat'son (totalj. Initial Tina/ on Oft rriinuro) '4 Q43Z a L ► *� t U 1 u. G 9743. �qn, t • .n r•r .� `z �: IV A 44 ` ^i v4 -A S .t 949A C C N��r t 0 r-14i4p N. ul8 T il �4Z. 1'B1 I All Air Samplesare Collected and Analp ed in'Accor&nrc[vide NIOSII i400(A Rule,;)Mullocls. p i ,,32 I;cfore signing l�lis-tl�icunietiy e.rily lltal•dtr cc�utrnt,uu arc signing is tt�trcct. i+ 4,4 - Sample locations Amch, identifying all protect nir sample /orations and/or Print: F n Date: Mated no[cst `' i a :ign: Time: t � Print: -- - _ = - 'Data v s Sign- j Ce ✓z, Print: Daate/: q q -: - - - - - -- - - --'---- '-- -- - - '- '- r� "•11 r 1�_. ..y:�:'-'i.Y._1:l Y•1ti'i``,'•'.i�.l.l�'L._ O rtj-9'f[r(� - - - — - — - -- --- - - - - --- ---- - -- - L S[gns . a a:..'�es�i.�ta-�r���.L.-LSd�_1.�1L[.31i'�.1.:�•�i ,.t.[, ". H�:siun I.J { t Fj/raivr llntr:09.01.2! t' :� is 790 Waieivliec.S(iakei Ro=dd:, • . I atlarii':NcwYoik 12110 ' 518.T811466(phone) . f•N L Fit A fa h1`E N 1 ,ti L L L C . va�atiiA:-menv:coin: _ PCM eet E'vi "nta1,;LLC:joli`Nil.b f . • ' Paradigm' n ovine :224. 226�A: Titnc I "glide Ficld'1I3. Lab ID; . i Whole Nutnliei: ;Niimliec. Analysis, Ftieis> :; Ha1f.E_`ztiers Total Fibers.: 'TotaL_Ficlds. Analyse iStartcd ; co : .i �J , -1' -- j: 4 9415 ; 31, 11 9442- : . �- -12 . Sam.P.IO Prepped bji. {Date Picppcdc . _ CD DateAnah=ed:. Analysis peHormed using an Olyiitpus CH-2 Microscope(SN 4A13289) . Date and'Timi:1'iintedi toff,