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DEMO-0187-2023
• • Office Use Only Permit#. 1 -1\/1,13 D 16"1--Z0 • DEMOLITION APPLICATION Permit Fee:$ i 1O 7bwn ofO eensb ry Invoice#'. Cod 742 Bay Rawl,Queensbury,NY 12804 • P:51 ww:8-761,8256. waueensbury.net Flood.Zone•, Y Reviewed Demolition Location: 920.RT 9 Tax Map ID#: 296.17-1-45 **AN ASBESTOS REPORT'IS REQUIRED WITH ALL DElOLITION.APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? Approved landfill . 2. Type of structure mei- demolished: . a. Resides - d.Storage Buildings f r fj \ re b.. Garage e.Other: - 1-13 • 3. What type -ilitiesare connected to the structure: a.: Gas lr i f:_Well-Water P - 'TOV A OF CQI,..)F:-�s` P,Llp,° b. Fuel Oil g. Public.Sewer BUILDING 8, CODES c. Propan h. Othe i • d. Electric ✓ i. None e. Public Water-IV' 4. Have ALL utilities(water,electric,etc.)been disconnected? Yes NOW' ADDITIONAL INFORMATION: 1. Two inspections are required;.an inspection to determine that utilities are . disconnected, and'a final inspection after the structure is removed and the site is cleaned ppand graded. 2. Twenty=four(24Yhour notification is required for inspections. 3. Workers'Comp insurance information is required to be submitted with this application. Declaration:I acknowledge that no structures)will be removed from the parcel until the demolition application has been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a permit has been issued:: , • I have read and agree to the above: PRINT NAME: Jared G ge o(-Queensbury Realty Partners,LLD SIGNATURE: DATE: 4/14/2023 Demolition Application - Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • • Applicant: Name(s): Queenstiury Realty Partners,.LLC-Attn:.Jared George_ Mailinl�Address;C/S/Z: 509 State Route 67,iMalta NY 12020 Cell Phone: 518-858-2637 - Land Line:. - Email:Jgeorge@tricapitalrealty:com • Primary Owher(S.): • Name;s): Same as applicant Mailing Address{C/S%Z: Cell Phone: • Land Line: Email: . ❑ Check if all work will be performed by property owner only • Contractor:(List.all-additional.contractorson the back of this form) Contact Name(s): Franco Construction Services-Attn:David Franco -- . Contractor Trade: General Contractor - Mailing.Address,C/S/Z: 1'CharltonRoad Suite 105,.Ballston Spa NY 12020 Cell Phone: 518-424=5787 . Land Line: . Email: david@francoconstructionllc.com **Workers' Comp documentation must be submitted with this.application** Contact Person for any questions regarding this project: Jared George Cell Phone: 518-$58-2637 : Land Line: Email:Jgeorge@tricapitafrealty.com • • Demolition Application - Revised June 2022 Mark Smith From: Jared George <jgeorge@tricapitalrealty.com> Sent: Monday,April 24, 2023 8:28 AM To: Mark Smith Cc: Mark Teliska Subject: 920 RT 9 Queensbury r - - You don't often get email from jgeorge@tricapitalrealty.com. Learn why this is important Hi Mark, As mentioned on the phone, the abated material was sent to Finch Pruyn. If you have further questions, please reach out to Mark Teliska from PCS at 518-365-4775. Thank you, Jared George • 518-858-2637 - - : This is an external email. Do not click links or open attachments unless you recognize the sender and know the content is safe. i P.O.Box 1024 Schenectady.NV 12301 4SPECTRVM (518)346-6374(Phone) Environmental Gssociates, inc. (518)346-4062(Fax) 'EXCEEDING OUR CLIENTS EXPECTRTIONS OP EXCELLENCE• www.4spectrum.com ASBESTOS PRE-DEMOLITION SURVEY/INSPECTION oF OvGo® e� FILE COPY 004 \N,C' FOR I BUILDING 920 ROUTE 9 QUEENSBURY, NY 12804 SPECTRUM PROJECT No.: 22-371 o LED A IQ O C ch JUNE 27, 2022 3 Wem O N Q F+ PREPARED FOR: PILE COPY 3 TRI CAPITAL REALTY CO M - 50 STATE ST. STE. #6 v ALBANY, NY 12207 N w Environmental Consulting&Management •Health&Safety Training •Laboratory Services t J SECTION I-INTRODUCTION On June 21, 2022, Spectrum Environmental Associates, Inc. (Spectrum) conducted a survey for the presence of asbestos containing materials at the building located at 920 Route 9 in Queensbury, NY. Mr. Chris Patti (Asbestos Inspector #04-06597) conducted this inspection following procedures and guidelines commonly used and accepted by federal and state regulations. The objective of the survey was to identify the presence and approximate locations and quantities of • suspect and/or confirmed asbestos containing materials. An initial walkthrough of the designated areas was conducted by an experienced asbestos inspector to observe and record materials used in the construction of the building. The inspector proceeded by assessing floors, walls, ceilings, surfacing materials, thermal systems insulation, roofing materials and other miscellaneous materials with the potential to contain asbestos. From observations, the inspector prepared a listing of building materials that are suspected to contain asbestos. The inspector selected these materials for inclusion in the inspection through professional experience and an understanding of the historical uses of asbestos. Generally speaking,if a building material within a structure could contain asbestos,the material was included in the inspection. Materials included in the survey were identified and recorded with respect to grouped homogeneous sampling areas. Representative bulk material samples were collected from locations within each homogeneous sampling area. Sampling information was recorded on chain of custody forms for documentation. Samples were individually preserved within a container and transported to an independent laboratory for asbestos analysis. Laboratory analysis of asbestos samples via polarized light microscopy(PLM)and/or transmission electron microscopy(TEM)was conducted by AmeriSci of New York,New York(ELAP# 11480, NVLAP#200546-0). Sample analysis was conducted as follows: • "Friable"Asbestos Samples—PLM • "Non-Friable" Organically Bound (NOB) Asbestos Samples—PLM and, if negative, TEM for confirmation as required under NYSDOH-ELAP regulations. SECTION H-LIMITATIONS The information provided in this report was compiled from'field and laboratory data obtained during the site visit. Observations noted and recorded are intended to represent the conditions that existed at the subject site at the time and date that the observations were made. Spectrum has not conducted its own analytical, but has utilized an independent NYS-DOH ELAP approved laboratory to provide the analytical results contained in this report. All discussions, findings, and conclusions are based on information that Spectrum received and understood to be factual. ATTACHMENTS TABLE 1-ASBESTOS SAMPLING RESULTS TABLE 2-ASBESTOS FINDINGS PHOTO ALBUM LOCATION MAPS LABORATORY REPORTS LICENSING AND CERTIFICATION • • • • TABLE 1 - ASBESTOS SAMPLING RESULTS 920 Rt.9 Spectrum Project#22-371 Date Sampled:June 21,2022 • Sample# Description Location/Area PLM Results TEM Results (%Type) (%Type) 17 Concrete Block Mortar Exterior Walls of Structure NAD NA. 18 Concrete Block Mortar Exterior Walls of Structure NAD NA • 19 Built Up Roofing Tar Entire Roof Under Rubber Membrane Roofing NAD NAD 20 Built Up Roofing Tar Entire Roof Under Rubber Membrane Roofing NAD •I NAD • • • • Note: Asbestos containing materials are greater than 1%asbestos. Trace is considered less than 1%asbestos. NAD-no asbestos detected,NA-not applicable,PS—Positive Stop,SF-square feet,LF—linear feet TABLE 2 - ASBESTOS FINDINGS 920 Rt.9 Spectrum Project#22-371 • Date Sampled:June 21,2022 • Material Location/Area Estimated Quantity* Condition/Damaged Floor Tile Mastic Floors Diner,Bathrooms,Kitchen,Managers Office,Storage Room Area 12x12 Floor Tile(White) Managers Office,Sink&Storage Area Floor —2,300 sf Fair • • 12x12 Floor Tile(Gray) Diner Area,Men&Women's Bathrooms *Quantities of identified ACM are estimates only and should be field verified prior to bid by the contractor or confirmed as part of an RFP or design specification. Please see the limitation listed above. • Asbestos%by PLM*-please refer to the PLM Bulk Asbestos Report for the method used. All asbestos locations on drawings are'approximate. All quantities are estimated and must be field verified prior to use as part of a. bidding document. Materials may extend or be hidden behind or within other materials or structural members. Any contractor or other user of this report is required to physically confirm the quantities and verify measurements of materials to be removed,to be bid for removal,or for any other purpose. Contractors are responsible to physically visit the site and confirm all quantities for bidding purposes. • • SF—square feet,LF—linear feet,ea—each PHOTO ALBUM • • • • • • • 0011111111** till f r 11 i .I 1 ff Jj11 1t 1' I I t s • 17, V' 21.2022 _ - 06.7.1.Via' • . _ is z �ri • I�, • >tiy 4r,c S. rf .r.; _1.LbGL • r---7— . , .... • • • • i e`,• 1 , . :94t'll....„ ,-. ,..-----:"— __, „..-• . f . . ( / : „\\,k• . . •t . ,.... , -_.•, . ' r , .... , 1 , ., ,, cs j,,,..., •• . •,..,„, ' -,,,;.. Z On, `..,.: ' ''' 460',' , / : ' '—.> ' .t,,,..4 ,,,•;.k, iE 'r. , . 1. - • .- " V v 11111111.1 ' I I II 1 1 ..., . 40...7...F:— '— •'".:7—., V. c•- -.. ., --- — ,..0.:' •‘.-„.1 - C16.21...t. _P" I A/22 J • • • • • • . , • • * • lir:N.' -'11 • ' - • 2h. ' kJ ' it- . - ' -- • a • „ tiLat . - - ,• , • • 1•. - • 1- • _ • t . ' k OC 21 2022 1. • • • • • • • • • • • . • LOCATION MAP(S) LABORATORY REPORTS • AmeriSci Job#: 222063233 Page 2 of 4 Client Name:Spectrum Environmental Associates, Inc. PLM Bulk Asbestos Report 22-371; 20 Route 9 Queensbury, NY, Demo Survey Through Out Client No. / HGA Lab No. Asbestos Present Total %Asbestos 6 222063233-06 NA/PS 3 Location:Sink And Store Room Area Floor-12 x 12 Floor Tile(WHITE) • Analyst Description:Bulk Material Asbestos Types: Other Material: 7 222063233-07 Yes 1.8% 4 Location:Diner Area Floor-12 x 12 Floor Tile(GRAY) (by NYS ELAP 198.6) by Ivan H. Reyes on 06/27/22 Analyst Description:Gray, Homogeneous, Non-Fibrous, Bulk Material Asbestos Types:Chrysotile 1.8% Other Material: Non-fibrous 13.3% 8 222063233-08 NA/PS 4 Location:Men And Womens Bathrooms-12 x 12 Floor Tile(GRAY) • • Analyst Description:Bulk Material Asbestos Types: - Other Material: 9 222063233-09 No NAD 5 Location:Diner Area Wall Behind Counter-Ceramic Tile Adhesive (by NYS ELAP 198.6) • by Ivan H.Reyes • on 06/27/22 Analyst Description:Tan, Homogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 15.6% 10 222063233-10• No NAD 5 Location:Diner Area Wall Behind Counter-Ceramic Tile Adhesive (by NYS ELAP 198.6) by Ivan H. Reyes on 06/27/22 Analyst Description:Tan, Homogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 21.3% • 11 222063233-11 No NAD 6 Location:Diner Area Ceilings-2 x 2 Acoustic Ceiling Tile (by NYS ELAP 198.6) by Ivan H. Reyes on 06/27/22 Analyst Description:White, Homogeneous, Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 39.5% • See Reporting notes on last page • AmeriSci Job#: 222063233 Page 4 of 4 Client Name:Spectrum Environmental Associates, Inc. PLM Bulk Asbestos Report 22-371; 20 Route 9 Queensbury, NY, Demo Survey Through Out Client No. / HGA Lab No. Asbestos Present Total % Asbestos 18 222063233-18 No NAD 9 Location:Exterior Walls Of Entire Structure-Concrete Block Mortar (by NYS ELAP 198.1) by Ivan H. Reyes on 06/27/22 • Analyst Description:Gray, Homogeneous, Non-Fibrous, Cementitious, Bulk Material Asbestos Types: Other Material: Non-fibrous 100% 19 222063233-19 No NAD 10 Location:Entire Roof Under Rubber Membrane Roofing-Built Up Roofing Tar (by NYS ELAP 198.6) by Ivan H. Reyes on 06/27/22 Analyst Description:Black, Homogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 6.3% 20 •222063233-20 No NAD 10 Location:Entire Roof Under Rubber Membrane Roofing-Built Up Roofing Tar (by NYS ELAP 198.6) by Ivan H. Reyes • on 06/27/22 Analyst Description:Black, Homogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 0.6% • Reporting Notes: (1) Sample prepared for analysis by ELM 198.6 method Analyzed by:Ivan H.Reyes Reviewed by:Marik Peysakhov /G Date:6/27/2022 �f *NAD/NSD=no asbestos'detected;NA=not analyzed;NA/PS=not analyzed/positive stop,(SOF-V)=Sprayed On Fireproofing containing Vermiculite; (SM-V)=Surfacing Material containing Vermiculite;PLM Bulk Asbestos Analysis using Olympus,Model BH-2 Pol Scope,Microscope,Serial#:229915,by Appd E to Subpt E,40 CFR 763 quantified by either CVES or 400 pt ct as noted for each analysis(NVLAP 200546-0),ELAP PLM Method 198.1 for NY friable samples,which includes the identification and quantitation of vermiculite,or ELAP 198.6 for NOB samples,or EPA 400 pt ct by EPA 600- M4-82-020(NY ELAP Lab 11480);Note:PLM is not consistently reliable in detecting asbestos in floor coverings and similar non-friable organically bound materials. NAD or Trace results by PLM are inconclusive,TEM is currently the only method that can be used to determine if this material can be considered or treated as non asbestos-containing in NY State(also see EPA Advisory for floor tile,FR 59,146,38970,8/1/94)National Institute of Standards and Technology Accreditation requirements mandate that this report must not be reproduced except in full without the approval of the lab.This PLM report.relates ONLY to the items tested.RI Cert AAL-094,CT Cert PH-0186,Mass Cert AA000054,N1 Lab ID #NY031. END OF REPORT • • • • • • • • • • • .AmeriSci Job#: 222063233 Page 2 of 2 Client Name: Spectrum Environmental Associates,Inc. Table • Summary of Bulk Asbestos Analysis Results 22-371; 20 Route 9 Queensbury,NY,Demo Survey Through Out Sample Heat Acld Insoluble • AmeriSci HG Weight Sensitive Soluble Non-Asbestos " ••Asbestos%by .•Asbestos%by Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% PLM/DS TEM • 17 17 9 — — — — .NAD NA Location: Exterior Walls Of Entire Structure-Concrete Block Mortar 18 18 9 — — — - NAD NA • Location: Exterior Walls Of Entire Structure-Concrete Block Mortar 19 19 10 0.246 89.9 3.8 .6.3 NAD NAD Location: Entire Roof Under Rubber Membrane Roofing-Built Up Roofing Tar • 20 20 10 0.164 98.8 0.6• 0.6 NAD NAD Location: Entire Roof Under Rubber Membrane Roofing-Built Up Roofing Tar • • • • • Analyzed by:Marik Peysakhov Reviewed by:Marik Peysakhov �G Date:6/27/2022 "Quantitative Analysis(Semi/Full);Bulk Asbestos Analysis-PLM by Appd E to Subpt E,40 CFR 763 or NYSDOH ELAP 198.1 for New York friable samples or NYSDOH ELAP 198.6 for New York NOB samples; TEM(Semi/Full)by EPA 600/R-93/116(or NYSDOH ELAP 198.4;for New York samples).Analysis using Hitachi,Model A7000-Noran 7 System,Microscope,Serial#:747-05-06.NAD=no asbestos detected during a quantitative analysis;NA=not analyzed;Trace=<1%;(SOF-V)=Sprayed On Fireproofing containing Vermiculite;(SM-V)=Surfacing Material containing Vermiculite;Quantitation for beginning weights of<0.1 grams should be considered as qualitative only;Qualitative Analysis:Asbestos analysis results of"Present"or"NVA=No Visible Asbestos"represents results for Qualitative PLM or TEM Analysis only(no accreditation coverage available from any regulatory agency for qualitative analyses):NVLAP(PLM)200546-0,NYSDOH ELAP Lab 11480,NJ Lab ID #NY031. Warning Note:PLM limitation,only TEM will resolve fibers<0.25 micrometers in diameter.TEM bulk analysis is representative of the fine grained matrix material and may not be representative of non- uniformly dispersed debris for which PLM evaluation is recommended(i.e.soils and other heterogenous materials). • • • • • spEcTRviii P.O.Bax 1024 Schenectady.NV 12301 • JEL.I (518)346-6374(Phone) \ Environmental Rssociates.Inc. (518)346-4062(Fax) 'roamO er Oct t erro rS Cxrrrr,rlets fir trcrtizsrr tvtvtv.4spet7rum.com BULK SAMPLING CHAIN OF CUSTODY(.v.03/07n014) • PROJECT INFORMATION It^„n 11. 22-371 Budding Name:920 Route 9 Queensbury NY Matrix Analysis Requested Turnaround Date Sampled. NeNlacatmn: 6-21-22 Demo Survey 0 Bulk ❑Paint 0 PLM—GLAP 198.1 ©'ISM—BLAP 198.4 0 RUSH ❑24 Hour rrsen2 of 2 mvesu6,ate Christopher Patti ❑Soil ❑Wipe ✓ ©I'LM—fiLAP 198.E ❑72 flour 5 Days SAMPLE IDENTIFICATION Sample ID ft: Group S:. ' Material Sample Location Condition/Comment 17 9 Concrete Block Mortar Exterior Walls of Entire Structure Good Condition 18 9 Concrete Block Mortar Exterior Walls of Entire Structure • Good Condition 19 10 • Built up Roofing Tar Entire roof under Rubber Membrane Roofing Good Condition 75 x 100 20 10 Built up Roofing Tar Entire roof Under Rubber Membrane Roofing Good Condition 75 x 100 • • 222 063233 • Unless otherwise stated please analyse each group to first(t")positive result. Comments: CHAIN OF CUSTODY Relinquished By Date Time Received By Date Time Method of Submittal I Christopher Patti 6•21-22 (rleyo n ri,c•UUud (c)"2-7-1,7 113/ .• 1 • Itt Environmental Consulting & Management Services • health & Safety Training • Laboratory Services P.O.Box 1024 Schenectady,NV 12301 B` (518)346-6374(Phone) Environmental fissociates, inc. (518)346-4062(Fax) ,r 'EXCEEDING OUR CLIENTS EXPECTRTIONS OP EXCELLENCE www.4spectram.com State of New York— Department of Labor Asbestos Certification STATI OF NE1y YQR E'Aiiift. er .a- •_-1' •,-ASBESTovcERTIFJCATE { `3, '`:'' :f,`IC_u�:. .. f il.•4�_r- • • 111111 • {;., ;,;C1HAARccISTVQ_PEIER'F''PAfi[I -:r: GcATEC d.1129)'D;INSP(O1)23)1 `%`` ri. 10 lVI�9,,a 8.154 ' MusT UE CARRI D;ON:ASfESTOS;PRO,JECTS' '1 i ....,-•.. :... ...Mom;......:. '�.n}-:;:::. - - - - - -- - G IF FOUND RETURN TO: • • EYES BRO NYSDOL - L&C UNIT m N NAIR BRO ROOM 161A BUILDING 12 "2 HOT 5' 09" STATE OFFICE CAMPUS ALBANY NY 12240 -N ® State of New York — Department of Labor Codes Certification A Asbestos Handler • B Restricted Handler -,Allied Trades C Air San1pling Technician • D Inspector E Management Planner F Operations and Maintenance G Supervisor H Project Monitor • I Project Designer Environmental Consulting illanageinent Services • health Safety Training • Laboratory Services - : . _ : - _ - • - - NEW YORK STATE DEPARTMENT OF HEALTH _ • - - - - -- .. - WADSWORTH CENTER -- - - - -_ Expires 1201 AM April 04;2023- 41 Issued April 01, 2022 - - -- --__ _ ____ = CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE - = Issued in accordance with and pursuant to section 502 Public Health Law of New York State AIR. PAUL J:1MA. - _ NY Lab Id No: 11480 - - ___;-- - AMERICA SCIENCE TEAM NEW YORK, INC - • 117P.AST3O HST - - -- NEW YORK, NY 10016 - . - -- _ _ _is hereby APPROVED as an Environmental Laboratory for the-category --- -_ ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE - = - - - - - All approved-subcategories and/€i analytes are listed below: -. • _ -':Miscellaneous - - Astiestos-in Fr-We-Materiel Item 198.1 of Manual - -- .=- - - EPA 600/M4/82/020 - --- Asbestos intort-Friable Material-PLM - Item 198.6 of Manual(NOB by PLMI - - - - Asbestos in Non-Friable Material-TEM Item 198.4 of Manual • Serial No.: 64683 - Pnojerty of the New York State Department of Hearth. Certificates are valid only at the address • - __ -- shown.must be conspicuously posted,and are printed=arisecure paper. Continued accreditation depends - - eh successful ongoing-paracfpation in the Program. Consumers am urged to call(518)485-5578 tsi- • verify the laboratorys accreditation status. -- _paw 1 of 1 - _ _ P.O.Sox 1024 SpE C7r7R1) Schenectady.NV 12301 (518)348-6374(Phone) Environmental Bssociates, Inc. (518)348-4062(Pax) 'EXCEEDING OUR CLIENTS EXPECTATIONS OF EXCELLENCE www.4spectnnm.com April 20, 2023 Mr. Jared,George Tri Capital Realty, 50 State St. Ste.#6 Albany,NY 12207 (518) 858-2637 FILE COPY j georgeAtricapitalrealty.com RE: 920 Route 9 Spectrum Project Number: 22-371 Asbestos Air Sampling Report Dear Mr. George: Spectrum Environmental Associates, Inc. (Spectrum) is providing this final report and attached documentation for the above referenced asbestos project. The scope of work performed by the abatement contractor involved the removal of asbestos containing materials from the following area(s): • —2,300 sf of floor tile&mastic from Diner&Office Area(4-13-23) New York State Department of Labor Industrial Code Rule 56.4-11(a)states"The PCM clearance air sample results shall be considered satisfactory when every clearance air sample demonstrates an airborne concentration of fibers of less than 0.01 fibers per cubic centimeter, or the established background level(s),whichever is greater." New York State Department of Labor Industrial Code Rule 56-9.1(d)(1) requires a final visual inspection be performed by a New York State Certified Asbestos Project Monitor who is appropriately trained and independent of the asbestos abatement contractor prior to the collection of the Clearance Samples. This was performed by Spectrum and the associated documentation is attached. The final visual inspection is to confirm that all have been removed and that the work area has been properly cleaned. Therefore, based on the final visual inspection(s) passing and the final air samples that were collected and analyzed on this project having met the New York.State requirements,the scheduled removal area(s) are considered clear and may be re-occupied. Attached you will find the following documents: • Final Report(s)of Analysis with Air Sampling Chain of Custody(s) • Sample Location Drawing(s) • • Project Monitor Final Visual Inspection(s) • Licensing and Certification(s) • Site Specific Variance(if applicable) Environmental Consulting&Management Services • Health&Safety Training • Laboratory Services • 'i • • • • SPECTRUM . P.O.Box 1024 Schenectady,IIPI 12301 E (518)348-8374(P) ,, 'Environmental associates,InC. (518)348 4082(F) 'EXCEEDING OUR CLIENTS EXPECTr7TIONS Of EXCELLENCE^ www.4spect7um.com - • NIO DOH 7 P.#11 FINAL4 REPORT OF PCM ANALYSIS Page NIOSH Method 7400(A Rules) 1 of 4 CLIENT:Tri Capital Realty PROJECT NAME:Diner Area—920 Rte.9 PROJECT#:22-371 50 State St.Ste.#6 Albany,NY 12207 ' Client Date Date Date Result Density Lab I.D. Sample# • Work Area . Location/Description Sample Type Collected Received Analyzed L.O.D. (f/cc) (f/mm2) 01436 1 Diner area/floors Field Blank 04/04/23 04/04/23 04/05/23 0.0 01437 2 Diner area/floors Field Blank 04/04/23 04/04/23 04/05/23 0.0 01438 ' 3, Diner area/floors IWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 1.3 01439 4 Diner area/floors IWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 0.0 01440 • 5 Diner area/floors IWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 4.5 01441 6 Diner area/floors IWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 5.1 01442 7 Diner area/floors IWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 2.5 01443 8 Diner area/ OWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 6.4 01444 9 Diner area/floors OWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 1.3 • 01445. •10 Diner area/floors OWA Phase IB .04/04/23 04/04/23 04/05/23 0.002 BDL 1.3 01446 11 Diner area/ OWA Phase IB 04/04/23 04/04/23 04/05/23 0.002 BDL 0.6 01447 12 Diner area/floors OWA ' Phase lB .04/04/23 04/04/23 04/05/23 0.002 BDL 2.5 01484 13 Diner/Floor Tile Field Blank 04/10/23 04/11/23 04/11/23 4.5 Microscope:Olympus CX43 Phase Contrast Field Ares:0.00785 nun' 'dmm'=fibers per Square Millimeter for=fibers per cubic centimeter • L 0 D.=Limit of Detection(7 dmtn) L.O.Q.=Limit of Quantification OVL-Overloaded with particulate or fibers OVLBL=Fibers exceeds QC limit Analyst: Analyst: ' Disclaimers: Laboratory Director, • r MOSH Method 7400 is used for estimating asbestos concentrations,but cannot differentiate between asbestos and other fibers. �jPit/i.K S rr `, -V �,t,.c..,:.__-- MOSH Method 7400 has an established range of 100 to 1300 dmm';any results outside this range arc potentially baud. ` Laborat6ry Precision(S,): Laboratory Precision(Sr): Reported Analytical Results are Based on Sample Data Provided by the Client. K[ wA !`.-v- 5-20 fibers/100 fields:.027 5-20 Sb413/100 fields.0.43 Analytical Results Dependent on Field Blanks Submitted with Samples. >2m50 fibc4100 fields:-0.tt >20-50 fibers/100 fields.012 Attached Chain of Custody indicates analyst and shall be considered pan of this final report ' >50-100116Wt00fiade.w.24 >50-100flbenit00 fide,=0.19 !Catalina Li Environmental Consulting & Management Services • health & Safety Training • Laboratory Services • • . . . SPECTRVM P.O.Box 1024 Schenectady.W 12301 (518)348-B374(P) Environmental Rssociates,inc. (518)348-4062(F) • 'EXCEEDING ODR CLIENTS EXPECTATIONS OF EXCELLENCE' • www.4spectrum.com • NIO DOH thud 7 P.# •FINAL REPORT OF PCM ANALYSIS • Pa e 3 o23 f4 NIOSH Method 7400(A Rules) Page 3 of 4 Client Date Date Date Result Density Lab LD. Sample# Work Area Location/Description Sample Type Collected Received Analyzed L.O.D. (f/cc) (f/mm2) 01509 30 Diner/Floor Tile Ambient Phase IIB 04/11/23 04/12/23 04/12/23 0.001 BDL • 5.1 01554 31 Diner/Floor Tile Field Blank 04/12/23 04/13/23 04/13/23 6.4 • 01555 32 Diner/Floor Tile Field Blank 04/12/23 04/13/23 04/13/23 4.5 01556 33 Diner/Floor Tile Remote Decon Entrance Phase IIB 04/12/23 04/13/23 04/13/23 0.001 BDL 1.3 01557 34 Diner/Floor Tile Remote Decon Exit Phase IIB 04/12/23 04/13/23 04/13/23 0.001 BDL 0.0 01558 35 Diner/Floor Tile Air Lock Phase IIB 04/12/23 04/13/23 04/13/23 0.001 BDL 2.5 01559 36 Diner/Floor Tile Critical 1 Phase IIB 04/12/23 04/13/23 04/13/23 0.001 BDL 3.8 01560 37 Diner/Floor Tile Critical 2 Phase IIB 04/12/23 04/13/23 04/13/23 0.001 BDL 0.0 01561 38 Diner/Floor Tile Neg.Air Exhaust Phase IIB 04/12/23 04/13/23 04/13/23 0.001 BDL 1.9 01562 39 Diner/Floor Tile Ambient Phase IIB 04/12/23 04/13/23 04/13/23 0.001 BDL• 0.0 - 01563 40 . Diner/Floor Tile Field Blank 04/13/23 04/13/23 04/13/23 • 5.1 01564 41 Diner/Floor Tile Field Blank 04/13/23 04/13/23 04/13/23 4.5 01565 42 Diner/Floor Tile IWA-Break Room Phase IIC 04/13/23 04/13/23 04/13/23 0.002 BDL • 2.5 01566 43 Diner/Floor Tile IWA-Office Area Phase IIC 04/13/23 04/13/23 04/13/23 0.002 BDL 0.6 01567 44 Diner/Floor Tile IWA-Rear Diner . Phase IIC 04/13/23 04/13/23 04/13/23 0.002 BDL 4.5 01568 45 Diner/Floor Tile IWA-Center Diner Phase IIC 04/13/23 04/13/23 04/13/23 0.002 BDL 0.0 Microscope:Olympus CX43 Phase Contrast Field Area:0.00755 mm3 Pat-fibers per Square Millimeter floe=fibers per cubic centimeter L.O D.=Limit of Detection(70mmt) L.O.Q.=Limit ofQuantification OVL-Overloaded with particulate or fibers OVLBL=Fibers exceeds QC limit • - Analyst: Analyst: Disclaimers: , Laboratory Director, NIOSH Method 7400 is toed for estimating asbestos concentrations,but cannot differentiate between asbestos and other fibers. A`itt_1/ rS r.trS �,,,•r„•,.a,c._, NIOSH Method 7400 has an established range of 100 to 130017mms;any results outside this range are potentially biased. .� Laboratory.Preeision(Sr): Laboratory Precision(Sr): Reported Analytical Results are Based on Sample Data Provided by the Client. _pi:aA.'i`_^'^ 5-20 filserel00 fide,-0.27 S-20 feue1100&Ids-0.43 Analytical Results Dependent on Field Blanks Submitted with Samples. >m-5o fibs✓too fiddee0.61 >m-St Dere.0 fidm=o.tu Attached Chain of Custody indicates analyst and shall be considered part of this final report. >50-100fibm✓100feldv=0.24 '50l00fibmll0ofiddr=0..9 Katalina Li Environmental Consulting & Management Services • Health Jr Safety Training • Laboratory Services Ra&1O24 • Sdretnectadj.AIV OM E : (518)348-8374(Phone] _4•,;_ Environmental elssociates, Ince .($18) 0-4oa2( ) `E.feitL Mc Doc CCEervrs Eyer0-Yr11ri.VS f/F ExCLLLrKCIf WW1E•48peci1 1ZLCo/IJ • AIR SAMPLING CHAIN OF CUSTODY (REv06-15-2017) • PROJECT INFORMATION SAMPLE TYPE TYPE OF ANALYSIS •TURNAROUND • Project#: 22-371 Date Collected: 4-4-23 a Phase IB(Background) 9 PCM-NIOSH 7400 O RUSH Job Site/Building: 920,rt.9,queensbury . _ Q"Phase IIA(Prep) O TEM-NIOSH 7402 O 12 Hour Room/Work Area: diner area/floors 0 Phase IIB(Removal) O TEM-AHERA O 24 Hour Rotameter#: H-5 Calibration Date: 3-21-23 O Phase IIC(Clearance) O Other ®48 Hour , Collected By(Print): eric k.rath 0 Air Quality O Other SAMPLE IDENTIFICATION • • Lab ID Sample Pump • Location Pump Pump Rate Rate Time L.O.D. Adjust Result F/mm2 . No. No. , No. On Off (LPM) (LPM) Volume Count • NAE=Negative Air Exhaust ' lir:mn hr:mn On Off . Mit Liters /100 F/cc 1! . I 1 Field Blank 1134 • n A 6 ,0 7 I L.R.1 2 Field Blank --- -- -- --- --- -- -- • 0 0 --- 6 (l 1 Z l y36 3 iwa 0914 1114 10 10 J? O 0 03Z 1 .6 AnL 4 0 ii3q 4 iwa 0915 1115 10 . 10 0 .0 . j0 )y110 5 iwa 0915 1115 10 10' . " 35 4 5 6 ►Uu l 6 • iwa 0916 1116 10 10 L.f 3,J • 4 NV_ 7 • - iwa • 0916 1116 10 10 .:)..6 �+ Jyy3 8 owa 0927 1127. 10 10 .o 6,y 5 /y y y 9 Owa 0927 1127 10 10 j-p ).3 P N 4 5 10 .owa 0928 1128 10 10 • 1.p _ 6 3 pi y4 11 owa 0928 1128 10 10 0,S cC P /q N q_ 12 owa 0929 1129 10 10 1 i 1 c . s . • ADDITIONAL INFO CHAIN OF CUSTODY J� � Report Results to: . Relinquished: Jr' .A=�G Date:4-4-23 Time: Phone/Fax: Received: _ / Date: 1-1 .{. -75 Time: m Coments: _ Sample Log-in: cc Date: Li-5-Z Time: • Sample Prep: ' 'S • Date:. ti-S-2: Time: Analyzed: / Date: ] Time: QA/QC Review: Date: -4� Time: NOTE:Spedr,o 8mliOomen/ah1ssve/ales,lac utilizes laboratories that meet the requirements set forth by AHERA 40 CFR 763.90(0(2)00. Rotameters are calibrated against a Dry Cal DC-Lite Primary Flow Meier manufactured by BIOS International Corporation. Environmental Consulting&Management Services • Health&Safety Training • Laboratory Services . • •. .. _ • + SPEC. TRVilif . PO'139.r.7o24 •Sdienedad'p A 1230r P. � rjde-�. 4rane� Envlravnmental llssociates, lnc:' • OS)MI 2(An) 'IIXCE2DIAC DV mil.4spec rum.Com • • AIR SAMPLING CHAIN OF CUSTODY (REv 06-15 2017) • • PROJECT INFORMATION •SAMPLE TYPE TYPE OF ANALYSIS TURNAROUND Project#: 22-371 Date Collected: 4-11-23 0 Phase IB(Background) 8 PCM-NIOSH 7400 0 RUSH • • Job Site/Building: 920,Rt.9,Queensbury • 0 Phase IIA(Prep) 0 TEM-NIOSH 7402 0 12 Hour Room/Work Area: diner/floor tile El Phase IIB(Removal) 0 TEM-AHERA 0 24 Hour • .Rotameter#: H-5 Calibration Date: 3-21-23 0 Phase IIC(Clearance) 0 Other ®48 Hour Collected By(Print): eric k.rath 0 Air Quality 0 Other • • SAMPLE IDENTIFICATION Lab ID Sample Pump Pump Pump Rate Rate Air Adjust 2 No. No. No. Location On Off Time L.O.D. Result F/mm (LPM) (LPM) Volume . Count NAE=Negative Air Exhaust hymn hymn On Off loin . Liters /10D F/cc 22 Field Blank 1 1.502 23 Field Blank --- -- -- --- --- -- __ ___ 5 ` 3 24 remote decon enterance 0822 1622 4 4 ,© f ej'to 0400) gco C1X/1 Qpg 25 remote decon exit 0822 1622 4 4 . 5.0 Si) . 6.q bos 26 air lock 0826 1626 4 4 27 • critical 1 0828 1628 .4 4 • 1` 6 1 .6 tint 1. 3 28 critical 2 0831 1631 4 . 4 r ao got 6<y l 29 neg. air exhaust 0833 1633 4 4 ! 01t 6 a lit .30 ambient 0836 1636 4 4 y0 8 5. 1 • • • • • • ADDITIONAL INFO CHAIN OF CUSTODY Report Results to: Relinquished: z, �� Date:4-11-23 Time: Phone/Fax: Received: Date: yam i Z-2,3 Time: Comments: Sample Log-in: Date: k-)2-23 Time: Sample Prep: • Date: '1-12-z3 Time: Analyzed: . Date: Time: QA/QC Review: Date: Time: • NOTE:Spedro,ffrnirenmeidalilssedares,Joe.utilizes laboratories that meet the requirements set forth by AHERA 40 CFR 763.90(i)(2)(ii). Rotameters are calibrated against a Thy Cal DC-Lice Primary Flow Meter manufactured by BIOS International Corporation. • Environmental Consulting&Management Services • Health&Safety Training • Laboratory Services • 1!o.Box 7024 S • Sdrencrladp.NV 12301 (518)346-6374(Phone) R T wlvw 4sped a n.corrr.I3nvironmental Rssociates, lnc. • (Sl8)$4I-4O 12(�) Gxcecnin�c Gos Gctc.vrs Exrecrtr►ays or 6xc�t;ccncc' . • AIR SAMPLING CHAIN OF CUSTODY (REv 06-15-2017) PROJECT INFORMATION SAMPLE TYPE TYPE OF ANALYSIS TURNAROUND Project#: 22-371 Date Collected: 4'13-23 0 Phase IB(Background) ®PCM-NIOSH 7400 ®RUSH. • Job Site/Building: 920,Rt.9,Queensbury O Phase IIA(Prep) 0 TEM-NIOSH 7402 0 12 Hour . Room/Work Area: diner/floor the 0 Phase IIB(Removal) 0 TEM-AHERA 0 24 Hour Rotameter#: H-5 • Calibration Date: 3-21-23 .A Phase IIC(Clearance) 0 Other 0 48 Hour Collected By(Print): eric k.rath . 0 Air Quality 0 Other 01. SAMPLE IDENTIFICATION Lab ID Sample Pump Location Pump Pump Rate Rate Time Au L.O.D. Adjust Result F/mm2 No. No. No. On Off (LPM) (LPM) Volume Count NAE=Negative Air Exhaust hymn hrmn On Off Min Liters /100 Ikei is so 3 40 Field Blank --- --- --- --- -- --- --- .L1 --- $,l • 41 Field Blank --- --- --- -- --- -- --- 3,5 --- 4.5 'g 155 42 6 IWA-break room 0654 0854 10 10 0-6 i Lue 6,001. 2.0 Q t-S , I 1 . 1564 43 IWA-office area 0654 0854 10 10 1 0.S _ a,b 060 44 IWA-rear diner 0656 0856 10 10 3,5 4.5 1 156 45 IWA-center diner 0657 0857 10 10 o.- 0.o ls6k 46 IWA-front diner 0658 0858 10 10 0-0 0.0 3 r5 0 47 OWA-far right air lock 0711 0911 10 10 7-.0 1,S Ise I 48 • OWA-center right air lock 0712 0912 10 10 0).6 t 3 • 44 /572 49 OWA-center air lock 0712 0912 10 10 b.a 0.,0 121s73 60 OWA-center left air lock 0713 0913 10 10 I p,o b•0 ? 15761 51 OWA-far left air lock 0714 0914 10 10 1 ' tl v Ls ' , . 3,E ADDITIONAL INFO CHAIN OF CUSTODY , /, Report Results to: Relinquished: ,�! i � Date:4-13-23 Time: . Phone/Fax: Received: -46-C. Date:4-(8-Z3 Time: Comments: Sample Log-in: a Date:4-13`23 Time: Sample Prep: 5��r. Date: (-l-'i$-Z3 Time:' �� Analyzed: •-; Date: 1/1 3 j1c3 Time: QA/QC Review: 1-L Date:Lf/r3/73 Time: . NOTE:Spedrrin, nronmen/a/Hssada/es lne.utilizes laboratories that meet the requirements set forth by AHERA 40 CFR 763.90(i)(2)(it). • Rotameters are calibrated against a Dry Cal DC-Lite Primary Flow Meter manufactured by BIOS International Corporation. Environmental Consulting&Management Services • Health&Safety Training • Laboratory Services • Ambient Remote Decon Entrance Decon 22-371 (4-10-23 thru 4-12-23) Diner Area-920 Rt.9 Phase IIB-NTS Remote Decon Exit • Air Lock _ I _I NAE awn n� • Critical 1 Critical 2 E P.0.8osr 1024 Schenectady;NV 12301 ,# SPECTRUM (518)348-6374(Phone) R.. EnvironmentalR (818)348-4082(Far) ss®ciates, Inc. www4spectrum.com 'EXCEEDING 002 CLIENTS EXPECTATIONS Of EXCELLENCE' State of New York— Department of Labor Asbestos Certification STATE OF,,NEnvoRK DEPARTMANT of LABOR _ S . QSBE 'CERT 5T05IFICATE " ` i t� ,' ;I jEAICa�K^Eii4TH . "� l C�ATFC 04123 SD INSP(oa/23 • ::¢ERT,•c oe a&42 't!. . .Rer :tiJ-4'.�1C :.r t:::•..-:j ..-ri-.. .: ... _i.!`.. ''.:.... .c. MUST`BE�CARRIEDON;AS®ESTQS PROJECTS :.......::: Hummirumiim 1111111111111111111111111 IF FOUND RETURN TO: EYES BLU NYSDOL — L&C UNIT 2 HAIR SAL ROOM 161A BUILDING 12 ="' HGT 5' 08" STATE OFFICE CAMPUS $ ALBANY NY 12290 N o State of New York— Department of Labor Codes Certification ' A Asbestos Handler B Restricted Handler-.Allied Trades C Air Sampling Technician D Inspector P Management Planner F Operations and Maintenance G Supervisor H Project Monitor l Project Designer Environmental Consulting&M;I anage/12elri Services a Health&Safely Training • Laboratory Services • • NEW YORK STATE DEPARTMENT OF HEALTH WADSWORTH CENTER ' ` e� I1 Expires 12:01 AM April 01,2024 Issued April 01,2022 Revised March 30,2023 3 • CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE Issued in accordance with and pursuant to section 502 Public Health Law of New York State MS. KATALINA LI NY Lab Id No: 11540 SPECTRUM ENVIRONMENTAL ASSOCIATES INC • • 2539ALBANY STREET SCHENECTADY NY .12304 • is herebyAPPROVED as an Environmental Laboratory for the category • ENVIRONMENTAL ANAL YSESAIRAND EMISSIONS All approved subcategories and/or analytes are listed below: Miscellaneous Fibers NIOSH 7400A RULES • • • • • • • • • • • Serial No.: 66431 • Property of the New York State Department of Health. Certificates are valid only at the address shown and must be conspicuously posted by the laboratory. Continued accreditation depends on the laboratory's successful ongoing participation in the Program. Consumers may verify a laboratory's accreditation status online at https://apps.health.ny.gov/pubdoh/applinks/wcelappublicweb/,by phone(518)485-5570 or by email to elap@health.ny.gov. 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