DEMO-000050-2017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: DEMO-000050-2017 Date Issued: Friday, March 2, 2018
This is to certify that work requested to be done as shown by Permit Number DEMO-000050-2017
has been completed.
Tax Map Number: 289.6-1-35
Location: 22 NACY RD
Owner: Kathi Miller, Frank Miller
Applicant: Rucinski-Hall Architecture
This structure may be occupied as a: Demolition of SFD and Garage
Asbestos Report Received By Order of Town Board
Cross Ref. Area Variance PZ 67-2016 TOWN OF QUEENSBURY
and Site Plan Review PZ 127-2016
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: DEMO-000050-2017
Tax Map No: 289.6.1-35
Permission is hereby granted to: Kathi Miller,Frank Miller
For property located at: 22 NACY RD
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Tvce of Construction
Owner Name: Kathi Miller Demolition-Residential $0.00
Owner Address: 20 Queens LN Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
DDDJ Enterprises
470 WEST MOUNTAIN RD
Queensbury,NY 12804
Plans&Specifications
Demolition of SFD and Garage
Asbestos Report Received
Cross Ref. Area Variance PZ 67-2016
and Site Plan Review PZ 127-2016
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,March 1,2018
(If a longer period is required,an application for an extension must be made to the wile Enforcement Officer
of the Town of Queensbury before the ex✓��_�rationn date.)
Dated at the Town o ueensb //Wed e c 1,2017
SIGNED M. (((nnnAAA...✓✓"!!/// �VJ ed
the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit#:
NO WORK MAY COMMENCE UNT PERMIT IS ISSUED �"' Permit Fee f��______
Provide 2 plot plans drawn to scale,showing lot siNS ing" c nt roads/streets. Show all existing structures
on property and indicate which are to be demoli h I dicate the location o a I i
G� FEB 16 2017
Date 5117 Demoli o a tion 22_ Opy2__
Map q� L��1= ToWtj OF OUEENSBURY ----
lax Ma ID y l COMMUNITY DEVELOPMENT
APPLICANT 1-N-IAL1"S1-40-- OWNER
Address 2Q_ �,_ � = Address
_L]�LlE�1:3Ah�l�L_ �L_L24��
---------------------------
Phone _ j��lQ _____________ Phone
- ---------------------------
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: yCRQaAt_l.% {�}AW hone: _Q
1. Person Responsible for Work b IA) W
2. Where will demolition material be disposed? spa
3. All buildings to be demolished require an Asbestos_Survey
4. Any building substantially damaged by fire must obtain an Asbestos Removal Permit from the Department of Labor
5. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begin
a) is there any asbestos in the building to be demolished _ Yes ____ No
b) If Yes,our office needs the following information ____Yes ____ No
Name of firm removing the asbestos 5 I�M Glllt�
License number of firms V
Indicate where the asbestos material will be disposed
6. Structure Information
a) Indicate the structure(s)to be demolished _eResidence ___ Garage ___ Business
_ Storage Bldg. --_ Other
b) Size of Structure }lxft� 37r X qOr Coeg* 51ot x %$"
c) Number of Stories rp-
5727R�Ctj
d) Foundation Type 6 1r # Gox, Mpiscr4111115-(
e) Foundation
f) Structure(s)
7. Utilities Information T01n i l -
a) Indicate utilities for this AU!LQi66 R pglewYgric _ _ Propane ___ Public Water ___ Public Sewer
On-site well water pump fife
a) Have you notified the Town Water Department for pub li water and sewer disconnect? Yes _ No t a
b) Have all utilities been disconnected? ____ Yes No 15111'
8. Sinature it I
Print Name: AIA.
- -- --- -- ---- ---- - -- ----------------
Signature: ----
----- Date
Town of Queensbury Building& Codes-Demolition Permit-December 2014
289.6-1-35 DEMO-000050-2017
,OPY Miller, Frank & Kathi
22 Nacy Road
TOWN OF OUEENSBURY Demo Only SFD & Garage
HANSON BUILDING DEPARTMENT
Based en esr Nmitrr - ^ah u.comniinnne
with our comments shall not be construed GEOLOGIC&ENVIRONMENTAL CONSULTANTS
indica6n the plans and speafieahons are in
AN VLEBuII,��ance with the Building Codes of
New York State.
FILE COPY
September 25,2015 D I C IE 9 W E
Mr. and Mrs.Frank Miller FEB 16 2017
20 Queens Lane
Queensbury,New York 12804 TOWN OF OUEENSBURY
BUILDING & CODES
RE: Pre-Demolition Asbestos Survey TOWN OF QUE S
22Nacy Road BUILDING & C D
Tax ID#289.6-1-35 d
Town of Queensbury,New York Reviewed By:
Date: im
Dear Mr. and Mrs.Miller:
Hanson Van Vleet, LLC conducted a pre-demolition asbestos containing material (ACM)
survey at a two story, three bedroom, residential structure, with a detached two story garage
and workshop building, located at 22 Nacy Road, in the Town of Queensbury, Warren
County,New York (Tax ID: 289.6-1-35) . The survey is being conducted to determine if any
ACM exists within the structure prior to demolition. The owner of record at the time of the
survey was Frank and Kathi Miller. HVV is a licensed by the New York State Department of
Labor under license # 05-0220 to perform asbestos inspections, sample collection and
surveys. Samples of all types of suspected asbestos containing material (SACM) were
collected. All samples were collected by a NYSDOL licensed Class D Inspector, in
accordance with 12 NYCRR Part 56 (referred to as Industrial Code Rule 56) and 29 CFR Part
1910. The sampling was conducted on August 28, 2015. A copy of the NYSDOL Asbestos
license is attached to this letter.
This survey was performed to determine the existence of ACM prior to demolition of the
structure. The work included the collection of representative bulk samples of each type of
suspected ACM.
Methods
The asbestos survey was conducted on August 28, 2015. Prior to initiating sampling, an on-
site walk-through inspection of the building was performed in accordance with Subpart 56-
5(e)of 12 NYCRR Part 56. Building plans were not available for review.
Based on the site inspection, sampling of materials was performed to evaluate for suspect
asbestos containing materials (ACM). Bulk samples were collected following standard
sampling procedures. The samples were placed in double sealed sample bags and delivered
by Federal Express to EMSL Analytical for analysis under formal chain of custody
procedures. Friable type materials were analyzed by Polarized Light Microscopy (PLM) via
the NY State ELAP 198.1 method. Non-organically bound (NOB) materials were analyzed
902 Route 146 (518)371-7940
Clifton Park,New York 12065 Fax(618)371-6885
i
Pre-Demolition ACM Survey
22 Nacy Road
Town of Queensbury,NY
Page 2 of 4
by PLM via NYS method 198.6 NOB. If the NYS method 198.6 NOB was inconclusive, the
NOB materials were then analyzed by transient electron microscopy (TEM) via NYS method
198.4 NOB.
INSPECTION RESULTS
The inspection revealed a two story structure with a detached garage and workshop building.
The garage structure was of wood frame construction on a concrete slab. The residence on the
property was also of wood framed construction on a concrete block foundation. A site
location map is attached to this letter report.
Interior of Dwelling
Flooring in the building consisted of two layers of vinyl flooring in the kitchen, ceramic tiles
in the bathroom, wood floors in the living room, and carpet over wood floors in the entire
second floor. The two layers of sheet vinyl flooring and associated mastic in the kitchen was
considered suspect ACM. Samples were collected of the sheet vinyl floor and associated
mastic in the kitchen.
Walls and ceilings throughout the house consisted of drywall with mudded joints. Textured
skim coat was present on the drywall in the bedrooms, hallways and living room. Acoustic
ceiling tiles were present in the kitchen. Samples of the drywall from the walls and ceilings
throughout the house, the textured skim coat,joint compound, and acoustic ceiling tiles were
collected.
Exterior of Dwelling
The exterior of the dwelling was finished with concrete texture. The main roof was metal with
an asphalt shingled porch roof on the lake side of the house. Samples of the roofing shingles
over the porch were collected. Window glazing was present on windows on the west and
south side of the house. Samples were collected of the window glazing. No other suspected
ACM was observed during the exterior inspection of the house.
Interior of Garage Building
The interior of the garage building was mostly unfinished wood framed construction with
some areas finished with dry wall. Multiple types of drywall were encountered in the second
floor rooms of the garage building. Joint compound was also observed on drywall in the
garage building. Floors consisted of wooden floors on the second floor and concrete floors on
the ground floor of the garage. Blown in insulation was encountered above the ceiling in the
second floor of the garage. Fiberglass insulation was encountered on the first floor of the
building. Samples were collected of the multiple types of drywall encountered throughout the
garage building, the joint compound on each type of drywall, and the blown in insulation
found above the second floor ceiling. No other suspected ACM was observed during the
interior inspection of the garage building.
Exterior of Garage Building
The exterior of the garage building was finished with concrete texture. The main roof was
metal with an asphalt shingled roof over the garage door. Samples of the roofing shingles over
the garage door were collected. Window glazing was present on windows on the west side of
the garage. Samples were collected of the window glazing. No other suspected ACM was
observed during the exterior inspection of the garage.
Pre-Demolition ACM Survey
22 Nacy Road
Town of Queensbury,NY
Page 3 of 4
Asbestos Containing Material Sampling Results
The structures at the property contained select materials considered suspected ACM. Three
samples of eighteen types of suspect ACM were submitted for analysis. The Analytical results
are summarized below. The laboratory analytical report and chain of custody are attached to
this letter.
Table 1
Asbestos Sampling Locations and Analytical Results
Sample Type of Material Location Result Approximate
No. Quantity
S-IA,B,C Roof Shingles Garage Building ND NA
S-2A,B,C Blown in Insulation Garage Building ND NA
S-3A,B,C Texture/Plaster Garage Building ND NA
S-4A,B,C Drywall Garage Building ND NA
S-5A,B,C Drywall Garage Building ND NA
S-6A,B,C Window Glazing Garage Building ND NA
S-7A,B,C Skim Coat Garage Building ND NA
S-B&B,C Joint Compound Garage Building ND NA
S-9A,B,C Window Glazing Dwelling ND NA
S-IOA,B,C Asphalt Shingles Dwelling Porch Roof ND NA
S-11A,B,C Vinyl Flooring Kitchen ND NA
S-12A,B,C Flooring Mastic Kitchen ND NA
S-13A,B,C Vinyl Flooring Top Layer Kitchen Floor ND NA
S-14A,B,C Ceiling Tiles Kitchen ND NA
S-15A Textured Sldm Coat Bedrooms, Hallways and 1.44% >1000 SQ FT
Living Room Chrysotile
S-15B Textured Skim Coat Bedrooms, Hallways and Positive Stop >1000 SQ FT
Living Room
S-15C Textured Skim Coat Bedrooms, Hallways and Positive Stop >1000 SQ FT
Living Room
5-16 No Sample# 16 -------------
S-17A,B,C Joint Compound Throughout Dwelling NDA NA
S-1 sA B,C Drywall Throughout Dwelling ND NA
Conclusions
Testing of all suspect asbestos containing materials was performed pursuant to 12 NYCRR
Part 56, (Code Rule 56). Materials are considered asbestos containing if they contain 1% or
more of asbestos.
The results of the asbestos survey identified asbestos on the interior of the structure. The
textured skim coat on the drywall in the bedrooms, hallways and living room of the dwelling
was found to contain asbestos. A photograph of the typical skim coat is attached.
Recommendations
The textured skim coat on the drywall in the bedrooms, hallways and living room of the
dwelling was found to contain asbestos. Abatement by a licensed NYSDOL abatement
Pre-Demolition ACM Survey
22 Nacy Road
Town of Queensbury,NY
Page 4 of 4
contractor is required prior to disturbing the materials during the demolition of the structure.
Prior to modification or removal, the textured skim coat must be removed by a licensed
asbestos contractor, or otherwise in accordance with 12 NYCRR Part 56 and 29 CFR Part
1910.
If you have any questions regarding this survey, please contact Hanson Van Vleet LLC at
(518) 371-7940.
Very truly yours,
Hanson Van Vleet, LLC
James Gironda
Geologist/Environmental Scientist
NYSDOL Class D Inspector Certificate#07-05263
CC:NYSDOL
1
I
] l
Typical skim coat observed throughout the bedrooms, hallways and living room.
EMSL Analytical, Inc. EMSLOrder 041526682
200 Route 130 North,Cinnaminson,NJ 08077 CustOmedD: HANS22
Phone/Fax (800)220-3675/(856)786-5974 CustomerPO:
hho:// .EMSL.com unnasblab(rDEMSL.cam PmjectlD:
Attn: James Gironda Phone: (518)371-7940
Hanson Van Vleet, LLC Fax: (518)3715885
902 Route 146 Received: 09/02/152:00 PM
Clifton Park, NY 12065 Analysis Date: 9/20/2015
Collected: 827/2015
Project: 22 Nacy Road
Test Report:Asbestos Analysis of Bulk Material
Analyzed Non Asbestos
Test Date Color Fibrous Non-Fibrous Asbestos
Sample ID S-1A Description Over garage bay-Roof shingles
041526682-0007 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Gray 8.8% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 Gray None Detected
Sample ID S-1 B Description Over garage bay-Roof shingles
041526662-0002 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/1 712 01 5 Green 6.8% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 920/2015 Green None Detected
Sample lD S-IC Description Over garage bay-Roof shingles
041526682-0003 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Green 10.2% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 Green None Detected
Sample ID S-2A Description Above garage ceiling-Insulation
0415266620004 Homogeneity Homogeneous
PLM NYS 196.1 Friable 9/172015 Brown 90.00%Cellulose 10.00%Non-fibmus(other) None Detected
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 196.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-2B Description Above garage ceiling-Insulation
041526682-0005 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 Bmwn 90.00%Cellulose 10.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Inifial Report From 09/20/2015 12:53:09
Test Report 198VCM-7.30.0 Printed:9120201512:53:09 PNI Page 1
EMSL Analytical, Inc. EMSL Order. 041526682
200 Route 130 North,Cinnaminson.NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
hito:/Aw .EMSL.wm cinnasblab0EM5L.wm ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-2C Description Above garage ceiling-Insulation
041526682-0006 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 Brown 90.00%Cellulose 10.00%Non-fibrous(otter) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3A-Tex(ure Description Upstairs in garage-Second layer drywall walls&ceiling
041526682-0007 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 Tan/Mite 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3A-Plaster Description Upstairs in garage-Second layer drywall walls&ceiling
041526682-00078 Homogeneity Homogeneous
PLM NYS 196.1 Friable 9/17/2015 Gray 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 196.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3B-Texture Description Upstairs in garage-Second layer drywall walls&ceiling
041526682-0096 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 Tan/White 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3B-Plaster Description Upstairs in garage-Second layer drywall walls&ceiling
041526682-=aA Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 Gray 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-3C-Texture Description Upstairs in garage-Second layer drywall walls&ceiling
041526682-0009 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 White 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Infial Report From 09/20/2015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/202015 12:53:09 PM Page 2
® EMSL Analytical, Inc. CusL order HANS268z
zoo Route 130 North,Cinnaminson,NJ 08077 CustomedD: HANS22
Phone/Fax: (800)220-3675/(856)7865974 CustomerPO:
hit-:ihw .EMSLcom dnnasblabrMEMSL.com ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-3C-Plaster Description Upstairs in garage-Second layer drywall walls&ceiling
041526682-00098 Homogeneity Homogeneous
PLM NYS 196.1 Friable 9117/2015 Gray 100.00%Non-fibrous(other) None Detected
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 196.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S4A Description Upstairs in garage-First layer drywall walls&ceiling
041526682-0Oo Homogeneity Homogeneous
PLM NYS 196.1 Friable 9/1 712 01 5 BrownlWhite 15.00%Cellulose 85.00%Non-fibrous(other) None Detected
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S40 Description Upstairs in garage-First layer drywall walls&ceiling
041526682-001 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 BmwnNVhite 15.00%Cellulose 85.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-4C Description Upstairs in garage-First layer drywall walls&ceiling
041526682-0012 Homogeneity Homogeneous
PLM NYS 198.1 Friable 91172015 White 15.00%Cellulose 85.00%Non-fibrous(other) None Detected
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 196.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-5A Description "New"'mom-garage-Drywall
041626682-0013 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 White 15.00%Cellulose 85.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S5B Description "New"room-garage-Drywall
041526682-04 Homogeneity Homogeneous
PLM NYS 196.1 Friable 91172015 White 15.00%Cellulose 85.00%Non-fibrous(other) None Detected
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 196.6 NOB Not Analyzed
TEM NYS 199.4 NOB Not Analyzed
Initial Report From 09202015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/202015 12:53:09 PM Page 3
® EMSL Analytical, Inc. sLorden 041526682
200 Route 130 North,CinnaCu
mineon,NJ 08077 CuSlOmeriHANS2
D: HANS22
Phone/Fax: (800)220-36751(856)786-5974 CustomerPO:
http A/ .EMSL.mm cinnasblabAEMSL.mm Project/):
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-5C Description "Neve room,garage-Drywall
041526682-0015 Homogeneity Homogeneous
PLM NYS 196.1 Friable 9/172015 White 15.00%Cellulose 85.00%Non-fibrous(other) Noire Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.8 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID SEA Description West side windows of garage-Window glazing
091526682-0016 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 White None Detected
Sample ID SEB Description West side windows of garage-Window glazing
041526682-0017 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 White None Detected
Sample ID SEC Description West side windows of garage-Window glazing
041526682-0016 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/17/2015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 White None Detected
Sample ID S-7A-Te)dure Description Garage-Skim coat on drywall
041526692-0019 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 Tan/Whfte 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 N013 Not Analysed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-7A-Plaster Description Garage-Skim coat on drywall
091526682-0019A Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 Gray 100.00%Non-fibmus(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Initial Report From 09202015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/20/201512:53:09 PM Page 4
EMSL
® EMSL Analytical, Inc. Custom r[D: HANS2682
200 Route 130 North,Cinnaminson,NJ 08077 CusromedD: HANS22
Phone/Fax (800)220-36751(856)786-5974 CustomerPO:
htto:/Av .EMSL.mm cinnasblaW_EMSL.mm ProjectiD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-78-Texture Description Garage-Skim coat on drywall
041526682-0020 Homogeneity Homogeneous
PLM NYS 196.1 Friable 9/17/2015 TanlWhite 100.00%Non-fibrous(other) None Detected
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 196.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-7B-Plaster Description Garage-Skim coat on drywall
041526682-=A Homogeneity Homogeneous
PLM NYS 196.1 Friable 9/17/2015 Gray 100.00%Nan-fibmus(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-7C-Texture Description Garage-Skim coat on drywall
041526682.0021 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 White 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 196.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S•7C-Plaster Description Garage-Skim coat on drymil
041526682-eo21A Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 Gray 100.00%Non-fibrous(other) None Detected
PLM NYS 188.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-8A Description Garage-Joint compound on drywall
0416266880022 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 White 100.00%Non-fibrous(other) None Defected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-8B Description Garage-Joint compound on drywall
091626682-0023 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 White/Green 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Initial Report From 09202015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/202015 12:53:09 PM Page 5
EMSL Analytical, Inc. EMSL Order. 041526682
200 Route 130 North,Clnnaminsen,NJ 08077 CuslomedD: HANS22
PhonelFaz: (800)220-36751(856)786-5974 C.ustomerPO:
h0P9Avew.EM5Lcom cinnasblabAEMSL.com Pro)edlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-8C Description Garage-Joint compound on drywall
041526682-0024 Homogeneity Homogeneous
PL NI NYS 198.1 Friable 9/17/2015 White 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 199.4 NOB Not Analyzed
Sample ID S-9A Description West and south side of house-Window glazing on windows
041528682-0025 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/17/2015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9/202015 White None Detected
Sample ID S-98 Description West and south side of house-Window glazing on windows
041526682-0026 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 White None Detected
Sample ID S-9C Description West and south side of house-Window glazing on windows
041526682-0027 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PL.M NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 White None Detected
Sample ID S-10A Description West side of house-Roof shingles on porch roof
041526562-0028 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Green 6.7% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9/20/2015 Green None Detected
Sample 10 5-1013 Description West side of house-Roof shingles on porch roof
041526682-0029 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Green 7.3% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 Green None Detected
Initial Report From 09202015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/202015 12:53:09 PM Page 6
EMSL Analytical, Inc. EMSLOrder. 041526682
200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-3675/(856)786-5974 CustomerPO:
hdo:/Av .EMSL.com cinnasblabrZEMSL.com ProjeellD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-10C Description West side of house-Roof shingles on porch roof
041526682-0030 Homogeneity Homogeneous
PUN NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/17/2015 Green 19.6% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9/2 012 01 5 Green None Detected
SampleiD S-11A Description Kitchen-Floor tiles under sheet vinyl
041526682-001 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Red Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 Red None Detected
SampleiD S-11B Description Kitchen-Floor tiles under sheet vinyl
047526682-0032 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PINI NYS 198.6 NOB 9/172015 Red Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 Red Nona Detected
Samp1e10 S-11C Description Kitchen-Floor tiles under sheet vinyl
047526682-0033 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Red Inconclusive:None Detected
TEM NYS 196.4 NOB 9202015 Red Nona Detected
Sample ID S-12A Description -Floor file mastic
041526682-0034 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Black Inconclusive:<1%Chrysotile
Inconclusive-<1%Total
TEM NYS 198.4 NOB 92012015 Black None Detected
Sample ID S-128 Description -Floor tile mastic
047526682-0035 Homogeneity Homogeneous
PUN NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Black Inconclusive:<1%Chrysotile
Inconclusive-0%Total
TEM NYS 198.4 NOB 9202015 Black None Detected
Initial Report From 09/2012015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/202015 12:53:09 PM Page 7
EMSL Analytical, Inc. EIVISL Order. 041526682
200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fe (800)220-3675/(856)7865974 CustomerPO:
htln:/A. .EMSL.wrn dnnasblabnEMSL.com ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-12C Description -Floor tile mastic
0415266820036 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Black Inconclusive:<1%Chrysotile
Inconclusive-<I%Total
TEM NYS 198.4 NOB 9202015 Black None Detected
Sample ID S-13A Description Kitchen-Sheet vinyl flooding
041526662-0037 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Brown <t% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 Brown None Detected
Sample ID S-13B Description Kitchen-Sheet vinyl flooring
041526682-0098 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Brown 1.1% Glass Inconclusive.None Detected
TEM NYS 198.4 NOB 9202015 Brown None Detected
Sample ID S-13C Description Kitchen-Sheet vinyl flooring
041526682-0039 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 196.8 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 Broom 2.4% Glass Inconclusive:None Detected
TEM NYS 198.4 NOB 9202015 Brown None Detected
Sample ID S-14A Description Kitchen-Ceiling files
041526682-0040 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/172015 White inconclusive:Norte Detected
TEM NYS 198.4 NOB 9202015 White None Detected
Sample ID S-14B Description Kitchen-Ceiling ties
041526682-0041 Homogeneity Homogeneous
PLM NYS 196.1 Friable Not Analyzed
PLM NYS 196.6 VCM Not Analyzed
PLM NYS 196.6 NOB 9/172015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9/20/2015 White None Detected
[initial Report From 0920/2015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/2012015 12:53:09 PM Page 8
EMSL Analytical, Inc. EMSL Omer. 041526682
200 Route 130 North,Cinnaminson,NJ 08077 CustomerID: HANS22
Phone/Fax: (80D)220-36751(856)786-5974 CustomerPO:
httn#A .EMSLmm dnnasb1abAEM5L.wrn PmjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-14C Description Kitchen-Ceiling files
041526682-0042 Homogeneity Homogeneous
PLM NYS 198.1 Friable Not Analyzed
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB 9/17/2015 White Inconclusive:None Detected
TEM NYS 198.4 NOB 9/20/2015 White None Detected
Sample ID S-15A Description Throughout house-Skim coat on drywall
041526692-0043 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 TanrWhite 98.56%Non-fibrous(other) 1.44% Chrysotile
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-15B Description Throughout house-Skim coat on drywall
011526682-0044 Homogeneity
PLM NYS 198.1 Friable 9/17/2015 Positive Stop
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 196.4 NOB Not Analyzed
Sample ID S-15C Description Throughout house-Skim coat on drywall
011526982-0045 Homogeneity
PLM NYS 198.1 Friable 9/17/2015 Positive Stop
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
SampleID S-17A Description -Joint compound on drywall
0415266a2-"8 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 White 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-17B Description -Joint compound on drywall
041526682-0047 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 White 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Initial Report From 09120/2015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/10/1015 12:53:09 PM Page 9
EMSL Analytical, Inc. EMSL Order 041526662
200 Route 130 North,Cinnaminson,NJ 08077 CustomerlD: FIANS22
Phone/Far.. (800)220-3675/(856)7865974 CustomerPO:
hftD:/Nv .EMSL.com cinnasbiaoAEMSL.com ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-17C Description -Joint compound on drywall
041526682-0048 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 White 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
SamplelD S-18A-Texlure Description Throughout house-Drywall
041526682-0049 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 Tan/White 100.00%Non-fibrous(other) Norm Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
SamplelD S-18A-Plaster Description Throughout house-Drywall
041526682-0049A Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 Gray 5.00%Cellulose 95.00%Norrfibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
SamplelD S-18BTexture Description Throughout house-Drywall
041526682-0060 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 TanlWhite 100.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Sample ID S-18BPlaster Description Throughout house-Drywall
041526682-0050A Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 Gray 5.00%Cellulose 95.00%Non-fibrous(other) None Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
SamplelD S-18C-Texture Description Throughout house-Drywall
041526882-0051 Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/172015 While 100.00%Non-fibrous(other) Norm Detected
PLM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzed
Initial Report From 0920/2015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/20201512:53:09 PM Page 10
EMSL Analytical, Inc. EMSL order 041526682
® 200 Route 130 r10N6 Cinnaminson,NJ 08077 CustomerlD: HANS22
Phone/Fax: (800)220-36751(856)786-5974 CustomerPO:
htty1twvw.EMSL.com cinnasblab(MEMSLcom ProjectlD:
Test Report:Asbestos Analysis of Bulk Material
Non Asbestos
Test Color Fibrous Non-Fibrous Asbestos
Sample ID S-18C-Plaster Description Throughout house-Drywall
641526682-MIA Homogeneity Homogeneous
PLM NYS 198.1 Friable 9/17/2015 Gray 5.00%Cellulose 95.00%NonAbrous(other) None Detected
FILM NYS 198.6 VCM Not Analyzed
PLM NYS 198.6 NOB Not Analyzed
TEM NYS 198.4 NOB Not Analyzad
Analyst(s)
Braff Poutton
Chris Little
Quynh Vu Benjamin Ellis,Laboratory Manager
or other approved signatory
NOB=Non Friable Organically Bound N/A=Not Applicable VCM=Vermiculite Containing Material
-In New York State,TEM is cunantly the only method that can be used to determine y NOB materials can be considered or treated as iron-asbestos containing.
All samples examined for the presence of vermiculite when analyzed via NYS 198.1.
-NYS Guidelines for Vermiculite containing samples ala available at him:twww.wadsworth.om/abced/elaocert4o sNennicuftalntedmGu'dance Rev07091320f
EMSL maintains liamlily limited to cost of analysis.This report relates only to the samples reported above and may not be reproduced,except in full,without written approval by EMSL.
EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client-Samples were
received in good condition unless otherwise noted.
This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP,NIST,or any agency of the federal government.This report may contain
data that is not covered by the NVLAP accreditation.
Samples analyme!by EMSL AnalyGml.Im Cireammon,NJ NYS ELAP 10872,PA IW684X=7
Initial Report From 09/20/2015 12:53:09
Test Report 198VCM-7.30.0 Printed:9/20/201512:53:09 PM THIS IS THE LAST PAGE OF THE REPORT. Page 11
OrderID: 041526682
EMSL Analytical, Inc.
Asbestos Chain of Custody 200 Route 130 North
EMSL Order Number Lab Use Only): Cinnaminson,NJ 08077
ams�nwurnrru.txc �'� / 5 '.�L PHONE:
1-800-220-3675
E:
(856)786-5974
Com any Name: HanHanson Van Meet LLC EMSL Customer ID:
Street: 902 Route 146 city: Clifton Park State/Province: NY
ZipPostal Code: 12065 Country:United States Telephone M 5183717940 Fax#: 518 3717940
Report To(Name): James Gironde Please Provide Results: ✓ Fax ✓ Email
Email Address: Jgironda@hansonvanvieet.com Purchase Order.
Protect Name/Number.. 22 Nacv Road EMSL Pro eet ID Infernal Use On
U.S.State Samples Taken: NY CT Sam les: CommerciallTaxable Residential/rax Exem t
EMSL-Bill to:id Same Different-d Bin to is Deferent note insumuons in Couunents-
Third Party Billing requires written authorization from third pally
Turnaround Time AT O tbns•-Please Check
El 3 Hour ❑6 Hour 24 Hour ❑48 Hour 72 Hour ❑ 96 Hour t Week • 2 Week
-For TEM Alr3 hr through 6 hr,please cell ahead to schedule.'There is a premium charge for 3 Hour TEMAHERA or EPA Level 11 TAT. You vett be asked to sign
an authorization form for this service Amnalvsis mpletedin accordance with EMSLe Tens and Conditions located in the AnalylicalPfice Guide.
PCM-Air LJCheck if samples are from NY TEM-AirLJ44.61nr TAT(AHERA amyl TEM-Dust
❑ NIOSH 7400 ❑ AHERA 40 CFR,Part 763 [3Micmvac-ASTM D 5755
❑ wt OSHA 8hr.TWA [] NIOSH 7402 ❑Wipe-ASTM D6480
PLM-Bulk(reporting limit) ❑ EPA Level 11 ❑Carpet Sonication(EPA 600/J-93/167)
❑PLM EPA 600/R-93/116(<1%) ❑ ISO 10312 Soif/RocklVenniculite
❑PLM EPA NOB(<1%) TEM-Bulk ❑PLM CARB 435-A(0.25%sensitivity)
Point Count ❑TEM EPA NOB ❑PLM CARB 435-B(0.1%sensitivity)
❑400(<0.25%)(]1000(<0.1%) ONYSNOB 198.4(non-friable-NY) ❑TEM CARB 435-B(0.1%sensitivity)
Point Countw/Gravimetric []Chatfield SOP ❑TEM CARB 435-C(0.01%sensitivity)
❑400(<0.25d/e)❑1000(<O.1%) MTEM Mass Analysis-EPA 600 sea 2.5 ❑TEM Qual.via Filtration Technique
❑ NYS 198.1 (friable in NY) TEM-Water:EPA 100.2 ]TEM Qual.via Drop-Mount Technique
n mta� rkwVolkSsie taoodMvem ae
0 NYS 198.6 NOB(non-friable-NY) Fibers>lopm ❑Waste ❑Drinking Other.
❑ NYS 198.8 SOF-V All Fiber Sizes ❑Waste ❑Drinking ❑
NIOSH 9002(<%)
Check For Positive Stop-Clearly Identify Homo e ousGroup I Filter Pore Size A' Sam le : ❑✓ 0.8 m E10.45jim
SamplersName:JameS Gironda Samplers Signature: �Iwj A/— d
plume/Area(Air) DatelTime
Samplej�# r Sample Descrition HA# Bulk p Sampled
S L "Wrl Get
R k_dS} 1) A
Sr P%3
jo
Client Sam le# s : A Vr=9S-1$� 1-stnsWe—, Total#pr sem lea
Relinquished(Client):
Received(Lab): e- G' Date: r—` Z f ~' Time: a%c>o
Comments/Special Instructions:
aircnne ents/S MNpe
CaN Wad Dwumut-NMbaCCa-16-1W)M%1
Page 1 of Z.. pages
Page 1 Of 2
u --
OrderID: 041526682
EMSL Analytical, Inc.
Asbestos Chain of Custody 200 Route 130 North
EMSL Order Number lab use Only):
L-)
Cinnaminson, NJ 08077
eem�ann�rneaWIN 15-_2 PHONE: 1-800-220-3675
FAX:
(856)786-5974
Additional Pages of the Chain of Custody are only necessary if needed for additional sample information
Volume/Area(Air) Date/Time
Sam le# Sample Description HA# Bulk Sampled
AAL w G� z` 6,1-sA,waiiewsZ
P� L w
L inc�c�w 4-c; U;Ad W.) OVI
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S '�Sl� L � :rn Cotik -fir. r v
-! e 1 0
A Son ( m _
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'Comments/Special Instructions:
If ivnrvJushe M TEM NOB.
Page Z of Z- pages
w wlea0oameM-Am�wa<oe-R9-imamtl
Page 2 Of 2
STATE OF NEW YORK - SEP ?-: .iF?JT OF LABOR
ASBESTOS CER11 RCATE
JAMES J-GIRONDA
CLASS(EXPIRES)
D INSP(1Ill S)
CERT'r )) OS263
MUST BE CARRIED 01, , ASBESTOS PROJECTS
New York State Department of Labor
Division of safety and Health,'
i License and Certhica(e,Unit
State Ceinpus,Budding 12,
x
Albany,NY 12240
ASBESTOS HANDLING LICENSE
Hanson Van Vleet, LLC ,FILE NUMBER: 05-0220
LICENSE NUMBER. 28.463
902 Route 146 y LICENSE CLASS: RESTRICTED
DATE OF ISSUE: 03/09/2015
Clifton Park, NY 1206, EXPIRATION DATE: 03/31/2016
� 1
T
Duly Authorized Representative=,D Kirby,VanVleet
This license his been issued m acpprdaficeilyithE� �ttcable provisions o Arlic e( 0`pf the Labor Law of New York State'a o
the New York Stete,Codes, Rules'nhd`I�egyl�a�tiops'(12 NYCRR P u t 56)' It is object to suspension or revocahodfor a(1)
serious violation of state,federal or loco,IaV'!s with regard to the conduct of at asbestos'pr�JJ'ecit,or(2)demopstratedJg ;p
responsibility m the conduct of any job"n olving asbestos or asbestos materia
rr
This Iice2se is valid only for the contractor gamed above and flus license o(a phofodopy must be prominently displa at. _
asbestos project worksite. This license verif`ie's that all persons employed by,thc licensee on an asbestos,proIject in New York
State have been issued an Asbestos Certificate,appropriate for the type of work they perform, by the New York State
Department of Labor.
:i
Eileen M.Franke, Director
SH 432(8112) For the Commissioner of Labor
289.6-1-35 DEMO-000050-2017
Miller, Frank & Kathi
22 Nacy Road
Demo Only SFD & Garage
HANSON
GEOLOGIC&ENVIRONMENTAL CONSULTANTS
VAN VLEET, LLC
January 3, 2017
Mr. and Mrs. Frank Miller
20 Queens Lane
Queensbury,New York 12804
RE: Pre-Demolition Asbestos Re-Inspection Survey D CZc
22 Nacy RoadTax ID#289.6-1-35F�Town of Queensbury,New York TOWI.t OFDear Mr. and Mrs. Miller: gUiLDiNHanson Van Vleet, LLC conducted a follow up inspection for suspect as
materials (ACM) at a two-story, three-bedroom, residential structure, with a detached two-
story garage and workshop building, located at 22 Nacy Road, in the Town of Queensbury,
Warren County, New York (Tax 1D: 289.6-1-35). The initial survey and sampling was
conducted on August 28, 2015. The follow up survey re-inspection was conducted on
January 3, 2017 to confirm the removal of previously identified ACM by the homeowner,
prior to demolition of the structure.
Inspection Results
The initial survey identified asbestos containing building materials in approximately 1000
square feet of textured skimcoat applied to select walls and ceilings in the three bedrooms,the
hallways, and the living room in the residential structure. An asbestos survey letter report
dated September 25, 2015 describes the initial pre-demolition ACM survey and laboratory
analytical results. No Suspect ACM materials were identified associated with the structure at
the time of the re-inspection on January 3,
2017. The textured skimcoat an
d associated
drywall in the three bedrooms, the hallways, and the living room was removed by the
homeowners prior to the follow up inspection on January 3,2017. No suspect ACM remained
associated with the structure on January 3,2017.
Conclusions
Upon removal of previously identified ACM by the homeowner, no suspect ACM is present
at the residential dwelling to be demolished at 22 Nacy Road, in the Town of Queensbury,
Warren County,New York(Tax ID: 289.6-1-35).NYS Code Rule 56 regulations do not apply
to owner occupied single family dwellings where the owner performs the work. (NYS Code
Rule 56 Subpart 56-1.3 (a))No further abatement is required prior to demolition. If you have
any questions regarding this survey,please contact us at(518)371-7940.
Pre-Demolition ACM Re-inspection Survey
22 Nacy Road
Town of Queensbury,NY
Page 2 of 2
If you have any questions regarding this survey, please contact Hanson Van Vleet LLC at
(518) 371-7940.
Very truly yours,
Hanson Van Vleet,LLC
James Gironda
Geologist/Environmental Scientist
NYSDOL Class D Inspector Certificate#07-05263
CC:NYSDOL
i
^.'J it id II:`Id l'lalil!IlYllit
I4Al
(I lII 11dSNI 0
(S3�IId:'J1`-�,SvT)
IV
New York State—Department of Labor
Division of Safety and Health
License and Certificate Unit
State Campus,Building 12
Albany,NY 12240
ASBESTOS HANDLING LICENSE
Hanson Van Vleet, LLC FILE NUMBER: 05-0220
LICENSE NUMBER: 28463
902 Route 146 ' LICENSE CLASS: RESTRICTED
! : DATE OF ISSUE: 03/24/2016
Clifton Park, NY 12065 EXPIRATION DATE: 03/31/2017
Duly Authorized Representative-D Kirby Vanvleet
This license has been issued in accordance with applicable provisions of Article 30 of the Labor Law of New York State and of
the New York State Codes,Rules and Regulations(12 NYCRR Part 56). It is subject t0 suspension or revocation for a(1)
serious violation of state,federal or local laws with regard to the conduct of an asbestop,project,or(2)demonstrated lack of
responsibility in the conduct of any job involving asbestos or asbestos material
This license is valid only for the contractor named above and this license or a photocopy must be prominently displayed at the
asbestos project worksite. This license verifies that all persons employed by the licensee on an asbestos project in New York
State have been issued an Asbestos Certificate,appropriate for the type of work they perform,by the New York State
Department of Labor.
LJ
Eileen M.Franko, Director
SH 432(8112)
For the Commissioner of Labor