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2007-563 TOVN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number. P20070563 Date Issued: Thursday, January 22, 2009 This is to certify that work requested to be done as shown by Permit Number P20070563 has been completed. Tax Map Number. 523400-303-016-0001-029-000-0000 Location: 463 DIX Ave Owner. DEAN & PAMLEA ROMER Applicant: DEAN & PAMLEA ROMER This structure may be occupied as a: Demolition By Order of Town Board TOWN OF QUEENSBURY 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 12804-5902 (518)761-8201 Community Development--Building _Codes (518),761-8256. , BUILDING PERMIT Permit Number: P20070563 Application Number. A20070563 Tax Map No: 523400-303-016-0001-029-000-0000 Permission is hereby granted to: DEAN &PAMLEA ROMER For properly located at: 463 DIX Ave 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. Tyne of Construction Value Owner Address: DEAN &PAMLEA ROMER Demolition 52 QUEENSBURY Ave QUEENSBURY,NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency J.W. LUCARELLI& SONS 117 VOSBURGH Rd MECHANICVILLE,NY 12118-0000 Plans &Specifications 2007-563 DEMOLITION $20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday, September 04,2008 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the To o nsbu ;zzfor , Se tember 04, 2007 4 SIGNED BY the Town of Queensbury. f NI Director of Building&Code Enforcement -3® . . .FFICEUSEON Y ....--.. . Q ..................... TAX MAP NO. PERMIT NO. Permission is hereby granted to the above named Applicant to demolish the build ni (s) 10 01 00 o described herein as set forth in the Application below. / , Director of Building &Codes Date 01 ----.:.----:---------------------------------- ---------------------- APPLICATION FOR DEMOLITION PERMIT: Fill in applicable spaces and submit two(2) plot plans,drawn to scale,showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures on the property and indicate which are to be demolished. Indicate on the plot plan the location of all utilities. APPLICANT/BUILDER:r'W,, ZyllekG U" ��r pc13 OWNER: _DZ-AJ /�O�►!;/ ADDRESS: ff7 Lam / cl i'} �D.,��iV"h4& � All ADDRESS: �� D/x Aic; PHONE NOS. /ct�7'fD�7 PHONE:_ �/y '793- /Oz-, PERSON RESPONSIBLE FOR WORK: ��i / .fi lnASeP�GI PHONE: l�V/0117 LOCATION OF DEMOLITION: �W T�/ / _; ��J ��,�;/ A)l WHERE WILL DEMOLITION MATERIAL BE DISPOSED? aV7;Yzit JIA)y ,fAdpeju. ASBESTOS INFORMATION: ✓ Is there any asbestos within the building to be demolished? YES__ NO ✓ If YES, our office needs the following information: o Name of firm removing the asbestos: 62W/d— ✓�iQA�,wI ?� o License number of firm: a P49 o Indicate where the asbestos material will be disposed:&12;y b y iy,l NOTE: A copy of Asbestos Removal Report must be filed with our office before demolition begins. STRUCTURE INFORMATION: ✓ Indicate which Structure(s)will be demolished: RESIDENCE GARAGE BUSINESS STORAGE BLDG. OTHER ✓ Size of structure: X ✓ Number of stories: ?-- ✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB ✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED ✓ Structures(s): WILL BE REPLACED WILL NOT BE REPLACED UTILITIES INFORMATION: ✓ Indicate utilities for this structure: GAS ELECTRIC PROPANE PUBLIC WATER ONSITE WELL-WATER PUMP PUBLIC SEWER Have you of d the own at Dept. for pu lic water and public sewer disconnect? YES NO Have I util' Ies een dis ed: YES y NO r QUESTIONS? CALL 761-8256 OR EMAIL codes0gueensburv.net U E OF APPLICANT VISIT OUR WEBSITE FOR MORE INFORMATION www.gueensburv.net Town of Queensbury - Community Development Office • 742 Bay Road, Queensbury, NY 12804 Queensbury Building & Code Enforcement - Reside tial Final Inspection Office No. (518)761-8256 Arrive: ",,1�� m p m Date Inspection request received: Inspector's Initials: NAME: /YI P VIiT#: �_ LOCATION: ATE: TYPE OF STRUCTURE: — _A co mments Buildin Number/Address visible from road Yes No T/ Chimne Hei t/"B"Vent/Direct Vent Location - Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Com lete/Exterior Finish Complete Platform at all exterior doors Guards at stairs, decks,patios more than 30 inches above ade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Interior Handrails @ stairs 2 or more risers Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate __ —i Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety lain Interior Smoke Detectors: Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Batterybacku : Carbon Monoxide Detector Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl S aces 18 inch x 24 inch access, 1 s .ft.-150 s . ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation Floor truss,draftaopping finished basement 1,000 s .ft. Emergency egress below Eade Gas Furnace shut-off within 30 feet or within line of site _ Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Tra /Water Temp 110 Enclosed Stairs Sheetrock Underside minimum/2"Gypsum \ Basement stairs closed rise>4 inches Q Garage Floor Pitched ` Garage fireproofing/'/a hour fire door/door closer _ �Y Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Site Plan /Variance re aired Flood Plain Certification,if re wired Okay to iss or Tem or /Perm t L:\Building&Codes Forms\Building&Codes\Inspection FormslResidential Final Inspection Form revised I00405.doe -=.. Alpine Environmental a �� = Services, Inc. REPORT OF PRE-DEPVIOLIT11 i t ASBESTOS INSPECTION Client/Owner: Mr. Dean Romer 52 Queensbury Avenue Queensbury, New York 12804' Location of Inspection: 463 Dix Avenue Queensbury, New York 12804 Project Number: 07-5169-AC Material or Area inspected: All accessible areas of the building Asbestos Material Found: Furnace Gaskets Friable Joint Compound Friable Transite Siding and Debris Non-Friable Transite Flue Pipe Non-Friable 12-inch Floor Tile and Mastic Non-Friable Window/Door Caulking Non-Friable Roof Coating on Metal Non-Friable Date of Inspection: 01/05/2007 Inspection Performed By: Alpine Environmental Services, Inc. 1146 Central Avenue Albany, New York 12205 Phone: (518) 453-0146 Fax: (518) 453-0175 info@alpineenv.com Inspector(s): Brian Gould NYS Department of Labor Asbestos Inspector Certificate #AH95-02582 Scope and Purpose This report is intended to document asbestos containing materials found during the pre-demolition inspection of the residential structure located at 463 Dix Avenue in Queensbury, New York. 1146 Central Avenue - Albany, New York 12205 - Phone:(518) 453-0146 • Fax:(518)453-0175 f s "Asbestos containing materials", as defined by the United States Environmental Protection Agency (EPA), is any material containing more than 1% asbestos as determined using the method specified in Appendix E, Subpart E, 40 CFR Part 763, Section 1, Polarized Light Microscopy. Materials easily crushed or pulverized by hand pressure are considered friable. Materials with a bituminous or resinous binder that are not easily crushed or pulverized by hand pressure are considered Non-friable Organically Bound (NOB). Friable and non-friable materials, excluding organically bound materials were analyzed using Polarized Light Microscopy (PLM). Non-Friable Organically Bound samples were analyzed using Transmission Electron Microscopy (TEM). All samples were analyzed by EMSL Analytical (FLAP 11506). Limitations This inspection addresses all accessible materials in the interior and on the exterior of the building. The crawlspaces were not accessible during this survey due to the limited space within the crawlspaces. Quantities of asbestos containing materials were estimated. These quantities are approximate and must be field verified. Results of inspection Bulk samples of plaster, drywall, 1 x1 ceiling tile, fiberboard wall panels, and fiberboard floor substrate were collected by Alpine Environmental Services and found to be non-asbestos containing materials by Polarized Light Microscopy. Bulk samples of furnace gasket, and drywall joint compound were collected by Alpine . Environmental Services and found to be positive for asbestos by Polarized Light Microscopy. Bulk samples of 9-inch floor file and mastic, linoieums, linoleum mastics, vapor barriers beneath linoleums, roofing shingles, vapor barrier beneath roofing shingles, wall panel adhesives, window glazing compound, and vapor barrier behind wood clapboard siding were collected by Alpine Environmental Services and found to be non-asbestos containing materials by Transmission Electron Microscopy. Bulk samples of 12-inch floor the and mastic, window/door caulking, and coating on metal roofing and flashing were collected by Alpine Environmental Services and found to be positive for asbestos by Transmission Electron Microscopy. Materials not sampled but assumed to be asbestos containing materials include: transite siding and transite flue pipe. Much of the asbestos containing transite siding has been damaged and removed from the building. Transite siding debris was discovered on the ground around the perimeter of the building, inside the first floor east kitchen, and second floor bedrooms, and on the flat roof of the building.-Transite siding debris may also be present beneath the piles of fill on the northwest side of the building. Asbestos Quantification Summary of asbestos containing materials: Material Quantity Condition Furnace Gaskets 3 square feet Good _ 1 Drywall Joint Compound 30 square feet Good Transite Siding 1,000 square feet Damaged Transite Siding Debris 1,800 square feet Damaged Transite Flue Pie 15 linear feet Good 12" Floor Tile and Mastic 10 square feet Good Window/Door Caulking 16 square feet Damage Coating on Metal Roofing 550 s uare*feet Good Conclusion Disturbance/Abatement of any asbestos containing materials, as well as air monitoring, must be performed by a NYS DOL licensed contractor, in accordance with state and federal regulations (NYS DOL ICR 56 and US EPA 40 CFR). If we can be of any further assistance to you on thin matter, please contact our office at(518).453-0146. Sincerely, Alpine Environmental Services, Inc. Brian Gould NYS Dept. of Labor Asbestos Inspector •1 Dix Avenue 463 Dix Avenue Queensbury, New York 18804 Basement Asbestos Containing Materials- Asbestos Containing Transite Flue Pipe Asbestos Containing Furnace Gaskets Alpine Environmental Services, Inc. Engineers and Safety Professionals 1146 Central Avenue Albany,New York 12205 Ph:(518)453-0146,Fx.(518)453-0175 Ernail:briang@atpineenv.com r Dix Avenue 463 Dix Avenue Queensbury, New York 12804 First Floor EEEEEEaa Asbestos Containing materialsi } �Asbestos Containing Joint Compound Asbestos Containing 12-Inch Floor Tile and Mastic Asbestos Containing Transite Siding Debris Alpine Environmental Services, Inc. Engineers and Safety Professionals 1146 Central Avenue Albany,New York 12205 Ph:(518)453-W46;Fx:(518)453-0175 Email:briang@alpineenv.corn Dix Avenue 463 Dix Avenue Queensbury, New York 12804 Second Floor Asbestos Containing Materials, Asbestos Containing Transite Siding Debris Alpine Environmental Services, Inc. Engineers and Safety Professionals 1146 Central Avenue Albany,New York 12205 Ph:(518)453-0146;Fx(518)453-0175 Email:briang@aipineenv.com a 01408/2007 04:07 2122900058 PAGE 02/04 EMSL A-naa'ytiCaa, Iric. * — IQ 1-1-1— "'. . —----i --- ­ 1 --.11-6- 307 Vitest 38th Street, New York, NY 10018 Phone: (212)29"OS1 Fax: (21-2)290-0058 Etli lii: manhat 1rl�rP,yc Pm�i�CQr�t Attn_ Brian Gould Customer ID: ALPi50 Alpine Environmental Services Customer PO'. 1146 Central Ave Received: 01/06/0710,03 AM Albany, NY 12205 EMSL Order 030700517 Fax; (518)453-0175 Phone: (518)453-0146 EMSL Pro); Project: 07-6169,AC/463 DIX AVENUE Analysis pate: 117=07 Report Date: 1/W2007 Asbestos Analysis of Bulk Materials by PUNT via the NY State ELAP 198.1 Method Non-Asbestos Asbestos >ample Location Appearance % Fibrous % Non-Fibrous % Type 1-01 BASEMENT ON Gray/White 33.30%Non-fibrous(other) 66.70% Chrysotile 130700517-0001 FURNACE/GASKET Fibrous Homogeneous '.-01 STAIR TO White/Blue 3.00%Heir 30,00%Ca Carbonate None Detected 20700617-0002 BASEMENT/ Fibrous 12,00%Nan-6binus(other) Pt ASTER Heterogeneous 55.00%Quartz :-02 1ST FLOOR WEST Tan/White 5.00%Hair 30.00%Gypsum None Detected 313 00517-Wes APT. KITCHEN/ Fibrous 25.00%Non-flbrous(other) PLA.ciTFR Homogeneous 40.00°�Quartz ••03 1ST FLOOR EAST White/Brown 3.00%Cellulose 20,000A Gypsum None Detected 10700517•0004 APT.LIVING ROOM Fibrous 3.00%Hair 24.00%Nan-fibrous(Other) /PI ASTER Heterogeneous a 50,00%Quartz -04 1ST FLOOR EAST Whitefran 5.00%Hair 25,00%Gypsum None Detected 5070517-00os APT.KITCHEN/ Fibrous 25,000/a Non-fibrous(other) PIASTFR Heterogeneous ° 45,00/°Quartz -05 2ND FLOOR FAST Tan/UVhite 3.00%Hair 30.00%Ca Carbonate None Detected 30700617-OWO APT, BEDROOM/ Fibrous 12.00%Non-fibrous(other) PI ASTER Homogeneous 55.00%Quartz •01 15T FLOOR WEST White/Brown 15.00%Cellulose 15.00%Ca Carbonate Notre Detected W09517-OW7 APT.BEDROOM/ Fibrous r)IZYvvAi t 60.00°J°Gypsum Heterogeneous 10.00%Non-fibrous(other) .nalyst(s) °ry` :teve JUsczuk(12) or other approved signatory 'Ltd^as been k„um to mms asbestos in a.•mall pbrcenleas or aambies wN ch contain sebeatos.Negative PLM m4wita cannot be guorontged.Semptes reported as<1^k or rwna igtecled snouid be tetied with TEM.The above lesi ropon relates only to the items tested Thle report may rot be raproemed,except In dill,wilhow written approval by EMSLAnotytical, nc.Tho abovo tent must not be ueed by�rto client to claim product andonwmor by NVLAF not any amrcy of thn United 9tstes Governrtwnt.Samples received In good candilmn unie9s ]l.-An i=rotaxi, -Mysie cerformed by EMSL Manhattan(NVLAP*1010gt3 S},NY FLAP 1150.5 'LTAPaintCount-1 q 01/08/2007 04:07 2122900058 PAGE 03/04 ENISL Aziaiytiicalt Inc. 307 West 38th Street.Now York, NY 10018 Phone: (i12i Fax: 1217)2110-005o Ernwf: m,<ki.hpVan(�(a?u!nr:!_=:,ti 3ttn: Brian Gould Customer ID: ALP150 Alpine Environmental Services Customer PO: 1146 Central Ave Received: 01106107 10.03 AM Albany, NY 12205 EMSL Order. 030700517 =ax: (518)453-0175 Phone: (518)453-0145 EMSL Prol: 'roject: 07.5169-AC/463 DIX AVENUE Analysis Date: 1!7/2007 Report Date: 1/8/2007 Asbestos Analysis of Bulk Materials by PLM Via the NY State ELAP 198.1 Method Non-Asbestos Asbestos ample Location Appearance % Fibrous % Non-Fibrous % TYPG _01 157 FLOOR WEST Cream 75,00%Ca Carbonate 1.50% Chrysotile 307005;7_000a APT,KITCHEN Non-Fibrous 10.00%Mica PANTRYI.10INT Homogeneous 13.50%Non-fibrous(other) i_09 1ST FLOOR WEST BrowNWhite 97,00%Cellulose 3.00%Matrix None Detected -V700$17-0009 APT. KITCHEN/1X1 Fibrous r.FIt INr TII F Heterogeneous i-01 1ST FLOOR WEST TanlBrown 95.00%Cellulose 5,00%Matrix None Detected +ao7005�7-W10 AFT,KITCHEN Fibrous Non-fibrous(other) PANTRY WAI i Homogeneous 3_02 1ST FLOOR EAST Beige 97.00%Cellulose 3,00%Matrix None Detected 1307Vo577.0011 APT.KITCHEN Fibrous RFNFATH Homogeneous _— — 6-03 EXTERIOR NORTH BrownBlack 90.00%Cellulose 10.00%Matrix None Detected oao7oosr7 potz WEST BEHIND Fibrous TRANSITF RIDING/ Heterogeneous Analyst(s) Steve Juscauk(12) or other approved signatory PLM has oxen known to mice"bastcs in a amofl percentage of asmolea which contain aspazlw.Negative PLM rnaufte Cannot bo guaramead.Samples reported as;.1%or nano datactod should bo teateo with TEM.Tha above teat rapon relates only to tho home tested.This report may not be rWootrad,except In ruR,without wAtten approval by EMSL Anat0cat, Inc.The above test mutt not be usod by the client to claim pradw endorsement by NVLAP nor any swricy of the tlrNted states Government.Samoles raceived in good wrialtlon unless othoM1Ase notod. nalVeta paec;rmed by EMSL Wianha:ion xNVIAP 0101040•9),NY ELAP 11505 PLMPointCount-1 THIS IS THE LAST PAGE OF THE REPORT, 2 01/08/2007 04:07 2122900058 PAGE 04/04 Alpine Environmental Services,Lic. ---� Pbone: (518)453-0146 1146 Card al Avenue f-`j (�'�yS 7 p'ac: (518)453-0175 Albany,NY 12205 7 LL..// ��--��`"' email:ulia@alpineenv_corn CRAMN OF CUSTODY Chen Alpine Environmental Services Project: 463 Dix Avenue 1146 Central Ave. Albany,NY 1.2205 Project Number: 07-5169-AC Contact: Sampled By: Brian Gould Phone/Fax:a '1 Date/Time Collected. 01-05-2007/08:00- Turnaround Time: 72 hot P.O_ Number: Log No. Sample Sample Location Sample Material .Analysis Results No. Perf%rmed 1-01 Basement Gasket PLM On Furnace 2-01. Stair to Basement Plaster PLM 242 1'Floor West Apartment Plaster PLM Kitchen, 2-03 1s`Floor East Apaxtcnent Plaster PLM Living Room 2-04 1'Floor East Aparimeaat Plaster F Kitchen 2-05 2 Floor East Apartment Plaster PLM Bedroom 3-01 1-`Floor West Apartmetd Drywall PLM Bedroom 4-01 1'Floor west Apartment Joint Compound PLM Kitchen Pantry 5-01 1 Floor West Apartment 1.x1 Ceiling Tile � PLM Kitchen C' 6-01 1 qt.Floor West Apx=ent Fiberboard PLM Kitchen Pantry Nail Panel . 6-02 1'Floor East.Apartment Fibefard, PLM G _ Kitchen beneath.Linoleum 6-03 Exterior North West Fiberboard PLM c> Behind Trm site Siding Disposition of Samples:Accept Reject Explain. Comments: Relinquished By F_-=ived By-, Date; Tent: Pa�C � pr 01/08/2007 15:36 2 PAGE 02/08 EMSL Analytical, Inc. 307 West 38th Street New York,NY 1401s Phone: (212)290.0061 Tax: (212)290-0064 Email_ .m>�rLh ttrrlLa Ls6l[P Attr1: Brian Gould Customer ID; ALPI50 Alpine Environmental Services Customer PO: 1146 Central Ave Received: 011OW710:04 AM Albany, NY 12205 EMSL Order 03070051E Fax: (518)45MI75 Phone: (518)45U146 Project: 07-S16"C1463 DIX AVENUE EMSL Analysis s Date: 1/8/2007 Report Date: 1/812007 Asbestos Analysis of Non-Friable Organically Bound materials by Transmission Electron Microscopy via NYS ELAP Method 168.4 %MATRIX %NON-ASBESTOS ASBESTOS %TOTAL SAMPLE LD DESCRIPTION APPEARANCE MATERIAL FIBERS TYPES ASBESTOS 7101-01 1ST FLOOR WEST Black 100.0 None <1% Chrysolite <1 03070041s-mol APT. Fibrous BATH/MASTICNB Homogeneous TO 9 INCH FT 7-01 1ST FLOOR WEST $fack/Beige 100.0 None No Asbestos Detected 030700er5-ao02 APT.BATHI9INCH Non-Fibrous FT Homogeneous 7-02 1ST FLOOR WEST Rust 91.5 None 8.50A Chtysattle $.5 030700515W=3 APT.BATH/12INCH Non-Fibrous FT Homogeneous 8A-01 1ST FLOOR WEST Bm" 100.0 None No Asbestos Detected 03070MI"04 APT.KITCHEN, Fibrous BOTTOM Homogeneous LAYER/UNOL EUM 88-01 15T FLOOR WEST Black 100.0 None No Asbestos Detected 03070001s005 APT.KITCHEN,TOP Non-Fibrous LAYER/LINOLEUM Homogeneous "2 1ST FLOOR WEST Cragm 100.0 None No Asbestos Detected 0 3 0 70051 6-OD G APT-BATH/ Fibrous LINOLEUM Homogeneous SM-04 1ST FLOOR WEST Black 100.0 None No Asbestos Detected 03070005.0007 APT.KITCHEN Fibrous PANTRYIMASTICIV Homogeneous 8 TO L 8-04 1ST FLOOR WEST Rust 100.0 None No Asbestos Detected 03070061&mao APT.KITCHEN Fibrous PANTRYIUNOL.EUM Homogeneous Anslyst(s) ` Malik Peysakhov(28) or other approved signatory Thle leoorstory is not responolbia for Si aNOW03 in total sample wren tho r=ldua only is submilea tot smaysi..The abv%e report tMates only to the Hams tested.This mart may rat be raprodixad,axtopt in hull,wWwA w4tum approval by EMSL Anaty(l ai,Inc.Samples monied In good ox-011on unless u•.herwisa rwad, ACCREDITAMNS:NVLAP 010104 -9 end NY STATE FLAP*115M "TNOB-2 1 01I-0812007 15:36 2 PAGE 03/08 EMSL Analytical, Inc. 307 West 38th Street; New York, NY 10018 PhonQ-. (212)250.0051 Fax: (2121290dt058 Email: lneoh me ?Pttt L�9tlf .. .­.'­­ Attn: urcw.c.sY..c.+ tlGiaL�,h�t.t+.yisuri Brian Goulid Custonie'ID: Al-pI50 Alpine Environmental Services Customer PO: 1146 (Central Ave Recurred: 01IM0710.04AM Albany, NY 12206 EMSL Order: 030700515 Fax (518)453-0175 Phase; (518)453,014$ Project 07-5169-ACI 463 DIX AVENUE EMSL FnOj; Analysis Date: 1/8/2007 Report Date: 118/2007 Asbestos Analysis of Non-Friable Organically Bound materials by Transmission Electron Microscopy via NYS FLAP Method 198,4 %MATRIX %NON-ASBESTOS ASBESTOS %TOTAL SAMPLE ID DESCRIPTION APPEARANCE MATERIAL, FIBERS TYPES ASBESTOS 8.05 1ST FLOOR EAST Black 100.0 None No Asbestos Detested 0807M5150M APT.STAIRS TO Nan-Fibrous SSMTIL.INOLEUM Homogeneous 8-06 1ST FLOOR EAST White 100.0 None No Asbestos Detected 030760V$-0o10 APT. Nan-Fibrous SATHILINOLEUM Homogeneous SM-07 1ST FLOOR EAST Black 10010 None No Asbestos Detected 0307MBIS- ll APT.HALLWAY/MAS Non-Fibmus TIC LINO Homogeneous 8-07 1 ST FLOOR FAST Beige 100.0 None No Asbestos Deteded 0 0707816-0Di2 APT,HALLWAY/ Non-Fibrous LINOLEUM Homogeneous 8VB1-08 2ND FLOOR EAST Seige 100.0 None No Asbestos Detected 0ao7ws,s.oafa APT.BEDROOM Non-Fibrous BOTTOM{VAPOR Homogeneous BARRIER BVB2--08 2ND FLOOR EAST Tan 100.0 None No Asbestos Detected a0070051sW14 APT.BEDROOM Non-Fibrous MIDI VAPOR Homogeneous BARRIERTO L 8-08 2ND FLOOR EAST Stack 100.0 None No Asbestos Detected 03070OW&W15 APT.BEDROOM Non-Fibrous TOPIUNOLEUM Homogeneous 9V8.01 MAIN ROOF Black 10010 None No Asbestos Detected 030700ta.0olei BENEATH Fibrous SHINGLESNAPOR Homogeneous BARRIER Analyst(s) Mar*Peysakhov(28) or other approved signsttre Thla is6oratnry la not reapanaiblw tar 56 aaaeataa In talal sample when the reaiduo only Is at�miiteei ice anaNela.lire shoe report rNatna anlY to ttto ik+ma tested.This rapwt may not tie eeprodueed,except tr+iWi,wNtrou!writton wpprovN by 61UISL Aneiyapt,U+e,SranPeae retelvod pt Aoad condttlan anises otlt�wlse Hated. ACCREDMAMONS:WLAP COINI8-9 8nd My SWE RAP i111506 NYtTNOt3 2 2 @1./08/2007 15:36 2 PAGE 04108 EMSL.AnalytiCalr Inc, 307 West 38th Street,New York, NY 10018 Rhona; (212)250-Oast Fax: {214 290-om Email: trtanhattanlabQernsT,com Attn: Snan Gould Alpine Environmental Services Customer i0: ALP150 Customer p0: 1146 Central Ave Received: 0/106/07 10:04 AM Albany, NY 12206 EMSL Order: 030700515 Fax (518)453-0175 Phon@: (518)453-014$ ProJeCt: 07-SI69-ACI 463 DIX AVENUE EMSL Proj: Analysis Date: 1/8/2007 Report Date: 1/8/2007 Asbestos Analysis of Non-Friable Organically Bound materials by Transmission Electron Microscopy via NYS ELAP Method 198.4 %MATRIX %NON ASBESTOS ASBESTOS %TOTAL SAMPLE ID DESCRIPTION APPEARANCE MATERIAL FIBERS TYPES ASBESTOS 9A 01 MAIN ROOF Black 100.0 None No Asbestos Detedad 030700515.0097 BOTTOM Non-Fibrous LAYERIROOF Homogeneous SHINGLES 9C-01 MAIN ROOF TOP Black 100.0 None No Asbestos Detected 0307=i5-001e LAYER!ROOF Non-Fibrous SHINGLES Homogeneous 9VB_02 GARAGE ROOF Black 100.0 None No Asbestos Detected 030700515-W19 BENEATH Fibrous SHINGLESNAPOR Homogeneous BARRIER 9-02 GARAGE Sktck 100.0 None No Asbestos Detected aao700raa020 ROOFIROOF Non-Fibrous SHINGLES Homogeneous M3 EAST APT.REAR Black 100.0 None No Asbestos Detected 0s0700515.0021 ENTRYI ROOF Fibrous SHINGLES Homogeneous 10-01 BACK LOWER Black 98-2 None 1.8% Chrysoble 1.8 0307001516.0oz2 ROOF ON METAL Non-Fibrous ROOFING Homogeneous 10-02 BACK LOWER 0307=15-W23 ROOF ON METAL. FLASHING/ROOF COATING Not Analyzed Analyst(s) Marik Peysakhav(28) or other approved signatory 1 Th{s laboratory is trot rm.WSW&for%osbanto;In total seenple wren the residue only+is.ulxtlltlad for anelyele.The aoow report reletes on y to the game tested.TWO report may ttoi� be mproducod,exa*k+to16 wit PA wrillen approval by EMSL An*Vyta:ot,lno,SwnplaF recehmd h good eondiffon unbae othawl-noted, 4 ACCREOITAT7oNS:NVLAPAID104M mnd W STATE FLAP#1150 NYITNOB-2 __ 3 PAGE 05/06 01,/08/2007 15:36 2 EMSL Analytical, Inc. 307 West 38th Street,Now York,NY 10018 Phone: (212)290.0061 Fax: (212)290-0058 Email. rxlML4—n14I11SL M Attn: Brian Gould Customer{D: AIP150 Alpine Environmental Services Custoaner PO: 1146 Central Ave Received; 01/06/07 10:04 AM Albany, NY 12205 EMSL,Order., M0700515 Fax: (518)453-0176 Phone. (518)453.0146 EMSL Proj: Project: 07-5169-AC1463 DIX AVENUE Anatysis Date: 1/a/2007 Report Date: 11812007 Asbestos Analysis of Non-Friable Organically Bound materials by Transmission (Electron Microscopy via NYS FLAP Method 198.4 %MATRIX YoNON-AsaEsTo8 ASBESTOS ASBESTOS AL SAMPLE ID DESCRIPTION APPEARANCE MATERIAL FIBERS 11-Oi 1ST FLOOR WEST Stack 100,0 None <1% Chrysolie <1 03070061&W24 APT_KITCHEN/ Nan-Fibrous WALL PANEL Homogeneous ADHESIVE 11-02 1ST FLOOR EAST Beige 100.0 None No Asbestos Detected 0g0700615M25 BATHROOW WALL Non-Fibrous PANEL ADHESIVE Homogeneous 12-01 EXTERIOR NORTH White 100.0 Nano -ei% AnthophyllEte tit 0 3 0100 51 5d026 WEST WINDOW/ Non-Fibrous WINDOW GLAZING Homogeneous COMP, 2ND FLOOR White/Bt=k 98.3 None <1% Anthophyilite 1.7 13-01 1.7% Chrysolite OWM154027 NORTH Non-Fibrous WINDOWICAULK Homogeneous 14-01 1ST FLR W APT:@ Brown 100.0 None No Asbestos Detected 030=515.0028 BACK DOOR, Fibrous BEHIND WOOD Homogeneous SIDING/VB Analysts) �'"" Mar1R Peysakhov(2$} or other appmved signatory TMia Islmta>ary F.nat roRppnelCle for%aetu,+on Inlotel sam�e whm+tt+e roe eh)a only Is aum Pled for sno lyaia.the at?ove rsporl slot"PHY ro the time tested.Thfp r�wt may not he n,ayaimad,except h full.wtMout wrhtmi approval by EMSL MOhAfwl,Inc.SiRn�ee retefued In good condidon uMeee aWae"sa noted M ACCI2EOITATIONS:NVLAP#i0f049-9 and NY S7ATE ELAP#t 1506 4 "TNOB-2 THIS IS THE LAST PAGE OF THE REPORT. 01/08/2007 15:36 2 PAGE 06/08 Ipine)F'T'yir0PM=t8I Senices,Inc. (518)43-041,146 Cmh-]ANrenne r 5- .16 Albany NY 72205 am: (518)453-o175 CHAIN OF CUSTODY Client Alpine Envirottmental Serylees Project 463 Dix Avenue 1146 Central Ave. Albapy,INY 12205 Project Number: 07-5169-AC Contact Sampled By: Brian Gould - - Phone/Fa?c_ Date/Time Collected, 0 1-05-2007 108'.00- . JMMW/4MwMWF0' Turnaround Time: 72 hours RO. Number.: Log No. Sample S&Uple Locafim snvle Material Analysis Results No. Performed. 7M-0 I .1-�Floor West Apartmaut MastjwVB to TEM. Bath 9-Inch Floor Tile Stop At 7-01 1""Floor West Apartment 9-Inch Floor Tile TEM First Positive Bath 7-02 X scFloor West Apartment 12-Inch Floor Tile TEM. Bath 8A-01 I s'Fl ooT West Apartment Linoleum TEM. Kitchen,Bottom Layer 9B-01 I"t Floor West Apartment Linoleum TEM Kitchen,Top Layer 8-02 l"Floor West Apartment Linoleum TEM Bath 8M-04 l'Floor West Apartment MastidVB to T✓M Kitchen Panty Linoleum. Stop At 8-04 1'Floot West Apartment Linoleum TEM -) First Positive Kitchen Pantry 8-05 1"Floor Fast Apartment Linoleum TEM Stairs to Basement 8-06 1 a Floor East Apartment Linoleum TEM Bathroom. 8M07 I'Floor East Apartment Mastic to Linoleum TEM. Hallway Stop At 9-07 1'Floor East Apartment Linoleum TEM First Positive Hallway Disposition of Samples:Accept_ Rejeot-Explai:o Comments, Vished By. Received By: Datc.: 01/08/2007 15:36 2 PAGE 07/08 Alpine Ens kOnmcrrta(Servi ces,Inc. 1146 Central Avenuc Phone. (518)453-0146 .Albany,NY 12205 Pax;t6I8)453-0175 emau.info u@adpinemV,com C- OF CUSTODY Client: Alpine Environmental Services Project: 463 Dix Avenue 1146 Central Ave. .Albany,NY 1220:5 P-Toject Number- 07-5169-AC Contact: Sampled By: Brian Gould Phone/Fax:A •/ Date/Time Collected: 01-05-2007/07:30-11:00 Turnaround Time: 72 hours' P-O_Number: Log No. Sample Sample Location Sample Matenal Analysis Results NO' Perked SVB 1-08 Floor Last Apartment Vapor Baniex to TENT Bedroom Bottom Linoleum ::T8V71327-082Floor'Last Apartment Vapor Baader to TEM Bedroom.Middle Linoleum Floor East Apartment Linoleum TEM Bedroom,Top 9VB-01 Main Roof Vapor Barrier TEM Beneath Shingles 9A-01 Main Roof Roof Shingle TEM Bottom Layer 9G-01 Main Roof Roof Shingle TEM Top.Layer 9VB-02 Garage Roof Vapor.Barrier 'TEM Beneath Shingles 9-02 Garage Roof Roof Shingle TEM 9-03 East Apartment Roof Shingle. 7UM Rear Entry 10-0 1 Back Lower Roof Roof Coating TENT On Metal Roofing Stop At 10-02 Back Lower Roof Roof Coating TEM First:Positive On Metal Flashing 11-01 1'Floor West Apartment Wall Panel TEM -v Kitchen .A.dhesNe .�`. Disposition of Samples:Accept Reject Explain Coznme ats: Relinquished By_ Received By,. Date: Time: page Z of 3 01/08/2007 15:36 2 PAGE 08/08 Alpine F-nvirc memaE Services,Inc. Phone:(5I9)453-0146 11A5 Central.Avense Pax(518)453-0175 Albaa3,NY 1=05 mall:inffD@gpz.*zeenv.com ChMN OF CUSTODY G'laent: Alpine Environmental Services �____. Project: 463 Dix Avenue 1146 Central Ave. Albany, NY 12205 Project N. =ber: 07-5169-A�C Contact: Sampled By: Brian Gould Phom/Fax: Date/Time Collected: 01.-05-2007/0730-11:00 Turnaround Time: 72 hours P.O. Number: Log No. Sample Sample Location Sample Material Analysis Results No. I Felftned 11-02 1"'Floor East Apartmetzt Wall Pagel TEM. Bathroom Adhesive 12-01 Exterior Witdow Glazing T..EJ'.vt Nora West Window Compmmd 13-0I, 2'Floor Caulk TEM Nort .Window 14.01 1a`Fli W Apartment; at Back Vapor Barrier TEM � Door,Behind Wood.Siding zz -...Y CJKM Disposition of Samples:Accept Reject BxPtam Comments, RehngWsucd By: Rcccived By. Date: rime: f 1 Palze 3 of 3 01/13/2007 00:31 2122900058 PAGE 02t03 EMSL. Analytical, Inc. 307 West 3M Street,New York, NY 10018 Phone: (212)200.11051 Fax: (212)290-00% e-mail: man►l, aptai�tBMmsi.�Qm Aitn: Alpine Environmental Services Customer(D: ALP150 1146 Central Ave Customer PO: Albany, NY 12206 Racehed: 01i12107 10:23AM Fax. (518)453-0175 Phone: (518)453-0146 EMSL Order, 030701099 Pr*ct; 07-5169•AC1463 DtX AVENUE EMSL Prof: Analysis Date; 1f1=07 Report Date: 1/12/2007 Asbestos Analysis of Bulk Materials by PLM via they NY State ELAP 199.1 Method Natt-Asbasfias �t sample Location Appearance °!. Fibrous % Non-Fibrous % Type 4-02 1 ST FLOOR;EAST Tan 25.00%Ca Carbonate None Dobeted 02001179s ooat APARTMENT SE Nan-Fibrous 58.00%Nen-fibrous(ether) ROOM rFil iNA Heterogeneous 20.00%Qutrrtz 4-03 1ST FLOOR:EAST Tan 60,00%Ca Carbonate 0.513%Chrysolite 08070d0994002 APARTMENT Fibrous 30.50%Non-fibrous(other) KiTrHFN rr-11 INt; Hetoeneaue -- - 4-04 'iST FLOOR;EAST White $0.00%Ca Carbonalts Nana DeWeted W070y099.00� APARTMENT Non-Fibrous 40.00%Non-fibrous(otter) RAT14POOM WAI i Homogeneous - - 4nalyst(s) 7sr8 D®9nskf(3) or other approved signatory PLM hea barn known io mine sebastta'ha ema"pert-togs of samplox whtcn contain eabesws.Negathe PLM results cannot ba guaranteed,Samplsa%eporlad as sly&or rmrut deiectad should be foaled with TEM,The above tact taport Lela w only w the Roma tested.This report may not ba reprodueod,ezcapt to full,whtwut writtan 80➢r ml by EMSL Ana(Wcal,Irte,The above tort must net be uaad by Cie efiard to claim Product endomemem by M!tAP nor any agency of ftro United Status Government Samples tneatved in good condition unless omeMrise noted. nolysis grfaftad by EMSL Manhattan WLAP k101048-0,NY ELM,1IMS PLMPointCount-1 THIS IS THE LAST PAGE OF THE REPORT. 1 01./13/2007 00:31 2122900056 PAGE 03/03 Alpine Eavuonmental Sezxices,Inc. L1/ Phone:(518)453-0146 1146 Cea�-al Avenue Fax:(518)453-0 175 Albany,NY 12205 S,AMg L E S MEMO email.info@aipineenv.com E a R ANALYSIS CHAIN OF CUSTODY �;C ;VED 81 EMSL Client_ Alpine Fnvi.ronmental Services Project: 463 Dix Avenue 11.46 Central Ave. 0 7 JAII 12 oe, '�'�.� Albany, N'lt 1.2205 ProjectNuuabm 07-5169 AC Cozx&, Sampled By: Brian Gould Phone/Fam 793-1492/745-8061 Date 1 Time Collected: 01-10 2007 i 15:30-16:00 Turnaround Time: 24 hours P.O.Number: Log No. Sample Sample Location Sample Material Analysis Resui�ts No. Performed 4-02 1-%Floor,Fast Apartment Joint Compoi and PLM SF Room Ceiling 4-03-• 1"'Floor;Eaq Apartment ' Joitrt Compound PLM- Kitchen Ceiling . 4^04 Is'n 140or East Apartment Joint Compound PLM Baffixoom Wall . Disposition of Samples:Accept Reject Explain Comments: ltelingzzushed By. R ved By. e: Time: Z:2 STATE OF NEW Y y f , i t 1 1 LABOR SAF N -IH�75A M :. ertl Bu1i DIN 2, STATx C Mi" RESTRICTED LICENS SE (� 'u IANDLING LIC ! , Asbestos Removal i' ' t Permitted Contractor: ALPIN. + TAL SE,RVICS(i„ 1 LICENSE NUMB INC. I t 4. .,�i 1146 ( +,N t ,�'�"i �,�s� DAT �1= ISSUE: AL 05 (� e '' !. .,EXP, TM. !-PATE: 'ilk 1 i�yam'• + ,� �r7 �x: :.2,;�„t;�"I�' �� %r ;wt�..l.-:;,. 04 Duly Authorize esei its e: CRAI w � M1l,y This license has. ee i accordanc r 1 1 I 4 #b i9��;+ , `10' � .t Labor Letw =i ew rk 'taf:e an.ci of the New York S ek s and Reg pnstl(l � Part,�5 ({" ibj (�r t�spensinn z �n violation of state, ra=l r` laws wit ,t a�r,to •; �upat o �1 ts pr �Je '„r(2) cler stiff i g Ncic r'.'responsihilil:�) •�^ K�} r+W � {3^A ',a.g�r ...&i.;,�S• S. ..411fi w ^IS , (f J in the conduct of a � asla.�st�" s� �d�jdrll��(Ct�t�����s t P +itl'r :xJ'"� v '�'•�, V This license is valid i co cta name`ai�a 1 tli Al A `i ah6for, py mugs pro �1�� yi sp(ayeci at the asbestos project work s li rifles that all persans�'�•m1515yedl y the licen ee o sbe,to rr !f t in NaA�York Slate have been issued a ( , ,appropriate for the type o.f work they l n,byi► e Iwsy'Ql'1;Stai:e Department of Labor. , t kpk h A ( ny OR O Ge I -b Director SH 432(6-03) M y t 'S.IONT�R le'LATI l' NEW YORK STATE DEPARTMENT OF HEALTH WADSWORTH CENTER Antonia C. Novello, M.D., M.P.H., Dr.P.H. '�. Expires 12:01 AM April 01,2007 Issued April 1, 2006 'n CERTIFICATE OF APPROVAL FOR LABORATORY SERVICE Issued in accordance with and pursuant to section 502 Public Health Law of Ate York State MR. JAMES HALL NY Lab Id No. 11506 EMSL ANALYTICAL, INC EPA Lab Code:NY01204 307 WEST 38TH STREET NEW YORK, NY 10018 is hereby APPROVED as an Environmental Laboratory for the category ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE All approved subcategories andlor analytes are listed below.* Chameterlstic Testing TCLP EPA1311 Metals i Lead,Total EPA 3050E Miscellaneous . Asbestos in Friable Material EPA 6001M411IM20 item 198.1 of Manual Asbestos in Non-Friable Materat-PLM item 198.6 of Manual(NOB by PLM) Asbestos in Non-Friable Material-TEM ITEM 198.4 OF MANUAL Lead in Paint EPA 7420 Serial No.:29539 Property of the New York State Department of Health.Valid ordy at the address sham.Must be Conspicuously posted.Valid certificates have a raised seal.Continued ar reditafron depends on successful ongoing participation in the Program_ Consumers are urged to call(518)485-55T0 to verify laboratory's accreditation status. Page 1 of 1 Embonmental STATE OF NEW`IORK-DEPAIR-MIENT OF LABOR j ASBESTOS CERTIFICATE i BRIAN - < C fPtRiS GAcL C(01/47) DQ(01107) = E GPL(0t/07)rKRM�(01/0 r 3 1 GERT#95-02582 }} DIV V#552647297 f ._MUST BE CARRIED ON ASBESTOS PROJECTS i S IF FOUND RETURN TO: EYES BLU WISDOL - L&C UNIT HAIR BRO ROOM 290A BUILDING 12 - HGT-6 t -0-0- -STATE -OFFICE _CAMPUS p$c w"r xpr -1 2 2.10 i 1148 Central Avenue • Aitany, Ne,,N York 1%05 • Fhcne:(518) 15_3�'114 . Fax:(518)45_3 �1175 w CLASSIC ENVIRONMENTAL INC. DBE / WBE / SBA 8(a) CERTIFIED 8/27/07 Town of Queensbury 742 Bay Road Queensbury, New York 12804 RE: Asbestos Removal @ 463 Dix Ave, Queensbury, New York The friable asbestos removal at 463 Dix Ave, New York has been completed. The removal and disposal consisted of all the friable materials called out in the demolition survey. All work was completed complying with the owner's scope of work, New York State and Federal Regulations. Due to the building condition the building will be taken down with the non friable materials in place. This meets both NYS & Federal regulations. If there are any questions I can be reached at 518-376-1552 Sincerely, Thomas Perrault CEI/GM TOWN OF QUEENSBURY 742 Bay Road, Queensbug4 NY 12804-5902 518-761-8201 May 31, 2007 Dean Romer 50 Queensbury Avenue Queensbury, NY 12804 Dear Dean: This letter will confirm our conversation on May 31" regarding your structure located at 463 Dbc Avenue. As we discussed, given the condition of the building, the general deterioration of the building, the fact that it has been used for extensive training by the fire service, the structure is reaching a point to where it is becoming unsafe, structurally as well as environmentally,and therefore should be removed from the property. As we had discussed, please provide all the necessary asbestos survey paperwork that was provided by the company you've retained to do an inspection of the property, and also copies of any paperwork to show that this material was removed from site prior to demolition. Please file for a demolition permit at your earliest convenience. If you have any other questions, please don't hesitate to contact me. Sincerely, TOWN OF QUEENSBURY 1 t f David HatiW, Director Building and Code Enforcement DH/mg "HOME TOME OF NATUR'kL BEAUTY . . . A GOOD PLACE TO LIFE" SE"1"1'LED 1763 C� Asbestos Project Notification Project Reference Number: 25618713 Type: Initial Notification Status: RECEIVED Notification Received: 8/11/2007 Payment Status: PAID Number of amendments: 0 Contractor Information FEIN:141828447 Classic Environmental Inc. Mailing Address PO Box 480 Clifton Park NY 12065 Asbestos License Number.29098 Duly Authorized Representative Sandra L Ingalls, Officer Phone Number: 518-664-1209 E-mail Address: Project Information Project Start Date: 8/21/2007 Project End Date: 8/31/2007 Project Location County: Warren Project Location Building Name: Vacant House Room or Location: Address Line 1: 463-Dix Ave Address Line 2: City Town or Village: Queensbury State: New York Zip Code: 12804 Buildina Information Current Use: Residential-single family Prior Use: Residential-single family Approximate Year Built: 65 Size(sq.ft): 9000 Federal Buildin : Buildin Representative/Site Contact Name: Dean Romer Phone Number: 518-793-1492 E-mail Address: n/a Cell Phone Number: n/a Phase Details Phase# Phase Start Date Phase End Date Phase Location jPhase Scope Sub-Contractor Details Name: Asbestos License Number. Ni htMeekend/Shift Work Details Party for Whom Work is beln Performed First Name: Dean Last Name: Romer Organization: Apt./Suite: Address Line 1: 52-Queensbury Ave Address Line 2: City Town or Village: Queensbury Province: State: NY Zip Code: 12804 Country: United States Contract Dollar Amount: $18 900.00 Variance Information Procedures and Type of Equipment and Ventilation Systems Used code rule 56 In-Plant Air Monitoring Firm Name: Alpine Environmental Services, Inc. Asbestos License Number. 29095 Laboratory Performina Analysis Name: Alpine Environmental Services ELAP Registration Number: 11170 Type of Asbestos Work Pipe Related: Yes Siding: Yes Clean up: No Vessel covering: No Caulking/mastic: Yes Spray-on insulation: No Roofing/flashing: Yes VAT: Yes Demolition: Yes Demolition Ref#: -Other-specify: Waste Transporter Name: Classic Environmental Inc. NYS DEC or EPA Permit Number: 5A 718 Phone Number: 518-664-1209 Apt./Suite: Address Line 1: P O Box 480 Address Line 2: City Town or Village: Clifton Park Province: State: NY Zip Code: 12065 Country: United States Landfill Name: Ontario County Landfill Phone Number: 1-585-526-4420 Apt./Suite: Address Line 1: 3555-Post Farm Road Address Line 2: City Town or Village: Stanley Province: State: NY Zip Code: 14561 Country: United States Type and Amount of Asbestos Containing Material Friable linear feet: 15 Friable square feet: 0 Non-friable linear feet: 0 Non-friable square feet: 3409 Fee Total linear feet: 15.0 Total square feet: 3409.0 Total Fee: 1000.0 Project Fee Schedule Linear Feet: Fee Square Feet: Fee 0-256 feet: $0 0-159 feet: $0 260-429 feet: $100 160-259 feet: $100 430-824 feet: $200 260-499 feet: $200 825-1649 feet: $500 500-999 feet: $500 1650 or more feet: $1000 1000 or more feet: $1000 Remarks AW EnvirolltY'!entW Services, Ine. PCM AIR SAMPLE DATA REPORT CLI_NT�t� ` M F'RQJECf��(,Vto P�oJ�cr� 67 .eta;'S`0AC RKAREA �.L�Tre COt+ECTrD BY_ K C3G.- ABATEMcNT C- DATE CO,I ECTED: CONTRACTOR PROJ.MONITOR(IF AN)) SUPERVISOR; Circle O BACKGROUND DURING FINALS PERSONAL QC's SAMP START STOP FMM FIBERS r ND. NOG LOCATION TWS Time WL ,�Al { f Mule cc RF V *-i3 60 Ibvi. (04 g qrD �1rw Xl�' 4 va6 �� i5 ti"1 �L t7 6Q g ��� �an •�G,aab 8 W�o 3. lag W9 64 140 pep 11•S •°9 Q 1 0 7960 00 40 q1to o 2- �' D do R' NQU cr7 8Y: -'l} —' 1• — — BY: SItaJ+r}ATURE i E: i IME: Comm %Ave.- n shoDPead 1. {� 3. SA PLES PnHPPED BY; PRt DAT F: TtME SAMPLES ANALYZED BY; ?RtNT A TIME: 1 yaV Samples Received Meet Lab SimpA Arxeptance Criteria(Cirde one): N - Below the limit of Detection [] t'>50%particulate matter, unreadable [)*—Sample damaged or missing icrosco Used: Seitz 5127920734G2! I Olympus CH700880/ hi Nikon 131-545 Stanfted DeVmfion ( Log# I Standard Dev Lag;#t /Stand2nd Dev I Log# AI SWOWd Dev WS 00H MA V 11740.MOSK lul- W 74W.A RW=.Rev.3,hsue 2.aMS.44,hW Asti-=Specw& vela Ams at S.-V.--0.027esmeLa5 C':l.S—T:teas=0 32m.20.s.5D 50.5100 .H QA I OC Officer xtn=:4.20,-10D nbw-e,2;,rtbcV=ees ba,eatwtated Mw sutR.acOw 14d Mans ays vge. Newt note that MuM of samples 0%0camd by M lien;Zen Do veered by Alpine Ylt*ogh dmmeonly. +nest n-ifits rclela ady ib tho hug wied.Ropes nay ra ao repro eft=d.acal in iA wirmut w rcm G-aig Peasiki8,C.-H.Lab DkVaD.;.Rep Awnssim of*Cirfe:.11vnbronm,3L OC_ Slgned_ Szzanned,_ DOL^ 1-'6 Central Avenue-Albany,Naw York 1205-Phona:(518)4-43.0145•Fax.(518)4,53-0175 Page I Of Z® 39Gd 3b1N3WNOSIAN3 3NId-jti SLIOESbHiS lS:bi L90Z/bL180 , �t4ar.l;"�a :�,,y @nvi;antnen:at �.��. Serf+icss, Inc.. �y� e, PCM AIR SAMPLE DATA REP/CART Ct!_h� rl/'C�. '' pRG'J_CT: ?try Demo ?ROJECi# Q� t5��4 C f, 1-4% Ls'/2-. / �} WORK AREA tS� ��✓� ! COLLECT ED BY: A8A T EMcNT Nome DATE N CONTRACTOR—7^ PROJ.MON17 TOR(IF ANY)- eOnal BACKGROUtJD ?ram DURING FINAL PERSONAL QC's SAW LOG START STOP TOTAL Raw TOTAL F1100 Fffim r-BFRS! NM NO. LOCATION Try TOO MIN. FW& vOLtA, noo �mm' QC �N, fu mm) FIciDS le 3 6 o to 0 ��v .io hv� I O r to 00 Utz 4t 119g5 p33 Ht oa t 3312-033 40 61 ao . 005, 0W0- — 33 44��- Ga° N0, 8���� . cob 0 ox - . I = I 'iJ BY: t TURE REM —VM:(SIGNATURE) ( DAM I TIME Comments: I Ave= fibersii00fipld 1. 2. �- //d 3. 14. SAM ILLS PREPPED BY. PRIED DA c TIME: 1 SAWLcS ANALYZED 3 RINT) I DATE: ( TIME: t ©a PAi mples Received Meet Lab Sample Acceptance Criteria(circta one). N "Below the limit of Datec*ion [] '''>50% particulate rmtfer, unreadable [] 'Sample damagad or missing croscope Used:( Leltz 6127920734402/ I] Olympus CH7008801 WL Nikon 131-545 Standard DavlaYon I top l yard Dw I LOO ISUndwd Dev 11 too fj Sandwd Dev Ws nt4-.Ax f9740:NICSH Mwod 7400,A Rdm,Ray.:,asuzZ W:554,NotAeeest Spa-lift �,m:Area o:s�?e=o.ca��a m=I�b M+ ,�c �-•cart,a:.S�riyeer�aT, :x>a a QA!QC Officer s=020-7a-+frosre-tia3.:`,o---Jaaga bean:araktthd MWreuara:any POW ibM 30-V6e• die_-+s note that rases o`samotes fit.E byf0-d ISM an be:va-w5ke by Alede:ftmp;Sr+.°a ty. 'mete nmms+elwo"to me ifeme cmd. R:aur:rney ra:be mprwUzed.=-ot in 6A wa,aL!r C;aig Pe7aikis.C1.'1.La✓' 7tri: ar R fir.oa ft-Wesm of MOM Ln%%v"wMhL QC_ S4i0d` S=.%^--d DJt._ ,= re„+-�I e;r�..,,8. ath�.IV tit„uY;irk I92rl,.?hone:!�1�1�ar-G1T3• Via:.ISiB)�;,3-�J9i3 Pa .IV Z0 39W W.LN3wW)8I 1N3 3NId-W C/TAFCbR TC TF:P T i aa7 io7 Seca A Z Envii.�onmt3ata! •� Services, Inc. PCM AIR SAMPLE DATA REPORT CLIENT '''�CSJ� + I +v►IW` PROJECT*- t rt Demo PROJECT=O (�l�l�f +AaleNv^k- LA3r WORK A COLLECTED BY: A3A 1 caVieNT c��r*�ActcFz +G DATE=11c:=D: EI d CONTRACT OR To PROJ.MONITOR(Cl AN SUP Vt Orel BACKGROUND PRE DURING rINA PERSONAL OC's ER50R: IWf UL rose '18s SAMP LOG LOCATION SrART 37M TOTAL No. NO. TIME T1W MtK aa1 Fps a QC F� - - /90 20 w boo 1/100 1a 3 #3g d bOD $ P 6 3 . 20? *6D 600 Boa g2 ao 60 ,io boo fl . Do�- ItIca Pt3 41 1 to �,09- is �. iccLiiv ISi iED :'SI" itirec RECei D Y: SIGNAT UDC DATE: TIME:- Comm FS Ave 00field 1. 2. 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