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DEMO-0609-2022 Office Use Only Permit#: i� bc�' OC, •20 ZZ-, DEMOLITION APPLICATION , Permit Fee.$ 'Fawn of Queensbury Invoice#: y 742 Bay Road,Queensbury,NY 12804 P:518-761-8256 www.aueensbury.net Flood Zone? Y (9-Reviewed By: rT� Demolition Location: 308 Cleverdale Road Tax Map ID#• 226.12-1-82 **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? Ace Carting, Fort Ann 2. Type of structure a demolished: a. Residen d. Storage Building b. Garage e. Other: c. Business 3. What type g1ilities are connected to the structure: Dij a. Gas LJ f. Well-Water P a OCT 0 3 2022 U b. Fuel Oil g. Public!ewer c. Propan h. Othe TOWN! OF CtUc�a a6�:4ii�Y d. Electric i. None BUiLl�le�C `C�e:'�=-G e. Public Water 4. Have ALL utilities (water, electric, etc.) been disconnected? Yes Fv_� No F ADDITIONAL INFORMATION: 1. Two inspections are required: an inspection to determine that utilities are disconnected, and a final inspection after the structure is removed and the site is cleaned up and graded. 2. Twenty-four(24) hour notification is required for inspections. 3. Workers' Comp insurance information is required to be submitted with this application. Declaration: I acknowledge that no structure(s)will be removed from the parcel until the demolition application has been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a permit has been issued. I have read and agree to the above: PRINT NAME: David W. Brownell / SIGNATURE: DATE: 16 12- 22 Demolition Application Revised June 2022 1 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): DBCarpentry, LLC(David W. Brownell) Mailing Address, C/S/Z: 396 Mcgowan Road, Schaghticoke, Ny 12154 Cell Phone: 518-361-1702 Land Line: Email: Dbcarpentry05@gmail.com • Primary Owner(s): Name(s): Robert&Jean Tarrant Mailing Address, C/S/Z: 41 Clifside Drive, Saratoga Springs, NY 12866 Cell Phone: 518-461-8715 Land Line: Email: tarrant930@aol.com ❑ Check if all work will be performed by property owner only • Contractor: (List all additional contractors on the back of this form) Contact Name(s): David Brownell DBCarpentry, LLC Contractor Trade: Builder Mailing Address, C/S/Z: 396 MCGowan Road, Schaghticoke, NY 12154 Cell Phone: 5183611702 Land Line: Email: dbcarpentry05@gmail.com **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: David Brownell Cell Phone: 5183611702 Land Line: Email: dboarpentry05@gmail.com Demolition Application Revised June 2022 (.INTACT.lbJF0RMATl9N i?LEAS.E PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AEI:EMAIL o Applicant: Name(s):_Robert&Ji;an Tarrant Mailing Address, Cf S/Z: 41 Clif#side Drive Cell Phone: (51s)461.-;3715 Lana Line: Email: tarrant930@aol.corn cp Primary,owner(s): Ndme(s)- {Sarre as Applicant) Mailing Address,£JS/Z: ... .Cell Phone: Land Line: Email: , [1 Check if all work g ill be performed by property yawner 2DIV 0 Contracton: Contact Name-(-): Crandall Excavating, Inc_ Contractor.Trade: Excavating Mailing Address,C/$/Z: 68 Woodchuck Hill Rd Cell Phone: (518)470-4694 Land Line: (518)793-0431 Email::chrisc 6dalldigs6gmeail.cflm "Workers" Comp documentation must be submitied with this a pllcatlon** Enkineer[s): Name()- Hutchins Enginearing"PLLC Failing Address,Cf S/Z- 169 Haviland Rd,Queensbury,NY 12804 Cell Phone: Land Line: (518)745-0307 !=mail: LWP0bie.Qgmail_c om Contact Persba'f6r Compliance in regards to this project: Chris Crandall Cell.Phone: (518).470-4694 Land Lime: (518)793-0431 -- Email: chriscrandalldigsOgmail.c;arn Declaration: Any permit or approval granted which is based upon or is granted in reliance Capon .any material representation or failure to:make a material factor.circumstance known by or can behalf of an applicant, shall:be void. I have read the regulations and agree to abide by these and all requirements of the Town of 1Queensbury Sanitary Sewage.Disposal ordinance. PRINT NAME: Robert-Tarrant SIGNATURE: DATE: W;� Se Yrcilp�lStatiors RevisedJuNr2022 Nationalgrid 300 Erie Boulevard West Syracuse,New York 13202 MICHAEL DINGMAN RE: Service Removal for Building Demolition 10/5/2022 To: MICHAEL This letter is to confirm that, per your request,National Grid has confirmed electrical service and meters have been removed at 308 CLEVERDALE RD QUEENSBURY NY 12804. The work was processed on work order#30661983, and meter# 30356899, was removed. If you have any questions or need further assistance,please feel free to contact us at 1-800-260-0054. Sincerely, Customer Connections , 'IM Nationalgrid - OCT 0 6 20E TOWN QF QUEENSBi BUJU) G& CODE- 18 Blackberry Lane CLEAR _ _ Queensbury, NY 12804 INSP ECTI ® CW 1..� —' � 0 1-� roan@clearvuinspections.com %T(2,VVh•, � QUEENSEURY 518.832.9213 BU11LD1NG DE PA,RTMiENT - Bas-d on our limited onirninaticn,compliance OCT 03 2022 with m OLlr comelifs shall not be construed as indicating iha plans and' srecificalions are in FiL °�'tali comp{lanca Gn;ith lthi- t.didinn Grades of TOWN Oi OUEEIl,!SBURY g I�l,e,,v Yor'r,St�afL.. �UlL®ING & CODES Pre-Demolition -Asbestos Survey 02 3 co o m� :< N (D Cl 00 9 —�+ O1 — N i U) N o M PROJECT NUMBER PREPARED FORI M O 10153 Robert&Jean Tarrant 41 Cliffside Drive O ' SITE LOCATION Saratoga Springs, NY 12866 N .308 Cleverdale N 308 Cleverdale Road PREPARED BY N Queensbury, New York 12804 Ryan Wild 18 Blackberry Lane Queensbury, New York 12804 Robert&Jean Tarrant,308 Cleverdale Road,Queensbury,New York,12804 -` Executive Summary Asbestos-Containing Material Field Survey 308 Cleverdale Single Family Dwelling 308 Cleverdale Road Queensbury, New York, 12804 I. SUMMARY OF FINDINGS On September 07, 2022, an asbestos-containing material (ACM)field survey was conducted at 308 Cleverdale Road located in Queensbury, New York(Site).The site was inspected to determine the presence of ACM in preparation for renovation.The ACM survey was performed at the request of Robert&Jean Tarrant. A summary of asbestos-containing materials is provided in the following table. However,this report should be read in its entirety, including detailed information that is contained in other sections and appendices.A total of 21 samples were collected from 9 suspect homogenous materials. Summary Table of Asbestos-Containing Materials le ID. -"S '"ace IVairie: " %:Numeric R of p al es t, tUlaterial"iGafiegor 6riala%1� 9 No Asbestos Detected ***Electrical was on during the survey and electrical insulation was not sampled*** Following the introduction, a table of ACM grouped by homogeneous areas is included in Appendix A of this report.A table presenting those materials sampled which did not contain asbestos can be found in Appendix B of this report.A complete listing of all suspect materials sampled is provided in Appendix C of this report.The original chain of custody & laboratory analytical reports are located in Appendix D of this report. Page 2 of 8 Robert&Jean Tarrant,308 Cleverdale Road,Queensbury,New York,12804 INTRODUCTION GENERAL INFORMATION ClearVU Inspections was retained by Robert&Jean Tarrant to conduct a pre-demolition survey.All methods and procedures employed in this survey were done in accordance with NYSDOL(New York State Department of Labor), OSHA(Occupational Safety and Health Administration), and USEPA(United States Environmental Protection Agency) regulations and protocol. The information contained in this report has been collected in accordance with existing regulations. If this document is to be utilized for bidding quotations, it cannot be held binding and must be field verified by those contractors submitting bids. PURPOSE The purpose of this survey was to identify, document, and measure specified asbestos-containing materials in this building, which may be disturbed during renovation/demolition/rehabilitation activities.Samples were collected of suspect accessible asbestos-containing building materials. Should any materials be encountered that are not identified in this report,they should be assumed asbestos containing until a representative number of samples are collected to document these materials as non-asbestos containing. LIMITATIONS&SCOPE OF SERVICES Provide a visual inspection of all accessible building components to determine the presence of suspect materials.The inspector physically assessed, quantified and conducted bulk sampling as required of suspect ACM (Asbestos Containing Materials)which were accessible or exposed.This report represents the locations and quantities of ACM (Asbestos Containing Materials) present as well as all sampled materials that tested negative for the presence of asbestos and their locations. Bulk sample analysis was performed by a participating New York State Department of Health Environmental Approval Program (NYSDOH-ELAP) certified laboratory. Buildings where power is connected, electrical wire sheathing could not and was not sampled. SAMPLING METHODOLOGY During the visual inspection process, an inventory of suspect materials similar in appearance and composition was created and grouped into homogeneous sampling areas. A homogeneous area is defined as a surfacing,thermal or miscellaneous material that is uniform in texture, age, and appearance.A representative bulk sampling plan was created in accordance with current USEPA(United States Environmental Protection Agency) requirements and guidelines. Bulk samples were then collected of suspect ACM (Asbestos Containing Materials)to identify the presence of asbestos. There are a number of materials, which rarely contain asbestos and are not specifically addressed in this report.Such materials include but are not limited to metal, glass, rubber, cinderblock and mortar. LABORATORY METHODOLOGY The friable bulk samples were analyzed by Polarized Light Microscopy(EPA Interim Method:Appendix A to Subpart F 40CFR Part 763) at magnifications ranging from 10x to 400x, and New York State Department of Health ELAP Item Number 198.1 (Polarized Light Microscopy Methods for Identifying and Quantitating Asbestos in Bulk Samples).The estimated phase abundances are provided in weight percent and are accurate to within 10 to 15 percent of the amount reported.These methods are sensitive to the detection of asbestos to less than one percent. Page 3 of 8 Robert&Jean Tarrant,308 Cleverdale Road,Queensbury,New York,12804 All non-friable organically bound (vinyl flooring, caulking, etc.) bulk samples were analyzed by New York State Department of Health ELAP Item Number 198.4 (Transmission Electron Microscopy Method for Identifying and Quantitating Asbestos in Non-Friable Organically Bound Bulk Samples). NOB samples were first reduced by the Gravimetric Matrix Reduction Method to determine if greater than one percent of material remained. If greater than one percent of the NOB material remained by weight,the sample was analyzed by Polarized Light Microscopy by New York State Department of Health ELAP Item Number 198.6 to determine if it contained greater than one percent asbestos. In accordance with New York State Department of Health regulations, Polarized Light Microscopy is not consistently reliable in detecting asbestos in non-friable organically bound materials, and in cases of a negative result TEM analysis is performed.This method is sensitive to the detection of asbestos to less than one percent by weight.A material is considered asbestos containing if it contains more than 1%asbestos. NYSDOL and USEPA regulations define asbestos containing material as containing greater than one percent (1%). Materials found to contain asbestos at concentrations of less than one percent(<1%) by weight are classified as containing trace amounts of asbestos. It should be noted, OSHA's definition of"asbestos containing" does not have a one percent(1%) cut-off,therefore, asbestos that is present in percentages less than one percent (<I%) continues to be covered by OSHA Construction Standard 29 CFR 1926.1101. Eurofins CEI-Lab ID#12048,completed the analysis. WARRANTY The field and laboratory results reported are considered sufficient in detail and scope to determine the presence of accessible and/or exposed asbestos-containing building materials.The findings contained within this report have been gathered in accordance with existing regulations and industry protocol. This survey and analytical methods have been used to provide information regarding the presence of suspect interior asbestos-containing building materials existing at the time of the inspection.This report is limited to the information available from the client at the time it was prepared. It is possible that conditions may exist which could not be identified within the scope of the survey or which were not apparent during the site visit. Page 4 of 8 : Robert&Jean Tarrant,308 Cleverdale Road,Queensbury,New York,12804 - Appendix A: ACM Homogenous Area Table .'Materiial Id' Material `Space"Name',It' Sectlon Name ,Friability i % °Current Condition,:. ;,;°Result ,Quay There are no homogenous materials for this project that are assumed or have tested positive containing asbestos Page 5 of 8 Robert&Jean Tarrant,308 Cleverdale Road,Queensbury,New York,12804 Appendix B: Tested Negative Homogenous Material Table Material; Material. Material Space` Section. Result Category Id Name . Name t Miscellaneous 001 001-Gypsum Wallboard Bathroom Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 001 001-Gypsum Wallboard Hallway Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 002 002-Cork Wall Panel Kitchen Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 002 002-Cork Wall Panel Living Unassigned Tested Negative by Lab(No Room Asbestos Detected) Miscellaneous 002 002-Cork Wall Panel Porch Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 003 003-floor vinyl Kitchen Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 004 004-Masonry Mortar chimney Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 005 005-Masonry Brick Porch Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 006 006-Masonry Block Porch Unassigned Tested Negative by Lab(No Mortar Asbestos Detected) Miscellaneous 007 007-Roofing, Composite Roof Unassigned Tested Negative by Lab(No Shingle Asbestos Detected) Miscellaneous 008 008-Roofing Paper/Felt Roof Unassigned Tested Negative by Lab(No Asbestos Detected) Miscellaneous 009 009-Sealant,Window Pane Exterior Unassigned Tested Negative by Lab(No Glazing Asbestos Detected) Miscellaneous 009 009-Sealant,Window Pane Roof Unassigned Tested Negative by Lab(No Glazing Asbestos Detected) Page 6 of 8 Robert&Jean Tarrant,308 Cleverdale Road,Queensbury,New York,12804 Appendix C: All Suspect Materials Sampled Sample ID Space. Section Material Analytical Regulatary.Result Name Name Result .' 001A Bathroom Unassigned 001-Gypsum Wallboard 0% Tested Negative by Lab(No Asbestos Detected) 001E Hallway Unassigned 001-Gypsum Wallboard 0% Tested Negative by Lab(No Asbestos Detected) 002A Living Unassigned 002-Cork Wall Panel 0% Tested Negative by Lab(No Room Asbestos Detected) 002B Porch Unassigned 002-Cork Wall Panel 0% Tested Negative by Lab(No Asbestos Detected) 002C Kitchen Unassigned 002-Cork Wall Panel 0% Tested Negative by Lab(No Asbestos Detected) 003A Kitchen Unassigned Multi-layer Parent Material 003A- Kitchen Unassigned 003-floor vinyl 0% Tested Negative by Lab(No Mastic Asbestos Detected) 003A- Kitchen Unassigned 003-floor vinyl 0% Tested Negative by Lab(No Vinyl Asbestos Detected) 003B Kitchen Unassigned Multi-layer Parent Material 003E- Kitchen Unassigned 003-floor vinyl 0% Tested Negative by Lab(No Mastic Asbestos Detected) 003B- Kitchen Unassigned 003-floor vinyl 0% Tested Negative by Lab(No Vinyl Asbestos Detected) 004A chimney Unassigned 004-Masonry Mortar 0% Tested Negative by Lab(No Asbestos Detected) 004E chimney Unassigned 004-Masonry Mortar 0% Tested Negative by Lab(No Asbestos Detected) 005A Porch Unassigned 005-Masonry Brick 0% Tested Negative by Lab(No Asbestos Detected) 005E Porch Unassigned 005-Masonry Brick 0% Tested Negative by Lab(No Asbestos Detected) 006A Porch Unassigned 006-Masonry Block 0% Tested Negative by Lab(No Mortar Asbestos Detected) 006E Porch Unassigned 006-Masonry Block 0% Tested Negative by Lab(No Mortar Asbestos Detected) 007A Roof Unassigned 007-Roofing,Composite 0% Tested Negative by Lab(No Shingle Asbestos Detected) 007E Roof Unassigned 007-Roofing,Composite 0% Tested Negative by Lab(No Shingle Asbestos Detected) 008A Roof Unassigned 008-Roofing Paper/Felt 0% Tested Negative by Lab(No Asbestos Detected) 008B Roof Unassigned 008-Roofing Paper/Felt 0% Tested Negative by Lab(No Asbestos Detected) 009A Exterior Unassigned 009-Sealant,Window Pane 0% Tested Negative by Lab(No Glazing Asbestos Detected) 009B Roof Unassigned 009-Sealant,Window Pane 0% Tested Negative by Lab(No Glazing Asbestos Detected) Page 7 of 8 Robert&Jean Tarrant,308 Cleverdale Road,Queensbury,New York,12804 Appendix D: Chain of Custody&Laboratory Report Page 8 of 8 Il I I I III I I II lllllll II l i II II I III CLEARVU n U FQZ3 D i r.s titkt Chain of Custody ClearW Inspections 18 BlackberryLane Project: 10153 /� ••� � ..v Queensbury,New York 12804 Site Location:308 Cleverdale ����" ��•��� 308 Cleverdale Road Queensbury,New York 12804 EUROF NS CEJ, INC Sampled By: Ryan Wild(ryan@clearvuinspections.com) SAMPLES ACCEPTED Reporting By:Ryan Wild(ryan@clearvuinspections.com) Purpose:Pre-Demolition Laboratory Notes CISTurn-Around Time Request - .,y. .•.2%:, :r.. ..:•:�.:.•...:-r?eL'hC: ir• _ .., - ^r7uir.,l iL*'r s`-r. .. ,. .., .. .. •a Stop after first positive for each HM 3 Day Samples :.,�.v ate' .xsiS�us6��i:',uf$:T.X°:+"aS; .��h'fi�:"�"-:"'.S>`r25K'�dxi::Y�`.«"-.°»a`,a:"� �r�va�'if2 v'e-:a:�'T>�-=R"..:e:<i•= v"� Sample ID Material Floor/Section Space Analysis NYELAP 198.1 & 001A 001 -Gypsum Wallboard Unassigned Bathroom 198.4 PLM&TEM where applicable NYELAP 198.1 & 001 B 001 -Gypsum Wallboard Unassigned Halfway 198.4 PLM&TEM where applicable - NYELAP 198.1 & 002A 002-Cork Wall Panel Unassigned Living Room 198A PLM&TEM where applicable NYELAP 198.1 & 002E 002-Cork Wall Panel Unassigned Porch 198.4 PLM&TEM where applicable NY ELAP 198.1 & 002C• 002-Cork Wall Panel Unassigned Kitchen 1'98.4•PLM&TEM where applicable ClearVU Inspections-Chain of Custody For Robert&Jean Tarrant 308 Cleverdale-10153 1 of 3 r Sample ID Material Floor/Section Space Analysis NYELAP 198.1 & 003A 003-floor vinyl Unassigned Kitchen 198.4 PLM&TEM where applicable NY ELAP 198.1 & 003E 003-floor vinyl Unassigned Kitchen 198.4 PLM&TEM where applicable NYELAP 198.1 & 004A 004-Masonry Mortar Unassigned chimney 198.4 PLM&TEM where applicable NYELAP 198.1 & 004E 004-Masonry Mortar Unassigned chimney 198.4 PLM&TEM where applicable NY ELAP 198.1 & 005A 005-Masonry Brick Unassigned Porch 198.4 PLM&TEM where applicable NYELAP 198.1 & 005B 005-Masonry Brick Unassigned Porch 198A PLM&TEM where applicable NYELAP 198.1 & 006A 006-Masonry Block Mortar Unassigned Porch 198.4 PLM&TEM where applicable NY ELAP 198.1 & 006B 006-Masonry Block Mortar Unassigned Porch 198A PLM&TEM where applicable NY ELAP 198.1 & 007A 007-Roofing,Composite Shingle Unassigned Roof 198A PLM&TEM where applicable NYELAP 198.1 & 007B 007-Roofing,Composite Shingle Unassigned Roof 198A PLM&TEM where applicable NYELAP 198.1 & 008A 008-Roofing Paper/Felt Unassigned Roof 198A PLM&TEM where applicable NYELAP 198.1 & 008B 008-Roofing Paper/Felt Unassigned Roof 198A PLM&TEM where applicable li ClearVU Inspections-Chain of Custody For Robert&Jean Tarrant 308 Cleverdale-10153 2 of 3 Sample ID Material Floor/Section Space Analysis NY ELAP 198.1 & 009A 009-Sealant,Window Pane Glaang Unassigned E)derior 198.4 PLM&TEM where applicable NYELAP 198.1 & 009B 009-Sealant,Window Pane Glaang Unassigned Roof 198.4 PLM&TEM where applicable P V 9.21.2022 15:00 Sampled By Date Time CS q 1� g;3O Received By Date Time Received By Date Time Received By Date Time P. V 9.23.2022 16:30 Relinquished By Date Time Relinquished By Date Time Relinquished By Date Time Analysis By Date Time CiearVU Inspections-Chain of Custody For Robert&Jean Tarrant 308 Cloverdale-10153 3 of 3 F 1 eurofins CEI September 29, 2022 ClearVU Inspections 18 Blackberry Lane Queensbury, NY 12804 CLIENT PROJECT: 10153 LAB CODE: N220282 Dear Customer: Enclosed are asbestos analysis results for Asbestos Bulk samples received at our laboratory on September 26, 2022. The samples were analyzed for asbestos using polarizing light microscopy (PLM) and / or transmission electron microscopy (TEM) by New York State ELAP approved methods. Sample results containing >1% asbestos are considered asbestos-containing materials (ACMs) per EPA regulatory requirements. The detection limit varies with the method chosen for the analysis. Eurofins CEI is accredited by the New York State Department of Health (NYSDOH) Environmental Laboratory Approval Program (ELAP), certificate #12048. Kind Regards, Tianbao Bai, Ph.D., CIH Laboratory Director NV( TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 ti®tie u rof ins CI ASBESTOS ANALYTICAL REPORT By: New York State ELAP Method Prepared for ClearVU Inspections CLIENT PROJECT: 10153 LAB CODE: N220282 TEST METHOD: NYS ELAP METHODS 198.1, 198.4 REPORT DATE: 09/29/22 TOTAL LAYERS ANALYZED: 21 # LAYERS >1% ASBESTOS: 0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Asbestos Report Summary e u rof i n s By: NEW YORK STATE METHOD CEI PROJECT: 10153 LAB CODE: N220282 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Lab ID Color Sample Description Total Asbestos% 001A N4455 White Gypsum Wallboard No Asbestos Detected.0% 001 B N4456 White Gypsum Wallboard No Asbestos Detected.0% 002A N4457 Brown Wall Panel No Asbestos Detected.0% 002B N4458 Brown Wall Panel No Asbestos Detected.0% 002C N4459 Brown Wall Panel No Asbestos Detected.0% 003A N4460A Gray,White Floor Vinyl No Asbestos Detected by 198.4 --------------------------------- -- ---- ------ -- - - - - - - ------ ---- N4460B Clear Mastic Insufficient Material 003B N4461A Gray,White Floor Vinyl No Asbestos Detected by 198.4 ------------------------------------------ - -------------------- N4461B Clear Mastic Insufficient Material 004A N4462 Gray Masonry Mortar No Asbestos Detected.0% 004E N4463 Gray Masonry Mortar No Asbestos Detected.0% 005A N4464 Brown, Red Masonry Brick No Asbestos Detected.0% 005B N4465 Brown, Red Masonry Brick No Asbestos Detected.0%. 006A N4466 Gray Masonry Block Mortar No Asbestos Detected.0% 006B N4467 Gray Masonry Block Mortar No Asbestos Detected.0% 007A N4468 Black Shingle No Asbestos Detected by 198.4 007E N4469 Black Shingle No Asbestos Detected by 198.4 008A N4470 Black Roofing Paper No Asbestos Detected by 198.4 008B N4471 Black Roofing Paper No Asbestos Detected by 198.4 Page 1 of 2 Asbestos Report Summary e u rof i n s By: NEW YORK STATE METHOD CEI PROJECT: 10153 LAB CODE: N220282 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Lab ID Color Sample Description Total Asbestos 009A N4472 Gray,Tan Window Glazing No Asbestos Detected by 198.4 009E N4473 Gray,Tan Window Glazing No Asbestos Detected by 198.4 Page 2of2 ASBESTOS BULK ANALYSIS ti�� e u r®fins By: NEW YORK STATE METHOD I Client: ClearVU Inspections Lab Code: N220282 18 Blackberry Lane Date Received: 09-26-22 Queensbury, NY 12804 Date Analyzed: 09-29-22 Date Reported: 09-29-22 Project: 10153 ASBESTOS BULK, NEW YORK STATE METHODS Client ID' Layer Number Lab ID Lab Description ,.Category Color 001A Gypsum Friable White Initial Observations: N4455 Wallboard Cellulose 20% Gypsum 80% Method: Final Results: 198.1 No Asbestos Detect(Tibtal Asbestos: No Asbestos Detected.0% 00113 Gypsum Friable White Initial Observations: N4456 Wallboard Cellulose 20% Gypsum 80% Method: Final Results: 198.1 No Asbestos Detectalabtal Asbestos: No Asbestos Detected.0% 002A Wall Panel Friable Brown Initial Observations: N4457 Cellulose 95% Binder 5% Method: Final Results: 198.1 No Asbestos Detectfebtal Asbestos: No Asbestos Detected.0% 002B Wall Panel Friable Brown Initial Observations: N4458 Cellulose 95% Binder 5% Method: Final Results: 198.1 No Asbestos DetectET(Otal Asbestos: No Asbestos Detected.0% 002C Wall Panel Friable Brown Initial Observations: N4459 Cellulose 95% Binder 5% Method: Final Results: 198.1 No Asbestos DetectdTabtal Asbestos: No Asbestos Detected.0% Page 1 of 8 ASBESTOS BULK ANALYSIS e u rof i n s By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220282 18 Blackberry Lane Date Received: 09-26-22 Queensbury, NY 12804 Date Analyzed: 09-29-22 Date Reported: 09-29-22 Project: 10153 ASBESTOS BULK, NEW YORK STATE METHODS ClientlD Layer,Number' Lab ID Lab Description Category Color 003A 1 NOB Gray, Initial Observations: N4460A Floor Vinyl White Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected N4460B 2 NOB Clear Initial Observations: Mastic Method: Final Results: Lab Notes: Insufficient sample present for 198.4 Total Asbestos: Insufficient Material analysis. 003B 1 NOB Gray, Initial Observations: N4461A Floor Vinyl White Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected N4461 B 2 NOB Clear Initial Observations: Mastic Method: Final Results: Lab Notes: Insufficient sample present for 198.4 Total Asbestos: Insufficient Material analysis. Page 2 of 8 ASBESTOS BULK ANALYSIS ° e u r®fins By: NEW YORK STATE,METHOD I Client: ClearVU Inspections Lab Code: N220282 18 Blackberry Lane Date Received: 09-26-22 Queensbury, NY 12804 Date Analyzed: 09-29-22 Date Reported: 09-29-22 Project: 10153 ASBESTOS BULK, NEW YORK STATE METHODS Ciient ID I.aypr Number Lab ID Lab Description Category. C,oior 004A Masonry Mortar Friable Gray Initial Observations: N4462 Binder 35% Silicates 65% Method: Final Results: 198.1 No Asbestos Detect6Tdbtal Asbestos: No Asbestos Detected.0% 004E Masonry Mortar Friable Gray Initial Observations: N4463 Binder 35% Silicates 65% Method: Final Results: 198.1 No Asbestos Detect(Tibtal Asbestos: No Asbestos Detected.0% 005A Masonry Brick Friable Brown, Initial Observations: N4464 Red Binder 85% Silicates 15% Method: Final Results: 198.1 No Asbestos Detect6fttal Asbestos: No Asbestos Detected.0% 005E Masonry Brick Friable Brown, Initial Observations: N4465 Red Binder 85% Silicates 15% Method: Final Results: 198.1 No Asbestos Detect(Tibtal Asbestos: No Asbestos Detected.0% Page 3of8 ASBESTOS BULK ANALYSIS e u r®fins By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220282 18 Blackberry Lane Date Received: 09-26-22 Queensbury, NY 12804 Date Analyzed: 09-29-22 Date Reported: 09-29-22 Project: 10153 ASBESTOS BULK, NEW YORK STATE METHODS Client ID Layer Number Lab ND Lab Description Category :.Color 006A Masonry Block Friable Gray Initial Observations: N4466 Mortar Binder 35% Silicates 65% Method: Final Results: 198.1 No Asbestos Detect(Tcbtal Asbestos: No Asbestos Detected.0% 006B Masonry Block Friable Gray Initial Observations: N4467 Mortar Binder 35% Silicates 65% Method: Final Results: 198.1 No Asbestos Detect(Tobtal Asbestos: No Asbestos Detected.0% 007A Shingle NOB Black Initial Observations: N4468 Fiberglass 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 007B Shingle NOB Black Initial Observations: N4469 Fiberglass 50% Matrix 50% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 4 of 8 ASBESTOS BULK ANALYSIS 4! e u rofi n S By: NEW YORK STATE METHOD 6 Client: ClearVU Inspections Lab Code: N220282 18 Blackberry Lane Date Received: 09-26-22 Queensbury, NY 12804 Date Analyzed: 09-29-22 Date Reported: 09-29-22 Project: 10153 ASBESTOS BULK, NEW YORK STATE METHODS Client ID' Layer Number Lab NR Lab Description Category Color 008A Roofing Paper NOB Black Initial Observations: N4470 Fiberglass 45% Matrix 55% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 008B Roofing Paper NOB Black Initial Observations: N4471 Fiberglass 45% Matrix 55% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected 009A Window Glazing NOB Gray,Tan Initial Observations: N4472 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 5 of 8 ASBESTOS BULK ANALYSIS eU rof i re s ti By: NEW YORK STATE METHOD CEI Client: ClearVU Inspections Lab Code: N220282 18 Blackberry Lane Date Received: 09-26-22 Queensbury, NY 12804 Date Analyzed: 09-29-22 Date Reported: 09-29-22 Project: 10153 ASBESTOS BULK, NEW YORK STATE METHODS Client ID gayer Number Lab ID Lab Description Category Color 009E Window Glazing NOB Gray, Tan Initial Observations: N4473 Matrix 100% Method: Final Results: Total Asbestos: No Asbestos Detected by 198.4 198.4 None Detected Page 6of8 s - i eur®fins CEI LEGEND Non-Anth = Non-Asbestiform Anthophyllite Non-Trem = Non-Asbestiform Tremolite Calc Carb = Calcium Carbonate NOB = Non-Friable Organically Bound SM-V = Surfacing Material Containing Vermiculite GLOSSARY OF TERMS Inconclusive- No Asbestos Detected PLM is not consistently reliable in detecting asbestos in floor coverings and other NOB materials. Currently, quantitative TEM must be used to determine if this material can be considered or treated as non-asbestos containing. Inconclusive- CR Conflicting Results: Sample yielded 1% or less asbestos as determined by gravimetric reduction and TEM analysis but had protruding fibers identified as asbestos during , preliminary examination -further sampling and analysis needed. Inconclusive-Trace (type of asbestos) detected at 1% or less Asbestos identified at 1% or less by the 198.6 method, and 0 asbestos points out of 400 (or more) nonempty points were counted. Further testing by TEM using NYS 198.4 method is required. Trace asbestos detected at less than 1% For methods 198.1 and 198.8, NYSDOH defines trace as samples where 0 asbestos points out of 400 (or more) nonempty points were counted, but did contain asbestos positively identified by PLM. Trace asbestos detected at less than 1% For method 198.4 NYSDOH defines trace as asbestos detected at 1% or less. REGULATORY LIMIT: > 1% by weight 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 7 of 8 ti� eurofins CEI DISCLAIMERS: Reported asbestos content verifiable only as the percentage of asbestos in residue submitted to laboratory. Samples with inconclusive results must not be interpreted as being non-ACM. This report relates only to the samples tested or.analyzed and may not be reproduced, except in full, without written approval by Eurofins CEI. Eurofins CEI makes no warranty representation regarding the accuracy of client submitted information in preparing and presenting analytical results. Interpretation of the analytical results is the sole responsibility of the customer. Samples were received in acceptable condition unless otherwise noted. This report may not be used by the client to claim product endorsement by NVLAP, NYSDOH or any other agency of the U.S. Government. Information provided by customer includes customer sample ID, location, volume and area as well as date and time of sampling. ANALYST(S): reg uff- 8.1 Brunilda Gjoka-0198.4 APPROVED Bti Tianbao Bai, Ph.D., CI Laboratory Director m V TESTING NVLAP LAB CODE 101768-0 730 SE Maynard Road • Cary, NC 27511 • 919.481.1413 Page 8 of 8 New York State r�epartme"nt-od L bo Division 44SafBtjr gind ealth Y ° License d Carti icate�,, t ' State Ca pusBildtrig 12 ✓ Albany;,-NY 12240 �L „ � � z y ASBESTOS HANDLING LICE SE'' Creafve.Space 1 , LRG dba ClearVUlpsplrctien s "%= I-"�LE NUMBER: dam ' LICENSE NUMBER: 28289, � -, _ I �. . 18�BIack,erry Lane _, `. I LICENSE CLASS: REST. ICT q� DATE OF ISSUE: 01/28I202 e Q ee st�btry;, lY 128:04. %� ' ri; � . EX PIRATI ) �DATE: 01/3112023 t_ q, 5 gpjj Jj( `.��.ned 1 ` I Quly�Aut orized Representative Ryan`W I .Y is license tias 1i en issued in ac o dat ce1with p lie it raszisEctt%S o r tcJ Q'of the La r Law of New Y©rk,S'a e o e Ne o St&.Codes,Rules anc `e ufatior��; i2 NSA@RRPart`5.6). `rt}s; lect to suspe�lSion or revoca�t n or a(1) s viokatio Nate,federal ar.l cal lar!s vttf ega} a the c nduetdarslesto 'project,or(2)demonstrated'lacf l .��, r^ re ponsibiliy rote conduct of any', igVolviti or asbestatel: aw }£j •4 s� } Thi cent e i('ya l only>for the contractor met�;a(�o+ ^c is cense o phoii py_mustb� pmi e tly displaye tthe asbestos project iyoll�site.-Thi pse verifies that all-,persons emplo�g.dby e lic see on an• asbestos projiuct wN,e- Y v( �.`r V State have been lslued a sbestos Certificate;appxop teohg�ty'peb_yf,wo they perform,by the ew York tat Departure t of L�bor. • � •�` .��'" §{ '�,`yam r . Amy Phillips,Director SH 432(8/12) For the Commissioner of Labor G 1\ r ............... ..,...." _,.. .- .._. .... .. �,. ;�'Y,'-...-.....;...--»�-.w ram^-".c. STATE QF NEW YOW-DEPARTMENT QF;LABO ,ASBESTQS CERTIFIG4TE 'L t RYAN"P'WlCD 'CLASS(EXPIRESf, H,PM -(05/23j,.1 MUST BE.CARRIED.ORASBESTOS PROJECTS -��� -. . - � IIIIIEEIII[6(Etf1,••• Ip�� 6[Fpt,,�;�; :IF FOUND,RSTLW TO: a EYES PRO*.. "HYSDOL — L&C UNIT a HAIR 06, R06K,1"62A HUILDING,-n ` ;.• WT OW STATE OFFICE-CA.MMS S ALBA*i NY'I2240 m .. - . wf - .'RYMWILD ^r r r .6t4 iftoaffQ.Lo,OULit i N S R£C T i O N S NEW YORK STATE DEPARTMENT OF HEALTH WADSWORTH CENTER Expires 12:01 AM April 01,-2623 ,. 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 DR: TIANBAO BAl NY Lab Id No: 12048 EUROFINS CEI, INC. 730 SEMAYNARD ROAD CARY, NC 2751-1 is hereby APPROVED as an Environmental Laboratory in conformance with the National Environmental Laboratory Accreditation Conference Standards(2016) for the category ENVIRONMENTAL ANALYSES POTABLE WATER All approved analytes are listed below: Miscellaneous . Asbestos EPA 100.2 Serial No.: 64945 �o.„ :. Property of the New York State Department of Health. Certificates are valid only at the address shown,must be conspicuously posted,and are printed on secure paper. Continued accreditation depends on successful ongoing participation in the Program: Consumers are urged to call(518)485-5570 to — Al - verify the'labbratorys accredltation.status. pp� Page 1 of 1 IT NEW YORK STATE DEPARTMENT 0 HEALTH:'* WADSWORTN CENTER _2023z�j�*pirecu:01 AM A ptil 01� Usiudd--A Dell 61. 2&2 -OF APPROVAL FOR LABORATORY CERTIFICATE-OF SERVICE Issubdin accordiince with and pursuant to section 502 Pubfic Health`Law of New Yolk-sidti? DR.—TIANBAO BAI- NY Lab Id No: 1204 oo EUROFINS CEI, 730 SE MAYNARD ROAD CAM N' C 275TI -Environmonta1Lq0orqtbiy thr the catiggizry ---�A.herebvAPPROVEUas an; ENVIRONMENTAL ANALYSES SOLID AND HAZARDOUS WASTE-= AI qoprqvvd su4categodes-andlorzmalytes are listed below. _Miscellaneous Asbestos In Ffi6ble MaterlaF item 198.1 of Manual— Asbefts ln*Nbn'-Friable Material-PLM 198A of Manual(MOB by PLM).. Asbestos In Non-Friable Material-TEM Item 198.4 of Manual Asbesf6g-Vermiculite-Contdfnitig Matedal Item 198.8 of Manual Serial No.-!:,64946 only at thiaddress�=P M party—of-ft New York State Department Hea'Iffi. -Ce M to ate a are valid "Mr.me IMPq -and are printed on secure paper. Continued accreditation shown;must be.ronspIcuously posted. depends n suoqpqsful on ping parOdpatop In the Program.-Consumers are urged to call 518y485-55?A verify Page 1 of I 236:12.1.82 a` s 1 x — }` CA.) � q , rrtzA � Y o `1 � m R7 3 N 8 9 x V� cn to to m�� n o H A A m 4 _ R A � Im y mnN I �T8daa Y9�M ix7p © !a'f��m m�ip ov m.o•� jl�-.N I waml., o,mlm•.'" i'""m�" �mtm..;, I ryaoo �aam:. 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