Abatement DocumentationSUBMITTAL COVER SHEET VMJR Project No.:8-22-202
Contractor:VMJR Companies, LLC.
73 Mohican Street
Glens Falls, NY 12801
(518) 792-1128
Project Description: (Project Title, Facility Name and Address)
Renovations and Alterations to 68 Quaker Road
68 Quaker Road, Queensbury, NY 12804
DASNY JDE #: 3612709999
Voluntary Provider:
Addictions Care Center of Albany, Inc.
Date: 6/24/2022
TO:FROM:
Cayla Walter, architecture +Brian J. Blake, VMJR Companies
Brian Barker, architecture +
Subcontractor / Material Supplier: STAR ROOFING
SUBMITTAL TYPE:
General Data Re-Submittal Information (Waiver)
Additional Notes: Please see attached
submittal containing Asbestos Abatement
Pre Work Submittals.
Product Data Shop Drawings Quality Control/Assurance
Test Reports Certificate Contract Closeout
Design Data Samples Other
Submittal Number and Title: 02 82 00-01(R1) Roof Abatement Pre Work Submittals
Part Type Description
028200 1.4A Pre Work Submittal Package
Contractor’s Certification:
All material and documentation contained within this submittal, meets all the requirements specified or shown to the best of our knowledge.
Brian J. Blake, Project Manager
Contractor/Contractor’s Representative (Print Name)
Brian J. Blake
Signature
C&C Unlimited, Inc.
6 Simmons Lane
Albany, NY 12204
518.729.5641 Office
May 18, 2022
Asbestos Project Occupant Notice
1.Owner – Addictions Care Center of Albany, Inc.
2.DASNY Project No. – 3612709999
3.NYS DOL Regional Office – NYS Department of Labor, Building 12, W.A. Harriman Campus
Albany, NY 12226
4.DASNY Project Manager and Number – Tony Casso, Jr. (518) 378-7847
Material to remove and dispose:
<30 SF of Roof Sealant
Removal dates: Week of 6/27/22
Location:68 Quaker Road, Queensbury, NY
Abatement Contractor:C&C Unlimited Inc. – 6 Simmons Lane Albany, NY
Asbestos License:# 08 – 41805
Project Monitor/Air monitor:Alpine Environmental Services
Address: 438 New Karner Rd, Albany, NY 12205
Phone: (518) 250-4047
License No.: 29095
Laboratory: Alpine Environmental Services
ELAP No.: 11740
Note: This posting is required by the New York State Department of Labor Code Rule 56. The
removal of this posting prior to the completion of the project is in violation of the rules and
regulations set therein.
C&C Unlimited, inC.
6 Simmons Lane
Albany, NY 12204
C&C Unlimited, Inc. – Asbestos Abatement Work Plan
Project:
ACCA - 68 Quaker Road, Queensbury, New York 12804
(DASNY Project Number 361270)
Scope of work:
30 SF of Black Roof Penetration Sealant
Abatement Description:
• Work will be performed in accordance with Industrial Code Rule 56.
• Work area will be isolated from the general public and other parts of the building.
• ACM removal will take place using a three-chamber decontamination unit including clean room, dirty
room and showers. Outside openings within 25 feet of the work area will be sealed with two sheet plastic
barriers of 6 mil in thickness.
• Polyethylene sheeting will be used as a drop cloth on the ground, around perimeter of building to catch
falling debris, as necessary.
• Warning signs and barrier tape will be posted around the work area.
• Amended water will be used to reduce fiber release.
• ACM will be double bagged into 6-mil polyethylene bags. ACM waste material will be labeled as per
various requirements including generator labels. Waste will be manifested and trucked to our facility
where the waste will be placed into a closed asbestos waste trailer and disposed as asbestos waste. All
waste will be manifested prior to shipment.
• The area will be fine cleaned by HEPA Vacuuming and wet wiping, as necessary.
• Secure visual as required by 3rd party Monitoring Company.
The following work practices will also be utilized in the work area as additional required safety measures:
Our company promotes a safe workplace, free of accidents, by the use a safety meeting among the working crew
every day before the start of the workday. Before the beginning of every workday our team will perform a safety
meeting to discuss the day’s tasks and goals and the safety measures to be taken to accomplish the day’s goals safely.
Personal Protection Equipment (PPE) and Use:
Once work commences, no one will enter the work area without wearing as a minimum the following personal
protective equipment: ½ face respirator equipped with HEPA filters and fitted to each individual person, full body
disposable suit equipped with a hood, safety glasses and hard hats. Laborers are further required to wear gloves
and ear protection inside the work area. The use of harnesses/fall protection will be utilized for this project as well.
C&C Unlimited, inC.
6 Simmons Lane
Albany, NY 12204
Decontamination Process:
Anyone who enters work area shall follow the following decontamination process to exit work area: Before entering
Equipment room HEPA vacuum disposable suits thoroughly to ensure no visible ACM debris, proceed to equipment
room and, without removing the respirator, remove safety glasses and hard hat and wet wipe and place inside the
shower. Remove disposable suit and place in ACM bag for disposal. Proceed to walk into the shower wearing
respirator, filters covered, or remove filters once in the shower and place HEPA filters inside ACM bag in the
equipment room for disposal. Clean respirator, glasses, hardhat and finish showering thoroughly. Proceed to clean
room, dry all equipment and finish dressing. Stow respirator into a protective bag for re-use.
Daily Containment Inspections:
Our competent person and crew will inspect the containment for breaches and damages prior to the removal of any
ACM on a daily basis. Any deficiencies are to be resolved before proceeding with any ACM removal activities.
Disposal:
Waste Hauler: SM Gallivan – 98 Niver Street, Cohoes, NY 12047
NYS DEC or EPA Permit Number: 4A-639
Disposal Facility: Green Ridge Landfill – 424 Peters Road, Gansevoort, NY 12831
Air Monitoring:
Air monitoring by 3rd party monitoring company is not needed for this project due to exterior abatement work.
Only final visual by 3rd party monitoring company is needed.
C&C Unlimited, Inc. will assume the responsibility of all OSHA required Personnel Monitoring. Personal air
sampling will be conducted daily during the abatement of asbestos by a 3rd party Monitoring Company and sent to:
Spectrum Environmental Associates, Inc.
2539 Albany St, Schenectady, NY 12304
(518) 346-6374
License No. 28464
ELAP No. 11540
Final Cleaning:
C&C Unlimited, Inc. will remove all visible accumulations of asbestos material and debris. All surfaces within the
Work Area will be cleaned to a condition of no visible debris. If the Project Monitor finds visible accumulations of
dust or bulk asbestos containing materials in the work area, C&C Unlimited, Inc. will repeat the cleaning until the
work area is in compliance.
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
C&C Unlimited, Inc.
P.O. Box 1151
Latham, NY 12110
FILE NUMBER: 08-41805
LICENSE NUMBER: 41805
LICENSE CLASS: FULL
DATE OF ISSUE: 11/15/2021
EXPIRATION DATE: 11/30/2022
Duly Authorized Representative Chris A Macdonald:
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 to suspension or revocation for a (1)
serious violation of state, federal or local laws with regard to the conduct of an asbestos 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.
Amy Phillips, Director
SH 432 (8/12)For the Commissioner of Labor
Fw: asbestos handling license->wia_8184807633591484470.pdf
->Message_16415895479681.JPG
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DIVISION OF MATERIALS MANAGEMENT
PART 364
WASTE TRANSPORTER PERMIT NO. 4A-639
Pursuant to Article 27 ,Titles 3 and 15 of the Environmental Conservation Law and 6 NYCRR 364
PERMIT ISSUED TO: PERMIT TYPE:
SM GALLIVAN, LLC
9 CRABAPPLE LANE
WATERVLIET, NY 12189
NEW
RENEWAL
MODIFICATION
CONTACT NAME:
COUNTY:
TELEPHONE NO:
SHAWN SEABURY
ALBANY
(518)271-6100
EFFECTIVE DATE:
EXPIRATION DATE:
US EPA ID NUMBER:
11/15/2021
11/14/2022
AUTHORIZED WASTE TYPES BY DESTINATION FACILITY:
The Permittee is Authorized to Transport the Following Waste Type(s) to the Destination Facility listed :
Destination Facility Location Waste Type(s) Note
Albany (City) SWMF Albany , NY Non-Hazardous Industrial/Commercial
Asbestos
Petroleum Contaminated Soil
Colonie (T) SWMF Colonie , NY Non-Hazardous Industrial/Commercial
Petroleum Contaminated Soil
Dunn C&D LF Rensselaer , NY Non-Hazardous Industrial/Commercial
ESMI of New York Fort Edward , NY Non-Hazardous Industrial/Commercial
Petroleum Contaminated Soil
Fulton County Landfill Johnstown , NY Non-Hazardous Industrial/Commercial
Asbestos
Waste Tires
Green Ridge RDF Gansevoort , NY Non-Hazardous Industrial/Commercial
Asbestos
High Acres Western Expansion Landfill Fairport , NY Non-Hazardous Industrial/Commercial
Petroleum Contaminated Soil
Hyland Landfill Angelica , NY Asbestos
Petroleum Contaminated Soil
Oneida-Herkimer Solid Waste Authority -
Leland Ave. Ext.
Utica , NY Non-Hazardous Industrial/Commercial
Ontario County Sanitary Landfill Stanley , NY Non-Hazardous Industrial/Commercial
Asbestos
*** AUTHORIZED WASTE TYPES BY DESTINATION FACILITY LISTING (continued on next page) ***
NOTE: By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the Environmental
Conservation Law, all applicable regulations, and the General Conditions printed on the back of this page.
ADDRESS:New York State Department of Environmental Conservation
Division of Materials Management - Waste Transporter Program
625 Broadway, 9th Floor
Albany, NY 12233-7251
AUTHORIZED SIGNATURE: ___________________________________ Date:_____/_____/_____
PAGE 1 OF 3
WASTE TRANSPORTER PERMIT
GENERAL CONDITIONS
The permittee must:
1. Carry a copy of this waste transporter permit in each vehicle used to transport waste. Failure to produce a
copy of the permit upon request is a violation of the permit.
2. Display the full name of the transporter on both sides of each vehicle and display the waste transporter
permit number on both sides and rear of each vehicle containing waste. The displayed name and permit
number must be in characters at least three inches high and of a color that contrasts sharply with the
background.
3. Transport waste only in authorized vehicles. An authorized vehicle is one that is listed on this permit.
4. Submit to the Department a modification application for additions/deletions to the authorized fleet of
vehicles. The permittee must wait for a modified permit before operating the vehicles identified in the
modification application.
5. Submit to the Department a modification application to add a new waste category or a new destination
facility, or to change the current waste or destination facility category. The permittee must wait for a
modified permit before transporting new waste types or transporting to new destination facilities.
6. Submit to the Department a modification application for any change to the permit.
7. Comply with requirements for placarding and packaging as set forth in New York State Transportation Law
as well as any applicable federal rules and regulations.
8. Contain all wastes in the vehicle so there is no leaking, blowing, or other discharge of waste.
9. Use vehicles to transport only materials not intended for human or animal consumption unless the vehicle
is properly cleaned.
10. Comply with requirements for manifesting hazardous waste, regulated medical waste, or low level
radioactive waste as set forth in the New York State Environmental Conservation Law and the
implementing regulations. Transporters who provide a pre printed manifest to a generator/shipper/
offeror of regulated waste shall ensure that all information is correct and clearly legible on all copies of
the manifest.
11. Deliver waste only to transfer, storage, treatment and disposal facilities authorized to accept such waste.
Permittee must demonstrate that facilities are so authorized if requested to do so.
12. Maintain liability insurance as required by New York State Environmental Conservation Law.
13. Maintain records of the amount of each waste type transported to each destination facility on a calendar
year basis. The transporter is obligated to provide a report of this information to the Department by
March 1 of each year.
14. Pay regulatory fees on an annual basis. Non payment may be cause for revocation or suspension of
permit.
15. This permit is not transferrable. A change of ownership will invalidate this permit.
16. This permit does not relieve the permittee from the obligation to obtain any other approvals or permits,
or from complying with any other applicable federal, state, or local requirement.
17. Renewal applications must be submitted no less than 30 days prior to the expiration date of the permit
to:
New York State Department of Environmental Conservation
Division of Materials Management, Waste Transporter Program
625 Broadway, 9
th Floor
Albany, NY 12233 7251
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DIVISION OF MATERIALS MANAGEMENT
PART 364
WASTE TRANSPORTER PERMIT NO. 4A-639
Pursuant to Article 27 ,Titles 3 and 15 of the Environmental Conservation Law and 6 NYCRR 364
PERMIT ISSUED TO: PERMIT TYPE:
SM GALLIVAN, LLC
9 CRABAPPLE LANE
WATERVLIET, NY 12189
NEW
RENEWAL
MODIFICATION
CONTACT NAME:
COUNTY:
TELEPHONE NO:
SHAWN SEABURY
ALBANY
(518)271-6100
EFFECTIVE DATE:
EXPIRATION DATE:
US EPA ID NUMBER:
11/15/2021
11/14/2022
AUTHORIZED WASTE TYPES BY DESTINATION FACILITY: (Continued)
The Permittee is Authorized to Transport the Following Waste Type(s) to the Destination Facility listed :
Destination Facility Location Waste Type(s) Note
Ontario County Sanitary Landfill Stanley , NY Petroleum Contaminated Soil
Waste Tires
Seneca Meadows LF Waterloo , NY Non-Hazardous Industrial/Commercial
Asbestos
Waste Tires
PAGE 2 OF 3
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DIVISION OF MATERIALS MANAGEMENT
PART 364
WASTE TRANSPORTER PERMIT NO. 4A-639
Pursuant to Article 27 ,Titles 3 and 15 of the Environmental Conservation Law and 6 NYCRR 364
PERMIT ISSUED TO: PERMIT TYPE:
SM GALLIVAN, LLC
9 CRABAPPLE LANE
WATERVLIET, NY 12189
NEW
RENEWAL
MODIFICATION
CONTACT NAME:
COUNTY:
TELEPHONE NO:
SHAWN SEABURY
ALBANY
(518)271-6100
EFFECTIVE DATE:
EXPIRATION DATE:
US EPA ID NUMBER:
11/15/2021
11/14/2022
AUTHORIZED VEHICLES:
The Permittee is Authorized to Operate the Following Vehicles to Transport Waste:
(Vehicles enclosed in <>'s are authorized to haul Residential Raw Sewage and/or Septage only)
22 (Twenty Two) Permitted Vehicle(s)
NY 1214D5
NY 1215D5
NY 12214PF
NY 18366PF
NY 18367PF
NY 3103C3
NY 3113D6
NY 3169C3
NY 3185C3
NY 3194C3
NY 3212C3
NY 3217C3
NY 3227C3
NY 3287C3
NY 63303PC
NY 63312PC
NY 63331PC
NY 72198PC
NY 78132PC
NY 82356PC
NY 82358PC
NY CB57034
End of List
PAGE 3 OF 3
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
PERMIT
Under the Environmental Conservation Law (ECL)
Permittee and Facility Information
Permit Issued To:Facility:
Waste Management - Green Ridge RDF LLC GREEN RIDGE RDF
424 Peters Rd PETERS RD & KOBOR RD
Gansevoort, NY 12831 GANSEVOORT, NY 12831
(518) 636-2141
Facility Location: in NORTHUMBERLAND in SARATOGA COUNTY
Facility Principal Reference Point: NYTM-E: 613.206 NYTM-N: 4784.236
Latitude: 43°12'08.7" Longitude: 73°36'23.5"
Authorized Activity: Construction and operation of a municipal solid waste (MSW) landfill and
operation of an industrial waste (paper sludge) landfill in accordance with 6 NYCRR Part 360 and the
attached permit conditions. The maximum waste acceptance rate for the two landfills is a cumulative of
275,000 tons per calendar year. The approved design capacity, as defined in Part 360.2(b)(14), is 1,500
tons per day. The municipal solid waste consolidated landfill is authorized to accept: municipal solid
waste, dewatered and stabilized sewage sludge, paper sludge from the Finch Paper and Irving Paper
mills, construction and demolition debris including asbestos, non-hazardous contaminated soils and
industrial waste (on a case by case basis with prior written Department approval). The industrial waste
landfill is authorized to accept paper sludge from the Finch Paper and Irving Paper mills. This is a
modification of the permit to include a variance from Part 363-6.6(a)(2)(ii) for the overlay liner of Phase
4B, see solid waste management permit condition 14(c).
Permit Authorizations
Solid Waste Management - Under Article 27, Title 7
Permit ID 5-4146-00018/00010
Renewal Effective Date: 3/22/2021 Expiration Date: 3/21/2031
NYSDEC Approval
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict
compliance with the ECL, all applicable regulations, and all conditions included as part of this
permit.
Permit Administrator:BETH A MAGEE, Deputy Permit Administrator
Address: NYSDEC Region 5 Warrensburg Sub-Office
232 Golf Course Rd
Warrensburg, NY 12885
Authorized Signature: ______________________________________ Date ___/____/____
Page 1 of 8
3 22 21
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
Permit Components
SOLID WASTE MANAGEMENT PERMIT CONDITIONS
GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
SOLID WASTE MANAGEMENT PERMIT CONDITIONS
1.Conformance With Plans All activities authorized by this permit must be in strict conformance
with the permit application, plans and materials prepared by the permittee or their consultant on the
dates listed below.
2.Permit Application Documents
Part 360 Permit Application (for the) Saratoga County Landfill, Volumes 1 and 2, dated March
1993 and prepared by Smith & Mahoney, P.C.; appended by a July 26, 1993 letter from Smith &
Mahoney, P.C.
Part 360 Permit Application (for the) SARATOGA COUNTY LANDFILL, Volumes 1 and 2, dated
February 1995, and prepared by Smith & Mahoney, P.C. This also includes 29 Engineering drawings
and 10 hydrogeologic drawings, prepared by Smith & Mahoney, P.C.
SARATOGA COUNTY PHASE I LANDFILL CELL CONSTRUCTION CONTRACT DRAWINGS –
RECORD DRAWINGS, dated June 26, 2000 and prepared by Malcolm Pirnie, Inc.
6 NYCRR Part 360 Permit Application (for the) Finch Waste Co. LLC Consolidated Landfill,
Volumes 1-3, dated September 2016 and prepared by CHA Consulting, Inc.
Engineering Drawings titled FINCH WASTE CO. LLC CONSOLIDATED LANDFILL, last revised
September 2016 and prepared by CHA Consulting, Inc. This includes the following sheets: G-001
through G-003; GT-001 through GT-006; GT-101 through GT-110; GT-201 through GT-203; GT-301
through GT-305; GT-401 through GT-406; GT-501; GT-601 through GT-606.
Part 360 Permit Modification Application (for the) Green Ridge RDF dated October 29, 2019 and
prepared by Finch Waste Co LLC.
October 29, 2019 letter to the Department RE: Request for Approval – Temporary Convenience
Station, which is an addendum to the Operations and Maintenance Manual of the 6 NYCRR Part 360
Permit Application (for the) Finch Waste Co. LLC Consolidated Landfill, Volume 3 Section 6, dated
September 2016.
Part 360 Permit Modification Application (for the) Green Ridge RDF dated April 2, 2020 and
prepared by Barton and Loguidice LLC.
Construction Quality Assurance / Construction Quality Control Manual (for the) Green Ridge RDF
dated April 2020 and prepared by Barton and Loguidice LLC.
May 14, 2020 letter to the Department RE: Supplemental Information to the April 2, 2020 Part 360
Permit Modification Application.
Facility Manual (for the) Green Ridge RDF updated January 2021 and prepared by Barton and
Page 2 of 8
Loguidice LLC.
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
3. Landfill Construction Requirements
A. Notification: The permittee shall notify the DEC [Region 5 sub-office, Warrensburg, (518) 623-
1200] at least five (5) days prior to:
i. Pre-Construction conference;
ii. Commencement of on-site construction;
iii. Commencement of soil liner placement;
iv. Commencement of geomembrane liner placement;
v. Commencement of testing of liner system leakage rate.
B. Future Construction of Phases 4 and 5 will require the following:
i. Construction drawings for each subsequent cell of landfill development shall be prepared and
submitted to the Department for review and approval. Upon approval of these construction
drawings, the permittee may begin construction. At the completion of construction, the permittee
shall submit a construction certification report, in accordance with 6NYCRR Part 363-6.19, to the
Department for approval. The construction certification report shall ensure that all construction of
the cell was performed in accordance with the Department approved construction drawings. The
ALR testing shall not be conducted while the ground is frozen;
ii. 60 days written notice of intent to initiate construction, including a schedule of construction
activities;
iii. Approval of the engineering plans and report by the Department if any substantive changes to the
approved documents are proposed;
iv. Subsequent landfill development must demonstrate compliance with the design, construction, and
closure/post closure requirements pursuant to the regulations in effect at the time of the subsequent
development. This includes an assessment of the need for additional leachate storage capacity
beyond what is presently provided due to leachate generation estimates. The leachate generation
estimate must be prepared in accordance with 6NYCRR Part 363-4.3(e)(1).
v. The construction notification requirements in special condition 3.a apply to each subsequent cell
construction.
Operation (placement of waste) in newly constructed cells shall not occur until the permittee has
received Department approval, in writing, of the construction certification report for that cell.
4. Existing Water Quality For landfill Phases 2, 3 and 4, four rounds of existing water quality data
will be obtained from monitoring wells MW-GL, MW-GI, MW-GB, MW-12L, MW-HL, MW-HI, MW-
HB, MW-RL, MW-RI, MW-RB, MW-TL, MW-TI and MW-TB. Sample collection and analysis will be
consistent with Section 5.2 of the Environmental Monitoring Plan, and the Additional Well Installation
and Testing Work Plan (Revised October 2020).
For landfill Phase 5, four rounds of existing water quality data will be obtained from monitoring
wells MW-LL, MW-JL, MW-JI, MW-JB, MW-KL, MW-OL, MW-QL, MW-AI and MW-AB.
Sample collection and analysis will be consistent with Section 5.2 of the Environmental Monitoring
Plan. At least 90 days prior to operation of Phase 5, the Permittee shall submit a report that
Page 3 of 8
interprets and evaluates the analytical data, and combines these results with the current existing
water quality database.
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
5. Operation Requirements
A. The operation of the facility shall be in strict conformance with the provisions of this permit, 6
NYCRR Part 360 series effective November 4, 2017 and the permit application documents (referenced
in condition #2 above). In the event of a conflict between any of the permit application documents
referenced in special condition #2, the most recent document shall control.
B. The permittee shall implement the Northern Harrier Mitigation Plan dated February 6, 1996, as
prepared by Beak Consultants Incorporated (the “Plan”). The Plan may be modified upon application of
the Permittee to the Department or upon request of the Department based upon changed conditions or
the determination that other areas of the site are more suitable for habitat. Any changes or revisions to
the Plan must first be approved by the Department.
By November 1 of each year for the life of this permit, the permittee shall provide to the
Department’s Office of Natural Resources, c/o the Region 5 Natural Resources Supervisor, a brief
report (“Annual Report”) detailing the following items:
i. Harrier Habitat - Status of activities to manage and maintain habitats for Northern Harriers as
required under the Saratoga County Landfill Northern Harrier Management Plan. This annual
report shall detail total acres presently under management for harriers, the type of vegetation
found in each field under management and activities such as mowing, cutting, planting, etc.
that took place on each field during the year in order to maintain and/or improve facility
property for Harrier nesting and hunting.
ii. Assessment of Use by Harriers - Personnel experienced in the identification of Northerner
Harriers shall conduct inspections of the mitigation site and facility area for the presence and
use of these areas by Northern Harriers. Such inspections shall occur during mid-May, early
and mid-June, early and mid-July, and early August of each year. A record of sightings will be
maintained which will include day, time of day, location, and type of harrier activity if any.
The locations of any sightings will be marked and maintained on a map. The Department shall
be immediately notified if any nesting pairs of harriers are identified. A copy of the inspection
logs and an assessment of the use of the area by harriers shall be provided to the Department in
the annual report.
6. Monitoring of the Pore Pressure Relief System
A. Pore pressure relief system outfalls listed in Table 2 of the Environmental Monitoring Plan
will be sampled and analyzed at the same frequency and for the same parameters as the
monitoring wells. If significant increases in water quality levels are detected, as defined in
Section 5.2.2 of the Environmental Monitoring Plan, the Permittee must initiate contingency
water quality monitoring and collect/treat this liquid.
B. All pore pressure relief system outfalls must remain free-flowing, unless written approval is
obtained from the Department.
Page 4 of 8
7. Potentiometric Surface Maps The Permittee shall submit updated potentiometric surface maps for
each monitoring horizon with each annual report. The maps must reflect seasonal high groundwater
conditions. Each annual report must also include a narrative that summarizes the effect of the landfill
and/or pore pressure relief system on groundwater elevations and flow patterns. This requirement may
be reduced at the Department’s discretion.
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
8. Groundwater Sampling for Dioxins/Furans The Permittee has requested and received
approval for a waiver from the requirement to analyze groundwater samples for dioxins and
furans, consistent with paragraph 360-2.11(d)(6). This waiver is based upon information
provided by the Permittee which demonstrates that dioxins and furans are not inherent in Finch
Paper Mill Sludge. If the Permittee elects to accept paper mill sludge from other sources, then
prior to acceptance of that sludge, either a separate waiver must be granted based on the
characteristics of the waste, or a representative number of monitoring wells (as approved by the
Department) must be sampled and analyzed for dioxins and furans.
9. Emerging Contaminants and Radionuclides In accordance with 6 NYCRR Part 363 and
Section 5.1.1 of the Environmental Monitoring Plan (EMP), if emerging contaminants are
detected in the facility’s primary leachate samples, a subset of groundwater monitoring wells
shall be proposed to the Department in the form of a work plan for sampling of PFAS, 1,4-
dioxane and radionuclides. The work plan shall be submitted as an amendment to the EMP and
include an implementation schedule to complete monitoring and establishment of EWQ trigger
values for those parameters. The implementation schedule shall be submitted within 180 days
from the day of permit issuance.
10. Repair/Replacement of Monitoring Wells Existing monitoring wells must be inspected
quarterly for evidence of damage. Quarterly reports must document the condition of all wells
and make recommendations for repair or replacement of wells as warranted.
11. Reports
A. An Annual Report, prepared in accordance with 6 NYCRR Part 360.19(k) and Part 363-8.2, must be
submitted to the Department no later than March 1 of each year for the prior calendar year’s operation.
B. An Environmental Monitoring Report, including all water quality monitoring results, must be
submitted to the Department within ninety (90) days after each scheduled quarterly sampling event.
12. Comprehensive Recycling Analysis (CRA)
A. The Permittee must not accept solid waste that originates in a municipality that has not
completed a Comprehensive Recycling Analysis (CRA) satisfying the requirements of 6 NYCRR
Part 360.11 unless, either another municipality prepares an approved CRA and the CRA
addresses the waste stream of that municipality, or a local solid waste management plan which
addresses 6 NYCRR Part 360.11 has been approved.
B. The Permittee must not accept solid waste that originates from a municipality that has not
implemented a recyclables recovery program detailed in an approved CRA or LSWMP.
13. Mandatory Source Separation The Permittee must not accept solid waste that originates
from a municipality that has not implemented a mandatory source separation law for recyclables.
Page 5 of 8
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
14. Variances
A. A variance from 6 NYCRR Part 363-6.3 with regard to the requirement for a minimum
separation of five (5) feet between the base of the constructed liner system and the seasonal high
groundwater table for the landfill is granted in accordance with 6 NYCRR Part 360.10.
B. A variance from 6 NYCRR Part 360.19(j) with regard to the allowable noise limits beyond
the property lines is granted in accordance with 6 NYCRR Part 360.10, if the Department is
presented with documentation, in the form of an approved site plan or a building permit, that a
residence is proposed to be constructed in an area that would likely be subject to noise exceeding
an hourly Leq of 57 dBA, the permittee must take whatever action necessary to mitigate noise
impacts so that sound impacts so that sound levels are maintained at or below that limit at the
residence and any associated area of frequent activity. The area of concern is defined at any
locations within 1,000 feet north or west of the landfill footprint. As the permittee moves out of
the Phase 1 footprint area, for which noise was projected, the Department may redefine this area
of concern.
C. A variance from 6 NYCRR Part 363-6.6(a)(2)(ii) with regard to the double composite liner
system, which requires, on slopes greater than 10% the secondary composite soil liner must meet
the requirements of subparagraph 363-6.6(a)(1)(ii) which requires a nominal 60 mil or thicker
HDPE geomembrane placed above and in direct and uniform contact with a minimum two-foot-
thick low-permeability soil layer that has a remolded hydraulic conductivity of 1x10-7
centimeters per second or less, is granted in accordance with 6 NYCRR Part 360.10. This
approval allows the low-permeability soil layer to be replaced by a geosynthetic clay liner (GCL)
on the overlay areas of the permitted Phase 4. Phase 5 will be evaluated separately.
15. Surety
The Permittee must maintain adequate surety or financial responsibility to ensure that the amount of
funds assured is sufficient to cover the cost of closure, post-closure care, and corrective action in
accordance with the requirements of 6 NYCRR Part 360.22. The Permittee shall maintain accurate and
current records which shall be available for inspection by DEC staff during normal business hours. In
accordance with 360.22(b)(3), the Permittee must annually adjust their closure cost estimates for
inflation and submit a copy of the adjusted estimate to the Department.
GENERAL CONDITIONS - Apply to ALL Authorized Permits:
1. Facility Inspection by The Department The permitted site or facility, including relevant records,
is subject to inspection at reasonable hours and intervals by an authorized representative of the
Department of Environmental Conservation (the Department) to determine whether the permittee is
complying with this permit and the ECL. Such representative may order the work suspended pursuant
to ECL 71- 0301 and SAPA 401(3).
The permittee shall provide a person to accompany the Department's representative during an inspection
to the permit area when requested by the Department.
Page 6 of 8
A copy of this permit, including all referenced maps, drawings and special conditions, must be available
for inspection by the Department at all times at the project site or facility. Failure to produce a copy of
the permit upon request by a Department representative is a violation of this permit.
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly
provided for by the Department, issuance of this permit does not modify, supersede or rescind any order
or determination previously issued by the Department or any of the terms, conditions or requirements
contained in such order or determination.
3. Applications For Permit Renewals, Modifications or Transfers The permittee must submit a
separate written application to the Department for permit renewal, modification or transfer of this
permit. Such application must include any forms or supplemental information the Department requires.
Any renewal, modification or transfer granted by the Department must be in writing. Submission of
applications for permit renewal, modification or transfer are to be submitted to:
Regional Permit Administrator
NYSDEC Region 5 Warrensburg Sub-Office
232 Golf Course Rd
Warrensburg, NY12885
4. Submission of Renewal Application The permittee must submit a renewal application at least 180
days before permit expiration for the following permit authorizations: Solid Waste Management.
5. Permit Modifications, Suspensions and Revocations by the Department The Department
reserves the right to exercise all available authority to modify, suspend or revoke this permit. The
grounds for modification, suspension or revocation include:
a. materially false or inaccurate statements in the permit application or supporting papers;
b. failure by the permittee to comply with any terms or conditions of the permit;
c. exceeding the scope of the project as described in the permit application;
d. newly discovered material information or a material change in environmental conditions,
relevant technology or applicable law or regulations since the issuance of the existing permit;
e. noncompliance with previously issued permit conditions, orders of the commissioner, any
provisions of the Environmental Conservation Law or regulations of the Department related to
the permitted activity.
6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or
another permit condition. Applications for permit transfer should be submitted prior to actual transfer of
ownership.
Page 7 of 8
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Facility DEC ID 5-4146-00018
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification
The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the
Department of Environmental Conservation of the State of New York, its representatives, employees,
and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the
permittee's acts or omissions in connection with the permittee’s undertaking of activities in connection
with, or operation and maintenance of, the facility or facilities authorized by the permit whether in
compliance or not in compliance with the terms and conditions of the permit. This indemnification does
not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or
intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under
Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision
under federal or state laws.
Item B: Permittee's Contractors to Comply with Permit
The permittee is responsible for informing its independent contractors, employees, agents and assigns of
their responsibility to comply with this permit, including all special conditions while acting as the
permittee's agent with respect to the permitted activities, and such persons shall be subject to the same
sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee.
Item C: Permittee Responsible for Obtaining Other Required Permits
The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-
way that may be required to carry out the activities that are authorized by this permit.
Item D: No Right to Trespass or Interfere with Riparian Rights
This permit does not convey to the permittee any right to trespass upon the lands or interfere with the
riparian rights of others in order to perform the permitted work nor does it authorize the impairment of
any rights, title, or interest in real or personal property held or vested in a person not a party to the
permit.
Page 8 of 8
SUBMITTAL COVER SHEET VMJR Project No.:8-22-202
Contractor:VMJR Companies, LLC.
73 Mohican Street
Glens Falls, NY 12801
(518) 792-1128
Project Description: (Project Title, Facility Name and Address)
Renovations and Alterations to 68 Quaker Road
68 Quaker Road, Queensbury, NY 12804
DASNY JDE #: 3612709999
Voluntary Provider:
Addictions Care Center of Albany, Inc.
Date: 3/30/2022
TO:FROM:
Cayla Walter, architecture +Brian J. Blake, VMJR Companies
Brian Barker, architecture +
Subcontractor / Material Supplier: MACFAWN ENTERPRISES
SUBMITTAL TYPE:
General Data Re-Submittal Information (Waiver)
Additional Notes: Please see attached
submittal containing
Product Data Shop Drawings Quality Control/Assurance
Test Reports Certificate Contract Closeout
Design Data Samples Other
Submittal Number and Title: 02 85 00-01 Mold Remediation Submittal Package
Part Type Description
1 PDF Work Plan
2 PDF Licenses
3 PDF Product Data
4 PDF SDS Sheets
Contractor’s Certification:
All material and documentation contained within this submittal, meets all the requirements specified or shown to the best of our knowledge.
Brian J. Blake, Project Manager
Contractor/Contractor’s Representative (Print Name)
Brian J. Blake
Signature
MacFawn Fire & Flood Restoration
NYS DOL License #00044
Project:VMJR, CRM-032122-012804 / 8-22-202 - ACCA - Quaker Rd. Queensbury
Location:68 Quaker Rd., Queensbury, NY 12804
Contact:Brian Blake
Assessor:Jeremy Fessette, Atlantic Testing Laboratories,Limited
Location within Property:Vestibule/Entry, Conference,Mech So., Mech No., Passage
Date Work to be Performed:3/31/22
Scope:
1.Set up warning signage on front door of building and on all full containment built
2.Vestibule/Entry
a.Place air scrubber in entry
b.Drape 6 Mil poly over window from top to bottom
c.Don applicable PPE
d.Remove rubber cove base from base of windows
e.Remove all rotten wooden sill
f.Place all affected materials in 6 Mil bag for disposal
g.HEPA vac entire working space
h.Apply antimicrobial to affected area and clean
i.HEPA vac entire working space
j.Apply encapsulate to remaining wood sill
3.Conference
a.Place air scrubber near work area
b.Don applicable PPE
c.Place 6 Mil poly over affected drywall and tape in place
d.Cut drywall outside perimeter of poly area
e.Place in 6 Mil bag for disposal
f.HEPA vac working area
g.Apply antimicrobial to affected area and clean
h.HEPA vac affected area
i.Apply encapsulate to affected area
4.Mechanical South
a.Place air scrubber near work area
b.Don applicable PPE
c.Place 6 Mil poly over affected drywall and tape in place
d.Cut drywall outside perimeter of poly area
e.Place in 6 Mil bag for disposal
f.HEPA vac working area
g.Apply antimicrobial to affected area and clean
h.HEPA vac affected area
i.Apply encapsulate to affected area
5.Mechanical North
a.Poly off doorway
b.Establish negative air pressure
c.Don applicable PPE
d.Remove ceiling and left side wall with water staining drywall
e.Place in 6 Mil bag for disposal
f.HEPA vac entire work area
g.Apply antimicrobial to affected areas and clean
h.HEPA vac entire work area
i.Apply encapsulate to affected area
6.Passage
a.Built 4FTx4FT chamber
b.Establish negative air pressure
c.Don applicable PPE
d.Remove affected drywall from ceiling
e.HEPA vac entire work area
f.Apply antimicrobial to affected area and clean
g.HEPA vac entire work area
h.Apply encapsulate to affected area
7.Decontamination and break down of containment
Extra Work Performed:
●N/A
Disclaimers:
Clearance testing results can not be guaranteed if containment is broken by unauthorized persons.
MacFawn Enterprises Inc. is not liable for air quality and testing results of affected and unaffected areas
after given clearance by a NYS license mold assessor and completion of the agreed upon scope of the
project.
NEW YORK STATE - DEPARTMENT OF LABOR
DIVISION OF SAFETY AND HEALTH
LICENSE AND CERTIFICATE UNIT
STATE CAMPUS BUILDING 12
LICENSE NUMBER 00044
DATE OF ISSUE:12/12/2019
EXPIRATION DATE 12/31/2021
This license is valid only for the contractor named above.
Eileen Franko, Director
FOR THE COMMISSIONER OF LABOR
Mold Remediator Company License
MacFawn Enterprises, Inc.
PO Box 13205
Albany, NY 12212
Note: The hazard category numbers found in GHS classification in section 2 of this
SDSs are NOT to be used to fill in the NFPA 704 diamond. Blue = Health Red =
Fire Yellow = Reactivity White = Special (Oxidizer or water reactive substances)
Fiberlock AfterShock (white) 8390
ICP Construction
Version No: 8.12
Safety Data Sheet according to OSHA HazCom Standard (2012) requirements
Issue Date: 06/21/2018
Print Date: 06/21/2018
S.GHS.USA.EN
SECTION 1 IDENTIFICATION
Product Identifier
Product name Fiberlock AfterShock (white) 8390
Synonyms Not Available
Other means of identification Not Available
Recommended use of the chemical and restrictions on use
Relevant identified uses Mold Remediation Coating
Name, address, and telephone number of the chemical manufacturer, importer, or other responsible party
Registered company name ICP Construction
Address 150 Dascomb Road Andover MA United States
Telephone 978-623-9980
Fax Not Available
Website http://www.icp-construction.com/
Email Not Available
Emergency phone number
Association / Organisation Chemtel
Emergency telephone numbers 1-800-255-3924
Other emergency telephone
numbers 1-813-248-0585
SECTION 2 HAZARD(S) IDENTIFICATION
Classification of the substance or mixture
Classification Skin Sensitizer Category 1, Carcinogenicity Category 1A, Acute Aquatic Hazard Category 2, Chronic Aquatic Hazard Category 2
Label elements
Hazard pictogram(s)
SIGNAL WORD DANGER
Hazard statement(s)
H317 May cause an allergic skin reaction.
H350 May cause cancer.
H411 Toxic to aquatic life with long lasting effects.
Hazard(s) not otherwise specified
Continued...
Not Applicable
Precautionary statement(s) General
P101 If medical advice is needed, have product container or label at hand.
P102 Keep out of reach of children.
Precautionary statement(s) Prevention
P201 Obtain special instructions before use.
P280 Wear protective gloves/protective clothing/eye protection/face protection.
Precautionary statement(s) Response
P308+P313 IF exposed or concerned: Get medical advice/attention.
P363 Wash contaminated clothing before reuse.
Precautionary statement(s) Storage
P405 Store locked up.
Precautionary statement(s) Disposal
P501 Dispose of contents/container in accordance with local regulations.
SECTION 3 COMPOSITION / INFORMATION ON INGREDIENTS
Substances
See section below for composition of Mixtures
Mixtures
CAS No %[weight]Name
57-55-6 1.24
1317-70-0 5-15
1309-48-4.<1
1897-45-6 <1
The specific chemical identity and/or exact percentage (concentration) of composition has been withheld as a trade secret.
SECTION 4 FIRST-AID MEASURES
Description of first aid measures
Eye Contact
If this product comes in contact with eyes:
Wash out immediately with water.
If irritation continues, seek medical attention.
Removal of contact lenses after an eye injury should only be undertaken by skilled personnel.
Skin Contact
If skin contact occurs:
Immediately remove all contaminated clothing, including footwear.
Flush skin and hair with running water (and soap if available).
Seek medical attention in event of irritation.
Inhalation If fumes, aerosols or combustion products are inhaled remove from contaminated area.
Other measures are usually unnecessary.
Ingestion Immediately give a glass of water.
First aid is not generally required. If in doubt, contact a Poisons Information Centre or a doctor.
Most important symptoms and effects, both acute and delayed
See Section 11
Indication of any immediate medical attention and special treatment needed
Treat symptomatically.
SECTION 5 FIRE-FIGHTING MEASURES
Extinguishing media
Jets of water.
Water spray or fog.
Special hazards arising from the substrate or mixture
Fire Incompatibility None known.
Special protective equipment and precautions for fire-fighters
propylene glycol
titanium dioxide (anatase)
magnesium oxide
chlorothalonil
Chemwatch: 9-298663
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Ingredient Material name TEEL-1 TEEL-2 TEEL-3
Fire Fighting Alert Fire Brigade and tell them location and nature of hazard.
Wear breathing apparatus plus protective gloves in the event of a fire.
Fire/Explosion Hazard
Non combustible.
Not considered a significant fire risk, however containers may burn.
May emit corrosive fumes.
SECTION 6 ACCIDENTAL RELEASE MEASURES
Personal precautions, protective equipment and emergency procedures
See section 8
Environmental precautions
See section 12
Methods and material for containment and cleaning up
Minor Spills
Environmental hazard - contain spillage.
Clean up all spills immediately.
Avoid breathing vapours and contact with skin and eyes.
Major Spills
Clear area of personnel and move upwind.
Alert Fire Brigade and tell them location and nature of hazard.
Environmental hazard - contain spillage.
Personal Protective Equipment advice is contained in Section 8 of the SDS.
SECTION 7 HANDLING AND STORAGE
Precautions for safe handling
Safe handling
Avoid all personal contact, including inhalation.
Wear protective clothing when risk of exposure occurs.
DO NOT allow clothing wet with material to stay in contact with skin
Other information
Conditions for safe storage, including any incompatibilities
Suitable container Polyethylene or polypropylene container.
Packing as recommended by manufacturer.
Storage incompatibility
Titanium dioxide
reacts with strong acids, strong oxidisers
reacts violently with aluminium, calcium, hydrazine, lithium (at around 200 deg C.), magnesium, potassium, sodium, zinc, especially at elevated
temperatures - these reactions involves reduction of the oxide and are accompanied by incandescence
dust or powders can ignite and then explode in a carbon dioxide atmosphere
None known
SECTION 8 EXPOSURE CONTROLS / PERSONAL PROTECTION
Control parameters
OCCUPATIONAL EXPOSURE LIMITS (OEL)
INGREDIENT DATA
Source Ingredient Material name TWA STEL Peak Notes
US NIOSH Recommended
Exposure Limits (RELs)
titanium dioxide
(anatase)
Rutile, Titanium oxide, Titanium
peroxide
Not
Available
Not
Available
Not
Available Ca See Appendix A
US ACGIH Threshold Limit Values
(TLV)
titanium dioxide
(anatase)Titanium dioxide 10 mg/m3 Not
Available
Not
Available TLV® Basis: LRT irr
US OSHA Permissible Exposure
Levels (PELs) - Table Z1
titanium dioxide
(anatase)Titanium dioxide: Total dust 15 mg/m3 Not
Available
Not
Available Not Available
US NIOSH Recommended
Exposure Limits (RELs)magnesium oxide Magnesia fume Not
Available
Not
Available
Not
Available See Appendix D
US ACGIH Threshold Limit Values
(TLV)magnesium oxide Magnesium oxide 10 mg/m3 Not
Available
Not
Available
TLV® Basis: URT; metal fume
fever
US OSHA Permissible Exposure
Levels (PELs) - Table Z1 magnesium oxide Magnesium oxide fume: Total
particulate 15 mg/m3 Not
Available
Not
Available Not Available
EMERGENCY LIMITS
propylene glycol Polypropylene glycols 30 mg/m3 330 mg/m3 2,000 mg/m3
propylene glycol Propylene glycol; (1,2-Propanediol)30 mg/m3 1,300 mg/m3 7,900 mg/m3
titanium dioxide (anatase)Titanium oxide; (Titanium dioxide)30 mg/m3 330 mg/m3 2,000 mg/m3
magnesium oxide Magnesium oxide 30 mg/m3 120 mg/m3 730 mg/m3
chlorothalonil Chlorothalonil; (Tetrachloroisophthalonitrile)0.13 mg/m3 1.4 mg/m3 8.6 mg/m3
Chemwatch: 9-298663
Version No: 8.12
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Fiberlock AfterShock (white) 8390
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Continued...
Ingredient Original IDLH Revised IDLH
propylene glycol Not Available Not Available
titanium dioxide (anatase)5000 mg/m3 Not Available
magnesium oxide 750 mg/m3 Not Available
chlorothalonil Not Available Not Available
Exposure controls
Appropriate engineering
controls
Engineering controls are used to remove a hazard or place a barrier between the worker and the hazard. Well-designed engineering controls can be
highly effective in protecting workers and will typically be independent of worker interactions to provide this high level of protection.
Personal protection
Eye and face protection Safety glasses with side shields.
Chemical goggles.
Skin protection See Hand protection below
Hands/feet protection
Wear chemical protective gloves, e.g. PVC.
Wear safety footwear or safety gumboots, e.g. Rubber
NOTE:
The material may produce skin sensitisation in predisposed individuals. Care must be taken, when removing gloves and other protective equipment, to
avoid all possible skin contact.
The selection of suitable gloves does not only depend on the material, but also on further marks of quality which vary from manufacturer to manufacturer.
Where the chemical is a preparation of several substances, the resistance of the glove material can not be calculated in advance and has therefore to be
checked prior to the application.
Body protection See Other protection below
Other protection
Employees working with confirmed human carcinogens should be provided with, and be required to wear, clean, full body protective clothing (smocks,
coveralls, or long-sleeved shirt and pants), shoe covers and gloves prior to entering the regulated area. [AS/NZS ISO 6529:2006 or national equivalent]
Employees engaged in handling operations involving carcinogens should be provided with, and required to wear and use half-face filter-type respirators
with filters for dusts, mists and fumes, or air purifying canisters or cartridges.
Prior to each exit from an area containing confirmed human carcinogens, employees should be required to remove and leave protective clothing and
equipment at the point of exit and at the last exit of the day, to place used clothing and equipment in impervious containers at the point of exit for purposes
of decontamination or disposal. The contents of such impervious containers must be identified with suitable labels.
Overalls.
P.V.C.
Respiratory protection
SECTION 9 PHYSICAL AND CHEMICAL PROPERTIES
Information on basic physical and chemical properties
Appearance Not Available
Physical state Liquid Relative density (Water = 1)Not Available
Odour Not Available Partition coefficient n-octanol /
water Not Available
Odour threshold Not Available Auto-ignition temperature (°C)Not Available
pH (as supplied)8.5 Decomposition temperature Not Available
Melting point / freezing point
(°C)Not Available Viscosity (cSt)Not Available
Initial boiling point and boiling
range (°C)Not Available Molecular weight (g/mol)Not Available
Flash point (°C)Not Available Taste Not Available
Evaporation rate Not Available Explosive properties Not Available
Flammability Not Available Oxidising properties Not Available
Upper Explosive Limit (%)Not Available Surface Tension (dyn/cm or
mN/m)Not Available
Lower Explosive Limit (%)Not Available Volatile Component (%vol)Not Available
Vapour pressure (kPa)Not Available Gas group Not Available
Solubility in water (g/L)Immiscible pH as a solution (1%)Not Available
Vapour density (Air = 1)Not Available VOC g/L Not Available
SECTION 10 STABILITY AND REACTIVITY
Reactivity See section 7
Chemical stability Unstable in the presence of incompatible materials.
Product is considered stable.
Possibility of hazardous
reactions See section 7
Chemwatch: 9-298663
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Conditions to avoid See section 7
Incompatible materials See section 7
Hazardous decomposition
products See section 5
SECTION 11 TOXICOLOGICAL INFORMATION
Information on toxicological effects
Inhaled The material is not thought to produce adverse health effects or irritation of the respiratory tract (as classified by EC Directives using animal models).
Nevertheless, good hygiene practice requires that exposure be kept to a minimum and that suitable control measures be used in an occupational setting.
Ingestion
Ingestion of propylene glycol produced reversible central nervous system depression in humans following ingestion of 60 ml. Symptoms included increased
heart-rate (tachycardia), excessive sweating (diaphoresis) and grand mal seizures in a 15 month child who ingested large doses (7.5 ml/day for 8 days) as
an ingredient of vitamin preparation.
The material has NOT been classified by EC Directives or other classification systems as "harmful by ingestion". This is because of the lack of
corroborating animal or human evidence.
Skin Contact
Skin contact is not thought to have harmful health effects (as classified under EC Directives); the material may still produce health damage following entry
through wounds, lesions or abrasions.
There is some evidence to suggest that this material can cause inflammation of the skin on contact in some persons.
Eye Although the liquid is not thought to be an irritant (as classified by EC Directives), direct contact with the eye may produce transient discomfort
characterised by tearing or conjunctival redness (as with windburn).
Chronic
Skin contact with the material is more likely to cause a sensitisation reaction in some persons compared to the general population.
There is sufficient evidence to suggest that this material directly causes cancer in humans.
Propylene glycol is thought to be sensitizing following the regular use of topical creams by eczema patients. Testing in humans showed that 16% of
exposed individuals, irritation occurred, with 12.5% showing toxic or allergic reactions.
Fiberlock AfterShock (white)
8390
TOXICITY IRRITATION
Not Available Not Available
propylene glycol
TOXICITY IRRITATION
Dermal (rabbit) LD50: 11890 mg/kg[2]Eye (rabbit): 100 mg - mild
Oral (rat) LD50: 20000 mg/kg[2]Eye (rabbit): 500 mg/24h - mild
Skin(human):104 mg/3d Intermit Mod
Skin(human):500 mg/7days mild
titanium dioxide (anatase)
TOXICITY IRRITATION
Inhalation (rat) LC50: >2.28 mg/l4 h[1]Not Available
Oral (rat) LD50: >2000 mg/kg [1]
magnesium oxide
TOXICITY IRRITATION
Not Available Not Available
chlorothalonil
TOXICITY IRRITATION
dermal (rat) LD50: >2500 mg/kg[2]Not Available
Inhalation (rat) LC50: 0.0775 mg/l/1h[2]
Oral (rat) LD50: 10000 mg/kg[2]
Legend:1. Value obtained from Europe ECHA Registered Substances - Acute toxicity 2.* Value obtained from manufacturer's SDS. Unless otherwise specified
data extracted from RTECS - Register of Toxic Effect of chemical Substances
PROPYLENE GLYCOL The material may cause skin irritation after prolonged or repeated exposure and may produce on contact skin redness, swelling, the production of vesicles,
scaling and thickening of the skin.
TITANIUM DIOXIDE (ANATASE)Exposure to titanium dioxide is via inhalation, swallowing or skin contact. When inhaled, it may deposit in lung tissue and lymph nodes causing dysfunction
of the lungs and immune system.
CHLOROTHALONIL
Chlorothalonil has low toxicity, according to animal testing. It irritates the skin and eye.
WARNING: This substance has been classified by the IARC as Group 2B: Possibly Carcinogenic to Humans.
ADI: 0.01 mg/kg/day NOEL: 1.5 mg/kg/day
Fiberlock AfterShock (white)
8390 & MAGNESIUM OXIDE &
CHLOROTHALONIL
The following information refers to contact allergens as a group and may not be specific to this product.
Contact allergies quickly manifest themselves as contact eczema, more rarely as urticaria or Quincke's oedema.
Fiberlock AfterShock (white)
8390 & PROPYLENE GLYCOL
The acute oral toxicity of propylene glycol is very low; large amounts are needed to cause perceptible health damage in humans. Serious toxicity generally
occurs only at blood concentrations over 1 g/L, which requires extremely high intake over a relatively short period of time; this is nearly impossible with
consuming foods or supplements which contain 1g/kg of PG at most.
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Ingredient Persistence: Water/Soil Persistence: Air
Ingredient Bioaccumulation
MAGNESIUM OXIDE &
CHLOROTHALONIL
Asthma-like symptoms may continue for months or even years after exposure to the material ends. This may be due to a non-allergic condition known as
reactive airways dysfunction syndrome (RADS) which can occur after exposure to high levels of highly irritating compound.
Acute Toxicity Carcinogenicity
Skin Irritation/Corrosion Reproductivity
Serious Eye Damage/Irritation STOT - Single Exposure
Respiratory or Skin
sensitisation STOT - Repeated Exposure
Mutagenicity Aspiration Hazard
Legend: – Data available but does not fill the criteria for classification
– Data available to make classification
– Data Not Available to make classification
SECTION 12 ECOLOGICAL INFORMATION
Toxicity
Fiberlock AfterShock (white)
8390
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
Not Available Not Available Not Available Not Available Not Available
propylene glycol
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
LC50 96 Fish 710mg/L 4
EC50 48 Crustacea >1000mg/L 4
EC50 96 Algae or other aquatic plants 19000mg/L 2
NOEC 168 Fish 98mg/L 4
titanium dioxide (anatase)
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
LC50 96 Fish 155mg/L 2
EC50 48 Crustacea >10mg/L 2
EC50 72 Algae or other aquatic plants 5.83mg/L 4
EC20 72 Algae or other aquatic plants 1.81mg/L 4
NOEC 336 Fish 0.089mg/L 4
magnesium oxide
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
Not Available Not Available Not Available Not Available Not Available
chlorothalonil
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
LC50 96 Fish 0.0076mg/L 4
EC50 48 Crustacea 0.0066475mg/L 4
EC50 72 Algae or other aquatic plants 0.0068mg/L 4
BCF 336 Algae or other aquatic plants 0.02mg/L 4
NOEC 240 Crustacea 0.0003mg/L 4
Legend:Extracted from 1. IUCLID Toxicity Data 2. Europe ECHA Registered Substances - Ecotoxicological Information - Aquatic Toxicity 3. EPIWIN Suite V3.12
(QSAR) - Aquatic Toxicity Data (Estimated) 4. US EPA, Ecotox database - Aquatic Toxicity Data 5. ECETOC Aquatic Hazard Assessment Data 6. NITE
(Japan) - Bioconcentration Data 7. METI (Japan) - Bioconcentration Data 8. Vendor Data
Toxic to aquatic organisms, may cause long-term adverse effects in the aquatic environment.
Do NOT allow product to come in contact with surface waters or to intertidal areas below the mean high water mark. Do not contaminate water when cleaning equipment or disposing of equipment
wash-waters.
Propylene glycol is known to exert high levels of biochemical oxygen demand (BOD) during degradation in surface waters. This process can adversely affect aquatic life by consuming oxygen
needed by aquatic organisms for survival.
Persistence and degradability
propylene glycol LOW LOW
titanium dioxide (anatase)HIGH HIGH
chlorothalonil HIGH HIGH
Bioaccumulative potential
propylene glycol LOW (BCF = 1)
titanium dioxide (anatase)LOW (BCF = 10)
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Ingredient Mobility
chlorothalonil LOW (BCF = 125)
Mobility in soil
propylene glycol HIGH (KOC = 1)
titanium dioxide (anatase)LOW (KOC = 23.74)
chlorothalonil LOW (KOC = 2392)
SECTION 13 DISPOSAL CONSIDERATIONS
Waste treatment methods
Product / Packaging disposal
Containers may still present a chemical hazard/ danger when empty.
Return to supplier for reuse/ recycling if possible.
Legislation addressing waste disposal requirements may differ by country, state and/ or territory. Each user must refer to laws operating in their area.
DO NOT allow wash water from cleaning or process equipment to enter drains.
It may be necessary to collect all wash water for treatment before disposal.
Recycle wherever possible.
Consult manufacturer for recycling options or consult local or regional waste management authority for disposal if no suitable treatment or disposal
facility can be identified.
SECTION 14 TRANSPORT INFORMATION
Labels Required
Marine Pollutant
Land transport (DOT): NOT REGULATED FOR TRANSPORT OF DANGEROUS GOODS
Air transport (ICAO-IATA / DGR): NOT REGULATED FOR TRANSPORT OF DANGEROUS GOODS
Sea transport (IMDG-Code / GGVSee): NOT REGULATED FOR TRANSPORT OF DANGEROUS GOODS
Transport in bulk according to Annex II of MARPOL and the IBC code
Not Applicable
SECTION 15 REGULATORY INFORMATION
Safety, health and environmental regulations / legislation specific for the substance or mixture
PROPYLENE GLYCOL(57-55-6) IS FOUND ON THE FOLLOWING REGULATORY LISTS
US - Pennsylvania - Hazardous Substance List
US - Rhode Island Hazardous Substance List
US - Washington Toxic air pollutants and their ASIL, SQER and de minimis emission values
US AIHA Workplace Environmental Exposure Levels (WEELs)
US ATSDR Minimal Risk Levels for Hazardous Substances (MRLs)
US Spacecraft Maximum Allowable Concentrations (SMACs) for Airborne Contaminants
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
TITANIUM DIOXIDE (ANATASE)(1317-70-0) IS FOUND ON THE FOLLOWING REGULATORY LISTS
International Agency for Research on Cancer (IARC) - Agents Classified by the IARC
Monographs
US - Alaska Limits for Air Contaminants
US - California Proposition 65 - Carcinogens
US - Hawaii Air Contaminant Limits
US - Idaho - Limits for Air Contaminants
US - Massachusetts - Right To Know Listed Chemicals
US - Michigan Exposure Limits for Air Contaminants
US - Minnesota Permissible Exposure Limits (PELs)
US - Oregon Permissible Exposure Limits (Z-1)
US - Pennsylvania - Hazardous Substance List
US - Rhode Island Hazardous Substance List
US - Tennessee Occupational Exposure Limits - Limits For Air Contaminants
US - Vermont Permissible Exposure Limits Table Z-1-A Final Rule Limits for Air Contaminants
US - Vermont Permissible Exposure Limits Table Z-1-A Transitional Limits for Air
Contaminants
US - Washington Permissible exposure limits of air contaminants
US - Wyoming Toxic and Hazardous Substances Table Z1 Limits for Air Contaminants
US ACGIH Threshold Limit Values (TLV)
US ACGIH Threshold Limit Values (TLV) - Carcinogens
US List of Active Substances Exempt from the TSCA Inventory Notifications (Active-Inactive)
Rule
US NIOSH Recommended Exposure Limits (RELs)
US OSHA Permissible Exposure Levels (PELs) - Table Z1
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
US TSCA Section 12(b) - List of Chemical Substances Subject to Export Notification
Requirements
MAGNESIUM OXIDE(1309-48-4.) IS FOUND ON THE FOLLOWING REGULATORY LISTS
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US - Alaska Limits for Air Contaminants
US - California Permissible Exposure Limits for Chemical Contaminants
US - Hawaii Air Contaminant Limits
US - Idaho - Limits for Air Contaminants
US - Massachusetts - Right To Know Listed Chemicals
US - Michigan Exposure Limits for Air Contaminants
US - Minnesota Permissible Exposure Limits (PELs)
US - Oregon Permissible Exposure Limits (Z-1)
US - Pennsylvania - Hazardous Substance List
US - Rhode Island Hazardous Substance List
US - Tennessee Occupational Exposure Limits - Limits For Air Contaminants
US - Vermont Permissible Exposure Limits Table Z-1-A Final Rule Limits for Air Contaminants
US - Vermont Permissible Exposure Limits Table Z-1-A Transitional Limits for Air
Contaminants
US - Washington Permissible exposure limits of air contaminants
US - Wyoming Toxic and Hazardous Substances Table Z1 Limits for Air Contaminants
US ACGIH Threshold Limit Values (TLV)
US ACGIH Threshold Limit Values (TLV) - Carcinogens
US NIOSH Recommended Exposure Limits (RELs)
US OSHA Permissible Exposure Levels (PELs) - Table Z1
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
CHLOROTHALONIL(1897-45-6) IS FOUND ON THE FOLLOWING REGULATORY LISTS
International Agency for Research on Cancer (IARC) - Agents Classified by the IARC
Monographs
US - California - Proposition 65 - Priority List for the Development of MADLs for Chemicals
Causing Reproductive Toxicity
US - California Proposition 65 - Carcinogens
US - California Proposition 65 - No Significant Risk Levels (NSRLs) for Carcinogens
US - Massachusetts - Right To Know Listed Chemicals
US - New Jersey Right to Know - Special Health Hazard Substance List (SHHSL):
Carcinogens
US - Pennsylvania - Hazardous Substance List
US - Washington Toxic air pollutants and their ASIL, SQER and de minimis emission values
US EPCRA Section 313 Chemical List
US List of Active Substances Exempt from the TSCA Inventory Notifications (Active-Inactive)
Rule
US Office of Environmental Health Hazard Assessment Proposition 65 No Significant Risk
Levels (NSRLs) for Carcinogens and Maximum Allowable Dose Levels (MADLs) for
Chemicals Causing Reproductive Toxicity
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
Federal Regulations
Superfund Amendments and Reauthorization Act of 1986 (SARA)
SECTION 311/312 HAZARD CATEGORIES
Flammable (Gases, Aerosols, Liquids, or Solids)No
Gas under pressure No
Explosive No
Self-heating No
Pyrophoric (Liquid or Solid)No
Pyrophoric Gas No
Corrosive to metal No
Oxidizer (Liquid, Solid or Gas)No
Organic Peroxide No
Self-reactive No
In contact with water emits flammable gas No
Combustible Dust No
Carcinogenicity Yes
Acute toxicity (any route of exposure)No
Reproductive toxicity No
Skin Corrosion or Irritation No
Respiratory or Skin Sensitization Yes
Serious eye damage or eye irritation No
Specific target organ toxicity (single or repeated exposure)No
Aspiration Hazard No
Germ cell mutagenicity No
Simple Asphyxiant No
US. EPA CERCLA HAZARDOUS SUBSTANCES AND REPORTABLE QUANTITIES (40 CFR 302.4)
None Reported
State Regulations
US. CALIFORNIA PROPOSITION 65
WARNING: This product contains a chemical known to the State of California to cause cancer and birth defects or other reproductive harm
US - CALIFORNIA PROPOSITION 65 - CARCINOGENS & REPRODUCTIVE TOXICITY (CRT): LISTED SUBSTANCE
Titanium dioxide (airborne, unbound particles of respirable size), Chlorothalonil Listed
National Inventory Status
Australia - AICS Y
Canada - DSL Y
Canada - NDSL N (chlorothalonil; propylene glycol; magnesium oxide)
China - IECSC Y
Europe - EINEC / ELINCS / NLP Y
Japan - ENCS Y
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Korea - KECI Y
New Zealand - NZIoC Y
Philippines - PICCS Y
USA - TSCA Y
Legend:Y = All ingredients are on the inventory
N = Not determined or one or more ingredients are not on the inventory and are not exempt from listing(see specific ingredients in brackets)
SECTION 16 OTHER INFORMATION
Revision Date 06/21/2018
Initial Date 06/22/2018
CONTACT POINT
**PLEASE NOTE THAT TITANIUM DIOXIDE IS NOT PRESENT IN CLEAR OR NEUTRAL BASES**
Other information
Ingredients with multiple cas numbers
Name CAS No
titanium dioxide (anatase)1317-70-0, 13463-67-7
magnesium oxide 1309-48-4., 83897-85-2
Classification of the preparation and its individual components has drawn on official and authoritative sources as well as independent review by the Chemwatch Classification committee using
available literature references.
The SDS is a Hazard Communication tool and should be used to assist in the Risk Assessment. Many factors determine whether the reported Hazards are Risks in the workplace or other
settings.
Definitions and abbreviations
PC－TWA: Permissible Concentration-Time Weighted Average
PC－STEL: Permissible Concentration-Short Term Exposure Limit
IARC: International Agency for Research on Cancer
ACGIH: American Conference of Governmental Industrial Hygienists
STEL: Short Term Exposure Limit
TEEL: Temporary Emergency Exposure Limit。
IDLH: Immediately Dangerous to Life or Health Concentrations
OSF: Odour Safety Factor
NOAEL :No Observed Adverse Effect Level
LOAEL: Lowest Observed Adverse Effect Level
TLV: Threshold Limit Value
LOD: Limit Of Detection
OTV: Odour Threshold Value
BCF: BioConcentration Factors
BEI: Biological Exposure Index
Powered by AuthorITe, from Chemwatch.
Chemwatch: 9-298663
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end of SDS
Note: The hazard category numbers found in GHS classification in section 2
of this SDSs are NOT to be used to fill in the NFPA 704 diamond. Blue =
Health Red = Fire Yellow = Reactivity White = Special (Oxidizer or water
reactive substances)
Fiberlock ShockWave 8310
ICP Building Solutions Group / Fiberlock
Version No: 7.8
Safety Data Sheet according to OSHA HazCom Standard (2012) requirements
Issue Date: 08/26/2020
Print Date: 08/26/2020
S.GHS.USA.EN
SECTION 1 Identification
Product Identifier
Product name Fiberlock ShockWave 8310
Synonyms Not Available
Other means of identification Not Available
Recommended use of the chemical and restrictions on use
Relevant identified uses Disinfectant, Virucide, Fungicide
Name, address, and telephone number of the chemical manufacturer, importer, or other responsible party
Registered company name ICP Building Solutions Group / Fiberlock
Address 150 Dascomb Road Andover MA United States
Telephone 978 623 9980|866 667 5119
Fax Not Available
Website
Email sds@icpgroup.com
Emergency phone number
Association / Organisation ChemTel
Emergency telephone
numbers 800-255-3924
Other emergency telephone
numbers 813-248-0585
SECTION 2 Hazard(s) identification
Classification of the substance or mixture
Classification Skin Corrosion/Irritation Category 1C, Acute Aquatic Hazard Category 1, Serious Eye Damage Category 1, Acute Toxicity (Oral) Category 4, Skin
Sensitizer Category 1, Chronic Aquatic Hazard Category 3
Label elements
Hazard pictogram(s)
Signal word Danger
Hazard statement(s)
H314 Causes severe skin burns and eye damage.
H400 Very toxic to aquatic life.
H302 Harmful if swallowed.
H317 May cause an allergic skin reaction.
H412 Harmful to aquatic life with long lasting effects.
www.icpgroup.com
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CAS No %[weight]Name
Hazard(s) not otherwise classified
Not Applicable
Precautionary statement(s) Prevention
P260 Do not breathe mist/vapours/spray.
P280 Wear protective gloves/protective clothing/eye protection/face protection.
P270 Do not eat, drink or smoke when using this product.
Precautionary statement(s) Response
P301+P330+P331 IF SWALLOWED: Rinse mouth. Do NOT induce vomiting.
P303+P361+P353 IF ON SKIN (or hair): Remove/Take off immediately all contaminated clothing. Rinse skin with water/shower.
P305+P351+P338 IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to do. Continue rinsing.
Precautionary statement(s) Storage
P405 Store locked up.
Precautionary statement(s) Disposal
P501 Dispose of contents/container to authorised hazardous or special waste collection point in accordance with any local regulation.
SECTION 3 Composition / information on ingredients
Substances
See section below for composition of Mixtures
Mixtures
68391-01-5 2.37
68956-79-6 2.37
64-02-8 0-5
497-19-8 0-5
84133-50-6 0-5
7732-18-5 85-95
SECTION 4 First-aid measures
Description of first aid measures
Eye Contact
If this product comes in contact with the eyes:
Immediately hold eyelids apart and flush the eye continuously with running water.
Ensure complete irrigation of the eye by keeping eyelids apart and away from eye and moving the eyelids by occasionally lifting the upper
and lower lids.
Continue flushing until advised to stop by the Poisons Information Centre or a doctor, or for at least 15 minutes.
Transport to hospital or doctor without delay.
Removal of contact lenses after an eye injury should only be undertaken by skilled personnel.
Skin Contact
If skin or hair contact occurs:
Immediately flush body and clothes with large amounts of water, using safety shower if available.
Quickly remove all contaminated clothing, including footwear.
Wash skin and hair with running water. Continue flushing with water until advised to stop by the Poisons Information Centre.
Transport to hospital, or doctor.
Inhalation
If fumes or combustion products are inhaled remove from contaminated area.
Lay patient down. Keep warm and rested.
Prostheses such as false teeth, which may block airway, should be removed, where possible, prior to initiating first aid procedures.
Apply artificial respiration if not breathing, preferably with a demand valve resuscitator, bag-valve mask device, or pocket mask as trained.
Perform CPR if necessary.
Transport to hospital, or doctor, without delay.
Ingestion
For advice, contact a Poisons Information Centre or a doctor at once.
Urgent hospital treatment is likely to be needed.
If swallowed do NOT induce vomiting.
If vomiting occurs, lean patient forward or place on left side (head-down position, if possible) to maintain open airway and prevent aspiration.
Observe the patient carefully.
Never give liquid to a person showing signs of being sleepy or with reduced awareness; i.e. becoming unconscious.
Give water to rinse out mouth, then provide liquid slowly and as much as casualty can comfortably drink.
Transport to hospital or doctor without delay.
Most important symptoms and effects, both acute and delayed
See Section 11
Indication of any immediate medical attention and special treatment needed
benzyl-C12-18-alkyldimethylammonium chloride
(C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride
EDTA tetrasodium salt
sodium carbonate
alcohols C12-14 secondary ethoxylated
water
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Treat symptomatically.
SECTION 5 Fire-fighting measures
Extinguishing media
The product contains a substantial proportion of water, therefore there are no restrictions on the type of extinguishing media which may be used. Choice of extinguishing media should
take into account surrounding areas.
Though the material is non-combustible, evaporation of water from the mixture, caused by the heat of nearby fire, may produce floating layers of combustible substances.
Special hazards arising from the substrate or mixture
Fire Incompatibility None known.
Special protective equipment and precautions for fire-fighters
Fire Fighting
Alert Fire Brigade and tell them location and nature of hazard.
Wear breathing apparatus plus protective gloves in the event of a fire.
Prevent, by any means available, spillage from entering drains or water courses.
Fire/Explosion Hazard
The material is not readily combustible under normal conditions.
However, it will break down under fire conditions and the organic component may burn.
Not considered to be a significant fire risk.
Decomposes on heating and produces toxic fumes of:
carbon dioxide (CO2)
other pyrolysis products typical of burning organic material.
May emit poisonous fumes.
May emit corrosive fumes.
SECTION 6 Accidental release measures
Personal precautions, protective equipment and emergency procedures
See section 8
Environmental precautions
See section 12
Methods and material for containment and cleaning up
Minor Spills
Environmental hazard - contain spillage.
Clean up all spills immediately.
Avoid breathing vapours and contact with skin and eyes.
Control personal contact with the substance, by using protective equipment.
Major Spills
Environmental hazard - contain spillage.
Moderate hazard.
Clear area of personnel and move upwind.
Alert Fire Brigade and tell them location and nature of hazard.
Personal Protective Equipment advice is contained in Section 8 of the SDS.
SECTION 7 Handling and storage
Precautions for safe handling
Safe handling
Avoid all personal contact, including inhalation.
Wear protective clothing when risk of exposure occurs.
Use in a well-ventilated area.
DO NOT allow clothing wet with material to stay in contact with skin
Other information
Conditions for safe storage, including any incompatibilities
Suitable container
Polyethylene or polypropylene container.
Packing as recommended by manufacturer.
Check all containers are clearly labelled and free from leaks.
Storage incompatibility None known
SECTION 8 Exposure controls / personal protection
Control parameters
Occupational Exposure Limits (OEL)
INGREDIENT DATA
Not Available
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Ingredient Material name TEEL-1 TEEL-2 TEEL-3
Ingredient Original IDLH Revised IDLH
Ingredient Occupational Exposure Band Rating Occupational Exposure Band Limit
Notes:Occupational exposure banding is a process of assigning chemicals into specific categories or bands based on a chemical's potency and the
adverse health outcomes associated with exposure. The output of this process is an occupational exposure band (OEB), which corresponds to a
range of exposure concentrations that are expected to protect worker health.
Emergency Limits
benzyl-C12-18-
alkyldimethylammonium chloride Alkylbenzyldimethyl ammonium chloride, (C12-C18)0.61 mg/m3 6.8 mg/m3 60 mg/m3
EDTA tetrasodium salt Ethylenediaminetetraacetic acid, tetrasodium salt, dihydrate 82 mg/m3 900 mg/m3 5,500 mg/m3
EDTA tetrasodium salt Ethylenediaminetetraacetic acid, tetrasodiumn salt; (Tetrasodium EDTA)75 mg/m3 830 mg/m3 5,000 mg/m3
sodium carbonate Sodium carbonate 7.6 mg/m3 83 mg/m3 500 mg/m3
benzyl-C12-18-alkyldimethylammonium
chloride Not Available Not Available
(C12-18)alkyldimethyl(ethylbenzyl)ammonium
chloride Not Available Not Available
EDTA tetrasodium salt Not Available Not Available
sodium carbonate Not Available Not Available
alcohols C12-14 secondary ethoxylated Not Available Not Available
water Not Available Not Available
Occupational Exposure Banding
benzyl-C12-18-
alkyldimethylammonium chloride E ≤ 0.01 mg/m³
EDTA tetrasodium salt E ≤ 0.01 mg/m³
sodium carbonate E ≤ 0.01 mg/m³
Exposure controls
Appropriate engineering
controls
Engineering controls are used to remove a hazard or place a barrier between the worker and the hazard. Well-designed engineering controls can
be highly effective in protecting workers and will typically be independent of worker interactions to provide this high level of protection.
The basic types of engineering controls are:
Process controls which involve changing the way a job activity or process is done to reduce the risk.
Personal protection
Eye and face protection
Chemical goggles.
Full face shield may be required for supplementary but never for primary protection of eyes.
Contact lenses may pose a special hazard; soft contact lenses may absorb and concentrate irritants.
Skin protection See Hand protection below
Hands/feet protection
Wear chemical protective gloves, e.g. PVC.
Wear safety footwear or safety gumboots, e.g. Rubber
When handling corrosive liquids, wear trousers or overalls outside of boots, to avoid spills entering boots.
NOTE:
The material may produce skin sensitisation in predisposed individuals. Care must be taken, when removing gloves and other protective
equipment, to avoid all possible skin contact.
Contaminated leather items, such as shoes, belts and watch-bands should be removed and destroyed.
The selection of suitable gloves does not only depend on the material, but also on further marks of quality which vary from manufacturer to
manufacturer. Where the chemical is a preparation of several substances, the resistance of the glove material can not be calculated in advance
and has therefore to be checked prior to the application.
The exact break through time for substances has to be obtained from the manufacturer of the protective gloves and has to be observed when
making a final choice.
Body protection See Other protection below
Other protection
Overalls.
P.V.C apron.
Barrier cream.
Respiratory protection
Type A Filter of sufficient capacity. (AS/NZS 1716 & 1715, EN 143:2000 & 149:2001, ANSI Z88 or national equivalent)
Cartridge respirators should never be used for emergency ingress or in areas of unknown vapour concentrations or oxygen content.
The wearer must be warned to leave the contaminated area immediately on detecting any odours through the respirator. The odour may indicate that the mask is not
functioning properly, that the vapour concentration is too high, or that the mask is not properly fitted. Because of these limitations, only restricted use of cartridge
respirators is considered appropriate.
Cartridge performance is affected by humidity. Cartridges should be changed after 2 hr of continuous use unless it is determined that the humidity is less than 75%,
in which case, cartridges can be used for 4 hr. Used cartridges should be discarded daily, regardless of the length of time used
SECTION 9 Physical and chemical properties
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Information on basic physical and chemical properties
Appearance Text
Physical state Liquid Relative density (Water = 1)Not Available
Odour Not Available Partition coefficient n-octanol
/ water Not Available
Odour threshold Not Available Auto-ignition temperature (°C)Not Available
pH (as supplied)11.0-12.0 Decomposition temperature Not Available
Melting point / freezing point
(°C)Not Available Viscosity (cSt)Not Available
Initial boiling point and boiling
range (°C)Not Available Molecular weight (g/mol)Not Available
Flash point (°C)Not Available Taste Not Available
Evaporation rate Not Available Explosive properties Not Available
Flammability Not Available Oxidising properties Not Available
Upper Explosive Limit (%)Not Available Surface Tension (dyn/cm or
mN/m)Not Available
Lower Explosive Limit (%)Not Available Volatile Component (%vol)Not Available
Vapour pressure (kPa)Not Available Gas group Not Available
Solubility in water Immiscible pH as a solution (1%)Not Available
Vapour density (Air = 1)Not Available VOC g/L Not Available
SECTION 10 Stability and reactivity
Reactivity See section 7
Chemical stability
Unstable in the presence of incompatible materials.
Product is considered stable.
Hazardous polymerisation will not occur.
Possibility of hazardous
reactions See section 7
Conditions to avoid See section 7
Incompatible materials
See section 7.Fiberlock Products and CPVC Compatibility: Manufacturers of chlorinated polyvinyl chloride (CPVC) pipe believe that it can be
sensitive to or incompatible with chemicals found in many commonly used household and industrial cleaning products, coatings, adhesives and
other compounds, and that those chemicals can cause stress cracks or pipe failure. Fiberlock recommends that users contact the pipe
manufacturer directly before applying any Fiberlock products to the CPVC pipe.
Hazardous decomposition
products See section 5
SECTION 11 Toxicological information
Information on toxicological effects
Inhaled
The material can cause respiratory irritation in some persons. The body's response to such irritation can cause further lung damage.
Not normally a hazard due to non-volatile nature of product
The material has NOT been classified by EC Directives or other classification systems as 'harmful by inhalation'. This is because of the lack of
corroborating animal or human evidence.
Ingestion
The material can produce chemical burns within the oral cavity and gastrointestinal tract following ingestion.
The material has NOT been classified by EC Directives or other classification systems as 'harmful by ingestion'. This is because of the lack of
corroborating animal or human evidence.
Skin Contact
The material can produce chemical burns following direct contact with the skin.
Skin contact is not thought to have harmful health effects (as classified under EC Directives); the material may still produce health damage
following entry through wounds, lesions or abrasions.
Open cuts, abraded or irritated skin should not be exposed to this material
Entry into the blood-stream, through, for example, cuts, abrasions or lesions, may produce systemic injury with harmful effects. Examine the skin
prior to the use of the material and ensure that any external damage is suitably protected.
Eye The material can produce chemical burns to the eye following direct contact. Vapours or mists may be extremely irritating.
If applied to the eyes, this material causes severe eye damage.
Chronic
Repeated or prolonged exposure to corrosives may result in the erosion of teeth, inflammatory and ulcerative changes in the mouth and necrosis
(rarely) of the jaw. Bronchial irritation, with cough, and frequent attacks of bronchial pneumonia may ensue.
Long-term exposure to respiratory irritants may result in airways disease, involving difficulty breathing and related whole-body problems.
Skin contact with the material is more likely to cause a sensitisation reaction in some persons compared to the general population.
Substance accumulation, in the human body, may occur and may cause some concern following repeated or long-term occupational exposure.
Fiberlock ShockWave 8310 TOXICITY IRRITATION
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Not Available Not Available
benzyl-C12-18-alkyldimethylammonium
chloride
TOXICITY IRRITATION
Oral (rat) LD50: 447 mg/kg[2]Not Available
Oral (rat) LD50: 650 mg/kg[2]
(C12-18)alkyldimethyl(ethylbenzyl)ammonium
chloride
TOXICITY IRRITATION
Not Available Not Available
EDTA tetrasodium salt
TOXICITY IRRITATION
Oral (mouse) LD50: 30 mg/kg[2]Eyes (rabbit): 1.9 mg
Oral (rat) LD50: 1260 mg/kg[2]Eyes (rabbit):100 mg/24h-moderate
Oral (rat) LD50: 2000-2200 mg/kg[2]Skin (rabbit):500 mg/24h-moderate
Oral (rat) LD50: 630 mg/kg[2]
sodium carbonate
TOXICITY IRRITATION
714 mg/kg[2]Eye (rabbit): 100 mg/24h moderate
dermal (rat) LD50: >2000 mg/kg[2]Eye (rabbit): 100 mg/30s mild
Inhalation (guinea pig) LC50: 0.4 mg/l/2h[2]Eye (rabbit): 50 mg SEVERE
Inhalation (rat) LC50: 1.15 mg/l/2he[2]Eye: adverse effect observed (irritating)[1]
Oral (mouse) LD50: 6600 mg/kg[2]Skin (rabbit): 500 mg/24h mild
Oral (rat) LD50: =4090 mg/kg[2]Skin: no adverse effect observed (not irritating)[1]
Oral (rat) LD50: 2800 mg/kg[2]
alcohols C12-14 secondary ethoxylated
TOXICITY IRRITATION
Not Available Not Available
water
TOXICITY IRRITATION
Oral (rat) LD50: >90000 mg/kg[2]Not Available
Legend:1. Value obtained from Europe ECHA Registered Substances - Acute toxicity 2.* Value obtained from manufacturer's SDS. Unless otherwise
specified data extracted from RTECS - Register of Toxic Effect of chemical Substances
EDTA TETRASODIUM SALT
* Sigma Aldrich - for the dihydrate
For ethylendiaminetetraacetic acid (EDTA) and its salts:
EDTA is a strong organic acid, with a high affinity for alkaline-earth ions (for example, calcium and magnesium) and
heavy-metal ions (such as lad and mercury), resulting in highly stable chelate complexes. The ability of EDTA to
complex is used commercially to either promote or inhibit chemical reactions, depending on application.
EDTA and its salts are expected to be absorbed by the lungs and the gastrointestinal tract; absorption through skin is
unlikely. They cause mild skin irritation, and severe eye irritation.
SODIUM CARBONATE
For sodium carbonate:
Sodium carbonate has little potential for skin irritation, but is irritating to the eyes. Due to its alkaline properties, irritation
of the airways is also possible.
There is no data available for animal studies regarding the repeated dose toxicity of sodium carbonate by any route.
There is no evidence that sodium carbonate causes whole-body effects under normal handling and use. Sodium
carbonate does not reach the foetus or the reproductive organs, which shows that there is no risk for developmental or
reproductive toxicity.
The material may cause skin irritation after prolonged or repeated exposure and may produce on contact skin redness,
swelling, the production of vesicles, scaling and thickening of the skin.
ALCOHOLS C12-14 SECONDARY ETHOXYLATED
Polyethers (such as ethoxylated surfactants and polyethylene glycols) are highly susceptible to being oxidized in the
air. They then form complex mixtures of oxidation products.
Animal testing reveals that whole the pure, non-oxidised surfactant is non-sensitizing, many of the oxidation products
are sensitisers. The oxidization products also cause irritation.
Humans have regular contact with alcohol ethoxylates through a variety of industrial and consumer products such as
soaps, detergents and other cleaning products. Exposure to these chemicals can occur through swallowing, inhalation,
or contact with the skin or eyes. Studies of acute toxicity show that relatively high volumes would have to occur to
produce any toxic response.
Both laboratory and animal testing has shown that there is no evidence for alcohol ethoxylates (AEs) causing genetic
damage, mutations or cancer. No adverse reproductive or developmental effects were observed.
Tri-ethylene glycol ethers undergo enzymatic oxidation to toxic alkoxy acids. They may irritate the skin and the eyes. At
high oral doses, they may cause depressed reflexes, flaccid muscle tone, breathing difficulty and coma.
Fiberlock ShockWave 8310 & BENZYL-C12-18-
ALKYLDIMETHYLAMMONIUM CHLORIDE &
(C12-18)ALKYLDIMETHYL(ETHYLBENZYL)AMMONIUM
CHLORIDE & EDTA TETRASODIUM SALT & SODIUM
CARBONATE
Asthma-like symptoms may continue for months or even years after exposure to the material ends. This may be due to
a non-allergic condition known as reactive airways dysfunction syndrome (RADS) which can occur after exposure to
high levels of highly irritating compound. Main criteria for diagnosing RADS include the absence of previous airways
disease in a non-atopic individual, with sudden onset of persistent asthma-like symptoms within minutes to hours of a
documented exposure to the irritant.
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Fiberlock ShockWave 8310 & EDTA TETRASODIUM
SALT
The following information refers to contact allergens as a group and may not be specific to this product.
Contact allergies quickly manifest themselves as contact eczema, more rarely as urticaria or Quincke's oedema. The
pathogenesis of contact eczema involves a cell-mediated (T lymphocytes) immune reaction of the delayed type. Other
allergic skin reactions, e.g. contact urticaria, involve antibody-mediated immune reactions.
BENZYL-C12-18-ALKYLDIMETHYLAMMONIUM
CHLORIDE &
(C12-18)ALKYLDIMETHYL(ETHYLBENZYL)AMMONIUM
CHLORIDE
The material may cause severe skin irritation after prolonged or repeated exposure and may produce on contact skin
redness, swelling, the production of vesicles, scaling and thickening of the skin. Repeated exposures may produce
severe ulceration.
Alkyldimethylbenzylammonium chlorides are in the list of dangerous substances of council directive, classified as
'harmful in contact with skin and on ingestion', and 'corrosive and very toxic to aquatic organisms'. It can cause dose
dependent skin and eye irritation with possible deterioration of vision, possible sensitisation in those with pre-existing
eczema. It does not cause cancer, genetic defect, foetal or developmental abnormality.
(C12-18)ALKYLDIMETHYL(ETHYLBENZYL)AMMONIUM
CHLORIDE & ALCOHOLS C12-14 SECONDARY
ETHOXYLATED & WATER
No significant acute toxicological data identified in literature search.
Acute Toxicity Carcinogenicity
Skin Irritation/Corrosion Reproductivity
Serious Eye Damage/Irritation STOT - Single Exposure
Respiratory or Skin
sensitisation STOT - Repeated Exposure
Mutagenicity Aspiration Hazard
Legend: – Data either not available or does not fill the criteria for classification
– Data available to make classification
SECTION 12 Ecological information
Toxicity
Fiberlock ShockWave 8310
Endpoint Test Duration (hr)Species Value Source
Not Available Not Available Not Available Not Available Not Available
benzyl-C12-18-alkyldimethylammonium
chloride
Endpoint Test Duration (hr)Species Value Source
Not Available Not Available Not Available Not Available Not Available
(C12-18)alkyldimethyl(ethylbenzyl)ammonium
chloride
Endpoint Test Duration (hr)Species Value Source
Not Available Not Available Not Available Not Available Not Available
EDTA tetrasodium salt
Endpoint Test Duration (hr)Species Value Source
LC50 96 Fish 1-592mg/L 2
EC50 48 Crustacea 140mg/L 2
EC50 72 Algae or other aquatic plants =1.01mg/L 1
EC10 72 Algae or other aquatic plants =0.48mg/L 1
NOEC 72 Algae or other aquatic plants =0.39mg/L 1
sodium carbonate
Endpoint Test Duration (hr)Species Value Source
LC50 96 Fish 300mg/L 2
EC50 48 Crustacea 265mg/L 2
NOEC 96 Fish =550mg/L 1
alcohols C12-14 secondary ethoxylated
Endpoint Test Duration (hr)Species Value Source
Not Available Not Available Not Available Not Available Not Available
water
Endpoint Test Duration (hr)Species Value Source
Not Available Not Available Not Available Not Available Not Available
Legend:Extracted from 1. IUCLID Toxicity Data 2. Europe ECHA Registered Substances - Ecotoxicological Information - Aquatic Toxicity 3. EPIWIN Suite
V3.12 (QSAR) - Aquatic Toxicity Data (Estimated) 4. US EPA, Ecotox database - Aquatic Toxicity Data 5. ECETOC Aquatic Hazard Assessment
Data 6. NITE (Japan) - Bioconcentration Data 7. METI (Japan) - Bioconcentration Data 8. Vendor Data
Very toxic to aquatic organisms, may cause long-term adverse effects in the aquatic environment.
Do NOT allow product to come in contact with surface waters or to intertidal areas below the mean high water mark. Do not contaminate water when cleaning equipment or disposing
of equipment wash-waters.
Wastes resulting from use of the product must be disposed of on site or at approved waste sites.
DO NOT discharge into sewer or waterways.
Persistence and degradability
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Ingredient Persistence: Water/Soil Persistence: Air
Ingredient Bioaccumulation
Ingredient Mobility
sodium carbonate LOW LOW
water LOW LOW
Bioaccumulative potential
sodium carbonate LOW (LogKOW = -0.4605)
water LOW (LogKOW = -1.38)
Mobility in soil
sodium carbonate HIGH (KOC = 1)
water LOW (KOC = 14.3)
SECTION 13 Disposal considerations
Waste treatment methods
Product / Packaging disposal
Containers may still present a chemical hazard/ danger when empty.
Return to supplier for reuse/ recycling if possible.
Otherwise:
If container can not be cleaned sufficiently well to ensure that residuals do not remain or if the container cannot be used to store the same
product, then puncture containers, to prevent re-use, and bury at an authorised landfill.
Legislation addressing waste disposal requirements may differ by country, state and/ or territory. Each user must refer to laws operating in their
area. In some areas, certain wastes must be tracked.
DO NOT allow wash water from cleaning or process equipment to enter drains.
It may be necessary to collect all wash water for treatment before disposal.
In all cases disposal to sewer may be subject to local laws and regulations and these should be considered first.
Recycle wherever possible.
Consult manufacturer for recycling options or consult local or regional waste management authority for disposal if no suitable treatment or
disposal facility can be identified.
Dispose of by: burial in a land-fill specifically licensed to accept chemical and / or pharmaceutical wastes or incineration in a licensed
apparatus (after admixture with suitable combustible material).
SECTION 14 Transport information
Labels Required
Marine Pollutant
Land transport (DOT): NOT REGULATED FOR TRANSPORT OF DANGEROUS GOODS
Air transport (ICAO-IATA / DGR): NOT REGULATED FOR TRANSPORT OF DANGEROUS GOODS
Sea transport (IMDG-Code / GGVSee): NOT REGULATED FOR TRANSPORT OF DANGEROUS GOODS
Transport in bulk according to Annex II of MARPOL and the IBC code
Not Applicable
SECTION 15 Regulatory information
Safety, health and environmental regulations / legislation specific for the substance or mixture
benzyl-C12-18-alkyldimethylammonium chloride is found on the following regulatory lists
US DOE Temporary Emergency Exposure Limits (TEELs)
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
(C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride is found on the following regulatory lists
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory US TSCA Chemical Substance Inventory - Interim List of Active Substances
EDTA tetrasodium salt is found on the following regulatory lists
US DOE Temporary Emergency Exposure Limits (TEELs)
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
sodium carbonate is found on the following regulatory lists
US DOE Temporary Emergency Exposure Limits (TEELs)
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
alcohols C12-14 secondary ethoxylated is found on the following regulatory lists
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
US TSCA Section 5(a)(2) - Significant New Use Rules (SNURs)
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National Inventory Status
water is found on the following regulatory lists
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory US TSCA Chemical Substance Inventory - Interim List of Active Substances
Federal Regulations
Superfund Amendments and Reauthorization Act of 1986 (SARA)
Section 311/312 hazard categories
Flammable (Gases, Aerosols, Liquids, or Solids)No
Gas under pressure No
Explosive No
Self-heating No
Pyrophoric (Liquid or Solid)No
Pyrophoric Gas No
Corrosive to metal No
Oxidizer (Liquid, Solid or Gas)No
Organic Peroxide No
Self-reactive No
In contact with water emits flammable gas No
Combustible Dust No
Carcinogenicity No
Acute toxicity (any route of exposure)Yes
Reproductive toxicity No
Skin Corrosion or Irritation Yes
Respiratory or Skin Sensitization Yes
Serious eye damage or eye irritation Yes
Specific target organ toxicity (single or repeated exposure)No
Aspiration Hazard No
Germ cell mutagenicity No
Simple Asphyxiant No
Hazards Not Otherwise Classified No
US. EPA CERCLA Hazardous Substances and Reportable Quantities (40 CFR 302.4)
None Reported
State Regulations
US. California Proposition 65
None Reported
National Inventory Status
Australia - AIIC Yes
Australia Non-Industrial Use No (benzyl-C12-18-alkyldimethylammonium chloride; (C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride; EDTA tetrasodium salt; sodium
carbonate; alcohols C12-14 secondary ethoxylated; water)
Canada - DSL Yes
Canada - NDSL No (benzyl-C12-18-alkyldimethylammonium chloride; (C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride; EDTA tetrasodium salt; sodium
carbonate; alcohols C12-14 secondary ethoxylated; water)
China - IECSC Yes
Europe - EINEC / ELINCS / NLP No (alcohols C12-14 secondary ethoxylated)
Japan - ENCS No (benzyl-C12-18-alkyldimethylammonium chloride; (C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride; alcohols C12-14 secondary
ethoxylated)
Korea - KECI Yes
New Zealand - NZIoC Yes
Philippines - PICCS Yes
USA - TSCA Yes
Taiwan - TCSI Yes
Mexico - INSQ No ((C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride)
Vietnam - NCI No ((C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride)
Russia - ARIPS No ((C12-18)alkyldimethyl(ethylbenzyl)ammonium chloride; alcohols C12-14 secondary ethoxylated)
Legend:Yes = All CAS declared ingredients are on the inventory
No = One or more of the CAS listed ingredients are not on the inventory and are not exempt from listing(see specific ingredients in brackets)
SECTION 16 Other information
Revision Date 08/26/2020
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Version Issue Date Sections Updated
Initial Date 05/21/2017
CPVC Compatibility
Fiberlock Products and CPVC Compatibility: Manufacturers of chlorinated polyvinyl chloride (CPVC) pipe believe that it can be sensitive to or incompatible withchemicals found in
many commonly used household and industrial cleaning products, coatings, adhesives and other compounds, and that those chemicals can cause stress cracks or pipe failure.
Fiberlock recommends that users contact the pipe manufacturer directly before applying any Fiberlock products to the CPVC pipe.
SDS Version Summary
6.8.1.1.1 08/26/2020 Classification, Ingredients, Supplier Information
Other information
Classification of the preparation and its individual components has drawn on official and authoritative sources as well as independent review by the Chemwatch Classification
committee using available literature references.
The SDS is a Hazard Communication tool and should be used to assist in the Risk Assessment. Many factors determine whether the reported Hazards are Risks in the workplace or
other settings. Risks may be determined by reference to Exposures Scenarios.
Definitions and abbreviations
PC－TWA: Permissible Concentration-Time Weighted Average
PC－STEL: Permissible Concentration-Short Term Exposure Limit
IARC: International Agency for Research on Cancer
ACGIH: American Conference of Governmental Industrial Hygienists
STEL: Short Term Exposure Limit
TEEL: Temporary Emergency Exposure Limit。
IDLH: Immediately Dangerous to Life or Health Concentrations
OSF: Odour Safety Factor
NOAEL :No Observed Adverse Effect Level
LOAEL: Lowest Observed Adverse Effect Level
TLV: Threshold Limit Value
LOD: Limit Of Detection
OTV: Odour Threshold Value
BCF: BioConcentration Factors
BEI: Biological Exposure Index
Powered by AuthorITe, from Chemwatch.
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end of SDS
ICP Building Solutions Group
Fiberlock 8317 Instant Mold Stain Remover
Version No: 4.5
Safety Data Sheet according to OSHA HazCom Standard (2012) requirements
Issue Date: 01/22/2020
Print Date: 01/22/2020
S.GHS.USA.EN
SECTION 1 IDENTIFICATION
Product Identifier
Product name Fiberlock 8317 Instant Mold Stain Remover
Synonyms Not Available
Proper shipping name Hypochlorite solutions
Other means of identification Not Available
Recommended use of the chemical and restrictions on use
Relevant identified uses Cleaning and removing mold and mildew stains
Name, address, and telephone number of the chemical manufacturer, importer, or other responsible party
Registered company name ICP Building Solutions Group
Address 150 Dascomb Road Andover MA United States
Telephone 1-978-623-9980
Fax Not Available
Website http://www.icpgroup.com
Email Not Available
Emergency phone number
Association / Organisation ChemTel
Emergency telephone
numbers 800-255-3924
Other emergency telephone
numbers Not Available
SECTION 2 HAZARD(S) IDENTIFICATION
Classification of the substance or mixture
NFPA 704 diamond
Note: The hazard category numbers found in GHS classification in section 2
of this SDSs are NOT to be used to fill in the NFPA 704 diamond. Blue =
Health Red = Fire Yellow = Reactivity White = Special (Oxidizer or water
reactive substances)
Classification Chronic Aquatic Hazard Category 2, Acute Aquatic Hazard Category 1, Metal Corrosion Category 1, Serious Eye Damage Category 1, Specific
target organ toxicity - single exposure Category 3 (respiratory tract irritation), Skin Corrosion/Irritation Category 1A
Label elements
Hazard pictogram(s)
SIGNAL WORD DANGER
Hazard statement(s)
H411 Toxic to aquatic life with long lasting effects.
H400 Very toxic to aquatic life.
H290 May be corrosive to metals.
H335 May cause respiratory irritation.
Continued...
H314 Causes severe skin burns and eye damage.
Hazard(s) not otherwise classified
Not Applicable
Precautionary statement(s) General
P101 If medical advice is needed, have product container or label at hand.
P102 Keep out of reach of children.
Precautionary statement(s) Prevention
P260 Do not breathe mist/vapours/spray.
P271 Use only outdoors or in a well-ventilated area.
Precautionary statement(s) Response
P301+P330+P331 IF SWALLOWED: Rinse mouth. Do NOT induce vomiting.
P303+P361+P353 IF ON SKIN (or hair): Remove/Take off immediately all contaminated clothing. Rinse skin with water/shower.
Precautionary statement(s) Storage
P405 Store locked up.
P403+P233 Store in a well-ventilated place. Keep container tightly closed.
Precautionary statement(s) Disposal
P501 Dispose of contents/container to authorised hazardous or special waste collection point in accordance with any local regulation.
SECTION 3 COMPOSITION / INFORMATION ON INGREDIENTS
Substances
See section below for composition of Mixtures
Mixtures
CAS No %[weight]Name
7681-52-9 5-10
1310-73-2 0-1
1300-72-7 0-1
1643-20-5 0-1
SECTION 4 FIRST-AID MEASURES
Description of first aid measures
Eye Contact
If this product comes in contact with the eyes:
Immediately hold eyelids apart and flush the eye continuously with running water.
Ensure complete irrigation of the eye by keeping eyelids apart and away from eye and moving the eyelids by occasionally lifting the upper
and lower lids.
Continue flushing until advised to stop by the Poisons Information Centre or a doctor, or for at least 15 minutes.
Transport to hospital or doctor without delay.
Removal of contact lenses after an eye injury should only be undertaken by skilled personnel.
Skin Contact
If skin or hair contact occurs:
Immediately flush body and clothes with large amounts of water, using safety shower if available.
Quickly remove all contaminated clothing, including footwear.
Wash skin and hair with running water. Continue flushing with water until advised to stop by the Poisons Information Centre.
Transport to hospital, or doctor.
Inhalation
If fumes or combustion products are inhaled remove from contaminated area.
Lay patient down. Keep warm and rested.
Prostheses such as false teeth, which may block airway, should be removed, where possible, prior to initiating first aid procedures.
Apply artificial respiration if not breathing, preferably with a demand valve resuscitator, bag-valve mask device, or pocket mask as trained.
Perform CPR if necessary.
Transport to hospital, or doctor, without delay.
Inhalation of vapours or aerosols (mists, fumes) may cause lung oedema.
Corrosive substances may cause lung damage (e.g. lung oedema, fluid in the lungs).
As this reaction may be delayed up to 24 hours after exposure, affected individuals need complete rest (preferably in semi-recumbent
posture) and must be kept under medical observation even if no symptoms are (yet) manifested.
Before any such manifestation, the administration of a spray containing a dexamethasone derivative or beclomethasone derivative may be
considered.
This must definitely be left to a doctor or person authorised by him/her.
(ICSC13719)
Ingestion
For advice, contact a Poisons Information Centre or a doctor at once.
Urgent hospital treatment is likely to be needed.
If swallowed do NOT induce vomiting.
sodium hypochlorite
sodium hydroxide
sodium xylenesulfonate
lauryldimethylamine oxide
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If vomiting occurs, lean patient forward or place on left side (head-down position, if possible) to maintain open airway and prevent aspiration.
Observe the patient carefully.
Never give liquid to a person showing signs of being sleepy or with reduced awareness; i.e. becoming unconscious.
Give water to rinse out mouth, then provide liquid slowly and as much as casualty can comfortably drink.
Transport to hospital or doctor without delay.
Most important symptoms and effects, both acute and delayed
See Section 11
Indication of any immediate medical attention and special treatment needed
For acute or repeated exposures to hypochlorite solutions:
Release of small amounts of hypochlorous acid and acid gases from the stomach following ingestion, is usually too low to cause damage but may be irritating to mucous
membranes. Buffering with antacid may be helpful if discomfort is evident.
Evaluate as potential caustic exposure.
Decontaminate skin and eyes with copious saline irrigation. Check exposed eyes for corneal abrasions with fluorescein staining.
Emesis or lavage and catharsis may be indicated for mild caustic exposure.
Chlorine exposures require evaluation of acid/base and respiratory status.
Inhalation of vapours or mists may result in pulmonary oedema.
ELLENHORN and BARCELOUX: Medical Toxicology.
For acute or short-term repeated exposures to highly alkaline materials:
Respiratory stress is uncommon but present occasionally because of soft tissue edema.
Unless endotracheal intubation can be accomplished under direct vision, cricothyroidotomy or tracheotomy may be necessary.
Oxygen is given as indicated.
The presence of shock suggests perforation and mandates an intravenous line and fluid administration.
Damage due to alkaline corrosives occurs by liquefaction necrosis whereby the saponification of fats and solubilisation of proteins allow deep penetration into the tissue.
Alkalis continue to cause damage after exposure.
INGESTION:
Milk and water are the preferred diluents
No more than 2 glasses of water should be given to an adult.
Neutralising agents should never be given since exothermic heat reaction may compound injury.
* Catharsis and emesis are absolutely contra-indicated.
* Activated charcoal does not absorb alkali.
* Gastric lavage should not be used.
Supportive care involves the following:
Withhold oral feedings initially.
If endoscopy confirms transmucosal injury start steroids only within the first 48 hours.
Carefully evaluate the amount of tissue necrosis before assessing the need for surgical intervention.
Patients should be instructed to seek medical attention whenever they develop difficulty in swallowing (dysphagia).
SKIN AND EYE:
Injury should be irrigated for 20-30 minutes.
Eye injuries require saline. [Ellenhorn & Barceloux: Medical Toxicology]
Excellent warning properties force rapid escape of personnel from chlorine vapour thus most inhalations are mild to moderate. If escape is not possible, exposure to high
concentrations for a very short time can result in dyspnea, haemophysis and cyanosis with later complications being tracheobroncho-pneumonitis and pulmonary oedema. Oxygen,
intermittent positive pressure breathing apparatus and aerosolysed bronchodilators are of therapeutic value where chlorine inhalation has been light to moderate. Severe inhalation
should result in hospitalisation and treatment for a respiratory emergency.
Any chlorine inhalation in an individual with compromised pulmonary function (COPD) should be regarded as a severe inhalation and a respiratory emergency. [CCINFO, Dow 1988]
Effects from exposure to chlorine gas include pulmonary oedema which may be delayed. Observation in hospital for 48 hours is recommended
Diagnosed asthmatics and those people suffering from certain types of chronic bronchitis should receive medical approval before being employed in occupations involving chlorine
exposure.
If burn is present, treat as any thermal burn, after decontamination.
Depending on the degree of exposure, periodic medical examination is indicated. The symptoms of lung oedema often do not manifest until a few hours have passed and they are
aggravated by physical effort. Rest and medical observation is therefore essential. Immediate administration of an appropriate spray, by a doctor or a person authorised by him/her
should be considered.
(ICSC24419/24421
SECTION 5 FIRE-FIGHTING MEASURES
Extinguishing media
Water spray or fog.
Foam.
Special hazards arising from the substrate or mixture
Fire Incompatibility None known.
Special protective equipment and precautions for fire-fighters
Fire Fighting Alert Fire Brigade and tell them location and nature of hazard.
Wear full body protective clothing with breathing apparatus.
Fire/Explosion Hazard
Non combustible.
Not considered a significant fire risk, however containers may burn.
May emit corrosive fumes.
SECTION 6 ACCIDENTAL RELEASE MEASURES
Personal precautions, protective equipment and emergency procedures
See section 8
Environmental precautions
See section 12
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Methods and material for containment and cleaning up
Minor Spills
Drains for storage or use areas should have retention basins for pH adjustments and dilution of spills before discharge or disposal of
material.
Check regularly for spills and leaks.
Clean up all spills immediately.
Avoid breathing vapours and contact with skin and eyes.
Major Spills Clear area of personnel and move upwind.
Alert Fire Brigade and tell them location and nature of hazard.
Personal Protective Equipment advice is contained in Section 8 of the SDS.
SECTION 7 HANDLING AND STORAGE
Precautions for safe handling
Safe handling Avoid all personal contact, including inhalation.
Wear protective clothing when risk of exposure occurs.
Other information
Store in original containers.
Keep containers securely sealed.
DO NOT store near acids, or oxidising agents
No smoking, naked lights, heat or ignition sources.
Conditions for safe storage, including any incompatibilities
Suitable container
Liquid inorganic hypochlorites shall not to be transported in unlined metal drums. Inner packagings shall be fitted with vented closures and
plastics drums and carboys shall have vented closures or be performance tested to a minimum of 250 kPa.
Lined metal can, lined metal pail/ can.
Plastic pail.
For low viscosity materials
Drums and jerricans must be of the non-removable head type.
Where a can is to be used as an inner package, the can must have a screwed enclosure.
Storage incompatibility
Contact with acids produces toxic fumes
Presence of rust (iron oxide) or other metal oxides catalyses decomposition of inorganic hypochlorites.
Contact with water can cause heating and decomposition giving off chlorine and oxygen gases.
Contact with acids produces toxic fumes of chlorine
Avoid contact with copper, aluminium and their alloys.
SECTION 8 EXPOSURE CONTROLS / PERSONAL PROTECTION
Control parameters
OCCUPATIONAL EXPOSURE LIMITS (OEL)
INGREDIENT DATA
Source Ingredient Material name TWA STEL Peak Notes
US NIOSH Recommended
Exposure Limits (RELs)
sodium
hydroxide
Caustic soda, Lye, Soda lye, Sodium
hydrate
Not
Available
Not
Available 2 mg/m3 Not Available
US ACGIH Threshold Limit
Values (TLV)
sodium
hydroxide Sodium hydroxide Not
Available
Not
Available 2 mg/m3 TLV® Basis: URT, eye, &
skin irr
US OSHA Permissible Exposure
Levels (PELs) - Table Z1
sodium
hydroxide Sodium hydroxide 2 mg/m3 Not
Available
Not
Available Not Available
EMERGENCY LIMITS
Ingredient Material name TEEL-1 TEEL-2 TEEL-3
sodium hypochlorite Sodium hypochlorite pentahydrate 13 mg/m3 140 mg/m3 290 mg/m3
sodium hypochlorite Sodium hypochlorite 2 mg/m3 54 mg/m3 630 mg/m3
sodium hydroxide Sodium hydroxide Not Available Not Available Not Available
Ingredient Original IDLH Revised IDLH
sodium hypochlorite Not Available Not Available
sodium hydroxide 10 mg/m3 Not Available
sodium xylenesulfonate Not Available Not Available
lauryldimethylamine oxide Not Available Not Available
OCCUPATIONAL EXPOSURE BANDING
Ingredient Occupational Exposure Band Rating Occupational Exposure Band Limit
sodium xylenesulfonate E ≤ 0.01 mg/m³
Notes:
Occupational exposure banding is a process of assigning chemicals into specific categories or bands based on a chemical's potency and the
adverse health outcomes associated with exposure. The output of this process is an occupational exposure band (OEB), which corresponds to a
range of exposure concentrations that are expected to protect worker health.
Exposure controls
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Appropriate engineering
controls
Engineering controls are used to remove a hazard or place a barrier between the worker and the hazard. Well-designed engineering controls can
be highly effective in protecting workers and will typically be independent of worker interactions to provide this high level of protection.
Personal protection
Eye and face protection
Safety glasses with unperforated side shields may be used where continuous eye protection is desirable, as in laboratories; spectacles are
not sufficient where complete eye protection is needed such as when handling bulk-quantities, where there is a danger of splashing, or if the
material may be under pressure.
Chemical goggles.whenever there is a danger of the material coming in contact with the eyes; goggles must be properly fitted.
Skin protection See Hand protection below
Hands/feet protection Elbow length PVC gloves
When handling corrosive liquids, wear trousers or overalls outside of boots, to avoid spills entering boots.
Body protection See Other protection below
Other protection Overalls.
PVC Apron.
Respiratory protection
Respirators may be necessary when engineering and administrative controls do not adequately prevent exposures.
The decision to use respiratory protection should be based on professional judgment that takes into account toxicity information, exposure measurement data, and
frequency and likelihood of the worker's exposure - ensure users are not subject to high thermal loads which may result in heat stress or distress due to personal
protective equipment (powered, positive flow, full face apparatus may be an option).
Published occupational exposure limits, where they exist, will assist in determining the adequacy of the selected respiratory protection. These may be government
mandated or vendor recommended.
Certified respirators will be useful for protecting workers from inhalation of particulates when properly selected and fit tested as part of a complete respiratory
protection program.
Use approved positive flow mask if significant quantities of dust becomes airborne.
Try to avoid creating dust conditions.
SECTION 9 PHYSICAL AND CHEMICAL PROPERTIES
Information on basic physical and chemical properties
Appearance Not Available
Physical state Liquid Relative density (Water = 1)Not Available
Odour Not Available Partition coefficient n-octanol
/ water Not Available
Odour threshold Not Available Auto-ignition temperature (°C)Not Available
pH (as supplied)14 Decomposition temperature Not Available
Melting point / freezing point
(°C)Not Available Viscosity (cSt)Not Available
Initial boiling point and boiling
range (°C)100 Molecular weight (g/mol)Not Available
Flash point (°C)Not Available Taste Not Available
Evaporation rate Not Available Explosive properties Not Available
Flammability Not Available Oxidising properties Not Available
Upper Explosive Limit (%)Not Available Surface Tension (dyn/cm or
mN/m)Not Available
Lower Explosive Limit (%)Not Available Volatile Component (%vol)Not Available
Vapour pressure (kPa)1.60 Gas group Not Available
Solubility in water Immiscible pH as a solution (1%)Not Available
Vapour density (Air = 1)Not Available VOC g/L Not Available
SECTION 10 STABILITY AND REACTIVITY
Reactivity See section 7
Chemical stability Unstable in the presence of incompatible materials.
Product is considered stable.
Possibility of hazardous
reactions See section 7
Conditions to avoid See section 7
Incompatible materials See section 7
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Hazardous decomposition
products See section 5
SECTION 11 TOXICOLOGICAL INFORMATION
Information on toxicological effects
Inhaled
The material can cause respiratory irritation in some persons. The body's response to such irritation can cause further lung damage.
Inhaling corrosive bases may irritate the respiratory tract. Symptoms include cough, choking, pain and damage to the mucous membrane.
The material has NOT been classified by EC Directives or other classification systems as "harmful by inhalation". This is because of the lack of
corroborating animal or human evidence.
Ingestion
Ingestion of alkaline corrosives may produce burns around the mouth, ulcerations and swellings of the mucous membranes, profuse saliva
production, with an inability to speak or swallow. Both the oesophagus and stomach may experience burning pain; vomiting and diarrhoea may
follow.
The material has NOT been classified by EC Directives or other classification systems as "harmful by ingestion". This is because of the lack of
corroborating animal or human evidence.
Swallowing hypochlorites may cause burning in the mouth and throat, abdominal cramps, nausea, vomiting, diarrhea, pain, inflammation f the
mouth and stomach, low blood pressure, shock, confusion and delirium. Severe poisonings may lead to convulsion, coma and death.
The material can produce severe chemical burns within the oral cavity and gastrointestinal tract following ingestion.
Skin Contact
The material can produce severe chemical burns following direct contact with the skin.
Skin contact is not thought to have harmful health effects (as classified under EC Directives); the material may still produce health damage
following entry through wounds, lesions or abrasions.
Skin contact with alkaline corrosives may produce severe pain and burns; brownish stains may develop. The corroded area may be soft,
gelatinous and necrotic; tissue destruction may be deep.
Contact may cause severe itchiness, skin lesions and mild eczema. Exudation and sloughing may occur.
Open cuts, abraded or irritated skin should not be exposed to this material
Entry into the blood-stream, through, for example, cuts, abrasions or lesions, may produce systemic injury with harmful effects. Examine the skin
prior to the use of the material and ensure that any external damage is suitably protected.
Eye
If applied to the eyes, this material causes severe eye damage.
Direct eye contact with corrosive bases can cause pain and burns. There may be swelling, epithelium destruction, clouding of the cornea and
inflammation of the iris.
Hypochlorite in pool water at concentrations of 1 ppm chlorine or less is non irritating to eyes if the pH is higher than 7.2 (slightly alkaline); At
lower pH sensation of stinging, smarting of eyes with transient reddening may occur but generally no injury.
Eye contact with a 5% hypochlorite solution may produce a temporary burning discomfort and slight irritation of the epithelium of the cornea, but
without injury.
The material can produce severe chemical burns to the eye following direct contact. Vapours or mists may be extremely irritating.
Chronic
Repeated or prolonged exposure to corrosives may result in the erosion of teeth, inflammatory and ulcerative changes in the mouth and necrosis
(rarely) of the jaw. Bronchial irritation, with cough, and frequent attacks of bronchial pneumonia may ensue.
Long-term exposure to respiratory irritants may result in airways disease, involving difficulty breathing and related whole-body problems.
Substance accumulation, in the human body, may occur and may cause some concern following repeated or long-term occupational exposure.
Reduced breathing capacity may result from chronic low level exposure to chlorine gas. Chronic poisoning may result in cough, severe chest
pains, sore throat and blood in the phlegm.
There has been some concern that this material can cause cancer or mutations but there is not enough data to make an assessment.
Fiberlock 8317 Instant Mold
Stain Remover
TOXICITY IRRITATION
Oral (Human)LC50: 0 mg/kg[2]Not Available
sodium hypochlorite
TOXICITY IRRITATION
Oral (rat) LD50: >5000 mg/kg[2]Eye (rabbit): 10 mg - moderate
Eye (rabbit): 100 mg - moderate
Skin (rabbit): 500 mg/24h-moderate
sodium hydroxide
TOXICITY IRRITATION
Dermal (rabbit) LD50: 1350 mg/kg[2]Eye (rabbit): 0.05 mg/24h SEVERE
Eye (rabbit):1 mg/24h SEVERE
Eye (rabbit):1 mg/30s rinsed-SEVERE
Eye: adverse effect observed (irritating)[1]
Skin (rabbit): 500 mg/24h SEVERE
Skin: adverse effect observed (corrosive)[1]
sodium xylenesulfonate
TOXICITY IRRITATION
Dermal (rabbit) LD50: >=2000 mg/kg[1]Eye: adverse effect observed (irritating)[1]
Oral (rat) LD50: >10 mg/kg[2]Skin: no adverse effect observed (not irritating)[1]
lauryldimethylamine oxide
TOXICITY IRRITATION
dermal (rat) LD50: >2000 mg/kg[1]Eye (rabbit): 50 ug/24h - SEVERE
Oral (rat) LD50: >600 mg/kg[1]Skin (rabbit): 2 mg/24h - SEVERE
Legend:1. Value obtained from Europe ECHA Registered Substances - Acute toxicity 2.* Value obtained from manufacturer's SDS. Unless otherwise
specified data extracted from RTECS - Register of Toxic Effect of chemical Substances
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Legend: – Data either not available or does not fill the criteria for classification
– Data available to make classification
SODIUM HYPOCHLORITE
The material may produce moderate eye irritation leading to inflammation. Repeated or prolonged exposure to irritants may produce
conjunctivitis.
as sodium hypochlorite pentahydrate
SODIUM XYLENESULFONATE
No significant acute toxicological data identified in literature search.
Toxicological data is available and well documented for representative toluene, xylene and cumene sulfonates (including sodium, potassium,
ammounium and calcium salts). These data show that hydrotropes have low toxicity for all routes, do not cause genetic damage, show no
evidence of causing cancer in long-term skin studies, and have not caused birth defects, developmental defects or reduced fertility.
<
LAURYLDIMETHYLAMINE
OXIDE
Amine oxides are readily metabolised and excreted after oral intake. They produced no mortality or skin sensitization on exposure but caused
reversible irritation of the eyes, skin and airways.
Fiberlock 8317 Instant Mold
Stain Remover & SODIUM
HYPOCHLORITE & SODIUM
HYDROXIDE & SODIUM
XYLENESULFONATE &
LAURYLDIMETHYLAMINE
OXIDE
Asthma-like symptoms may continue for months or even years after exposure to the material ends. This may be due to a non-allergic condition
known as reactive airways dysfunction syndrome (RADS) which can occur after exposure to high levels of highly irritating compound.
Fiberlock 8317 Instant Mold
Stain Remover & SODIUM
XYLENESULFONATE
For alkyl sulfates; alkane sulfonates and alpha-olefin sulfonates
Most chemicals of this category are not defined substances, but mixtures of homologues with different alkyl side chains. Common physical and/or
biological pathways result in structurally similar breakdown products, and are, together with the surfactant properties, responsible for similar
environmental behavior and essentially identical hazard profiles with regard to human health.
Acute toxicity: These substances are well absorbed after ingestion; penetration through the skin is however, poor.
Fiberlock 8317 Instant Mold
Stain Remover & SODIUM
HYPOCHLORITE
Hypochlorite salts are classified by IARC as Group 3: NOT classifiable as to its carcinogenicity to humans.
Evidence of carcinogenicity may be inadequate or limited in animal testing.
Hypochlorite salts are extremely corrosive and can cause severe damage to the eyes and skin. A number of skin cancers have been observed in
mice, when applied to their skin.
SODIUM HYDROXIDE &
LAURYLDIMETHYLAMINE
OXIDE
The material may produce severe irritation to the eye causing pronounced inflammation. Repeated or prolonged exposure to irritants may
produce conjunctivitis.
The material may cause severe skin irritation after prolonged or repeated exposure and may produce on contact skin redness, swelling, the
production of vesicles, scaling and thickening of the skin. Repeated exposures may produce severe ulceration.
Acute Toxicity Carcinogenicity
Skin Irritation/Corrosion Reproductivity
Serious Eye Damage/Irritation STOT - Single Exposure
Respiratory or Skin
sensitisation STOT - Repeated Exposure
Mutagenicity Aspiration Hazard
SECTION 12 ECOLOGICAL INFORMATION
Toxicity
Fiberlock 8317 Instant Mold
Stain Remover
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
Not
Available Not Available Not Available Not
Available
Not
Available
sodium hypochlorite
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
LC50 96 Fish 0.032mg/L 4
EC50 48 Crustacea 0.026mg/L 2
EC50 72 Algae or other aquatic plants 0.018mg/L 2
NOEC 72 Algae or other aquatic plants 0.005mg/L 2
sodium hydroxide
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
LC50 96 Fish 125mg/L 4
EC50 48 Crustacea 40.4mg/L 2
EC50 96 Algae or other aquatic plants 3180000mg/L 3
NOEC 96 Fish 56mg/L 4
sodium xylenesulfonate
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
LC50 96 Fish >1-mg/L 2
EC50 48 Crustacea >1-20mg/L 2
EC50 96 Algae or other aquatic plants >=230mg/L 2
NOEC 504 Crustacea <30mg/L 2
lauryldimethylamine oxide
ENDPOINT TEST DURATION (HR)SPECIES VALUE SOURCE
LC50 96 Fish 1.235mg/L 3
EC50 48 Crustacea 2.9mg/L 2
EC50 72 Algae or other aquatic plants 0.015mg/L 2
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EC10 72 Algae or other aquatic plants 0.002mg/L 2
NOEC 72 Algae or other aquatic plants 0.003mg/L 2
Legend:Extracted from 1. IUCLID Toxicity Data 2. Europe ECHA Registered Substances - Ecotoxicological Information - Aquatic Toxicity 3. EPIWIN Suite
V3.12 (QSAR) - Aquatic Toxicity Data (Estimated) 4. US EPA, Ecotox database - Aquatic Toxicity Data 5. ECETOC Aquatic Hazard Assessment
Data 6. NITE (Japan) - Bioconcentration Data 7. METI (Japan) - Bioconcentration Data 8. Vendor Data
Very toxic to aquatic organisms, may cause long-term adverse effects in the aquatic environment.
Do NOT allow product to come in contact with surface waters or to intertidal areas below the mean high water mark. Do not contaminate water when cleaning equipment or disposing
of equipment wash-waters.
For Chlorine:
Atmospheric Fate: Atmospheric chlorine forms hydrochloric or hypochlorous acid in the atmosphere, either through reactions with hydroxyl radicals or, other trace species, such as
hydrocarbons. These acids are believed to be removed from the atmosphere primarily through precipitation washout/dry deposition.
In freshwater, the hypchlorites break down rapidly into non-toxic compounds when exposed to sunlight. While chlorine levels decline rapidly In seawater, hypobromite (which is acutely
toxic to aquatic organisms) is formed.
Prevent, by any means available, spillage from entering drains or water courses.
DO NOT discharge into sewer or waterways.
Persistence and degradability
Ingredient Persistence: Water/Soil Persistence: Air
sodium hydroxide LOW LOW
lauryldimethylamine oxide LOW LOW
Bioaccumulative potential
Ingredient Bioaccumulation
sodium hydroxide LOW (LogKOW = -3.8796)
lauryldimethylamine oxide HIGH (LogKOW = 4.673)
Mobility in soil
Ingredient Mobility
sodium hydroxide LOW (KOC = 14.3)
lauryldimethylamine oxide LOW (KOC = 18660)
SECTION 13 DISPOSAL CONSIDERATIONS
Waste treatment methods
Product / Packaging disposal
Containers may still present a chemical hazard/ danger when empty.
Return to supplier for reuse/ recycling if possible.
DO NOT allow wash water from cleaning or process equipment to enter drains.
It may be necessary to collect all wash water for treatment before disposal.
Recycle wherever possible.
Consult manufacturer for recycling options or consult local or regional waste management authority for disposal if no suitable treatment or
disposal facility can be identified.
SECTION 14 TRANSPORT INFORMATION
Labels Required
Marine Pollutant
Land transport (DOT)
UN number 1791
UN proper shipping name Hypochlorite solutions
Transport hazard class(es)
Class 8
Subrisk Not Applicable
Packing group III
Environmental hazard Environmentally hazardous
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Special precautions for user
Hazard Label 8
Special provisions 386, IB3, N34, T4, TP2, TP24
Air transport (ICAO-IATA / DGR)
UN number 1791
UN proper shipping name Hypochlorite solution
Transport hazard class(es)
ICAO/IATA Class 8
ICAO / IATA Subrisk Not Applicable
ERG Code 8L
Packing group III
Environmental hazard Environmentally hazardous
Special precautions for user
Special provisions A3 A803
Cargo Only Packing Instructions 856
Cargo Only Maximum Qty / Pack 60 L
Passenger and Cargo Packing Instructions 852
Passenger and Cargo Maximum Qty / Pack 5 L
Passenger and Cargo Limited Quantity Packing Instructions Y841
Passenger and Cargo Limited Maximum Qty / Pack 1 L
Sea transport (IMDG-Code / GGVSee)
UN number 1791
UN proper shipping name HYPOCHLORITE SOLUTION
Transport hazard class(es)
IMDG Class 8
IMDG Subrisk Not Applicable
Packing group III
Environmental hazard Marine Pollutant
Special precautions for user
EMS Number F-A , S-B
Special provisions 223 274 900
Limited Quantities 5 L
Transport in bulk according to Annex II of MARPOL and the IBC code
Not Applicable
SECTION 15 REGULATORY INFORMATION
Safety, health and environmental regulations / legislation specific for the substance or mixture
SODIUM HYPOCHLORITE IS FOUND ON THE FOLLOWING REGULATORY LISTS
GESAMP/EHS Composite List - GESAMP Hazard Profiles
IMO IBC Code Chapter 17: Summary of minimum requirements
IMO MARPOL (Annex II) - List of Noxious Liquid Substances Carried in Bulk
International Agency for Research on Cancer (IARC) - Agents Classified by the IARC
Monographs
International Air Transport Association (IATA) Dangerous Goods Regulations
International Maritime Dangerous Goods Requirements (IMDG Code)
United Nations Recommendations on the Transport of Dangerous Goods Model
Regulations
US Coast Guard, Department of Homeland Security Part 153: Ships Carrying Bulk
Liquid, Liquefied gas or compressed gas hazardous materials. Table 1 to Part 153
--Summary of Minimum Requirements
US CWA (Clean Water Act) - List of Hazardous Substances
US Department of Transportation (DOT) List of Hazardous Substances and Reportable
Quantities - Hazardous Substances Other Than Radionuclides
US Department of Transportation (DOT) Marine Pollutants - Appendix B
US Department of Transportation (DOT), Hazardous Material Table
US DOE Temporary Emergency Exposure Limits (TEELs)
US Postal Service (USPS) Hazardous Materials Table: Postal Service Mailability Guide
US Postal Service (USPS) Numerical Listing of Proper Shipping Names by
Identification (ID) Number
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US Toxicology Excellence for Risk Assessment (TERA) Workplace Environmental
Exposure Levels (WEEL)
US TSCA Chemical Substance Inventory - Interim List of Active Substances
SODIUM HYDROXIDE IS FOUND ON THE FOLLOWING REGULATORY LISTS
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GESAMP/EHS Composite List - GESAMP Hazard Profiles
IMO IBC Code Chapter 17: Summary of minimum requirements
IMO Provisional Categorization of Liquid Substances - List 3: (Trade-named) mixtures
containing at least 99% by weight of components already assessed by IMO, presenting
safety hazards
International Air Transport Association (IATA) Dangerous Goods Regulations
International Maritime Dangerous Goods Requirements (IMDG Code)
United Nations Recommendations on the Transport of Dangerous Goods Model
Regulations
US - Alaska Limits for Air Contaminants
US - California OEHHA/ARB - Acute Reference Exposure Levels and Target Organs
(RELs)
US - California Permissible Exposure Limits for Chemical Contaminants
US - Hawaii Air Contaminant Limits
US - Idaho - Limits for Air Contaminants
US - Idaho Toxic Air Pollutants Non- Carcinogenic Increments - Occupational Exposure
Limits
US - Michigan Exposure Limits for Air Contaminants
US - Minnesota Permissible Exposure Limits (PELs)
US - Oregon Permissible Exposure Limits (Z-1)
US - Tennessee Occupational Exposure Limits - Limits For Air Contaminants
US - Vermont Permissible Exposure Limits Table Z-1-A Final Rule Limits for Air
Contaminants
US - Vermont Permissible Exposure Limits Table Z-1-A Transitional Limits for Air
Contaminants
US - Washington Permissible exposure limits of air contaminants
US - Wyoming Toxic and Hazardous Substances Table Z1 Limits for Air Contaminants
US ACGIH Threshold Limit Values (Spanish)
US ACGIH Threshold Limit Values (TLV)
US AIHA Workplace Environmental Exposure Levels (WEELs)
US Coast Guard, Department of Homeland Security Part 153: Ships Carrying Bulk
Liquid, Liquefied gas or compressed gas hazardous materials. Table 1 to Part 153
--Summary of Minimum Requirements
US CWA (Clean Water Act) - List of Hazardous Substances
US Department of Transportation (DOT) List of Hazardous Substances and Reportable
Quantities - Hazardous Substances Other Than Radionuclides
US Department of Transportation (DOT), Hazardous Material Table
US DOE Temporary Emergency Exposure Limits (TEELs)
US NIOSH Recommended Exposure Limits (RELs)
US NIOSH Recommended Exposure Limits (RELs) (Spanish)
US OSHA Permissible Exposure Levels (PELs) - Table Z1
US OSHA Permissible Exposure Limits - Annotated Table Z-1 (Spanish)
US Postal Service (USPS) Hazardous Materials Table: Postal Service Mailability Guide
US Postal Service (USPS) Numerical Listing of Proper Shipping Names by
Identification (ID) Number
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
SODIUM XYLENESULFONATE IS FOUND ON THE FOLLOWING REGULATORY LISTS
US - Idaho Toxic Air Pollutants Non- Carcinogenic Increments - Occupational Exposure
Limits
US - Vermont Permissible Exposure Limits Table Z-1-A Transitional Limits for Air
Contaminants
US Coast Guard, Department of Homeland Security Part 153: Ships Carrying Bulk
Liquid, Liquefied gas or compressed gas hazardous materials. Table 1 to Part 153
--Summary of Minimum Requirements
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
US TSCA Section 12(b) - List of Chemical Substances Subject to Export Notification
Requirements
US TSCA Section 5(a)(2) - Significant New Use Rules (SNURs)
LAURYLDIMETHYLAMINE OXIDE IS FOUND ON THE FOLLOWING REGULATORY LISTS
International Air Transport Association (IATA) Dangerous Goods Regulations
International Maritime Dangerous Goods Requirements (IMDG Code)
United Nations Recommendations on the Transport of Dangerous Goods Model
Regulations
US Department of Transportation (DOT), Hazardous Material Table
US Postal Service (USPS) Hazardous Materials Table: Postal Service Mailability Guide
US Postal Service (USPS) Numerical Listing of Proper Shipping Names by
Identification (ID) Number
US Toxic Substances Control Act (TSCA) - Chemical Substance Inventory
US TSCA Chemical Substance Inventory - Interim List of Active Substances
Federal Regulations
Superfund Amendments and Reauthorization Act of 1986 (SARA)
SECTION 311/312 HAZARD CATEGORIES
Flammable (Gases, Aerosols, Liquids, or Solids)No
Gas under pressure No
Explosive No
Self-heating No
Pyrophoric (Liquid or Solid)No
Pyrophoric Gas No
Corrosive to metal Yes
Oxidizer (Liquid, Solid or Gas)No
Organic Peroxide No
Self-reactive No
In contact with water emits flammable gas No
Combustible Dust No
Carcinogenicity No
Acute toxicity (any route of exposure)No
Reproductive toxicity No
Skin Corrosion or Irritation Yes
Respiratory or Skin Sensitization No
Serious eye damage or eye irritation Yes
Specific target organ toxicity (single or repeated exposure)No
Aspiration Hazard No
Germ cell mutagenicity No
Simple Asphyxiant No
Hazards Not Otherwise Classified No
US. EPA CERCLA HAZARDOUS SUBSTANCES AND REPORTABLE QUANTITIES (40 CFR 302.4)
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Name Reportable Quantity in Pounds (lb)Reportable Quantity in kg
Sodium hypochlorite 100 45.4
Sodium hydroxide 1000 454
State Regulations
US. CALIFORNIA PROPOSITION 65
None Reported
National Inventory Status
National Inventory Status
Australia - AICS Yes
Canada - DSL Yes
Canada - NDSL No (lauryldimethylamine oxide; sodium xylenesulfonate; sodium hypochlorite; sodium hydroxide)
China - IECSC Yes
Europe - EINEC / ELINCS / NLP Yes
Japan - ENCS Yes
Korea - KECI Yes
New Zealand - NZIoC Yes
Philippines - PICCS Yes
USA - TSCA Yes
Taiwan - TCSI Yes
Mexico - INSQ No (lauryldimethylamine oxide)
Vietnam - NCI Yes
Russia - ARIPS Yes
Legend:Yes = All CAS declared ingredients are on the inventory
No = One or more of the CAS listed ingredients are not on the inventory and are not exempt from listing(see specific ingredients in brackets)
SECTION 16 OTHER INFORMATION
Revision Date 01/22/2020
Initial Date 05/22/2017
CONTACT POINT
**PLEASE NOTE THAT TITANIUM DIOXIDE IS NOT PRESENT IN CLEAR OR NEUTRAL BASES**
SDS Version Summary
Version Issue Date Sections Updated
3.5.1.1.1 01/22/2020 Advice to Doctor, Chronic Health, Environmental, Fire Fighter (extinguishing media), Fire Fighter (fire fighting), Ingredients,
Personal Protection (hands/feet), Spills (major), Supplier Information
Other information
Classification of the preparation and its individual components has drawn on official and authoritative sources as well as independent review by the Chemwatch Classification
committee using available literature references.
The SDS is a Hazard Communication tool and should be used to assist in the Risk Assessment. Many factors determine whether the reported Hazards are Risks in the workplace or
other settings.
Definitions and abbreviations
PC－TWA: Permissible Concentration-Time Weighted Average
PC－STEL: Permissible Concentration-Short Term Exposure Limit
IARC: International Agency for Research on Cancer
ACGIH: American Conference of Governmental Industrial Hygienists
STEL: Short Term Exposure Limit
TEEL: Temporary Emergency Exposure Limit。
IDLH: Immediately Dangerous to Life or Health Concentrations
OSF: Odour Safety Factor
NOAEL :No Observed Adverse Effect Level
LOAEL: Lowest Observed Adverse Effect Level
TLV: Threshold Limit Value
LOD: Limit Of Detection
OTV: Odour Threshold Value
BCF: BioConcentration Factors
BEI: Biological Exposure Index
Powered by AuthorITe, from Chemwatch.
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end of SDS
SUBMITTAL COVER SHEET VMJR Project No.:8-22-202
Contractor:VMJR Companies, LLC.
73 Mohican Street
Glens Falls, NY 12801
(518) 792-1128
Project Description: (Project Title, Facility Name and Address)
Renovations and Alterations to 68 Quaker Road
68 Quaker Road, Queensbury, NY 12804
DASNY JDE #: 3612709999
Voluntary Provider:
Addictions Care Center of Albany, Inc.
Date: 6/15/2022
TO: FROM:
Cayla Walter, architecture +Brian J. Blake, VMJR Companies
Brian Barker, architecture +
Subcontractor / Material Supplier: MACFAWN ENTERPRISES
SUBMITTAL TYPE:
General Data Re-Submittal Information (Waiver)
Additional Notes: Please see attached
submittal for Mold Remediation Closeout.
Product Data Shop Drawings Quality Control/Assurance
Test Reports Certificate Contract Closeout
Design Data Samples Other
Submittal Number and Title: 02 85 00-02(R1) Mold Remediation Closeout
Part Type Description
028500 1.2B Closeout Documentation
Contractor’s Certification:
All material and documentation contained within this submittal, meets all the requirements specified or shown to the best of our knowledge.
Brian J. Blake, Project Manager
Contractor/Contractor’s Representative (Print Name)
Brian J. Blake
Signature
No exceptions taken.
-Cheyenne J. Dashnaw, ATL (06-17-22)
P.O. Box 13205
Albany, NY 12212
(877) MACFAWN
info@macfawn.com
www.macfawn.com
VMJR, CRM-032122-12804 - Final Report
Claim ID
VMJR, CRM-032122-12804
Date of Loss
Mar 22, 2022
Date Claim Created
Mar 22, 2022
Type of Loss
Mold
Project Manager
Evan MacFawn
Address
68 Quaker Road, Queensbury, NY
12804, USA
Policyholder Name
Brian Blake
Policyholder Email
BJBlake@vmjrcompanies.com
Policyholder Phone Number
(518) 321-9743
Report Details
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This is a final report of the services performed at the specified project location. This report
contains all the applicable pictures, sketches, notes and documentation. If you have any
questions please reach out the office at (518) 785-6719.
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Table of Contents
4General Notes
4Exterior
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Overview Photos
5Entry Way
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Overview Photos
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Room Notes
7Conference Room
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Overview Photos
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Room Notes
9Mechanical Room South
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Overview Photos
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Room Notes
11Mechanical Room North
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Overview Photos
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Room Notes
13Passage
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Overview Photos
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Room Notes
Attachments
1. Mold Remediation Work Plan - VMJR ACCA CRM.pdf
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General Notes
Site Super
John Howard 518-742-6730
Hard hats required when not in containment
Hazard sign back entrance
Mar 31, 2022Mar 31, 2022
9:29 AM ET9:29 AM ET
Exterior
OVERVIEW PHOTOS: Exterior
Photo 1Photo 1 Mar 22, 2022Mar 22, 2022
11:12 AM ET11:12 AM ET
Photo 2Photo 2 Mar 22, 2022Mar 22, 2022
11:12 AM ET11:12 AM ET
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Entry Way
OVERVIEW PHOTOS: Entry Way
Photo 1Photo 1 Mar 22, 2022Mar 22, 2022
11:18 AM ET11:18 AM ET
Photo 2Photo 2 Mar 22, 2022Mar 22, 2022
11:18 AM ET11:18 AM ET
Photo 3Photo 3 Mar 22, 2022Mar 22, 2022
11:18 AM ET11:18 AM ET
Photo 4Photo 4 Mar 22, 2022Mar 22, 2022
11:18 AM ET11:18 AM ET
Photo 5Photo 5 Mar 22, 2022Mar 22, 2022
11:19 AM ET11:19 AM ET
ROOM NOTES: Entry Way
EQ Setup
Mar 31, 2022Mar 31, 2022
3:41 PM ET3:41 PM ET
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Final Photos
Mar 31, 2022Mar 31, 2022
4:00 PM ET4:00 PM ET
Mar 31, 2022Mar 31, 2022
4:06 PM ET4:06 PM ET
Mar 31, 2022Mar 31, 2022
4:25 PM ET4:25 PM ET
Mar 31, 2022Mar 31, 2022
4:25 PM ET4:25 PM ET
Mar 31, 2022Mar 31, 2022
4:25 PM ET4:25 PM ET
Mar 31, 2022Mar 31, 2022
4:25 PM ET4:25 PM ET
Encapsulated
Mar 31, 2022Mar 31, 2022
4:20 PM ET4:20 PM ET
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Conference Room
OVERVIEW PHOTOS: Conference Room
Photo 1Photo 1 Mar 22, 2022Mar 22, 2022
11:24 AM ET11:24 AM ET
Photo 2Photo 2 Mar 22, 2022Mar 22, 2022
11:24 AM ET11:24 AM ET
Photo 3Photo 3 Mar 22, 2022Mar 22, 2022
11:25 AM ET11:25 AM ET
Photo 4Photo 4 Mar 22, 2022Mar 22, 2022
11:25 AM ET11:25 AM ET
Photo 5Photo 5 Mar 22, 2022Mar 22, 2022
11:25 AM ET11:25 AM ET
Photo 6Photo 6 Mar 22, 2022Mar 22, 2022
11:25 AM ET11:25 AM ET
Photo 7Photo 7 Mar 22, 2022Mar 22, 2022
11:25 AM ET11:25 AM ET
Photo 8Photo 8 Mar 22, 2022Mar 22, 2022
11:27 AM ET11:27 AM ET
Photo 9Photo 9 Mar 22, 2022Mar 22, 2022
11:27 AM ET11:27 AM ET
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ROOM NOTES: Conference Room
EQ setup
Mar 31, 2022Mar 31, 2022
2:12 PM ET2:12 PM ET
Final Photos
Mar 31, 2022Mar 31, 2022
3:30 PM ET3:30 PM ET
Mar 31, 2022Mar 31, 2022
3:30 PM ET3:30 PM ET
Mar 31, 2022Mar 31, 2022
3:30 PM ET3:30 PM ET
Encapsulated
Mar 31, 2022Mar 31, 2022
3:31 PM ET3:31 PM ET
Mar 31, 2022Mar 31, 2022
3:31 PM ET3:31 PM ET
Mar 31, 2022Mar 31, 2022
3:31 PM ET3:31 PM ET
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Mar 31, 2022Mar 31, 2022
3:31 PM ET3:31 PM ET
Mechanical Room South
OVERVIEW PHOTOS: Mechanical Room South
Photo 1Photo 1 Mar 22, 2022Mar 22, 2022
11:26 AM ET11:26 AM ET
Photo 2Photo 2 Mar 22, 2022Mar 22, 2022
11:26 AM ET11:26 AM ET
Photo 3Photo 3 Mar 22, 2022Mar 22, 2022
11:26 AM ET11:26 AM ET
Photo 4Photo 4 Mar 22, 2022Mar 22, 2022
11:26 AM ET11:26 AM ET
Photo 5Photo 5 Mar 22, 2022Mar 22, 2022
11:26 AM ET11:26 AM ET
Photo 6Photo 6 Mar 22, 2022Mar 22, 2022
11:26 AM ET11:26 AM ET
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ROOM NOTES: Mechanical Room South
EQ setup
Mar 31, 2022Mar 31, 2022
1:38 PM ET1:38 PM ET
Final Photos
Mar 31, 2022Mar 31, 2022
2:27 PM ET2:27 PM ET
Mar 31, 2022Mar 31, 2022
2:27 PM ET2:27 PM ET
Mar 31, 2022Mar 31, 2022
2:27 PM ET2:27 PM ET
Mar 31, 2022Mar 31, 2022
2:27 PM ET2:27 PM ET
Mar 31, 2022Mar 31, 2022
2:28 PM ET2:28 PM ET
Mar 31, 2022Mar 31, 2022
2:28 PM ET2:28 PM ET
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Mechanical Room North
OVERVIEW PHOTOS: Mechanical Room North
Photo 1Photo 1 Mar 22, 2022Mar 22, 2022
11:28 AM ET11:28 AM ET
Photo 2Photo 2 Mar 22, 2022Mar 22, 2022
11:28 AM ET11:28 AM ET
Photo 3Photo 3 Mar 22, 2022Mar 22, 2022
11:28 AM ET11:28 AM ET
Photo 4Photo 4 Mar 22, 2022Mar 22, 2022
11:28 AM ET11:28 AM ET
Photo 5Photo 5 Mar 22, 2022Mar 22, 2022
11:28 AM ET11:28 AM ET
ROOM NOTES: Mechanical Room North
Neg.Air
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Mar 31, 2022Mar 31, 2022
9:46 AM ET9:46 AM ET
Mar 31, 2022Mar 31, 2022
9:46 AM ET9:46 AM ET
Hazard sign and
containment
Mar 31, 2022Mar 31, 2022
9:42 AM ET9:42 AM ET
Final photos
Mar 31, 2022Mar 31, 2022
11:47 AM ET11:47 AM ET
Mar 31, 2022Mar 31, 2022
11:50 AM ET11:50 AM ET
Mar 31, 2022Mar 31, 2022
11:50 AM ET11:50 AM ET
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Passage
OVERVIEW PHOTOS: Passage
Photo 1Photo 1 Mar 22, 2022Mar 22, 2022
11:31 AM ET11:31 AM ET
Photo 2Photo 2 Mar 22, 2022Mar 22, 2022
11:31 AM ET11:31 AM ET
Photo 3Photo 3 Mar 22, 2022Mar 22, 2022
11:32 AM ET11:32 AM ET
ROOM NOTES: Passage
Neg.Air
Mar 31, 2022Mar 31, 2022
11:23 AM ET11:23 AM ET
Mar 31, 2022Mar 31, 2022
11:24 AM ET11:24 AM ET
Mar 31, 2022Mar 31, 2022
11:24 AM ET11:24 AM ET
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Mar 31, 2022Mar 31, 2022
11:24 AM ET11:24 AM ET
Containment
Mar 31, 2022Mar 31, 2022
11:36 AM ET11:36 AM ET
Mar 31, 2022Mar 31, 2022
11:36 AM ET11:36 AM ET
Mar 31, 2022Mar 31, 2022
11:36 AM ET11:36 AM ET
Mar 31, 2022Mar 31, 2022
11:36 AM ET11:36 AM ET
Mar 31, 2022Mar 31, 2022
11:37 AM ET11:37 AM ET
Final photos
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Mar 31, 2022Mar 31, 2022
1:19 PM ET1:19 PM ET
Mar 31, 2022Mar 31, 2022
1:19 PM ET1:19 PM ET
Mar 31, 2022Mar 31, 2022
1:19 PM ET1:19 PM ET
Mar 31, 2022Mar 31, 2022
1:19 PM ET1:19 PM ET
Encapsulated
Mar 31, 2022Mar 31, 2022
1:36 PM ET1:36 PM ET
Powered by Encircle Page 15 of 15
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SUBMITTAL COVER SHEET VMJR Project No.:8-22-202
Contractor:VMJR Companies, LLC.
73 Mohican Street
Glens Falls, NY 12801
(518) 792-1128
Project Description: (Project Title, Facility Name and Address)
Renovations and Alterations to 68 Quaker Road
68 Quaker Road, Queensbury, NY 12804
DASNY JDE #: 3612709999
Voluntary Provider:
Addictions Care Center of Albany, Inc.
Date: 6/8/2022
TO: FROM:
Cayla Walter, architecture +Brian J. Blake, VMJR Companies
Brian Barker, architecture +
Subcontractor / Material Supplier: MACFAWN ENTERPRISES
SUBMITTAL TYPE:
General Data Re-Submittal Information (Waiver)
Additional Notes: Please see attached
submittal for an updated Mold Remediation
License.
Product Data Shop Drawings Quality Control/Assurance
Test Reports Certificate Contract Closeout
Design Data Samples Other
Submittal Number and Title: 02 85 00-03 Current Remediation License
Part Type Description
1 Current Remediation License
Contractor’s Certification:
All material and documentation contained within this submittal, meets all the requirements specified or shown to the best of our knowledge.
Brian J. Blake, Project Manager
Contractor/Contractor’s Representative (Print Name)
Brian J. Blake
Signature
No exceptions taken.
-Cheyenne J. Dashnaw,
ATL (06-09-22)
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