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DEMO-0689-2023
' w- � Office Use Only E a. Permit#: bG- 0 6 b -SO 2-6 WN. ' ' DEMOLITION APPLICATION Permit Fee: $ UQ! Town of Queensbury Invoice#: 1/210c 742 Bay Road,Queensbury,NY 12804 a, .� P:518-761-8256 www.queensbury.net Flood Zone? Y Reviewed By: e Demolition Locations c 74il2LJ 121) Tax Map ID#: 299 7- I - 1-7 **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? 2. Type of structure to be demolished: a. Residence_ d. Storage Bieipling b. Garage e. Other: c. Business �" 16) I „—„-,--s- 3. What type of utilities are connected to the structure: �` " l�, a. Gas f. Well-Water Pump OCT �0 202 3 iy b. Fuel Oilg. Public Sewer TOW c. Propane h. Other SULDINQ EENSSURY d. Electric i. None OO®ES e. Public Water 4. Have ALL utilities (water, electric, etc.) been disconnected? Yes No V ADDITIONAL INFORMATION: 1. Two inspections are required: an inspection to determine that utilities are disconnected, and a final inspection after the structure is removed and the site is cleaned up and graded. 2. Twenty-four (24) hour notification is required for inspections. 3. Workers' Comp insurance information is required to be submitted with this application. Declaration: I acknowledge that no structure(s)will be removed from the parcel until the demolition application has been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a permit has been issued. I have read an,I a ree o the ab e: PRINT NAME: I G ill-,4 Pr.10 J/22 SIGNATURE. �/ DATE: (J/23 Demolition Application Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Appli.ca t: Name(s): �c-J f(r/ ' TVI ALt y /Lc i Mailing Address, C/S/Z: Q. ?L ( CIO za,aivs2td( Cell Phone: 5n) 3(o(I,26( Land Line: Email: VIA 12 5Ze 6 (0:J€.( I 0- aat • Primary Owner(s): Name(s): 5'4J/� 111-X � Z" Mailing Address, C/S/Z: Cell Phone: Land Line: Email: Ieck if all work will be performed by property owner only • Contractor: (List all additional contractors on the back of this form) Contact Name(s): Contractor Trade: Mailing Address, C/S/Z: Cell Phone: Land Line: Email: **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: A-11.GA/e.-( elf Cell Phone: ,77 3� (—/, .C� Land Line: Email: '1 2 uU1 [ L . 10_C /1./ Demolition Application Revised June 2022 289.7-1-17 DEMO-0689-2023 Rozell, Mike NORTHEASTERN 56 Reardon Rd ENVIRONMENTAL Demolition of back camp TECHNOLOGIES CORP. 1476 ROUTE 50-P.O.Box 2167 BnLLsroN SPA,NY 12020 • - '�_ p ' FILE C P Phone:(518)884-8545-Fax:(518)8849710ii �'QUEE`�Si I?`{ rw,3 y ! !� www.neenvironmentaltech.com �,',;, �,;;; j i ('�+,i i is `_INT , �' an August 2,2022 �; ,rr,. _ cr t,: _i , Lek.' 2G2� �. i. OCT 3 0 Michael Rozell 93 Tee Hill Road Queensbury,New York, 12804 TO ©BUILL�FI Q��..U&GOUES Y Sent Via E-MAIL:Mrozell(c�Rozelllnd.com Dear Mike, This letter summarizes the building inspection&material testing services Northeastern Environmental 'Technologies Corporation administrated for you at(2)residential structures located at 56 Reardon Road Queensbury,New York(hereinafter termed the Site). • To support the demolition work we understand you intend to complete at the Site;representative samples of building materials were obtained by a NYS Certified and AHERA trained asbestos inspector.The building material samples were subsequently shipped and tested by EMSL Analytical Laboratory in Depew,New York and AmeriSci New York Laboratories for the presence of asbestos. The purpose of this work is to alert you to asbestos containing materials that may complicate and/or add cost to your contemplated demolition work. The results of the completed services identify the following: Single Family Home(Rear Structure) The results of the pre-demolition asbestos survey indicated that the following samples obtained contained greater than 1%asbestos. 1) Roof—1,200 SF • 2) Joint Compound-800 SF Lake House Camp(Waterfront Structure) The results of the pre-demolition asbestos survey indicated all building material samples analyzed contained asbestos less than 1%asbestos. • A copy of the PRE-DEMOLITION REPORT OF BUILDING MATERIAL SURVEY,SAMPLING&EVALUATION OF ASBESTOS-CONTAINING MATERL4LS report for each structure are included as Attachments A&B. If you have questions or need additional assistance please call me. . Sincerely, NOR T ENVIRONMENTAL TECHNOLOGIES CORPORATION • . Je frey T.Wink • President Attachment A Single Family Structure (Rear) , CERTIFICATION PAGE PRE-DEMOLITION REPORT OF BUILDING MATERIAL SURVEY, SAMPLING AND EVALUATION OF ASBESTOS-CONTAINING MATERIALS SINGLE FAMILY RESIDENCE (REAR) 56 REARDON ROAD QUEENSBURY,NEW YORK 12804 Survey Date:January 25,2018 Updated June 20, 2022 Prepared for: Michael Rozell 93 Tee Hill Road Queensbury,New York,12804 John Snyder,MBA July 20,2022 NYS DOL Certified Inspector i TABLE OF CONTENTS 1.0 PURPOSE AND SCOPE OF SERVICES 1 2.0 REPRESENTATIVE ASBESTOS-CONTAINING MATERIAL SURVEY 1 2.1 Homogeneous Areas 1 2.2 Hazard Assessment Factors 1 2.3 Sampling Strategy 2 2.4 Laboratory Analytical Results 3 3.0 RESULTS 3 4.0 ASSUMPTIONS AND LIMITATIONS 4 ATTACHMENTS Attachment A Laboratory Analysis Report with Chain of Custody Documentation Sample and Asbestos Location Drawing Attachment B Company,Personnel,and Laboratory Accreditations and Licenses 11 1.0 PURPOSE AND SCOPE OF SERVICES The purpose of this project was to conduct a pre-demolition asbestos survey of the single- family home located at 56 Reardon Road in Queensbury,New York 12084. The structure inspected is located on the rear portion of the lot.The following services were provided for this matter. Conduct a representative asbestos survey in the identified areas,which include: 1. Survey the site building. 2. Identify accessible suspect asbestos-containing materials(ACMs)that were not previously tested. 3. Quantify ACMs,including material condition and location. 4. Collect and analyze bulk additional samples of suspect friable and non-friable materials to eliminate suspect materials as asbestos containing. 2.0 REPRESENTATIVE ASBESTOS-CONTAINING MATERIAL SURVEY A NYS Certified and AHERA trained asbestos inspector conducted the asbestos survey of the building materials targeted for demolition. The areas were visually inspected for the presence of materials in the path of demolition that are suspected to contain asbestos. Bulk samples of the identified suspect ACMs were collected and placed into individual containers for transport to a National Voluntary Laboratory Accreditation Program (NVLAP)and a New York State Department of Health Environmental Laboratory Approval Program(ELAP)-accredited laboratory for analysis. Materials visibly identified as non-asbestos(fibrous glass,foam rubber, wood, etc.)were not sampled. The asbestos survey consisted of three basic procedures: 1) conducting a visual inspection of the structures;2)identifying homogeneous areas(HAs)of suspect surfacing,thermal system insulation,and miscellaneous materials; and 3)sampling accessible,friable and non-friable suspect materials. 2.1 Homogeneous Areas Prior to collecting any samples,HAs were identified and listed to develop a sampling strategy. A homogeneous sampling area can be described as one or more areas of material that are similar in appearance and texture and that have the same installation date and function. The actual number of samples collected from each homogeneous sampling area may vary,based on the type of material and the professional judgment of the inspector. 2.2 Hazard Assessment Factors From the list of suspect homogeneous materials,a physical assessment was performed for each material on the list. A physical assessment includes evaluating the condition,assessing the potential for disturbance,and determining the friability of each material. Friability is a term used to describe the ease in which a building material inherently lends itself to disturbance. By Page 1 defmition, "friable"materials are those that can be crumbled or reduced to powder by hand pressure when dry. Each material on the list was further classified into one of three categories, which have specific sampling requirements for each category. Surfacing Materials: Refers to spray-applied or troweled surfaces such as plaster ceilings and walls,fireproofing,textured paints,textured plasters,and spray- applied acoustical surfaces. Thermal System Insulation: Refers to insulation used to inhibit heat gain or loss on pipes,boilers, tanks,ducts,and various other building components. Miscellaneous Materials: Refers to friable and non-friable products and materials that do not fit in any of the above two categories such as resilient floor covering, baseboards,mastics,adhesives,roofing material,caulking,glazing, and siding. This category also contains wallboard and ceiling tile. All confirmed ACMs were then assessed by their condition as good(intact),fair(damaged)or poor(significantly damaged)per Title 40 Code of Federal Regulations Part 763. Material with localized significant damage was also assessed as poor when observed. 2.3 Sampling Strategy The asbestos inspection was conducted according to New York State Department of Labor Industrial Code Rule 56 guidelines using a minimum number of samples collected from each HA,which also meets the sampling requirement found in 29 CFR 1926.1101. Sample collection depends on the category that the HA falls into and the amount of material present,as follows: _ GUIDELINES FOR DETERMINING THE NUMBER OF SAMPLES TO TAKE ' . . HA CATEGORY HA SIZE SAMPLES REQUIRED. Surfacing Materials <1,000 SF 3 1,000-5,000 SF 5 >5,000 SF 7 or more Thermal System Insulation No Stipulation 3+(Must also sample all repair patches) Miscellaneous Materials No Stipulation Per AHERA,these materials must be sampled"in a manner sufficient to determine whether or not they contain asbestos"typically 2-3 samples based upon inspector judgment. If the analytical results indicated that all the samples collected per HA did not contain asbestos, then the HA(material)would be considered a non-ACM. However, if the analytical results of one or more of the samples collected per HA indicate that asbestos is present in quantities of greater than 1 percent asbestos by weight(as defined by EPA),all of the HA(material)would be treated as an ACM regardless of any other analytical results. Material,which can visually be determined to be non-asbestos(i.e., fibrous glass,foam rubber, etc.)by the accredited inspector are not required to be sampled. Page 2 Miscellaneous materials require adequately representative sampling,which is typically done by collecting from two to three samples per material. Inspectors typically rely on other survey observations such as the condition,friability,and quantity of material to determine what would be a sufficient amount of samples to accurately evaluate the presence or absence of asbestos content. Actual collection of a bulk asbestos sample involves physically removing a small piece of material and placing it in a marked, airtight container. Sample containers are marked with a unique identification number,which is also noted in the field notes. 2.4 Laboratory Analytical Results The samples were sent to EMSL Analytical Laboratory in Depew,New York for analysis. ' • Friable Samples—Friable suspect asbestos containing material samples were analyzed utilizing Method EPA/600/R-93/116 with New York State ELAP 198.1 revision to facilitate compliance with both AHERA and the•New York State Department of Health polarized light • microscopy(PLM)analytical techniques. All fibers observed were identified to determine whether or not they contained asbestos. • Non-Friable Samples—Non-friable organically bound(NOB)suspect asbestos containing material samples were analyzed utilizing Method EPA/600/R-93/116 with New York State FLAP 198.6 and 198.4 revisions to facilitate compliance with both AHERA and the New York State Department of Health polarized light microscopy(PLM)and transmission electron microscopy(TEM)analytical techniques. These non-friable organically bound samples must be weighed to record initial sample weights,then subjected to muffle furnace and acid bath sample preparation to eliminate the organic constituents. If the remaining inorganic sample residue is 1%or less of the original sample weight,the sample is considered a non-asbestos containing material. If the remaining inorganic sample residue is greater than 1%of the original sample weight then the sample must be analyzed using either PLM or TEM analytical techniques to determine that the sample is an asbestos containing material(positive)or TEM to prove that the sample is a non-asbestos containing material (negative). A non-friable organically bound sample must be proven a non-asbestos containing material utilizing the NYS ELAP 198.4 TEM test method to be in compliance with the New York state Department of Health. 3.0 RESULTS The results of the pre-demolition asbestos survey of the single-family home located at 56 Reardon Road in Queensbury,New York 12084 indicated that the following samples obtained contained greater than 1% asbestos. • Roof—1,200 SF • Joint Compound-800 SF Page 3 Attachment A contains the complete asbestos laboratory analysis report with chain of custody documentation and a sample location diagram. Attachment B contains the Company,Personnel and Laboratory Accreditations and Licenses. The building survey included limited destructive sampling for"hidden"materials. If,during the course of demolition,any material is discovered that is not listed in the laboratory samples results it must be treated as asbestos containing material and handled appropriately or sampled by an inspector according to NYS and EPA regulations. One(1)copy of the results of the building/structure asbestos survey shall be immediately transmitted by the building/structure owner as follows: • One(1)copy of the completed asbestos survey shall be sent by the owner or their agent to the local government entity charged with issuing a permit for such demolition,renovation, remodeling or repair work under applicable State or local laws. • The completed asbestos survey for controlled demolition(as per Subpart 56-11.5)or pre- demolition asbestos projects shall also be submitted to the appropriate Asbestos Control Bureau district office. • The completed asbestos survey shall be kept on the construction site with the asbestos notification and variance, if required,throughout the duration of the asbestos project and any associated demolition,renovation,remodeling or repair project. 4.0 ASSUMPTIONS AND LIMITATIONS The results,findings, conclusions, and recommendations expressed in this report are based only on conditions that were noted during the inspection of the single-family home located at the rear of 56 Reardon Road in Queensbury,New York 12084 on the dates of the survey work. • The selection of sample locations and frequency of sampling was based on observations and the assumption that like materials in the same area are homogeneous in content. • Refer to Section 1.0 Purpose and Scope of Services of this report to see clarification of survey locations that were in our scope of work. (This is Standard in Surveys) • Exterior areas below grade were not inspected. Foundation sealers,buried piping,and other items may exist below grade which may contain asbestos. • Masonry was excluded from the survey. • Vermiculite was not discovered during the survey. It may existing in concealed spaces. If found it must be assumed to contain asbestos and must be abated accordingly. Random penetrations were made to walls, ceilings,attic floor,and block foundation and no vermiculite was observed. It still may exist in the structure as only full demolition will , reveal all materials. • The siding was peeled back in several areas. No cement board or transite siding was observed. Only full removal of the outside siding would reveal all layers and locations of other materials. If discovered,work must stop, and the discovered materials must be tested. • Page 4 • • This report reflects the conditions found at the date and time of the inspections. Conditions of the area may change due to external events or forces. Re-inspection of the area may be required prior to the start of any work if an extended period of time has passed or if • disturbances have occurred. • Electrical wiring and electrical components were not sampled as it could not be confirmed that the building was de-energized at the time of the survey. • Additional layers of flooring,wall systems,or ceiling systems may exist. Only full demolition would reveal all layers. If discovered these items must be sampled if not sampled previously. All quantities are estimates. The asbestos abatement contractor is to confirm the quantity prior to bidding. Our professional services have been performed,our findings obtained,and our conclusions and recommendations prepared in accordance with customary principles and practices in the fields of environmental science and engineering. This statement is in lieu of other statements either expressed or implied. This report does not warrant against future operations or conditions,nor does it warrant against operations or conditions present of a type or at a location not investigated. J Page 5 s ATTACHMENT A BULK SAMPLES WITH CORRESPONDING RESULTS SAMPLE AND ACM LOCATION DIAGRAMS EMSLEMSL Order: 141900296 Analytical, Inc. Customer ID: AWEV42 490 Rowley Road Depew,NY 14043 Customer P0: Phone/Fax:(716)651-0030/(716)651-0394 Project ID: http://www.EMSLcom/buffalolab@emsl.com Attention: John Snyder • Phone: (518)376-7345 AirWater Environmental Fax: PO Box 1071 Received: 01/26/2019 11:02 AM Averill Park,NY 12018 - Analysis Date: 02/02/2019 Collected: 01/25/2019 Project: 56 Reardon Road/56 Reardon Road Queensbury/Rear Camp/Structure Test Report:Asbestos Analysis of Bulk Materials by PLM via the NY State ELAP 198.1 Method Non-Asbestos Asbestos. Sample Description Appearance %Fibrous %Non-Fibrous %Type 001-01 Kitchen-Sheetrock Gray 15%Cellulose 85%Non-fibrous(Other) None Detected 141900296-0001 Fibrous Homogeneous HA:001 Paper and sheetrock layers included In analysis. 001-02 BR-Sheetrock Gray 15%Cellulose 85%Non-fibrous(Other) None Detected 141900296-0002 Fibrous Homogeneous HA:001 '• Paper and sheetrock layers Included in analysis. • 002-01-Joint Kitchen-Joint White 10%Cellulose 90%Non-fibrous(Other) None Detected Compound Compound Fibrous 141900296-0003 Homogeneous HA:002 002-01-Sheetrock Kitchen-Joint Gray 5%Cellulose 95%Non-fibrous(Other) None Detected 141900296-0003A Compound Fibrous Homogeneous • HA:002 002-02 BR-Joint Compound White 97.6%Non-fibrous(Other) 2,4%Chrysotile 141900296-0004 Fibrous Homogeneous HA:002 • auth code:014123 Analyst(s) NA C. ZLP-e.— Margo Burgio(5) Rhonda McGee,Laboratory Manager or other approved signatory EMSL maintains liability limited to cost of analysis.This report relates only to the samples reported and may not be reproduced,except In full,without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client This report must not be used by the client to claim product certification,approval,or endorsement by NVLAP,NIST or any agency of the federal government. Non-friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted.All samples examined for the presence of vermiculite. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 Initial report from:02/02/2019 10:20:02 • I Printed 2/2/2019 12:44:46PM Page 1 of 1 EMSL Analytical, Inc. EMSL Order: 141900296 Customer ID: AWEV42 EMSL 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax:(716)651-0030/(716)651-0394 Project ID: http://www.EMSL.com/buffalolab@emsl.com Attention: John Snyder Phone: (518)376-7345 AirWater Environmental Fax: PO Box 1071 Received Date: 01/26/2019 11:02 AM Averill Park,NY 12018 Analysis Date: 02/01/2019 Collected Date: 01/25/2019 Project: 56 Reardon Road/56 Reardon Road Queensbury/Rear Camp/Structure Test Report:Asbestos Analysis of Non-Friable Organically Bound Materials by PLM via the NY State ELAP 198.6 Method Matrix %Non-Asbestos Sample ID Description Appearance Material Fibers %Asbestos Types 003-01 BR Window-Window White 100%Other None Inconclusive:No Asbestos Detected 141900296-0005 Glaze Non-Fibrous • Homogeneous HA:003 003-02 Back Window-Window White 100%Other None Inconclusive:No Asbestos Detected 141900296-0006 Glaze Non-Fibrous Homogeneous HA:003 004-01 Bath-Bath Floor Layer 1 Gray/Black 100%Other None Inconclusive:No Asbestos Detected 141900296-0007 Non-Fibrous Homogeneous • HA:004 004-02 Bath-Bath Floor Layer 1 Gray/Black 100%Other None Inconclusive:No Asbestos Detected 141900296-0008 Non-Fibrous Homogeneous HA:004 005-01 Bath-Bath floor bottom White 100%Other None Inconclusive:No Asbestos Detected 141900296-0009 layer Non-Fibrous Homogeneous HA:005 005-02 Bath-Bath floor bottom White 100%Other None Inconclusive:No Asbestos Detected 141900296-0010 layer Non-Fibrous Homogeneous HA:005 006-01 Kitchen-Main Floor Tile Black/Blue 100%Other None Inconclusive:No Asbestos Detected 141900296-0011 Non-Fibrous Homogeneous HA:006 006-02 BR-Main Floor Tile Black/Blue 100%Other None Inconclusive:No Asbestos Detected 141900296-0012 Non-Fibrous Homogeneous HA:006 007-01 Bath-Bath Covebase Brown/Gray 100%Other None Inconclusive:No Asbestos Detected 141900296-0013 Non-Fibrous • Heterogeneous HA:007 • Polarized Light Microscopy(PLM)Is not consistently reliable in detecting asbestos in floor coverings and similar non-friable organically bound materials. Quantitative Transmission Electron Microscopy Is currently the only method that can be used to determine if this material can be considered or treated as non-asbestos containing.The test results contained within this report meet the requirements of NELAC unless otherwise noted.EMSL maintains liability limited to cost of analysis.This report relates only to the samples reported above and may not be reproduced, except infull,without written approval by EMSL The above test report relates only to the Items tested. EMSL beam no responsibility for sample collection activities or analytical method limitations.Samples received in good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 Initial report from:02/01/2019 13:43:25 -rt.; ifi ^;;G7 Printed 2/2/2019 12:44:43PM Page 1 of 3 EMSL Analytical, Inc. EMSL Order: 141900296 • Customer ID: AWEV42 EMSL 490 Rowley Road Depew,NY 14043 Customer PO: TeVFax:(716)651-0030/(716)651-0394 Project ID: httpJ/www.EMSL.com/buffalolab@emsl.com Attention: John Snyder - Phone: (518)376-7345 AirWater Environmental Fax: PO Box 107f Received Date: 01/26/2019 11:02 AM Averill Park,NY 12018 Analysis Date: 02/01/2019 Collected Date: 01/25/2019 Project: 56 Reardon Road/56 Reardon Road Queensbury'/Rear Camp/Structure Test Report:Asbestos Analysis of Non-Friable Organically Bound Materials by PLM via the NY State ELAP 198.6 Method Matrix %Non-Asbestos Sample ID Description Appearance Material Fibers %Asbestos Types 007-02 Bath-Bath Covebase Brown/Gray 100%Other • None Inconclusive:No Asbestos Detected 141900296-0014 Non-Fibrous Homogeneous HA:007 008-01 Bath-Bath Covebase Yellow 100%Other None Inconclusive:No Asbestos Detected 141900296-0015 Mastic Non-Fibrous Heterogeneous HA:008 008-02 Bath-Bath Covebase Yellow , 100%Other None Inconclusive:No Asbestos Detected 141900296-0016 Mastic Non-Fibrous Heterogeneous HA:008 009-01 Bath-Bath Panel Mastic Beige 100%Other None Inconclusive:No Asbestos Detected 1419002960017 Non-Fibrous Heterogeneous HA:009 009-02 Bath-Bath Panel Mastic Beige 100%Other None Inconclusive:No Asbestos Detected 141900296-001 a Non-Fibrous Heterogeneous HA:009 010-01 . Main Roof-BR Window Black 90.4%Other 9.6 Glass Inconclusive:No Asbestos Detected 141900296-0019 Fibrous Homogeneous HA:010 010-02 Main Roof-Back Window Black 90%Other 10 Glass Inconclusive:No Asbestos Detected 141900296-0020 Fibrous Homogeneous HA:010 011-01 Bath-Porch Roof Top Gray/Black/Green 96.2%Other 3.8 Glass Inconclusive:No Asbestos Detected 141900296-0021 Layer Fibrous Homogeneous HA:011 011-02 Bath-Porch Roof Top Gray/Black 96.6%Other 3.4 Glass Inconclusive:No Asbestos Detected 141900296-0022 Layer Fibrous Homogeneous HA:011 • 'Polarized Light Microscopy(PLM)is not consistently reliable In detecting asbestos in floor coverings and similar non-friable organically bound materials. Quantitative Transmission Electron Microscopy is currently the only method that can be used to determine if this material can be considered or treated as non-asbestos containing.The test results contained within this report meet the requirements of NELAC unless otherwise noted.EMSL maintains liability limited to cost of analysis.This report relates only to the samples reported above and may not be reproduced, except infull,without written approval by EMSL The above test report relates only to the items tested. EMSL bears no responsibility for sample collection activities or analytical method` limitations.Samples received In good condition unless otherwise noted. Samples analyzed by EMSL Analytical,Inc.Depew,NY NYS ELAP 11606 • Initial report from:02/01/2019 13:43:25 C;3 '1D;c 6f.::Printed 2/2/2019 12:44:43PM Page 2 of 3 • EMSL Analytical, Inc. EMSL Order: 141900296 Customer ID: AWEV42 EMSL 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax:(716)651-0030/(716)651-0394 Project ID: httpJ/www.EMSL.com/buffalolab@emsl.com Attention: John Snyder Phone: (518)376-7345 AirWater Environmental Fax: PO Box 1071 Received Date: 01/26/2019 11:02 AM Averill Park,NY 12018 Analysis Date: 02/01/2019 Collected Date: 01/25/2019 Project: 56 Reardon Road/56 Reardon Road Queensbury/Rear Camp/Structure Test Report:Asbestos Analysis of Non-Friable Organically Bound Materials by PLM via the NY State ELAP 198.6 Method Matrix %Non-Asbestos Sample ID Description Appearance Material Fibers -%Asbestos Types • 012-01 Bath-Porch Roof Bottom Gray/Black 100%Other None Inconclusive:<1%Chrysotile 141900296-0023 Layer Fibrous Inconclusive:<1%Total Homogeneous • HA:012 012-02 Bath-Porch Roof Bottom Brown/Gray/Black 98.1%Other None 1.9%Chrysotile 141900296-0024 Layer —Fibrous 1.9%Total Homogeneous HA:012 • • • auth code:014123 Analyst(s) NA C /4 D Margo eurgio(20) Rhonda McGee,Laboratory Manager • or other approved signatory ' 'Polarized Light Microscopy(PLM)Is not consistently reliable in detecting asbestos In floor coverings and similar non-friable organically bound materials. Quantitative Transmission Electron Microscopy Is currently the only method that can be used to determine If this material can be considered or treated as non-asbestos containing.The test results contained within this report meet the requirements of NELAC unless otherwise noted.EMSL maintains liability limited to cost of analysis. This report relates only to the samples reported above and may not be reproduced. except Infull,without written approval by EMSL.The above test report relates only to the items tested. EMSL bears no responsibility for sample collection activities or analytical method limitations.Samples received in good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 11606 `_ Initial report from:02/01/2019 13:43:25 r,•,,;;r T.);,; ti:it;:Printed 2/2/2019 12:44:43PM Page 3 of 3 • EMSL Analytical, Inc. EMSL Order: 141900296 Customer ID: AWEV42 - EIVISL 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax:(716)651-0030/(716)651-0394 , Project ID: httpJ/www.EMSL.com/buffalolab@emsl.com Attention: John Snyder Phone: (518)376-7345 AirWater Environmental Fax: . PO Box 1071 Received Date: 01/26/2019 11:02 AM Averill Park,NY 12018 Analysis Date: 02/02/2019 Collected Date: 01/25/2019 Project: 56 Reardon Road/56 Reardon Road Queensbury/Rear Camp-/Structure Test Report:Asbestos Analysis of Non-Friable Organically Bound materials by Transmission . Electron Microscopy via NYS ELAP Method 198.4 Matrix %Non-Asbestos %Total _S_ample ID _ Description Appearance Material Fibers .%Asbestos Types Asbestos 003-01 �, BR Window-Window White 100%Other None No Asbestos Detected None 141900296-0005 Glaze Non-Fibrous Detected Homogeneous HA:003 ' 003-02 Back Window- White 100%Other None No Asbestos Detected None '141900296-0006 Window Glaze Non-Fibrous Detected Homogeneous HA:003 1 004-01 Bath-Bath Floor Layer Gray/Black 100%Other None No Asbestos Detected'1 None 141900296-0007 1 Fibrous Detected Homogeneous HA:004 004-02 Bath-Bath Floor Layer Gray/Black 100%Other None . No Asbestos Detected None 141900296-0008 1 Non-Fibrous I, Detected . Homogeneous HA:004 005-01 Bath-Bath floor White 100%Other •None No Asbestos Detected None 141900296-0009 bottom layer Non-Fibrous Detected Homdgeneous , .HA:005 005-02 Bath-Bath floor White 100%Other None No Asbestos Detected None 141900296-0010 bottom layer Non-Fibrous Detected Homogeneous HA:005 006-01 Kitchen-Main Floor Black/Blue 100%Other None No Asbestos Detected None 141900296-0011 Tile Non-Fibrous Detected Homogeneous HA:006 006-02 BR-Main Floor Tile Black/Blue 100%Other None No Asbestos Detected None 141900296-0012 Non-Fibrous Detected ' Homogeneous HA:006 I 007-01 • Bath-Bath Covebase Brown/Gray 100%Other None No Asbestos Detected None . N 141900296-0013 Non-Fibrous Detected Heterogeneous HA:007 Analytical Sensitivity 41%Asbestos.This laboratory is not responsible for%asbestos in total sample when the residue only Is submitted for analysis.The above report relates only to the ferns tested.This report may not be reproduced,except In full,without written approval by EMSLAnalydcal,Inc.Samples received In good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Dapew,NY NYS ELAP 11808 Initial report from:02/02/2019 12:10 PM • Printed.02/02/201912:44 PM rrS:?.-7.-7 ,67r).+ ,U^'i:i_;U': Page 1 of • EMSL Analytical, Inc. EMSL Order: 141900296 Customer ID: AWEV42 EMSL 490 Rowley Road Depew,NY 14043 Customer PO: Tel/Fax:(716)651-0030/(716)651-0394 Project ID: http://www.EMSL.com/buffalolab@emsl.com Attention: John Snyder Phone: (518)376-7345, AirWater Environmental Fax: PO Box 1071 Received Date: 01/26/2019 11:02 AM . Averill Park,NY 12018 Analysis Date: 02/02/2019 • Collected Date: 01/25/2019 Project: 56 Reardon Road/56 Reardon Road Queensbury/Rear Camp/Structure Test Report:Asbestos Analysis of Non-Friable Organically Bound materials by Transmission Electron Microscopy via NYS ELAP Method 198.4 Matrix %Non-Asbestos %Total Sample ID Description Appearance Material Fibers %Asbestos Types Asbestos • 007-02 Bath-Bath Covebase Brown/Gray 100%Other None No Asbestos Detected None . 141900296-0014 Nan-Fibrous Detected Homogeneous HA:007 008-01 Bath-Bath Covebase Yellow 100%Other None No Asbestos Detected None 141900296-0015 Mastic Non-Fibrous Detected Heterogeneous HA:008 008-02 Bath-Bath Covebase Yellow 100%Other None No Asbestos Detected None 141900296-0016 Mastic Non-Fibrous Detected Heterogeneous - HA:008 009-01 Bath-Bath Panel Beige 100%Other None No Asbestos Detected None 141900296-0017 Mastic Non-Fibrous Detected Heterogeneous HA:009 009-02 Bath-Bath Panel Beige 100%Other None • No Asbestos Detected None 141900296-0016 Mastic Non-Fibrous Detected Heterogeneous HA:009 010-01 Main Roof-BR Black 100%Other None No Asbestos Detected None 141900296-0019 Window Fibrous Detected Homogeneous HA:010 010-02 Main Roof-Back Black 100%Other None No Asbestos Detected None 141900296-0020 Window Fibrous • Detected Homogeneous • HA:010 011-01 Bath-Porch Roof Top Gray/Black/Green 100%Other None No Asbestos Detected None 141900296-0021 Layer Fibrous • Detected Homogeneous HA:011 011-02 Bath-Porch Roof Top Gray/Black 100%Other None No Asbestos Detected None 141900296-0022 Layer Fibrous Detected Homogeneous HA:011 • Analytical Sensitivity<1%Asbestos.This laboratory is not responsible for%asbestos In total sample when the residue only Is submitted for analysis.The above report relates only to the Items tested.This report may not be reproduced,except In full,without written approval by EMSLAnalyacal,Inc.Samples received In good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS ELAP 1180E Initial report from:02/02/2019 12:10 PM Printed 02/022019 12:44 PM r:E3_.T=.`5:wB__,^t: r::?r Page 2 of: EMSL Analytical, Inc. EMSL Order: 141900296 Customer ID: AWEV42 EMSL 490 Rowley Road Depew,NY 14043 • Customer P0: Tel/Fax:(716)651-0030/(716)651-0394 I Project ID: http:/lwww.EMSL.com/buffalolab@emsl.com Attention: John Snyder Phone: (518)376-7345 AirWater Environmental Fax: PO Box 1071 Received Date: 01/26/2019 11:02 AM Averill Park,NY 12018 Analysis Date: 02/02/2019 Collected Date: 01/25/2019 Project: 56 Reardon Road/56 Reardon Road Queensbury/Rear Camp/Structure Test Report:Asbestos Analysis of Non-Friable Organically Bound materials by Transmission Electron Microscopy via NYS ELAP Method 198.4 Matrix %Non-Asbestos %Total Sample ID Description Appearance Material Fibers %Asbestos Types Asbestos 012-01 Bath-Porch Roof 141900296-0023 Bottom Layer HA:012 Not Analyzed 012-02 Bath-Porch Roof 141900296.0024 Bottom Layer • HA:012 Not Analyzed auth code:014123 0,Analyst(s) ' `li ,P'0-- Shauna Strnad(18) • Rhonda McGee,Laboratory Manager • or other approved signatory • Analytical Sensitivity<1%Asbestos,Thls laboratory is not responsible for%asbestos in total sample when the residue only Is submitted torenalysts.The above report relates only to the Items tested.This report may not be reproduced,except In full,without written approval by EMSLAnalydcal,Inc.Samples received In good condition unless otherwise noted. Samples analyzed by EMSLAnalytical,Inc.Depew,NY NYS CLAP 11808 Initial report from:02/02/2019 12:10 PM Printed:02/022019 12:44 PM %St3_Y'R;J'?;!1A_7^'i;;__�J°i Page 3 of O • ,'..lUJ 1...9,0 0-Zc)C • AIRWATER ENVIRONMENTALp I,Client: Jeff,W 2.Projritt Name 56.Reardon Road 2a.Peeled Aildrest._Jr '+"Reardon Road ' ' Jeff:W '�H • Queeriebu.. . `•• 3.Project Number N/A 4.InapectoriSignature.Snyder, .: ,y.a�+. 5.CollectionDate: 01/25/19 rJ 6.Sample TAT: 9.Comments:(Field) up 7.Building Name: Rear Camp 8.Sampling Areas: StrUCtOre O o 24 HR ❑48 HR p g a 72 HR _S Da X Analyse to First Positive By Homogeneous Material N ❑ Other 1 ee m m X For Negative.NO8 PLM s,continue to TEM • BULK SAMPLE LOCATION TYPE OF MATERIALS 10. 11.Bulk 12.Sampled Material 13.Type of Material 14:Sample Location 15. •16, 17.Quantity 18.Asbestos Homogeneous Sample ID - Friability Condition (LF,SF,EA) Content(Type Area Number Number Surf TSI MISC Sample (N/F) (G,D,SD) &%) ~001 01 Sheetrook ' x Kitchen NF G • 02 x BR NF G . 002 01 Joint Compound x Kitchen NF G • to• sv 02 x -BR NE G ..0 co 003 01 Window Glaze x. . BR Window NF G • 0 02 x Back.Window NF G • N, 004 01 Bath Floor Layer 1 x Bath•- NF G 02 x .' ".Bath .. NF G . . N 005 01 Bath floor bottom layer x . . Bath : F G 02 .is -Bath F G 006 01 Main Floor Tile x Kitchen ' . NF G 02 x . ' BR NF G 007 01 Bath Covebase .x • .Bath NF G 02 .x Bath NF G CHAIN OF CUSTODY LAB INFORMATION 19:Relinquished By: 20.Date 21,lime 22.Received By: . 23.Date' 24.Time. 25.Lab Name 26.Date 27.Time I "4.9�..l, 1/25/19 7:30 PM a Analyzed By: '11 ' 'b:OC by:. , lil.." : .. • c.Lab Batch#: ' • 28.Project Manager. 29.Results To: 30: Special Instructions: �t 5 l �—� �,., ' John'Snyder S '1 %,E` - Y Snyder)@nycap.rr.com . . . j n\'. =,-`. jii • -BY: Ss-4c-twl Fx Its o. 4,M • 0 )L:Z 9 06 Z 9 1; AIRWATER ENVIRONMENTAL, I.client: Jeff W 2,Project Name 56 Reardon Road se ProjectMgdreas.56 Reardon Road ' ' .Jeff:W H Queensbury a NiArojeci Number 4,Inspector(Signature Snyder • A4 fp.e. 5.Collection Date: 01/25/19 N 6.Sample TAT: 9.Comments:(Field) F'' 0 24 HR ❑48 HR 7,Building Name: Rear Camp 8.Sampling Areas:..Structure 72 NR • X Analyze to First Positive By Homogeneous Material o Cl Othe 4' ke X For Negative NOB PLM s,continue to TEM rn BULK SAMPLE LOCATION TYPE OF.MATERIALS 10. 11.Buk 12,Sampled Material 13.Type of Material . 14:Semple Location 15. 16. 17..Quantity 18.Asbestos Homogeneous Sample ID Friability Condition (LF,SF,EA) Content(Type Area Number Number Surf = TSI •MIS Sample (N/F) (G,D,SD) &%) C 008 01 Bath Covebase Mastic x Bath NF G 02 x. Bath. NF G 009 01 Bath Panel Mastic .. x Bath NF G ,i1 02 x Bath. NF G w .0 On01 Main Roof x BR Window NF G N 02 x Back Window NF G ro 011 01 Porch Roof Top Layer x Bath NF . G 02 x Bath NF G N 012 01 Porch Roof Bottom Layer x Bath. NF G 02 x Bath NF G CHAIN OF CUSTODY . . LAB INFORMATION 19.Relinquished By: 20.Date 21.Time 22,Received By: 23.Date 24.Time 26.Lab Name 28.Date 27:Time I ,!.91v 01/25/19 7:30 PM -a.Analyzed By: II - b.QCby: ' III c.Lab Batch#::. 28.Project Manager. 29.Raaults To: 30:;Special Instructions: ., - John.Snyder Y 4@ Y Sn de ' n cap.rr.com { Residential structure located at 56 Reardon Road Queensbury Sample Locations 003-01 006-01 006-02 001-01220-01 001=02-002=02 003-02• 011-01011-02 005-01,005-02 02-01,012-02 004-01,004-02 007-01,007-02 Roof 010-01,010-02 009-01,009-02 010-01,010-02 ACM Location-Roof • ACM Location Joint Compound- All sheetrock ceilings and walls—including bath. Most walls are wood. • • • .II +- s...._. _-. -.._. -... • • 1 ATTACHMENT B LICENSE AND CERTIFICATIONS ,,;,.',.7-';.::::'--:::..;:'':: ::-.'.-•.,',:':;,:,,-,.. New York State Oep4rtfi)ent4e.f.1.;abot•-7:,, . • .,,,,;-•.;:- .„;-:::::-....• "\••:. 'i•Division of Safety And Health, License and'Cettlficatk.LInit? 1., ••:--,.,: State Campus Budding 12 '," •', '-"° Albany NY..12441r''"LT -..' t:',i,..;%• , ..;,:.;;' , •',:J. ;:t:-..,. , I,- ..6...:. .. ,„..:-!c's-•.=.;..•,:":"'.t.,.----',-,,,,.`...°114,-;..1y.--:.,,,. ' .. . . . •".•,..,"' .,,'''.. '''';'..:... .:-' .:,-,"_;ASBESTOS HANDLING LICENSE::c.,•„,., /••''''',,,...:,,--....,1, -‘,1-, ,•-:-::: 'i -:_\-: .); ,eff••?.' s_ "•••-"--• - - •'-' ''• •;-••,,. s• .---- -:••• ,•-••_7•.;:•:::--7,7,' -.'•• , ,• '.•: Aiiiiiater.Enviroiiinenter, LLC - ‘`.•%;.':','. ..;...')Th, ). /....;,;. •:y.fILE NUMBER: 16975i3 r.:!.',',_,•;,„ ',. , . . i ' ''.;2:-:-.i.:F.;":::,.:' „;.'./ \'''.5.•:' '.J. ''''''' LICENSE NUMBER.:.9-7582f-",":-•-•„!--:;' ( _ •=.1.:•••.p,,,-,,,,, ,,,-•,:,:;-.;.....,•,-4", ( Pg:),Box,,1071„.•,:;' ';'3.4.'"'" .•''`,\''''''')A' 1 LICENSE CLASS: RESTRICTED •••;',•`0, .!'-'•: .•• ,-•,•' i,• .,,':-.1.:!g:.,.. 1 i DATE OF ISSUE: 11/21k01.8 rAii'erill:Park,INY 12018 .,,,:'4..1., -(••'.;-" .-!,''', 11 EXPIRATION DATE: 11/30/2019 ---.7'!„.• V', .•• - •34.. -• . i-If ,,••••„:•,. :i •!'s.??..) \:,;;:, ,,,-.-•,..,::::-••-•'• ...',\ (,.., ,-.-:•-. I : 6 ,:„, t; ,,..:‘, ,t') - i..1{..,,.. r2 .1,_ t , „,.. „., ,e,,,,,--,,.-..: -,--- -- .„ ;,,!-:!--..' /-, ,„1,. . ..„-:,,,,;,%,..;.-_-:2.:.•.0&. •,1',..Y`?:,-...Cs.\ ,,,e'P 1'.....-,}•!-; ';',s 11,'1 \',2, .,;.s'.;.' . ''',;.A ;' /• -''`'. l''\' /,71:‘';;•'- '•;--t-r-,-.2----;77•1-6 , '' ,,:." 1 .,,- '..-77-:-:•1-42.7,---,,5'- 't?,,. ;:,...,J ," 1? ._:,%• •...-. ...... --:-:. . ! ,, i i k,,,!f i A..4 I-i k‘,11)11‘ 1IAII\ri.:4:7,<::.';::.';..-,.,. - -• -- 77.772,'..*?.3 ;;' i 1 \ 'i.,=.1 r:1 .g'Z' i ij",-:'...:',1•"‘ATrI,`,•;:;:: ::: .. -:.__ -• ' -• ....7.F.A,.v !„,:-.1i.41.\.!°::. -..;i; if tihci :i .;k:- -- . . /.".--,..... -IN'l e ,VI ',,1!,/,!•,-:‘, r;;;, i .-:":1 $'4' t'0'.' I..i 'e..• /,,..):,- --- '..., . .....1V1 nil ., e: ,i i ,:.'..: 'A L:4! P.-'• .i , Wi."."- • ....5,,,,Duly Aulhorizect Representative;.-.4;49hRITSny,q9c,- • -:-.-;••,; ••,•;' •/...:;,,-..7 ,, .ii; .•:•7,:5;.,...•,:, Fc ''Zt-,,,•,=-1 v.:: i•:cin. I :Yid-1,, ::,•:::', .. 4,1----•:'' ...:: )?7,,•',---i r.ilQi . .,.." r )::,,;,,, .., ti 'il 1-; t•-• .-. t''') i;i:I '..t..7 Ir!,71;::',.:',:?:,:i.;',.;::/:,,.F.'.:-,; ,, i'iA,01,), /' :' ' p. r1 /,,,, ,,, '' ''C'' ' '''''' "'''•""".•' '' '' ' xile theIi) Lawofy lc State and of hisliens_elas been issued in aceorda PelWith: pplicableprovisto4,op cle: 0.,of L pr New .or • a , ..,, . the I•lew-YOik'•State Codes,Rules:44•14iiiiatidiisr2,N'Y.cRifart16)F1---ig. irPc t to suif;6tision or revocati1Ontf?r a(1) 0t'-.--o.,:,•,s,u d iV-li-olatio--,f---,o:,f state,federal--c---f'lLokpal"i-a--W.0.sA,.eW-;:•;i;•9&,hs‘,.Fy.,2ei'',1•g,a,ri'dVi•,''-.-:::the c,•!onc.i.X.u:-7t':t ofa Osb e,st,.o--.gi-;p4fr.§6..fg'''-•q,r:5'';:: ';-,or(2)demo.:•-.-t§tf frA:a,*t,..,I,.l'..:a.,.c.,,cIc,-p f re0ohsibilitY in hehonduct of anYsjdbi'inplviriegjor2asbiS0:iafe: 'ik', -4 > ? " - ZP 41, i; , , . ,k. . A , , Thiitpeiie i altd-only for 149 contractor named and thi§iiicense ofiphotbcopy .s.j must be displayedagil ....•..,:\ asbestos prApct...worksite..rj.Thig,lipcpse verifies that,411,persphs-emplsymot:hy4the licepsee on anasbestos,..projeptn..-N.!‘,)115,k State have been,IsSued an Asbestos Certificate,-appipriatg filizit4tpe,a-vyriilthey perform,by the New YorkState' . ..- .. ---___ _..----..— .,-,.,... • Department of Lahor. .,'-:',.. -:;-, . . ., '''':',,-,,, ''1' •'....:. .1''T.--,, s'4,.3.;•:::',:-.,._ .,-,7, ....:.-:,'" ...‘:,:,, ',, * ''-.:.•.'• ' /i ,..•-•5-, ,r d! f --' '-'4:-4,-: ..: a" 'Ai-,. __ • L',.. ''...-,:i \-,--, %.'-- .: ....- `0,.'„•- ..„-.).. 1 ,.: ....:., -., E:,-;,- ,.,!-.,: .s:.,'::::,,,, ke,-.,.., 1:•! ‘,2,. \,., ; ..•,-. ••••••. •••:-..::.-_....„-1:,-, ;'-,; i t, '..;,..::.;, 1 ....v..,.....'.•• . ' •-:-.! .•,,7.--.-.,,,,..,...„. _.,......,....,-,,--ef'.17;,, Sileen M.Franko, Director ..:.-... . -:•..-re-'-',.--'-'" SH 432(8/12) For the Commissioner of Labor • • • • • — . . ..... John Snyder NYS Certified Asbestos Building Inspector and Project Designer #06-5196 StA1i(14'MIA tiTABttiten'ttiApe'.-'}�` kSF t(CA%Fi[Dmtd'►SI[Sffl4�kCTB • WE ARE :YOUR DOL Department ATE of Labor • DIVISION OF SAFETY&HEALTH LICENSE AND CERTIFICATE UNIT,STATE OFFICE CAMPUS,BLDG.12,ALBANY,NY 12226 ASBESTOS HANDLING LICENSE Airwater;Environmental,LLC 4E.Vatrano,Road,Albany, NY, 12205 . • License_Numper:97582 License=Class: RESTRICTED Date-of Issue:•12/05/2022- •. EzpirationDate:.12/31/2023 • £.:; Duly Authorized Representative:John T Snyder 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.(?),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 ' • For the Commissioner of Labor SH 432(1221) . . MEW L• i /LI: li evizti,,is ae,Utrldro orcmc,coraFoolo,ri);svcre,•z; 11?it-•••- N.-- n.... SIF . .'. qq4ERATOR iNfOR;;IATION(E.,;zosolltw to comple.le) . . ; n)GerYoralors Memo. IV IX''.7q .1__I "Gioro-' Lrece• Ed "''' Cr'k*;°''''''''+bA'.4--(_,tLtl.Ytfe-A- ' - th Cricerelor's A 0 (2-45--- ..1,;::-4, ome.,e4s. tO ‘tt.ZLit-,0.4-1 i _.a...ail Nr.-(f.____;, _P-B°c( , 1.._--- --- . . .c)Generators Repreconnev,i........... ( I)Telephone Ntlfither.4,57:e.) c... CO I d)Teleperoa Numbers(61 ),_;;,/\.9 1. I ).'" n-•- •ei WASTE MANAGEMENT APPROVAL CODE III $ ri i 1 I I q c,i,,,,,,,....•.,w,..,.•Az__,,A, , it... 4 c_i. m),,, ,,,s ONLY•tJ PriAbfe: En Bent. --.—'-^dablo —lr,5.W•ing.4,2 . 0).L3inaloolt Wast.,A(2f."-".: ./1 -../- .... ‹,,don•fitelite; 0 n)ariPOWI Vi,4106 _ n)Type el Containers: rig_ I TYPE OF DONTADIEFIS . . TR•TRUCK _Tre 4- Conic Yee& Either___ 1 Dirl•PriErAL DRIA1 DP-PLASM intIM 6 tiVntr1P.i Of CoecittliaenS: I eA,•BAG . St3-6 NIL PLASTIC BAG a)I hereby tocrr2nt that the n!aaVP earned aanterial le the ce,ne nisteri el an re pron anted en the Spociat Waste DispeeelApp.itentien - Identified by the above CDC WASTE CODE end each silo:arid!.was r:mood le thy thump rt en the shipment ante reference'I heloo, ....8C'12 11.'"PLASTIC BAG ' '' 1A4.•1;it . • .r-\ , r--C/ • r --, Genemlor's&Immo Apeel:1;2%OtYltie'hatel nor-eta el G•••,,mt-i. s Aorineri..•' lent ShinicArd,DniA .;.;,-,-•,,,,,,,,,,,,......,- ,—,-----. SECTION 2 TRANSPORTER 1 . SECTION 3 TRANSFER FACILITY-(Oc-mpIete il oppiiCeidle) a)Tr?neptiler'ne Name, __:1"..k- ail Qi"._11.,----v......__;__...._. it. )Transfer For.elikin Wane: • . b'l Trellthertaile Add)ese• 1 3.-A9 • er .A_ li)Treader FeePty's Mthese;c)TeldOh,ano Number(.3-4: 7 V7— vy9,‘ _ c,Telepl•iond,Itereher.; ) dt yealcle Leone NerStPia_ n)151i;n:or GeV:Iran No.; _ _ a)Tree,'ar Container bia: - • -- I) Nacre ol TiAln:ar:Facillya . h ilec,e.oi Diner ionalitypel.. renanzed Aigelo fp:Fit:Vol ,a)1 hereby',vermeil,lien the alteva rh.-ett4 and deocrihioi risdienz',ors recr..h,,,,i g)I hereby orantreo tat' J abOVe.arrorod.1(.6d iiteccriced rriOlcoDiI*.aas revolved , the genenalOf as the date it receipt ref:mix:A Irerornw from the Ite.h.rlyt,tter,in the Belt el••,•ntr7i tedereriv,d beta,o, .. r,ahar,ni Eih,er Deal al ftecidri S,graluie el-,;,,,eler Fiaciley't,Atrhp.rio:',),,,,I Date of Ertelcr — hontley werreal OW the ohone rainzd MI del'aniff,'"4,.;a'eel'nnli.IIC4T:'‘Fi. 11)i la5retY.' reel g Ihai the ntae:a reinr,f rail dczeitherl inctyriel,,,,..-., ,crod • ,Othcko;itch:Inn)as canieroInntion en tear In:al detkery redorena4 rake. ta the inzprolci•nhle,,,.m&•:,,,,',;. ele atee cn?r,,:,!;;,:,,,,v;f2.31!,,An tette .w,e1 hitto-ri. ,- I •rt- ,r, . „„_ : L 5,7,,Ikle 5,urrin, .,,,,z,,..;!0.;:sanna,.....„....,,,, S'ellatire CA Ign;":S!,t5.F5a;WS renor•cd,5ar..; OF....5i rn.;.,a,' --,,,,...,,---......t......r.,.....; .r.,i,,,,,Ani=,;,..--,,-..•;:i.,-,,,,z,.;,•--1.-- -- SECTIOfq 4 . TRANSPORTER»,:jC,z,ampik,:ze if z=p0if.tni,,,) • .SECTION 5 OESTINADV1 i..,..)iflpc$..al i,r,ciiiiv) la)Triw:poei:I's Nry:-.F., ...—..____ .. _ :a) ,,xr.,,,,,}freiddirle NTT*: , r, .1•:- 7..-.,_, " - - \ h)Warivane;•s Adenass-___—.—— — ,lin)FTrysical Ao'ne,...s:Y.c?y rerc ar...... .va•-6/4°ri. ' . ::,TA;A14) Ninb"M:f ;________ .. c)Teleahone thocher.3(8 Wine of Dlgeesal Forilihfc .- %2.1. 174, - • e)Ira&at Coneassrier Be:___—_—. — - Azeficezed. ;.1mr.illyp..))_— f)The reetr, • ifelivo•erf11 h Lho Trecoperter hed bon htr ',*P fr:tre DitIpX.3I I) ni...rtn of Driver(pdootypo) — Facility. --. stfiN.. hcodby orartant'ihal the ekes monad and ck,heribed Ftetentni wrzl moroh...t1' • r o l.hri,i', ,_;..:Aol :e...A•lpirlefererterd Wave. 0/4,72 ,,, s:K.,..itY.$ 31Fiiii,115(kin .,:f.'ne,',,ai fle.:",n.;TPZ.5i;.,, .g)The rofiei-el ileintored by the\Icor:perm-Kee Bear 1•4".-ctul tea rlIspotal he 1 , ;,,'L•enodio al Dial' Odle..,:r Reee,p1 ow Diotocitiol FtdOlITIc. h)I boraby WA-1:MM thtft the cD•eve,named and sicorirtheri nunerfel are doEver•ed rtA to tictivety deed re,,t,teriCod Baler Skialani Li C;i4Y,nral really's MI:se:ire,'Ageril Dela a F4 rroa S4-olore cl Great ' Eta cl pokey • ...,'iriiatire of Driver ladto m .. ..., ----. SECTION 6 ASBESTOS(oporator In comp.:%04 . . — -------,-- 0 -41:10,,,Is ezi7n4,1 As Be ,.,gony whin mom,he zee,cpennice„ccoihrge,cc stipareracc the fcciI4 leelag derictlehod or rorievroco,en tn., erohn•iFian or itiovelloto apoire'don h.. i IT_ e( e! ,476 6( 0.6 (-- a)Operator's Name" _ —. r..)reinatare,Numbrx.),,,,,- ) .-- i b)(P91510( ii5dTEC5'. m,.1_ '‘.b_l-t O i\ — - • • . . 6)Go-commanded special l'olnelhl ininidAitn and edak"cal lolcceatoeio ---,-/-3 " ________ _ .. .• e)Optctaten Ceotitleztorro I twenty lotor..n1 rod-,.leoldle fleet the contold an hole riron,Ignaherri etc twly cell tnal..VM.1"f d.nneittic,d AnnaVa t'd prof as onlkeing 115400 ; .. and ets cifoielled,sonatftcri,&Id IVO,I,W,end an,In ett T55955t.Li topper cennIch tea th-tineyidd by ItIghdrey cease e-.:n to knoca4,3 ketaroctichal Si dardoet4 i ithsr,reguldforop,crilli=nrsioe nejar otonderW "id M'6,44*. / , • 9-- • OporZtied Name Icenlitype) Slandnue at Opt,;;;;:t Authalizei Agent Dan I)Pie AgOICy A/AT, — _,,,,.*...........*1 :. Nome end Menem' -- — 111;CD:58;W-1c) WHIP,"-D..67N.vroi,liTISPOFALFAC,LITT) ,-..lANAFIT-TRANSPORTIcP, Pild,<-TP.ANSPORTER COLD-SENER ATOP - W ¢ ":_ Waste Management Green Ridge LF Reprint 424 Peters Rd Ticket# 124823 WASTE MANAGEMENT Gansevoort, NY, 12831 Ph: (518) 636-2141 Customer Name WM-FTEDWARDHAULING WM FT EDWA Carrier WM WASTE MANAGEMENT Ticket Date 09/18/2023 Vehicle# 417251 Volume Payment Type Credit Account Container Manual Ticket# Driver Hauling Ticket# Check# Route Billing # 0000069 State Waste Code Gen EPA ID Manifest NA Destination , Grid I 25 LIFT 1 Profile 118925NY (NON FRIABLE ASBESTOS) Generator 190-WMFORTEDWARD WM FORT EDWARD Time Scale Operator Inbound Gross 37380 lb In 09/18/2023 13: Inbound SD #605115 Tare 34240 lb Out 09/18/2023 13: Outbound SD #605115 Net 3140 lb Tons 1.57 Comments Product LD% Qty UOM Rate Tax Amount Origin 1 Asb Non Fri-Tons-A 100 1.57 Tons WAR Total Tax Driver's Signature V (L Total Ticket I �� i - sue ,r: .,t 0YealR4 • "" `""" ' t.Jl a. " tt wa.'3 is attostos r,�>�:cxa;rt-"E:,II S: s •WASTE tO.A.N10 11NT R Yfa c ki NOT erel e`,were_,the r:a;2 v3:Y: .)rr.;+,Z 3,•s Me 5 Mul tf::3,}).._....„.,._.___..,.m._ . >:--vs.r.»az>azaa.....�.,..�.�azmnrvrrm^q,>..R--- am✓ax CT"oa'd i '' 7€FRATon IN;Czts AT;C?/(r anitCatol tacY�sn3�fets) _ a)r 'at a Naire._...1 At.! �- i;t;ar�;'sj Y re-Ase t(Nemn3• _.ITr^'f t� TsU • .-...,-�_____ ,G azl sAa1ra 4 tvo_. I : GI ¢i L>'.1aaw 1Zb C ., t- y c)Goss-ales Represehv .__ _ 5 Teo/Anne rrd one Number.sig)_ �/ -! _ :.1 Telephone Number;61 8 t- .9(0[ 1)`r — 1 ['�J[�'`� . es).,ASTER`A;AGE'.I_N'i APPRC:'§,LCQ E 1 1 1 _,i 1 3 1 ! I; Gammon Name el Write/, A1, ' _1_, _I mpA as e ONLY-,,3_/Fria b: Beth: __,__ Iranpa •tr `na yp D a pton C was:✓ �" �z''-J _ 1 ,_en•,«t,ae; h4A D n)Typa ol DOr/tetheB•T Tips OF CON'TataYERS hi Disposal✓el:anE' Y TR-TtTJCli .___Tons Cubic Yards Other — DM•METAL DRUM DP-PLASTIC MUM I) hna w dt r x atr.r' r BA•BAG BB•5 MIL PLASTIC BAG fl,I heroby warrant that the above named material is is e Ssre material se represented on the Special edaate Dtapeeal AdolLe Len BC••ip AIL PLASTIC BAG Identified by the above CDC WASTE CODE and each material was I: eyed Is th Itansparter an he shipment date re eranet belee •t-,wra.oes A n3;s; }v..,a n :asrcYar6 of G .ttsw s Aothor i ,,...,�.....®.,�,EtT n ,s;,rat.: ...____.. SECTION 2 TRANSPORTER I SECTION 3 TRANSFER FACILITY,(C£rn t:t e if p^3:ie•:xis a)Tr'Ys ma's t'.me U .�crv/'((/I(�(`/7} E_"7��J}'' _ ' .{)Transfer Fsrsat/s Nac�! ------ ------ ` .1.-A, �7 ' e ._ - _. /_____ hi Transfer TArrilets Areitess_ `:,iTeta:Iaa+`af;ixtSkr:; Tarphaze ( ._____,.,._.. _.._...__a :0 Vehicle Loose t.'a=State--.._.._.__ - - �--- V0;rcia l.i:CATM:sa r n<S!ate"____�...... ..__ _` . —_• ... nS Tom:er or v;:"�:3:"f3r No.-_ .-___..». _ I 1 }.a at.c!Tran's.,s awl:S7 �.. . il?.:z 0'U^rG?a"iL:r;,a}_-- -.__....._._-- --.._ "tnon'fl+`rl:::n:(r.irU}Tpek. _..._.. ....._.._—. ;)I hereby?rts-,hed thst the'.:xes_nr.:ae:l end cheer::;t ree eria?etas re:ot.•s:I g)I rieteby rrnrarrr:tat'•above WWI and dsaet1b d maletlalorLe received Both the generale,en the detP Ci Pcceipt rshe£nee 01 bolo 1. from tilO traor,st?rl,,ie Ire deft 01 r::::'ia,r?:?e:srsd hekhs. e n•ur .Stgrrtlu'e s,l'7:este'l st:Ita{s Atolod.thd Agent Dote of R,7:4P It I Year;;: entrant that t€.;:there mated aril to*.,etej. ..._ ..,.a:;dell:ar:,.. It;I hereby-_i:reat s«al'A:,sst>eo r:'t s- rul J aeriberi t::z.'.hat s Y,'1 e?.1:1resee.. Y :�,, at -,r t0 the^.',1.;:)'t55;ftt.cst" .,.`.^,a'i ,et+m..?r,:,'s5 cc 15t5 a5 5^µ ,,,,fy >;ctt:�:t�acicsra?or:urnx«:i.^,s:;t„a t?L.?dal:�ct ieil:'f.r;,-€era.4b4 ha;rr.... rote,, el to rA. `,;• `. `De;Ne^' _ 5vrsalM:1 Teen:s!us:',tdl/S Ak.ihM n,.' tOI C...)..,.,:.,gym!ICve 9 >w.,.. SECT'nw 4 TSANScOr`i'.R uu (Csampz€ein it app',ic:'tb)jriireirON 5 _ a �Lsat?Nt:Ti';l ,m ass€='sto €ty) fr (h:,xaaJ Fa:�t* �' ill SetsW'ee5 A3 Y.3 _ � J +, ha k2f! 7'tML Vt�fi s T,tysaNwtrb..=r:' ' C)Teea1YAX:NUsin:5( i_ _ _. _. r?Vesicle Lizooth.NthrSeue__.__...----_—...,_ .__ — di a}lt�rz of Diapetral Fu::"n • m}Tsaai x Container aa. Aa:asoe2e4 is tt?ws ne.)— .. se A __.._.�._.�..-._"._.�_....._..�,. The rtteL'ai^ Sthrir�f the TrtrWpnri:r has a•e$Vend at;¢st a't.:rq�x€ • II) Nth:ra at Doerr 0 15Ltyp70I .-.____._... ...._ Peony. . 0 I y errs t that the attar roomed end dZ d nt_terlal wad neoth ei -. � (....._ . ,_ ea togs 4r•a r 0.s, ',.'rxed e elow. 'atwat;se a"r-',cseJ Fttnhtts ,.:cc Theon, Date ct Far e e •- ..... _ .!..t4� Ito Disposal€n S t t..,.,tin , s.,,c F ._l Cl - g)TI;2 rrsa.x*+:.'s;�i:•<':�>]b` t*n rzt°;cr� tc ,;o.� .;,,,,,,era 0 Dsivw p to ms ol lIp€. • b)I hereby srront that the ahehe nsmRd sod described oreledsi tees delivered _.._ ..._.. - - Cs the&Avery data Wiwi ttCSSd Mow. Signanru Ll Ctspmal Fat;,n/s Autth need Agent On of Re;:curt .. :r'Irtabl,r,t t Grauer_ ^{� OM;C V'� .y Data et i?Lstii�(#t.__ SECTION B a� ,,° ASBESTOS;opEctor to cre nE.�.:o'oo.) ,. , �. ,..p..<..--_,.... .1:),-me,tr.Is dolma as the ',.pay e-ht: -'eras,k le!,opera the,,eonaa,�of(Supefele et the tszilny 4;11 c&:ner,,wzi a son tttai as the s:,eleigca a r53CCkm ,ot`bYSam Yr, , - -tJV r 8)Oa9ra!Or'sName 1/ ej Tr3�,r 4cmber ).. � r 1 t - d)ft2arnrrsrxbd:c*edoi harm;^gyp ps;;vsx,tss rued ca:.Yy?zwzt ir:ktmai>W?'t: "....,....,....� — II)t }'.leSlar a F;or".i:,caiinot.I h:eeby vernal turd 4sse ue that the cost!er:to el Life,do0rolgurtsrtt ore it.Ay end se-tumult doste td ova by Enpwr citpying narse .and Era oteseB',ed d 4:. assulttd,zlaisrr,a eves In at tcsye proper e cte saerica foe&newt try i:la,hrosy aceeer-tc to sa 4lc&'r'''a krtrznagur d='d doradotx laot ratans ctr z v !Bore,ra n 'x � �— '-2 . ratan Nalne On:5 We) SOsutre of OpSlorsi'Authorized • Data - 8 Fkasootesitie A /`i///f , Name and Addrrat -- _ it £tsBtQ-+d; ;t?ITE•DE,. .'lO•1pS%r=ALr:CLiFY) CANARY-TA;NSPCR ER ✓INK-TRASPOR_;'ER FCs..)•GENEAATop i i=. V I, Waste Management Green Ridge LF Reprint 424 Peters Rd Ticket# 124823 WASTE MANAGEMENT Gansevoort, NY, 12831 Ph: (518) 636-2141 Customer Name WM-FTEDWARDHAULING WM FT EDWA Carrier WM WASTE MANAGEMENT Ticket Date 09/18/2023 Vehicle# 417251 Volume Payment Type Credit Account Container Manual Ticket# Driver Hauling Ticket# Check# Route Billing # 0000069 State Waste Code Gen EPA ID Manifest NA Destination Grid I 25 LIFT 1 Profile 118925NY (NON FRIABLE ASBESTOS) 1 Generator 190-WMFORTEDWARD WM FORT EDWARD Time Scale Operator Inbound Gross 37380 lb In 09/18/2023 13: Inbound SD #605115 Tare 34240 lb Out 09/18/2023 13: Outbound SD #605115 Net 3140 lb Tons 1.57 Comments Product LD% Qty UOM Rate Tax Amount Origin 1 Asb Non Fri-Tons-A 100 1.57 Tons WAR Total Tax y Driver's Signature \/ IC Total Ticket �1 I 161111U6, ® NIFE T WASTE MANAGEMENT 1.Generator's US EPA ID No. Manifest Doc'No. : . 2.Page 1 of . - NON-HAZARDOUS MANIFEST .m ;x.c,r's iG N,Joller 1 l- 3.Generator's Mailing Address: Generator's Site Address(If different than A.Manifest Number , MICHAEL ROZELL mailing): WMNA' , 13127937 , 79 WARREN ST APT 202 B.State Generator's ID GLENS FALLS,NY 12801 56 REARDON RD • ':::,;; t, r1:7r:.i'?r's li's • . • 4.Generator's Phone 518-361-1205 5.Tran porter 1 Company Name 6. • US EPA ID Number ;, • . - C.StateTransporter'sID ^I;: ?;:.ns;:.'..,:, :i' ,/' ,,!f ` , r.',:,\., ; r.pi,. ,D i;iu.iflil.'r a ® � / re : D.Transporter's Phone • 7..Transporter 2.Company Name 8. US EPA ID Number • E.State Transporter's ID St...).;.:.,: .ran:;;:*t i:.r . - 7rgiSSS' ,'Ti' .r Orri 1n'„ N,1 i;1'• i i.EPAEPAi:D t�;'.11'Li' '1 • - ' .. r. F.Transporter's Phone -•+I<,:! ,t:_ 9.Designated Facility Name and Site Address 10, US EPA ID Number. W OF NEW YORK AT GREEN RIDGE LANDFILL G.State Facility ID - N/A `. .:Ii.-1'-,,..1i:s,,,s; M 424 PETERS RD. - \•• US 1:1'a.:i::f\;t,'-ol-m H.State Facility Phone 518-636-2141 c - GANSEVOORT;NY 12831 11.Description of Waste Materials Sz.Containers 13.Total Sa.Unit G P No.. Type Quantity yyt,/�rol, l•Misc.Comments E a. NON DOT REGULATED MATERIAL ••' i,,, i R WM Profile# 127251NY V• "l'r;;rila f';,,,,;i_,r. . - _' i'. / . A b. „'i;;s'C°, 1: - . . I0„'! T l'ic,? ,l' ' . .11. . ,.a, . .:+1, .. 0 • i,",• . R WM Profile# VPs,i Pr..;I' . ;,..J;Yil,r:r. c. - tla:T... • - i„a. i • WM Profile# ,:h,i; -,G,. PJtsr,,i;.n. . ; - d. •Chas,; "::nr=. f;�tai . i.i G•, ,`.,.- !'i., •'1fL, • .c':ni' i :. WM Profile# 'll.i1'.f:;iir',, :,-Wo i- - • • , J. Additional Descriptions for Materials Listed Above . - • K.Disposal Location • - Cell Level ' - Grid 15. Special Handling Instructions and Additional Information •:: a—127251NY—Friable Asbestos • Weight is estimated . Purchase Order# i'u:,h: i O:d, r 1`t:!itr;ze, EMERGENCY,CONTACT/PHONE NO.: , ' ' 16. GENERATOR'S CERTIFICATE - • I hereby certify that the above-described materials are not hazardous wastes as defined by CFR Part 261 or any applicable state law,have been fully and accurately described,classified and packaged and are in proper condition for transp rtation;according to applicable regulations. I?rin ed Name Sigfia�tre Month Day Year � , c re' ( , fit;'1�' ,/ � 10. 1Y ) _ ` T 17. Transporter 1 Acknowledgement of Receipt of Materials `/ R A Printed Name . . ,Signature • 0 -Month Day Year q 5 o '18. Transporter 2 Acknowledgement of Receipt of Materials • ' ' " Printed Name w" • Signature ' Month Day Year 19. Certificate of Final Treatment/Disposal ', - • n I certify,on behalf of the above listed treatment facility,that to the best of my knowledge,the above-described waste was managed in compliance with all applicable laws,regulations,permits and licenses on the dates listed above. 1 20. Facility Owner or Operator: Certificationrof receipt of non-hazardous materials covered by this manifest. T Printed Name �, w���- { ( .•i Signature S ( `� • 1Month { Day Year Y /mil: `✓ O�aS�'.�ii1� J\ .i �� -- , /'.-�� () •fl White-TREATMENT,STORAGE,DISPOSAL FACILITY COPY Blue-GENERATOR#2 COPY (Yelllow-GENERATOR#1 COPY Pink-FACILITY USE ONLY j w-?{ Gold-TRANSPORTER#1 COPY `�J • [WMSolutions.com] Profile 127251NY (Michael Rozell) has been approved Eastern TSC <wm@wmsolutions.com> Thu 10/12/2023 12:10 PM To:mjrteehill@live.com <mjrteehill@live.com> • • Notice of Profile Approval: 127251NY • Profile Number: 127251 NY . Waste Stream: friable asbestos Generator Name: Michael Rozell • Disposal Site: • Green Ridge RDF Expiration Date: 10/11/2024 • Dear Michael Rozell, We are pleased to inform you that Profile 127251NY has been approved by • our Eastern TSC Technical Service Center. Your Waste Approval Terms and Conditions can be found on either your Profile Form or Approval Form. Both documents are available as a PDF in the Approved Tab in your • • WMSolutions.com account. • Please share your thoughts about our performance by answering this one simple question. How would you rate your overall experience with the Profile review process? • • - 1 2 3 4 5 6 7 8 9 10 (Poor-Excellent) Please feel free to email us at TSCEastern@wm.com or call 800.963.4776 with any questions. • Thank you for choosing WM. . • Evotorn TSC rtst?J;v'^ _.%f�i You:ire i'OGO ViE this 01:)..."c190 i:S 2 rt;g..euod user et MSoltition3.coni. • TSCEastern@wm.com • ti you've received this r'nes age in error, of it you prefer not to receive email mess-_ge, offering ser ACE'S related 'C tv:rlvii SoIuttiorrs.com you can un subscribe at any lime by updating your email Communication Settings. Regardless of your communications preferences, WM will send you entails regarding billing matters and service related interruptions. WM respects your privacy.To review our Privacy Policy,click here. 6,"r)2023 0,M Intellectual Property Holdings,L..L C.All rights reserved. W `gym EZ Profile/1-' Requested Facility:Green Ridge RDF ❑Unsure Profile Number: 127251 NY ❑Multiple Generator Locations(Attach Locations) B Request Certificate of Disposal ❑Renewal?Original Profile Number: A.GENERATOR INFORMATION(MATERIAL ORIGIN) • B.BILLING INFORMATION '❑ SAME AS GENERATOR 1.Generator Name:Michael Rozell • 1.Billing Name.Michael Rozell . .2.GeneratorSite Address:56 Reardon Rd. 2.Billing Address•79 Warren St Apt 202 ' (City,State,ZIP) Queensbury NY 12804 (City,State,ZIP)Glens Falls NY 12801 . . 3.County: Warren 3.Contact Name:Michael Joseph Rozell ' 4.Contact Name:Michael J Rozell 4.Email:mjrteehill@live.com 5.Email:mjrteehill@live.com 5.Phone:(518)361-1205 6.Fax: 6.Phone:(518)361-1205 7.Fax: 7. P.O.Number: • 8. Generator EPA ID: 0 N/A 8. Payment Method: ❑Credit Account ❑Cash aCredit Card at Gate 9. State ID: 0 N/A j D.REGULATORY INFORMATION -.__.._..._.._..__...._......_.._..._....-----_..._._......_..._..__..-.--.---..._....._i 1.EPA Hazardous Waste? 0 Yes* Id No C.MATERIAL INFORMATION • Code: J • 1.Common Name:friable asbestos • • . 2.State Hazardous Waste? ❑Yes iFd'No Describe Process(es)Generating Material: ❑See Attached • Code• sheetrock joint filler 3.Is this material non-hazardous due to Treatment, ❑Yes* R No Delisting,or an Exclusion? 4.Contains Underlying Hazardous Constituents? ❑Yes* 10 No • 5.Does the material contain benzene? ❑Yes' e7 No 6.Facility remediation subject to 40 CFR 63 GGGGG? ❑Yes' el No 2.Material Composition and Contaminants: ❑See Attached 7.CERCLA or State-mandated clean-up? ❑Yes' td No 1.sheetrock with 2.4tfasbestos 97-100% 8.NRC,State-regulated,NORM or TENORM waste? ❑Yes* to No 2. *If Yes,see Addendum(page 2)for additional questions and space. 3' 9.Contains PCBs? 4 If Yes,answer a,b and c. . ❑Yes EB'No 4' a. Regulated by 40 CFR 761? ❑Yes ❑ No Total comp.must be equal to or greater than 100% z1004 b. Remediation under 40 CFR 761.61? ❑Yes ❑ No 3.State Waste Codes: LAIN/A . c. Were PCBs imported into the US? ❑Yes ❑ No 4.Color:white 110.Regulated and/or Untreated 1 5.Physical State at 70'F: El Solid ❑Liquid CI Other: 1 ❑Yes e1 No Medical/Infections Waste? 6.Free Liquid Range Percentage: to 0 N/A i 11.Contains Asbestos? OYes ❑ No 7.pH: to 0 N/A ! -9 If Yes: ❑Non-Friable ❑Non-Friable-Regulated ifff Friable 8.Strong Odor: ❑Yes Elf No Describe: . 1 12.Contains Dioxins?(If Yes,please attach analysis) ❑Yes, id No . 9.Flash Point: ❑<140'F ❑140'-199'F ❑z•200' iiil N/A ' F.SHIPPING AND DOT INFORMATION • 1. r8 One-Time Event ❑Repeat Event/Ongoing Business E.ANALYTICAL AND OTHER REPRESENTATIVE INFORMATION • ; 2. Estimated Annual Quantity/Unit of Measure: 1 1.Analytical attached ❑Yes ❑Tons 10 Yards ❑Drums ()Gallons ❑Other Please identify Lab Report(s)and list specific representative Sample ID#s: 3. Container Type and Size: 6m garbage bags double bagged 4. USDOT Proper Shipping Name - R N/A 5. Estimated Start Date 10/10/2023 • 2.Other information attached(such as SDS)? ❑Yes ; 6. Transportation Needed? ❑Yes* 0 No G.GENERATOR CERTIFICATION(PLEASE READ AND CERTIFY BY SIGNATURE) By signing this Waste Management('WM-)Profile,I hereby certify that all Information submitted in Name(Print): Michael Rozell - . . this and all attached documents contain true and accurate descriptions of this material,and that all homeowner relevant information necessary for proper material characterization and to identify known and Title: suspected hazards has been provided.Any analytical data attached was derived from a sample that is none representative as defined in 40 CFR 261-Appends 1 or by using an equivalent method.All changes Company: occurring in the character of the material(i.e.,changes in the process or new analytical)MI be 10/10/2023 identified by the Generator and be disclosed to WM prior to providing the material to WM.I am aware Date: that there are significant penalties for knowingly submitting false information. Certification Signature Q' I am authorized to sign on behalf of the Generator and I have confirmed with the Generator m that information contained in this profile,as well as supporting documents provided,are /I �/��///� /A� /��/yy accurate ae and complete. Ve"e�� to R0--❑ I am a duly authorized employee of Generator holding a position of technical responsibility with direct knowledge of the waste stream and the information contained in this profile,and I confirm that information contained in this profile,as well as supporting documents are ' accurate and complete. r,,,,,,.,.e, QUESTIONS?CALL 800 963 4776 FOR ASSISTANCE Revised February 20,2023©2023 WM Intellectual Property Holdings,L.L.C. '44 Industrial Waste & Disposal Exhibit A - `� Services Agreement J Profile number:127251 NY TSR; Thomas Conde Sales person: 242 A.GENERATOR B. CUSTOMER BILLING INFORMATION 1. Name: Michael Rozell 1. Name: Michael Rozell 2. Address: 56 Reardon Rd. 2. Address: 79 Warren St Apt 202 City: Queensbury County: Warren City: Glens Falls State: NY ZIP code: 12804 State: NY ZIP code: 12801 _ — 3. Contact name: Michael Joseph Rozell C.FACILITY ❑See Attached 1. Name(s): Green Ridge RDF 4. Email:mjrteehill@live.com 5. Phone:(518)361-1205 6. Fax: 7. P.O.number: D. MATERIAL 1. Name:friable asbestos 2. Anticipated volume:1 Cubic Yards E.CHARGES ❑See Attached DESCRIPTION RATE ( MINIMUM Green Ridge RDF Treatment Method Direct Landfill i$250.00/Ton i 1/Ton • • • I I I � • • • Other services not listed above will Incur additional charges that vary by location and are subject to change without notice.Payment of invoice represents agreement of such charges. PLEASE REVIEW SECTION F WHICH CONTAINS IMPORTANT COMMENTS REGARDING YOUR WASTE STREAM. Last revised on December 12,2016 QUESTIONS?CALL 800 963 4776 FOR ASSISTANCE ©2016 Waste Management Industrial Waste & Disposal Exhibit A Services Agreement F. COMMENTS O See Attached • The Company reserves the right to refuse any load or discontinue any waste stream should such waste pose a threat to human health or safety, prove to be operationally;challenging, or is in violation of any Company permit. • All loads must be accompanied by proper shipping paper. • If the Company received authorization to make changes to your waste profile during the approval process, your acceptance and execution of this Exhibit A confirms the accuracy of the changes. • If WM (or a WM contracted hauler) is not providing the transportation services, you must ensure that the transporter is licensed and approved to haul the applicable Special Waste and/or Hazardous Waste. All third-party transporters must comply with WM safety requirements and procedures (including without limitation, wearing a hard hat, safety glasses, steel-toe boots, and safety vest). If transporting to a Chemical WM facility, a Tyvek suit and respirator are also required. Please review and abide by safety information by visiting WMSolutions.com/safety. • Prices quoted herein are valid for 30 days. Unless WM is hired for this project prior to the expiration of this 30 day period in which case pricing remains valid in accordance with the terms. of the Service Agreement. • Pricing is based on the information provided on your profile and the representative data previously submitted. Charges incurred for additional services not listed above will be subject to standard rates and, payment of the invoice represents mutual agreement of those charges. • The Energy Surcharge percentage can fluctuate on a weekly•basis; please see www.wm.com/esc for more information on the Energy Surcharge and its calculation and historical values. The actual percentage rate applied. to the total project invoice will be determined on the date each load is received. • Please see profile approval form for special handling instructions. Additional special terms and conditions may be defined on your original quotation. • The work contemplated by this Exhibit A is to be done In accordance with the terms and conditions of the Industrial Waste&Disposal Services Agreement or other contractual agreement between the parties dated: 10/12/2023 YOUR ACCEPTANCE OF THESE TERMS CREATES A BINDING AGREEMENT AS FOLLOWS:(I)TYPE OR SIGN YOUR NAME AND TITLE WHERE INDICATED BELOW OR(II)YOUR TENDER OR DELIVERY TO COMPANY OF THE INDUSTRIAL WASTE DESCRIBED IN THE COMPANY APPROVED PROFILE SHEET AND(IF APPLICABLE)CONFIRMATION LETTER-SHALL CONSTITUTE YOUR ACCEPTANCE OF THESE TERMS WITHOUT YOUR SIGNATURE. COMPANY' y ei:E'__ (i Date: 10/12/2023 Signature: ' /€' .e' K�� ��'�Date: 10/12/2023 Name:Thomas Cee Name:Michael Rozell Title: i/ Title: homeo,Fihdf"3-• • Last revised on December 12,2016 QUESTIONS?CALL 800 963 4776 FOR ASSISTANCE r2016 Waste Management 4 * a INDUSTRIAL WASTE &DISPOSAL SERVICES AGREEMENT COMPANY: Finch Waste Co LLC CUSTOMER: Michael Rozell A WASTE MANAGEMENT COMPANY Address: 424 Peters Rd Address: 79 Warren St City/State/Zip: Gansevoort,_NY,12831-21V `i City/State/Zip: Glens Falls,NY,12801 Signed: r' r (J� , Signed: 7/(j,kte • Authorized Signature AuthorizedSignature Name: Thomas C de Name: (IGIm,I-Rozell Title: Technical Service Representative 10/12/2023 Title: homeowner 10/12/2023 Effective Date: 10/12/2023 Date Initial Term: 36 months Date AGREEMENT This INDUSTRIAL WASTE&DISPOSAL SERVICES AGREEMENT,consisting of the terms and conditions set forth herein,and Exhibit A,and/or Confirmation Letter(s)and the Profile Sheet(s)entered into from and after the date hereof from time to time(all of the foregoing being collectively referred to as the'Agreement'),is made as of the Effective Date shown above by and between the Customer named above,on its and its subsidiaries and affiliates behalf(collectively,"Customer')and the WM entity named above('the Company'). TERMS AND CONDITIONS • 3..SERVICES PROVIDED.The Company and/or its affiliates will provide Customer with collection, (in accordance with Section 9)and pay or reimburse Company for any and all costs,damages and/or management,transportation,disposal,treatment and recycling services("Services)for Customer's fines incurred as a result of or relating to Customer's tender or delivery of Nonconforming Waste or non-hazardous Solid Waste,Special Waste,Hazardous Waste,and/or Recyclables,as described on other falure to comply or conform to this Agreement,including costs of inspection,testing and analysis. Exhibit A and/or Confirmation Letter(s) and/or applicable Profile Sheets (collectively 'Industrial Company also may impose volume(imitations on inbound deliveries,reject any Industrial Waste that Waste").'Solid Waste'means garbage,refuse and rubbish including those which are recyclable but could adversely impact the receiving facility,or Company may terminate the Agreement or the applicable excluding Special Waste and Hazardous Waste.'Special Waste'includes polychlorinated biphenyl Exhibit A telated to such Industrial Waste. ('PCB')wastes,industrial process wastes, asbestos containing material, petroleum contaminated 5.SPECIAL HANDLING;TITLE.If Company elects to handle,rather than reject,Nonconforming soils, treated/de-characterized wastes,incinerator ash,medical wastes,demolition debris and other Waste,Company shall have the right to manage the same in the manner deemed most appropriate by materials requiring special handling in accordance with any applicable federal,state,provincial or local Company given the characteristics of the Nonconforming Waste.Company may assess and Customer laws or regulations.'Hazardous Waste means any hazardous,toxic,or radioactive substances,as shall pay additional charges associated with delivery of Nonconforming Waste,induding,but not limited such terms are defined by any applicable federal, state, provincial or local laws or regulations. to,special handling or disposal charges,and costs associated with different quantities of waste,different 'Nonconforming Waste'means waste that(a)is not in conformance with waste descriptions given by delivery dates,modifications in operations,specialized equipment,and other operational,environmental, Customer under this Agreement, in an Exhibit A, Confirmation Letter(s) or the Profile Sheet health,safety or regulatory requirements.Title to and ownership of acceptable Industrial Waste shall incorporated herein; (b)is prohibited from being received,managed or disposed of at a transfer, transfer to Company upon its final acceptance of such waste. storage or disposal facility used hereunder by federal,state or local law,regulation,ordinance,permit 6.COMPANY WARRANTIES. Company hereby represents and warrants that:(a)Company will or other legal requirement;(c)is non-hazardous Solid Waste that contains regulated Special Waste or manage the Industrial Waste in a safe and workmanlike manner in full compliance with all valid and Hazardous Waste; (d) is or contains any infectious waste, radioactive, volatile, corrosive, Flammable, explosive, biomedical, biohazardous material,regulated medical or hazardous waste or applicable federal,state and local laws,ordinances,orders,rules and regulations;and(b)it will use toxic substances,as defined pursuant to or listed or regulated under applicable federal, state or local disposal and recycling facilities that have been issued permits,licenses,certificates or approvals required law, except as stated on Exhibit A, the Profile Sheet or Confirmation Letter; or (e) contains by valid and applicable laws,ordinances and regulations necessary to allow the facility to accept,treat and/or dispose of Industrial Waste.Except as provided herein,Company makes no other warranties and information protected by federal, state or local privacy or data security laws,including but not hereby disclaims any other warranty,whether implied or statutory. limited to the Health Insurance Portability and Accountability Act of 1996,as amended('HIPAA"). 2.CUSTOMER WARRANTIES.Customer hereby represents and warrants that all Industrial Waste 7.UMITED LICENSE TO ENTER.When a Customer is transporting Industrial Waste to a Company facility,Customer and its subcontractors shall have a limited license to enter a disposal facility for the collected by or delivered to the Company shall be in accordance with waste descriptions given in this sole purpose of off-loading Industrial Waste at an area designated,and in the manner directed,by Agreement and shall not be or contain any Nonconforming Waste.When the Company handles Special Company.Customer shall,and shall ensure that its subcontractors,comply with all rules and regulations or Hazardous Waste for Customer,Customer will provide the Company with a Generator's Waste Profile of the facility,as amended.Company may reject Industrial Waste,deny Customer or its subcontractors Sheet('Profile Sheet)describing all Special or Hazardous Waste,and provide a representative sample entry to its facility and/or terminate this Agreement in the event of Customer's or its subcontractors' of such waste on request.In the event this Agreement includes transportation by the Company, failure to follow such rules and regulations. Customer shall,at the time of tender,provide to the Company accurate and complete documents, shipping papers or manifests as are required for the lawful transfer of the Industrial Waste under all 6.CHARGES AND PAYMENTS.Customer shall pay the rates('Charges')set forth on Exhibit A applicable federal, state or local laws or regulations. Tender or delivery shall be considered or a Confirmation Letter,which may be modified as provided in this Agreement.Company reserves the nonconforming if not in accordance with this Section. Customer further represents and warrants that it right,and Customer acknowledges that it should expect Company to increase,add or modify the will comply with all applicable laws,ordinances,regulations,orders,permits or other legal requirements Charges payable by Customer hereunder during the Term.The Charges may be adjusted by Company applicable to the Industrial Waste.Customer shall provide the Company and its Subcontractors a safe to account for:any changes or modifications to,or differences between,the actual equipment and work environment for Services performed on any premises owned or controlled by Customer. Services provided by Company to Customer and those specified on Exhibit A;any increase in or to 3.TERM OF AGREEMENT.The Initial Term of this Agreement shall be as set forth above and if no recoup all or any portion of,disposal,transportation,processing,energy and fuel costs,or environmental compliance fees or costs,or recovery of the Company's and affiliates'costs associated with host such term is set forth above,it shall be 36 months,commencing on the Effective Date set forth above. community fees,waste disposal taxes and similar charges paid to municipal or other governmental This Agreement shall automatically renew thereafter for additional terms of twelve(12)months each authorities or agencies to engage in recycling and waste collection,transfer,processing,disposal and ("Renewal Term",with"Initial Term,"collectively,the Term")unless either party gives to the other party treatment;any change in the composition,amount or weight of the Industrial Waste collected by written notice of termination at least ninety(90)days prior to the termination of the then-existing term; Company from Customer's service location(s) from what is specified on Exhibit A (including for provided that Company gives Customer notice by certified mail,at least one hundred five(105)days container overages or overflows) of the Industrial Waste; increased costs due to uncontrollable and no more than one hundred twenty(120)days prior to the end of the term,of said automatic renewal, circumstances,including,without limitation,changes(occurring from and after three(3)months prior and of Customer's right to terminate.However,the terms and conditions of this Agreement shall remain to the Effective Date)in local,state,federal or foreign laws or regulations (or the enforcement, in full force and effect,in accordance with its terms,with respect to any uncompleted or unfinished interpretation or application thereof),including the imposition of or increase in taxes,fees or surcharges, Services provided for in an Exhibit A,Confirmation Letter and/or Profile Sheet until such Services are or acts of God such as floods,fires,hurricanes and natural disasters. Company also reserves the right completed. Notice of termination received at any other time will be considered ineffective and the to charge Customer additional charges for Services provided by Company to Customer,whether Agreement will be considered automatically renewed upon completion of the then-existing term. requested or incurred by Customer,including,but not limited to,dig out,minimum load charges,profile 4.INSPECTION;REJECTION OF WASTE. Title to and liability for Nonconforming Waste shall approval charges,all at such rates that Company is charging its customers at such time The Company remain with Customer at all times.Company shall have the right to inspect,analyze or test any waste may also increase the charges by an amount equal to the average percentage increase for the previous delivered by Customer.If Customer's Industrial Waste is Nonconforming Waste,Company can,at its twelve-month period in the Consumer Price Index for Water&Sewer&Trash Collection Services,as option,reject Nonconforming Waste and return It to Customer or require Customer to remove and published by the U.S.Department of Labor,with the amount of the increase based on the most current dispose of the Nonconforming Waste at Customer's expense.Customer shall indemnify,hold harmless information available from the U.S.Department of Labor 30 days prior to the date of the increase,unless Revised April 15,2023 0 2023 WM Intellectual Property Holdings,L.L.C. Page 1 of 2 • the parties have otherwise agreed to a different CPI as stated in an Exhibit A. Without limiting the Recycling Services are subject to a Recyclable Material Offset(RMO)charge to the extent that(a)the foregoing,Company also reserves the right to adjust all pricing provided in an Exhibit A at any time with Company's processing cost per ton,including costs of disposal for contamination and profit margin, thirty(30)days'advance written notice,to Customer,Changes to the Charges payable under this exceeds(b)an amount equal to recydables value per ton minus an amount for profit margin.The RMO Agreement may be agreed to orally,in writing or by other actions and practices of the parties,including, charge,including profit margin,processing and disposal costs and recyclable value shall be determined without limitation,electronic or online acceptance or payment of the invoice reflecting such changes, by the Company from time-to-time,in its sole discretion,based on applicable operating data and market and written notice to Customer of any such changes and Customer's failure to object to such changes, information.If recyclables value exceeds processing costs,plus profit margin,a RMO credit may apply, which shall be deemed to be Customer's affirmative consent to such changes.Increases to Charges as at the Company's sole discretion. specified in this Section may be applied singularly or cumulatively and may include an amount for 12.ASSIGNMENT d SUBCONTRACTING.This Agreement shall be binding on and shall inure to Company's operating or profit margin.Customer acknowledges and agrees that any increased Charges the benefit of the parties and their respective successors and assigns.Customer acknowledges and under this section are not represented to be solely an offset or pass through of Company's costs.All agrees that the Company may utilize unaffiliated subcontractors that are not affiliates of Company to Charge adjustments as provided above and in Section 5 shall take effect upon notification from Company provide the Services to Customer.Customer may not broker the disposal of Industrial Waste through to Customer.Customer shall pay the rates in full within thirty(30)days of the invoice date. third parties under this Agreement without Company's express written consent. Company shall send all invoices for Charges and any required notices to Customer under this Agreement 13.ENTIRE AGREEMENT. This Agreement and its exhibits and attachments represent the entire to Customer's billing address specified at the top of the Agreement. Unless specifically agreed to in understanding and agreement between the parties relating to the Services and supersedes any and all writing by Company and subject to such additional costs that Company may charge,in its discretion, prior agreements,whether written or oral,between the parties regarding the same;provided that,the Company shall not be required to bill Customer using Customer's or any third party billing portal or terms of any national service agreement or lease agreement for compactors or specialty equipments program. In no event shall the use by Company of Customer's or any third party bring portal or- between the parties shall govern over any inconsistent terms herein. program,or any terms thereof,operate to amend or supplement the terms and conditions of this 14.TERMINATION; LIQUIDATED DAMAGES. Company may immediately terminate this Agreement,which will remain binding in accordance with its terms.Customer shall pay all invoiced Charges within thirty(30)days of the invoice date,by check mailed to Company's payment address on Agreement,(a)in the event of Customer's breach of any term or provision of this Agreement,including Customer's invoice.Payment by any other method or channel,including in person,online or by phone, failure'to on a timely basis,or(b)if Customer becomes insolvent,the subject of an order for relief shall be as allowed by Company and subject to applicable convenience fees and other costs charged in bankruptcy,receivership,reorganization dissolution,or similar law,or-makesan assignment for the benefit of its creditors or if Company deems itself insecure as to payment ('Default").Notice of by Company,from,time to time.Any Customer invoice balance not paid within thirty(30)days of the termination shall be in writing and deemed given when delivered in person or by certified mail,postage date of invoice is subject to a late charge,and any Customer check returned for insufficient funds is prepaid, return receipt requested. In the event Customer terminates this Agreement prior to the subject to a non-sufficient funds charge,both to the maximum extent allowed by applicable law. Customer acknowledges that any late charge charged by Company is not to be considered as interest expiration of the Initial or Renewal Term('Term')for any reason other than as set forth in Section 3,or on debt or a finance charge,and is a reasonable charge for the anticipated loss and cost to Company in the event Company terminates this Agreement for Customer's default,Customer shall pay the for late payment.If payment is not made when due,Company retains the right to suspend Services until following liquidated damages in addition to the Company's legal fees,i if any:(a)if the remaining Term (including any applicable Renewal Term)under this Agreement is six(6)or more months,Customer , the past due balance is paid in full.In addition to full payment of outstanding balances,Customer shall shall pay the average of its six(6)most recent monthly Charges(or,if the Effective Date is within six(6) be required to pay a reactivation charge to resume suspended Services.If Services are suspended for months of Company's last invoice date,the average of all monthly Charges)multiplied by six(5);or more than fifteen(15)days,Company may immediately terminate this Agreement for default and recover any equipment and all amounts owed hereunder,including liquidated damages under Section 14. (b)if the remaining Term under this Agreement is less than six(6)months,Customer shall pay the average of its six(6)most recent monthly Charges multiplied by the number of months remaining in the 9.INDEMNIFICATION.The Company agrees to indemnify,defend and save Customer harmless Term.Customer shall pay liquidated damages of$100 for every Customer waste tire that is found at the from and against any and all liability(including reasonable attorneys'fees)which Customer may be disposal facility.Customer acknowledges that the actual damage to Company in the event of termination responsible for or pay out as a result of bodily injuries(including death),property damage,or any is impractical or extremely difficult to fix or prove,and the foregoing liquidated damages amount is violation or alleged violation of law,to the extent caused by Company's breach of this Agreement or by reasonable and commensurate with the anticipated'loss to Company resulting from such termination any negligent act,negligent omission or willful misconduct of the Company or its employees,which and is an agreed upon charge and is not imposed as a penalty.Collection of liquidated damages by occurs(1)during the collection or transportation of Customer's Industrial Waste by Company,or(2)as Company shall be in addition to any rights or remedies available to Company under this Agreement or a result of the disposal of Customer's Industrial Waste,after the date of this Agreement,in a facility at law.In addition to and not in limitation of the foregoing,Company shall be entitled to recover all owned by a subsidiary or affiliate of the Company provided that the Company's indemnification losses,damages and costs,including attorneys'fees and costs,resulting from Customer's breath of obligations will not apply to occurrences involving Nonconforming Waste. any other provision of this Agreement in addition to all other remedies available at law or in equity. Customer agrees to indemnity,defend and save the.Company harmless from and against any and all 15.EQUIPMENT. All equipment furnished by Company shall remain its property; however liability(including reasonable attorneys'fees)which the Company may be responsible for or pay out as Customer shall have care,custody and control of the equipment and shall be liable for all loss or damage a result of bodily injuries(including death),property damage,or any violation or alleged violation of law to the equipment and for its contents while at Customer's service location(s)or otherwise under its care, to the extent caused by Customer's breach of this Agreement or by any negligent act, negligent custody and control. Customer will not overload,move or alter the equipment,or allow a third party to omission or willful misconduct of the Customer or its employees, agents or contractors in the do so,and shall use it only for its intended purpose. At the termination of this Agreement,Company's performance of this Agreement or Customer's use,operation or possession of any equipment furnished equipment shall be in the condition in which it was provided,normal wear and tear excepted.Customer by the Company. shall provide safe and unobstructed access to the equipment on the scheduled collection day.Company Neither party shall be liable to the other for consequential,incidental or punitive damages arising out of may suspend Services or terminate this Agreement in the event Customer violates any of the the performance of this Agreement except for third party claims related to violations of law. requirements of this provision.Customer shall pay,if charged by Company,any additional Charges, 10.UNCONTROLLABLE CIRCUMSTANCES. Except for the obligation,to make payments determined by Company in its sole discretion,for overloading,moving or altering the equipment or' hereunder,neither party shall be'in default for its failure to perform or delay in performance caused by allowing a third party to do so,and for any service modifications caused by or resulting from Customer's events beyond its reasonable control,including,but not limited to,strikes,riots,imposition of laws or failure to provide access.Customer warrants that Customer's property is sufficient to bear the weight governmental orders, fires, acts of God, and inability to obtain equipment, permit changes and of Company's equipment and vehicles and agrees that Company shall not be responsible for any regulations,restrictions (including land use)therein,and the affected party shall be excused from damage to Customer's pavement or any other surface resulting from the equipment or Services. performance during the occurrence of such events. 16.CONFIDENTIALITY. Except as required by law,the parties agree that the rates set forth on 11.RECYCLING SERVICES. The following shall apply to the collection and recycling of fiber and Exhibit A,a Confirmation Letter,including any adjustments thereto,and any other pricing information non-fiber recyclables("Recyclable Materials).Special terms and conditions,if any,with respect to such shall be considered confidential and shall not be disclosed to third parties without the other party's Services shall be set forth on an exhibit to this Agreement and shall be incorporated herein. written approval. Single stream Recyclable Materials ('Single Stream') wit consist of Customer's entire volume of 17.MISCELLANEOUS. (a)The prevailing party will be entitled to recover reasonable fees and • uncoated office and writing paper, magazines, pamphlets, mail, newspaper; flattened, uncoated court costs,including attorneys'and expert fees,in enforcing this Agreement.In the event Customer cardboard,paperboard boxes;aluminum food and beverage containers,tin or steel cans;glass food fails to pay Company all amounts due hereunder,Company will be entitled to collect all reasonable and beverage containers,and rigid container plastics#1,#2 and#5excluding all types of plastic film. collection costs or expenses,including reasonable attorneys'and expert fees,court costs or handling Any material not specifically set forth above,including but not limited to loam,film plastics,plastic bags, fees for returned checks from Customer; (b)The validity,interpretation and performance of this napkins,tissue,paper towels,or paper that has been in contact with food,is unacceptable.Glass may Agreement shall be construed in accordance with the law of the state in which the Services are not be accepted at all locations.All Single Stream must be clean,dry,unshredded,empty,loose and performed; (c)If any provision of this Agreement is declared invalid or unenforceable,then such unbagged. provision shall be deemed severable from and shall not affect the remainder of this Agreement,which Source-separated wastepaper,cardboard,plastics and metals shall consist of Customer's entire volume shall remain in full force and effect;(d)Customer's payment obligation for Services and the Warranties of such materials and be provided in accordance with the most current ISRI Scrap Specifications Circular and Indemnification made by each party shall survive termination of this Agreement;(e)Company shall and any amendments thereto or replacements thereof. All other Recyclable Materials will be delivered act as an independent contractor pursuant to this Agreement and nothing herein shall create a in accordance with industry standards or such specifications communicated to Customer by the partnership,joint venture or any other relationship between the parties. Company from time-to-time. • The Company reserves the right,upon notice to Customer,to discontinue acceptance of any category of Recyclable Materials as a result of market conditions related to such materials and makes no representations as to the recyclability of the materials.Collected Recyclable Materials for which no commercially reasonable market exists may be landfited at Customer's cost. Notwithstanding anything to the contrary contained herein, Recyclable Materials may not contain Nonconforming Waste,Hazardous Waste,Special Waste or other materials that are deleterious or capable of causing material damage to property,personnel or the public or materially impair the strength or the.durability of structures or equipment(all"Excluded Materials'). • The Company may reject in whole or in part,or may process,in its sole discretion,Recyclable Materials not meeting the specifications.Customer may be charged a contamination fee for increased handling, processing, transportation and disposal, including profit margin, related to such non-conforming Recyclable Materials and any Recyclable Materials which contain Excluded Materials. Revised April 15,2023®2023 WM Intellectual Property Holdings,L.L.C. Page 2 of 2 H i { C rt nG o croo3 Cr) � x3roHnro mrimwrtowwwr-Gw 0 G7 r nO rt O cn M w G G K n m HirrP•rtrtrG xrt DGREEdRIDGELANDFILL Hm rt aG m h r•H.rnCD m r•w m cD o y4;4 PETERS ROAD r• i x • to n* rr * o o H w �G m G rG rt rt. CD DJ Co w rt m 1-3 t7 r ;II i GANLVOORT,NY 12831 3186362141 `Drtcnr• o o tr in I,- o `r rt w rH r- En Hr-Hw 3r 9 o rt r-n rt z am K.�1� m CD m 2 'L y io iw - m to ,�;-n rt m y p;m o o o rt Cashier:Green Ridge Landfill w rr O NJ w L.) N a s n 3i o H G cam co n m .r.:Transaction 100002 r i O r o o�1 nm Total 1-3 0 v r-�1> i $250.00 m G h 1--Irt CI w O HI z IV N i VISA 8500 CREDIT CARD SALE $25D.00 _� > rr ar > K. N m I-, Cr 0 OC t' -] O. N -'w Nw p• o t c G ;v o o as o � r cn Retain this copy for statement � ta N �, W �,c m • validation �' o w rn mom w o b m 35� x v ti � w 17-Oct•202310:14:22A o Co 0 a r z S250.00 I Method:EMV n �N, w ' K m m 0-3 N- Visa Credit XXXXXXXXXXXXB500 La o o o cn o r rt MICHAEL J ROZELL ri 0 0 o v n Reference ID:329000504591CD `"' m AUthIQ:907141 m N �Na) Fm-, n nnn n c n rf 1-, hi m r-a"hK O m w MID:********6992 °rt n P. If)"�`, H. AID:A0000000031010 o t� r-x m w r a o = n rop art r-rm AthNtwkNm:VISA r >i° G m " m m 4 • SIGNATURE m H" " o h H r O Online:https://clover.com/p Ntri /NSTR98W2DJTQ2 r H H H V k b H r O Payment NSTR98W2DJTQ2 0 Q H H Clover Privacy Policy ct- https://clover.com/privacy 0 1-3 z 1-3 n 0 O m w hi H G G r ri O w 5 m CD cn 0 HO X rt in r•Hi G x i4 • 9 r H. nor G N T O O O O Si r r r NrYtYrs' .e rT� 289.7-1-17 DEMO-0689-2023 Rozell, Mike � J Y 56 Reardon Rd AirWater Environmental,LLC. c. Demolition of back camp September 29,2023 Mike Rozell 56 Reardon Rd. Queensbury,New York 12804 RE: Asbestos Visual Inspection 1200 SF of Roofing& 800 SF of Joint Compound 56 Reardon Rd. Queensbury,New York 12804 On October 26,2023 Bruce Campbell Jr.,A NYS Licensed Asbestos Inspector(# 15-11979) performed a visual inspection at 56 Reardon Rd. in Queensbury,New York(hereinafter termed the Property)to confirm the removal of the above noted asbestos containing,materials(ACM) previously documented at the Property during the pre demolition survey work(i.e., Survey dates January 25,2018 and June 20,2022). This letter memorializes ACM previously proven to be in the structure are no longer present*. The results,findings,conclusions,and recommendations expressed in this report are based only on conditions that were noted during the inspection of the Property on the dates of the work,all assumptions&limitations listed in Section 4.0 of the July 22,2022 survey report apply. If you have questions regarding the findings of this survey,please do not hesitate to contact us. Sincerely, AirWater Environmental LLC. • John Snyder,NYS Certified Asbestos Inspector + 4 z1e Principal i F- it, 4; Enclosure OC t 3 0 26223 " OUmENSBUR TOWN Ol BUILDING 8'CQDES *NOTE:AirWater Environmental was not present at the Property during ACM removal or disposal activities. WE ARE .YOUR DOL 4Department ATE Of Labor DIVISION OF SAFETY&HEALTH LICENSE AND CERTIFICATE UNIT,STATE OFFICE CAMPUS,BLDG.12,ALBANY,NY 12226 ASBESTOS HANDLING LICENSE Airwater Environmental,:LLC • 4E Vatrano Road,Albany,NY, 12205 License Number: 97582 • License Class: RESTRICTED . Date of Issue: 12/05/2022 Expiration Date: 12/31/2023 . Duly Authorized Representative: John T Snyder This license has been issued in accordance with applicable provisions of Article 30 of the LabohLaw 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 off work they perform,by the New York State-Department of Labor. - /// Amy Phillips,Director • For the Commissioner of Labor SH 432(1221) . • STATE t F idVil YO K'_UEFARTMME-1't'OF LABOR: ,"„.3.I`."'a" ASBESTOS'CERT1P:CA , :BRIJCE W r1PBELL.SR' . " ClJLS5(EXPIRES) . 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