HomeMy WebLinkAboutALL DOCS - 12-00370 - 131 W 2nd S - DemolitionBuilding Sofely Deporlment
Application for Demolition
Permit #:
6ZS.OO n."\J
lt\ 63?e/5
property owners: iled,u^tllrS G^e"lr--",(Jo q
Site Ad&ess: . l: I tnlas t 24 S " ,-+1', Re.b,-..^ , aO 63yW
Start Date:l.s )o
Applicant Infonnation (c'.+oJName:e Irtc
??os e ?ac tV City/ST/Zip:
Business phone:
"oB-LlSg:-
qe)cellPhone: ?ov '3rts-
Contact Information
Person or Company doing the demolition: Da PofCo )^"
Address: ))oS g )Al z\/City/S"f /Zip:5
compliance with the
Businessphone: A -uli$-,tOoo celphone: )ct - 3t3,74lo Ll
Demolition Information
Completion Date:
For more information about asbestos abatement and disposal in Idaho, contact:
Industrial Hygiene Resource
206 Murray St
Garden City lD 83714
208-323-8287
wwwindustrialhygieneresources.com
I understand the EPA
The U'S. Envfuonmental Ptotection Agency @,PA) regulates the abatement and disposal of asbestos-containing materials from anypublic ot private building involving demolition, renovation, tepair, construction, and maintenance activiues.
http: / /deq.idaho.gov./airlprog issues/pollutants /asbestos.cfm
EPA cetifies and licenses asbestos-temoval contractors, inspects asbestos-abatement proiects, and enforces laws regarding the properremoval and disposal of asbestos-containing materials.
Currendy, EPA and DEQ conttact with Industtial Hygiene Resoutces in Garden City, Idaho, to regulate asbestos removal and disposalprojects in Idaho.
irements_regarding asbestos removal and agree to provide information showing
d6.ls p the City of Rexburg prior to demolition.
Summary of what is being demolished:
Signature of Applicant:
u. s. EN\rrRoilh** pRorECTroN AGENC" - rG* oF rDAHo
NOI]FICAI]ON OF DEMOLruON AND RENOVATION
OPEMTORPROJECT#POSTMARK DATERECEIVED NOTIFICATION
I. TYPEOFNOIIFICAfiON: COIIRIESY -x-ORIGINAL
-CANCELED
REVISED
tr. FACILNYDF,SCRIPIION:
Building Name: Vacant house
Address: 131 WesL 2" South
City: Rexburg
County: Madison
State: Id ZipCode: 83440
Site Location:
Building Size (Square Feet) 22(D *bfFloors: 1 andbasement Age in yean: 52
PresentUse: Residence/apartments
Use: same
hior
III. TYPEOFOPEMIION: X-DEMO -OPOEREDDEMO _RENOVATION _EMERGENCYRENOVATION _FIRETRAINING
IV. Is Asbestos fte.sent? (check one)
insoection
-Yes -No Will revise if Asbestos is found in tle
V. Facilitylnformation:
Owner Name: Hemming hoperties
Address: 160 West 2'South, suite 200
City: Rexburg
Code: 83440
State: Id 7;rp
Contact: Eric Aibaugh
Fax:
Telephone: 208-201-8734
Removal Conaacts Name: Great Basin Services, Inc License: CSR012012-29
Address:P. O. Box 238
City:
ZtpC&e:83221
Blactfoot Stat€: Idaho
Contact:Dave hice Telephone: 208-785-l'16'1 Far 208-785-4053
Other Operator (demolition/general)
Ucense: RCE-2339
Ileadwaters C-onstruction
Address: 639 West 9500 South. Suite I
City: Victor
Zip Code: 83455
State: Id
Contact: Chad Richards Telephone: 208-313-2W2 Fax:
VI. Procedure, including analytical methods, employed to det€ct the Eesence of aud to estimatc &e quality of RACM and Category I and Category tr
non-flable Pl"Mlabtesting
V11. Aproxinate Amount of Asbestos Mahrials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
)
will revise if Asbestos is found.
YItr. Scheduled Dates Demolition or Renovation: Starr Aug-8-2012
tV. Dates for Asbestos Removal (MM/DD/YD : Start: will revise if Asbestos is found.
X. Description of planned Demolition or renovation work to be preformed and netiodG) to be employe4 including demolitiol or renovation techniques to be used
aud description of affected facility compotrents: Complete demo of existing house using excavators, backhoes, and water to keep down visible dust Asbestos removed
orior to demo
XI. Description of work practices and engineering contols to be used to comply witl the requiremelts, including asbestos removal atrd wast€
hardling emission control procedures: Will revise ifAsbestos is found in inspection
nI.Wasb Transporter #l: ASBESTOS ONLY
Name:Great Basin Services, Inc
Address: P.O. box 238
City: BlacKoot Stare: Idaho
ZipCode:83221
Contact: Dave Price
208-785-1'167 Far208-785-4053
Telephone:
Wasb Transporter#2:
Name: N/A
Address:
City:State:
ZipC&e
Contact:Telephone:
Fax:
ril.Waste Disposal Asbestos only
Name:Bannock County landfill
Address: 1500 North Fort Hall Mine Road
City: Pocatello
Zip Code: 83201
Stat€: Idaho
Contact: Scale House
Fax
Telephone: n8-23fi0f0'l
)fiV. Emergency Demolition (Complete item XIV and all otlrer sections, only if t]ris proi:ct is an Emergency Demo)
1. Attach a copy of the Order to this notice.
Titie
Code):
2. Name of Authority Issuing Order: NA
4. Datsof Order MM/DD/IY)
3. Authority of Order (Citation of
Date Ordered toxv.Emergency Renovation (Attach separate sheet with the following information if proict is Emergency Renovation.)
1. Date and Hourof Emergence N/A
2. Description of Sudden, Unexpected Event.
3. Explanation of how the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
XVI. Description of procedurcs to be followed ia the event that unexpected MCM is found or nonfriable ACM become"s cnrmble4 prlverized or
reduced to powder.
Evacuate area, wet down ACM, enclose area, post warnings and contain . Stop spread of air-bom fiber release.
XVII. I certify that an individual taircd in the provisions of NESHAPS (40 CFR PART 61, SIEPART M) will be on site during the demolition or
renovation and evidence that tle required haining has been accomplished by this person will be available during normal business hours.
Sipature of Owner/Operator Date
Tlrye or Print Name and Title
Jdy-25-2012 Dave hice / Owner Secretary
XUL I acknowledge the existence of laws pmhibiting the submission of false or misleading statemetrts and I certify tlat facts contained in this
notification are Eue, accurate, and complete.
Julv-25-2012 Dave Price
Owner / Secartarv
Siemture of Owner/Operator Date TYpe or Print Nane and Title
Original Notification must be mailed or hand delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovation
begins, except emergency demolition and emergency renovations which must be submitted as soon as possible before operations begin. (Formrev.3t24l99
u. s. *wrRoffi** pRorECTroN AGEN." ,Q,, oF rDAHo
NOTIFICATION OF DEMOLMON AND RENOVATTON
OPEMTORPROJECT#POSTMARK DATERECEIVED NOTIFICATTON
I. TYPtsOFNOTIFICATION: COIJRIESY _x-ORIGINAL -ISI*REVISED
-CANCELED
tr. FACILITYDESCRIPIION:
Building Name: Vacant house
Address: 131 West. 2' South
City: Rexbwg
County: Madison
State: Id TlpCcdg. 83440
Site Location :
Building Size (Square Feet)22ffi #ofFloors: 1 and basement Age in years: 52
PresentUse: Residence./apartments
Use: same
Prior
m. TYPE OF OPEMTION: X-DEMO - ORDERED DEMO - RENOVATION - EMERGENCY RENOVATION - FIRE TRAINING
IV. IsAsbestosPresent? (checkone)Yes _x-No
V. Facilitylnformation:
Owner Name: Hemming Properties
Address: 160 West 2'South. suite 200
City: Rexburg
Code: 83440
State: Id 7'rp
Contact: Eric Albauglr
Fax:
Telephone: 208-201-8734
Removal C,ontactor Name: Great Basin Services, Inc License: CSR012012-29
Address:P. O. Box 238
City:
T,tpCcd'e:.83221
Biackfoot State: Idaho
Contact:Dave Price Telephone: 2A8:785-I'167 Fax:208-7854053
Other Operator (demolition/general)
License: RCE-2339
Headwaters Construction
Address: 639 West 9500 Souttr. Suite I
City: Victor
Zip Code: 83455
State: Id
Contacl Chad Richmds Teleohone: 208-313-2W2 Fax:
VI. Procedure, includiag analytical nethods, employed to detect the presence of and to estimate the quality of RACM and Category I and Category tr
non-fiable PWl,abtesting
Vl l. Approrimate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
VItr. Scheduled Date,s Demolition or Renovation: Starr Aue-8-2012
IV. Dabs for Asbestos Renoval (MM/DDflfY) : Start No Asbestos found in survev
X. Description of planned Denolition or reuovation work to be preformed and netlod(s) to be employe4 including demolition or renovation techniques m be used
and descriptioo of atrected faciliry components: Complete demo of existing house using excavators, backhoes, and water to keep down visible dust Asbestos removed
prior to demo
n. Desaiption of work practices and engineering connols to be used to comply wifl the requiremenb, including asbestos removal and waste
handling emissim co'otol p'rocednos: NO Asbestos is found in inspection
)trL S/aste Traosporbr #l: ASBESTOS ONLY
Name: Great Basin Services, Inc
Address: P.O. box 238
City: BlacKoot State: Idaho
ZipCode:83221
Contact Dave Price
208-785-1767 Far208-7854053
Telephone:
Waste Transporter #2: General Construction debris
Name: N/A
Address:
City:
ZipCode:
State:
Contact:Telephone:
Fax:
xtr.Waste Disposat Asbesos only
Name:Bannock Coun8 landfill
Address: 1500 Norttr Fort Hall Mine Road
City: Pocatello
T.rpCcdre;83201
State: Idaho
Contacf Scaie House
Fax
Telephone: 208-23GW7
)(V. Emergp.ncy Demolition (Complete item XIV and all other sections, only if this proi:ct is an Emergency Demo)
1. Attach a copy of the Order to this notice.
3. Au0rorityof Order(Citationof
Code):
2. Name of Authority Issuing Order:
4. Date of Order MM/DD/YD
Date Ordered to Begin --
_XV. Emergency Renovation (Attach separate sheet with dre following information if proi:ct is Emergency Renovation.)
1. Dah and Hourof Emergence N/A
2. Description of Sudden, Unexpected Event.
3. Explanation of how the even caused unsafe conditions or equipment damage or an unreasonable financial burden,
Xy1. Description of procedures to be followed in the event that unexpected RACM is found or nonftiable ACM becones crumbled pulverized or
reduced to powder.
Evacuate area, wet down ACM, enclose area, post wamings and contain . Stop spread of air-bom fiber rclease.
XVtr. I c€rtifv that an individual tained in the provisions of NESHAPS (40 CFR PART 61, SIIBPART M) will be on site during the demolition or
renoyation and evidence that the required taining has been accomplished by this person will be available during normal business houn.
Sienaturc of Owner/Operator Date
Type or Print Name and Title
Julv-3G2012 Dave Price / Owner Secretary
XUL I acknowledge the exisEnce of laws prohibiting the submission of false or misleading statcments and I certify that facB contained in this
notification are tue, accurate, aod complet€.
Julv-3&2012 Dave Price
Type or Print Name and Title
Original Notification must be mailed or hand delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovation
begins, except emergency demolition and emergency r€novations which must be submitted as soon as possible before operations begin. (Form rev.324D9
Presented to
Chad Richards/Headwaters Construction
July-30-2012
Vacant house located at 131 West, 2d South, Rexburg, Idaho
Presented by:
Great Basin Sewices, Inc
Blackfoot,Idaho
208-785-1767
Dave Price, Inspector
Certificate # BIROI I I 812-3 I
Introduction
On JULY-17-2012, accredited AHERA Inspector Dave Price of Great Basin Services
preformed an Asbestos inspection on the vacant house/apartments at l3l West,2d South,
Rexburg Idaho. This inspection was requested by Chad Richards. This survey was conducted
to facilitate the funue Demolition ofthis structure. This building is considered an apartment,
with separate living areas, so this inspection is required by EPA, along with a Notification for
Demolition. Also,local landfills will not accept materials from house demos that have not been
inspected for Asbestos. They require that no Asbestos be present in the demo materials that they
accept.
Background
The house/apartment, is approximately 60-45 years old and has been remodeled and
added on to several times. It is currently vacant. lt is a single level structure, with a partial full
finished basement ( two apartrnents) The total sq ft ofthe house/apartment is aprox 1400 on the
main floor. The house has wood framed walls with brick on the outside. On the inside there is
drywall on the walls and ceilings. The roof has 2 layers of shingles. There was some fiberglass
insulation in the attic. And walls. There was also some fiberous insulation in the attci No boiler
or piping insulation was found. Also a detached garage in the back of the property was inspected.
The only suspect materials found and tested were the shingles on the roof.
Sampling
Dave Price, accredited AHERA inspector collected 22 samples of suspect Asbestos
Containing Material (ACM). These were broke down into a total of 30 separate materials, that
were tested. I sample came back as containing Asbestos Materials. ( meaning they are more
ttraun l% asbestos) In this sampling scheme, sampling locations and number of samples were
selected so that they were representive of the homogeneous sampling areas with regard to the
material present and it's potential asbestos content. The sampling scheme was designed to be
comprehensive and intended to identify ACM that might be disrurbed during Demolition/
Renovation activities.
ACM ,under current regulation, is defined as material with an asbestos content lo/o or
greater by volume. Any sample analyzed by "polarized light microscopy'' ( PLM) method as
containing a tace to less than l0% asbestos must be re-analyzed " by point count method" or
must be assumed, to be ACM.. All samples were shipped to and analyzed by EMSL Analytical,
San Leandro, Califomia. EMSL is a AIHA accredited lab and participate in the NVLAP
program. The materials were sampled forthe purpose of identifring possible Asbestos
containing materials, that would need to be removed, before Demolition of this building. This
survey can be used, to satisfr EPA and OSHA regulation requirements for renovation and/or
demolition activities. See drawings for building layout and sample locations.
Conclusions and Recommendations :
The following identifies the material, location, approx. quantity and condition of all materials
identified as containing asbestos. Out of 33 separate materials sampled,2 samples were found
to contain Asbestos. These 2 samples that came back containing Asbestos, but under the EPA
limits of lo/o. This materials, by EPA rule are not considered ACM and can remain in the house
and be disposed ofas general construction debris.
No Asbestos materials above thelVo limitwas found.
No asbestos removal needed for this demo.
flowwer, demo contractor must sill follow EPA Demolition regulations( see attached info)
concerns for owners and/ or Demolition contractors:
Roofing : Roofing materials, shingles, built-up roofs, tar, etc., are typically NON-FRIABLE
materials and fall *ier the National Emissions Siandard for Hazardous Air Pollutants ( NESHAP)
regulations found in Appendix A to Subpart M,- Interpretive Rule Governing Roof Removal
operiions. This rule stJtis that removal of non-Friable roofing materials involving 5580 sq ft or
more is subject to NESHAP regulations, only if equipment that crumbles, chips, or otherwise
renders the roofing materials frable, is used. During the course of typicd demo of the entire
house, keepingtf,is material from becoming friable, may be unattainable. This is why we
recommend that all Asbestos Materials be removed prior to demo. Also, most landfills will not
accept roofing materials as general construction debris unless Asbestos testing has been done on
ttrat materiai, to variff thalthe roofing is below the EPA regulated amount of lo/o. If roofing
materials are found to contain lYo, or more, Asbestos, the landfill may require to separate any
Asbestos materials and may require packaging or labeling separate from General Construction
Debris, or will not accept thi materiatat all. Demo Contractor will need to follow all applicable
rules if asbestos roofing materials are not removed prior to demo.
Floor tile: Floor tile is typically NON-FRIABLE and.EPA therefore does not require removal prior
to demo. However the same holds true for floor tile as roofing, if it is made to become friable by
crumbling, chipping, sanding, grinding, ect during demo, then this material must be removed prior
to demo. Also landfills may requiie that any Asbestos materials be separated from general
constnrction debris, and or puit ug.a differently before disposal, or not accept the material at all.
The Demo contractor will need to follow all applicable rules if non-friable Asbestos floor tile or
mastic are not removed prior to demo.
Other non- friable materials such as, flooring mastic, roofing mastic, glues, are also treated the
same as the non-friable materials listed above.
l. Asbestos containing materials should be removed with trained and certified, Asbestos
abatement workers, using approved methods. The Asbestos material must be packaged,
transported, labeled, and disposed of as required by EPA.
2. A EPA Notification foi ttre Asbestos removal and/or Demolition, of this project will need to be
filed, before Abatement and/or Demolition begins. If the asbestos arnounts are under the regulated
threshold amoun! or are not Regulated Asbestos Containing Material (RCAI\O, then only a
courtesy EPA Notification is required.( No l0 day waiting period, before removal of asbestos). If
the asbestos removal amounts are above the regulated th'reshold amounts, or are RACM, then a l0
working day EPA notification is required. For Removal This notification requires that the
abatement and demolition contractors wait l0 working days, from date of postmark, before
abatement or demolition can begin. The abatement must start on the date stated in this notification.
Also the demolition must start on the date listed as the Demolition start date. Failure to start on the
dates listed, may constitute wamings and/or fines from EPA. These dates may be changed, if
needed, by sending EPA a revision before the original state date has been reached.
* The Demolition Contractor must pay attention to Section XVU , of the EPA
Notification Of Demolition And Renovation, which states: An individual
trained in the provisions of NESHAPS, (40 CFR Part 61, subpart IvI) will be on
the job-site during the demolition or renovation, and evidence that the required
training has been accomplished by this person and will be available during
normal business hours.
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Test Reporf Asbestos Analysis of Bulk Materials via EPA 600rR-93r116 andlor EPA
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Non.Asbostos A3bostos
96 TuoeSamplo Descrlptlon Appoaranca % Flblous
EMSLOT&r: 091209513
Cuslom€rlD: GBSV62
CuslomerPO:
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% ilon.Flbrous
WDW-{ll-Drywall MAIN
09rm9513ffi
BrouUWhite
FLOOR/MTHRO FbrousOitt"SECORNER Hmrogeneors
10% @lulose dl% Norfibous (other)None Dsbctod
WDW-01-Joint
Compqrd
09tlilFrwta
MAIN Whlts
FLOOR/MTHRO Non-FtbrousOM€ECORNER
Hotnogql€ous
1 00% Non-fibrous (other)<l% Chrysodle
CS-02€klm Coat fVtAlN White
FLOORISTORAGE Non-Fibrqrs@tmn'3&7 RooM€EtLtNG ;.iil;il,
100% Non-fibouE (olher)<l% Chryrotlle
CDW-02-Dr!'wdl
09lxp5t34ooE
MAIN Broryn/WhlbFLOORSTORAGE Fbrors
Homogeneoug
12% Cellulose 88% Non-ftbrous (dher)Nono Detocted
&CDw-0l.Orywatl APT B/UVING
ROOU-0et4)51uxne 8ASEMENT
CEIUNG
BrorYilWhib
Flbrcus
Homogeneos
16% @llulose &f% NorFfibrous (dter)Nono Del8ctod
&CDW41-Joint APTBIIIVING
Compound ROOtrl-
@t2utsts,n,eA #itff*
White
Non-Fibrous
Homogeneous
8% Glass 92% Non-fbrws (dher)]lone Detactod
&WDw-ol.I)ryrd APTBEEDROOM
#l.BASEMENToslnwtuplo wA[I
Brown/l/t/hile
Flbrous
Homogeneqrs
10% Cellulee 90% Nanfibros (other)None Detected
Anatysl(e)
JennltuK€B/tutg(W)BaSla Ke, Labo.atory Mansger
or o0|er app.oved slgnatory
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Test Report P1"C,T7.16.0 Pdnted: 7/31f201212j.B:42 pM
EMSL Analytical, Inc
2lil5 Polvoora Avo , Sulto 230, Ssn L.esndro, CA 0.lS77
PhmelFu (510) 89$3675, (510) s9$38s0
lrfrolr mr rr.€msl.com sanloandrclgb@Gm3l. com
% Flbmus
EMSLOdeT: 091209513
CustomerlDi GBSV62
CustomerPO:
PrdectlD:
Atn: DaVe pfaCe phone: (2oO) 7afFlz67
Great BaSin ServiCes, Inc. Far (208) 78$4053
pO BOX 239 Rscdt€d: o7nan29:fi)AM
Analysls Date TnAnOP
Btackfoot, lDg3221 collecied: 7n4non
Project HOUSEAT 131 WEST,2NDSOttTH, REXBURG, tD
Test Reporh Asbestos Analysis of Bulk Materials via EPA 600/R-93r116 and/or EPA
600/M4-82-020 Method(s) uslng Potarized Light Microscopy
Non.Asbostos Asbostoo
cA ?umSample Deecdptlon Appearance
&WDW-Ol.Joht APT BEEDROOM White
Gompound #I.BASEMENT Fbrous
@linnts!l{,|l,at WALL
FblerogeneotF
10% Glass 90% Non-fibrous (other)llone Detsc'ted
A-WDW-0l0ryurd APT A/IJVING
ROO[tsWALto9l2wlw11
Brown/Whne
FlbroJs
Homogsneoug
12% Cellulce 88% Non-flbon (other)ilono Detscted
A-WDW-OlrIdnI APTA/LIVING
Compound ROOir-WAlL
uttN95tu,ot1A
White
Fibrous
'10% Glass s)% NoFfibrorrs (other)None Detecbd
Homogeneous
A{DW-{r1-DUrax APTA/BEDROOM
#1€EILINGag|mrEl3412
Brorn/Whlb
Flbrous
Hornogeneots
10% Cdlulc€
3% Glass
87% Nofttibous (olh€r)ilono Dotectod
A-CDW{11{oinl APTA/BEDROOM White
Compound #lCElLlNG Fibrqrs
og,z@s'ultt2A Homogen€ous
't5% Glsss 85% NofFfibotrs (ofier)None Dclocted
INS-lnsulaton
ogtNgslwrs
MAIN Tan
HOUSEATTIC Fibrous
HomogEneous
95% Celluloce 5% NorFfibous (olh€r)None llobc-ted
R$01-SRof
Shlngle
oetzoe!il34r4
fUAN Brqiln Tan/Blad(
HOUSE/NORTH RbrousSIDEROOF.
BOTTOMLAYER Homogen€ous
20% @lulce 80% Norrfibans (olhe)Nons Detecleel
Andyst(s)
JennifuKdrtg(W)Baojia t(s, L€boratory Manager
a other sppro,ed gign8tory
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Test Report PLir-7.1 6.0 P rlnled;. 7 t31 ti2012 12:8:42 pM
EMSL Analytlcal, lnc
22ll Potyollsa Avo, Suho 2:l0, San Loandrc, CA o.(t77
Phoney'Far (510189$3875r(s10)8953080
l'rlto:rrwwur.omsl.com
EMSLOrder: 091209513
GnstomerlD: GBW62
CuslornerPo:
ProJecllD:
Attn: DaVe prlce Phme: (2oEr78$1787
Great Basln Servlces, Inc. Fac (208) 78$4053
pO BOX 23g Reodwd: 07126/129:d)AM
Ana[Fis Dats 7nAnO12
Bfackfoot aDB32z1 cdleded: 7n4m12
Prolec{: HOUSE AT l3l UttEgT,2t{DSOUTH, REXBURG, lD
Test Reporfi Asbestos Analysis of Bulk Materials via EPA 600rR-93r116 andlor EPA
600rM4-82-020 Method(s) uslng Polarized Light Mlcroscopy
Non-Asbeglog ArlEbc
RS-02-&Roof
Shingle
@tNp51Upt,
MAIN Brown/Tan/Black
HOUSE/SOUTH Non-Flbror.rsSIDE ROOF.
BOTTOMIAYER H€l€rogeneous
20% @lluloee 80% Ncr'flbrous (olher)l{one Detected
RS-0&B-Rof
Shingle
@t&!tsrunt0
MAIN Brovn/Tar/Bhck
HOUSE/ROOF- FbrotsRIDGE.BOTTOM
TAYER Homogen€ous
20% Cellulose 80% Nm.flbrous (other)Nono Detocted
RS-01-T-Rod
Shlngh
09120p513{o17
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HOUSE/NORTH FbrousSIDE ROOF.TOP
I-AYER Het€rogen€ous
20% Glass 80% Ncrfibrous (other)Nono Dotectod
RS-02-T-Rod
Shingle
@t2@513jo10
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LAYER Homog€n€oLrg
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RS-o&T-Rocf
Shingle
09tn9ilwtg
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IAYER Homogeneota
20% Glaes 80% Nm-tibrous (o[|er)None Deloc-ted
GR-01-Roof Sldngle
ogl4rgt3&tn
MAIN
HOUSE'GARAGE
ROOF.EAST SIDE
Brown/TaryBhck
Flbro.rg
Homogeneos
80% Ncr-fibrws (other)llono DetoctodCellulose
GR-{12-RmfSNngle MAIN
HOUSECTAMGE0ertus&4nt ROOF-WEST
SIDE
Brorn/TsrVBhck
Fibrqrs
Hofirogeneous
20% Cellulce 80% Nm-fibrous (othef)libno Dotoclod
Analyst(s)
JalnfarKeedng(&)Ba{la }G, Laboratory Managieror oth€r approved slgnatory
EMsL'Ehla|.'t||i8!||ltyt|'n|tsd!oco3tdo'l8r91a.T{s.tEpsq.:q!9'{y|o-lhPs8mpb5.9po'ted8ndmaynoooF9oducod.6rod|nM.g|tno.ttwd[snapplqatuyF!po8|t{.ly-6'!8mp|ocoI6c|bl8c0t.d6or8m|ytlc8|-m€hd||m|1st|oi'.|rrterpotiuonancuggoftort..sdt!aFih.mcpoiuluttiyocun.cuortntgahullpodjd6tfc8{0n,8ppfolE|'66'do6€montD'.1tivtAP'},|tsTofar-agencyoffolodera|.goB0ing'{Nond|eUeolpm|tdtyoo6omaicteigr!d'tipootortmartr
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RepottAmended:Ol31ho12 12:36:42ReplscesthslnltalR€port071292012 09:32:lg.neasonCoOe:GtientCtrarUetoproJea
Te3l Reporl Purl-7.16.0 Prlnted: 7/312012 12:,8:42 pM
EMSL Analytleal, Inc
223t Polyoiliga Avo r Srrlts 230, San Leanclro, CA 945n
Pt$ndFax {510)Fg$'3b751{510)SS$3S80
htisiAirirrr,va$sl. coin aanbafdrolab&en$l.pq{n
T*st Reporh Asbestos Analysis of Bulk Materials vie EPA 600rR-93J{ 16 and/or EPA
600/M4-82-020 Method{s} using Polarized Light Microscopy
r,lp!.A,ppesXqs
Anooarance oA Flbmue oA t{on-Flbrous
EMSL Otder: 09120s5l3
eustomerlD: GB$VOC
Custsn€rPO:
FrcJ€ottD:
Asfr*|os
Yo TvuaSamrle Dsscriotion
Altn: gayg pfig6
Great Basin Seruiees, Inc,
PO Box 238
Blackfoot, W88t:21
proiecl HOUSE *T lgl W€ST,2ND SOUTH, REXBURG, lD
Phoner
Fax:
Receiwd:
Andysis Dde;
Cs||eded:
(?08) 78s1767
tr08) 785-4053
07128112 9:00AM
7n8r2012
7124t2012
GR-o&RoofShingh MAIN Sroffr|lTadBhck
Fibrous
Homogeneqirs
30% Cdlrlo$e 70% Non-fibrous (other)Nons Dotoctod
09t2495',34.f22 I.OUSSGARA6E
ROOFRIOOE
Baojia lG, Laboratory Manag€r
s olh6|apprs/ed s&nilory
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Transactiontturu"ffi
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