HomeMy WebLinkAboutALL DOCS - 12-00297 - BYUI College Ave - Demolition35N leE
Rexbutg, lD 83440
Applicant
Name:
Applicant's Address
Business Phone:?q{ - 79 tL
Building SofetY DePorlment
Clty ol Rexburg
Phone: 208.372.2326
Fox: 208.359.3022
Application for lv
$25.00 Fee Paid: Yes/No Permlt
City/ST/Zip:
CITY OF
www.rexbvrg.org
77
Contact Information
Person or Companv doing the demolidon: -/ : \ / 4
'
4'"^*," "-"ii,---g cffirruiP'
Business phone: .-< 4-*L Ce[Phone: 5'f ree
Demolition I
Property C)wners:
SiteAddress: / ( I
Start Date:Completion
Summary of what is being demolished:
The u.S. Environmental protection Agency (EpA) tegulates the abatement and disposal of asbestos-containing matedals from any
public or private building involving demolition, ,.rro.r""rio.r, repair, construction, and maintenance activities'
ilttp: / /deq.idaho.gov/airlProg issues /pollutants/asbestos'cfm
EpA certifies and licenses asbestos-removal conffactors, inspects asbestos-abatement proiects, and eoforces laws regarding the ptoper
removal and disposal of asbestos-containing materials'
currently, EpA and DEe conttact with Industrial Hygiene Resources in Garden city, Idaho, to tegulate asbestos temoval and disposal
proiects in Idaho.
For more information about asbestos abatement and disposal in ldaho, contact:
Industrial Hygiene Resource
206 Murray St
Garden CitylD 837L4
208-323-8287
www.industrialhygieneres ources' com
REXBURG
cl" --*'-'*
Am eri n\ F amilY Co m munitY
I understand the EPA requirements tegarding asbestos femoval and agfee to provide information showing
-^-.f^.:^-- rn rlra (-iftr niRexhurs nrior to demolition.compliance with the regulations to the City of Rexbu
Signatute of
Great Basin Services'Inc
P.O. Box 238
Blackfoot,Idaho 83221
Office: 208-785-1767
Cell: 208-681-6462
July-25-2012
RE: Vacant House located at 119 Center' Rexburg' Idaho
To Whom it maY concern:
Great Basin Services has removed the asbestos_materials found in the Inspection report'
Sitver sealer * o"rr.ii"iroof and th. ffi;;;;'J"tg9t the wall paneling' All Asbestos
materials were disposed of at u" epe ei;;;; i*dfill as required by EPA' The remammg
;;;il my be disposed of as non asbestos waste'
Dave Price
fY?
t
, ?ot" oF rDArro-?'*'oL PRoTEcTIuN A-E"'- ' ---u. s. ENt+
U.,A.''''" DDSCRIPTION:
nuitOing Nu*t' Vucanr|lYt/"P"ttt*
Address: I 19 Center
Site Location ' toTplttt hou*
ffing sire (sqY" YDryroxtaoo '"". ""-. ::]II.\I^TINN FRETRAINING
RENOVATION
No Will revise if asbestos is found in survey
tV. I. ArUt'tot Pttttntlghtckone)
Owner Name: BYu-ldaho
License: CSR012012-29
;;;. t'r'lho*-18-M il*., *r.-o6t*' t*11152()4.B.24
Address: 4132 East 100 North
Fa,x:NA
contact: JeremY wray
p.^oprlnre. including analytical
:::;;i;' PLM Lab testins
uuu-uF"'-
il[P**ito" At""tt "f Atbt'Nonfriable Asbestos Material
Not to be RtrygutoNonfr iable Asbestos, Material
to be RemoveoRACM to be Removed
Will revise as needed
ComPlete: @
il.sctredulerlD@
il*,.rro'n'o@
Will revise if needed ComPlete:
::'J:'ffi iJ."&;-4t 4"" ""'
Waste Transporter #1:
Name: Creat Basin Services' lnc
Address: P'O' box 238 Zip Code'.8322r
TelePhone: 208-785-l'761
ffio-_*.ot'pot3tt 'ts@
N*., Bunnotk Cj""ry L*dfin
l-u-*.rr' "oo
North Fort Hall Mine Road
TelePhone: 208-236-0607
if this project is an Emergency Demo)
ffii
iagfig'fffitP*P;;,i Ren'va"n)
i*$itmq,#;',':t*'. """'"'".,,t,, B:sei#jliloolsh:T:k€YJ$fi;;n-s'aft::nltjfis::eg$el,:3=::-;"""'--"-N{ becomes crumbred, purverized or
ff-'*,";L.;;":#I,*"H,"-#,';.;4treduced'" '""u.J;* .';"TE$.;il,HlK:*:.:'*"i;.
ffi ;;iif L;"l*.'1,"J#ffi:: ;Li'H ;;ii * il'.
signature orownerroperator '*-tt-t' it":tji:::l; #?;3;;;il;;;;;;;
I ecknowledge the existence llaw-s nrofrifi'ting the submission of false or
t
iltlill#?;;-t'o" "ccu'at"
and complete'
ffitify that facts contained in this
;f i#5"T#'il11111fi1il1*$Xk'ou'rneil,,""noo.o-o'r*i:'^:'Jfl[iffi:trilllil],ilffiii#;;';;;p*'a*- ,- . - Ei..frniqu" to Ue lsed and
H'iftilffi'tr::'1T*Til:i*'T:ilrfi f; *'rr*"'li'
/ handring emission .on'ii pio..ou'o-' R*t *o *'t'""'i*i'e [p' Td :iry T-kf',3,Tli:iii fitfri']ffi';'rffix*ff{ffit ;;5:fny " -
rvill bc removed urine n*o "ioi"im'tt'oo"i'ine
uts' scrafets' hand lo'ls' wats'r to *;;;;';iitncriat rsmoved wilt bc double-bt*o' t*
-/
HT:'i:i;T'#T,il$*1;j;f 't';Xl'tlff ;**''*lf - "" "'"''
Xll. WoJte TrsusPoder f l:
Namc: Grat Basin Scrrices' Inc
Addrus: P.O' box 238
Xtt. WastcDisPosil: ASBESTOSONLY
Address: 1500 Nonh FqltltMi*Rltt
anO af t oilrcr sections' only itthis pmject is an Emergency Demo)
i;ffi;fitof the oider to$js notice'rr ntsvr. swrJ -- -"-
ordgr. NA -
2. Namc of AuthoritY Isulttg to Bogini.' frriioiitY ot o'ao (gl{':i.oi
4. L)BE or urscr rv"ruvv' '
ifffir mne following
EmergcncY Bmu"-"!on (A1T^ .,,^i'iiotiuoo lto* of Emsrgence FUA
i, Slifilirit';r suildcn, UnotpTl-t-d, T::1:or an unreasonable financial burden
i. Eiil#iil""]ffi t'; ;"' ;"*" "*"*d or nonfriable Aclfl bccomes crumblcd, pulvcrhcd or
ffilllffi'r;"d;-.
-
"arl;;- *er down AcM, .n.r*" *4 por, o*tins rn,l *ntt
ffi(40cFR.PAR.t-n-':j!1i*M)wi|lbeonsiter|.uriogthedcmoli6onorrequired trninrng hrts becn 'il"til'$fliiiil;;;;;;iffi';;irJt o"'t'4;;i1ltnb'iillil*'Jii't'u'
Dave Prioe / Ownq Stt"tary
----
prohibit|ngthcrubmirs|oloffal$c0rmi$|ts.tlngstarcmensondlccttifythstfrct$cont{|ngdintbir
T''p-;t Pti"t Nsme alrd Title
ffiotu'fcofgfrnu,lo *eetendst beforsdemolition orrenove!9n
I-'i^--^r-8"^'lrinodsvs(Monday'FrtdayeXcluslngtwA!''"'-:'-.:;':L*ii tFamrcv-3f2489gr,::iy.11[*i"#$'*'
u. s. El{vlRroxutEonrnt, PRoiiqgTIoN AGENcY
xormrciiior'l -or Ps. $,q+ryIon mq n
TE OF IDAIIO
ATION
. ,"r" o" nurrrlceTroll: -:fljunr.slY
ll. FACILiTY DESCRIFTIONT
Address: l19Ccnter
Sitclncation : mmPlcte house
Buitrting Size (Squrrt Fca)aprox 1400
Prcscnt Use: Vacant ., .
,r.T'pEo'orr*rron, -*-or*o -o*ou*roor*o -**o*@t*P"ou4r9* -tt*tt*E
lV, I$AcbestosPrescnt? (chcckonc)*Nowil@
Address: Univusily opcratittt B"ttdi"g f S2' 525
Removal Coutrlctor Nrmt: Grcot Bsoln Scrr'lces' lnc
DgvePrice TelePhonc: 208-?85'176?
Licensc: Rce46l8, PWC{'16204-B-24
Addrcss:4132 East t00 North
the qunlity of RACM and Ce tegory I and Cetegory ll
non.fisblc PLM Lsb tcetinq , . .
-- '" ' "
Vll. Apprortn.t A*utt of Atb*t"t M
aprox l0 sq fl of
Surfacc A.rea (Square fcet
UrU. *.O.Uot.U Dstss Demolltlon or Rcnwrtion: $tail:
lV. Dat0s for Arb*bt ktot"l (MmDryU
7V fty' ?d/"ez
Building SofetY DePorlmenT
City ol Rexbutg
Phone: 208.372.2326
Fox: 208.359.3022
www.rexburg.org
Permit #
$25.00 Fee Paid: Yes/No Permit APProved: Yes/No
CI'TY OF
laa<?\ ---
fffi1 Rrxn*uRc
Y^u(lrrrw,//
\W "\men''sLamill'comnwni:7*
Application for Demolition
Applicant's Address: )7 4 (zvtt - '
*"r".r, ,non ' ZeF-4/- Z/4
35N ljE
Rexburg, lD 83440
Contact Inforrnation
Person or Company doing the demolidon:
Address:
Business Phone:
Demolition Inform
Property Owners:
Site Address
Start Date:
fia
q ci*/sTtzip: f42z? rTa'
*Opnor,.' 2O'?- Z-af-' 143O
/o ?z*
City/ST/ZiP:
Cell Phone:
/'*-U" Zz-tk
Sumrnary of what is
TheU.S.EnvironmentalPtotectionAgency.@'PA)regulatesthe.abatementSlddise.osalofasbestos-coxtaininsmaterialsfromany
public or private building i;;;h;g O*1"11?1:-tt'ooltiott' repair' construction' and maintenaoce actlvlues'
tttp, l.q.iduho.go',' 'i' f'og its't''e' t ollutatttt 'sbettot tf-
EpA certifies and licenses asbestos-removar contractors, inspects asbestos-abatement proiects, and enforces laws regarding the proper
removal and disposal of asbestos-contalrung maternrs'
currently, EpA and DEQ contract with Industrial Hygiene Resources in Garden city, Idaho, to regurate asbesros removal and disposal
projects in ldaho.
For more information about asbestos abatement and disposal in ldaho' contact:
Industrial HYgiene Resource
206 MurtaY St
Garden City ID 83714
208-323-8287
www.industrialhyfienetesources' com
r underctand the EpA requirements regarding asbestos removar and agree to provide information showing
compliance *i,f, ,f,. ,.gJl*ioi, ,o *rJcity of Rexburg prior to demolition'
Signature of APPlicant:
//5 &12
i| d i ns Sof etY o. ?fl_l,T,t ll CITY OIi
REXBURG
Clr, ---'*
Americai lamilY CatnmunitYPhone: 208.372.2326
Fox 208.359'302235N lnE
Rexburg, lD 83440
Applicant Information
Name:
Applicant's Address:
Business Phone:
Contact Information
Person or Company doing the demolition
Address:
Business Phone:
Demolition Information
Start Date:
Application for Demolition
Permit #:
Ctty/Sl /Zip:
Cell Phone: zag
$25.00 Fee Paid: Yes/No Permit APProved: Yes/No
lo/o
www.rexburg.org
fi4r',b
Ciry/ST/ZiP:
Cell Phone:
Summary of what is being demolished:
The u.s. Eovironmental protection Agen_c1 @,pA) regulates the abatement and disposal.of asbestos-containing materials from any
public or prrvate burldrntt;;';'"*::l*i:::?"J1i"::.f,'"' construction' and maintenance actrvlues'
EpA certifies and licenses asbestos-removal conffactors, inspects asbestos-abatement projects, and enforces laws regarding the proper
;;;;i;;JJsposal of asbestos-containing materials'
currentry, EpA and DEQ conuact with Indusuial Hygiene Resources in Garden city, Idaho, to regulate asbestos removal and disposal
projects in Idaho'
For more information about asbestos abatement and disposal in ldaho' coritact:
Industrial HYgiene Resource
206 MurtaY St
Garden CitY ID 83714
208-323-8287
www.industrialhygieneresoutces'com
I understand the EpA fequifements regafding asbestos femoval and agree to provide information showing
compliance *ith ar" '"gtit"'iot' to the"City olRexburg ptiot to demolition'
Signature of APPIicant:
t u. s. ENvr*o*t*rAL pRorEcrroN AGENC' -?ot" oF rDAHo
NOTIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPEOFNOTIFICATION: COURTESY x ORIGINAL REVISED CANCELED
II. FACILITY DESCRIPTION:
Building Name: Vacant House
Address: I l8 College Ave
City: Rexburg State: Id Zio Code'. 83460-8205 County: Madison
Site Location : all ofhouse
Building Size (Square Feet) 2000 #of Floors: 2 and basement Age in years: 47 plus
Present Use: Vacant Prior Use: Residential
III.TYPEOFOPERATION: _x-DEMO -ORDEREDDEMO RENOVATION EMERGENCYRENOVATION FIRETRAINING
lV. Is Asbestos Present? (check one) _Yes No Pending inspection
V. Facility Information:
OwnerName: BYLJ-Idaho
Address: University Poerations Building # 82, 525 South Center
City: Rexburg State: Id ZipCode: 83460-8205
Contact: Rulon Nielson Telephone: 208496-2660 Fax:208-496-2490
Removal Contractor Name: Great Basin Services. Inc License: CSR0l181l-02
Address:P. O. Box 238
City:Blackfoot State: Idaho Zip Code:83221
Contact:Dave Price Telephone: 208-785-1767 Fax 208-785-4053
Other Operator (demolition/general) Unknorvn at this time, rvill revise License:
Address:
City:State:Zip Code:
Contact:Telephone:Fax:
VI. Procedure, including analytical methods, employed to detect the presence ofand to estimate the quality ofRACM and Category I and Category Il
non-fiable PLM Lab testing
Vl1. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category II Category I Category II
Pipes (linear feet)
Surface Area (Square feet
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknorvn Complete:
IV. Dates for Asbestos Removat (MM/DD/YD : Will revise Complete:
DaysAileek Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Hrs of Operation
X' Oescription of planned Demolition or ,.nH!,on work to be preformed and method(s) to be employed, including demolition o. ..nonatioltechnidues to be used and description ofaffected facility components:
'XI' Description of work practices and engineering controls to be used to comply with the requirements, including asbestos removal and wastehandliog e.ission control procedu.es: Asbestos abatem"nt only, Post area with wa*ing signs, Iimit access to public. Will revise accordingly
Name: Great Basin Services, Inc
Address: P.O. box 238
City: Blackfoot
Contact: Dave Price
Zip Code:83221
Fax:208-7854053
State: Idaho
Telephone: 208-785-17 67
Waste Transporter #2:
Name: N/A
Address:
City:
Contact:Telephone:
State:Zip Code:
Fax:
XU. Waste Disposal: ASBESTOS ONLy
Name: BannockCountyLandfill
Address: 1500 North Fort Hall Mine Road
City: Pocatello State: Idaho ZipCode: g3204
Contact: Scale house Telephone: 20g-236-0607 Fax:2Og_ 236- 0609
Emergency Demo)xIV. Emergency Demolition (Complete item XIV and all other sections, only if this project is anl. Aftach a copy ofthe Order to this notice.
2. Name of Authority Issuing Order: NA
3. Authority of Order (Citation of Code):
xv.4. Date of Order (MluyDD/yy)
EmergencyRenovation(AttachseparatJergencyRenovatio-n.)
[. Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
3. Explanation ofhow the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
xvr.Description of procedures to be followed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized orreduced to powder.
Evacuate are4 wet down ACM, enclose area, post wamings and contain. Stop spread ofair-born fiber release.
July 29-2011 Dave Price / Owner Secretary
xvII' I certify that an individual trained in the provisions of NESHAPS (40 cFR PART 61, SUBPART M) will be on site during the demolition orrenovation and eviden-ce that the required training has been accomplished by this person will be available during normal business hours.signature of owner/operator Date rype or print Name and ritle
xvII.I acknowledge the existence oflaws prohibiting the submission offalse or misleading statements and I certify that facts contained in thisnotilication are true, accurate, and complete.
s
Original Notification -u* O.
begins, except emergency demolition and emergency renovations which must be submitted as ,oon * porri-bl" before operations begin. (Form rev.3/24lgg
u. s. ENvTRoNfiTAL PROTECTTON AGENCY - il.t" oF rDAHO
NOTTFTCATION OF DEMOLTTION ANDT,ENOVATIqN-
QPERATORPROJECT# I POSTMARK DATE RECEIVED NOTIFICATION
I. TypEoFNOTIFICATIoN: CoURTEsy -ORIGINAL -lil-REVIsED -CANCELED
II, FACILITY DESCRIPTION:
BuildingName: Vacant House
Address: I 18 College Ave
City:RexburgState:IdZipCode:83460-8205county:Madison
Site Location : all ofhouse
Building size (Square Feet) 2000 #ofFloors: 2 and basernent Age in years: 47 plus
Present Use: Vacant Prior Use: Residential
rrl.TypEOFopERATIoN: -x-DEMO -ORDEREDDEMO -RENOVATION -EMERGENCYRENOVATION -FIRETRAINING
fV. Is Asbestos Present? (check one) -x-Yes -No
I V. Facility Informationl
I'
I O*orrNu*e: BYU-Idaho
I Addt.tr, University Operations Building # 82, 525 South Center
| .t^,'Pevhrrro State: Id Zip Code: 83460-8205
I vrlJ. rw^vsr5
I
I Contact: RulonNielson Telephone: 208-496-2660 Fax:208-496-2490
I nerovat Contractor Name: Great Basin Services, Inc License: CSR 0l I 81 l-02
I Addr.tt, P. O. Box238
II cinr Blackfoot State: Idaho ZipCode:83221
| ""r' --
I contact: Dave price Telephone: 20g-785-1767 Fax: 208-785-4053
I
I otn., operator (demolition/general) unknown at this time, rvill revise License:
I
I Address:
| .t^, state: ZiP Code:
I n^-.^^r. Telenhone: Fax:
vI. procedure, including analytical methods, employed to detect the presence of and to estimate the quality of RACM and category I and category II
non-fiable PLM Lab testing
V1l, Approximate Amount of Asbestos Mrterials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category II Category I Category II
Pipes (linear feet)
Surface fuea (Square feet aprox 250 sq ft of sheet
vinyl flooring
Facility Components (cubic feet)
vIII. Scheduled Dates Demolition or Renovation: start: Unknown, will revise
IV. Dates for Asbestos Removal (MM/DD/YY) : Sept-8-2011 Complete: Sept-8-2011
Complete:
DaysMeek l tvtonOav l Tu.tduy -l--ttdnttduy Thursday Friday Saturday Sunday
Hrs of Operatiot I | | 9am-12 noon
v
X' Description ofplanned Demolition or renovation work to be preformed and method(s) to be employed, including demolition or renovationJ.echniques to be used and description ofaffected facility components:
XI' Description of work practices and engineering controls to be used to comply rvith the requirements, including asbestos removal and lvastehandling emission control procedures: Asbestos abatement only, Post area with waming si[ns, limit access to public. Critical bariors, negative airinclosure, hand removal with adequate wetting. All material to be double-bagged, labeled and transported in an inclosed trailer for disposal at an EpA approvedlandfill
XII. Waste Transporter #1: ASBESTOS ONLY
Name: Great Basin Services, Inc
Address: P.O. box 238
City: Blackfoot
Contact: Dave Price
Waste Transporter #2i
Name: N/A
Address:
city:
Contact:
State: Idaho
Tefephone: 208-785-17 67
Zip Code:83221
Fax:208-785-4053
State:
Telephone:
Zip Code:
Fax:
XII. Waste Disposal: ASBESTOS ONLY
Name: Bannock County Landfill
Address: 1500 North Fort Hall Mine Road
City: Pocatello State: Idaho ZipCode: g3204
Contact: Scale house Telephone: 20g_236-0607 Fax20g_ 236- 0609
xrv.Emergency Demolition (Complete item XIV and all other sections, only if this project is an Emergency Demo)I . Aftach a copy of the Order to this notice.
2. Name of Authority Issuing Order: NA Title3. Authority of Order (Citation of Code):
xv.
2. Description of Sudden, Unexpected Event.
3. Explanation ofhow the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
4. DateofOrder(MlWDD/yy) D"t"Ord.r.dt"B.gl"EmergencyRenovation(AttachsepaIatesheetwithtt'"f@ergencyRenovatioi.)
l. Date and Hour of Emergence N/A
xvl. Description of procedures to be followed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized orreduced to powder.
a,postwamingsandcontain.Stopspreadofair-bomfiberrelease.
KVII. I certify that in the provisions of NESHApS (40 CFR
that rfquired training has been accomplished
Date
Sept-7-20 l I
Sign of
PART 61, SUBPART M) will be on site during the demolition orby this person rvill be available during normal business hours.
Type or Print Name and Title
Dave Price / Owner Secretary
prohibiting the submission of false or misleading statements andcomplete.
xvII.Iac
noti I certify that facts contained in this
Type or Print Name and Tifle
original Notification must be mailed or hand delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovationbegins, except emergency demolition and emergency renovations which must be submitt.a * ,oon ^ por.fl, before operations begin. (Form rev.3t24l99
."1 ,'.' O O
,
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 B:45 AM
121 105800
7t3112011
Test Report: Asbestos Analysis of Bulk Materials via EPA 6001R-93/116 Method using
Polarized Light MicroscoPY
Non-Asbestos
Yo Fibrous % Non-Fibrous
Asbestos
% TypeAppearanco
dlh, :#:,l"1:xllll,li:lll;hoenix, AzB5a17
V
Attn: DaVe PriCe
Great Basin Services, lnc.
PO Box 238
Blackfoot, lD 83221
Fax (208) 78$4053 Phone: (208) 785-1767
Project BYU ldaho 118 College St, Rexbury ld'
Sample Description
98o/o Non-fibrous (other)None Detected
#1-01-Linoleum Apartment #1
12110fi0o4@1 Bathroom Vinyl
Gray/White
Non-Fibrous
Heterogeneous
2% Glass
None Detected
Tan/Clear
Non-Fibrous
Heterogeneous
100% Non-fibrous (other)#1-O1-Mastic APartment #1
12110'J004{y,1A Bathroom Vinyt
None Detected
#1-0'l-Backing
12110fi0040o18
Apartment #1
Bathroom Vinyl
Black
Fibrous
Homogeneous
75% Cellulose
5% Synthetic
20% Non-fibrous (other) -/
None Det€cted
#1-02-Linoleum
12110fi004002
Apartment #1
Kitchen Vinyl
GrayMhite
Non-Fibrous
Heterogeneous
15% Cellulose
2% Glass
83o/o Non-fibrous (other)
100% Non-fibrous (other)None Detect€d
#1-02-Mastic
1211058004co24
Apartment #1
Kitchen Vinyl
Beige
Non-Fibrous
Homogeneous
Black Mastic present, but insufiici6nt mat€rial foranalysis
93% Non-fibrous (other)None Detected
#3-01-Linoleum
121105€,004003
Apartment#3
Bathroom Vinyl
GrayM/hite
Non-Fibrous
Heterogeneous
5% Cellulose
2% Glass
Mike J. Wilfiams (42)Michelle Wilson, Laboratory Manager
or other appro\ted signatory
, ,, EEiEiEw"r,, -"-- :."EM-ffi;n6ins I'abilii!, I'miteo to osi6EEiliGlTreport mtatssonlv.to he samples reported and may nol t
beacnorspmsibilityforsamP|eco|I4tionactivitiessana|ytlcarmenooriiritaiii$:,'IiTrr:I":Tr::,:""::x:l**::'"''3n::':,lY."j,::""f5i}l1H$#[1[::THf&",f'm;i?j':[fi?fj:"gl'tUL"":']li?'X,:&?*?J#""1"'"d'if';: -'i$;;i;i;ci"iliJsi;''n""t
oroblem mat ix aM therefore EMSL recommends gravimetric reouaion prioi io anaiisis. sampt6s ieeiwd in good con;ilon unless otheffise noted Estimated acuracy' precision
;nd uncJrtainty data 8\ailaue upon request
Test Report PLM-7.23.0 Printed: 8/1/2011 9:47:15 AM
Fax: (208) 785-4053
Project: BYU ldaho'118 College St, Rexbury ld'
Phone: Q08)785-1767
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07/30/1 1 8:45 AM
121 105800
7t3112011
Test Report: Asbestos Anatysis of Bu|k Materials via EPA 600/R.931116 Method using
Polarized Light MicroscoPY
Non-Asbestos Asbestos
% TyPe% Fibrous % Non'Fibrous
Attn: Dave PriCe
Great Basin Services, Inc'
PO Box 238
Blackfoot, lD 83221
Sample DescriPtion Appearance None Detected
100% Non-fibrous (other)
#3-01-Mastic
12110ficf'40034
Apartment#3
Bathroom VinYl
Tan
Non-Fibrous.
Homogeneous
None Detected100% Non-fibrous (other)
#3-02-B-Mastic 1
1211058004004
Apartment #3
Kitchen- Bottom
Layer
Beige
Non-Fibrous
Heterogeneous
40% Non-fibrous (othe|50% Chrysotile
#3-02-B-Linoleum
121105800{@44
Apartment #3
Kitchen- Bottom
Layer
Gray
Fibrous
Heterogeneous
10% Cellulose
None Detected100% Non-fibrous (other)
#3-02-B-Mastic 2
12110fi004cf48
Apartment #3
Kitchen- Bottom
Layer
Brown/Tan
Non-Fibrous
Homogeneous
Stop Poslttue (Not
AnalYzed)#342-T
121105f,0040p5
Apartment #3
Kitchen ToP Layer
None Detected
20o/o
2o/o
Cellulose
Glass
78% Non-fibrous (other)
12110fi0040p6
Apartment #4
Kitchen VinYl
Gray/White
Non-Fibrous
Heterogeneous
i rePorttrom OBIO1l20l1 09:47:15
Analyst(s)
arz$dk tttleeru
Michelle Wilson, Laboratory Manager
or other approved signatoryMike J. Wliams (42)
hout writton appm€l bY EMUL EM)L
beacno'€sponsibi|ityt*."'p."*u"iuJn"iti'lti".o,"*ryticar.er'oorii.itajioif..tnt",pi"t"tion"nousedWth€c|i€nttoc|aimprducI@ni;;tion,apprra|,or.endo,..,n'rtovliVrnF,rtsTi,"ny"g"n"yorrr."rii.".'iiii"".''i
ofouem matfix and the€fore EMSL recommends gravim€tdc ,*uo,on pnor irlilivrir] bJ*pr6. i"*i*o in g-J"oni*ion unress othe*ise noted Estimated acdracy' p€crsron
lJurrertainty oata availabl€ upon rsquest
AZ I'IVLAP Lab Code 2008114'
Test Report PLM-7'23.0 Printed: 8/1/2011 9:47:15 AM
EMSL Analytical, Inc.
3356 West Catalina Drive, Phoenix, AZ 85017
Phone: (602) 276-4344 Fax: t6021 276-4053 Email: p!qenirbb@.9!nska-!!
Attn: Dave PriCe
Great Basin Services, Inc.
PO Box 238
Bfackfoot, aD 83221
Fax (208) 7S5-4053 Phone: (208) 785-1767
Project: BYU ldaho'l'18 College St, Rexbury ld.
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 B:45 AM
1 21 105800
7t31t2011
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using
Polarized Light MicroscoPY
Samph Descriptlon App€arance
Non-Asbestos
% Fibrous % Non'Fibrous
Asbestos
7o Type
None Detected
#4-01-Mastic APartment #4
12110fi004@6A Kitchen Vin$
Beige
Non-Fibrous
Homogeneous
100% Non-fibrous (other)
#4-01-Linoteum2 Apartment#4
12110'j0040068 Kitchen Vinyl
Grayffello\/
Non-Fibrous
Heterogeneous
10% Cellulose 65% Non-fibrous (other)25% Chrysotile
#4-02-Linoleum
121105800-0@7
Apartment #4
Bathroom Vinyl
GrayMhite
Non-Fibrous
Heterogeneous
15% Cellulose 85% Non-fibrous (otheO None Detected
100% Non-fibrous (other)None Deteeted#4-02-Mastic
12110fi0o4@74
Apartment #4
Bathroom Vinyl
Tan
Non-Fibrous
Homogeneous
#6-01-Linoleum
12110fi00{(n8
Apartment #6
Bathroom Vinyl
10% Cellulose 65% Non-fibrous (other)25% GhrysotileGray/white
Fibrous
Heterogeneous
100% Non-fibrous (other)None Detected
#6-0't-Mastic
12110fiOO40084
Apartment #6
Bathroom Vinyl
Brown
Non-Fibrous
Homogeneous
lr]l$tdk {ilfu*r1t
Michelle Wilson, Laboratory Manager
or other appro\€d signatory
, e)aept in tull, withoul witten appD\al by EMSL. EMSL
Girsnobiporrsioirityiorsamptecoticti*Jitiuit"'o,"n,iytica|mehod[mitations..|nterpietationau"uJov1n"irGnitoir"i*pro<i,"rce'iii;ii'on"pp'*r.o'.ino*.anenttyt.tvne.nt{l*t.,r:,.,j.I"^11f:,^s,:f:::l:jf:*::|:"fg^""i":'lx*j.l*.y#:*,
;fi#;"#ilii!lli#-iil-sr_?l;mmenoJ bravinietnc reduaion prior to anarysis. Sampres ieeiwd in gmd condiuon unless otheMise noied. Estimated acdracv, ptecision
;nd urcerlainty data atailaue upon request.
EMSL lnc. Phcnix Az I'IVLAP Lab CPde 200811{,
Anatyst(s)
Mike J. Williams (42)
Test Report PLM-7.23.0 Printed: 8i112011 9:47:'15 AM
+EMSL Analytical, Inc.
3356 West Catalina Drive, Phoenix, AZ 85017
Phone: (6021 276.4344 Fax: 1602' 276-4053 Emait:
Attn: DaVe priCe
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 83221
Customer lD:
Customer PO:
Receircd:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
121 1 05800
Fax (208) 78S4053 Phone: (208) 785-1767
Project: BYU ldaho 118 College St, Rexbury ld.7t3'v2011
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using
Polarized Light Microscopy
Samplo Description Appearance
Non-Asbestos
Yo Fibrous % Non-Fibrous
Asbestos
% Type
*6-01-Flooring Apartment #6 BrownMhite
1211osa@4ooa' Bathroom Vinyl Fibrous
Heterogeneous
98% Cellulose 2% Non-fibrous (other)Nons Detected
#6-02-Linoleum 1 Apartment #6
12110o,0o4.',s Kitchen Vinyl
GrayMhite 15o/o
Non-Fibrous 2%
Heterogeneous
Cellulose
Glass
83% Non-fibrous (other)None Detected
#6-02-Mastic
12110fi004009A
Apartment #6
Kitchen Vinyl
Beige
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
#6-02-Linoleum 2
12110fi004009/B
Apartment #6 75% Non-fibrous (other)26% Chrysotllsvinyl
Yellor/
Non-Fibrous
Heterogeneous
#00-Floor Tile
1211058004010
2nd Floor White
Bathroom, Top Of Non_Fibrousstairs Homogeneous
100% Non-fibrous (other)None Detected
#00-Mastic 1
1211058004010A
2nd Floor Clear
Bathroom, Top Of Non-Fibrousstairs Homogeneous
100% Non-fibrous (other)None Detected
Analyst(s)
Mike J. Wiiliams (42)Michelle Wilson, Laboratory Manager
or other approved signatory
EMsLmaiilalns|iabi|ity|imitedtocostoJanalysis.ThisreM.re|atgson|yto.|hesamp|esrepor1edandmavno
beaRno€sPs5ibi|ity'orsampleco||stionactjMtjesorana|yti€|m€hod|imita1ions.lnterpr€tationanduseoftest!u|ts
usedbytheclienttoclaimprc(tctcertifcation,approEl,tendorsmttbyNVLAP,NISToranyagencyofthefederal go\€mment. Non-fiaOt,eorganicallyboundmal€rialspresentaproblem matrix 8nd lhmfore EMSL re@mmends gravimettic reducrion pritr to analysis. Samptes eeiwd in good mndition untess otheruise notei. EslimaGd ac@@y, precisionand urerlainty data a€ilaue upon r€quesl.
EMSL Analytical, Inc. Phmnix AZ IWLAp Lab Code 20091
Test Report PL[/t7.23.0 Printed: 8/1/201 1 9:47:15 AM
lrlrU$jt t,,Jtfueo,,
'/Lv
^l' EMSL AnalYtical, Inc'
a#t 3356 west catalina Drive, Phoenix, AZ 85017-
Phone: (6021 276'4344 Fax: {602} 27i:!9qq--!rngil: ohoenixlab@elosllg$#r
Attn: Dave PriCe
Great Basin Services, lnc.
PO Box 238
Bfackfoot, lD 83221
Fax (208) 78S4053 Phone: (208) 785-1767
Project: BYU ldaho 118 College St, Rexbury ld'
Customer lD:
Customer PO:
Receiwd:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 B:45 AM
't 21 105800
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using
Polarized Light MicroscoPY
Description Appearance
7t31t2011
Non-Asbestos
Yo Fibrous % Non'FibrousSample
Asbestos
o/o lype
#00-Linoleum 2nd Floor
12110s@4o1ol Bathroom, Top Of
Stairs
GrayMhite
Non-Fibrous
Heterogeneous
65% Non-fibrous (othe0 35% Chrysotile
100% Non-fibrous (other)None Detected#00-Mastic 2
121105€004010c
2nd Floor Tan
Bathroom, Top Of
Stairs Non-Fibrous
Homogeneous
#7-01-Linoleum
121105€00{011
Apartment#7
Bathroom Vinyl
GrayMhite
Non-Fibrous
Heterogeneous
15olo Cellulose
2% Glass
2% Synthetic
81% Non-fibrous (otheo None Detected
100o/o Non-fibrous (other)None Detected#7-01-Mastic
12110580040114
Apartment #7
Bathroom Vinyl
Brown
Non-Fibrous
Homogeneous
#7-01-Backing
121105€'00.00118
Apartment#7
Bathroom Vinyl
Black
Fibrous
Homogeneous
85% Cellulose 15% Non-fibrous (other)None Detect€d
100% Non-fibrous (other)None Detected#7-01-Leveler
1 211058004011C
Apartment #7
Bathroom Vinyl
Gray
Non-Fibrous
Homogeneous
Analyst(s)lrXm$k t/Jtusn,
Michelle Wilson, Laboratory Manager
or other approved signatory
ffitofana|ysis'Thisreportre|atesonryePtinfu|l,withoutwrittena!po\albyEMSL.EMSL;;;;;;;p*'ibi|ityicJampIecoltctionaitivitiesoran.atyti€lmghodtimiiations.'|n|erp;€tationandusoftestresu|tsaBtherspmsibi|ityofti]Eirjvt!Jr.-"i1i.j;1#;f;afii"nli,p,i-r'_".i'ioo's**ttyHvue.NtST6ranyagencyot1h€fed€ra|gowmment.Non.ldabteorganica||yUndmatg
oiooreir matrixano rhffifore EMSL recommenod lravimetric redudion pri; to anatysis. sampt6s eeired in g@d condition unless othemise noied. Estimated acaracy, Prsision
and urcettainty data a\ailable upon r€quest.
lnc. PhGnix Az I'W|AP Lab Code 200811{, 420937
Mike J. Wiilians (42)
Test Reoort PLM-7.23.0 Printed: 8/1/2011 9:47:15 AM
rl /v|'
Fax (208) 78$4053
Projecl BYU ldaho 118 College St, Rexbury ld'
Phone: (208) 785-1767
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
121 105800
7t3112011
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R'93/116 Method using
Polarized Light MicroscoPY
Non-Asb€tos
o/o Fibrous % Non-Fibrous
Asbestos
o/o TypeAppearance
. .1, EMSL AnalYtical' Inc.-
€ttEll 3356 West Catalina Drive, Phoenix' AZ 85017\|r
Attn: DaVe Price
Great Basin Services, lnc.
PO Box 238
Bfackfoot, lD 83221
Sample Description
83% Non-fibrous (other)None Detected
#7-02-Linoleum Apartment #7
1211osaooeo12 Kitchen Vinyl
Gray/Vvhite
Non-Fibrous
Heterogeneous
15olo Cellulose
2olo Glass
None Detected100% Non-fibrous (other)#7-02-Mastic
121105a00{o124
Apartment #7
Kitchen Vinyl
Tan
Non-Fibrous
Homogeneous
None Detected
#7-02-Flooring
121105f,0040128
Apartment #7
Kitchen Vinyl
Tan/White
Fibrous
Heterogeneous
98% Cellulose 2% Non-fibrous (otheQ
None Detected
#2-01-Linoleum
1211058004013
Apartment #2
Green Vinyl
White/Green
Non-Fibrous
Heterogeneous
100% Non-fibrous (other)
Two ssmple bags for this prcject are labeled as '*241"' No sample is lab€led '?242'
None Detected
#2-01-Backing
121105f0040134
Apartment #2
Green Vinyl
BrowrvBlack
Fibrous
Homogeneous
80% Cellulose 20% Non-fibrous (other)
83% Non-librous (other)None Detected
#2-01-Linoleuml Apartment#2 Vinyl
121105€A0.4014
Graylwhite
Non-Fibrous
Heterogeneous
15% Cellulose
2% Glass
Two sample bags ftr this Poject are labelod as '32-O l" No sample is lab€
Analyst(s)
Mike J. Wliams (42)
ar:rfudk t,Jtlesa,
Michelle Wilson, Laboratory Manager
or other appro\€d signatory
, , :: :: : : | 6 ffi iifriiElEFi?i anO may not be reprodued, e)c€pt in tull,.without wnu€n appro€r ov EMDL EMi
ffi,",11fi',13s'',#iliJilil.lHi:r'fil:ft':fllllqieri*j1;liF^.:i':*'.*:1.Tli;:'i**:**#'ffi::1tly"*n:,:.xr,;n:,:i"t#[T$trbearsnor€sponsibi|ilyforsample.co||ectonacwlxssqana|yu€tr||g!|w|t|ii;fi.Nii5;.;;;;;6;y;fGi"i"i"igi*.'.nr.Non.friabborganicauieO oy ttre itienr to ciaim pmduct csrtifi€tion. apprc\61. tr.endTt9"ot-91
troblem mat ix and thereforo EMSL fecommends gfavmetric reouaion pnol io a-niivrii. sampres i"ceireo in gmd condition unless otheNise noted' Estimated acofacy' precrsron
;nd uncertainty data a\ailable upon request.
Lab cod6 2008114, A20937
Test Report PLt\&7.23'0 Printed: B/1/201 1 9:47:1 5 AM
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
1 21 1 05800
7t3112011
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using
Polarized Light MicroscoPY
Description Appearance
Non-Asbestos
Yo Fibrous % Non-Fibrous
Asbestos
% Type
^{\ EMSL AnalYtical, lnc.
a#h 3356 west catalina Drive, Phoenix, AZ 85017
\U Jhone: 16021276-4344 Faxt {602} 276'4053 ttu"'-
Attn: DaVe PriCe
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 83221
Fax (208) 785-4053 Phone: (208) 785-1767
Project: BYU ldaho 118 College St Rexbury ld.
Sample
100% Non-fibrous (other)None Detected
#2-0'l-Mastic 1
12110fi0040144
Apartment#2 Vinyl Tan
Non-Fibrous
Homogeneous
#2-01-Linoleum 2
121105800{0148
#2 Mnyl Gray
Fibrous
Heterogeneous
Apartment
6nt\
10% Cellulose 50% Non-fibrous (other)
\*
.140e/o_
:-hfvsotllel
Two smple bags lorthis poject are labeled as'S2o1". No sample is labeled1s24z'
1 00o/o Non-tibrous (other)None Detected
#2-01-Mastic 2
121105f00.o014c
Apartment #2 Vinyl Tan
Non-Fibrous' Homogeneous
None Detected
Apartment#2 Vinyl GraY
Non-Fibrous
Homogeneous
100% Non-librous (other)#2-01-Leveler
12110fi004014D
None Detected
RS.O3
121 1058004015
Bottom Layer
Shingles On Small
Roof Over Stairs
Erown/Red/Black
Fibrous
Heterogeneous
40olo Cellulose
5% Synthetic
55% Non-fibrous (otheo
85% Non-fibrous (other)None Detected
RS-02
1211058004016
Middle Layer On
Small Roof Owr
Stairs
Gray/Black
Non-Fibrous
Heterogeneous
15% Glass
Analyst(s)
Mike J. Wtlliams (42)
Ir-ta*ik llJ@*
Michelle Wilson, Laboratory Manager
or other approved signatory
t be repmd!@d, €rept in full' without wtittenFg'J[15$trJ'fnliYilTiff'[;THiHIiiil"lTiffig11Ttr3ffiili;ii|ii,![6$"#,:"ii:i*::{:^di"*;'r:::l':$""*:*::['J5:m*g*:l:3::f &";'""5i;'ii :1ii''if,;f ilii,i'l"Jiii,i'iir, li-J'ir-"
probtem matdxand theretm EMSL ecommerioj lravinieuic reoraion p,ioi io "Ji"is. sampr6s riceiwa in gmd ondition unless oth€rwise not€d Estimated acajracy' ffecision
and urrcertainly data a€ilablg upon rsquest.
Test Report PLM-7.23.0 Printed: B/1l2011 9:47:15 AM
Attn: Dave price
Great Basin Services, tnc.
PO Box 238
Bfackfoot, lD 99221
Fax; (208) 78S-40S3 phone: (208)785_,:767
Project: BYU ldaho 118 Coltege St, Rexbury ld.
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
1 21 1 05800
7t31t2011
Test Report: Asbestos Anarysis of Burk Materiars via EpA
Polarized Light Microscopy
Non-Asbestos
600/R-93/1 1 6 Method using
Sample Description Appearance Asbestos
% Type
EMSL Analytical, Inc.
3356 West Catalina Drive, phoenix, AZg5A17
t4!9' (60219!:j!1q rr': {602} 2r6.40s3 Emait:
Yo Fibrous % Non-Fibrous
RS-o1
1211058004017
Top Layer Of
Shingles On Small
Roof Sarne As Mn
Rf
Brown/Black
Non-Fibrous
Heterogeneous
15% Glass 85% Non-fibrous (other)None Detected
f nitial report from 08101 l2!1'l Og47i1 s
Analyst(s)
Mike J. Wiiliams (42)lrl;u$lt- tdtlde*
Michelle Wilson, Laboratory Manageror other approred signatory
EMSL maintains liability limited to c
F!.q{'Fiil"1!{li[r#,i:,"9'frit"i;"l;sl*e.xg"rullr$r'igtr5.;ikr,",,.Txi#i:*rxl:r#liit'#""#i*:rl*::r.T,i]:.::":*proHem maldxand thmfoG EMSi mdmmad. ^8,;6-r;^.^r..::^- -:-l:S'i'#JHff,i1}"':tr8tr"'tr".ffilf;i.:Iffiffiii#,il""il1 il""n'ry'.H!ii,?J'",T.:;T,T:::X"f;:ifffi*: .igglSS;"t'.'"l?*m":**l,li#;:J"
Test Report PLld-2.23.0 pdnted: 8/1/2011 9:47:15AM THIS IS THE LAST PAGE OF THE REPORT.
RgXBURG
Applicant Information
Appl-icant's Address:.=
Business Phone:
Contact
Person or
Information
Company doing the demolition
,.: , FA gj#a
'6 - z l"V cel phone: 20 I -Z-a /i 6 e 3 a
Application for Demolition
Permit #:
$25.00 Fee Paid: Yes/No Permit Approved: Yes/No
City/ST/zip:
Cell Phone:
Addressr
Business Phone:
Demolition Information
;;;-",,", fl' 4no/ o/ fu* 6oi/ a/ zas
Site Address: - /2 '?
f '
starr T)are' LomPleuon nate:
The U.S. Environmental protection Agency (EPA) regulates the abatement and disposal of asbestos-containing materials from any
public or private building involving d"Lo[tio", ,.rro.rrtio.t, repait, construction, and maintenance activiUes'^hte : / / deq.idaho.gov /air /Ptog issues /pollutants / asbes tos'cfm
EpA certifies and licenses asbestos-removal contfactors, inspects asbestos-abatement pro,ects, and enforces laws regarding the proper
removal and disposal of asbestos-containing materials'
Currently, EpA and DEe contract with Indusuial Hygiene Resources in Garden City, Idaho, to regulate asbestos removal and disposal
proiects in Idaho.
For more information about asbestos abatement and disposal in Idaho, contact:
Industrial Hygiene Resource
206 Murray St
Garden Crty ID 8371'4
208-323-8287
www.indusftialhygieneresources.com
I understand the EPA requirements regarding asbestos removal and agree to provide information showing
compliance with the regulations to the City of Rexbutg ptiot to demolition.
Building SofetY DePortme
Summary of what is being demolished:
Signature of Applicant:
U. S. ENVIRONMENTAL PROTECTION AGENCY. STATE OF IDAHO
NOTIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPEOFNOTIFICATION: COURTESY x ORIGINAL REVISED CANCELED
II. FACILITY DESCRIPTION:
Building Name: Vacant House
Address: l2l College Ave
City: Rexburg State: Id ZipCode: 83460-8205 Counw: Madison
Site Location : all ofhouse
Building Size (Square Feet) 1200 #ofFloors: I and basement Age in years: 50
PresentUse: Vacant Prior Use: Residential
III. TYPE OF OPERATION: -x_DEMO _ ORDERED DEMO RENOVATION EMERGENCY RENOVATION FIRE TRAINING
lV. Is Asbestos Present? (check one) _Yes _No Pending inspection
V. Facility Information:
OwnerName: BYUJdaho
Address: University Poerations Building # 82, 525 South Center
City: Rexburg State: Id Zip Code: 83460-8205
Contact: Rulon Nielson Telephone: 208496-2660 Fax:,208496-2490
Removal Contractor Name: Great Basin Services. Inc License: CSR0ll8ll-02
Address:P. O. Box 238
City:Blackfoot State: Idaho Zip Code:83221
Contact:Dave Price Telephone: 208-785-1767 Fax 208-785-4053
Other Operator (demolition/general) Unknown at this time, will revise License:
Address:
City:State:Zip Code:
Contact:Telephone:Fax:
VI. Procedure, including analytical methods, employed to detect the presence of and to estimrte the quality of RACM and Category I and Category II
non-fiable PLM Lab testing
Vll. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category Il Category I Category II
Pipes (linear feet)
Surface Area (Square feet
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknown Complete:
fV. Dates for Asbestos Removal (MM/DD/YY) : Will revise Complete:
DayslWeek Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Hrs of Operation
' X' Description of planned Demolition or renovation rvork to be preformed and method(s) to be employed, including demolition or renovationtechniques to be used and description ofaffected facility components:
XI' Descriptionofworkpracticesandengineeringcontrolstobeusedtocompryrviththerequirements,incrudingasbestosremovarandwaste
handling emission controt procedu..r] A.b.rio, ubur.r.nt onry, post areawith wi ic. Will revise accordingly
XII. Waste Transporter #l: ASBESTOS ONLY
Name: Great Basin Services, Inc
Address: P.O. box 238
Zip Code:83221
Telephone: 209-7 BS-17 67
XII. Waste Disposal: ASBESTOS ONLY
Address: 1500 North Fort Hall Mine Road
Fax:208- 236- 0609xrv' lH:il?ffillii:""!!:Lffi:J:#,It and arr other sections, onrv irthis project is an Emergency Demo)
2. Name of Authority Issuing Order: NA3. Aurhorirv of o "ai. rti"i*'li^ 't=, "- Title3. Authority of Order (Citation of Cide}
(MM/DD/Y$
vation (Atfrch cencrcrp "h.-r
Date Ordered to Begin
l. Date and Hour of Emergence N/A2. Description ofSudden, Unexpected Event.
age or an unreasonable financial burden
xvr' Description of procedures to be foltowed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized orreduced to powder.
Evacuate areq wet down ACM, enclose area, post wamings and contain . stop spread of air-bom fiber release.
xvII' I certify that an individua.t trained in fhe provisions of NESHAps (40 cFR PART 6r, SUBPART M) wiil be on site during the demorition orrenovation and evidence that the required training has been ,.;;i;;;;;this person roirr ne """ir"ni. during normar business hours.Signature of Owner/Operator D"ra
ttt'" Pcrsolr wlll De avall8ble
t"rt r;;r; _Dave pri., / o*n.l{:"'r:;Print Name and ritle
-
notificrtion are true, accurate, and comptete.
Type or Print Nami andTjt-tte
begins, except emergencY demolition anO "r"tg"nrv rcnovltions wtricfr must be submiftel before operations begin. (Form rev.3/24199
o_ oU. S. ENVIRONIVTENTAL PROTECTION AGENCY. SiT, TN OF IDAHO
rat'(
NOTIFICATION OF DEMOLITION AI\D RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPE OF NOTIFICATION: -COURTESY - ORIGINAL _tsr REVTSED _ CANCELBD
II. FACILITY DESCRIPTION:
Building Name: Vacant House
Address: l2l College Ave
City: Rexburg State: Id ZipCode: 83460-8205 County: Madison
Site Location : all ofhouse
Age in years: 50
Present Use: Vacanl Prior Use: Residential
III.TYPEOFOPERATION: _X-DEMO -ORDEREDDEMO -RENOVATION -EMERGENCYRENOVATION FIRETRAININC
IV. Is Asbestos Present? (check one)_x_Yes -No
V. Facility Information:
OwnerName: BYLJ-Idaho
Address: University operations Building # 82, 525 South Center
City: Rexburg State: Id ZipCode: 83460-8205
Contact: Rulon Nielson Telephone: 208496-2660 Fax:208-496-2490
Removal Contractor Name: Great Basin Services. Inc License: CSR0ll8ll-02
Address:P. O. Box 238
City:Blackfoot State: Idaho ZipCode:83221
Contact:Dave Price Telephone: 208-785-176'l Fax: 20g-7854053
Other Operator (demolition/general) Unknown at this time. will revise License:
Address:
City:State:Zip Code:
Contact:Telephone:Fax:
VI' Procedure, including analytical methods, emptoyed to detect the presence of and to estimate the quality of RACM and Category I and Category IInon-fiable PLM Lab testing
Vl1. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category II Category I Category II
Pipes (linear feet)
Surface Area (Square feet 120 sq ft sheet vinyl 635 sq ft floor
tile
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknown Complete:
IV. Dates forAsbestos Removal (MNVDD/YY) : Aug-25-2011 Complete: -Aug-26-201 I
DaysMeek I Monday Tuesday I Wednesday Thursday Friday Saturday Sunday
Hrs of Operation 3pm- 5pm 9am-l2noon
X' Description of planned Demolition or renovation work to be preformed and method(s) to be employed, including demolition or renovatio;techniques to be used and description ofaffected facility components:
XI' Descriptionofworkpracticesandengineeringcontrolstobeusedtocomplyrviththerequirements,includingasbestosremoval"nor"rrf
n"ndring t*ittion tonttol pto".ou..., atu"tlot uuurcr.nt onty, poriur* i,i'tn*u*ing ridnr, tin,.ii'uJ."ri'io-public. wirl revise accordingry
XII. Waste Transporter #l: ASBESTOS ONLY
Name: Great Basin Services. Inc
Telephone: 208-7BS-17 67
XIL Waste Disposal: ASBESTOS ONLY
Name: BannockCountyLandfill
Address: 1500 North Fort Hall Mine Road
Telephone: 208-236-0607 Fax:2Og_ 236- 0609
xlv' Emergency Demolition (complete item xv and all other sections, onry if this project is an Emergency Demo)1. Aftach a copy ofthe Order to this notice.2. Name of Authority Issuing Order: NA3. Rurhoriry of order (crtation orcffi4. Date of Order (MM/DD/yy)
-xv. Emergency R""oi;;io;1;;;# ate ordered to Begin
Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
t damage or an unreasonable financial burden.
ffireduced to powder.
wet down AcM, encrose area, post wamings and contain . stop spread of air-bom fiber release.
:d in the provisions of NESHAPS (40 CFR PART 61, SUBPART M) wiil be on site during the demolition or
fquired training has been accomplished by this person will be available during normal business hours.I Date T-.-^ ^-Type or Print Name and Title- ^tr rn-itT ,ave price / owner Secretary
ffinotificatiofre-t$e, dccufte5no "olnpt.t..
' '
Date Type or trint N.me aniTiite-
original Notification must be mailed or hand delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovationbegins' except emergency demolition and emrrt.n.t riiiitiiltiliJt#ffio * ,oo. sible before operations begin. (Formrev.3/24/99
0PERA'I'Or
sltipping r;;r;:u,
inlernati, ';r:ri r,i;
Fntr.,tiip*rP:
Narne: (;
Addre.ss: l'.
...r,.r -.---:_...:r-, '.1 rcc_. ' :..ilt oI recell)t of nlater
IiASIN SI'ITVICES, INC.
1: t.rti . lI,,\cI(FOo.x,lD g3221
'l'itle
'tf.:
ntl'.,'i.
'4,-'
Phone: 208-785-1767
Phone:
9- ,l--
uatc (ttilt/DDTYY)
Ngnrc:
Atltlrtss:
;,.)lgnitlurc
.l I l. i'
.iri:i4.,:ll
-^- )/ i.'
l-i::]j.]C]A|.I0N:|hcrebycertifythatthe'lbovcuun,..t
.,.)tiriliutc cxccpl i$ n0ted in I
-.n
i:!:fr"
trrc ;r'ovc nantnnalcri.rl has trecn ^"#anct ro rhe besr of my knowlcdge
Odra. /&A ,X,.Qr*"/+ Z ,l _-, //z'fitlc -S-ignutr,r"_ .. _,
/ Daie rlnyuoryyr ,
i\.li]]]1s(]{l,|).,lj.]nsl)or(errutainsPINK,WDSrerains"u
' 'i.
EMSL Analytical, Inc.
3356 West Catalina Drive, phoenix, AZ Bf01Z
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 93221
Fax (208) 7S$40S3 phone: (208)785_1267
Project: BYU-tdaho, 121 College St, Rexbury tdaho
Customer lD;
Customer PO:
Receiled:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
0713011'1 8:4S AM
121105795
7t31t2011
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-g3/116 Method usingpolarized Light Microscopy
Sample Non-Asbestos
Descrlption Appearance % Fibrous % Non-Fibrous
Asbestos
o/o TypeMF-01-Vinyl Flooring
1 21 1057954001
Main Floor Kitchen
Vinyl- Mutti Laprs
Brown/Gray
Non-Fibrous
Heterogeneous
15% Cetlulose 75% Non-fibrous (other)lg%: Ohrysotite
MF-01-Backing
1211057954N1A
Main Floor Kitcher
Vinyl- Multi Layers
Black
Fibrous
Heterogeneous
50% Cellulose
3% Synthetic
47% Non-fibrous (other)None Detected
MF-01-Leraeter
12110579540018
Main Floor Kitchen
Vinyl- Multi Layers
Brourn
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
MF-01-Board
1211057954@1C
Main Floor Kitchen
Vinyl- Mutti Layers
Tan
Fibrous
Homogeneous
100% Cellulose 0% Non-fibrous (other)None Detected
MF-o2-Vinyl Ftooring
1211057954002
Main Floor Back
Entry Way By Sink
Green
Non-Fibrous
Homogeneous
'100% Non-fibrous (other)None Detected
MF-02-Backing
121 1057954002A
Main Floor Back
Entry Way By Sink
Black
Fibrous
Homogeneous
50% Celtulose
3% Synthetic
47% Non-fibrous (otheo None Detected
Initial report from 0BtO1 p:O1.t 08:35:44
Analyst(s), 1,.,N Ltden-
Michelle Wilson, Laboratory Manageror other appro\€d signatory
Cheryl Alvarado (18)
il:.sfl il'#iil",..i3::iT1usedbyth6c|ienttoc|aimproduclcertjfcation,appo€|,.tino..'n*-toyr'rvLe1rrs|5i-"ii|"f;;';'"':i:.::r'j#f"ll!':.$.:l.''H,;[*$?*:u#":r"r*
r"x'l"#Hf1*jLtf...Hlf*T""ocg;#"t";.;f;"tl|toanalysis,sampr6s,1L-iGln-goloonaiuonuntessottrwise'noie.o].estimatedacr&y,fecision
hc. Ph@nix AZ t'.lVLAp Lab Code 2@81.t4, 420937
Test Report Pltvl-7.23.0 printd:8t112011 8:35:44 AM
,t
GBSV62
071301118:4S AM
121't05795
7t31t2011
EMSL Analytical, Inc.
3356 West Catalina Drive, phoenix, AZ 85012
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, ,D g9221
Fax: (208) 7S$4093 phone: (208)7Bs_1767
Project: ByU-ldaho, 121 Coltege St, Rexbury ldaho
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-g3/116 Method usingpolarized Light Microscopy
Non-AsbestosSampleDescriptionAppearance% Fibrous % Non-Fibrous
Asbestos
o/o TypeMF-02-Mastic
1211057954ff/28
Main Floor Back
Entry Way By Sink
Brown
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
MF-02-Board
12110579540c.2C
Main Floor Back
Entry Way By Sink
Tan
Fibrous
Homogeneous
100% Cellulose 0% Non-fibrous (other)None Detected
BM-0l-Vinyl Flooring Basement Kitchen
12110s7ss4@3 MultFla!€rs Brown
Non-Fibrous
Helerogeneous
15% Cellulose 75% Non-fibrous (other)1107o Chrysotllri
BM-01-Mastic 1
121105795406A
Basement Kitchen
Multi-Layers Tan
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
BM-01-FloorTile
1211057954@38
Basement Kitchen
Multi-Layers White
Non-Fibrous
Homogeneous
t3'll /95% Non-fibrous (other)60lo Chrysotile
BM-01-Mastic 2
1211057954@3C
Basement Kitchfi
Multi-Layers Black
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
f nitial report frorn OBtOl t2011 08:35:44
Analyst(s)
Cheryl Alvarado (tB)
EMSL maintains tiabilty timG&G?t otuearcnoreip,cnsi;iri,vi,i'i"li-rr'JJri'-crErvsrs rnrsrerErtrelalestrlvtolhesamptesreFftTTftTiffiiG
useo Dy rhe ctienr to ctaim orcaucr enill:l*t:1t:::.1, T:Yi€l-mehod limitaliont. lnturpLi"ii--",ii;:!;;i"",9vgl't|v|grw|J|ui|tylq5moeco||ectionactivitiestanatylielmenodtimitaiiJ;1;;.i&f'1x.i:yn;I!ereprduced'ereptinf|t.withoutm'tten,ElfGiT!!f
us^e! bv lhe client toclaim product @rtificarion. approwt, * "';;;;;1d ffffif "iTf|f:]9i:^q_r-.,?:] lg.J ^:rtt. "r" irr" ruip*"iuiiiiv oi:ri"{-1b|emTaJri-xaFtr,""ioi"ila-dG"ommendsoravimelric.*,,^,.^.^"jjIu.l|-.t'ltst6.enya9ncy-oiGi"ou,u,go*'menl'Non-friab|eto,'f|:i}J|:'^:|.T:,:.l1??:problem matrixand thererore EMSL r€cordd;;;;ffi;;'[iu""ionff ""*H' Nrsr oranv asencv of the federar gowrr"nr.- ion-r,i-"iiirUffirii,';i"i;H1[:'"?i"
::::f:f1y-::..Yitl::f:4il
q'qtPndtoanarvsis samplesBceiwdinsmdmniitionunru""ar'u*iJ.'i'i"ilEsrimaredacqrracy,piecision
Inc. Phoenix Az I'.IVLAp Lab Codg 2OOg11{, AZO937
Test Report P1M7.23.0 printed: 8/1/2011 8:35:44 AM
EM$L Analytical, Inc.
3356 West Catalina Drive, phoenix, AZ gF017
Phone: (602)276-4344 E_894:f-49q3 Ernait: phoenixtab@emst.com
Attn: Dave Price
Great Basin Services. Inc.
PO Box 238
Bfackfoot, lD 83221
Fax (208) 78$,4053 Phone: (2OS) 7e}-fl67
Project: BYUldaho, 121 Gollege St, Rexbury ldaho
Customer lD:
Customer PO:
Receiwd:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
121105795
7t31t2011
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-93/116 Method using
Polarized Light Microscopy
Sample Descriptlon Appearance
Non-Asbestos
Yo Fibrous % Non-Fibrous
Asbestos
o/o Type
BM-O2-Mnyl Flooring
1211057954@4
Bathroom ln
Basement
Brown
Non-Fibrous
Heterogeneous
15% Cellulose 75% Non-fibrous (olher)1016 Ohrysotlle
BM-o2-Mastic 1 Bathroom In Tan
121rostss4oo4A Basement Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
BM-O2-Floor Tile Bathroom ln
1211os7gseoo4B Basement
White
Non-Fibrous
Homogeneous
95% Non-fibrous (other)60/6 Chrysotlle
BM-02-Mastic 2
1211057954004C
Bathroom ln
Basemenl
Black
Non-Fibrous
Homogeneous
C'rl 100% Non-fibrous (other)None Detected
RS-o1
1211057954c,5
Roof Bottom Layer Recl/Black
Shingles Non_Fibrous
Heterogeneous
10% Glass 90% Non-fibrous (other)None Detected
RS-02
121 1057954006
Roof Top Laya
Shingles
BlacUGreen
Fibrous
Heterogeneous
25% Cellulose 75% Non-fibrous (otheQ None Detected
Analyst(s)
Cheryl Atvarado (18)Michelle Wilson, Laboratory Manager
or other approved signatory
EMSLmaintains|iabi|ity|imi|ed|ocostoJana|ysis'ThisreportreFtes
:::f#,fr'mT?l:r,j*."TfiX1j:.?,::nu"*T.i"S[fj-T1yJi1"1?p.11t9qtl"ti*;;i!.;F.!urr"areiherelpmsibliifoi-trre'crient rhiscpqrmustnotbeusedbytheclienttoc|aimpoductcertiRcation,appo\a|,gdndorsgnentb,yNvue.Nrsi.5,uny"!;;;y;ilh;;;;;;G;;;;ifi;t],";d;;i;:i;j;;i.;i"T";;::f'problem mattix and therefore EMSL recomm€nds gravimetric redudion pritr to anatysis. sampl6s ieceileo in gooo mnoltion unless othswise note;. Estimated acoracy, precisionand uncertainty data aEilable upon requssl.
EMSL Inc. Pho€nix Az |JVLAP Lab Code
lrl{ry#jt l,,Jtfua*
Test Report Pllvl-7.23.0 Printed: 8l'112011 8:35:rf4 AM TH]S IS THE LAST PAGE OF THE REPORT.
/z* 6z/7.
CITY OF
35N l$E
Rexburg, lD 83440
Building Sofety
Clty of Rexburg
www.texburg.org
Application for Demolition
Permit #:
$25.00 Fee Paid; Yes,/No PermitApproved: Yes/No
REXBURG
c\' *---*--*-
Americqi Famifu Carrmunitv
Applicant Information
Name:
Applicant's €zf Gafu-t?7 ciq, / sr /zip"4z x/cqo.. nz*/a f??+bza6- /r, - ,nt,Business Phone: ZOB- ft/ - Z6t, Cellphone: Zog -fu/"-A7a
Contact Information
Person or Company doing the demol_ition:
Address:City/ST/Zip:
Business Phone:Cell Phone:
Demolition Information
Property Owners
Site Address
Start Date:Completion Date:
Summary of what is being demolished:
2
The U'S' Environmental Protection Agency (EPA) regulates the abatement and disposal of asbestos-containing materials from anypublic or private building involving demolition, r.ttorr"tiorr, repa"ir, construction, an-d maintenance activifles.htqr: / /deq.idaho.gov/airlprog issues /pollutants /asbestos.cfir
EPA certifies and licenses asbestos-removal conttactors, irispects asbestos-abatement projects, and enforces laws regarding the properremoval and disposal of asbestos-containing materials.
Currendy, EPA and DEQ contract with Industrial Hygiene Resources in Garden Ciry, Idaho, to regulate asbestos removal and disposalprojects in ldaho.
For more information about asbestos abatement and disposal in Idaho, contact:Industrial Hygiene Resource
206 Murray St
Garden Ciry ID 83714
208-323-8287
www.industrialh)'gieneresources.com
I understand the EPA requitements regarding asbestos removal and agree to ptovide information showingcompliance with the regulations to the city oi Rexburg prior to demolition.
Signarure of Applicant
t{"
4, t
U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF IDAHO
NOTIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPEOFNOTIFICATION:_COURTDSY _x_ORTGINAL REVISED CANCELED
II. FACILITY DESCRIPTION:
Building Name: Vacant House
Address: 124 College Ave
City: Rexburg State: Id ZipCode: 83460-8205 County: Madison
Site Location : all of house
Building Size (Square Feet) 1300 #ofFloors: I and basement Age in years: 55
PresentUse: Vacant Prior Use: Residential
III. TYPE OF OPERATION: _X-DEMO - ORDERED DEMO - RENOVATION - EMERGENCY RENOVATION FIRE TRAINING
IV. Is Asbestos Present? (check onc) _yes _No Pending inspection
V. Facility Information:
Owner Name: BYU-Idaho
Address: University Poerations Building # 82, 525 South Center
City: Rexburg State: Id ZipCode: 83460-8205
Contact: Rulon Nielson Telephone: 208496-2660 Fax:208496-2490
Removal contractor Nanre: Great Basin services, Inc Licelse: csR 0l lgl l-02
Address:P. O. Box 238
City:Blackfoot State: Idaho Zip Code:83221
Contact:Dave Price Telephone: 208-785-1767 Fax 20g-7g5-4053
Other Operator (dcmolition/gcne ral) Unknown at this time. will revise License:
Address:
City:State:Zip Code:
Contact:Telephone:Fax:
-
VI' Procedure,includinganalyticnl nrethods,employedtodetectthepresenceofandtoestimatethequatityofRACMandCategorylandCategoryll
non-fiable PLI\{ Lab tcsting
Vll. Approximate Amount of Asbcstos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category Il Category I Category II
Pipes (linear feet)
Surface Area (Square feet
Facility Components (cubic feet)
VIII. Scheduled Dates Dcrrrolition or lLenovation: Start: Unknown Complete:
IV. Dates for Asbestos llcruoval (i\'L\[/DD/YY) : Will revise Complete:
DaysMeek Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Hrs of Operation
X.Descriptionofp|anncdDcnro|itionorrenovationworktobepreformedandmethod(s)tobeemployed,'n.,uffi
techniques to be used and descripfion of affected facility components:
XI. Description of lvork prrlctices and engineering controls to be used to comply with the requirements, including asbestos removal and wastehandling emission control proccdures: Asbestos abatement only, Post area with warning signs, limit access to publi.. Will revise accordingly
XII. Waste Transporter #1: ASBESTOS ONLY
Name: Great Basin Services. Inc
Address: P.O. box 238
City: Blackfoot State: Idaho ZipCode:83221
Contact: Dave Price Telephone: 208-7 85-1767 Fax:208-7854053
Waste Transportcr li I
Name: N/A
Address:
City:State:Zip Code:
Contact:Telephone:Far:
XII. Waste Disposal: ,\SUDSTOS ONLy
Name: BannockCountl,Landfill
Address: 1500 North Fofl I-tall Mine Road
City: Pocrtclk-r State: Idaho ZioCode: 83204
Contact: Scalc lroLrse Telephone: 208-236-0607 Fax208- 236- 0609
XIV. Emergency Dcnruli(iort (Comptete item XIV and all other sections, only if this project is an Emergency Demo)l. Attach a copy of rlrc Order to this notice.
2. Name of AutlioLirl lssuing Order:
3. Authority of Ortle r lCiration ol'Code):
4. Date of Ordcr rI:\liDDlYY Ordered to Besin
_XV. Emergency llcrrur aliurr (Attach scparate sheet with the following information if projeclis Emergency Renovation.)
I.
2.
3.
Date and Hour ol'Enrergence N/A
Description o1'Sutiden. Uncxpeoted Event.
Explanation ol'horv the evetr caused unsafe conditions or equipment damage or an unreasonable financial burden.
XVI.Description of procedures to be follorved in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized orreduced to pon (lcr.
Evacuate area,lqdown ACM, enclose area, post warnings and contain . Stop spread of air-bom fiber release.
xvu.I certify thatil ll ir id rral thc provisions of Nf,SHAPS (40 CFR PART 61, SUBPART M) will be on site during the demolition orired training has been accomplished by this person will be available during normal-business hours.renovation viderrtc tl
Signature of Date
July 29-2011
Type or Print Name and Title
Dave Price / Owner Secretary
xvu.I acknorvlcJge I certify that facts contained in thisnotification a
Signature of Date Type or Print Name and Title
original Notificati(\rr rrrtrst be mailed or hand delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovationbegins, except ernerscru'demolition and emergency renovations which must be submitted ur roon u. po.rfl. before operations begin. (Form rev.3/24199
IDAHO
OPERATOR PROJECT #
I. TYPE OF NOTTFTCATTON: ----COURTESY _ oRIGINAL
II. FACILITY DESCRIPTION:
Building Name: Vacant House
Address: 124 College Ave
Zip Code: 83460-8205
Site Location : all ofhouse
Building Size (Square Fect) 1300 #ofFloors: I and basement
III. TYPE oF OPERA].IO.r.:
-RENOVATION -EMERGENCY RENOVATION -FIRETRAININGfV, Is Asbestos present? (cleck one)_x_No No asbestos found in inspectionV. Facility Information:
Owner Name: ByU-ldaho
Address: University pticrations Building # g2, 525 South Center
Contact Rulon n*iclsurr
Removal Contractor.\anre: Grcat Basin Services, Inc License: CSR0ll8ll-02
Zip Code:83221
DavePrice Telephone: 20g_7g5-1767
Other Operator. ((lcr| (,li tion/gcncral)Unknown at this time, will revise
Procedure, inclurli rrx :r n:rll,tical
non-fiable l,Lr\l Lab icsrirrg
ntetlrods,emp|oyedtodetectthepresenceofandto.,.''",.
Vll. Approximate Anrourrt of Asbcstos Ifaterials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed Nonfriable Asbestos Material
Not to be Removed
Facility Components (cuirii iicr;
VIII. Scheduled Dltcs t)rrrolition or Rcnovatiolr: Start:rr-____*,
fV. Dates for Asbcsros lirriroval (IIU/DD/yy) : n/a
Hrs of Operation
.X. Description 0f plarrrr' ,! !)e rtrolition or rcnovation work to be preformed and method(s) to be employeF, rncluding demolition or renovation
techniques to be uscd ar!i ,!i:criptioil ofal'fectcd facility components:
XI. Descriptionoflr'orliJrnrcficcsandengineeringcontrolstobeusedtocomplywiththerequirements,includingasbestosremovalandwaste
handlingemissiorlcorr:,rl proccdurcs: Asbestosabatementonly,Postareawithwamingsigns, limitaccesstopublic. Will reviseaccordingly
XII. Waste Transportcr ri I : ;\SBESTOS ONLY
Name: Great li:r.;n Scrvices. Inc
City: Black 1,, ,r
Fax208-7854053
Waste Trattsport' r' '1:
City:
Contact:
Zip Code:
Fax:
tr thc proYisions of NESHAPS (40 CFR PART 61, SUBPART M) will be on site during the demolition or
rilcd training has been accomplished by this person will be available during normal business hours.
Type or Print Name and Title
Dave Price / Owner Secretarv
XII. Waste Dispusal r[s'fos oNt-\'
Name: ll:in rrrtv Landllll
Address: l:r ith Fort IIall Nfine Road
i,irr (Conrpletc itern XIV and all other sections, only if this project is an Emergency Demo;' Ordcr to this notice.
NA
City: Pr"State: Idaho ZipCode:83204
Telephone: 208-236-0607 Fax:208- 236- 0609
,trrtt:.r Ord;r Title
XlV. Emergcnc.v l)rr
l Attach a ci,i)r
2. Nanrc oi','.r,
3. Autlrority , :'
4. Date trl f :r
_XV. Emcrgcnc\ li,
l. Date and llor
2. Description ,
3. Explanatiorr ,
XVI. Description ol'1,
reduccd to P(,\'
XVII. I c€rtil,r' I h:r t rr ,
fenovAti{lll it r,
Signaturc ol ('
XV[. I acknorrlcrllr
notilic:ttir,rrlr
Original Notilic:
begins, exccl'l er
- rlatri)ir ol eoJc):
llDD//\'Y)Date Ordered to Beein
, rr (,,Utaclr scparate sheet with the following information if project is Emergency Renovation.)
rrcrgctrce N/A
'rr, Unerpcctcd Event.
r he even caused unsafe conditions or equipment damage or an unreasonable financial burden.
'rrcs to be lbllo$'ed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized or
iate area, u'et down ACM, enclose area, post wamings and contain . Stop spread of air-bom fiber release.
l:til s prohibiting the submission of false or misleading statements and I certify that facts contained in this
rlrd c0nrl)lete.
f:rtor Date Type or Print Name and Title
'i be tttailccl or harrd delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovation
tie nterlition and ernergency renovations which must be submitted as soon as possible before operations begin. (Form rev.3l24l99
Attn: Dave Price
Great Basin Services, Inc.
PO Box 238
BlacKoot, aD 83221
Fax: (208) 78$4053 phone: (208)7A5_1767
Project: BYU-ldaho, 124 College St., Rexbury ld
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
121103258
7t30t2011
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-g3/116 Method using
Polarized Light Microscopy
Sample Description Appearance
Non-Asbestos
o/o Fibrous % Non-Fibrous
Asbestos
o/o Type
EMSL Analytical, Inc.
3356 West Catalina Orive, phoenix. AX g$01?
Phone: (6021 276.4344 Fax: {60?} 276-40i3 Emait:
SV-O1-Sheet Vinyl
121 1032584001
Sheet Vinyl By
Garage Door
Beige
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
SV-01-Backing
121 1032584001 A
Sheet Vinyl By
Garage Door
Black
Fibrous
Homogeneous
50% Cellulose
3% Synthetic
47% Non-fibrous (other)None Detected
SV-01-Mastic
12110325840018
Sheet Vinyl By
Garage Door
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
FB-01
121 1032584002
Fiber Board Under
Bathroom Tile
Gray
Non-Fibrous
Homogeneous
Cellulose 75% Non-fibrous (other)None Detected
RS-o1
1211032584003
Roof Shingle North BlacUcreen
Side Non-Fibrous
Heterogeneous
10% Glass 90% Non-fibrous (other)None Detected
RS-02
121 1032584004
BIack/Green
Non-Fibrous
Heterogeneous
'10% Glass 90% Non-fibrous (other)None Detected
Analyst(s)
Cheryl Alvarado (6)
}"t;rs*rk UJW*
Michelle Wilson, Laboratory Manager
or other approved signatory
tMSLmainiains|iabi|ity|imitedtocost^oJ-1ifi....Th
f:fii'[-jiji?',j':',jf"#fJX"3l'T::l]"T'"fi":,9T."yj:T.lgl^"Ii"'Tll9li:usedbythec|ienttoclaimprductcrtilication,appro€|'ordnoorsanen1tyrvree'r.rrsr6'"ny"!;d;;G#;:r;i"H;Hi":if"j[.,["J{:?iJ::i};.l;"..g#
:l?i,"#J5lfi1".:%:f"'.$:lf[rendsgravimetricreductjonprioitoana|ysis'sampr6JriceiieJii,i""o-""oiti"",";;;.;i;;;;.;;::
Inc. Phoenix AZ NVLAP Lab Code 20081 14, AZO937
TestReport PLM-7.23.0 Printed: 8/1/2011 8:26:21 AM THIS IS THE LAST PAGE OF THE REPORT.
Building Sofety Depo
Phone: 208.372.2326
Fox: 208.359.3022
ry'r 'a//?'
REXBURG
Application for Demolition
Permit #:
$25.00 Fee Paid: Yes,/No Permit Approved: Yes/No
Applicant Information
'//-
Appl-icant's Address:2f a"*-57 ,,/ST/Ztp:
Business pn""r, Zaf- 476- 24.fl celphone: Zo8- p/-6so
Contact Information
Person or Company doing the demolition:
Address:City/ST/Ztp:
Business Phone:Cell Phone:
Demolition Infotmation
Ptoperty Owners:
SiteAddress: , 4,/'7a ,
StartDate:_CompletionDate: ._ ,
Summary of what is being demolished:
The U.S. Environmental Protection Agency @,PA) regulates the abatement and disposal of asbestos-containing materials from any
public or private building involving demolition, renovation, repair, construction, and maintenance activitjes.
http: / /deq.idaho.gov /airlprog issues /pollutants /asbestos.cfm
EPA certifies and licenses asbestos-removal conftactors, inspects asbestos-abatement proiects, and enforces laws regarding the proper
temoval and disposal of asbestos-containing materials.
Currendy, EPA and DEQ contract with Industrial Hygiene Resources in Garden City, Idaho, to regulate asbestos removal and disposal
projects in Idaho.
For more information about asbestos abatement and disposal in Idaho, contact:
Industrial Hygiene Resource
206 Murray St
Garden Ctty ID 83714
208-323-8287
www.industrialhygieneresources. com
I undetstand the EPA requitements regatding asbestos removal and agree to provide
compliance with the regularions to the city of Rexburg prior to demolition.
Signature of Applicant
)'-
information showing
U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF IDAHO
NOTIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPEOFNOTIFICATION: COURTESY X ORIGINAL REVISED CANCELEI)
II. FACILITY DESCRIPTION:
Building Name: Vacant House
Address: 145 College Ave
City: Rexburg State: Id Zip Code: 83460-8205 County: Madison
Site Location : all ofhouse
Building Size (Square Feet) 1000 #ofFloors: I and basement Age in years: aprox 65
Present Use: Vacant Prior Use: Residential
III.TYPEOFOPERATION: x DEMO ORDEREDDEMO RENOVATION -EMERGENCYRENOVATION -FIRETRAININC
IV. Is Asbestos Present? (check one) -Yes _No Pending inspection
V. Facility Information:
OwnerName: BYLJ-Idaho
Address: University Operations Building # 82, 525 South Center
City: Rexburg State: Id Zio Code'. 83460-8205
Contact: Rulon Nielson Telephone: 208-496-2660 Fu<:208496-2490
Removal Contractor Name: Grsst Basin Services, Inc License: CSR0llSll-02
Address:P. O. Box 238
City:Blackfoot State: Idaho ZipCode:83221
Contact:Dave Price Telephone: 208-785-1767 Fax: 208-7854053
Other Operator (demolition/general) Unknown at this time' will revise License:
Address:
City:State:Zip Code:
Contact:Telephone:Fax:
VI. Procedure, including analytical methods, employed to detect the presence of and to estimate the quality of RACM and Crtegory I and Category II
non-fiable PLM Lab testing
Vll. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfr iable Asbestos Material
Not to be Removed
Category I Category tl Category I Category II
Pipes (linear feet)
Surface Area (Square feet
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknown Complete:
lV. Dates for Asbestos Removal (MM/DD/YY) : Will revise Complete:
DaysAileek Monday Tuesday Wednesday Thursday Friday Saturday Sunday
I{rs of Operation
X' Description ofplanned Demolition or renovation rYork to be preformed and method(s) to be employed, including demolition or renovationtechniques to be used and description ofaffected facility components:
XI.Descriptionofworkpracticesandengineeringcontrolstobeusedtocomplywiththerequirements,,n.,uu,nffi
handling emission control procedures-: Asbesios abatement only, Posi arla irri'th waming signs, limit access to public. will revise accordingly
XII. Waste Transporter #l: ASBESTOS ONLY
Name: Great Basin Services. Inc
Address: P,O. box 238
Telephone: 208-7 85-17 67
XII. Waste Disposal: ASBESTOS ONLY
Address: 1500 North Fort Hall Mine Road
Telephone: 208-236-0607 Fax:208- 236- 0609
lTl:H?ffil11ti!""t::l,tJil:jf#,It and arr other sections, onrv irthis project is an Emergency Demo)
2. NameofAuthoritylssuinqOrder: NA3.. A.thority of oro;r tti,#.; "ii
ritle
4. DateofOrder(MM/DD/y$'
.Emergency Re"""rii""1an".il l#.i:lj:.r,,:r,ll. Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
ent damage or an unreasonable financial burden.
Description of procedures to be
reduced to powder.
in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized or
ACM,enclosearea,post wamings andcontain. stopspreadofair_bornfiber release.
XVU. I certify th /in tlpgovisions of NESHAPS (40 cFR PART 61, SUBPART M) wiil be on site during the demolition orreluffea training has been accomplished by ttris person will be available during normal business hours.Daterury zg-ioli nave price / ownelflcerflfin'lv"t. and ritte
larvs prohibiting the submission of false or misleading statements and I certify that facts contained in thisand complete.
Date Type or print Name aiiTiiii
originalNotificationmustbemailedorhanddeliveredatleasetenworkingdsys(Monday-Fridayexcluding*",u.no,)ffi
begins, except emergency demolition und .rergency renouution, which must be submifte;e before operations begin. (Form rev.3l24/99
U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF'IDAHO
NOTIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPB oF NoTIFICATION: _couRTESy _ ORTGTNAL _lst REVTsED CAI\CELED
II. FACILITY DESCRIPTION:
Building Name: Vacant House
Address: 145 College Ave
City: Rexburg State: Id ZipCode: 83460-8205 County: Madison
Site lncation : all ofhouse
Building Size (Square Feet) 1000 #ofFloors: 1 and basement Age in years: aprox 65
Present Use: Vacant Prior Use: Residential
III. TYPE OF OPERATION: -X-DEMO - ORDERED DEMO - RENOVATION - EMERGENCY RENOVATION - FIRE TRAINING
fV. Is Asbestos Present? (check one)x Yes No
V. Facility Information:
OwnerName: BYU-Idaho
Address: Univenity Operations Building # 82, 525 South Center
City: Rexburg State: Id Zip Code:, 83460-8205
Contact: Rulon Nielson Telephone: 208-496-2660 Fax..208496-2490
Removal Contractor Name: Great Basin Services, Inc License:csR 0l 181 l-02
Address:P. O. Box 238
City:Blackfoot State: Idaho Zip Code:83221
Contact:Dave Price Telephone: 208-785-1767 Fax 20g-7854053
Other Operator (demolition/general) Unknown at this time, will revise License:
Address:
City:State:Zip Code:
Contact:Telephone:Fax:
vI.Procedure, including analyticat methods, employed to detect the presence of and to estimate the quality of RACM and Category I and Categorynon-fiable PLMLabtesting il
Vll. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category II Category I Category II
Pipes (linear feet)
Surface Area (Square feet 70 sq ft ofsheet vinyl and 836 sq ft of
floor tile, aprox 300 sq ft ofroofing
materials
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknown Complete:
IV. Dates for Asbestos Removal (MM/DD/I.I] : Aug-22-2011 Complete: Aug-23-2011
DaysAVeek I Monday Tuesday I Wednesday Thursday Friday Saturday Sunday
Hrs of Operation | 9am-Spm 8am-5pm
X' Description of planned Demolition or renovation work to be preformed and method(s) to be employed, including demolition or renovationtechniques to be used and description ofaffected facilify components:
xI' Description of work practices and engineering controls to be used to comply with the requirements, including asbestos removal and wastehandling ttittion tonttol ptoc.dut.s: esu.siot arate.ent onty, post urea *iit *a*ing signs, iir',ii-u-.orr'io-*blic. will revise accordingly
XII. Waste Transporter #1: ASBESTOS ONLy
Name: Great Basin Services. Inc
Address: P.O. box 238
Telephone: 208-785-1767
XII. Waste Disposal: ASBESTOS ONLY
Name: BannockCountyLandfill
Address; 1500 North Fort Hall Mine Road
Telephone: 208-236-0607 Fax208- 236_ 0609
xrv' Emergency Demolition (complete item XIV and all other sections, only if this project is an Emergency Demo)l. Attach a copy ofthe Order to this notice.
2- Name of Authority Issuing Order: NA Title3. Authority of Order (Citation of Cod,
4. Dare of Orde. (MMDD/yy)
-xv.EmergencyRenovation(AttachsprojectisEmergencyRenovation.)
l. Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
3' Explanation ofhow the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
Description of procedures to be followed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized orreduced to powder. ,Evacuate2eiffigt$d/n y'cM, enclose area, post wamings and contain . Stop spread of air-born fiber release.
XVII. I certify that an isions of NESIIAPS (40 CFR-PART 61, suBpART M) will be on site during the demorition orning has been accomplished by this person will be available during normaliusiness hours.Date
Aug-22-20n Dave price / ow"J#il;**"-'Name
and ritle
xvu' I^l!!T{"dgtnee)fs^tlyiyrlarvsprohibitingthesubmissionoffalseormisleadingsratementsandlcertifythatfactscontainedinthis
notifiytrtion are ty'f, ayrtraft, and complete.
Signature of Owner/Operator Date Type or Print Name and Title
original Notification must be mailed or hand delivered at lease ten ygfing dsys (Monday-Friday excluding weekends) before demolition or renovationbegins' except emergency demolition and emergency renovations which mist u. *urnittJo * *on as possible before operations begin. (Form rev.3l24/gg
Upon transfer: Orvner/operalor retains GOLD, TransDorler rins ItlNK, WDS retrins y scnds conrpletcd WHITE copy to operator in ilenr 2.
EMSL Analytical, lnc.
3356 West Catalina Drive, Phoenix, AZ g5017
Phone: (60 ) 276-4344 Fax: {602} 276"4053 Emait:
Attn: Dave Price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 83221
Fax (208) 785-4053 phone: (20S) 785-1267
Project: BYU ldaho 145 co[ege St Rexbury td.
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
'12't105796
7t31t2011
Test Report: Asbestos Analysis of Bulk Materiats via EPA 600/R-93/116 Method using
Polarized Light Microscopy
Sample Descrlption Appearance
Non-Asbestos
o/o Fibrous % Non-Fibrous
Asbestos
olo Type
MF-SV.O1
1211057964001
Main Floor Front Brown/Beige
Entry Way Vinyl Non_Fibrous
Heterogeneous
85% Non-fibrous (other)"l!.e/qr-@l!!,Vs,0rtlh
MF-SV-02
121105796@2
Main Floor Kitchen Tan/Red
Vinyl Fibrous
Heterogeneous
60% Cellulose 40% Non-fibrous (other)None Detected
MF-SV-03
1211057964003
Main Floor
Bathroom Vinyl
WhitdBeige
Non-Fibrous
Heterogeneous
85% Non-fibrous (other)15% Ghrysotlle ,
MF.FT-OI
1211057964@4
Main Floor Under Black
Bath Vinyl Fibrous
Heterogeneous
60% Cellulose 40% Non-fibrous (other)None Detected
B-FT-01-Floor Tile Basement Floor
1211os7s64oos Tile Main Hall
Red
Non-Fibrous
Homogeneous
92% Non-fibrous (other)870 Ct1ryg61ilE
B-FT-o1-Mastic
1211057964005A
Basement Floor Black
Tile Main Hall Non-Fibrous
Homogeneous
90% Non-fibrous (other)10olo Chrysotile
Analyst(s)
Amanda Lang (8)
Cheryl Alvarado (1)
Michelle Wilson, Laboralory Manager
or other approved signatory
EMsLmaintains|iabi|ity|imitedtocostoJana|y.sis,Thisreporlr€
bearsnorespofisibi|ityftsamp|€co||*tionacti!itiesoran;|yticalmenodhitations.'rnterpietaiiom
used by the client to claim poduct @rtifcation, approwl, c dndsse.nft by NVLAP, lrsr 6r "ny atJncy or t " ieo.rar go*.ment. Non-friable oroanicalv bound merdriets nrqenruv.tqyPvvo|'uE|Ugsq||qtoy|\vuH,N|i|ofanya9encyorneted€ralgowmment.Non.friab|epfob|emmatrixandthereforeEMsLrecommendsgravimetricrduc{ionpdo;|oam|ysis.Samp|6srieir1eoin!oooonoitionunlessotheMisenote-d
and urcriainty dat8 a€ilabl€ upon requesl.
Az I'JVLAP Lab Cod,e 2008114. 420937
Test Report PLI!4-7.23.0 Printed: 8/1/2011 9:1S:14 AM
G2.4 'ettrh'
.t
EMSL Analytical, lnc.
3356 West Catalina Drive, phoenix, AZ 85017
Phone: (6021 276-4344 FglggA ryg-40s3 Emait: ohoenixtab@emst.com
Attn: DaVe priCe
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 89221
Fax (208) 78il053 phone: (208)7A5_1767
Project: BYU ldaho 14S Coilege St Rexbury ld.
Sample Description Appearance
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
121105796
7t31t201'l
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-g3/116 Method using
Polarized Light Microscopy
Non-Asbestos
o/o Fibrous % Non-Fibrous
Asbestos
% Type
B.SV-o1
1211057964@6
Basement Vinyl
Over Tile Kil
Tan/Beige
Non-Fibrous
Heterogeneous
85% Non-fibrous (other)15olo Chrysotile
RS-01
1211057964007
Basement Roof
Shingle North Side 857o Non-fibrous (other)None DetectedRed/Black 15% Gtass
Non-Fibrous
Heterogeneous
RS.02
1211057964008
Basement Roof
Shingle South Sirle
Red/Black
Non-Fibrous
Heterogeneous
15% Glass 85% Non-fibrous (other)None Detocted
Analyst(s)
Amanda Lang (8)
Cheryl Atuarado (1)
]c*qrlk tCtrus*.
Michelle Wilson, Laboratory Manager
or other approrred signatory
EMSLmaintainS|iabi|ity|imiledtocostofana|ysis.
bearsnorspmsibi|ity'tsamp|eco|lstionaitivitiesga#tyri-tmut'ojt'iurions.hterp;ebtionano,ii,oiie.r,"surt.
Sj,Xgtl",ij'jl*";:"j:i"Hl"l,TgHl**"p*g-T:TT-:l*uvyiei,ysi;;;;i;{il;},;rrh"[rerar sowmment Non-rriabretrsanicaryrrundmateriarsoesenr:AT#l:fflfJ:g:l:f"'ml*:gFdJffi;#;ilil'"-;?ii'"niJ;:ifi1?J"":H[?'ffi::f::l':ifnfri*:J."#f:';#'.:1"$X*T"1"fJ,1';:::iJl"
Inc. Ph@nix Az TWLAP Lab Code 2008114. M0937
Test Report PLM-7.23.0 printed: 8/j/201 1 9:1 5:14 AM THIS IS THE LAST PAGE OF THE REPORT.
/t7 6//7aI
35N I'E
Rexburg, lD 83440
Building Sofety Deporlment /*/-,-a5Aciry or Rexburs f#H"\
www.rexburs.ors "'!'X,13i';'l'li';'33fi W
CITY OT
REXBURGtu_-"_"
Am ericai farnily Cauw unit)l
Application for Demolition
Permir #:
925.00 Fee Paid: Yes/No Permit Approved: Yes/No
Applicant Information
Name: A7A --/al2
App[cant'sAddress: fg * n City/ST/Zip:, - = 7/t,//a
Business pt'ron , Za? - t?'4 - 269 CeI phone: U-? - Ze/ ! 6 4g a
Contact Information
Petson or Company doing the demolition:
Address:Ctty/ST/Zip:
Business Phone:Cell Phone
Demolition Information
Property Owners:
SiteAddress: --
/ '?- /oeane
Start Date: _ Completion Date, _
Summary of what is being demolished:
The U.S' Envitonmental Protection Agency (EPA) tegulates the abatement and disposal of asbestos-containing materials from anypublic or private building involving demolition, renovation, repair, construction, and maintenance activities.http: / /deq.idaho.gov/aitlprog issues/pollutants /asbestos.cfm
EPA certifies and l-icenses asbestos-removal contractors, inspects asbestos-abatement proiects, and enforces laws regarding the properremoval and disposal of asbestos-containing materials.
Currendy, EPA and DEQ contract with Industtial Hygiene Resources in Garden City, Idaho, to regulate asbestos removal and disposalprojects in ldaho.
For more information about asbestos abatement and disposal in Idaho. contact:
Industrial Hygiene Resource
206 Murray St
Garden City ID 83714
208-323-8287
www.industrialhygieneresources.com
I undetstand the EPA requirements regarding asbestos removal and agree to provide information showingcompliance with the regulations to the city of Rexbutg prior to demolition.
Signature o f Applicant:
U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF IDAHO
NOTIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPE OF NOTIFICATION: COURTESY _x_ ORIGTNAL
II. FACILITY DESCRIPTION:
_ REVISED CANCELED
Building Name: Vacant House
Address: 137 College Ave
City: Rexburg State: Id Zip Code: 83460-8205 County: Madison
Site Location : all ofhouse
Building Size (Square Feet) I 100 #ofFloors: I and basement Age in years: aprox 60
Present Use: Vacant Prior Use: Residential
III. TYPE OF OPERATION: -X-DEMO - ORDERED DEMO - RENOVATION - EMERGENCY RENOVATION - FIRE TRAJNING
IV. Is Asbestos Present? (check one) _yes _No pending inspection
v.Facility Information:
OwnerName: BYLJ-Idaho
Address: University Poerations Building # 82, 525 South Center
City: Rexburg State: Id ZipCode: 83460-8205
Contact: Rulon Nielson Telephone: 208-496-2560 Fax:208-496-2490
RemovalcontractorName:GreatBasinservices,Inc License: csR0llgll-02
Address: p. O. Box 238
City: Blackfoot Srate: Idaho ZipCode:g3?l2l
Contact: Dave price Telephone: 20g-795-1767 Fax 20g-7g5_4053
Other Operator (demolition/general) Unknown at this time, will revise License:
Address:
City:
Contact:
State:
Telephone: Fax:
Zip Code'.
vI' Procedure, including analytical methods' employed to deteet the presence of and to estimate the quality of RACM and category I and category IInon-fiable PLM Lab testing
Vll. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category II Category I Category II
Pipes (linear feet)
Surface Area (Square feet
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknown Complete:
W, Dates for Asbestos Removal (MM/DD/yy) : Will revise Complete:
DaysAileek Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Hrs of Operation
v
X' Description of planned Demolition or renovation work to be preformed and method(s) to be employed, including demolition or renovationtechniques to be used and description ofaffected facility components:
XI' Description of work practices and engineering controls to be used to compty with the requirements, including asbestos removal and wastehandling emission control procedures: Asbestos abatement only, Post area with waming signs, limit access to publi". wil revise accordingly
xII.Waste Transporter #l: ASBESTOS ONLy
Name: Great Basin Services. Inc
Address: P.O. box 238
City: Blackfoot State: Idaho Zip Code:83221
Contact: Dave Price Telephone: 208-785-1767 Fax208-785-4053
Waste Transporter #2i
Name: N/A
Address:
City:State:Zip Code:
Contact:Telephone:Fax:
XII. Waste Disposal: ASBESTOS ONLy
Name: BannockCountyLandfill
Address: 1500 North Fort Hall Mine Road
City: Pocatello State: Idaho ZipCode:83204
Contact: Scale house Telephone: 208-236-0607 Fa.r:208-236-0609
XIV. Bmergency Demolition (Complete item XIV and all other sections, onlvl. Attach a copy of the Order to this notice.
2. Name of Authority Issuing Order: NA
if this project is an Emergency Demo)
3. Authority of Order (Citation of Code):
4. Date of Order (MIWDD/Y Ordered to Beginxv.Dmergency Renovation (Attach separate sheet with the following informationifproject isEmergency Renovation.)Date and Hour of Emergence N/A
Description of Sudden, Unexpected Event
Explanation of how the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
XVL Description ofprocedures to be followed in the event that unexpected RACM is found
reduced to powder. , Evacuatey're4 rlet down ACM, enclose area, post rvarnings and contain^tt'
or nonfriable ACM becomes crumbted, pulverized or
. Stop spread ofair-bom fiber release.
,d in the provisions of NESHAPS (40 CFR PART 61, SUBPART M) will be on site during the demolition orrequired training has been accomplished by this person rvill be available during normal business hours.
Date
JuIy 29-2011
Type or Print Name and Title
Dave Price / Owner Secretary
;i,.#n"#;dril-_ a l,
Original Notification must be mailed or hand delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovationbegins' except emergency demolition and emergency renovations which must be submitted * ,oon ^ porribl. before operations begin. (Form rev.3/24/99
U.S.ENVIRONMENTALPROTECTIONAGENCY-STATEOFIDAHO
NOTIFICATIONoFDEMOI/ITIONANDRENovATIoN
DATE RECEIVED
I. TYPEOFNOTIFICATION:lst REVISED -CANCELED
II. FACILITY DESCRIPTION:
Address: 137 College Ave
Zio Code: 83460-8205
Site Location : all ofhouse
Building Size (Square Feet) 1100 #ofFloo:s: I and basement Age in years: aProx 60
III. TYPE OF OPERATION: -x-DEMO - ORDERED DEMO RENOVATION -EMERGENCYRENOVATION _FIRETRAINING
lV. Is Asbestos Present? (check one)
Address: University Poerations Building # 82, 525 South Center
Telephone: 208-496-2660 Fax 208-496-2490
Removal Contractor Name: Great Basin Services, Inc License: CSR0ll811-02
Dave Price Telephone: 208-785-1767 Fa'r:208-785-4053
Other Operator (demolition/general) Unknown at this time' will revise
vI. procedure, including analyticat methods, employed to detect the presence of and to estimate the quality of RACM and category I and category II
non-fiable PLM Lab testing
V11. Approximate Amount of Asbestos Materials:
Nonfriable Asbestos Material
Not to be Removed
Nonfriable Asbestos Material
to be RemovedRACM to be Removed
9x9 floor tile
1073 sqft
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknown
lV. Dates for Asbestos Removal (M}\{/DD/YY) : Aug-10-2011 Complete: Aug-10-2011
X' Description of planned Demolition or renovation work to be preformed and method(s) to be employed, including demolition or renovationtechniques to be used and description ofaffected facility components:
XI' Description of work practices and engineering controls to be used to comply rvith the requirements, including asbestos removal and wastehandling emission control procedures: Asbestos abat€ment only, Post area with warning signs, limit access to public. Negative air, critical bariors, handtemouul *ith *et t"thodt. All Asbtstos *ute.iul te*oued doubl.-bagg"d, lab.led, and transpitei t" "" Epa .ppr*iJi*of,ri} ..qr"r!.
XII. Wrste Transporter #1: ASBBSTOS ONLY
Name: Great Basin Services, Inc
Address: P.O. box 238
Tefephone: 208-785-t7 67
Waste Transporter #2:
XII. Waste Disposal: ASBBSTOS ONLY
Name: Bannock County Landfill
Address: 1500 North Fort Hall Mine Road
Contact: Scale house Telephone: 208-236-0607 Fax:208-236-0609
xlv. Emergency Demolition (Cornplete item XIV and all other sections, only if this project is an Emergency Demo)l. Attach a copy of the Order to this notice.
2. Name of Authority Issuing Order:_ NA
3. Authority of Order (Ciration of Code):
4. DateofOrder(MM/DD/yy) @xv.EmergencyRenovation(Attachseparatesh''t*itht@ergencyRenovation.)
l. Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
3. Explanation of how the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
Description ofprocedures to be
reduced to powder.
followed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized or
downACM, enclose area, post wamings and contain. stop spread ofair-born fiber release.
XV[. I certify that an the provisions of NESHAPS (40 CFR PART 6I, SUBPART M) will be on site during the demolition orired training has been accomplished by this person will be available during normal"business hours.
Type or Print Name and Titte
Dave Price / Owner Secretary
XVIL I acknorvledhe the ex arvs prohibiting the submission offalse or misleading statements and I certify that facts contained in thisand complete.
Date Type or Print Name and Title
original Notification must be mailed or hand delivered at lease ten rvorking dsys (Monday-Friday excluding weekends) before demolition or renovationbegins, except emergency dernolition and emergency renovations which must be submitted us soon a, porrilbl. before operations begin. (Form rev.3l24l99
Upon transfer: Orvncr/o[)eraror rctains GOLD,.fransporter ns PINK, WDS n:tair:s y and sends conrplcted WHITE copy to operator in item 2
EMSL Analytical, lnc.
3356 West Catalina Drive, phoenix, AZ gS01Z
Phone: (602) 276{344 Fax: (602} 276-4053 Emait:
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
BfacKoot, lD 83221
Fat<: (208) 785-4053 phone: (208)7A5-1761
Project: BYU. ldaho 137 Coltege St Rexbury ldaho
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
121105797
7t31t2011
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-g3/116 Method using
Polarized Light Microscopy
Sample Descripfion Appearance yo
Non-Asbestos
Fibrous % Non-Fibrous
Asbestos
% Type
#2-01-B-Floor Tile
1211057974@1
Apartment #2 Tan/Orange 15% Cellulose 85% Non-fibrous (other)None DetectedKitchen Bottom Non_FibrousLaYer Homogeneous
#2-01-B-Backing
1211057974@1A
Apartment #2 Black
Kitchen Bottom FibrousLaYer Homogeneous
50% Cellulose
3% Synthetic
47% Non-fibrous (other)None Detected
#2-01-B-Mastic
12110579740018
Apartment #2 Brown
Kitchen Bottom Non_FibrousLaYer Homogeneous
100% Non-fibrous (other)None Detected
#2-01-B-Board
1211057974001C
Apartment #2 Tan
ffi Bottot
:,::"::
100% Cellulose 0% Non-fibrous (other)None Detected
Homogeneous
#2-Ol-T-FRtur Tile lfn9llf - Gray 15% cellulose 80% Non-fibrous (other) ::5?o rohrvsofite'
1211057974002 Kitchen Top Layer Non_Fibrous
Heterogeneous
Ohryseille'
#2-01-T-Mastic 1
1211057974002A
Apartment #2
Kitchen Top Layer
Tan
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
Analyst(s)
Cheryl Alvarado (19)Michelle Wilson, Laboratory Manager
or other approved signatory
maintains|iabi|ity|imited(ocGtofamty€is.rnisre
rc responsibilily for sample collstion activitios or analyti€t mefrod limitaiions. hterprelation and use of testbeat.no-rsponsibi|ityi.'.*;nr"""rr99-@;.df1;";.;;;f;tEiff.J'.;i"d;:1ji.ift'5f"xTf.t".tl?l".j.ET"T'5fi'iJ5.$.lliJl'[]i'".i!1.l'[l
nj*'*ffii":ff.|:",:i"i#il9.T:ffj;Tn$:::g:13*lli*lilti:l{ii-;*"",1"_tqgilo"rars-owmmenr Non-rriabreo.sanica'yboundmareriarspresenra!ffi"##Hi"J$"':trH?j[:l ff:gTends braMmetric reduction prioi to anaivsi;. s;'p';.-'1;-iG;-oJlilHff:'; #il#g';#?:'lTllf":"f5JrT;:::i#
Test Report PLM-7.23.0 Printed: B/1/201 17:38:24 AM
t4
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
BfacKoot, lD 99221
Fax (208) 7S$40S3 phone: (208)785_1762
Project: BYU- tdaho 137 Cottege St Rexbury ldaho
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 B:45 AM
121105797
7t3112011
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-g3/116 Method usingPolarized Light Microscopy
Sample Description Appearance
Non-Asbestos
o/o Fibrous
Asbestos
o/o Type
EMSL Analytical, Inc.
3356 West Catalina Drive, phoenix, AZ g5017
l lljn r"r, (eo2lz16_4oss Emait:
% Non-Fibrous
#2-01-T-Backing
12110579740028
Apartment #2
Kitchen Top Layer
Black
Fibrous
Homogeneous
50% Cellulose
3% Synthetic
47% Non-fibrous (other)None Detected
#2-0'l-T-Mastic 2
1211057974@2C
Apartment #2
Kitchen Top Layer
Brollrn
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
#2-03-Vinyl
121105797-cf'03
Apartment#2
Bathroom Vinyl
White
Non-Fibrous
Heterogeneous
25% Cellulose
2% Synthetic
73% Non-fibrous (other)None Detected
#2-03-Mastic
1211057974003A
Apartment #2
Bathroom Vinyl
Brown
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
#2-03-Backing 1
12110579740038
Apartment#2
Bathroom Vinyl
Black
Fibrous
Homogeneous
80% Cellulose 20% Non-fibrous (other)None Detected
#2-03-Backing 2
12110579740c3C
Apartment #2
Bathroom Vinyl
Gray
Fibrous
Homogeneous
80% Cellulose 20% Non-fibrous (other)None Detected
lnitial report from OBl01 t2O1 1 07 :38:24
Analyst(s)
EMSL maintaire ti"bitity timit"
ffi";:'ji1ij.:,'jf''?tJ:.gl'T::[t'"s?'g.?":|i?,.**TJimitalions'|nt€rp;etationandus6oiiestresutlsareth€responsibi|ityofproue; matdx and ttrererofu gudil""mm.ff. ^..i;mar;^ --,.-,^- -.^l ]V,LAP, Nlsr or any agency of the feoerar gowmmenl Non-friabte troanreuv h'nd m.rAi.rc ^.a-^^.I,i i"ff:lli1y.",:"#[:ffijffi"tff*r",ioJii"""i"ilJi;i,iii;;i;"#;'i:u;i,i|"[".l",H,f::ifL3ifti*: "11,"#3:,;"f:11ixr":*"m:"1;3k*1""EMSL Anatyri€t. Inc. ph@nix AZ iWLAp Lab qode 20081 1O, AZO937
Test Report qLM-2.23.O pdnte'j. Al1t2O11 7:38:24 AM
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 89221
Fax: (208) 78$4053 phone: (208)785-1767
Project: BYU- ldaho 137 Coltege St Rexbury ldaho
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM
121105797
7t31t2011
Test Report: Asbestos Analysis of Bulk Materials via EpA 6001R-g3/116 Method usingPolarized Light Microscopy
Non-Asbetos
Sample Descrlpfion Appearance Asbestos
o/o Type
EMSL Analytical, Inc.
3356 West Catalina Drive, phoenix, AZgi}fl
EI,g. 1602) t9M1_ F"*' {602} 2r6-40s3 Emait:
% Fibrous % Non-Fibrous
B-01-Floor Tile
1211057974004
Basement Floor
Tile In Kit & Dining
Red
Non-Fibrous
Homogeneous
98% Non-fibrous (other)?/o Chrysotile
B-01-Mastic
121 1057974004A
Basement Floor
Tile In Kit & Dining
Black
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
B-01-Lerreler
12110579740048
Basement Floor
Tile ln Kit & Dining
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
B-02
1211057974005
Basement Sheet
Vinyl On Floor
Tile, Kitchen
Stop Positive (Not
Analyzed)
B-03
1211057974006
Basement Floor
Tile In Hallway Stop Positive (Not
Analyzed)
B-04-Sheet Vinyl
1211057974007
All On Floor Tite
Sheet Vinyt In
Back Entry Way
White
Non-Fibrous
Homogeneous
98% Non-fibrous (other).,?/o Chrysotile
report frorn 0810112011 O7:Zg:24
Analyst(s)]trj$k l7Jt&ae*
Michelle Wilson, Laboratory Manager
or other approved signatory
Cheryl Atuarado (19)
EMSL maintains liabilily limited to cost oDeacnorsptsibi|ity'orsmo|e@||ectlonaitivltiesaanLtyticar_m-etr#rimihrio6.-.r1t9,i6iliiJ,*iii.,.
;.:THtffili":,llT5:f"H;"-j."flI:f*"**:f*-T':*:s-litNVLA',Nrsroranvas€ncvorrhereoeasowmmsn. Non-rriabreoroanicarvrn,ndm.rad.,c^-.^^,:i?l'i'##:ffiU1"':il:ffiiH,iffiST"tuJ fifi;;;J';;;p;";liJ""ill.il'l!ilX"J.",X"*"'["J,T"g::XT'":i,,fffii*'; ii"#fffi:?:1Tlll*."Xfffifi*-'
Test Report PLM-7.23.0 printed: 8/1/20 j 1 7:38:24 AM
Attn: Dave priCe
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 8322'l
Fax: (208) 785-4053 phone: (20A)785-1767
Project: BYU- ldaho 137 College St Rexbury ldaho
Sample Descripfion Appearance
Customer lD:
Customer PO:
Receired:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
07130111 8:45 AM'121105797
7r31t20'11
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-93/116 Method
Polarized Light Microscopy
using
Asbestos
o/o Type
Non-Asbestos
o/o Fibrous % Non-Fibrous
EMSL Analytical, lnc.
3356 West Catalina Drive, phoenix. AZ g5017
Phone: (6021 276-4344 Far: (6021 Zt6-4053 Emait:
B-04-Mastic
1211057974007A
All On FloorTile
Sheet Vinyl In
Back EntryWay
Black
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
BRS-o1
1211057974@8
All On Floor Tile Red/Black
Roof Sttingles Non_FibrousNo(n Sloe Heterogeneous
15% Glass 85% Non-fibrous (other)None Detected
RS-02
121 1057974009
All On Floor Tile Red/Black
fool. slinstes Non-Fibrousuoutn sloe Heterogeneous
15% Glass 85% Non-fibrous (other)None Detected
Analyst(s)
Cheryl Atvaraclo (19)
]|ffi#jr- t'Jttsso,'
Michelle Wilson, Laboratory Manager
or other approved signatory
trMDLma|nIa|ns[ao|||ty||mlleolocostoIana|y.sis.ThisrePortre|at€sontytolhesamplesreportedanomayi6i-bereEoouceo,@
rt*"'n.m.J?j,Ej*.^Tf,':'T]lTIl^Tt,jlT.iTl{:T].T:|."ji.|Til"Ji?1s.-rnterpietatlonarJuii,oi-t"srr"!,rts","usedbythec|ieniloc|aimprdUctertjfica!919leov.at,g.einommentoyrvLee,Nrsro'"ny"g"n"y;;lh;6ii;;H;i"r;#[itu;i;:l;J.:';;';i"i;:.:[::?i.prob|emmatdxand|hef€foreEMsLrecommeMsgravimetricredudionpriortoana|ysis.Samp|6s6ceii.oing*o*noitionun|€ssotheMisenoie-d'Estimatedacdracy.ecision
and urcenainty data aEilabls upon request.
Test Report PLM-7.23.0 Printed: 8/1/2011 7:38:24 AM THIS IS THE LAST PAGE OF THE REPORT.
./25 &/*
Building Sofely Deporlme
35N IrE
Rexburg, lD 83440
Application for Demolition
Permit #:
$25.00 Fee Paid: Yes/No PermitApproved: Yes/No
Applicant Information
Name
Applicant's Address:/sr/zip: r?e,fl g, -L44.B?10
Business PLto"e, ZOB '4?1o' 24€/Cellphone: Z.aE'Za/ - C69o
Contact Infotmation
Person or Company doing the demolition:
Addtess:City/ST/Zip:
Business Phone:Cell Phone:
Demolition Inform ation
Property Owners:
Start Date:Completion Date:
Summary of what is being demolished:
a// k///'4)< az/ gpaze .hr*
The U.S. Environmental Protection Agency @PA) regulates the abatement and disposal of asbestos-containing materials from any
public ot pdvate building involving demolition, renovation, repair, construction, and maintenance activitres.
http: / /deq.idaho.gov/airlprog issues/pollutants/asbestos.cfm
EPA cenifies and licenses asbestos-removal contractors, inspects asbestos-abatement proiects, and enforces laws regarding the propet
removal and disposal of asbestos-containing materials.
Currendy, EPA and DEQ contract vrith Industrial Hygiene Resources in Garden City, Idaho, to regulate asbestos removal and disposal
proiects in Idaho.
For more information about asbestos abatement and disposal in Idaho, cofltact:
Industrial Hygiene Resource
206 Murray St
Garden CiLy ID 83714
208-323-8287
www.industdalhvsienetesources.com
I understand the EP
compliance with the
A requirements regarding asbestos removal and agree to provide infotmation showing
regulations to the City of Rexburg prior to demolition.
Signature of Applicant:
U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF IDAHONSIIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE R$Er*rE!NOTIFICATION
I. TYPE OF NOTIFICATION: _COURTESY _oRIGINAL REVISED _CANCELEDlst
II. FACILITY DESCRIPTION:\
Building Name: Vacant House
Address: 105 College Ave
County: MadisonCity: Rexburg
Site Location : all ofhouse
State: Id Zip Code'. 83460-8205
BuildingSize(SquareFeet)1100 #ofFloors: landbasement
Present Use: Vacant
Age in years: 50 plus
Prior Use: Residential
III. TYPE OF OPERATION:x DEMO -ORDEREDDEMO -RENOVATION -EMERGENCYRENOVATION -FIRETRAINING
IV. Is Asbestos Present? (check one) _yes No pending inspection
V. Facility Information:
OwnerName: BYU-Idaho
Address: Universiry Poerations Building # g2, 525 South Center
City: Rexburg State: Id ZipCode: g3460_g205
Contact: Rulon Nielson Telephone: 208496-2660 Fax:208496-2490
Removal contractor Name: Great Basin services, Inc License: csR 0l lgl l-02
Address: p. O. Box 23g
City: Blackfoot State: Idaho ZipCode:g322]
Contact: Dave price Telephone: 20g_7g5_1767 Fax 20g_7g5_4053
Other Operator (demolition/general) Unknown at this time, will revise License:
Address:
/-irr.ur!J. State: Zip Code:
Contact: Telephone: Fax:
vI' Procedure, including analytical methods, employed to detect the presence ofand to estimate the quality ofRACM and category I and category IInon-fiable PLM Lab testing
Vl1, Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Category I Category II Category |Category II
Pipes (linear feet)
Surface Area (Square feet aprox 200 sq ft of sheet vinyl aprox 200 sq fl
floor tile
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: Unknown Complete:
rv. Dates ror Asbestos *.ryIgrrp!ryIf sept-z-il[ co.prefls.p,-zji
DaysAileek I Monday \--llTuesday I Wednesday _.\=--I nursday Friday Saturday Sunday
Hrs of Operation 9am-5pm
ffitechniques to be used and description ofafecteJ ia.ititj.ornpon.otr,
xI' Description of work practices and engineering controls to be used to compry with the requirements, incruding asbestos removar and waste,-^,^3ju.ttlF:Tissioncontrol.procedureJ eto.r6ruuut.rentonly,postareawithwaminssisns rimita.^Fcar^h,,hr;^ ^-:.:^^, 1--:-.incrosure, wet hand removar merhods. ar materiar ooffi#;:ilJd,ilff:"U:,#Tlli ilili;jliilii::.fifiilXXi.,""';,ffir;;,:i,ff,*,ffi,;required.
XII. Waste Transporter #l: ASBESTOS ONLY
Name: Great Basin Services, Inc
Address: P.O. box 238
Zip Code:83221
Contact: Dave Price Telephone: 209-785-1767
XII. Waste Disposal: ASBESTOS ONLY
Name: BannockCountyLandfill
Address: 1500 North Fort Hall Mine Road
Telephone: 208-236-0607 Fu<:208-236- 0609
1ffiil?"Tfflf;;".t,::L::il:JlT}t and au othersections, onry irthis project is an EmergencyDemo)
2-. Name of Authority Issuing Order:
4. DateofOrder(MM/DD/y$'
lmergency Renovation r,qnr"ti ate Ordered to Begin
2. Description ofsudden, Unexpected Event.
age or an unreasonable financial burden.
xvl'
rDescript["0:11:"r"to"tes
to tre fx" in the event that unexpe$ed RACM is found or nonfriabre ACM becomes crumbred, purverized or
ACM, enclose area, post warnings and contain . stop spread ofair-bom fiber rerease.
XVII. I certify that a he provisions of NESHApS (40 cFR .ART 6r, suBpART M) wilr be on site during the demorition orred training has been accomplished by ilris person wiil ie available during normal business hours.
/r' DAte "v' r[g' uurrus!! Iuurs'
Type or print Name and TitleAug-3 I -20 I I Dave frice I Ownei "sicreiu.y
or misleading statements and I certify thst facts contained in this
Signature of Owner/Operator Type or Print Name and Title
fore operations begin. (Form rev.3/24/99
upon ransrer uwner/operator retains GOLD, Transporter retains PINK, wDs retains yELLow and WIIITE copy to operator in item 2.
/r7 6/?- 4a.
Building Sofety Depo
REXBURG
$25.00 Fee Paid: Yes/No Permit Approved: Yes/No
,t#
Application for Demolition
Permit #:
Applicant In
Name:
Applicant's Address:zf izip, rZz,/z/ryry - -T/
)ef,-/-a/ 54e Sz
City
Business yho,,", Z2/ *r?b'zc,n Cell Phone:
Contact Information
Person or Company doing the demol-ition:
Address:City/ST/Zip:
Business Phone:Cell Phone:
Demolition Information
Property Owners: -f,
Site Addtess
The U.S. Environmental Protection Agency (EPA) tegulates the abatement and disposal of asbestos-containing materials from anypublic or private building involving demolition, renovation, repair, construction, and maintenance activitres.
http: / /deq.idaho.gov/aitlprog issues /pollutants /asbestos.cfm
EPA certifies and licenses asbestos-removal contractors, inspects asbestos-abatement prorects, and enforces laws regarding the properremoval and disposal of asbestos-containing materials.
Currendy, EPA and DEQ contract vrith Industrial Hygiene Resources in Garden Ciry, Idaho, to regulate asbestos removal and disposalproiects in Idaho.
For more information about asbestos abatement and disposal in Idaho. contact:
Industrial Hygiene Resource
206 Murray St
Garden City ID 83714
208-323-8287
www.indusftialh]'gieneres ources.com
I understand the EPA requirements regatding asbestos removal and agree to provide information showingcompliance with the regulations to the city of Rexburg priot to demolition.
5-z
Statt Date: Completion Date: _
Summaryofwhatisbeingdemol-isn O, 4-Sr- noy' T //
Stgnatute of Applicant
.a
''t
U. S. EI\TVIRONMENTAL PROTECTION AGENCY - STATE OF IDAHO
NOTIFICATION OF' DEMOLITION AND RENOVATION
OPEMTOR PROJECT #PoSTMARK I pnrenrcetvro NOTIFICATION
l. TYPEoFNOTIFICATION:_x_CoURTEsy _0RIG|NAL _REvtsED _CANCELED
II. FACILITY DESCRIPTTON:
Building Name: Vacanr Housc
Addrcss: 144 Collegc Ave
City: Rexburg Statc: ld Zip Codc: 83460.8205 Counly: Madison
Site Location : mof of house
BuildingSize(Squarc Fect) 1200 #ofFtoors: I Age in yean: 3l
Prescnl Usc: Vacant Prior Use: Residential
TII.TYPEOFOPERATION: -T-DEMO -ORDEREDDEMO _RENOVATION _EMERGENCYRENOVATION _FTRETRAINING
lV. lsAsbcaaosPrcscnt? (chechonc)_x_Yes -No
V. Faclllty lnformrtlon:
Owncr Namc: BYIJ-ldaho
Addrcs: Univenity Opentions Building # 82, 525 South Center
City: Ro$urg State: Id ZipCode: 8346G8205
Contact: John Reed Tefephone: 2084962435 Fa* 20E496-2490
Removal ConFactor Name: Grcat Brsln Servlces. Inc License: CSR0l20l2-29
Addrcss:P. O. Box 238
City:Blackfoot Stolc: tdsho ZipCodet E3221
Contact:Dave Price Tclephonc: 208.785- | 767 Fax: 208-?E54053
Othcr Operator (dcmolltlon/gcocrst) Unknown at ahls tlmc Llccnse:
Addrcss:
City:Statc:Zip Codc:
Contact:Telephone:Fax:
Vl. Procedurc, Including anrlylicrl mcthods, cmptoyed to detcct the prcseocc ofrnd to estlmotc the quallty of RACM and Category I rnd Crtcgory llnon-llablc PLM Lrb teealng
Vll. Approrlm.tc Amount of Asbestor Matcriabi
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriablc Asbestos Material
Not to be Removed
Catcgory I Calcgory ll Catcgory I Calqgpry ll
Papcs (lincar f€et)
Surfacc Arca (Square feet Aprox 100 sq ll
of roofing mastic
Facility Componcnts (cubic fecr)
VU]. Schcddcd Dates Dcmolitlon or Renovralon: Start: Unknown Complctc
lV. Drt$ for Asbcctos Remov€t (MM/DD/yy) lMay-B-2012 Complete: May-8-2012
DaysAteck I Monday Tucsday Wednesday Thursday Friday Saturday Sunday
Hrs of Opcrrtioo 12 noon.5pm
x. - Dcscriptlon of planned Dcmotltioo 0r renovrtion worL to be prcformed ond mclhod(s) to be cmployed, Including demolition or rcnovrtlontcchnlqr$ to be uscd and dcscrlptlon ofalTected faclllty componcnrs:
Xl' Dcscrlpllon ofwork practicer and cnglnccring controts to be used lo comply wlth thc rcquiremcnts, Inctudlng asbeslos removat and wasachandllng cnlslon conlrol proccdurcs: Asbestos abalcmcnt only, Post arca ivith rvarning signs, limir access ro pu-Uti'a. Rooting materials witt bc rcmovedusing hand methods. Metal rvill be cut and mastic will be rcmoved along with rooting mastic. All material rviil bc badcd inro a 6 mill polly, doubtc lincd dumptrailcr and ttken lo and EPA approvcd tandfiil.
XIl. Wrstc Transporter#l: ASBESTOS ONLY
Name: Grcat Basin Services, lnc
Address: P.O. box 238
City: Blackfoot State: ldaho ZlpCode:83221
Contacl: Davc Price Telephone: 208-7 85-1767 Fa*208-785{053
Wastc Truosportcr f2:
Nams; N/A
Addrcss:
City:Slsle:Zip Code:
Contact:Telephone:Fax:
Xll. W.sac Dl$osat: ASBESTOS ONLy
Name: Bannock County Landfill
Addrcs: 15(D North FortHall MincRoad
City: Pocatello Slate: ldaho Zip Code: 83204
Contacc Scalc housc Tefephone: 208a36-0607 Fa*208-23G0609
Xlv. Emcrgency Demolltlon (Conrplctc item XIV and all other scctions, only if rhis prcjcct is an Emcrgcncy Demo)l. Attoch a copy of the Order to this notice.2. NomcofAutftoritylssuingOrder: NA3. Authority of Order (Cihrion
4. Date ofOrdcr to Begin.xv.Emcrgency Renovatlon (Attach separate shect rvith thc information is Emergcncy Rcnovation.)t.
2.
3.
Datc and Hour ofEmergencc N/A
Description of Suddcn, Unexpected Event.
Explanation ofhow thc even causcd unsafe conditions or equipmenl damagg or an unreasonablc financial burdcn.
xvl' Dcscrlptioo of proccdurcs to bc follorvcd in lhc evcnt thst unerpcctcd RACM ls found or nonfrlsble ACM becomcs crumblcd, pulverlzcd orrcduced lopowdea *Grflcfa'
tct down ACM, cnclosc arca post rvamings and contain . Srop sprcad of air-bom fibcr rclcasc,xvtt'tcertttvtft""'".'"'ffi
[tf,lL'01#lnfi ::H:rcnovrtldn and cvldc4l
stcnatuleolfiftlh
_l-l
original Notificotion must bc mailcd or hand delivcrcd at leasc ten uorking dsys (Monday-Fridoy excluding weekends) bcforc demolition or renovationbcgins, cxcept emer8oncy demolition and emergcncy .enovations which mist tie suumirted as soon 0!r possiblc bcfore operstions begin, (Form rcv,3D4lgg
Typc or Prlnt Namc and Tltlc
.+
a o
R.Q. I'Iaz*rdous liubstrnre: Solid N,0.S. (asbcstns): ORM-[ NA-gIgg
13
GENNRATOR
Lo$risn: r{q 6[qrl";;. , Rrybuxg 4nL:'** oun*Jl-#; g iX',tLi;;-,-J.; blJ,,,3 a , $Vo * a cnnp,suQ *
orrncr's Nanre: f{VtS - -ru {) {^) KCt A orynerns Ptronc: Zn,p -4qL *
RIAT BASIN SgrTvrCtis. n*c
Mniling Addrcss:
Ceinlact ?crson:
Ir.o. Box:38
3LACKrOOT.ID 33221
DrlYIl I'RICS
Contrnctor I.D. Nunrber: ^ ^.c-s<.ot AOtZ-Qz-l
's Phoner 208-785-1767Waste Disposal Sitc (llCIS) DffiTINATIONI
Name: BANNOCK couNTy LAt{or[L wDs l]honc;20s-236.0607il{ailingAcldressr ls00 N0RTH I}ORT }IALL tvlfi\lg noADI'OCATTLLO, tD 8320t
Ti??S"Oifxtjfrtonsible irgcttc)' tr-r.rcal. Dhtricl T Il'*.gln.r $'hurerrcnrnfitiory'rcrrrxllion ilorificarrior! nussElr):
Description of waste materials 6. Cantainers
Nun:bcr Type
Spccinl lludling tnstiuitiorx andlffiiilffirTlnfornt,rrjom
UfllKA't t]&'$ CEITTI!-ICATION; I he rrtry dcchrrc lhirt rho crxrtdnlr of rhis conri*nurcnr an: fullv ;urd r,shipping nanre irncl {rs classitied. pa*ketl. mlrkcd rld htrclcil, rnrl *rr: in rll n:spcrs in praprl.urrditirlud,r;i*}Vrrinternrlionnl anrl grrvcnrm*nt r*gullrirxrs. {Ohrlin signarure in lrsnr l0 bcforo ritking $old rlrccr fnr r(r"i1rt.l
')
ttl
.PAVE PRICE owNER I V IPrintcdtylxd Narrre l.irlc Sjignatrr(r.. ./ |
de*qrit cd lbove b-v proper
acconling to ::pplietblc
nslrorter I (Acknorvledgilmit k,f rece{Tim
|rlanre: GREATSASINSfiRVIC$i,INC.
Addressr P.0. BOX 138 . 3LACKSOOT.,ID lt322t
DAVE PRICE
PrintetVrypd Nlnrr:
nsporler 2 (Ackuorvlcd-ecrnE'rGf.ffi
Namet
Addrcss:
Prinfccfrylxrt Nanrc
Plrone:
Signntur*
1VASTE DISPOSAL SITB
wA.sTI}DI$Il0sALsI,I"ECI'It?trIcA.l.IoN:|hcrelryeonifylhat|heaItovcnuu."
J-i#;;' p;;:,=rr-to &,,*#*"8- "*I.*,/,^o.,, ,(L
Upon|rirnl|cr:0rvrur/cptr:rtorrctninl60L},'lhtnsporterrc|lin*l'lNK.wns*.nln,"nl
lYS { a/lprc
35N lilf
Fexburg. ln d3{{0
ct'tY ()t:
REKBI.IRffi'cb
.rt tttsricri iirlrrijr (,'r.rrrrrrrrrni!y
Applic*nt I nfirrm ation
Application for Demolition
Fennir#; /fr #4e2+
lfS.*O f*
Applicnnt'sAdclress: E{Ciry/S1'/Zip:
Business Phonc, /a4f-Ceil thr:ner
Contact Information
Person or Company doi*g thr rlsmolition:
r\ddrcs*:Ciry/liT/iiip:
Business Phr:ne;Celj ])htrns:
Ilemoli tion Info rm ntiun
Frr:p*rty (h*'ners:
$itr: Addxcss:
St*rt Dar*:Cumpletion Datc:
Sumrnnry *f whrr is hcing dem*lish*d:
The u's' H'nvironmcntnl l)*otecd*n Agency @PA) rcgulates the abatemrnt nnd dirpos*l of asbesrr:s-conrni:*ng mrrcrials from anypublc ar privatc buildrng involving duloliiion, .*r,odtion, repdr, consruc***, and maintenance *ctivities.httF: / /deg"iclaho.gov/air /pr$* issuqs,/pollutpnts,rasbesto+,cfrn
liPA certifies and licenses aslms*$s-rcmov*l c+nrr*ctots, inspects asbcstos-abatemEn* pralect** r*d enforces laws rcgarding the properremoval and disp*sal of a*heslr:s-c$nternirg materiels.
currcn*y' f,PA nnd DH'Q contract wilh Industrial Hygienc Rer*urcss in Gard*n ciry, Itialro, to regrrlare asbesros removal nnd dispos*lpro,{st:i rn ldah*"
Iror:nore infr:rmada* about asbestos ahnr*rr:ent and disp**ar i:r rdah*, cc*tf,ct:i ndustrial Hygiu nc Resource
206 N{urray St
Gardec Ciry tD 83714
208-323-8287
wrvrv.iFdusrrialhvgjcnqr+suprce s.cq{n
I uuderuta.nd the
c()mpliaftce with
EPA requirem*nt$ regarding a*hesios rerncval -and 1gr€r to provide informatian showingthe regulatiggs_fo rk City of Rexburg pri+r to demalirion.
qI
lvl'
Signature <l f Applicanr:
/1./ La({?rc
35N l4E
Rextrurg. lD ffi44A
Building Sofety Deportm*nl
Clty of Rexbulg
Pt an€:2Q8.372.2326
fox: 20S.359.302?ffi.rex#ilfs.org
|1t1'tlI
ITEXBI.IRG. (\r
Inerirrt! ljrurir' ( u*rnrunify
Application for Demo[tion
Permir#: . f.?,. fltttrl[]L
$25.00 ltee P"i;
Applicant Infarmation
m^*,,,F74:-Z&4o - , ." . .
Applicant's.i.ld,**u, 5e{ {#//ef 4 Ciry/ST/Zip:
^ -. Sa WS#*
BusinesoPhone: Z( B - fr6- trn Ccllphore: eoW
Contact Information
Person or Company doing the demoli*q:nr
Addrcssr
Busincss Phorre:
Demolition Inform atio n
Ciri/S'r/Zip
Cell Phar":e
Prop*rty Owners: _
SiteAddress: * #,,'?t ',',',!t *
Summary of what is being dcmoLished:
The U'S' Hnvironmentel Protectio* Age*cy (EPA) regutates thr abrt*msnt and disposal nf asbestos-*antnining materials from anypublic or privatc building invclving demolitiorr, r*nr:veti*n, repair, construction, and mainrcnnncc acsivities.htqr:/ /dcq.idaho.gov/dr/pnrg issr.lr:* {ppllutants /ashestos.cfm
EPA certifics and liccnscs rgbctlos*temoval conrrnctors, inspects asbcstos-abatern*nt proiects, and enforces laws rcgard.ing the praperremoval and dispcsnl oi asbestos-contnir*ng materi*ls.
Currcntly, HPA and DHQ contrnct with Industrial I'lygrene Resources in Gard*n Ciry, Idaho, to re6ular* asbesros rem.val and disposalprojectr in ldahr:.
FOr more informntjor: a!:our asbesr*s abiucment ancr dispr:s;rl in Idr:h*. srrnlrcr:
Industrial Hygrene Resource
204 il{urrny St
Gardea City ID 83714
208-323-8?87
www.industrialhygicperep<.rr*ct:s.s.pm
I underetand the
complianc€ with
fPA tequiremant* regarding aabt*lot rem$vfll end egres to provide informati+n showingrhe regulatinr$_rp the Citygf Rexburgprior ro demolition.
Signnrurc of Applicant:
/{# tafi*
eportmenl;H;I @ {iI!T C)I
J$N t'{
Rexhu.g, tD 83418
RflXSTI{TG- r)s'
,{ ffi rri(lii f il mil}, ttil, tfi | k rli lt,
Building $nfefy S
rvww.aexburg.ors
Applicant Informadon
Narne:
Confact Information
Psrson *r Company doing the dem$lirion:
Addrcss:
Susi*ess Phoae
Demclitian f nformafion
Application for Demolirion
Permir #:
$?5"fi0 Fec Paid:
7c,4n
BF#b
Ciq'/S'l/Zip:
Cell Phone:
Properry Owners:
Si:e Adrlrers:
Start l)atc:
Summary of what is bcing dcmolished:
The u'$' finvir*nmentql
11*11"" lg**:{ {TPA} regularrs t}re abatemerrt and disp*ear of a$bfsros-containing materials from nnypublic or private buildins
hrtn:,/,/dec,id*r".**.r.,;ljlj.l*,:1.*flf::.1c1$l'|nt*$n, repair, cnnstrucricn, rnd mainrcnance acrirrieies" l
:-ffifffiT:,i,||i:lT-#::;:::"TffiHH.[H:'$' r'spects asbestos-abaremenr Frolecrs, nnrr enrorces laws r*garding the proper
cu*endy' EP"{ a',d DEQ contract with Indus*rial t'{vginne Resources in $ard*n fliry- Idaho, t* re&r-rlate *sbestos remcval and disoos*lprolccr* in ldaho.
For morc infirrmntion abouf asbesros *brrcn:cr:f and disposar i* rtlah', c,,r.!t"criI ndus trial Flvgiene Re*ource
2G6 J\{urray Sr
Cisrden Crry ID 83714
20fi-3?)-{}?87
rlnvw.industrial hy{ienere sourcen.qnrn
: #ffi.T:: ffi -T:i.ffiil"ffi il%T :f fi . * "; ;:n:#.llf -,lf, ffi * p ro v i rr e i n rorm a do n s h owin g
Signarurc af Applicanr:
Brilding $afety Seportmenf xffl;"-a,cityofRexburs
6-ffi\\-",f,m@*1
w\4r'wroxourso,s '*ili;f#:iiiiiii \ffiY
iltrY()t;
35N frf
Rerbur#, lD 83,C18
RHXBURG
_{1L_..-
,{$rdrifci li:rnilr. (i:rurru+rlv
Application far Demolition
Permit #:
$i5.$0 Fee Faid:No Permit
-H?
Applicant Infiormation
Narne H;I /4,p
Applicant'sAddress: 2;A> - {a*/W Af Ciri,/tiT/Zip: W fgfWn
BusinessPhone; Aa#:{f6- Z-eS7 ceilph.ne: _Zm
Cuntn*t Infirrmatian
Pe:son cr Company doing the demoliticn
Addrcss:City/S"l'lZip:
Busincss Phonc:Ccll ilh,nne:
Dernoli tion kformatian
Properrv Owners: /4 4 4,;3
Site Addres*;
St*rt D*te:Complerion D*ter
Summary of
2
'rhe u's' Environmental Prarection Agency ffiFr\) r*gulttcs the abarement and dispar*l .f a*h*sros-containing matcrials frcm anypublic or PlY"l* building involving d*molition, ,*norotio.r, repai*, c*nstnrctjcn, rnd rnrintenance actir,ities.;sZaski$$.$im
HPA ccrrifies and licenscs asbestos-remsval co*tractors, inspecrs r*hcsto*-nbrtemcnr proiects, and rnforces laws regarding the propcrremoval and disposd of ashestos_conta"in:ing mererials_
curren*ly' HIA *nd l)EQ contract with Industrial Hygien* Resr:urces in fi*rden civ, Id*ho, to rcgulatc asbestos removal ancl disposalprojects in ldaho,
For more information ahorrt nsbcstas ahatem*nt n*cr crisposrr in ldaho, conracrlInrlu*tri*l l-lygien* Rs**urce
206 Murray St
Gnrdcn Ciry ID S3714
208-323-8281
w,+'w"ifl llir*t{ialhy#*.neresourcqs.cnm
I unde rxtand th* EPA req*irements regarding nsbee t*n removal *nd agrce to provide information showingcompliance with the tegulati*Il|Lf#ctre cit-v oT Rc*burg prior to demoli*ion,
Stgrrafurc of Applicanr:
Building Sofely Deportment
REXBURG
Applicant Information
Name:
Applicant's Address:
Business Phone:
Contact Information
Person or Company doing the demolition:
Address:
Business Phone:
Demolition Information
Property Owners:
Site Address:
Start Date:
Summary of what is ing demolished
APPlicatio"r*,?,t-tut"1z-
c czct 1
$25.00 Fee Paid: Yes/No Permit Approved: yes/No
/v*
Cell Phone:
City/ST/Zip:
Cell Phone:
4*-4
dt
Completion
'14
al,a2
The u'S' Envitonmental Protect-ion Agency @'PA) regulates the abatement and disposal of asbestos-containing materials from anypublic ot private building involving demolition, t..rorr"tion, repair, construction, and maintenance actjvitres.http: / /deq.idaho.gov/airlprog issues /pollutants /asbestos.cfm
EPA cetifies and licenses asbestos-removal contractors, inspects asbestos-abatement projects, and enforces laws regarding the properremoval and disposal of asbestos-conta-ining materials.
Currently, EPA and DEQ conftact with Industrial Hygiene Resources in Garden City, Idaho, to regulate asbestos removal and d.isposalpfotects ln ldaho.
For more informatjon about asbestos abatement and disposal in Idaho, contact:
Industdal Hygiene Resource
206 Murray St
Garden City ID 83714
208-323-8287
www.industrialhygieneresources. com
I understand the EPA requirements
compliance with the regulati
regarding asbestos removal and agree to provide information showing
le City ot}glburg prior to demolition.
Signature of
Great Basin Services, Inc
P.O. Box 238
Blackfoot,Idaho 83221
Offrce: 208-785-1767
Cell: 208-681-6462
March-2l-2012
RE: Vacant house located at 155 College, Rexburg, Idaho
To Whom it may concern:
Great Basin Services has removed the asbestos found in the Inspection on this house.
Aprox 40 sq ft of sheet vinyl and 40 sq ft of duct tape on heat ducts in basement. All asbestos
materials removed, were taken to Bannock County landfill. This is an EPA approved landfill
which accepts Asbestos..
Dave Price
U.S.BPA WASTE SHIPiVIBNT RBCORD FOR REGULATED r\SBBSTOS \4/ASTE IVIATERIAL
Il.Q. I'Inznrdour^ Sub.stancc: Solirl N,O.S. (asbcstos): OllM-E NA-g188
1;2'l
13
GENERATOR
rk site nnnre: V/+<r+,,tt ff ur;2 q-
Loctttionr lS5 ci',tir,,r- A"; . Re'nLur'., JiL
i\'lailingAddre.ss: ,G.5 !o,4h .('e'vl'rg, t?"e xbu'!),rL g4Uo'8zas
orvrrcr'sNarrrc: l/j\'U- Ll. / ,'Orvrter'ts Phone:
r's Plrorre: 208-785-17 67
3,,ffiill;il::' ;t:i:it'lf tutt*cris' rNc' cou(ractor I'D' Nr'rbcr: a.,,ai-a1
IILACI(FOO'r, ID 8322I
Contact Pcrson: DAVIi PRICII
\{/nstc D isposul .Si tc (\\,DS) DES'IINA'| ION r
Narnc: BANNOCI( couNTY LANDFILL lvDS l,hnr.re: 208-236-0607
iVlailingArldrcss: 1500 NORTI-I FORT I{AI_L I\,IINE ROAD
I'OCATNLLO,ID 83201
Nnntcnndnddrcssol.rcspprrsi|llcagelrcy('l.rrc:r|'DlstrlctorUl'A0lfccryhcrc<tcrttolit|ott/t'(}ttov|ltlu(bE& /Dlto 6/A A,tl "'9u;/, qnD Nt tr-t.)p {-Jlt - -;;/; oiir
Ntrruber
7. Total:Qubntify
(Cubic Yardg
Descdption of waste materials
Spcciirl }landling Inslnrction.s aud ntklitioual inlbrnratinnl
OPDRATOIITS CERTIFICATION: t l"'"t .i, rtc.tnrc thirl rh!, conrcru$ or'rhi.s consignnrcnr rlcssribc(l nbovc by propcr
shippirrg untttc itnd aru cla.ssil'ictl. pitckr:tl. rttlrkcrl lntl lnbclctt, arrcl ;uc in nll rcspccts in propcr cor Irighwny according to applicllrlcintcrniltionxl lrntl sovcrn111gtr1 rcgulatiorrs. (Otrtain sigu;rtrr.r in ltent l0 bcfore tnking Cold shcct
PAV-E PRICE
l'fln(cu,rtypcd Nfl|l10
sportbi t (Ack nrenf of receipt ol'nratcrials)
Nanrc: GITEAT BASIN SDIt\{CllS, tNC.
Addrcss: IlO. BOX 238 . BLACIffOO'I',ID 832?l
DAVE PitICE ... " ,,.. A_ciltu{Rt'iirrii:iilrypcii i.l-rfi; * ' -*'
t.irtc
Nanre:
Addlcssl
l'rintc0typctl r\anrc
cknorvledgcnrcnt ol' rcccipt of inatciialT
Ilhouc:
) rgriIurc
WASTE DISPOSAL SI'T'B
T,ii":.,i"l1i3:.t
$ tZQ- J'
Dltc tsttnltrfftr
U;lontransfer:orvncr/<4lcrittorrcrlrinsGol,D,.Irlnsportcrr.ct:rirrsI|tNI(,\\,DSrctainsYl'l,I,o\vu<lsr:nt|scolrt1r|u|ud'ffi
U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF IDAHO
NOTIFICATION OF DEMOLITION AND RENOVATION
OPEMTOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPEOFNOTIFICATION: COURTESY x ORIGINAL -REVISED CANCELED
IT. FACILITY DESCRIPTION:
Building Name: Vacant Housc
Address: 155 Collcge Ave
City: Rexburg Stat€: ld Zip Codc 83460-8205 County: Madison
Site Location : all ofhouse
BuildingSize(SquucFcet)1000 flofFloors: landbasement Age in years: aprox 64
Prescnt Usc: Vacant Prior Usc: Residential
III.TYPE OFOPERATION: x DEMO ORDERED DEMO RENOVATION EMERGENCY RENOVATION FIRETRAININC
lV. lsAsbestorPresent? (checkone)Ycs No
V. Faclllty Informrtlon:
OwncrNamc: BYU-ldaho
Addrcss: University Operstions Building # 82, 525 South Center
City: Rcxburg State: ld Zip Code: 83460-8205
Contact: Rulon Nielson Telephone: 208496-2660 Fax:20849G2490
Removal Contractor Namc: Grcat Basln Scnices. Inc Licenser CSR0llSll-02
Addrcss:P. O. Box 238
City:Blackfoot Store: ldoho ZipCode:83221
Contact:Dave Price Telcphone: 208-785-1767 Fax: 208-7854053
Other Operator (demolltlon/general) Unknown Llccnsc:
Address:
Cityl Slatc:Zip Code:
Contsot:Telephone:Fnx:
Vl. Procedurc' Includlng analytlcal mcthods, employed to detect the prcsence of rnd to csllmste the quallty of RACM and Catcgory I and Category ll
non.firble PLM Lsb testlng
Vl l. Approxlmste Amount of Asbcstos Materlals:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Catcgory I Catcgory ll Cstcgory I Cuegory Il
Pipcs (lincar fcct)
Surhcc Area (Squarc fcct sprox 40 sq fl ofshcct vinyl flooring
and aprox 40 sq ft of duct tape
Facility Componcnts (cubic fcet)
VIII. Schedulcd Dgtes Demolltion or Rcnovation: Stan: Unknorvn Complcte:
lV. Dates for Asbestos Rcmovsl (MM/DD/YV) : Mar-t9-2012 Complcle: Mar-20-2012
Doys/WccklMondrylTucsdaylWcdncsday Thursday Friday Saturday Sunday
HrsofOperatlon I garn-5pm I gam.l2noon
X. Descrlption of planned Dcnolltlon or renovallon rvork to be prelormed and method(s) to be employcd, Includlng demolition or renovallon
technlques lo bc used and descrlption of affected facllity componcnts: Rcmovol ofshcct vinyl flooring in bathroom, and duct tape on heat ducts in buement.
Xl. Dcacrlptlonofworkprsctlcesandenglnccringcontrolslobcuscdlocomplylviththcrcquiremcnts,lncludlngasbcstosremovalsndwaslc
handllng cmlslon conlrol procedures: Asbestos abatemenl only, Post area with rvaming signs, limit acccss to public, Shect vinyl flooring lo be rcmoved
using critical banion, negative air inclosure, wct rcmoval methods using hand scrapers, bars, etc. All acm double bagged, labeled, and loaded into and inclosed
trailcr for disposal. Duct tapc will be removed using glove-bag melhods, and cul and wrap mcthods, crilical banion, negative air inclosurc, drop cloths undct work
lrcas. Mosi rvill bc wrappcd with 2 laycrs of6 mill poly and heat vcnt 8nd duct tape disposed as one unit. Both arcas incapsulaled upon completion.
Xll. Waste Transporter #l: ASBESTOS ONLY
Namc: Grcat Basin Services, lnc
Address: P.O. box 238
City: Blackfool Statc: ldaho ZigCode:83221
Contact: Dave Pricc Tclcphone: 208-785-176?Fax208-785'4053
Weste Transporter f2:
Name: N/A
Addrcss:
City:State:Zip Code:
Contact:Tclcphonc:Fax:
Xll. Waste Dlsposal: ASBESTOS ONLY
Namc: Bannock County Landfrll
Addrcss: 1500 North Fort Hall Mine Road
City: Pocatcllo State: ldaho ZipCode: 832fi
Contactl Scale house Telephonc: 208t36.0607 Fax:208.236-0609
XlV. Emergcncy Demolitlon (Completc item XIV and all other sections, only if this projcct is an Emergency Demo)
l. Attsch a copy of the Order to this notice.
2. Namc of Authority lssuing Order:
3. Authority ofOrdcr (Citation of
_xY,
4. DateofOrdcr(MNeDD/YY) DateOrderedr,oBmctgcncy Rcnovrtion (Attsch scparalc shcct with the following information if project is Emcrgency RenovEmcrgcncy Rcnovrtion (Attsch scparalc shcct with the following information if
l. Date and Hour of Emcrgcnce N/A
is Emcrgency Renovation,)
2. Dcscription ofSudden, Uncxpected Event.
3. Explanation of how the even causcd unsafe conditions or cquipment damage or 8n unreasonable financial burden.
XVl. Dcrcription of procedures to bc fotlowed In the event that uncxpected MCM ls found or nonfrlable ACM becomes crumbled, pulverized orreduced to powder.
l!\uaty6re*y'et'down ACM, enclosc area, post wrmings and contain . Stop sprcad of air-born fiber r€leasc.
:ll In the provisions of NESHAPS (40 CFR PART 61, SUBPART M) wlll br on site during ahe dcmolltlon orrcqulred tralnlng has becn accompllshed by thls person rvlll bc nvaltablc durlng normrl buslncss hours.
Datc
Mar-2-2012
Type or Print Namc and Tllle
Dave Price / Orvner Secretary
Xvll. I ac*noivl{agc of laws prohiblling lhe submlsslon of false or mlsleadlng statement$ and I certlfy that fasts conlalned lnthlsand complete.
Slgnature of Owner/Operator Type or Print Namc and Tltlc
Originel Notilication must be moiled or hand delivered at tease ten working dsys (Monday-Friday excluding rveekends) before demolition or renovationbegins, exccpt emergency dcmolition and cmergency renovations which must be submittcd as soon as posibtc beforc operations begin, (Form rcv.j124199
t
091202567
.ii
-.{l€h-.i q !';. '=:ia/'llEEir''
Chain of Custody
Asbestos Lab Services
Pleass prbtejl
ClLrtSeqdcf
i;qffi5;l*,7
EI}ISLAnalyt*=|. lrc.
Snib230
!235 PolvorosaAve
Satr lxan&o,
cA 945n
Phoeic (510) 89F367s (888r4sr367s
Fac (5I0) 895€6E0
hQ//BmR-eBsLcoEr
TotatSaruplcc *--AJ-
r*.3fr1*M-_
,'2-"7'z-E;'(u.**___L_. -!<_
I( ll t I' Al z.-t- tt t'{
t l, /l t( lt /f
fr t( c /( lt tlI5"i
l( ; lr J t( ;
,z'/ I r/JAt't-/ Vt'rtt,, I ',
tt t( t(
I 1t tl
Chato ofCtrtody
A5bc$bs Lab Servnws
t:
i
I
t-
r'qgmffi
EilSLAae!ficrf trc.
Sdb230
?23iiHlwacrAvo
SoIr@&0,
6 %5n
m@610)EgF
367s (888X55367s
FocOI0)E9t:t6E0
@a/r3rv.cusLcoo
TbtolSratscsF-_
, o'.-ohRecefeed:.
t
EMSL Analytical, Inc
2236 Polvorcga Avo , Sulte 231t, San Loandro. CA 945|7
Phone/Fd (510)89$3675/(510)99$3630
hilo:r/srrrw.emgl.com
Attn: DaVe Pfl6e phone: (208) 7Sg.i76z
Great Basln Seruices, Inc. Fo( (208) 785'4053
pO BOX 239 Received: 0zt2$t1z 9:00 AM
Analysis Dale: 2ngnVz
Bfackfoot, lD g3zz1 collecled: 2n7no12
Projecft BYU.IDr l55 Collego Houso
Test Report Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 and/or EpA
600tM4-82-020 Method(s) using polarized Light Microscopy
Non.Agbestog
Roof on garage Gray/Black
Non-Flbrous
Homogeneouo
80% Non-llbrous (olher)
EMSLOrder: 001202587
CustomerlD: GBSV62
CustornerPO:
PrqecflD:
20olo Glass
R{2-Roof
09tm2fitw2
Roof d| S,side
mdn hcuse
Black/Green
Non.Fibrous
Homogeneous
1006 Glass 90% Non.librous (olher)None Detocted
R-03-Roof
091m2&fM
Roof on N.side
maln hdJse
Blaclorcreen
Non-Fibrous
Homogeneous
10% Glass 90% Non.librous (olfier)Nono Detected
R-03-Mastic
091?025f7@tA
Rootm N.side
mdn hcxJse
Black
Non-Flbrous
Homogeneous
I 00% Non-tibrous (other)Nong Dotectod
R-$-Roof
09tm26l@1
Roof on N.slde
maln hqrse
BlacUGreen
Non.Fibrous
Homogen€ous
107o Glass 9006 Non-fi brous (other)None Detect€d
R.05.Root
tN|202fi7q05
Roof on S.slde
main hqJse
BlacUGreen
Non-Flbrous
Homog€neous
15% Glass 85% Non-llbro.rs (other)None Dotoctod
WC-01-Caulk
@12t28t&
Front bydoor Gray/white
Non-Flbrous
Homogeneous
100o/o Non-librous (othe|Nono lletscted
Analyst(s)
Jennita Keeflng (34)Eaojla Ke Labralory Manager
or olher approrcd slgnatory
EMSL msldtsins ilaulty llrnltod to cost ol 8*trir.69poNH|ny|d!ancecd|80qr8ctMugsoralulytcoriano<nmturtoris.rnrorpafons'tdusoatgsi;tduelo-ttrororponliuttityo'0F|8d.p'tdrcl ooi,[cato|l rppmtd, or d1dt tmentty twue, MST w any a9m1 or rhe recorsi so'ror;di' ii;fr;6 *"niqnv bd]nd deir,rr ffiad , ,*m 6rrie .d rh6r^a srrclp.!dJd00n,[catoqrppmtd.ordrd'.'m€nt.q.r].P'N|STwanya9r1o|6oi;i6i,i;;f;i'ffEtlf;ei.;.i#'f#iiF;::i""T;sHf.';;'';;".,fJio:""!t'',
oc0'nm0.tEgra{m'|,|cB6Jcd$D.|ortoana|y5tr.Sorrptesrocotttoiigod'co'di$6unr6sgotr'eri'iiondoi''tiumarooaca,rac1'pfeb|on8'|du'lcs
6$adod Dy u.dl6nt hlldlnomstollst! msnrtactueovit0r mutupo topt li.o. nncoum, *irrmorJ. iiij lilrifr-.o or e srngtu ,"rp6. lbno ootoctod E <rrtssfipbr sratvEd bv EMst Ansly4lcst. tnc s8n !o6ndm, cA NMlp L8b co{b tor(X0.i itA AA@(r201. WA C2oO7
Tesl Report PLI+7.23.0 Prlnted:3/1n012 9:49:07 AM
EMSL Analytical, Inc
2235 Pohorosa Av6 , Sulto 230, San Losndro, CA 945'77
Phone/Foc (510) 89$3075 / (510) E95.36E0
htlo:/rww\r.emsl.com
Ann: DaVe Pfige Phone: (208) 78$1767
Great Basin Services, Inc. Fax (208) 78540s3
pO BOX 23g Received: 02nu12 9:00AM
Analysie Date: zngnwz
Btackfoot, lD g322i collected: ?,27n012
P.o,e6{ BYU.ID, 165 Collego Houoe
Test Reporfi Asbestos Analysis of Bulk Materials via EPA 600rR-93/115 and/or EPA
600rM4-82-020 Method(s) using Polarized Light Mlcroscopy
EMSLOrder: 091202567
CustomorlDi GBSV62
CustomerPo:
ProlectlD:
Non-Asbgstog
WC-01-Nlasdc
09t2u87MA
Yellov
Nofl-Fibrous
Homogeneous
100% Non-fibrous (olher)Front bydoor
WC-02-Ceulk
Nl?o287@7
2nd floor Gray/White
Non-Flbrous
Hqnogeneous
100% Non-librous (olher)Nons Dstsctsd
WC.02-lilastic
091t2fi14wA
2nd floor Yellor',
Non-Flbrous
Homogeneous
1 007o Non-fi brous (other)None ltotoctod
SV-Ol-SheetMnyl latfloor
09t2u256f&8
Gray/WhitefYellofl
Non.Fibrous
Hornogeneous
5% Celluloee 6570 Non-fi brous (olher)30% Chryeotlle
SV.o1.Masllc
09tzutfi7MA
lst floo.Black
Non-Flbrous
Homogeneous
100% Non-fibrous (other)Nono Dotectsd
SV-02-SheetVinyl 2ndfloor
0912t2fif4@
Brorrrn/GraU/Plnk
Non-Flbrous
Homogeneous
30% Cellulose 70% Non-llbrous (olher)None Dotsctod
SV-02-ltiaslic
Ntm2s7a09A
2nd floor Broryn
Non-Fibrous
Homogeneous
1 0006 Nonfibrous (oth€r)None Dotocted
Analysl(s)
Jenniler Keeling (34)Baojia Ke, Labcatory Msnager
or fier approved gignalory
EMsLm8la|sh'|i8u|ity[nitodtocogto'an8lys|t..n!!cpo.t'elatu.ontytor!Pr,'pctPoncu|i|''orr8'nc.cd|6!on8c{t.|tier68n8tytlc8tm'€thodtim|t8Uo6s.tntelpraitonairouseutosrlilsdrs;;hor83Po(|!ibi|ilyo||d
ffi"f.$j$ffiffi;'#Sifj3}:l,Iff'.i$H-lg:l'*g'*j*f3ltrg:*":{*F{i::rslrj'tery-l'{slqib;4-Jp.r"".r,r,",,o,ho'"ro'EMsL['wtsrM!q|t.pPrm.or€nqo'aom0nl!''iIvLAP.l'[sTor8Iryo9encyottho..ed6r8tgo\6rinont.Ndit|8!|ootgElliattyuouircmatortaigplosint-fpriuem'&d|m!ndlerr{n9|r|o.€d,d|mpdof.to8na!L']!:9qne!P"99tvootigodlmnarmun6iidi;6oir;j.Ei]rmirooaq;urscy.plelllonaf.lqtl|lod by lho clleil hdldhgtflst9|lslr msrtrifactur€dilth murupto rays-6 0.e. ilndoum;tntd.*i;;i;j;;;ifrio ai o rrngloiftiru. G,ii ci-tecii;L "r*SEfipler anslyrad by EMsLArElyricst, hc son Losndo, cA NVup Lsb co{te toto4E3. MA AAoooaol. wA c2oo7
T€st Reporl PLirt7.23.0 P.lnted: 3/1/2012 9jg:07 AM
EMSL Analytical, Inc
2235 Polvorosa Ave , Sulto 230, San Leandro, CA 94577
PhonelFax: (510) 895-3675 / (510) 895-3680
hllo://wwv.omsl.com
Attn: DaVe Pfice phone: (208) Z85-1767
Great Basin Services, lnc. Fax: (208) 7854053
pO BOX 239 Received: 02|2BhZ9:00AM
AnalysisDate: 212912012
Blackfoot, lD g3zz1 collected: 2t27t201?
Proiect: BYU.ID / 155 Collego House
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-931116 and/or EPA
6001M4-82-020 Method(s) using Polarized Light Microscopy
EMSL Order: 091202567
CuslomerlD: GBSV62
CuslomerPO:
ProjecllD:
Asbostos
% Tvos
Non-Asbostos
Samplg Ooscrlptlon Appoaranco yo Flbrous % Non-Flbrous
SV-O2-TarFelt 2ndfloor
0912u567{,A9B
Black
Fibrous
Homogeneous
B0% Cellulose 20% Non-librous (otheo Nono Dotoctod
WP-o1-Plaster
09t202567.&10
Bedroom #1 Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)Nons Dstocted
WP-01-Skim Coat Bedroom #1
09t202567410A
White
Non.Fibrous
Homogeneous
1 00o/o Non-fibrous (otheo Nono Dotoctod
WP-02-Plaster
091242567&tt
Living room by
fireplace
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)Nono Dotocted
WP-o2-Skim Coat Living room by
ort2o2s6t.@t1A fireplace
White
Non.Fibrous
Homogeneous
100% Nonjibrous (othe4 None Dot€cted
WP-03-Plaster
0912025674o12
Bedroom #2
upstairs
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (olheo Nono Detoctod
WP-o3-Skim Coat Bedroom #2
ostzo2s67.@rz[ upslairs
White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)Nono Ootocted
Analyst(s)
Jennifer Keeling (34)Baojia Ke, Laboatory Manager
or other approved signatory
EMsLmain|ain8|i6u|ity|imitedlocostorana|ysis.ThiscPtriro|at8sonlyto|hosamp|os'cpo'1ed8ndmaynolb0lcploduced.eE!p|itlfuL.wilhor,l9'irrunffi
ptod]clcani[gum'0pp|ow|.ofcndorseme||!y.NvLAP'NlSToranyogsncyoflhe'edo'a|0owrmenl.Nonilab|ooi9a
(fmmerds grarlmolJic r€dudim pdoflo areqmstodb,lhocllenl,buildhgm8terittsmorufac{uredwrlhmulliplolaya;s(i.e. lindoum,wa[board.olc.]are,opoiro,rasas'ngrosample t]cnoDstected=<.|y6
somplos ao6lyzod by EMsL Amryricar. Inc son Loondro. cA NVLAP Lob cods 10to,tB-J, MA M\ooozoj. wA c2007
Tesl Reporl PLM-7.23.0 Printed: 3/1/2012 g:49:07 AM
EMSL Analytical, lnc
2235 Polvorosa Avo, Sulto 230, San Loandro, CA 9.1577
Phone/Fu (510) 89$3675, (510) 89t3880
htlo:nwsw.€msl.com
Non-Asbostog
Sompl9 Dogcrlptlon Appearance clo Flbrous of Non.Flbrous
Attn: DaVe Pfige Phone: (208) 78$1767
Great Basln Servlces, Inc. Far (208) 78$4053
pO BOX 239 Received: o2nu12 9:00AM
AnalpisDato: 212512012
Bfackfoot, lD g3221 collected: ?i27,2012
Projed: BYU-ID, 155 College House
Test Report Asbestos Analysis of Bulk Materials via EPA 600rR-93t116 and/or EPA
600/M4-82-020 Method(s) uslng Polarized Llght Mlcroscopy
EMSLOrder: 091202567
CuslomerlD: GBSV62
CustomerPO:
ProjectlD:
Asb€8tos
% Tvoo
WP.&.Plashr
09t202&7Q13
Bedroom#3
upstalrs Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None t,ttsctod
WP-&€KmCoal Bedroom#3
ostm?nr{/tg upslairs
White
Non-Fibrous
Homogsneous
100% Non-librous (other)Nong Dotoctsd
CP-02-Plaster
091m256/414
Dlning room Gray
Non-Flbrous
Homogeneous
1 0070 Non-tibrous (olher)Nono Dotectod
CP-o2-Sktn Coat Dinlng roonr
@l2026tat1A
Whits
Non-Flbrous
Homog€neous
1000/6 Non-flbrous (other)Nons Dolectod
CP-o&Plaster
09rm2sla15
Be<lroom#2
upstahs
Gray
Non-Fibrous
Hfirogeneous
100% Non-tibrous (olher)None Detoct€d
CP.03-Sktncost B€droomf2
ogt'olfft{x/r'A uPstairs
Whit€
Non-Fibrous
Homogeneous
100016 Non-fibrous (olhsr)None Detectod
CP-0+Plaster
@tt2874na
Hallway upstalrs Gray
Non-Flbrous
Homogeneous
1 007o Non-librotts (olher)None llotoctod
Analyst(s)
JenniterKeenng p4)Bsojia Ko. Labcatory Manager
or olher aPpfoied slgnalory
ElitsLmgint8|N|igu!|yllmltdioco3tdsn8|y!|'.-Ttl3BPoft'9t8t€son|ytooteE8mp|srEpofted8ndm8'ndb8BP'od/cod.o}cgptinf!,sitholJtwno
B'po'Flu|lu.'q8ndecd|G!on8diudororm8lytbr|mdhod|im|t,8uois,trrrtcpai{onaircusocrtcatri:rltsoninererpoirlioitii7o|'dg!dJdcotti|tc8Uc|'sp9F,6.oJaxbcdnont!y.Nvl.AP,NlsToio'|y89q'EIo'the|edsr8|!o!grmont.Nootirb|eorBd;dtyborliromatel|a|s
.!€omm0nd8.galm0|,|c'g6Jcd€'|p'|orl08n8|y!lr.somp|$f9co|wd|ngoodcornfiounl6$o6sN|tomtoo.esumatedocirracy,poc!l|orranourd
tEqEttod by lho db.n hdldno matstlslr msidactuod wlh muttlpte taye- 11.e. tinceum, wdtDo8rd. otc.) Iro Bporlod o! a ltr|gto rninite. mm oao<feO. <if6
sEnph! 6n8lr.8d ry EMsl Ardydcst, tnc s8n Losndro, cANvLAp Lsbcodo 101048n, MA Mo@201. wAc2ooT
lnitlal report lrom 0310112012 09:49:07
Tesl Repod PLM-7.23.0 Printed:3/1/2012 9:49:07 AM
EMSL Analytical, Inc
2236 Polvoros! Ave . Sulte 230, San Loandro, CA 945'7
Phone/Fax (510)89S3675/(510)895.3680
hllp:rr$^r/sr.sm sl.com sanleandrolab{Oemsl.com
Aun: DaVe PfiCe phone: (2oB) 7A$1767
Great Basln Services, lnc. Fot: (208) 78$'4053
pO BOX 23g Received: 0ZnUlZ 9:00AM
Anal)6isDate: 212912012
Blackfoot, aD ggzzl collec{ed: 2t27nu2
ProJect BYU.ID, 155 College Houee
Test Report: Asbestos Analysis of Bulk Materials via EPA 600rR-93/116 andlor EPA
600rM4-82-020 Method(s) using potarized Light Microscopy
EMSLOrder: 091202567
CustomerlD: GBSV6-2
CustomerPO:
Pr{ecUD:
Asbostos
c/" Tvne
Non.Asbostoe
Sample Doscrlptlon Appearanco elo Flbrous 06 Non-Flbrous
CP-0+Skbnooat Hallwayupstalrs Whlte 1 007o Non-fibrous {olher)None Dotoctod
0912w5/i7416d Non-Flbrous
Homogen€ous
lNS4l-lnsulalion 2ndfloorcelling
09rm2 7alf
gro$rn
Fibrou8
Homogeneous
987o Min. Wool 2oA Non-tibrous (other)None Dotocted
lNS42-lnsulallon 2ndfloorwalt
091Nzfi7o10
Gray
Flbrous
Homogeneous
100% Cellulose 0% Non-fibrous (other)None Detocted
lNs-03
091202'f7019
Chlmney Gray
Flbrous
Homog€neous
75% Min. Wool 25% Non-fibrous (olher)None Dotoctsd
WDW-Ol-DryYrall Mahnofr
oslmz&7ea balhroornwall
Brown/White
Non-Flbrous
Homogeneous
15% Celtulose 85% Non-llbrous (other)Nono llatected
DT{1-Duc.t Tape Basem€nt heat
ogtzngf,Td,2t ducts
Gray/Whlle
Flbrous
Homogeneous
20% Non.fibrous (olher)80% Chrysoulo
Analyst(s)
JenniferKeetng (34)Baciia Ke, Labcatory Managa
or olher appro\red slgnatory
EMsLm8|nl8h|||6b||ity0mnGd-tocogto|8n8tyst'.Ixs.GPqtrl9tq6onl'to|h€s8mPlosFpo'reoi*'naynaoooprooucoo.ereptlntt,l.witnorltwttten8ppoB|byEMsL|€3po6ibui|ylo.r8mcocd|e!sacdut|$or5mtyt|cs|mdhodumttatons'tnerpctdion8,|dtRoottost6'!t1snthsBPonriblt|tyo'0Dct|onLp|odldC8'ffc8uoqoppaoE|.of€'xbfEgignt!y.NvuP.N|sTo's|'€9€nc'o'|he|6derar9o'ernorentN;f'&|6;'ls'1ai''6i;d;Gf;iiprootemmeuxam
Ec0mmg6t-e'atn0l,bt€djC!mFo.ros,|8lFls's8mptott6cohddtngodocorrotumurisso0B^v|aenobd'Estmiteoacimcy,pcbrmd|du1E€ltsinty(t|l|ob|.
rlqltt6d bythc dl.d' hddngmslod8ls n8rU'8ctured wlh mulupto l8y8a (Lo. tindoun, wsllbooro. ac.l ao reporrooat a ornde r6iit'pto. Nofto orredo;= .t%
s8flplo! snslrrod !y EMSL Ansty{'c81. tf|c s8n Lasndro. cA NvLAp L8b codo 1oto4&3. MA AAOO2ot. WA C2oO7
Test Report PLM-7.23.0 Pdnted:3/120i2 9:49:07 AM
4
THIS IS THE LAST PAGE OF THE REPORT.
Building $nf*ly ilepartmenl
/F,f Co/?*
cltY(lr"
J#N ftre
Rexburg, D BJ4{O
Clty of Rexburg
Fhon€: 2AA3!2,2526
Fax: 208.3Sg.S0II
REXfiURG" {\.'
A tneriu\ Ik uilll Crt rnnt u n rtyiYtryw.texbu.g,grg
Applicant Informafion
Application for Dernoli tion
Perrnir #: /"$ d{i#? H '
$2i.lr0 Frec paid: ffelNo t,"r*t. apf.o,r**tffiJill-
susin**s Fhon*: ep$ *f?6 -.4-ry Ceil ?honc: ^A;Z;;-ffi
Contast Inf+rmatian
Person or Company d*ing:he dsm*litior::
Addtcss:Ciry/ST/Zip,
fiusiness Phonr:Cell Ph*ne:
Demolition In formation
Propcrty Owners:
Start Datel
Surnmary of what is denrciirhed
Complcri*n f)are:
;,H{,i;#ff tffi ffi ilf ',*.*fr :n#:*Hffi n$THr,ffi ::,T;r#*HJ:ffi ,trngma,eriatsfromanyhrm;/./dec.idahn o^.'/"ill^-^^ :--I--- ,- ,, '
*l*,T*'J-*;Tlru;m||ilT;Tf;ffi1ffiffif:-'i*spects asbe*t*s'rbrtemenr pr$io{*$, and enfsrces laws regarding rhe proper
currcndv' EPA and D['Q coner** u'ith Industriel Hygi*ne Resourc*s in cart]rn ciry, rcrah*, r' r*gulnte asbesros rcmo'al and crisp*salproiects in ldaho.
For more information about rstr*sros abarement and di*poser in ldaho, conracr:lndus erial l{ygi*ne Resource
206 il'lurr*y St
Gnrdrn Ciry ID 8l7t4
?08-323-8287
wrr'lv,industrjalhy{riqnsr*qqurces, corr:
f anderutand the EpA requiremenrs
compliance with the re
uli
Site,{cldress:
Signarure of Applicant;
rcgarding ash*ntos r"_f ::"13"d tF:** tn provide information showingtr City uf R*grutg prior r* demalition.
35N fdg
Rexburg" lD831t0
//7 6//7rr
LrtY{flf,ity of ftexburg
Phone: 2il8.372.2326
Fo* 20S"3J0.J022
FGXBURG
{\r -
.,1m rricai j.irDrih, Cornf rilrr!ty
3uilding $afety Deporlmenf
www.rgrfovrg"#ag
Appli cation for llemoli tion
Petmir #l
$?5.ff0 F'*r Paid:c) Pemit Approved:
Applicant Information
Applicant'sAddress: # fu.b 6/ Ciry/ST
Business v,u"u, -fuf -#4 *,26J7 CeilIlhonr: kffi
Contnct Information
Person or Comp*ny doing rhc demolirj*n
Addtess:Ciry/#T/Zip:
Business Phone:C*ll Phoae:
Demslition Information
Summary of what is be.ing dcmolished
'ITre u's" Enrrironmcntnl Prr:tc-ctron Agency (1lPA) regulates the abaremrnt and di*pa*nl of asbusr*s-con1a*ri*g ma:*rinls fram any
fl*Tr";t::::t^b-ud$nsinvolving dernolitioa, renov*ri{rn, rcpai"r, consr*rction, and rna"intenanc* ncrivi'rs.
EPA certifies and licenses asbestos-remcrrn"l conrractors, inspects asbestos-abatement praiects, and enfi:rces lnws regarding thc properremoval and disposal of asbc*:os*cantaining mnt{rials.
currently' E'PA tnd DEQ conaact 'r"irh lndustrial Hvgienc H"*s*urces in Gar*en ciry, Idaho, tc regr:le{* ashssros remar,*l and disp*salprolects in ldaho.
Fsr mnrc informrrion nbour asbest.,s ahaf*ment and disposar in rdahr:, c.,nfaf,r:Indusrrial Hygr*ne Resource
?06 Muray St
Gardcn Ciry ID 837la
208-3?3-S287
wwrr-indust'ialhr gieneresourfes.com
I understand the EPA r*quirements regarding frsbestos rcmoval and ag*ee tn provide information showingc*mpliance with thc regurarions,fglfuilcirv niRexburg pri*r ta dcm*rition,
Sign**ur* of .AppLlcanr:
/"s {-o//#"e
Building Safety Depclrtment
Cl'ty of Rexburg
Pfloner 208.iru.1i26
farr 208.ii9.J012
Application for Demoliti*n
F*rmit #:d#q4
625.00 Fee Paid:o Permir
rIi.0"f
REXBURG
llmcrira! ha*i\, Oentnunily
Appticant Informatian
N*m*r
.45
Susincs* phone' ZOB -4f& * Ac
www.rexCrurg. org
-/"'- 5fte/ciq..,sr,/Zip. Ecrl g,_ ^f48.
Citp/$ I/Zlp:
/No
B#e
Contact Information
Person or Campany dorrg rhe demolirinn:
Addrcss:
BusinessPhone;Ceil Phone:
Demoli tion Inform ntion
Property Owners:
$ite Address:
Start l)*te:
Summary of what is being cl*molished:
iH.4;
?he u'$' Environmental Protection fu*"1r (EPA) regu.lat** thn ab*r*ment and disposal of asbestos-*r:fl{finrng mareri*ls from anyfli;;*::;::1*..*lf:"*ing de;orrio,', ,*,,o,i,ion,,.d,;;;.*,, ,"a main(c{,irn{e activiues.
:H;ilflT$:ffi*rffi*:::Jtr1,*mm:s, inspects asb*stos-abatem*nt projccts, a*cr enrcrces raws rcg",rrding the proper
curr**tly' IFA tnd DEQ conuact with lndust'rial Ht'srene .]tcsnurces in (inrdcn ciry, rdrho, ro regulnre a*lrcsros removal ancl disp*salprot€crs in ldaho.
For morc infamra*on abouf asbestos ni:rt*rnenr and rjisposal in ldaho, conra*:lnrJusrial Hvgiene Resonrce
206 l\{urrry St
Garden Citv ID 83714
20s"3?3-lJ2fi?
wrvw.urdus trialhygiene respurcrs,com
I under*tand ttre HFA requir*menfc
compliance with the regulatioggror
regatding ncbcut*s rernoval and agree to provide'" qi.]' of Rexburg prior to demolltion. '
Applicanr's Address:Ciry ST/7.ip ,r#*
Compl*tion Dare:
Signalurc of Applicanr:
information showing
Building Scfely Depcrtmenf
lfT C*/$r #t-,
iltlY ()t.
REXBURG
e\,
,4 mt ria\ lkrniJr, (i*rnrurrr rrrtl
3JN I'f
R*xhu|g. aO dJ440
Cliy of R*xburg
Pho*e: 20t.J7?,2386
Foxr t0B.i.S9.JSl2www.rs.{burg_org
Applic*tion fior Demolition
Applicant In
N*me:6 -#A
Applicant's Addruss:
Busincss Phone:7-{,fri7 crn r}hone:
#92++
Contact Informadan
Person or Company *oing the dcmolitir.r*:
.4,ddress;
Business Phone:
Ci*yl$VZipr
Cell Fhonc:
Demolitian In f,orm aticn
Prop*rry Clwnersr 5*e$ite ,tddrrss:
$tnrt D*te:Compie rion Dare:
Summary of what is hei*g demolishccl:
The u's' Environmental
l:-t-:,:-t." lg.t:{ {EPA) rcgrtares rhe abaremenr nnd disposal .,f ashesros-c*r[,iT r ll#: ]Yff : T:ji* :: n::*:.*ru;Hil::;T' IH::, Til"#' :H:1T:Hlt m n g ma'le ria'Is rro m a nv
,1Hil..JT*lliffi:il'-*:::.,'J#:HH,:fi['s, inspecrs asbesros-atratemenr prajc*s, and enrorces rarvs reg3rdir:s the proper
curteody' E'A and DEQ c**trnct with Industrial I l1,gi*ne Rcssurcrs in Ga:den ci*y, Idaho, ro r€gulnr* asbesros rcmoval rnd disr:*sxrpr*iects in ldahc.
F.,r morc informatinn nbout asbesr** a,arcment anrJ dispesnr in idnho, cofitacr:I ndustrial l{ygiene Rcsnurc*
206 N{urray St
Garden Ciry ID B3Tla
208-3?3-8?S?
www.indus kialhFgien#rcsqurces.cqm
Pcrm* #: /#F #d!} ry F
$25.00 tree fria,
f understand the HpA requirementscompliance with the regulatiors_tn_r
$ignatu:e of Applicanr:
'#'f :f ;:5:1T ;;Tffi
';1;eff e .to prcv i de i n ro rm a ri o n s h owi n g
7t *aY 4(4 b*r,4
Butlding $ufety9epnrtmenr
Clty af Rexburg c:]',y (Jtr
Phone: 2A8J72.232d
fflxi 20S..3i?.30??
Application for Demolition
ilcrmit #:
Applicantlnformation
Name:
Applicant's Addtess
Busincss Phone: Z4
Contact Informadon
P*r*on *r Cornp*ny doing rhe dem$:.irrun
Addrcssr
Susiness Phone:
Demolition Inform ation
Propcrty ()wrrers:
Sire Addr*ss:
Star Daie:
$25.00 frce Paid: yss,/No Permit Approved: yes/No
.{4i,
Ciri./5iT/Zip;
Cell llhone: Z-Pf-.,L-pt * i6 SO "
ilitl'/li'f/?ip
CelI Ph*a*:
//*-
/+d" ;r;ry*+
Itr-i,i,Hffi Tffi tri|,i4t:*p6s3ilruff Tff lT::;il:il j,*,J#,:lT.T;H:,X,rngma,eria'sfromany
:HiillJT$1lru:XT;::."'iilf*il,ffiots, inspects asrrcsros arratemenr prcircts, and cnror*s laws regarding rhr proper
currendy' EPA and I)HQ contrncr with Indus*ial Ilygj*rre Resourcss in Garden {)ir1,, rdaho, tcr *cgulate asbestos rem'val *nd tlisposalprujecrs irr ldah*.
Fr:r mcre informntion about asbcst*s nbarr:m*nt and disp*sal in l**ho, contacr:I ndustrial Hygieae Res*urce
2t)6 N{urray Sr
fiarden Ciry lD 8371420fi- 3?3-8r*?
www..indus trirthyf,irne{n**rurF*+.cem
:#ffiff :: *H 3:*"T;Hffi il:%#f fi :iffi il:A: :J [ffi ffi e ro p ravid e i n ro,m atic n s h owi n g
$ignnrure of Applicant
ry^Y {a/y"
crTY {)l:
11/Ww.fexburg.otg
Clty of Xexburg
fl1#ns: ZfiA.St2-2326
faxr 20$.Ji9.i0l?
REXBURG(\'
Am $ c*'t I;anri$ (:u ilrtnun i r.
Suilding Safety Depurtmenl
35tJ tFf
fioxborg. lD AJ4t0
Applicant Infarmation
Application for Oemoli tion
Perrrut fl: /e 4 i pq -L
faS.OO f*.
fs#
Contact Infotmation
Person or Company doing the dernr:liti*n:
Add*ess:Ciry/$'l7Zip:
Business Phone:Ccll ilhone:
Demoliti*n Informafon
Properry ()wners:
Sire Address:
Start Date;Campletioa Date:
$urnmary r:f whar is being <iemoli*hed:
ff{i,x-m:;p", .*pqrs:tfiru:il--;l;J3Tffi :,*:'*f*-#.T:ffirnsma,cria,sfr*marrv
:H"TilffTfotlilTrilH:ff,ffi"$ffif:,:::*-inspecm asbesros-aha**menr projecrs, and rnr*rces raws regarding:he proper
currcrrtly' HPA and DHQ contract with Inclrrstrial H,vgicnc Resources in Garden f,i*y, Idahu, to r*g*late asbesros removar and d"isocsarprnj*cts in ldaho.
IFor mr:re informntion about asbesto$ abatqmcnt a*d dsposal i' reraho, c(rfifacr:lndrrs*ial l.Iygicnc Rcsourcc
?Od i\{urrny $r
Gard*n Ci*y ID SJ?14
208-323-8?87
www. industrialhygif ncres<,+rces.co{n
lXi;::::'JH n:U."Tfr:Hil:%ffif f;::;T#;;Tffi::X;fl;;e,c providc i*,rorme,ion shawing
Sfu,rnarure o f A pplicant:
&f;Pr/
Building Sofety Deportment
Phone: 208.372.2326
fox: 208.359.3022
REXBURG
Application for Demolition
Permit #:
$25.00 Fee Paid: Yes/No Permit Approved: Yes,/No
'/./7 J>Aa
; rs/*o
6/3 a
City/ST/Zip:
Cell Phone:
5;a
Applicant Information
Name:
Contact Information
Person or Company doing the demolition:
Address:
Business Phone:
Demolition Infiorm ation
Property Owners:
Site Address:
Start Date:
The u'S' Environmental Protection Agency @'PA) regulates the abatement and d.isposal of asbestos-containing materials from anypublic ot private building involving demolition, renovation, repait, construction, and maintenance activitjes.http: / /deg.idaho.gov/airlprog issues/pollutants /asbestos.cfm
EPA certifies and licenses asbestos-removal contractors, irispects asbestos-abatement projects, and enforces laws regarding the properremoval and disposal of asbestos-containing materials.
Currently, EPA and DEQ contact with Industrial Hygiene Resources in Garden ciry, Idaho, to regulate asbesros removal and disposalprolects ln ldaho.
For more information about asbestos abatement and disposal in Idaho, contact:Industrial Hygiene Resource
206 Murray St
Garden CiqID 83714
208-323-8287
www.industrialh)rgieneresources. com
Summary of what is
r undetstand the EPA requirements tegarding asbestos removal and agtee to provide information showingcompliance with the regglarie*erattr e city 5fftxburs+ffr to demolition.
t
Presented to
John Reed/ BYU-Idaho
Feb-3-2012
Vacant house located at24East,l't South, Rexburg,Idaho
Presented by:
Great Basin Services, Inc
Blackfoot, Idaho
208-785-1767
Dave Price, Inspector
Certificate # BIROI 1 I 812-3 I
Introduction
On Jan-25-20I2 , accredited AHERA Inspector Dave Price of Great Basin Servicespreformed an Asbestos inspection on the vacant house at 34 East 1't South, Rexburg, Idaho. Thisinspection was requested by John Reed. This survey was conducted to facilitate the futureDemolition of this structure. This inspection, on a residential house is not required by EpA,however local landfills will not accept materials from house demos that have not been inspectedfor Asbestos. They require that no Asbestos be present in the demo materials that they accept.
Background
The house is is approximately 60 - 70 years old and has been remodeled and added on toseveral times. It is cumently vacant. It is a 2 level structure, with a partial basement, The total
sq ft of the house is aprox 1800 on the main with 600 in the basement. The house has wood
framed walls with wood/metal siding on the outside. On the inside there is some drywall, somestucco, some fiberboard and some ceiling tiles. There is drywall with texture on the ceilings in
most rooms on the main floor.. The roof had the old shingles removed and new wafferboard
metal roofing over that. The only wall/attic insulation found was Fiberglass. There was no floorinsulation found. No boiler or piping insulation was found. .
Sampling
Dave Price, accredited AHERA inspector collected 19 samples of suspect Asbestos
Containing Material (ACM). These were broke down into a total of 3S ,.purut" materials, thatwere tested. 1 sample came back as containing Asbestos Materials. ( meining they are morethan I%o asbestos) In this sampling scheme, sampling locations and number oisamples wereselected so that they were representive of the homogeneous sampling areas with regard to the
material present and it's potential asbestos content. The sampling gh.*. was designed to becomprehensive and intended to identify ACM that might be disturbed during Demolition/
Renovation activities.
ACM ,under current regulation, is defined as material with an asbestos content lo/o orgreater by volume. Any sample analyzedby "polaized light microscopy" ( pLM) method ascontaining attace to less than I\Yo asbestos must be re-analyzed," by point count method,, ormust be assumed, to be ACM.. All samples were shipped to and analyzedby EMSL Analytical,San Leandro, California. EMSL is a AIHA accredited lab and pafticipate initre NVLApprogram. The materials were sampled for the pu{pose of identifuing possible Asbestos
containing materials, that would need to be removed, before Demolition of this building. Thissurvey can be used, to satisff EPA and OSHA regulation requirements for renovation and/ordemolition activities. see drawings for building layout and sample locations.
Conclusions and Recommendations:
The following identifies the material, location, approx. quantity and condition of all materialsidentified as containing asbestos. Out of 35 separate materials sampled, I samples were foundto contain, 1 percent, or more, asbestos. This sample is CP-0l-Skim Coat. This sample wasseparated from the original sample, CP-01 Plaster. It is the top skim coat finish. A more strigentand expensive type of lab analysis, called EPA 400 Point Count sampling method, *u, ,"qu.rt.dfor this material. The sample came back at <3ohAsbestos and therefoie is considered anAsbestos containing material as per EpA regulations.
This material will need to be removed prior to demo.
concerns for owners and/ or Demolition contractors:
Laboratory Results
ffiturzfl
Asbestos Lab Senrices
Please print all informatioo l9gibty.
srrykt Yo. rfl hdcd tr *r rr rrttortrdor &rn L' **.5a3{1s
'12 Loc:(G,lrtlrclt lt$Or.!. ffti-tti}, n:*e n*rb tr*Geo{c
091201207
t
r".,.ir,*Bt.d:. rr. !--r:.1
r -:,sit ltr'' Ir:';'
Chain of Custody EtltSLAmlyticaf lncguire 230
2235 Polvoroea Ave
San ["€andro,
cA 945n
Phme (510) 895-
5675 (8t8)455-367s
Fax: (510) E95-3680
htg://rrrvw.cosLcom
ConryE: GrcatBasin$yiceg tnc B&7o: @BasiaSeryiccs,lnc
iddrawt: P.O. Box238;Ad&wI: P-o.Bo(23E
4ddrssZ:Ad*qt2:
:lty, State: Btacif,oot, Idaho City, $ue: Bhckfoot ldalro
?$PostCdc: $nl ZlPorCde:83?31
lowrfiV: usa Counlqt: usa
?ontadNste Devehie Atta; Daw Price
ohone:20L785-t767 Phorc: m&"785-1767
.8;Fs:
1tnall:gEl767@Sliraitcos EnaII: gbsl76'I@brraitom
E*ISLg4:P.O- Nuntb
Tol4NwNnnbs: A(-td- Hasto@ 34r trE -SA,r(1" U.;E; f
IT'ATRIX fiIRNAROT'ND
l- lir f- soll l- *r*o-vec l- 3Bours l- otlorrs l- geoeD:.y
or 12 llours*
l- 24 Hours
(l day)
7""*I- oriu*ing
lVrter
l- lE Hours
(Zdays)
lVrz Hoor"
I tsorpl
l- 96 Hoars
(4 daf's)
J- lzo Hours
(5 days)
l- wipc l- Wastetrster f tg+bours(6t0da3rs)
AIft': t E*, forrtt' Flclrl Et rb.rd ttsfcddc- Ttcn E I grtobu
lg. Yor rfl bcdcd 6 dn rr rrdor&r&r &o la r|rlrc'n-art,d€rec c$ lS0-Zl0.tCtS 6{i1licc F lrr ro,leodiu:
:Atr TEMAIT TEI1{_W-ATFBl-- wtosg 7{D(A} rq,or Aqust ree+ r AHERA 40 CF& pafr 763 subparr E i- epn too.l
l- ost{A wTWA T Ntosg 7402 f' EpA t00-z
[- Otber: t- EPA Levet It r- ]fyS tSA:
--.Bttlk TEld-EIILf IEM_I4ieforaeAl|i€e .
EPA6fi)/R-93/ll6 lDropMurrt(Qualitadve) TASTMD5755-95rq,'osriwm,shxJl
EPA Point Count [- Ctretfietd SOP - l9SS4 i- Wp" eualftative
f- Ny st-augcd Point count f- reM NoB (Grzvimetric)Nys t98.4
f PLM NOB (6ravimcric)NY$ 198.1 i- Elvl$L SrandardAddhioo: Xep
i- Nlostt gooz: l- Asbcs*os
f- gN{Sl. $tandard Addition: PLlt[Ssi! i- Sitica NIOSH 7s00
I- q'ualitative T EPA Protocol Quartitarive gflt-EB
r_ i ---l- gUSl MSD 9000 Metlrcdriuersrrncr T
4r6rzaa7
'i'-"'a (z*
http JlrJ',umr,ernsl.com/COC
oe12o;o7re
,
.'Ja--*+*h--,!&r.i'-_:jri'i*€€P.'
Cftafu of Cu$tody
Asb6to$ I-ab Services
" -/,47c11f
fu<
,raLL +frr4*"
'lx s*e;re,
Ptcaseprintallffi
C4runxv
EMSLAnalytft:al' lrc-
Suib230
!2?5 FolvorosaAve
SaL@&qcA 945n
Pbors(510)89.F
36?s (W)1sU3675
Fa'cBl0)E95€660
Etto:/rtnr.etslcoa
ToEIssEl€* /q'-w-
ro,.*3|0O-&-
Tlas 7 !.-*a?
It lt . ^-J-,^- !
It t t
| ( t(
cDU-o1
htF//i,r,tttw QrzTnaa6
091201207 ' .'
'rai.f.,h'.ri$friti
C&afu of Custody
Asbestoe Lab Services
LL
c4wtTfP
EMSLAnebrlicel, |rc.
$dtB230
32?5FolvoreAve
SaLca&o,cA vrsn
Ptdc(5t0)895-
3675 (W)1sr367s
Fbc (510)895-3660
e@:/r?rr.gnrtcoa
Tbe
Ths
SA}'PI.8NI'I|EN ;SA|AT,ED
k)OtilzDI
t-:
Otlt/atL .{)p.r,,,n / I R,utnr.r* La'^J,
tLrDu) -A7 Bns.*'** t{,.l*J},,rt nt Ll fi.,
u)6ut fl?'i^
" lL Onu ttt*LL RiS
.-d
)a>nr *4
TJ ,-Ol
tli-- t So,.ir* tB"4p inLi -&Je,n*,*<
tttOut-O{A r*LL cl p,,t )A.LI Ru R*'+l <l*,^u - -----7--:r*
II
Ii
ItlhtF:/rtrflrw.snstsn/cpc_mncm -- fin7nw6j
EMSL Analytical, lnc
2235 Polvorosa Ave , Suite 230, $an Leandro, CA 94572
Phone: (810) S95-3675 Fax: (S10) 895-36S0 Ernait: s-_ .aen4rciab@g tu _
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 99221
Fax: (208) 78S-40S3 phone: (208) Z85-1767
Project: BYU-|D HOUSE @ 24E, lST SOUTH, REXBURG, tD
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01130112 9:00 AM
091201207
2t2t2012
Test Report: Asbestos Analysis of Bulk Materiats via EpA 600/R-g3/116 and/or EpA600/M4-92-020 Method(s) using porarized Light Microscopy
Sample Dsscription Appearance
Non-Asbestos
% Fibrous % Non-Fibrous
Asbestos
% TypeFT-o1-Floor Tile
0912012074001
FLOOR -
BEDROOM #2
Green
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
FT-01-Backing
091201207.{001A
FLOOR.
BEDROOM #2
GrayA/arious/Blac
k
Fibrous
Homogeneous
80% Cellulose 20% Non_fibrous (other)None Detected
SV-O1-Sheet Vinyl
091201207-0002
KITCHEN FLOOR Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
SV-01-Backing
091201207-00024
KITCHEN FLOOR Gray
Fibrous
Homogeneous
70% Celtulose 30% Non-fibrous (other)None Detected
SV-02-Sheet Vinyl
091201207-0003
FLOOR -
UPSTAIRS
BATHROOM
Tan
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
SV-02-Backing
091201207-0003A
FLOOR -
UPSTAIRS
BATHROOM
Gray
Fibrous
Homogeneous
70olo Cellulose 30% Non-fibrous (other)None Detected
lnitial report from 02t02t2}12
Analyst(s)
Jorge Leon (35)Baojia Ke, Laboratory Manageror other approved signatory
Uuetorogn|l|ca[on||ntaIionsinherentinPLM,as
myrequireadditiona|testingbyTEM-to@nfmasoestosquaniitiei.'.ii"","o*t",t,"ponretatesoniytotrieiiem.lestedandrynotbereprcrtuejrnany|omwithouttheeress
il?ifJ"13f:""":H'":y:iflfi::;i!*,fJi:.'i:iiilt:lfi:liiltif,',::';:"i;litjtttlff";::l'*:*1.f:U',",#,iT:flf,""rana,ytie,nerhod,imtaiions
83, MAMO0o2o1. wAc2oo7
Test Report PLM-7.23.0 ptintedi2t2t2}12 11:04:07 AM
EMSL Analytical, Inc
2235 Polvorosa Ave , Suite 230, San Leandro, CA 94577
Phonc: (510) 895.36Z5 Fax: (S101 895-3680 Emait: s
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 93221
Fax: (208) 785-4053 phone: (208) 7Bs_1767
Project: BYU-ID HOUSE @ 24E, 1ST SOUTH, REXBURc, tD
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01130t12 9:00 AM
091201207
2t2t2012
Sample Descripflon Appearance
Test Report: Asbestos Analysis of Bulk Materials via EpA 600/R-g3/116 and/or EpA600/M4-82-020 Method(s) using potarized Light Microscopy
Non-Asbestos
% Fibrous % Non-Fibrous
Asbestos
% Type
SV-03-Sheet Vinyl
0912012074004
FLOOR.
BASEMENT
WASHER/DRYER
ROOM
Tan
Non-Fibrous
Homogeneous
1007o Non-fibrous (other)None Detected
SV-03-Backing
0912012074004A
FLOOR.
BASEMENT
WASHER/DRYER
ROOM
30% Non-fibrous (other)None DetectedGray 70% cellulose
Fibrous
Homogeneous
CT-01-Ceiling Tile
091201207-0005
CEILING -
BASEMENT HALL
BrownMhite
Fibrous
Homogeneous
60% Cellulose 40% Non-fibrous (other)None Detected
CP-01-Plaster
091201207-0006
CEILING -
LIVING ROOM
BY FRONT DOOR
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
CP-o1-Skim Coat
091201207-0006A
CEILING -
LIVING ROOM
BY FRONT DOOR
Tan
Non-Fibrous
Homogeneous
98% Non-fibrous (other)2% Chrysotile
CP-02-Plaster
091201207-0007
CEILING.
BEDROOM #2
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
lnitial reporl from O2l02t 201 2 1 1 :04.07
Analyst(s)
Jorge Leon (35)Baojia Ke, Laboratory Manager
or other approved signatory
Oue to magnitiction timitations inherentmayrequireadditiona|testingbyTEMtocon'irmasbeStosquantities-TheaboV.etestreportre|atesoniytotrieiiemstestan
wfittenapprova|ofEMsLAm|ytical,|nc.EMsL's|iabi|ityisii'it"otot'iJ't.
lnterpr€tation aM use of lest results are the responsibilii ot lhe client.samptes received in 9@d mndition untess otheruise noted.by EMSL Analyti€|, Inc San Leandro, CA NVLAP Lab Code 101O4q-3, MA AAOOO2O1, WA C2OO7
Test Report PLM-7.23.0 printed: 2t21201211:04:07 AM
EMSL Analytical, Inc
2235 Polvorosa Ave, Suite 230. San Leandro. CA 94527
Phone: (510) 895-3675 F3I. [910] A95,3680 Email: ,9a11tcandrotab@ern€l.com
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 83221
Fax: (208) 785-4053 phone: (208) 785-1767
Project: BYUJD HOUSE @ 24E, tST SOUTH, REXBURG, tD
Sample Description Appearance %
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01130112 9:00 AM
091201207
2t2t20't2
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 and/or EpA600/M4-82-020 Method(s) using potarized Light Microscopy
Non-Asbestos
Fibrous % Non-Fibrous
Asbestos
% fype
CP-02-Skim Coat
091201207-0007A
CEILING -
BEDROOM #2
Tan/VVhite
Non-Fibrous
Homogeneous
100% Non-fibrous (otheo None Detected
CP-O3-Plaster CEIL|NG - Grav
os12o12o7-oool BEDROOM #1 Non-Fibrous
Homogeneous
100% Non-fibrous (otheQ None Detected
CP-03-Skim Coat CEILING -
os12o12o7-ooo8A BEDROOM #1
Tan/White
Non-Fibrous
Homogeneous
1 00o/o Non-fi brous (other)None Detected
WP-01-Plaster
091201207-0009
WALL - KITCHEN Gray
Non-Fibrous
Homogeneous
1 00o/o Non-fi brous (other)None Detected
WP-o1-Skim Coat WALL - KTTCHEN
091201207-0009A
White
Non-Fibrous
Homogeneous
1007o Non-fibrous (other)None Detected
WP-02-Plaster
0912012074010
UPSTAIRS
BATHROOM
Gray
Non-Fibrous
Homogeneous
100%o Non-fibrous (otheQ None Detected
lnitial report from 02102120'1 2
Analyst(s)
Jorge Leon (35)Baojia Ke, Laboratory Manager
or olher approved signatory
::ff.91':Tii:tliT:1[T: jT:f *:j:r::P::rf]b::s.rmyrequireadditiona|testingbyTEMtoconfirmasbestosqUantities.rnea.bmiesii"ii,t'--"r"i!i.*ivtl'i"ii;':"tf#;;.;f;.i;;&lj,f:ff
i1[t.gfn"""fi''J::'1P:::i!*''g::^"*P]1liI,i:],f19,1".]l"^3-:i."f"!:]y"iieGLL"i^,""*Interpretation and use of test results are the respmsibitiiy of the ctient.samptes eceiied i" s;;J"iliri;" q;il;il;il;;;d;.
EMSL Analyti€|, trc San Leandrc, CA NyLAp Lab Cods .tO1048_3, MA MOOO2O1, WA C2OO7
Test Report PLM-7.23.0 Printed: 2t2t201211:04:07 AM
EMSL Analytical, lnc
2235 Polvorosa Ave , Suite 230, San Leandro, CA 94577
-IP!e,,(5191 895-367 36s0 Emait: santeand-rsla!@errcta=om
Attn: Dave Price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 83221
Fax: (208) 785-4053 phone: (208) Z85-1767
Project: BYU-|D HOUSE @ 24E, 1ST SOUTH, REXBURG, lD
Sample Description Appearance
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01130112 9:00 AM
091201207
2t2t2012
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-g3/116 andlor EpA600/M4-82-020 Method(s) using potarized Light Microscopy
Non-Asbestos
o/o Fibrous % Non-Fibrous
Asbestos
% Type
WP-o2-Skim Coat
091201207-0010A
UPSTAIRS
BATHROOM
White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
CDW-01-Drywall
091201207-0011
CElLlNc - White Z0% CeilutoseRA-qtrNi|trNIT;;l;;;;1't^^^, r-rDrous| ,\vvrvr Homogeneous
80% Non-fibrous (other)None Detected
CDW-01-Texture
091201207-0011A
CEILING -
BASEMENT
LAUNDRY ROOM
White
Non-Fibrous
Homogeneous
1 00o/o Non-fibrous (other)None Detected
CDW-02-Drywall
091201207-0012
CEILING -
BEDROOM #3
White
Fibrous
Homogeneous
20% Cellulose B0o/o Non-fi brous (other)None Detected
CDw-o2-Texture
091201207-0012A
CEILING -
BEDROOM #3
White
Non-Fibrous
Homogeneous
1007o Non-fibrous (other)None Detected
CDW-03-Drywall
091201207-0013
CEILING - BIG
ROOM WITH
STAIRS
White
Fibrous
Homogeneous
207o Cellulose B07o Non-fi brous (other)None Detected
lnitial report from 02t0212012
Analyst(s)
Jorge Leon (35)Baojia Ke, Laboratory Manager
or other approved signatory
Due to mgnification limitations inherent in pLM, aamyrequireadditiona|testin9byTEMto@nfirmasbeslosquantities'Theabortestr€por1Ie|atesoniytot|ieitem.testecandmynotb€reprodUced|nany'ormwith
H[i"J"i3f:?","j,:',:y:i,fJ:::i! *], *::"""kllliY,' :l'911,rnlerpretation and use of lest results are the responsibility of the ctient.sampres reeiieo tn g@J m;ltlj" t"ilri iirjiiiijJ!iJt.ij.samples analyzed by EMSL Anatyticat, tnc san Leandro, cA twlAp Lab code 101048-3, MA AAooo2o.t, wA c2oo7
Test Report PLM-7.23.0 Printed: Zt2t2O121 1 :04:07 AM
EMSL Analytical, Inc
2235 Polvorosa Ave, Suite 230. $an Leandro, CA 94527
Phone: {510) 895-3625 Fax: {S10} 895_36g0 Email: s
Attn: Dave Price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 89221
Fax: (208) 785-4053 phone: (208) 785_1267
Project: BYU-ID HOUSE @ 24E, 1ST SOUTH, REXBURG, tD
Sample Descrlption Appearance
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01130112 9:00 AM
091201207
212t2012
Test Reporfi Asbestos Analysis of Bulk Materials via EpA 600/R-g3/116 and/or EpA600/M4-82-020 Method(s) using potarized Light Microscopy
Non-Asbestos
% Fibrous % Non-Fibrous
Asbestos
% TypeCDW-o3-Te)dure
091201207-001iA
CEILING - BIG
ROOM WITH
STAIRS
White
Non-Fibrous
Homogeneous
'100o/o Non-fibrous (other)None Detected
CDW-04-Drywall
0912012074014
CEILING - White
UPSTA|RS BATH Fibrous
Homogeneous
20% Cellulose B0% Non-fibrous (other)None Detscted
CDw-o4-Texture
0912012074014A
CEILING,
UPSTAIRS BATH
White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
WDW-O1-Drywall
091201207-0015
BASEMENT
LAUNDRY White
Fibrous
Homogeneous
20% Cellulose 80% Non-fibrous (other)None Detected
WDW-01-Texlure
091201207-0015A
BASEMENT
LAUNDRY
White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
WDW-02-Drywall
091201207-0016
WALL -
BASEMENT
BEDROOM #5
White
Fibrous
Homogeneous
20% Cellulose 80% Non-fibrous (other)None Detected
No apparent texture present on subr{tted samDle
lnitial report from 021 0212012
Analyst(s)
Jorge Leon (35)Baojia Ke, Laboratory Manager
or other approved signatory
to magnification limitat,on.'nn"r"m-vrequireadditionartestinsbvrEMtoconr,r;a'oesto.t,inriii"s ifJri-f;i;',:i"'i:i;f?'ii":i{Tfi-J$f,:iT:1'f;,BH::#f*ieiYflT:*mwnttenapprova|ofEMsLAm|yti€|,|nc'EMSL,s|iat!i|ityisiimitedtotheco'st9f?!3!v'i:.
Interprelalion and use of t6st resulls are the responsibiliiy of the ctient.sampres reeived in g@d condation unless otheruise noted.EMSL Analytical, Inc San Leandro, CA NVLAP Lab Code 1
Test Report PLM-7.23.0 printed: 2t2t201211:04:07AM
EMSL Anatytical, Inc
2235 Polvorosa Ave , Suite 230, San Leandro, CA g4S77
Phone: (510)895-3675 Fax: (i10)895-36A0 Ernait: s
Attn: Dave price
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 89221
Fax: (208) 7SS4O53 phone: (208) Z85_1767
Project: BYU{D HOUSE @ 24E, 1ST SOUTH, REXBURG, tD
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01130112 9:00 AM
0e1201207
2t3t2012
Test Report: Test Report: Asbestos Analysis
and/or EPA 600/M 4-92-OZO. euantitation
of Bulk Materiat via EpA 600/R-93/116
using 400 Point Count procedure
Non-AsbestosSample
CP-01-Skim Coat
091201207-0006A
Description
CEILING. LIVING
ROOM BY FRONT
DOOR
% Fibrous % Non-Flbrous
Asbestos
% Type
97.00% Non-fi brous (other)3.00% ChrysotileTan
Non-Fibrous
Homogeneous
lnitial report trom 0210212012 1 1 :04:07
Analyst(s)o--'-ry
ero@
or other approved signatory
Jennifer Keeting (1)
re@ived in good condition unlesi oifi-eruse
EMSL Anatyticat. tnc San Leandro, CA NVLAP Code 101048-?, MA MOO02O1, WA C2OO7
Test Report PLMPf C-7.121.0 printed: 2l3t2}.t2 12:13:32 pM THIS IS THE LAST PAGE OF THE REPORT.
Certifications
l^--- -)- T\ -i .
I vfA4lT l{rrc\11\rr vdL DASIn services, Inc
P.O. Box 238
Blackfoot, Idaho 83221
Office: 208-785-1767
Cell: 208-681-6462
Nlar-20-2012
RE: Vacant House located at24East 1nd South, Rexburg, Idaho
To Whom it may concern:
Great Basin Services has removed the asbestos materials found in the Inspection report.Living room ceiling plaster and skim coat. All Asbestos materials were disposed of at an EpAApproved landfill as required by EPA. The remaining material my be disposed of as nonasbestos waste.
Dave Price
,.\ r]
/ )t /-l_4-
R.Q.Ilazardou.s Substance: Solid N.O.S. (asbestos): ORM-B NA_91gg
GENERATOR
Location: \qe, {f 50u41,. , €.exb''x"r.i'c'
MailingAcldrcss: 5A{ 5o.rfh C<'rlt'<. f(c rlcue.gl ]:rJ 9346O'yZO{
Orvncr's Nanre: t{Vt i ^orvrrer's Ptro "", 2!)9 -4 {6' ZOperator's Name: GREAT BAS
IVlailingAddress: P.O. BOX 238 eSKOIZ-CItZ--2€.t
I}LACKFOOT ID 83221
Cqltac! Person: DAVE PRICE Olrcralor's Phone: 2$8-7 85-17 67lVaste Disposal Site
Name:
Mailing Addre.ss:
(WDS) DESfINT\1I'ION:
BANNOCK COUNTY LANDFILL
15OO NORTI{ FOIIT I-IALL MINEPOCATELLO.ID 83201
District or B{A offico rvhcrc donrolirion/rclrovrrlon notificrriorr rtrs sent):lnn A&l./J,.-o <..,J - o^A 'i'ii'j:r- t,r<> r
Description 0f waste materials 6.Containers @Number 'Ilpe (Cubic y,ards)
'Dpecrar Handring Instructions and additional inforniatinn:
Name: GREAT BASIN SERVICES, INC.
Address: P,O. BOX 238 . BLACKFOOT,ID g322l
DAVE PRICE
Printcd/ry1rud Nanrc
Phone:
(Acknowledgement@
Name:
Address:
rrirrti.J7ryp.,t Xunt"
WASTE DISPOSAL SITE
DISP0SAL sI'l'E CBR1'IrICA!'ION: I hereby certify tlutt thc ahoi,c nar'ctl4rarerial lr.* becn .cccpr!.d un, ,o ,ffiffiffipe is true, nccurirte ilnd conlplete e.\ccpt ns nor,j.l in itcnl i2. I \t,,f h**"/ft ir r*., n".i,n,r. rnd conrplere r..""piri, n,u".r iu irc'r 12.
Itrlcd/ttillerial ll't$ becn acccptr'd.nd to tltc bc'st of nty knor
p7ta, il, #.,{-,.fir- ,,*,.,;33,
Upontransfcr:owtler/opcrotorrctainsG0I,D,.lians1nr|crretaiosPlNI('.WDSretltinsyIILLOwntttlscn<ls"nu.n,"...ffi
Great Basin Services, Inc
P.O. Box 238
Blackfoot,Idaho 83221
Office: 208-785-1767
Cell: 208-681-6462
Mar-20-2012
RE: Vacant House located at23 East 2nd South, Rexburg, Idaho ( Tenda Rossa Apartments)
To Whom it may concern:
Great Basin Services has removed the asbestos materials found in the Inspection report.
Sheet vinyl flooring, duct tape, and floor tile. All Asbestos materials were disposed of at an
EPA Approved landfill as required by EPA. The remaining material my be disposed of as non
asbestos waste.
Dave Price
Presented to
BYU-Idaho/ John Reed
Ian-27-2012
Tenda Rossa Apartments, Rexburg, Idaho
Presented by:
Great Basin Services, Inc
Blackfoot,Idaho
208-78s-r767
Dave Price,Inspector
Certificate # BIRO2021 1-07
Introduction
On Jan-I9-201I , accredited AHERA Inspector Dave Price of Great Basin Services
preformed an Asbestos inspection on the vacant building ( Tenda Rossa Apartment building)
Rexburg,ldaho. This inspection was requested by John Reed. This survey was conducted to
facilitate the future Demolition of this structure. This inspection, before demo, will indicate the
presence, or lack of, Asbestos Containing Materials (ACM).
Background
The original building was a single family dwelling and has been added on to, remodeled,
multiple times. These additions and remodels were apparently done at several different times
using different building materials. The original house is aprox 60-70 years old with the additions
some what newer. It is currently vacant. It is a 4level structure, with a small apartment in the
basement, one at ground level, one on the 2nd story of the addition, and one on the original level.
The original building has wood framed/brick walls as exterior walls and wood framed covered
with stucco on the outside. The additions have wood frame walls with drywall/stucco. On the
inside there is some drywall, some stucco, some fiberboard and some ceiling tiles. The roof has I
layer of shingles over older shingles on the original part. On the additions there are some
shingles, and a built-up roof on the flat roof area. This flat roof area has a newer rubber-roof
covering the older built-up roof system. There was some fibrous insulation in the attic of the
old house portion, and newer fiberglass insulation in all of the additions. There was no floor
insulation found. There was duct tape materials found on all of the heat ducts under the original
house area.
Sampling
Dave Price, accredited AHERA inspector collected 40 samples of suspect Asbestos
Containing Material (ACM). This is more than a typical apartment building of this size..
Because of all the different types of suspect materials found, and apparent different additions, we
could not consider them to be homogenous, so these different types of suspect materials had to be
tested separately. These were broke down into a total of 84 separate suspect materials, that were
tested at the lab. 6 samples came back as containing Asbestos Materials. ( meaning they are
more than 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 disturbed 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 trace 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, California. EMSL is a AIHA accredited lab and participate in the NVLAP
program. The materials were sampled for the purpose of identiffing possible Asbestos
containing materials, that would need to be removed, before Demolition of this building. This
survey can be used, to satisff 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 84 separate materials tested at the lab, 6 samples were
found to contain, I percent, or more, asbestos.
Recommendations: Our recommendations, concerning the materials that tested positive for
asbestos, are as follows
Apartment # 2* Sample # 2-FT-0f , 2FT-02 These are the 9"x 9" floor tites located in Apartment # 2, in
the Iiving room, bedroom 2, and hallway. These tested at 5o/o Asbestos.* Sample # 2-SV-04 This is the Sheet vinyl flooring located in the back bathroom # 2. This
material tested at 600/0 Asbestos.
Apartment # 3* Sample number 3-FT-01. This is the floor tile in the bedrooms of the basement apartment.
This material tested at 4o/o Asbestos.* Sample number il. 3-DT-01 This is the duct tape material that runs through-out the
basement. This material tested at80o/o Asbestos
* sample number 4-FT-01 This is ,tltffiiffIf"lis in att the rooms and under the sheet
vinyl of the kitchen. This material tested at SVo Asbestos
( see attached sheet for info on roofing and floor tile , in Concerns for
owners/demo contractors) EPA states that these materials can be left in place during a
demo as long as they are not to be rendered friable, using typical demo methods. ( air-born)
Howeverr local landfills will not accept any kind if Asbestos materials if they tested at more
than the I %. EPA does not regulate or recognize materials as Asbestos Containing
Materials ( ACM) if the amounts of Asbestos are less than I 7o.
Samples numbers 2-cDw-0r, 2-wDw-02, 4-cDw-01, 4-wDw-01, all tested at <l%o
asbestos, and are not considered Asbestos Containing materials and can be disposed of as
General Construction debris.
No other materials tested positive for asbestos.
Concerns for owners and/ or Demolition Contractorsr
Roofing : Roofing materials, shingles, built-up roofs, tar, etc., are typically NON-FRIABLE
materials and fall under the National Emissions Standard for HazardousAir Pollutants ( NESHAp)
regulations found in Appendix A to Subpart M,- lnterpretive Rule Governing Roof RemovalOperations. This rule states that removal of non-Friable roofing materials involving 5580 sq ft ormore is subject to NESHAP regulations, only if equipment that crumbles, chips, or otherwiserenders the roofing materials friable, is used. However some landfills will not accept roofing
materials as general construction debris unless Asbestos testing has been done on that material. Ifroofing materials are found to contain Asbestos, some landfills will require to separate any
Asbestos materials and may require packaging or labeling separate from General Construction
Debris. Demo Contractor will need to follow all applicable rules if non-asbestos roofing materials
Floor tile: Floor tile is typically.StififfiiH1,|ii8f,X ilt#rh., does not require removar 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 landfrlls may require that any Asbestos materials be separated from general
construction debris, and or packaged differently before disposal. The Demo contractor will need to
follow all applicable rules if non-friable Asbestos floor tile or mastic are not removed prior to
demo.
* The DemolitionlRemoval Contractor must pay attention to Section XVII , of
the EPA Notification Of Demolition And Renovation, which states: An
individual trained in the provisions of NESHAPS, (40 CFR Part 61, subpart
M) will be on the job-site during the demolition or renovation, and evidence
that the required training has been accomplished by this person and witl be
available during normal business hours.
Laboratory Results
01\as'q32
Pleasc ptiss 8lt information legibly'
r.Epacr. Yo! ro DGlte.d to*B
i-- NtosE Trlol{A)rqs-EAuslls leet
l- ostttwrnva
l- oter:
sBnlB
600/R-93/l 16
EPA Point Count
f NYsbadtredPohtcoutrt
l- rLM NOA (Oravisstric) NYt 196.t
F Nrostr gooz:
l- EM8lguodurd Addition; :
l- gua[anve
r
lEItrAl' - TEI4-lv-4f,FR
T AHERA,IOCF& Fart763 Sutpart E - EPA l0o-l
f NpSHT4oz f EPA lU):
i- EPA l-evel ll t- NYS 198:
TET4EUL6
l- U'rop tvtorrt (Qrnlitative)
i-- Cbatfietd SOP - 198&{B
r TEIvt NOB (Gravime&ic) litYS 198.4
i- gMSL Ssrdard Additioa:
-P-tMEntl
j- EPA Pt0tocol Qualitdivt
l- epa hdocol Quutibliv€
T EMSLMSD9000Medrod
EE![-I4iefo;sc1!!fry
l- asnu D f/5$95rq,".trriwngicxtl
l- Wipeguafn*ive
xRp
i- A.*es*e
i- SilicaNIOSH 7500
g[gFa
r
htFl ruu,ur.erFl.oorntcoCStnUctnZadon=pint&ServicacatSelefr3&l-abssele"' 4l6nOO7
RECETVED JAN 2 4 ?012 n
a{+Z q@f{
09120n955
v
,*1s-:oih".i.Sifii?
e: Y;..,A.sbestos Lab
Chain of,CustodY
Sersices
EMSLAralYtita[ lnc
Suite 230
2235PotvorooaAve
Sttt L€andrc'
cA %577
Phqte; (510)895-
s675 (Wr455a6ls
Fa: (510) E95-3680
htQy'rtvrvw.easlcoat
,-l::
?atngo: C
-
cwgr* Bhckfrog ldaho -
. | ., 1. ' t
VilTatCde:8TE2l
CounttY: rEiB
Atta: Daw Price. ,.. , - -; : :: :-
Phuze: 2OE-7E5-1761
Fs:
Enall: gosl-_
PO- nIut fu
tor@rlouratLes-
TJA 6Esr+ ++/r1TorutNonqTtnmbs- Tc r, r{l 7t
7a, )1Lt . t
MATRIT(llal{ABoul{D
l- fft I- soil I-:rtro-vac [- SEouls l- egocrs f- saoeuay
or 12 Horrs*
l- z4ltours
(l day)
F**I- orating
W.ter
l- 48HouF
(2dgl"''.'
[[ zz Roors' (Jd8ts)
l- 95 Hours
(4 daYs)
l- uo tlosrs
(5 days)
l- wtps l- Wegnuater l- l4l+ boars (&10 dafr)
TBM AR.J hoss 6 !?lrt raaeutgw-e*-r.g-
eEol4 Yo rt !E!t&ad fo d:Bs rtdotlafu &r 6t"i
t r prrrfoa cte4s &rlnocr !!,
rcrrie
it! t!6(E6re'ffi,qblt:ollre tlloo-S'ii! tbB.itaohlE(tsds
00l.:t@!r55
,#C.hatu of CustodY
Asbestos Lab Serviees
Og1amn:z fu,+ |
E6lAna$lical' loc'
&dba0
ZD5FolvoreAve
fui'taen'cA 94.5n
PboG610)8*F
%15 (Wr)15r36ts
Foc(510)t9t36E0
ErOa//krmcnsLcoar ^
Toilaf ssEpres n-€ {o
r-,*-8*3-,:sll Ptl
$m+.lte+l-fr9&
r-rEr .
+L;wg
VIL
/r fa h t.iVF
la ; lC t. t./,
ftETEOA6
091200!r59
-#iC.tain of CtstodY
A$b6tos Lab Serrvices
i
fitaoo1s;>fr{"42
EMSLAna}tical' loc-
SuttB230
!235PohoreAve
Silit@do'eA yt'n
lhffi(510)EgF3675 (8g,)1sr36'ts
F4(5to)t9t3660
nQ:/rkrwssLcoa
Tffit plcs*-
fg=-
l*M ar-k
Tlsr
UiJcAeq)
I
z
Saeu'ot CciLi*g t,- / r q lt- Bd*qom4t
}G-Prtfinm - pftIn\gy
:
lt:
t( rt l(
,.no;H iC&atu ofch$tody
i
Abbestos Lab Services
ffiB00qo>fu"#s
E$dSLArztylicaf loc.
$b230
?2i5PotrpreAve
SeL€adro,cA ntn
Ptonc(510)E9.F
3615 (Sg)t6r367s
Fas (sI0) E9t:t6E0
@r//w*wcoslcoo
Tb*slS@phs*_
ea@
P&asepintelt@
Gesttudef(i
t r i
-#;Chain ofChstody
AFbestos Lab Servies
I
ff{laoqgt prs* - 4
EhflSLArelgnce[ lec.
$rtE230
Z4i5ttlrct@Ave
Solradlo,cA grsn
Ib@6t0)6rFws (wr1sr36?s
Foc(5t0)E9$3680
hQ:/rlrcrs.eost oa
To{alSa FlF*_
Tbe
2frU012
5hf
.l+
rafi'i'funF
RECEIVEt] JAN
HMSL Analytica{, {nc
2235 Polvorosa Ave , $uite 130, $arr Leandro, CA 945?7
Phoro: {510}895-3615 Fflx: {$10,895.39S0 Emait; siil}kjtr(,lrolfrh&ery,rl-1ls*il
s1
Attn: DAVe pfice
Great Basin Services. lnc.
P0 Box 238
Blackfoot, lD 83221
Fax: (208) 7854053 Phone: (208) 785-1767
Projecl: BYU ld. - Tonda Rossa Apartment on E. And South,
Rexbury, ld,
Samplo Dcacription Appearance
Customer lO:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Dale:
GBSV62
01124112 9:00 AM
091 200955
1t25t2912
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 and/or EPA
600/M4-82-020 Method{s} using Polarized Light Microscopy
Nor-Asbostos
% Fibrous % Non-Flbfous
Agb6sto.s
% Type
1-SV-01-Sheel Tenda Rossa Apt White
Vinyl #1 kitchen Non_Fibrousottzoo,s,ooot
Heterogeneous
100% Non-fibrous (other)None Oetectsd
1-SV-01-Backing Tenda Rossa Apt
09,?ooe5$oooil #1 kilchen
Gray
Fibrous
Heterogeneoug
70% Cellulose 30q/o Non-fibrous (other)Nono 0otoclod
1-SV-O1-Mastic
0s12009s50@t8
Tenda Rossa Apt Yellow
#1 kitchen Non-Fibrous
Heterogeneous
1 00e/o Non-fibrous (otheo None Doiscted
\
1-WP.01-Plaster Tenda Ros$a Apt
11za1ss5.ooo2 #1 living rm
Not Submlttod
1-WP-o1-Skim Coat Tenda Rossa Apt
lstzaos&5iooozA #1 living rm
White
Non-Fibrous
Helerogeneous
100% Non-fibrous (other)Non€ Dotsctod
1-WP-01-Texlure Tenda Rossa Apt
oslpoog!!_ooozl #1 living rm
White
Non-Fibrou$
l"leterogeneous
1007o Non-fibrous (other)None Oetsctod
lnitial repoil irom 01 t2ffi[1zWil 5:{{--
Analysl(s)
Baojia Ke, Laboratory Manager
or other approved signatory
Adam C. Fink (31)
Rui Cindy Geng (52)
Uggtoro0o||i€tionlimilalion9lnhoren|inPLi|,63be6tos'ib€'sind,rEnsi
:3jnYfflJyg::tll9,ll-lFY-,: TI($ asb€slos q!€nlitis. rna 6b€v6 tesl eporl relates oniy to rhe ireos resrrd lnd my oot be rsproducod in onr rom wtholr rhe ssreseMitlsna'povslofEMsLAEl'iiql.|n€'EMs|5|i8u|i|yi5liniroororr.ocotroraoarlsii-Eli-"l.i-*ii,""'i'ipili'Jiili,ii.];*'i';,#;f#f;f;;f;;uirfl;;f:
lolerr(€la$oo and us ol t6l tesu,lr are thg (gspmsibllitt of lhe ctisnt.sstrlples rcceiv€d ifl gsd endilion udirls athd\lss mt€d
53mPlo5 €MSL Analfiical, |nc Sad Ltrndrs. CA NVLAP Lab Codo 10 j0d0.X, MA AAOOO?01, WA C2007
Terl Report PLM-7.23.0 pfinted 1tZStZO12 10;15:tB pM
Attn: P"u" pr1""
Great Basin Services, lnc.
P0 Box 238
Bfackfoot, lO 83221
Fax: (208) 785-4053 phone: (209) 785-1761
Project: BYU td. - Tenda Rossa Apartmont on E. Znd South,Roxbury, ld.
Samplo Dascrlpflon Appearancg
Cuslomer lO:
Customer PO:
Received;
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01124112 9:00 AM
091200955
1t25t2012
Test Report Asbestos Analyais of Bulk Materials via EPA 600/R-93/116 and/or EpA
600/M4-82-020 Method{s} using Forarized Light Microscopy
Non.Asbostos
% Fibrous % Non.Fibrous
l\sbestos
% Tyge
EMSL Analytical, Inc
2235 Folvorosa Ave , Suite 230, San Leanclro. CA g4ST7
Phors: {5{Sl 835.3675 Fa:: (510t *99-3SS0 €rililil;
1-WP-02-Texture
0x?a095&ao03
Tenda Ro$sa Apt White
#1 bedroom Non-Fibrous
Helerogeneous
100% Non-fibrous (other)None Detected
1-WP-02-Oryu/all TendaRossaApt Bro\,1n/yvhile
a*toosssooo3' #1 bedroom Fibrous
Heterogeneous
107o Celfulose 90o/o Non-fi brous (other)Non€ Dstectgd
1-CP-01*PlEster Tenda Rossa Apt
astzoossrooa4 #1 llving m
Tan
Non-Fibrous
Heterogeneous
1 00o,t Non-fi brous (other)Nono Detectod
1-CP-01.Skim Coat Tenda Rossa Apt
oil2oassrooa4A #'l living nn
White
Non-Fibrous
Heterogeneous
100% Non-tibrous (other)None Detsctsd
1-CP-01-Texture TendaRossaApt
os12aoss5io004} #1 living rm
White
Non-Fibrous
Heterogeneous
100Yo Non-fibrous (o{her)None Dstsctod
1-CP-01"Felt
091?0095'00046
Tenda Rossa Apt Yellow
#1 living rm Fibrous
Heterogeneous
95% Cellulose 5Yo Non-fibrous (olher)None Dstectsd
Inltial reporl fiom AU2S|2012 2Z:15jB
Analysl(s)
Adan C. Fink (31)
Rui Cindy ceng (5?)Baojia Ke. Laboratory Manager
or olher approved signatory
Dle lo nragnilica|lon linttrtionr intto*ryBquir6additiona|la'tingbyTEMto6rfimasoestosquantltiei.rtreJioetesrreponr9lalasoniytottieitomJierto<tandmaynotbo'gproducodinan
f'fjifX""*'f :i,#ll*ii 9:,,:j:!"1n*y.':l'n*rJli*-* "r "niil,iJ.-'eiaslrnl6rpt0l6riotr and use of torl tssullr 8rs ths rssponsibitii or rhe crienlsampris reCeiiJtlJiJir-iiirilji iifiilir#i,ilil #:EMSL An8tyil6t, Inc Ssn Loandfo.cA twlAp Lab code 10.1048.3. MA
Tesl Report PLM-7.23.0 ptlnted:1t25t2012 10:15:18 pM
EMSL Analytical, Inc
2235 Polvorosa Ave, Suite !30,San Leandro, CA 94577
phono: 15101B$5-36?5 Fax: 1510)895-3680 g'r$il; $-i1til*0ndr$]l_b@.gi!!Cle.9tn
Attn: Dave price
Great Basin $ervices, lnc.
PO 8ox 238
Bfackfoot, lD 83221
Fax: (208) 7854053 Phone: (208) 785-1767
Project: BYU ld. - Tonda Rossa Apartment on E. 2nd South,
Rexbury, ld,
Samplo Dsscrlption Appearance
Customer lD:
Customer PO:
Received:
EM$L Order;
EMSL Proj:
Analysis Date:
GBSV62
011?41'12 9:00 AM
091200955
1t25t2012
Test Report: Asbestos Analysis of Bulk Materials via EPA 6001R-93/116 andlor EPA
S00tM4-82-020 Method(s) using Potarized Light Microscopy
Non-Asbostos
% Fibrous % Non-Fibrous
Asglos
o/o lypa
t-CP-01-Plaster Tenda Ro$sa Apt fan
oslzoossrloas #1 bedroom Non-Fibrous
l'lelerogeneous
1 007o Non-fi btous (olher)Nono DotoctEd
1-CP.ol-Skim Coat Tenda Rossa Apt White
oolzaosssidx,sl #1 bedroom Non-Fibrous
Heterogeneous
100% Non-librous (other)None 0otoct€d
1-CP-01-TeEure Tenda Rossa Apl
oer?@95$ordss #1 bedroom
White
Non-Fibrous
Heterogeneoug
100% Non-librous (other)Nono Dot€ct€d
1-CP-01-Fell
09r?04955000w
Tenda Rossa Apl Yellow
#1 bedroom Fibrous
Helerogeneous
95% Cellulose 5olo Non-fibrous (other)None Dotectod
'l-lnsulation
091200955,0006
Tenda Rossa Apl Black
#1 bedroom Fibrous
Heterogeneous
95% Glass 5olo Non-fi brous (olher)Itlono Dgtscted
2-FT-01-9x9 Floor Apt #2 living room
Tile
0912W$5,A001
Tan
Non-Fibrous
Helerogeneous
95o/o Non-librous (other)5olo Chrysotile
lnilial repo( kom 0112612012 22:15:'tB
Analyst(s)
Adam C. Fink (31)
Rui Cindy Oeng (52)
Eaojia Ke, Laboratory Manager
or olher approved signatory
Ugslona0niftc8lt0d|itrJ|,alioolinhofoilinPLM,asboslos'ibo(6inomnoon
rJ reqlim addiliooaltesting by TEM to coftitrn asbcltos quantitles. Ihs abor€ lest rapon rlater oniy lo fie item lsstsd and my fot bo raproduced in any fom with6an ths orpr6sssri|l€nappfoydlo'€MsLAr6|y1ica|,|r.EHsus|iabi|llyin'ir,tedtothesslo'soa|ys;ieust.uaars.nJrnsiiiliiyrolsamp
lnterp{€lat on snd us ot tsl rosults aB tho r€spmsibiliiy ot rho crient.sampror receiied in gmJ;;iiii;^ rni5;;;rfiil;;;r;
€MSL Analylal, ltrc San Loandro. CA NVLAP Lab Code 101048_3. MA wA cr007
Test Report p1M.7.23.0 Printed: 1/2Sl2012 10:15:18 pM
EMSL Analytical, lnc
2235 Polvorosa Ave , $uite ?30, $an Leandro, CA 94577
Phone: {5101 895-3075 Fax: 1510} S95-3680 Emait: $.S-t1!st4dtglnh@eg!*],S*$!
Atln: Fave prioe
Great Basin Services, Inc,
PO Box 238
Bfackfoot, lD 83221
Fax: (208) 7854053 Phone: (208) ZBS"17O7
Pfoject: BYU ld. . Tenda Rossa Apartment or E. 2nd South,Rexbury, ld.
Sample Descrlptlon AppBaranc@
Cuslomer lD:
Cuslomer PO:
Received:
FMSL Order:
EMSL Proj:
Analysis Dale:
G8SV62
01t24112 9:00 AM
091 2009s5
1t25t2012
Test Report: Asbestos Analysis of Bulk Materials via EPA 6001R-93/116 andlor EPA
600/M4-82-020 Method{s} using Polarized Light Microscopy
Non-Asbestos
% Flbrous o/o Non.Fibrous
Asbostos
% fypa
2-FT-01-Mastic Apl #2 living room
091200'55.AA07A
Btack
Non-Fibrous
Helerogeneous
100% Non-librous (other)Nons Dotected
2"FT-01-Maslic Aptf2 tiving room Yeilow
aslzoaeis.oooTg Non-Fibrous
l-leterogeneous
10090 Non-fibrous (other)Nono Detectod
2-FT'02-Floorlile Apt#2 bedroom 1
ost?0w510608
Tan
Non-Fibrous
Heterogeneous
95% Non-fibrou$ (olher)5% Chrysotila
2-FT-02-Mastic
49120095'00a8A
Apl#2 bedroom 1 Black
Non-Fibrous
Heierogeneou$
100o/o Non-librous (other)None D€t€ct€d
2-FT-02.Mastic
09120095t0a088
Apt #2 bedroom 1 Yellow
Non-Fibrous
Heterogeneous
100% Non-fibrous (other)None Dotsctad
2-SV-01"Sheet
Vinyl
49124095r000s
Apt #2 hallway by Tan
bathroom Non-Fibrous
Heterogeneous
100% Non-tibrous (other)None Oetectcd
lnitial reporl kom 01 t25l 2012 22: I S:1 I t
Analyst(s)
Adam C. Fink (31)
Rui Cindy Geng (52)Baojia Ke, Laboratory Manager
of other approved signatory
Drq lo rognin€lioft Imita*ons innam!tequireadditiomltollingbyTeMlocontimssbestosqlantitios. Theabowtestreoortrstatosontvtotheitamst6srdrndmvndrhobn6d,,.^dir! tequre adouom' iling by TEM lo conlim ssbestos q!antitios. The abow test report rsrator oniy lo rie items tsst;c aod mt;;i ; ;f;;if uiy ro*,vrr,orr rrru urpiuriwill€n8pp.ovalo'EMsLAnalytical.lncEMsL.siiabi||tylsiimiledto|hcco'|ol.am|y'ii,eiiiiiii
'ntorprglationsod uso ol l€sl rsults src tho ro5pm$ibility ol ths clioflt.ssmptos recetved in good coildition unt;ss oinwiso noteo.EMSL Anslytiet, trc $ao LeandJo" CA llylAp Lab Codo 10104&3, MA AAO002ot, W C2007
Test Report pLM-7.23.0 Printed: 1t25l20.12 10:1i:18 pM
FM$L Analytical, Inc
2235 Polvorosa Avo , $uito 230, $an Lsandro, CA94877
phono: {510} 8S5"30?5 Far: {$10} 896"3S110 Email: sfi:lq'3ndrulatt@*,$jrl,ss{r|
Altn: DaVe price
Great Basin Senrices. lnc.
PO Box 238
Blackfoot, lD 83221
Fax: (208) 78$4053 Phone: (208) 785-1767
Projecl: BYU ld" - Toflda Rossa Apartmont on F. 2nd Southr
Roxbury, ld,
$amplo 0s6crlptign Appearanco
Customer lD:
Customer PO:
Received;
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
A1Q4l12 9:00 AM
091200s55
1t25t2012
Test Report: Asbestos Analysis of Bulk Materials via EP.A 600/R'931116 andlor EPA
60OlM4-82-020 Method(s) using Polarized Light Microscopy
Non-4pbestos
Yo Flbrous % Non.Fibrous
4sh6stos
%'rype
2-Sv-01-Backing Apl #2 hallway by Tan 70Yo Celtulose
ostzoosglooosA balhroom Fibrous
Het€rogeneous
30o/o Non-librous (other)Nono Detect€d
2-SV-o'l-Ma$lic
0s1200p69.0a098
Apt irz hallway by
balhroom
Insuftlclent Matsrial
2-SV-02-Sheel
Vinyl
oc12ao95to0t0
Apt #2 bathroom Gray
#1 Non-Fibrous
Heterogeneous
100% Non-fibrous (otheO None Dotoctod
2-SV-02-Baeking Apl #2 bathroom
alr?oggllao1dA #1
Tan
Fibrous
Helerogeneous
20% Cellulose B0o/o Non-fi brous (othe0 None Detoctod
2-SV'03-Sheel
Vinyl
an2a095ra0tl
Aot #2 kitchen Tan
Non-Fibrous
Heterogeneous
100% Non-fibrous (other)None Detsctad
2-Sv-03-Backing Apt #2 kitchen
09r20095500fi4
Tan
Fibrous
Heterogeneous
60% Cellulose 40% Non-Jibrou$ (otheO Nono Det6ctod
lililial feporf irom ol nsiaolyzz:s'n !a
Analyst(s)
Adam Q, Fink (31)
Rui Cindy Geng (52)
Eaojia Ke, Laboratory Manager
or other approved signalory
wsroroqnrul[on||n6lFn'lnnerentnFLi.|'asbo3l09libaGindineo6lon5be|osthe'oslufioncsPabiliryo|PtMroynotxcelgctoo@
nE,'6qqi'qadditiona|-|cEt'n9byTFMlomJimosbs5tosquntities'Thoabwolestr€Por1to|atesoniytotlieitomslest;dsndmaynotoereproducedinanyffthdlfe4'es3
witlon approval ot EMSL An€lylical, Inc.
Inlerprolatiofl dnd lEo ol l€st lB$ult5 d(s lho respqsibitity ol hs ctisnt.Ssmplos mcsived in 0&d eodition unl;ss othoMso nol€d
EMSLAnslyricar, lrE San Lcandrc, cA fwlAp L8b codc 10104a.3. MA M000201. wA c?007
Tesl Repori PLM-7.23.0 Printed 1125/2A12 10:15:18 PM
fMSL Analytical, lnc
2235 Polvoroga .Avs , $uite ?30, San Leandro. CA 94$77
Phore:_ (510) 895.3675 Fax: {510} 895.3680 rmritr $Urs"0.$(liol.slr.&{lm*ts"0.m
Alh: Dave price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lA ffi221
Fax: (208) 7854053 Phone: (208) 785-1767
Project; BYU ld, - Tenda Rossa Apartment on E. Znd South,
Roxbury, ld.
Sample Dsscrlption App66rance
Cuslomer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysi$ 0atel
GBSV62
01124112 9:00 AM
091200s55
1t25t2012
Test Report: Asbestos Analysis of Bulk Materials via EPA S00lR-93/116 and/or EpA
600/M4-8?-020 Method{s} using polarized Light Microscopy
Non-Asbosto!
% Fibrous % Non.Fibrous
Asbostos
o/o Typo
2-Sv-03-Mastic Apt #2 kitchen Yeilow
oglzoagsraot$ Non-Fibrous
Heterogeneous
1 0OYo Non-librous (other)None D€tected
2-SV-04-Sheet Apt#2bathroom Bro$n/BlackvinYl *2 Non-Fibrous09t2a095raot2
Heterogeneous
1 00o/o Non-librous (other)Nono Oetected
?-Sv-04-Backing Apt #2 bathroom
agl?aagssootzA #2
Tan
Fibrous
Heterogeneous
40% Non-fibrous (other)600/o Chrysotile
2-FB-01-Ceiling tile Apt #2 hail by
os12ooss5aa13 kitchen
White
Fibrous
Heterogeneous
90o/o Cellulose 10% Non-fibrous (other)Nono Detectsd
2-COW.01-0rywall Apt #2 living room
09124095540t4
Bro$nfwhite
Fibrous
l'leterogeneous
10% Cellulose 9Ooy'o Non-librou$ (other)None Ootected
2-CDW-01-T€xlure Apt #? tiving room
49120095f;.4414A
Tan
Non-Fibrous
Heterogeneou$
100o/o Non-fi brous (other)<1% Chrysolils
lnitial report trom 0112512012 22:15:18 I
Analyst(s)
Adam Q. Fink (31)
Rui Cindy Geng (52)
Baoiia Ke, Labofatory Manager
or olher approved signatory
mavto$.drcaddilionalteslinsbvTEMroconlirmasbssrosqsnrfies. Theabovsra.rreporrretatosoniyrorlie[e*uJ,iiJ"ii.ii"iri,r;;If;liry;;;"l;H&;iT
m:Hft*li3:f,5X'*5,f:!^lf$lli:l'991j"_.q"_f-lily9vlf, eusLloars'orosponsiuiiiryrorunpra'colccr,oni.u,irosoi"a^jryrc6rtBthodlimitationslntet retatic{rarrduseot teslrsulls ero thsrespesibitii ot rhsclienlsa"pre" rereiiJr"gi;J;fil" fiii;';il;;;ffi;d;
Inc San Leandrc, CA NVLAp Lab Codo 10ro4g-3, MA AA000?01. WA C?00?
Test Report PLM-7,23.0 Printed:1t25t2012 10:1S:18 pM
Altn: Dave price
Great Easin Services, lnc.
PO Box 238
Blackfoot, lD 83221
Fax: (208) 7854053 Phone: (208) 785-1767
Customer lD:
Customer P0:
Received:
EMSL Order:
EMSI Proj:
Analysis Date:
GBSV62
01124112 9:00 AM
091 200955
1t25t2012
Project: BYU ld. - Tonda Rossa Apartment on E, 2nd South,Rexbury, ld.
Samplo Description Appearanco %
Test Report Asbestos Analysis of Bulk Materials via EPA 600/R-g3/116 andtor EpA600/M4-84-020 Method(s) using polarized Light Microscopy
Non-Asbostos
Flbrous % Non-Flbrous
Asbestos
o/o Type
EM$l- Analytical, Inc
2235 Polvorosa Avc , $uite 230, gan Learrtlro. CA 945??
phone: {5lg)895-36t5 Fox: {gj0}B99.J6B0 Enril:
2-CDW-02,Dryv€il Apt #2 bath #1
09120W55,4,At5
BrownMhite
Fibrous
Helerogeneous
'10% Cellulose 9070 Non-fibrous (other)l{ono Dotsctod
2-CDW-02-Texture
09124@55.A0164
Apt #2 bath #1 White
Non.Fibrous
Heterogene0us
'100% Non-fibrous {other)Non6 0stgcted
2-CDW-03-Drywall
09tzow55aaft
Apt #2 bedroom
#2
Brownrvvhite
Fibrous
Helerogeneous
1oYo CelluJose 90% Non-fibrous {other}Nono Detectsd
2-CDW-o3-TeXure
agl?a@5s0016A
Apl #2 bedroom
#2
white
Non-Fibrous
Heterogeneous
100% Non-fibrous (othe0 Nons Detected
2-W0W-01"Drywall
091200955.A017
Apl #2 living room BrovnfuVhite
Fibrous
Hel€rogeneous
10o/o Cellulose 90% Non-librous (olher)Nono Det€ctod
2-WDW-0aOrywa[ Apt #2 kitchen
0912409354018
Browl/Vvhite
Fibrous
Heterogeneous
10% Cellulose 90% Non-fibrous (other)Nono Detectod
lnitial report kom 01t25t2012 Z2:j5:18
Analyst(s)
Adam C. Fink (31)
Rui Cindy Geng (gZ)
*:::#flHi:tji*5mayr6qqiroaddiliona|tsslingbyrEMto@n''ma3hsto9qwntili..'rr.lii6ii-iJiiiii;i.,{ir;r,i,"":iiL:fitJ'ff.n.iq?;ir##?;::ii"";';1;j?:$*T
mngn8pprovalolEMsLA&|ytical'|nc'EMsL,3|iabi|ityisiiiiroorornJcosr-or:nal
IntortrBlailon dnd us€ of totl tolutts ete oe rusrffsibitiiy of tn6 clinnr.s"6"i *cau"a In gsd sodttion udess oihemso rorod.EMSL Andytcat, trc Ssn LsaMro. CA I,WLAP Lab Cod€ tO1O4&3. fdA MO0O?01, WA CAOOT
PLM-7.23.0 Ptinled 1tZStZ01Z 10:1S:19 pM
Attn: Dave Price
Great Basin $ervices, Inc.
P0 tsox 238
Bfackfoot, tD 83221
Fax: (208) 7854053 Phone: (208) 785-1762
Project: BYU ld, - Tonda Rossa Apartmsnt on E, znd South,
Rexbury, ld.
Samplo DEscrlptlon Appsarance
Customer lO:
Cuslomer PO:
Received:
FMSL Order:
EMSL Proj:
Analysis Date:
G8SV62
41n4/12 9:00 AM
091200955
1n5t2l12
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 andlor EpA
6001M4-82-020 Method(s) using potarized Light Microscopy
Non-Asbestos
% Flbrous % Non-Fibrous
Asbsstos
% Type
EMSL Analytical, Inc
2235 Polvorosa Ave , Suite 230, $an Leandro, CA 94SZl
Phono: 1510)895.36?5 Frx: {510)895.3690 Enrait:
2-WOW-02.Jolnt Apt #2 kilchen Tan
comPound Non-Fibrousagt?00959'ot8A
Heterogeneous
100% Non-fibrous (other)<170 Chrysotllo
2-WDw-03-Drywall Apt #2 bedroom BrownANhile 10?s Ceilulose
awzoosssoots #3 Fibrous
Heterogeneous
90% Non-fibrous (othe{None Detectod
2-WDW-03-Texture Apt #2 bedroom
os.tzoagss.oatgA *3
White
Non-Fibrous
l'lelerogeneoug
100% Non-librous (other)Nono Detected
2-WDW-03-Joint Apt #2 bedroom
Compound #3
ofi2awtrao198
White
Non-Fibrous
Heterogeneous
100% Non-fibrous (other)Nono Petsctgd
3-FT-01-FloorTile Apt#3 bedroom
ostaoagss.oozo #1
Tan
Non-Fibrous
l-leter0geneous
96% Non-fibrous (other)4Yo Chrysotile
3-FT-01-Maslic
0s12aa96uaaaaA
Apl#3 bedroom Btack
#1 Non-Fibrous
l-leterogeneous
100% Non-fibrous (other)Nong Det€ctod
f nilial report fram 01 l$12A12 22:-1 5:18
Analyst(s)
Adan C, Fink (31)
Rui Ctndy Geng (5?)
Baojla Ke, Laboratory Manager
or other approved signatory
*: :ms#Hlt1l':Pj':.i9sn,t^t!mvt€guiroadditiffiltostiogbvTgMtocontimasbest*qoantidos. rheabov€resrrepcnrorarosoniyrorrisrremsre#;a-;j;i.ff;;iJd*ff;A;;iltlif&flT
#:J":tJ*i:f|.*]f::!!:'."EI1Ls|.1b'l'lyisti'nte!tolhgcos1o'an8lygi;El'lsl.o"uo,J'"ul'*.;;ii;y|or3an|6coigInte'proltiion and us€ ol l$t rcsulls ato tho rsspmsibilii ol lhe dief,t.sanptas rs€ived in good condttion urlleuu "tnririll,iiltijEMSL Analylical. tm San Lesndo, CA IwLAP Lab Code 10104&3, MA
Test Report PLM-7.23.0 Ptinted'. 1t2StZ012 10:1S:18 pM
EMSL Analytical, fnc
2235 Polvorosa Ave, Suite 230, San Leandro, CA g4SZ7
Atln: Dave price
Great Basln Servlces, Inc.
PO Box 238
Blackfoot, lD 83221
Fax: (208)78$4053 phone: (200) 785-1767
ProJect: BYU ld. - Tends Rossa Apartment on E, 2nd South,Rexbury, ld.
Sample Descrlptlon Appearanco %
Cuslomer lD:
Cuslomer PO:
Received:
EMSL Order:
EMSL Proj:
Analysls Date:
GBSV62
01124112 9:00 AM
091200955
112st2012
Test Report Asbestos Analysls of Bulk Materials via EPA 600/R-93/116 and/or EpA
600rM4€2-020 Method(s) uslng polarlzed Light Mlcroscopy
Non-Asboatog
Flbrous % Non.Flbroug
Asbostos
% Type
3-SV-o1-Sheet
Vinyl
491?@955,0?1
Apl#3 bathroom Tan
Non-Flbrous
Helerogeneous
100% Non-fibrous (other)None Detocted
$SV{l.Backing Apt #3 bathroom
0912@9W21A
l /hite
Flbrous
Heterogeneous
10% Cellulose 90% Non-flbrous (other)Nono Dotected
&SV-01-Mastic
091200955{0218
Apl #3 balhroom Vvhite
Non.Flbrous
Helerogeneoug
100% Non-fibrous (other)Nono Ootectod
3-SV-01-Sheel
Mnyl
09tM95r@2tC
Apt #3 bathroom t/Vhite
Non-Flbrous
Heterogeneous
'l 0006 Non-fibrous (other)NonoDotected ,
Analyst(s)
Actam C. Flnk (31)
Rul Chldy cang (52)
Baojla Ke, Laboratory Manager
or olher appro\red signatory
txe 10 fl|'lr!fic80on tiritslonE inn€mnt in pt!i. ssb3stos tibsrs tiati
g:1,ij1ry^dg:l$t_d!9.q1 TF{ 9 gq!!! ssboslos qusntitiot. Tho 6bora rssr rspod re|€les oniy ro nie nerB t$t;d snd my not bewtll|(ttl 8p9(0v8l of EUSL Arlslyucsl lnc. EMSU! lleulity l! tirfiled to tho cogt d ansrvrli. EMSL oean-m m3mddliry fd smro'6rr.dir
mry'"qid;adgdgglld.netti€Mi;sqlli;bosdqu"r'ri',ot'ih"il;il1;i-tifiiliifiil'ili"",ilHf,#;ffiffffi8#ffiSHffiffi'fi,S.lffiffi
mtm33.:Ill,SlllT! p *]f!:ffli,Yl$ggqJl"-gllJllJlli eugl oeap-no rapmrigiriry gr senpre'ooriecron iaivrui dil"iryrcar 'r€rhod rin rrrons.hbtFstEloo Itd us d 1s3t rosults 8rF tho FlpoatliHtiay of th8 cll€ntssrnpts! Bcatvod in ged cordiUon unlllo oUtenrige nooC.
Test Reporl P1M.7.23.0 Printed: 1/2512012 i0:1S:i8 pM
EM$L Analytical, Inc
2?3$ Polvorosa Ave , $uite 2S0, $an Ltlandro, CA 94577
phone; 15101 895-3675 rax: 1510) tI'5"3680 €,nnil: $$t]ls{|rrlr.olilh@ilfirl,cafir
Altn: Dave Price
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 83221
Fax: (208) 785-4053 Phonei (208) 785-1767
ProJ€ct: BYU ld, - Tonda Rossa Apartmont on E. znd South,
Roxbury, ld.
Sample Doscriptlon /qppsaranco
Non-Asbsstog
e Flbrous % Non-Fibrous
Customer lDi
Customer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01124112 9:00 AM
091200s55
1t25t2012
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 and/or EPA
600/M4-82-020 Method{s} using Polarized Light Microscopy
% Typo
3-SV-01-Backing Apl #3 bathroom Tan
ostzoogsraoal> Fibrous
Heterogeneous
20% Cellulo$e 80od Non-tibrous (other)None Dstoct6d
3-SV-01-Leveler Apt#3bathroom
a9t20a9s5&218
White
Non-Fibrous
f{eterogeneous
100% Non-fibrous (other)None Oetected
3-OT-01 Duct Tape Apl #3 furnace
oglzoogsgaozz room
Gray
Fibrous
Homogeneous
20% Non-fibrous (othe0 80% Chrysotil6 ,
3-WDW.01.Plaster Apl #3 bedroom
osnaosStrr,z3 #2
White
Non-Fibrous
l'lomogeneous
100% Non-fibrous {other)Nono ootoctod
3-WDW-01-Skim Apl #3 bedroom
Coat *2
09t20a95raa8A
White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)Non€ Dotscted
3'CDw{1-Plaster Apt #3 bedroom
auzoasaSlr,zi #1
White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
hifial reporl fom 0112512A12 22:15:18 l
Analyst(s)
Adam C. Flnk (31)
Rui Cindy Geng (52)
Baojia Ke, Laboralory Manager
or olher approved signatory
tIel0magni|ic0$0n|irdlalionsinhef€nlinPLM.asb€$toslibof5indimefision5bo|ow|heresotution€pabt|llyo|PLMma'n..be@
fayr€quifoaddilionalt,$tingbyTEMlocot{ima5b€rtosq0afli|igs.T'Eabwsto5treporl{ota|e9on|yto|ioit€t8to5|lftndmaynotoorepocurdina
hfino'r'pprov8lo'EMsL.Ana|ytlcal'|naEMsu5|iat'|ityi5|idtedto|h6costo'analysis'EMsLbea'snorespo|sibitityto'sa|
lnlerF€tdlion ar( uta ot tegl losulls 3re tilo tesponsibilrry of lhe dient,Sanptes r€csived ,n oood caftrrtion untgss olh€(Mso oot6d.
Samplos EMSL Analyilcal, Inc San Lesndfo, CA |WLAF Lab cade 101o{{r.3. MA M000201. wA c?007
TestReport PLM-7.23.0 Printed: 1/25/2012 10:15118 pM
EM$L Arralytical, lnc
2235 Polvorosa Ave , Suite ?30, $arr Leandro. CA 94927
Phono: {510} 895.3S75 F0xr {510} 895'3680 Emaili .q.illtoand"rals.h(ggu$.Lqgm
Altn: Ssyg pdss
Great Basin $ervices. Inc,
PO Box 238
Blackfoot, tD 83221
Fax: (208) 785-4053 Phone: (208) 785-1767
Project: BYU ld. . Tenda Rossa Apartmont ot E. 2nd South,
Rexbury, ld.
Sample Descrlption App6aranc6
Customer l0:
Customer PO:
Received:
EM$L Order:
EMSL Proj:
Analysis Datei
GBSV62
01124t12 9:00 AM
091200955
1ft5/2}12
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 and/or EPA
600/M4-82-020 Method{s} using Polarired Light Microscopy
Non-Asbostqs
% Fibrous o/o Non.Fibrous
Asbosto$
% Type
3-C0W01-Drywall Apt #3 bedroom White
ostzofftss"oa?4A #1 Non-Fibrous
Homoseneous
107o Cellulose 90% Non-fibrous (other)Nons Dotsctod
4-FT.01-Floor Tile Apl tl4 living room Tan
ostzao$roozi Non-Fibrous
Homogeneous
9506 Non-tibrous (other)5% ChrysotilB.
4-FT-01-Mastic
a9t20o95500?.5A
Apt Ci4 living room Black
Non-Fibrous
Homogeneous
1 00o/o Non-fi brous (other)Nons Dstocted
4-FT-02 Floor Tile Apt #4 bedroom
osr;,aagslwz6 #1
Stop Positlve (Not
Anallrred)
4-SV-01-Sheel
Wnyl
a912AO9S$O027
Apt t,4 kitchen Tan
Non-Flbrous
Homogeneous
100Y0 Non-fibrous (other)None Detected
d-Sv-01-Backiag Apt #4 kitchen
09t?0095&ao27A
White
Fibrous
Homogeneous
60Yg Cellulose
2070 Glass
2070 Nsn-fibrous (other)Nono D6t6cted
lnitial report from A12512012 22:15:18 --"1
Ij
Analyst(s)
Adan C. Fink (31)
Rui Cindy Aeng (52)
Baojia Ke, Laboratory Manager
or olher approrcd signatory
DU6|oma9ni|icalionlifr|a$onsinntrenlinp|M.a9bestosfiber$inoimnsions
m'yrqUjr88ddil1omtlo5tiogbyTE|utoconjimasboE|o$quan|itiosTllo8bwelsst(eporlrstalesoniytollioil0m3testodandmaynotb
witt€n approvst of EMwn€n appfovg ottMSL Anstytl€t, Inc.
ht6tprclauon 8nd us or lesf t€ssl(6 ale |ha ospssibility of ihe clirnt Sarple3 rueiv€d in gsd sr}'itton !r*;ss orhoMs€ roted
Inc Ssr Leandro. CA NVLAP Lab Cod€MA M000201. WA C2007
Test Report PLM-7.23.0 ?finled:112612012 10:1i:18 pM
Attn: DaVe price
Oreat Basin Services, lnc.
P0 Box 238
Blackfoot,lD 83221
Fax: (208) 785-4053 phone: (208) Z85-1767
Project: BYU ld, - Tonda Rossa Apartment on E. Znd Sorrth,
Roxbury, ld.
Samplo Description App@6ranco
Cust0mef lD:
Cuslomer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GBSV62
01124112 9:00 AM
0s1200955
1t25t2012
Test Report: Asbestos Analysis of Bulk Materials via EPA 6001R-93/116 andlor EpA600/M4-82-020 Method{s} using potarized Light Microscopy
Non.Aebsstos
% Flbrous % Non.Flbrous
Asbsstos
ilo Typd
EMSL Analytical, Inc
2235 Polvorosa Ave, $uitc t30, S:rn Leandro. CA 94577
Phooo: {510} 8gs-!675 F x: (S10} A$g.t6g0 Emdit:
4-SV.02"Sheel Apt #4 bathroom White
VinYl Non-Fibrousa9t?04t5r8028
Homogeneous
100% Non-fibrous (other)Nono 0etectsd
4-SV-02-Backing Apt #4 bathroom Gray
actzooqsrwtA Fibrous
Homogeneous
40% Cellulose
40olo Glass
20% Non-fibrous (otheO Nons Odtectsd
4-SV-02-Mastic
a9t?aoq5w0?88
Apt #4 bathroom White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)Non€ Detectsd
4-CDw-01-Drywall Apt #4 bedroom
ofi2a*srao2s #2
White
Non-Fibrous
Helerogeneous
10% Cellulose 90o/o Non-fibrous (othe0 Nonq Detsctod
4-CDw-01-Texture Apt #{ bedroom
0gl20Og5{rOOZgA #2
White
Non-Fibrous
Homogeneous
100% Non-librous (other)<1% Chrysotilo
4-WDw-01-Orywalt Apr #4 tMng room
oc12w5wa30
While
Non-Fibrous
Homogeneous
10% Cellulose 90% Non-tibrous (other)Nong Dgtectod ,
iiliGi ;iln rroiini/a5/2itTa 22Ji:
i
Analyst(s)
Adam C, Fink (31)
Rui Clndy Geng (52)Baojia Ke, Laboratory Manager
or olher approved signalory
lofisonitl€tion liritations inhor€nl ln plM,fEyreqUlrsdditjm|]*s|in9byTEMtocon{ima9bs3lo9quan|llies'ln;"*.!,iJJtiiili"ii'H;iflffr.;'JJ#f[i,f1T;iiH3iJj?;:iie.;';i;;lil:f
written8ppI0v8|ofEMsLAm|y|ica|,tnc"EMsL,$|iabi|ityisiimitodtoths@$to|.an','';:Ei,sl;;;;;;riiliiylorsar
lntoQr€lation and ure ot rcstmsull$ aE lrro tegponslbiliiy of ths 6licnt.sdnpler &aeJlgd In good condition vnlGls othrryd$o noroo.€MSL Anslyricot, Irtc San Le6ndrn,,CA NVLAP Lab Code rOt04&3, MAAAO00?01. WA C2002
Test Reporl PLM-7.23.0 Printed: 1/2512012 10:.tS:.19 pM
Altn: Dave Price
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 83221
Fax: (208) 78M053 phone: (A0g) 7g5-1267
Project: BYU ld, . Tenda Rossa Apartrnsnt on E. Znd South,
Rexbury, ld.
Samplo Descriptlon App6€rance
Customer lD:
Customer PO:
Received:
EMSL Order:
EMSL Proj;
Analy$is Dale:
GBSV62
41124t12 9:00 AM
091200955
1t25t2412
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-9t/118 and/or EpA600/M4-82-020 Method(s) using potarized Light Microscopy
Non-Asbestos
Ys Fibrous % Non-Fibrous
A.sbostos
o/o Typo
EMSL Analytical, Inc
2235 Polvorosa Aye , Suito ?30, Sarr Leandro, CA g4SZ7
Pho'ro: {510) 895-36?5 Fax: {$101 8s$.3s80 €mftit: 5,irl
4-WDW-o1-Texture
0917AA96,A80A
Apt #4 living room White
Non-Fibrous
Hotnogeneous
100o/o Non-fibrous (other)<1% Chrysotile
OS-01-$tucco Outside apt Gray
ostz}ass&alit gomptex ' ftont of Non.Fibrousbld" Homogeneoug
100% Non-fibrous (other)None Detectod
OS-01-Skim Coat Outside apt
oslzoogsroo3lA complex - front of
btd.
White
Non-Fibrous
Homogeneous
'100% Non-fibrous (olher)Nono Oetectod
OS-02-$tucco
09120095sA032
Outside apt Gray
complex - W. side Non.Fibrousol old Homogeneous
1 007o Non-fibrous (other)Nono D6t6stod
OS.o2'Skim Coat Outside apt
osllooss&oa3zA complex - W, Bide
ot bld
White
Non-Fibrous
Homogeneou$
l00o/o Non-fibrous (other)Nono Detectsd
OB.'l Brick Mortar Outside apt
ost2ooe55ioo33 complex - brick
monar
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)Nono Detected
lnitial report trom 01 t2512e12 22:1 5:18
Analyst(s)
Adam C. Fink {31)
Rui Cindy Oeng (52)Baojia Ke, Laboratory Manager
or olher approved signalory
oue t0 rnagoilica||ofl linitations ishersnl id pt M, aioestos nlers in?fr;iililb€ffisd0i6;my rcquro Sddi|joml tesling by T€M lo @0tifm asb€stos qwoitia8. Ths abwo resr r6pon .aratos tePoded as <1% or nomyi:l1'&;1;idili!^;;,ii{'il:._Eiif"""#;iil"ffilli!'{iffJT':ffi}!",fffi'A*H,ll$Hffl*:lf#'"iilffJ;ifiiffjJ;gfiglHfm",jf:lnler!rcl8lion 8td lse ot lss[osufls ero fto te$ponsibiliiy of the etiant.Senptei recerveo In good condrtron udsss orheeis€ mted.Jnc San Lsandro, cA twLAF Lab codo 101048.3. MA
Test Reporl p1M.7.23.0 pnnled:1t25t2012 10:15:18 pM
gM$L Analytical, lnc
2235 Polvorosa Ave, Suitc 230, $an Leanclro, CA 94571
Fhone: {510} S}q3675 fsx: {510} 8{5-3S90 Ernait: s*ltlr-afld.al$h.&*rHi[sq]ll
Attn: Dave Price
Great Basin Services, Inc.
PO Box 238
Blackfoot, lD 83221
Fax: (208) 7854053 Phone: (209) 785-1167
Proi€ct: BYU ld. " Tsnda Rossa Apartmsnt on E, Znd South,
Rgxbury, ld.
Samplo Descrlption App€aranco
Customer lD:
Cuslomer PO:
Received:
EMSL Order:
EMSL Proj:
Analysis Date:
GgSV62
41n412 9:00 AM
091200s55
1125t2012
Test Reporfi Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 and/or EpA
600/M4-82-020 Method(s) using polarized Light Microscopy
Non.Asbestos
Yo Fibrous % Non.Fibrous
Asbsstos
% Typa
FB-0'l Fiber Board Outside apt Bro\,rin/Btack
ost?oos6$Q034 complex- S€ Fibrouscomer Heleroqeneous
90% Cellulose 10% Non-fibrous (other)Nons DEtected
R-01 Rooting
09r?0095"t00J5
Outside apl Black
complex- roof - Non_Fibrouslront sloe Homogeneous
20% Cellulose 809o Non-fibrous (other)Nons Dotoctsd
R-02 Rooling
091240955-0036
Outside apl Btack
complex - roof - Non-FibrousDacK sloe Homogeneous
20% Cellulose B0% Non-fibrous (other)llono Dotected
R-03 Rooling
09124095$0037
Outside apt Black
complex- roof - Non-FibrousItont sloe Homogeneous
20% Glass 80o/o Non.fibrous (othe{None D€tected
R-04 Roofing
491204915.0038
Outside apt Black
complex. roof - Non-Fibrousback stcte Homogeneous
20% Glass 8070 Non-fibrous {other)llone Oetected
R-05-Rooling 1
0912w959.AW9
Outside apt Btack
complex- roof . Non_FibrousoacKsloe Homogeneous
20Yo Glass B0% Non-fibrous (other)None Dotected
lnilial report ftom 01t25t2012 22:15,18
Analyst{s)
Adam C" fink (31)
Rui Cindy 6eng (52)
Baojia Ke, Laboratory Manager
or other approved signatory
::::g*?lTliTlIT: igg:li't-1M' ts,rby requrs addallonal t\tslinq bv TEfvi lo contim asbsstos quantl0as. Tho dbs€ test fopon datos oniy to lio tems resi# ioi riy ;6;i;i; uiy ,o* *1nou g," ur9n.r,wiltef approvsl qf EMSL Ar€tylcat, lncwtefapprovg|glEMsLAnalyt|ca|,lncEMsL.9||abi|ityl3iimit6dtotheco$tofana|ysii.EMsLuearsnoresponsioitityroisarpre,coliid,dii-ii;;
lnlerprct0tion 6nd use ot tsst f€3ull! am lho l63po$lbiljiy ot tho cli€nt.sarplos recovod In good condition unloss othorulss notqd.
Inc San Lsandro, CA NV!4p Ldb Coda 10t049"3, MA MO@201, WA CZO07
Test Reporl PLV|-7.23.A Printed: 1/ZSl2012 .10:1S;18 pM
EMSL Analytical, Inc
2235 Polvorosa Ave , Suite 230, San Leandro. CA 94572
Atln: DaVe prlce
Great Basin Services, Inc.
PO Box 238
Bfackfoot, lD 83221
Fax (208)785.4053 phone: (208) 785-1767
Project BYU ld. . Tenda Roesa Apartment on E. 2nd South,Rexbury, ld.
Sample DescrlpUon Appoarance
Cuslomer lD:
Cuslomer POi
Recelved;
EMSL Ordec
EMSL Proj:
Analysls Dale:
GBSV62
01124112 9:00 AM
091200955
1t25t2012
Test Report: Asbestos Analysis of Bulk Materials via EPA 600/R-g3/116 and/or EpA600rM4€2-020 Method(s) using potarized Light Microscopy
Non.Asbeetos Asbeslos
R-O$Roofng 2
0912@955{o:t9A
OutsldE aptcomptex - roof -
backslde
Black
Non-Flbrous
Homogeneoug
c/a Flbroue
20o/oGlass
% Non-Flbrous
60% Non-fibrous (other)
o/o
None Doteclod
R-06Roofing 1
091?@9551Xr'0
Oulslde apt
complex - roof -
under rubble roof
Black
Non-Flbrous
Homogeneous
20% Cellulose 80% Non-fibrous (olher)None Detectod
R{GRoofing 2
0912W95'0o40A
Outside apt
complex. root -
under rubble roof
Black
Non-Flbrous
Homogeneous
10% Glass 90% Non-librous (other)l{on9 Detec{od
R-0STar
0912w95'{f{0€
Outside apl
complex. roof -
under rubble root
Black
Non Fibrous
Hgmogeneous
100% Non-fibrous (other)None Detected
tualyst(s)
Adam C. Flnk (31)
Rd Andy Geng (i2)Baoria Ke. Laboralory Manager
or other approved slgnalory
may.Bqrd'6addrlomrleruauyieurosydarbesroEdd'ii;;:'r.";;fF;l;;";fifitrff,fifl":iJ#lfr{l;i.#'f,T;,Trffffiffiifft#ffiffiwt|t8n8p9Bdo'EMsLAnslytlcsl.tnc.EMsL's||sb[|ty|3iiilreororrreiogiaen8|yerieu.sflein,nJnfiriiityrorra'rprecolloctto'r8c{v|do!or8n8|ytjidEt'
InteD.€buonsrd uroottlstro:urB mther€spo,rslutii of uro di".r.saoprii rocdod r" eo&-diii;;".ii;i.'oii.*i." norua
Test Report PLM-7.23.0 printed: 1/25/2012 10:15:18 pM THIS IS THE LAST PAGE OF THE REPORT.
4vn'o+ >
(h/ ?).-
'- ,:|;:
Drawings and locations
=o
g)
@
9ooE
:O
qn
!{os. (rl
oo
CNEF'AO t:{'oia€o
ro:E
=.Eo==o
O:taa-r o'
Oa6,o+tO
Tn -h
-r, | .nn(- l^r -l I('lc= crOsN)
i --i
lir;it
clro l"
vrA(ot!', -
O,J =o)
do_fr
-u
mv
=mno
TI
@g
rq
zo
=
J
U)oc
oaIO
o
@Io
.Tt
u,I
O mq,q,
.J,
J.z ._\Cnrcor-ul5
=N)oz
w0),.'.F
..J
IU)
"/\I;{ c)
.-+ I
J
I
€-u
IO
N)-{o
Jo-
0)
7o
@a0)
E0)
=3o
:J
F.|.
+h
..A
ooo-
do
3
..s
I
E-u
I
O
J
FaLU
=
FU)
uJ
o+
o
=Ic{
oIF+
?N
=oOO
ci=
J
No
IFII
ci-:th
otUc0
cf)o
I
a
NNtYY3o
=I
NO-.!- c\
! K*
mct
oIc0
tLIc{
oI
U)
IN
ilillir--i ? |
,I'Itl
I
lrllrl
I
I
I
IU
O
z
E,
l
LL
ilB
EJEK
cf)
Ac{
=H-uJYcoN
IFl-zfo()(au-
N
coEEoo-
$aooE.
$EcoF
Hilefi
=cotN
a>-l -rl
Plrv4mutlz
dgansfi
qlDo
€z
G)I
=U
€IO
o
{on
om
tpmU
N)
5-l
?gcn -{
IO
;
t_*- ,
l----.-.--
(.r)
I-T1
ctrimo
UJI
-11 ?
CUn;{z6
o
FN
(r)
Io
I
€IO
J
a-l s
Io
IO.A cdTtm
@z-{g
fincno
@a
!
n-l
rnz-l
s
AI
@
ION)
tpmo
tocl(p+
m(f
?.AN)
sicl
>
t-o
zo
Certifications
I or)
IFI rF
IHt'*
IIL-_.rl!]
"\ lF
, \I A-hx
\l c,\'l.h\\\lo'-.,\ I u Li( -',.1 3 E3\\ls ^F:''',1; $lsl\ 'i.x:t!{'\ -tl< E 6 K
--"'ll,^g" .q E H s
.l l!' v-!^'i'-l,R ?cax<3{e ii sYEq) k traE#s8E*t eno -=\i.i E.=I e;EaEs€R
/-t '
*l
5l hlo{l Ylc.rl
4 rlFlolt -t olr{ gl":l
El pl?l
'!l=tlEl iils' g't'Hl
(!oc)
H F! (! ..Eb# g
d<;5FQZUrI]
Uz
U -$*Z u*
)q goF
r, ,:tsc
tl rh '{€ N\r'H
d = iio ^'|q z iE x
e tS Ft ryy klu !-'; 9 EE *r FEE' p 8B q
? 3.E E? frd; 4il H? 543 ig" 6n tr ! E! z
F 3.f -i =.- A
a FiF g3 5Z.xrsq
o t :'^ 'r
,v ;€ tr
!l ;iqrF 6<n
Z ?Ei-'i s,-
AF{sn
II
a$
ER
iig
o
IG
:
fi-'q
t rod
Hg
$HE*E a*E$E
r cj F. =Es€
s q HF SEEE: E3^ EeHE.*r
n E€ 6lHFtEI ;5 $g fiEEgr Ei EsSE$gEB EE€F
E OtrO
* eSBH F$ UEE$
u?oo
$!rOc\CD
N
F
Oul--toL
o
*f
goIIttrl
$.t
I'oLoo
rho
o#(ro
IIqr
ELoo
EDo965EcoEg6EE3
EEf-bo'(Utrtt€trFga.att
$gSEoooEO-:!= llt5.EvIUz
I.l3l9lc{l
alsgt$
Fl
I
-fl-r: