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Home My WebLink About5529 S Timberline Rd - Special Inspections/Field Verification - 09/20/2016�5�� Resenroes Enutrohnmental Inc r Effective January 1 2015 Reservoirs; Envnonmental OA Manual T 1OAOC1Lab1Reservoirs Enwmnmental OA Manual doc RE-1 LAB Reservoirs Environmental, /nc. IPPPI September 20 2016 RLH Engineering 541 East Garden Drive Unit S Windsor CO 80550 Dear Customer Subcontract Number NA Laboratory Report RES 360372 1 Pro/ect # / P O # 16065 Project Description Child Adyocacy Center Reservoirs Environmental Inc is an analytical laboratory accredited for the analysis of Industrial Hygiene and Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP) Lab Code 101896-0 for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the American Industrial Hygiene Association (AIHA) Lab ID 101533 Accreditation Certificate #480 for Phase Contrast Microscopy (PCM) analysis This laboratory is currently proficient in both Proficiency Testing and PAT programs respectively Reservoirs Environmental Inc has analyzed the following samples for asbestos content as per your request The analysis has been completed in general accordance with the appropriate methodology as stated in the attached analysis table The results have been submitted to your office RES 360372 1 is the job number assigned to this study This report is considered highly confidential and the sole property of the customer Reservoirs Environmental Inc will not discuss any part of this study with personnel other than those of the client The results described in this report only apply to the samples analyzed This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of the U S Government This report shall not be reproduced except in full without written approval from Reservoirs Environmental Inc Samples will be disposed of after sixty days unless longer storage is requested If you have any questions about this report please feel free to call 303 964 1986 Sincerely CA-, a Ma r t� Jeanne Spencer President P 303-964 1986 5801 Logan Street Suite 100 Denver CO 80216 1416frRESI ENV F 303-4774275 www rehab win Page 1 of 1 as a classroom(s) a cafeteria gymnasium hallways designated by a person certified to prepare management plans design abatement projects or conduct response actions GAC - General Abatement Contractor Homogeneous area - an area of surfacing material thermal system insulation material or miscellaneous material that is uniform in color texture or time of installation Miscellaneous material - building material on structural components structural members or fixtures such as floor and ceding tiles and does not include surfacing material or thermal system insulation NESHAP - National Emissions Standards for Hazardous Air Pollutants (40 C F R Part 61) E( PA) Subparts (General Provisions and M (National Emission Standard for Asbestos) NIST - National Institute of Standards and Technology Nonfnable - material which when dry may not be crumbled pulverized or reduced to powder by hand pressure NVLAP - National Voluntary Laboratory Accreditation Program O&M - Operations and Maintenance Operations and maintenance program - a program of work practices to maintain friable ACBM in good condition ensure clean up of asbestos fibers previously released and prevent further release by minimizing and controlling friable ACBM disturbance or damage OSHA - Occupational Safety and Health Administration PLM - Polarized Light Microscopy Polarized Light Microscopy - an analytical technique used for identifying types of asbestos fibers in bulk material samples PPE - Personal Protective Equipment Public and Commercial Building - any building which is not a School Budding except that the term does not include any residential apartment budding of ten or fewer units Single-family residential dwellings currently intended as such are excluded from this definition This definition includes all industrial buildings School - any institution that provides elementary or secondary education School building - Any structure suitable for use as a classroom including a school facility such as a laboratory library school eating facility or facility used for the preparation of food w Any gymnasium or other facility which is specially designed for athletic or recreational activities for an academic course in physical education Any other facility used for the instruction or housing of students or for the administration of educational or research programs Any maintenance storage or utility facility including any hallway essential to the operation of any facility described in this definition of school building Any portico or covered exterior hallway or walkway of any facility described in this definition of school building Any exterior portion of a mechanical system used to condition interior space of any facility described in this definition of school budding SFRD - Single -Family Residential Dwelling Structural member - any load -supporting member of a facility such as beams and load supporting walls or any non load -supporting member such as ceilings and non load -supporting walls Surfacing ACM - surfacing material that is ACM Surfacing material means material that is sprayed on troweled on or otherwise applied to surfaces such as acoustical plaster on ceilings and fireproofing materials on structural members or other materials on surfaces for acoustical fireproofing or other purposes Thermal system insulation - material applied to pipes fittings boilers breeching tanks ducts or other interior structural components to prevent heat loss or gain or water condensation or for other purposes TSCA - Toxic Substances Control Act TSI - Thermal System Insulation VAT — Vinyl Asbestos (floor) Tile VCT - Vinyl Composition (floor) Tile V INTRODUCTION The Voices Carry Child Advocacy Center (CAC) contracted RLH Engineering Inc (RLH) to perform a pre -renovation Asbestos Survey at CAC located at 5529 South Timberline Road Fort Collins CO The intent of this Survey was to identify Asbestos Containing Materials (ACMs) that would need to be properly removed and disposed of prior to renovation of the facility The facility is a commercial structure of approximately 1 000 SF in size The structure is being renovated into exam rooms This report presents the results of the Survey conducted on September 7 2016 Asbestos Bulk Samples were collected by Mr Derek Spinuzzi and submitted to Reservoirs Environmental Services Inc (REST) for PLM Analysis Mr Spinuzzi is an EPA -accredited and CDPHE-certified Asbestos Inspector RESI is a NIST/NVLAP- accredited laboratory SURVEY METHODOLOGY The intent of this Survey was to identify Asbestos Containing Materials (ACMs) that would need to be properly removed and disposed of prior to renovation of the facility The following tasks were performed to complete the Survey • Building Systems/Homogeneous Materials Assessment - An initial walkthrough of the facility was conducted to identify building components building systems accessible Homogeneous Areas/Materials This information was recorded on field -generated forms and floor plans The condition and friability of each suspect Homogeneous ACM was assessed The following observations were made during this Survey regarding the subject facility Foundation Type Concrete Basement Structure Type Stone and Concrete Single Story w/Basement Roof Type Wood-Framed/Sheathed with Wood -shake Shingles Exterior Facade Stone Interior Floors Finishes Hardwood Floors Concrete Interior Wall Finishes Plaster (2 types) Textured Drywall Stone Wood Paneling Interior Ceiling Finishes Plaster Ceiling Tile Heating System Cooling System Radiant Heat Not Applicable VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC Complete Information regarding Homogeneous Materials Including material types quantities and ACM status are Indicated in Appendix — A Homogeneous Materials Report • Sampling Methodology/Collection - Each homogeneous suspect ACM was quantified based upon square -footage linear footage or total units A Bulk - sampling Plan was developed based upon the type and quantity of suspect Homogeneous ACMs The Bulk Sampling Plan determined the appropriate location and quantity of samples to be collected Bulk samples were randomly collected from each homogenous area of suspect budding materials as follows • Surfacing Materials • At least three bulk samples were collected from each homogenous area that is 1 000 SF or less • At least five bulk samples were collected from each homogenous area that is greater than 1 000 SF but less than or equal to 5 000 SF • At least seven bulk samples were collected from each homogenous area that is greater than 5 000 SF • Thermal System Insulation • Three (3) samples were collected from each homogenous area of thermal system Insulation • Miscellaneous Materials • A minimum of Two (2) samples were collected for miscellaneous materials NOTE The stated quantity of samples is the minimum required by regulations At the discretion of the Inspector additional samples may have been collected to confirm homogeneity of materials • Sample Identification/Analysis - After Bulk Samples of suspect ACM were collected sample locations were recorded on field forms and/or floor plan drawings Each sample was assigned a unique sample number recorded on a Chain of Custody and delivered to a Laboratory for PLM Analysis • Sample numbers were assigned using the following format 12345-0101- ABC01-01 The first five numerals are the project number assigned to the project by RLH Engineering Inc (RLH Engineering Project Numbers are assigned using the last two numerals of the year and three numerals showing the sequence in which each project was performed) The following four numerals are the month and day the sample was collected The next two or three letters and two numbers are the homogeneous material Identification number The last two numerals are the sequential sample for each homogeneous material Example of Sample Numbenng and Sequence 2 VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC For the first floor tile sample taken on February 13 2002 for Project Number 02001 the sample number would be 02001-0213-FT01-01 The second sample of the same floor tile would be 02001-0213-FT01- 02 The first sample of a second floor the sampled on the same day would be 02001-0213-FT02-01 and the following sample 02001-0213-FT02- 02 • Bulk samples analyzed for asbestos were delivered to Reservoirs Environmental Services Inc (REST) RESI is accredited through the National Voluntary Laboratory Accreditation Program (NVLAP) administered by the National Institute of Standards and Technology (NIST) Samples were recorded on a RESI Chain of Custody form and delivered with the samples to the laboratory at which time the individual delivering the samples signed the Chain of Custody form assigning custody of the samples to the laboratory • Bulk samples were analyzed for asbestos content by Polarized Light Microscopy (PLM) In the state of Colorado samples of friable materials indicating asbestos content of less than 1% but greater than 0% (including TR or Trace) must be further analyzed using a Point Count technique Samples meeting this criteria were further analyzed by Point count In addition at the discretion of the Inspector samples in which the asbestos content is less than 3% may have had a Point Count performed to determine the exact percentage of asbestos in the material • A Sample Report indicating Sample Numbers Material Descriptions Sample Locations and ACM Content is included with this report as Appendix B • Laboratory Results with copy of the Chain of Custody are included with this report as Appendix C • Report Generation - Upon receipt of Laboratory Results this Report was completed including the attached Figures and Appendices The Floor Plans were generated in AutoCAD format which depict Homogeneous Material Locations Sample Locations and Locations of ACM or Assumed ACM REGULATORY INFORMATION The Asbestos Hazard Emergency Response Act (AHERA) sets forth state-of-the-art requirements for proper asbestos inspections in buildings AHERA requirements initially applied to K-12 schools only but have been extended by other state and federal regulations to include all public and commercial buildings as a requirement prior to renovation or demolition The AHERA standards were used in the inspection process for this survey 3 VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC An ACM is defined as any material that contains greater than one percent (1 %) asbestos as determined by laboratory analysis using polarized light microscopy (PLM) The Environmental Protection Agency (EPA) and the Occupational Safety & Health Administration (OSHA) distinguish between friable and non -friable forms of ACM Friable materials can be crumbled or reduced to powder by hand pressure when dry Non -friable materials cannot be crumbled pulverized or reduced to powder by hand pressure when dry Friable materials are more likely to be released into the air especially if Impacted or damaged during normal use renovation or demolition of a building Therefore the distinction between friable and non -friable ACMs is important The EPA further distinguishes non -friable AGMs as Category I and Category II Category I non -friable ACMs include floor tiles and tar -impregnated roofing felts and removal of these ACMs is generally not required prior to demolition if they are in good condition Category II ACMs are all other non -friable ACMs and must be removed prior to normal demolition In the state of Colorado samples of friable materials indicating asbestos content of less than 1% but greater than 0% (including TR or Trace) must be further analyzed using a Point Count technique If a Point Count is conducted the result of the Point Count must be used rather than the initial PLM analysis Whether removed or remaining in a structure during demolition the confirmed or presumed ACMs are subject to USEPA National Emission Standards for Hazardous Air Pollutants (NESHAP) and OSHA regulations NESHAP requires in 40CFR61 145 that each owner or operator of a demolition activity provide the administrator with written notice of intent Federal requirements which govern asbestos identification management abatement work or shipment and disposal of asbestos waste materials include the following OSHA U S Department of Labor Occupational Safety and Health Administration (OSHA) including but not limited to • Occupational Exposure to Asbestos Tremolite Anthophyllite and Actinolite Final Rules Title 29 Part 1910 Section 1001 and Part 1926 Section 1101 of the Code of Federal Regulations • Respiratory Protection Standard Title 29 Part 1910 Section 134 of the Code of Federal Regulations • Construction Industry Title 29 Part 1926 of the Code of Federal Regulations • Access to Employee Exposure and Medical Records Title 29 Part 1910 Section 2 of the Code of Federal Regulations • Hazard Communication Title 29 Part 1926 Section 59 of the Code of Federal Regulations and • Specifications for Accident Prevention Signs and Tags Title 29 Part 1910 Section 145 of the Code of Federal Regulations DOT U S Department of Transportation including but not limited to Id VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC • Hazardous Substances Title 29 Part 171 and 172 of the Code of Federal Regulations EPA U S Environmental Protection Agency (EPA) including but not limited to • Asbestos Hazard Emergency Response Act (AHERA) Regulation • Asbestos -Containing Materials in Schools Final Rule & Notice Title 40 Part 763 Sub -part E of the Code of Federal Regulations • Training Requirements of (AHERA) Regulation • Asbestos -Containing Materials in Schools Final Rule & Notice Title 40 Part 763 Sub -part E Appendix C of the Code of Federal Regulations • National Emission Standard for Hazardous Air Pollutants (NESHAPS) and • National Emission Standard for Asbestos Title 40 Part 61 Sub -part A Sub -part M (Revised Sub -part B) of the code of Federal Regulations State of Colorado Colorado Department of Public Health and Environment (CDPHE)Including but not limited to • Air Quality Control Commission Regulation No 8 (5CCR 1001-10 Part— B) • Solid Waste Regulation Section 5 5 of 6CCR 1007-2 Regulations Pertaining to Solid Waste Disposal Sites and Facilities Many components found within buildings are comprised of or function through the use of materials that are considered hazardous materials or hazardous waste upon disposal These items are commonly referred to Regulated Building Materials (RBMs) Federal and state requirements which govern management shipment and disposal of RBMs include the following DOT U S Department of Transportation including but not limited to Hazardous Substances Title 29 Part 171 and 172 of the Code of Federal Regulations EPA U S Environmental Protection Agency (EPA) including but not limited to • Comprehensive Environmental Response Compensation and Liability Act (CERCLA) • Resource Conservation Recovery Act (RCRA) • Toxic Substances Control Act (TSCA) 5 VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC SURVEY RESULTS The Inspection and laboratory results Identified the following ACMs ASBESTOS CONTAINING MATERIALS (ACMs) No asbestos containing materials were Identified as part of this survey VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC RECOMMENDATIONS The following recommendations are made with respect to the ACMs Identified in the facility ASBESTOS CONTAINING MATERIALS (ACMs) No asbestos containing materials were Identified as part of this survey EXCLUSIONS/LIMITATIONS RLH Engineering Inc has performed this survey using state -of -the art techniques in a manner that is consistent with the level of care and expertise exercised by Individuals and firms in the Asbestos Inspection profession RLH cannot guarantee that all ACMs were Identified and sampled by this Survey Sampling for this Survey was performed using non-destructive methods whenever possible This means that samples were taken in small amounts and in inconspicuous locations to prevent damage to the building finishes to the greatest extent possible Accessible locations were inspected and sampled throughout but materials were not significantly demolished to gain access to locations that were otherwise inaccessible If during the course of renovation or demolition suspect materials not identified in this report are encountered work should be stopped for additional assessment and sampling Likewise if materials identified in this report are encountered in locations not identified in this report work should be stopped for additional assessment and/or sampling The intent of this Survey was to identify ACMs that would need to be properly removed and disposed of prior to renovation of the facility Locations and quantities of materials discussed in this report are approximate This document should not be used as a bid document for the removal repair encapsulation enclosure or Operations & Maintenance (O&M) of any ACM discussed in this report Bid documents should In general include specific information regarding the location and materials to be abated a description of specific work practices and procedures contract document information and other project specific Information In some cases these documents need to be developed by EPA -accredited and CDPHE-certified personnel Contact RLH Engineering in the event that these services are required SIGNATURES This Survey was performed by RLH Engineering Inc a CDPHE-registered Asbestos Consultant (Reg # 14755) Asbestos Bulk Samples were collected by RLH Project Manager Derek Spinuzzi Mr Spinuzzi is currently accredited by the EPA and certified by CDPHE as an Asbestos Inspector Copies of all appropriate accreditations and certifications are included with this report as Appendix D Please contact us if you have any questions regarding this report 7 VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC Sincerely RLH Engineering Inc Derek Spinuzzl Project Manager Asbestos Inspector #14068 VOICES CARRY CAC / PVH ACM SURVEY PVH/CAC Reservoirs Environmental Inc Reservoirs Environmental OA Manual Effective January 1 2015 0 \DAOC\LAB\Reservoirs Environmental OA Manual doc RESERVOIRS ENVIRONMENTAL INC NVLAP Lab Code 101896 0 TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number Client Client Project Number / P 0 Client Project Description Date Samples Received RES 360372 1 RLH Engineering 16065 Child Adyocacy Center September 08 2016 Method EPA 600/R 93/116 Short Report Bulk ND=None Detected Turnaround 3 5 Day Date Samples Analyzed September 19 2016 TR=Trace <1 % Visual Estimate Trem/Act=Tre m of ite/Asti n o late Client Lab L Asbestos Content Non Non Sample ID Number A Sub Asbestos Fibrous — Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) (%) (%) (%) 16065 090716 DW01 01 EM 1705066 A White compound w/ tan paint 25 ND 0 100 B White/tan drywall 75 ND 30 70 16065 090716 DW01 02 EM 1705067 A White compound w/ tan paint 30 ND 0 100 B White/tan drywall 70 ND 35 65 16065 090716 DW01 03 EM 1705068 A White compound w/ tan paint 35 ND 0 100 B White/tan drywall 65 ND 40 60 16065 090716 P01 01 EM 1705069 A Off white granular plaster w/ off white paint 100 ND 0 100 16065 090716 P01 02 EM 1705070 A Off white granular plaster 35 ND 0 100 B White compound w/ tan paint 65 ND 0 100 16065 090716 P01 03 EM 1705071 A White compound w/ tan paint 30 ND 0 100 B Off white granular plaster w/ white paint 70 ND 0 100 16065 090716 P02 01 EM 1705072 A Off white granular plaster w/ white paint 100 ND TR 100 16065 090716 P02 02 EM 1705073 A Off white granular plaster w/ white paint 100 ND 0 100 16065 090716 P02 03 EM 1705074 A Off white granular plaster w/ white paint 100 ND TR 100 TEM Analysis recommended for organically bound material (I a floor tile) if PLM results are <1% P 303 964 1986 5801 Logan Street Suite 100 Denver CO 80216 1-866 RESI ENV F 303-477-4275 w reilao corn Page 1 of 2 W Q POIIDNe VALLEYNCEIPITAL VCICe4 CANNY CHILD A CCACY CENTER HONIODA1100W fRbMt Ft.. CO Nelwl 1 \smNN nOA 4W M/ YCN1 �0 9 ED W 9V4 fG W� j sW 1 y1 pIIQ- GJ ] IAi 0.1YPlFD 1 NCp9WPERl H' y� i MU � a C� bA � O @ v� bA � C � Bw EA B 5�� ®a x 1 /O x � w` a " U j O O F 1 UP Z F U) tl�939 in FNe / U ul i O m 0. > ¢ e BASEMENT LEVEL FLOOR PLAN MAIN LEVEL FLOOR PLAN a SCALE 3116 =1 -0 SCALE 3116 =1-0 FLOORS RLH Eno neer no 10/4/2016 10 15 AM Chid Advococv Center survev dwo P DREVALLEYHMPITAL VdC[&CMRYCHlWI V=ACYCM1rER HRma ..lfti s Cell„g &w II cw NNiwW &uNl MbeRs 1 a.mltY ICY? .om wb�o ro m ns I xaaaus 9 n w+e war n a or @ @ v Ho yl mpe am..n am wv ow m m 0 m e..a avo a> Pod o v _0 a] I I m F nmaw (Oao)pa) WfA wo@ 75 Li Ho mo MCAI@ 0 _ _ Itrm wv y10 L va 9 H a0 v�pW� V03 RF@ P@ ; N 9r N0 I � .oaa ro 9A rL_ I N49L9 Eo PM45-, P02-04 -� P02-03 H G ZG H H G G O urFM G I G BASEMENT LEVEL FLOOR PLAN SCALE 3116 1 -0 RLH Enameenno 10/4/2016 10 15 AM Chid Advococv Center survev dwo c MAIN LEVEL FLOOR PLAN SCALE 3116 -1 -0 CEILINGS & WALLS IN por c�U�> W am�L9' y a 0O R 6a �uro array. W 0 m PW DRl VALLEYXOlPITAL VDICCl CARRYCNM1D ADVOCACY CENTER OF W99 H 111BEBnBWf NaroNNB 11NAN1 Bob WB_ _ _t Rsbrbl 9 nRl N nM WC414�—i1T—_ Ou rlly ACXT —FAT v®nirMw wF� 14� I I vam MNel VrN WW41 WCAt-0t bw menetr 1 SW 41 swJ nT No --BMW w ui 2 C% Q �^a A � 6� W .r r bU � C wcoi-02 i L a Z W shot 01 W � o a s m r= }> UP g g 0 N[] O 1--I ®a8g i P ram- U u $ 048 rrm u aou SM0142 WG01 01 BASEMENT LEVEL FLOOR PLAN WGol-02 MAIN LEVEL FLOOR PLAN SCALE 3116 =1-0 SCALE 3/16 1 -0 TSI &MISCELLANEOUS RLH Eno neer no 10/4/2016 10 15 AM Ch Id Advococv Center survev dwo POUDRE VALLEY HOSPITAL - VOICES CARRY CHILD ADVOCACY CENTER Homogeneous Materials - Floors Code Material Sample Number Quantity ACM? 1 wood NOT SAMPLED — NON SUSPECT stone NOT SAMPLED NON SUSPECT POUDRE VALLEY HOSPITAL - VOICES CARRY CHILD ADVOCACY CENTER Homogeneous Materials - Ceilings & Walls Code Material Sample Number Quantity ACM? A wood paneling NOT SAMPLED - - NON SUSPECT B 2 x 4 pinhole ceiling the CT1 01 CT1 02 460 SF NO C not used D light ridges knockdown texture DW01-01 DW01-02 225 SF NO on drywall DW01 03 E rough texture plaster P01-01 P01 02 P01-03 700 SF NO F window (door) (glass) WC01 01 WC01-02 75 LF NO WG01 01 WG01-02 G fibrous stone mortar SM01-01 SM01 02 875 SF NO H sand texture plaster P02-01 P02-02 P02 03 1 150 SF NO P02-04 P02-05 I wood NOT SAMPLED - NON SUSPECT POUDRE VALLEY HOSPITAL - VOICES CARRY CHILD ADVOCACY CENTER Homogeneous Materials - TSI & Miscellaneous Material Sample Number Quantity ACM? cream window caulking WC01 01 WC01-02 75 LF NO cream window glazing WG01-01 WG01 02 75 LF NO fibrous stone mortar SM01-01 SM01 02 875 SF NO Poudre Valley Hospital RLH Engineering Inc Voices Carry Child Advocacy Center Project Number 16065 September 2016 Page 1 of 1 Sample ID Number Material Location Results of Laboratory Analysis by Polarized Light Microscopy Reservoirs #360372 1 09-08 16 16065 090716 DWOI-01 light ridges knockdown texture on main level west wall of bathroom NO drywall 16065-090716-DWO1-02 light ridges knockdown texture on main level south wall of bathroom NO drywall 16065-090716-DW01-03 light ridges knockdown texture on main level east wall of north room NO drywall 16065-090716 POI-01 rough texture plaster main level west wall of south room NO 16065 090716 P01-02 rough texture plaster main level north wall of north room NO 16065-090716 P01 03 rough texture plaster main level south wall of south room NO 16065 090716 P02-01 sand texture plaster main level eastern ceiling area of south room NO 16065-090716 P02-02 sand texture plaster main level western ceiling area of north room NO 16065 090716 P02 03 sand texture plaster basement central ceiling area of north room NO 16065-090716-PO2-04 sand texture plaster basement central ceiling area of south room NO 16065-090716 P02-05 sand texture plaster basement, south wall of north room NO 16065-090716 SM01 01 fibrous stone mortar basement stairway north wall NO 16065 090716 SM01 01 fibrous stone mortar basement stairway south wall NO 16065-090716 CT01 01 2 x 4 pinhole ceiling tile main level northeastern area of south room NO 16065 090716 CT01 02 2 x 4 pinhole ceiling the main level southern area of north room NO 16065 090716 WC01 01 cream window caulking main level north window NO 16065-090716 WC01-02 cream window caulking main level north wmdow NO 16065-090716 WG01 01 cream window glazing main level south window NO 16065 090716 WG01 02 cream window glazing main level south window NO Reservoirs Environmental Inc Effective January 1 2015 Reservoirs Environmental OA Manual T \DAWLab\Reservoirs Environmental OA Manual ooc REI LAB Reservoirs Environmental, Inc. T September 20 2016 RLH Engineering 541 East Garden Drive Unit S Windsor CO 80550 Dear Customer Subcontract Number NA Laboratory Report RES 360372 1 Project # I P O # 16066 Project Description Child Adyocacy Center Reservoirs Environmental Inc is an analytical laboratory accredited for the analysis of Industrial Hygiene and Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP) Lab Code 101896 0 for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the American Industrial Hygiene Association (AIHA) Lab ID 101533 - Accreditation Certificate #480 for Phase Contrast Microscopy (PCM) analysis This laboratory is currently proficient in both Proficiency Testing and PAT programs respectively Reservoirs Environmental Inc has analyzed the following samples for asbestos content as per your request The analysis has been completed in general accordance with the appropriate methodology as stated in the attached analysis table The results have been submitted to your office RES 360372-1 is the job number assigned to this study This report is considered highly confidential and the sole property of the customer Reservoirs Environmental Inc will not discuss any part of this study with personnel other than those of the client The results described in this report only apply to the samples analyzed This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of the U S Government This report shall not be reproduced except in full without written approval from Reservoirs Environmental Inc Samples will be disposed of after sixty days unless longer storage is requested If you have any questions about this report please feel free to call 303 964 1986 Sincerely Vu i ga Man for Jeanne Spencer President P 303-964 1986 5801 Logan Street Suite 100 Denver CO 80216 1-866 RES) ENV F 303-477-4275 www reilab cam Page 1 of 1 Reservoinl Environmental Inc Reservoirs Environmental CIA Manual Effective January 1 2015 Q %QAQC%LAB\Reservoirs Environmental CIA Manual doc RESERVOIRS ENVIRONMENTAL INC NVLAP Lab Code 101896 0 TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number Client Client Project Number / P O Client Project Description Date SamDles Received RES 360372 1 RLH Engineering 16065 Child Adyocacy Center September 08 2016 Method EPA 600/R 931116 Short Report Bulk ND=None Detected Turnaround 3 5 Day TR=Trace <1% Visual Estimate Trem/Act=Tremolite/Actinollte Date Samples Analyzed September 19 2016 Client Lab L Asbestos Content Non Non Sample ID Number A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) (%) (%) (%) 16065 090716 DW01 01 EM 1705066 A White compound w/ tan paint 25 ND 0 100 B White/tan drywall 75 ND 30 70 16065 090716 DW01 02 EM 1705067 A White compound w/ tan paint 30 ND 0 100 B White/tan drywall 70 ND 35 65 16065 090716 DW01 03 EM 1705068 A White compound w/ tan paint 35 ND 0 100 B White/tan drywall 65 ND 40 60 16065 090716-P01 01 EM 1705069 A Off white granular plaster w/ off white paint 100 ND 0 100 16065 090716 P01 02 EM 1705070 A Off white granular plaster 35 ND 0 100 B White compound w/ tan paint 65 ND 0 100 16065 090716 P01 03 EM 1705071 A White compound w/ tan paint 30 ND 0 100 B Off white granular plaster w/ white paint 70 ND 0 100 16065 090716 P02 01 EM 1705072 A Off white granular plaster w/ white paint 100 ND TR 100 16065 090716 P02 02 EM 1705073 A Off white granular plaster w/ white paint 100 ND 0 100 16065 090716 P02 03 EM 1705074 A Off white granular plaster w/ white paint 100 ND TR 100 TEM Analysis recommended for organically bound material (i a floor tile) if PLM results are <1% P 303 964 1986 5801 Logan Street Suite 100 Denver CO 80216 "68 RESI ENV F 303477-4275 vmw reilsb corn Page 1 of 2 Reservoirs Environmental Inc Reservoirs Environmental QA Manual Effective January 1 2015 0 \QAQC\LA8%Reservoirs Environmental QA Manual ooc RESERVOIRS ENVIRONMENTAL INC NVLAP Lab Code 101896 0 TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number Client Client Project Number / P O Client Protect Description Date Samples Received RES 360372 1 RLN Engineering 16066 Child Adyocacy Center September 08 2016 Method EPA 600/R 93/116 Short Report Bulk ND=None Detected Turnaround 3 5 Day Date Samples Analyzed September 19 2016 TR=Trace <1 % Visual Estimate Trem/Act=Trem of ite/Actin of ite Client Lab L Asbestos Content Non Non Sample ID Number A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) (%) (%) (%) 16065 090716 P02 04 EM 1705075 A Off white granular plaster w/ white paint 100 ND 0 100 16065 090716 P02 05 EM 1705076 A Off white granular plaster w/ white paint 100 ND 0 100 16065 090716 SM01 01 EM 1705077 A White plaster 20 ND 0 100 B Off white granular plaster 80 ND 0 100 16065 090716 SM01 02 EM 1705078 A White plaster 10 ND 0 100 B Off white granular plaster 90 ND 0 100 16065 090716 CT1 01 EM 1705079 A Light gray/white ceiling tile 100 ND 68 32 16065 090716 CT1 02 EM 1705080 A Light gray ceiling tile 100 ND 67 33 16065 090716 WC01 01 EM 1705081 A White caulk w/ white paint 100 ND 0 100 16065 090716 WC01 02 EM 1705082 A White caulk w/ white paint 100 ND 0 100 16065 090716 WG01 01 EM 1705083 A White glazing w/ orange paint 100 ND 0 100 16065 090716 WG01 02 EM 1705084 A White glazing w/ orange paint 100 ND 0 100 TEM Analysis recommended for organically bound material (I a floor tile) if PLM results are <1% 0'aKlQue Ph -am Analyst / Data QA P 303 964 1986 5801 Logan Street Suite 100 Denver CO 80216 1-866 RESI ENV F 303477-4275 w reilab com Page 2 of 2 Reservoirs Environmental Inc Reservoirs Environmental OA Manual Effective January 1 2015 0 \OAWLABtReservoirs Environmental GA Manual occ RESERVOIRS ENVIRONMENTAL INC NVLAP Lab Code 101896 0 TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME RES Job Number Client Client Project Number / P O Client Project Description Date Samples Received RES 360372 1 RLH Engineering 16065 Child Adyocacy Center September 08 2016 Method EPA 600/R 93/116 Short Report Bulk ND=None Detected Turnaround 3 5 Day Date Samples Analyzed September 19 2016 TR=Trace <1% Visual Estimate Trem/Act=Tremolite/Actlnollte Client Lab L Asbestos Content Non Non Sample ID Number A Sub Asbestos Fibrous Number Y Physical Part Mineral Visual Fibrous Components E Description Estimate Components R (%) (%) (%) (%) 16065 090716 P02 04 EM 1705075 A Off white granular plaster w/ white paint 100 ND 0 100 16065 090716-P02 05 EM 1705076 A Off white granular plaster w/ white paint 100 ND 0 100 16065 090716 SM01 01 EM 1705077 A White plaster 20 ND 0 100 B Off white granular plaster 80 ND 0 100 16065 090716 SM01 02 EM 1705078 A White plaster 10 ND 0 100 B Off white granular plaster 90 ND 0 100 16065 090716-CT1 01 EM 1705079 A Light gray/white ceiling the 100 ND 68 32 16065 090716 CT1 02 EM 1705080 A Light gray ceiling tile 100 ND 67 33 16065 090716-WC01 01 EM 1705081 A White caulk w/ white paint 100 ND 0 100 16065 090716 WC01 02 EM 1705082 A White caulk w/ white paint 100 ND 0 100 16065 090716 WG01 01 EM 1705083 A White glazing w/ orange paint 100 ND 0 100 16065 090716 WG01 02 EM 17050B4 A White glazing w/ orange paint 100 ND 0 100 TEM Analysis recommended for organically bound material (I a floor tile) if PLM results are <1% 0"#LQtue Pham Analyst / Data QA P 303 964 19M 5601 Logan Street Suite 100 Denver CO 90216 1-866 REST ENV F 303-477-4275 vm v reAeb corn Page 2 of 2 Dw Dater W is Due Time: ) l-j 541 East Garden Drive, Unit S Windsor, CO 80550 I Nurroar arww p 0 a / 6 C 6 i gan Resei-vv/i-s Ersv/i-o�sme/i�c_ ✓�' ioSt Derryer CA e@16•Ph 303 BB119es •:a 301477J275 •TollFftrrr, -. Paper: 703-609-201111 RES 3 72 INVOICE TO: IF DIFFERENT CONTACT INFORMATIC ng C.I" Derek Spinuui CO4a "°dial' Ph" 970-219-9481 P^p e ;ESTOS LABORATMY HOURS: Weekdays: Tam - 7pm I PCM / TEM RUSH (Same Day) _PRIORITY (Ned Day) .�LSTANDARD (Rush PCM - 2hr, TEM - 6hr-) MISTRY LABORATORY HOURS: Weekdays: Sam - 5pm I(s) I Dust _ RUSH _ 24 hr _3-5 Day A 8 / Metals & Welding -Pr or notification is e Scan / TCLP _ RUSH _ 5 day _10 day required for RUSH turnarounds" mcs — 24 hr _ 3 day _5 Day E.coli 0157: H7, Coliforms, S.aureus _ 24 hr _2 Day _3 5 Day Salmonella. Listens, E. coli, APC. Y 6 M _ 48 Hr _3-5 Day Mold _ RUSH _24 Hr __48 Hr __3 Day _5 Day "Turnaround hmra eslabinA a la:watery priority, lub)ecl If, i;! ordlory volunue and art n+u duarunleed AAdmmiial feel apply for ahamoun wr.,., d♦and holways Special Instructions: 7 - 6"1 G4 (�, - __(Sample ID's must be DWcl - V �2 N i c 4C a O y 0 m - O _ _ O W 0 O Y LL O + % y O a g O J S w /= C $ r ro O e U n♦ 0 W+ ff MtcaoaloLuor � VALID MATRIX CODES Au = A Bulk = B Dust = D Paint = P Sal = S Wipe = W Swab = SW F = Food rinking Water = DW Waste Water = WW 0 = Other ••ASTM E 1792 approved wipe media only' E > N Date Time EE Collected Collected LAB NOTES: EM Number (Laboratory Use Only) 5 10 -' J �1 _ 0,1 k Number of samples received (Additional samples shall be listed on attached long form ) NorE HE wW enaiyrs xxmwrp sa�M� baf W ipdn femnaben rpilraparp wN nel ba nsporiaide rd moll d prnsaonr n caKulstprrs ra from tM matcav ...r.......,.i—I-i,...e...rrt—ar,�•.,.., .n.x ..,.,.r._-----ii.L_"' �I^9 a�v of afi�MM afr siplala raarVmfianN rapgMrllalNa agrees MIaWillaaslof all1WO.Y-swp4om Per **NN d 4 5 Retl ukthed By: _ DaMlTlme /- b Ct'. l SanlpbClor orlon: On ice Temp. (P) YM / No Sealed Intact Yes / No Yes I No Laboratory Use On Received B l ��A Date?xne� �.w Carrier Rssadts. Contact Phone Emad Fax Date Time krstials Contact Phone Email fax Dais Time Initials Contact Phone Email Fax Date Time Initials Contact Phone Email Fax Deb Time Initials i -Lull version 1 R'! Reservaira Env/conmenta/, Inc. 5601 I09Mn S1 Derner CO 60216 • Ph 303 964 1905 • FM 303477 4775 • Ton Free %6 RE SI ENV RES Job ii Page � of 2 _ rr'' Submitted by /�_ W �r� r ! 7, 7 REQUESTED ANALYSIS VALID MATRIX CODES LAB NOTES: IP. nr $ L W y a o r' a.6 tt F p 4p E n J F a m t a I W w i �, o 6 C Te 0 3 o a h o I y IS r: a � o ' E S -� E2 o z tl $ N w �• w u rn > i MICROBIOLOGY 'R p Air ` A Bulk = B Dust = D Paint = P Soil = S Wipe = W Swab =SW F=Food Unnking water = pW Waste water = WW O =other ••ASTM E 1792 apgrovea wipe media oNy" E o $ 0 Date Time y y ` Collected Collected E a o "'mdyyy nn mm ro n § EM Number It atwratory Uw Only) Client sample ID number Sam ID's must be unique) 0 2 c 2 6Z 1 7-2011 version 1 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Al ASL i~ has met the regtstLatioi '.Commission Regula.. _ _activities-s;:r.eq li t, Iss�xed; January 27, 2016 xres: January 30, 2017 the Air Qual. rform asbesto the state of - Colorado Department of Public Health and Environment ASBESTOS CERTIFICATION* This certifies that Derek Spinuzzi Certification No.: 14068 has met the requirements of 25-7-507, C.R.S. and Air Quality Control Commission Regulation No. 8, Part S, and is hereby certified by the state of Colorado in the following discipline: Building Inspector* Issued: November 04, 2015 Expires: November 04, 2016 * This certificate is valid only with the possession of a current Division -approved training course certification in the discipline specified above. Due DateDOS,VLF to Due Time as 541 East Garden Drive Unit S Windsor CO 80550 t4E1 L-AXB f�eservofrs E�svfroamersta/. /mac_ T 5801 Logos St Denver GO 80216 Pt 303 964 1989 Few 303.477,4275 Tell Free 1106 RESI ENV Pager 303 509 2098 INVOICE TO IIF DIFFERENTI rnNTerT i Nbnbor anww p o a- 1 b b rn s I De cAp4cnftACD11on L (� I t. r> 40y 06AG y Gf.l.t 7E /L iESTOS LABORATORY HOURS Weekdays lam Tom I PCM / TEM _ RUSH (Same Day) _. PRIORITY (Next Day) XSTANDARD (Rush PCM - 2hr TEM = 6hr ) :MISTRY LABORATORY HOURS Weekdays Sam 5pm Its) / Dust _ RUSH _ 24 fir _3.5 Day A 8 / Metals & Welding Prior notification is e Scan I TCLP _ RUSH _ 5 day _10 day required for RUSH turnarounds 24hr _3 MICROBIOLOGY LABORATORY HOURS Weekdays gam 8 m E toll 0157 H7 Coliforms S auraus _ 24 fir _2 Day _3.5 Day Salmonella Listerla E colt APC Y & M _ 48 Hr _3 5 Day Mold _ RUSH _24 Hr _48 Hr_3 Day _5 Day Turnaround Umaa establish a laboratory priority subject to laboratory volume and are not guaranteed Additional fees apply far afterhourn, wapkands and holidays Instructions (Sample ID s must be I I00nber Derek Spinu2 Phan° 970 219 9481 RES Air = A I Bulk = B Dust = D I Paint = P Soil = S _ Wipe = W Swab = SW F = Food )nnking Water = DWI Waste Water - W W _ O = Other ASTM E 1792 approved wipe media only I ( m f E m CUB I = II Date ( Time mE < l n I Collected } Collected tq M i >Z 1 mmrodgy ( mmm arp EMI Number (Laboratory Use Only) Ci of --- _- Ejf O W s f 1 5 _ - °Z -- I I ci _ I i 9 Number of samples received (Additional samples shall be listed on attached long form ) NOTEREIvAam"asxs1wig fimyas, bond upon mftwmaYonreeeivowo MWa nab be mpmWHe for enma a emusgne in calm nns resulWip from a Mw . hvr.'.�rf m IM. rhaln r] .NMI nv�Mwe_nn wnnAn✓ vxwwn�nM...n� n ...r unr 1n -- r lib iMraaery Of orlgvW data By agmp rbenUWWM ropresemeWo agroas tW supN6sion of the losvwp samples for rogtwatoe _._,__ __ _.__- _ _ _. _._. 1_,.. Relinquished By kC q DateTme / - d '1% z / �'� A Sample Condition Temp IF ) On ice Yes I No Sealed intact Yes / No Yes I No Laboratory Use Oni 5(,L q Received By Vim-.--- DatelTme �, Center Results jConW Phone Email Fax Date Time Initials Contact Phone Email Fax Date Time Initials Contact Plane Email Fax Date Time initials lContact Phone Entail Fax Date Time Initials 7 ZU11-version 1 REQUESTED ANALYSIS VALID MATRIX CODES LAB NOTES "ir = ^ Bulk = e F4 Reservoirs En vironmen ta/. Inc_ T 5801 Logan St Oo ve 0080216 pa 303964 1988 Fax 3044774275 Tdl F eo 66e itESl ENV t{I { 1 _ Dust = D Paint - P I I ! I Soil = g Wipe = W — RESJob# Y gE O I Swab = SW I F= Food DnnWng Water =DWJ Waste Water-WW , Page 2 of ! { i 0=Other — o t m I ASTM E 1792 approval wlpo moala only Submitted by 2`$ {�(oia!— im1 �$ to{81 r gla �' ! s r f i> e1 - — o t H r^ 3 m I! r$ Igg I (p !` I o w i Date Time ; 8 1 Collected I Collected EM Number I^ E r H I i w I w LS LN I> 12 i y o s c r MicrtoeioLocr W c E 5 a.araa�. ruvmm alp (Laboratory Use Only) Client sample ID number (Sam le IDs must be umclue) + ,E r t13 112 a_ 16-- 17 _ 4 y 18 21 22 23- 24- 25 26 27 28- 29 , ! r! l I t+ } I 1- 30 32 33 34 35 36 37 39 7 2011 version 1 40- 41 Asbestos Survey Voices Carry Child Advocacy Center 5529 South Timberline Road Fort Collins, CO 80528 Prepared for: Poudre Valley Hospital I Voices Carry CAC 5529 South Timberline Road Fort Collins, CO 80528 Prepared by: Is a M engineering, inc. Facility Planrung, Fnglneenng, Q Environinental Services 541 East Carden Drive, Unit S Windsor, CO 80550 RLH Project Number 16065 October 2016 TABLE OF CONTENTS EXECUTIVE SUMMARY DEFINITIONS/ACRONYMS INTRODUCTI 1 SURVEY METHODOLOGY 1 Building Systems/Homogeneous Materials Assessment 1 Sampling Methodology/Collection 2 Sample Identification/ Analysis 2 REGULATORY INFORMATI 3 SURVEY RESULTS 6 Asbestos Containing Materials 6 RECOMMENDATION 7 EXCLUSIONS/LIMITATIONS 7 SIGNATURES Figures 1 — 3: Floor Plan Drawings, depicting Locations of Homogeneous Materials, Locations of ACM, and Bulk Sample Locations - Drawing #1, Basement and Main Level Flooring Materials - Drawing #2, Basement and Main Level Ceiling/Wall Materials - Drawing #3, Basement and Main Level TSI/Misc. Materials Appendix A - Homogeneous Materials - Floors - Ceilings/Walls - Thermal Systems Insulation/Miscellaneous - Regulated Building Materials Appendix B - Sample Report Appendix C - Laboratory Results with Chain of custody Appendix D - Asbestos Inspector Accreditations and Certifications 7 EXECUTIVE SUMMARY The Voices Carry Child Advocacy Center (CAC) contracted RLH Engineering Inc (RLH) to perform a pre -renovation Asbestos Survey at CAC located at 5529 South Timberline Road Fort Collins CO The intent of this Survey was to identify Asbestos Containing Materials (ACMs) that would need to be properly removed and disposed of prior to renovation of the facility The facility is a commercial structure of approximately 1 000 SF in size This report presents the results of the Survey conducted on September 7 2016 The scope of work included a survey of the building and building materials identification of suspect ACMs and collection and analysis of bulk samples The inspection and laboratory results identified the following ACMs ASBESTOS CONTAINING MATERIALS (ACMs) No asbestos containing materials were identified as part of this survey The intent of this Survey was to identify ACMs that would need to be properly removed and disposed of prior to renovation of the facility Locations and quantities of materials discussed in this report are approximate This document should not be used as a bid document for the removal repair encapsulation enclosure or Operations & Maintenance (O&M) of any ACM discussed in this report Bid documents should in general include specific information regarding the location and materials to be abated a description of specific work practices and procedures contract document information and other project specific information in some cases these documents need to be developed by EPA -accredited and CDPHE-certified personnel Contact RLH Engineering in the event that these services are required IF DEFINITIONS/ACRONYMS ACBM - asbestos -containing building material ACM - asbestos -containing material ACWM - asbestos -containing waste material AHERA - Asbestos Hazard Emergency Response Act APCD - Air Pollution Control Division ASHARA - Asbestos School Hazard Abatement Reauthorization Act AQCC - Air Quality Control Commission Asbestos - Asbestiform varieties of chrysotde amosite (cummmtonite-grunerite) crocidolite anthophylite tremolite and actinolite Asbestos -containing building material - surfacing ACM thermal system insulation ACM or miscellaneous ACM that is found in or on interior structural members or other parts of a school building or state budding Asbestos -containing material - material containing more than 1% asbestos CDPHE - Colorado Department of Public Health and Environment Category I non -friable asbestos -containing material - asbestos -containing packings gaskets resilient floor covering and asphalt roofing products containing more than 1 percent asbestos as determined using the method specified in Appendix E Supbart E 40 C F R Part 763 section 1 polarized light microscopy (EPA 1995) Category II non -friable ACM - any material excluding category 1 non -friable ACM containing more than 1 percent asbestos as determined using the methods specified in Appendix E Subpart E 40 C F R Part 763 section 1 polarized light microscopy (EPA 1995) that when dry cannot be crumbled pulverized or reduced to powder by hand pressure Demolition - the wrecking or taking out of any load -supporting structural member of a facility together with any related handling operations or the intentional burning of any facility EPA - Environmental Protection Agency Friable - material when dry may be crumbled pulverized or reduced to powder by hand pressure and includes previously nonfnable material after such previously nonfnable material becomes damaged to the extent that when dry it may be crumbled pulverized or reduced to powder by hand pressure Functional space - a room group of rooms or homogeneous area (including crawl spaces or the space between a dropped ceding and the floor or roof deck above) such tin