NOTIFICATION OF DEMOLITION Southwest Clean Air Agency. DESCRIPTION OF PLANNED DEMOLITION WORK, METHOD(S) TO BE USED: Use excavator to crush building and load debris into dump truck

NOTIFICATION OF DEMOLITION Southwest Clean Air Agency

11815 NE 99th Street, Suite 1294 Vancouver, WA 98682

Voice: (360) 574-3058 Fax: (360) 576-0925 www.swcleanair.org

(10 day waiting period from date submitted) (Form must be filled out completely)

Notification # Must include fee

~ ~ ~'TI'~ ~-~ Notification Fee: $60.00

\ r I LJ Emergency Fee: $120.00

/Cf- O/J-9 c:_~\L* 2.Z."2 f D ~N 1 4 2019 l 1. TYPE OF NOTIFICATION (l!I Original D Revised D Cancelled): SOUTHWEST CLEAN

A!R AGENCY 2. TYPE OF OPERATION D Partial Demolition l!I Complete Demolition D Ordered Demolition

~ SWCAA Reviewed D Emergency Demolition D Fire Training

3. FACILITY DESCRIPTION (Example: Residence, Barn, Carport)LJSed car lot - small sales office

Commercial Name or Description:

Address:8314 NE Hwy 99

city: Vancouver State:WA County: c I ark

Present use: Va cant Prioruse:Sales office

4. FACILITY INFORMATION

ownerName: MOB Investments Mailing Address:832Q NE Hwy 99

city:Vancouver I State:WA Zip Code:98665

contact:Mike Sinclair Phone: 360-566-8192

s. NAME AND AHERA cERT1F1cAT10N NUMBER oF AsBEsTos INSPECTOR: Bob Farace, #170311

6. ATTACH A COPY OF THE ASBESTOS INSPECTION REPORT Report must include laboratory name, analyst, sample type, location sample was taken and analytical method used to detect the presence of asbestos materials.

7. ASBESTOS REMOVAL CONTRACTOR (IF APPLICABLE): 0 No asbestos present, see attached AHERA Reoort

Name:Green Deconstruction Services Address:S823 N. Harborgate Street

city: Portland ·I State:QR Zip Code:972Q3

contact:Bob Gordon Phone:(503) 236-4299

8. DATES ASBESTOS REMOVAL OCCURRED (mm/dd/yy) Start: \ \ z.."\ l iq Complete: I 11.-5"1 l~ Asbestos Case Number: l ~ J O'J.io 9. DATES DEMOLITION WILL OCCUR (mm/dd/yy) Start: 'l~lq Complete: I l3a I \ct

10. DEMOLITION CONTRACTOR or FIRE DEPARTMENT:

Name:Folden Construction, Inc.

Address: 11026 NE St. Johns Road

city:Vancouver I State:WA County: c I ark

Contact and Phone#Adam Folden (360) 546-2291

SWCAA FORM N0.23 REVISED 01/01/2019

11. DESCRIPTION OF PLANNED DEMOLITION WORK, METHOD(S) TO BE USED:

Use excavator to crush building and load debris into dump truck. 12. FUGITIVE EMISSIONS/DUST FROM DEMOLITION ACTIVITIES MUST BE CONTROLLED/PREVENTED DURING ALL PHASES OF THE PROJECT.

13. IF UNEXPECTED ASBESTOS CONTAINING MATERIAL (ACM) IS FOUND DURING DEMOLITION, STOP WORK, NOTIFY SWCAA AND CONSULT/HIRE A CERTIFIED ASBESTOS ABATEMENT CONTRACTOR.

14. IF DEMOLITION IS ORDERED BY A GOVERNMENT AGENCY, PLEASE IDENTIFY THE AGENCY BELOW:

Name: I Title:

Agency:

Date of Order (mm/dd/yy): I Date Ordered to Begin ( mm/dd/yy ):

15. FOR EMERGENCY DEMOLITIONS: (Contact SWCAA prior to work)

Date and Hour of Emergency (mm/dd/yy) (hh/mm):

Description of the Sudden, Unexpected Event:

EXPLANATION OF HOW THE EVENT CAUSED UNSAFE CONDITIONS OR WOULD CAUSE EQUIPMENT DAMAGE OR AN UNREASONABLE BURDEN: (ATTACH ADDITIONAL PAGE IF NECESSARY)

16. I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT.

Adam Folden ~') t!~1~6) (Type or Print Name) / (Date) /

.

HAVE YOU PERFORMED A HAZARDOUS MATERIALS ASSESSMENT ON THE STRUCTURE? ii YES D NO

The Washington State Dangerous Waste Regulations (WAC 173-303) require that demolition debris be evaluated to determine if it is dangerous. The evaluation should be completed before demolition to ensure that hazardous constituents are not released to the environment and do not present a risk to human health during or after demolition. These requirements apply to all buildings being demolished and are the responsibility of the property owner. The Washington Department of Ecology's website, https://ecology.wa.gov/Regulations-Permits/Guidancetechnical-assistance/Dangerous-waste-guidance/Common-dangerous-waste/Construction-and-demolition , provides more information about the requirements and about sampling and testing construction materials to determine if they present a risk. For more information please contact a Hazardous Waste Inspector at the Washington Department of Ecology Southwest Regional Office: 360-407-6300.

SWCAA FORM N0.23 REVISED 01/01/2019

OSI A Division of Willamette Construction Services Inc.

OR CCB# 221268 • OR DEQ ABATEMENT# FSC791 WA L&I REGISTRATION# GDSl***828MO • WA L&I ABATEMENT# ABNC00001672

Pre-Renovation Limited Hazardous Building Materials Survey Report 8314 NE Hwy. 99, Vancouver\/VA.98665

Prepared for:

Kristy Johnson

General Information Laboratory Asbestos Data Inspector Certifications

8823 N. HARBORGATE STREET, PORTLAND, OR 97203 P (503) 236-4299 • F (503) 961-1183


OR CCB# 221268 • OR DEQ ABATEMENT# FSC791 WA L&I REGISTRATION# GDSl***828MO • WA L&I ABATEMENT# ABNC00001672

ASBESTOS INSPECTION

Hwy. 99 Project 8314 NE Hwy. 99, Vancouver, WA. 98665

1.0 INTRODUCTION

Green Deconstruction Services (GDSI) has completed a Demolition Limited Hazardous Building Materials Survey prior to demolition for Folden Construction, Inc. , at a site located at 8314 NE Hwy. 99., in Vancouver, WA. The site was not occupied at the time of this survey. The survey for asbestos containing building materials was completed December 26, 2018 at the request of Kristy Johnson by Bob Farace (Certification# 170311 ), an accredited AHERA Building Inspector under 40 CFR, Part 763, Subpart E, and Appendix C. This report presents the asbestos survey methods, findings, and conclusion.

2.0 PURPOSES AND SCOPE

Various local, state, and federal regulations govern the use and management of Asbestos Containing Materials (ACM). The codes are generally focused on preventing airborne emissions of asbestos fibers and addressing public and worker health concerns for exposure to asbestos during demolition or renovation projects. The Environmental Protection Agency (EPA) requires that any material that contains greater than 1 % asbestos be handled as an asbestos containing material.



OR CCB# 221268 •OR DEQ ABATEMENT# FSC791 WA L&I REGISTRATION# GDSl***828MO • WA L&I ABATEMENT# ABNC00001672

3.0 SUSPECT MATERIALS TESTED FOR ASBESTOS CONTENT

The number of samples taken for any surfacing material is determined by 40CFR Part 763.86, which requires:

- 3 samples for each material that is present in quantities of 1,000 SF or less. - 5 samples for each material that is present in qualities of 1,000 - 5,000 SF. - 7 samples for each material that is present in qualities of greater than 5,000 SF.

In some cases, the inspector is allowed to use discretion and take fewer samples of factory manufactured (not site mixed) materials such as VCT, ceiling tile, and roofing. The following materials were tested for asbestos content and returned results of greater than 1 % asbestos, we have also listed materials that contained trace amounts or <1 % of asbestos:

fine compact powder, off- Main Entrance; NAD Poor white with paint, blue Office Area

lB fine compact powder, off- Main Entrance; NAD Poor white Office Area

IC compact chalky material Main Entrance; NAD Poor with a er, white Office Area

2A fine compact powder, off- Back Area NAD Poor white with paint, white

2B fine compact powder, off- Back Area NAD Poor white

2C compact chalky material Back Area NAD Poor with a er, white

3A fine compact powder, off- Bathroom NAD Poor white with paint, white

3B fine compact powder, white Bathroom NAD Poor 3C compact chalky material Bathroom NAD Poor

with paper, white




4D hard vinyl, black with Bathroom NAD Poor coatin , brown

SA mastic, orange Main Entry; NAD Poor Throughout

SB flexible vinyl, green Main Entry; <1% Poor Tbrou bout

SC fibrous backing, gray Main Entry; 40% Poor Tbrou bout

SD compressed fibers, brown Main Entry; NAD Poor Throughout

4.0 SUBJECT SITE DESCRIPTION

The subject site is a wood frame building used as Commercial space. Selected areas of this building are targeted for demolition.

S.O SURVEY METHODOLOGY

The scope of services included identification of any suspected ACM within the specific areas that could be impacted by upcoming activities, to bulk sample and analyze those suspect materials and to provide a report of findings. A general walkover examination was initially completed to plan the survey, identify functional spaces (spatially distinct areas within the work area), and to develop a sampling scheme for homogeneous areas of suspected ACM. The interior finishes were visually inspected for suspect ACM. Bulk samples were collected in a representative manner by the Inspector based on suspected material contents, as defined by Regulatory Codes or guidance's for sampling methods and as applicable to the planned activities. The samples were placed into airtight plastic bags and hand delivered to LabCor in Portland, Oregon. LabCor Portland, Inc. is a NVLAP accredited laboratory for the analysis of bulk materials using Polarized Light Microscopy (PLM).




6.0 RECOMMENDATION

This report represents GDSI's findings and conclusions based on the scope of services agreed to by the client and within the client's schedule and budget. All findings are based on readily available and reasonably ascertainable information on site conditions at the time of the survey and for the known regulations in affect at that time. The services provided include professional opinions and judgments based on readily available information, field observations and measurements, and analytical reports by an independent laboratory.

The materials identified in this report as Asbestos Containing should be monitored semiannually and any changes to their condition noted. If, over time, any of these materials are removed from the structure, notes should be made and the quantities should be subtracted from the Asbestos Inventory. All activities impacting these materials should be conducted by a Licensed Asbestos Abatement Contractor using Certified Asbestos Workers under the direction of a Certified Asbestos Supervisor.

The specific conditions and limitations of the AHERA Building Inspector Certification have influenced these results. The bulk samples collected in connection with this survey only indicate the presence or absence of the investigated contaminant within the discrete sample units . Although each sample was collected from an area most likely to be affected by the contaminant and accessible to the inspector, affected areas may exist in areas not sampled or for potential contaminants not selected for analysis and characterization. Any analytical results included in this report should be considered only as indicators of possible site conditions with specific statistical significance and influenced by sampling technique and laboratory methodology.

GDSI recommends that any impact to the Materials> 1 % listed as asbestos containing in this report be conducted using approved asbestos abatement methods including notification to the local air pollution authority (DEQ), wet removal methods, Engineering controls to capture any asbestos fibers during removal. We further recommend the use of a licensed Asbestos Abatement Contractor. For materials listed as <1 % ACM we recommend that a Negative Exposure Assessment (NEA) be produced prior to extensive Renovation by the client, to provide for OSHA Compliance with this material during the project.




7.0 LIMITATIONS OF THIS REPORT

We have prepared this Survey Report to aid in maintaining this property and reference for potential future Remodeling/ Demolition projects. This report is for the exclusive use of Folden Construction Inc., the structure owner, and GDSI. This report applies only to the subject detailed above and shall not be relied upon by any other party without the prior written consent of the inspector that prepared the report.

GDSI's work is performed in a professional manner with the best interests of our client in mind. GDSI's objective is to perform our work with care, exercising the customary thoroughness and competence of professionals in the relevant disciplines; in accordance with the standard for these services at the time and location those services are rendered. It is important to recognize that even the most comprehensive scope of services may fail to detect environmental liability on a particular site. Therefore, GDSI cannot act as insurers and cannot "certify or underwrite" that a site is free of environmental contamination and no expressed or implied representation or warranty is included or intended in our reports except that our work was performed within the limits prescribed by our client, with the customary thoroughness and competence of our profession.

Within the limitations of scope, schedule and budget, our services have been executed in accordance with generally accepted practices in this area at the time this report was prepared. No other conditions, expressed or implied, should be understood. Nothing in this report should be interpreted as legal advice; the information contained here is for information only.

Bob Farace AHERA Building Inspector Certification No. 164145




8.0 SAMPLE LIST OF MATERIALS THAT MAY CONTAIN ASBESTOS AND MAY BE PRESENT AND HIDDEN ON ANY CONSTRUCTION, RENOVATION OR DEMOLITION SITE

• • • • • • • • • • • • • • • • • • • • • • •

• • •

• Ductwork flexible connections Window glazing

• Acoustical ceiling texture "popcorn" Stucco • Electrical cloth Cement pipes

• Electrical wiring insulation Cement board/transite

• Roofing shingles Duct tape/paper

• Built-up roofing Furnace insulation • Base flashing Vinyl sheet flooring/mastic • Rolled roofing Vinyl floor tile/mastic • . Caulking/putties Poured flooring • Incandescent light fixture backing Pipe insulation/fittings • Brick mortar Plaster/ wall joints

• Vinyl wall coverings Textured paints/coatings • Vapor barrier Ceiling tiles/panels/mastic • Cement roofing shingles Spray-applied insulation

• Gray roofing paint Blown-in insulation Fireproofing • Nicolet (white) roofing paper

• Sub flooring slip-sheet Sink insulation Packing materials • Mudded pipe elbow insulation

• HV AC duct insulation High temperature gaskets • Boiler/tank insulation Lab hoods/table tops • Breaching insulation Elevator brake shoes

Asphalt flooring • Paper firebox in walls • Fire doors Paper on backside of fiberglass

insulation • Fire blankets

Erkot roofing material • Fire curtains/hose • Electrical panel partitions Laboratory fume hoods • Chalkboards Construction mastics • Joint compound/wallboard


OSI A Division of Willamette Construction Services In c.


Note: This list does not include every product that may contain asbestos. It is intended as a general guide to show which types of materials may contain asbestos.

9.0 SUGGESTED PROCEDURE FOR COMMUNICATING SURVEY FINDINGS TO AFFECTED PARTIES

The results of this survey should be posted on site for ALL CONTRACTORS AND SERVICE PERSONNEL to see. A copy of this report should be provided to all persons who may come in contact with materials that are known to contain asbestos. The following is a signed acknowledgment to be collected and signed by anyone who is provided a copy of this report.

I acknowledge that I have read and understand the report titled:

Demolition Limited Hazardous Building Materials Survey Report 5314 NE Hwy. 99., Vancouver, WA 98665

I further acknowledge that hidden asbestos materials (refer to list contained in section 8.0 of this report) may exist in concealed areas that may be exposed during demolition. If suspect materials (refer to list contained in section 8.0 of report) are discovered that have not been tested, I will treat these materials as asbestos until additional testing proves otherwise.


~~=~d Lab!Cor Portland, Inc. BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http://www.labcorpdx. net

Inc .lllh 4321 SW Corbett Ave., Ste A l':· f!Ji ; 1 Portland, OR 97239 ~ .... -w;.:_;: : ~ Asbestos and Environmental Analysis

Client: Green Deconstruction

23331 NE Halsey St. Wood Village, OR 97067

Job Number: 189078

Project Name: 8314 NE Hwy 99

Project Number: 8314 NE Hwy 99 Vancouver WA

Project Notes:

Client Sample ID: Sample ID: S1

Client Sample Description: Sheetrock w/c Tape , Tex, Mud; Main Entrance; Office Area

Asbestos Mineral Fibers Layer

Layer 01

fine compact powder, offwhite with paint, blue

Layer 02

fine compact powder, offwhite

Layer 03

compact chalky material with paper, white

Percent: Chrysotile Amosite Crocidol ite

5 %

5 %

90 %

Other Fibers Fibrous Mineral Glass Cellulose Wool Synthetic

Layer 01

Layer 02

Layer 03 Trace

Client Sample ID: 2

Client Sample Description: Asbestos Mineral Fibers

Layer 01

fine compact powder, offwhite with paint, white

Layer 02

fine compact powder, offwhite

Layer 03

compact chalky material with paper, white

Trace

Trace

2 %

Sample ID: S2

Sheetrock w/c Tape , Tex, Mud; Back Area

Layer Percent: Chrysoti le Amosite Crocidolite

5 %

5 %

90 %

Other Fibers Fibrous Mineral

Layer 01

Layer02

Layer 03

Glass Cellulose Wool Synthetic

2 %

Page 1 of 4

Other

Other

Report Number: 189078R01 Report Date: 01 /03/2019

Date Analyzed:

Analyst:

Date Analyzed:

Analyst:

P.O. No: n/a

01 /03/2019

Joseph Kulm

Percent Asbestos:

01 /03/2019

Joseph Kulm

Matrix 100 %

100 %

98 %

NAO

NAO

NAO

Percent Asbestos:

Matrix 100 %

100 %

98 %

[}!]W~£Gil® TESTING v

NVlAP lab Code: 200741 ·0

NAO

NAO

NAO

~~=~d Lab/Cor Portland, Inc. BULK SAMPLE ASBESTOS ANALYSIS Phone: (503) 224-5055 http://www.labcorpdx. net

Jn Ul\ 4321 SW Corbett Ave., Ste A !J ! ~ Portland, OR 97239

."" ~ .. " ~ Asbestos and Environmental Analysis

Client: Green Deconstruction 23331 NE Halsey St. Wood Village, OR 97067

Job Number: 189078


Project Number: 8314 NE Hwy 99 Vancouver WA Project Notes:

Client Sample ID: 3

Client Sample Description:

Asbestos Mineral Fibers

Sample ID: S3

Sheetrock w/c Tape, Tex, Mud; Bathroom Layer

Percent: Chrysotile Amosite Crocidolite

Layer 01 fine compact powder, off- 5 % white with paint, white

Layer 02 fine compact powder, off- 10 % white

Layer 03

compact chalky material 85 % with paper, white


Layer 01 Layer 02 Layer 03 Trace

Client Sample ID: 4 Sample ID: S4

Client Sample Description: Flooring ; Bathroom Asbestos Mineral Fibers Layer


Homogeneous

hard vinyl, black with 100 % coating , brown


Trace

Page 2 of 4

Other

Other


Date Analyzed:

Analyst:

Date Analyzed:

Analyst:

P.O. No: n/a

01 /03/2019

Joseph Kulm

Percent Asbestos:

NAO

NAO

NAO

Matrix 100 %

100 %

100 %

01 /03/2019

Joseph Kulm

Percent Asbestos:

Matrix 100 %

[}8W~&cnt TESTING v

NVLAP lab Code: 100741·0

NAO

~~!~d Lab/Cor Portland, Inc. lnCJJt!!\ 4321 SW Corbett Ave. , Ste A ~ i'i:; ; · Portland, OR 97239 ~:cf:::~: ;

Client: Green Deconstruction 23331 NE Halsey St. Wood Village, OR 97067

Job Number: 189078 Project Name: 8314 NE Hwy 99


Client Sample ID: 5

BULK SAMPLE ASBESTOS ANALYSIS

Asbestos and Environmental Analysis

Phone: (503) 224-5055 http://www.labcorpdx. net

Report Number: 189078R01

Report Date: 01 /03/201 9

P.O. No: n/a

Sample ID: SS Date Analyzed: 01 /03/2019

Client Sample Description: Sheet Vinyl + Mastic; Main Entry; Throughout Analyst: Joseph Kulm Asbestos Mineral Fibers Layer


Layer 01

mastic, orange 5 %

Layer 02

flexible vinyl , green 30 % Trace

Layer 03

fibrous backing , gray 35 % 40 %

Layer 04

compressed fibers, 30 % brown


Layer 01 Trace

Layer02 Trace

Layer 03

Layer 04 99 %

Page 3 of 4

Other

Percent Asbestos:

Matrix 100 %

100 %

60 % 1 %

~W~£cm® TESTING ):[-'

NVIAP lab Code: 200741·0

NAO

<1 %

40%

NAO

:;:~;~d Lab/Cor Portland, Inc. lncif, H\ 4321 SW Corbett Ave. , Ste A

.:-f!J ~ · Portland, OR 97239 .. ::"'~- =: " ..

Client: Green Deconstruction

23331 NE Halsey St. Wood Village, OR 97067

Job Number: 189078



BULK SAMPLE ASBESTOS ANALYSIS

Asbestos and Environmental Analysis

Phone: (503) 224-5055 http://www.labcorpdx.net


P.O. No: n/a

This laboratory participates in the National Voluntary Laboratory Accreditation Program (NVLAP). Testing method is per 40 CFR 763 Subpart E, Appendix E, PLM. This report and the data contained therein cannot be used to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the U.S. Government.

• "NAD" is No Asbestos Detected. ·Asbestos consists of the following minerals: chrysotile, amosite, crocidolite, tremolite, actinolite, anthophyllite. • Material binders, such as those found in vinyl floor tiles, may prevent the detection of small diameter asbestos fibers. A gravimetric preparation and point-count is recommended for such samples. ·Quantitative analysis by PLM point count or TEM may be recommended for samples testing at< or= to 1% asbestos. • The following estimate of error for this method by visual estimation of asbestos percent are as follows: 1% asbestos : >0-3% error, 5% asbestos: 1-9% error, 10% asbestos: 5-15% error, 20% asbestos: 10-30% error. ·This report pertains only to the samples listed on the report. Report considered valid only when signed by analyst.

Reviewed by:

~{J:z~ Analyst

Page 4 of 4 ~W~£cm® TESTING v

NVlAP Ub Code: 200741·0

Green Deconstruction Services, Inc. 23331 NE Halsey St. Wood Village, OR. 97067

Phone: 503-239-6858 Fax: 503-232-6130

Bulk Samples

Sampled By: Bob Farace Lab# _____ _

Project Name: & 3 J t./ ;J £; ft IVY Cf' 1 831</ #J; IA t/9 ~

Date: I 2- J '2.-4' / / l I I

~) Project Location: lo./ 7 nC~"'-~ A- Reg.~ Rush [ ]

Sample Description of Material Sample Location Homogeneous Area Sq. Ft. Condition ID# of

Material

( s i., ~.e..-rn:s c.-F- v I c... tv/A-11'\ t/ ff1e- a-

~or T.4 i:;>it...., 'T-4. ti111tJ . f3 II krA.lt C ~ .../ J4-Y"-'\.

"'& ;;~rock. i..v/c '6 .i <-}::-

t/JnH., T~ 1V11-td ff-~~~

3 d~/-ro~/:-w/c, ~t?--l 7~ Wluj - ~JI, t:t!d"V1

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~ Pl/)~YIY1.?j '!?"'-Ti .. ro~~

5 Sk~+-J/; t- /1'lA1Rt £1tf~1 'ifr()µ"'-j(!)(;(. r l

, // /J.-1~~ nc:.... I u \ ....

(

Sent To: ' LAB - COR Relinquished By:

Received By: _____________ Date Received: ______ _

<!tertif irate of <!tompletion

EPA Provider# 1085

Instructor

This is to certify that

Bob Farace has satisfactorily completed

4 hours of refresher training as an

AHERA Building Inspector

to comply with the training requirements of TSCA Title II, 40 CFR 763 (AHERA)

170311 Certificate Number

~ () ARGUS

". I! TRAINING•CONSULTING ()

A C?r(<lCCn COMPANY

Nov 14, 2018 Expires in 1 year.

Date(s) of Training

Exam Score (if applicable) :

ARGUS PACIFIC, INC I 21905 64th AVE W. SUITE I 00 I MOUNTLAKE TERRACE.WASHINGTON 98043 I 206.285.3373 I ARGUSPACIFIC.COM

Documents

NOTIFICATION OF DEMOLITION Southwest Clean Air Agency. DESCRIPTION OF PLANNED DEMOLITION WORK, METHOD(S) TO BE USED: Use excavator to crush building and load debris into dump truck