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Good Faith Survey (HazMat),PBS, RHA Sunset Gardens,090921.pdf
214 E GALER STREET, SUITE 300 SEATTLE, WA 98102 206.233.9639 MAIN 866.727.0140 FAX PBSUSA.COM Hazardous Materials Survey Report Sunset Gardens Commercial Office Building 2900 NE 10th Street Renton, Washington 98056 Prepared for: Renton Housing Authority & McCullough Allen 2900 NE 10th Street Renton, Washington 98056 September 9, 2021 PBS Project No. 41439.012 Hazardous Materials Summary Report Renton Housing Authority Sunset Gardens Renton, Washington ©2019 PBS Engineering and Environmental Inc. i 9/9/2021 PBS Project No. 41439.012 TABLE OF CONTENTS 1 INTRODUCTION .............................................................................................................................................. 1 1.1 Project Background ................................................................................................................................................................... 1 1.2 Building Descriptions ............................................................................................................................................................... 1 1.3 Survey Process ............................................................................................................................................................................ 1 2 FINDINGS ......................................................................................................................................................... 2 2.1 Asbestos-Containing Materials (ACMs) ............................................................................................................................ 2 2.2 Lead-Containing Components ............................................................................................................................................. 2 2.3 Mercury-Containing Components ...................................................................................................................................... 2 2.4 PCB-Containing Components ............................................................................................................................................... 3 3 RECOMMENDATIONS .................................................................................................................................... 3 3.1 ACMs .............................................................................................................................................................................................. 3 3.2 Lead-Containing Components ............................................................................................................................................. 3 3.3 Mercury-Containing Components ...................................................................................................................................... 4 3.4 PCB-Containing Components ............................................................................................................................................... 4 APPENDICES APPENDIX A: Photo Sheet And PLM Bulk Sampling Information PLM Bulk Sample Inventory PLM Bulk Sample Laboratory Data Sheets and Chain of Custody Documentation Previous PBS PLM Inventory and Lab Data – Dated Nov 22, 2017 APPENDIX B: AA Lead Paint Chip Sampling Information AA Lead Paint Chip Sample Inventory AA Lead Paint Chip Laboratory Data Sheets and Chain of Custody Documentation APPENDIX C: Certifications Hazardous Materials Summary Report Renton Housing Authority Sunset Gardens Renton, Washington 1 9/9/2021 PBS Project No. 41439.012 1 INTRODUCTION 1.1 Project Background PBS Engineering and Environmental, Inc. (PBS) performed an additional hazardous materials survey of the commercial office building (Renton Housing Authority) located at 2900 NE 10th Street, Renton, Washington, in conjunction with the planned renovation/demolition of the structure. The intent of this investigation is to ensure that the Renton Housing Authority is in compliance with applicable regulatory requirements that a "good faith inspection” for ACMs be performed prior to demolition/renovation activities. At the request of the Renton Housing Authority, all accessible areas of the building were inspected for the presence of asbestos-containing materials (ACMs), lead-containing paint (LCPs), PCB-containing light ballasts, and mercury-containing fluorescent lamps and thermostats. 1.2 Building Descriptions Renton Highlands Library is a wood-frame, single-story concrete slab-on-grade structure that was originally constructed in circa 1982 (approximately 14,000 square feet). Interior walls and ceilings consist mainly of gypsum wallboard and suspended ceiling tiles. Heat is supplied to the building by a forced-air HVAC system. Building exterior walls consist of brick masonry. Windows and exterior doors are aluminum framed. Roofing consists of a white -rubber membrane roof and beneath which is a built-up asphaltic roof system.. Ceiling plenum has fiberglass batt insulation below the roof deck. Pipe insulation in the building is fiberglass with non-suspect fittings. 1.3 Survey Process Accessible areas included in the project scope were inspected by AHERA Certified Building Inspectors Ferman Fletcher and Kaitlin Soukup in August 2021. PBS endeavored to inspect all accessible areas of the scope of work. Inaccessible areas consist of those requiring selective demolition, fall protection, or confined space entry protocols in order to gain access. PBS performed selective demolition of gypsum wallboard at locations around sinks to survey associated water lines. When observed, suspect materials were sampled. All samples were assigned a unique identification number and transmitted for analysis to Seattle Asbestos Test (NVLAP #201057-0) under chain-of-custody protocols. Samples were analyzed according to EPA Method 600R-93/116 using Polarized Light Microscopy (PLM), which has a reliable limit of quantification of 1% asbestos by volume. Information regarding the type and location of sampled materials can be found on the attached PLM Sample Inventory. Suspect ACMs may exist in inaccessible areas. PBS endeavored to determine the presence and estimate the condition of suspect materials in all inaccessible areas included in the scope of work. While PBS has endeavored to identify the ACM that may be found in concealed locations, additional unidentified ACM may exist. Hazardous Materials Summary Report Renton Housing Authority Sunset Gardens Renton, Washington 2 9/9/2021 PBS Project No. 41439.012 2 FINDINGS 2.1 Asbestos-Containing Materials (ACMs) Federal and state regulations define ACMs as any material that contains greater than 1% asbestos. Black floor mastic, associated with 12” floor tiles (non-ACM) in kitchen, closet, stock room, electrical room and coy room (assumed total approximately 1,100 square feet). Refer to the photo sheet with a figure showing ACM location. Non-ACMs: The following materials sampled and found not to contain detectable concentrations of asbestos: Carpet mastic – throughout Ceramic floor tile and associated grout and mortar – restrooms 12” floor tile (Blue) – copy room and storage rooms (however the black mastic/glue is ACM) 12” tan floor tiles (kitchen) – however the black mastic/glue is ACM Ceramic wall tile and associated adhesives – restrooms throughout Covebase and associated mastics – throughout Wall texture (type 1) – heavy texture Wall texture (type 2) – light texture Wallboard and joint compound mud, throughout 12” ceiling and glue (on walls) Sinks patch compound Grey duct sealants – Fan Rooms and Mechanical room Duct liner material – Mechanical room Sink backsplash panel mastic Built-up asphaltic roofing – Throughout roof level (beneath white rubber membrane roofing) Caulking on window frames Brick mortar Entry floor mats (associated mastic) For a complete listing of representative bulk sampling and associated laboratory analysis, refer to the Attachments. 2.2 Lead-Containing Components Twelve representative painted coating were sampled for lead content. The samples were assigned unique identification numbers and transmitted to NVL Laboratories, Inc. (AIHA IH #167337) in Seattle, Washington under chain-of-custody protocols for analysis using Flame Atomic Absorption. Lead was not detected above the Lab detection level (no lead detected per analysis method). See attachments for location and result of paint samples. 2.3 Mercury-Containing Components All fluorescent light tubes including HID lamps (High-intensity bulbs). are presumed to contain mercury. Approximately 300-plus four-foot fluorescent light tubes were identified during PBS survey. Hazardous Materials Summary Report Renton Housing Authority Sunset Gardens Renton, Washington 3 9/9/2021 PBS Project No. 41439.012 2.4 PCB-Containing Components PBS inspected representative fluorescent light fixture ballasts throughout the building. Light fixture ballasts inspected were observed to have “No PCB” labeling. PBS recommends all ballasts be inspected prior to disposal during construction. Magnetic ballasts should be presumed to contain PCBs and properly removed, stored, transported and disposed of in accordance with Washington Administrative Code (WAC) 173-303 Dangerous Waste Regulations and 40 CFR Part 761 Subpart D. 3 RECOMMENDATIONS 3.1 ACMs ACMs (floor mastic/glue) were identified at the subject site and will be impacted. PBS recommends that ACMs (if present) that may be impacted by the planned upgrades and be removed prior to construction activities, or impacted, only by a qualified Washington State licensed asbestos abatement contractor according to applicable local, state and federal regulations (not limited to WAC 296-62- 077). A qualified Washington State licensed asbestos abatement contractor should be employed to manage, handle, and remove all such ACMs according to applicable local, state and federal regulations. These Asbestos state and federal regulations include, but not limited to Washington State Labor and Industries’ WAC 296-62, 296-65, local clean Air Pollution Agency rules, AHERA 40 CFR 763, OSHA 29 CFR and US EPA NESHAP 40- CFR Part 61. Advisory Notice - ACM Caution (Hidden Materials): The possibility exist that suspect ACM may be present at concealed locations in wall and ceiling cavities, within HVAC equipment and potentially in other select concealed areas. These may include, but are not limited to waterproofing membrane, vapor barriers, internal gasketing, mastics, caulking, and sealants on HVAC equipment, construction adhesives, electrical insulators, below grade pipe covering and insulation. In the event that suspect ACMs not included in this report are encountered during construction, contractors should stop work immediately and inform the Owner promptly for confirmation testing. All untested materials should be presumed asbestos-containing or tested for asbestos content prior to impact during construction. 3.2 Lead-Containing Components Representative painted coatings were found not to contain lead by laboratory analysis. If Lead paint are detected: Impact of painted surfaces with detectable concentrations of lead requires construction activities to be performed according to Washington Labor and Industries regulations for Lead in Construction (WAC 296-62-155). Workers impacting LCP should be provided the proper personal protective equipment and use proper work methods to limit occupational and environmental exposure to lead until an initial exposure assessment has been conducted. Painted coatings may exist in inaccessible areas of the work area or in secondary coatings. Any previously unidentified painted coatings should be considered lead containing until sampled and proven otherwise. All waste shall be handled in accordance with WAC 173-303. Hazardous Materials Summary Report Renton Housing Authority Sunset Gardens Renton, Washington 4 9/9/2021 PBS Project No. 41439.012 3.3 Mercury-Containing Components Fluorescent lamps are known to contain mercury and mercury vapors. All fluorescent lamps at this site are presumed to be mercury-containing. PBS recommends that all fluorescent lamps be carefully handled and recycled/disposed of in accordance with the contract documents and applicable regulations during demolition activities. Breakage of lamps should be avoided to prevent potential exposures to mercury. Washington Department of Safety and Health requires specific training, RCRA metals training for worker protection, handling, engineering controls and disposal practices when performing this work. All waste shall be handled in accordance with WAC 173-303. 3.4 PCB-Containing Components PBS recommends all light ballasts be inspected prior to disposal. Magnetic ballasts should be presumed to contain PCBs and properly removed, stored, transported and disposed of in accordance with Washington Administrative Code (WAC) 173-303 Dangerous Waste Regulations and 40 CFR Part 761 Subpart D. Electronic ballasts do not contain PCB’s and can be disposed of as general debris in compliance with applicable codes and endpoint facility requirements. Report prepared by: Kaitlin Soukup AHERA Building Inspector Cert. No. 179143 Exp. 10/14/2021 Review by: Willem Mager AHERA Building Inspector/Sr. Project Manager Cert. No. IR-21-0536B, Exp. 1/21/2022 APPENDIX A Photo Sheet and PLM Bulk Sampling Information PLM Bulk Sample Inventory PLM Bulk Sample Laboratory Data Sheets PLM Bulk Sample Chain of Custody Documentation And PBS Sample Inventory and Lab Results -Dated Nov 22, 2017 Sunset Gardens, 2900 NE 10th St, Renton, WA PBS 41439.012 Renton Housing Authority 9/9/2021 Photo 1: Figure - Location of asbestos-containing black floor mastic under non-ACM vinyl floor tiles (highlighted). ACM is assumed under walls of the space. Photo 2: Location of asbestos black floor mastic under non-ACM vinyl floor tiles kitchen room. Sunset Gardens, 2900 NE 10th St, Renton, WA PBS 41439.012 Renton Housing Authority 9/9/2021 Photo 3: Storage/stock room with blue non-ACM floor tiles; the black mastic is ACM. Photo 4: Non-ACM ceiling tiles, wallboard walls, textures walls and carpet mastic. Sunset Gardens, Renton, WA Renton Housing Authority PBS Engineering + Environmental PBS Project #41439.012 PLM ASBESTOS SAMPLE INVENTORY Material Type Sample Location Lab Description Lab Result Lab 41439.012 -01 Walk off mat Mastic Northeast entry Layer 1: Off-white/black mastic NAD SAT 41439.012 -02 12” Blue Vinyl Floor Tile North Copy Room Layer 1: Yellow/clear mastic with debris NAD SAT Mastic Layer 2: Blue tile NAD Layer 3: Black mastic NAD 41439.012 -03 12” Blue Vinyl Floor Tile Kitchen; Northeast Corner Layer 1: Blue tile NAD SAT Mastic Layer 2: Black mastic NAD 41439.012 -04 12” Blue Vinyl Floor Tile North Stock Room Layer 1: Blue tile NAD SAT Mastic Layer 2: Black mastic NAD 41439.012 -05 12” Tan Vinyl Floor Tile Northwest Mech Closet Layer 1: Tan tile NAD SAT Mastic Layer 2: Black mastic 3% Chrysotile 41439.012 -06 12” Tan Vinyl Floor Tile Kitchen; Northeast Closet Layer 1: Tan tile NAD SAT Mastic Layer 2: Black mastic 3% Chrysotile 41439.012 -07 Carpet Mastic Northeast Office Layer 1: Yellow mastic NAD SAT 41439.012 -08 Carpet Mastic Southwest Open area Layer 1: Yellow mastic NAD SAT 41439.012 -09 Carpet Mastic Main Entry West Vestibule Layer 1: Yellow mastic NAD SAT 41439.012 -10 Carpet Mastic Southeast; Middle Office Layer 1: Yellow mastic NAD SAT 41439.012 -11 Carpet Mastic Northwest Conference Room Layer 1: Yellow mastic NAD SAT 41439.012 -12 Small Ceramic Floor Tile Northwest Men’s Restroom Layer 1: Blue ceramic NAD SAT Grout Layer 2: Gray sandy/brittle material NAD Mortar Layer 3: Off-white mastic NAD 41439.012 -13 Wall Texture (Type I)North Stock Room Layer 1: White powdery material with paint NAD SAT Layer 2: White chalky material with paper NAD PBS Sample # 9/9/2021 NAD - No Asbestos Detected 1 of 4 Sunset Gardens, Renton, WA Renton Housing Authority PBS Engineering + Environmental PBS Project #41439.012 Material Type Sample Location Lab Description Lab Result LabPBS Sample # 41439.012 -14 Wall Texture (Type I)Southwest Open Area Layer 1: White powdery material with paint NAD SAT Layer 2: White chalky material with paper NAD 41439.012 -15 Wall Texture (Type I)North Open Office Layer 1: White powdery material with paint NAD SAT Layer 2: White chalky material with paper NAD 41439.012 -16 Wall Texture (Type I)Reception Layer 1: White powdery material with paint NAD SAT 41439.012 -17 Wall Texture (Type I)Southeast; Middle Office Layer 1: White powdery material with paint NAD SAT 41439.012 -18 Ceiling Texture (Type I)Northwest Men’s Restroom Layer 1: White powdery material with paint NAD SAT Layer 2: White chalky material with paper NAD 41439.012 -19 Wall Texture (Type I)Main Entry West Vestibule Layer 1: White powdery material with paint and paper NAD SAT 41439.012 -20 Wall Texture (Type II)Northeast Office Layer 1: White powdery material with paint NAD SAT Layer 2: White chalky material with paper NAD 41439.012 -21 Wall Texture (Type II)Northeast Office Layer 1: White powdery material with paint NAD SAT Layer 2: White chalky material with paper NAD 41439.012 -22 Wall Texture (Type II)Northeast Office Layer 1: White powdery material with paint NAD SAT Layer 2: White chalky material with paper NAD 41439.012 -23 Ceramic Wall Tile Mastic Northwest Men’s Restroom Layer 1: Yellow mastic NAD SAT Layer 2: Trace white powdery material NAD 41439.012 -24 Wall Texture Northwest Conference Room Layer 1: White powdery material with paint NAD SAT 9/9/2021 NAD - No Asbestos Detected 2 of 4 Sunset Gardens, Renton, WA Renton Housing Authority PBS Engineering + Environmental PBS Project #41439.012 Material Type Sample Location Lab Description Lab Result LabPBS Sample # Joint Compound Layer 2: White chalky material with paper NAD Gypsum Wallboard 41439.012 -25 Wall Texture Kitchen; Water Heater Closet Layer 1: White powdery material with paint and paper NAD SAT Joint Compound Layer 2: White chalky material with paper NAD Gypsum Wallboard 41439.012 -26 Joint Compound Southwest Conference Room Layer 1: White powdery material with paint and paper NAD SAT Gypsum Wallboard Layer 2: White chalky material with paper NAD 41439.012 -27 Blue Vinyl Covebase Southwest Conference Room Layer 1: Dark blue rubbery material NAD SAT Covebase Mastic Layer 2: Off-white mastic NAD Layer 3: Off-white fibrous material with paint NAD 41439.012 -28 Blue Vinyl Covebase Reception Layer 1: Dark blue rubbery material NAD SAT Covebase Mastic Layer 2: Yellow mastic NAD 41439.012 -29 Blue Vinyl Covebase Northwest Hallway Layer 1: Dark blue rubbery material NAD SAT Covebase Mastic Layer 2: Trace yellow mastic NAD 41439.012 -30 Blue Vinyl Covebase Northwest Conference Room Layer 1: Dark blue rubbery material NAD SAT Covebase Mastic Layer 2: Yellow mastic NAD 41439.012 -31 2’x4’ Fissure Lay-in Ceiling Tile Reception Layer 1: Gray fibrous material with paint NAD SAT 41439.012 -32 2’x4’ Fissure Lay-in Ceiling Tile Northwest Hallway Layer 1: Gray fibrous material with paint NAD SAT 41439.012 -33 2’x4’ Fissure Lay-in Ceiling Tile Kitchen Layer 1: Gray fibrous material with paint NAD SAT 41439.012 -34 Sink Patch Kitchen Layer 1: Black soft/loose material NAD SAT Layer 2: Clear/yellow plastic NAD 41439.012 -35 12” Glued-on Acoustic Wall Tile Northeast Office Layer 1: Gray fibrous material with paint NAD SAT Layer 2: Brown mastic NAD Layer 3: White chalky material with paint and paper NAD 9/9/2021 NAD - No Asbestos Detected 3 of 4 Sunset Gardens, Renton, WA Renton Housing Authority PBS Engineering + Environmental PBS Project #41439.012 Material Type Sample Location Lab Description Lab Result LabPBS Sample # 41439.012 -36 Roofing - Membrane roof Roofing Membrane - Core Layer 1: Black asphaltic material NAD SAT North center area Layer 2: Black asphaltic fibrous material NAD Layer 3: Black asphaltic material NAD Layer 4: Black asphaltic fibrous material NAD Layer 5: Black asphaltic material NAD 41439.012 -37 Textured Gypsum Wallboard Exterior Soffit; West elevation Layer 1: White powdery material with paint NAD SAT 41439.012 -38 Textured Gypsum Wallboard Exterior Soffit; North elevation Layer 1: White powdery material with paint and paper NAD SAT 41439.012 -39 Textured Gypsum Wallboard Exterior Soffit; South elevation Layer 1: White powdery material with paint NAD SAT Layer 2: Brown chalky material with paper NAD 41439.012 -40 Joint Compound Exterior Soffit; North elevation Layer 1: White powdery material with paint NAD SAT Gypsum Wallboard Layer 2: Brown chalky material with paper NAD 41439.012 -41 Window Frame Caulk North elevation; East Window Layer 1: Dark gray soft/elastic material with debris NAD SAT 41439.012 -42 Window Frame Caulk West elevation; North window Layer 1: Gray soft/elastic material NAD SAT 41439.012 -43 Brick Mortar Northwest Corner Layer 1: Gray sandy/brittle material NAD SAT 9/9/2021 NAD - No Asbestos Detected 4 of 4 APPENDIX B AA Lead Paint Chip Sampling Information AA Lead Paint Chip Sample Inventory AA Lead Paint Chip Laboratory Data Sheets AA Lead Paint Chip Chain of Custody Documentation Sunset Gardens, Renton, WARenton Housing AuthorityPBS Engineering + EnvironmentalPBS Project #41439.012AA LEAD PAINT CHIP SAMPLE INVENTORYPBS Sample #Paint Color / Component or SubstrateSample LocationResults (mg/kg)Results (%)Lab41439.012 -PB01 Brown / GWB / Exterior Soffit North Elevation <57 <0.0057 NVL41439.012 -PB02 Brown / GWB / Wall Southwest Conference 2 <160 <0.016 NVL41439.012 -PB03 Light Grey /Green / GWB / Wall Open Office Beneath Purple Trim <140 <0.014 NVL41439.012 -PB04 Yellow / GWB / Wall Reception <180 <0.018 NVL41439.012 -PB05 Blue / GWB / Wall Reception <130 <0.013 NVL41439.012 -PB06 Purple / GWB / Wall Open Office Area <94 <0.0094NVL41439.012 -PB07 Brick MortarNorthwest corner<40 <0.0040 NVL41439.012 -PB08 Light Pink / GWB / Wall West Wall; Southwest Conference Room 2 <130 <0.013 NVL41439.012 -PB09 White / GWB / Wall North Hallway<78 <0.0078 NVL41439.012 -PB10 White / GWB / Wall Kitchen <150 <0.015 NVL 9/9/2021mg/kg = Milligrams per kilogram< = Less than the Limit of Detection1 of 1 Sincerely, Nick Ly, Technical Director RE:Total Metal Analysis Method: EPA 7000B Lead by FAA <paint> Item Code: FAA-02 August 30, 2021 PBS Environmental - Seattle Willem Mager 214 E Galer St. Suite. 300 Seattle, WA 98102 Enc.: Sample results NVL Batch # 2115245.00 Client Project: 41439.012 Location: RHA: Sunset Gardens Dear Mr. Mager, NVL Labs received 10 sample(s) for the said project on 8/27/2021. Preparation of these samples was conducted following protocol outlined in EPA 3051/7000B , unless stated otherwise. Analysis of these samples was performed using analytical instruments in accordance with EPA 7000B Lead by FAA <paint>. The results are usually expressed in mg/Kg and percentage (%). Test results are not blank corrected. For recent regulation updates pertaining to current regulatory levels or permissible exposure levels, please call your local regulatory agencies for more detail. At NVL Labs all analyses are performed under strict guidelines of the Quality Assurance Program. This report is considered highly confidential and will not be released without your approval. Samples are archived after two weeks from the analysis date. Please feel free to contact us at 206-547-0100, in case you have any questions or concerns. page 1 of 4 Analysis Report Total Lead (Pb) RHA: Sunset Gardens PBS Environmental - SeattleClient: 214 E Galer St. Suite. 300 Seattle, WA 98102 Mr. Willem MagerAttention: Address: Project Location:Samples Received: 10 Samples Analyzed: 10 Client Project #: 41439.012 Batch #: 2115245.00 Date Received: 8/27/2021 Lab ID Client Sample # Sample Weight (g) Results in mg/Kg Results in percent RL in mg/Kg Matrix: Paint Method: EPA 3051/7000B 21098631 41439.012-Pb01 0.1740 57 <57 0.0057< 21098632 41439.012-Pb02 0.0627 160 <160 0.016< 21098633 41439.012-Pb03 0.0692 140 <140 0.014< 21098634 41439.012-Pb04 0.0543 180 <180 0.018< 21098635 41439.012-Pb05 0.0389 130 <130 0.013< 21098636 41439.012-Pb06 0.1067 94 <94 0.0094< 21098637 41439.012-Pb07 0.2487 40 <40 0.0040< 21098638 41439.012-Pb08 0.0755 130 <130 0.013< 21098639 41439.012-Pb09 0.1276 78 <78 0.0078< 21098640 41439.012-Pb10 0.0651 150 <150 0.015< FAA-02 ClientSampled by: Shalini PatelAnalyzed by: Nick LyReviewed by: 08/30/2021Date Analyzed: 08/30/2021Date Issued: Small sample size(<0.05g) for 41439-012-Pb05.Comments: Bench Run No:2021-0830-01 mg/ Kg =Milligrams per kilogram RL = Reporting Limit Percent = Milligrams per kilogram / 10000 '<' = Below the reporting Limit Note : Method QC results are acceptable unless stated otherwise. Unless otherwise indicated, the condition of all samples was acceptable at time of receipt. Nick Ly, Technical Director page 2 of 4 PBS Environmental - Seattle 2115245.00 10 Company NVL Batch Number Total Number of Samples RHA: Sunset Gardens 2 DaysTAT 8/31/2021Due Date 11:45 AMTime (866) 727-0140Fax willem.mager@pbsusa.comEmail Project Manager Mr. Willem Mager (206) 233-9639 (800) 628-9639Office: Phone Rush Samples Rush TAT NoAH 41439.012Project Name/Number:Project Location: Sample ID Description A/RLab ID LEAD LABORATORY SERVICES Subcategory Item Code Flame AA (FAA) Metals FAA-02 EPA 7000B Lead by FAA <paint> 214 E Galer St. Suite. 300 Seattle, WA 98102 Address 41439.012-Pb011 A21098631 41439.012-Pb022 A21098632 41439.012-Pb033 A21098633 41439.012-Pb044 A21098634 41439.012-Pb055 A21098635 41439.012-Pb066 A21098636 41439.012-Pb077 A21098637 41439.012-Pb088 A21098638 41439.012-Pb099 A21098639 41439.012-Pb1010 A21098640 Office Use Only Print Name Company Date TimeSignature Faxed Emailed Company Date TimeSignature ClientSampled by Kelly AuVuReceived by CourierRelinquished by Shalini PatelAnalyzed by Results Called by NVL NVL 8/27/21 8/30/21 1145 Print Name Entered By: Kelly AuVu Date: 8/27/2021 Time: 12:13 PM Special Instructions: page 3 of 4 page 4 of 4 APPENDIX C Certifications Kaitlin M. Soukup AHERA Building Inspector This is to certify that 4 hours of online refresher training as an 179143 Certificate Number Instructor: Oct 14, 2020 Date(s) of Training Expires in 1 year. to comply with the training requirements of has satisfactorily completed TSCA Title II, 40 CFR 763 (AHERA) EPA Provider # 1085 N/AExam Score: (if applicable)Andre Zwanenburg 01/21/2022 01/21/2021 ASBESTOS INSPECTOR REFRESHER Course Date: Expiration Date:Certificate:IR-21-0536B for Portland, ORCourse Location: For verification of the authenticity of this certificate contact: PBS Engineering and Environmental Inc. 4412 S Corbett Avenue Portland, Oregon 97239 503.248.1939 Andy Fridley, Instructor In accordance with TSCA Title II, Part 763, Subpart E, Appendix C of 40 CFR 4-Hour AHERA Inspector Refresher Training; AHERA is the Asbestos Hazard Emergency Response Act enacting Title II of Toxic Substance Control Act (TSCA) HAS SUCCESSFULLY COMPLETED THE TRAINING COURSE WILLEM MAGER THIS IS TO CERTIFY THAT CCB #SRA0615 4-Hr Training __________________________