30178 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO. 30r7
BUILDING DIVISION • APPLICATION/PERNIIT PLUMBING-MECHANICAL I
BUILDING PROJECT IDESTIb'ICArioet -
BUILDINOA SANITARY NO. API'LICA'I'ION SUBMITTAL DATE
• D
OWI•¢R'S P}I• NAME: E: �� COMAATOR'S AME: NO .O NIC IONTROLa\RCHITECDENGINEER: LIC NO: ADDRES. .� L -
n C
el
CONTACT: PHONE: BUILDING PERMIT INFO
p u Q.Consultant Fees Paid by Applicant(Initial) RLDG HLEC9'- PLUMB MECH
J�- LICENSEDCONTRAC'T R5DF.CI.ARATION QTY ELECTRIC PERMIT FEE ❑ ❑
1 hereby affirm then 1 am licensedder provisions of Chapter 9(commencing JOB DESCRIPTION
{QaZ th Socllon7RW)af Di isien3of the Business and Pmlbsslons GMs,and my liunseix
FOO in full force and effect- PERMIT ISSUANCE RESIDENTIAL
aULy License s Lica ❑SFDWL ❑KITCHEN REMODEL
F-T�W Date - Commmrdu t APPLIANCES-RGSIDENTIAI. ❑ADDITION ❑PLUMBING RE-PIPE
F.Dvai CHITELTS DECLARATION PANELS ❑MULTI"UNIT ❑STRUCTURAL
Z04ZK Iueersmnd my Nansshsll bemadaspublic records MODIFICATION
OZ-, Up 10 200 AMPS
,C
Licensed Professional ❑INTERIOR ❑CHIMNEY REPAIR
22 OWNF.IIDUILDER DECLARATION 281-IRBBAMPS IMPROVEMENT i..
I hereby affirm thm 1 an exempt from the Connector',License Law for the OVER TI01AMP5 El13ATH REMODEURF.PAIR MOHMOLITION
!3 OtU(`following mason.(Section 7831.5.Business and Professions Code:Any cityor county ❑OTHER
W
F which requires a permit In ciammot alter,improve,demolinn,r,r repair any drudure SIGNS ELECTRICAL
f0fnn�•prumn,its issuance.alsorcquirestheapplicamficrsuch perminoflensignedsmtement SPECIAL CIRCUFUMISC.
Pr thin M10 is licensed pursurm to the provisions of the Conmmmr's License Law(Clmlmr9
'Qq (commencing with Seninn 78803 of Divisinn3 ell'the Business and Prolewions Code)or
tRal pO TEMP.METER OR POLI!(NST. El NEW
61 o that he is exempt therefrom and the basis for the alleged ex laccou n.Any vi"".Try of
' � Section 71131.56 ❑NF.W BLDG/ADDITION [I DEMOLITION
y by applicant fiaaiwnnn euhjccts the upplicvnnn acivil penalty ell POWER DEVICES ❑TENANT SERVICE
r mammon frvehondM dal"I arydarld IMPROVEMENJI g '
apo ❑I,as ownerofthe pnspeny.nr my employees with wages astheir sole compensation. SWIMMING POOL ELECTRIC
VVGG!! will Jo the work.and thoomentre isnot intendedoraffeed fortune(St .700,Rusinas ❑OTHER
W 3 and Professions Code:The Commodes License Law does not apply m an owner of OUTLETS-SWITCHES-FIXTURES
pmpeny who builds or improves thereon,and who does such work himself or through
his own employees,provided that such improvements are not intended or offered fm NEW REST DEN'1'IAL ELECTR S O, k`
male.If,bowever,the building or improvement issold within one year of completion,Ne SQ.FT.FLOOR 5/SQ.ET.
owiter-bui will have the harden of proving Nm he did not build or improve for pm �� f1 gl 911
E] 1 of sole.). /J(•I 1.7 ,l
❑ L umttheowner of the pop my,70,14.n sines ad contracting with Lcensed commons to TOrA C�I IIdV
ennatmd me project(sec.7o4a,13aamexx and Prorexxmms code:?Too ennmoc,.rx Li-
censeLaw does not apply to an owner of propoy who builds or improves them,.,and QTY. PLUMBING PERMIT FE' VifY of VDI'
who cr,mmct for such Projects with a amtmoo b)Leonard pursuers the Contractor's
License Lnw. PERMIT ISSUANCE
ElI am exempt under Sec. ,B&P C for this reason
ALTER-DRAIN&VENT-WATER(CA)
Owner Uma VALUATION
ffiWORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE 1�O
I Immor,arm under penalty of perjury one of the following declarations: �j
]I have and will maintain a Certificate ofConvanuo self-inwre for Workers Coupon- DRAINS-RUOR,ROOF,AREA,COND' STORIES TYP[CONSTRUCf10N
cation,as provided for by Section 311X1 of the Latwr Gale,for the performance(if the
work for whichthis perms is issued. FIXTURES-PER TRAP
1 have and will maintain Workers Compensation Insurance,as required by Section
37Woftha labor Cade, Nelc rmer"of the work fnrwbich this permit icicsued. 'GAS-EA.SYSTEM-1 INC.4 OUTLETS
My Work ,', an at:::.lmm� cecarr ninon Palicynumher OCC GROUP AI'N
Carrier: I ` Policy No:11.L_ >,.([I]S'111 GAS-EA.SYSTEM-OVER 4(EA)
CERTIFICATE OF EXE PITON FROM WORK r I
COMPF.NSAI'ION INSURANCE GREASFJINDUSTRL WASTE INTERCEPTOR
Otis section nee not be completed if Ne permit is for one hundtW dollars($100, BUILDING DIVI4ION f•P.ES
or less.) GRFASL'TI2AP PLANCHECK FEE
Loy any that persnt in dorformaanymannesol rbc work for which Nis[tic Wrkersued,[,hollCommn- SEWER-SANITARY-STORM EA.21X)FT.
not employ any person is my manner cel as to become subject to the Workers'Cempcn- ENERGY THE
O Z Ammon taws of Califr,mia.Dam WAFER HEATER WNENTMLF.CfR
Z Applicant GRADING FEE _
y NOTICE bj APPLICANT.WdI:If.Compensafter ation
this Certificate ofE Latin,
odd,youshould WATER SYSTEM/IREATING
[" become subject ns the Wnrhds Compensation provisions of the Labor CMe•you must SOILS FEF:
W Iti fnt¢wiN comply wird such provisions nr this Permit shall be JccmW revoked. WATER SERVICE
� O! CONSTRUCTION LENDING AGENCY NEW RESIDENT'IAL PLMB. SQ.IR. PAT[)
I hereby affirm that hem is a construction lending agency further performance of Data Receipt#
fA - the workfnr which this permit is issued(Sao.3097.Civ.C.)
O 1- lender's Name 'TOTAL:
DJLenders Address TOTAL:
Ly • 1 comfy that 1 have read this application and shute that the missive information is BUILDING FEE
V) counsel.I agree to comply with all city and county ordinances and sham laws relating at QTy, MECHANICAL PERMIT PI?E
V wZ-t building connotation.and herebyoutimnze repmsentativesol Nis city,.eructation the SEISMIC FEE
abnvc-memruled progeny for indention purposes. PERMIT ISSUANCE
(We)agree to save,indemnify and kceti harmless The City of Cupcninn again., ELECTRIC FEE
liabilities,judgments.cost and expenses which may in tiny way seems against said City gLT[R UR ADD TO MESH.
in consequence of the grouting of this permit. PLUMBING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,0X0 CPM)
SOr�_�>R�EGULAy�'�/NS. / ^^^��� / MECHANICAL PEE
NL1 vel (1\ihl � �•_\ L.-.f,U AIR HANDLING UNIT(OVER IG,"CFM) CONSTRUCTION TAX
StgnaiureV,l Apbxullonrnttoc !/Dote EXHAUST HOOD(WMULTI HOUSING MITIGATION IEE
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle hamrdous material HEATING UNIT CU 100.030 RTI)
as defmaT by the Calendar,Municipal Code,Chapter 9.12,mad Ne Heath and Safety
Cale,Section 25532(a)? HEATING UNIT(OVER I WJXW BTU)
❑Yee .[:]No - VENTILATION FAN(SINGLE RESID) PAH)
Will the not or future building occupant use equipment or device which
Date Receipt#
hat hrd
ozuomr co
us air eomominents to defined by the Bay Aren Air Quality Mnnagemcot BOILER-COMP(3HP OR 100,100 BTU)
isWct? TOTAL:
❑Yes �No BOILER-COMP(OVER 100,000 BTU)
"
I have reel the hoz rah,.,mmenalsl AIR CONDITIONER ISSUANCE DATE
requirement uMcr Cha our fi95 of the Call-
Heehh&Safety Celle.Sections 25505,25533 and 25534,1 ondcstand that if the NEW RESIDEN"TIAL M13CH. SQ.IT.
building does out emormly have a tenon,that it is my resloasibility m maify the oecupant
of the nNuimmemtx which mush be met prior to issuance of a Centeno of Occupancy, '�-��//�'y �.
OwnerauN
nroritedagB
enr Date TOTAL: ISSUED Y �/ )-05-ff/
OFFICE
a
, _ ASBESTOS REMOVAL E.R.T Fax:408-866-4186 Jul 22 '96 ':53 P.01
�y r `
• ' E' ENVIRONMENTAL REMEDIATION TECHNOLOGIES
R -
T
INITIAL BUILDING SURVEY FOR SUSPECT
ASBESTOS-CONTAINING MATERIALS (ACBM)
SUBMITTED TO:
DRAEGER CONSTRUCTION
265 DILLON AVE
CAMPBELL, CA 95008
ATTN: DAN BURNHAM p
dp �NSp 2 Iy96
017Y0
c°vvOFp
STUDY AND REPORT BY: UpFgTjN�TMENT
ENVIRONMENTAL REMEDIATION TECHNOLOGIES
2305 S. WINCHESTER BLVD
CAMPBELL, CA 95008
(408)866-4141
THIS REPORT COVERS THE SURVEY CONDUCTED AT:
FIRE DAMAGED
ST. JOHN'S RESTAURANT
19541 RICHWOOD DRIVE
CUPERTINO, CA 95014
ERT REF. NO,#9807-192
DATE:JULY 18, 1996
ASBESTOS REMOVAL E.R.T Fax:408-866-4186 Jul 19 '96 13:51 P.03
ASBESTOS SURVEY REPORT 4 9607-192
PAGE 1 OF 3
• TNTRODUCTSONL
ON JULY 18, 1996 ENVIRONMENTAL REMEDIATION TECHNOLOGIES PROVIDED ASBESTOS
SURVEYING SERVICES TO DRAEGER CONSTRUCTION. THE ASBESTOS SURVEY ENCOMPASSED
SEVERAL ASPECTS, INCLUDING A VISUAL, SURVEY BY AN EPA ACCREDITED ASBESTOS
INSPECTOR.
PURPOSE AND SC_OPR OF SURVEY,
THE CONTRACTOR, DRAEGER CONSTRUCTION, REQUESTED A14 ASBESTOS SURVEY TO
DETERMINE THE PRESENCE OR ABSENCE OF ASBESTOS AND TO PROVIDE INFORMATION ABOUT
THAT MATERIAL TO AID IN REMOVAL OR BEFORE THE FACILITY IS RENOVATED.
APPLICABLE AROULATION9, ,
THE CALIFORNIA CODE OF REGULATIONS, TITLE 8 CONTAINS A CLAUSE WHICH REFERS TO
EMPLOYEE NOTIFICATION OF HAZARDOUS SUBSTANCES PRESENT IN THE WORK AREA. THIS
CLAUSE, CONTAINED IN ARTICLE 110, SECTION 5194 OF THE CODE, REQUIRES THAT THE
EMPLOYER DEVELOP A WRITTEN HAZARD COMMUNICATION PROGRAM WHICH INCLUDES THE
METHOD EMPLOYERS PLAN TO USE TO INFORM ANY EMPLOYEES SHARING THE SAME WORK
AREA WITH ANY HAZARDOUS SUBSTANCE TO WHICH THE EMPLOYEES MIGHT BE EXPOSED
WHILE PERFORMING THEIR WORK. THE HAZARD COMMUNICATION PROGRAM SHALL INCLUDE
SUGGESTIONS FOR APPROPRIATE PROTECTIVE MEASURES.
DEMOLITION OF A BUILDING REQUIRES COMPLETE ABATEMENT OF ASBESTOS HAZARDS PRIOR
TO RAZING AS PER NCSHAPS ASBESTOS REGULATION 40 CFR SECTION 61.145-61.147 .
BAY AREA AIR QUALITY MANAGEMENT DISTRICT, SUPPLEMENTAL NOTIFICATION, NES-HAP
REQUIREMENTS, THAT AN INDIVIDUAL TRAINED IN THE PROVISIONS OF REGULATION 40
• CFR PART 61, SUBPART M WILL BE ON SITE DURING THE DEMOLITION AND EVIDENCE THAT
THE REQUIRED TRAINING HAS BEEN ACCOMPLISHED BY THIS PERSON AND WILL BE
AVAILABLE FOR INSPECTION DURING NORMAL BUSINESS HOURS.
DISCUSSION OF RES LTB,
SOME OF THE BUILDING MATERIALS FOUND AT THE SITE HAVE BEEN CATEGORIZED AS
HOMOGENEOUS MATERIALS, AND WERE GROUPED TOGETHER POR SAMPLING. AN HOMOGENEOUS
MATERIAL IS A BUILDING MATERIAL THAT IS CONSISTENT IN VISUAL APPEARANCE AND
TEXTURE THROUGHOUT THE BUILDING, AND WAS INSTALLED IN EACH AREA AT ABOUT THE
SAME TIME. WHEN A SINGLE SAMPLE OF HOMOGENEOUS MATERIAL IS DETERMINED TO
CONTAIN ASBESTOS, THE ENTIRE HOMOGENEOUS MATERIAL 19 THEN DETERMINED TO BE
ASBESTOS.
SOME MATERIALS CAN BE VISUALLY IDENTIFIED BY AN EXPERIENCE INSPECTOR AS
ASBESTOS CONTAINING. THOSE MATERIALS WERE NOT SAMPLED, BUT INSTEAD WERE
'ASSUMED" TO CONTAIN ASDESTOS. EXPERIENCE ALLOWS US TO ESTIMATE THE ASBESTOS
CONTENT OF THOSE SAMPLES WHICH ARE ASSUMED TO CONTAIN ASBESTOS.
A TOTAL OF 6 SAMPLES WERE COLLECTED AT THE SITE DURING THE INSPECTION AND THEN
ANALYZED IN STRICT COMPLIANCE WITH APPLICABLE STANDARDS USING IDENTIFICATION
AND QUANTIFICATIONS IN ACCORDANCE WITH THE "EPA INTERIM METHOD OF
DETERMINATION OF ASBESTOS IN BULK SAMPLES" (FEDERAL REGISTER, APPENDIX A,
5/7.7/82) . TO BE CLASSED As ASBESTOS, FIBERS HAVE TO FIT INTO ACCEPTED RANGES
OF INDICES AND BIREFRINGENCE DETERMINED BY IMMERSION IN MATCHING REFRACTIVE
INDEX LIQUIDS AND DISPERSION STAINING. METHOD. CONCURRENTLY, THE RELATIVE
ABUNDANCE OF ANY ASBESTOS MATERIAL, OTHER THAN FIBERS AND THE BINDERS AND
•
ASBESTOS REMOVAL E.R.T Fax:408-866-4156 Jul 19 '96 13:51 P.04
ASBESTOS SURVEY REPORT 09607-192
• PAGE 2 OF 3
FILLERS IS DETERMINED. QUANTITIES ARE BASED ON A REAL COVERAGE AND THICKNESSOF
VARIOUS SPECIES PRESENT. THE LOWEST DETECTION LIMIT IS<1%.
THE FOLLOWING INFORMATION COVERS THE ASBESTOS IDENTIFICATION BY POLARIZED
LIGHT MICROSCOPY. THE RESULTS INDICATE WHETHER OR NOT ASBESTOS WAS DETECTED
AND LISTS QUANTITIES OF FIBROUS ASBESTOS AND NON-ASBESTOS MATERIAL AND MAJOR
CONSTITUENTS OF THE NON-FIBROUS BALANCE FOUND IN EACH SAMPLE. EACH SAMPLE IS
ANALYZED FOR THE SIX ASBESTOS FORM MATERIALS: CHRYSOTILE, AMOSITE,
CROCIDOLITE, TREMOLITE, ACTINOLITE AND ANTHOPHYLITE.
SAMDI.R C hL'a__cR2 TION LOCATION RESULTS
R-01 ROOFING (HOT MOP) ROOF NONE-DETECTED
SR-02 COMP. SHEETROCK, TAPE NONE-DETECTED
AND JOINT COMPOUND
INS-03 INSULATION NONE-DETECTED
SR-04 COMP. SHEETROCK, TAPE NONE-DETECTED
AND JOINT COMPOUND
FOK-05 FIRE DEBRIS KITCHEN AREA NONE-DETECTED
• FOF-06 FIRE DEBRIS FRONT AREA NONE-DETECTED
THE STATE OF CALIFORNIA CONSIDERS ANY AMOUNT FROM 0.18 TO BE ASBESTOS
CONTAINING MATERIAL. THE EPA CURRENTLY CONSIDERS THE RESULTS OF LESS THAN It
AS NEGATIVE.
DURING DEMOLITION A CERTIFIED SUPERVISOR TRAINED IN THE PROVISIONS OF THE
MANDATORY REGULATION (40 CFR PART 61, SUBPART M) IS REQUIRED. ERT C'A14 PROVIDE
`PHIS INDIVIDUAL FOR A CHARGE OF $300.00 PER DAY. THE PURPOSE OF THIS
INDIVIDUAL IS TO IDENTIFY ANY SUSPECTED ASBESTOS LOCATED IN AREAS INACCESSIBLE
THAT WAS NOT VISABLE DURING THIS INSPECTION.
ENVIRONMENTAL REMEDIATION TECHNOLOGIES MAKES NO REPRESENTATION AS TO THE
ASBESTOS CONTENT OF ANY MATERIALS LOCATED BEHIND WALLS, FLOORS, CEILINGS,
INACCESSIBLE AREAS, OR ANY OTHER LOCATIONS NOT SHOWN ABOVE IN THIS REPORT.
RESPECTFULLY SUBMITTED,
DOMINICK FANELLI, REA, CEI, REP
• EPA/AHERA ACCREDITED 05
ROSH ASBESTOS CONSULTANT 92-0067
ASBESTOS REMOVAL E.R.T Fax:408-866-4186 Jul 19 '96 13:52 P.05
ASBESTOS SURVEY REPORT k 9607-192
• PAGE 3 OF 3
NOTE: IF DEMOLITION
IF A BUILDING IN QUESTION IS TO BE DEMOLISHED, THE ONLY OPTION AVAILABLE IS
REMOVAL. HISTORICALLY, OUR COORDINATION WITH REGULATORY AGENCIES AS WELL AS
THE DISPOSAL SITES INVOLVED HAVE ALLOWED SOME NON-FRIABLE ASBESTOS THAT IS NOT
TO BE RE-CYCLED TO BE BURIED WITHOUT FIRST BEING REMOVED. IT IS POSSIBLE THAT
A SUBSTANTIAL COST SAVINGS CAN BE REALIZED BY THIS COORDINATION. AREAS THAT
• ARE INACCESSIBLE FOR INSPECTION (E.G. CHASE, PIPE BEHIND WALLS, DUCT WORK TO
REGISTERS) ; MAY REQUIRE AN ABATEMENT PROFESSIONAL ON HAND AT THE TIME OF
DEMOLISHING IN THE EVENT THAT ADDITIONAL ASBESTOS-CONTAINING MATERIALS ARE
FOUND, WE CAN PROVIDE THOSE SERVICES TO YOU OR THE DEMOLITION CONTRACTOR.
UNDERSTANDING:
ENVIRONMENTAL REMEDIATION TECHNOLOGIES MAKES NO REPRESENTATION AS TO THE
ASBESTOS CONTENT OF ANY MATERIALS LOCATED BEHIND WALL, FLOOR, CEILINGS OR
INACCESSIBLE AREAS. WRITTEN NOTIFICATION OF ALL DEMOLITION JOBS MUST BE MADE
BY THE DEMOLITION CONTRACTOR PRIOR TO DEMO TO ALL REGULATORY AGENCYS HAVING
JURISDICTION IN THE GEOGRAPHICAL AREA.
ASBESTOS IN VINYL FLOOR TILES:
THE ANALYSIS OF VINYL FLOOR TILES BY PLM IS DIFFICVLT AT BEST. DURING
MANUFACTURING THE ASBESTOS FIBERS ARE INTENSELY GROUND AND REDUCED TO FIBRILS
• OF LESS THAN 10 MICRONS IN LENGTH. THE EPA PLM METHOD IS SUITABLE ONLY FOR
THE POSITIVE DETERMINATION OF TILE. IF A TILE IS FOUND TO BE NEGATIVE EITHER
TEM OR SEM ANALYSIS SHOULD BE USED TO CONFIRM THAT IT IS NEGATIVE. THIS IS
BECAUSE THE ASBESTOS FIBER SIZE IN TILE IS VERY SMALL (LESS THAN 10 MICRONS)
AND THE LIMIT OF RESOLUTION OF ANY PLM MICROSCOPE IS IN THE ORDER OF 10
MICRONS. FURTHERMORE, THE TILE FIBERS ARE CARRIED IN A POLYMER MATRIX THAT
HELPS OBSCURE THE FIBERS. OFTEN THE FIBERS ARE ROLLED UP INTO TIGHT SINUOUS
BALLS THAT MAKE DISPERSION STAINING ALL BUT IMPOSSIBLE.
•
ASBESTOS REMOVAL E.R.T Fax:408-866-4186 Jul 19 '96 13:53 P.06
1�•
EVIROlrMl'.1A1rT AL
REMEDIATION J �1
i
TECHNOLOGIES Bulk Asbelstota�►�>��`� Tri
Roport
Environmental Remediation Tech
PLM
2306 South Winchester Blvd. Person to ooaea: Oo W*k Feil
CampbellCA 85008 COlf"M phoft' (408)860.4141
FAXchorm: (406)804,4186
lourdmee Order Nuri w: C2192 Report Prepared on: July 18, 1868 at:16:04
Job Number: 8 9.192 oematpoeoirvkwpgenurnw: 39429
HM � (e elure) lobo►elary mene0er: fit'
Job Deeorlpllon: its amaged St JohnB Restaurant Polon are)
Lab sample Chem Sa Nurnbp Asbeerne Fibers r
Number erd Doecrbtion eroetedl p event Remarks
L39429.1 R-01 "'�"—
N-D, 396 Cellulose Stocktnutiisyerteo0np. N&Wm of egr"
Roofing 38%Fiberglass is 6%asicate and W,o.Vanb bkders.
L39429.2 SR•02 N.D. 22%Cellulase White joint compound pleder.tdaiance or
Carp sheetrack,tape,)olrtt comp eampb is 78%unspecM ed non•ttlrous
matOn91,
L39429.3 Ina-03 N.D. 2%Cellulose Shk*Rwous kwlellon. Da19noe o1 sample
Insulation 85% Mineral Wool Is 13%unspWied non-torous mateAai.
1.39429-4 SR-04 N.D. 20%Calluiose While JoInt corrpoum plaster. 8414no9 0l
Comp sheetrook, tape&P" comp 2% Fibergl= unrrO it;715'k unrn FC'isd rton-nbrous
mtc8ettel.
L-39429-5 FOK-06 N.D. 81ar e dol .eele6artoe of trample is 87%
Fire debris 3% Fiberglass unspeOied non4ibroue materiat.
L39429.6 FDF-06 N-1). 12% Cellulose 81eak fire debris. 6eimtoo of eampio is e.,%
Fire debris 3% Fiberglass unspeaw non•Hbrouo material.
End or report.
• Chrfw le.Ameeke, oroddolko.Tremelke,ActlWft#,end An4h"11to ere eebemoe Mbere. N.o..None Deteged
2305 South Winchester Blvd. • Campbell, CA 95008 (406)866.4141 • Fax (408) 866.4186
ASBESTOS REMOVAL E.R.T Fax:408-866-4186 Jul 19 '96 1353 P.07
ENVIRONMENTAL
REMEDIATION
TECHNOLOGIES
ENVIRONJ(t:NTAL
Avrw"/N Auacratrdt
EXAMINATION OF BULK SAMPLES
FORAMS7O6
The following covers the asbestos Identification by polarized light microscopy.
The attached information indicates whether or not asbestos was detected and lists quantities of
fibrous asbestos and.hon-asbastos material and major constituents of the non-fibrous balance
found In each sample. Each sample Is analyzed for the six asbestiform materials; chrysotilo,
amosite, crocidolite, tremolite, actinolite and anthophyllite.
Identiffcation and quantifiations were performed in a000rdanoe with the "EPA Interim Method of
Determination of Asbestos In Bulk Insulation Samples" (Federal Register, Appendix A.
6/27/82). Reported asbestos percentages were estimated based on comparison to reference
samples provided by EPA.
Analysis is Initiated by gross examination of the sample using a sleromicroscopo. Any obvious
• fractions are noted and samples of each fraction are mounted in a refractive Index liquid suitable
for the sample, Preliminary evaluation to determine the possible species It asbestos present is
performed by morphology, birefringence, extinction characteristics and refractive Index
relative to the mounting liquid. To be classed as asbestos, fibers have to fit Into accepted ranges
of indices and birefringence determined by Immersion In matching refractive index liquids and
dispersion staining method.
Concurrently, the relative abundance of any asbestos material, other than fibers and the binders
and fillers Is determined. Quantities are based on areal coverage and thickness of various
species present. The lowest detection limit is ci%. in California, positive test results that
indicate the sample contained 0.1% (1/10 of 1%) or more asbestos, as per California Code of
Regulations, "Title 8, Section 341.6 et seq.-
Samples will be retained for six months unless otherwise instructed. it has been a ploasure
serving you, and we look forward to serving you again in the near future.
Respectfully Submitted,
Dominick ranelli, REA, CEI, REP
EPA/AHERA Accredited #5
• DCSH Asbestos Consultant 92-0067
2305 South Winchester Blvd. Campbell, CA 95008 • (408)866-4141 • Fax(408)866.4186