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11020094 INSTALLATION CERTIFICATE CF-6R-ENV-01 Envelope— Insulation; Roofing; Fenestration (Page 1 of 3) Site Address: . , Enforcement Agency: Permit Number: 12 g7 If more than one person has responsibilityfor installation of the items on this certificate, each person shall repare and sign a certi to applicable to the portion of construction for which they are responsible;alternatively, the person with chi nfi te o n shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with ch box e o ensure the mandato measures have been met. Description of Insulation 1. RAISED FLOOR '�� . Material: 6L,C., 6, Brand Name: Thickness(inches): C �k Thermal Resistance(R-Value). t ❑ §150(d): Minimum R-13 insulation in raised wood-frame floor or equivalent U-factor. 2. SLAB FLOORIPERIMETER Material: Brand Name: Thickness (inches): Thermal Resistance(R-Value): Perimeter Insulation Depth(inches): ❑ §150(1): Water absorption rate for the insulation material alone without facings is no greater than 0.3%;water vapor permeance rate is no greater than 2.0 perm/inch and shall be protected from physical damage and UV light deterioration. 3. EXTERIOR WALL a. Insulation Type(e.x. Batt, Loose Fill, Spray Foam) a. Thermal Resistance(R-Value): b. . Insulation Type(e.x. Batt, Loose Fill, Spray Foam) b. Thermal Resistance(R-Value): Brand: Spray/Loose fill) Spray/Loose fill)Installed Actual Thickness Contractor's min installed weight/ft2 lb (inches): Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value) ❑ §150(c): Minimum R-13 insulation in wood-frame wall or equivalent U-factor. Exterior Foam Sheathing(rigid Insulation) Material: Brand Name: Thickness(inches) : Thermal Resistance(R-Value) 4. FOUNDATION WALL Material: Brand Name: Thickness (inches): Thermal Resistance(R-Value): 5. CEILING Batt or Blanket Type: Brand Name: Thermal Resistance(R-Value): Loose Fill Type: Spray Foam Type: Brand Name: Installed Actual Thickness(inches): Contractor's min installed weight/ft2 lb Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value): ❑ §150(a): Minimum R-19 insulation in wood-frame ceiling or equivalent U-factor. 6. ATTIC ROOF INSULAT ON AND/OR ATTIC RADIANT BARRIER 6tS �� Brand Name: Material: `��be vi S Material: Brand Name: Thickness(inches): Thermal Resistance(R-Value): ❑ §118(a): Insulation installed meets Standards for Insulating Material. ❑ §150(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-ENV-01 -Envelope — Insulation; Roofing; Fenestration (Page 2 of 3) Site Address: 1 ZZ Enforcement Agency: Permit Number: s - 02 00 Y -Description of Roofing Products CRRC Product ID Manufacturer Product Roof Roof Product Initial Solar Aged Solar Thermal Number' Information Brand/Model Type Area Sloe Weight 2 Reflectance Reflectance' Emittance 11 ❑3 ❑3 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at ww.coolroofs.org/products/search.php 2. The weight in lbs per square feet of the roofing product being installed. 3. Check box if the Aged Reflectance is a calculated value using the equation below,footnote 4. 4. If the aged reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the initial reflectance value from the directory and use the equation(0.2+0.7( iniliat—0.2)to obtain a calculated aged value. ✓OCHECK APPLICABLE BOX BELOW IF EXEMPT FROM THE ROOFING PRODUCT"COOL ROOF"REQ UIREMENT.• ❑ The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from the above Cool Roof criteria. ❑ Roof constructions that have thermal mass over the roof membrane with a weight of at least 25 lb/ft2 is exempted from the above Cool Roof criteria. To apply Liquid Field Applied Coatings, the coating must be applied with a minimum dry mil thickness of 20 mils across the entire roof surface and meet minimum performance requirements listed in§118(i 3 and Table 118-C. Select the applicable coatin ❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coatiniz Other ✓ ❑ CRRC-1 Label Attached to CF-6R (Note if no CRRC-1 label is available, this compliance method cannot be used and another method is required to meet compliance). FENESTRATION/GLAZING Product # Total Quantity Add.Exterior Comments/ Manufacturer/Brand Name U- Product of NFRC of Like Product Area Shading Dev. Location/Special Item GROUP LIKE RODUCTS factor' SHGC' Panes Certified°2 (Optional) ft2 or Overhang Features 1 � /L 2 3 4 5 6 7. 8. 1. Use values from a fenestration product's NFRC Certified Label.For fenestration products without an NFRC label,use the default values from Section 116, Table 116-A and 116-B of the 2008 Energy Efficiency Standards. 2.NFRC Label Certificates shall not be removed until the building inspector has verified the efficiency.Enter Yes or No. ❑ §116(a)1:Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. ❑ §116(a)2 and 3: Actual fenestration products installed are equivalent to or have a lower U-factor and/or a lower SHGC than that specified on the Certificate of Compliance(Form CF-IR). ❑ §116(a)4: Fenestration products(except field-fabricated windows)have a label listing the certified U-Factor,certified Solar Heat Gain Coefficient(SHGC),and infiltration that meets the requirements of§10-111(a) ❑ §117: Exterior doors and windows weather-stripped;all joints and penetrations caulked and sealed. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-ENV-01 Invelope — Insulation; Roofing; Fenestration (Page 3 of 3) Site Address: ,-� Enforcement Agency: Permit Number: Z- . }ail 0 00 DECLARATION STATEMENT a I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. • 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction(responsible person). • 1 certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation)conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF-1R that apply to the installation have been met. • I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) - .t Vx `` c Y,\ Responsible Person's Name: r Responsible Person's Signature: �-A,-�'c�*\". � } - ,X-11 CSLB License: - Date Signed: Position With Company(Title): 4.6 S `� Zbl 2008 Residential Compliance Forms August 2009 • INNOVATIONS FOR LIVING ,. Personal Protective Equipmenrt WHMS Pictograms m DOT Pictograms i Not Nat i Controlled i Regulated I Protective Safety j Gloves Glasses ' I I Product Name: Low Density Fiber Glass Insulation/Insulation Board-Unfaced Products MSDS Manufacturer 13614-NAM Number: Synonyms: Acoustical Backing Board,Attic Door Insulator,Attic Hatch Insulator,Attic Scuttle Insulator,Batts in Bags,Blended Blowing Wool,Cathedral Batt Insulation,Cavity Wall,Cold Storage Wall,Curtain Wall 225,ECOTOUCHTM,FDM ARP100, FDM ARP125,Flexible Marine,Flexible Type 75 AF-FDM,HV- WPA 24,HV-26,H2V-1000,H2V-2000,Insulation Batts, Manufactured Housing Insulation,Masonry Wall Insulation, Metal Building(all types),Metal Framing Batts,Metal Framing Insulation,Multi-purpose Insulation,Noise Stop Board,Pink@ `.. Insulation,Pink Pak,QuietZone@Acoustic Batt,RA Series, M 0 Shaft Wall,Sill Sealer,Sonobatts@,Sound Attenuation Batts, Standard Blend,Super Pink R Blowing Wool,ThermaGlas@, Marine Board,ULTRAVANTAGET"Comfort TouchT",Unfaced Duct Wrap,Warm-N-Dri@,Aislhogar,Aislacustic T"',MBI,MBI Certified R,Attic Blanket@,Flexible Duct Media FIBERGLAS@ Insulation with PureFiberTechnology@,Metal Building HMS FIBERGLAS@ Insulation with PureFiberTechnology@ Product Use/Restriction: Insulation Health Hazard Manufacturer Name: Owens Corning Insulating Systems,LLC Fire Hazard 1 Address: One Owens Corning Parkway Toledo,OH 43659 Rendlvtty 0 Customer Service Phone 1-800-GET-PINK or 1-800-438-7465 Personal X N umber: Protection Health Issues Information: 1-419-248-8234(8am-5pm ET) Chronic Health Effects Technical Product 1-800-GET-PINK or 1-800-438-7465 I nformation: Emergency Phone Number: 1-419-248-5330(after 5pm ET and weekends) CHEMTREC: 800-424-9300(24 hours everyday) Canutec: (613)996-6666(Canada 24 hours everyday) Website: www.owenscorning.com MSDS Creation Date: December 16,1997 MSDS Revision Date: July 14,2011 Chemical Name CAS# Ingredient Peroenrt Cured Binder N/A 0-15 by weight Fiber Glass(Wool) 65997-17-3 85-100 by weight Non-Hazardous Statement: The remaining components of this product are non-hazardous or are in a small enough quantity as to not meet regulatory thresholds for disclosure.These components contain no substances or impurities which would influence the classification of this product. Applies to Product Emergency Overview: Exposure to dust may be irritating to eyes,nose,and throat. Route of Exposure: Eye contact Low Density Fiber pass I nsulationtl nsulation Board-Unfaced Products Owens Coming Insulating Systems.LLC 11111G IG ll VII Potential Health Effects: Eye: May cause irritation. Skin: May cause skin irritation. Inhalation: May cause irritation of respiratory tract. Ingestion: Ingestion of this product is unlikely. Chronic Health Effects: Long term use or contact with this product has not been shown to cause chronic health effects. Carcinogenicity: This material is not considered a carcinogen. Potential Environmental Effects: There is no known ecological information for this material. Aggravation of Pre-Existing Chronic respiratory or skin conditions may temporarily worsen from exposure to Conditions: this product. OSHA Regulatory Status: This product is considered hazardous by the OSHA Hazard Communication Standard(29 CFR 1910.1200). Eye Contact: Immediately flush eyes with plenty of water for at least 15 to 20 minutes. Ensure adequate flushing of the eyes by separating the eyelids with fingers. Do not rub or scratch eyes. If eye irritation persists,consult a specialist. Skin Contact: Wash off immediately with soap and cold water. DO NOT use warm water because this will open up the pores of the skin,which will cause further penetration of the fibers. Use a wash cloth to help remove fibers. DO NOT rub or scratch affected areas. Remove contaminated clothing. If irritation persists get medical attention. Never use compressed air to remove fibers from the skin. If fibers are seen penetrating from the skin,the fibers can be removed by applying and removing adhesive tape so that the fibers adhere to the tape and are pulled out of the skin. Inhalation: Move to fresh air. If symptoms persist,call a physician. Ingestion: Accidental ingestion of this material is unlikely. If this does occur,watch person for several days to make sure intestinal blockage does not occur. Rinse mouth with water and drink water to remove fibers from the throat. If symptoms persist,call a physician. Note to Physicians: Treat symptomatically. Flammable Properties: Non Flammable. Flash Point: None. Flash Point Method: Not applicable. Lower Flammable/Explosive Limit: Not applicable. Upper Flammable/Explosive Limit: Not applicable. Extinguishing Media: dry chemical foam carbon dioxide(CO2) water fog Protective Equipment: Wear self-contained breathing apparatus(SCBA)and full fire fighting protective gear. Unusual Fire Hazards: Hydrogen chloride to be released from the PVC barrier and vinyl facings during a fire. Hazardous Combustion Carbon monoxide. Byproducts: Carbon dioxide. Ammonia. Other undetermined compounds could be released in small quantities. Universal Fire And Explosion Not available. Hazards: NFPA Ratirx>�: NFPA Health: 1 NFPA Flammability: 1 Low Density Fiber Glass Insulation/Insulation Board-Unf aced Products Owens Comina Insulating Svstems.LLC Personnel Precautions: Avoid contact with skin and eyes. Environmental Precautions: Prevent further leakage or spillage if safe to do so. Methods for containment: This material will settle out of the air. Prevent from spreading by covering,diking or other means. Methods for cleanup: Use an industrial vacuum cleaner with a high efficiency filter to clean up dust and fiber contamination. Avoid dry sweeping. Pick up and transfer to properly labeled containers. Other Precautions: Does not apply. ------------ Handling: Avoid dust formation. Do not breathe dust. Wear personal protective equipment. Storage: Keep product in its packaging until use to minimize potential dust generation. Product should be kept dry and undercover. Hygiene Practices: Wash hands before breaks and immediately after handling the product. Remove and wash contaminated clothing before re-use. Engineering Controls: Provide local exhaust and/or general ventilation to maintain exposure below regulatory and recommended limits. Dust collection system must be used in transferring operations,cutting or machining or other dust generating processes,such as using power tools. Vacuum or wet clean-up methods should be used. Eye/Face Protection: Safety glasses with side-shields. Skin Protection Description: Protective gloves. Long sleeved shirt and long pants. Respiratory Protection: When workers are facing airborne particulate/dust concentrations above the exposure limit they must use appropriate certified respirators. A properly fitted NIOSH approved disposable N 95 type dust respirator or better is recommended. Other Protective: When the temperature of the surface being insulated exceeds 250°F(121°C), including initial startup,the binder in these products may undergo various degrees of decomposition depending on the temperature in the application. The need for respiratory protection will vary according to the airborne concentration of the decomposition products released and accumulated in the area. Mkar the appropriate respiratory protection according to the conditions and exposure levels in the area. General Hygiene Considerations: Wash hands before breaks and immediately after handling the product. Remove and wash contaminated clothing before re-use. EXPOSURE GUIDELINES I ngredient Guideline OSHA Guideline AOGIH Ontario Canada Mexico Fiber Glass(Wool) PEL-TWA:1 f/cc TLV-TWA:1 f/cc TWAEV-TWA: TWA:0.15 mg/m3 (Respirable) (Respirable) 0.05 mg/m3 or 1 f/c c ST E L:0.6 mg/m3 Physical State Appearance: Fibrous. Odor: organic Boiling Point: No Data Melting Point: No Data Specific Gravity: No Data Solubility: Insoluble in water. Vapor Density: No Data Vapor Pressure: No Data LowDensity Fiber Gass Insulation/Insulation Board-Unfaced Products QA"Canino Irsulatino Svstems.LLC pH: No Data Viscosity: Not applicable. Flash Point: None. Flash Point Method: Not applicable. Chemical Stability: Stable under normal conditions. Hazardous Polymerization: Hazardous polymerization does not occur. Conditions to Avoid: None expected Incompatible Materials: No materials to be especially mentioned. Special Decomposition Products: See Section 5 of MSDS for hazardous decomposition products during a fire. Applies to Product Acute Toxicity: Dusts may cause mechanical irritation to eyes and skin.Ingestion may cause transient irritation of throat.Inhalation may cause coughing,nose and throat irritation,and sneezing. Carcinogens: ACGIH NIOSH OSHA IARC NTP MEXICO Cured Binder No Data No Data No Data No Data No Data No Data Fiber Glass(Wool) A3 Animal No Data No Data Group 3-Not Biosoluble A3 Animal Carcinogen Classifiable as to glass wool is not Carcinogen its considered to b Carcinogenicity carcinogenic to Humans. Applies to Product Sensitization: No information available. Mutagenicity: No information available. Reproductive Toxicity: No information available. Teratogenicity: No information available. Neurological Effects: No information available. Cured Binder: Ingestion: Inhalation-Rat LD50:7 gm/kg-[Autonomic Nervous System-Other(direct) parasympathomimetic Behavioral-Muscle weakness Lungs,Thorax,or Respiration-Respiratory depression] Inhalation-Mouse LD50:7 gm/kg-[Autonomic Nervous System-Other (direct)parasympathomimetic Behavioral-Muscle weakness Lungs,Thorax,or Respiration-Respiratory depress ion](RTECS) Fiber Glass(Wool) Chronic Effects: In June of 2011,The National Toxicology Programs'12th Report on Carcinogens revised its 1994 classification of glass wool(respirable)fibers as reasonably anticipated to be carcinogenic.NTP now classifies only certain biopersistent glass wool fibers as carcinogenic.Under the revised classification,none of the glass wool fibers manufactured by Owens Corning are classified by NTP as carcinogens. In October 2001,the International Agency for Research on Cancer(IARC) classified fiber glass wool as Group 3,not classifiable as to its carcinogenicity to humans.The 2001 decision was based on human studies and animal research that have not shown an association between inhalation exposure to dust from fiber glass wool and the development of respiratory disease.This classification replaces the IARC finding in 1987 of a Group B designation possibly carcinogenic to humans.. In May 1997,the American Conference of Governmental Industrial Hygienists (ACGIH)adopted an A3 carcinogen classification for glass wool fibers.The ACGIH A3 classification considers glass wool to be carcinogenic in experimental animals at relatively high doses,by routes of administration,at sites,or by mechanisms that it does not consider relevant to worker exposure. It also reviewed the available epidemiological studies and concluded that they do not confirm an increased risk of cancer in exposed humans.Overall,the ACGIH found that the available medical/scientific evidence suggests that glass wool is not likely to cause cancer in humans except under uncommon or unlikely routes or levels of exposure. As such no national or international body considers soluble glass wool LowDensity Fiber Gass Insulation/Insulation Board-Unfaced Products Owens Carina Insulating Svstems.LLC Applies to Product Ecotoxicity: This material is not expected to cause harm to animals,plants or fish. Bioaccumulation: Not available. Biodegradation: Not available. Mobility In Environmental Media: Not available. Applies to Product Waste Disposal: Dispose of in accordance with Local,State,Federal and Provincial regulations. Contaminated Packaging: Empty containers should be taken for local recycling,recovery or waste disposal. RCRA Number: No EPA Waste Numbers are applicable for this product's components. RCRA Characteristics: This material is not expected to be a characteristic hazardous waste under RCRA. DOT Shipping Name: Not Regulated. IATA Shipping Name: Not Regulated. Canadian Shipping Name: Not Regulated. IMDG Shipping Name: Not Regulated. ADR Shipping Name: Not Regulated. RID Shipping Name: Not Regulated. ICAO Shipping Name: Not Regulated. MEX Shipping Name: Not Regulated. Inventory Status Japan ENCS EINECS Number Philippines PICCS China South Korea KECL Cured Binder Not listed Listed KE-35185 Fiber Glass(Wool) Not listed 266-046-0 Listed Listed KE-17630 Australia AILS Canada DSL Tom►Inventory Status Cured Binder Listed Listed Listed Fiber Glass(Wool) Listed Listed Listed Applies to Product Canada Reg,Status: This product has been classified in accordance with the hazard criteria of the Controlled Products Regulations and the MSDS contains all of the information required by the Controlled Products Regulations. Canada WHMIS: Not controlled. CA PROP 65: The following statement(s)are provided under the California Safe Drinking Water and Toxic Enforcement Act of 1986(Proposition 65): WARNING!This product contains a chemical known to the State of California to cause cancer. SARA: This product does not contain any chemicals which are subject to the reporting requirements of the Superfund Amendments and Reauthorization Act of 1986 (SARA)Title III(40CFR,Part 372). Section 311/312 Hazard Categories: Acute Health Hazard: Yes Chronic Health Hazard: Yes Risk of ignition: No Sudden Release of Pressure Hazard: No Reactive Hazard: No Clean Air Act: This product does not contain any Hazardous Air Pollutants(HAPS). Low Density Fiber(lass Insulation/Insulation Board-Unfaced Roducts OAens Comina Insulatina Systems.LLC State Right To Know RI MN IL PA MA Cured Binder No Data No Data No Data No Data No Data Fiber Glass(Wool) Listed Listed Listed Listed Listed NI Cured Binder No Data Fiber Glass(Wbol) No Data HMIS Health Hazard: 1 HMIS Fire Hazard: 1 HMIS Reactivity: 0 HMIS Personal Protection: X MSDS Creation Date: December 16,1997 MSDS Revision Date: July 14,2011 MSDS Revision Notes: Tox info update Disclaimer: Reasonable care has been taken in the preparation of this information,but the manufacturer makes no warranty of merchantability or any other warranty, expressed or implied,with respect to this information.The manufacturer makes no representations and assumes no liability for any direct,incidental or consequential damages resulting from its use. Copyright©1996-2011 Actio Corporation.All Rights Reserved. Low Densitv Fiber Glass Insulation/Insulation Board-Unfaced Products OAens Comina Insdakina Svstems.LLC