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12080305 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10522 CYPRESS DR C0N'7'RACPOR:Y'B5-TMBE PERMIT NO: 12080305 QGFF_Rf.ftMf?D OWNER'S NAME: 'rAO YING YAU 0 'L DATE ISSUED:08292012 O�,�WNNER'S PHONE: 408725250 '� PHONE NO: CI LICENSED CO\MACfOR'S DECLARATION JOR DESCRIPTION: RESIDE\PIAL COMMERCIAL 11 License Class Lic.N G RE-ROOF 26 SQ- ROOF OVERLAY OF EXISTING / _ MULTIFAMILY DWELLING Contmdo Date I hereby a m Ih 1 am ' nsed unJ the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. hereby affirm under penally of perjury one of the following two deelarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$70000 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for die performance of the work for which this APN Number:31630051.00 Occupancy Type: permit is issued. APPLICANTCERTIFICATION I certify than have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA ' , OM LAST CALLED INSPE TI N. indemnify and keep harmless the City of Cupertino against liabilities,judgments, - costs,and expenses which may accrue against said City in consequence of the � ) ! / granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: til with all non-pointsot cc regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date Q(r All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-RUILDER DF,CLARA'rION Signature of Applicant: Date: 1 hereby affirm that 1 nm exempt from the Contractor's License Law for one of the lnllowing two rensons: ALI,ROOF COVERINGS' O RE CUASS"A"OR BETTER I,as owner of property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&•Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to IIA%ARDOIIS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Ilealth&Safety Code,Sections 25505,25533,and 25534. I will 1 hereby'affirm under penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Ilealth&Safety Code,Section 25532(x)should Istore or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the flay Area Air Quality Management District performance of the work for which this permit is issued e'ill maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Ilealth&Safety Code.Sections'S505,25533,and 2 534. Section 3700 of the Labor Code,for the performance of the work for which this ized agent Owner or authorUote: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONST'RUCT'ION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must 1 hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked w'ork's for which this permit is issued(Sec.3097,Civ C.) Lender's Name ,\I'['LICAN'I'CER'1'IFIGVI'ION Lender's Address I certify that I have read this applicatiodmid state that the above inromation is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ,\RCIII'rF.CI"S DECLARATION and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may occrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date REROOF TEAR-OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O.. BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(Dkuoertino.org PROTECT ADDRESS APNa O Sd"t- eJ I'_ OWNER NAME P NE — l E-MAIL DO au L STREET ADDRESS CITY. STATE ZIP V FAX CONTRACTOR NAMELICENSE NUMBER LICENSE TYPE BUS.LIC.a r e G COMPANY AME E-MAIL FAX (,o tr cold / ✓vl n- dw CSI o Lf X 7_ / STREET AD RESS CI .STATE.ZIP ONE /Ss Geneva tla T°/S H PH77 -33�� I UNDERSTAND AND AGREE TO THE FOLLOWING: I. The re-roof project shall comply with all applicable provisions of the 2010 California Codes. 2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777- 3228 from 7:30 - 3:30pm (Mon-Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection. For Tear-Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. Progress and Final Inspections will be given a two hour window. 3. Tear-Off Inspection is required. Any and all dry-rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails/fasteners shall be either completely knocked-down or removed prior to this inspection. 4. if plywood is installed, a plywood Nailing Inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. Progress Inspection is required when approximately 50%of roof covering is installed. 7. A Final Inspection and approval shall be obtained from the building inspector when the re-roofing is completed. To receive a final sign-off, the following items will be verified: a. Flat roofs shall have a minimum of/" per foot of slope and demonstrate there is no ponding. b. Listings from approved testing agencies for all pre-manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter/downspouts installed, debris removed. 8. NOTE: .If you call for a tear-off or plywood nailing inspection and the work is not complete, you will be charged a re-inspection fee of$126.00. The re-inspection fee shall be paid before another inspection can be scheduled. By my signing below, 1 certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. 1 understand and agree to comply with the re-roof policy stated above. I also understand that smoke detectors and carbon monoxide etectors are required to be installed in accordance with Sections R314 and R315 of the 2010 California Residential C Signature of Applicant/Agent: Date:_005� ze ReroofPolicv_201 l.doc revised 02116/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 10522 cypress dr. DATE: 08129/2012 REVIEWED BY: bobs. APN: BP#: 'VALUATION: $7,000 *PERMIT TYPE: Building Permit PLAN CIIECK•TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAn1ATION 1SFDWLROOF USE: PERMIT TYPE: .41 WORK 1 roof overlay of existing mult)(family dwelling. SCOPE Atech. Plait Check Plumb. Plan Check Elec.Plan Check Mech. Permit Fee: Plumb. Permit Fee: Elec.Permit Fee: Other Adech.Insp. Othr,r Plumb 1ne11. Other Elce.Insp. Ej ,llech.Insp.Fee: Plumb. hasp. Fre: Elec.Insp. Fee: NOTE: This estimate does not include fees due to other Departments(i.e. Planting, Public Works, Fire,Sanitary Sewer District,School District, etc). These fees are baser/on the prelintinan information available and are onh•air estimate Contact floe De r or arddri7 info. FEE ITEMS (Fee Resolution 11-053 Elf 71111/) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 2,600 s.f. Re roof Suppl. PC Fee: Q Reg. 0 OT0,0 hrs $0.00 $390.001 IREROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee D Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Adminictratire Fee: Work Without Permit? 0 Yes Q No $0.00 G Advanced Planning Fee: $0.00 Select Non-Residential E) Travel Documentation Building or Structure 0unentatian Fuer: � Strong Motion Fee: IBSEISnOCR $0.70 Select an Administrative Item Bldg St ds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $1.701 $390.001 TOTAL FEE: $391.70 Revised: 07/01/2012 REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION O� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 O� ` CUPERTINO (408)777-3228• FAX(408)777-3333•buildino(ocunertino.org 1� PROJECT ADDRESS OS rc C ^ r- APNY I / O 2 o5-/ OWNERNANffi (n IJ U PHONE s_ �SO` E-AUJIL -J STP.EE'r ADDRESS CITY, STATE,ZIP I FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑ OWNER ❑ O\\'NEIt aun.GIt ❑ OWNERAGfM 110 fMICrOR ❑CONntACrORAGFM ❑ ARCHITECT' Cl ENGINFER ❑ DEVELOPER ❑TENANT CONT11,47NAME LICENSE NUMBER LICENSE T\'PE BUS.LIC.0 r COMPANY NAME E-MAIL FAX L0 Sm 000 e°Z13 misn-Cai" Sta -/ 7_? STREET ADD s CITY,STATE,ZIP / PHONE s eu K wt 1�d 7 -33Ua- ARCHITEC,ENGINEER NAME LICENSE NUN®ER BUS.LIC.k CONVANY NAN(E E-NIAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑ SFD or Duplex "ultl-Fainly, ROOF AREA: VALUATION: STRUCTURE: ❑ Commercial �� 6 S73 - ;970 "- a O EXISTINGROOFTYPE: ❑BUILT-UPROOF P-ASPHALTSHWGLES ❑W'OODSHAKES 13 WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE mtEPLACE ❑YES IF NO. PLY'W'OOD ❑ w ❑ PLY'WD ❑ OSB PITCH: �// ROOF IIYo 9LA RS• -� ❑ Ha" NV' ❑CD. -- LZ CLASS A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF t7.ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT a DESCRIPTIO IJF'wORK; C r l Osl 4,&Pn 1 e r C4,7 GW em Ft /a h Y By my signature below,I certiiv to each of the following: Iran the property owner or authorized agent to act on the proper•owner's behalf. t have read this application and the information 1 have provi ed is correct. [have read the Description of Work,and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build' construction. 1 authoraz ep rives of Cupertino to enter the above-id stifled p per'for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTALINFOIZKATI00UIRED - OFFICEUSEONLY - _If building is associated with a Home Owners Association,provide letter PLANCUECK TYPE ROIUTIFG SLIP- of approval from HOA. 6-1-111-THE-COUNTER �1 B o�RC PLAN REVIEW _Provide Planning approval to verify if there any restrictions. ❑ r1pRLss ❑ PLaN9lnCreiN Rn tsw _Provide copy of Manufacturer's Installation Specifications. C] STANDARD El naE DE" Psigned copy of Cupetvno•s Tear-Off Policy. ❑ OTHERv . Reroofdpp_201 Ldoc revised 03/16/11 t O ® o a 2603 Camino Ramon,Suite 200 San Ramon,CS 94583 877 285 8450 877 285 1445 in, August 8, 2012 Vulcan Construction 1685 Russell Ave. Suite H Santa Clara, CA 95054 Limited Asbestos Survey RE: 1001 N. De Anza Blvd. Cupertino, CA 95014 Claim No. Lab No. 12A36008 Introduction This letter report presents the results of the limited asbestos-containing material (ACM) survey conducted by Protera Inc. for the potential abatement at the above referenced site. Methods The asbestos survey was restricted to the materials to be disturbed by the demolition of the residence and/or at the direction of claims adjuster and/or contractor. The following materials were sampled: 1. 3rd floor area 1 -drywall/joint compound composite 2. 3`d floor area 2-drywall/joint compound composite 3. 3rd floor area 3-drywall/joint compound composite 4. 3'd floor area 4-drywall/joint compound composite 5. 3d floor arca 5-skim coat 6. 3'd floor area 6 -skim coat 7. 3`d floor area 7-skim coat 8. 3rd floor area 8-skim coat 9. 3rd floor area 9-acoustic ceiling tile 10. 3'd floor area 10-acoustic ceiling tile 11. 3`d floor area I 1 -acoustic ceiling tile 12. 3'd floor area 12 -acoustic ceiling the 13. 3'd floor attic-lay in insulation 14. 3`d floor area 14-vinyl the flooring/mastic, 1 layer 15. 3rd floor area 15-vinyl the flouring/mastic, 1 layer 16. tad floor area 16-drywall/joint compound composite 17 2nd floor arca 17-drywall/joint compound composite 18. 2"d floor area 18-drywall/joint compound composite 19. tad floor area 19-skim coat 20. 2"d floor area 20-skim coat 21 tad floor area 21 -skim coat 1 22 2"d floor area 22-acoustic ceiling the 23. 2"d floor area 23-acoustic ceiling tile 24. 2nd floor area 24-acoustic ceiling tile 25. 2"d floor area 25-vinyl tile flooring, I layer 26. 2nd fl000r area 26-vinyl tile flooring, 1 layer Other areas or materials at the site were not surveyed. Materials suspected of containing asbestos and scheduled to be disturbed by possible demolition/abatement appear in the attached Limited Asbestos Survey Summary Table. Since the asbestos survey was restricted based upon the possible abatement, if revisions to the anticipated abatement are made that impact additional materials or areas, it is important that Protera Inc. be contacted to review the changes and/or conduct additional asbestos survey work to address potential impacts to untested materials. No previous asbestos survey reports were provided for review. No as-built construction records were provided for review. Materials to be disturbed by possible repairs and suspected of containing asbestos were sampled in accordance with the federal EPA AHERA protocols. Suspect materials were grouped and classified as homogeneous materials based on their color. texture and time of construction (i.e., similar appearing materials in different construction phases of a building are classified as separate materials) and samples representative of the materials were collected. Materials determined by the inspector to be non-suspect, such as wood, metal, glass, and fiberglass insulation, were not sampled. Because destructive investigation was not conducted, additional untested materials may be present behind walls,column enclosures or similar areas, or in inaccessible areas such as locked rooms. Samples were collected in such a manner as to minimize release of the material into the surroundings. Material type, sample number, sample location and other pertinent information were recorded at the time of sampling. Each sample was placed in an airtight polyethylene bag labeled with a unique sample number and submitted to an accredited laboratory for analysis. Samples were analyzed in accordance with EPA Method 600/R-93-116, using polarized light microscopy (PLM) with dispersion staining and using visual area estimation to determine percent asbestos content. This method allows for the identification of the primary types of asbestos used in building materials. The lower limit of detection for this method is one percent. Samples containing less than one percent asbestos by PLM with visual area estimation are reported as Trace. Findines Asbestos was identified in the following materials and/or areas: • None Detected Approximate measurements only,not for bidding purposes. Laboratory reports are attached Conclusions Materials for which sample analysis by PLM resulted in greater than one percent asbestos (for any one sample collected from a homogeneous material) are classified as ACM under regulations promulgated by (but not limited to) the following agencies: federal EPA, Bay Area Air Quality Management District (BAAQMD) California EPA (Cal-EPA), federal OSHA and Cal/OSHA. These materials are also classified as asbestos-containing construction material (ACCM) under Cal/OSHA and California Contractor Licensing Board(CCLB)regulations. Limited Asbestos Survey The agencies use the following definitions: Federal EPA: materials containment greater that one percent asbestos are ACM BAAQMD: materials containing greater than one percent asbestos are ACM Cal/OSHA: materials containing greater than 0.1%asbestos by weight are ACCM CCLB: materials containing greater than 0.1%asbestos by weight are ACCM Materials shown in the table as containing more than one percent asbestos are regulated materials under the Bay Area Air Quality Management District (BAAQMD) District Regulation 11-2, Cal/OSHA regulations, and numerous additional regulations. Some of the regulatory requirements with significant logistical impacts on building owners and contractors include, but are certainly not limited to, those appearing below. Materials containing more than one-tenth of one percent asbestos also require licensing for asbestos with the CCLB and registration with Cal/OSHA. Certain Cal/OSHA requirements apply to materials containing any level of asbestos. including exposure assessments and wet work methods. BAAQMD District Regulation 11-2-401.3 requires that for every demolition or for every renovation involving the removal of 100 sq ft/lin ft or greater of Regulated Asbestos Containing Material (RACM), a notification must be made to the BAAQMD at least 10 working days prior to commencement of demolition/renovation. For residential buildings of four or fewer dwelling units, 72 hour prior notification is acceptable with the payment of an additional fee. These materials should not be disturbed, except by a licensed asbestos abatement contractor who complies with all applicable regulations. Under the California Health and Safety Code Section 25915 et. seq., notification about asbestos containing construction materials must be provided initially by the building owner within 15 days of receipt of the infomaation to co-owners, tenants, employees, contract workers, or others who may encounter the material, and the notification must be provided annually thereafter. Notification of new asbestos information (such as any ACM or ACCM identified in this report) must be provided within 15 days of the end of each 90-day period. Under Cal/OSI-IA regulation, this information must also be provided to contractors, sub-contractors or others whose work may disturb ACM or ACCM, prior to submission of bids and performance of work. For detailed regulatory requirements in specific situations, Protera Inc. should be consulted, or the applicable regulations should be examined. Limitations The survey was conducted by personnel accredited as an asbestos building inspector under the federal Environmental Protection Agency (EPA) Asbestos Hazard Emergency Response Act and work under the direction of a Certified Asbestos Consultant (CAC) certified by the California Division of Industrial Relations, Department of Occupational Safety and Health Administration (Cal/OSI-IA) Protera Inc. did not disassemble building equipment; such as fans, ducts, and electrical equipment. Consequently, equipment may contain untested gaskets, packings, internal components, overspmy of building materials and the like. If the aforementioned materials or any other untested suspect materials are encountered during abatement, they should be treated as ACM and not disturbed, unless sampling and analysis of the materials proves otherwise. If revisions to the renovation project are made that impact additional materials or areas, it is important that Protera Inc. be Limited Asbestos Survey 3 contacted to review the changes and/or conduct additional asbestos survey work to address potential impacts to untested materials. Protera Inc. has performed this asbestos sampling in a substantial,and workmanlike manner, in accordance with generally accepted methods and practices of the profession, and consistent with that level of care and skill ordinarily exercised by reputable environmental consultants under similar conditions and circumstances. No other representation, guarantee or warranty, express or implied, is included or intended in the asbestos survey report. If you have any questions please call at your earliest convenience. Thank You, Nefi Hernandez Certified Asbestos Consultant #00-2858 Operations Manager Limited Asbestos Survey 4 - {r Uw /� B Contact: Date Sampled: 08/06/12 'v e Company: Protera Inc Date Received: 08/07/12 UMB ANALYTICAL INC. Address: 2603 Camino Ramon, Suite 200 Date Analyzed: 08/07/12 26010 Eden Landing Rd.Suite C Hayward.CA.94545 San Ramon, CA 94583 UMBA ID k: 9708 510.786.0507 1 510.786.0509 N Phone: 877.285.8450 Fax: 877.285.1445 Project 12A36008 Comments: 1001 N De Anza Blvd ASBESTOS PLM TEST REPORT: EPA METHOD 600R/-93-116 Sample Description Appearance Fibrous Non-Fibrous Asbestos Content 1 DW/JC Composite 3rd Floor Area 1 White Brown Cellulose 20% 80% None Detected Fibrous Fiberglass <1% 9708-1 Heterogenous 2 DW/JC Composite 3rd Floor Area 2 White Brown Cellulose 20% 80% None Detected Fibrous Fiberglass <1% 9708-2 Heterogenous 3 DW/JC Composite 3rd Floor Area 3 White Brown Cellulose 30% 70% None Detected Fibrous 9708-3 Heterogenous 4 DW/JC Composite 3rd Floor Area 4 White Brown Cellulose 30% 70% None Detected Fibrous Fiberglass <1% 9708-4 Heterogenous 5 Skim Coat 3rd Floor Area 5 White Cellulose 40% 60% None Detected Fibrous 9708.5 Heterogenous 6 Skim Coat 3rd Floor Area 6 White Cellulose 40% 60% None Detected Fibrous 9708.6 Heterogenous 7 Skim Coat 3rd Floor Area 7 White Cellulose 70% 30% None Detected Fibrous 9708-7 Heterogenous B Skim Coat 3rd Floor Area 8 White Cellulose 30% 70% none Detected Fibrous Fiberglass <1% 9708-8 Heterogenous 9 Acoustical Tile Ceiling 3rd Floor Area 9 White Cellulose 50% 15% None Detected Fibrous Mineral Wool 35% 9706-9 Heterogenous 10 Acoustical Tile Ceiling 3rd Floor Area 10 White Cellulose 50% 15% None Detected Fibrous Mineral Wool 35% 9708-10 Heterogenous 11 Acoustical Tile Ceiling 3rd Floor Area 11 White Cellulose 50% 15% None Detected Fibrous Mineral Wool 35% 9708.11 Heterogenous 12 Acoustical The Ceiling 3rd Floor Area 12 White Cellulose 50% 15% None Detected Fibrous Mineral Wool 35% - 9708-12 Heterogenous 13 Lay-In Insulation 3rd Floor Attic Beige Mineral Wool 100% 0% None Detected Fibrous Cellulose <1% 9708-13 Homogenous 14 Linoleum 3rd Floor Area 14 Cream 0% 100% None Detected Tile Non-Fibrous 9708-14a Homogenous ^ 08/07/12 Authorized Signatory Date due to magoinclum limitations Inherent In el albas os fibers In dimensions below,the resolution mpatllllty of PLM may not Ce intMtep. samples mpone0 as<1%or none deReiM may require additional testing by TEM to termini esoeses quantities. The above test report relates only t0 the Items tested and may not be reproduceo In any to=without the erpress women ePpmval of UMB A,alydUl,interpretation is left to the company and/or persons Who mMu6N the reld work. The test retort shall not be reproduced esttpt In hill,without written approval of the UMB Aner ball. The reason must not be used try the otent to main proal cenl0patlon,appreval,or eMOrsement by NVLAP.NIST,of any agamey N the henral p wemmem. All samples were rtteivM in a¢ep[abie tool unless otherwise hotels. UMB Arannital monewas me right to dispose of all samples after a penal of thirty(30)days,aG mems;to all state am Inial guloolnes,houses otherwise saammed. 1 of 2 U �/� Contact: Date Sampled: 08/06/12 M i Company: Protera Inc Date Received: 08/07/12 UMB ANALYTICAL INC. Address: 2603 Camino Ramon, Suite 200 Date Analyzed: 08/07/12 26010 Eden Lending Rd.Suite C San Ramon, CA 94583 . Hayward.CA.94545 UMBA ID #: 9708 510.786.0507 1 510.786.0509 fx Phone: 877.285.8450 Fax: 877.285.1445 Project: 12A36008 Comments: 1001 N De Anza Blvd ASBESTOS PLM TEST REPORT: EPA METHOD 600R/-93-116 Sample Description Appearance Fibrous Non-Fibrous Asbestos Content 14 Linoleum 3rd Floor Area 14 Tan Cellulose <1% 100% Mastic Non-Fibrous None Detected 9708-14b Homogenous 15 Linoleum 3rd Floor Area 15 Cream 0% 100 Tile Non-Fibrous None Detected 9708-15a Homogenous 15 Linoleum 3rd Floor Area 15 Tan Cellulose <1% 100% None Detected Mastic Non-Fibrous 9708-15b Homogenous 16 DW/JC Composite 2nd Floor Area 16 Gray White Brown Cellulose 30% 70% Fibrous Fiberglass <1% None Detected 9708-16 Heterogenous 17 DW/JC Composite 2nd Floor Area 17 White Cellulose 40% 60% None Detected 9708-17 Heterogenous 18 DW/JC Composite 2nd Floor Area 18 White Cellulose 30% 70% Fibrous None Detected 9708.16 Heterogenous 19 Skim Coat 2nd Floor Area 19 White Cellulose 40% 60% None Detected 9708-19 Heterogenous 20 Skim Coat 2nd Floor Area 20 Gray Cellulose 30% 70% None Detected Fibrous Fiberglass <1% 9708-20 Heterogenous 21 Skim Coat 2nd Floor Area 21 White Cellulose 50% 50% None Detected Fibrous 9708-21 Heterogenous 22 Acoustical Tile Ceiling 2nd Floor Area 22 White Cellulose 50% 15% Fibrous Fiberglass 35% None Detected 9708-22 Heterogenous 23 Acoustical Tile Ceiling 2nd Floor Area 23 White Cellulose 50% 15% None Detected Fibrous Fiberglass 35% 9708-23 Heterogenous 24 Acoustical Tile Ceiling 2nd Floor Area 24 White Cellulose 50% 15% Fibrous Fiberglass 35% None Detected 9708-24 Heterogenous 25 Linoleum 2nd Floor Area 25 Cream 0% 100% None Detected Non-Fibrous 9708-25 Homogenous 26 Linoleum 2nd Floor Area 26 Cream 0% 100% None Detected Non-Fibrous 9708-26 Homogenous 6 08/07/12 Authorized Signatory Date Due of ma9nlncetem Jlml-atime,Inherent In PIH,es4estos theme In chrobslpm skew ma resolution e4paelllty of PLM may not be a¢eaee. samples reported as<l%or none eeteeted may require aOEWonal estLq by TEM to confirm asbestos ouandtlbe. TM above test report relates only to the Items tested and may not M reproduced In any forth without:he express wrimen approval of UMB Arelf thal.Interp2tatlon Is left to tl¢rnmpany and/or persons who conducted the flew work. The test report shall not be monlauted except In full,without written approval of the UMB AW1,0 al. rhe rep]n must not be useo by the diem to Wim pmdu6 denidation,approval,or endorsement by IMAP,NIST or any ageroy of the federal govcmment. All samples ward, N.In acttptable condl[lon unless oNerwlse roteo. UMB Analytical reserves Ne right to blabbed,a all samples after a paned 0 be ty(30)days,shadowing to all state and federal puldel unless otherwise loodfied. 2 of 2 4 2603 Camino Ramon.Suite 200 San Ramon,CA 94583 877 285 8450 877 285 1445 fax August 6, 2012 Vulcan Construction 1695 Russell Ave Suite H Santa Clara, CA 95054 RE: 1001 N. De Anza Blvd. Cupertino, CA 95014 Lab No. 12A36008 On August 6, 2012 a site technician used a Niton XLp X-ray fluorescence (XRF) lead paint analyzer to sample paint for ]cad. The lead based paint survey was conducted in order for the contractor to protect workers from lead and comply with 8 CCR 1532.1 should lead be found in areas scheduled for demo/renovations due to loss. This survey is intended to give representative information regarding lead based paint. This survey is not being done as a Lead Hazard Evaluation as defined by California Department of Public Health (CDPH) in CCR Title 17. Location Component Substrate Color Condition Reading mg/cm2 1 3rd floor area 1 wall drywall white Intact 0.0 2 3rd floor area 2 wall drywall white Intact 0.0 3 3rd floor area 3 wall drywall white Intact 0.0 4 3rd floor area 4 wall drywall white Intact 0.0 5 2nd floor area 16 wall drywall white Intact 0.0 6 2nd floor area 17 wall drywall white Intact 0.0 7 2nd floor area 18 wall drywall white Intact 0.0 Condition (I=Intact;F=Fair;P=Poor) No Detectable lead was found. Samples were found to be below detection Iimit of the instrument. Protera Inc. has performed representative sampling of identified painted surfaces scheduled for remodel/renovation. Definition of Lead Based Paint EPA/HUD/DHS: 1.0mg/cm2; 5000 PPM; .5%by weight OSHA/CalOSHA: Any detectable lead If you have any questions please call at your earliest convenience. Thank You; Nefi Hernandez CDPH Inspector/Assessor#8754 Operations Manager Limitations: This report is not to be considered a Lead Ha=a•d Assessment. This report has been conducted per request to allow onsite contractors to protect workers in compliance with 3 CCR 1532.1 Protera bnc. has performed representative sampling of identified painted surfaces scheduled for remodel/ renovation. Should arty additional painted surfacesvnot covered or listed in this report, be identified at the jobsite, said painted sur faces must be assumed to contain lead. These recommendations/findings are based upon visual inspection and/or samples taken and are limited to the tine, place aid roamer of the samples collected at the Property and are further limited by the variability associated with the inspection methodology established by industry guidelines. These results1report are not to be considered a guarantee as to health or habitability. The results reported bi, Protera Inc. cannot be interpreted in airy way as an indication that the Property is, or is not,free from conditions that could pose a risk to human health or safety. nor of the suitability of the Property for any propose whaisoever: No other representation, guarantee or warranty, express or implied.is included or intended in this report.