04-6745 (DSF)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504- - (760) 777-7012
0 78=495 CALLE TAMPICoFAX (760) 777-7011
LSM QUINTA, CALIFORNIA 92253 INSPECTION-REQU'E.STS (760) 777-7153-
OCT-
77-7153OCT 18 2004 BUILDING PERMIT
gyp.
ci-Applica.t-ion Number0( 4-00006745 Date 10/14/04
�P'roperty-'A d ss . . . . 78590 SINGING PALMS .DR
APN: 643-181-015.-27 -2043 -
Application description . . . DEMO - SINGLE FAMILY
Property Zoning . LOW DENSITY RESIDENTIAL
Application valuation... 0
Owner Contractor.
PH RANCH LLC DEMO UNLIMITED, INC.
78370 HWY 111 81750 AVENUE 50
LA QUINTA CA 92253 INDIO CA 92201
(760) 775-5884
WCC: STATE FND
WC: 0460942103 01/01/05
CSLB: 473328 05/31/D5
CCC:
Other struct info . . . NUMBER OF UNITS 1.00
---------------------------------------------------------------------------
Permit DEMO PERMIT
Additional desc
Permit Fee 45.00 Plan Check Fee .00
Issue Date . . . . Valuation 0
Qty Unit Charge Per Extension
BASE FEE 45.00
Special Notes and Comments
DEMO TO BARE GROUND OF EXISTING SFD
.Fee summary Charged Paid Credited Due
Permit -Fee Total 45.00 .00 00. 45.00
Plan Check Total .00 .00 .00 .00
Grand Total 45.00 .00 .00 45.00
P.O. BOX 1504
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date: v
Applicant: / ', / I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with. Section 7000) of Division 3 of the Business and Professionals
Code, andnse is in full force and effect.
ss / License No.
Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U I, as owner of the 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. BA P.0for tthiis. reason
Date/�1 Owner J
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier ' Policy Number
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 workers'
compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with thos provisions.
—Date 4A"licant C&Z
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
I certify that (.have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
constructions, and hereby authorize representatives of this co my to enter upon the above-mentioned property for inspection purposes.
Date j{� l: (�I Signature (Applicant or Agent): 0—al"
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DEVELOPMENT
October 1, 2004
Ed Randall
78-495 Calle Tampico
La Quinta, CA 92253.
Re: Demolition"Permits
78-550 Singing Palms Dr: .
78-590 Singing Palms Dr.
Dear Ed
Pursuant to your requirement for owner permission to do the subject demolition, this
letter is to act as that approval. If you=have*any; questions please don't hesitate to call me
at 760-771-1755:
Sincerely,
Ed Alderson
Construction Manager
71361 San Gorgonio Road Rancho Mirage, California 92270 760.771.1755 Fax 760.771.0202
RECORDING REQUESTED BY:
Stewart Title Cuaranly.
WHEN RECORDED MAIL TO:
PH. Ranch, L.LC
78370 Highway 111
La Quinta, CA 92253
ORDER NO. 501259736
ESCROW NO. 30110092DE
APN . 643 -181.-01.5
an
DOC 11:3 2004-05603..G.5
20/2004 08:00A Fee:27.00
21 of 1 Doc T Tax Paid
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk & Recorder
I IIIIII IIIIII VIII IIIIII IIII VIII IIIIII III VIII IIII IIII
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$ I
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PAGE
SRE
DA
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MISC.
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COPYLONG
REFUND
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EXAM
GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s):
DOCUMENTARY TRANSFER TAX is: • $424.05
Monument Preservation Fee is: $0.00
O computed on full value of property conveyed, or
❑ Unincorporated area: 9 ''City of La Quinta
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Wilfred Huerta, and Doreen Huerta, linsband and wife as joint tenants
hereby GRANT(S) to
PH Ranch, LLC, a California limited liability company
CITY TAX $0.00 h
the following described real property in the City.of La Quinta, County of Riverside, State of California:
Lot 27, of Tract No. 2043, as shown by Map on file in Book 41, Pages 6-7, inclusive. of Maps, Records of Riverside
County, California.
DATE: 10 April 2004
STATE OF CALII'�,[ZNIA
�.•-/l } ss.
COUNTY OF ry�S�G� }
On ✓� ,Zoo before me, 16�-"---T Jo �>'/C , �2-
r personally appeared ;
personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person(s), whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed
the same in his/her/their ,authorized capacity(ies), and that by
his/her/their signature(s) on the instrument the person(s) or the entity
upon behalf of which the pepon(s) acted, executed the instrument.
WITNESS my n d-ofrc)ial seal. .
Srguature
Doreen Huerta
MAIL TAX STATEMENTS AS, DIRECTED ABOVE
(Phis area for official notarial seal)
RECORDING, REQUESTED BY:
Stewart Title Guaranty..
WHEN RECORDED MAIL TO:
PI -I Ranch, LLC
78370 Highway 11 I
La Quinta, CA 92253
ORDER NO. 30110093DE
ESCROW NO. 301.10093DE
APN. 643-181-014
DOC p 2004-05351�o i
07/09/2004 08:00A Fee:30.00
Page I of 2 Doc T Tax Paid
Recorded in Official Records
.County of Riverside
Gary L. Orso
Assessor, County Clerk & Recorder
.- I IIIIII IIIIII 11111 IIIIII 11
I IIIIII IIIIII III VIII IIII IIII
M
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PAGE
SIZE
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SMF
MISC.
UA
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LONG
REFUND
NCHG
EXAM
0-2607 GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s):
DOCUMENTARY TRANSFER TAX is: $549.45 CITY TAX $0.00
O . Monument Preservation Fee is: $0.00
0 computed on full value of property conveyed, or
❑ Unincorporated area: 0 City of .La Quinta
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Robert Donald Morin, trustee of the Crossed Sabres Trust, dated 27 December 1996
hereby.GRANT(S) to
PH.Ranch,.LLC !, A CALIFORNIA LIMITED LIABILITY COMPANY
the following described real property in the City of La Quinta, County of Riverside, State of California:
Lot 26, of Tract No. 2043, as shown by Map on file in Book 41, Pages 6-7, of Maps, Records of Riverside Couray,
California.
DATE:, 9 April 2004
STATE OF CALIFORNI
} ss.
COUNTY. OF u/l/��S- }
On _ on before me,J�3
perso ally appe/are
personally known to. me (or proved to me on the basis of satisfactory.
evidence) to be the person(s), whose name(s) is/are subscribed to the .
within instrument and acknowledged to'me that he/she/they executed
the same in his/her/their authorized capacity(ies), and that by
his/her/their signature(s) oVrstoA(s)
hinstrument the person(s) or the entity
upon behalf of whichlthe pacted,.executed the instrument..
'WITNESS my hand/ancVoffi AjAeal.
Signature
Robert Donald Morin, trustee
MAIL TAX STATEMENTS AS DIRECTED ABOVE
KAREN 10 EGAKIS
COMM. # 1428740
t40TARY PUBm • i;AUFORNIA
RIVERSIDE COUNTY
Comm. ).JULY 4 2007
cthis area for.ofticial notarial seal)
WY �of La.. Uinta
Developers PM -1.0 --
Approval. -Form.
Prior to the issuance of a Demolition Permit for the project listed below, Public Works
approval must be obtained. Please return "this form to the Building and Safety Department
only after approval.
Project Address:�7$rj OQ 1
Applicant Name/Phone#:
Scope Of Work: o ' o
------------
To limit dust at thisjobsite I will:
Maintain Adequate Watering at all Times.
3� Prevent Trackout .
Tarp All Vehicles Removing Debris from Site
Limit Work in High Wind Conditions
o
0
-------------
0
f \ w
Public Works Department Approval is Hereby granted:
John .Freeland, Senior Engineer Date
City o
La Qu.m.. ta
Developers PM -10 ' Approval Form
Prior to the issuance of a Demolition Permit for the project listed below, Public Works
*approval must be obtained. Please return this form to the Building and Safety Department
only after approval.
-71
Project Address:
Applicant Name/Phone#: 7'<b � . L,
o
Scope Of Work:
To limit dust at this jobsite I will:
j Maintain Adequate Watering at all Times.
Prevent Trackout
Tarp All Vehicles Removing Debris from Site
c .Limit -Work in High Wind Conditions
o
0
0
Q6�
Public Works Department Approval is Hereby granted:
John .Freeland, Senior Engineer Date
SCOTT MORMON & ASSOCIATES,
P.O. Box 55329 31855 Date Palm Drive, Ste." #3-507
Riverside, CA 92517 Cathedral City, CA 92234
(909)624-1665 (760)323-7743
ASBESTOS SURVEY REPORT
Completed On
August 10th, 2004
PLM0803#0906
Client: Madison Development Company
78370 Highway 111; Suite 200 _
La Quinta, CA
Project: Point Happy Ranch Estates
78590 Singing Palms
La Quinta, CA
(2 -story single family home)
On August 03rd, 2004 an asbestos inspection and bulk sampling was conducted at'the above project
address. Bulk samples were taken of all suspect asbestos containing -building materials (ACBM) at the
request of the client named above. A' total of (9) bulk samples were submitted to Carolina
Environmental; Inc. located at: 107 New Edition Court in, Cary, NC (NVLAP Code 101768-0 and Cal.
Environ. Lab. Cert. #2483) to estimate the percentage of asbestos by volume and determine the type(s) .
present \.
Carolina Environmental, Inc. determines percentages and type of asbestos by using EPA approved
method 600/M4-82-020: Interim Method for the Determination of Asbestos in, Bulk Samples: Bulk
samples' are analyzed by PLM (Polarized Light Microscopy). Asbestos, is quantified by using the visual
arena estimation technique and can only determine the approximate percentage of asbestos present.
After a thorough search is conducted. and no asbestos is detected "none detected" will be noted in the
report.- The essence of polarized light microscopy is not to emphatically determinethat no asbestos is
present, merely -that none was detected'or, if it was, it was likely to be less than 1.0% of the sample.
When findings reveal less than or close to 1.0% asbestos contained in a sample, -further analysis may be '
called for on additional samples to confirm or denounce the initial findings. The California Code of
Regulations (CCR 1529) requires bulk sampling be conducted. according to the A.H.E.R.A, protocol
provisions of 40 CFR Part 763.86.(The A.H.E.R.A. protocol recommends three '(3) or more friable
surfacing samples from,a homogeneous area be collected. and analyzed before any building material is
determined .to be non -asbestos containing. Scott Morrison & Associates conducts asbestos inspection J
surveys- following the A.H.E.R.A. inspection protocol.
ASBESTOS INSPECTION BY: Timothy Morrison, DOSH #0273142
BULK SAMPLES ANALYZED BY: Carolina Environmental, Inc., NVLAP #1"01768-0 e
r
0
P.O. Box 55329
Riverside, CA 92517
(909)624-1665
i
SCOTT MORRISON &•ASS_ OCIATES
31855 Date Palm Drive, Ste. #3-507
Cathedral City, CA 92234
(760)323-7743
The results on the following page(s) indicate that asbestos was detected in 00 of the 09 samples
analyzed.
PLM0803#0906
Sample #MD -01
Type of material: ceiling drywall
Location: interior ceiling of closet under staircase
`
Area: throughout interior ceilings of home .
Friable:no .
Results: none detected
_ Sample #MD -02
Type of material: wall board= brown (1rst layer)
Location: interior west wall of northeast bedroom
Area: throughout interior walls of home
Friable:no
Results: none detected
Sample #MD -03
Type of material: drywall (2nd layer) ,
Location:behind sample #MD -02
Area: throughout interior walls of home
Friable:no
Results: none detected •
Sample WD -04
Type of material: stucco- tan (1 rst layer)
Location: exterior north wall
Asea: throughout exterior walls
Friable:no
Results: none detected
Sample #MD -05
Type of material: plaster- gray (2nd layer)
Location: behind sample #MD -04
Area: throughout exterior walls
Friable:no
Results: none detected
Sample #MD -06
Type of material: drywall
Location: interior east'wall of garage „
Area: throughout interior walls of garage
Friable:no
Results: none detected
Sample #MD -07
Type of material: stucco- tan (1rst layer)
Location: exterior east wall
Area: throughout exterior walls l
Friable:no
Results: none detected
Sample #MD -08',
Type of material: plaster- gray (2nd layer)
Location: behind sample #MD -07
Area: throughout exterior walls
Friable:no
Results:, none detected
I
(2)
I
SCOTT MORRISON* ASSOCIATES
P.O. Box 55329 / 31855 Date Palm Drive, Ste. #3-507
Riverside, CA 92517 Cathedral City, CA 92234
(909)624-1665 (760)323-7743
PLM0803#0906
Sample #MD -09 Type of material: roof felt- black'
Location: exterior roof under cement tiles
Area: throughout exterior roof
Friable:no : Results: none detected
Note: All asbestos containing building material(s) containing greater than 1.0% asbestos by volume or
weight, must be removed by a state certified asbestos abatement contractor prior to any demolition or
renovation of the property.
Inspector
Scott C. Morrison
Certified Asbestos Consultant
DOSH#92-0248 t
Z
(3) .
SCOTT MORRISON & ASSOCIATES.
P.O. Box 55329 31855 Date Palm Drive, Ste. #3-507
Riverside, CA 92517 Cathedral City, CA 92234
(909)624-1665 (760)323-7743
� 1 '
ASBESTOS SURVEY REPORT
Completed On
August 10th, 2004
PLM0803#1907
Client: Madison Development. Company
78370 Highway 111; Suite 200
La Quinta; CA
L
Project: Point Happy Rnach Estates
78550 Singing Palms
La Quinta, CA
(single family home with attached garage)
On August 03rd, 2004 an asbestos inspection and bulk sampling was conducted at .the above project
address. Bulk samples were taken of all suspect asbestos containing building materials (ACBM) at the ,
request of the client named above. A total of (19) bulk samples were submitted to Carolina
Environmental, Inc. located at: 107 New Edition Court in Cary, NC (NVLAP Code 101768-0 and Cal.
Environ. Lab. Cert. 02483) to estimate the percentage of asbestos by volume and determine the type(s)
present . •
Carolina Environmental, Inc. determines percentages and type of asbestos by. using EPA approved
method 600/M4-82-020: Interim Method for the Determn inatioof Asbestos in Bulk Samples. Bulk
samples are analyzed by PLM (Polarized Light Microscopy). Asbestos is quantified by using the visual
arena estimation technique and can only determine the approximate percentage of asbestos present.:
After a thorough search is conducted,and no asbestos is detected "none detected" will be noted in the
report. The essence of. polarized light microscopy is not to emphatically determine that no asbestos is
present, merely that none was detected or, if it was, it was likely to be less than 1.0% of the sample.
When findings reveal less than or close to 1.0% asbestos contained in a sample,. further analysis may be
called for on additional samples to confirm or denounce the initial findings. The California Code of
Regulations (CCR 1529) requires bulk sampling be conducted according to the A.H.E.R.A. protocol
provisions of 40 CFR. Part 763.86. The A.H.E.R.A. protocol recommends .three (3) or more friable
surfacing samples from a homogeneous area be collected and analyzed before any. building material is
determined to be non -asbestos containing. Scott Morrison & Associates conducts asbestos inspection
surveys following the A.H.E.R.A. inspection protocol.
ASBESTOS INSPECTION BY: Timothy Morrison, DOSH #02-3142
BULK SAMPLES ANALYZED BY: Carolina Environmental, Inc., NVLAP #101768-0
(1)
SCOTT MORRISON & ASSOCIATES .
- P.O. Box 55329
.31855 Date Palm Drive, Ste. #3-507
Riverside, CA 92517
Cathedral City, CA 92234
(909)624-1665
(760)323-7743
The results on
the following page(s) indicate that asbestos was detected in 00 of the 1.9 samples
analyzed.
PLM0803#1907
Sample #MD -10
Type of material: smooth coat -white (1rst layer)
Location: interior west wall of southwest bedroom
Area: throughout interior walls of''room'
Friable:no
Results: none detected
Sample #MD-11
Type of material: drywall- pink (2nd layer)
Location: behind sample #MD -10
Area: throughout interior walls of room
Friable:no
Results: none detected
Sample MD -12.
, Type of material: sprayed on fireproofing
Location: interior walls of HVAC closet
Area: 2'x 3'x5'•
Friable:yes
Results: none detected
Sample #MD -13
Type of material: final coat .(1rst layer).
Location: interior ceiling of northwest hallway bathroom
Area: throughout *interior ceiling of bathroom
Friable:no
Results: none detected
Sample #MD -14
Type of material; drywall (2nd layer)
Location: behind sample WD -13,
Area: throughout interior ceiling of bathroom
Friable:no
Results: none detected .
" Sample #MD -15
Type of material: texture coat
Location: interior'east wall of northwest bedroom
Area:. throughout interior walls of northwest bedroom"
Friable:no
Results: none detected
Sample #MD -16
Type of material: rolled vinyl floor-blue/gray(1Yst layer)
.
t Location: floor of north garage
Area: approx. 135 sq. ft.
Friable:no
Results: none detected
Sample #MD -17
Type of material: floor mastic- brown (2nd layer)
Location: under sample #MD -16
Area: approx. 135 sq. ft. "
Friable:no. '
Results: none detected
(2)
i
SCOTT MORMON & ASSOCIATES �
P.O. Box 55329 31855 Date Palm.Drive, Ste. #3-507
Riverside, CA 92517 i Cathedral City, CA 92234
(909)624-1665. (760)323-7743
PLM0803#1907
Sample #MD -18
Type of material: raked finish
Location: interior west wall of diningroom F
Area: throughout interior west wall of diningroom only
Friable:no
Results: ,none detected
Sample #MD -19
Type of material: texture coat- white
Location: interior east wall of southeast bathroom
Area: throughout interior walls of bathroom
Friable:no
Results: none detected '
Sample #MD -20
Type of material: acoustic ceiling
Location: interior ceiling of southeast bedroom closet
Area' approx. 55 total sq. ft.
-Friable:yes
Results: none detected
Sample #MD -21
Type of material: acoustic ceiling
Location: interior ceiling of southeast bedroom, closet
Area: approx. 55 total sq. ft.
Friable:yes
Results: none detected l
Sample #MD -22
Type of material: acoustic ceiling
Location: interior ceiling of closet next to south entrance
Area: approx. 55 total sq. ft.
Friable:yes
Results: none detected 1
Sample #MD -23
Type of material: exterior plaster
Location: exterior north wall.'
Area: throughout exterior walls
' Friable:no
Results: none detected
Sample#MD-24
Type of material: exterior plaster
Location: exterior south wall
Area: throughout exterior walls,
Friable:no
Results: none detected
Sample #MD -25
Type of material: tarred felt (1 rst layer)
Location: exterior roof above garage
Area: throughout exterior roof above'garage
Friable:no
Results: none.detected
(3)
1
SCOTT MORRISON & ASSOCIATES
P.O. Box 55329
, ' 31855 Date Palm Drive, Ste. #3-507
Riverside, CA 92517
Cathedral City, CA 92234
(909)624-1665
(760)323-7743
PLM0803#1907
i
Sample #MD-26
Type of material: tarred felt (2nd layer)
Location: under sample #MD-25
Area: throughout exterior roof above garage
Friable:no
Results: none.detected
Sample.#MD-27
Type of material: roof felt (1rst layer)
Location: exterior roof above home
Area: throughout exterior roof above home
Friable:no
Results: none'detected,'
Sample #MD-28
Type of material: roof felt (2nd layer)
Location: under sample #MD-27
'
Area: throughout exterior roof above home
Friable:no
Results: none detected
i
Note: All asbestos containing building material(s) containing greater than 1.0% asbestos by volume or
weight, must be removed by a state certified asbestos abatement contractor prior to any demolition or
renovation of the
property.
•
Inspector
Scott C. Morrison
Certified Asbestos Consultant
DOSH#92-0248
.
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• s
Aug -10-04 11,32am Frcm-CAROLINA ENVIRONMENTAL +4811442 T-300„ P.02/05 F-178
LABORATORY REPORT
CAROUNAENMONNIENTM INC.
10WwEcMonCouit,Cay. W'27511
ASBESTOS BULK ANALYSIS
Pfe m-.-(919) 481-14'!3 Fax (819)•t81-1ct42
Client: Scott Morrison & Associates
CEI Lab Code: A04-571-5
31855 Date Palm. Dr: Suite
3-5o7
Received: 08-09-04
Cathedral City, CA 92234
Analyzed: oB-10-04
Reported: 08-10-04
Analyst: Gary A. Swanson
Project: PLM0803#0906
CEI
CLIENT ID LA13 ID
NO
ASBESTOS
HOMOGENEITY DESCRIPTION
- MD -01 A286874
CEILING DRYWALL
ND
Heterogeneous,
Brown, White, Fibrous, Bound
BIND 77%
CELL 20%
FBGL 3%
MD -02 A286875
WALLI sOARD
ND
Heteroganeous,
Brown, White, Fibrous, Bound
BIND 80%
CELL 20%.
DRYWALL (TEXTURED MATERIAL)
NU E
MD 03 A286876
Homogeneous,
Whoe, Non-fibrous, Bound
BIND 100%
MD -04 A286877
STUCi;O
Ni)
Homogeny :ous,
Tan. Non-fibrous, Bound'
BIND 100%
r
MD -05' \A286876
PLAs-I ER
ND
Homogern:ous,
Gr(.v, Fibrous, Bound
BIND 93 °%
FBGL 7
MD -06 A286)Mi
DRYWALL
NO
Homogennous,
Write, Fibrous, Bound
RINf7 93%
CELL -5% ;
FBGL 2%
f
Page 1
i ,
Aug -10-04 11:32am Frcm-CAROLINA ENVIRONMENTAL
+4811442
7-300 P.03/05 F -lib
CAROUNAEWRONMEN'7AI,INC.
Project:
PLM0803#0906
107 Now Edition Cour , Cary, Nc, 27511
Phone' 919.481-1413 Fax: 919AA-1442
Lab Code:
A04-5715
CLIENT iD
LAB II?
HOMOGENEITY OESCRIPTION
A8E3E5TQS
MD -07 A286880
STUC(:a
ND
Hornogeneous,
Tan Non-fibrous, Bound
BIND'
i00%
L
MD. -08 A286381
ND
PLASII:R
Homogeneous,
Gree, Fibrous, Bound
BIND
93% FBUL
7 %
MD -09 A286882
y
NU
Ro F IM.T
Homogem:ous,
Bla(rc, Fibrous, Bound
Y
TAR
20% CELL
80%
Page 2
i
Page 2
Aug -10-04 11:32am From -CAROLINA ENVIRONMENTAL
+4811442 T-300 P.04/05 F-178
The following definition-, apply to the 0breviations' used in the ASBESTOS BULK
ANALYSIS REPORT:
CHRY
= Chrysotile
(,ELL
= Cellulose
DEBR = Debris
AMOS
= Amosite
FI3GL
= Fibrous Glass
BIND = Binder
CROC
= Crocidolite
oRGN
= Organics
BILI = Silicates
TREM
= Tremolite
3YNT
= Synthetics
GRAV = Gravel
ANTH
= Anthophyllile
WDLL
= Wollastonite
MAST= Mastic
ACTN
= Actinolite'
c;ERWL = Ceramic Wool
ALAS =Plaster
N 0 = None Uete(.ted NTREM = Non-Asbestifomi PERL = Penne
NANTH = Non-Asbesriform Tremolite RUBR =Rubber
Anthophyllite
CLIENT: Scott: Morrison & As-iociate's
PROJECT: PLM08013#0906
CEI LAS cane: A04-5715
Stereoscopic microscopy and pol: irized light microscopy coupled with dispersion staining is the analytical technique used
for sample identification. The: percentage of e,,ch component is visually estimated by volume. These results pertain only
to the samples analyzed. Thc san iples were an, ilyzed as submitted by the client and may not be representative of the larger
material in question. Unless notiiled in writinci to return samples, Carolina Environmental, Inc. will discard all bulk samples
after 30 days.
Many vinyl floor tiles have been m.rnufactured i using greater than 1% asbestos. Often the asbestos was milled to a fiber
size below the detection Hmir. of polarized light microscopy.' Therefore, a "None Detected" (ND) reading on vinyl floor the
does not necessarily exclude the presence of ; asbestos.. Transmission electron microscopy provides a more conclusive
form of analysis for vinyl floor tiles.
It is certified by the signature beiow that Carclina Environmental, Inc, is accredited by the National Voluntary Accreditation
Program (NVLAP) for the analy!;,is of asbesto!: in bulk materials. The accredited test method is EPA i 6001 M4-82 / 020 for
the analysis of asbestos in building materials Procedures described in EPA / 600 / R-93 1 116 have been incorporated
where applicable. The dete,tion limit for the method is 0.1 % (trace amount): Carolina Environmental, Inc.'s NVLAP
accreditation number is #101768-c1. This repo i is not to be used to claim product endorsement by NVLAP or any agency
of the U. S. Governmsnt, This report and its ::ontents are only valid when reproduced In full. Dust and soil analyses for
asbestos using PLM are not covered under NVLAP accreditation.
ANALYST
REVIEWED BY
7ianbao Rai, Ph.D.
Laboratory Director Enid of Report
CHAIN OF CUSTODY
From: Scott Morrison '& Associates
ti P.O. Boz 55329
Riverside, CA 92517
(760) 323-7743
0
CTIent. AAD) 3 &IQ se mi�
a
m
Job No.,iiD�O3' �Site Addr+es
77
to
LL
E
[*s
[n
Q
.4 d6f6 Y?�UZ6 SJR
To: Carolina Environmental, Inc. '
107 New Edition Court
Cary, NC 27511
(919) 481-1413
SAP Code I0I76 -o CA Zr" oma'
Person 'Taking Samples:
rim L_v` S llt,U?M
Sample #
Saffiple Date
Material & Description
P AA -Pb
Other Informadon
MA—01
OB -03
a!G"fz Visj/} L
.ro3
�L w�-ZL
kt>
R to
LA C
Fax in Results ? Y No
Relinquished sy: IDaternmse: c� - 06- �r� Deceived By: vnAp Daterrime:&9 f
Maiffaa'To: Scott Morrison & Asedates, 31855 Date Palm Dr, Ste. #3-507, Cathedral City, CA 92234, (760) 323.7743
Aug-10-04 02:39pm From-CAROLINA ENVIRONMENTAL
+4811442 T-318P.02/0T F-197
LABORATORY REPORT
CNpUK�eMRON?AENTAL,INC
ASBESTOS BULK /ANALYSIS
10TNewr dffiwC .,r%CnNrz7511
1'I-ane: W9) 48114"13 Rax (919) 481.1412
• �
,
a
Client: Scott Morrison & Associates
CEI Lab Code: A04-5716
31855 Date Palm Dr. Suite 3-E,07
Received: 08-09-04
Cathedral City , CA 92234
Analyzed- .08-10-04
Reported: 08-10=04
Analyst: Gregory J. Manes
'Project: PLM0893#190 T
•c;EI bio
CLIENT ID LAB 9® HOMOGENEITY DESCRIPTION ASBESTOS
MD-10 A28688:i PLASI ER SKIM COAT
NO
Heterogeneous, Wr. te, Flbrdus; Bound
l91ND
97% CELL 3%
MD-11 A2813884 DRYWALL
NO
Heterogei eons, Pini<, Tan, Fibrous, Bound
BIND
75% CELL 26%
MD-12 A286885 SPRAY—ON
ND
Heterogeneous, W1 site, Fibrous, Bound
BIND
97% CELL 3%
MD-13 A286886 FINAI COAT
Heterogeneous,_ Wi site, Fibrous, Bound
BIND
97% CELL 3%
o
MD-14 A28688.7 DRYWALL
ND
-Hete:roge:neous, Pi .k, Tan, Fibrous, Bound A
BIND
75% CELL 25% L
H
MQ-15 A286888 TEX I URE
ND
Hetorogcneous; W rite, Blue, Fibrous, Bound
BIND
97% CELL 3%
Page 1
Aug -10-04 02:40pm
From -CAROLINA ENVIRONMENTAL +4811442
T-318
P.03/0T F-197
CAROLINAMRONIVIEWAL,MG
Project: PLM0803#1907
.
107 New Edition Court,
Cary, NO 27511
Phone; 919.481-1413
Fare; 9194fs1-1442
Lab Code: A04-5716
I
.
j
CLIENT ID
C �p
HOMOGENEITY DESCRIPTION
ASBESTOS
1.
MD -16
A286889
F1_00!:ING
NO
Heterogeneous,
Wh Le, Grey, Fibrous, Bound
SIND 60%
CELL
FBGL.
10%
MD -17
A286890
MASTIC
ND
Heterogeneous,
Brown, Fibrous, Sound
BIND 93%
CELL
5%
FBGL
2%.
MD -18
A28(389-1
RRAKEI) FINISH
NO '
Heterogelieous,
Off white, White, Fibrous, Bound
BIND 97%
CELL
3%
MD -19
A286892
TEXTURE
ND
Heterogeneous,
White, Non-fibrous, Bound
BIND 98%
CELL
2%
MD -20
A286893
ACOI ISTIC CEILING
NO
Heterogeneous,
W!iite, Fibrous, Bound
BIND 97%
CELL
3%
MD -21
A286894
AM ISTIC CEILING
ND
Heterogeneous,
Write, Fibrous, Bound
BIND 97 %
CELL
3
MD -22
A2868E5
AM ISTIC CEILING
ND �I
Hetcrogeneous,
Write, Fibrous, Bound
-BIND . 97%
CELL
Page 2
Aug -10-04 02:40pm
From -CAROLINA ENVIRONMENTAL
+4811442
T-318
P"04/07 F-197
cAROUNAEW[RONIWENTAL,INC
Project:
PLM0803#1907
1b1 New Edition CouA,
Cary, NC 27.1i 11
Phor� 919481-1413
Fax: 91941-1442
uab Code:
A04-5716
CLIENT ID
CEI
HOMOGENEITY DESCRIPTION
ASBESTUS
LAIS ID
MD -23
A286896
EXTEkIOR PLASTER
ND
Heterogeneous,'
Pini,, Grey, Non -fibrous,. -Tightly Bound
UND
98 Qk CELL
2%
MD -24
EXTEI:IOR PLASTER,
NO
A286897
Heterogeneous,
Pini., Grey; Non-fibrous, Tightly Bound
BIND
.98% CELL
2%
Mu -25
NO
ROOF ING
A286898
Heterogeneous,
Bla,:k, Fibrous, Bound
BIND
50% CELL
5%
FBGL
t
45%
MD -26
A286891)
ROOF ING
NO
Heterogeneous,
Blak k, Fibrous, Bound
BIND
50% CELL
5%
FBGL
45%
MD -27
A286900
ROO[ ING FELT
ND
Heteroger ieous,
Black, Fibrous, Bound
BIND
58% ' CELL
2%
FBGL
40%
MD -28-
A28690'I
R001 ING FELT
NO
Heteroge,reous,
Bleck, Fibrous, Bound
BIFID
58% CELL
2%
FBGL
4.0%
a
Page 3 , .
Aug -10-04 02:40pm From -CAROLINA ENVIRONMENTAL +4811442
T-319 P.05/07 F-197
The following definitions apply to tho' abbreviations used in the ASBESTOS BULK
ANALYSIS REPORT:
CHRY = Chrysotile
CELL = Cellulose
DEER = Debris
AMOS = Amosite
FBGL = Fibrous Glass
BIND = Sin,der
CROC = Crocidolite
ORGN = Organics
SILI = Silicates
TREM = Tremolite
SYNT. = Synthetics
GRAY = Gravel
ANTH = Anthophyllile
WDLL = Wollastonite
MAST = Mastic
ACTN = Actinolite
CERWL = Ceramic Wool
PLAS = Plaster
N D = None IOeterted
NTREM = Non-Asbestiform
PERL = Perlite
NANTH = Non-Asbec.tiform
Tremolite
RUBR =Rubber
Anthophyllite
CLIENT: Scott Morrison & Associates
PROJECT: PLM0803#1907
CEI LAB CODE: A04-571 6 -
Stereoscopic microscopy and polarized light microscopy coupled with dispersion staining is the analytical technique used
for sample identification. 'rhi: percentage of e. ich component is visually estimated by volume. These results pertain only
to the samples analyzed. The samples were analyzed as submitted by the client and may not be representative of the larger
material it question. Unless notified in writirn.l to return samples, Carolina Environmental, Inc. will discard all bulk samples .
after 30 days.
Many vinyl floor tiles have been manufactured i;sing greater than 1 % asbestos. Often the asbestos was milled to a fiber
size below the detection limit of polarized light microscopy. Therefore, a "None Detected" (ND) reading on vinyl floor tile
does not necessarily exclude the presence of : sbestos. Transmission electron microscopy provides a more conclusive
form of analysis for vinyl floor tiles.
It is certified by the signature below that Caruiina Environmental, Inc. is accredited by the National Voluntary Accreditation
Program (NVLAP) for the ;inalysis of asbestos in bulk.materials.,The accredited test method is EPA/ 600 / M4-82 / 020 for
the analysis of asbestos in building materials Procedures described in EPA/ 600 / R-031 116 have been incorporated
where applicable. The detection limit for the r,ethod is 0.1 % (trace amount): Carolina Environmental, Inc.'s NVLAP
accreditation number is #101768-1). This repo i is riot to be used to claim product endorsement by NVLAP or any agency
of the U. S. Government. This report and its ..ontents are only valid when reproduced in full, ;Dust and soil analyses for
asbestos using PLM are not covc.-red under NVLAP accreditation.
ANALYST
REVIEWED BY __
Tionbao Bmi, Ph.D.
Laboratory Director
End of Report
CHAIN
PF CUMgJ l
a
From: Scott Menison & Associates To: Carolina Environmental, Inc.
]P.O. Bog 55329 107 New Edition Court o
Riverside, CA 92517 Cary, NC 27511 A
(760) 323.7743 (919) 401-1413 N
NVLAP Code 10176&0 CA BLAP #2483 0
of !J ��t�lE Person Taking Samptes:
Client: DfSo t �
Job '�o<,.�¢l . Site Addm-&-y
Information
M
_ z
C
lZl �i/�.• r W � 1 O
z:
a
T
rAA in
Relinquished By:
Received By:41,t�a Date/Time:
Maf'px To: Scott Morrison & Asociates, 311155 Date Palm Dr., Ste. #3-507, Cathedrai City, CA 92234, (760) 323-7743
Date
S7!'2
Ma tenial
Description AA Pb
Other
ple #
E
If.}R _ JR1
�. Ea .. �%lV\V
' J� %IA
Information
M
_ z
C
lZl �i/�.• r W � 1 O
z:
a
T
rAA in
Relinquished By:
Received By:41,t�a Date/Time:
Maf'px To: Scott Morrison & Asociates, 311155 Date Palm Dr., Ste. #3-507, Cathedrai City, CA 92234, (760) 323-7743
fW A FN OF CUSTODY
Kul/ - S // (o
From: Scott 1VlorriOn Associates To: Carolina Environmental, Inc.
147 New Edition Court
• P.O. Boa 55329
riverside, CA 92517 Caa°y, NC 17511
(760)323-7743 {919) i81.-1413
1dVLAF Code 101768--0 CA FLAP #2W
j--(7�, rw � Perm Taloing Samples �' �'"
Client.
Site Address' ,tr►G��..6- ��/4 Ch -S , (..fit ter
Job Yeo. _
Sample # Sande Date Material & Descrilrtion / AA -Pb Other infomation
k.h. K '--) KlIr—
&Z
CctLs-m C. GE
yz,7
a -Ti$
Fax in Results ? ✓ 'Yes Me
Reiinyuisbed By:
Date/Time: FJi --ey Received By: DateANme•
1Vlail/l'4a Tq; Scott Morrison & Asoeiates, 31955 Date Palm Dr., Ste. 0-547, Cathedral City, CA 92234, (760) 323-7743