04-4531 (DEMO)k
+,
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING -PERMIT
Application Number C04-000104531 i Date 5/24/04
Property Address . . . 46115 JEFFERSON ST
APN: 649-071-011-20 -2190 -
Application description . . . DEMO - COMML/OTHER
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 0 .
Owner Contractor
------------------------ ------------------------
CITY-OF LA QUINTA EMERY LAND CLEARING & GRAD INC
78495 CALLE TAMPICO P.O. BOX 1009
LA QUINTA CA 92253 THERMAL CA 92274
(760) 391-5840
WCC: STATE FUND
WC: 116532004 04/12/05
CSLB: 600283 11/30/05
CCC: C21
--------------------------
Structure Information -------------------------
Occupancy Type . . . . DWELLG/LODGING/LONG <=10
Flood Zone . . . . . .. NON -AO FLOOD ZONE
---------------------------------------------------------------------------
-
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
COMPLETE DEMOLITION OF EXISTING HOME AND
•IMPROVEMENTS
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Grand Total
Charged Paid
45.00 .00
.00 .00
45.00 .00
Credited- Due
.00 45.00
00 .00
.00 45.00
MAY 2 5 2004' lu
CITY OF LA QUINTA
FINANCE DEPT.
P.O. BOX 1504
78-495 CALLE TAMPICO Ot
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: 041- 4 31
Applicant:
Applicant's Mailing Address:
C7�
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-701 1
INSPECTIONS (760) 777-7153
Date:
Arcrinect or tngineer'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, and my Licens , is in full force and effect. / Q
/License Class_ Zqd' License 01 rf/ (>U_y ;
/Date'/1T ntractor r
OWNERILDER 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 1, 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.).
U 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.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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.
�1 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
issued My rkers' co pens ition nce carrier and policy number are: permit is
Cartier 2 � e .n ci old icy Number _ 1 `42i i L>q—
_ 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 a ree that, it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those pr visions.
/bate Applicant
WARNIN : FAILURE TO SECURE WORKERS' OMPENSATION COVERA 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.
I herebyaffirm under CONSTRUCTION LENDING AGENCY
penalty 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
Lenders Address
IMPORTANT APPLICANT ACKNOWLEDGEMENT
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, indemnity and hold harmless the City of La Quinta, 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 dayt from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above inform n is correct I a ree to comply with all city and county ordinances and state laws relating to building
construction and he by authorize repres ntatives of this county to enter pon the abo ntioned property
r p party for inspection purposes.
Date " l Signature (Applicant or Agent):
SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT
NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL
MAIL FORM AND FEE TO SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 900745641
'.^ w.'S' .,...•r i , t. y .,.. y , . f.A .,= o s.�t �, n
OIL
AQMI)'USE ONLY SCREEN BY RECEIVED; POSTMARK fNTERED`BY NOTIFICATION #
�!.� 1. ..: ,. wT . 3.� .✓..*:',.4Ya'.Y.e Y^•^"1P . Keb::iu. J r ..h:.e r.:. :N . .. 1. ^A. 2 ^..:. . Abt ' v.. - ,•� Fr',
COMPLETED BY COMPANY EMERY LANDCLEARING PHONE 760/391-5840
LORI EMERY V.P. AND GRADING, INC.
DATE 5/26/04 CHECK # ?� .�} FEE $118.41 PROJECT #
1
NOTIFICATION TYPE
ORIGINAL REVISION DATES REVISION OTHER (highlight) CANCELLATION
PROJECT TYPE
DEMOLITION ORDERED DEMOLITION RENOVATION (rernovah EMERGENCY REMOVAL PLANNED RENO (annual)
SITE INFORMATION
SITE NAME CITY OF LA QUINTA ROAD EXPANSION PROJECT
SITE ADDRESS 46-115 JEFFERSON STREET CROSS STREET WESTWARD HO
CITY LA QUINTA STATE CA ZIP 92253 COUNTY RIVERSIDE
DESCRIBE WORK AND LOCATION DEMOLISH AND REMOVE AND DISPOSE OF HOUSE FOR PROPOSED ROAD EXPANSION
BUILDING SIZE (SQ Fr) 2,124 NUMBER OF FLOORS 1 BUILDING AGE (YEARS) 43 NUMBER OF DWELLING UNITS 1
COMMERCIAL HOSPITAL INDUSTRIAL Ocher OFFICE PUBuC BLDG. -HOUSE SCHOOL SHIP UNNICOLLEGE
SITE OWNER CITY OF LA QUINTA ADDRESS 78.495 CALLE TAMPICO
CITY LA QUINTA STATE CA ZIP 92253 CONTACT MR TOM HARTUNG PHONE 7601177-7019
REQUIRED BUILDING
INFORMATION
ASBESTOS YES NO
PRESENT?
ASBESTOS YESNO
SURVEY? •
ASBESTOS - YES NO
REMOVED?
BUILDING TO BE YES NO
DEMOLISHED?
PROJECT DATES
START 6/1/04 END 6/22104 WORK SHIFT (day, swing, night)
ASBESTOS AMOUNT TO BE
REMOVED (n square feet)
FRIABLE
CLASS I
CLASS II
TOTAL AMOUNT (add row)
ASBESTOS REMOVAL FROM
SURFACES PIPES COMPONENTS
AMOUNT OF EACH TYPE OF
ASBESTOS (in square feet)
ACOUSTIC CEILING
I LINOLEUM
INSULATION
FIRE PROOFING
DUCTING
STUCCO
MASTIC
FLOOR TILES (VAT)
DRY WALL
PLASTER
TRANSITE
ROOFING
OTHER
()
CONTRACTOR INFORMATION
CSLB LICENSE # 600283 OSHA REG # AQMD ID # 100435
NAME EMERY LANDCLEARING AND GRADING, INC. ADDRESS P.O: BOX 1009
CITY THERMAL STATE CA ZIP 92274 SITE SUPVR JAMES C. EMERY PHONE 760/774-9493
WASTE TRANSPORTER #1
LANDFILL
ADDRESS
ADDRESS
CITY
STATE
ZIP
CITY
STATE
ZIP
Asbestos surveys are required prior to Demolition and Renovation
SCAQMD NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL
MAIL FORM AND FEE TO SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 90074-5641
WASTE TRANSPORTER #2
WASTE STORAGE SITE
ADDRESS
ADDRESS
CITY STATE ZIP
CITY STATE ZIP
CONTROLS: DESCRIBE WORK PRACTICES AND CONTROLS TO BE USED AT THE RENOVATION AND DEMOLITION SITE. Procedure # 1, 2, 3, 4, 5 or Other.
For asbestos removals circle the combination of Rule 1403 procedures used. Procedure 4 and 5 submit plans for AQMD prior approval.
ASBESTOS DETECTION PROCEDURE: CIRCLE THE PROCEDURES AND ANALYTICAL METHODS USED TO DETERMINE ASBESTOS IN THE BUILDING:
Surrey, Bulk Sampling, Inspection, PLM, PCM, TEM, Assumed as Asbestos-PACM, Describe Other.
FOR DEMOLITIONS GIVE THE COMPANY NAME AND DATES OF THE ASBESTOS REMOVAL: TRESIERRAS CONSTRUCTION 4/21/04
FOR ORDERED DEMOLITION SEND A COPY OF THE ORDER AND GIVE THE AGENCY NAME & PHONE #
AUTHORIZING PERSON: MR. TOM HARTUNG TITLE BUILDING AND SAFETY DIRECTOR
DATE OF ORDER 5/17/04 DATE ORDERED TO BEGIN: 6/1/04
FOR EMERGENCY ASBESTOS REMOVAL GIVE THE NAME AND PHONE NUMBER OF THE PERSON DECLARING/ALITHORIZING THE EMERGENCY, DATE AND HOUR OF
EMERGENCY AND DESCRIBE THE SUDDEN, UNEXPECTED EVENT:
EXPLAIN HOW THE EVENT WOULD CAUSE UNSAFE CONDITIONS, EQUIPMENT DAMAGE OR UNREASONABLE FINANCIAL BURDEN:
CONTINGENCY PLAN: DESCRIBE ACTIONS TO BE FOLLOWED IF UNEXPECTED ASBESTOS IS FOUL DURING DEMOLITION OR ASBESTOS MATERIAL BECOME
DISTURBED, CRUMBLED, PULVERIZED, OR REDUCED TO POWDER.
STOP PROJECT HAVE CERTIFIED ASBESTOS REMOVAL CONTRACTOR REMOVE AND DISPOSE OF.
TRAINING CERTIFICATION: I certify that an individual trained in the provisions of regulation AQMD Rule 1403 and NESHAP will be on site during the removal and
evidence that the required training has been accomplished by this person will be available for inspection during normal business hours.
Company Name EMERY Print name of owner/opoat Signa ofo / dor Tittle of owner/operator Date 5/26/04
LANDCL.EARING AND LORI EMERY
GRADING, INC. VICE PRESIDENT
INFORMATION CERTIFICATION: I certify that the above informationis and I have enclosed any required attachments.
Company Name EMERY Print name of owner/operator a f Tittle of owner/operator Date 51204
LANDCLEARING AND LORI EMERY VICE PRESIDENT
GRADING, INC.
Notifications can not be accepted without the required fee (AQMD Rule 301). Asbestos removals of les9than 100 square feet are exempt from notification and fees.
Please make checks payable to "SCAQMD". Fees are per notification, not refundable, and vary according to the project size. Fees are as follows:
DEMOLITION OR ASBESTOS REMOVAL PROCEDURE 4 OR 5 PLAN $ 331.21
FROM 100 TO 1,000 SQUARE FEET $ 29.52 SPECIAL HANDLING FEE $ 28.17
FROM 1,001 TO 5,000 SQUARE FEET $ 90.24 REVISION OF NOTIFICATION $11.94
FROM 5,001 TO 10,000 SQUARE FEET $211.22 RETURNED CHECK CHARGE $ 29.28
MORE THAN 10,000 SQUARE FEET $331.21 CANCELLATION OF NOTIFICATION $ 0.0
DEMOLITION OF LESS THAN 100 SQ FT $ 29.52 ASBESTOS REMOVAL AT owner- $ 29.52
occupied, single -unit dwelling
MAIL FORM AND FEE TO: SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 000745641 Page 2 of 2
TELEPHONE: (909) 396-2336 FAX: (909) 3963342 Form REV 20030627
FORMS, INSTRUCTIONS, AND THE RULE 1403 CAN BE OBTAINED FROM AQMD WEB SITE AT HTTP://WWW. AONM.GOV
C. -AMM 1.. 1... 4-A ..# ')IQ= C rrrwd— n h— No—n A Q— rA o97Rr. A 407 ronoi zoa )nnn
SCOTT MORRISON & ASSOCIATES
0.6.B11 8k 55329
Riverside, CA 92517
(909) 624-1665 DOSH 92-0248
ASBESTOS SURVEY REPORT
Completed On
March 8th, 2004
PLM0226#4025a
Client: c/o Tom Hartung's Office
City of La Quinta Redevelopment
P.O. Box 1504
La Quinta, CA 92253
Project: 46115 Jefferson Street
La Quinta, CA .
(single family home)
31855 Date Palm Drive, Ste. 43-507
Cathedral City, CA 92234
(760)323-7743
On February 26th, 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 (8) 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 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 analyzedbeforeany 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.
i
ASBESTOS INSPECTION BY: Timothy Morrison, DOSH #02-3142
BULK SAMPLES ANALYZED BY: Carolina Environmental, Inc., NVLAP #101768-0
(1)
P.O. Box 55329
Riverside, CA 92517
(909)624-1665
SCOTT MORRISON & ASSOCIATES
31855 Date Palm Drive, Ste. #3-507
Cathedral City, CA 92234
DOSH 92-0248 (760) 323-7743
The results on the following page(s) indicate that asbestos was detected in 03 of the 08 samples
analyzed.
PLM0226#4025a
Sample #QN-01
Type of material: acoustic ceiling- white
Location: interior ceiling of southeast bedroom
Area: approx. 1450 total sq. ft.
Friable:yes
Results: 5% Chrysotile asbestos
Sample #QN-02
Type of material: drywall only
Location: interior west wall of east -central bedroom
Area: throughout interior walls of bedrooms
Friable:no
Results: none detected
Sample #QN-03
Type of material: acoustic ceiling- white
Location: interior ceiling of southwest livingroom
Area: approx. 1450 total sq. ft.
Friable:yes
Results: 5% Chrysotile asbestos
Sample #QN-04
Type of material: rolled vinyl floor- white
Location: floor of kitchen
Area: approx. 225 sq. ft.
Friable:no
Results: none detected
Sample #QN-05
Type of material: acoustic ceiling- white
Location: interior ceiling of north -central room
Area: approx. 1450 total sq. ft.
Friable:yes
Results: 5% Chrysotile asbestos
Sample #QN-06
Type of material: stucco -brown (1 rst layer)
Location: exterior north wall
Area: throughout exterior walls
Friable:no
Results: none detected
Sample #QN-07
Type of material: plaster- grey (2nd layer)
Location: behind sample #QN-06
Area: throughout exterior walls
Friable:no
Results: none detected
I
Sample #QN-08
Type of material: roof felt- black
Location: exterior south roof under wood shingles
Area: approx. 2500 sq. ft. throughout exterior roof
Friable:no
Results: none detected
(2)
P.O. Box 55329
Riverside, CA 92517
(909) 624-1665
SCOTT MORRISON & ASSOCIATES
DOSH 92-0248
31855 Date Palm Drive, Ste. #3-507
Cathedral City, CA 92234
(760)323-7743
Note: All asbestos containing building material(s) containing greater than 1.0% asbestos by volume or
weight, must be removed by a state certified asbest s abatement contractor prior to any demolition or
renovation of the property.
A
Inspector
Scott C. Morrison
Certified Asbestos Consultant
DOSH#92-0248
(3)
Mar -04-04 08:10am From -CAROLINA ENVIRONMENTAL
CAROUMENVIRONMENTAL, INC.
107 New EdMm Cour% Cary, NC M11
Phone; (919). 4811413 Fax -(919)4811-11442
+4611442 T-405 P.02/05 F-530
LABORATORY REPORT
ASBESTOS BULK ANALYSIS
Client: Scott Morrison & Associates
CEI Lab Code:
A04-1473
31855 Date Palm Dr. Suite 3-507.
Received:
03-03-04
Cathedral City, CA 92234
Analyzed:
03-04-04
ACOUSTIC CEILING
Reported:
03-04-04
Project: PLM0226#4025a
Analyst:
Gary A. Swanson
CLIENT ID LAB ID HOMOGENEITY DESCRIPTION ASBESTOS
QN-01 A234308 ACOUSTIC CEILING CHRY 5%
Homogeneous, White, Fibrous, Loosely Bound
CHRY 5% BIND 95%
QN-02 A234309 DRYWALL
Homogeneous, White, Fibrous, Bound
BIND 93% CELL 7%
QN-03 A234310 ACOUSTIC CEILING
Homogeneous, White, Fibrous, Loosely Bound
CHRY 5% BIND , 95%
ON -04 A234311
VINYL FLOORING
Homogeneous,
White, Grey, Fibrous, Bound
VINYL 65% CELL 10%
-
BIND 20% FBGL 5%
QN-05 A234312
ACOUSTIC CEILING
Homogeneous,
White, Fibrous, Loosely Bound
CHRY 5% BIND 95%
QN-06 A234313 - STUCCO
Homogeneous, Brown, Non-fibrous, Bound
BIND 100%
NO
CHRY 5%
ND
CHRY 5%
ND
Page 1
Mar -04-04 09:10am From -CAROLINA ENVIRONMENTAL
+4811442 T-405 P.03/05 F-530
CAMUNAENV61OWV1Fff , M Project: PLM0226#4025a
107 New Edition Court, Cary, NC 27911
Phone: 919481-1413 Fax : 919481-1442
Lab Code; A04.1473
CLIENT.ID LJC �D HOMOGENEITY DESCRIPTION ASBESTOS
QN-07 A234314 PLASTER. ND
Homogeneous, Grey, Non-fibrous, Bound
BIND 100%
QN-08 A234315 ROOF FELT
Homogeneous, ; Black, Fibrous, Bound
TAR 25% CELL 75%
ND
Page 2 ,
Mar -04-04 09:11am From -CAROLINA ENVIRONMEN'AL
+4911442 7-405 P.04/05 F-530
The following definitions apply to the abbreviations used in the ASBESTOS BULK
ANALYSIS REPORT:
CHRY
= Chrysotile
CELL.
= Cellulose
DEBR = Debris
AMOS
= Amosite
FBGL
= Fibrous Glass
BIND Binder
CROC
= Crocidolite
ORGN
= Organics
SILI = Silicates
TREM
= Tremolite
SYNT
= Synthetics
GRAY = Gravel
ANTH
= Anthophyllite
WDLL
= Wollastonite
MAST = Mastic
ACTN
= Actinolite
CE:RWL = Ceramic Wool
ALAS = Plaster
N D = None Detected NTREM = Non-Asbestiform PERL = Perlite
NANTH = Non-Asbestiform Tremolite
RUBR =Rubber
Anthophyilite
CLIENT: Scott Morrison & Associates
PROJECT: PLM0226#4025a
CEI LAB cone. A04-1473
)tereoscopic microscopy and polarized light microscopy coupled with dispersion staining is the analytical technique used
or sample identification. The percentage of each component is visually estimated by volume. These results pertain only
o the samples analyzed. The samples were analyzed as submitted by the client and may not be representative of the larger
naterial in question. Unless notified in writing to return samples, Carolina Environmental, Inc. will discard a!I bulk samples
ifter 30 days.
Aany vinyl floor tiles have been manufactured using greater than 1 % asbestos, Often the asbestos was milled to a fiber
:ize below the detection limit of polarized light microscopy. Therefore; a "None Detected" (ND) reading on vinyl floor tile
Ices not necessarily exclude the presence of asbestos. Transmission electron microscopy provides a more conclusive
arm of analysis for vinyl floor tiles.
t is certified by the signature below that Carolina Environmental, Inc, is accredited by the National Voluntary Accreditation
)rogram (NVLAP) for the analysis of asbestos in bulk materials. The accredited test method Is EPA 1600 / M4-821020 for
he analysis of asbestos in building materials. Procedures described in EPA / 600 / R-93 / 116 have been incorporated
vhere applicable. The detection limit for the method is 0.1 % (trace amount). Carolina Environmental, Inc.'s NVLAP
iccreditatlon number is #101768-0. This report is not to be used to claim product endorsement by NVLAP or any agency
>f the U. S. Government. This report and its contents are only valid when reproduced in full. Dust and soil analyses for
asbestos using PLM are not covered under NVLAP accreditation.
REVIEWED BY
JV
lJF�a dmf, Ph.
Laboratory Cirector End of Report
-.L
0
Cl -
CHAIN OF CUSTODIA`
From: Scott Morrison & Associates To: Carolina Environmental, Inc.
P.O. Box 55329 107 New Edition Court
Riverside, CA 92517 Cary, NC 27511
(760) 323-7743 (919) 451-1413
NVLAP Cade 101768-0 CA CLAP #2483
Client: Cts LA aLLIpT& Person Taking Samples: Ih : R�trso,Jy_�oSi(aZ-?�lZ
.lob No. Pum �zusgo25� Site Address: �� i i� )�F��S aN grUer � LA nu I�
Sample !#
o .
Sample Date i
Material & Description
P M AA -Pb
Other Information
--01
Q -b
(e7
0 -2 -z oq
A i-t.c- CG Ua� - - N
o LLc V l w i�O W H I
A C ouS-r-i C j C t L t� NG -
Tu -c o — 0
Roof- 'FF-ur —
Howts P —
Fax in Results 7 ✓ No
S'
Date/Time: 2 - /n. Received BY: � DatelTime. ,
Relinquished By:
g
Mail/Fax To: Scott Morrison & Asociates, 31855 Date Palm Dr., Ste. 93-507, Cathedral City, CA 92234, (760) 323-7743
04/13/2004 14:06 6267943339 TRESIERR4S INC PAGE 02
AGREEMENT
This AGREEMENT, made and entered into at Altadena, Los Angeles County, California,
this 'day of April 2004, by and between TRESIERltA:;' CONSTRUCTION, INC.
(hereinafter "CONTRACTOR"), with its principle office at 2235 N. Lake Ave., Suite
107, Altadena, CA 91001 and CITY OF LA QUINTA (hereinafter "CUSTOMER"), with
its principle office at La Quinta, P.O. Box 1504, La Quints, CA 92253, California.
1. SCOPE OF WORK: SUBCONTRACTOR hereby a,�rei;,s to perform the following
construction work at the job site address of 46115 Jefferson Street, La Quinta, California:
A. CONTRACTOR to remove and dispose approx. 2000 sq.ft, of acoustical spray
ceiling,
B. CONTRACTOR to remove and dispose-approx. of asbestos containing floor tilt
and mastic,
C. CONTRACTOR to provide SCAQMD and Cal C-sha notices,
D. CONTRACTOR to dispose all material at an app•ovied landfill and provide
a manifest thereof,
E. CUSTOMER to provide CONTRACTOR with rn;cessary EPA Numbers.
2, COMMENCEMENT AND COMPLETION: CONTIZM.'TOR to commence
abatement ten (10) working days after required notices to SC�l,QMD have been given.
Notices will be given upon CONTRACTOR receiving fully e-,;ecuted contract from
CUTOMER.
3. , CONTRACT PRICE: CUSTOMER agrees to na-v CONl-RACTOR the sum of r'our
Thousand Three Hundred Fifty -Three US Doll(� 4,35�.0f►) upon completion of all
work.
4. ENTIRE AGREEMENT: This Agreement contains the! entire understanding
between the parties and supersedes any prior or contemporaneous written or oral
agreement between the parties. There are no representations, warranties, agreements,
arrangements, or understandings, oral or written, between the parties relating to the
subject matter of this AGREEMENT except as specifically se: forth in this
AGREEMENT.
5. SEVERABILITY: The invalidity of any provision of this AGREEMENT as
determined by a court of competent jurisdiction shall in no way affect the validity of any
other provision of this AGREEMENT.
6. HEADINGS: The headings at the beginning of the various provisions and/or sub -
provisions in this AGREEMENT are for information purpcses only and shall not be
construed to define, limit, expand or affect any provision. oi'tfds AGREEMENT.
PAGE 1 OF 2 s
/ ,so
04/13/2004 14:06 6267943339. TRESIERRAS INC. PAGE 03
7. COUNTERPARTS: This AGREEMENT may be signed it) one (l) or more
counterparts, each of which shall constitute an original but all of which together shall
constitute one and the same document.
8. GOVERNING LAW AND JURISDICTION: This AGREEMENT shall be
governed under the laws of the State of California and jurisdiction shall lie in Riverside
County, California.
9: ATTORNEYS FEES: In the event any party to this AGREEMENT commcnces
any action or proceeding against the other party to enforcE- the terms of this
AGREEMENT or to declare rights under this AGREEWNT, the partyprevailing in
such action or proceeding shall be entitled to recover from the other party the prevailing
party's reasonable attorney fees and costs, :including, but not limited to filing, fees, expert
witness fees, witness fees, and any and all other fees and costs.
10. INDEMNITY: Contractor shall defend, indemn:.
fy :1nd hold harmless the City,
its officers, employees, representatives and agents ("Indemnified Parties"), from and
against those actions, suits, proceedings, claims, demands, losses, costs, and expense,
including legal costs and attorneys' fees, for injury or death of person(s); for damage to
property (including property owned by the City) and errors and omissions committed by
Contractor, its officers, employees and agents which arise out of the negligent
performance under this Agreement, except to the extent of such loss being caused by the
City's own negligence or that of its officers, employees, or agents. In the event the
Indemnified Parties are made a party to any action, lawsui-:, o,' other adversarial
proceeding in any way involving such claims, Contractor Ehall provide a defense to the
Indemnified Parties, or at the City's option, reimburse the :gnd;:mnified Parties their costs
of defense, including reasonable attorney fees incurred in clefe:nse of such claim. in
addition Contractor shall be obligated to promptly pay any final judgment or portion
thereof rendered against the Indemnified Parties.
0
Page 2 of 3
04/13/2004 14:06 6267943339 TRESIERR4S INC
11. STATE LICENSE BOARD: Contractors are requ:.reC. by law to be licensed by
the California Contractor's State License Board. Any questions concerning a contractor
may be referred to the registrar of the board whose address is: Contractor's State
License Board, 9835 (3x -the Street, Sacramento, CA 95826.
�
Executed onApril / 3 s, , 20U4, at La Quinta, California.
CONTRACTOR:
TRESIERRAS CONSTRUCTION, INC.
By:
�
Name and Title y
CUSTOMER: ,
CITY OF LA QUINTA.
By:
Name & Title
11
r
PAGE 3 OF 3
PAGE 04
FROM`:GBRI(TCLEY ENVIRONMENTAL FAX NO. :909 381 3433- Mar.'25 2004 11:13AM P1
lu'RK"TLEY JENVIROPTMEN"111AL
Environmental Retn.ediation Contractor.
FAX COVER SIHEE'T
DATE: March 25, 2004 TIME:
TO: CITY OF LA QUINTA REDEVELOPMENT PHONE: 760777-7013.,.
ATTN: TOM HARTUNG FAX: 760-777-7011
FROM: IAN GORDON
ATTACHED IS THE PROPOSAL AND CONTRACT YOU REQUESTED. IF ACCEPTABLE PLEASE SIGN
4
AND RETURN TO US AS SOON AS POSSIBLE.
WE APPRECIATE THE OPPORTUNITY TO SID THIS PROJECT FOR YOU. PLEASE CALL IF YOU HAVE ANY
QUESTIONS OR WISH TO HAVE AN ORIGINAL MAILED.
THANK YOU.
. T
IAN G`ORD
PROJECT MANAGER / ESTIMATOR
KEI
Number of pages including cover sheet: 3
957 Rede Strcct, Stn Bemardino, CA 92411, Lic. No. 610114 CATJOSHA No. 49
909-888-2010 800-530-3366 FAX 909-361-3433 1'
FROM'z:BRIC,KLEY ENVIRONMENTAL FAX NO. :909 381 3433 Mar. 25 2004 11:13AM P2
D�UCK"LEY ]ENVI �)N I�1(l�I��IC AL
Environmental Remediation Contractor
PROPOSAL & CONTRACT
March 25, 2004
CLIENT: CITY OF LA QUINTA REDEVELOPMENT PROPOSAL h UMBER: - 10725
ATTN: TOM HARTUNG JOB NAME: SFR - VACANT
ADDRESS:
P. 0. BOX 1504
CITY:
LA QUINTA, CA ZIP: 92201
PHONE:
760-777-7013
FAX: 760-777-7011
SITE ADDREfiS: 46115 JEFFERSON STREET
CITY: LA QUINTA, CA ZIP: 92201
PROPERTY C WNER:
CONTRACTPMOUNT: $5,795.00
REMOVE AND DISPOSE OF ASBESTOS CONTAINING MATERIALS (ACM) PER SITE INSPECTION ON
3/24/04 & SCOTT MORRISON SURVEY #4026A, IN QUANTITIES AND LOCATIONS AS OUTLINED BELOW:
THROUGHOUT DWELLING
• APPROX. 2,000 SQ. FT. OF ACOUSTIC CEILING SPRAY
• APPROX. 40 SQ, FT. OF LINOLEUM IN KITCHEN.
COST $5,545.00
PROVIDE THIRD PARTY ON SITE CLEARANCE AIR SAMPLING AND ANALYSIS BY AN INDEPENDENT,
LICENSED AND CAL/OSHA CERTIFIED CONSULTANT / N.LO.S.H. CERTIFIED LAB TECHNICIAN.
COST $150.00
SOUTH COAST AQMD NOTIFICATION FEE FOR THIS PROJECT: COST $100.00
CLIENT/OWNER TO PAY ALL RE -NOTIFICATION FEES
(MINIMUM $25.00 EACH) AND TO BE RESPONSIBLE FOR
ALL FEES IF THE PROJECT IS CANCELLED.
THIS PROPOSAL IS BASED ON PREVAILING WAGE DETERMINATION SC -102-882-1-2003-1, ISSUE DATE
FEBRUARY 22, 2003 AT THE RATE OF $29.90 PER HOUR.
BRICKLEY ENVIRONMENTAL WILL PROVIDE ALL OSHA REQUIRED PERSONAL AND CLEARANCE AIR
MONITORING AND HAVE SAMPLES ANALYZED BY AN INDEPENDENT AND CERTIFIED LABORATORY.
AT THE COMPLETION OF THIS PROJECT AND UPON PAYMEN-', BRICKLEY ENVIRONMENTAL WILL
PROVIDE COMPLETE DOCUMENTATION Le, NOTIFICATION LETTERS, WASTE MANIFEST, CERTIFICATE
OF INSURANCE, SUPERVISOR'S DAILY LOGS ETC.
ALL REGULATED WASTE GENE=RATED FROM THIS PROJECT WILL BE PROPERLY DISPOSED OF AT AN
EPA, . STATE OR LOCAL REGULATORY AGENCY APPROVED DISPOSAL FACILITY, UTILIZING THE
APPROPRIATE WASTE DISPOSAL MANIFEST.
OWNER TO PROVIDE WATER AND ELECTRIC AT JOB SITE. BRICKLEY ENVIRONMENTAL WILL PROVIDE
NECESSARY CONNECTIONS,
967 Reece Street, San Bernardino, CA 92411, Lic. No. 610414 GAL/OSHA No. 4A Pngn I n12
909-888-2010 800-530-3386 FAX 909-381-3433
f,
FROM BRIC-KLEY ENUIRONMENTAL FAX NO. :909 381 3433 Mar. 25 2004 11:13AM P3
WORK SHALL BE PERFORMED IN ACCORDANCE WITHIN OSHA, EPA, AND STATE REGULATIONS.
THE ABOVE WORK TO BE COMPLETED IN A SUBSTANTIAL. AND WORKMANLIKE MANNER ACCORDING
TO STANDARD PRACTICES FOR THE SUM OF:
FIVE THOUSAND SEVEN HUNDRED NINETY-FIVE""""**"."' .......""'°**""DOL':LARS ($5,795.00)
A. TERMS: DUE UPON RECEIPT UNLESS OTHERWISE ARRANGED
B. THIS PROPOSAL MAY BE WITHDRAWN BY BRICKLEY ENVIRONMENTAL IF NOT ACCEPTED WITHIN 30 DAYS.
C. CONTRACTOR WILL MAINTAIN INSURANCE IN THE AMOUNT OF $1,000,000.00 OR AS REQUIRED BY
SPECIFICATIONS.
D. CONDITIONS: THE TERMS AND CONDITIONS AS FOLLOW ARE EXPRESSLY INCORPORATED INTO THIS
CONTRACT.
IAN 0QRbON PFIOJECT MANAGER I ESTIMATOR KEH
ACCEPTANCE OF PROPOSAL
THE ABOVE PRICES, SPECIFICATIONS, AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU
ARE AUTHORIZED TO DO THE WORK SPECIFIED. PAYMENT WILL BE MADE AS OUTLINED ABOVE,
CLIENT
CITY OF LA QUINTA REDEVELOPMENT AUTHORIZED SIGNATURE
#10725
DA
TITLE
ADDITIONAL TERMS & CONDITIONS OF CONTRACT
TERMS: DUE UPON RECEIPT UNLESS OTHERWISE ARRANGED, INTEREST AT THE RATE OF 11/2% PER MONTH WILL
BE CHARGED ON ALL PAST DUE ACCOUNTS. IN THE EVENT OF FAILURE: TO PAY ANY OF THE AMOUNTS DUE ON
THIS INVOICE, ALL COLLECTION COSTS, AND/OR ATTORNEY'S FEES IN THE COLLECTION OF ANY SUCH AMOUNT,
WILL BE PAID BY THE CLIENT.
UNLESS OTHERWISE STATED, IN THIS PROPOSAL, BRICKLEY ENVIRONMENTAL WILL PROVIDE ONLY THE OSHA
REQUIRED PERSONAL Alit MONITORING, THE OWNER SHALL PROADE, AT THEIR COST, ALL ADDITIONAL
TESTING AND ALL FINAL CLEARANCE TESTING OR RETESTING ON THIS PROJECT,
THIS BID OFFER IS BASED ON REMOVAL OF CERTAIN TYPES AND QUANTITIES OF HAZARDOUS AND NOW
HAZARDOUS MATERIALS AS LISTED IN THE PROPOSAL, IF ADDITIONAL OR CONCEALED HAZARDOUS MATERIALS
ARE FOUND AND THE OWNER CHOOSES ABATEMENT, A CHANGE ORDER WILL BE REQUIRED TO ALLOW THE
ADDITIONAL COSTS AND TIME TO COMPLETE THE ADDITIONAL WORK.
PLEASE. BE ADVISED THAT THE OWNER OF THE PROPERTY AND GENERATOR OF ANY HAZARDOUS MATERIALS
MAY BE SUBJECT TO MANIFEST / EPA NUMBER FEES ISSUED BY THE: DEPARTMENT OF TOXIC SUBSTANCES
CONTROL (13TSC). ALL FEES ISSUED BY DTSC ARE THE RESPONSIBILITY OF THE OWNER / GENERATOR. FEES
ARE BILLED DIRECTLY FROM DTSC AND ARE NOT INCLUDED IN THE CON"RACT AMOUNT.
ALTHOUGH BRICKLEY ENVIRONMENTAL TAKES PRECAUTIONS TO AVOID DAMAGE TO FINISHED SURFACES, SOME
DAMAGE MAY OCCUR, BRICKLEY ENVIRONMENTAL SHALL NOT BE RESPONSIBLE FOR ANY SUCH REASONABLE
COSMETIC DAMAGES NOR SHALL PAYMENTS TO BRICKLEY ENVIRONMENTAL BE REDUCED OR WITHHELD AS A
RESULT THEREOF. I.e. DAMAGE=S STE=MMING FROM PLACEMENT CR REMOVAL OF POLYETHYLENE AND
WOOD/DRYWALL BARRIERS AND FASTENING MATERIALS WHICH ARE REQUIRED TO HOLD BARRICADES IN PLACE
DURING ABATEMENT. ALL REPAIRS OR REFINISHING WILL BE PERFOF.MED ONLY UNDER SEPARATE WRITTEN
AGREEMENT OR CHANGE ORDER BETWEEN BRICKLEY ENVIRONMENTAL AND OWNER.
THE OWNER, BY ACCEPTANCE OF BRICKLEY ENVIRONMENTAL BID OFFER. HEREBY AGREES 1-0 ABSOLVE
BRICKLEY ENVIRONMENTAL OF ANY AND ALL RESPONSIBILITY FOR ITEMS OR OBJECTS WHICH MAY BE
REPORTED DAMAGED, DESTROYED OR MISSING, UNLESS OWNER CAN PROVE BEYOND A REASONABLE DOUBT
THAT AN EMPLOYEE OR SUB CONTRACTOR OF BRICKLEY ENVIRONMENT 4L IS THE RESPONSIBLE PARTY.
CONTRACTORS ARE REQUIRED BY LAW TO BE LICENSED AND RE=GULATE=D BY THE CONTRACTORS' STATE
LICENSE BOARD. ANY QUESTIONS CONCERNING A CONTRACTOR M.\Y BE REFERRED TO THE REGISTRAR,
CONTRACTORS' STATE: LICENSE BOARD, P,O. BOX 26000, SACRAMENTO, -,ALIFORNIA 95826.
Pepe 2 or 2
04/23`/'2004"."09t4:3" 6267943339 TRESIERRAS INC PAGE 02
r,•S
Tudslerms Consirvctlon, Inc.
General Contractors
2235 North lake Avenue, Suite 107, Attadem , CA 91001
Tel: (626) 794 333 Fax: (626) 794-3339.5tate license 725996
April 23, 2004
Tom Hartung .
City of La Quints
P.O. Boa 1504
.LA Quinti, CA 92253
j INVOICE NO. ill
Job Site: 46115 Jefferson Street, 1A QUhA California.
46305 Jcffason SUVCe La Quinta, Califomiia
Asbestos Abatement.100 %o Completed
TOTAL DUE UPON RECEIPT........................ ............. ........... S 4,353.00
APPROVED FOR PAYMENT
BY
611
ACCOUNT NO. a -1 - s�. 3,2-10
DESCRIPTI o� Sp STos aba.Z'
AM%T�p ta'AY—=--
3 �3 • °°
r
SCOTT M[O ZRISON & 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
INVOICE
Date: March 16, 2004
Client: Tom Hartung's Office Project/ P.O#
City of La Quinta Redevelopmemt
P.O. Box 1504
La Quinta, CA 92253 "
''Project. 46115, 462.80,4630 5 46395; File name: PLM0226#4025a-e
and 46450 Jefferson St. '
La Quinta, CA
(5 single-family homes)
Inspection date: February 26, 200
asbestos inspection/ bulk sampling: 5 single-family homes @ $125.00 ea. _ $625.00
40 total bulk samples for analysis (PLM) @ $20.00 each = $800.00
# hours of travel time @ $ each = included
Total amount due =.$1,425.00
Please send payment to: 31855 Date Palm Drive, Ste. #3-507
Cathedral City, CA 92234
Terms: Net 15 days
Thank you.
0
APPR VE FOR PAYMENT
BY '
BY
ACCOUNT NO T, e YC�oG1O�J
DESCRIPTION
AMT. TO PAY�SyJg2-5 V#
41-555 Cook Street, Suite 250
Palm Desert, California 92260
Tel: (760) 776-1238 Fax: (760) 776-1636
LETTER OF TRANSMITTAL
TO: Tim Jonasson
FROM: _Edna Rosales
SUBJECT: Peterson's House Keys 46-115 Jefferson Street
DATE: February 6, 2004
SENT\YIA: [ j',MES8ENGER [ " ]"MAIL [ ]-FedEx [ x-] Han —1361iveted '[ ']Fax: ---
Comments:
3
tb .
The above is transmitted: ( ) DO NOT MAIL; Call for Pickup- 776-1238
( ) as requested () For Review and comment ( )For info
( ) For Review and comment ( ) For signature
W'y Date: