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LICENSED CONTRACTOR 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 License is in full force and effect.
License # Lic. Class Exp. Date
4733iS C21 A . C v,3112(
r ! +.f�.. r j'j I'1,-`
Date' •�- `' Sig,iature of Contractor ,_ �;
OWNER -BUILDER DECLARATION,`N
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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. 70-11, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).,.,.,,',,
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S 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
Sec'ion 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
UATB FUND ; 046942101
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) 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 those'provisions.
Date::`:: "t .r,s� Applicant ';.r. /, : ? Cr i_.
Warning: Failure to secure Workers' Compensation coverage is, unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
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 I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
.! t
Signature (Owner/Agent)+,. t;. JJ , ��' *_ u DateU'I,. '' t'!!
BUILDING PERMIT PERMIT#
DATE. VALUATION LOT aBt.Ai0.'S TRACT 1'
JOB SITE
ADDRESS
APN
' k-623 ��l�,4��' T CLUD DPJV
OWNER
CONTRACTOR/DESIGNER/EN (NEER
:f3 , ".) CHAPMAN
1YEM0 URLS41M. D, DIC:.
It8-305 otDI AM YS 52
81730 AVE, 50
L.A. O'STIDd' A CA 97,251
W.T710 CA, 92201
(760,,V, i7'.- s5 ra MIR. 1346
USE OF PERMIT
DFRf�0LISH SPI..) AMF.`3'Yt.3S R.1WORT CLSaR.MNMf CT1 MATTATCH110.
U M� ARY
Fylyw�
y'? 3`�C'�y'KE
M FEV, 101 WOy 00
�
L �U;Cyl�u'.�2 :'t 1.?:�i'.A,1 D PLAN CIMC2,
$4.5.110
LES* I'n-PAW
$0.00
F°.
— 9 Wirm. nt . VMS DUE NOW
CITY OF LA OUINTA
FINANCE DEPT
FA 5.W
RECEIPT
DATE, j
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond -Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
I
n,
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rr
CHAPMAN
GOLF DEVELOPMENT
April 24, 2001
Via hand delivery
Mr. Greg Butler
CITY OF LA QUINTA
78-195 Calle Tampico
La Quinta, CA 92253
Re: 51-623 Desert Club Drive
Dear Greg,
Please accept this letter as authorization for Demo Unlimited Inc. to demo the existing
structure located on 51-623 Desert Club Drive. If you have any questions or need
additions�mformation, please contact Christina Dores at (760) 564-3355.
TVhank .
Sinc r y,
David Chapman
President
DC/cjd
78505 Old Avenue 52 - La Quinta, CA 92253 0 Office: 760-564-3355 Fax: 760-564-2356
COMMONWEALTH, LAND TITS Ca ..
REC2RDING REQUESTED BY:
COMMONWEALTH LAND TITLE COMPANY
10.EE0NN61RDT pE 6015TT1500
WHUNLE 00TH R� SpOSWWN QOW,D.
L t ST WI NTS ��:
CHAPMAN GOLF DEVELOPMENT
78505 OLD AVENUE 52
LA QUINTA, CA 92253
DOC 88 2000-250017
06/28/2000 08.:00A Fee:26.00
Page 1 of 1 Doc T Tax Paid
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk 8 Recorder
M S
U
PAGE
SIZE
DA
PCON
APN: 769-152=-002 n
GST DEED , :
The undersigned grantor(s) declare(s):
Documentary transfer tax is $208,.45
(XXX) Computed on full value'of property conveyed, or SC
{ ) Computed on full value less liens and encumbrances remaining at time of sale.
( ) Unincorporated area; City of L A QIa1NTM__ _— i _ and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
MERON B. YESSAYIAN, a married man as his separate property who acquired title as a single
man
hereby GRANT(S) to
CHAPMAN GOLF DEVELOPMENT, a California Limited Liability.Company
the real property in the City of LA QUINTA, County of RIVERSIDE, State of California,
described as:
LOT 2 IN BLOCK 2 OF UNIT 1 OF THE DESERT CLUB TRACT, AS SHOWN BY MAP ON
FILE IN BOOK 19, PAGE 75 OF MAPS, IN THE OFFICE"OF THE COUNTY RECORDER OF
SAID COUNTY.
Dated June 15, 2000
State of California
County of - } S.S.
On i ,Z -U U 0
b e f o r _ —
personally appea d
61 V
personally known to me (or proved to me on
the basis of satisfactory evidencei to be
the person(a) whose name(91'is/axe subscribed
to the within instrument and acknowledged to
me that he/sem� executed the same in
his/h -Lr authorized capacity(reg), and
that by his/hen signature(s) on the
instrument the person(a), or the entity upon
behalf of which the person(s-i acted, executed
the instrument.
WITNESS my hand and offi 'al seal.
Signaturervir�
MAIL TAX STATEMENTS TO:
M-Qr�'-R'
�jwm'i ct'�'
MERON B. YESSAYIAN
OFFICIAL SEAL
• �'� , PAM SURABIAN
Q = COMM # 1215935 n
Notary Public - California Y
RIVERSIDE COUNTY _
My Commission Expires
MAY 11, 2003
(This area for official notarial seal)
Farm 45.,vdoOMB No. 2050-0039IExpira19-30.991 See Instructions on back of page 6.
Please print or type. form designed for use on elite (12 -pitch) typewriter.
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Department of Toxic Substances Control
Sacramento, California
DTSC 8022A (1/99)
EPA 8700-22
DO NOT WRITE BELOW THIS LINE.
White: TSDF SENDS THIS COPY TO DTSC: WITIliN 30
To: P.O. Box 3000. Su c—oto. CA 9581?
T -d EEbE I86 606 Te4U0WU0J1AU3 ROTAotUB eZS=OT TO 60 ReW
UNIFORM HAZARDOUS
I. Ga"staters US EPA 10 No. Manifest Document No.
2. Pogo 1 Information in'lhe shaded areas
not required by Federal low.
WASTE MANIFEST
(^ 0
3 1B
1 of 1
1�Af�eaerat� Moiling Address Ss
FR
A. State Manifest Document Number
7850 OLD AVENUE 52 51623 DESERT CLUB DR.
20875044
B. State Generator's ID
LA QUINTA, CA 92201 LA QUIWA, CA 92253
4. Generator's Phone ( 760 ) 775-5884
S. Transporter 1 Company Name 6. US EPA ID Number
C. Slate Transporter's ID (Reserved.]
BRICKLEY ENVIRONMENTAL C AI RI 01 01 01 01.51 31
11 7 3
D. Transporters Phone (909) 888-2010
7. Transfer 2 Company Name 8. US EPA ID Number
E. State Transporter's ID Reserved.]
ECfI, 953 W. REECE ST.
F. Transporler's Phone 909 884-7424
SAN BERNARDINO, CA 92411 CI Al RI 010 01014191,01614
9. Designated Facility Name and Site Address 10. US EPA ID Number
G. State Facility's ID
AZUSA LAND RECLAMATION
1211 W. GLADSTONE
H. Facillty's Phone
AZUSA, CA 91702 11®lp+01019101017
— 0719
11. US DOT Description (including Proper Shipping Name, Hazard Class, and ID Number(
_
12. Containers
13, Total
Quantity
14. Unit
WI/Vol
1. Waste Number
No.
Type
_
a.
State
15 1
G
R.Q. ASBESTOS, 9, NA2212, PG III (NAERG#171)-6/A
EPA/Other
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State
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EPA/Other
A
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tae
T
O
E1101har
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d. — --
State
EPA/Other
1. Additional Descriptions for Materials listed Above
K. Handling Codes far Wastes
listed Above
NON RCRA WASTE
°
b'
ASBESTOS CONTAINING CONSTRUCTION MATERIALS
03
e.
d.
15. a ft" lrV"Tkb*fttfarmaio`PHONE 800-530-3366
EMERGENCY PHONE 800-535-5053
957 W. REECE ST. SAN BERNARDINO, CA 92411
SCAQMD PHONE (909) 396-2336
EPA REGION I% PHONE 415-744-1089
2186 E. COPLEY DR.
75 HAWTHORNE ST., SAN FRANCISCO, CA 94105
DIAMOND BAR, CA 91756-4182
16. GENERATOR'S CERTIFICATION: I hereby declare That the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed,
marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations.
If 1 am o large quontiy generator, I cerfify that I have a progrom in place to reduce the volume and
hhove disposal
toxicity of waste generated to the degree I have determined to be aconomico6y
future
practicable and that I selected the practicable method o treatment, storage, or currently available to me which minimizes the present and threat to human health
the environment; OR, if I am a small I hwe made a faith effort to mini ize waste the best waste management that is
and quantity generator, good
availab( to me and that I can afford.
my generation and select method
Printed Ty Name_
ignature — -
Month Day Year
/ "r[
0S O
Tr ns or r I Acknove em of Receipt of MaterialsI �X
R
A
Print�TyName
Signature
Month Day Year
P
0
1 r ns ower 2 Ackncwled a ent of Receipt of Materials
R
T
Printed/Typed Name
Signature
Month Day Year
F
R
19. Discrepancy Indication Space
f
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20. Facility Owner or Operator Certification of receipt of hazardous materials covered by his manifest except as noted in Item 19.
T
Printed/Typed Nome
Signature
Month Day Year
Y
DTSC 8022A (1/99)
EPA 8700-22
DO NOT WRITE BELOW THIS LINE.
White: TSDF SENDS THIS COPY TO DTSC: WITIliN 30
To: P.O. Box 3000. Su c—oto. CA 9581?
T -d EEbE I86 606 Te4U0WU0J1AU3 ROTAotUB eZS=OT TO 60 ReW
SOUTH COAST'AIR QUALITY MANAGEMENT DISTRICT
NOTIFICATION OF DEMOLITION OR:ASSESTOS REMOVAL.
21865 E: Copley Drive, Diamond Bar, CA 917654182.(909),3W2000
MAIL FORM AND FEE TO SCAQMD, ASBESTOS NOTIFICATIONS, FILE.# 556411 -LOS ANGELES CA 90074x641
a:vr,,w�:ye[fiwggy n^ft'S .. :�•.... - r -', �;fla +M:+ -=a �s ..i n�i
hT '% �"� ter t�tynv:•r?; � y�•y. .cl.�'=�b/.Sib`Atwa:;..r�,
:AtONLY. RECF.ItIED , �:HYii�p
SCREEN �: � ' � r P rFi - DIS
:'`7`s".�`:4.ii�.;`•-Gs. q`'a1h'11 ... .. r ."nb�._�:.,'47i1G.'-. t. r... E.- 4 ;y...�i A��l.-`�-t.+v. •_.e4 ...,
COMPLETED BY �Rp� n� COMPANY: DEMO UNLIMITED INC. PHONE 760-715,884h+L
DATE _014 0 l C CK #
(� �j (� FEE $ PROJECT #
NOTIFICATION TYPEORIGINAL
REVISION DATES REVISION OTHER (highligM)
CANCELLATION
PROJECT TYPE
EMOLITION ORDERED DEMOLITION RENOVATION (removal) EMERGENCY REMOVAL `?`. PLANNED RENO (annual)
SITE INFORMATION
SITE NAME:
SITE ADDRESS l
i ' U CROSS STREET:
CITY: 6
STATE: a ZIP COUNTY: 1 U d
DESCRIBE WORK AND LOCATION
e IM T h U U b e,
BUILDING SIZE (SQ FT)1 ado NU BER OF FLOORS: ' BUILDING AGE (YEARS)b'26 NUMBER'oF DWELLING UNITS: 1
BLDG PRIOR I PRESENT USE
COMMERCIAL HOSPrrAL INDusTRIAL Other OFFICE PUBLIC BLDGOUSE'SCHooL
SHIP UNNICOLLEGE
SITE OWNER::DR,E cGhjq 3 ADDRESS: � g�d� old
CITY:Zqtn'ra
STATE: ZIP: �a CONTACT:leis PHONE _
REQUIRED BUILDING
INFORMATION
ASBESTOS YES N0
PRESENT?
ASBESTOS ES NO
SURVEY? •
ASBESTOS
.,.REMOVED?
ES NO
BUILDING TO BE YES NO
DEMOLISHED?
PROJECT DATES
START: ln4q .O END: h JC _'ll _ (
1 o'
WORK SHIFTS, swing, night); 36
ASBESTOS AMOUNT TO BE
REMOVED (in square feet)
MmLd
CLASS I
CLASS II
Al
TOTAL AMOUNT (add rove)
ASBESTOS REMOVAL FROM
SURFACES PIPES
COMPONENTS
AMOUNT OF EACH TYPE OF
ASBESTOS (in square feet)
ACOUSTIC CEILING
I LINOLEUM
INSULATION
FIREPROOFING
DUCTING
STUCCO
MASTIC
FLOOR TILES (VAT)
DRY WALL
PLASTER
TRANSITS
I ROOFING
OTHER
(describe)
CONTRACTOR INFORMATION
CSLB LICENSE # 473328 OSHA REG #
AQMD ID # 97499
NAME DEMO UNLIMITED INC.
ADDRESS 81750 AVENUE 50
CITY INDIO
STATE CA ZIP 92201 SITE SU
PHONE 760-775;58 84
WASTE TRANSPORTER #1
-P -VR:
�DFI�, pr
Z ri n C
ADDRESS
ADDRESS„ &__7D
P6 W�
CITY
STATE ZIP
CITY:4 L
STATE t0(JS� `15
* Asbestos surveys are required prior to Demolition and Renovation
xri:?:..cJte9 i..15�.•�"';,:�.,s. _ ,,.'i .?�4C �" n1`..�. .,n,:Lx;H• !< 1'. `;av
-i-•---•-•�--=�-..r.,� ' � ,v.t•r:.. A .11:,'.!.' � 1. _ ,�, � �^, 4.�\ • , 1. •. , ,,..��5S � �.�
SCAQMD NOTIFICATION OF DEMOLMON OR-ASOBTOS:REMOVAL .
MAIL ORIGINAL TO SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES.CA 900745641
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. PnxGedure # 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.
Bulk Sampling, Inspection, Survey, PLM, PCM, TEM, Assumed as Asbestos, Describe Other: •,. '
FOR DEMOLITIONS GIVE THE COMPANY NAME AND DATES OF THE ASBESTOS REMOVAL-
EMOVALFOR
FORORDERED DEMOLITION SEND A COPY OF THE ORDER AND GIVE THE AGENCY NAME4 PHONE #
AU'rdORIZING PERSON: TITLE
DATE OF ORDER DATE.ORDERED TO BEGIN:
FOR EMERGENCY ASBESTOS REMOVAL GIVE THE NAME AND PHONE NUMBER OF THE PERSON DECLARING/AUTHORIZING 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:
CONTINGENCII PLAN: DESCRIBE ACTIONS AND PROCEDURES TO BE FOLLOWED IF UNEXPECTED ASBESTOS IS FOUND•DURING DEMOLITION OR NONFROBLE
ASBESTOS MATERIAL BECOME CRUMBLED, PULVERIZED, OR REDUCED TO POWDER.
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 Print name of owner/operator Signature of owner/operator Tittle of ownedoperator Date
INFORMATION CERTIFICATION: I certify that the above information is correct and I have required
I%L'►V� lJn lr M►Te� ZnG C���<y<� Cu�CI 7.U�����, �
Comparry Name Print name of ownedoperritor Signature of ownedo Time of owr 0 Date
Notifications can not be accepted without the required fee (AQMD Rule 301). Asbestos removals of less than 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 site. Fels are as follows:
DEMOLITION OR ASBESTOS REMOVAL PROCEDURE 4 OR 5 PLAN $ 30253
FROM 100 TO 1,1X)0 SQUARE FEET $ 26.96 SPECIAL HANDLING FEE = $ 25,73
FROM 1,001 TO 5,000 SQUARE FEET $ 82.42 REVISION OF NOTIFICATION $10.91
FROM 5,0017010,000 SQUARE FEET $192.93 RETURNED CHECK CHARGE $ 26.75
MORE THAN 10,000 SQUARE FEET $302,53 CANCELLATION OF NOTIFICATION $ 0.0
DEMOLITION OF LESS THAN 100 SQ FT $ 26.96 RESIDENTIAL ASBESTOS REMOVAL ' $ 26.96
' owner 'ed, si e•und dwelling
-ATTENTION: Keep a copy of your notification. State law requires that you provide a copy of the demolition notification to Building and Safety before issuance of a
demolition permit. For questions call 909-396-2336. For your convenience please mail the form and fee and do not hand carry to AQMD.
VALfBRM AND FEE TO: SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES CA 90074.5641
1HONE: (909) 396.2336 FAX: (909) 396.3342 - Form REV 200610 Page 3 of 2
FORMS, INSTRUCTIONS. AND THE RULE 1403 CAN BE OBTAINED FROM AQMD WEB SITE AT HTTPJ/WWWAQMD.GOV
04/23/2001 07:40 7603237743 SCOTT MORRISON & ASS
SCOTT MORRISON & ASSOCIATES
3243 Arlington Ave., Suite 206
Riverside, California 92506
(909) 624-1665 DASH 92-0248
PAGE 03
1130 G. Fuerte Circle
Palm Springs, CA 92262
(800) 824-3353
Sample #1 Type of materiatacoustic ceiling spray
Location: living room veiling
Area:approx 1,200 total sq_ ft. throughout interior
Friabte:yes Results: 12% Ch ysotDe asbestos
Sample 02 Type of materiatceiling plaster/ white, granular
Location:kdehen ceiling
Area -kitchen ceiling
Friable:no Results: none detected
Sample #R3 Type of material -final coat, gratnula r
Location. -interior wall, living room
Area: interior wall -1st layer
Friable:no Reawlts: none detected
Sample #4 Type of materialmall plaster, It brown coat
Location: Interior wall, living room
Area: interior wall -2nd Mayer
Friablemo Results: none detected`
Ssanple 05
Type of material:linoteum
Location:NE bedroom bathroom
Areas:approx. 25 sq. 1L
Friable:no
Results:none detected
Sample altt3
Type of materiedinoleum mastic/ black
Location:under sample 95
Area:approx. 25 sq. ft.
Friabtemo
Results: 6% Civywdle asbestos
Sample #7 Type of materiat:oeiling acoustic spray
Location -,bedroom ceiling
Area:approx. 1,200 total sq. ft. throughout interior
Friable:yes Results: 16% Mysotlis asbestos
Sample #e Type of material:tar A gravel roofing
Lvcationxod above living room
Area:roof lost layer
Friabie:r►a Results: none detected
(2)
.e'i�; :��:. _ }),. _. -ter �.Y: :5.X',,33 y.�tl'�,4? n. L. iia¢ tip;,.• �`
Q,, yl �(�.
04/23/2001 07:40 7603237743 SCOTT MORRISON & ASS
SCOTT MOMSON & ASSOCIATES
324:3 Arlington Ave., Suite 206
Riverside, California 92506
(909) 624-1665 DOSH 92-0248
PLN4041900904
Sample *9 Type of material: asphalt felts
Location: roof above garage
Area -roof -2nd layers
Fhable:no Results: none detected
PAGE 04
1130 E. Fuerte Circle
Palm Springs,CA.92262
(800)824-3353
Note: AN eabestos containing building materiels) 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.
Scott C. Morrison
Certified Asbestos Consultant
DOSHM-0248
(3)
.a.'}ti�4•�..�':�.:;'>�y'.��S,r9;.'.,`Z:r;s jig.. 1•�';;�'1:;>:� 4,�:�i;.l�..,;�t�t 4.Sea'T
04/23/2001 07:40 7603237743 SCOTT MO BISON & ASS
3243 Arlington Ave., Suite 206 SCOTT MOMSON & ASSOCIATES
Riverside, California 92506
(909) 624-1665 ROSH 92-0248
PLN1041900904
PAGE 03
1130 G. Fuerte Circle
Palm Springs, CA 92262
(800) 824-3353
Sample #I Type of materfaf:acouatic ceiling spray
Location: living roots ceiling
Area:approx 1,200 total sq. ft throughout ~or
Friable. -yes Results: 12% Cfrysat>lla s: 04ft
Semple 02 Type of material ceifing piasterl white, granular
f ccation:Icitchen ceiling
Area -kitchen ceiling
Friabie:no Results: none detected
Sample 03 Type or materiatnow coed, wow*
Locatiorrinterior wall, Wing room
Anes: interior wail -181: layer
Friable:no Results: none detected
Sample *4 Type of ntatsrial:wall plaster, It brown coat
LocatiorrinteriorwaH, living room
Area W tion well -2nd layer ...
Friabte:no Resufta` none deteoeed
Sample 05 Type of. -Oft annow-im
LocadwNE bedroom bathroom
Armapprox 25 sq. fL
Frieble:no Resulta:nons detected.
Sample #S Type of tnatetiat:linoieum mastic! black
Locatiarrunder aemple 05
Amempprox. 25 sq. ft
Ftiable:no Results: 9% Chrysotlle asbestos
Semple #7 Type of nu f inai:oeiling somata spray
Lccation:bedr=n-oeHing
Armwprox.1,2W tori Iq ft: throughout interior
Friable:yes Results: 16% gxysabts asbestm
Sample as Type of ffwW sl:tar & gnnW roofing
Loasdon:roof above living room
Arewrocf 1 at layer
Frieble:no Results: none detected
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