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06-2616 (DEMO) Hazardous Building Materials Investigation ReportHAZARDOUS BUILDING MATERIALS INVESTIGATION •REPORT , L La Quinta Country Club 77-750 Avenue 50. La Quinta, California 92253 Table of Contents Introduction 1 Building Description a 2 Asbestos Containing Building Materials 3 . Lead Based, Paints 5 Mold 6 Summary 10 Limitations 12 References 13 Appendix A Site Plan Appendix B Asbestos Sample Analysis 'Reports and Chain of Custody Appendix C XRF Sampling Results Appendix D Spore Trap Sample Analysis Reports Appendix E DHS Form 8552 Appendix F XRF Performance Characteristics Sheet t HAZARDOUS BUILDING MATERIALS INVESTIGATION REPORT ® La Quinta Country Club 77-750 Avenue 50 La Quinta, California 92253 Introduction Pacific Environmental Company was retained by the La Quinta Country Club to conduct an investigation to identify the presence of asbestos -containing materials (ACMs), lead -based paint (LBP), and microbial contamination at, the. La Quinta'Country Club, located in La Quinta, California. All work was conducted by State of California certified personnel and sampling was conducted in accordance with established sampling protocols. Laboratoryanalysis for asbestos was performed, by AmeriSci Los Angeles, and Laboratory analysis for microbial contamination was performed by Environmental Microbiology Laboratory Inc., both of which are independent and accredited laboratories. Our survey of the facility included the following; o An initial investigation to locate suspect ACMs. o An investigation to locate suspect LBPs. o Visual evaluation, moisture analysis, air and surface sampling to identify potential microbial contamination. o Physical assessment of suspect materials.. o Laboratory analysis of collected samples. . o Preparation of this written report which details our findings. o Preliminary cost to cure estimates associated with potential renovation or demolition. 4 Our scope of services included the performance of an asbestos survey inspection of the facility to identify asbestos-containingmaterials that will have to be removed by qualified personnel prior to renovation or demolition. Lead -Based Paint testing was performed using a portable X-ray fluorescence (XRF) analyzer. The inspection was performed by a certified lead inspector/assessor. Testing was patterned after the Department of Housing and Urban Development's document titled Lead -Based Paint: Interim Guidelines For Hazard Identification and Abatement in Public and Indian Housing (1997 Revision). The HUD/EPA action level of 1.0 mg/cm2 was used in determining if the paint is classified as containing lead for this report. In order to evaluate indoor air quality concerns associated with potential mold contamination, microbial sampling and assessment was conducted, based in part on the protocols outlined in Bioaerosols: Assessment and Control. ACGIH. Since no exposure guidelines have been established by any governmental agency, the term "contamination" is used to indicate the presence of mold or fungus at levels higher and/or qualitatively different from ambient outdoor, air. The term is also used to indicate visible fungal growth on surfaces and in wall cavities. Field services for this evaluation were •conducted on March 25`h and April 5`h, 2005 by staff hygienists whom are certified by DHS. and Cal/OSHA. Michael Lyssy, a State Certified As Consultant and Registered Environmental Assessor, coordinated the activities and reviewed the final report. Pacific Environmental Company 1 .i' ..r , Building Description The subject site is the Country Club building for the Gold Course at the La Quinta Country Club, located`at 77-750 Avenue 50, in La .Quinta, California. The country club facility was initially constructed over a slab on grade foundation between 1960 and 1962 and was in fair condition at the time of our site inspection. According to information obtained from management at La Quinta Country Club, members of the club are debating whether to renovate the facility or demolish the existing structures to build a new facility. Geological conditions underneath the facility have caused the structure to move as much as five inches in some locations. This movement has caused water lines to burst and other moisture related issues within the building, creating an environment conducive to mold growth. The country club is.a single -story structure that occupies 52,919 square feet, with an outdoor patio area adding an additional 2,815 square feet. The current facility is comprised of a clubhouse and maintenance area for the golf course. The center section of the clubhouse was built between 1960 and 1962, and is comprised of a lobby and reception area, with offices, restrooms, a lounge, and a main dining area. The pro shop is located just west of the dining room, and the director's room is located ,across the hall from the shop. The east wing of the building was built or renovated between 1989, and 1991 and contains the kitchen, laundry, staff dining room, administrative rooms, offices, restrooms, a small maintenance area, mechanical room, and various storage rooms. The locker room, gym, and spa facilities are located in the west wing of the building, which was renovated circa 1987. This area contains men's and women's locker rooms, card rooms, gyms, massage rooms, an aerobics room, barber, steam room, and various storage rooms. The area west of the locker rooms is comprised of golf cart storage, the central maintenance area, a lunchroom, offices, restrooms, poison storage room, and various other storage rooms. Interior wall finishes in the club include plaster, drywall, wood, plaster over drywall, and some block walls located in the golf cart storage' areas. Interior floorings include carpet over bare concrete, painted concrete, stone tile, ceramic tile, and limited applications of linoleum and vinyl floor tile. The ceilings are coated with acoustic material in select areas of the club and there are limited applications of ceiling tile present also. The exterior of the structure is stucco with limited applications of wood siding. The roof is divided into various levels, the center section of which is foam coated with a layer of tar underneath. The remaining fifty percent of the roof is composite sheeting, located on the east and west wings of the building. A parapet wall with decorative tile encircles a majority of the roof. All of the non -electrical and gas pipe runs we observed on the roof are insulated with fiberglass. Various ducting runs on the roof are insulated with a foam layer. According to communication.with club management, the roof is approximately five .years old. Pacific Environmental Company 2 4shestos — Containinc Asbestos -containing material (ACM) is defined by the Federal Environmental Protection Agency (EPA) as material containing more than one percent asbestos as determined by PLM. Title 8, Section .1529, of the California Code of Regulations, however, defines asbestos -containing construction material (ACCM) as any. manufactured construction material that contains more than one -tenth of one percent asbestos•by weight. A visual assessment of the suspect building materials located throughout the property was completed prior to the collection of samples. During the visual assessment, the'building materials suspected of containing asbestos were categorized by homogeneous areas. Materials are classified as homogenous when they appear uniform, have a consistent texture and appear to have been installed at the same time. The laboratory testing for the bulk samples was conducted in accordance with the recommended EPA, Interim Method for Determination of Asbestos in Bulk Samples (EPA-6OO/R-93/116, July 1993). Based on the results of our survey services, the following materials are classified as asbestos -containing materials (ACM) or asbestos -containing construction materials (ACCM): a Building Material Location Estimatedoty. West Room of Cart Storage &, 3,500 SF Two Stora a Rooms Adjacent to North Access Area Behind Kitchen Liquor Room 500 SF Visible'. Acoustic Ceiling Material Storage Area South Adjacent to Restrooms in 100 SF Women's Locker Room Multiple Layers of Vinyl Flooring Room Adjacent to Kitchen Restroom 90 SF Plaster Storage Loft Above Dining Room 500 SF Visible" Thermal Systems Insulation . Elbow Fittings Roof, Above Mechanical Room (Above Kitchen Area) 1 Elbow Visible — wore: vve were onry aoire ro access aoove me ceaing in certain areas, and therefore, although approximately 500 SF of acoustic material was visible, there may be additional material above the ceiling in this area. ' I "Note: We had limited access to this area during the site inspection. Approximately 500 SF of the plaster material was visible; however, there is likely additional material here that we were unable to access. This plaster is visibly different and is easily discernable from other plaster in the building. Prior renovations likely involved the removal of this material in other areas. —Note: There was only one TSI elbow visible at the time of the inspection; the majority of elbows observed were foam and the insulated pipes were covered with fiberglass. There may be additional TSI located within the walls that we were unable to access during our site inspection. The individual sample results are detailed in the following table: Sample Number Material Sampled Sample Location Analytical Results -Fdabllfty/, Condition 001 Stucco Exterior, East End ND N/D 002 Stucco Exterior, Cart Storage Area ND N/D 003 Stucco Exterior, Cart Storage South ND N/D 004 Stucco Exterior, Cart Storage South ND N/D 005 Stucco Exterior, Outside Men's Locker Room ND N/D 006 Stucco Exterior, North ND N/D Pacific Environmental Company 3 r a Sample Number Material Sampled Semple Location Analytical Results Friability/ Condition 007 Stucco Exterior Dining Area NO N/D 008 Roof Core Exterior, East Roof ND N/G 009 ' Penetration Mastic / Tar Exterior, East Roof, Parapet Supports ND N/G 010 Roof Core Exterior, West Roof NO N/G 011 Parapet Flashing Exterior, West Roof NO N/G 012 Penetration Mastic Exterior, West Roof Pipes ND N/G 013 Water Proofing Exterior, Roof - Under Clay Tiles NO N/G 014 Roof Core Exterior, Foam Covered Roof NO N/G 015 Roof Sheeting & Tar Exterior, HVAC Room Old Roofingon Wood Platform)NO N/D 016 Drywall / Joint Compound East Maintenance Room ND N/G 017 Drywall / Joint Compound Storage Next to Staff Dining Room ND N/G 018 • Drywall / Joint Compound Bar Area in Dining Room ND N/G 019 Drywall / Joint Compound Lounge NO N/G 020 Drywall / Joint Compound Women's Locker Room NO N/G 021 Drywall / Joint Compound Golf Cart Storage Room NO N/D 022 _ Drywall / Joint Compound Men's Card Room ND N/D 023 r Drywall Storage Loft Above Dining Room . ND N/D 024 Plaster Kitchen NO N/D -025 Plaster Men's Restroom, Kitchen ND N/D ' 026 Plaster Storage Loft Above Dining Room 2% Chrysotile N/D 027 Acoustic Ceiling Material West Room of Cart Storage 7% Chrysotile F/D 028 Acoustic Ceiling Material West Room of Cart Storage 7% Chrysotile F/D 029 Acoustic Ceiling Material West Room of Cart Storage 7% Chrysotile F/D 030 Linoleum, Grey Stones Men's Restroom, Kitchen NO N/D ' 031 Flooring Core (Wood Grain VFT on Top) Room Adjacent to Kitchen Restroom 14% Chrysotile N/D 032 Vinyl Floor Tile, Wood Grain Liquor Room, Kitchen ND N/D 033 Acoustic Ceiling Material Custodian's Room, Dining Area ND F/D 034' 12"xl2" Ceiling Tile Room Adjacent to Kitchen Restroom NO N/G 4/5 001 Acoustic Coatings Access Area Behind Liquor Room 2% Chrysotile F/G 4/5 002 Acoustic Coatings Access Area Behind Liquor Room NO F/G 4/5 003 Acoustic Coatings Access Area Behind Liquor Room ND F/G 4/5 004 Thermal Systems Insulation Elbow Roof, Above HVAC (Above Kitchen) 4% Chrysotile F/D , = - --y- rnauro. rnauuuy wues rv=rvun-mauie; r=rnauie ND=None Detected Condition: Condition Codes: G=Good; D=Damaged Limit of quantification is 1 % i r F t Pacific Environmental Company 4 a -. Paint Lead -based paint is of concern both as a source of direct exposure through ingestion of paint chips, and as - a contributor to lead interior dust and exterior soil. Lead was widely used as a major ingredient in most interior and exterior oil -based paints prior to 1950. Lead compounds continued to be used as corrosion inhibitors, pigments and drying agents from the early 1950's. In 1972,�the Consumer Products Safety Commission limited lead content in new paint to 0.5% (5000 ppm) and, in 1978, to 0.06% (600 ppm). For the purposes of this report, painted surfaces with readings at or above 1.0 mg/cm2 are considered positive for lead -based paint.. Cal/OSHA considers a paint to be lead -containing if it contains greater than 600 ppm (Title 8 CCR, Section 1532.1), which is below the limit of detection for the XRF used in this inspection. Prior to performing the Trigger.Tasks outlined in Section 1532.1, verification paint chip samples should be collected and analyzed to eliminate the potential for false negatives. Current industry standards suggest that when it is determined that paint abatement and/or interim control activities will be performed on components, they should be performed according to practices that will be described in the HUD Guidelines and the regulations to be promulgated under section 402 of the Toxic Substances Control Act (TSCA), 15 USC 2682. Testing of the painted surfaces was patterned after the inspection protocol in Chapter 7 of the HUD Guidelines for the Evaluation and Control of Lead -Based Paint Hazards in Housing (Revision 1997). The method employed for paint testing was X-Ray Fluorescence (XRF) using an EDAX MAP4 lead paint analyzer (Serial Number M41509), with the capability to measure the lead content in dry paint films, in the range of 0 to 50 milligrams per centimeter square. The on -site assessment capability of the XRF equipment typically reduces and may even eliminate the number of paint chip samples that may need to be collected and sent for laboratory analysis. The instrument's calibration was verified according to the manufacturer's specifications in compliance with the Performance Characteristic Sheet (PCS) developed for this instrument. The PCS. is located in the appendices, of, this report. The readings from this instrument produce a 95% confidence level that the "lead" reading accurately reflects the actual level of lead in the tested surfaces, relative to the federal action level. Title 17 defines "lead hazard" as deteriorated lead -based paint, lead contaminated dust, lead contaminated soil, disturbing lead -based paint or presumed lead -based paint without containment, or any other nuisance which may result in persistent ad quantifiable lead exposure.. SB 460 makes it illegal to create a lead hazard or to have a condition that is a lead hazard in residential or public buildings. The following table represents the results of our findings: Area LBP Components Interior Ceramic Wall and Shower Tile in Women's Locker Room Sampling for this inspection was representative and any components that were not tested, but are similar to those components that tested positive for LBP should be considered and treated as lead laden. Pursuant to Title 17, California Code of Regulations, Division 1, Chapter 8, a completed Department of Health Services (DHS) Form 8552 "Lead Hazard Evaluation Report" is included with this report and has been forwarded to the DHS, Childhood Lead Poisoning Prevention Branch. Pacific Environmental Company 5 Complete Removal to . Line Item Removal For' Facilitate Structural Demolition Renovations = West Room of Cart Storage & $13,000 $0 Asbestos • Acoustic Ceiling y Two Storage Rooms Adjacent to North Access Area Behind Kitchen Liquor $3 000 $0 Abatement. Material Room Storage Area South Adjacent to 11,000 $0 Restrooms in Women's Locker Room Multiple Layers of Vinyl Floorin Room Adjacent to Kitchen Restroom $500 $0 Plaster Storage Loft Above Dining Room - $3,500. $0 Thermal Systems Insulation Elbow Roof, Above Mechanical Room (Above $1,000 $0 Fittings Kitchen Area) Lead Abatement "Ceramic Shower Tile $3,000 $0 Mold Impacted Removal wall systems with elevated moisture in locker $0 .' $40,000 Materials room, steam room. Kitchen', liquor "room and men's restroom/chan a room in Kitchen area Totals $25,000.00 - $40,000.00 Y 'Limitations This report is not intended to. identify all hazards orunsafe conditions or to implyfthat others do not exist. The conclusions and recommendations presented herein are based upon the agreed scope of work outlined in this report and were necessarily limited to the information provided by the samples collected and laboratory -analysis completed. Pacific Environmental Company makes no warranties or guarantees as.to the accuracy or completeness of information provided, or compiled.by:others. This report is not a legal opinion. ',The services performed by Pacific Environmental Company have been conducted in a manner consistent with the level of care ordinarily exercised .by members of our profession currently practicing under similar conditions. No other warranty, expressed or implied, is rriade'regarding the quality, fitness, or results to be achieved as a consequence of this report or impacted by information not properly disclosed to Pacific at the time of this report. It further states that no responsibility is assumed for the control o'r correction of conditions or - practices existing at the premises of the client. Our liability•is limited to the fees charged for this project. Pacific Environmental Company 12 Mold Mold, also know as fungi, are a group of microscopic organisms that can be found virtually everywhere: indoors and outdoors. In the presence of continuous or excessive moisture, mold can reproduce rapidly to produce potentially adverse environmental conditions. It is our goal to determine if these conditions exist inside of the evaluated areas at the time and date of, our investigation. It' is generally accepted in the scientific and medical communities that molds can be allergenic, infectious, and can sometimes produce mycotoxins. There are no uniformly accepted numerical guidelines for the interpretation of microbial contamination. This absence of standardization makes it somewhat difficult to establish comprehensive conclusions about whether or not adverse conditions do exist. The conclusions drawn in this report are' intended to provide some basic interpretative information using certain assumptions and facts that have been extracted from a number of authoritative bodies and peer reviewed text. In the absence of set standards, the user of this information must determine the applicability of this report to each unique situation. Identification of the presence of a particular mold in an indoor environment does not necessarily mean the occupants are or are not being exposed to unhealthy conditions. Air sampling generally indicates the different types of bioaerosols, primarily mold spores, that are present in the ambient air in a referenced area. Air sampling is also used to reveal information concerning airborne spore diffusion and to determine if cross contamination is occurring between two separate areas. The collection of air samples is attained, in accordance with the commonly accepted protocol published by the American Industrial Hygiene Association. In the United Sates, no federal agency has clear authority to regulate exposure to biological agents associated with building related illnesses. Countable bioaerosols have no Permissible Exposure Limits (PELs), or Threshold Limit Values (fLVs) for the following reasons: the culturable/countable bioaerosols have no single entry; the human response range varies greatly from one individual to the next; it is not possible to collect and evaluate all bioaerosol components using a single sampling method; and the information relating bioaerosol concentrations to health effects is generally insufficient to describe exposure response. Due to the wide variety of microorganisms found across different regions of the United States and the influence of normal humidity and temperature conditions, the concentrations of bioaerosols vary significantly from area to area. With the absence of exposure limits, it is common industry practice, as supported by the American Conference of Governmental Industrial Hygienists (ACGIH) and the Environmental Protection Agency (EPA) guidelines, to compare outside bioaerosol concentrations and species to inside' bioaerosol concentrations and species. Generally speaking, the indoor air flora should be quantitatively lower than, but qualitatively similar (genus or species) to that of outdoor air. In this inspection, areas of contamination were identified through comparison to outdoor bioaerosol control samples and visual identification of impacted materials. Non -viable air sampling was performed using Air-O-Cell Cassettes. The Air-O-Cell Cassette utilizes spore - trap technology for the microscopic analysis of fungal spores, pollen, dust particles, and fibers. Most common fungal genera can be positively identified including Stachybotrys spores. Fungi such as Penicillium and Aspergillus can also be identified, but may be grouped together as indistinguishable. The sampler was used with the conventional method of calibration by mounting a rotameter to the pump and adjusting the flow rate to 15 liters per minute (Ipm). To prevent cross contamination during sampling, the tubing was cleaned between every use. Standard laboratory alcohol wipes were used for this procedure. Field personnel thoroughly wiped the top and the backside air inlet (venturi) on the top cap to prevent any contamination between sampling episodes. The results are reported as total, meaning they include both viable and non- viable fungal spores. Facilities management personnel report of several water intrusion events over the years which in turn were the areas that we focused our evaluation on. The results of the sampling are detailed`in / the following tables: Pacific Environmental Company 6 ' Sample No. Sample No. Sample Location a Total Spore Count Count/M3 Total Spores Present Count/M3 Sam le Result s- Basidiospores 13 001 Southeast Offices 493 Cladosponum 160 Negative Penicillium/Aspergillus 320 ' Basidiospores 53 002 Women's Locker Room 132 Bipolaris/Drechslera 13 - Negative � • - Cladosponum 53 , Smuts, Periconia Myxomycetes. 13 ~' Basidiospores 53 003 Men's Locker Room 119 Other Brown 13 Negative Penicillium/Aspergillus 53 004 Dining Area 40 • • Alternana 27 Basidiospores 13 {Negative w Basidiospores 53 ' ; Botrytis 43 • ` 005 Kitchen, Men's 412 Cladosponum 53 Trace Restroom Other Brown 13 - PenicilliurrVAspergillus 267 Ulocladium 13 - 006 Outside Control > 280 y Asospores 107 Basidiospores 160 Control Sample Smuts, Penconia, Myxomycetes 13 (for comparison) Wall Chek-Women's 007 • Locker Room Wall 33, Other Brown 33 Negative Cavity s Chaetomium 133 - Wall Chek, Men's t A PenbIllum/Aspergillus 4,800 " r " 008 Steam Room Wall . 5,467 Smuts, Penconia, Myxomycetes 67 Positive { Cavity a , Stachybotrys 467 1 009 Wallchek, South east Office Wall Cavity 11200 • Penicillium/Aspergillus 1,200 Trace i Liquor Room Wall Penicillium/Aspergillus 1,870 010 ` Cavity 2,370 Stachybotrys 500 Positive t Basidiospores 53 - 012 Liquor Room 734 Cladosponum 53 Positive Penicilllurr✓Aspergillus 1,870 . • Stachybotrys 500 , By Steam Room, ' R Ascospores 53 _ 013 outside hallway 11.9 Basidiospores 53. Negative Other Brown 13 s • Pacific Environmental Company 7 Sample No. Sample Location Total Spore Count Count/M3 Total Spores Present Count/M3 Sam le Result 015 Bar RoomDining Area 106 Cladosponum 53, Negative PenicilliumlAspergillus 53 Men's Restroom near" Cladosponum 480 016 Kitchen 706 PenicilliumlAspergillus 213 Negative Smuts, Penconia, Myxomycetes. 13 BipolanslDrechslera 13 017 Southeast Office 79 PenicilliumlAspergillus 53 Negative Smuts, Penconia, Myxomycetes. 13 Ascospores 267 Basidiospores 53 Control Sample 018 Control Sample, Exterior 1,200 Cladosponum 480 PenicilliumlAspergillus 373 (for Comparison) Smuts, Periconia, Myxomycetes.27, Two swab samples were also collected from surfaces that appeared to have mold growth present during the inspection: one from a wall surface in the Liquor .Room and one from beneath the carpet outside of the steam room. The results of the direct microscopic analysis did indicate the presence of Stachybotrys contamination in these, areas. Specific comments for these areas are detailed in the descriptions, below C The potential areas of concern that were brought to our attention and subsequently evaluated included the following: Kitchen: It was reported that, during a prior renovation project, portions of a wall collapsed revealing extensive mold growth. The source of water intrusion was reportedly repaired and the renovations were completed. It is unknown if all impacted materials were removed during the renovation. Moisture levels in the northwestern and western walls were elevated at the time of our evaluation. Based on the air sampling,. results, there does not appear to be active mold proliferation on the general kitchen area; however given the conditions of the saturated walls, the conditions are present for potential contamination. The source of the moisture`should be evaluated and repaired, in order to prevent future microbial amplification. Kitchen Area Men's.Changing Room/Restroom: There apparently was a fire in this area which has resulted in subsequent roof leaks. Moisture levels of the wallboard materials were elevated at the time of our inspection and the air sample indicates slightly elevated levels of. PenicilliumlAspergillus type spores. Given the conditions of the saturated walls, the conditions are present for potential contamination. The source of the moisture should be evaluated and repaired, in order to prevent future microbial -amplification. Women's Locker Room: Moisture levels on the west and northwest walls in the locker room are elevated, and we were told that the locker room has a history of some past flooding. The results of the air sampling in this area do not indicate aerosolized mold contamination. The source of the moisture should be evaluated . and repaired, in order to prevent future microbial, amplification. ReceptionlEast Ofces: Occupants have mentioned allergenic -like symptoms that would be typical of mold proliferation here; however, there were no substantial indications of past water damage and the sir samples , are typical. of normal air conditions. Pacific Environmental Company 8 . Steam Room: Given the "wet" nature of this area, there is always 'a concern for potential microbial growth. Wood trim and portions of the walls have been replaced. The carpet outside of the steam room is excessively moist and there are indications .of contamination one the floor below the carpet. This is not an uncommon or unexpected condition for this type of area, given the excessive moisture created. by the -steam, and the cellulose -rich material that is generally used, in' carpet backing. The wall cavity that we sampled has been impacted with mold growth; however, the ambient air near the entry is clean. Our recommendations for , this area are to replace the carpet near the door with a finish material that is more resistant to water, and to evaluate the perimeter wall construction and remove/replace impacted wall materials in'an effort to restrict future moisture from impacting the wall cavities. Access Area Behind Liquor Room: A poition of'the wall has collapsed as a result of past water intrusion. The air sample and the swab sample of the impacted areas indicate growth of Stachybotrys spores. These types of spores are generally regarded as very, unhealthy; the'source of water intrusion needs to be rectified and the impacted materials need to be removed and replaced. General Comments:, There are indications of water staining in,the east areas of maintenance. Given the' separation issues at the clubhouse, the potential for old and new water conduits associated with roof expansion is high. While the roof may be only five years old' there are likely historical areas throughout the facility that have microbial contamination that is trapped be_ hind ' ceilings and inside of wall cavities,' as, evidenced by the past"issues that were relayed to us. a Pacific Environmental Company 9 Asbestos -Containing Materials The identified asbestos -containing acoustic ceiling material, flooring materials, plaster, and TSI elbows need to be removed by a licensed and certified asbestos abatement contractor if they are going to, be affected by renovation , or demolition activities. Otherwise, the identified ACMs are in good condition and can be managed in place. Asbestos must be handled in strict accordance with the various federal, state, and local regulations. Failure to abide by these regulations can result in penalties to,both the contractor as well as the owner. Detailed below are the regulations and procedures to follow when working with ACM at the property. All asbestos related work must be completed in accordance with the following regulations: o South Coast Air Quality Management District Rule 1403 Requirements o National Emissions Standards for Hazardous Air Pollutants, 40 CFR 61, M o Occupational Safety and Health Administration, Asbestos in the Workplace, 29 CFR 1910.1001 o Occupational Safety and Health Administration, Asbestos Construction Standard, 29 CFR 1926.1101 o Title 8; California Code of Regulations Section 1529, Cal -OSHA Construction Standard All asbestos waste must be properly disposed of and documented. Waste Manifests must be submitted at the end of a project. Disposing of a known hazardous waste is illegal in the State of California. Every effort was made to sample all of the building materials, however some materials may have been concealed and could not be exposed without demolition. If any additional materials are encountered during the renovation or demolition activities, please call us and we will sample and analyze accordingly. Lead -Based Paints The greatest potential for lead exposure from lead painted or glazed architectural components occurs when the paint has become defective, when the paint is applied to a friction or impact component where the paint is continually disturbed or when the paint is disturbed through routine maintenance, renovation or demolition activities. The only identified lead components were ceramic finishes in the women's locker room showers. The lead is likely in the glazing of the tile and does not present a hazard in its' current 'condition. If the tile is to be impacted by renovation or demolition activities, then it should be removed by' certified personnel utilizing appropriate engineering controls and personal protective equipment. All future work that will involve the disturbance of the LBP the should be completed in accordance with the .following regulations. o Title 17, California Code of Regulations, Division 1, Chapter 8: Accreditatiort, Certification and Work Practices for Lead -Based Paint and Lead Hazards. o Title 8, California Code of Regulations, Section 1532.1: Cal/OSHA Construction Safety Orders, Lead. Pacific Environmental Company 10 ` C ' r ` o "Guidelines for the Evaluation and Control of Lead -Based Paint Hazards in Housing," US Department of Housing and Urban. Development, June 1995 o All waste generated from any lead related work must be properly profiled and disposed of. Waste manifests documenting the disposal site will need to be submitted at the end of each phase of the job. MMMMMMM1T1 Please note that our findings and recommendations are based on our observations, moisture analysis and analysis of available testing data and laboratory results. Any irregular health related symptoms suspected should be discussed with a physician. This report is based on the conditions at the time of the inspection. All sources of the moisture should be evaluated and repaired, in order to prevent future microbial amplification in the areas that we noted. Any mold related demolition work should be conducted by trained personnel utilizing appropriate engineering controls and proper personal protective equipment in conjunction with industry standards. We have made several specific recommendations for the individual areas evaluated in this report and,. as stated previously, based on the separation issues at the clubhouse, the potential for old and new water conduits associated with roof expansion is high and there are likely historical areas throughout the facility that have microbial contamination that is trapped behind ceilings and inside of wall cavities. General Recommendations and Cost -to -Cure Budgets { Pacific Environmental recommends that all future renovation, demolition, construction or abatement activities with the potential for disturbing identified hazardous building materials, be performed by properly trained and .qualified personnel. -These activities should. employ state-of-the-art techniques, and be conducted in accordance with all applicable local, State and Federal laws and regulations. For future planning purposes, we are providing the following rough estimates for abatement of the identified . .materials. These figures are;estimates based on current wage rates, estimated quantities and site conditions. The figures provided in this rough order of magnitude estimate are in no way a quote for the abatement services. You will need to have a licensed and, certified abatement contractor provide a proposal for the abatement,work. The costs associated with hazardous materials removal for renovation will depend on the areas, that are renovated. If the identified ACM and LBP materials are not going to be disturbed by the renovations, then abatement is not required. For individual items that will be affected, you can use the unit costs provided in the Complete Removal column for planning purposes as well. There is no mold remediation necessary if the building is demolished. The figures' provided for mold remediation if the building is to be renovated do not take into account the .costs associated with building back affected areas. Another point for consideration associated with any abatement is the potential "down time" that -will be required while the abatement efforts are being carried out.' During abatement, access to the affected areas will need to be restricted to authorized personnel only. f, Pacific Environmental Company 11 l' References Title 17, California Code of Regulations, Division 1, : Chapter 8: Accreditation, Certification and Work' Practices for Lead -Based Paint and Lead Hazards. Title 8, California Code of Regulations, Section1532,1: Cal/OSHA Construction Safety Orders, Lead. "Guidelines for the Evaluation and Control „of Lead -Based Paint Hazards in Housing," US Department of Housing and Urban Development; June 1995 South Coast Air Quality Management District Requirements National Emissions Standards for Hazardous Air Pollutants, 40 CFR 61, M Occupational Safety and Health Administration; Asbestos in the Workplace, 29 CFR 1910.1001 Occupational Safety and Health Administration, Asbestos Construction Standard; 29 CFR 1926.1101 Title 8, California Code of Regulations Section 1529, Cal -OSHA Construction Standard Pacific Environmental Company 13 - r Site •- Location o 021 020 033 T7. 027 03 005 r , 4 - - - • f ' •. ^ . - .. _ " • yr. .! ♦ . .. K ,, .• v , r _ * ... s. , t + , DATE PREPARED: -. DRAWN BY: DRAWING TITLE: • _ 4/18/2005 ML Site and Sample Location' Plan • F:,i1 REVISION: REVISION DATE: La Qulnta Country Club • V 77-750 Avenue 50 - r • ®- PROJECT NO: r + APPROX. SCALE: La Qulnta, California _ - n 05076 NTS - NAME: CLIENT: �FIGURE NO.Ej 77Z zardous Building Materials Investigation, La Quinta Country Club 9050L-631 N Dade: PACIFIC ENVIRONMENTAL COMPANY1-4 Chen Site: itl1 �U:vrl �' : cc: iris : SLle 107 _ a ! ��cc3 w,�_w° .;-li-x:t:a °2�• r7 P ;,'•q�``ti.•-'--"-•%� • . "�;�"{£':s-7?''f: ins ASBESTOS BULK SAMPLE FIELD AND DRAW OF CUSTODY Sample Materrat Sampled Sample Location Number f `` � A Iti� l �'ZO�•:+►�4 r•-1 � CW) WAS A-rat-70 rrblE Fftbkv- r,cdes- Pi=�t-i : f=F:iahjE tvr_f4e`-e G*et-!ee r_ems:n Co-.f k-q Caces G= or-d. D=� gged Anatyt ea; Metbad: Pi. M • Turn Arod i aloe:Ln 1 0 - ` m m N 1 N m to t..a C�,;r,�•. C� C �b 40: Sean Tittema ' '1Uantity ' Analytical i Friability Condition !Results t --- CHAIN OT CUSTODY: Sean Tilterna zr ter— t I=e Elfblow Narne sowaffe lime " 905Q31�31 Date* PACIFIC ENVIROMMENTAL COMPANY C !�� cam; .01 Tv Su 07 Pr Ct No: d i- IJ"2 NlL"iWi- _ B If :'i:l'3 92e 3 .!t".'•r��. Ins!edorfS Sean Tffiema ASBESTOS BULK SAMPLE FIELD LOG AND GRAIN OF CUSTODY :Analytical : Friability Cattd�fiot: � f: Same Locatior sample ' �!Ateriai armpl Cuantit; Results i } Number e OZ a � � 41 b� rat K R r kiwi v Q ZrlCilrlKametwe m j to � m r M Fi+lFw'e: NA=NCir'1r:a'yzad FZbbe_Fr.� ' �s�es: N= en Nik'ri; rla �p� C� �'r. Co �n Ca:es C�ia: i dr=;ram L0 04 Analytical Method. PLM �) Turn Aromd Time: 44~� . CD i� fa ,� N m 1 1 - CHAIN OF CUSTODY-. - i Sean i dlema f °� sda�ne S� _ "� j - i ' llama signmre mm 1 t PACIFIC ENVIRONMENTAL. COMPANY 30101 Town Center Drive, Suite 107 Laguna Niguel: California 926T7 (949)363-72Q0 • Fax (49)363-7110 ASBESTOS BULK SAMPLE FIELD LOG ARID CHAIN OF CUSTODY Date: went: l� (20 44. — Sde: � F VOW W. Ins - Sean -Mlema UUDU41123 - Number MaWn"al Sampled Sample Location Qua.ft Ana dal Re ( Friabi�ty I Condition z i I i c i i ►va-a�ui.v-aryQa+ nrau�: rrwoo�cy awu� iv-rti�rw�sue. r-rrrn.�a , ,Aif�hoae CetecLd Cwdti tM Cc=- ion Codas- G Good: 0=cW-'0gw _ CHAIN OF CUSTODY: • Sean i diema (/Q Tum Around Time: 24 Hcur tVz�nr r ' Tuna [fie SigrAre [}abeliime m A m m N i9 m cn w Lo w m m w A 1-+ A T A . D r m A m A XRF InspectionData UNDERSTANDING THE INSPECTION DATA The following information has been provided as a guide to interpreting the data inthe following -reports. 1. Project Name <- Name and address of the project for this inspection. 2. Project'Number Identifying Project Number. This number should be included regarding any inquiries about this project. 3. Instrument ` Name of XRF manufacturer: 4. Unit Name or identifying information about the unit inspected. 5. Area This field is used to differentiate interior, exterior, room or areas. 6. Component Name of architectural component tested. 7. Location. Side of room where tested component is located. "A" side is the entry or street side. "B", "C", "D" sides are directly to the right, or. clockwise from the ''A" side. A number to the right of the side (A2) indicates a replicate ` component on the same side of the room. For interior components, replications are counted from, left to right (clockwise). Where there is no definitive street side, locations are identified as north, south, east and west. 8. Color Color of the top layer of the paint. 9. Substrate The surface directly under the paint. 10. Condition The condition of the paint. 11. Pb (mg/cm2) ; The amount of lead on the painted surfaces.' 12. Result A reading is positive if it is equal to or -greater than the federal action level. FIELD DATA REPORT PROJECT NAME: La Quinta Country Club, 77-750 Avenue 50, La Quinta, California PROJECT NO.:05076 INSTRUMENT: MAP4 Unit Area Component Location Substrate Condition Color Pb m cm2 Results Clubhouse Exterior Wall A Stucco Intact Tan 0.0 Ne ative Clubhouse Exterior Wall B Stucco Intact Tan 0.0 Clubhouse Exterior Wall C Stucco Intact Tan 0.3 -Negative Ne ative Clubhouse _ Exterior Wall D Stucco Intact Tan 0.0 Negative Clubhouse Exterior Maintenance Patio Steel N/A Metal Defective Tan 0.3 Negative Clubhouse Exterior Patio Handrails C Metal Intact Tan 0.4 Negative Clubhouse Exterior Patio Support Posts C Wood Intact Tan 0.0 Negative Clubhouse Exterior Patio Ceiling C Wood Intact Tan 0.1 Ne ative Clubhouse Exterior Patio Window Frame C Wood Intact Tan 0.0 Negative Clubhouse Exterior Fascia C Wood Intact Tan 0.4 Negative Clubhouse Exterior Roof HVAC Mechanical Wall D Brick Intact Tan 0.0 _Negative Women's Locker Rm Bathroom Wall A Drywall Intact Peach 0.1 Negative Women's Locker Rm Bathroom Wall B Drywall Intact Peach 0.2 Negative Women's Locker Rm Bathroom Wall C Drywall Intact Peach 0.0 Negative Women's Locker Rm Bathroom Wall D Drywall Intact Peach 0.0 Ne ative Women's Locker Rm Bathroom Ceiling N/A Drywall Intact Peach 0.1 Ne ative Women's Locker Rm Bathroom Lower Cabinet B Wood Intact Peach 0.1 Negative Women's Locker Rm Bathroom Ceramic Floor Tile N/A Ceramic Tile Intact White 0.4 Negative Women's Locker Rm Bathroom Ceramic WaIVShower Tile D Ceramic Tile Intact White/Tan 12.3 Positive Women's Locker Rm Game Room Wall A Drywall Intact Peach 0.0 Women's Locker Rm Game Room Wall B Drywall Intact Peach 0.2 -Negative _Negative Women's Locker Rm Game Room Wall C Drywall Intact Peach 0.1 Negative Women's Locker Rm Game Room Wall D Drywall Intact Peach 0.1 Negative Women's Locker Rm Game Room Door C Wood Intact Peach _ 0.1 Negative Women's Locker Rm Game Room Support Columns N/A Drywall/Concrete Intact Peach 0.3 Negative Women's Locker Rm Game Room Door Frame C Wood Intact Peach 0.1 Negative Women's Locker Rm Locker Area Wall A Drywall Intact Peach 0.2 Negative Women's Locker Rm Locker Area Wall B Drywall Intact Peach 0.1 Negative Women's Locker Rm Locker Area Wall C Drywall Intact Peach 0.1-- Negative Women's Locker Rm Locker Area Wall D Drywall Intact Peach 0.2 Negative Women's Locker Rm Restroom Near Massage Rm Wall A Drywall Intact White 0.0 Negative Women's Locker Rm Restroom Near Massage Rm Wall B Drywall Intact White 0.1 Negative Readings are expressed in mg/cm2 The HUD/EPA action level for lead -based paint is 1.0 mg/cm2 Negative readings are below LOD for XRF FIELD DATA REPORT PROJECT NAME: La Quinta Country Club, 77-750 Avenue 50, La Quinta, California PROJECT NO.: 05076 INSTRUMENT: MAP4 Unit Area Componentm Location Substrate Condition Color Pb cm2 Results Women's Locker Rm Restroom Near Massage Rm Wall C Drywall Intact White 0.1 Negative Women's Locker Rm Restroom Near Massage Rm Wall D Drywall Intact White 0.1 Negative Women's Locker Rm Restroom Near Massage Rm Baseboard D Ceramic Tile Intact White 0.1 Ne ative Women's Locker Rm Restroom Near Massage Rm Door A Wood Intact White 0.1 Ne ative Women's Locker Rm Restroom Near Massage Rm Door Frame A Metal Intact White 0.0 Negative Women's Locker Rm Restroom Near Massage Rm Ceiling N/A Drywall Intact White 0.1 Negative Women's Locker Rm Restroom Near Massage Rm Ceramic Wall Tile C Ceramic Tile Intact White 0.1 Negative Women's Locker Rm Restroom Near Massage Rm Ceramic Floor Tile N/A Ceramic Tile Intact White 0.0 Negative Women's Locker Rm Restroom Near Massage Rm Ceramic Shower Tile D Ceramic Tile Intact White 0.1 Negative Golf Cart Storage Men's Restroom Wall A Drywall Intact White 0.0 Negative Golf Cart Storage Men's Restroom Wall B Drywall Intact White 0.0 Negative Golf Cart Storage Men's Restroom Wall C -Drywall Intact White 0.0 Negative Golf Cart Storage Men's Restroom Wall D Drywall Intact White 0.0 Negative Golf Cart Storage Men's Restroom Ceramic Wall Tile C Ceramic Tile Intact White 0.0 Negative Golf Cart Storage Men's Restroom Ceramic Floor Tile N/A Ceramic Tile Intact White 0.4 Negative Men's Locker Rm Restrooms Ceramic Wall Tile A Ceramic Tile Intact Blue 0.2 Negative Men's Locker Rm Restrooms Ceiling N/A Drywall Intact White 0.1 Negative Men's Locker Rm Restrooms Ceramic Floor Tile N/A Ceramic Tile Intact Blue 0.1 Negative Men's Locker Rm Shower / Sauna Room Ceramic Wall Tile A Ceramic Tile Intact Blue 0.1 Negative Men's Locker Rm Shower / Sauna Room Ceiling N/A Drywall Intact White 0.2 Negative Men's Locker Rm Shower / Sauna Room Ceramic Floor Tile N/A Ceramic Tile Intact Blue 0.0 Negative Men's Locker Rm Gaming Room Wall A Drywall Intact Wallpaper 0.1 Negative Men's Locker Rm Gaming Room Wall B Drywall Intact Wall -paper 0.2 Negative Men's Locker Rm Gaming Room Wall C D all Intact Wallpaper 0.1 Negative Men's Locker Rm Gaming Room Wall D Drywall Intact Wallpaper 0.1 Negative Men's Locker Rm Gaming Room Ceiling Woodwork N/A Wood Intact Beige 0.1 Negative Men's Locker Rm Gaming Room Window Frame A Wood Intact White 0.1 Negative Men's Locker Rm Gaming Room Ceiling N/A Drywall Intact Beige 0.2 Negative Men's Locker Rm Gaming Rm. Restroom Wall A Drywall Intact White 0.0 Ne ative Men's Locker Rm Gaming Rm. Restroom Wall B Drywall Intact White 0.0 Negative Men's Locker Rm Gaming Rm. Restroom Wall C Drywall Intact White 0.0 Negative Men's Locker Rm Gaming Rm. Restroom Wall D Drywall Intact White 0.0 Negative Readings are expressed in mg/cm2 The HUD/EPA action level for lead -based paint is 1.0 mg/cm2 Negative readings are below LOD for XRF FIELD DATA REPORT PROJECT NAME: La Quinta Country Club, 77-750 Avenue 50, La Quinta, California PROJECT NO.:05076 INSTRUMENT: MAP4 ` Unit Area Component Location Substrate Condition Color Pb m cm2 Results Men's Locker Rm Gaming Rm. Restroom Door C Wood Intact _ White 0.1 Negative Men's Locker Rm Gaming Rm. Restroom Ceramic Wall Tile B Ceramic Tile Intact Peach 0.2 N_e qative Men's Locker Rm Gaming Rm. Restroom Door Frame C Wood Intact White 0.1 Ne ative Men's Locker Rm Gaming Rm. Restroom Ceiling N/A Drywall Intact White _ 0.0 Negative Men's Locker Rm Gaming Rm. Restroom Ceramic Floor Tile N/A Ceramic Tile Intact Peach 0.2 ative Dining Main Corridor Wall A Plaster Intact White 0.1 _Ne Negative Dining Main Corridor Wall B Plaster Intact White 0.0 Negative Dining Main Corridor Wall C Plaster Intact White 0.1 Ne ative Dining Main Corridor Wall D Plaster Intact White 0.1 Negative Dining Main Corridor Stained Wood Components N/A Wood Intact Tan 0.0 Negative Dining Main Corridor Door Frame C Wood Intact White 0.3 Negative Dining Main Corridor Floor Tile N/A Ceramic Tile Intact Mauve 0.0 Negative Dining Restrooms Wall A Drywall Intact Wallpaper 0.1 Negative Dining Restrooms Wall B Drywall Intact Wallpaper 0.0 Negative Dining_ Restrooms Wall C Drywall Intact Wallpaper 0.0 Negative Dining Restrooms Wall D Drywall Intact Wallpaper 0.0 Negative Dining Restrooms Ceiling N/A Drywall Intact Beige 0.1 Negative Clubhouse Administration Offices Wall A Drywall Intact White 0.1 Negative Clubhouse Administration Offices Wall B Drywall Intact White 0.0 Negative Clubhouse Administration Offices Wall C Drywall Intact_ White 0.0 Negative Clubhouse Administration Offices Wall D Drywall Intact White 0.0 Negative Clubhouse Administration Offices Door Frame C Wood Intact White 0.1 Negative Clubhouse Administration Offices Window Frame A Wood Intact White 0.1 Clubhouse Administration Offices Ceiling N/A Drywall Intact White __Negative 0.0 Negative Clubhouse Dining Room Mix of Walls & Wood A Plaster Intact White 0.1 Negative Clubhouse Dining Room Mix of Walls & Wood B Plaster Intact White 0.2 Negative Clubhouse Dining Room Mix of Walls & Wood C Plaster Intact White 0.1 Negative Clubhouse Dining Room Mix of Walls & Wood D Plaster Intact White 0.1 Negative Clubhouse Kitchen Wall A Plaster Intact White 0.1 Negative Clubhouse Kitchen Wall B Plaster Intact White 0.0 Negative Clubhouse Kitchen Wall C Plaster Intact White 0.0 Ne ative Clubhouse Kitchen Wall D Plaster Intact White 0.2 Ne ative Readings are expressed in mg/cm2 The HUD/EPA action level for lead -based paint is 1.0 mg/cm2 Negative readings are below LOD for XRF 3 r , FIELD DATA REPORT PROJECT NAME: La Quinta Country Club, 77-750 Avenue 50, La Quinta, California 1 PROJECT NO.:05076 INSTRUMENT: MAP4 Unit Area .,Component Location Substrate Condition ' Color- Pb m cm2 Results Clubhouse Kitchen Door Frame D Wood Intact White 0.1 Negative Clubhouse Kitchen Ceiling N/A Plaster Intact White 0.2 Ne ative Clubhouse Kitchen Ceramic Floor Tile N/A Ceramic Tile Intact Brown 0.5 Negative _ Kitchen Liquor Room Wall A Plaster Intact White 0.1 Negative Kitchen Liquor Room Wall B Plaster Intact White 0.2 Negative Kitchen Liquor Room Wall C Plaster Intact White 0.2 Negative Kitchen Liquor Room Wall D Plaster Intact White 0.2 Negative Kitchen Liquor Room Door C Wood Intact White 0.2 Ne ative Kitchen Liquor Room Door Frame C Wood Intact White 0.1 Negative Kitchen Liquor Room CeilingN/A Plaster Intact White 0.1 Ne ative Kitchen _ Restroom Wall A Plaster Intact White 0.1 Neciative Kitchen Restroom Wall B Plaster Intact White 0.0 Negative Kitchen Restroom Wall C Plaster Intact' White 0.0 Negative Kitchen Restroom Wall D Plaster Intact White 0.0 Negative Kitchen _ Restroom Door C Wood Intact White 0.1 Negative Kitchen Restroom, Door Frame C Wood Intact White 0.0 Negative Kitchen Restroom Ceiling N/A Plaster Intact White 0.0 Negative r Readings are expressed in mg/cm2 The HUD/EPA action level for lead -based paint is.1.0 mg/cm2 Negative readings are below LOD for XRF 4 Environmental Microbiology Laboratory, Inc. 1010 N Central Avenue, Glendale, CA 91202 (858) 569-5800 Fax (858) 569-5806, www.emlab.com Client: Pacific Environmental Company . Date of Submittal: 04-08-2005 C/O: Mr. Michael Lyssy Date of Receipt: 04-08-2005 Re: La.Quinta Country Club Date of Report: 04-11-2005 DIRECT MICROSCOPIC EXAMINATION REPORT Background Miscellaneous MOLD GROWTH: Molds seen Other General Debris and/or Spores Present* with underlying mycelial and/or Commentstt Impression Description sporulating structures' Lab ID -Version$: 632571-1: Swab sample 011: Liquor room 'Light Very few 3+ Stachybotrys species None Mold growth < '1+ brown hyphae with no associated spores, ID unknown Lab ID -Version: 632572-1: Swab sample 014: Outside steam room under carpet Light Very few 3+ Stachybotrys species None Mold growth * Indicative of normal conditions, i.e. seen on surfaces everywhere. Includes basidiospores (mushroom spores), myxomycetes, plant pathogens such as ascospores, rusts and smuts; and a mix of saprophytic genera with no particular spore type predominating. Distribution of spore types ` seen mirrors that usually seen outdoors. t Quantities of molds seen growing are listed in the MOLD GROWTH column and are graded 14 to 4+, with 4+ denoting the highest numbers. tt Some comments may refer to the following: Most surfaces collect a mix of spores which are normally present in the outdoor environment. At times it is possible to note a skewing of the distribution of spore types, and also to note "marker" genera which may indicate indoor mold ` growth. Marker genera are those spore types which are present normally in very small numbers, but which multiply indoors when conditions are favorable for growth. t o "Version" greater than 1 indicates amended data. y I t a • Y r a r EML ID: 144074, Page I of 1 Client: Pacific Environmental Company C/O: Mr. Michael Lyssy Re: La Quinta Country Club Environmental Microbiology Laboratory, Inc.` 1010 N Central Avenue, Glendale, CA 91202 (858) 569-5800 Fax (858) 569-5806 www.emlab.com Date of Submittal: 04-08-2005 Date of Receipt: 04-08-2005 Date of Report: 04-11-2005 SPORE TRAP REPORT: NON -VIABLE METHODOLOGY Location: 001: Southeast office 002: Women's locker room 003: Men's locker room 004: Dining area Comments (see below) A None None None Lab ID -Version$: 632553-1 632554-1 632555-1 632556-1 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 Alternaria 2 27 Arthrinium Ascos ores* Aureobasidium Basidios ores* 1 13 4 53 4 53 1 13 Bi olaris/Drechslera group 1 13 Botrytis Chaetomium Clados orium 12 160 4 53 Curvularia E icoccum Fusarium M rothecium Ni ros ora Other brown 1 13 Other colorless Penicillium/As er illus !yvest 24 320 4 53 Pithom ces Rusts* Smuts*, Periconia, Myxom cetes* 1 13 Stachybotrys " Stem h lium Torula Ulocladium Unknown Zygomycetes Background debris 1-4+ 2+ 2+ 2+ 2+ Sample volume (liters) 75 75. 75 , 75 TOTAL SPORES/M3 493 132 1 1 119 40 Comments: A) 12 of the raw count Penicillium/Aspergillus type spores were present as a single clump. * Most of these spore types are not seen with culturable methods (Andersen sampling), although some may appear as non-sporulating fungi. Most of the basidiospores are "mushroom" spores while the rusts and smuts are plant pathogens. t The spores of Asperglllus and Penicillium (and others such as Acremonium, Paecdomyces) are small and round with very few distinguishing characteristics. They cannot be differentiated by non -viable sampling methods. Also, some species with very small spores are easily missed, and may be undercounted. tt Background debris indicates the amount of non -biological particulate matter present on the trace (dust in the air) and the resulting visibility for the analyst. It is rated from 1+ (low) to 4+ (high). Counts from areas with 4+ background debris should be regarded as minimal counts and may be actually higher than reported. Background debris also affects the reporting limit for some spore types. The reporting limit is dependent on spore size, background debris, sample volume, and the percentage of the trace analyzed. It is important to account for sample volumes when evaluating dust levels. The minimum reporting limit is based on a raw count of one, which the lowest count'that can be detected. t A "Version" greater than 1 indicates amended data. EML ID: 144074, Pagel of 4 `r 1 Client: Pacific Environmental Company C/O: Mr. Michael Lyssy Re: La Quinta Country Club Environmental Microbiology Laboratory,'Inc. 1010 N Central Avenue, Glendale, CA 91202 (858) 569-5800 Fax (858) 569-5806 www.emlab.com Date of Submittal: 04-08-2005 Date of Receipt: 04-08-2005 Date of Report: 04-11-2005 SPORE TRAP REPORT: NON -VIABLE METHODOLOGY Location: 005: Kitchen, men's RR 006: Control, exterior 007: Wall check, women's locker 008: Wall check, men' s steam room Comments (see below) None None None None LabID-Version$: 632557-1 632558-1 632559-1 632560-1 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 Alternaria Arthrinium Ascos ores* 8 107 Aureobasidium Basidios ores* 4 53 12 160 Bi olaris/Drechslera group Botrytis 1 13 ' Chaetomium 4 133 Clados orium 4 53 Curvularia E icoccum Fusarium Myrothecium Ni ros ora Other brown 1 13 1 33 Other colorless Penicillium/As er illus typestypest 20 267 144 4 800 Pithom ces - Rusts* Smuts*, Periconia, Myxomycetes* 1 13 2 67 Stachybotrys 14 467 Stem h lium Torula Ulocladium 1 13 Unknown Zygomycetes Background debris 1-4+ 2+ 2+ 4+ 4+ Sample volume (liters) 75 75 30 30 TOTAL SPORES/M3 412 280 33 5 467 Comments: * Most of these spore types are not seen with culturable methods (Andersen sampling), although some may appear as non-sporulating fungi. Most of the basidiospores are "mushroom" spores while the rusts and smuts are plant pathogens. t The spores of AspergiUus and Penicillium (and others such as Acremonium, Paecilomyces) are small and round with very few distinguishing characteristics. They cannot be differentiated by non -viable sampling methods. Also, some species with very small spores are easily missed, and may be undercounted. tt Background debris indicates the amount of non -biological particulate matter present on the trace (dust in the air) and the resulting visibility for the analyst. It is rated from 1+ (low) to 4+ (high). Counts from areas with 4+ background debris should be regarded as minimal counts and may be actually higher than reported. Background debris also affects the reporting limit for some spore types. The reporting limit is dependent on spore size, background debris, sample volume, and the percentage of the trace analyzed. It is important to account for sample volumes when evaluating dust levels. The minimum reporting limit is based'on a raw count of one, which the lowest countthaf can 'be detected. t A "Version" greater than I indicates amended data. EML ID: 144074, Page 2 of 4 1. Client: Pacific Environmental Company C/O: Mr. Michael Lyssy Re: La Quinta Country Club Environmental Microbiology Laboratory, Inc. 1010 N Central Avenue, Glendale, CA 91202 (858) 569-5800 Fax (858) 569-5806 www.emlab.com Date of Submittal: 04-08-2005 Date of Receipt: 04-08-2005 Date of Report: 04-11-2005 SPORE TRAP REPORT: NON -VIABLE METHODOLOGY Location: 009: Southeast office wall 010: Liquor room 012: Liquor room 013: , By steam room, outside hall Comments (see below) None None None None LabID-Version$: 632561-1 632562-1 632563-1 632564-1 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 Alternaria Arthrinium ' Ascos ores* 4 53 Aureobasidium Basidios ores* 5 67 4 53 Bi olaris/Drechslera group Botrytis Chaetomium Clados orium 8 107 Curvularia E icoccum - Fusarium M rothecium Ni ros ora Other brown 1 13 Other colorless Penicillium/As er illus typestypest 36 1 200 56 1,870 32 427 Pithom ces Rusts* , Smuts*, Periconia, Myxomycetes* Stachybotrys 15 500 10 •133 Stem h lium Torula Ulocladium Unknown Zygomycetes Background debris 1-4+ 4+ > 4+ 2+ 2+ Sample volume (liters) 30 30 75 75 TOTAL SPORES/M3 1 1,200 2 370 1 734 1 119 Comments: * Most of these spore types are not seen with culturable methods (Andersen sampling), although some may appear as non-sporulating fungi. Most of the basidiospores are "mushroom" spores while the rusts and smuts are plant pathogens. t The spores of Aspergillus and Penicillium (and others such as Acremonium, Paecilomyces) are small and round with very few distinguishing characteristics. They cannot be differentiated by non -viable sampling methods. Also, some species with very small spores are easily missed, and may be undercounted. tt Background debris indicates the amount of non -biological particulate matter present on the trace (dust in the air) and the resulting visibility for the analyst. It is rated from l+ (low) to 4+ (high). Counts from areas with 4+ background debris should be regarded as minimal counts and may be actually higher than reported. Background debris also affects the reporting limit for some spore types. The reporting limit is dependent on spore size, background debris, sample volume, and the percentage of the trace analyzed. It is important to account for sample volumes when evaluating dust levels. The minimum reporting limit is based on a raw'count of one, which the lowest count'thaf can be detected. - " - t A "Version" greater than I indicates amended data. EML ID: 144074, Page 3 of 4 Client: Pacific Environmental Company C/O: Mr. Michael Lyssy Re: La Quinta Country Club Environmental Microbiology Laboratory, Inc. 1010 N Central Avenue, Glendale, CA 91202 (858) 569-5800 Fax (858) 569-5806 www.emlab.com Date of Submittal: 04-08-2005 Date of Receipt: 04-08-2005 Date of Report: 04-11-2005 SPORE TRAP REPORT: NON -VIABLE METHODOLOGY Location: 015: Bar room, dining area 016: Men's RR, kitchen 017: Southeast office 018: Control, exterior Comments (see below) None None None None LabID-Version$: 632565-1 632566-1 632567-1 632573-1 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 raw ct. spores/m3 Alternaria Arthrinium Ascos ores* 20 267 Aureobasidium Basidios ores* 4 53 Bi olaris/Drechsleragrout) 1. 13 Bot tis Chaetomium { Clados orium 4 53 36 480 36 480 Curvularia E icoccum Fusarium Mylothecium Ni ros ora Other brown Other colorless Penicillium/As er illus typestypest 4 53 16 213 1 4 53 28 373 Pithom ces Rusts* Smuts*, Periconia, Myxomycetes* 1 13 1 13 2 27 Stach bot s Stem h lium Torula Ulocladium Unknown Zygomycetes Background debris 1-4+ 3+ 3+ 3+ 3+ Sample volume (liters) 75 75 75 75 TOTAL SPORES/M3' 106 706 79 1 200 Comments: * Most of these spore types are not seen with culturable methods (Andersen sampling), although some may appear as non-sporulating fungi. Most of the basidiospores are "mushroom" spores while the rusts and smuts are plant pathogens. t The spores of Aspergillus and Penicillium (and others such as Acremonium, Paecilomyces) are small and round with very few distinguishing characteristics. They cannot be differentiated by non -viable sampling methods. Also, some species with very small spores are easily missed, and may be undercounted. tt Background debris indicates the amount of non -biological particulate matter present on the trace (dust in the air) and the resulting visibility for the analyst. It is rated from 1+ (low) to 4+ (high). Counts from areas with 4+ background debris should be regarded as minimal counts and may be actually higher than reported. Background debris also affects the reporting limit for some spore types. The reporting limit is dependent on spore size, background debris, sample volume, and the percentage of the trace analyzed. It is important to account for sample volumes when evaluating dust levels. The minimum reporting limit is based on a raw count of one, which the lowest c6unf that can be detected. $ A "Version" greater than I indicates amended data. EML ID: 144074, Page 4 of 4 l CHAIN OF CUSTODY ((D*DENVIRONMENTAL 111111111111111111111111111111111111 MICROBIOLOGY WEATHER Fog Rain Snow ! Wind Clear REQUESTED: 866.8.6653 www.EML&b.com LABORATORY, INC. None ! 000144074 88 PLEASE SEE REVERSE SIDE FOR ADOrMNAL MicroEAB' LOCATIONS • Light ( NonCuiarable -'--T- '--'-�--- 1150 Bayhill Dr. #100, San Bruno, CA 94066 - AIHA EIWLAP #1028S6 Moderate Tape oelK. ...._ -_ ._.....r _......� Spore Swib Biocassme Andersen, SAS, Swab, Requests 5473 Kearny Villa Road, #130, San Diego, CA 92123 - AIHA EMLAP *160266 Heavy Trap Bulk Water, Bulk, Dust, Sou, Contact Pit. CONTACT INFORMATION i i i �--_ .P�_......f_..-- -.....__..._ _._.....-_ !! �30101 Town Center DOSuite 107 ,�_,C_omPaYBranch: CEnvironmental !Address:La una_Ni Conwcc: e Mike Lyssy !Fax results? N iFaz: (949) 363-7110 4 kr,d i S .._..___.__..—._.. .. ......_.._.....---'-----....-..._...... •---'----'- - ...........--"-'-"------- •--'---'---"- _ S i i i : r c /949 363-7200 ' ! ! Phont. l !Email results N IEmail: mlk::t�p8C1(IC6f1VIrOTIIT1B11121.COIT1 Q ^g ! 2: I t t r PROJECT INFORMATION TURN AROUND TIME CODES - (TAT) N a - i b fr; � �l ; Vro�ecc i��-_ 4(w 4n. G'.a STD -- S--ta--nd'-a-rd---(-D—EF-A'-U--L-T -4-8•---7-.2—H_o_._u_r.) ,E .. Rushes received after2 oron = r e Project —ng e.° I Zip Code: ; Date: ND - 24 Hour (+50%) weeltendsr will be considered _.-..._.-----._._.._..... received the nen business day. 2 y o C < < i PO Number. SD - Same Business Day Rush (+75%) Release alert us in advance of i x � ` � i � � , •g o I q Send Inwiee to: weekend analysis needs. F ? i ? ! i 4 s i r WH - Weekend/Holiday (+100%) 3 '+t a I € I g4g I �g t I'm a! mt t o I I d! lij5 Oi F V Sample TAT Tots: NOTES SAMPLE IO DESCRIPTION Type Above Volume/Area g II (below) ( ) (as Iicsble) R— day, Temp. RH, etc) ,� ; m ! ,w� n I �' I �'. '• f ? ; i ay.?... 5m..aL,- ,,;,4 . 04_ f.. .. .................Sr....' D .. s �a ► y°F 7Y 7� x+ , _.._..._ _..._. _ �..... . i . _........ .....__.......__...._...._.....__..^. D.OF �o> _... I _ Y 10Lf ! '...5. t:.aes,.., • �Ms ea. i r : 0oo0 �$... _. .__.. e/ S vN_�•�_.......... •�,.i..'._. o�r�:_._.. 'sT��ST.. I. 3oL�►._��_._7_'._ ._.._..%yob -•' X- . . t ;�..T_. _.. .1..............tc r_. j. i_.... /tws5-4Ft T....... T.._ . 3t�V ?.l�F__..35_.�,--. �`_._. __i .1 ........' Sr - - 5 %,e sT Nip -........ _........._. ..._.._.... r ... Sir 7 SAMPLE TYPE CODES RELINQUISHED BY DATE & TIME RECEIVED BY DATE & TIME SC - BioCassette CP --Contact Plate T.- Tape D -Oust r A1S-Andersen t stage I ST-SponeTrap: SW -Swab W.Water ._._._.._.._.._..._......_........._ljlzefon,ak,genco. A25 - Andersen 2-sca a Burkard... I B -Bulk 50 - Soil -..._ ..._.._._....... SAS -Surface Air --"-----._.._._.__..._... ..... ...... .......................... . Sampler P -Pure Culture re O -Ocher OCapyeight 2003 Envkvnmental Microbiology Laboratory. Inc. (STD) TAT by defaWt. Contact us at 868 888.66S3 Doc. #200176 Rev. *11 - Origin Date 04/22/02 - Rev. Date: 11/11/03 Our Allergen Analysis COC can be downloaded at www.EMLab.com OCapyeight 2003 Envkvnmental Microbiology Laboratory. Inc. (STD) TAT by defaWt. Contact us at 868 888.66S3 Doc. #200176 Rev. *11 - Origin Date 04/22/02 - Rev. Date: 11/11/03 Our Allergen Analysis COC can be downloaded at www.EMLab.com ENVIRONMENTAL I�IIII11l�pIIINIIIIIIf�I�IIII�IG�IN�I CHAIN OF CUSTODY MICROBIOLOGY WEATHER >bs Rain snow' Wind Cka. 866ASS.66S3 www.EMLabcom (ND LABORATORY, INC. None _ REQuMEO 000144074 • PLEASE SEE REVERSE SIDE FOR ADDITIONAL MicroLAB— LOCATIONS • J Light I Non GderaLk 11 SO Bayhill Dr. #100, San Bruno, CA 94066 ' A1HA EMIAP #102856 � Moderate _ I 1 _ I T, --j--.. Spore Swab easseme -nderse BioCAn, SAS, Swab, Requatx 5473 Kearny Villa Road, #130, San Diego, CA 92123 — AIHA EMLAP #160266 SwabHeavy I — , Trap 8u1t water, Bulk Dust, Sal, Contact Ph. CONTACT INFORMATION Premium Pacific Environmental ( 30101 Town Center DrJSuite 107 Req. add'I CompanylBranch: I Address: -•--�Legu081J' CA 92&77 Mike Lyssy 949-- _._._....__. _ ; c _ r Contact: I Fax results) Y / N _ fax: ( ) 363-7110 s o li l e ----- --- ----- - ----r— (949) 363-7200 {{ d Phone: (Email results? Y N Email: mlkeeQ paclflcenvirOnmentai.com 2 I l S e a PROJECT INFORMATION TURN AROUND TIME CODES - (TAT) N F l ! E F 3 I (� ` 's ProJKt_ _—! ..... Sam m G.15•� �--- STD _Standard (DEFAULT 48_72 Hour).- - Rushes received after2pm o/ on S EProject Zip Code:_ Da g -. _. ND - 24 Hour(+50%) weekends, will be considered r >r received the next business day. r yob t PO Number. SD -Same Business Day Rush (+7596) Please alert us in advance of e 8 E a e Send Invoice to: --------------------- weekend analysis needs. w E I ry;�k- Weeend/Holiday (+10096) C g' 4 i v O e r„ Total g m a 3i II O 2 DESCRIPTION ( )VuSAMPLE ID me/Aron /�TNO TU of day, Temp. �Below ate) lmi IL tvie Xeo m .C�t.3..-- - - �eG•r+.... no e.. v I 0 _.. , Pam.... -- - _ ........_...,.....r*.ur-- ._t....5._ T__•i STa�I _....-- s L --' .� ---� t..- -'! `._.... _.. _... I ............ .... ---��s��._—SLIP .�__.1�•_.(,��.%4�r�' -r5 - ._.... I3•f_.....r....... SCfl��s...../�1n.�._.......51 ..._. ST�O -SL. - gy �7Y-� --- X - - - - I.... I X Q..!.__._.._.._..._._.....�_o�a.1._.__CEric...� ........... . . ... ........+.. . ........... 6r-'-STi��....... .................... ............ _........8`..'_.1:�'..- 1 _....._..._.-.__._....__.... ......__..._...__.._.. - - I , . ... -i I ...... . . .. .... ... .... .. . ... ............. .. ..... ..... ... SAMPLE TYPE CODES RELINQUISHED BY DATE &TIME RECEIVED BY DATE & TIME SC - Biocassette CP - Conan Plate I T -T—ape 1' —O - Ousr_ Al S - Andersen 1-stage ST - SporeTrap: Sw -- Swab l W _ Water A25 - Andersen 2-sage turkard... 1 B • Bulk I SO -Soil _. .... ---------------- SAS - Surface Air Sampler P - Pure Culture 0.Other.. OCopyright 2003 Environmental Murobiology Laboratory, Inc (STD) TAT by default. Conan is at 866.888.6653 Doc *200176 Rev. M11 - Origin Date: 04/22/02 - Rev.Data 11111 /03 Our Allageru Analysis COC can be downloaded at www-EMLab.00m State of Cafiomia--Heath and Human Services Agency t ' LEAD HAZARD EVALUATION REPORT . r � t DepartMent of Health services Section 1—Date of Lead Hazard Evaluation 04/05/05 Section 2—Type of Lead Hazard Evaluation (Check one box only) . . ® Lead inspection ❑!Risk assessment ❑ Clearance inspection ❑ Other (specify) Section 3-Structure Where Lead Hazard Evaluation Was Conducted Address [number, street. apartment (it applicable)) city County ZIP code La Quinta Country Club, 77-750 Avenue 50 La Quinta San Bernardino 92253 Canatrucbw date (year) of Type of structure (check one box only) structure 01/01/60 Single family dwelling ❑Multi -unit building ❑ Child -occupied facility ®Other (specify),Country Club Section 4—Owner of Structure (If business/agency, list contact person) Name Telephone number La Quinta Country Club (760 ) 564-4151 Address (number, street, apartment (it applcable)) City stall ZIP code 77-750 Avenue 50 La Quinta California 92253 ' Section 5—Results of Lead Hazard Evaluation (Check one box only) , ❑ No lead -based paint detected. A lead inspection was conducted following the procedures outlined in Title 17, California Code of Regulations,'Division 1, Chapter 8. No lead -based paint was detected during this lead inspection. This structure is found to be lead -based paint w free. • - 1. ❑ No lead hazards detected. Lead hazard evaluation was conducted following the procedures outlined in Title 17, 'Califomia Code of Regulations, Division 1, Chapter 8. No lead hazards were detected. �. ® Lead -based paint and/or lead hazards detected. Lead hazard evaluation was conducted following the procedures outlined in Title 17; California Code of Regulations, Division 1, Chapter 8. Lead -based paint and/or lead hazards were detected. Section 6—Individual Conducting Lead Hazard Evaluation • Name Telephone number Scan Tiliema/Pacific Environmental (949 ) 363-7200 Address (number, street, apartment (H applicable)] State rs 1P code 30101,Town Center Drive, Suite 107 Laguna Niguel California' 2677 Brand name and serial number of any portable x-ray fluoresoence (XRF) instrument used (If applicable) EDAX Map 4 Serial Number M41590 DH8 certification number Signature � pope l .I-1646 � � _ 44/28/05 Section 7—Attachments A. A foundation diagram or sketch of the, structure indicating the specific locations of each lead hazard or 'presence of lead -based paint; f ' B. Each testing method, device, -and sampling procedure used; C. All data collected, including quality control data, laboratory results, including laboratory name, address, and phone number. a First copy and attachments retained by inspector Second copy and attachments retained by owner Third copy only (no attachments) mailed to: Department of Health Services Childhood Lead Poisoning Prevention Branch Reports 1515 Clay Street, No. 1801 Oakland, CA 94612 .` - — — .._ _ _. _ _ • , . _ .. FAX (510) 622-5002 - .. ..t OHS 85U (299) SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL MAIL FOOM AND FEE TO SCAM. ASBESTOS NOTMATIM FILE # SMI. LOS AHMMU CA 90074.5841 AQMD USE ONLY SCREEN BY RECEIVED POSTINM ENTERED BY NATION ilt . COMPLETED BY COMPANY ABSOLUTE ABATEMENT & PHONE 114449-1015 CHUCK BAILEY DEMOLITION DATE 7-6-06 CHECK # 2054 FEE 4 307A5 PROJECT # 347-M NOTIFICATION TYPE ORtGmIal REvl m Dares Rmm OmR (koWigM) CAKE"MN DRAWO r ORnERM OMLInON R!9TWATM (remo A EIu xLr REtaOVaL PLANNED Rt o(anrulall PROJECT TYPE SITE INFORMATION SITE NAME LA QUINTA COUNTRY CLUB SITE ADDRESS 77-750 AVE 50 CROSS STREET CITY LA QUINTA STATE CA ZIP COUNTY RflA3W106 DESCRIBE WORK AND LOCATION VARIOUS AREAS BUILDING SUE (So FT) 8.0W NUMBER OF FLOORS 1 BUILDING AGE ffAM 3S. NUMBER OF DWELLING UNITS 0 BLDGPRIORIPRESENTUSE HOSMAL IWATIM Odd OIM Ptmut&= MOUSE SCHOOL SHIP UW1001IESE SITE OWNER LA QUINTA COUNTRY CLUB ADDRESS 77 750 AVE 50 CITY LA QUINTA STATE CA ZIP CONTACT MANAGEMENT PHONE 760-0483157 REQUIRED BUILDING DWORMATION ASBESTOS YE NO PRESENT? 'ASBESTOS SURVEY? ASBESTOS YES NO BUILDING TO BE YES NO REMOVED? DEMOLI�7 PROJECT DATES START 7.2046 END B-1m WORK kay _�Wiq, nigllb 'ASBESTOS AMOUNT TO BE REMOVED (in square feeq FRIABLE 6,192 CLASS 12,50D CLASS 0 TOTAL Atl WW (add row) 8,692 'ASBESTOS REMOVAL lFRIM SURFACE P0'ES COMPONENTS 'AMOUNT OF EACH TYPE OF ASBESTOS pn square feet) ACOUSTIC CEILING 6000 LINOLEUM 10 I INSULATION 2 FIRE PROOFING DUCTING STUCCO MASTIC FLOOR TILES (VAT) DRY WALL PLASTER 2,500 I TRANSITS I ROOFING OTHER (d wft) CONTRACTOR INFORMATION CSLB LICENSE # 813525 OSHA REG 4 849 AQMD ro # 143132 NAME Absolute Abatement & Demolition ADDRESS CITY Futimon STATE CA ZIP =31 SITE SUPVR Peter Dm%adofOcw0 Mtedtna PHONE 714449-1015 WASTE TRANSPORTER ci Abaotate Asafee as & Deoon LANDFILL Lai Paz Cewrgr Lmxo ADDRESS 25H E. FendarAve HIL Apt 25M NO" 9 12B CITY Fullerton STATE CA ZIP 92831 CITY Pa" STATE AZ ZIP 85344 Not required for demolition notifications r asbesbs Surveys are required prior to Demolition and Renovation. Forms, instructions, and the Rule 1403 can be obtained from AQMD web site httplhvm.agmd.gov Page 1 of 2 . 4 . , SCAQMD NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL MAIL FORM AND FEE TO SCAGAID, ASBESTOS NOTIFICATIONS, FILE 8 56641, LOS ANMES CA 900T4.6841 WASTE TRANSPORTER 12 E.C.T.L • WASTE STORAGE SITE ADDRESS P.D. Box 731e ADDRESS CITY San Bemart ino STATE CA YIP 92411 CITY STATE ZIP *CONTROLS' DESCRIBE WORK PRACTICES AND CONTROLS TO BE USE13AT THE RENOVATION AMID DEMOLMOtN SITE. Procedure ? 4soroftw. For asbestos removals c0e the combination of We 1403 procedures used. Procedure 4 and 5 submit plates forAOMD prior approval (See procedure 415 guidelines) ° ASBESTOS DETECTION PROCEME. Circle ft procedures and analytical methods used to delen, rate tM presence of abbe M in the 6uddeeg. Sammy, Bulk Sampling, Inspection, PLM, PCM, TEM. Ammed as Asbestos-PACM, Describe Other (See wo" gtedgl'ems dmdallst): FOR DEMOLITIONS GIVE THE COMPANY NAME AND DATES OF THE ASBESTOS REMOVAL: FOR ORDERED DEMOLITION SENDA COPY OF THE ORDER AND GIVE THE AGENCY NAME & PHONE AUTHORIZING PERSON: TITLE DATE OF OROM DATE ORDERED TO 8EGIR ' FOR EMERGENCY ASBESTOS REMOVAL GIVE TILE NAI,IE AND PHONE NUMBER OF THE PERSON oEuARNmwTHDR=G THE EMOS CY. RATE AND HOUR OF EMERGENCY AND DESCRIBE TFE SUDDEN, VNMC1EDEVENT(QisBubod/ a W+papN�dya:gpJaa aprN►1pt�f�j EXPLAIN HOW THE EVENT WOULD CAUSE LANSAFE CONCITiONS, EQUpL(ENT DAMAGE OR UNREASONABLE RNANCIAL BURDEN: CONTINGENCY PLAN: DESCRIBE Auras TO BE FOLLOWED IF UNDXPECTED ASBE5= IS FOUND OURWG DEMMITIDH OR A6BESTOS MATOM BECOME DISTURBED, CRUMBLED. PULVa 99MORREDUCED TOPOWDER (Da�6iditldAJaagtdaHOestasr sapropdursSpStOopproralPriwtaaoAwaup}_ ° TRAINING CERTIFICA7FDM: I certify that an individual bat din the provisions or regulation AQMD Rude 1403 and NESHAP vffi bean sb du" the MMoval and evidence that the required training has been aocomptashed by Ihls person will be available for I during normal business houm Company Name Print narme of ovmertopet�or Signataae aF or�raerlcperatar? ) Ta1Ie orowateAoperata Oats 7 6 t18 INFORMATION CERTIFICATKK I owtify that the above information is correct and I have enclosed nX(ulrsd attadm=ts. -P Company Name Printnameofoamertaperator Signadureo! TWeofownentpwtor Dade74-06 Not'afacarhms can not be a0woled WOW the reWM tee (Rule 301 I Ast>3fts removals of hme rm 100 square reel arc exempt from nol fan and fees. Please make cheadrs payable to'SCAQMD'. Fates are per noiHlce6on. not m6nd ft and vary according to the poled sim Fear are as follow PROJECT SIZE In square feet DEMOUTION OR REMOVAL ADDITIONAL SERVICE CHARMS 1,000 or Ieaas $ 39.11 — Special 9 39.11 1,00110 6,000 $119.57 Rel�tm toNo5liaGon--$ 39.11 5,001 to 10,000 $ Z79.87 Returned Check Fee -- S 31.97 10,001 to 50,000- $ 438.&5. Plammd Renovation — - $ 438.85 60.001 to 100,000 $ 6i6.00 Procedure 4 or 5 Plan—$ 438.85 100 001 or mate $1060.00 ATTENTION: Keep a copy of ywir ndiGaatlon. Stara law requires than you provide a copy of the demob nuffm Mort fo Building end Sarfety before issuance of a demolition pemat. For questions call M9 3W2336. please mail the form and fee to AQMD. Mating Saves dry. money and mdam trAc and air pollution ' MAIL FORM AND FEE TO: SCAt1141D, ASBESTOS NOTIFICATIONS, FILES 55541, LOS ANGELES CA OW44MI Pg 2 of 2 FORMS, INSTRUCTIONS, AND THE RULE 1403 CAN BE OBTAINED FROM AQMD WEB SITE AT HM://W W W.AOMD.GOV SCAQW is bca Ud at 21865 Copley Drhre, Diamond Bar, CA 91765.4182 PHONE: (908) 39&2336 FAX: (9 N) 39&3W REV20050ti15 ca/ba 7r1H.-a iw-4waItm" aaninc=" OCAS-rbb-hT/ RGI:/T gGM7./A7.//a1 TE OF .- CTIFICA• �MPLE ' ABS- LUTE-A.8A. WWAIWN, & E111QL T1011 U1VIT L'F(T1.�R?`U1Y,:CA 92831: ' . ' 6':: :t Ly ' -; s .151 - ,aiy:Goodemol" . • �'�'�` Hake!•-C,�'�S� 801 �• ` ,'• •'`�Ji.`\ r ,i. 'r•' '� '• •yam 14- 1' 40• : :;: : % ti �i ,h. ,• J�jl' :� Q�4tri o, =�rMb. �7�'a•'so....;ave, • :a' iifta*.�:. le:,••br K R ,ate+iseot" ,D" ' itlilrori rei» d, als "",'bt' ir ;ti_ ,•, �, .�! o�'e aisb�st, .� pin"'ngrdaleriols•oir•tl{e abav�,r,^erenced• �o Cl,sile/sl}rlci�fre p�t.1•��7.•0 ,, " :1VIAteriQlsreiiipyeiy�reQer.ccintrac;: ;:,`' ,ti m3 .,� `;1 �lbaleirieiil�'&•1?¢rrlglftion•.:: • ' .• ::,�` ::�16s'o :'i:• - :. .. . C Wt k Owner m m CD Ln