Pr
epared For:
Facilities Modernization Department
Cupertino Union School District
10301 Vista Drive, Door 10
Cupertino, CA 95014
Prepared By:
Concord Office Oakland Office
1116 Willow Pass Court
Concord, CA 94520
Phone: (925) 689-9737
Facsimile: (925) 689-1420
155 Filbert Street, Suite 101
Oakland, CA 94607
Phone: (510) 835-9737
Facsimile: (510) 835-9740
June 25, 2018
SES Pr
oject Number 18-018
HAZARDOUS MATERIALS MANAGEMENT REPORT
FINCH AVENUE PROPERTY PROJECT
10480 FINCH AVENUE
CUPERTINO, CA 95014
Attachment E
This report has been prepared for the exclusive use of the Cupertino Union School District (CUSD) as it pertains to the hazardous materials related work completed to support the Finch Avenue project.
Consulting services provided by Sensible Environmental Solutions Inc. (SES) were consistent with the level of care and skill ordinarily exercised by other environmental consulting professionals practicing in this field under similar circumstances and conditions. SES makes no other representation, guarantee, or warranty, expressed or implied, in fact or by law, for any particular purpose or otherwise, concerning any of the services furnished by SES.
Mitchell M. Edwards, CAC, CDPH
Senior Industrial Hygienist
TABLE OF CONTENTS
SECTION 1 – HAZARDOUS MATERIALS MANAGEMENT REPORT
Page
1.1 INTRODUCTION .............................................................................................................................. 1
1.2 PROJECT DESCRIPTION ..................................................................................................................... 1
1.3 PROJECT ROLES .................................................................................................................................. 1
1.3.1 Consultant ................................................................................................................................. 1
1.3.2 Contractor .................................................................................................................................. 2
1.4 PROJECT PROCEDURES .................................................................................................................... 2
1.5 FINAL CLEARANCE INSPECTIONS AND SAMPLING........................................................................ 2
1.5.1 Asbestos Interiors ...................................................................................................................... 2
1.5.2 Asbestos Cement Pipe Removal .............................................................................................. 2
1.5.3 Lead Interiors and Exteriors ...................................................................................................... 2
1.6 WASTE DISPOSAL INFORMATION ..................................................................................................... 2
1.8 CONTRACTOR SUBMITTALS .............................................................................................................. 3
1.9 RECOMMENDATIONS .......................................................................................................................... 3
SECTION 2 – DAILY PROJECT LOGS
SECTION 3 – LABORATORY REPORTS AND CHAIN OF CUSTODY DOCUMENTATION SECTION 4 – INSPECTION FORMS
SECTION 5 – PHOTOGRAPHS
SECTION 6 – WASTE MANIFESTS
SECTION 7 – SES REPRESENTATIVE CERTIFICATIONS
SECTION 8 – SES ROTOMETER CALIBRATION DATA
APPENDICIES – CONTRACTOR SUBMITTALS
A. Notifications
B. Worker Acknowledgement Forms / Worker Certifications C. Employee Daily Rosters
D. Work Area Entry/Exits
E. Manometer Logs
F. Personal Air Sample Results
G. DOP Testing Documentation
SES No.: 18-018 June 25, 2018
1 HAZARDOUS MATERIALS MANAGEMENT REPORT
FINCH AVENUE ABATEMENT
1.1 INTRODUCTION
This comprehensive report contains a detailed account of the hazardous materials activities performed at the subject facility from June 4, 2018 through June 8, 2018. This report includes the following information: Project description; Project roles of the Consultant and the Contractor; Project procedures; Final clearance inspections and sampling; Waste disposal information; Project related paperwork; Contractor’s submittals; and Recommendations for Cupertino Union School District (District).
1.2 PROJECT DESCRIPTION
The Contractor’s Hazardous Materials Scope of Work consisted of the removal, clean-up, and disposal of the following hazardous materials prior to demolition of the property structures.
A. Exteriors of Buildings (Zone 1)
1. Removal of all loose and flaking lead-based paint (LBP) and application of a primer.
B. Main house (Zones 2, 3, 5 and 6)
1. Zone 2 (northeast restroom, utility rooms and garage hallway):
a. Removal of all asbestos containing (AC) 9”x9” vinyl floor tile.
2. Zone 3 (basement and crawlspace):
a. Removal of all AC duct wrap and tape on ductwork.
3. Zone 5 (dining room west wall):
a. Intact removal of all asbestos cement pipe inside the west wall of dining room.
4. Zone 6 (kitchen and restrooms):
a. Removal of all ceramic wall, floor and counter tile with lead glazings.
C. Shop interior (Zone 4)
1. Zone 4 (Shop interior ceiling-mounted heater:
a. Intact removal of heater with AC insulation paper.
1.3 PROJECT ROLES
1.3.1 Consultant
SES was retained by the District to conduct compliance observation and monitoring services during hazardous materials related activities. Services included reviewing the contractor’s submittals; conducting visual inspections before, during and after hazardous materials related work; collecting air samples during hazardous materials related work; completing daily project documentation; conducting final visual clearance inspections for asbestos; conducting clearance air sampling for asbestos; conducting clearance inspections for lead; and providing a hazardous materials management report upon project completion.
SES No.: 18-018 June 25, 2018
2 1.3.2 Contractor
Coastwide Environmental Technologies, Inc. (CE) was retained by CUSD as the Hazardous Materials Contractor for the project.
1.4 PROJECT PROCEDURES
Hazardous materials related work including set-up, removal, waste load-out and decontamination was conducted in accordance with the Contract Documents and applicable federal, state and local regulations and recommended standards. For specific procedures for each type of hazardous material removed, please reference the hazardous materials technical specification sections of the Contract Documents (i.e. 02 82 00, 02 83 00 and 02 84 00) and CE’s pre-job submittal package.
1.5 FINAL CLEARANCE INSPECTIONS AND SAMPLING
1.5.1 Asbestos Interiors
At completion of final detail cleaning, SES conducted final visual inspections to document the work areas had been decontaminated and cleaned in accordance with the Contract Documents. Upon receipt of an acceptable final visual inspection, CE applied an encapsulant in the work areas to lock down any residual fibers. Once the work areas were sufficiently dry, SES collected clearance air samples from inside the Zones 2, 3 and 4 containment areas using non-aggressive air sampling techniques in accordance with the Environmental Protection Agency (EPA) 40 CFR Part 763 Sub Part E - Asbestos-containing Materials In Schools; Final Rule and Notice where friable ACMs were removed. Upon receipt of acceptable clearance air sample documentation (all samples below 0.01 fibers per cubic centimeter as analyzed by phase contrast microscopy), CE removed the containments for unrestricted access.
1.5.2 Asbestos Cement Pipe Removal
At completion of final detail cleaning, SES conducted a final visual clearance inspection to document the Zone 5 work area had been decontaminated and cleaned in accordance with the Contract Documents. Upon receipt of an acceptable final visual inspection for the mini-containment work areas, CE removed the poly mini-containment, signage and barrier tape for unrestricted access
1.5.3 Lead Interiors and Exteriors
At completion of final detail cleaning, SES conducted final visual clearance inspection to document the work areas had been decontaminated and cleaned in accordance with Contract Documents.
Upon receipt of an acceptable final visual inspection for exterior work areas, C E removed the poly drop sheets, signage and barrier tape for unrestricted access.
1.6 WASTE DISPOSAL INFORMATION
The following table represents the hazardous materials waste streams generated during the project, the amount of waste generated and the designated waste disposal facilities. For additional information regarding waste streams generated please reference copies of the waste manifests provided in Section 6 of this report.
Type of Waste Quantity Waste Disposal Facility
Non-hazardous asbestos waste (Vinyl floor tile
and mastic and asbestos cement pipe) 2 CY Kirby Canyon, Morgan Hill, CA RQ hazardous asbestos waste (Duct wrap
and tape) 3 CY Altamont Landfill, Livermore, CA
Hazardous waste solid (lead paint chips) 12 pounds Clean Harbors, Button Willow, CA Legend:
CY: Cubic Yards
SES No.: 18-018 June 25, 2018
3 1.7 PROJECT RELATED PAPERWORK
Project related paperwork has been compiled in the following sections including: Daily Project Logs, Laboratory Reports and Chain of Custody Documentation, Inspection Forms, Photographs, Drawings with Containment Locations, Waste Manifests, SES Representative Certifications and SES Rotometer Calibration Data.
1.8 CONTRACTOR SUBMITTALS
SES approved CE’s Pre-job submittal package for this project as noted on June 7, 2018. The required pre-start and progress submittals were collected during the course of the project and are provided in the Appendices section of this report.
1.9 RECOMMENDATIONS
SES recommends that the District retain this report for their records to document the hazardous materials related activities completed at the site. An electronic copy of this report has been provided to Michael Veloria for record keeping purposes for the District.
Sensible Environmental Solutions Inc.
DAILY PROJECT LOGS
ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
DAILY SUMMARY REPORT
Client Name: Cupertino Union School District Report Date: 6/4/18 Project Name: Finch Avenue Abatement
Address: 10480 Finch Avenue, Cupertino, CA 95014
Type of Abatement: Asbestos Mold Lead PCBs SES Project #: 18-018 Location(s) of Work: Zone 1 – Exteriors of shop, house, garage and out buildings, Zone 2 – NE utility room, restroom and garage hallway, Zone 3 - Basement/crawlspace Abatement Activity: Lead containing paint scrape on exterior walls, eaves and fascia of Zone 1 work areas, preparation work of Zone 2 and Zone 3 work areas.
Method(s) of Abatement: Wet scraping of lead-based paint Contractor: Coastwide Environmental Shift Duration (hours): 8 # Workers Onsite: 4
Item Yes No N/A Deficiency/Action Taken
Outside ambient air samples below standards X
Negative pressure maintained at specification requirements X Work area(s) meet smoke test requirements X
Work area barrier(s) maintained in good condition X
Work area signs in-place and maintained in good condition X Waste bags properly labeled X
Material worked/maintained wet X
HEPA vacuums used X
Removed material promptly bagged X
Waste material removed from work area(s) daily X
Work area(s) clean/end of shift/day X
PPE and hygiene facilities/practices adequate X
SUMMARY OF DAILY EVENTS
SES and Coastwide mobilized to the site and toured the buildings to review the scope of work. SES met with CUSD representative, Travis Kirk, to gain access to the property and discuss schedule and scope of work.
Coastwide began work area preparation for asbestos abatement work in Zone 2 – Northeast restroom, utility room and garage hallway and Zone 3 – basement and crawlspace. Coastwide also prepared the exterior of the shop and outbuildings (Zone 1) then began scraping of loose and flaking lead containing paint from walls, eaves and fascia.
SES Representative: Mark Stockwell
Cc to: Mitch Edwards
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/4/18
Time Details
0700 SES and Coastwide arrived on site. SES project manager, Mitch Edwards met with site technician, Mark Stockwell to review the scope of work and tour the site. Coastwide’s supervisor, Ben Cardenas and 3 crewmen began mobilizing equipment.
0710 CUSD representative, Travis Kirk arrived on site and reviewed the scope of work and utilities status and unlock the buildings.
0720 SES toured the project site with Ben Cardenas and reviewed the scope of work for asbestos abatement, lead paint removal and stabilization, and other hazardous materials within the scope of work. SES also discussed the clearance inspection methods with Coastwide. 0800 Coastwide began installing polyethylene drop sheeting along the base of the exterior walls of the shop and southeast out buildings in preparation for lead paint removal and stabilization from the exterior walls, eaves and fascia.
0830 SES finished reviewing Coastwide’s worker certifications and medical release information. SES discovered that 1 of Coastwide’s workers was not certified to do lead work, Omar Yanez. Ben Cardenas was informed, and he pulled Omar from the lead crew and had him begin preparation work inside the house for pending asbestos abatement work. SES provided a preparation inspection of the Zone 1 preparation measures and approved the work area, authorizing Coastwide to continue paint removal and stabilization.
0840 Ben Cardenas informed SES that a rental generator would be arriving later this morning to run the negative air machines and other equipment once asbestos abatement begins. He also stated that his DOP testing firm was arriving this morning to test the negative air machines and HEPA vacuums. 0900 Coastwide started preparing the Zone 2 – northeast utility room, restroom and garage hallway, and Zone 3 - basement and crawlspace, for upcoming asbestos abatement work. According to Ben Cardenas, this work won’t begin until tomorrow or Wednesday. SES PM offsite. 0915 Envirostar’s representative, Ed, arrived on site to DOP test the HEPA filtration machinery. Coastwide has not yet received their generator so the testing will need to wait until it arrives. 0915 SES left the jobsite to obtain site keys from the CUSD maintenance office. 1000 Envirostar left the jobsite. They will return tomorrow morning to DOP test once a generator is obtained to operate the HEPA filtration machinery.
1100 Coastwide broke for lunch.
1130 Coastwide’s power generator arrived on site, delivered by the rental company. 1200 Coastwide’s crewmen returned from lunch. Two workers continued lead paint removal/stabilization on shop and southeast buildings while Ben Cardenas and 1 other worker continued preparation work in the house.
1220 Ben Cardenas opened the main water valves to the building after cutting a zip tie that secured the water main at the street.
1240 Ben Cardenas and 1 other worker removed the mercury containing thermostats located in the house.
The thermostats will be wrapped in polyethylene sheeting and disposed of as mercury containing waste.
1315 Coastwide’s lead paint removal crewmen finished scraping the chipping and peeling paint from the southeast shop and outbuildings. The crewmen relocated the work area to the central shed where they placed polyethylene sheeting on the ground around the building perimeter and prepared to begin paint stabilization. SES began a preliminary visual clearance inspection of the shop and southeast outbuildings. The paint removal/stabilization work appeared to have been completed as required, however, the remaining painted surfaces were found to be badly chalking and SES informed Ben Cardenas that the re-priming would not likely adhere to the exterior paint surfaces. SES recommended that Coastwide bring rags to the jobsite and wet wipe the exterior paint before stabilization priming. He stated that he would do so tomorrow. SES will complete a final visual inspection of Zone 1 – exterior paint removal once the wet wiping is completed, and before the priming is started. 1330 Coastwide finished establishing the regulate work area around the central shed and SES completed a preparation inspection before authorizing the crewmen to continue paint removal/stabilization on the building.
1400 SES walked the perimeter of the house with Ben Cardenas to inspect for damaged painted surfaces that would require paint stabilization scraping. Minor quantities of damaged paint were identified, mostly on the flower box framing below the windows, some eaves and portico framing, and on various window framing around the building. Coastwide will finalize the paint stabilization on house tomorrow. 1410 Ben Cardenas was instructed to turn off the water to the site and secure all doors before leaving at the end of each day. Coastwide will also secure its equipment inside the building each night.
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/4/18
Time Details
1440 Coastwide finished scraping and stabilizing lead containing paint from the central shed and began cleaning up polyethylene sheeting and bags. SES authorized the crewmen to deregulate the work area for the night.
1500 Coastwide finished cleaning up the jobsite and began securing the perimeter doors and gates. 1515 Coastwide finished securing the site, turned off the water and left the jobsite.
ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
DAILY SUMMARY REPORT
Client Name: Cupertino Union School District Report Date: 6/5/18 Project Name: Finch Avenue Abatement
Address: 10480 Finch Avenue, Cupertino, CA 95014
Type of Abatement: Asbestos Mold Lead PCBs SES Project #: 18-018 Location(s) of Work: Zone 1 – Exteriors of shop, house, garage and out buildings, Zone 2 – NE utility room, restroom and garage hallway, Zone 4 – Shop ceiling-mounted heater Abatement Activity: Zone 1 - Lead containing paint scrape on exterior walls, eaves and fascia, primer painting of walls, Zone 2 - preparation work and abatement of vinyl floor tile, and Zone 4 preparation and wrap & cut removal.
Method(s) of Abatement: Wet scraping of lead-based paint, wet scrape of vinyl floor tile, wrap & cut of heater Contractor: Coastwide Environmental Shift Duration (hours): 8 # Workers Onsite: 4
Item Yes No N/A Deficiency/Action Taken
Outside ambient air samples below standards X 1st day of sampling Negative pressure maintained at specification requirements X Work area(s) meet smoke test requirements X
Work area barrier(s) maintained in good condition X
Work area signs in-place and maintained in good condition X Waste bags properly labeled X
Material worked/maintained wet X
HEPA vacuums used X
Removed material promptly bagged X
Waste material removed from work area(s) daily X
Work area(s) clean/end of shift/day X
PPE and hygiene facilities/practices adequate X
SUMMARY OF DAILY EVENTS
• Zone 1: Coastwide completed lead paint removal and stabilization in Zone 1 today. SES completed final visual clearance inspections throughout the day and approved the work before Coastwide relocated to different areas of the property.
• Zone 2: Coastwide finalized preparation of the work area (northeast restroom, utility rooms and garage hallway).
SES approved the containment construction with a preparation inspection before Coastwide was authorized to start removal of asbestos containing (AC) vinyl floor tile in the work area. Upon completion of the abatement, SES completed a visual clearance inspection and authorized Coastwide to encapsulate the work area. SES will collect non-aggressive PCM air clearance sampling in the work area tomorrow.
• Zone 4: Coastwide completed the preparation of the containment at the shop ceiling mounted heater and SES approved the containment. The heater with AC insulation was removed by the wrap and cut removal method.
The heater was wrapped in polyethylene sheeting and removed intact without disturbing the AC insulation. SES completed and approved a final visual clearance inspection and authorized Coastwide to encapsulate the work area. SES will collect a clearance air sample tomorrow.
SES Representative: Mark Stockwell
Cc to: Mitch Edwards
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/5/18
Time Details
0600 SES and Coastwide arrived on site. Two of the lead workers began setting up equipment to continue lead paint removal around the perimeter of the house. Ben Cardenas and the 4th worker staged HEPA equipment for DOP testing.
0610 Envirostar arrived on site and began DOP testing Coastwide’s HEPA equipment (3 air filtration machines, 2 vacuums and 2 air scrubbers). All equipment passed the DOP testing and certification stickers were attached to each machine.
0615 Coastwide’s supervisor, Ben Cardenas, walked the perimeter of the house with his 2 lead workers and SES and denoted areas where damaged paint was located on window box shelves, window frames, portico columns and walls. SES also directed Coastwide to remove damaged paint from concrete sidewalks.
0715 Coastwide finished preparation measures for Zone 2 – the northeast containment of the house at the utility room, restroom and garage hallway. SES completed a preparation inspection of the work area and authorized Coastwide to begin removing the AC floor tile in the work area. SES inspected the Zone 2 manometer and observed average negative pressure between -0.060 and -0.082 inches water column.
0745 Coastwide’s lead paint removal crewmen began stabilizing paint removal areas on the west side exterior perimeter of the house using an airless sprayer and primer paint. SES inspected the areas completed and confirmed that the damaged paint had been removed and stabilized appropriately. 0815 Coastwide finished the gross removal of the AC vinyl floor tile from Zone 2 and began bagging the waste and detail cleaning the floor. SES verified that the non-friable waste was double bagged in non- labeled waste bags. SES confirmed again that the analytical results for the flooring in Zone 2 (018- M28-01 & 018-M28-02) yielded 5% chrysotile asbestos in the floor tile only and the associated mastic was “non-detect” for asbestos, therefore, Coastwide will be able to leave the floor mastic in place after the tile is removed.
0920 Coastwide finished loading out waste bags from the Zone 2 containment, as well as wet wiping and HEPA vacuuming. Ben Cardenas requested a visual clearance inspection of the work area. 0930 SES entered the Zone 2 containment to complete a visual clearance inspection. SES walked the work area with Coastwide’s worker and identified several areas where 3-dimensional floor tile debris remained on the floor surface. The debris was difficult to identify due to the non-asbestos containing floor mastic remaining on the concrete floor surface. Coastwide was directed to continue cleaning with a hand scraper rather than a spud bar, then HEPA vacuum a second time before requesting another visual clearance inspection.
0955 Coastwide requested a second visual clearance inspection of the Zone 2 containment. SES entered the work area and inspected the floor with the worker. SES identified numerous areas where additional floor tile debris was located and Coastwide’s worker followed behind and cleaned the areas immediately.
1010 SES approved the Zone 2 containment and authorized Coastwide to encapsulate the work area. 1015 Coastwide’s crewmen broke for lunch.
1115 Coastwide returned from lunch and one worker continued lead paint removal and stabilization on the south and east exterior walls of the house. The second lead worker began spray paint stabilization of the central shed. A third worker and the supervisor, Ben, began preparation of the shop to remove the ceiling-mounted heater which contains asbestos insulation. 1140 Coastwide’s paint sprayer relocated to the shop and southeast outbuilding to continue spray paint stabilization of the exterior of these buildings.
1145 SES inspected the preparation efforts of the heater in the shop – Zone 4. SES observed the Coastwide worker was not wearing a respirator and suit since the ACM material was inside the heater and would not be disturbed during removal. SES recommended that the worker wear PPE as the ACM is friable and may be dislodge during removal. SES also recommended that Coastwide install a mini containment around the heater work area in order to more easily collect and pass air clearance sampling tomorrow. Ben Cardenas began installing a polyethylene curtain around the work area. 1215 Coastwide finished the wrap & cut removal of the shop heater Zone 4 and SES inspected the work area before approving the visual clearance. SES authorized Coastwide to encapsulate the work area.
Clearance samples will be collected tomorrow in the work area. 1240 Coastwide finished encapsulating the Zone 4 work area. 1300 Coastwide’s lead workers relocated. The paint scraper moved from the south and east sides of the house to the northeast corner near the garage, and the paint sprayer moved from the shop to the south and east sides of the house.
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/5/18
Time Details
1315 Coastwide collected all lead and asbestos debris bags and properly labeled the bags. SES asked Ben Cardenas how Coastwide intends to dispose of the lead ceramic tile waste. Ben was not aware if the ceramic tile debris would be disposed of as CA hazardous lead waste or if it would be sent in for characterization analysis. He stated that he would discuss this with his supervisor, Jose. SES requested that he obtain the information as soon as possible in order to coordinate waste disposal pickup before the end of the week. Ben state that he would get an answer tomorrow. 1330 Coastwide finished paint stabilization painting for the day and began cleaning the equipment. One lead worker continued to scrape damaged paint around the exterior of the garage. Coastwide will need to complete the remaining stabilization painting tomorrow. The remaining workers began cleaning up the jobsite and securing supplies and equipment for the night. 1350 Coastwide turned off the water main for the night. 1415 Coastwide and SES secured the doors to the property and left the jobsite.
ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
DAILY SUMMARY REPORT
Client Name: Cupertino Union School District Report Date: 6/6/18 Project Name: Finch Avenue Abatement
Address: 10480 Finch Avenue, Cupertino, CA 95014
Type of Abatement: Asbestos Mold Lead PCBs SES Project #: 18-018 Location(s) of Work: Zone 2 – NE utility room, restroom and garage hallway, Zone 4 – Shop ceiling-mounted heater, Zone 3 – house basement and crawl space, Zone 5 – house dining room Abatement Activity: Zones 2 and 4 – air clearance sampling, Zone 3 – abatement AC duct wrap; Zone 5 – removal of asbestos cement pipe
Method(s) of Abatement: Manual removal
Contractor: Coastwide Environmental Shift Duration (hours): 8 # Workers Onsite: 3
Item Yes No N/A Deficiency/Action Taken
Outside ambient air samples below standards X
Negative pressure maintained at specification requirements X Work area(s) meet smoke test requirements X
Work area barrier(s) maintained in good condition X
Work area signs in-place and maintained in good condition X Waste bags properly labeled X
Material worked/maintained wet X
HEPA vacuums used X
Removed material promptly bagged X
Waste material removed from work area(s) daily X
Work area(s) clean/end of shift/day X
PPE and hygiene facilities/practices adequate X
SUMMARY OF DAILY EVENTS
• Zones 2 and 4: SES collected non-aggressive PCM air clearance samples today. Results are pending.
• Zone 3: Coastwide completed the preparation of the containment (house basement and crawlspace) and SES approved the preparation measures before authorizing Coastwide to begin abatement. Coastwide conducted removal of the metal HVAC ducting with AC insulation and work will be completed tomorrow.
• Zone 5: Coastwide discovered a 10” diameter asbestos cement flue exhaust pipe in the crawlspace of the house and determined it rose through a wall in the dining room to the roof. Ben Cardenas installed a mini-containment in the dining room and removed the pipe in 2 sections, minimizing breakage during the effort. SES inspected the work area after the abatement effort and verified that the asbestos cement pipe had been removed properly.
SES Representative: Mark Stockwell
Cc to: Mitch Edwards
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/6/18
Time Details
0600 SES and Coastwide arrived on site. Coastwide had a 3-person crew on site, one supervisor and 2 workers. The two workers began installing the remaining preparation measures in the Zone 3 work area, in order to begin abatement of AC duct wrap/tape. Ben Cardenas stated that Coastwide will use a wrap and cut removal method to complete abatement. The workers will wet the ACM duct wrap/tape, then cover the wrapped sections of ductwork in polyethylene sheeting before disconnecting the non- ACM-covered sections of ductwork. All removed sections of ductwork will be placed on polyethylene sheeting then burrito wrapped and labeled for friable disposal as RACM. 0620 Coastwide assisted SES in installing electrical to the shop and northeast section of the house in order for SES to collect non-aggressive PCM air clearance samples. 0630 SES began installing air testing pumps in the Zones 2 and 4 work areas. 0640 SES entered the Zone 2 work area and installed one pump inside the containment and one pump outside.
0646 SES started 2 non-aggressive PCM air clearance samples in Zone 4. One sample was collected inside the mini containment and a second was collected outside the containment barrier yet inside the shop. 0655 SES completed a pre-abatement inspection of the Zone 3 work area. Coastwide had installed all of its critical barriers and a one stage decontamination chamber. SES inspected Coastwide’s manometer and observed that negative pressure inside the work area was averaging -0.04 inches water column.
SES authorized Coastwide to begin abatement in Zone 4.
0700 Coastwide’s two abatement workers entered the Zone 4 containment to begin abatement. 0730 Coastwide’s supervisor, Ben Cardenas, continued preparations in the house restrooms and kitchen to ready the work areas for removal of the lead containing ceramic tile. He also continued removing various appliances in the kitchen of the house for disposal. 0840 SES completed a calibration check on the clearance samples being collected in Zones 2 and 4 and found that the pumps were running at the same flow rates. 0856 SES retrieved the air samples collected in Zone 2 – northeast restroom, utility rooms and garage hallway.
0902 SES retrieved the air samples collected in Zone 4 – shop mini-containment at the ceiling mounted heater unit.
0915 Ben Cardenas requested a preparation inspection of the kitchen work area in order to begin removing the lead containing ceramic tile from the counter tops. SES directed Coastwide to cover floor and various surfaces with polyethylene sheeting to minimize the cleanup efforts. Coastwide was also directed to place “lead hazard” signage on the doorways to the kitchen before starting the removal work.
0930 Ben Cardenas informed SES that his crewmen in the basement had discovered a transite pipe leading from the basement up through the house. SES and Ben Cardenas accessed the roof and opened a plaster wall in the dining room of the house to determine the exact location of the pipe. A 10-inch diameter asbestos cement pipe was revealed inside the wall. SES and Coastwide estimated that the pipe is approximately 12 feet long. SES recommended that Coastwide install a mini-containment inside the dining room since the pipe is too heavy and too long to remove intact without breaking it into sections. Alternatively, Coastwide was allowed to break the pipe within a glovebag; however, Ben Cardenas believed that method would be too difficult to break the pipe inside the confinement of the bag enclosure.
1000 Coastwide broke for lunch.
1010 SES left the jobsite to deliver the air clearance samples to Forensic Analytical Lab for Rush analysis. 1100 Coastwide returned from lunch and 2 workers returned to Zone 3 basement/crawlspace containment to continue removing duct wrap/tape. Ben Cardenas continued to open the access hole in the wall of the dining room to uncover the transite pipe. He also began installing a mini-containment in the dining room.
1200 SES observed that Ben Cardenas had finished installing the mini-containment in the dining room (Zone 5) and he requested a preparation inspection of the work area. SES recommended installing an asbestos sign on the work area before beginning to break the pipe into manageable sections. 1215 SES approved the containment measures for Zone 5 – transite pipe mini-containment, and Ben Cardenas donned protective equipment and began breaking the pipe. All waste was either burrito wrapped or placed in waste bags. SES observed that the transite pipe was removed intact with minimal breakage at the collar seems. A total of 2 five-foot burritos and 2 waste bags of debris were generated.
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/6/18
Time Details
1310 SES entered the Zone 3 basement containment to inspect the progress of the abatement effort.
Coastwide had finished removing all the duct insulation and was in the process of wrapping the remaining debris. All ductwork has been removed from the basement and the crawlspace and had been wrapped or bagged. Coastwide will complete the final cleaning tomorrow morning, loadout debris and then request a final visual clearance inspection. Coastwide intends to lock down encapsulate the work area after a successful visual clearance, and SES intends to collect clearance air samples on Friday.
1345 Coastwide’s crewmen began exiting the Zone 3 containment and started cleaning the work site and securing equipment and supplies.
1315 SES and Coastwide left the jobsite.
ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
DAILY SUMMARY REPORT
Client Name: Cupertino Union School District Report Date: 6/7/18 Project Name: Finch Avenue Abatement
Address: 10480 Finch Avenue, Cupertino, CA 95014
Type of Abatement: Asbestos Mold Lead PCBs SES Project #: 18-018 Location(s) of Work: Zone 3 – house basement and crawl space, Zone 6 – kitchen and restrooms of the house Abatement Activity: Zone 3 – final detail cleaning and loadout of ACM waste; Zone 6 – removal of ceramic tile with lead glazings
Method(s) of Abatement: Zone 3 – Wet-wiping and HEPA vacuuming; Zone 6 – manual removal.
Contractor: Coastwide Environmental Shift Duration (hours): 8 # Workers Onsite: 5
Item Yes No N/A Deficiency/Action Taken
Outside ambient air samples below standards X
Negative pressure maintained at specification requirements X Work area(s) meet smoke test requirements X
Work area barrier(s) maintained in good condition X
Work area signs in-place and maintained in good condition X Waste bags properly labeled X
Material worked/maintained wet X
HEPA vacuums used X
Removed material promptly bagged X
Waste material removed from work area(s) daily X
Work area(s) clean/end of shift/day X
PPE and hygiene facilities/practices adequate X
SUMMARY OF DAILY EVENTS
• Zones 2 and 4: Clearance results for Zones 2 and 4 were below industry standards and Coastwide removed the containments for unrestricted access.
• Zone 3: Coastwide completed final detail cleaning today. Upon successfully completing the effort, SES approved the visual clearance of the work area and authorized Coastwide to encapsulate the work area. SES will collect clearance air samples tomorrow.
• Zone 6: Coastwide had 3 workers begin removing the lead containing ceramic tile from Zone 6 (house kitchen and restrooms). Coastwide finished the tile removal effort in the kitchen, the master restroom and the northwest guest restroom. SES provided preliminary work area preparation inspections, and upon completion of the removal SES provided final visual clearance inspections. These 3 work areas within Zone 3 were cleared and Coastwide was authorized to dismantle the work areas. The remaining southeast guest bathroom and northeast guest bathroom will be completed tomorrow morning.
SES Representative: Mark Stockwell
Cc to: Mitch Edwards
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/7/18
Time Details
0600 SES and Coastwide arrived on site. Coastwide has a 5-person crew on site, one supervisor and 4 workers. SES informed Coastwide’s supervisor, Ben Cardenas that the containments at Zone 2 – northeast restroom, utility rooms and garage hallway, and Zone 4 – shop ceiling mounted mini- containment had both passed air clearance testing and the containment barriers could be dismantled.
One worker was assigned to take down these two containments. A second worker was assigned to continue the final cleaning effort in the basement/crawlspace of the house (Zone 3), and 2 lead workers were assigned to begin demolishing the lead glazed ceramic tile in the kitchen and restrooms (Zone 6).
0620 Coastwide’s crewmen established negative pressure in the kitchen and master bathroom and SES inspected the containments, finding them appropriate to begin lead demolition work. Containment barriers were in place, “lead hazard” signage was placed on the entrance doors to the containments and negative air pressure was observed.
0640 Coastwide’s crewmen began ceramic tile demolition on the kitchen and SES informed Ben Cardenas that if noise was noticeable in the street or the edges of the property the crewmen would have to stop the work until after 0700.
0645 SES directed Coastwide to stop the ceramic tile demolition work until after 0700. Ben Cardenas stopped the workers.
0700 Coastwide continued demolishing ceramic tile in the kitchen and master bathroom of the house. 0715 Coastwide began loading out friable asbestos waste debris bags from the Zone 3 basement containment. SES observed that the manometer for the Zone 3 containment was adequate, recording lower than -0.03 inches water column. SES observed that the bags were double wrapped, goose neck tied, and properly labeled. All debris bags had generator labels attached. SES inspected the generator labels and confirmed that the EPA ID numbers matched that used for Sedgwick Elementary School of:
CAC002964442. Also, SES obtained a copy of Coastwide’s friable ACM waste manifest and confirmed the generator’s labels matched the manifest number: 015975640 JJK. 0800 Coastwide finished loading out ACM waste bags from the Zone 3 basement containment of the house and finalized cleaning.
0810 SES rep enters Zone 3 for the final visual clearance inspection. Upon inspecting the first 3 or 4 locations SES discovered suspected duct wrap debris on the surface of the hardened dirt floor of the crawlspace. SES also observed both sheetrock and plaster debris on the soil surface under these penetrations. SES discontinued the inspection and recommended that Coastwide bring a small HEPA vacuum into the crawlspace and vacuum a 3 to 4 square foot section of the hardened soil floor surface.
Coastwide will complete this effort before requesting a second visual clearance inspection. 0850 Coastwide finished removing the lead glazed ceramic tile in the kitchen of the house and requested a visual clearance inspection. SES entered the work area and found that all ceramic tile debris had been completely removed and surfaces in the kitchen had been wet wiped appropriately. SES authorized the visual clearance of the work area and authorized Coastwide to deregulate the work area and take down the containment barriers.
0910 Coastwide’s lead crewman relocated to the south bathroom of the house and SES inspected the regulated work area prior to authorizing the crewmen to begin ceramic tile demolition. Negative pressure had been established, all doors and windows had been isolated with polyethylene sheeting and “Lead hazard” signage was in place. Coastwide started demolition. 0930 Coastwide requested a second visual clearance inspection of the Zone 3 – house basement/crawlspace containment. SES suited up again, entered the work area and began the inspection accompanied by one of Coastwide’s workers. During the inspection, SES identified areas under register vent holes in the subfloor where additional plaster and sheetrock debris was observed.
Although no additional duct insulation paper was identified, SES directed Coastwide’s worker to continue HEPA vacuuming the soil surfaces in these areas to remove questionable materials. SES accompanied the worker throughout the crawlspace and oversaw the cleanup effort. 1015 Coastwide broke for lunch.
1020 SES finished the visual clearance inspection of the Zone 3 basement/crawlspace and approved the work area. SES and Coastwide’s worker exited the work area and informed Ben Cardenas that Zone 3 had passed the visual inspection. Coastwide was authorized to encapsulate the work area. 1115 Coastwide returned from lunch. The three lead workers continued ceramic tile demolition in the master bathroom and south guest bathroom and began demolition in the north guest restroom. One worker continued removing containment barriers in the shop (Zone 4) and in the kitchen (Zone 6). Ben Cardenas and one other worker began preparing to encapsulate the Zone 3 basement and crawlspace in preparation for tomorrow morning’s non-aggressive PCM air clearance testing. 1145 Coastwide began encapsulating the Zone 3 containment.
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/7/18
Time Details
1230 Coastwide continued loading out lead containing debris bags consisting of lead-glazed ceramic tile and mortar from the Zone 6 work areas.
1250 SES was requested to sign the hazardous waste manifest for asbestos generated by Coastwide. The total amount of waste yielded approximately 3 cubic yards of asbestos waste consisting of ductwork, ACM duct wrap and tape, and other debris.
1310 Coastwide requested a visual clearance inspection of the master bathroom following ceramic tile demolition. The work area was found properly cleaned and SES authorized Coastwide to deregulate the work area and take down the containment barriers and turn off the negative pressure machine. 1320 Coastwide requested a visual clearance inspection of the northwest guest restroom following ceramic tile demolition. The work area was found properly cleaned and SES authorized Coastwide to deregulate the work area and take down the containment barriers and turn off the negative pressure machine.
1345 Coastwide’s supervisor, Ben Cardenas informed SES that the crew would not finish the remaining work in the Zone 6 work areas this afternoon. They still have the final cleaning effort in the southeast guest bathroom and need to start the small work area in the shower of the northeast restroom. He anticipates that the crew will need approximately 3 hours to finish the work tomorrow morning as well as loading out the remaining lead containing waste and helping SES collect the air clearance samples in Zone 3. Ben stated that Coastwide had not yet received the analytical results for the lead waste characterization sample that was collected, so he doesn’t know if the ceramic tile waste bags will be able to be disposed of as construction debris or not. His supervisor, Jose informed him that results should be known before the crew finishes tomorrow morning. 1415 Coastwide finished cleaning up the jobsite for the day and securing the site buildings. SES and Coastwide left the jobsite.
ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
DAILY SUMMARY REPORT
Client Name: Cupertino Union School District Report Date: 6/8/18 Project Name: Finch Avenue Abatement
Address: 10480 Finch Avenue, Cupertino, CA 95014
Type of Abatement: Asbestos Mold Lead PCBs SES Project #: 18-018 Location(s) of Work: Zone 3 – house basement and crawl space, Zone 6 – kitchen and restrooms of the house Abatement Activity: Zone 3 – non-aggressive PCM air clearance testing, Zone 6 – removal of lead glazed ceramic tile
Method(s) of Abatement: Wet removal and demolition of lead glazed ceramic tile Contractor: Coastwide Environmental Shift Duration (hours): 8 # Workers Onsite: 3
Item Yes No N/A Deficiency/Action Taken
Outside ambient air samples below standards X
Negative pressure maintained at specification requirements X Work area(s) meet smoke test requirements X
Work area barrier(s) maintained in good condition X
Work area signs in-place and maintained in good condition X Waste bags properly labeled X
Material worked/maintained wet X
HEPA vacuums used X
Removed material promptly bagged X
Waste material removed from work area(s) daily X
Work area(s) clean/end of shift/day X
PPE and hygiene facilities/practices adequate X
SUMMARY OF DAILY EVENTS
• Zone 3: SES collected non-aggressive PCM air clearance samples in the basement and crawlspace of the house. Results pending.
• Zone 6: Coastwide completed removal of the lead containing ceramic tile at remaining lead work areas and SES completed and passed the final visual clearance inspections. Coastwide provided analytical documentation that waste characterization analysis indicated the ceramic tile could be disposed of as regular construction debris and did not present a lead hazard. Coastwide also demobilized most equipment and supplies, although the regulated work area and containment barriers for Zone 3 remained in place pending air clearance sample analysis. If the samples fail clearance testing, SES and Coastwide will return on Monday to re-clean and re-test.
SES Representative: Mark Stockwell
Cc to: Mitch Edwards
Daily Notes – CUSD – Finch Avenue Abatement
SES Project No. 18-018
Date: 6/8/18
Time Details
0600 SES and Coastwide arrived on site. Coastwide has a 3-person crew on site, one supervisor and 2 lead trained workers. Coastwide began the final cleaning process in the southwest guest bathroom and began lead ceramic tile demolition in the northeast guest restroom. 0615 SES began setting up air sampling pumps to collect non-aggressive PCM air clearance samples in the basement and crawlspace of the house (Zone 3).
0630 Ben Cardenas provided SES with the analytical results for the wastes characterization sample that was collected of the ceramic tile debris collected from the kitchen and restrooms of the house. The result indicated that the ceramic tile can be disposed of as construction debris, therefore, Coastwide will not need to transport and dispose of the material with a waste manifest. Ben also provided SES with a lead waste manifest for the small amount of lead chip waste collected from the scraping of the exterior surfaces of the site buildings. This waste will be disposed of as hazardous waste as it is assumed to exceed the limit for disposal. A total of 2 bags of lead paint chips totaling approximately 12 pounds will be disposed of.
0705 SES entered the Zone 3 basement containment and set up air sampling pumps. 0719 SES started the air clearance samples in Zone 3.
0805 Coastwide requested a visual clearance inspection of the southwest guest bathroom in Zone 6. SES inspected the work area and found it properly cleaned. SES authorized Coastwide to deregulate and remove the containment.
0820 SES entered the Zone 3 containment to complete a mid-run calibration check. All pumps were running as originally calibrated.
0830 Coastwide requested a visual clearance inspection of the final Zone 6 work area in the northeast guest restroom near the garage. SES inspected the work area and approved the ceramic tile removal.
Coastwide was authorized to deregulate and remove the containment barriers. 0840 Coastwide began a final cleaning of the jobsite, retrieving equipment and supplies and loading its truck.
0915 Coastwide’s non-hazardous waste bin arrived on site. Ben agreed to wait for approximately15 minutes until the samples in Zone 3 were retrieved before Coastwide started loading out bags of ceramic tile. 0920 SES entered the Zone 3 basement containment to post calibrate the sampling pumps and retrieve the air sample cassettes.
0930 Coastwide started loading out its non-hazardous waste and demobilizing remaining supplies and equipment.
1030 Coastwide and SES secured the buildings and left the jobsite.
Sensible Environmental Solutions Inc.
ASBESTOS AIR LABORATORY REPORTS AND CHAINS OF CUSTODY
Final Report
Airborne Fiber Analysis
NIOSH 7400 Method, Issue 2, 15 August 1994, counting rules 'A' Sensible Environmental
1116 Willow Pass Court
Robert Sutton
Concord, CA 94520
Client ID:
Report Number:
Date Received:
Date Printed:
First Reported:
Date Analyzed:
A238207
3266
06/07/18
06/07/18
Job ID/Site: FALI Job ID:18-018 - Cupertino Union School District-Finch Avenue Abatement-10480 Finch Avenue, Cupertino CA 95014
3266
Sample ID Lab Number Date Collected Volume (L) Fibers Fields LOD F/cc Fibers/cc 06/06/18
06/07/18
Total Samples Submitted:
Total Samples Analyzed:
4 2
Fibers/mm2
12040931 06/05/18 0.002 < 0.0021.5 100 <7.01350.2018-01 12040932 06/05/18 0.002 < 0.0020.0 100 <7.01331.4018-02 Analytical results and reports are generated by Forensic Analytical Laboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s)tested and results are based upon sample information provided by the client. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALI. The client is solely responsiblefor the use and interpretation of test results and reports requested from Forensic Analytical. This report must not be used by th
e client to claim product endorsementby NVLAP or any other agency of the U.S. Government. FALI is not able to assess the degree of hazard resulting from materials analyzed.
FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Samples are not blank corrected unless otherwise noted. All samples were received in acceptable condition unless otherwise noted.
Intralaboratory Relative Standard Deviation (Sr) per 100 graticule fields: 5 to 20 fibers: 0.59; >20 to 50 fibers: 0.51; >50 fibers: 0.48 Tad Thrower, Laboratory Supervisor, Hayward Laboratory
1 of 1
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218
Final Report
Airborne Fiber Analysis
NIOSH 7400 Method, Issue 2, 15 August 1994, counting rules 'A' Sensible Environmental
1116 Willow Pass Court
Robert Sutton
Concord, CA 94520
Client ID:
Report Number:
Date Received:
Date Printed:
First Reported:
Date Analyzed:
A238209
3266
06/06/18
06/06/18
Job ID/Site: FALI Job ID:18-018 - Cupertino Union School District- Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
3266
Sample ID Lab Number Date Collected Volume (L) Fibers Fields LOD F/cc Fibers/cc 06/06/18
06/06/18
Total Samples Submitted:
Total Samples Analyzed:
6 4
Fibers/mm2
12040937 06/06/18 0.002 < 0.0022.5 100 <7.01263.9018-05 12040938 06/06/18 0.002 < 0.0023.0 100 <7.01263.9018-06 12040939 06/06/18 0.002 < 0.0022.0 100 <7.01302.2018-07 12040940 06/06/18 0.002 < 0.0020.5 100 <7.01302.2018-08 Analytical results and reports are generated by Forensic Analytical Laboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s)tested and results are based upon sample information provided by the client. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALI. The client is solely responsiblefor the use and interpretation of test results and reports requested from Forensic Analytical. This report must not be used by th
e client to claim product endorsementby NVLAP or any other agency of the U.S. Government. FALI is not able to assess the degree of hazard resulting from materials analyzed.
FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Samples are not blank corrected unless otherwise noted. All samples were received in acceptable condition unless otherwise noted.
Intralaboratory Relative Standard Deviation (Sr) per 100 graticule fields: 5 to 20 fibers: 0.59; >20 to 50 fibers: 0.51; >50 fibers: 0.48 Tad Thrower, Laboratory Supervisor, Hayward Laboratory
1 of 1
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218
Final Report
Airborne Fiber Analysis
NIOSH 7400 Method, Issue 2, 15 August 1994, counting rules 'A' Sensible Environmental
1116 Willow Pass Court
Robert Sutton
Concord, CA 94520
Client ID:
Report Number:
Date Received:
Date Printed:
First Reported:
Date Analyzed:
A238246
3266
06/08/18
06/08/18
Job ID/Site: FALI Job ID:18-018 - Cupertino Union School District-Finch Avenue, Cupertino CA 945014
3266
Sample ID Lab Number Date Collected Volume (L) Fibers Fields LOD F/cc Fibers/cc 06/07/18
06/08/18
Total Samples Submitted:
Total Samples Analyzed:
4 2
Fibers/mm2
12041470 06/06/18 0.001 0.00727.5 100 35.01900.8018-11
12041471 06/06/18 0.001 0.00414.0 100 17.81911.4018-12
Analytical results and reports are generated by Forensic Analytical Laboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s)tested and results are based upon sample information provided by the client. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALI. The client is solely responsiblefor the use and interpretation of test results and reports requested from Forensic Analytical. This report must not be used by th
e client to claim product endorsementby NVLAP or any other agency of the U.S. Government. FALI is not able to assess the degree of hazard resulting from materials analyzed.
FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Samples are not blank corrected unless otherwise noted. All samples were received in acceptable condition unless otherwise noted.
Intralaboratory Relative Standard Deviation (Sr) per 100 graticule fields: 5 to 20 fibers: 0.59; >20 to 50 fibers: 0.51; >50 fibers: 0.48 Tad Thrower, Laboratory Supervisor, Hayward Laboratory
1 of 1
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218
Final Report
Airborne Fiber Analysis
NIOSH 7400 Method, Issue 2, 15 August 1994, counting rules 'A' Sensible Environmental
1116 Willow Pass Court
Robert Sutton
Concord, CA 94520
Client ID:
Report Number:
Date Received:
Date Printed:
First Reported:
Date Analyzed:
A238325
3266
06/11/18
06/11/18
Job ID/Site: FALI Job ID:18-018 - Cupertino Union School District- Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
3266
Sample ID Lab Number Date Collected Volume (L) Fibers Fields LOD F/cc Fibers/cc 06/08/18
06/11/18
Total Samples Submitted:
Total Samples Analyzed:
4 2
Fibers/mm2
12042005 06/07/18 0.001 < 0.0014.5 100 <7.01982.8018-15 12042006 06/07/18 0.001 < 0.0010.5 100 <7.01968.3018-16 Analytical results and reports are generated by Forensic Analytical Laboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s)tested and results are based upon sample information provided by the client. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALI. The client is solely responsiblefor the use and interpretation of test results and reports requested from Forensic Analytical. This report must not be used by th
e client to claim product endorsementby NVLAP or any other agency of the U.S. Government. FALI is not able to assess the degree of hazard resulting from materials analyzed.
FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Samples are not blank corrected unless otherwise noted. All samples were received in acceptable condition unless otherwise noted.
Intralaboratory Relative Standard Deviation (Sr) per 100 graticule fields: 5 to 20 fibers: 0.59; >20 to 50 fibers: 0.51; >50 fibers: 0.48 Tad Thrower, Laboratory Supervisor, Hayward Laboratory
1 of 1
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218
Final Report
Airborne Fiber Analysis
NIOSH 7400 Method, Issue 2, 15 August 1994, counting rules 'A' Sensible Environmental
1116 Willow Pass Court
Robert Sutton
Concord, CA 94520
Client ID:
Report Number:
Date Received:
Date Printed:
First Reported:
Date Analyzed:
A238353
3266
06/09/18
06/09/18
Job ID/Site: FALI Job ID:18-018 - Cupertino Union School District, Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
3266
Sample ID Lab Number Date Collected Volume (L) Fibers Fields LOD F/cc Fibers/cc 06/09/18
06/09/18
Total Samples Submitted:
Total Samples Analyzed:
5 3
Fibers/mm2
12042223 06/08/18 0.002 < 0.0022.5 100 <7.01225.6018-19 12042224 06/08/18 0.002 < 0.0022.0 100 <7.01225.6018-20 12042225 06/08/18 0.002 < 0.0023.5 100 <7.01235.2018-21 Analytical results and reports are generated by Forensic Analytical Laboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s)tested and results are based upon sample information provided by the client. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALI. The client is solely responsiblefor the use and interpretation of test results and reports requested from Forensic Analytical. This report must not be used by th
e client to claim product endorsementby NVLAP or any other agency of the U.S. Government. FALI is not able to assess the degree of hazard resulting from materials analyzed.
FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Samples are not blank corrected unless otherwise noted. All samples were received in acceptable condition unless otherwise noted.
Intralaboratory Relative Standard Deviation (Sr) per 100 graticule fields: 5 to 20 fibers: 0.59; >20 to 50 fibers: 0.51; >50 fibers: 0.48 Tad Thrower, Laboratory Supervisor, Hayward Laboratory
1 of 1
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218
Sensible Environmental Solutions Inc.
LEAD AIR LABORATORY REPORTS AND CHAINS OF CUSTODY
Client ID:
Report Number:
Date Received:
M198912
Job ID / Site: 18-018, Cupertino Union School District
Sensible Environmental
1116 Willow Pass Court
3266
FALI Job ID:
Date Analyzed:
3266
Robert Sutton
Concord, CA 94520 Date Printed: 06/08/18
06/08/18
Metals Analysis of Air Filters
First Reported: 06/08/18
06/06/18
Final Report
16/5/18 Total Samples Submitted:Date(s) Collected:
1Total Samples Analyzed:
Sample Number Lab Number Result
Result Reporting Method
Volume Units Limit* ReferenceAnalyte
Pb018-01L 30804131 < 3 ug/m3 3 2,244 L NIOSH 7082
* The Reporting Limit represents the lowest amount of analyte that the laboratory can confidently detect in the sample, and is not a regulatory level. The Units for the Reporting Limit are the same as the Units for the Final Results.
Analytical results and reports are generated by Forensic Analytical at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by Forensic Analytical to any third party without prior written request from client. This report applies only to the sample(s) tested. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by Forensic Analytical. The client is solely responsible for the use and interpretation of test results and reports requested from Forensic Analytical. Forensic Analytical is not able to assess the degree of hazard resulting from materials analyzed. Forensic Analytical reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Any modifications that have been made to referenced test methods are documented in Forensic Analytical's Standar d Operating Procedures Manual. Sample results have not been blank corrected. Quality control and sample receipt condition were acceptable unless otherwise noted.
Daniele Siu, Laboratory Supervisor, Hayward Laboratory
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218 1 of 1
Sensible Environmental Solutions Inc.
INSPECTION FORMS
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
LEAD INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 1 – Exterior walls, soffits, eaves, fascia, window framing, and flower box shelves of house, shop, central shed and outbuildings
BUILDING NAME: House, shop, central shed and outbuildings
DISTRICT NAME: Cupertino Union School District SES REF. NUMBER: 18-018
PROJECT TITLE: Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
DESCRIPTION OF LEAD WORK:
Material Description Room Name and No. Quantity
Removed Abatement Method Quantity
Remaining
Stabilization of loose
and flaking LBP
House 200 SF Hand scraping,
painting with primer
None
Shop, homestead and out buildings 800 SF None
Central shed 80 SF None
Legend: LC – Lead-containing LBP – Lead-based Paint SF – Square Feet` LF – Linear Feet
CONTRACTOR’S PRE-START VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found it to be prepared in accordance with the Contract Documents and associated Regulations and is ready to start abatement operations.
NAME: Benjamin Cardenas INSPECTION DATE: 6/4/18
SIGNATURE: CERTIFICATION #: 2289
CONTRACTOR’S FINAL VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found no dust, debris or residue.
This inspection included all surfaces including pipes, beams, ledges, walls, ceiling, floor, Decontamination Unit, sheet plastic, etc.
NAME: Benjamin Cardenas INSPECTION DATE: 6/7/18
SIGNATURE: CERTIFICATION #: 2289
CONSULTANT PRE-START VISUAL INSPECTION
CONSULTANT hereby certifies that he has conducted a pre-abatement visual inspection of the referenced Work Area and verifies that the Contractor has prepared the Work Area in accordance with the Contract Documents and is ready to start abatement operations.
NAME: Mark Stockwell INSPECTION DATE: 6/4/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
CONSULTANT FINAL VISUAL INSPECTION
CONSULTANT hereby certifies that he has performed the final visual inspection of the referenced Work Area and verifies that this inspection has been thorough and to the best of his knowledge and belief, the Contractor's Certification above is a true and honest one.
NAME: Mark Stockwell INSPECTION DATE: 6/7/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
LEAD INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 1 – Exterior walls, soffits, eaves, fascia, window framing, and flower box shelves of house, shop, central shed and outbuildings
BUILDING NAME: House, shop, central shed and outbuildings
CLEARANCE DUST WIPE SAMPLING FOR LEAD
CONSULTANT hereby certifies that the results of dust wipe samples collected and analyzed in this work area meet the clearance criteria indicated below:
Not Applicable – Cleared by Visual Inspection Only for the following Reasons: Exterior work area and buildings being demolished.
NAME: Mark Stockwell INSPECTION DATE: 6/7/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 2 – Northeast restroom, utility rooms and garage hallway
BUILDING NAME: Main house and garage
DISTRICT NAME: Cupertino Union School District SES REF. NUMBER: 18-018
PROJECT TITLE: Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
DESCRIPTION OF ASBESTOS WORK:
Material Description Room Name and No. Quantity
Removed Abatement Method Quantity Remaining
AC vinyl floor tile N.E restroom, utility
rooms & garage hall 206 SF Manual removal None
Legend: AC- Asbestos-containing SF – Square Feet LF – Linear Feet
CONTRACTOR’S PRE-START VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found it to be prepared in accordance with the Contract Documents and associated Regulations and is ready to start abatement operations.
NAME: Benjamin Cardenas INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 17361217
CONTRACTOR’S FINAL VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found no dust, debris or residue.
This inspection included all surfaces including pipes, beams, ledges, walls, ceiling, floor, Decontamination Unit, sheet plastic, etc.
NAME: Benjamin Cardenas INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 17361217
CONSULTANT PRE-START VISUAL INSPECTION
CONSULTANT hereby certifies that he has conducted a pre-abatement visual inspection of the referenced Work Area and verifies that the Contractor has prepared the Work Area in accordance with the Contract Documents and is ready to start abatement operations.
NAME: Mark Stockwell INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
CONSULTANT FINAL VISUAL INSPECTION
CONSULTANT hereby certifies that he has performed the final visual inspection of the referenced Work Area and verifies that this inspection has been thorough and to the best of his knowledge and belief, the Contractor's Certification above is a true and honest one.
NAME: Mark Stockwell INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 2 – Northeast restroom, utility rooms and garage hallway
BUILDING NAME: Main house and garage
ASBESTOS CLEARANCE AIR SAMPLING
CONSULTANT hereby certifies that the results of air samples collected and analyzed in this work area meet the clearance criteria indicated below:
1 Non-aggressive PCM Samples at or below 0.01 Fibers/cc SES Clearance Air Sample Numbers: 018-05
NAME: Mark Stockwell INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 3 – Basement and crawl space of house
BUILDING NAME: Main house basement and crawl space
DISTRICT NAME: Cupertino Union School District SES REF. NUMBER: 18-018
PROJECT TITLE: Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
DESCRIPTION OF ASBESTOS WORK:
Material Description Room Name and No. Quantity
Removed Abatement Method Quantity Remaining
AC HVAC duct wrap /
tape
Basement and
crawlspace of house 90 LF Wrap and cut None
Legend: AC- Asbestos-containing SF – Square Feet LF – Linear Feet
CONTRACTOR’S PRE-START VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found it to be prepared in accordance with the Contract Documents and associated Regulations and is ready to start abatement operations.
NAME: Benjamin Cardenas INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 17361217
CONTRACTOR’S FINAL VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found no dust, debris or residue.
This inspection included all surfaces including pipes, beams, ledges, walls, ceiling, floor, Decontamination Unit, sheet plastic, etc.
NAME: Benjamin Cardenas INSPECTION DATE: 6/7/18
SIGNATURE: CERTIFICATION #: 17361217
CONSULTANT PRE-START VISUAL INSPECTION
CONSULTANT hereby certifies that he has conducted a pre-abatement visual inspection of the referenced Work Area and verifies that the Contractor has prepared the Work Area in accordance with the Contract Documents and is ready to start abatement operations.
NAME: Mark Stockwell INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
CONSULTANT FINAL VISUAL INSPECTION
CONSULTANT hereby certifies that he has performed the final visual inspection of the referenced Work Area and verifies that this inspection has been thorough and to the best of his knowledge and belief, the Contractor's Certification above is a true and honest one.
NAME: Mark Stockwell INSPECTION DATE: 6/7/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 3 – Basement and crawl space of house
BUILDING NAME: Main house basement and crawl space
ASBESTOS CLEARANCE AIR SAMPLING
CONSULTANT hereby certifies that the results of air samples collected and analyzed in this work area meet the clearance criteria indicated below:
2 Non-aggressive PCM Samples at or below 0.01 Fibers/cc SES Clearance Air Sample Numbers: 018-19 and 018-20
NAME: Mark Stockwell INSPECTION DATE: 6/8/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 4 – Shop interior at ceiling-mounted heater
BUILDING NAME: Shop
DISTRICT NAME: Cupertino Union School District SES REF. NUMBER: 18-018
PROJECT TITLE: Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
DESCRIPTION OF ASBESTOS WORK:
Material Description Room Name and No. Quantity
Removed Abatement Method Quantity Remaining
Heater with AC paper
insulation Shop 2 SF Wrap and cut None
Legend: AC- Asbestos-containing SF – Square Feet LF – Linear Feet
CONTRACTOR’S PRE-START VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found it to be prepared in accordance with the Contract Documents and associated Regulations and is ready to start abatement operations.
NAME: Benjamin Cardenas INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 17361217
CONTRACTOR’S FINAL VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found no dust, debris or residue.
This inspection included all surfaces including pipes, beams, ledges, walls, ceiling, floor, Decontamination Unit, sheet plastic, etc.
NAME: Benjamin Cardenas INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 17361217
CONSULTANT PRE-START VISUAL INSPECTION
CONSULTANT hereby certifies that he has conducted a pre-abatement visual inspection of the referenced Work Area and verifies that the Contractor has prepared the Work Area in accordance with the Contract Documents and is ready to start abatement operations.
NAME: Mark Stockwell INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
CONSULTANT FINAL VISUAL INSPECTION
CONSULTANT hereby certifies that he has performed the final visual inspection of the referenced Work Area and verifies that this inspection has been thorough and to the best of his knowledge and belief, the Contractor's Certification above is a true and honest one.
NAME: Mark Stockwell INSPECTION DATE: 6/5/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 4 – Shop interior at ceiling-mounted heater
BUILDING NAME: Shop
ASBESTOS CLEARANCE AIR SAMPLING
CONSULTANT hereby certifies that the results of air samples collected and analyzed in this work area meet the clearance criteria indicated below:
1 Non-aggressive PCM Samples at or below 0.01 Fibers/cc SES Clearance Air Sample Numbers: 018-07
NAME: Mark Stockwell INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 5 – Dining room mini-containment
BUILDING NAME: House at dining room
DISTRICT NAME: Cupertino Union School District SES REF. NUMBER: 18-018
PROJECT TITLE: Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
DESCRIPTION OF ASBESTOS WORK:
Material Description Room Name and No. Quantity
Removed Abatement Method Quantity Remaining
Asbestos cement pipe
flue Dining room 12 LF Manual removal None
Legend: AC- Asbestos-containing SF – Square Feet LF – Linear Feet
CONTRACTOR’S PRE-START VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found it to be prepared in accordance with the Contract Documents and associated Regulations and is ready to start abatement operations.
NAME: Ben Cardenas INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 17361217
CONTRACTOR’S FINAL VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found no dust, debris or residue.
This inspection included all surfaces including pipes, beams, ledges, walls, ceiling, floor, Decontamination Unit, sheet plastic, etc.
NAME: Ben Cardenas INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 17361217
CONSULTANT PRE-START VISUAL INSPECTION
CONSULTANT hereby certifies that he has conducted a pre-abatement visual inspection of the referenced Work Area and verifies that the Contractor has prepared the Work Area in accordance with the Contract Documents and is ready to start abatement operations.
NAME: Mark Stockwell INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
CONSULTANT FINAL VISUAL INSPECTION
CONSULTANT hereby certifies that he has performed the final visual inspection of the referenced Work Area and verifies that this inspection has been thorough and to the best of his knowledge and belief, the Contractor's Certification above is a true and honest one.
NAME: Mark Stockwell INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
ASBESTOS INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 5 – Dining room mini-containment
BUILDING NAME: House at dining room
ASBESTOS CLEARANCE AIR SAMPLING
CONSULTANT hereby certifies that the results of air samples collected and analyzed in this work area meet the clearance criteria indicated below:
Not Applicable – Cleared by Visual Inspection Only.
NAME: Mark Stockwell INSPECTION DATE: 6/6/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
LEAD INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 6 – House kitchen, northeast restroom, guest restroom adjacent dining room, south bathroom and master bathroom
BUILDING NAME: House
DISTRICT NAME: Cupertino Union School District SES REF. NUMBER: 18-018
PROJECT TITLE: Finch Avenue Abatement, 10480 Finch Avenue, Cupertino, CA 95014
DESCRIPTION OF LEAD WORK:
Material Description Room Name and No. Quantity
Removed Abatement Method Quantity
Remaining
Ceramic wall and floor tile
with lead glazings
House kitchen 42 SF
Pneumatic chisel, hand
demolition, wet methods,
HEPA vacuuming
None
House NE restroom 10 SF
House NW guest restroom 58 SF
House SW bathroom 240 SF
House master bathroom 166 SF
Legend: LC – Lead-containing LBP – Lead-based Paint SF – Square Feet LF – Linear Feet
CONTRACTOR’S PRE-START VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found it to be prepared in accordance with the Contract Documents and associated Regulations and is ready to start abatement operations.
NAME: Benjamin Cardenas INSPECTION DATE: 6/4/18
SIGNATURE: CERTIFICATION #: 2248
CONTRACTOR’S FINAL VISUAL INSPECTION
CONTRACTOR hereby certifies that he has visually inspected the Work Area and has found no dust, debris or residue.
This inspection included all surfaces including pipes, beams, ledges, walls, ceiling, floor, Decontamination Unit, sheet plastic, etc.
NAME: Benjamin Cardenas INSPECTION DATE: 6/7/18 & 6/8/18
SIGNATURE: CERTIFICATION #: 2248
CONSULTANT PRE-START VISUAL INSPECTION
CONSULTANT hereby certifies that he has conducted a pre-abatement visual inspection of the referenced Work Area and verifies that the Contractor has prepared the Work Area in accordance with the Contract Documents and is ready to start abatement operations.
NAME: Mark Stockwell INSPECTION DATE: 6/4/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
CONSULTANT FINAL VISUAL INSPECTION
CONSULTANT hereby certifies that he has performed the final visual inspection of the referenced Work Area and verifies that this inspection has been thorough and to the best of his knowledge and belief, the Contractor's Certification above is a true and honest one.
NAME: Mark Stockwell INSPECTION DATE: 6/7/18 & 6/8/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
SENSIBLE Section 01 11 00 - Appendix G
ENVIRONMENTAL
SOLUTIONS INC. ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
LEAD INSPECTION FORM
LOCATION OF ZONE / WORK AREA: Zone 6 – House kitchen, northeast restroom, guest restroom adjacent dining room, south bathroom and master bathroom
BUILDING NAME: House
CLEARANCE DUST WIPE SAMPLING FOR LEAD
CONSULTANT hereby certifies that the results of dust wipe samples collected and analyzed in this work area meet the clearance criteria indicated below:
Not Applicable – Cleared by Visual Inspection Only for the following Reasons: Building is scheduled for demolition and will not be re-occupied by children.
NAME: Mark Stockwell INSPECTION DATE: 6/7/18 & 6/8/18
SIGNATURE: CERTIFICATION #: 96-2021 / 570
Sensible Environmental Solutions Inc.
PHOTOGRAPHS
Finch Avenue Project (SES 18-018)
Zone 1 preparation measures for lead paint removal and
stabilization
Zone 1 preparation measures for lead paint removal and
stabilization
Zone 1 preparation measures for lead paint removal and
stabilization at the shop
Zone 1 preparation measures for lead paint removal and
stabilization at the shop
Zone 1 exterior paint scraping at the shop and outbuildings Zone 1 exterior paint scraping at the central shed
Finch Avenue Project (SES 18-018)
Zone 1 paint stabilization repainting at the main house Zone 1 paint stabilization and scraping at the front walkway of the main house
Zone 1 paint stabilization and repainting of the central shed Zone 1 paint stabilization and repainting of the shop
Zone 1 post removal surface of the shop following paint scraping
Zone 1 post removal and stabilization of the flower box shelves of the main house
Finch Avenue Project (SES 18-018)
Zone 1 post stabilization painting of the homestead Zone 1 post stabilization painting of the central shed
Zone 1 post stabilization painting of the shop Zone 2 preparation at decontamination chamber at west end of hallway to the garage
Zone 2 pre-removal view of existing vinyl floor tile Zone 2 view of manometer recording sufficient negative air pressure inside work area
Finch Avenue Project (SES 18-018)
Zone 2 preparation of work area at air filtration exhaust in garage
Zone 2 preparation measure including isolation of windows and view port
Zone 2 removal work included hand scraping of floor tile in the utility room
Zone 2 removal work showing partially removed floor tile in hallway to the garage
Zone 2 non-friable floor tile waste bags Zone 2 airless sprayer used to wet flooring materials and suppress airborne dust during removal
Finch Avenue Project (SES 18-018)
Zone 2 post removal view of utility room showing non-asbestos containing floor mastic remaining after floor tile was removed Zone 2 post removal view of restroom showing non-asbestos containing floor mastic remaining after floor tile was removed
Zone 3 preparation measures showing entrance to basement at decontamination chamber
Zone 3 manometer recording sufficient negative pressure inside basement/crawlspace containment
Zone 3 air filtration machine attached to HVAC opening in living room
Zone 3 preparation of basement/crawlspace vents to isolate containment
Finch Avenue Project (SES 18-018)
Zone 3 staging area of containment showing workers wrapping asbestos containing ductwork
Zone 3 staging area showing HVAC ductwork wrapped and
ready for loadout and labeling
Zone 3 air scrubbing air filtration machine located in staging area of basement
Zone 3 workers wrapping HVAC ductwork in polyethylene
sheeting
Zone 3 post removal view of crawlspace showing absence of HVAC ductwork after removal work was completed
Zone 3 post removal view of crawlspace showing view of hard pan dirt floor after HEPA vacuuming
Finch Avenue Project (SES 18-018)
Zone 4 view of ceiling mounted heater in shop prior to removal Zone 4 view of asbestos containing insulation inside heater prior to removal
Zone 4 preparation of isolated work area prior to heater removal
Zone 4 view of heater after being wrapped in 2 layers of 6 millimeter polyethylene sheeting before removal
Zone 4 final wrapping of heater Zone 4 view of ceiling mounting hangers after removal of heater
Finch Avenue Project (SES 18-018)
Zone 5 view of transite flue pipe located inside west wall of dining room
Zone 5 preparation of mini-containment to isolate removal of transite pipe during work
Zone 5 mini-containment constructed to isolate removal of transite pipe during work
Zone 5 view of transite pipe during process. Note minimal breakage at sections coupling
Zone 5 five foot section of transite pipe wrapped in 2 layers of polyethylene sheeting after removal
Zone 5 empty wall cavity in west wall of dining room after transite pipe removal
Finch Avenue Project (SES 18-018)
Zone 5 empty wall cavity in west wall of dining room after transite pipe removal
Zone 5 empty ceiling and roof cavity after removal of transite pipe
Zone 6 preparation measure to isolate east door of kitchen prior to ceramic tile demolition
Zone 6 preparation measure to filter and scrub air within the regulated work area using a HEPA air filtration machine
Zone 6 preparation showing HEPA exhaust tubing at master bathroom Zone 6 preparation at northeast restroom near garage
Finch Avenue Project (SES 18-018)
Zone 6 removal or lead containing ceramic tile from kitchen counter Zone 6 waste bags of ceramic tile debris
Zone 6 final condition of kitchen counter and back splash following removal of ceramic tile
Zone 6 final condition of master bathroom floor and walls following removal of ceramic tile
Zone 6 final condition of northeast restroom floor following removal of ceramic tile
Zone 6 northwest guestroom counter following removal of ceramic tile counter
WASTE MANIFESTS
Sensible Environmental Solutions Inc.
Sensible Environmental Solutions Inc.
SES REPRESENTATIVE CERTIFICATIONS
State of California
Division of Occupational Safety and Health
Certified Asbestos Consultant
Mark Alan Stockwell
This certification was^sued fyit}»Division of
Occupational-Sa^tysntfHealttj:.as authorized
by Sections Hio'etsetj: of the Business and
Professions Code.
State of California Department of Public Health
Lead-Related
Construction Iyfi«
Inspector/Assessor 02/22/2019
Mark A. StockwellaH ID *: 570
Asbestos Project Designer
Refresher Training Course
5rk Stockwe
has successfully completed the Asbestos Project Designer Refresher course approved by the California Division of Occupational Safety and Health for purposes of certification required by Title 8, Article 2.7 Chapter 3.2, Section 341.16 and the accreditation required under the Toxic Substances Control Act, Title II. Conducted by M&C Environmental Training, Inc., 1619 Beverly Place, Berkeley, California 94707. Tel. #(510) 525 -1388 Course Approval Number: CA-003-10
Location: Oakland, California
Dates: April 4, 2018
Director of Training: John McGinnis
Expiration: April 4, 2019
Certificate Number 43616 DR
Asbestos Inspector
Refresher Training Course
Fark Stock W€4J
has successfully completed the Asbestos Inspector Refresher course approved by the California Division of Occupational Safety and Health for purposes of certification required by Title 8, Article 2.7 Chapter 3.2, Section 341.16 and the accreditation required under the Toxic Substances Control Act, Title II. Conducted by M&C Environmental Training, Inc., 1619 Beverly Place, Berkeley, California 94707. Tel. #(510) 525 - 1388 Course Approval Number: CA-003-06
Location: Oakland, California
Dates: April 5, 2018
Director of Training: John McGinnis
Expiration: April 5,2019
Certificate Number 43624 IR
Asbestos Management Planner
Refresher Training Course
has successfully completed the Asbestos Management Planner Refresher course approved by the California Division of Occupational Safety and Health for purposes of certification required by Title 8, Article 2.7 Chapter
3.2, Section 341.16 and the accreditation required under the Toxic Substances Control Act, Title II. Conducted by M&C Environmental Training, Inc., 1619 Beverly Place, Berkeley, California 94707. Tel. #(510) 525 -1388 Course Approval Number: CA-003-08
Location: Oakland, California
Dates: April 5, 2018
Director of Training: John McGinnis
Expiration: April 5, 2019
Certificate Number 43648 PR
Asbestos Contractor/Supervisor
Refresher Training Course
•k Stock well
has successfully completed the Asbestos Contractor/Supervisor Refresher course approved by the California Division of Occupational Safety and Health for purposes of certification required by Title 8, Article 2.7 Chapter
3.2, Section 341.16 and the accreditation required under the Toxic Substances Control Act, Title II. Conducted by M&C Environmental Training, Inc., 1619 Beverly Place, Berkeley, California 94707. Tel. #(510) 525 -1388 Course Approval Number: CA-003-04
Location: Oakland, California
Dates: April 6, 2018
Director of Training: John McGinnis
Expiration: April 6, 2019
Certificate Number 43662 SR
Sensible Environmental Solutions Inc.
SES ROTOMETER CALIBRATION DATA
SES-7 Current Calibration Date: 5/14/2018
Type: High Flow Next Calibration Date: 11/14/2018
Calibration Conducted By: Matt Reynolds
SES-7
2.00 1.91
3.00 3.09
4.00 4.16
5.00 5.28
6.00 6.28
7.00 7.21
8.00 8.31
9.00 9.12
10.00 10.03
11.00 11.04
12.00 12.00
13.00 13.05
14.00 14.14
15.00 14.99
This rotometer was calibrated with a Gilian Flowmeter as a Primary Standard. A best fit curve of calibration data was produced and graphed. A table of best fit values is attached to the rotometer. Rotometer readings and corresponding actual values may be read from the graph or table. All readings were taken from the center of the ball on the rotometer.
All calibration readings utilizing the rotometer should be taken from the center of the ball. 1116 Willow Pass Court, Concord, CA 94520
101 Filbert Street, Suite 101, Oakland, CA 94607 Phone: 510-835-9737 Fax: 510-835-9740
CALIBRATION DATA FORM
11/14/18
Phone: 925-689-9737 Fax: 925-689-1420
ENVIRONMENTAL SOLUTIONS WITH A SENSIBLE APPROACH
Assigned
Staff:
Rotometer #:
3.09 4.16
5.28 6.28
7.21 8.31
9.12 10.03
11.04 12.00
13.05 14.14
14.99 2
3 4
5 6
7 8
9 10
11 12
13 14
15 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Actual Reading (LPM)
Rotometer Reading (LPM)
Sensible Environmental Solutions Inc.
NOTIFICATIONS
Job #: 10443
Note: Any changes in the information provided to the district office by the written notice shall be reported to the district office within 24 hours of such change.
DIVISION OF OCCUPATIONAL SAFETY AND HEALTH
Contractors State License Board License Number:
10480 Finch Ave. Cupertino CA 95014
Company/Employer Name:
Headquarters Address:
COASTWIDE ENVIRONMENTAL TECHNOLOGIES, INC.
170 Second Street Watsonville, CA 95076
*Name of Certified Supervisor: Benjamin Cardenas
(831) 761-5511
*Name of Qualified person in charge of air monitoring, laboratory work and respirators: Jose Fregoso Describe type, scope and work practices of job:
Type of Business: Educational
Estimated number of employees on this job 4
*Name of Certified Asbestos Consultant:: Sensible Environmental Solutions, Inc.- Mitchell Evaluation of potential for exposure:
Projected job starting date: 06/04/18 Projected completion date: 06/08/18 CAL/OSHA Form 183B rev 04/2004
STATE OF CALIFORNIA
DEPARTMENT OF INDUSTRIAL RELATIONS
Do not send this notification to DOSH Headquarters or to DOSH Consultation.
This will not satisfy the notification requirement and could result in citation.
Temporary Worksite Notification for Asbestos-Related Work Prior to the start of each job or phase of asbestos-related work requiring the employer or contractor to be registered, Section 341.9 of the California Code of Regulations (8 CCR 341.9) requires notifications to the nearest DOSH District Office.
Kitchen, Bathroom, Crawlspace, Attic.
Address of Temporary Worksite and Precise Location: Sedgwick Elementary School New Addition 523560
DOSH-ACRU (Cal/OSHA) Asbestos Registration Number: 058
And/or "Report of Use" Registry Number:
Renovation. Wet Methods Provide full containment, negative air filtration, H.E.P.A. vacuuming and cleaning. Glovebags where applicable. Protective clothing and respiration equipment to be worn.
Low
Floor Mastic, Grinding, Floor tile, Heat Shield - Furnace, Heating duct, LEAD Paint Chips Removal of:
Nearest Intersection: Phil Ln.
Job # 10443
Santa Clara County
Concentration of lead in disturbed materials:
*Amount of area to be disturbed
*Supervisor name:
CET Job # 10443
STATE OF CALIFORNIA
Division of Occupational Safety and Health
* Name of employer doing "Lead Work" *Address *Zip Code COASTWIDE ENVIRONMENTAL TECHNOLOGIES, INC. 170 Second Street Watsonville, CA 95076
Supervisor:
Rodrigo Gutierrez Gutierrez
*Phone
(831) 761-5511
Shift
*Street address or location of job
Sedgwick Elementary School New Addition
10480 Finch Ave.
City
Cupertino
County
Santa Clara
*Precise Location of work (building no., room no., etc.) *Job start date/time
06/04/18
*Job completion date/time
06/08/18
LEAD-WORK PRE-JOB NOTIFICATION
(Note: Items marked * are required)
523560California Contractor's license number
*Number of lead-job workers:
California Department of Health Services Lead Certificate No. (if applicable)
Pager/cellular phone no.
*Approximate duration of "Lead Work" in days
5 Nearest cross Street
Phil Ln.
Zip Code
95014
Entity contracting the lead-work Address
10301 Vista Drive
Zip Code
95014
Phone
408/252-3000x347
Pager/cellular phone no.
Type of structure and use:
Scope of work and work practices: (check all that apply) *Describe lead-related work to be done (check all that apply) parts per million (ppm)
*Name of notifier
Rodrigo Gutierrez
Title:
Estimator
*Date Signed:
5/31/2018
This information is provided in accordance with Title 8, California Code of Regulations, Construction Safety Order Section 1532.1 (p). 662
4 Annual Notification for Steel Structures
101 - 1,000 square feet
Mg/CM2
*Describe paint removal methods (check all that apply)
Assumed to be lead containing:
Day
Swing
Graveyard
Other
Torch Cutting/Welding
Duration of work:
% percent by weight
Residence
Cupertino Union School District
Surface Preparation
Water/Moisture Damage Repair
Window/Door Repair/Replacement
Wall Repair
Paint Removal
Demolition
Other:
Manual Scraping/Sanding
Power Sanding/Grinding
Chemical Stripping
Demolition
Heat Guns
Abrasive Blasting
Hydroblasting
Torch Cutting
Welding
Other:
Yes
Kitchen, Bathroom, Exterior Surfaces
CET Job #
10443
State of California - Health and Human Services Agency
ABATEMENT OF LEAD HAZARDS NOTIFICATION
Section I - Structure Where Abatement of Lead-Based Paint or Lead Hazards is Scheduled Section 6 - Individual Conducting Abatement (Supervisor or Company and Supervisor) Address (number, street, apartment number, if applicable) Sedgwick Elementary School New Addition
10480 Finch Ave.
County
Santa Clara
If you would like more information, please contact the following:
Projected starting date 06/04/18 Projected ending date 06/08/18 Department of Health Services
POST AT ALL ENTRANCES TOP WORK AREA AND STRUCTURE
DHS Certificatation Number
Zip Code
95014
Section 5 - Property Owner or Manager
Address
10301 Vista Drive
Zip Code
95014
Telephone number
408/252-3000x347
State
CA
Section 2 - Summary of Specified Work and Location(s) Where Lead-Based Paint or Lead Hazards Will Be Abated Notifier Rodrigo Gutierrez Title Estimator
DHS 8551 (11/05)
662
Work is being conducted to abate lead-based paint or lead hazards in or on this structure. For more information, please contact the individuals and/or agencies listed below.
City
Cupertino
Kitchen, Bathroom, Exterior Surfaces
Description of work to be performed: Interior Exterior Both Interior and Exterior Permanent (> 20 years)
Yes No Don't know
Temporary (< 20 years
Do any children reside on the property?
Type of abatement (check one box only)
Section 4 - Restrictions on Entering Work Area
List specific times and/or dates residents are not allowed to enter work areas, if applicable. 06/04/18 06/08/18
Supervisor:
COASTWIDE ENVIRONMENTAL TECHNOLOGIES, INC.
170 Second Street Watsonville CA 95076
Rodrigo Gutierrez Gutierrez
(831) 761-5511
California Contractor's license number
City
Cupertino
Name and company Telephone number
Address (number, street) Zip CodeStateCity
523560
Section 7 - Local Environmental Health Agency
Telephone number
This form shall be mailed to:
Department of Health Services
Childhood Lead Poisoning Prevention Branch Reports
850 Marina Bay Parkway, Bldg P, 3rd Floor
Richmond, CA 94804-6403
FAX (510) 620-5656
Is this form a revision of a
previously submitted
abatement notification form?
No
Cancelled project
Section 3
to
Type of structure
Single Family Dwelling
County of Santa Clara Dept of Environmental Health 408-918-3400 Cupertino Union School District
Yes (Date of other form: )
COASTWIDE ENVIRONMENTAL
WORKER CERTIFICATIONS
Sensible Environmental Solutions Inc.
COASTWIDE ENVIRONMENTAL
EMPLOYEE DAILY ROSTERS
Sensible Environmental Solutions Inc.
COASTWIDE ENVIRONMENTAL
WORK AREA ENTRY/EXIT LOGS
Sensible Environmental Solutions Inc.
COASTWIDE ENVIRONMENTAL
MANOMETER LOGS
Sensible Environmental Solutions Inc.
Sensible Environmental Solutions Inc.
COASTWIDE ENVIRONMENTAL
ASBESTOS PERSONAL AIR SAMPLES
Final Report
Airborne Fiber Analysis
NIOSH 7400 Method, Issue 2, 15 August 1994, counting rules 'A' Coastwide Environmental
170 Second Street
Project Manager
Watsonville, CA 95076
Client ID:
Report Number:
Date Received:
Date Printed:
First Reported:
Date Analyzed:
A238598
1895
06/21/18
06/21/18
Job ID/Site: FALI Job ID:10443 - Sedgwick Elementary School New Addition, 10480 Finch Ave., Cupertino, CA 95014
1895
Sample ID Lab Number Date Collected Volume (L) Fibers Fields LOD F/cc Fibers/cc 06/14/18
06/21/18
Total Samples Submitted:
Total Samples Analyzed:
1 1
Fibers/mm2
12043974 06/05/18 0.007 0.010
26 Name: Omar Nunes
7.0 100 8.9360.01
(8-Hour TWA) Note: Sample 12043974 was used to calculate an 8-Hour Time Weighted Average of 0.004 fibers/cc. * The TWA calculation is derived from the data documented on the associa ted chain of custody and assumes there is no exposure for the remaining n on-sampled po rtion of the workers 8 hour shift.
This information should not be used for determining a Negative Exposure Assessment with out proper evaluation of th e data.
Analytical results and reports are generated by Forensic Analytical Laboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s)tested and results are based upon sample information provided by the client. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALI. The client is solely responsiblefor the use and interpretation of test results and reports requested from Forensic Analytical. This report must not be used by th
e client to claim product endorsementby NVLAP or any other agency of the U.S. Government. FALI is not able to assess the degree of hazard resulting from materials analyzed.
FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Samples are not blank corrected unless otherwise noted. All samples were received in acceptable condition unless otherwise noted.
Intralaboratory Relative Standard Deviation (Sr) per 100 graticule fields: 5 to 20 fibers: 0.59; >20 to 50 fibers: 0.51; >50 fibers: 0.48 Tad Thrower, Laboratory Supervisor, Hayward Laboratory
1 of 1
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218
Final Report
Airborne Fiber Analysis
NIOSH 7400 Method, Issue 2, 15 August 1994, counting rules 'A' Coastwide Environmental
170 Second Street
Project Manager
Watsonville, CA 95076
Client ID:
Report Number:
Date Received:
Date Printed:
First Reported:
Date Analyzed:
A238597
1895
06/21/18
06/21/18
Job ID/Site: FALI Job ID:10443 - Sedgwick Elementary School New Addition, 10480 Finch Ave., Cupertino, CA 95014
1895
Sample ID Lab Number Date Collected Volume (L) Fibers Fields LOD F/cc Fibers/cc 06/14/18
06/21/18
Total Samples Submitted:
Total Samples Analyzed:
2 2
Fibers/mm2
12043972 06/06/18 0.045 0.065
Name: Juan Medina
8.0 100 10.160.0JUAN MEDINA 1
12043973 06/06/18 0.003 0.108
Name: Juan Medina
102.0 54 240.6860.0JUAN MEDINA 2
Filter loaded with particulate which may affect analytical result.Comments:
(8-Hour TWA) Note: Samples 12043973 and 12043972 were used to calculate an 8-Hour Time Weighted Average of
0.101 fibers/cc.
* The TWA calculation is derived from the data documented on the associa ted chain of custody and assumes there is no exposure for the remaining n on-sampled po rtion of the workers 8 hour shift.
This information should not be used for determining a Negative Exposure Assessment with out proper evaluation of th e data.
Analytical results and reports are generated by Forensic Analytical Laboratories Inc. (FALI) at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by FALI to any third party without prior written request from client. This report applies only to the sample(s)tested and results are based upon sample information provided by the client. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by FALI. The client is solely responsiblefor the use and interpretation of test results and reports requested from Forensic Analytical. This report must not be used by th
e client to claim product endorsementby NVLAP or any other agency of the U.S. Government. FALI is not able to assess the degree of hazard resulting from materials analyzed.
FALI reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Samples are not blank corrected unless otherwise noted. All samples were received in acceptable condition unless otherwise noted.
Intralaboratory Relative Standard Deviation (Sr) per 100 graticule fields: 5 to 20 fibers: 0.59; >20 to 50 fibers: 0.51; >50 fibers: 0.48 Tad Thrower, Laboratory Supervisor, Hayward Laboratory
1 of 1
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218
Sensible Environmental Solutions Inc.
COASTWIDE ENVIRONMENTAL
LEAD PERSONAL AIR SAMPLES
Client ID:
Report Number:
Date Received:
M199245
Job ID / Site: 10443, Sedgwick Elementary School New Addition, 10480 Finch Ave., Cupertino, CA 95014
Coastwide Environmental
170 Second Street
1895
FALI Job ID:
Date Analyzed:
1895
Project Manager
Watsonville, CA 95076 Date Printed: 06/19/18
06/19/18
Metals Analysis of Air Filters
First Reported: 06/19/18
06/14/18
Final Report
(AIHA-LAP, LLC Accreditation, Lab ID #101762)
106/04/18 Total Samples Submitted:Date(s) Collected:
1Total Samples Analyzed:
Sample Number Lab Number Result
Result Reporting Method
Volume Units Limit* ReferenceAnalyte
Pb#691-1 30804818 13 ug/m3 6780 L NIOSH 7082
* The Reporting Limit represents the lowest amount of analyte that the laboratory can confidently detect in the sample, and is not a regulatory level. The Units for the Reporting Limit are the same as the Units for the Final Results.
Analytical results and reports are generated by Forensic Analytical at the request of and for the exclusive use of the person or entity (client) named on such report. Results, reports or copies of same will not be released by Forensic Analytical to any third party without prior written request from client. This report applies only to the sample(s) tested. Supporting laboratory documentation is available upon request. This report must not be reproduced except in full, unless approved by Forensic Analytical. The client is solely responsible for the use and interpretation of test results and reports requested from Forensic Analytical. Forensic Analytical is not able to assess the degree of hazard resulting from materials analyzed. Forensic Analytical reserves the right to dispose of all samples after a period of thirty (30) days, according to all state and federal guidelines, unless otherwise specified. Any modifications that have been made to referenced test methods are documented in Forensic Analytical's Standar d Operating Procedures Manual. Sample results have not been blank corrected. Quality control and sample receipt condition were acceptable unless otherwise noted.
Daniele Siu, Laboratory Supervisor, Hayward Laboratory
3777 Depot Road, Suite 409, Hayward, CA 94545 / Telephone: (510) 887-8828 (800) 827-FASI / Fax: (510) 887-4218 1 of 1
DOP TESTING DOCUMENTATION
Sensible Environmental Solutions Inc.
Certificate number Equipment Manufacturer Model Number Serial Number Pass/Fail Coastwide Environmental
170 Second Street
Watsonville, CA 95076
Testing performed for:
Project location/description:
Testing requested by:
Date Tested:
P.O. Number:
DOP Aerosal Smoke Challenge Certificate
6/5/18 (Tue)
10443
Sedgwick Ele. School
10480 Finch Ave.
Cupertino, CA 95014
Project Number: 18-321
Manager:
Ralph Guzman
53436 Negative Air Unit Aerospace 2000 Passn/a
53437 Negative Air Unit Aerospace 2000 Passn/a
53438 Negative Air Unit Aerospace 2000 Passn/a
53439 Negative Air Unit Dri Eaz F 284 Pass42758
53440 Negative Air Unit Drieaz Defender 500 Pass45026
53441 HEPA Vacuum Pulse Bac PB-550 Pass0838
ANSI-N510-1989 * FEDERAL STANDARD 209E * UL586-1990
10962 Bigge St San Leandro, CA 94577 phone (510) 568-5996 Fax (510) 568-7993 Manager:
Certificate number Equipment Manufacturer Model Number Serial Number Pass/Fail Testing performed for:
Project location/description:
Testing requested by:
Date Tested:
P.O. Number:
DOP Aerosal Smoke Challenge Certificate
6/5/18 (Tue)
10443
Sedgwick Ele. School
10480 Finch Ave.
Cupertino, CA 95014
Project Number: 18-321
Manager:
Coastwide Environmental
170 Second Street
Watsonville, CA 95076
Ralph Guzman
53442 HEPA Vacuum Nilfisk GD930 Passn/a
ANSI-N510-1989 * FEDERAL STANDARD 209E * UL586-1990
10962 Bigge St San Leandro, CA 94577 phone (510) 568-5996 Fax (510) 568-7993 Manager: