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38C-010 (2)
C� E I . SAMPLING FORM L/�C3S COMPANY CONTACT INFORMATION Company: Ba state Contracting Services,lnc. Job Contact: James Beaudry Project Name: 108 Grove Street Northampton, Ma. Project ID#: Bruce Volz Tel: 413-781-0821 VOLUME/ SAMPLE ID# DESCRIPTION]LOCATION AREA COMMENTS 1 9"X9" Floor Tile/Mastic 2 Black Vapor Barrier 3 Black Coating On Double Sink 4 Black Cove Base Adhesive 5 White Wallboard Adhesive 6 Sheetrock/Joint Compound Walls 7 12"X 12" Floor Tile/ Mastic 8 Sheetrock/Joint Compound Walls 9 Wallboard Ahhesive 10 Texture Ceiling 11 Texture Ceiling 12 Black Mastic On Brick 13 9"X9" Floor Tile/Mastic 14 Sheetrock/Joint Compound Walls 15 Texture Ceiling 16 Texture Ceiling 17 Sheetrock/Joint Compound Walls 18 Paper On Backside Of Fiberglass 19 Texture Ceiling 20 Glazing On Windows 21 Exterior Roofing Shingles 22 Black Vapor Barrier 23 Red Transite Wall Siding 24 Black Vapor Barrier Under Red Siding 25 Black Vapor Barrier Under Wood Siding 26 Black Tar 27 lRoofing Shingles On Garage Page _2_of 2 VERSION CCOC.0112.2/2.LD Customer COC Page 2 CP I CHAIN OF CUSTODY L/N.iBS LAB USE ONLY.' 107 New Edition Court, Cary, NC 27511 CEI Lab Code: Tel: 866 481-1412; Fax: 919-481-1442 CEI Lab I.D. Range: q( z'4-Z— R I COMPANY CONTACT INFORMATION Company: Ba state Contracting Services,inc. Client#: Bruce Volz Address: 352 Albany Street Springfield, Ma. 01105 Job Contact: James Beaudry Email:james@baystatecontracting.com Tel: 413-781-0821 Project Name: 108 Grove Street Northampton, Ma. Fax: 413-734-6224 Project ID#: Bruce Volz P.O. #: TURN AROUND TIME ASBESTOS MET'HOD' 4'HR* 8 HR" 24 HR 2 DAY 3 DAY 5 DAY PLM BULK EPA 600 a a L] ® O PLM POINT COUNT(400) EPA 600 D a PLM POINT COUNT(1000) EPA 600 0 0 0 PLM GRAVIMETRIC EPA 600 E:] 0 0 0 PLM GRAV w POINT COUNT EPA 600 O o D PCM AIR NIOSH 7400 0 TEM AIR AHERA O Cl D TEM AIR EPA Level II 0 0 TEM AIR NIOSH 7402 0 TEM BULK CHATFIELD '? D TEM DUST WIPE ASTM D6480-05 El 0 TEM DUST MICROVAC ASTM D5755-03 0 0 0 TEM QUALITATIVE CEI LABS O D D O D D OTHER: 0 0 Q LEAD`P;41NT METHOD „' 4,WR`;, 8 HRk U HR 2 DAY 3 DAY 5 DAY LEAD PAINT EPA SW846 7000B LEAD WIPE EPA SW846 7000B 0 LEAD SOIL EPA SW846 7000B D D LEAD AIR NIOSH 7082 D a OTHER: = D REMARKS: �--, Accept Samples i Reject Samples 4elinquipihed B y.- � I Date/Time Receive By: DateJTime James Beaud J / 01/0912014 @ 3:00 / '°��° *Call to co fir/9USH analysis. t Samples will be disposed of 30 days after analysis VERSION CCOC.0112.112.1_0 Customer COC Page 1 ASBESTOS BULK ANALYSIS CEIBy: POLARIZING LIGHT MICROSCOPY L/�C35 Client: Baystate Contracting Services, Inc. CEI Lab Code: A14-0277 352 Albany St. Date Received: 01-10-14 Date Analyzed: 01-13-14 Springfield, MA 01105 Date Reported: 01-14-14 Project: 108 Grove Street Northampton, MA; Bruce Volz ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 25 Vapor Barrier Homogeneous 70% Cellulose 30% Tar None Detected A1626266 Black Fibrous Tightly Bound 26 Tar Heterogeneous 10% Gravel 5%Chrysotile A1626267 Black,Red 85% Tar �e Fibrous y Tightly Bound 27 Shingle Heterogeneous 20% Fiberglass 20% Gravel None Detected A1626268 Black,Brown 60% Tar Fibrous Tightly Bound r e� Page 5 of 6 ASBESTOS BULK ANALYSIS CEI ^IBS By: POLARIZING LIGHT MICROSCOPY L Client: Baystate Contracting Services, Inc. CEI Lab Code: A14-0277 352 Albany St. Date Received: 01-10-14 Date Analyzed: 01-13-14 Springfield, MA 01105 Date Reported: 01-14-14 Project: 108 Grove Street Northampton, MA; Bruce Volz ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 18 Paper Heterogeneous 65% Cellulose 20% Metal Foil None Detected A1626259 Tan,Variously 5% Fiberglass 10% Tar Fibrous Bound 19 Texture Heterogeneous 75% Binder None Detected A1626260 Beige,Off-white 15% Silicates Non-fibrous 10% Paint Bound 20 Glazing Heterogeneous 95% Binder None Detected A1626261 Tan 5% Paint Non-fibrous Bound 21 Shingle Heterogeneous 20% Fiberglass 20% Gravel None Detected A1626262 Black,Variously 60% Tar Fibrous Tightly Bound 22 Vapor Barrier Homogeneous 70% Cellulose 30% Tar None Detected A1626263 Black Fibrous Tightly Bound 23 Transite Heterogeneous �iI 2% Paint 15%Chrysotile A16262((6��4 Red,Grey G/ 83% Binderf Fibrous 1 I Tightly Bound 24 Vapor Barrier Homogeneous 90% Cellulose 10% Binder None Detected A1626265 Black Fibrous Tightly Bound Page 4 of 6 ASBESTOS BULK ANALYSIS C= EIBy: POLARIZING LIGHT MICROSCOPY L./�.C35 Client: Baystate Contracting Services, Inc. CEI Lab Code: A14-0277 352 Albany St. Date Received: 01-10-14 Date Analyzed: 01-13-14 Springfield, MA 01105 Date Reported: 01-14-14 Project: 108 Grove Street Northampton, MA; Bruce Volz ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 12 Mastic Homogeneous 30% Silicates None Detected A1626253 Black 70% Binder Non-fibrous Tightly Bound 13 Floor Tile Homogeneous 98% Vinyl 2%Chrysotile A1626254A Green ' r o ,' i/► It I t ; �y,/� Fibrous I J l / %q ��M N'7 Tightly Bound A1626254B Mastic Homogeneous 97% Mastic 3%Chrysotile Black / ry ,�F- Fibrous tb 150 Tightly Bound 14 Sheetrock/Joint Heterogeneous 25% Cellulose 15% Calc Carb None Detected A1626255 Compound Grey,White 55% Gypsum Fibrous 5% Paint Bound 16 Texture Heterogeneous 75% Binder None Detected A1626256 White 15% Silicates Non-fibrous 10% Paint Bound 16 Texture Heterogeneous 5% Cellulose 10% Paint 3%Chrysotile A1626257 White,Tan , J 35% Binder r Fibrous X/0 47% Calc Carb /so (OUM Bound 17 Sheetrock Heterogeneous 50% Cellulose 10% Paint None Detected A1626258 Grey,White 40% Gypsum Fibrous Bound Lab Notes: No joint compound present. Page 3 of 6 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY L/�.EiS Client: Baystate Contracting Services, Inc. CEI Lab Code: A14-0277 352 Albany St. Date Received: 01-10-14 Date Analyzed: 01-13-14 Springfield, MA 01105 Date Reported: 01-14-14 Project: 108 Grove Street Northampton, MA; Bruce Volz ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % Layer2 Adhesive Homogeneous 90% Mastic 10%Chrysotile A1626247 Brown ` -7 t X (0"y //�5F J1 6,kt�f B1Gk Fibrous P?F V Tightly Bound 7 Floor Tile Homogeneous 100% Vinyl None Detected A1626248A Grey,Variously Non-fibrous Tightly Bound A1626248B Mastic Homogeneous 100% Mastic None Detected Tan Non-fibrous Tightly Bound 8 Sheetrock/Joint Heterogeneous 25% Cellulose 15% Calc Carb None Detected A1626249 Compound Grey,Variously 55% Gypsum Fibrous 5% Paint Bound 9 Adhesive Homogeneous 5% Cellulose 95% Mastic None Detected A1626250 Tan Fibrous Tightly Bound 10 Texture Heterogeneous 5% Cellulose 10% Paint 3%Chrysotile A1626251 White,Tan _ 35% Binder Fibrous / ) n 47% Calc Carb , t,lti r tJJ./n Id CL, ll�v Bound 11 Texture Heterogeneous 5% Cellulose 10% Paint None Detected A1626252 Tan 35% Binder Fibrous 50% Calc Carb Bound Page 2 of 6 ASBESTOS BULK ANALYSIS By: POLARIZING LIGHT MICROSCOPY L/�C-35 Client: Baystate Contracting Services, Inc. CEI Lab Code: A14-0277 352 Albany St. Date Received: 01-10-14 Date Analyzed: 01-13-14 Springfield, MA 01105 Date Reported: 01-14-14 Project: 108 Grove Street Northampton, MA; Bruce Volz ASBESTOS BULK PLM, EPA 600 METHOD Client ID Lab Lab NON-ASBESTOS COMPONENTS ASBESTOS Lab ID Description Attributes Fibrous Non-Fibrous % 1 Floor Tile Homogeneous 90% Vinyl 10%Chrysotile A1626242A Red Fibrous ll i +C �"J Tightly Bound X '� f A1626242B Mastic Homogeneous 100% Mastic None Detected Black Non-fibrous Tightly Bound 2 Vapor Barrier Heterogeneous 50% Cellulose 25% Cellulose None Detected A1626243 Black,Brown 20% Synthetic Fiber 5% Mastic Fibrous Tightly Bound 3 Sink Undercoating Homogeneous 97% Tar 3%Chrysotile A1626244 Black e� i� ( Fibrous ) SF_ t � +ck Tightly Bound 4 Adhesive Homogeneous 100% Mastic None Detected A1626245 Tan Non-fibrous Tightly Bound 6 Adhesive Homogeneous 90% Mastic 10%Chrysotile A1626246"" '/ Brown L �� /l� �J �i�GJ Fibrous �+ Tightly Bound, 6 Sheetrock Heterogeneous 30% Cellulose 10% Silicates None Detected Layer 1 White,Tan 60% Gypsum A1626247 Fibrous Bound Lab Notes: No joint compound present. Page 1 of 6 a Asbestos Report Summary By: POLARIZING LIGHT MICROSCOPY L/�f�5 PROJECT: 108 Grove Street Northampton, MA; Bruce CEI LAB CODE: A14-0277 Volz METHOD: EPA 600/ R93 / 116 and EPA 6001 M4-82/ 020 ASBESTOS Client ID Layer Lab ID Color Sample Description % 1 A1626242A Red Floor Tile ISUMM10 A1626242B Black Mastic None Detected 2 A1626243 Black,Brown Vapor Barrier None Detected 3 A1626244 Black Sink Undercoating .' 4 A1626245 Tan Adhesive None Detected 5 A1626246 Brown Adhesive 6 Layer 1 A1626247 White,Tan Sheetrock None Detected - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Layer2 A1626247 Brown Adhesive DIMMM.IRMO 7 A1626248A Grey,Variously Floor Tile None Detected A1626248B Tan Mastic None Detected --- 8 A1626249 Grey,Variously Sheetrock/Joint Compound None Detected 9 A1626250 Tan Adhesive None Detected 10 A1626251 White,Tan Texture 1811T.9m.MW 11 A1626252 Tan Texture None Detected 12 A1626253 Black Mastic None Detected 13 A1626254A Green Floor Tile A1626254B Black Mastic 14 A1626255 Grey,White Sheetrock/Joint Compound None Detected 15 A1626256 White Texture None Detected 16 A1626257 White,Tan Texture 17 A1626258 Gre White Sheetrock _ _�._.�_ N- one Detecte d- y, 18 A1626259 Tan,Variously Paper None Detected 19 A1626260 Beige,Off-white Texture None Detected 20 A1626261 Tan Glazing None Detected 21 A1626262 Black,Variously Shingle None Detected 22 A1626263 Black Vapor Barrier None Detected 23 A1626264 Red,Grey Transite 24 A1626265 Black Vapor Barrier None Detected _ 25 A1626266 Black Vapor Barrier None Detected 26 A1626267 Black,Red Tar 27 A1626268 Black,Brown Shingle None Detected Page 1 of 1 CE IL^BS MAR 2 4 2015 ��'`,:i'` ,; cilons ASBESTOS LABORATORY REPORT Prepared for Baystate Contracting Services, Inc. PROJECT: 108 Grove Street Northampton, MA; Bruce Volz CEI LAB CODE: A14-0277 DATE ANALYZED: 01/13/14 DATE REPORTED: 01/14/14 TOTAL SAMPLES ANALYZED: 27 #SAMPLES >1% ASBESTOS: 10 TEL: 866-481 -1412 www.ceilabs.com