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17C-224 (13) r ' CERTIFICATION OF VISUAL iYSPECTION CLIENT: PROJECT NUMBER: F i 4s 3�— CC� GENERAL LOCATION(bldg. Name,treet, etc,): . �� — 1 ;`7 t- c:11�"n e&I /'-J" ABATEMENT CONTRACTOR: )1r0 it ILCU;1 METHOD OF ABATEMENT: /` r; 11,4- TYPE AND QUANTITY OF MATERIAL ABATED: SUSPECT MATERIAL REMAINING IN WORK AREA: SPECIFIC AREA INSPECTED: CERTIFICATION OF VISUAL INSPECTION In accordance with Specification for this project and any applicable regulations the Contractor hereby certifies that he has visually inspected the work area (all surfaces including pipes, beams, ledges, walls, ceiling and floor, decontamination unit, sheet plastic, etc.) and has found no visible dust, debris or residue. By: (Signature) - �l�//`t�/`�� — ^ Date: i (Print Name) S /'�' ��'� ( //9 i r/ r%A (Print Title) Sy/.�C-- (// cj le- Accreditation Number- �J S 7 3c? Stater OWNER'S REPRESENTATIVE CERTIFICATION The Owner's Representative hereby certifies that he has accompanied the Contractor on his visual inspection and verifies that this inspection has been thorough and to the best of his knowledge and believes the Contractor certification above is a true and honest one. ; �� z / By: (Signature) ii"LCt,(�( t;�i�- Date: (Print Name) �i 'id(►N / ��i/r�'� (Print Title) Accreditation Number �� �' I State: CERTIFICATION OF VISUAL a�°SPECTION CLIENT: PROJECT NT_JMBER: , GENERAL LOCATION(bldg. Name, s�tlreet, etc,): ABATEMENT CONTRACTOR: r1 {�� �'_y J__ METHOD OF ABATEMENT: 1, ,nt 6 ox2-! TYPE AND QUANTITY OF MATERIAL ABATED: SUSPECT MATERIAL REMAINING IN WORK AREA: SPECIFIC AREA INSPECTED: �,�� �� �Cl!4 —, CERTIFICATION OF VISUAL INSPECTION In accordance with Specification for this project and any applicable regulations the Contractor hereby certifies that he has visually inspected the work area (all surfaces including pipes, beams, ledges, walls, ceiling and floor, decontamination unit, sheet plastic, etc.) and has found no visible dust, debris or residue. By: (Signature) / /- — G! i 2 Date: c�3 (Print Name) ( (Print Title) UI /C V / S Cy Accreditation Number �J� � � -� �' I State: OWNER'S REPRESENTATIVE CERTIFICATION The Owner's Representative hereby certifies that he has accompanied the Contractor on his visual inspection and verifies that this inspection has been thorough and to the best of his knowledge and believes the Contractor certification above is a true and honest one. ry� n By: (Signature) ✓ C� Date: AS (Print Name) Jar aeP6�'�/r��� (Print Title) 2qj Q Accreditation Number �/H 71(SIP State: IVI DAILY SITE LOG Page of Project Named D d C S Date: / Project#: I I C( 7-3)�—e 0 Project Monitor: 6 0144b¢ A 4-d T Client: U Project Manager: TEVIE OBSERVATIONS/ACTIONS r� id ' lc ,4-rPr-4- 3 e /` rJd 3 Yl I d L FT— Lc �'r ti L� i S C'('b�C,� ti i K < S C 7 I n0 '�NSS . f Css LA trice, r �S ,tit e e 0 G p 5 5 (?-q C'# Lt /(f f4. t� 5 -t- d /73c� S, — w C��. ATC Representative Signature Title Cert.# CYA DAILY SITE LOG Page of Project Name. a �� s�" Date: Project#: �� 7`3 Project Monitor: •Y� Client: f- "- 1 w Project Manager: TEME OBSERVATIONS/ACTIONS /, C). q C cc -7� C'���u� bc- C1'-e-)( /4 4 C, 61 G(A- r 11 u,�,pj�d I - s ')V- C < < ATC Representative Signature Title Cert.# LVA A 9 l 4{p a T l 9'I N C. AIR SAMPLING LOG _ Project Name: 60 LSt Collection Date: 3 D 1 _ Da f Analysis: Q Project 4: � l 9 73�-G � Project Monitor: (w1114-h,,4- CIVI TEM Circe one 1 vQ � yr ( ) Client: F'0-1d C i l 1 6- - Project Manager: t 10 k. LJ i S S it U) M Specify Turnaround Time: Site Location: &y (,J0 sal Rotometer Number: Analyst Signature: Work Area: 1 S4— !;,o n (3.rs c�r� Send Results to: Location Sample Pump Pump Time Flow Rate Volume LOD Actual Adjusted Analyst Sample# or Type On Off rains) (LPK (Liters) Count Count Result ID Worker Name/SSN/Task (1-10) (F/Ods) (F/Flds) (F/CC) Initials :U ' Field Blank 3qA Field Blank Field Blank o7 6"). f ! U SJ/cv 4,0 i 075 s' s� f C�3 0 1 4603 3� a Y Reference Slide Du licate Slide --!t3 a y1 r d Work Phase: 1)Area Background 3)During Prep Work 5)During Final Clean 7)Final Air Clearance 9)Associated Work 2)Pre-Abatement 4)During Removal _6)During Glovebag Removal 8)Personal Air Sample 10) Hazard Assessment i, Relinquished By: - 4 L L`4. z,1--/4- Date: '�� 7- �' � Received By: Date: •. v 73 William Franks Dr. West Springfield,MA.01089 413.781.0070 •• ••^•' °•• ^'• Fax 413.781.3734 • A S$ O C I A T E S I N C. ASBESTOS PCM AIR SAMPLE ANALYSIS REPORT CLIENT NAME JOB SITE SAMPLED BY DATE SAMPLED ATC JOB# Ford Gillen Architects jGo West Bldg.,3rd Floor Bruce Callahan I 23-Feb-05 8 1.19738.0008 ANALYTICAL SERVICE LICENSE#: AAOOOOO5 AAR ANALYST NAME: DATE OF ANALYSIS: SAMPLE# SAMPLE LOCATION SAMPLE TYPE VOLUME FIBERS/FIELD FIBERS/CC 33 - Field Blank Field Blank 0/100 34 Field Blank Field Blank 0/100 35 1st Floor Final Air Clearance 1280 4/100 1.003 36 let Floor Final Air Clearance 1240 5.5/100 1.003 37 1st Floor Final Air Clearance 1280 3.5/100 <.003 38 let Floor Final Air Clearance 1280 41100 <.003 39 Basement Final Air Clearance 1240 5/100 <.003 40 Basement Final Air CleamncE 1264 4/100 1.003 ,() YVA LTC A 4 3 8 4 V A.t!! I N C. AIR SAMPLING LOG _ Project Name: �,0 ( 's Collection Date: / G S (Analysis: Project#: S-If i 5 3ss-6 064- Project Monitor: C r TEM(circe one) Client: Fo-^d 6-i l I e,— Project Manager: i�t- ��"( lC tJ/S,>"C(ry-ti TEM Specify Turnaround Time: Site Location: (s o L�,Xs� A Id ti T--l ,`e, 6-(4 Rotometer Number: f�t) l-i I( Analyst Signature: Work Area: _ d (-I Send Results to: Location Sample Pump Pump Time Flow Rate Volume LOD Actual Adjusted Analyst Sample# or Type On Off (Minx) (LPA (Liters) Count Count Result ID Worker Name/SSN/Task (1-10) (F/Flds) (F/Flds) (F/CC) Initials 3) Field Blank ��eU Field Blank ° Field Blank 7 3' 006 3 /' Reference Slide Duplicate Slide Work Phase: 1)Area Background 3)During Prep Work 5)During Final Clean 7)Final Air Clearance 9)Associated Work 2 Pre-Ab ent, 4)During Rernov 6)During Glovebag Removal 8)Personal Air Sample 10) Hazard Assessment Relinquished By: ']�t tC '' " ' Date: Received By: Date: i C 73 William Franks Dr. } West Springfield,MA.01089 413.781.0070 ••••^••••• Fax 413.781.3734 �•A•S S 0 C I AT ES INC ASBESTOS PCM AIR SAMPLE ANALYSIS REPORT CLIENT NAME JOB SITE SAMPLED BY JDATESAMPLED1 ATC JOB# Ford Gillen Architects IGo West Bldg_3rd Floor 113ruce Callahan I 18-Feb-05 181,19738.0008 ANALYTICAL SERVICE LICENSE#: AA000005 AAR ANALYST NAME. DATE OF ANALYSIS: SAMPLE# SAMPLE LOCATION SAMPLE TYPE VOLUME FIBERS/FIELD FIBERS/CC 27 Field Blank Field Blank 0/100 28 Field Blank Field Blank 0/100 29 2nd Floor Front Final Air Clearance 1280 4/100 <.003 30 2nd Floor Front Final Air Clearance 1240 3.5/100 <.003 31 2nd Floor Front Final Air Clearance 1280 5/100 <.003 32 2nd Floor Front Final Air Clearance 1248 4/100 <.003 WC A 4=4; .*E, I N C AIR SAMPLING LOG Project Name: 60 WC'S Collection Date: u -!I C�J Date of Analysis: 1 S a S Project 4: �► 1�� 0 0 5- Project Monitor: ; � 6 11 it AA lv PCM or TEM circe one > > wee �- ( ) Client: Fo,-1 6-1 1 i - Project Manager: 0 C v I L k- t V * S it, — If TEM Specify Turnaround Time: Site Location: 6-o ikY-sd-(3 1d 9-Rotometer Number: 1-6 i+-I I Analyst Signature: Work Area: 'J d -C-I I�r r- Send Results to: Location Sample Pump Pump Time Flow Rate Volume LOD Actual Adjusted Analyst Sample# or Type On Off (Mins) (LPM) (Liters) Count Count Result ID Worker Name/SSN/Task (1-10) (FMds) (F/Flds) (F/CC) Initials Iq Field Blank Field Blank Field Blank �1 1�3o 16�o �} is� � � l ips 00 x'03 "/1 0c) o63 31 51 �1 IS 33 16,3 15� ��� i .� rvLl I--)�� I�,�3 i 1535 lb /� !s 0-31 oo3 (94b Reference Slide rear 7 153,5 %E&5 Duplicate Slide 14- Work Phase: 1)Area Background 3)During Prep Work 5)During Final Clean 7)Final Air Clearance 9)Associated Work 2)�re-Abatement - 4)During Removal 6)During Glovebag Removal 8)Personal Air Sample 10) Hazard Assessment -� Relinquished By: Date: -- Received By: Date: 73 William Franks Dr. West Springfield,MA.01089 413.781.0070 _ •• •••`^ ••••• Fax 413.781.3734 ....•A 5 S 0 C I A T E S I N C. ASBESTOS PCM AIR SAMPLE ANALYSIS REPORT CLIENT NAME JOB SITE SAMPLED BY DATE SAMPLED ATC JOB# Ford Gillen Architects jGo West Bldg.,3rd Floor 113ruce Callahan 15-Feb-05 181.19738,0008 ANALYTICAL SERVICE LICENSE#: AAOOOOO5 AAR ANALYST NAME. DATE OF ANALYSIS: SAMPLE# SAMPLE LOCATION SAMPLE TYPE VOLUME FIBERS/FIELD FIBERS/CC 14 Field Blank Field Blank 0/100 15 Field Blank Field Blank 0/100 16 2nd Floor Front Final Air Clearance 1280 10/100 .004 17 2nd Floor Front Final Air Clearance 1248 12/100 .005 18 2nd Floor Front Final Air Clearance 1264 8.5/100 .003 19 2nd Floor Front Final Air Clearance 1280 7.5,/100 .003 20 2nd Floor Front Final Air Clearance 1240 8.5/100 .003 21 2nd Floor Front Final Air Clearance 1264 10/100 .004 22 2nd Floor Front Final Air Clearance 1280 9/100 .003 23 2nd Floor Front Final Air Clearance 1248 12/100 .005 24 2nd Floor Front Final Air Clearance 1232 8/100 .003 25 2nd Floor Front Final Air Clearance 1240 7.5/100 .003 26 2nd Floor Rear Final Air Clearance 1280 9/100 .003 (VV,V A 45691ATe:1 INC. AIR SAMPLING LOG / Project Name: '-0 (OJO.S� Collection Date: � O.� Date of Analysis: Project#: !R-) i 9?3 'J-6"0©S-- Project Monitor: n u � �— PCM or TEM(eirce one) Client: EG-d L 11 Nib, Project Manager: >7e� r r i�_k l `S S iZv1 ri t If TEM Specify Turnaround Time: Site Location:6-v Rotometer Number: It ! Analyst Signature: Work Area: 3 d+I o o Send Results to: Location Sample Pump Pump Time Flow Rate Volume LOD Actual Adjusted Analyst Sample# or Type On Off (Mina) (UM) (Liters) Count Count Result ID Worker Name/SSN/Task (1-10) (F/Hds) (F/Fids) (F/CC) Initials I Field Blank Field Blank Field Blank 003 � y A .3 iii tA-o 003 n 3 co-3 IG 11 3 I' Y,�Y 0-3 003 31 /E 1` `,' /0 C�0 6 Reference Slide (�, 1 3 y 5� `3-1) 16/4 / �,v � 406-3 Duplicate Slide 1 /.L Work Phase: 1)Area Background 3)During Prep Work 5)During Final Clean 7)Final Air Clearance 9)Associated Work 2)Pre-Abatement 4)During Removal 6)During Glovebag Removal 8)Personal Air Sample 10) Hazard Assessment Relinquished By: %--z,, Date3 1//2 Received By: Date: ` v 73 William Frank s Dr. West Springfield,MA.01089 "`:.j{ 413.781.0070 rc Fax 413.781.3734 •A 5S 0C I AT ES INC. ASBESTOS PCM AIR SAMPLE ANALYSIS REPORT CLIENT NAME JOB SITE I SAMPLED BY DATE SAMPLED ATC JOB# Ford Gillen Architects IGo West Bldg.,3rd Floor I Bruce Callahan I 15-Feb-OS 181.19738,0008 ANALYTICAL SERVICE LICENSE* AA000005 AAR ANALYST NAME. DATE OF ANALYSIS: SAMPLE# SAMPLE LOCATION SAMPLE TYPE VOLUME FIBERS/FIELD FIBERS/CC 1 Field Blank Field Blank 0/100 2 Field Blank Field Blank 0/100 3 3rd Floor Front Final Air Clearance 1224 8/100 .003 4 3rd Floor Front Final Air Clearance 1280 7/100 .003 5 3rd Floor Front Final Air Clearance 1240 6/100 .002 5 3rd Floor Front Final Air Clearance 1280 7.5/100 .003 7 3rd Floor Front Final Air Clearance 1216 6/100 .002 a 3rd Floor Front Final Air Clearance 1264 4.5/100 c003 9 3rd Floor Front Final Air Clearanc 1240 6/100 .002 10 3rd Floor Front Final Air Clearance 1248 8/100 .003 11 3rd Floor Front Final Air Clearance 1232 7/100 .003 12 3rd Floor Front Final Air Clearance 1280 10/100 .004 13 3rd Floor Right Final Air Clearance 1280 5/100 <.003 0. iYJ p,PR 2 Ila � ✓ �t�``t� htivilt i Gv �•;. l 73 William Franks Drive West Springfield, MA 01089 www.atcassociates.com 413-781-0070 A s s o c I A T e s i N c . Fax 413-781-3734 Environmental, Geotechnical and Materials Professionals April 21 2005 � � ^�' OR 2 � 2005 Ms. Kathleen Ford ' vr1U u1LLCI� f1riV�7� tV Ford Gillen Architects Inc. 409 Main Street Amherst, MA 01002 RE: Air Sample Monitoring Go West Building, 3rd Floor, Rte. 9, Northampton, MA. ATC Associates Inc. Project No. 81-19739-0008 Dear Ms. Ford: Enclosed are the air sample results for the above referenced location taken on February 15, 2005. Final air samples were at or below the EPA Standard of 0.01 fibers per cubic centimeter. If you should have any questions, please feel free to contact our office. Sincerely, ATC Associates Inc. Derrick Wissman Brian Williams JO Senior Project Manager Branch Manager DW/sjf Enclosure NOATMH/Ford Gillen Architects,Inc/81-1973 9/0006a.doc Ford Gillen Architects, i. 1 409 Main Street TRANSMITTAL F: Amherst,MA 01002 Tel 413-253-2528 Fax 413-256-1553 DATE: 4/26/05 f gaof f ice @f ordgillen.com Kathleen E.Ford,AIA William V.Gillen,AIA TO: Tony Patillo Northampton Planning RE: Go West, Florence, MA JOB NO.: 2226 Urgent _ By MAIL For Your Quote Under Separate Cover By Express Mail Per Your Request Review and Comment x_By KF —X—For Your Use Other Enclosed: ATC Air Sample Monitoring report dated 4/21/05. �\�4 Kathleen E. Ford cc: Pat McCarthy(Valley CDC)