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Home My WebLink AboutPotters- Insight Environmental 1000-24-2-1 INSIGHT Environmental Inc. FULL INTERIOR & EXTERIOR ASBESTOS SURVEY At 675 Skippers Lane Orient, NY 11957 Inspection Date: August 22, 2018 Report Date: September 4, 2018 Prepared For: PETER COOK ARCHITECT 728 MONTAUK HIGHWAY WATER MILL, NY 11976 Attn: Mr. Rick Tloczkowski Prepared By: INSIGHT ENVIRONMENTAL, INC. 74 E. Main Street Patchogue, NY 11772 (631) 654-2780 President: Insight Environmental, Inc. 7uh-rr- acr Vice President: Insight Environmental, Inc. Gem ge . Maul TABLE OF CONTENTS Section Title 1.0 Executive Summary 2.0 Asbestos Inspection 2.1 Asbestos Inspection Methodology 2.2 Bulk Sampling Activities 2.3 Analytical Methodology 2.4 Summary of Asbestos-Containing Materials 3.0 Conclusions and Recommendations Appendices Appendix A Asbestos Bulk Sample Analysis Results Appendix B Sample Location Diagrams Appendix C Reconnaissance Photographs Appendix D Certifications Section 1.0 Executive Summary Insight Environmental, Inc. has conducted a full asbestos inspection of the residential property located at 675 Skippers Lane, Orient, NY 11957 on August 22, 2018. The building in question is a —1,800 square foot, vacant,two-story residence with an unfinished basement and a pitched roof. The inspection was specific to all suspect asbestos containing building materials throughout the interior and exterior of this building to facilitate the renovation of the structure. New York State requires that the asbestos survey information be transmitted by the building owner as follows: 1. One copy of the completed survey shall be sent by the owner or their agent to the local government entity charged with issuing a permit for such demolition, renovation, remodeling or repair work under applicable State or local laws. 2. The completed asbestos survey for controlled demolition or pre-demolition asbestos projects shall also be submitted to the appropriate Asbestos Control Bureau district office. 3. The completed asbestos survey shall be kept on the construction site with the asbestos notification and variance, if required, throughout the duration of the asbestos project and any associated demolition, renovation, remodeling or repair project. During the course of the asbestos inspection performed on August 22, 2018, Insight Environmental, Inc. collected a total of 48 bulk samples of suspect Asbestos Containing Building Materials. All samples were remanded for Polarized Light Microscopy (PLM) analysis; fifteen (15) samples were friable in nature and thirty-three (33) samples were Non-friable Organically Bound (NOB). All NOB samples that were deemed negative (28 Total) were remanded for Transmission Electron Microscopy (TEM) analysis in accordance with the New York State Department of Health's Environmental Laboratory Approval Program (ELAP) requirements. All samples were labeled and sealed immediately upon collection and remanded to AmeriSci Richmond (ELAP #10984). Summarily, analysis has revealed asbestos containing materials to be present in the basement insulation wrap and flue cement,floor tile within the living room, kitchen, both 15t and 2nd floor bathrooms, floor tile mastic and in the exterior siding and roof. According to New York State Industrial Code Rule 56, a material is considered "asbestos- containing" when asbestos represents greater than one (1) percent of the material's content by weight. For more detailed information see Section 2.4 and Appendix A. 2.0 Asbestos Inspection 2.1 Asbestos Inspection Methodology This asbestos inspection included an inventory of all accessible locations within all elevations of the building. Suspect and presumed asbestos containing materials were classified as Surfacing Material or Miscellaneous material and then categorized into homogeneous groups. A "homogeneous group" is any material that appears similar; like color, function, usage, and characteristics. Samples of suspect ACBM's were collected in representative locations within each homogeneous group. It should be noted that when a sample of a given homogenous group is determined to contain asbestos, then it is assumed that all similar materials within the building are also ACM (Asbestos Containing Material). The asbestos inspection was conducted by George W. Maul a NYS certified Asbestos Inspector License#98-13806. 2.2 Bulk Sampling Activities Bulk Sampling activities were conducted according to the following guidelines: ➢ Sampling was conducted in unoccupied areas. ➢ Surfaces of the material to be sampled were wetted with amended water mist prior to collection. ➢ Samples were collected with a core borer, knife, or other approved sampling tool. ➢ Sampling tools were decontaminated between each sample. ➢ Sample containers were labeled with a date and unique sample ID number using a permanent marker. ➢ Individual sealable containers were used to contain each of the collected samples. Samples were double-bagged for transportation to the laboratory. ➢ All multi-layered system components, when possible, were separated by strata in the field and remanded for individual analysis. These sampling procedures were implemented in an effort to provide control of samples through analysis and reporting. 2.3 Analytical Methodology All bulk samples were transported and relinquished to AmeriSci Richmond analytical Laboratory for analysis. AmeriSci is a NYS Environmental Laboratory Approval Program accredited laboratory (ELAP #10984). Asbestos bulk samples were analyzed utilizing Polarized Light Microscopy (PLM) methodology in accordance with EPA600/M4-82-020. Samples deemed negative when analyzed by PLM, but determined to be non-friable organically bound materials (such as floor tiles, mastics, and roofing materials) were remanded to transmission electron microscopy (TEM) Analysis in accordance with ELAP certification manual section 198.1, subsection 6.3.2.2.1, which states, in part: "...PLM analysis alone cannot definitively confirm a non-friable organically bound material (NOB) to be non-asbestos containing. This determination can only be made by analyzing such samples by transmission electron microscopy (TEM) methodology". Bulk Sample Analysis Results can be found in Appendix A. 2.4 Summary of Asbestos-Containing Materials Table 2.4: Material Asbestos % Location Quantity Condition Friable Insulation 80.0% Basement — 6 Sq. Ft. Intact Yes Wrap Flue Cement 44.4% Basement — 3 Sq. Ft. Intact No Light Brown 8.5% Living Room —433 Sq. Ft. Intact No 9x9 Floor Tile White/Olive 10.6% Kitchen —178 Sq. Ft. Intact No 9x9 White/Olive 1.4% Kitchen —178 Sq. Ft. Intact No 9x9 Tile Mastic White Pattern 12.3% Bath 1 —22 Sq. Ft. Intact No 9x9 Floor Tile Cream 9x9 9.1% Bath 2 —37 Sq. Ft. Intact No Floor Tile Cream 9x9 1.6% Bath 2 —37 Sq. Ft. Intact No Floor Mastic Siding Board** 21.2% Exterior Side — 1600 Sq. Ft. Intact Yes Roof Shingle 3.2% Exterior Roof — 2000 Sq. Ft. Intact j No *Quantities are estimates only and must be field verified for bidding purposes. **Please note that six extra transite shingles are stored in the attic of the home ***Although not anticipated,additional pipe insulation may exist inside walls and ceilings throughout.Should the contractor encounter suspect asbestos containing materials during renovation,we recommend that they stop work immediately and contact our firm so that we may inspect the area in question. Section 3.0 Conclusions and Recommendations Disturbance of this quantity of asbestos is regulated in NYS under 12 NYCRR Part S6 "Asbestos". Summarily,this will require retention of a licensed NYS Asbestos abatement contractor, independent third-party project monitor/air sampling technician. Notification to the NYS DOL Asbestos Control Bureau is required. My office can assist you in both asbestos project design and project monitoring/air sampling that will be required by the NYSDOL Engineering Services Unit (ESU). Only NYS licensed personnel may enter, contain, remove and dispose of these materials. Air Sampling is required prior to, during, and at the completion of asbestos abatement activities. Appendix A Asbestos Bulk Sampling Analysis Results Please Reply To: AmeriSci Richmond 13635 GENITO ROAD AMERI So MIDLOTHIAN,VIRGINIA 23112 TEL: (804)763-1200-FAX:(804)763-1800 r" FACSIMILE TELECOPY TRANSMISSION To: George Maul From: William M.Dunstan Insight Environmental AmeriSci Job#: 118082015 Fax#: Subject: ELAP-PLM/TEM 48 hour Results Client Project: 18-0579; Renovation Inspection; Email: gmaul@insightenvironmental.com,leont@insightenvi 675 Skippers Lane,Orient,NY ronmental.com,johtip@insightenvironmental.com,an drea@insightenvironmental.com;jurick@insightenvir onmental.com Date: Sunday,August 26,2018 Number of Pages: Zd Time: 13:19:00 (including cover sheet) Comments: CONFIDENTIALITY NOTICE: Unless otherwise indicated,the information contained in this communication is confidential information intended for use of the individual named above. If the reader of this communication is not the intended recipient,you are hereby notified that any dissemination, distribution or copying of this communication is prohibited. If you have received this communication in error,please immediately notify the sender by telephone and return the original message to the above address via the US Postal Service at our expense. Samples are disposed of in 60 days or unless otherwise instructed by the protocol or special instructions in writing. Thank you. Certified Analysis Service 24 Hours A Day- 7 Days A Week Competitive Prices visit our web site-www.amerkel.com Boston-Los Angeles-New York-Richmond AmeriSci Job#: 118082015 Client Name: Insight Environmental Table I Summary of Bulk Asbestos Analysis Results 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Sample Heat Acid Insoluble AmeriSci HG Weight Sensitive Soluble Non-Asbestos �* Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% 01 1 1 ---- ---- C Location: Basement;Insulation Wrap 02 2 1 - Location: Basement;Insulation Wrap 03 3 1 -- - Location: Basement;Insulation Wrap 04 4 2 Location: Basement;Flue Cement 05 5 2 -- Location: Basement,Flue Cement 06 6 2 _ ---- Location: Basement;Flue Cement 07 7 3 0.241 21.0 49.4 29.6 Location: Living Room;Light Brown 9x9 08 8 3 0.401 21.7 33.3 45.0 Location: Living Room;Dark Brown 9x9 09 9 4 0.062 90.7 9.1 0.1 Location: Living Room;Floor Tile Mastic 10 10 4 0.093 94.5 5.4 0.0 Location: Living Room;Floor Tile Mastic 11 11 5 0.087 64.3 11.9 23.6 Location: Dining Room;Linoleum Floor 12 12 5 0.104 76.7 12.8 10.5 Location: Dining Room;Linoleum Floor 131-1 13 6 0.158 25.3 27.0 47.6 C Location: Kitchen;White W/Olive Streak 9x9 131-2 13 6 0.055 65.4 20.1 13.0 C Location: Kitchen;White W/Olive Streak 9x9 141-1 14 6 0.184 25.3 26.1 48.6 Location: Kitchen;White W/Olive Streak 9x9 141-2 14 6 0.084 59.2 28.6 12.3 C Location: Kitchen;White W/Olive Streak 9x9 See Reporting notes on last page AmeriSci Job#: 118082015 Client Name: Insight Environmental Table I Summary of Bulk Asbestos Analysis Results 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Sample Heat Acid Insoluble AmeriSci HG Weight Sensitive Soluble Non-Asbestos Sample 9 Client Sample# Area (gram) Organic% Inorganic% Inorganic% 151-1 15 7 0.222 24.9 22.7 52.4 { Location: Bath 1;White Pattern 9x9 151-2 15 7 0.070 87.2 9.3 3.3 C Location: Bath 1;White Pattern 9x9 16L1 16 7 0.241 24.9 23.7 51.5 Location: Bath 1;White Pattern 9x9 16L2 16 7 0.056 76.6 19.6 3.7 C Location: Bath 1;White Pattern 9x9 17 17 8 0.095 27.7 17.5 54.8 Location: Bedroom 1;Ceiling Tile 18 18 8 0.081 23.4 19.4 57.2 Location: Bedroom 1;Ceiling Tile 19 19 9 0.098 89.5 6.7 3.8 Location: Kitchen;Ceiling Tile 20 20 9 0.068 80.9 10.9 8.1 Location: Kitchen;Ceiling Tile 211-1 21 10 0.252 33.7 64.9 1.4 Location: Bath 1;Green Cove Base 21 L2 21 10 0.192 64.9 16.9 18.1 Location: Bath 1;Green Cove Base 221-1 22 10 0.246 33.5 65.5 0.8 Location: Bath 1;Green Cove Base 221-2 22 10 0.236 66.8 15.2 18.1 Location: Bath 1;Green Cove Base 23 23 11 ---- ---- ---- ---- Location: Dining Room;Ceiling Drywall 24 24 11 --- --- -- Location: Dining Room;Ceiling Drywall 251-1 25 12 .--- ---- ---- ---- Location: Bath 1;Wall Board 251-2 25 12 0.137 76.8 12.2 10.9 Location: Bath 1;Wall Board See Reporting notes on last page AmeriSci Job#: 118082015 Client Name: Insight Environmental Table I Summary of Bulk Asbestos Analysis Results 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY AmeriSci Sample Heat Sample# HG Weight Sensitive Soluble Insoluble Client Sample# Area (gram) Organic% ° �No�ntos26L12612 �Inor;anlc /° Location: Bath 1;Wall Board 26L2 26 12 0.103 66.1 Location: Bath 1;Wall Board 17.2 16.6 27 27 13 _ Location: Dining Room;Ceiling Spackle 28 28 13 ---- Location: Dining Room;Ceiling Spackle ___ 29 29 C 14 0.151 65.7 Location: Bath 2;Shower Wall 25.5 8.8 30 30 Location: Bath 2;Shower Wall 14 0.159 64.6 24.6 10.9 31L1 31 15 0.218 23.7 Location: Bath 2;Cream 9xg 51.4 24.9 31L2 31 15 0.068 60.5 Location: Bath 2;Cream 9xg 24.0 13.9 32L1 32 C 15 0.231 24.0 Location: Bath 2;Cream 9x9 53.2 22 7 32L2 32 15 0.072 54.5 Location: Bath 2:Cream 9xg 30.1 15.4 33 33 16 C Location: Ceiling Cavity;Fiberglass Insulation --- 34 34 16 Location: Ceiling Cavity,Fiberglass Insulation -" 35 35 17 Location. Bedroom 2;Closet Wall Board 36 36 17 Location: Bedroom 2;Closet Wali Board ` 37 37 18 Location: Second Floor;Wall Drywall -� 38 3$ 18 Location; Second Floor;Wall Drywall See Reporting notes on cast page AmeriSci Job#: 118082015 Client Name: Insight Environmental Table I Summary of Bulk Asbestos Analysis Results 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Sample Heat Acid Insoluble AmeriSci HG Weight Sensitive Soluble Non-Asbestos Sample# Client Sample# Area (gram) Organic% Inorganic% Inorganic% 39 39 19 0.451 8.3 1.6 90.1 Location: Exterior Siding;Siding 40 40 19 0.377 8.9 2.9 88.1 Location: Exterior Siding;Siding 41 41 20 0.239 22.2 67.5 10.1 Location: Exterior Window;Caulk"Total Asbestos Concentration For Multiple Asbestos Types Present Is Less Than 1%" 42 42 20 0.303 24.9 63.3 11.6 Location: Exterior Window;Caulk"Total Asbestos Concentration For Multiple Asbestos Types Present Is Less Than 1%" 43 43 21 0.267 21.2 47.2 31.6 Location: Roof;Shingle 44 44 21 0.325 19.5 48.2 29.1 C Location: Roof;Shingle 45 45 22 0.531 11.4 75.1 13.4 Location: Exterior Window;Glazing 46 46 22 0.493 9.5 69.4 21.0 Location: Exterior Window;Glazing 47 47 23 0.141 95.5 4.1 0.4 Location: Exterior Siding;Tar Paper 48 48 23 0.134 96.9 3.1 0.1 Location: Exterior Siding;Tar Paper TEM Anal yzed By:Jean L.May Date Analyzed:8/25/2018 Reviewed By; 1 Date I Semi-Quantitative Analysis:NA4rno stos detected; NA=not analyzed; NAPS=not analyzed due to positive stop;Trace=<1%; PLM analysis by EPA 600/R-93/116 per 40 CFR 763(NVLAP Lab Code 101904-0)or NY ELAP 198.1 for New York friable samples which includes quantitation samples)or EPA 400 pt ct by EPA 600/M4-82-020(NY ELAP Lab#10984); TEM prep by EPA 600/R-93/116 Section 2.3(analysis by Section 2.5,not covered by NVLAP Bulk accreditation); or NY ELAP 198.4 for New York NOB sample "' Warning Notes:Consider PLM fiber diameter limitation,only TEM will resolve fibers<0.25 micrometers in diameter. TEM bulk analysis is representative of th be representative of non-uniformly dispersed debris,soils or other heterogeneous materials for which a combination PLM/TEM evaluation is recommended;Qua should be considered as qualitative only. /000 � AmeriSci Richmond 13635 GENITO ROAD AmEmScl MIDLOTHIAN,VIRGINIA 23112 TEL:(804)763-1200•FAX:(804)763-1800 s ,s. PLM Bulk Asbestos Report Insight Environmental Date Received 08/24/18 AmeriSci Job# 118082015 Attn: George Maul Date Examined 08/26/18 P.O.# 74 East Main Street ELAP# 10984 Page 1 of 12 Suite #1 RE: 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, Patchogue, NY 11772 NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 1 118082015-01 Yes 80 % 1 Location: Basement;Insulation Wrap (by NYS ELAP 198.1) by William M. Dunstan on 08/26/18 Analyst Description: Gray,Heterogeneous,Fibrous,Bulk Material Asbestos Types:Chrysotile 80.0% Other Material: Non-fibrous 20% 2 118082015-02 NA/PS 1 Location: Basement; Insulation Wrap Analyst Description: Bulk Material Asbestos Types: Other Material: 3 118082015-03 NA/PS 1 Location: Basement; Insulation Wrap Analyst Description: Bulk Material Asbestos Types: Other Material: 4 118082015-04 Yes 44.4 % 2 Location: Basement;Flue Cement (by NYS ELAP 198.1) by William M.Dunstan on 08/26/18 Analyst Description: Gray,Heterogeneous, Fibrous,Cementitious,Bulk Material Asbestos Types:Chrysotile 44.4% Other Material: Non-fibrous 55.6% 5 118082015-05 NA/PS 2 Location: Basement;Flue Cement Analyst Description: Bulk Material Asbestos Types: Other Material: See Reporting notes on last page AmeriSci Job#: 118082015 Page 2 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 6 118082015-06 NA/PS 2 Location: Basement;Flue Cement Analyst Description: Bulk Material Asbestos Types: Other Material: 7 118082015-07 Yes 8.5 % 3 Location: Living Room;Light Brown 9x9 (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: Brown, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types:Chrysotile 8.5% Other Material: Non-fibrous 21.1 % Comment: Heat Sensitive(organic):21.0%;Acid Soluble(inorganic):49.4%; Inert(Non-asbestos):21.1% 8 118082015-08 NA/PS 3 Location: Living Room;Dark Brown 9x9 Analyst Description: Bulk Material Asbestos Types: Other Material: Comment: Heat Sensitive(organic):21.7%;Acid Soluble(inorganic):33.3%;Inert(Non-asbestos):45.0% 9 118082015-09 No NAD 4 Location: Living Room;Floor Tile Mastic (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Brown,Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 0.2% Comment: Heat Sensitive(organic):90.7%;Acid Soluble(inorganic):9.1%; Inert(Non-asbestos):0.2% 10 118082015-10 No NAD 4 Location: Living Room;Floor Tile Mastic (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Brown, Heterogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 0.1 % Comment: Heat Sensitive(organic):94.5%;Acid Soluble(inorganic):5.4%; Inert(Non-asbestos):0.1% See Reporting notes on last page AmeriSci Job#: 118082015 Page 3 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 11 118082015-11 No NAD 5 Location: Dining Room; Linoleum Floor (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: White, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 23.7% Comment: Heat Sensitive(organic):64.3%;Acid Soluble(inorganic): 11.9%; Inert(Non-asbestos):23.7% 12 118082015-12 No NAD 5 Location: Dining Room; Linoleum Floor (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: White,Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 10.5% Comment: Heat Sensitive(organic):76.7%;Acid Soluble(inorganic): 12.8%; Inert(Non-asbestos): 10.5% 13 118082015-13L1 Yes 10.6 % 6 Location: Kitchen;White W/Olive Streak 9x9 (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description:White, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types:Chrysotile 10.6% Other Material: Non-fibrous 37% Comment: Heat Sensitive(organic):25.3%;Acid Soluble(inorganic):27.0%; Inert(Non-asbestos):37.0% 13 118082015-13L2 Yes Trace (<0.25 % pc) 6 Location: Kitchen;White W/Olive Streak 9x9 (EPA 400 PC) by William M. Dunstan on 08/26/18 Analyst Description: Black, Heterogeneous,Non-Fibrous, Bulk Material Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 14.4% Comment: Heat Sensitive(organic):65.4%;Acid Soluble(inorganic):20.1%;Inert(Non-asbestos): 14.4% 14 118082015-14L1 NA/PS 6 Location: Kitchen;White W/Olive Streak 9x9 Analyst Description: Bulk Material Asbestos Types: Other Material: Comment: Heat Sensitive(organic):25.3%;Acid Soluble(inorganic):26.1%;Inert(Non-asbestos):48.6% See Reporting notes on last page AmeriSci Job#: 118082015 Page 4 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 14 118082015-14L2 Yes Trace (<0.25 % pc) 6 Location: Kitchen;White W/Olive Streak 9x9 (EPA 400 PC) by William M. Dunstan on 08/26/18 Analyst Description: Black, Heterogeneous, Non-Fibrous, Bulk Material Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 12.3% Comment: Heat Sensitive(organic):59.2%;Acid Soluble(inorganic):28.6%;Inert(Non-asbestos): 12.3% 15 118082015-15L1 Yes 12.3 % 7 Location: Bath 1;White Pattern 9x9 (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description:White, Heterogeneous, Non-Fibrous, Bulk Material Asbestos Types:Chrysotile 12.3% Other Material: Non-fibrous 40.1 % Comment: Heat Sensitive(organic):24.9%;Acid Soluble(inorganic):22.7%;Inert(Non-asbestos):40.1% 15 118082015-15L2 Yes Trace (<0.25 % pc) 7 Location: Bath 1;White Pattern 9x9 (EPA 400 PC) by William M. Dunstan on 08/26/18 Analyst Description: Black, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 3.4% Comment: Heat Sensitive(organic):87.2%;Acid Soluble(inorganic):9.3%; Inert(Non-asbestos):3.4% 16 118082015-16L1 NAPS 7 Location: Bath 1;White Pattern 9x9 Analyst Description: Bulk Material Asbestos Types: Other Material: Comment: Heat Sensitive(organic):24.9%;Acid Soluble(inorganic):23.7%;Inert(Non-asbestos):51.5% 16 118082015-16L2 Yes Trace (<0.25 % pc) 7 Location: Bath 1;White Pattern 9x9 (EPA 400 PC) by William M.Dunstan on 08/26/18 Analyst Description: Black,Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 3.8% Comment: Heat Sensitive(organic):76.6%;Acid Soluble(inorganic): 19.6%; Inert(Non-asbestos):3.8% See Reporting notes on last page AmeriSci Job#: 118082015 Page 5 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total %Asbestos 17 118082015-17 No NAD 8 Location: Bedroom 1;Ceiling Tile (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description:Tan,Heterogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 54.8% Comment: Heat Sensitive(organic):27.7%;Acid Soluble(inorganic): 17.5%; Inert(Non-asbestos):54.8% 18 118082015-18 No NAD 8 Location: Bedroom 1;Ceiling Tile (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Tan, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 57.2% Comment: Heat Sensitive(organic):23.4%;Acid Soluble(inorganic): 19.4%; Inert(Non-asbestos): 57.2% 19 118082015-19 No NAD 9 Location: Kitchen;Ceiling Tile (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description:White/Tan,Heterogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 3.8% Comment: Heat Sensitive(organic):89.5%;Acid Soluble(inorganic):6.7%; Inert(Non-asbestos):3.8% 20 118082015-20 No NAD 9 Location: Kitchen;Ceiling Tile (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: White/Tan,Heterogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 8.1 % Comment: Heat Sensitive(organic):80.9%;Acid Soluble(inorganic): 10.9%; Inert(Non-asbestos):8.1% 21 118082015-21 L1 No NAD 10 Location: Bath 1;Green Cove Base (by NYS ELAP 198.6) by William M. Dunstan Analyst Description: Green,Heterogeneous,Non-Fibrous, Bulk Material on 08/26/18 Asbestos Types: Other Material: Non-fibrous 1.5% Comment: Heat Sensitive(organic):33.7%;Acid Soluble(inorganic):64.9%; Inert(Non-asbestos): 1.5% See Reporting notes on last page AmeriSci Job#: 118082015 Page 6 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 21 118082015-21 L2 No NAD 10 Location: Bath 1,Green Cove Base (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Gray, Heterogeneous,Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 18.2% Comment: Heat Sensitive(organic):64.9%;Acid Soluble(inorganic): 16.9%;Inert(Non-asbestos): 18.2% 22 118082015-22L1 No NAD 10 Location: Bath 1;Green Cove Base (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: Green,Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 0.9% Comment: Heat Sensitive(organic):33.5%;Acid Soluble(inorganic):65.5%;Inert(Non-asbestos):0.9% 22 118082015-221-2 No NAD 10 Location: Bath 1;Green Cove Base (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Gray,Heterogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 18.1 % Comment: Heat Sensitive(organic):66.8%;Acid Soluble(inorganic): 15.2%; Inert(Non-asbestos): 18.1% 23 118082015-23 No NAD 11 Location: Dining Room;Ceiling Drywall (by NYS ELAP 198.1) by William M. Dunstan on 08/26/18 Analyst Description: Gray/Brown, Heterogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Cellulose 5%, Non-fibrous 95% 24 118082015-24 No NAD 11 Location: Dining Room;Ceiling Drywall (by NYS ELAP 198.1) by William M.Dunstan on 08/26/18 Analyst Description: Gray/Brown, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose 5%, Non-fibrous 95% See Reporting notes on last page AmeriSci Job#: 118082015 Page 7 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total %Asbestos 25 118082015-25L1 No NAD 12 Location: Bath 1;Wall Board (by NYS ELAP 198.1) by William M. Dunstan on 08/26/18 Analyst Description., Green/Brown,Heterogeneous, Fibrous, Bulk Material Asbestos Types: Other Material: Cellulose 95%, Non-fibrous 5% 25 118082015-251-2 No NAD 12 Location: Bath 1;Wall Board (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Gray, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 10.9% Comment: Heat Sensitive(organic):76.8%;Acid Soluble(inorganic): 12.2%; Inert(Non-asbestos): 10.9% 26 118082015-26L1 No NAD 12 Location: Bath 1;Wall Board (by NYS ELAP 198.1) by William M.Dunstan on 08/26/18 Analyst Description: Green/Brown, Heterogeneous, Fibrous, Bulk Material Asbestos Types: Other Material: Cellulose 95%, Non-fibrous 5% 26 118082015-261-2 No NAD 12 Location: Bath 1;Wall Board (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Gray,Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 16.6% Comment: Heat Sensitive(organic):66.1%;Acid Soluble(inorganic): 17.2%;Inert(Non-asbestos): 16.6% 27 118082015-27 No NAD 13 Location: Dining Room;Ceiling Spackle (by NYS ELAP 198.1) by William M.Dunstan on 08/26/18 Analyst Description: White, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 100% See Reporting notes on last page AmeriSci Job#: 118082015 Page 8 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 28 118082015-28 Yes Trace(<0.25 % pc) 13 Location: Dining Room; Ceiling Spackle (EPA 400 PC) by William M. Dunstan on 08/26/18 Analyst Description: White/Gray, Heterogeneous,Non-Fibrous,Bulk Material Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 100% 29 118082015-29 No NAD 14 Location: Bath 2;Shower Wall (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: Multi-Colored, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 8.8% Comment: Heat Sensitive(organic):65.7%;Acid Soluble(inorganic):25.5%; Inert(Non-asbestos):8.8% 30 118082015-30 No NAD 14 Location: Bath 2;Shower Wall (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: Multi-Colored, Heterogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 10.9% Comment: Heat Sensitive(organic):64.6%;Acid Soluble(inorganic):24.6%;Inert(Non-asbestos): 10.9% 31 118082015-31 L1 Yes 9.1 % 15 Location: Bath 2;Cream 9x9 (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: White, Heterogeneous,Non-Fibrous,Bulk Material Asbestos Types:Chrysotile 9.1 % Other Material: Non-fibrous 15.8% Comment: Heat Sensitive(organic):23.7%;Acid Soluble(inorganic):51.4%;Inert(Non-asbestos): 15.8% 31 118082015-31 L2 Yes Trace (<0.25 % pc) 15 Location: Bath 2;Cream 9x9 (EPA 400 PC) by William M. Dunstan on 08/26/18 Analyst Description: Black, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 15.5% Comment: Heat Sensitive(organic):60.5%;Acid Soluble(inorganic):24.0%;Inert(Non-asbestos): 15.5% See Reporting notes on last page AmeriSci Job#: 118082016 Page 9 of 12 Client Name: Insight Environmental PLM Sulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total %Asbestos 32 118082015-32L1 NAPS 15 Location: Bath 2;Cream 9x9 Analyst Description: Bulk Material Asbestos Types: Other Material: Comment: Heat Sensitive(organic):24.0%;Acid Soluble(inorganic):53.2%;Inert(Non-asbestos):22.7% 32 118082015-32L2 Yes Trace (<0.25 % pc) 15 Location: Bath 2;Cream 9x9 (EPA 400 PC) by William M.Dunstan on 08/26/18 Analyst Description: Black, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 15.4% Comment: Heat Sensitive(organic):54.5%;Acid Soluble(inorganic):30.1%;Inert(Non-asbestos): 15.4% 33 118082015-33 No NAD 16 Location: Ceiling Cavity; Fiberglass Insulation (by NYS ELAP 198.1) by William M. Dunstan on 08126/18 Analyst Description: Green, Heterogeneous, Fibrous, Bulk Material Asbestos Types: Other Material: Fibrous glass 98%, Non-fibrous 2% 34 118082015-34 No NAD 16 Location: Ceiling Cavity;Fiberglass Insulation (by NYS ELAP 198.1) by William M.Dunstan on 08/26/18 Analyst Description: Green,Heterogeneous,Fibrous,Bulk Material Asbestos Types: Other Material: Fibrous glass 98%, Non-fibrous 2% 35 118082015-35 No NAD 17 Location: Bedroom 2;Closet Wall Board (by NYS ELAP 198.1) by William M. Dunstan on 08/26/18 Analyst Description: Tan, Heterogeneous, Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose 95%, Non-fibrous 5% See Reporting notes on last page AmeriSci Job* 118082015 Page 10 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 36 118082015-36 No NAD 17 Location: Bedroom 2;Closet Wall Board (by NYS ELAP 198.1) by William M. Dunstan on 08/26/18 Analyst Description:Tan, Heterogeneous,Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose 95%, Non-fibrous 5% 37 118082015-37 No NAD 18 Location: Second Floor,Wall Drywall (by NYS ELAP 198.1) by William M.Dunstan on 08/26/18 Analyst Description: Gray/Brown, Heterogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Cellulose 5%, Non-fibrous 95% 38 118082015-38 No NAD 18 Location: Second Floor;Wall Drywall (by NYS ELAP 198.1) by William M. Dunstan on 08/26/18 Analyst Description: Gray/Brown, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Cellulose 5%, Non-fibrous 95% 39 118082015-39 Yes 21.2 % 19 Location: Exterior Siding; Siding (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Cream, Heterogeneous,Non-Fibrous,Bulk Material Asbestos Types:Chrysotile 21.2% Other Material: Non-fibrous 68.9% Comment: Heat Sensitive(organic):8.3%;Acid Soluble(inorganic): 1.6%; Inert(Non-asbestos):68.9% 40 118082015-40 NA/PS 19 Location: Exterior Siding;Siding Analyst Description: Bulk Material Asbestos Types: Other Material: Comment: Heat Sensitive(organic):8.9%;Acid Soluble(inorganic):2.9%; Inert(Non-asbestos):88.1% See Reporting notes on last page AmeriSci Job#: 118082015 Page 11 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 41 118082015-41 NA 20 Location: Exterior Window;Caulk Analyst Description: Bulk Material Asbestos Types: Other Material: Comment: Heat Sensitive(organic):22.2%;Acid Soluble(inorganic):67.5%; Inert(Non-asbestos): 10.3% 42 118082015-42 NA 20 Location: Exterior Window;Caulk Analyst Description: Bulk Material Asbestos Types: Other Material: Comment: Heat Sensitive(organic):24.9%;Acid Soluble(inorganic):63.3%; Inert(Non-asbestos): 11.8% 43 118082015-43 No NAD 21 Location: Roof,Shingle (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: Black, Heterogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 31.7% Comment: Heat Sensitive(organic):21.2%;Acid Soluble(inorganic):47.2%;Inert(Non-asbestos):31.7% 44 118082015-44 Yes Trace(<0.25 % pc) 21 Location: Roof;Shingle (EPA 400 PC) by William M. Dunstan Analyst Description: Black, Heterogeneous,Non-Fibrous,Bulk Material on 08/26/18 Asbestos Types:Chrysotile <0.25%pc Other Material: Non-fibrous 32.3% Comment: Heat Sensitive(organic): 19.5%;Acid Soluble(inorganic):48.2%; Inert(Non-asbestos):32.3% 45 118082015-45 No NAD 22 Location: Exterior Window,Glazing (by NYS ELAP 198.6) by William M.Dunstan Analyst Description: White,Heterogeneous,Non-Fibrous,Bulk Material on 08/26/18 Asbestos Types: Other Material: Non-fibrous 13.5% Comment: Heat Sensitive(organic): 11.4%;Acid Soluble(inorganic): 75.1%; Inert(Non-asbestos): 13.5% See Reporting notes on last page AmeriSci Job#: 118082016 Page 12 of 12 Client Name: Insight Environmental PLM Bulk Asbestos Report 18-0579; Renovation Inspection; 675 Skippers Lane, Orient, NY Client No. / HGA Lab No. Asbestos Present Total % Asbestos 46 118082015-46 No NAD 22 Location: Exterior Window;Glazing (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: White, Heterogeneous, Non-Fibrous,Bulk Material Asbestos Types: Other Material: Non-fibrous 21.1 % Comment: Heat Sensitive(organic):9.5%;Acid Soluble(inorganic):69.4%;Inert(Non-asbestos):21.1% 47 118082015-47 No NAD 23 Location: Exterior Siding;Tar Paper (by NYS ELAP 198.6) by William M. Dunstan on 08/26/18 Analyst Description: Black,Heterogeneous,Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 0.4% Comment: Heat Sensitive(organic):95.5%;Acid Soluble(inorganic):4.1%;Inert(Non-asbestos):0.4% 48 118082015-48 No NAD 23 Location: Exterior Siding;Tar Paper (by NYS ELAP 198.6) by William M.Dunstan on 08/26/18 Analyst Description: Black, Heterogeneous, Non-Fibrous, Bulk Material Asbestos Types: Other Material: Non-fibrous 0.1 % Comment: Heat Sensitive(organic):96.9%;Acid Soluble(inorganic):3.1%; Inert(Non-asbestos):0.1% Reporting Notes: Analyzed by:William M.Dunstan W Date: 8/26/2018 Reviewed by: *NAD=no asbestos detected, Detection Limit<1%,Reporting Limits:CVES=1%,400 Pt Ct=0.25%, 1000 Pt Ct=0.1%;"Present"or NVA="No Visible Asbestos"are observations made during a qualitative analysis;NA=not analyzed; NA/PS=not analyzed/positive stop; PLM Bulk Asbestos Analysis by EPA 600/R-93/116 per 40 CFR 763(NVLAP Lab Code 101904-0)and ELAP PLM Analysis Protocol 198.1 for New York friable samples which includes quantitatian of any vermiculite observed(198.6 for NOB samples)or EPA 400 pt ct by EPA 600IM4-82.020(NYSDOH ELAP Lab# 10984): CA ELAP Lab#2508;Note:PLM is not consistently reliable in detecting asbestos in floor coverings and similar NOB materials. NAD or Trace results by PLM are inconclusive,TEM is currently the only method that can be used to determine if this material can be considered or treated as non-asbestos-containing in New York State(also see EPA Advisory For floor tile,FR 59, 146,38970,8/1/94). NIST Accreditation requirements mandate that this report must not be reproduced except in full without the approval of the laboratory. This PLM report relates ONLY to the items tested. Relinquished By: RECEIVED DatelTime: twl �� BUL Received By: Daterrime: A n ERI SCI Relinquished By: Date/Time: Received By: Daterrime: WWW.AMERISCLcoM ompany:lnsight Environmental Inc. roect:Renovation InspectiorAmvuSc'#: Street Address:74 East Main Street, Suite 1 Drol M r.George W. Maul Patchogue State:NY Zip:11772 21rol Address: 675 Skippers Lane, Orient hone:631.654.2780 Cell: nalysis: ✓EPLM; Q Positive Stop; OTEM; Mil ax Results? Y❑ Fax#:631.654.2781 ASTM Dust Microvac Wi a ; qualitative; mail Results? Y O Email: GMaul@lnsightenvironmental.com Turnaround Time: 48 hr Material' esults to:George W. Maul Sampled By: George W. Maul Date sa Special Instructions or Comments: Lab ID Field ID Location Sample Description dust 1 Basement Insulation Wrap 2 _ Basement Insulation Wrap 3 Basement Insulation Wrap 4 _ Basement Flue Cement 5 Basement Flue Cement 6 Basement Flue Cement 7 Living Room Light Brown 9x9 8 Living Room Dark Brown 9x9 9 Living Room Floor Tile Mastic 10 Living Room Floor Tile Mastic 11 Dining Room Linoleum Floor 12 Dining Room Linoleum Floor 13 Kitchen White w/Olive Streak E 14 Kitchen White w/Olive Streak E 15 Bath 1 White Pattern 9x9 16 Bath 1 White Pattern 9x9 17 Bedroom 1 Ceiling Tile Mwed,Bulk C*C,rev Jon 2018 Relinquished By: RECEIVED Date/Time: 1 BUL Received By: Date/Time: AmERI Scl Relinquished By: Date/Time: vzj Received B • Date/Time: WWW.AMERISCI.COM EmS Qmpany:lnsight Environmental Inc. ro�:Renovation Inspectior�' " Street Address:74 East Main Street, Suite 1 ro M r.George W. Maul .it.: Patchogue State:NY Zip:11772 Proj Address: 675 Skippers Lane, Orient hone:631.654.2780 Cell: Analysis: ✓QPLM; 0 Positive Stop; QTEM; 0 I ax Results? Y El Fax#:631.654.2781 ASTM Dust Microvac Wi ❑Qualitative; mail Results? YD Email: GMaul@lnsightenvironmental.com ITurnaround Time: 48hr Material' esufts to:George W. Maul Isampled B : George W. Maul Date Sa Special Instructions or Comments: Lab ID Fieid ID Location Sample Description dust 18 Bedroom 1 Ceiling Tile 19 Kitchen Ceiling Tile 20 Kitchen Ceiling Tile 21 Bath 1 Green Cove Base 22 Bath 1 Green Cove Base 23 Dining Room Ceiling Drywall 24 Dining Room Ceiling Drywall 25 Bath 1 Wall Board 26 Bath 1 Wall Board 27 Dining Room Ceiling Spackle 28 Dining Room Ceiling Spackle 29 Bath 2 Shower Wall 30 Bath 2 Shower Wall 31 Bath 2 Cream 9x9 32 Bath 2 Cream 9x9 33 Ceiling Cavity Fiberglass Insulation 34 Ceiling Cavity Fiberglass Insulation Amed8d,Bunt CoC,rav Jan 2018 Relinquished By: RECEIVED Date/Time: jam++ Bul Received By: Datefrime: AMERJ`7CI Relinquished By: Date/Tfine: Received @ : By Date/Time: - +ERISCI.COM �ompany-lnsight Environmental Inc. ,.gect.Renovation Inspectior'm'S°'#: Street Address:74 East Main Street, Suite 1 2rol Mgr:George W. Maul 1tv: Patchogue State:NY Zip:11772 F ddress:675 Skippers Lane, Orient hone:631.654.2780 Cell: is: ✓QPLM; ✓0 Positive Stop; EITEM; Q I ax Results? Y 0 Fax#:631.654.2781 Dust Micravac Vlr e ; 0{�ualitative; mail Results? YD Email: GMaul@lnsightenvironmental.com ound Time: 48 hr Material es to:George W. Maul ed By: George W. Maul Date Sa Special Instructions or Comments: Lab ID Field ID Location Sample Description dust 35 Bedroom 2 Closet Wall Board 36 Bedroom 2 Closet Wall Board 37 Second Floor Wall Drywall 38 Second Floor Wall Drywall 39 Exterior Siding Siding 40 Exterior Siding Siding 41 Exterior Window Caulk 42 Exterior Window Caulk 43 Roof Shingle 44 Roof Shingle 45 Exterior Window Glazing 46 Exterior Window Glazing 47 Exterior Siding Tar Paper 48 Exterior Siding Tar Paper Amedit BuNt CoC,rev Jon 2018 Appendix B Asbestos Containing Material Sampling Location Diagrams 675 Skippers Lane, Orient, NY 1st Floor Elevation 13, 14 16 Kitchen Dining Room 1 Living Room .: 7,s /l Created by Insight Environmental Inc. 675 Skippers Lane, Orient, NY 2nd Floor Elevation CL Bedroom 4 Bedroom 3 Attic/Storage CI 31, Bedroom 2 32 CL Bath Created by Insight Environmental Inc. 43,44 Root 675 Skippers Lane, Orient, NY i Basement Elevation 1, 2, 3 4, 5, 6 Created by Insight Environmental Inc. Appendix C Reconnaissance Photographs i. J r Pipe wrap installed on the structuralsir- b- the basement rr Y { Flue cement in the basement w r , ��l� 1��l a •r — View of the Living Room sample location—Light Brown 9"X9"Floor tile 1 w. 10 Ar f h� v Poo �. 00 View of the Kitchen sample•location— White w/Olive streak 9"X9-'Floor tile r View of the Bathroom #1 sample location — White pattern 9"X9"Floor tile ram_ -.,•. � 'a. l r k 4k View of the Bathroom #2 sample location —Cream 9"X9"Floor tile t View of the transite shingles at the exterior of the building—note slight damage l!!� ti.. +'oil View of the transite shingles stored in the attic M1'�� "�� CIS,'+� t• - ••tY��. g�� .:_�'��'r`• • N+ � #.� _ - �_ , �i -ate`•- ` +� - - �. •ram, !� �.. View 1the roofelevation Appendix D Certifications New York State—Department of Labor Division of Safety and Health License and Certificate Unit State Campus,Building 12 Albany,NY 12240 7 ASBESTOS HANDLING LICENSE . Insight Environmental, Inc. FILE NUMBER: 02-0279 Suite 1 LICENSE NUMBER: 28434 74 East Main Street LICENSE CLASS: RESTRICTED DATE OF ISSUE: 05/10/2018 Patchogue, NY 11772 EXPIRATION DATE: 05/31/2019 z Duly Authorized Representative—John J Paciulli: This license has been issued in accordance with applicable provisions of Article 30 of the Labor Law of New York State and of the New York State Codes,Rules and Regulations(12 NYCRR Part 56). It is subject to suspension or revocation for a(1) serious violation of state,federal or local laws with regard to the conduct of an asbestos project,or(2)demonstrated lack of responsibility in the conduct of any job involving asbestos or asbestos material. 4 This license is valid only for the contractor named above and this license or a photocopy must be prominently displayed at the asbestos project worksite. This license verifies that all persons employed by the licensee on an asbestos project in New York State have been issued an Asbestos Certificate,appropriate for the type of work they perform,by the New York State Department of Labor. Ll �.r Eileen M. Franko, Director SH 432(8/12) For the Commissioner of Labor STATE OF NEW YORK-DEPARTMENT OF LABOR r—{ ASBESTOS CERTIFICATE i GEORGE W MAUL c_ CLASS(EXPIRES) C ATEC(Oq/18) D INSP(09/19) CERTN 98-13806 GhjtVA 565991 142 MUST BE CARRIED ON ASBESTOS PROJECTS �nnu111�1r�auim�n /00"� INSIGHT Environmental Inc. September 4, 2018 Peter Cook Architect, AIA 728 Montauk Highway Water Mill, NY 11976 Attn: Mr. Rick Tloczkowski Re: Limited Lead Based Paint Evaluation—675 Skippers Lane, Orient, NY 11957 Dear Mr. Tloczkowski: Pursuant to your request, our office has conducted paint chip bulk sampling of various suspect Lead-based painted surfaces that will be disturbed by upcoming remediation, renovation and demolition. As such, a total of five paint chip samples were collected from various exterior and interior window surfaces, ceiling and wall paint, and painted brick. All samples were submitted to AmeriSci Richmond (ELAP#10984), for analysis by EPA 7000E Method to determine the presence of lead-based paint. According to the U.S. Department of Housing and Urban Development, any paint chip sample determined to contain equal or greater than 0.5% lead is considered lead-based paint containing. Results regarding the sample analysis indicate that lead-based paint is present in three of the five samples collected. Please note that based on these results, we recommend all of the windows/doors and window/doors components be treated as lead-based paint containing surface. Additionally,the painted brick fireplace, and the painted brick in the kitchen to be considered lead containing. Please see the sample analysis results in the table below. Lead-Based Paint Containing Materials: Sample# Material Lead % by Location Condition _ Weight L1 White Painted Brick 2.7% Kitchen Stove Slightly Damaged L4 White Window Sill 1.8% Bedroom #3 Damaged Paint L5 White Window Sill 2.3% Exterior-South Damaged Insight Environmental, Inc. — 74 East Main Street, Suite#1, Patchogue, NY—631.654.2780 fax: 631.654.2781 CONCLUSIONS & RECOMMENDATIONS It is required that work disturbing confirmed Lead-Based Paint containing surfaces in public housing be conducted by a NYS EPA Certified Lead Abatement firm as stipulated by the Toxic Substances Control Act (TSCA) Section 402 (a)(1) to conduct Lead Based Paint Activities with personnel that have received appropriate training pursuant to 40 CFR Part 745.226. Should any materials identified to contain lead-based paint require salvaging,these substrates will require abatement of lead in their entirety. Only those areas as identified by the architect will be required to be abated prior to demolishing the structure. Chemical abatement is recommended for the areas to be salvaged by the demolition contractor; e.g. peel away or similar. Following abatement activities, the balance of the home may be demolished using traditional demolition techniques, with poly (plastic sheeting) protection of soils surrounding the foundation. These poly sheets will be folded upon themselves and included in the waste stream. All waste generated is subject to Toxicity Characteristic Leachate Procedure (TCLP) for characterization and disposal purposes. All debris containing equal to or greater than 5 parts per million (.5% by weight) is defined as lead containing waste and must be disposed of in accordance with the applicable RCRA (Resource Conservation and Recovery Act) requirements. Due to the mass of concrete and the miniscule concentration of lead, the materials will likely be disposable and Construction and Demolition (C&D debris). The selected contractor must be "Lead Safe" certified and in compliance with 29 CFR 1926.62 OSHA's Lead in Construction industry standard. Upon completion of removal of all lead containing construction materials, soil/wipe sampling is recommended to ensure the work has been completed safely and effectively. Enclosed herewith, please find a copy of the analytical results and photographs of prevailing conditions at the time of my inspection. If you should have any questions regarding this report, or require further assistance in this matter, please do not hesitate to contact the undersigned at your earliest convenience. Respectfully submitted, INSIGHT ENVIRONMENTAL, INC. Leon W.Tregerman, EPA Risk Assessor Gpe ge . Maul, Vice President Project#18-0579 Potters 1 675 Skippers Lane,Orient,NY 11957 ATTACHMENT A Analytical Lead Paint Chip Analysis 3 Potters 1 675 Skippers Lane,Orient,NY 11957 Please Reply To: ��1 AmeriiSci Richmond 13635 GENITO ROAD AmERI So MIDLOTHIAN,VIRGINIA 23112 TEL:(804)763-1200•FAX:(804)763-1800 FACSIMILE TELECOPY TRANSMISSION To: George Maul From: Amber Jiles Insight Environmental AmeriSci Job#: 118082130 Fax#: Subject: Lead(paint)48 hour Results Client Project: 18-0579; 675 Skippers Lane; 675 Email: gmaul insi tenvironmental.co leon Skippers Ln,Orient,NY @ gla m, t@insightenvi ronmental.com,johnp@insightenvironmental.com,an drea@insightenvironmental.com,jurick@insightenvir onmental.com Date: Thursday,August 30,2018 Number of Pages: q Time: 16:50:04 (including cover sheet) Comments: CONFIDENTIALITY NOTICE: Unless otherwise indicated,the information contained in this communication is confidential information intended for use of the individual named above. If the reader of this communication is not the intended recipient,you are hereby notified that any dissemination, distribution or copying of this communication is prohibited. If you have received this communication in error,please immediately notify the sender by telephone and retum the original message to the above address via the US Postal Service at our expense. Samples are disposed of in 60 days or unless otherwise instructed by the protocol or special instructions in writing. Thank you. Certified Analysis Service 24 Hours A Day• 7 Days A Reek Competitive Prices visit our web site-www.meriad.com Boston•Los Angeles•New York•Richmond RLsiD La60/Vl0'rlss- Lead Paint Chip Environmental Hazards Services, L.L.C. Analysis Report 7469 Whitepine Rd Richmond,VA 23237 Telephone:800.347.4010 Report Number: 18-08-04310 Client: Amed-Sci Received Date: 08/28/2018 13635 Genito Road Analyzed Date: 08/30/2018 Midlothian, VA 23112-400 Reported Date: 08/30/2018 Project/Test Address: 118-08-2130; 18-0579; 675 Skippers Lane; Orient, NY Collection Date: 08/22/2018 Client Number: Fax Number: 48-3042 Laboratory Results 804-763-1800 Lab Sample Client Sample Collection Location Pb(ug/g) %Pb by Narrative Number Number ppm Wt. ID 18-08-04310-M L1 KITCHEN BEHIND STOVE; 27000 2.7 BRICK PAINT 18-08-04310-002 L2 DINING ROOM;CEILING 62 0.0062 PAINT 18-08-04310-003 L3 BEDROOM 2;WALL PAINT 87 0.0087 18-08-04310-004 L4 BEDROOM 3;WINDOW SILL 18000 1.8 PAINT 18-08-04310-005 L5 EXTERIOR;WINDOW SILL 23000 2.3 L04 PAINT Page 1 of 2 Environmental Hazards Services, L.L.0 Client Number: 48-3042 Report Number: 18-08-04310 Project/Test Address: 118-08-2130; 18-0579;675 Skippers Lane;Orient, NY Lab Sample Client Sample Collection Location Pb(ug/9) %Pb by Narrative Number Number ppm Wt. ID Sample Narratives: L04: Sample contains substantial amounts of substrate which may affect the calculated results with units of ppm and%by weight. Preparation Method: ASTM E-1979-17 Analysis Method: EPA SW846 7000E Reviewed By Authorized Signatory: Deborah Britt QA/QC Cleric The HUD lead guidelines for lead paint chips are 0.50%by Weight,5000 ppm,or 1.0 mg/cm2. The Reporting Limit(RL)for samples prepared by ASTM E-1979-17 is 10.0 ug Total Pb. The RL for samples prepared by EPA SW846 3050B is 25.0 ug Total Pb. Paint chip area and results are calculated based on area measurements determined by the client. All internal quality control requirements associated with this batch were met,unless otherwise noted. The condition of the samples analyzed was acceptable upon receipt per laboratory protocol unless otherwise noted on this report.Results represent the analysis of samples submitted by the client.Sample location,description,area,etc.,was provided by the client. Results reported above in mg/cm3 are calculated based on area supplied by client This report shall not be reproduced except in full,without the written consent of the Environmental Hazards Service,L.L.C. ELLAP Accredtitation through AIHA-LAP,LLC(100420),NY ELAP#11714. LEGEND Pb=lead ug=microgram ppm=parts per million ug/g=micrograms per gram Wt.=weight Page 2 of 2 Relinquished By: DatelTime: I � Bu Received By: Date/Time: AmER1 SC! Relinquished By: Date/Time: Received B : Daterrime: WWWAMEwsci.coM SIGHT ENVIRONMENTAL Company: IN 74 E Main Street, Suite 1 Street Address: roj mu: L=&^ Patchogue 11772 r � State: NY Zip: ra' Address: C7�-f P(-j !i Qom' Bane: 631-654-2780 Fax: 631-654-2781 naiysis: _PLM; _PosifiTe Stop; _TEM; Y ell: Fax: ASTM Oust Microvac,^( j le ; Qualitative; -mail Q.,r►� @insightenvironmental.com Verba[ Results: Y / N urnaround Time: 44 l r Materia Results to: ara led By: Date S Special Instructions or Comments: Lab ID Field ID Location Sample Description dui �✓:,, .� AmeriSci,Bulk CoC,rev May 20,2009 ATTACHMENT B Photographic Record of Prevailing Conditions 4 Potters 1 675 Skippers Lane,Orient,NY 11957 4#� INSIGHT Environmental Inc. September 6, 2018 Peter Cook Architect, AIA 728 Montauk Highway Water Mill, NY 11976 Attn: Mr. Rick Tloczkowski Re: Limited Initial Fungal Assessment—675 Skippers Lane, Orient, NY 11957 Dear Mr. Tloczkowski: Pursuant to your request, I have conducted a preliminary inspection for mold colonization throughout the above-referenced residential dwelling.This inspection was prompted in response to visible suspect fungal colonization within in the home. This inspection comprised; I. A thorough visual and olfactory inventory of prevailing conditions throughout the home. II. Measurement of temperature and relative humidity within representative areas of the dwelling. III. Measurement of available moisture levels in select building materials throughout the dwelling. IV. Development of a photographic record of prevailing conditions observed at the time of inspection. V. Indoor ambient air sampling to characterize and enumerate total aerosolized fungal structures (total airborne molds) within representative areas of the dwelling and outdoors, for comparative (negative control) purposes. Findings of our inspection are as follows; Basement: 1. Upon entry to the basement a significant malodor associated with fungal metabolic activity was immediately noted.This condition is likely attributed to a myriad of factors including elevated humidity, lack of air circulation, excess organic dust concentrations, water intrusion and foundation wall seepage. 2. At the time of our inspection, water staining and heavy fungal colonization was noted on the underside of the subfloor and joists in the basement and crawlspace. Moisture survey of these areas revealed predominantly saturated conditions throughout all substrates. 3. Evidence of water intrusion was observed at the Bilco door and foundation walls throughout the basement. It appears that the leader discharge is too close to the foundation wall at the exterior allowing for seepage to occur. 4. Pools of water were observed on the slab during our investigation. 74 East Main Street, Suite#1, Patchogue, NY—631.654.2780 fax: 631.654.2781 —www.insightenvironmental.com 5. Moisture survey of the foundation walls and cement slab revealed saturated conditions at the time of inspection. 6. Relative humidity throughout the basement was recorded at 81.8% rH and the temperature was recorded at 73.4' Fahrenheit. Please note that fungal colonization may occur naturally in environments with greater than 60% relative humidity. 7. Analysis of the air samples obtained from throughout the basement elevation revealed significantly elevated concentrations of Ascospores, Aspergillus/Penicillium, Bispora, and Cladosporium genera fungi when compared to the outdoor ambient air. First Floor: 1. Upon entry to the home a malodor associated with fungal metabolic activity was noted. 2. Staining, water damage, and in some instances, fungal colonization was observed at the ceiling finishes in the kitchen, dining room, living room, and bedroom #1. It appears that each of these areas have been subject to leaks from above over the course of time. 3. Fungal colonization was observed on the flooring in bedroom #1. Moisture survey of this area revealed elevated water content. 4. Moisture readings collected from the remainder of substrates throughout the first floor revealed mostly elevated concentrations.This finding suggests that the space has been subject to elevated humidity for a significant period of time, resulting in the saturation of building materials. 5. Fungal colonization was observed in the sink and bathtub in the 15t floor bath. 6. Staining and fungal growth was observed in the sink and base cabinetry in the kitchen. 7. The average relative humidity and temperature throughout the first floor were recorded at 80.3% rH and 74.6* Fahrenheit at the time of the inspection. Please note that fungal colonization may begin naturally in environments with greater than 60% humidity. 8. Analysis of the air sample obtained from the living room revealed low concentrations and similar speciation of fungi, while analysis of the sample collected from the kitchen revealed elevated concentrations of Aspergillus/Penicillium genera fungi when compared to the outdoor ambient air. Second Floor: 1. Upon entry to the second floor no malodor associated with fungal metabolic activity was noted. 2. No obvious signs of significant water damage or fungal colonization were noted. 3. The average relative humidity and temperature throughout the second floor were recorded at 80.6% rH and 76.1' Fahrenheit at the time of the inspection. Please note that fungal colonization may begin naturally in environments with greater than 60% humidity. 4. Analysis of the air sample obtained from bedroom#2 revealed low concentrations and similar speciation of fungi, while analysis of the sample collected from bedroom#4 revealed slightly elevated concentrations of Aspergillus/Penicillium fungi when compared to the outdoor ambient air. CONCLUSIONS& RECOMMENDATIONS 2 Significant mold conditions have been identified throughout the crawlspace and basement elevation of the home as a result of elevated humidity concentrations, lack of air circulation, 675 Skippers Lane, Orient, NY 11957 presence of excess organic nutrient and dust concentrations, and moisture intrusion within the base ment/crawlspace. Water damage and fungal colonization was observed throughout the first floor due to leaks from above, and also elevated humidity concentrations, lack of air circulation, presence of excess organic dust concentrations. Slightly elevated concentrations of aerosolized mold were identified in the 2nd floor bedroom#4 due to either a hidden fungal amplification site of cross contamination from the kitchen. Our office has prepared a mold remediation plan that will address visible mold colonization/ contamination encountered, or reasonably presumed at the time of inspection, without regard for causation. A copy of this document is attached herewith as Attachment C of this report and may be used by the licensed mold remediation firm to establish minimum Personal Protective Equipment (PPE), engineering controls, preliminary material removals, decontamination activities, content handling, and establishes project completion criteria the remediation contractor must adhere to. Any proposed deviation from this plan must first be approved in writing in advance of alteration to the plan. All mold remediation must be performed by those trained in mold remediation, use and care of respiratory protection, Article 32 of the New York State Department of Labor and the IICRC S520 (Standard and Reference Guide for Professional Mold Remediation). In the event a conflict arises between these sources,the most stringent means/methods shall be applied. Said mold remediation contractor is also required to; 1.) Prepare a Microbial Remediation Work Plan and submit it to the property owner/owner representative. Plan must identify EPA registered product(s) that will be used and obtain approval from the owner/occupant prior to use/application. 2.) Post Notification of the impending project at all entries to the dwelling. 3.) Post warning signs at the entry to all regulated work areas where microbial remediation will be performed. 4.) Provide full face APR (Air Purifying Respirators)to all workers for completion of all phases of microbial remediation.These respirators may be either operated in negative mode or Powered Air Purifying Respirators; PAPR's are preferred. Cartridges must be NIOSH (National Institute for Safety& Health) compliant for HEPA (High Efficiency Particulate Arresting (HEPA) with a minimum efficiency of 95% (99.975% preferred) and coupled with an Organic Vapor filtration media to reduce exposure to Microbial Volatile Organic Compounds (MVOC's). 5.) Maintain containment(s) until written approval to remove it is granted by our office. Failure to maintain containment to this standard is a violation of Article 32 of New York State Labor Law. 6.) Comply with all other applicable Asbestos (NYC/NYS) and Lead-Based Paint (EPA) regulations prior to implementation of the scope of microbial remediation. 7.) Possess a minimum $50,000 GL(General Liability) insurance policy, with environmental pollution Endorsement for mold remediation work. It is required that at the conclusion of all mold remediation activities, that a follow-up visual inspection be conducted. General requirements for final visual inspection include: 1.) All moisture sources must be remedied. 675 Skippers Lane, Orient, NY 11957 2.) No visible mold colonization may remain. 3.) No malodor associated with mold colonization may remain. 4.) No demolition debris may remain. 5.) No waste may be stored in the work area. 6.) No gravimetrically or electrostatically accumulated particulate (dust) may remain. 7.) Temperature and relative humidity are within acceptable limits as prescribed by ASHRAE seasonal thermal comfort standards. Post microbial remediation verification sampling will also be used as a tool to assist in the post remediation investigation process to ensure that material removals and decontamination efforts are sufficient, and that constituency and enumeration of fungal matter are similar to those encountered in outdoor air and/or indoor reference (un-impacted) areas of the residence. Please refer to Attachment C for further detail on air sample/surface sample clearance criteria. Additional recommendations for the property-owner include: 1.) Install proper circulation and dehumidification within the entire home including the crawlspace to reduce humidity concentrations and help prevent future fungal colonization year-round. 2.) Increase leader discharge distance to a minimum of 6 feet. 3.) Properly grade all planting beds to prevent a negative pitch toward the foundation wall. 4.) Seal all holes and vents in the foundation wall. 5.) Properly seal the soil bottom crawl with 6mil poly sheeting and duct taping as necessary. 6.) Retain a licensed professional engineer to evaluate and make recommendations to cure water intrusion at the basement. Enclosed herewith, please find all supporting analytical documentation, photographic record of prevailing conditions at the time of inspection, mold remediation plan, methods & procedures, disclaimer and firm/personnel licensure. If you should have any questions regarding this report, or require further assistance in this matter, please do not hesitate to contact the undersigned at your earliest convenience. Respectfully submitted, INSIG NVIRONMENTAL, INC. org . Maul, Vice President Mold Assessor License#MA00022 Project#18-0579 675 Skippers Lane, Orient, NY 11957 ATTACHMENT A Supporting Analytical Documentation 5 675 Skippers Lane, Orient, NY 11957 ATTACHMENT B Photographic Record of Prevailing Conditions 6 675 Skippers Lane, Orient, NV 11957 Staining observed at the ceiling in the kitchen R I� Staining observed at the ceiling in the kitchen } 7 675 Skippers Lane, Orient,NY 11957 r Elevated moisture detected in the floor tile in the kitchen/pantry area k Elevated moisture detected in the wall finish in the pantry t ' I i 8 Elevated moisture detected in the wall finish in the 1st floor bath 675 Skippers Lane, Orient, NY 11957 47 Fungal colonization observed in the sink and bathtub in the 151 floor bath 3 " or .3 rc 's 9 Fungal colonization noted on the flooring in Bedroom#1 675 Skippers Lane, Orient, NY 11957 .!r Elevated moisture detected in the flooring in Bedroom #1 \411 'r Wft -TAM Staining observed at the ceiling in Bedroom#1 10 Elevated moisture detected in the wall finish in Bedroom #1 - 675 Skippers Lane, Orient, NY 11957 r, Fungal colonization noted in the sink and beneath the base cabinet in the Kitchen 11 AM Heavy water damage and fungal colonization noted at the ceiling in the dining room 675 Skippers Lane, Orient NY11957 i i t v Elevated moisture detected in the ceiling finish in the dining room Staining and fungal colonization noted on the ceiling in the living room 12 -i 6755kippers Lane, Orient, NY11957 Fungal growth noted on joists and subfloor in the crawl Overview of the basement elevation 675 Skippers Lane, Orient,NY 11957 Staining and fungal colonization noted on the exposed joists and subflooring throughout t ' F. x Pooling water found in the basement elevation 14 675 Skippers Lane, Orient, NY 11957 ATTACHMENT C Mold Remediation Plan 6755kippers Lane, Orient, NY11957 ATTACHMENT D Methods& Procedures Measurements of available moisture were made in impacted and reference finish,framework and structural materials (as accessible) using a Flir MR77 moisture meter. General Air Quality parameters temperature and relative humidity were obtained at affected areas, un-impacted adjacent areas and outdoors using a Flir MR77 Moisture meter. Air sampling to characterize and enumerate total aerosolized (airborne)fungal structures was conducted in areas of concern, indoor reference areas and outdoors for comparative (negative control) purposes. Buck BioAire impaction cassette pumps were employed in conjunction with Allergenco-D oval slit impaction cassettes.All pumps were pre and post calibrated to a mean flow rate of 15 liters per minute using a Buck rotameter. Samples were run a duration of five minutes achieving a total volume of 75 liters per sample location. All samples were sealed immediately upon collection and remanded to Hayes Microbial Consulting for analysis via optical microscopy. Hayes Microbial Consulting is an American Industrial Hygiene Association (AIHA) accredited and proficient environmental and clinical microbiology laboratory. Please refer to Attachment A for further detail on these analyses. 16 675 Skippers Lane, Orient, NV 11957 ATTACHMENT E Disclaimer The report and remediation protocol attached herewith relates only to those areas required to be tested or areas specifically requested to be tested by the client/customer, and actually tested. The professional opinions expressed in this document are based solely on the scope of work conducted and sources referred to therein.The presented data was collected and analyzed using accepted industry methods, procedures and practices in effect at the time this report was generated. Primary evaluative techniques are derived from the American Conference for Governmental Industrial Hygienists(ACGIH) text Bioaerosols,Assessment and Control. This report represents the levels of airborne/surface contaminants at the time of sampling. No inferences regarding other conditions, locations or materials at a later or earlier time may be based on the contents of this report. No other warranty,express or limited is made. Insight Environmental, Inc.'s, liability and that of its contractors and subcontractors, arising from any services rendered hereunder, shall not exceed the total fee paid by the client to Insight Environmental, Inc.for this project. This report was prepared for the sole use of our client.The use of this report by anyone other than our client or Insight Environmental, Inc. is strictly prohibited without the expressed written consent of Insight Environmental, Inc. Portions of this report may not be used independently of the entire report. Should there be any change in the conditions of the areas tested, Insight Environmental, Inc. should be contacted as early as is practical. At the time of this writing there are no mandated standards concerning acceptable or unacceptable levels of fungal growth.All analytical data, statements and findings provided reflect conditions of the site at the time of our visit(s). Microbiological contamination may exist in areas that were not accessible or related to the incident or project. 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E N aj -0 -z cc L O1 ° LC a O E U ❑ '-^ „ v E � v Ew V) Lw _m 14 Gj rV ni U 675 skippers Lane, Orient, NY Basement Elevation - 1, 3 ' 4, 5, 6 Created by Insight Environmental Inc. 7-cl i O Z Az E Cr O j j C co Lij co cfl co �S CO) J COv co _ �1L�15 ❑ ro 4 ° -m � a ;J ) o 0 0 _ c O � a J Q a - - IC 0CIO co � a co U 0 _U Q TL1 NEW YORK STATE-DEPARTMENT OF LABOR DIVISION OF SAFETY AND HEALTH LICENSE AND CERTIFICATE UNIT STATE �4 CAMPUS BUILDING 12 Mold Assessor Company License Insight Environmental, Inc. LICENSE NUMBER 00Q23 74 East Main St, Ste#1 PATCHOGUE, NY 11772 DATE OF ISSUE; 12/20/2017 EXPIRATION DATE 12/31/2019 This license is valid only for the contractor named-above. � 1 Eileen Franko,Director FOR I'HE COMMISSIONER OF LABOR r� I STATE OF NEW YORK-I)EPARTMENT OF LABOR MOLD AWSOR GEORGE MAUL EXPIRES: 12-19 I:i R•Te M490022 11((IIIIIIIII gl1ta11�f� a� r f }I{Y Typical interior window sill iY- i - 1 Zu Typical exterior window components 5 Potters 1 675 Skippers Lane,Orient,NY 11957 ' 1 .a b r n i T. f View of the painted brick in the kitchen Potters 675 Skippers Lane,Orient,NY 11957 ATTACHMENT C Certifications 7 Potters 1 675 Skippers Lane,Orient,NY 11957 I?t ifrb Enu* ttrianmrntal Protrrtiv LIlt's is to rrrtt*flj t at FD S r Leon William Tregerman has fulfilled the requirements of tire Toxic Substances Control Act(TSCA) Section 402, anc received certification to conduct lead-based paint activities pursuant to 40 CI=R Part 745.22 Risk Assessor tr ton All EPA Administered Lead-based Paint Activities Program States, Tribes and Te This certification is valid from the date of issuance and expires May 11, 2019 LBP-R-1500-1 Certification# �,OVID Sr r"� May 05, 2016 ��' +� ' John Gorman, Chief Issued On o Pesticides & Toxic Substt �T��` PRaT�o�4�