HomeMy WebLinkAbout22-4037City of Zephyrhills,}}r► >� 5335 Eighth Streett4��`?��
Zephyrhills, FL 33542-004037-202
Phone: (813) 780-0020
Fax: (813) 780-0021 Issue Date: 07l21/2022
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02 26 210010 05600 0020 6606 Gall Boulevard
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Name: R C LINCOLN INC
Permit Type: Add/Alter (Commercial) Contractor: RYMAN CONSTRUCTION O
Class of Work: Add/Alter Commercial FLORIDA INC
Address: 6529 Stadium Dr
Building Valuation: $750,000.00
ZEPHYRHILLS, FL 33542
Electrical Valuation: $130,000.00
Phone: (813) 629-3673
Mechanical Valuation: $70,000.00
Plumbing Valuation: $50,000.00
Total Valuation: $1,000,000.00
Total Fees: $7,764.00
a
Amount Paid: $7,764.00
Date Paid: 7/21/2022 9:06:49AM�
A,`~i ,. \ .. vl \ 1' Av?? ?\?r {'i;xl ''st`i 1 t\ t\ S "\.t \ ' ;,v 1 t,{.. v..y: {?? 1 i2v :? a•`ltt•
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lYt \,. ..: �<. ,2 ..{..?.,.1.?\.\ ..� :.<. ., . M ?\.z....I \ f
ADD SMALL ADDITION TO EXTERIOR 1 INTERIORREMODEL6870 SQ FT
Mechanical Plan Review Fee $195.00 Building Plan Review Fee $1,895.00
Electrical Plan Review Fee $345.00 Plumbing Plan Review Fee $145,00
Electrical Permit Fee $690.00 Fire Plan Review Minimum Fee $24.00
Plumbing Permit Fee $290.00 Building Permit Fee $3,790.00
Mechanical Permit Fee $390.00
REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection, whichever is greater, for each subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
Complete Plans, Specifications.. fee Must AccompanyApplication.All performed ir
Ordinances.accordance with City Codes and • OCCUPANCY BEFORE
NO OCCUPANCY BEFORE •
CONTRACTOR SIGNATURE
ENW4—M ��M
i
r r r, • - • y r r: r • r. •
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received
Phone Contact for Permitting ( 813)701-8181-
1t###t## #s###
Owner's Name Rod Lincoln owner Phone Number ((813) 782-1298
Owner's Address 1 6606 Gall Blvd, Zephyrhills, FL 33542 Owner Phone Number
Fee Simple Titleholder Name Rod Lincoln Owner Phone Number (813) 782-1298
Fee simple Titleholder Address 6606 Gall Blvd, Zephyrhills, FL 33542
JOB ADDRESS 6606 Gall Blvd, Zephyrhills, FL 33542 LOT# NA
SUBDIVISION INA PARCEL ID# 02-26-21-001 A-OOAOO-0000
(OBTAINED FROM PROPERTY TAX NOTICE)
WORE( PROPOSED ElINSTALL
CONSTR 8 ADD/ALT Yes SIGN Yes DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
TYPE OF CONSTRUCTION BLOCK [_y.;1 FRAME Fy-.Tl STEEL
DESCRIPTION OF WORK Interior and exterior renovations of Sonny's
BUILDING SIZE I 1 StOry SO FOOTAGE 687® HEIGHT
=BUILDING $ 750 00OT� VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE NA PROGRESS ENERGY W.R.E.C.
130,000 f
PLUMBING $ 50,000 �L i
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
70,000
Yes GAS Yes
ROOFING FesI SPECIALTY =
OTHER
00
CD 11
FINISHED FLOOR ELEVATIONS
FLOOD ZONE AREA
=YES
.
NO
BUILDER COMPANY I Ryman Construction of Florida Inc.
SIGNATURE REGISTERED N FEE CURREN LLV N_J��
Address 36413 SR-54, Zephyrhills, FL 33541 License# CGC1517772
ELECTRICIAN COMPANY TBD
SIGNATURE REGISTERED Y / N FEE CURREN �Y I N
Address License # = ^^-1
PLUMBER COMPANY TBD
SIGNATURE REGISTERED -Y / FEE CURREN
Address License #
MECHANICAL COMPANY TBD
SIGNATURE REGISTERED L_KLN__j FEE CURREN Y / N
Address License # �—
OTHER COMPANY
SIGNATURE REGISTERED YIN FEE CURREN
Address E License #
##$E#ttl3t#tt##!#tlE##ill€#itlt#�#t##ti#3t#[fi#61;t€###€SIfEIe#
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w) Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $7500)
** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways..needs ROW
813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021
Building Department
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions" which may be more restrictive
than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they
may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and
contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements
may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division —Licensing Section at 727-847- 8009,
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this
application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is
not entitled to permitting privileges in Pasco County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or
expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that
such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery
Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final
power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior
to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that 1, the applicant,
have been provided with a copy of the "Florida Construction Lien Law —Homeowner's Protection Guide" prepared by the Florida Department of
Agriculture and Consumer Affairs. If the applicant is someone other than the 'owner", I certify that I have obtained a copy of the above described
document and promise in good faith to deliver it to the "owner" prior to commencement.
CONTRACTOR'SIOWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with
all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as
indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all
laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I
understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I
must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection -Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterANastewater Treatment.
Southwest Florida Water Management District -Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers -Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Health Unit -Wells, Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency -Asbestos abatement.
Federal Aviation Authority -Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone W" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to
commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or
other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as
authority to violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from
thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work
authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a
period of six (6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to
exceed ninety (90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered
abandoned.
FLORIDA JURAT (F.S. 117
OWNER OR AGENT V - Ll ?--f % 4s-` "61 ` r--
Sub rib d ffirmed) Wefore me this
Who is/, me or has/have produced
499_as identification.
_ (z�grl`ublic
Commission No. r4'Cw ;�105'536
Who is/are personally known to me or has/have produced
as identification.
lee
Notary Public
Commission No.
Name of to r a e
Name of N aN, Tinted WW"AOIE LYNCH -TERRY
DEBORAH WONC,
Notary Public
Notary Public - State of Florida
Commission # GG 938292
2,
EM
, State of Ffurida
COMfulssion # GG 265538
EBorded
Mo
f Ap
rvOlk"", My Comm, Expires Apr 4, 2024
6' i MY Comm. Expires Oct 17, 2022
Bonded through National Notary Assn.
through National Notary A� V womm-,
Contractor/Homeowner:
Date Received:
Site:
Permit Type:
Approved w/no comments: El
N
I
LWO
Approved w/the below comments: Denied w/the below comments: El
P LR/Lt4A
Zvi fj c —fi-r4 Of4�1 I a-f
0'" a 1) 1 -,f i o4r,
This comment sheet shall be kept with the permit and/or plans.
-110
Bil ss -jBUII Official Date Contractor and/or Homeowner
4
(Required when comments are present)
ONE
liffam,
parmillo, BAC-004037-2022 Forest ID No 02 215 210010 05600 0020
lk NOTICE OF COMMENCEMENT
MR==
THE UNUERSIGNEDhemby gins notice that Improvementwill be rnada to ourtainneal prop", and In mocordoncewith Chapter
tot Information Is provided in this Notice of Cornmencoment
i, Description of Properv, Peace! Identification No, 12 10 210011
Street Address:
2. General Description of Irnprowmant Add 4"11 addition to Warier I Interior remodel 6870 sq. it,
1 Ovmr Wannaflon or Less" Information it the Lessee con(raded for the improvernant;
R.G. UncdIn. loc.
sstss�asor- Nams,
Zephyrhils
FL
Ad se
City
state
Wem$4 h PmpertT
Nam of Fear Simple Titleholder.
(it different fternownerliged above)
Addy ess Ryrron, Construction of Florida, Inc.
state
4. ContreoW
Nome
36413 SR 54
FL
Address
C,b,,W,T0W,mN,: (813)702.0825
Address city Slate
Amount of Sond: Telephone Nw
Londw. WA
Name
Address City $%to
Lenders TvIephono No.:
T. Persons YANn the State of Fladdar riesouded by the amw upon vftm notices or other documents Mq be served as Provided by
Section )13.13(i)(aX7), Florida Statutes:
Name
Address city state
Telephone Number of Doslimated Person:
in addition to hTmseX the amer destanstas Of —
to r&Ww a copy afths LWW$ Notice as ProviLWIrt SoOW7`1113(1)(b)Fluride Slatutes.
Telephone Number of Person at Erdity Designated by Omar.
1k, Expiration date of Notice of (ft expiration date may fast be before twe completion of construction and final payment to
contractor, but Wit be one year from the date ofreconfirril urden a different date is specified): IIJ312011
!111!!!!!! 1111111111 i ii ii ii ii ii ii ii ii ii 111 1 1 W
'I it 0
0 010
ME 7=1
M@v "El
Personally K"M " produced Identification C3 mown
Type of identification Pmduc*d Nams,
A'i'; DESORAH WONG
a sieristy public. St#tv of Florida
lay Comm, Expires Oct 11, 2027
Wneled throe NAU0941 Ho%oty A%sn-
" State Of Florida, County Of Pasco
r This is to certify that the foregoing is a
j true and correct copy of the document
� , on file or of public record in this office.
Witr ess my hand a offieial seal this
day of 2
f a*N5iA
yi )( %o.CPZ•Jt"Ie5, Clerk Comptroller
sco ouy,
Deputy Clerk
top Ljo -3 7
WEEIMM
Reference: Limited Asbestos Assessment
Sonny's Restaurant — 6606 Gall Boulevard
Zephyrhills, Florida 33542
JH1 Project No, 22-42
Dear Mr. Stabinsky:
JH1 Consultants, LLC (JH1) is pleased to provide the enclosed report detailing our limited asbestos
assessment at the referenced location,
Introduction
We understand that the Interior and a portion of the roof at the Sonny's Restaurant at 6606 Gall
Boulevard in Zephyrhills, Florida is scheduled for future renovation activities. In preparation for these
activities, you requested that JH1 collect samples of suspect asbestos containing materials (ACMs) that wil]
be disturbed during the course of the renovations and submit them for asbestos analysis. The sampling
was performed by Mr. James Harbison on July 29, 2022. An asbestos -containing material (ACM) is defined
by State and Federal regulations as a building material • greater than one percent (> 1 %) of one
of the six asbestos minerals regulated by the Environmental Protection Agency (EPA) and the OSHA.
This asbestos assessment was performed in general accordance with JH1's proposal number JH1 -22-0
dated July 25, 2022. The service was performed under the direction of Mr. Eddie Stabinsky of Ryman
Construction of Florida, Inc. (Ryman). I
Demolition and renovation in public and commercial buildings are regulated by OSHA, EPA, and Florida
Department of Environmental Protection (FDEP). The EPA and FIDEP require asbestos assessments,
conducted by accredited individuals, prior to renovation and/or demolition projects. Code 40 of Federal
Regulations Part 61, Subpart M, Final Rule, National Emissions Standards for Hazardous Air Pollutants
(NESHAP) and FDEP regulations require asbestos assessments, followed by the proper removal, and
disposal of ACM that is affected by renovation or demolition. The identification of ACMs will aid in the
prevention of occupational exposures and/or environmental releases of airborne asbestos, Identification
of ACM is also required by OSHA 19261101. The EPA, OSHA, and FDEP define ACM as materials
containing greater than one percent asbestos in a representative sample. However, OSHA also regulates
materials containing less than or equal to one percent asbestos.
Site and Project Description
Site Description
The subject site is a Sonny's Restaurant that is currently open for business. The building was constructed
circa 2007, JH1 understands that portions of the interior floors, walls and ceilings and a portion of the
balcony roof and exterior siding will be impacted during upcoming renovations. The walls are wallboard
with ceramic tile finishes in some areas and the ceilings consist of suspended ceiling tiles. The HVAC
system was a forced air metal duct unit, and the air ducts is covered by fiberglass insulation. The floor is
concrete slab with carpet and ceramic tile finishes. The roof is metal with a Styrofoam insulation. The
exterior siding consists of paint on Masonite.
Assessment Methods
Sampling and Analysis
A visual assessment of the referenced structure was performed to determine the HAs of suspect ACMs
that will be disturbed during demolition and renovation activities. Based on EPA definitions used in the
Asbestos Hazard Emergency Response Act (AHERA), 40 CFR 763, an HA of asbestos -suspect building
material has the same color and texture and is thought to be installed within the same timeframe. JH1
assessed the areas scheduled to be demolished or renovated for suspect ACMs, including thermal syste
insulation (TSI), surfacing materials, and miscellaneous materials. Representative samples of asbestos-
Aw"k-WONVE411
applicable State regulations.
and submitted to Eurofins CEI Laboratories, Inc. of Cary, North Carolina for analysis by Polarized Light
Microscopy (PLM), coupled with dispersion staining in general accordance with the EPA 600/R-93/116
Method. Laboratories used for sample analysis are accredited by the National Voluntary Laboratory
�H'11 Consudting, 1 2
Accreditation Program (NVLAP), which is administered by the National Institute of Standards and
Technology (NIST). The laboratory analysis reports the specific type of asbestos mineral identified (if any)
and the percentage of asbestos present in each sample,
Suspect ACMs were assessed based on the observed condition (good, fair or poor) and potential for
disturbance due to the scheduled renovation/demolition, Identified ACM were also categorized based o
the EPA's NESHAP regulation categories. Friable ACM is classified as an ACM that can be crumbled to a
powder by moderate hand pressure. Non -friable ACM is classified as either Category I Non -friable AC
or Category 11 Non -friable ACM. Category I and Category 11 Non -friable ACM are distinguished from ea
other by their fiber release potential when damaged, Generally, Category I Non -friable ACM, which
includes intact ACM roofing materials, gaskets, packing, and resilient floor coverings is less likely to
become friable and release fibers in a damaged state. Category 11 Non -friable ACM include all other no
friable ACM excluding Category I that have a high probability of being rendered friable during removal
y activities or demolition. All Friable ACM, Category I Non -friable ACM that has become friable, Categor I
11 Non -friable ACM that has a high probability of becoming or has become crumbled, pulverized, or
reduced to powder by the forces expected to act on the material in the course of demolition or
renovation operations are considered to be a Regulated Asbestos -Containing Material (RACM). I
Based on the results of the bulk samples collected and analyzed, asbestos was not detected by laboratory
analysis for the samples submitted.
The summary of bulk asbestos results, laboratory report and copy of the asbestos inspector's certificate is
attached.
Assumptions and Limitations
This report is provided for the sole use of Ryman. Use of this report by any other parties will be at such
party's sole risk, and JH1 disclaims liability for any such use or reliance by third parties. The results
presented in this report are indicative of conditions only during the time of the sampling period and of
the specific areas referenced. Under no circumstances is this report to be used as a bidding document, or
as a project design or specification.
JH1 performed the services in accordance with generally accepted practices of reputable environmental
consultants undertaking similar studies at the same time and in the same geographical area. JH1 has
endeavored to meet this standard of care. No other warranty, expressed or implied, is intended or made
with respect to this report or JH 1's services. Users of this report should consider the scope and limitations
related to these services when developing opinions as to risks associated with the site.
The possibility exists that suspect materials were undetected in inaccessible or concealed areas such as
inside pipe chases or wall voids. If additional suspect materials are discovered during the planned
destructive activities, bulk samples must be collected by an accredited asbestos inspector and analyzed
for asbestos content,
�6fv
assistance, please contact us at (813) 502-6262.
Sincerely,
James E. Harbison, IHT, MBA Adelmarie Bones, MSPH, CIH, CSP
Senior Industrial Hygienist Florida Licensed Asbestos Consultant
FL License #AX103
" H J, C oin,n5s i " i n g i 4
lti
Table I — Summary of Asbestos Samplin�N
Table I -Summary of Asbestos Sampling
FProject Name: Sonny's Restaurant Project Number: 22-42
Sampling Ntedsl- 07/29/22
HOMOGENEOUS AREA SAMPLE DATA
_
1
2 x 2 Suspended Ceiling
Tile (Black)
Dining Area
2,000 SF
I
Misc.
Good
1
1
DininArea
g
ND
2
Dining Area
ND
2
Carpet Glue
Dining Area
2,000 SF
I
Misc.
Good
3
Dining Area
ND
4
Dinin Area
ND
3
Wall Surface and WBJC
Various Areas
TED
I
Misc.
Good
5
Entrance
ND
6
Dining Room
ND
7
Men's Restroom
ND
4
Exterior Siding
Exterior
TBD
I
Misc.
Good
8
Entrance
ND
9
-_
East Side
ND
5
2 x 4 Smooth Ceiling
Tile
Kitchen
TBD
I
Misc.
Good
10
Kitchen Ceilinq
ND
11
Kitchen Ceiling
g
ND
ND = None Detected NA = Not Applicable
'Category: F=Friable I=Category 1, Non -Friable
'Type;
'Condition:
Misc, = Miscellaneous Sur = Surfacing
SF = Square feet LF = Linear feet
ll=Category 11, Non -Friable
TS1 = Thermal System insulation
Good, Fair or Poor Accessible during renovation or demolition with Potential for Disturbance; Low or High
'Sample Location: Refer to attached field drawing for specific sample locations. Quantities are approximate and should not be used for cost estimates or bidding purposes.
MI'm
JH"', con-lillul"o
Asbestos Report Summary
4�eurofins
EI By: POLARIZING LIGHT MICROSCOPY
C
PROJECT: Sonny's LAB CODE: B228024
METHOD: EPA 600 / R93 116 and EPA 600 M4-82 / 020
HA1®1
13228024.01
Black,Gray
Ceiling Tile
None Detected
HA1-2
13228024.02
Black,Gray
Ceiling Tile
None Detected
HA2-3
13228024.03
Tan
Carpet Glue
None Detected
HA2-4
13228024.04
Tan
Carpet Glue
None Detected
Layer 1
13228024.05
White
Surface Material
None Detected
----------
------
Layer 2
----------
13228024�05
--------
White
--------------
Wallboard
---------------
None Detected
HA3-6
Layer 1
5228024,06
White
Surface Material
None Detected
---------------------------------------------------------------
Layer 2
13228024�06
White
Wallboard
None Detected
HA347
Layer 1
13228024.07
White
Surface Material
None Detected
-----------
-----
Layer 2
----------
B228024,07
---------
White
----------------
Wallboard
------------
None Detected
HA4-8
6228024,08
Tan
Exterior Siding
None Detected
HA4-9
13228024.09
Tan
Exterior Siding
None Detected
HA5-1 0
13228024. 10
Off-white
Drywall Ceiling Tile
None Detected
HA5-11
5228024.11
Off-white
Drywall Ceiling Tile
None Detected
ASBESTOS BULK ANALYSIS
eurofins
By: POLARIZING LIGHT MICROSCOPY
C El!
'Client: JH 1 Consulting
1235 Barmere Lane
Brandon, FL 33511
Project: Sonny's
WUM
Lab
HAI -1
Ceiling Tile
Heterogeneous
60%
Cellulose
15%
Perlite
None Detected
B228024.01
Black,Gray
20%
Fiberglass
5%
Paint
Fibrous
Bound
HAI -2
Ceiling Tile
Heterogeneous
60%
Cellulose
15%
Perlite
None Detected
B228024,02
Black,Gray
20%
Fiberglass
5%
Paint
Fibrous
Bound
HA2-3
Carpet Glue
Heterogeneous
5%
Cellulose
95%
Mastic
None Detected
B228024.03
Tan
<1%
Binder
Fibrous
Bound
HA
Carpet Glue
Heterogeneous
5%
Cellulose
95%
Mastic
None Detected
B228024.04
Tan
<1%
Binder
Fibrous
Bound
HA3-5
Surface Material
Heterogeneous
85%
Binder
None Detected
Layer 1
White
10%
Calc Carb
B228024,05
Non -fibrous
5%
Paint
Bound
----------------
Layer
---
Wallboard
------------
Heterogeneous
----
20%
-----
Cellulose
-----
80%
--------
Gypsum
------------
None Detected
B228024.05
White
Fibrous
Bound
No joint compound.
HA3-6
Surface Material
Heterogeneous
85%
Binder
None Detected
Layer 1
White
10%
Calc Carb
B228024.06
Non -fibrous
5%
Paint
Bound
730 SE Maynard Road - Cary, NC 27511 - 919.481,1413
ANALYSISASBESTOS BULK
B,POLARIZING
C Ell
Brandon,
Client: JH 1 Consulting
Project: Sonny's
!
l
bra�COOfd"C
1
�L�b
� rtpti ra
A �
ibrous
t-
�!�Layer2
g _Wallboard
�Heterogeneous
�20%
Cellulose
60%
� Gypsum �
None Detected
B228024.06
White
Fibrous
Bound
No joint compound.
HA3-7
Surface Material
Heterogeneous
85%
Binder
None Detected
Layer 1
White
10%
Calc Carb
B228024.07
Non -fibrous
5%
Faint
Bound
Dyer 2 m
Wallboard ®- ®m _ _Heterogeneous
20%
Cellulose _
- 80%
- Gypsum _ _
- _ _alone Detected
B228024.07
White
Fibrous
Bound
No joint compound.
HA4-8
Exterior Siding
Heterogeneous
60%
Binder
None Detected
6228024,08
Tan
35%
Silicates
Non -fibrous
5%
Paint
Sound
HA4-9
Exterior Siding
Heterogeneous
60%
Binder
None Detected
B226024.09
Tan
35%
Silicates
Non -fibrous
5%
Paint
Bound
HA -10
Drywall Ceiling Tile
Heterogeneous
20%
Cellulose
75%
Gypsum
None Detected
6228024.10
tiff -white
5%
Fiberglass
<1%
Mica
Fibrous
Bound
HA5-11
Drywall Ceiling Tile
Heterogeneous
20%
Cellulose
70%
Gypsum
None Detected
B226024.11
Off-white
5%
Fiberglass
<1%
Mica
Fibrous
5%
Vinyl
Bound
e u rofi n s
LEGEND: Non-Anth = Non-Asbestiform Anthophyllite
Non-Trem = Non-Asbestiform Tremolite
Calc Carb = Calcium Carbonate
METHOD: EPA 600 / R93 / 116 and EPA 600 / M4-82 / 020
REPORTING LIMIT: <1% by visual estimation
REPORTING LIMIT FOR POINT COUNTS: 0.25% by 400 Points or 0. 1 % by 1,000 Points
REGULATORY LIMIT: >1 % by weight
Due to the limitations of the EPA 600 method, nonfriable organically bound materials (N013s) such as
vinyl floor tiles can be difficult to analyze via polarized light microscopy (PLM). EPA recommends that
all NOBs analyzed by PLM, and found not to contain asbestos, be further analyzed by Transmission
Electron Microscopy (TEM). Please note that PLM analysis of dust and soil samples for asbestos is
not covered under NVLAP accreditation. Estimated measurement of uncertainty is available on
request
This report relates only to the samples tested or analyzed and may not be reproduced, except in full,
without written approval by Eurofins CEI. Eurofins CEI makes no warranty representation regarding
the accuracy of client submitted information in preparing and presenting analytical results.
Interpretation of the analytical results is the sole responsibility of the client. Samples were received in
acceptable condition unless otherwise noted. This report may not be used by the client to claim
product endorsement by NVLAP or any other agency of the U.S. Government.
��11�ri
3=
ANALYST: APPROVED BY:
Rosa in a ruz Tianbao Bai, Ph.D., CIH
Laboratory Director
NV( CR,1
T G ESTIN
NVLAP LAB CODE 101768-0
730 SE Maynard Road - Cary, NC 27511 - 919.481 1413 Page 3 of 3
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Consultants
,ert!ficate oj Uompfetion
Has successfully completed the below course with a score of 70% or better. This course
�Ozs vTrvents
set forth in 40 CFR Part 763 (AHERA model Accreditation Plan) for purposes of
accreditation required under TSCA Title 11. This course was conducted in English through
the Pinnacle Training Facility located at 10 Independent Avenue Nitro, WV.
Friday, May 13, 2022
X219M
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OUTIME
Training Hours m
4 hours 4L)
— Instructors Michael . Pauley