HomeMy WebLinkAbout22-4192BGR-004192-2022
Issue D. 05/31/2022
Zmmv 17ma ;FM U
Address: 917 W Washington Ms 316
CHICAGO, IL 60607
Phone:
Building Valuation: $5,490.00
Electrical Valuation: $1,00
Mechanical Valuation: $1.00
Plumbing Valuation: $1.00
Total Valuation: $5,493.00
Total Fees: $100.00
Amount Paid: $100.00
Date Paid: 5131/2022 12:09:15PM
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.
1:111pl,111111111! j!j1!jyj1j =1�111 11 = = ��
23131���
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
WCONTRACTOR SIGNATURE PEIMIT OFFICEC)
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
rew-T.T.73T.F.67, 1 M-
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting
Owner's Name Sixth Avenue LLC c/o Duff & Phelps, A oil §ne Number
Owner's Address 917 W Washington MS 316 Chicago IL 6 607OwnerPhoneNumber
Fee Simple Titleholder Name I I Owner Phone Number (
i
Fee Simple Titleholder Address
JOB ADDRESS
39465 Tabetha Drive Unit 109A
LOT#
SUBDIVISION
PARCEL ID#
12-26-21-0026-00500-0000
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
NEW coNSIRe ADD/ALT SIGN
DEMOLISH
e
INSTALL REPAIR
PROPOSED USE SFR Q COMM OTHER
TYPE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORK
demo and legal disposal of SF mobile home
BUILDING SIZE ---_ SO FOOTAGE 720 HEIGHT
=BUILDING $ 5490.00 VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL
$
AMP SERVICE 0 PROGRESS ENERGY
0 W.R. E.C.
=PLUMBING
q I
=MECHANICAL $
VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING SPECIALTY = OTHER
FINISHED FLOOrVATIONS
FLOOD ZONE AREA =YES NO
000AAA
BUILDER COMPANY Johnson's Excavation & Services, Inc.
SIGNATURE k 1 4Z
-^""s REGISTERED Y/ N FEE CURREN I Y/ N
Address 1706 rapnel d, Plant City, FL 33566 License# I CBC059540
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRENY I N
Address License# �—
PLUMBER COMPANY
SIGNATURE l REGISTERED Y/ N FEE CURREN Y/ N
Address I License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y / N FEE CURREN Y ( N
Address License #
OTHER SIGNATURE ^� COMPANTEREDY
FEE CURRENY / N
Address License # �^
IIti11III11111111111IIIlIIII1111IIIII1111III1111I11111If1IlY11I1111
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 subdivisionstlarge 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 $7600)
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
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'S/OWNER'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, Water/Wastewater 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 'V" 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.
0 :4 0IF-3111 0 [slim Lai :901
91:4 0
OWNER OR AGE T Agent_ CONTRACT
scn � s
Subscrib�ed and or rm6d) before me this
s 0 Cr sworn
_C ad
nth A Johnson y
Jo
0'sl p rs. to 0,
Who is/ personally to me or has have produced Who is/a personally
s " r( 7, as identification.
Commission
me o0has/have produced
as identification.
Public
INSTR#2022118015OR BK10621 PG1 954 Page 1 of 1
05/26/2022 09:27 AM Rcpt: 2460867 Rec: 10.00 IDS: 0.00 IT: 0.00
Nikki Alvarez-Sowles, Esq., Pasco County Clerk& Comptroller
Permit Number
Mp CIS OF COMMENCEMEWT
4 Af
maul Lt-7u' =2 L =7
4, Controotor
Narnqjohnsorft Qx vatl nn erv' , jag,__ —Telephone Wrrlber, 8,13-752-7097
13, Surety
)rw Number
of Bond
6. Lander
7. Persons imlithrn the $tote of Florida dosion4ted by Owpor upon whom notices or otbar documents may
be sema as provIdeil by FRWda Statutw.
--,---Telephone Numbor--
6. In addidon to hfiaz>alf or herself, owner designates the foltowino to rapelvo a copy of the Usnoes
Notloo as provIded In §7W13(f)(b), Rodda fthfts.
Telephone NumLw__
.............
VAMI
ArsonanyKnown ,aP.,OR Prot used f!D—
Type of ID
TAIUMS, AM CAN
NEMMNTlWuS1rx0
'AIN KMUOWG� COWULT
tAc e
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WmO44��mONINO �PuWc
SUSAN L.
OWAI
(I N I NAG 911739 j'12,
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Florida Department of DEP Form 62-257.900(1)
Effective 10-12-08
Environmental Protection Page 1 of 2
L
Division of Air Resource Management
A
NOTICE OF DEMOLITION OR ASBESTOS RENOVATION
TYPE OF NOTICE (CHECK ONE ONLY): nx ORIGINAL 171 REVISED El CANCELLATION [:1 COURTESY
TYPE OF PROJECT (CHECK ONE ONLY): nx DEMOLITION [__1 RENOVATION
IF DEMOLITION, IS IT AN ORDERED DEMOLITION? 171YES [I NO
IF RENOVATION:
IS IT AN EMERGENCY RENOVATION OPERATION? E]YES E3 NO
IS IT A PLANNED RENOVATION OPERATION? 171YES [I NO
I. Facility Name Sixth Avenue LLC
Address 39465 Tabetha Dr
City Zephyrhills State
Site Unit 109A
Building Size 720
FL Zip 33542 County Pasco
Consultant Inspecting Site Greenfield Environmental
(Square Feet) #of Floors 1 Building Age in Years 50
Prior Use: 171 School/College/University [I Residence [I Small Business El Other
Present Use: El School/College/University 171 Residence E] Small Business n Other
It. Facility Owner Sixth Avenue LLC Phone (Ja131J52-7097
Address 917 W. Wasington MS 316 C/o Duff & Phelps, A Kroll Business
City Chicago State IL Zip 60607
111. Contractor's Name JOHNSON'S EXCAVATION & SERVICES, INC. - DONATHAN A JOHNSON Phone ((813) 52-7097
Address 1706 E Trapnell Rd
City Plant City State FL Zip 33M6
Is the contractor exempt from licensure under section 469.002(4), F.S.? [-] YES 171 NO
IV. Scheduled Dates: (Notice must be postmarked 10 working days before the project start date)
Asbestos Removal (mm/ddlyy) Start: Finish: Demo/Renovation (mm/dd/yy) Start: 06/13/2022 Finish: 06/30/2022
V. Description of planned demolition or renovation work to be performed and methods to be employed, including demolition or renovation techniques
to be used and description of affected facility components. demo done by excavator and legal disposal of removed product by roll off
Procedures to be Used (Check All That Apply):
V1. Procedures for Unexpected RACM: Stop, Contain area, call environmental compliance services
VII. Asbestos Waste Transporter: Name JOHNSON's EXCAVATION & SERVICES, INC. - DONATHAN A JOHNSON Phone ((813) 52-7097
Address 1706 E Trapnell Rd
City Plant City State FL -Zip 33566 4936
Vill. Waste Disposal Site: Name ENTERPRISE LF & RECYC (FKA SID LARKIN & SON, INC.) Class
Aririr,-.q-q 41111 Enterprise Rd
Imam*
State FL
Zip 33525 1589
IX RACM or ACM: Procedure, including analytical methods, employed to detect the presence of RACM and Category I and 11 nonfriable ACM
physical assessment, sampling and analysis for suspect material
Amount of RACM or ACM* X. Fee Invoice Will Be Sent to Address in Block Below: (Print or Type)
0 square feet surfacing material
0 linear feet pipe
0 cubic feet of RACM off facility components
0 square feet cementitious material
0 square feet resilient flooring
0 square feet asphalt roofing
*Identify and describe surfacing material and other materials as applicable-
0
Other materials or facility components description:. (R)ACM to remain in place during demolition:
I certify that the above information is correct and that an individual trained in the provisions of this regulation (40 CFR Part 61, Subpart M) will be on -site
during the demolition or renovation and evidence that the required training has been accomplished by this person will be available for inspection during
normal business hours.
Donathan Johnson 05/23/2022
(Print Name of Owner/Operator) (Date)
05/23/2022
(Signature of Owner/Operator) (Date)
IGreenfield I
C-E Environmenfal
T*1w.
MwN A 0.0ND
I I •ZI 13 1 Z I I z 10 jj T-TV 1:1 :R Y-T I
M
MOBILE HOME UNIT #1 09A
393466 T"AVENUE
ZEPHYRHILLS, FLORIDA
February 11, 20119
GE Proiect.
Equity Lifestyle Properties
Mr. Nicholas Eilerman
6100 West Lemon Street
Tampa, Florida 33609
•
��Igpgjijiiigggg g zi�gi
The survey and laboratory analysis conducted at mobile home Unit #109A located at
were found to contain asbestos in amounts greater than one (1) percent. These mate6als
are two (2) types of friable (Regulated) material in the form of vinyl floor sheeting and light
fixture insulation, and five (6) types of Category I non -friable materials in the form of two
(2) types of vinyl floor tile, two (2) types of caulking and a roofing surfacing material with
mastic.
J!���Jzliiqilpyqn;
Section eege
1.DINTRODUCTION. ............... -----'--........ '----------............... --1
2.0 FACILITY [}ESCR(PTK]N-----..... —_--- ....... -------...... .... ...... 2
6,QCONCLUSIONS .'—...... ..... ....... -----------'—'.---.'......... .......... 9
APPENDIX A-
PHOTOGRAPH LOG
APPENDIX B-
LABORATORY ANALYTICAL RESUL
I
APPENDIX C-
CERTIFICATIONS
GE Project No. 2821-0190
A survey for asbestos -containing materials (AGMs) was conducted by Greenfield
Environmental, Inc. (GE) at the mobile home Unit #1 09A located at 39345 6' Avenue in
Zephyrhills, Florida. The survey was performed on January 31, 2019 by Nicholas Barron,
Accredited EPA Inspector for GE. GE is a Florida Licensed Asbestos Consulting Firm with
a corresponding license number of ZA-0000268.
The survey was conducted in order to identify any asbestos -containing materials which
for Hazardous Air Pollutants (NESHAP) Regulation.
More specifically, our scope of services for this project consisted of the five following
steps:
- Site Walk -Through and Observations,
- Bulk Sampling of Suspect ACMs,
- Polarized Light Microscopy (PLM) Analysis of Bulk Samples,
- Hazard Assessment and Evaluation, and
- Final Report Development.
The findings of this report represent Greenfield Environmental, Inc.'s (GE) best
professional judgement and no other warranty is expressed or implied. This report is
intended only for the use of EQUITY LIFESTYLE PROPERTIES and its agents. The
contents should not be relied upon by any other parties without the expressed written
consent of GE.
1
metal with styrofoam insulation or vinyl paneling over styrofoam insulation. The HVAC
system consists of window units and a wall heater unit. The unit exterior consists of metal
siding and caulking. The roof is finished with a bare metal roof over roof surfacing materials
at the metal sub rooft and caulking.
OA
9
GE Project No. 2821-0190
The sampling conducted in this asbestos survey was performed in accordance with Title
40, Code of Federal Regulations (CFR), Part 763 for suspect ACMs, The EPA regulations
require that sample locations be randomly selected. All suspect asbestos -containing
materials and PACM (materials presumed to contain asbestos under the OSHA Asbestos
Rule, 29 0,4P4vefe-fdaitified,?.-i�4�I s,7,ra oles o • -T_akt9ited_
The bulk sampling procedure utilized for collection of suspect samples required the
establishment of homogeneous sampling areas. A homogeneous sampling area is defined
as an area of friable or non -friable material of similar type that appeared to be applied or
installed during the same general period of time. Ali sample locations were identified with
numbers corresponding to those listed in Section 5.0 "Description of Materials" of this
report.
Samples which were collected from these pre -determined homogeneous sampling areas
were labeled and transported to Air Quality Environmental, Inc. (NVLAP No, 200759-0)
for analysis. All samples were analyzed using EPA approved Polarized Light Microscopy
(PLM) coupled with dispersion staining. Properties such as refractive indices, birefringence,
sign of elongation and extinction angle are unique to crystalline asbestos forms and are
used to identify the type of asbestos mineral as chrysotile, amosite, crocidolite,
anthophyllite, tremolite or actinolite. Percentages of the identified types of asbestos are
determined by visual estimation. Attempts are made to mix the sample thoroughly to
provide a more accurate percentage. Any material containing greater than one percent
(11%) by weight of any type of asbestos is considered by the EPA to be an ACM and if
disturbed must be handled according to specific regulations. The laboratory analytical
report is included in APPENDIX B.
3
GE Project No. 2821-0190
4.0 SUSPECTED ASBESTOS -CONTAINING MATERIALS
��i INNER' EVEN I � I'M! lit
evaluation of the mobile home Unit #1 09A:
• Wrap with Fiberglass Insulation
• Fiberboard
• Vinyl Floor Tile with Mastic
• Vinyl Floor Sheeting
• Laminate
• Wall Mastic
Caulking
• Light Fixture lnsufation
• Electric Wire Wrap
• Concrete
• Wrap with Mastic and Fiberglass Insulation
• Vinyl Door Covering with Mastic
Roof Surfacing Material
Textured Block and Mortar
9
GE Project No. 2821-0190
Homo.
Sample—
.... . . . ...
Description/
Asbestos
Approx.
Area
Numbe,
. .................... ..
Location
Content
'Quantity'
White Wrap with Yellow
Fiberglass Insulation
No
Located at Ceilinq Areas in
Asbestos
the Northern Portion of the
Detected
Unit
Brown Fiberboard Located
No
at Northwest Room Floor
bestos
areas Under Carpeting
- ----
Detected
If III
Brown 9 x 9" Vinyl Floor
11
07
Mtic n
Tile with Brown asd
No
08
Black Backing Locatedaat
1
1 Asbestos
4 Non-
I
09
Floors in the East Side of
Detected `
Friable
the Southern Trailer Portion
��i
of the Unit
White Stone Pall ttern 12"2%
12" Vinyl Floor Tile with
Chrysotile
100
Brown Mastic Located at
Square
North Bedroom Floor and
Mastic - N
Feet
North Bathroom Floor
Asbestos
Areas
Detected
Sheeting -
Tan Worm Pattern Vinyl
20%
Floor Sheeting with Yellow
i Chrysotile
170
Mastic Located at the
Square
Kitchen Floor and South
Mastic - No
i
Feet
Bedroom Floor Areas
Asbestos
Detected
Tan Stone Pattern Vinyl
Floor Sheeting Located at
the Kitchen Cabinet Interior
Surface Areas
s,r
a • �
�rLocation
Tile
'
PebbleWhi
White Patternr
r
1
12" Vinyl Floor
Non -
r
Yellow r !
Mastic - No
r
Feet
Souththe trFloor il
Asbestos
Detected
�
1 Pattern :III
rril
Non -
Covering
Friable
Counter TopsDetected
White Tile Pattern
No
Fiberboard Located at the
Asbestos
North Bathroom Walls
Detected
Green Tile Pattern
29
Bathroom Shower Walls and
Asbestos
jj
30
Adjacent + within
Detected
the North Bedroom
'V
Tan Wall Mastic underNo
II
PlasIc Tiles Located1
Asbestosi
Non-
i r
South Bathroom and Kitchen
Detected
Friable
i
Wall Areas
fi
aWhiteCaulking
Located .t
No
Non -
$
the Tub/Shower
Asbestos#
i .'
M
#
Detected
r
WhiteLiht Fixture
�Located
In
Insulation
Chryssr
rrr
Square
"
,+
t r r a~
Asbestos
• f
YellowFixture
r* bM. g
s
Paner Located at the
Asbestos
Fri. r -
r#r
(',F- Prniprt No 2821 -01 PO
Sample
Number
Description/
Location
Asbestos
I i
I Content
Condition
Approx.
1, Quantity
Green/Black Electric Wire
with Black Mastic
Wrap•
Located at the Wall Cavities•
and Upper Ceiling Areas
Throughout the South Trailer
Portion of the Structure
Black Caulking Located at
..... .. . ....
the Metal Exterior Building
11 2%
Chrysotile
Non-
25
Square
seams at the Southern
I
Asbestos
Friable
Feet
Trailer Portion of the Unit
I
White Caulking Located at
10%
15
the Exterior Window
i
Chrysotile
Non-
Square
Seams at the Southern
Asbestos
Friable
Feet
n of the Unit
Trailer Portiouu
White Caulking Located at
No
North Addition Exterior
Asbestos
Non -
Building, Door and Window
Detected
Friable
Seams
Concrete Located at
Entrance Stairs and Pier
No
Asbestos
Non -
Friable
Foundation Areas
Detected
Concrete Located at the
No
No• n-
Carport and Shed Slab
Asbestos
Friable
Areas
Detected
Brown Wrap with Black
Mastic and Yellow
No
Fiberglass Insulation
Asbestos
Located at the Upper Ceiling-i
1! Detected
Areas within the Southern
Trailer Portion of the Unit
•No
Asbestos
Non -
1
Detected
Friable
F-
Description/
Asbestos
--- ---
Condition
Location
ontent
White Caulki g Located at
No
I
Non -
Upper Roof Seams and
I Asbestos
Friable
Penetrations
Detected
Tan Caulking Located at
Ili o
No
Non -
Lower Sub Roof Vent
Asbestos
Friable
Penetration Seams
Detected
White
Layer - No
White Roof Surfacing
Asbestos
Material over Black/Silver
Detected
600
Mastic Located at the
Non-
Square
Lower Sub Roof over the
Black/
Friable
Feet
Southern Trailer Portion of
Silver
the Unit
Mastic -
2%
Chrysotile
White Roof Surfacing
Nor
Material Located at Lowe
Asbestos
Non -
Sub Roof Areas on the
etecte
Friable
Northern Portion of the Un it
- ------- ------------- ---
Textured Concrete Block
No
Non- i
with Mortar Located at West
Asbestos
Friable
Planter Box Wall Areas
Detected
R
GE Project No. 2821-0190
6.0 CONCLUSIONS
The results of our observations and laboratory testing at the mobile home Unit #109A
% WnP1146-
collected, seven (7) of the materials sampled were found to contain asbestos in ar'nounts
greater than one (1) percent.
Friable (Regulated) materials were discovered during our inspection in the form of vinyl
floor sheeting and light fixture insulation. Friable ACMs are materials that which contain 1 %
asbestos or greater and when dry may be crumbled or reduced to powder by hand
pressure. Friable ACMs pose the greatest threat to human health because of the tendency
to release harmful asbestos fibers into the air when disturbed.
Category I non -friable asbestos -containing materials were discovered during our survey
in the form of two (2) types of vinyl floor tile, two (2) types of caulking and a roofing
surfacing material mAth mastic. Category I non -friable ACMs are materials which contain
1 % asbestos or greater and cannot be crumbled, pulverized or reduced to powder by hand
pressure. Category I non -friable ACMs are those in which the asbestos fibers are bound
am
MUMEM
0
GE Project No. 2821-0190
111111; lip! •• i
In
Nicholas E. Barron
Project Manager
AHERA Inspector #61218726
MEMO 11 1111 � M� 11 � 1 11111
M-1 33m=.
, WN CA I W.fir— em -VA
Michagiw- . Roth-enburg, PE
Florida Licensed Asbestos Consultani
r �, � pie � +
Upper Photo: Front View of Site #109A Photograph Date:
1/31/19 Greenfield
Lower Photo: Rear View of Site #109A Project # Environmenfal
2821-0190
Upper Photo: View of HA#4 Photograph Date:
1/31/19 Greenfield
s Lower Photo: View of HA#5 Project # jf#1i
2821-0190
Upper Photo: View of HA#7 Photograph Date:
1/31/19 Greenfield
Lower Photo: View of HA#13 Project # Environmental
2821-0190
Upper Photo: View of HA #16 Photograph Date:
1f 31/19 Greenfield
Lower Photo: View of HA#17 Project # Environmental
2821-0190 _
Upper Photo: View of HA#25 Photograph Date:
1/31/19 Greenfield
Project # Environmentol
2821-0190
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Client Name: Greenfield Environmental Project Name: ELS #2821-0190
432 3rd Street North 39345 6th, Ave, Zephyrhills, FL
St. Petersburg, Florida 33701 Date Analyzed: February 5, 2019
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Lab —
Client #
Sample IIL* --
Description
% Asbestos
% Other Fibers
% Binders
428635
1
Insulation Wrap
white wrap
NAD
10% Glass Fibers
90% Binders
yellow insulate
NAD
10011/a Mineral Wool
428636
2
Insulation Wrap
white wrap
NAD
10% Glass Fibers
90% Binders
yellow insulate
NAD
100% Mineral Wool
428637
3
Insulation Wrap
white wrap
NAD
10% Glass Fibers
90% Binders
yellow insulate
NAD
100% Mineral Wool
428638
4
Fiberboard
brown
NAD
100% Cellulose
428639
5
Fiberboard
brown
NAD
100% Cellulose
428640
6
Fiberboard
brown
NAD
100% Cellulose
428641
7
Flooring
tan vinyl
NAD
30% Cellulose
70% Carbonates and Binders
black backing
NAD
40% Cellulose
60% Bitumen and Binders
brown mastic
NAD
100% Carbonates and Binders
42$642
8
Flooring
tan vinyl
NAD
30% Cellulose
70% Carbonates and Binders
black backing
NAD
40% Cellulose
60% Bitumen and Binders
brown mastic
NAD
100% Carbonates and Binders
428643
9
Flooring
tan vinyl
NAD
30% Cellulose
70% Carbonates and Binders
black backing
NAD
40% Cellulose
60% Bitumen and Binders
brown mastic
NAD
100% Carbonates and Binders
428644
10
Vinyl Tile
tan vinyl
2% Chrysotile
98% Carbonates and Binders
brown mastic
NAD
100% Binders
428645
11
Vinyl Tile
Not Analyzed, Stop
At First Positive
428646
12
Vinyl Tile
1
Not Analyzed, Stop
At First Positive
t7he!W San1pies , wereanaly2edbylayers.
considers a MAIWIal to be asbestos comuinirq only d4conlairis more than 1% asbestos by P-al�bmlcd Visual Arvin Esbmattorr,
be further analyzed by point counting when the results indicattf leas than 10% asbemios by UVAE, Air Quality Elivironfnental
utilizes CVAE on a routine basis and does not mci'xle poml courittog unles., sD(t-<v1fic; fly requested. Additionally, i"se results
may trot bareproduced except intull, Itus report data is to be interpreted only by the person (s) wtion) have :.oifectvu the
samples. Further-nore, this report map not be, used as a datirn to ptodict certlficatlwn, approval or endorsement by NVLAR
NI -ET or any rather agcint;y of the Federal QOwOrnMeftt
+Floor Tile and other resinously bosjnd rnaterrals, when analyzed by EPA method, may yield false negative results because of
Hitter ono to se{izaratury chase ty lane zc f+b�rs sr ti ,rt dr tecbrr� fitters v! sar.ut icnf th and di ttntter. When a definitive iesultis
Anaiyrzed by,
Atambu-o
Lab File Number: 49313 Analysis Pages 1 of 5 NVILAP Lab Code 200769-0
Client Name: Greenfield Environmental
432 3rd Street North
St. Petersburg, Florida 33701
Project Name: ELS #2821-0190
39345 6th Ave, Zephyrhills, FL
Date Analyzed: February 5, 2019
Asbestos, bulk Sample Analysis lest lvletnoQ, iLm
i uz, - izrA iviemoa - ouvtm-wx i-to -
Z)px M To sue arc t OT I-arl (0,1
ILab#
Client #Sam
le T e
Oescd pLion
% Asbestos
% Other Fibers
% Binders
428647
13
Sheet Vinyl
yellow vinyl
20% Cbrysotile
80% Carbonates and Binders
yellow mastic
NAD
100% Binders
428648
14
Sheet Vinyl
Not Analyzed, Stop
At First Positive
I
428649
15
Sheet Vinyl
Not Analyzed, Stop
At First Positive
428650
16
Vinyl Tile
yellow vinyl
NAD
65% Cellulose
40% Carbonates and Binders
5% Synth Fibers
428651
17
Vinyl Tile
yellow vinyl
NAD
55% Cellulose
40% Carbonates and Binders
5% Synth Fibers
428652
18
Vinyl Tile
yellow vinyl
NAD
55% Cellulose
40% Carbonates and Binders
5% Synth Fibers
428653
19
Vinyl Tile
white the
2% Chrysotile
98% Carbonates and Binders
yellow mastic
NAD
100% Binders
tan file
NAD
30% Cellulose
70% Carbonates and Binders
428654
20
Vinyl Tile
Not Analyzed, Stop
At First Positive
428655
21
Vinyl Tile
Not Analyzed, Stop
At First Positive
428656
22
Fiberboard
white
NAD
70% Cellulose
30% Carbonates and Binders
428657
23
Fiberboard
white
NAD
70% Cellulose
30% Carbonates and Binders
428658
24
Fiberboard
white
NAD
70% Cellulose
30% Carbonates and Binders
428650
26
Fiberboard
white
NAD
80% Cellulose
20% Carbonates and Binders
428660
26
Fiberboard
white
NAD
80% Cellulose
20% Carbonates and Binders
428661
27
Fiberboard
white
NAD
80% Cellulose
20% Carbonates and Binders
428662
28
Fiberboard
green/white
NAD
80% Cellulose
20% Carbonates and Binders
428663
29
Fiberboard
green/white
NAD
80% Cellulose
20% Carbonates and Binders
428664
30
Fiberboard
green/white
NAD
80% Cellulose
20% Carbonates and Binders
tThesesa,npieswem,ar,atyzedbyLiyem. Specific layer or component asbestos content is Indicated when relevant 1hekHA
considers a material to" asbestos containing only ifitcoritainsrnore than 1'4, aStNIVOS by Caii0fb!eC1',/i5ua1Area Evirnition
(CVAF-) EPA regulations also,i idicate &,at Ret
br* (u ther analysed by penni ecduni n wnsrn the resorts ncicate less a un 1G`t set sloe byCVAE Air Ciiialay
utilizes; CVAF on A routine hasK and dots not include o0LI int GOnti-IC
may lot be reprOduCod exospl in full This repW data ir, tQ be Cr.,,y Cy the pv,"�n i,) whahove co)'I',Oed thi-
samj>les. Furthermore, this report may not be used as claim to prodtcl certification. apprc.vai or tsndorsement t y NVLAR
N' IST or any ciliar agency o ( the Fe4f"ri3i ',ovemutent
tFtm Tile aroi otner re64rioOSJy bOurM materials, when analyzed by EPA method. may yield faise riogative resWls because of
tfm;fatrans in rvparating descry txrund 6trers anti to detecting ftrcrs tf s� xtl h;ng{� and diameser. 40'lypn a defrn!fiv@ result r^;
required, AQE recommends utilizing aftemativa malriods, of idel)LACahon. including Transini%sion E!,,ctron Mscrosoopy.
Ana;vzed ry.
Lab File Number: 49313 Analysis Pages 2 of 5 NVLAP Lab Code 200759-0
Client Name: Greenfield Environmental Project Name, ELS #2821-0190
432 3rd Street North 39345 6th Ave, Zephyrhills, FL
St. Petersburg, Florida 33701 Date Analyzed: February 5, 2019
Asbestos, Bulk Sample Analysis Test Method: PLM I DS - EPA Method - 600/R-931116 - EPA Appx E to Subpart E of Part 763
JLab #
Client #
Sam le 11pe
Description
% Asbestos
% Other Fibers
% Binders
428665
31
Caulk
tan NAD
100% Binders
428666
32
Caulk
tan NAD
100% Binders
428667
33
Caulk
tan NAD
100% Binders
428668
34
Caulk
white NAD
100% Carbonates and Binders
425669
35
Caulk
white NAD
100% Carbonates and Binders
428670
36
Caulk
White NAD
100% Carbonates and Binders
428671
37
Insulation
white 60% Chrysotile
10% Cellulose
30% Carbonates and Binders
428672
38
Insulation
Not Analyzed, Stop At First Positive
428673
39
Fiberboard
yellow NAD
80% Cellulose
20% Carbonates and Binders
428674
40
Fiberboard
yellow NAD
8011/6 Cellulose
20% Carbonates and Binders
428675
41
Fiberboard
yellow NAD
80% Cellulose
20% Carbonates and Binders
428676
42
Mastic wrap
green wrap NAD
70% Cellulose
20% Carbonates and Binders
10% Glass Fibers
black mastic NAD
100% Bitumen and Binders
428677
43
Mastic wrap
green wrap NAD
70% Cellulose
20% Carbonates and Binders
10% Glass Fibers
black mastic NAD
100% Bitumen and Binders
428678
44
Mastic wrap
green wrap NAD
70% Cellulose
20% Carbonates and Binders
10% Glass Fibers
black mastic NAD
100% Bitumen and Binders
428679
45
Mastic
black 2% Chrysotile
98% Binders
428680
46
Mastic
Not Analyzed, Stop At First Positive
1
428681
47
Mastic
Not Analyzed, Stop At First Positive
Spec4fc layer or component aslrstotl rontani is indicates when relevant. 1 he EioA
considers a material to be asbestos conlaimcg only it i, contains more than llf,, asbestos by Calibrated Visuat Area E sftmatton
(CVAE), EPA regularWris also ndicale that Regulated Asbestos Containing Materials wh,ci) afe fr,abla or may becou$4-, frtoWe
be kttler artaiyzed by Pont counting when the results rhd4cote less than !D^b arawwio, by CVAF AsrQt4a;;lyEiv-onWnW(
tifili7es GVAE on a rokAne hasm and am6 n<)t inctude point counting unless specificahy reque-qted, Additionally, these nasvlh,
may npl t)e teProduceti oxwlx in full- This report data pS to be mterpreto only by the person (s) whom have ceflocied the
samples Furthernwe, "his report may net be utwd as 4 ciaur to product (;erffcatxon. apaprvviil oc oindorwirneril by NV AP,
N1ST (>t any otheialltmoV of the Feder-1 Govwn;Tw.,il
tFifoor Tito am curer resineusrp bt:furrd malecials,when analyzed byE PAmcthod,array yield tol5c regat ve results bot;au*e of
lintitall,ons in separating riaselybouittJ fibers and ndvlocfi-,tg fil:rersofsmall length and diameter When adefin'ttvcrosaltlb
Anil * Yeo lw
Lab File Number: 49313 Analysis Pages 3 of 5 NVLAP Lab Code 200759-0
Client Name: Greenfield Environmental Project Name: ELS #28211-0190
432 3rd Street North 39345 6th Ave, ZephyrhUls, FL
St, Petersburg, Florida 33701 Date Analyzed: February 5, 2019
Asbestos, Bulk Sample Analysis Test Method: PLM I DS - EPA Method - 600/R-931115 - EPA Appx E to Subpart E of Part 763
Lab 4 ---
Client #
Sample Type
Description
% Asbestos
% Other Fibers
% Binders
428682
48 ,
I Mastic
white
10% Chrysotile
90% Binders
42$683
49
Mastic
Not Analyzed, Stop
At First Positive
428684
50
Mastic
Not Analyzed, Stop
At First Positive
428685
51
Caulking
white
NAD
100% Carbonates and Binders
428656
52
Caulking
white
NAD
100% Carbonates and Binders
428687
53
Caulking
white
NAD
100% Carbonates and Binders
428W
64
Stucco
grey
NAD
100% Quartz and Binders
428689
55
Stucco
grey
NAD
100% Quartz and Binders
428690
56
Stucco
grey
NAD
100% Quartz and Binders
428691
57
Stucco
grey
NAD
100% Quartz and Binders
428692
58
Stucco
grey
NAD
100% Quartz and Binders
428693
69
Stucco
grey
NAD
100% Quartz and Binders
428694
60
Insulation
yellow insulate
NAD
100% Mineral Wool
black mastic
NAD
100% Bitumen and Binders
brown backing
NAD
100% Cellulose
428695
61
Insulation
yellow insulate
NAD
100% Mineral Wool
black mastic
NAD
100% Bitumen and Binders
brown backing
NAD
100% Cellulose
428696
62
Insulation
yellow insulate
NAD
100% Mineral Wool
btack mastic
NAD
100% Bitumen and Binders
brown backing
NAD
100% Cellulose
4286S7
63
Fiberboard
white
NAD
30% Glass Fibers
70% Carbonates and Binders
green mastic
NAD
100% Binders
white insulate
NAD
100% Synthetics
428698
64
Fiberboard
white
NAD
30% Glass Fibers
70% Carbonates and Binders
green mastic
NAD
100% Binders
while insulate
NAD
100% Synthetics
t 1rhese samples were anaW" by layers. Spmtrio layer or component asbestos coritent is inoicitied when Wevalit, The EPA
(.cInsicer'sa Material to t>e asbestos containing only it it ceAains more than 114,asbestos by Calibrated Visual Area Estimation
(cVAE), EN, r"ulalions also n Ouic"ate that Regulaled AsWstc,H Containing Mate rials whto are 4 iable c- may become triable,
Jae hjrther analyzed by point cotioting when the resu;ts indicate l,"O, than 10% asbestos by Cs(AE, Air Owality Erivironmental
utilizes CVAF on a roulane hasis and dues not li"iduon point requested
This report data is to be interpreted only by the person (s) whom have cnilecled the,
Sarrlple$r Furthiirmare, this report may not be used as a Gain: *,opromo ciortificoton, 4i�uwii o, by NV AP,
N'l,'5T cx axis
; agency of ihe Fix w,,Kr> smmw� t
tFloor Tile and other iresinious)y bound matoriat5, when analyzed by EPA mejtod, may yield Use ncqat,vc 7eswiv� because of
limitations in separating c4o*oly bound lilbors and in detecting fibers Of smaii, tongtil and diamoterf. When a definitive result is
required, AQE rocommenoiR utilizing altarnative methods of identification, ininluinng Transmission F 711ctron Microscopy,
Analyzed by
(:�Gian-ar;u Araii-ibuto
Lab File Number: 49313 Analysis Pages 4 of 5 NVLAP Lab Code 200769-0
Client Name: Greenfield Environmental
432 3rd Street North
St, Petersburg, Florida 33701
Project Name'. ELS #2821-0190
39345 6th Ave, Zephyrhilts, FL
Date Analyzed: February 5, 2019
AS0eSt0S,tJUIKsample AMYSIS
[Lab i
Client #
SaMp!e Type
Description
% Asbestos
% Other Fibers
% Binders
428699
65
Fiberboard
white
NAD
30% Glass Fibers
70% Carbonates and Binders
green mastic
NAD
100% Binders
white insulate
NAD
100% Synthetics
428700
66
Caulking
white
NAD
100% Carbonates and Binders
428701
67
Caulking
white
NAD
100% Carbonates and Binders
428702
68
Caulking
white
NAD
100% Carbonates and Binders
428703
69
Caulking
tan
NAD
100% Carbonates and Binders
428704
70
Caulking
tan
NAD
100% Carbonates and Binders
428705
71
Caulking
tan
NAD
100% Carbonates and Binders
428706
72
Roofing Material
white layer
NAD
100% Carbonates and Binders
bick/slv mastic
211/9 Chrysatile
98% Bitumen and Binders
428707
73
Roofing Material
Not Analyzed, Stop
At First Positive
428708
74
Roofing Material
Not Analyzed, Stop
At First Positive
428709
75
Mastic
white
NAD
100% Binders
428710
76
Mastic
white
NAD
100% Binders
428711
77
Mastic
White
NAD
100% Binders
428712
78
Stucco
white
NAD
100% Quartz and Binders
428713
79
Stucco
white
NAD
100% Quartz and Binders
428714
80
1
Stucco
1
white
1
NAD
1
1
100% Quartz and Binders
tThwao- samptes were anafyzmd by ,3yers Toe, EPA
(CVAM
be fwther anaiyzeC by point countMq when IM results indicale tess than asbe-�,o5 by OVAL. Air QualAyEnvironmerital
utilizes CVAE on a routme t*s,s and does noimlude pciml tountiog unless speafically requeszed. Additionally, these results
Tni5 report dw;A is w tv Ivrpmled,�)Ny by" pemon (,;)whom nave CoIWIPd the
4FWrTile and other fesurwyly bound n,aWrW!;,"en tiaiyzed by CPAmtnod, may ywidtaf5e negatw,, ro5ut'sbe'.;ju*L- of
limitations in separating Close!y bound fitters and m deIectmq 6"rs of small length and diarneter, when a definitive rvwn IS
Ana;¢:ed
M
Lab File Number: 49313 Analysis Pages 5 of 5 NVLAP Lab Code 200769-0
a' r'