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1415 84TH ST SE 2022-07-21
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1415 84TH ST SE 2022-07-21
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Last modified
7/21/2022 9:01:54 AM
Creation date
7/21/2022 8:59:37 AM
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Address Document
Street Name
84TH ST SE
Street Number
1415
Notes
SPACE 141
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` I <br /> ' OrderID: 512102681 • • • /� <br /> Asbestos Chain of Custody <br /> EM61_ EMSL Order Number <br /> r�(tabb}use onl)1: <br /> -seyutsL MAMMAL,UM. #5 .1 2 1 O 2 PHONE: <br /> uuwv<m�r+nwaiers..��urwo, FAX: " <br /> Company Namme: Affordable Asbestos Inspection EMSI.Customer ID: <br /> Street: 5909 315th st Ct s, Roy Washington cu Puyallup state or Province: Ilia. <br /> 21plPastai Code: 98373 Country:use Telephone#:2533810580 _ Fax#: <br /> Report To(Name): Randy Marsh Please Provide Results via: 0 Fax El Email <br /> emu Address: asbestosready@outlook.com Purchase Order Number: <br /> Client Project ID: 1415 84th et east,#141 Everett EMSL Protect ID(Internal Use on►l) <br /> State or Province Collected: Wasbingkm �CT only DCommerciaUTaxabie ❑Resldentlt alltax Exempt <br /> EMSL-BNU to:❑Same Q Different-If bill to Is different note Instructions in comment Mk/party bang requireswritten authorization horn third pally <br /> Turnaround Tima(TAT)Options Please Check <br /> ❑3 Hr1 I ❑44.5Hr1 1 ❑6 Hr1 l❑24 Hr 1 ❑32 Hr2 I ON 48 Hr 1 ❑ 72 Hr I❑ 98 Hr I ❑1 Week I ❑ 2 Week <br /> • 'Premam Service Charge apples ter3 Hour TEM AHEM orEPA LovellI TAT—you ass be asked tasks an authoriration,rorm. TEMAIr 3.6 Hours please csAahead to schedule <br /> 832 flour TATavaleble humlecf tests calx samples must be submWedb&if:30 am, <br /> PCM-Air TEM—Air1 ' TEM-Settled Dust <br /> O NIOSH 7400 0 AHERA 40 CFR,Pert 763 0 Microvac-ASTM D 5755 <br /> O w/OSHA 8hr.TWA 0 NIOSH 7402 0 Wipe-ASTM D64480 <br /> PLM-Builcjr Rprtino limit) 0 EPA Leven! CI Carpet Sonicatlon(EPA 6001J53/167) <br /> l l PLM EPA 600/R-93/116(<1%) 0 ISO 10312 Soil—,Rock—Vermiculite(rej ytipq)imltt <br /> ❑PLM EPA NOS(0%) TEM-Sulk 0 PLM EPA 800/R-9311 15 with milling prep(<0.25%) <br /> point Count 0 TEM EPA NOB • ❑TEM EPA 600/R-93/116 with milling prep(<0.1%)" <br /> ❑400(<0.25%)❑1000(<0.1%) 0 NYS NOB 198.4(non-friable-NY) ❑TEM Qualitative via Filtration Prep <br /> Point Count w/Gravimetrtc ❑TEM EPA 800/R 93/116 with milling 0 TEM Qualitative via Drop Mount Prep <br /> D 400(<0.25%)❑1000(<0.1%) prep(<0.1%)' 0 Cincinnati Method EPA 600/R-04I004—PLM/TEM <br /> Q NYS 1_98.1(triable-NY) _TEM—Water:EPA 1002 'towerrepar**limits avatalbte an request <br /> ❑ NYS 198.8 NOB(non-friable-NY) Fibers>10pm 0 Waste 0 Drinking Other test iolease specify): <br /> O NYS 198.8 SOF-V ' Ali Fiber Sizes 0 Waste 0 Drinking <br /> ❑ NIOSH 9002(<1%) <br /> JJ Stop At First Positive(clearly Identify homogenous areas b Filter Pore Size(Air Sam les): 0 0.8pm 0 0.45pm <br /> Sampler's Name: 1I2 Sampler's Signature: ittigletike. ,/erg ,( <br /> Sample# Volume. or DatePrime <br /> Sample Description/Location Homogenous Area Sampled <br /> 1. kitchen flooring 8131/21 11:30 <br /> 2 master bathroom flooron»mminnum <br /> 3 guest bathroom floor <br /> 4 utility flooring tostmommunnennamo <br /> 5 exterior window sealant °""""�m"nt°°' no <br /> _ <br /> Client Sample#(s):5 - Total#of Sample.:'5 <br /> Relinquished by(Client 4ir.1 Date: ,.'9w'"" ',.''1—, Time:9e":" ,,rt* . <br /> Received by(Lab): / 4. ` ,_,,.,_ Date: ` (3/''r21 Time: /0.T a <br /> Comments/Special ins: ctions: <br /> S C .0 k Ice,CS 34 t 1 yl?r3 <br /> 3 ca c1e u <br /> Controled Document—COC-06Asbetaoe—R12.1-1101r1919 <br /> EMSL Analytical,Inc.'s MA:LA Testing)Laboratory Terns and Colleens are incorporated into this chain of custody by reference <br /> in their entirety.Submtsslon of samples to EMSLAnalytical Inc.constitutes acceptance and acknowledgment of all terms end conditions. Ir <br /> Page 1 of pages <br /> Page 1 Of 1 <br />
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