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5.0 ASBESTOS AND LEAD TESTING RESULTS <br />Batch #: WATK2304035 <br />%VAmr lob use only <br />CHAIN OF CUSTODY <br />Client/Company Name: Bob Goodmark <br />Address: 3217 Lombard Ave, Everett, WA, 98201 <br />Office Phone #: <br />Project Manager: Bob Goodmark Email: rlgoodmarkl@att.net <br />Project Manager Phone #: (713) 385-7548 <br />Project Name: TEMPLE BETH OR, Parcel #00439076300900, Survey <br />Project/PO Number: <br />Project Address:3217 Lombard Ave, Everett, WA, 98201 <br />Asbestos <br />Lead <br />Mold <br />Sample Condition <br />x <br />PLM Bulk Asbestos <br />Paint Chip <br />Bulk <br />Good <br />PLM Tape Lift <br />Swab <br />Tape Lift <br />HSevere <br />Damaged <br />PLM 400 Point Count <br />Air <br />Air <br />Damage <br />PLM 1000 Point Count <br />note: separate form requiredfor <br />lead and mold oirsomples <br />Turnaround Time: Number of Samples: 69 <br />SEQ# <br />Sample ID/Location <br />Sample Description <br />SEQ# <br />Sample ID/Location <br />Sample Description <br />1 <br />1-1 Exterior Shed <br />Tar Paper <br />26 <br />10-3 Bath <br />Wall-Paint/Texture/Wallboard <br />2 <br />1-2 Exterior Shed <br />Tar Paper <br />27 <br />11-1 Kitchen <br />Backsplash Tile <br />3 <br />2-1 Exterior <br />Roofing Materials <br />28 <br />11-2 Kitchen <br />Backsplash Tile <br />4 <br />2-2 Exterior <br />Roofing Materials <br />29 <br />12-1 Attic <br />Blown in Insulation <br />5 <br />3-1 Exterior Shed <br />Roofing Materials <br />30 <br />12-2 Attic <br />Blown in Insulation <br />6 <br />3-2 Exterior Shed <br />Roofing Materials <br />31 <br />13-1 Attic <br />Foil/Paper/Mastic/Insulation <br />7 <br />4-1 Living Room <br />Carpet Mastic <br />32 <br />13-2 Attic <br />Foil/Paper/Mastic/Insulation <br />8 <br />4-2 Living Room <br />Carpet Mastic <br />33 <br />14-1 Attic <br />Paper/Mastic/Insulation <br />9 <br />5-1 Kitchen <br />LVP/VCT <br />34 <br />14-2 Attic <br />Paper/Mastic/Insulation <br />10 <br />5-2 Kitchen <br />LVP/VCT <br />35 <br />15-1 Living Room <br />Square Ceiling Tile <br />11 <br />6-1 Pantry <br />Sheet Vinyl/Mastic <br />36 <br />15.2 Living Room <br />Square Ceiling Tile <br />12 <br />6-2 Pantry <br />Sheet Vinyl/Mastic <br />37 <br />16-1 Bath <br />Rectangle Ceiling Tile <br />13 <br />7-1 Bath <br />Vinyl/Mastic (Mutt. Layers) <br />38 <br />16-2 Bath <br />Rectangle Ceiling Tile <br />14 <br />7-2 Bath <br />Vinyl/Mastic (Mutt. Layers) <br />39 <br />17-1 Basement <br />Pink Insulation/Plastic <br />15 <br />8-1 Basement <br />Carpet Mastic <br />40 <br />17-2 Basement <br />Pink Insulation/Plastic <br />16 <br />8-2 Basement <br />Carpet Mastic <br />41 <br />18-1 Basement <br />Wall-Paint/Texture/Wallboard <br />17 <br />9-1 Living Room <br />Wall Paint/Texture/Wallboard <br />42 <br />18-2 Basement <br />Wall-Paint/Texture/wallboard <br />18 <br />9-2 Bed 1 <br />Wall-Paint/Texture/Wallboard <br />43 <br />18-3 Basement <br />Wall-Paint/Texture/Wallboard <br />19 <br />9-3 Bed 1 <br />Wall-Paint/Texture/Wallboard <br />44 <br />19-1 Basement <br />Foil/Paper/Mastic/Insulation <br />20 <br />9-4 Kitchen <br />Wall-Paint/Texture/Wallboard <br />45 <br />19-2 Basement <br />Foil/Paper/Mastic/Insulation <br />21 <br />9-5 Dining <br />Wall-Paint/Texture/Wallboard <br />46 <br />20-1 Kitchen <br />Sink Undercoat <br />22 <br />9-6 Hall <br />Wall-Paint/Texture/Wallboard <br />47 <br />20-2 Kitchen <br />Sink Undercoat <br />23 <br />9-7 Upstairs Bed 1 <br />Wall-Paint/Texture/Wallboard <br />48 <br />21-1 Kitchen <br />Countertop <br />24 <br />10-1 Bath <br />Wall-Paint/Texture/Wallboard <br />49 <br />21-2 Kitchen <br />Countertop <br />25 <br />10-2 Bath <br />Wall-Paint/Texture/Wallboard <br />50 <br />22-1 Bath <br />Shower Surround Caulk <br />Print Name <br />Signature <br />Company Name <br />Date <br />Time <br />Sampled <br />Cooper Belisle <br />WAT <br />6/2/2023 <br />10:30am <br />Relinquished <br />Cooper Belisle <br />A A <br />WAT <br />6/2/2023 <br />10:30am <br />Delivered <br />Cooper Belisle <br />A, Pl <br />WAT <br />6/2/2023 <br />1:00pm <br />Received <br />Cooper Belisle <br />WAT <br />6/2/2023 <br />1:00pm <br />Analyzed <br />Cooper Belisle <br />G <br />WAT <br />6/5/2023 <br />8:15am <br />Reported <br />Cooper Belisle <br />/' <br />WAT <br />6/5/2023 <br />11:10am <br />How would you like to be notified? Email x Phone <br />Washington Asbestos Testing LLC guarantees the test results provided are of a precision normal with the type of methods recognized in asbestos analysis. Washington Asbestos Testing <br />LLC accepts no legal responsibility for the purpose for whichthe client uses the test results. By signing this Chain of Custody form the client agrees to relieve Washington Asbestos Testing <br />LLC of any and all (lability that may arise from the test results. <br />11200 Kirkland Way Ste. 340A, Kirkland, WA 98033 • (425) 658-7286 <br />12811 8th Ave W Ste. 8101, Everett, WA 98204 - (425) 374-8706 <br />watestingllc.com <br />Page 25 of 39 <br />