HomeMy WebLinkAboutB10-0285I �
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.�.', ��� Department of Community Development
� � .,� "�' �� 75 South Frontage Road
� ' � �-�• fi '� � �. " ,� , ' Vail, Colorado 81657
� . �"� � �`.����' � ��;.� ��` -Tel: 970�d79-2128;�
� � Fax: 970-479-24�52
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TRANSMITTAL FORM
Revision Submittals:
1. "Field Set° of approved plans MUST accompany revisions.
2. No further inspections wiil be performed until the revisions are approved & the permit is re-issued.
3. Fees for reviewing revisions are $55.00 per hour (2 hour minimum), and are due upon issuance.
Pertnit #(s) information applies to: Attention: () Revisions
B10-0285 Martin Haeberle (�) Response to Correction Letter
� attached copy of correction letter
� ( ) Deferred Submittal
��/� 1�1l�SDA� ( ) Other
Project Street Address:
610 W. Lionshead Circle
(Number) (Street)
Building/Complex Name: The Landmark
Contact Information:
Company: Olsen Construction LLC
703 Description / List of Changes:
(Suite #) Resubmittal of drawings in response to
Company Address: 610 W. Lionshead Circle
City: Vail State: CO Z�P: 81657
Contact Name: Howard Olsen
Contact Phone� 970 389-2881
E-Mail holsen@altergroup.com or olsenconst@gmail.com
Revised ADDITIONAL Valuations (Labor & Materiala)
(DO NOT include original valuation)
Building:
Plumbing:
Electrical:
Mechanical:
Total:
$
$ 0
comments.
(3 copies)
(use additional sheet if necessary)
Date Received:
�
OCT 1 2 2010
TOWN OF VAIL
Ol-Jan-10
a
r � �
0
Architectural Comments:
SheetA00z
�1D -�Z� �
1. Please include building type �nd required protection for all structural and non structural elements.
See section 6Q2 I9C _
; �� �'1 P�' � ��'
SheetA202
7,. Plans refl�ct wood elements at the stairs that are not exempt from by section 6D3 IBC. Re�ise plans.
�e� � ao�
5heet A203
1. Blocking a t structural element does not comply with section 6o3 IBC. Revise plans
��� ��� �9�
Structural Comments:
Sheet 51.21
1. Provide design data sheet reflecting load design and special inspection criteria. Reference section
1603 IBC.
� ���fs .��0�6� .
Pl�mbing Camments:
Sheet P2.0
1. Clarify compfiance with the state plumbing code at the dishwasher trap.
��� �'�e�- ��
Mechanita� Comments:
Sheet M2.0
0
l. Show how ventilatian is to be provided to the new bedrooms in the loft area. Reference section
1203.4 fBC. _� /�^
�' � � ���� � � � � �
Eleetrical Comments:
Sheet E3.0
�
�s
1. Annotate c�n plans that the proposed lighting shall have 5096 high efficacy lighting per the IECC.
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' Permit � .. lD - D3 97
SPECIAL tNSPECTtON AND TESTING
{To applicants of projects rcquiring Specia[ Inspection or T
The owner ar t�is�her re�resentatrve. an the advi� of the design
r,omplete. seai, s�gn and submit a copy of lhe Sper,4�l Inspe
Schedulzci to the To:m oE Vaii for review ancS approval. Sn
R�otucoeied or faxed signatures ars acceptable.
The rnvner arzd hislher general con?ractor, where a�l�cab'e,
condit�ons appiECable io Special Inspection Tes�ng:
i. Ccr.t�actor is r�spens�b;e for pro�er notif�cation to the Ins�
(isted :;Pac�e t i j!t3C 17(kl
2. Only tf�e �estir� laboratory shoutd take samptes and transpoR tht
3. Copies af �!i laooratory repars and inspect�ons are ta be sent dir
agency ar� a �veeiciy basis.
4. InspecLon age�cy to subm�t rtames and quaffi�cadons of on-site
for review and aprrovaL( Pa3ge 2}
5. The s�ec�al ittspector ts raspor�slDle to immediaiely notify the To
any concerns and!cr prob�ems encountered.
6. IE is the resp.nnsibility nt the confraclor to review the Fown
�nspectron ur testmg requ:rements that may b2 not�d. A pre-ca
recomrnended to �es;ew spe�iai inspection proc�ciutes
7 The speciai inspector st,a:l �se enly the Town o# Vaii approved dr
8. All spzciai Fnspect:an fiesd reports must be ieft on site (or rev�
required ins���:c:tivns or r� inspections
BEI'ORE OCGUPANCY WILL BE GiZANTED: Tne speaai inspeci
seated siatement Fh�t al[ iterTis requiri�g tesling and inspection v�ere
�ested andiar inspected shall be �oted in this statement. A copy o? tt
job sFte fcr the Building inspector's revie�v piiar ;n fir,af inspection
A^know'edgemeni:
g per Sectio� 1701 of the 1$C►
>sionai m respcnsibie charge, stzall
Agreement and Stn�cturat Tests
ros are requ�red on both pages.
a�so adcno�vladge the following
�ion o� Testing agency for rterris
to th�ir laborak�ry.
tiy t� the Town of Vail by the Testing
�cial �nsoectors to the iown at Va11
1 ot Vail BuiWing OfTicial in w►itiny af
V2if approveti pi3n5 fpr additional
ruci�on conferene2 at the �ob site is
by Ehe Town� of Va�l staff prior to
n agenc�� sha+l submit a signed and
Uillec+ and reported. Thp�e items n�S
stateme:�t sha6s be maintained a: ihe
Owner
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F,gencY� —__ .. ._�tr�.` • -- T���D�RT • PO��OCk �O-�I � �Q
:iiy�ialur�� : i9 ti�t;�:: D:i!<`
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Arch/Eng: `- _ �------
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S�qn:i!ure F'nnj Nan�i� Oate
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�yy�iIt S�.t t i Job Adci s: i
1 V}iiy UF Pr�� ' Permit i- �
SPECIAL INSPECTION AND TESTING �GREEMENT
iTo applicants of projects requiring Special inspection or Te ing per Section 1701 of the iBC)
The owner or his�her representative, on the adwce of ,he design
complete. seal, sign and sutxnit a copy of the Spec;k-,I Insp
Scheduled to the Town of Vail for r�view and approvai. S
photocoaed or faxed signatures are acceptable.
Fhe owner and hislher general contractor, where apphcab!e
conditrons appNcable to Speciai inspection Testing:
1. Cor.lsactor is respons�ble for proper noM�catwn to the InsF
iisted t;Page 1j (ISC 170�C)
2. Only tftie !�g;irg Iaboraiory should take samples and VanspoA the
3. Copies of a!I laooratory reports ar.d inspect�ons are to be sent dir
agen�y �n a weekly b2sis.
4. Inspect�on agency to subm�t names and quairt:ca6ors of on-site
for review a�d ap�rovaL( Page 2)
5. The spec�al inspector �s respa�sible to immediately notify the To
any concems and?or problems encountered.
6. It i5 the responsibility of the cOnitador to review the TOwn
inspedion or testing reqwrements that may be noted. A pre-co
recommend=d to review special inspection procedures
7 The speYis? �nspector sha!i use only the Town of vau approved dr
8. AII spe:�al �nspect:on fietd reports must be !eft on site �or rev�
rec�uired inspzctions ar re inspettions
stonal m responsible cnarge, Sh31)
�greement and Stn�ctura{ Tests
es are requ�red on both pages,
aiso adcnowledge the toilowing
o! TesUng agency for items
to their laboratory.
tly to the Town of Vail by the Teshng
msoectors to ihe Town of Va�l
of Vail Bullding Oflicial �n wrifing ot
Vail aoproved pfans for additional
ruct�on conference a[ lhe �ob sde is
by the Town of Vail staff pnor to
E3EfORE OCCUPANCY WIL� BE GRANTED The speaal inspec�n agency shall submit a signed and
sealed statemenf th�t all ifems requiring tesling and inspeuion were �illed and reported. Those items noi
tested 2ndror �nspected shall be noted in this statement. A copy or th I sta[ement shakt be maintamed a: the
job site fcr fhe Building Insnector's review prior ta fina: inspw-tion
Acknowleclgement: •
Ov�rrer �— _ ��/f�� /p//1/m
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Speeial InscecHar `` � �'�
Agency: __ Ro?�e�C._R�c�_ Ro,_�_RT �1i • Po\\OCk 10-9 -\Q
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ProjeCt /I��
a��n�En9. __._ _. Bob Redwine 10 -12 -10
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NOTE: THIS PERMIT MUST BE POSTED ON JOBSITE AT ALL TIMES
:
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Town of Vail, Community Development, 75 South Frontage Road, Vail, Colorado 81657
p. 970.479.2139, f. 970.479.2452, inpsections 970.479.2149
ADD/ALT COMM BUILD PERMT
Job Address: 610 W LIONSHEAD CIR VAIL
Location......: UNIT 703
Parcel No....: 210106330074
OWNER HARARI, PHILIPPE 04/15/2010
411 MICHIGAN AVE
MIAMI BEACH, FL
33139
APPLICANT OLSEN CONSTRUCTION
PO BOX 1067
OKEMOS
MICHIGAN 48805
License: 879-B
CONTRACTOR OLSEN CONSTRUCTION
PO BOX 1067
OKEMOS
MICHIGAN 48805
License: 879-B
09/08/2010 Phone:970-389-2881
09/08/2010 Phone:970-389-2881
Description:
DEMO OF ALL FINISHES AND CABINETS. DEMO OF TWO WALLS.
Occupancy:
Type Construction:
Permit #: B10-0285
Project #: Q�' 1,�� US�i�-
Status . . : ISSUED
Applied . . : 09/08/2010
Issued . .. : 09/13/2010
Expires . ..: 03/12/2011
Valuation: $2,000.00
Total Sq Ft Added: 0
.........................................,..............,.,...,,..........»....... FEE SUMMARY .....,..,.,.........,....,...,,,,.,........,...,..........,..,....,,,,,.,.,..,.,..
Building Permit Fee-----> $69.25 Will Cal Fee------------------> $4.00 Total Calculated Fees------------> $118.26
Plan Check-----------------> $45.01 Use Tax Fee--------------------> $0.00 Additional Fees--------------------> $0.00
Add'I Plan Check Hours-> $0.00 Restuarant Plan Review-----> $0.00 TOTAL PERMIT FEES------------> 5118.26
Investigation------------> $0.00 Recreation Fee---------------> $0.00
Payments--------- ---> 5118.26
Total Calculated Fees-------> $118.26 BALANCE DUE-----------------> $0.00
...............................................................,..,..,,........,.........,..................x.......,.....,.,.............,...........,............,.,,,............,...
DECLARATIONS
I hereby acknowledge that I have read this application, filled out in full the information required, completed an accurate plot plan, and state that a�l the information
as required is correct. I agree to comply with the information and plot plan, to comply with all Town ordinances and state laws, and to build this structure
according to the towns zoning and subdivision codes, design review approved, International Building and Residential Codes and other ordinances of the Town
applicable thereto.
REQUESTS FOR INSPECTION SHALL BE MADE TWENTY-FOUR HOURS IN ADVANCE BY TELEPHONE AT 970.479.2149 OR AT OUR OFFICE FROM
8:00 AM - 4:00 PM.
Signature of Owner or Contractor
Print Name
bld_a It_con struction_pe rm it_041908
Date
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APPROVALS
Permit #: B10-0285 as of 10-06-2010 Status: ISSUED
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Item: 05100 BUILDING DEPARTMENT
09/13/2010 JRM Action: AP
ffffrf�rllrwtfftlrlrHA'1fiFY'f1�lY444f44+Hrf4}�ffl�R�RR1HLfrY'Y'Y'4Yiif#44R441`#ifilf'R44R1r1rR�f4f'R4lrbfifitrfrt#frT�RYY'ikY(A'feti44t44iI�f`f4lrfrff'f'ef'kflrRf' VRfr V 4Y'4fik#Y`tt#+4Y4Rff44tfRtffRZARkitRHRff1r1M1wtf1MlrV fV �1rfV
See the Conditions section of this Document for any that may apply.
bld alt construction_permit_041908
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CONDITIONS OF APPROVAL
Permit #: 610-0285 as of 10-06-2010 Status: ISSUED
......................................................................................................... �....,..........,........,.,,........,...,,.....,.,...,..,..........,,......
Cond: 1
(FIRE): FIRE DEPARTMENT APPROVAL IS REQUIRED BEFORE ANY
WORK CAN BE STARTED.
Cond: 12
(BLDG.): FIELD INSPECTIONS ARE REQUIRED TO CHECK FOR CODE
COMPLIANCE.
bld_a It_con structio n_perm it_041908
********+***************************************************�*******************************
TOWN OF VAIL, COLORADOCopy Reprinted on 09-13-2010 at 16:59:41 09/13/2010
Statement
***�******************************************�****�*********+************+*****************
Statement Number: R100001299 Amount: $118.26 09/13/201004:59 PM
Payment Method: Check Init: JRM
Notation:
-----------------------------------------------------------------------------
Permit No: B10-0285 Type: ADD/ALT COMM BUILD PERMT
Parcel No: 2101-072-1700-1
Site Address: 720 W LIONSHEAD CR VAIL
Location: UNIT 703
Total Fees: $118.26
This Payment: $118.26 Total ALL Pmts: $118.26
Balance: $0.00
****************************+**********+**+*****+*******************************************
ACCOUNT ITEM LIST:
Account Code Description Current Pmts
-------------------- ------------------------------ ------------
BP 00100003111100 BUILDING PERMIT FEES 69.25
PF 00100003112300 PLAN CHECK FEES 45.01
WC 00100003112800 WILL CALL INSPECTION FEE 4.00
`° �`� �' 4. �.', �S`� Department of Community Development
�° t4' . , � -
s �;. 75 South Frontage Road
"�, , � '
' �► � �.. � . Vail .Colorado 81657
� , ,, { , �: � � � . , � . ' �, �-,�,� ,
.��� �, � � . Tel: 970-479-2128:
' • �' f Fax: 970-479-24�2
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��� • � � ��, . ��,,��� '� " Web: www.vailgov �om .
# �~���F . e�elopment Review.Coordinatot
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BUILDING PERMIT APPLICATION
Separate permits are required for electrical, plumbing, mechanical, fireplace, etc.
Project Street Address:
610 West Lionshead Circle
(Number) (Street)
Building/Complex Name: The LBndma�k
Contractor Information:
Company: Olsen Construction LLC
703
(Suite #)
Company Address: 610 W. Lionshead Circle
City: Vail State: CO ZiP: 81657
Contact Name: Howard Olsen
Contact Phone: 970 389-2881
Office Use: pEVOs � DOOq
Project #: PQT 1n— O� 3�7' ,
DRB #:
Building Permit #: � % fl — Q � � �j
Lot #: Blodc # Subdivision:
Detailed Scope and Location of Work: Demo Of 811
finishes and cabinets. Demo of two walls
E-Mail olsenconst@gmail.com (use additional sheet if necessary)
879.g Work Class:
Town of Vail Contractor Registration No.:
New ( ) Addition ( ) Remodel ( �/) Repair ( ) Other ( )
X Work Type
Contractor Signature (required) Interior (�/) Exterior () Both ()
Property Information Type of Building:
Parcel #: 210106330074 Single-Family (✓) Duplex () Multi-Family ()
(For parcel #, contad Eagle County Assessors Office at 970-328-8640 or CommerCial
visit www.eaglecounty.us/patie) ( ) Other ( )
Tenant Name:
Owner Name: Phillippe Harari
Valuations (Labor & Materials)
Building:
Plumbing:
Electrical:
�a��� _
$
$
Mechanical: (including fireplace) $
Total:
Does a Fire Alarm Exist? Yes (�) No ( )
Monitored Alarm? Yes (� No ( )
Does a Sprinkler System Exist? Yes (� No ()
#& Type of Existing Fireplaces: Gas Appliances �
Gas Log Wood/Pellet Wood Burning
#& Type of Proposed Fireplaces: Gas Appliances
Gas Log Wood/Pellet Wood Burning _
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Ol-Jan-10
A� D�,s�cstos Test:ing ancl Coxlsi�lting
J�o�n R. I'ctcY•�n�n
:�: .�: :{: :�: :�; :�: �: .�. :E: :�: :}:
P.O. Box 1230 Clifton, C4. b 1520-123Q
Cell 97U-270-3689 I-Iorne Phone 970-464�-5265
INSPECTION l�_EP(JR1' �'RI;Pt�RCD rOR:
Destination Resorts
610 W. LionsHeld Circic
Vail, CO. 81657
LOCATION:
The La�idlvlark
6l U W. LionsI-Teaci Circle
Vail, CU. 81657
REPORZ' PRFP�I,RED I3Y:
John R �etez�l�iari
Ins��ector Manager
Cer-tific��te Nn. c5c501
2
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O�OZ 9� �f1�'
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�
" �� A� D Asbcs�tas Tcstin�; and Conslxlting
��O�lll �. Pe�;C�'I11=iI1
f�sb�stos rI'esling, I'rojecl llesign, �11C� COI1Sl11[.IIl�
INTRODUCTION:
On Augusl 22nc1, 2006, ai� inspeetion/survey was eonclucted aiici 20
bulk samples were collected from the;
The LandMac•k
610 W. Li�nsllead Circle
Vail., CO. S16�7
The pui��ose oi� ttae insPectior�/suzvey was to loc�ate and sar�iple
suspected asbestos containiug materials Cliat mi�l�t be present in the
designated areas of the buil.dings tl�at are plannecl fo�� renovation.
The irispection was iiiade, ai�d tl�ie sainp.(es were col.IecCecl by .Iohr� R.
Peterrrian, a.ii A.rl.�.R.t�.. and SCate o1' Color�do CerCiliecl As�eslos
Inspector. Great care w<�s takeri c:l�Yring tlie inspeclion and salnplin� to be as
aecurate as possible. It should be noted �hat ininimal clamage was clo��e lo
the existing building struct:�_ires d�.u-in� the inspection so lhere is no
documentation for uriseen conditiorls oi• stored iCenls.
All samples were analyzed by DCN[ Science Lab in Wheata�idge, CO.
This laboratory is deemed "Proficient" in the L?.P.A.Quality Assurance (QA)
program for the determination oi� as6estos in bullc materials, and is
accredited by the American I-[ygiene Association (AI�A).
SANiPLING Pl2.OTOCOL:
A random samp(ing scl�erne was used �o sample che s�.ispect rr�at.erials �ha�
were discovered. If during any fulure demolition or renovation work,
suspect m�terial is �iscovered that hasn't been sampled ancl ��ould be
disturbed, work sl�ould be h�Ited unlil the mate��i11 llas been tested.
3
A& D Asbestos Te�ti��g and Co�lsu�t�ng
John R. Peterm���
Asl�estvs"lestirr.�, P�•oject Desigrt, arad Corisaclting
The L�ndMarlc
610 W. Lioi�sI-lead Cii�cle
Vail, CO. 81657
BUILDING DLSCRIPTION:
The LanclMarli COI1SiSCS Oi�'two multi-st�ry buildings with a connecting
uncierground parlting garage. The'�'ower 13uilclic�g is lhe e�ist building willl
seven stories, �nd a gaz�age level. The Town I-Ious� liuilcling i��s single level
vnits oii Che firsl floor, and loft units oil lhe tip levels. Tliis survey covers
the inside of tl�e builctings. Tlie in[.eri�r walls are covered iii sheetrocic with
a ligh� texture, and wood paneling. Note: Ira sor�ae areas a textrire Iras bee�t
tro►veled nver flic� origi�tal finrsli. The ceilings are sheetrock witll a l�eavy
spray-on text«re, and twin t:ee concrete witli tlie satue spray-on texture. The
basemenc area l�ias suspenciecl ceiling t:iles througllout, and nlosl have been
replaced rlot long ago. Tlie olcler tiles wer.e tested in lhe F3ilty's Grill arcz.
The floors are covereci witl� carpel, ceraYnic tiles, 'ctI1CI Slleet Vl11yI f�00rlil�_
The slzeel vinyl was not tesled in this survey. The heat:ing is provicieci by
b�iseboard 1leacirig, �ind fireplaces. No suspect ther�llal syste�ii iilsL�latioil was
observed during tiiis inspection. Tlle �;arage ceiling 1-iacl a spr�y-on Cire
prooLing that was rnostly removed prior to this inspectio�i.
CONCLUSIONS AND R�C411��1VIr!;NllATI4NS:
Presl�rried Asbestos con�aining i�l�iterials, presenti in the i�ttiidings, are as
follows:
l . Spray-on cei.li��g texture
2_ Sl�eet vinyl flooring
3. L:�terior siclin� boarcl
�
A�Z D As�estos 'I'estiii� ax��c� Consulting
JO�IIl �. I���;e�'I11711
AsbE�st�,sTe,sti�tb>, Pr�jec,•l� Desig�i, cu�a.�l Cort,sccl.tirzg
L.aboratory Analysis oi tYie bulk sampl.es coliected du�-iti� t.11is iiispeclic�n
inclicate that Asbestos was detected in �ill of the com�osite slieetrock
samples_ IIowcvec, t:lie Asbeslos coiltent is less than t.11e Regulatozy Limit
(Greater than 1% As�esCos). rhe As�PSt�os coYlter�t of lhe sampies was
veri�iied by tlic Required Poinl Cotult Analysis. The samPles collected were
taken from lhe original areas of (.l�e builclings. If conclilionS are encountered
that are not the original construction, additional tesliug or documentation
may be required. li' the renovatioil work will. impact on tile tl�ree ��res�imed
Asbestos cot�tliriing inaterials listeci, I:he P.A.C.M. must lae handled as pez-
Colo. �eg. #8 prior to dist:�Yrbanc,e of �lae materiais.
s
Date: August ??, 2006
Location: The LandMark, 610 W. LionsHead Circle, Vail, CO. 8i657
SAIVIPLE LOCATIONS
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1S
20
SAMPL� iVUMBER
LM-3
LM-8
LM-8
!.M-B
LM - B
LM - B
LM-B
LM - B
!.M - �
LM - B
LM - 6
LM-B
LM - B
LN1-B
Ltrrl - B
�M-B
�M-B
LM-$
LM-S
LM-8
041
On2
OQ3
004
OQ5
aa�
oa�
.riQ&
£}Q9
010
0� 1
C12
�13
�14
015
416
�17
(}18
0'i 9
C2�
AREA SAMPLE RENiOVcD FR�M
Garage Ceifing By Lok�by Entrance
Garage �ei(ing By S. �xit Door
Garage Ceiiing By Entry Gate
Lob�y Area Biffy's Crili
Loiaby Area 3iily's Grill
Lobby Area �i11y's Griil
Tawe: TM7G� �hl. Bedroor� Cfosat
To�rer �6�1 �. Bedro�m Clcszt
i owec'-.`5Q4 Upstairs W. Be�room C(oset
Tower r402 E. Bedroom Closet
Tower �3Q5 �Y. Bedroorn Closet
i ovrer n�a3 E. Bed: oorn C(oset
Tower n10'i W. Bedroorn Cioset
� awer �13 Vi/. 5ec:r�crn Cics�t
i ower R27 tl�stairs PI. Se�raor,� Cios�t
Tower n11 Haliway �tarage C(aset
Tower n25 LJps.airs S. Bedroom Cfaset
Tower n18 1�iain Fioor be�room Closet
T. wer �2 c. Sedraorn Closef
Tower #+5 i-ial;wGy C(osef by Kii�hen
DESCRlFTI�t�
Spray-on Fireproffing
Spray-cn rireproffing
5pray-Qn Fireproffing
Ceiling Tile
Ceiling Ti1e
�eilir,g � iie
Composite Sheetro�lc w/Lt. Texture
CornposE#e Sh��trock wlLt. Te�ur�
Carnposit= S!�eatrock w/Lt. Texture
Cornpesii? ahe�trock w/Lt. Tex:ure
Composita She�t,-ock w/Lt. Texture
Cornpcsi�e S�eeirocic w/Lt. � exture
Compcsits Sheetroc� wlLt. Texture
�o:n�osite S�:eet; a:.k wlL;, i ex#ure
Cor;�p�s�fe S�e�;rack w/Lt. Tex�ure
Cornposite S�eetrock w/Lt. i �xtur�
Compesit� S�es�racic v4r/Lt. Texture
C'Jiil�?OSEic She�:rock w/Li. Tex:ur�
Composife Sheetr�ck w/Lt. Texture
Cornposi�= S�entrock w1LL. i exture
FRlA,BLE
YES
Y�S
YES
YE�
YES
Y�S
NO
NO
NO
h! Q
�d Q
[� O
�O
NO
NJ
NG
�0
�a
NO
�a
Qate: August ??, 20Q6
� Location: The LandMark, 610 W. LionsHead Circ{e, Vail, CO. 8�657
z
SAwIPLE �2.EStiLTS:
i
2
3
�
5
6
7
8
9
10
11
12
13
t �{
i�
�5
17
�8
19
20
KEY:
0
�
J
:
�
:
J
)
J
,
� •
SAM°LE NUMBER DESCRIP i ION
E.M-6
LM-B
LM-B
LM-8
LM-8
LM-B
LM - B
LM - B
LPIi - B
!PJI-B
Livt - B
LM - B
��n - a
�.� � b
��/9 - a
LNi - B
LM - B
LM - 3
LM - B
LlUi - B
oa�
402
Oi13
oo�
0�5
0a5
007
OCS
00�
010
Q11
Q12
O1J
�; i �
��5
Ci6
017
Oi8
�3 i 9
QZQ
Spray-on Fire�roffiing
Spray-on Fireprafiing
S,pray-on Firept'offing
Cei(ing Tile
Ceiling 7ite
Ceiiing Tiie
Composite Sheetrock w/Lt. i ex�ure
Corzposite Shestrock wl! t. Tex}ure
Composite Sheet�ock wlL:. T�xture
Compcsiie Shestrock w(Lt. Texture
CoRtposite Sheet: Qck w/Lt. T�xt�re
Cornposife Sheetrack w/L:. i e� �r�
Co�posite Sheetrock w/f.t. i �x�ure
CG�i��}OSlta Site�tTOCk W/�t. i °„:L�i?
Cor�posiie Sheetrack w/Li. i e�tttre
Composite Sheefrock w/Lt. iext=.:re
Composite Sheetrock w/Lt. �"ex�ure
CompositQ Sheetrock wlL�. TexLure
Ccr�posite Sheetrock wlL�. T�xture
�omposite Sheetrock wlLt. Textur=
�HRY - Chryso:i(e
t�AD - t�o asbestos Det�cteci
PC - Point Cou�: Ar�alysis
asaESras ��r�E
t�a�
N�D
N��
t3Lt�
NAD
[�A�
C;�RY/PC
CHRY/PC
CFi�Y/PC
CEiRY/?C
�HRYlPC
CHRYIr'C
�F#RY(PC
�� :RY!?C
�.+i"7:r'�i i�! :'� V
CE-?RY/PC
Ctit�l`IPC
CF:RY!PC
C�RY/?C
CKr`�.vIPC
°ia
o.�o
o.o�
Q.�O
t?.00
0.�0
�J.flG
£i.01
Q.02
a.o�
0, 01
0.�2
0.01
a.c�
�.��
4.G2
fl.02
Q.02
�J. J1
O.QZ
0.�4
Date: August ??, 2006
Location: The LandM�rk, 6�0 W. LionsHead Circle, Vaii, CC�. 81E57
POT�NTi�L FO� DISTUR�3ANC�
Samrie Numt�er Accessibility
yes/no
1 �M - B 001 YE5
2 z� - a ooz Y=s
3 LM - B 403 Y�S
q LM - S 004 Yc5
5 LM - B 045 YES
6 LS�i - B OOfi YES
7 LtU1- B 0�7 YE�
8 Lfltl - 8 OQ8 YES
� LN� . B D09 YES
t0 LM - 6 410 YE�
4 i LM - B 011 YES
i2 LM - B 012 YES
i3 LM - � �.i3 Y�S
e� LRII - B �14 `� c5
1� LM- 8 4�5 YES
f8 Lf�i - B ��6 Y�S
�7 LM - 8 O�f l Y�S
i8 LM - B 018 YES
�S LP�i - 8 c�i9 YES
20 Lt�h - B �Za Y�S
K�Y;
�IIOD - Modera�e
P�tential
contact
LOW
zow
La W
MOD
MOD
t�oa
HIGH
HIGH
NiGH
HIGN
HIGH
:-3{GH
u�G,y
�iIGH
ri1CH
HlG�?
HiCH
��}GH
HiCii
fi1GH
Influence
vibration
LOt(ti
LOW
LOW
LOW
!.G W
! 011+�
LONI
�OW
LOW
LOW
LOW
!.0 W
�OW
LOW
GO4'Y
LOW
LOl1Y
LC7t+V
LOW
LOW
F�otentiai
air �r�sion
�.C711V
LO W
�aw
L01A�
LOW
L�YV
LOVY
LQ�1(
LOW
LaW
LaW
E.a1+Y
E6W
E o�v
L�W
L01+Y
LOW
LOW
�av�
LOt�'V
Located in Pfenum
yeslno
[V �
NO
rvo
NO
�i O
NO
NO
NO
NO
NO
NO
h!O
NQ
NO
NO
NO
NO
NO
NO
NO
Date: A:�gust ??, 2Q06
Loca�ior�: The LanciMark, 61 Q t�N. LionsNead Circle, Vaii, CO. 81657
SUSP��T NT�.TE�.A.L C��i�I�'IONS
S�ti4PL� Nt1MB�R TYr:. OF SUSPECT
MATcRiAL
1! M- B 001 St3t�
2 LM - B GQ2 SUR
3 LM - B a�3 �t1R
4 LM - B Q04 �t1ISC
� LM - B Q05 MlSC
6 LM - B OOo �ISC
� �E,� - s o07 su�
� LNi - � 008 St�R
9 LAt! - S DOa S�lR
1C LM-B Oi0 St3t-�
1 i ! iVi - 8 011 S;3R
12 LM - 5 �12 SUR
13 LM - ss 013 SL�R
�4 L�J� - B �14 ��.��
�5 Lh1 - B 015 SUR
10" LA1i - B Q16 �UR
17 L�i - � 077 S�1R
i 8 LM -� 018 Sl�R
1� Lf�1- 8 Oi9 SU�
2�? LPUf - B Q20 5:3�
K�Y:
SUR - Sur�acirg
MfSC - Miscellaneo�:s
PHYS - FhysicaI
OV�R�` LL CC�IQ{TiON QAMAG�D % TYFE �r= �JAMAGE
i�GOR
POOR
POOR
caoQ
GGGD
�OOD
u00D
�CGQ
Goo�
GOOJ
�00�
r'aOR
��o�
rC�R
�oo�
GC1�D
G^O�
GOQC
G�JO�
cooa
YES
Y�S
YcS
NO
t� O
�ta
Na
NO
r�o
NO
i� O
��
�o
u0
rao
NO
NO
t�;3
�t0
ho
iG�.Qu Fi-�YS
� 00.00 PHYS
? 00.00 PHYS
Q.4Q tv/A
�.00 hE/A
�.00 NIA
G.00 t�d/A
Q.QO lvlA
o.oc wa
Q.00 t�/A
Q.OQ hl�A
0.00 t�tlA
a.00 wa
C�.fiO !�/A
o.00 nua
O.OQ �V/A
G.pO N/A
(}.�0 N/A
Q.O� N�A
�.ao ��A
��
� ,
^+ _ • , � DCt�i SCIErICE [�ORATORY. MC.
�[`' 12621 W. 49TH Al'Ei{U� WI'I IIb
'NHEAT RIDGE, CC 30017 (39:) 4G3-82:C
2
�
L^
C.;
C
C�
:D
4'
�
C
T�
.:1
Q
J
C�
c
c
a,
U
��
r
L:
Q
� �
N
M '�
:v
O �
" �W
� y
�
ti
�
O �
3
Q �
d
G;
CLSETIT:
A& D ASSe'STDS T��'G gCONSULTi'�:G
6:3 35 ira �p,v�
PAL,lSADE. CO 815:6
I7CMSL CLI�'?'
SANiPLE SP.MPL�
1TJM36R T�'UT.4Bc'R
� LM•8-D01
-? :.M-B-OG2
� L!v{-i3-0'J�
.4 LM�S-Ox
•5 !1vE•c•OGS
-6 t_#�f-S-0O:
.7 '.,bt-FrCOi
-E LM-S-COf�
BUI.K ASBEST� TEST R.x'GRT
PAG� � OF 5
,4NA1.YS15 DnTE: 8-25-96
FiEYOATiNG DA?E: 8-28-06
RSC�L"T Cr. i �' 8-23•65
CL1ENt )OB ?t0.: 7"He LA�'.+�ul1tK
PRUJE.,�':'T�71E: Et0 tV. LIOTiSY.EADCR. • V,4(L, CO 9L6S7
DChf51 PKOtFL7_ ADAT2B9
P: R�AGr. C]3�iPCSf i ION HY V1iUAL ES': JrSnTc'
$�Pi.c
DATE D�SCR1PilON
3•�2•06 A. GR`YFIEROUSM1ULTiC�t,OR�
Da9R:5 (i}
g_Z?-Jfi i:_ GR:YF73ROl"t54YlULTi��7'iO�D
D'cPR'.S (I)
8•Z?-0C A. GREY r'�ROUS•CR: t' F.=S^'i (�
8 �?-06 A. W"d:TB PATi�IT
B. i F,N P:.R:.1TiC C5I[�NC� 17_c
&•i2-06 A. WHITE PiL'?!T
s. axor�x c�Ltr��� n�e
S-2_-06 n. WHIF= FAINi
E. ': At` F�P1177� C'r:ILC`v T.r E
8-.'2-QG A. WH(i'EPA.T(T
t
B. �VilCi'E CRYw'ALL NFUD
t:. TAPI FIHP.QUS
n. w[�t���xYw�,�i:
x•2't-uo A. 'vktY LRi`1%rnl.i i�rivt7
B. H'HIiE' PAfN7
C. w'H1 i c DitY1YAL.L h1UD
II. T.qh! F16RJUS
E. lYH f iE DRY 5V ALL
���( �
70i/� PFf
?ERCc:�f: ASBESTCS ASBFS7'aS CTI'�I:,Tt:IBY.O'�S ti0?J•FIB�'.OUS ID
Of SADtP"_E i„PE Af+r'vE •ro ;T SAAIPLE COPIS7T'UE^�I'S C3NJ'I-i 1'UEHTS tYL
f00�1Y t�D 90�� 1n.Q
ND
100 Y.: A'D 94.0 6.0
_ �
100.�% ND �.fl ?�.`�
1vt�
]D% ATD l.R :Q0.0
57D% ND 'S.0 ZS.O
u�
slY�:, ND 0.0 1oD.0
964.e ?J D ) C4.0 O.0
Ni.�
2D°.o h�TJ G.0 ]�0.0
98A% ND i3.0 27.0
��
2.o-:b ND 0.0 I00.0
2.fY.S C[-�3tYSOTiLE �IR•l} Q.5 U•0 99.5
;p , Vp lC0.0 U.0
42 C°: kD _ 1.0 99.0
<o. ;
� . ,a •S: ,j.O 7 (.�1. tl
I.OS. ND Q.0 100.0
3CY< C.�-L'.YS071LE �R-!� 0.5 OA 99.5
12.EPh ND 14''v.G o."v
8:.0'3'0 l�D TR 10U.0
�0.1
SBc�OS IcST1NG & CDN5l1[.TING
!4 RGA D
D� CO 815'_5
SAMP! z
D�TE DESCC?i"30N
8-2�sti A. wtii?'� DRYwA..L h{:ID
3. 11r�?� PAiNT
C. TAN FIBROL'S
;J. WH17'iDRYWk_L
F-:2tib A. 1V:i1Tc PAiN i
Fi. l'Jh� i c DRY14/�� !.4;jL
c =aa �a�ous
a. W_�itlE DRYIYA:.L
8•Z�•OG A. TAN P.�I�'�
B. WHIT_DRYWA:.�;.{UJ
C. TA,ti RBROL'S
F'i W3-itT'eDRYWrI�L
8-L-06 A. id'Fil'i c PAlNT
8_ YrHITEDRYWAt,l. MUD
C. 7AN iJBROUS
D. K'I�4FEDRYWALL
8-^i-Co A. WHiTE PAI2��T
S_ �`Nii= rjRYWq;,L 4;UU
C. TAN FtBRO��S
v. J:riiT_ Dn'i i7r.iu
DCM SCiE?(CE LABORRTOP.Y, CNC.
t7.�t21 W.4STH AVENUE, Liv(T KG
WHFAT R(DGE. CO 89031 (30J ) 4b3•82 iJ
BLLK ASRFSFGS TEST R5?ORT
PAGb2 OF S
a�AL'tSISDATE. a•25L6
RbPOF.TiNG DATE. 8•iS-06
�EIPT DATE: 8-�3-06
CL!�*fT JOB N0- i riE LA.^�M/tft}:
PROJEx.-i'FITL�: 6)U 1V. L:�:�SY.F.n' OC2. - VnU.., CO 8i617
DChiS:PROJ'eCT: ADa;285
PERCf1`]TAGE CGM?CSLTION 6Y VLCUAL FSI1hiAT�
�' =� i . -
70TA1
TCTAL PERCENTAGE
PERC=_t�IT :."BESTUS !�SSE�i05 C7H'cRF1BROl;S NON-PlBROItS iDcK7Ir"lcD
Or'SA.4L°.= ??'?E kf�Nv'c °/. STiSAMPLE CONST7TU�TS CON�fTU'?175 h4A7=R;tiLS
ID% CNFYSOTII�'-. �'R•:) :.G 9.D 49.0 100.0
2.L"/. NU J.0 IflG.O ]020
' SD'h *ID 1 CpA 0.0 1UO.0
826'/e t�T :.0 99.0 100.0
<n. i
ID% ND �.0 I�D.fl Ifln.O
�!Y/o C.'-�'.RYSOi�(.E i?R-if OS .7.0 99_S 10�.0
�sn�i :v� ►�.a oa �ao.o
r_a�� rru �_o ss.a ioo.o
�. i
2fYi6 I�[!) 0.9 I�JA IOQ.Q
31I'/ Gi"r.YS�T:LE [Z'it�l� I.0 6.0 s^9.0 t00,6
ifY.: ND ](n.0 0.o t00.0
4�.C/o 1�D Fit i^v0.0 t00.0
Cl..t
I D°:o !FJ D.0 :OOA JOOA
2iYy C:iP,:50I�it fTR-S i f.0 0.0 44.0 104.0
bA% ND 1?�.0 0.0 }oo.0
91 A9e ND 1.0 99.0 IOO.0
� <a.�
: C90 ND 0.9 1 p0.0 100.0
4.0�: C4F1'S071LE �TR•1j 0_i • 0.0 99.i 1U0.0
12.9% Np IC(!.0 C.0 TQ0.0
82v.- .... ..., 5:'.t !_..,
�. I
TO?.3L
�RCENT.:GE
iDEN-iF1EJ
Kar-_zu� s
1 �)0.0
i K.0
( �t1.0
�oa.a
1QO.G
tc�.o
�oo.o
roo.o
0
c
�
TGT t.
:RCEh?AGE
D`T�tTL4lcD
ur�;�,�L;
i09.G
lOD.O
i0Q.4
ioa.o
1!?0.0
ica_o
too.o
! 00.0
lOD.O
! �Q.O
I�O.Q
I�0_D
1•3^.0
1•30.0
140.0
���o.o
1 �xI.O
1 iR7.0
! �#�.0
� uo.o
, . e�uLK nS�ESTOS �WALYSiS - POIN�r Cc�uNT MEi'NOD
i�nce: � or• 4
CLIENT: nNALYSIS DAT[;: R-31-06
A&� nSt3ESTOS 1'ESTING R[t'ORTt1JG U/�TE: 6-� i-OC,
65] �6 Y/1 t20AD Rf;CEIPT DAT�: 8•28-06
PALlSADG. CO 8152G CUENTJ08 NO.: TI�l� LA�IUMARK
PRO.�PCT Tft'LE' 610 W. L(Or1Sf{GAD CR, • VAIL
DCMSI. PR�>1GCT: Au�i'290
CROSS RCFL'RENCE: AC�AI'289
PGRCF:NTACL COMPOSIl'IOTJ F!Y ARh;��VOLU�1t::
DCM (_nD tJO.: -I -2 -:t -A
SAMPLG DA"1'E: 8•1?-UG 8-12-D6 F-22•OG 8-22-UG
°/� OF TQl'AL 5AMPLFt 2.030 3.0"/e l.l)"/0 2.0°/a
CUEN'I'NO._ lM-8•U117 LM-(�-006 I.tvl-l3-OQ9 LA4•U•UI(>
N.nR7' D PAftT C PAR"I' n PAttT B
nSBL•STtFORM MINLRhL FIi3ERS:
r1�RYSO'fILE 0.25"/0
AMOS1't'E ND
CROCIDQLITE Np
TIi eMOLITE•ACTINOLITf NI�
nNT��IOPHYt,LITr Nr�
TCn'nL A5�LS70S COUNTP_D U?S°/
"1'OTAL ASt9ESTUS IN !•AYER f1.25°�
l'OTAL ASDf:S'fOS iN SAMpLE Q•01%
hOTF,S; SA'�iPLF,S NO. I- 5 AitG WHfTE DRYW�LL MUD.
ND - NONE DGTFCI'E1)
TOTAL AS(3ESTOS COUN"t'ED a
TO�rn[, nSB��TOS �N LnYER =
TOTAL ASBESTOS IN SntvlFLE _
DGI�1hlIT1UNS
b 5 0°/
ND
ND
Nb
Nl?
0.50°/u
�.SO%
().02�ti
n.�s^i,
r� o
ND
tJ p
ND
0.75'/0
0.75%
U.O 1 %
ats��o
��
r�in
NU
NV
0.2 S%
0.25%
0.0 !'/e
.S
5-22•06
:i.l)'%
Ltit-fl-Ql I
PnRI' B
TIIE AMOUNT OF ASEIESTOS PR6SENT iN "Ti1G SAti1P(.F.. EXPRfSSGO
A5 A 1'L'•RCENT.
1'{1F t`[!nCGNT Of :�AMP(.E REtvlAiNfNG TIMES ASL�C•S1'OS COUN"1'ED
EXPiZE55f:D nS A PEEtCL-Nl".
71{6 Pf.=RCENT Of TC)TAL SIIMPLC (FR(?hi }'LMlS{�i ANA�,YSIS)
r(MBS TIIE TOTAL nSBESTOS IN LaYEIt (11� NO AS�ESTOS IN
U1'HL•:tL LAYF.kSj.
� ���
n 75^i,
NU
ND
ND
ND
t).'7$ °,�o
0.75°�6
iL02%
6
�' d L9�t3E9bE0E qe-� i�ua � ag tJJt[ eEE : O T 90 [ E ��H
. __.� __
OULK ASBESTOS AN�LYSIS - POINT COUNT ME'THOD
' PAGC 2 OF 4
GI.IENT: nNn[.1'SIS DATE: 8-31•UO
a&U ASDFiTOS TGSYING RENORTING DATE: 8-11-UA
b5.t 36 !/4 KOAD RLCGIPI' DA"�L: 8-28-06
PAUSADE. CO RIS26 i:uGNT'10a ti0.: �rlte LnNVM�R�
PRO)ef,'I' TI'fLG: 610 W. l.IONSiiG�U CR. - vAiL
OCtvtSL PKn1ECT: nDA"P290
CROSS REFER�Ni:L: Rnn ra89
1'f:RCETJI'AC�� COMPOSETION IlY AREA/VO1_UML•
UCM LnBNO,: -G -7 -8 -�
Cp1v1f'tE DA7G� 8-22-UG 6-?2•06 8-22-06 8-2Z•04
�ro <>r rorn�, S,nMPLG; Z.oaia �,u;� <►.o.o �.u;o
CLIETlT tv0: t_M-B-(ti2 LM-(3-O{3 LM•E3•014 LM-f3-415
YART D i'ART (S PaRT D PnRI� [1
ASt3ESTfFORh1 MIUE(tAL fIBERS:
CtIRYS�TI LF.. 0•5��%'�
nA10�iTF �'�U
CROCIUOLI"1'E 1�IU
TRGM01.17'E-ACTINbC,lTG ND
AN 1'HOPHYI>uTE ���
"I'OTAL ASI3ESTOS CUUNI'LD (� 5�"/�
'I'O'fAt AS�iESTOS ltJ t-AYER �•?�"�>
TOTAL ASl)ESTOS IN tiAh1PLE o.ol^ro
NOTL•S: SnMPLrs NO. b• IU �R� wlllTr: GRYWAL� �tUD.
ND - NONE UCTF..G1'ED
TOTAI. ASDFSTOS COUt�'rE6 =
TO"fAL ASdGSTOS IN LAYER -
TO�'AL nS�GS"1'OS IN SAMPLE w
p�fINITIUNS
0.5 A'/�
r� n
ND
ran
!V D
1}. SO%
0.50%�
(1.02:n
0.2590
TY U
ND
;� u
t�+U
O.ZS%
0.25°/a
(1.0 i"�
p.75%
iJU
V l�
ND
tJU
11.75%
0-�5°/
O.U'!",�.
-Ip
a-22•4G
^.0°,G
i,M-e�oi��
PAR�I 0
E�.75%
ra�
ND
ND
Np
0.75%
�1.75•h
0.02!/„
'TN� AMOUNT OF ASDGSTOS PRESEN7' IN TFI� 5AMPLC PXPRESSCU
�5 A PCRCENT.
THE FGRCBT�"i'Of SAh1PLF: RGh1AMlNG TIMES ASBGSl"OS COUN7t1}
fiXPRLSSGD AS A PERCENT.
'I'HC PfRCF.NT OF TOTAL SAn1PLC (FR(�M PLM/SM ANALY$IS)
'T'lMGS TI i� TOTAL A58E-"+TOS IN �.AYER (lF NO ASDGti��'t)S IN _�� -----
o-r<<�cR �nvFn;;�. -_��-.--------
����
6
E'd L9�(3E91�GOE q�-I a�u���S W:](I ��E�UI JO TE �ntl
bI'd �IE;�OT 90 90 da�
,
17,d21 W. 49T11 �VBNU�, UNI't'qb
WIiEA'C RIt3GE. CO R0013 (?0:�} 461-8274
t)UI.K ASF�L'Sl'05 ANALYSiS - POIN'C CfSUt�"1' ME'I'l lOD
vnGB 3 Or a
CLIENT: ANAI.YS(S DA'1'G: B-,l I-(1G ..
A&D AS86S'fOSTL-STING REPOftTINti DATE: 3•3l-UG
6S1 l�i 1/4 ROAD CIECEIPT pA'fG: b-2�-��
PnUSnDti. C:Q 81526 CLIENT l0� NO.: t ti� LArvuM�RK
pF�p.IGCTTI"TLE: G10 W. LlONStIFAU CR. - �Alt.
C�CMSL PROIECt: ADA1'?�t1
(:aoss k6FERerv�t� n[��rZa�
PGRCEi`'CA(iR COMNOSfIInN E3Y ARl'.A�vOLUMi3
QCM LAB NO,: -I1 -12 -13 -14
SAMPLG D�"rS; F-?2•O6 R-22•0( 8-22-06 R-2�•OG
%OF'TOTAL SnMPLG: � 0"/a �.ii�r� i.U°i� 7-f�io
C1,16NT t�0.� L�•i-[3•Ol7 I.M-B-OlB LM-E3•019 LM�E3-020
PAR7 U NART � FAR'i' A PART C
ASBES�'fFORM,�SINPRAI_ F(DERS;
CHRYSO'fILE 0.75%
ncv�aslrE r�u
CROC:IDOLITE ND
TREMOLITF AC1'1NOLI7� M�
ANTt�OPFiYLLiTE NU
TOTAt, ASBESTOS COU?�TGU � �S°�^
TOTA1� ASBESI'OS IN I.AY6R 0-75%
TOTA1, n58EST05 I1� Snt�l�Lt �����'-%
NOT£S: SAMPLGS N0. 1 1- 14 ARE WFUTA. DRYWALL MU�.
ND • NONr DET6C'ffl�
TOTAI. ASaEST�S COUN"fED =�
TOTAL ASBCS'i'()S tN LAYLR �
TOTAL ASBESTOS IN SAMf'LL =
DEF[NI'TIONS
I.OQ%,
NU
ND
r�o
NU
I .p0°,�
I -00%
(1.01 °/n
t .�5°i
1JD
T�D
��! D
ND
�.75%
I .75%
�.112%a
0.50°/
Nn
N t�
Nn
r� D
O.SQ%
0.50%,
p.(14�,�
THE AMOUNT Or !�S(3GST�S PR�SENT IN'1'fiB SA�vtPLf: EXNRESSED
nS A !'�RCGN'P.
"f{-16 I'k:RCENT 0� S�MPLE RENiAINING 1'rME5 A5[3CSTOS COUNTG�
EXPR.ESSG� AS A PERCENT.
'1'I�L� PERCENT Oh �CO'�AL SAMi'LE (FROM PLM/SM ANAI.YStS�
TIMES 7'IIB 1'OrAL ASDCSTUS tN LAYECL (tf Np n5�BSTOS IN
OTFICR LAl'CR;I. _—
� � � " �� - ----
�, • d L9�8E9bE0[� qe� aoua t aS W�Q
Si'd
m
�EE � () I JO T E �nt1
eTE �fli �ln Un da
!_ _ ���
�:� s �� �� ) Asbestos Testing t� Cansuiting
;,-,��,Tr�,,,<,«.,��- ��,,.;,,,� �,��.r,�„� c��,��,�,�,�:r��s;,��s,�,.T,4��<<r.s .Jahn R. Peterman
Testiug • Project Design • Consulting P.�. BOY. 123Q
� ;Clifton, C4 �1520-1230
' John R. Petecman
(970)-l6�-5265 P.O. Box 1230 �
Cell ;970) 270-3689 Clifton, CO. 8 1 520-1230 ,�•
- _ __- ._ . � . ' _ •_ , f .
ADDRESS
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CITY, STATE, ZIP
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DATE DATE REC�UIRED TERN]S
8
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SH1P TO
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ADDRESS
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HOW SHIPPED ' REQ. fVO: OR DEPT. FOR
QUANTITY - DESCRIPTION
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1MPORTANT
- PLEASE SEND COPIES OF YOiJR lNVOICE kUIT}-
PURCHASE ORDE� NUMBER MUSi APPEIIR ON ALL ORIGWAL 81CL OF LADING.
1NV010ES - PACKAGWG, ETG. " —
PURCHASING AGENT ,r�
PLEASE NOTIFY US 1MMEDIATELY IF YOU ARE UNABLE �y ¢� � , � ;-
TO COMPLEfE ORDER BY DATE SPECIFIED. ,�f�-' �-�-��1,�„ r �' �.�„�.Y �,,{;� �• '., •,
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B10-0285 : Entries for Item:90 - BLDG-Final 14:41 01/14/2013
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