HomeMy WebLinkAboutB10-0144 Inspection Items for B10-0144 14:46 09/16/2013
Sec Item Id Descri tion A r Re Items Action Inheritable
10 BLDG-FOOTING Yes O 1 PA No
* 20 BLDG-Foundation/Steel No O 0 No
* 21 PLAN-ILC Foundation Plan No R 0 No
* 22 PLAN-ILC FRAMING No O 0 No
* 30 BLDG-Framin No O 0 No
50 BLDG-Insulation No O 0 No
* 60 BLDG-Sheetrock Nail No O 0 No
'� 70 BLDG-Misc. Yes O 2 AP No
535 DIA-30 DAY REMINDER No O 0 No
* 536 DIA-SITE/LANDSCAPING No O 0 No
* 90 BLDG-Final No R 0 No
Total Rows: 11
a
Page 1
NOTE: TH/S PERM/T MUST BE POSTED ON JOBSITE AT ALL TIMES
.�
TOWN OF VAII, '
Town of Vail, Community Development, 75 South Frontage Road,Vail, Colorado 81657
p. 970.479.2139, f. 970.4792452, inpsections 970.4792149
ADD/ALT MF BUILD PERMIT Permit #: B10-0144
Project #: PRJ10-0020
Job Address: 1817 MEADOW DR VAIL Status. . : ISSUED
Location......: UNIT 6,CAPSTONE TOWNHOUSES Applied . . : 06/23/2010
Parcel No....: 210312304006 Issued... : 08/09/2010
Expires . ..: 02/05/2011
OWNER BOYMER, ROBERT JAMES 06/23/2010
PO BOX 1001
VAIL
CO 81658
APPLICANT BOYMER CONSTRUCTION 06/23/2010 Phone:970-476-2958
POBOX1001
VAIL
CO 81658
License: 152-B
CONTRACTOR BOYMER CONSTRUCTION O6/23/2010 Phone: 970-476-2958
P 0 BOX 1001
VAIL
CO 81658
License: 152-B
Description:
ADDITION&REMODEL INCLUDING CARPORT, ENTRY STAIRS
Occupancy: R2 Valuation: $56,000.00
Type Construction:VA Total Sq Ft Added: 337
................................................................................. FEE SUMMARY .._.........,.....,,............_._......,......,...,....,.,,...._..__.+,......,
Building Permit Fee------> $685.75 Will Cal Fee---------------------> $4.00 Total Calculated Fees-------------> $2,291.39
Plan Check--------------------> $445.74 Use Tax Fee---------------------> $920.00 Additional Fees-----------------------> $0.00
Add'I Plan Check Hours-> $0.00 Restuarant Plan Review-----> $0.00 TOTAL PERMIT FEES--------------> $2,291.39
Investigation-----------------> $0.00 Recreation Fee-----------------> $235.90
Payments-------------------------------> a2,291.39
Total Calculated Fees--------> $2,291.39 BALANCE DUE------------------------> $0.00
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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 all 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- • PM.
i
Signature o w r or Contractor a e
Print Name
b Id_a It_co n stru ct i o n_pe rm it_041908
f*4iit�tXwkR�ikf��frtf*�t4lxe}wkYkf4���l�wff�k��fffflww����M�lRRfNRwffffif*+*ffftwwwww#k��f!!f�#*wtwwfi�444�xfi##�R���k4*44xwxtftf+�44t#�flRkwwwf#�44�fttff}R��k#kwwftlftff�ffi##kNwfY��
APPROVALS
Permit#: 610-0144 as of 08-09-2010 Status: ISSUED
.....................................................................................................................................................................................
Item: 05100 BUILDING DEPARTMENT
07/08/2010 cg Action: CR sent comments to
applicant. see laserfische
08/05/2010 Martin Action: AP
Item: 05400 PLANNING DEPARTMENT
08/05/2010 RLF Action: AP
Item: 05600 FIRE DEPARTMENT
06/24/2010 mvaughan Action: AP monitored fire
alarm system required.
08/05/2010 drhoades Action: AP Revisions dated as
received by TOV on July 21, 2010 approved with same
notes/conditions as VFES approval done by MLV on June 24,
2010.
•xxt'4'ky'/fte�ff�f4twYrYlYl�4fffttMi4i1'/f�4fffrfrfMYlrtffflflttt�FRYrYrrt#ilffLffY4RfiY`YI�F�k4#1(#*ffA�4hYYrYrMftf`44fR4xfrkhYrYl�k1(4il�t��Rt'knrt�k�kililir/rlex�rftM�RY4i(i(f`t4tfpf'RtRhR#f4�kiliFYr��trXlr�RfkY'fr�kfifi(#i#�!R V f#fY'ffY44t4�
See the Conditions section of this Document for any that may apply.
bld_alt_construction_perm it_041908
..............................................................................................................................................................«.,.,.,,...,,..,...,.,,
CONDITIONS OF APPROVAL
Permit#: 610-0144 as of 08-09-2010 Status: ISSUED
..............................................................................................»».......,......,......,....,,..,,,,...,..............,..,.....,,.......,,.,...........
Cond: 12
(BLDG.): FIELD INSPECTIONS ARE REQUIRED TO CHECK FOR CODE
COMPLIANCE.
Cond: 14
(BLDG.): ALL PENETRATIONS IN WALLS, CEILINGS, AND FLOORS TO
BE SEALED WITH AN APPROVED FIRE MATERIAL.
Cond: 1
(FIRE): FIRE DEPARTMENT APPROVAL IS REQUIRED BEFORE ANY
WORK CAN BE STARTED.
bld_alt_construction_perm it_041908
*************************************+***************************++********************+++**
TOWN OF VAIL, COLORADOCopy Reprinted on 08-09-2010 at 14:28:07 08/09/2010
Statement
�**************+*************�*******+**+************************�**+**�********************
Statement Number: R100001015 Amount: $2,291.39 08/09/201002 :27 PM
Payment Method: Check Init: JRM
Notation:
-----------------------------------------------------------------------------
Permit No: B10-0144 Type: ADD/ALT MF BUILD PERMIT
Parcel No: 2103-123-0400-6
Site Address: 1817 MEADOW DR VAIL
Location: UNIT 6, CAPSTONE TOWNHOUSES
Total Fees: $2,291.39
This Payment: $2,291.39 Total ALL Pmts: $2,291.39
Balance: $0.00
*****************************�**************************************************************
ACCOUNT ITEM LIST:
Account Code Description Current Pmts
-------------------- ------------------------------ ------------
BP 00100003111100 BUILDING PERMIT FEES 685.75
PF 00100003112300 PLAN CHECK FEES 445.74
RF 11100003112700 RECREATION FEES 235.90
UT 11000003106000 USE TAX 4% 920.00
WC 00100003112800 WILL CALL INSPECTION FEE 4 .00
-----------------------------------------------------------------------------
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BUILDING PERMIT APPLICATION
Separate permits are required for electrical, plumbing, mechanical, fireplace, etc.
Project Street Address: Office Use: � `
����,1 c�.����4�.`' �P Project#: P�cJ I O— �/�
(Number) (Street) (Suite#) DRB#: 1`�1�O�Q�S 3
BuildinglComplex Name• � __ T I�-��L Building Permit#:�j`d — � � �l�
Contractor Information:
Lot#: Block# Subdivision: -
Company:� , ���� C�
i
Company Address: P[�. ����'�� Detailed Scope and Location of Work: '�1'1 l D� ��� ;
City:��L�� State: (�� Zip: '� �
Tr 3
' Contact Name: ��. ���L�S� '
. �Contact Phone: ��C'CJ. � -�L�-1 �
�
� (use additional sheet if necessary) �
E-Mail
Work Class:
�Town of Vail Co actor Registration No.: ���g � � �� �� P � ) Other( ) 1
New Addition Remodel Re air
t
j X � Work Type �
�Co ctor Signatur r quired) Interior O Exterior O Both(✓� '
Property Information Type of Building: �
Parcel#:?I O�( ��(�`�1"(/(JCp Single-Family( ) Duplex( ) Multi-Family(� �
(For parcel#,contact Eagle County Assessors Office at 970-328-8640 or Commercial Other
�visitwww.eaglecounty.us/patie) � � � � �
�Tenant Name: Does a Fire Alarm Exist? Yes( ) No(� ;
� Monitored Alarm? Yes( ) No( ✓� ?
Owner Name: __ ��t�•��s �l/��i-� °
�[- Does a Sprinkler System Exist? Yes( ) No(,� j
�Valuations(Labor&Materials)
#8�Type of Existing Fireplaces: Gas Appliances
�� Gas Log Wood/Pellet Wood Buming� �
�Building: $ � �.
� #8�Type of Proposed Fireplaces: Gas Appliances �
�Plumbing: $ ��'j_� Gas Log Wood/Pellet Wood Burning� �
( ___._ ._--_. _.__. -- ....--. . _ _....._.._. .._..�
Electrical: $ � OOr�, ��
Date Received: � � � � � �
Mechanical:(including fireplace) $
Total: $ ��� � D
I-_-_--._ _. __._ __ _ . � JUN � 1 2010
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_.----------
I h 5ura n c.,c_ e,sc� TOWN f�F VAIL
- ay-10
't �
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� � � H E RRO N� Phone(303)763 9639
f Enterprises USA,Inc. Fax(303)763 9686
` � E-Mail Lennie.Herron�comcast.net
` Hazardous Materlals•Mold"Asbestos*Lead Paint Website www.HERRON-Enterprises.com
� _ Environmental Services"Industrial Hygienists 7261 W Hampden Ave Lakewood Colorado 80227-5305
's
July 28,2010
To: Mr.Bob Boymer ,_ �
/
HERRON�Project No.: 0715102
Job No.: Verbal
Location: Unit#6,1817 Meadow Ridge Rd.,Vail,CO 81657 �
Date(s)of Service: July 15-23,2010 �
Services Requested: Environmental Consultation/Limited Asbestos Building Inspection
Scope of Work
Per your request, and under the guidelines defined, HERRON� Enterprises USA, Inc. (HERRON�) has concluded the �
Environmental Consultation/Limited Asbestos Building Inspection at the aforementioned property.
Local, state and/or federal regulations, including but not limited to the Air Quality Control Division (AQCC) Regulation 8,
OSHA 1926.1101, and EPA (NESHAP) 40 CFR Part 61 may require a comprehensive asbestos inspection prior to a
renovation or demolition. This inspection requires an AHERA and State certified asbestos building inspector identifying and
sampling any friable and non-friable asbestos containing materials which could be affected by the activity.
HERRON�was contracted by the Client,to perform:
a Environmental Consultation/Asbestos Services, Limited Asbestos Building Inspection, specifically tailored to Friable �
and Non-Friable Suspect Asbestos Containing Materials (ACM), associated with the aforementioned property,
specifically;
Client directed Limited Asbestos Building Inspection prior to a renovation of Unit#6,1817 Meadow Ridge Rd.,Vail,CO
81657 as follows:
�
White DrywaWJoint Compound
�
Tan Stucco �
Gray Attic Insulation �
5 Day turnaround PLM Analyses; �
It was expressly advised that although this is a Limited Asbestos Building Inspection, it is comprehensive to the �
aforementioned materials. Only materials impacted requiring response actions have been instructed and authorized by the
Client. Under the protocol of limited sampling whereas not `all' suspect materials outside of the response action areas
were sampled, under local, state and/or federal regulations, including but not limited to AQCC Regulation 8 and OSHA
29 CFR 1926.1101,a certain protocol for sampling,number of samples obtained, and assessment is required.
HERRON�was subsequently contracted by the Client,to perform: �
Not Applicable.
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HERRONm Project No.0715102 Page No.-1 July 28,2010
Limited Asbestos Building Inspection
�
�
�
�
.�
� Phone 303 763 9639 �
� H E R RO N� Enterprises USA,Inc. Fa�c(303)763 9686
�
� E-Mail Lennie.Herron�comcastnet �
Hazardous Materials*Mold*Asbestos*Lead Paint Website www.HERRON-Enterprises.com
_ Environmental Services*Industrial Hygienists 7261 W.Hampden Ave.,Lakewood,Colorado 80227-5305
�
Assumptions,and Limitations �
This Environmental Consultation/Limited Asbestos Building Inspection is applicable in whole, not in part, to the entire $
contents of the document. �
�
HERRON� and this Environmental Consultation/Limited Asbestos Building Inspection make no representation or �
assumptions as to past and/or future conditions/occurrences of the specific area(s)inspected. The results, conclusions and/or
recommendations expressed in this Environmental Consultation/Limited Asbestos Building Inspection are based solely on the
conditions which were observed at the time of this Environmental Consultation/Limited Asbestos Building Inspection.
�
HERRON�'s inspection incorporated non-destructive sampling techniques and visual inspections in areas which were �
visible/accessible. Conditions and/or materials which were not inspected and/or commented on may very well differ from �
those which were inspected and/or commented on. �
�
Closure �
This report is provided for the use of the Client as it applies to the subject property. Its preparation has been in accordance �
with generally accepted practices in asbestos,and industrial hygiene. �
�
Thank you for the opportunity to be of service. Should you have any questions or comments regarding this report, please do �
not hesitate to call HERRON�Enterprises USA,Inc. �
Sincerely, �
�_�. �
�
�. �
Sincerely, �
�
�
�
Jamie L.Herron-Carson �
Project Manager �
HERRON�Enterprises USA,Inc. �
�
�
Certified Asbestos Building Inspectars(s): Jamie L. Herron-Carson �
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HERRONm Project No.0715102 Page No.-2 July 28,2010 �
Limited Asbestos Building Inspection �
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� � H E R RO N� Phone(303)763 9639
Enterprises USA,Inc. Fax(303)763 9686 �
- ,�1r E-Mail Lennie.Herron@comcastnet �
�°- Hazardous Materials*Mold*Asbestos*Lead Paint Website www.HERRON-Enterprises.com
Environmental Services"Industrial H qienists 7261 W.Hampden Ave.,Lakewood,Colorado 80227-5305
Recommendations �
�
As Regulated Asbestos Containing Materials were not discovered during this inspection,further action is not required. �
�
�
Conclusion �
�
Based on the information generated by this report, we conclude that the aforementioned property dces not have Regutated °
Asbestos Containing Material(s) (RAC1Vn, in accordance with local,state,and/or federal regulations for purposes of a �
renovation or demolition(when conducted in accordance with local,state and/or federal regulations). �
�
�
In order to comply with local, state, and/or federal regulations, the following ACM, or assumed ACM will have to be �
removed ifthey will be affected by the renovation:
None Detected. �
�
�
Materials that contain<=1.0%Asbestos are not considered Asbestos Containing Materials by NESHAPS or EPA but may �
still be covered by OSHA. OSHA regulations may apply during potential disturbance activities. r
�
Although a material may have been determined to contain <=1.0% Asbestos, or during a demolition, if the composition of �
drywalUjoint compound(when the joint compound does not cover the entire surface)has been determined to contain<=1.0% �
Asbestos, this document serves as a Hazard Communication and should be followed during an activity such as a renovation �
or demolition, to ensure that an exposure does not occur. The Ma�mum Allowable Asbestos Level (MAAL) may not be
exceeded at `any' time in accordance with local, state, and/or federal regulations, including but not limited to AQCC
Regulation 8(State),29 CFR 1926.1101 (OSHA),40 CFR Part 61 EPA(NESHAP),and 40 CFR 763 EPA(AHERA). �
Suspect materials which were sampled and deternuned to contain r-1.0% Asbestos (refer to Attachments), by PLM and/or �
PLM Point Count analysis aze: �
�
�
Tan Exterior Stucco, Surfacing Material (S), <1,000 Square Feet, Non-Friable, Good Condition (Current Condition) �
throughout,3 Sample(s), �
042210-2A,N Wall,4' from ground,6' from W Wall(previously sampled) �
042210-2B,N Wall, 1' from ground,3' from W Wa11(previously sampled) �
042210-2C,N Wall,at E Wall,3' from ground(previously sampled) s
�
White DrywalUJoint Compound, Surfacing Material (S), <1,000 Square Feet, Non-Friable, Good Condition (Current �
Condition)throughout Kitchen,2°d Floor Spare Bedroom,3 Sample(s), �
071510-1A,Kitchen by back door
071510-1B, Stairwell Ceiling �
071510-1 C,Kitchen below window �
�
Gray Attic Insulation, Thermal System Insulation (TSI),>160 Square Feet, Friable, Good Condition(Current Condition) �
throughout Attic,3 Sample(s), �
071510-2A,2°d Floor Spare Bedroom �
071510-2B,2"d Floor Spare Bedroom �
071510-2C,2°d Floor Spare Bedroom �
�
Suspect materials which were not within the Scope of Work at the time of the inspection were: '
�
l. `All' EPA suspect Materials not requested. �
�
�
2. `Any' confirmed or suspect ACM which may have been concealed at the time of the inspection. #
HERRONm Project No.0715102 Page No.-3 July 28,2010 �
Limited Asbestos Building Inspection �
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,
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. �
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' � � H E RRO N� Phone(303)763 9639 �
Enterprises USA,Inc. Fax(303)763 9686
� E-Mail Lennie.Herrona�comcast.net �
Hazardous Materials*Mold*Asbestos*Lead Paint Website www.HERRON-Enterprises.com
Environmental Services*Industrial Hygienists 7261 W.Hampden Ave. Lakewood,Colorado 80227-5305 �
3. During a normal inspection, and more specifically when non-destructive sampling techniques are employed, it is not �
within the scope of the inspection to remove surface materials to inspect the structures and/or materials which may be �
under the surface, i.e., within or under concealed areas such as under carpet, under sub-floors, within chases, walls, �
crawlspaces, tunnels, etc., to remove suspect Asbestos Containing Material(s), to move and/or sample electrical wiring
which has not been 'locked out', etc. All said areas are to be assumed as containing>1.0% Asbestos, until such a time �
that these areas are made accessible,and/or rendered safe so that sampling can be performed. �
4. HERRON� recommends e�reme caution during a renovation or demolition of these areas in the event that an area �
which was not suspect, visible, accessible and/or specified during the inspection, is discovered to contain or is suspected
of containing an Asbestos Containing Material (ACM). Under local, state and/or federal regulations, should such an �
event occur,the Client and or Contractor is required to cease operations which may effect this(these)material(s)until an
inspection is concluded and a determination is made by an AHERA and State Certified Asbestos Building Inspector. �
�
5. It was expressly advised that although this is a Limited Asbestos Building Inspection, it is comprehensive to the �
aforementioned materials. Only materials impacted requiring response actions have been instructed and authorized by �
the Client. Under the protocol of limited sampling whereas not`all' suspect materials outside of the response action areas �
were sampled, under local, state and/or federal regulations, including but not limited to WAQS&R Regulation and ,
OSHA 29 CFR 1926.1101,a certain protocol for sampling,number of samples obtained,and assessment is required. �
6. Disturbance of these areas could create a potential health hazard. �
�
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Suspect materials which were visually inspected and determined to be Non-ACM materials at the time of the inspection were: �
Not applicable. �
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HERRON�Project No.0715102 Page No.-4 July 28,2010 �'
Limited Asbestos Building Inspection �
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� E-Mail Lennie.Herron�comcast.net
� Hazardous Materials*Mold*Asbestos*Lead Paint Website www.HERRON-Enterprises.com
_ Environmental Services"Industrial Hygienists 7261 W.Hampden Ave. Lakewood Colorado 80227-5305
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HERRONm Project No.0715102 Page No.-5 July 28,2010
Limited Asbestos Building Inspection
REI LAB Reservoirs Environmenta/, /nc. �
July 23, 2010 Laboratory Code: RES
Subcontract Number: NA �
Laboratory Report: RES 195441-1 �
Project#/P.O.# 0715102 �
Project Description: None Given
Lennie Herron
Herron Enterprises, USA, Inc.
7261 W. Hampden Ave. �
Lakewood CO 80227
�
Dear Customer,
Reservoirs Environmental, Inc. is an analytical laboratory accredited for the analysis of Industrial Hygiene �
and Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab �
Code 101896-0 for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM)
analysis and the American Industrial Hygiene Association(AIHA), Lab ID 101533-Accreditation Certificate �
#480 for Phase Contrast Microscopy (PCM) analysis. This laboratory is currently proficient in both
Proficiency Testing and PAT programs respectively.
Reservoirs Environmental, Inc. has analyzed the following samples for asbestos content as per your
request. The analysis has been completed in general accordance with the appropriate methodology as
stated in the attached analysis table. The results have been submitted to your office.
�
RES 195441-1 is the job number assigned to this study. This report is considered highly confidential �
and the sole property of the customer. Reservoirs Environmental, Inc. will not discuss any part of this study �
with personnel other than those of the client. The results described in this report only apply to the samples
analyzed. This report must not be used to claim endorsement of products or analytical results by NVLAP or �
any agency of the U.S. Government. This report shall not be reproduced except in full, without written �
approval from Reservoirs Environmental, Inc. Samples will be disposed of after sixty days unless longer �
storage is requested. If you have any questions about this report, please feel free to call 303-964-1986. �
�
�
Sincerely, �
�
- - �
. ��,%��/
_,
�--��$- � .- �-�
� ---
Jeanne Spencer Orr �
�
President �
�-�---/ u�,._r �w �
Analyst(s): <1� �
Paul D. LoScalzo Wenlong Liu �
Michael Scales Rich Wegrzyn �
Anita Bridges Robert R. Workman Jr. �
¢
�
�
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P:303-964-1986 5801 Logan Street,Suite 100 Denver, CO 80216 1-866-RESI-ENV �
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RESERVOIRS ENVIRONMENTAL, INC.
NVLAP Lab Code 101896-0 Page 2 of 2 � �
TDH Licensed Laboratory#30-0136
TABLE PLM BULK ANALYSIS, PERCENTAGE COMPOSITION BY VOLUME � '
RES Job Number: RES 195441-1
Client: Herron Enterprises, USA, Inc.
Client Project Number/P.O.: 0715102
Client Project Description: None Given
Date Samples Received: July 16, 2010
Analysis Type: PLM, Short Report
Turnaround: 5 Day
Date Analyzed: July 23, 2010
ien � ta�a on on-
Sample ID Number A Sub Asbestos Fibrous
Number Y Physical Part � Fibrous omponent
E Description (%) Mineral � vtsuai omponents (%)
R ; Estimate(% %
071510-1A EM 603320 A White texture w/white paint 20 ND 0 100
B Tan/white drywall 80 ND 10 90
077510-1B EM 603321 A White compound 50 ND 0 100
B Tan/white drywall 50 ND 15 85
071510-1C EM 603322 A White texture w/brown paint 30 ND 0 100
B Tan/white drywall 70 ND 10 90
071510-2A EM 603323 A Brown fibrous material 100 ND 80 20
071510-2B EM 603324 A Brown fibrous material 100 ND 80 20
071510-2C EM 603325 A Brown fibrous material 100 ND 80 20
071510-3A EM 603339 A White compound 30 ND 0 100
B Tan/white drywalt 70 ND 15 85
ND=None Detected
TR=Trace,<I%Visual Estimate
Trem-Act=Tremolite-Ac6nolite
Note:Further analysis by TEM is recommended for organically bound material(i.e.floor tile) Data QA
if PLM results are<1%.
Due Date: '� Z�3 �� RES 441
Due Time: R�� R��s�i-vo�r.� L�i�virc��r�i�rstal� fn,�_ .
5801 Loqan St.Denver,CO 80218•Ph:303 964-7988•Faz 303�77-4275•Toll Free�866 RESi-ENV
Paper:303-509-2098
INVOICE TO: IF DIFFERENT CONTACT INFORMATION:
Comperry: o� � Campnny: CoNact: CoMaQ:
Addrese: ______ — Addraea: Plcn�: Phorro: __ __.____._______
______..
— ___— _—_ F�z: __—__-- _— F�x:
----'--- Od�PoGe�'— --- CeYlpager.
PmJect NumbsrenNor P.0.8: Fiinl D�t�DN"iv�nbN Em�G Addnu:
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Pmhd Deac�iqbNlocatlon:�—
A ESTOS LABORATORY HOURS:Weekda : 7am-T m REQUESTED ANALYSIS VALID MATRIX CODES LAB NOTE3:
M PCM I TEM _RUSH(Same Day)_PRIORITY(Next Day) STANOARD Air e A Bulk=B � ��g _
l
(Rush PCM=2hr,7EM■8hr.) � - �„`-- Dust=D Paint=P 1 , -�
CHEMISTRY LABORATORY HOURS:Weekda s: Sam-5 m Soil=S Wipe=W �- �r�. ,
MNaI(s�I Dust _RUSH_24 hr. 3-S Day s x Swab=SW F=Food
"PHar notllicatlon h � � �d
RCRA 8 I Nl�tals 8 Welding � Drinking Water=DW Weste Water=W W
Fumo Scan i TCLP _RUSH_5 day_10 day required ror rtuSH � , � � � --- ____.
arounds" + �, � � O=Other
Organics _24 hf. _3 day_5 Day ` a �7 � � `d "AS7M Et792 approved wipe media only"
MICROBIOLOGY LABORATORY HOURS:Weekda s: 9am-B m g `�—'� � � � � � � �
E.eoli 0737:H7,Collfortns,S.aureua _24 hr. _2 Day _3-5 Day � �a = � m � � � �
Salmonalla,Listeria,E.coli,APC _48 hr. _3-5 Day W �m o a a F + � p � a
Yeast:MoW _3-5 Day_7 Da � � m �` ^o � + � � �
t` � � � � �
"TUrnaround dmes esWblish a la6oratory prlority,suEJeet to laboratory volume and are no[guaranteetl.Addkional fees R � � $ � X� � � = S + � + �
appfy tor aftemouro,weekenes and holidays." � �� o - Q a m id �^ + � i y + c � m �
Speciallnstructio�: N Q; d � ' ~ y � � � � � > � �
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' � �` � �- <Sa � w '� � u�l t� vi y W �� � � Dafe Time (Laboramry Uae Onh)
C l i e n t s a m l e I D n u m b e r s a m i e i��s m u s c b e u n u e � r ca�ected couected
P I G � W � � p ��y' M I C R O B I O L O G Y O �� � � mm�d d l y y h N mm alp
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4 _ 2
5 �
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Number of samples received: � (Additional samples shall be listed on aMached long fortn.)
NOTE:REI w�tl anelyu inmmUq wmPba Wad upon in(ortnNbn reoaWad and wiM nol be resporolWs for errors a ombabne in ealeuletbrro roau�ng from Me ineccasay ot o�iginal deta.By apning di�rrt/mmp�ny ropns�rrtativ�epreeo 11rt su6miaion of Ihe(dbw4p sampbc foI roqups(ed
�nelycls as Indlated on ihie CFUiin o uMody ahall aonstduts sn�n.lytlul wrvbr proemeM witli payment tamr ot NET 30 days.6iMe to oomp�y with peyment terms may reeup in a 1.5%monthly ints�sd aurchergs.
Relin Uf8h@d B : """-- DatefTime�� ��' �
� Sample Conditlan: On Ice Sealed Intact
Laboratory Use ly^ �,��,�� �Q=�� Temp.(F°) Yes/No Yes I No Ye /No
' Recefved B : DatelTime: Carrier.
Results: �ntacl Pa e Phone Email Fan Date Time Initials Contact Pa Ptrone Ema(I F� Date Time Initlals
Contact P Phone Email Fax Date Time Initials Contact Pa Phone Email Fax Date Time Initials
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