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� ,� �€ ����ST'�� A��1"EMENT' PERi�1�T'
���, ��� � � ��, �� �� Permit application will not be accepted wifhout the fotiowing:
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�,� ii ,�/��� Copies of General Abatement Certificate and State of Colorado Certification
U �` ��JZ� Site plan with details addressiny: waste container storage location, waste load out area
�°�'��,r�„y�.;� �-�, ,���� E location, entry and exiting details of abatement area, details of entry and exiting plans
"°°"�°••°�-==°°-��°=�°'c�-d--�--�' for the occupants of the structure in unaffected areas.
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;Project St et Address: Office Use:
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;(Number) (Street) Suite# Project#:_ �� ���
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�<��! Building Permit#:
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Asbestos Permit#: /�1 �I'J�d " �vQs
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'Contractor Information- Lot#: J Block#�Subdivision: v �1`
;Company: i�lYKl> /�"/l`��L.�/'TiA i.t/ ��`s'�4 t i''.�s r:t T" �
Company Address: /`; ��, .�5�'�� %� Z%,�' �} r
� Detailed Description of Work: ; j-'����,�g;� ,f/ �
City: �/�%ii'1 ri i`✓� State: �t`3 Zip: �(„J{(,� `� � - / _ �
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Town of Vail Contractor Registration Na.: ;;
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;Complete Valuation for Asbestos Abatement Permit: ` � �
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;Asbestos Abatement$: � ,� y�� �-� ;Date Received:
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On iviay 2 , 2010, NIr. Steve Shurtliff of DS Consulting, Inc. ( DSC) performed a full building inspection and
asbestos sampling at 375 Forest Rd, Vail, Colorado, in order to identify potentially hazardous friable and
non-friable asbestos-containing nnaterials (ACM) within the above-referenced, single -family residence
scheduled for demolition. The Colorado Departmen� of Public Health and Environment's (CDPHE)
Regulation 8, Part B defines an asbestos-containing material (ACM) as a ma�erial containing more than 1 %
asbestos .
Mr. Shurtliff performed asbestos bulk-sampling of drywall (surfacing rnaterials) , resilien� floor tile
(miscellaneous material) , vinyl flooring (miscellaneous material) , ceiling tile (miscellaneous matet-ial) ,
and perlitic plaster (miscellaneous material) in a total of thir�r-three (33) locations within the main level,
lower level, and upper level of the residence (see Appendix A for sample locations) . All thirty-three (33)
bulk-samples were analyzed by Reservoirs Environmental, Inc. (NVLAP # 101896) with four (4)
laboratory results of resilient floor tile /mastic and vinyl flooring being positive for asbestos between 8% �
and 20 % Chrysotile (see Appendix C for laboratory results) .
Multiple samples of drywall (surfacing material) were initially analyzed and reported as containing a
t�°aee amount of Chrysotile asbestos after visual estimations ; however, after these samples were re -
analyzed using the point-count method, the samples reported to conCain less than 1 % asbestos and are
not considered asbestos - containing materials (ACM) . These drywall samples do contain asbestos and
should be treated as such. OSHA guidelines for worlcer protection should be followed when disturbing
this material.
The following sampled materials were found to contain asbestosgreater than 1 % (ACNI) :
. ' • ,
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P A ° a eo e � � a e e e t
Resilient Lower Level Miscellaneous Non- .��_ 1, 200Ftz Good 8% - 10 %
C'T01 - 01 Floor Tile Floor Material Priable Chrysotile
Vinyl Lower Level Miscellaneous 20 %
VF01 - 01 Friable �+- / - 60ft2 Good Chrysotile
Plooring Bathroom Material
Main Level 20%
Vin 1 Miscellaneous
Y Master Friable -� / - 75ftz �� � d Chr so�ile
VF02 - 01 �looring Material y
Bathroom
Vinyl Upper Level l�tiscellaneous 20%
VF03 - 01 Friable +/- 100ft2 Good Chrysotile
Flooring Bathroom Material
*Quantities are approximations and subject to field verification.
2
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A full building inspection and bulk-sampling for ACI� was cor�ducted at 3 `75 Forest Rd, Vail, Colorado, by
N[r. Shurtliff on May 2, 2010, at the request of Mr. Mil�e Foster with Triumph Developtnent. Mr. Shu�tliff
is a Colorado State Certified Building Inspecf:or; having EPA Accreditation # 15413 (see Appendrx B for
certificate) . The purpose of the inspection was to identify, sample and assess potentially hazardous
friable and r�on -friable ACM within the residence ,
�Ia Stt°u�t�ral Desr�rt
The structure is a wood-framed, multi-level, single -family residence .
III. 5arn�lin� anet Anal3�tical Pt°oc�el� �°�s
The inspection, assessment and sampling were conducted by an EPA and AHERA accredited Building
Inspector qualified by experience, education and training in the recognition of potential ACM and
approved bulk-sampling techniques . The asbestos bulk-sampling was conducted on suspect ACM with a
limited number of bulk- samples being collected within the residence .
The inspection, assessment and sampling were performed in accordance with Environmental Protection
Agency/AHERA recommended procedures. These procedures call for the visual inspection of the area of
concern and the collection and analysis of representative bulk-samples of suspect material.
Some minor destructive sampling was conducted. Walls, columns and perimeter pipe chases were not
broken into in order to locate and quantify suspect ACM . It should be noted that additional ACM might be
located in these and other inaccessible areas.
Random bulk-samples, representative of the suspect asbestos -containing building materials (ACBM) of
each homogeneous area (HA), were collected according to the guidelines published as Environmental
Protection Agency (EPA) Final Rule : Title II of the Toxic Substances Control Acti (TSCA) , 15 USC, Sections
2641 through 2654 and in compliance with 40 CFR, Part 763 . Representative satnpling is based on the
following criteria :
1 . The dis�ribution of the suspect material throughout the HA.
2 , The suspect material' s physical characteristics and application.
3 . Random sampling patterns determined fo� each HA.
Suspect materials sampled and analyzed should be considered to be representative of materials in each
HA if they exhibit similar physical characteristics and the application of the sampled material can be
correlated to the application of un-sampled material. Bulk-samples collected were analyzed utilizing the
EPA' s Method �r the Determination of Asbestos in Bullz Buildina Materials (EPA 600/ R/ 116, July, 1993)
and the McCrone Research Institute' s The Asbestos Particle Atlas as methods references. Analysis of the
bull�-samples was performed on the "date reported, " as listed in the bulk-sample analysis report.
3
�V. Notes �� �ep �rt Forrn�t
Suspect materi �ls alike zn appearance and application wet�e sampled as HAs . Suspect materials were
divided into three classifica�ions :
1 . Surfacing lt�aterial: sprayed or troweled onto structural building member.
2 . Thermal Systern Insulation (TSI) : any type of pipe, boiler, tanlc, or duct insulation.
3 . Miscellaneous 1Vlateriai : other suspect materials, floor tile, sheet vinyl/linoleum, ceiling 'ciles,
insulation, and finishing materials .
Condition assessments were performed by the accredited inspector at the time of inspection. Condition
assessments are listed in the following section. Ratings of " good, " " dama�ed, " and "significantly
damaged " are meant to indicate the overall condition of the material.
A material in "good" condition has no visible damage or deterioration, or showing only very limited
damage or deterioration.
A material in " damaged " condition has the following characteristics : The surface is crumbling, blistered,
water-stained, gouged, marred or otherwise abraded over less than one -tenth of the surface if the
damage is evenly distributed (one - quarter if the damage is localized) . Accumulation of powder, dust or
debris similar in appearance to the suspect material on surfaces beneath the material can be used as
confirmatory evidence. A material in "significantly damaged" condition has one or more of the following
characteristics :
• The surface is crumbling or blistered over at least one -tenth of the surface if the damage is evenly
distributed (one -quarter if the damage is localized) .
• One -tenth (one -quarter, if localized) of the material is hanging from the surface, deteriorated, or
showing adhesive failure.
. Water stains, gouges, or mars are over at least one -tenth of the surface if the damage is evenly
distributed (one-quarter if the damage is localized) . Accumulation of powder, dust or debris
similar in appearance to the suspect ma�erial on surfaces beneath the material can be used as
confirmatory evidence .
Response-action recommendations for asbestos -containing HAs are listed in the section VII .
Recommendations may be for° more than one HA, if materials are alilce. Recommendations are either
" general" o�• "immediate. " An immediate recommendation indicates the presence of asbestos greaCer
than 1 % within the bulk-sample, or a bulk-sample in the same HA, and should be addressed accordingly.
A general recommendation indicates asbestos does not exist greater than 1 % within the bulk-sample, or
a bullc-sample in the same HA, and no further abatement activities are required for removal of the
material. Any sample reporting a "TRACE" amount of asbestos must be considered to be positive foi�
asbestos greater than 1 % unless it is analyzed by the point-count method to be less than 1 % .
Vo It�s�ectot° Comrnents
Chrysotile asbestos was ideni:ified during the bulk-sampling conducted at 375 Forest Rd, Vail, Colorado .
A total of thirty-three (33 ) bulk-samples were collected from the above -referenced residence. Four (4)
bullc-samples tested positive (greater than 1 %) for asbestos .
■ Asbestos was identified in the lower level resilient floor tile and mastic (miscellaneous material)
sample FT01 - 01 at 10 % Chrysotile in the black mastic and 8 % in the tan tile
4
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IVlarch 16 , 2010 Labor�tory Code: �2��
� ubcontract Nurnber: Np,
Labora4ory Repor�: ��5 1II7704-1 ,2
F�rnject # / 6�.0. # 2006
Project L�escription : 375 Forest �d . , Vail, C�
Steve Shurtliff
DS Consulting , Inc.
3247 S . Indiana St.
Lakewood CO $0228
Dear Customer,
Reservoirs Environmenfial , Inc. is an analytical laboratnry accredited for fhe analysis of Industrial Hygiene
and Environmental mafrices by the National Voluntary Laboratory Accreditation Program (NVLAP) , Lab
Code 101896-0 for Transmission Electron Microscopy (TEM ) and Polarized Light IVlicroscopy (PLNI)
analysis and the American Industrial Hygiene Association (AIHA) , Lab ID 101533 - Accredifation Cerfificate
#480 for Phase Contrast Microscopy (PCM) analysis . This laboratory is currently proficient in both
Proficiency TesYing and PAT programs respectively .
Reservoirs Environmental , Inc. has analyzed the following samples for asbestos content as per your
request. The analysis has been compieted in general accordance with the appropriate methodology as
stated in the attached analysis table . The results have been submitted to your office .
RE� 187704-1 ,2 is the job number assigned to this study. This reporfi is considered highly confidential
and the sole property of the customer. Reservoirs Environmental , Inc. wi� l not discuss any part of this study
with personnel other than those of the ciient. The results described in fihis 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
approvai from Reservoirs Environmenfal , Inc. Samples will be disposed of after sixty days unless longer
storage is requested . If you have any que�tions aboufi this report, piease feel firee to call 303-964- 1986 .
Sincerely ,
_ _.,
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Jeanne Spencer Orr
President __._______ .___..__
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Analyst(s) :
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Paul D , LoScalzo W�nlong Liu
Michaei Scale� Rich Wegrzyn
Anita Bridges James Venendaal
Adam Kinch Louis A. Church Jr.
Robert R . Workman Jr.
P: 303-964-1986 5801 Logan Street, Suite 100 Denver, CO 80216 1 -866-RESI-ENV
F: 303-477-4275 www. reilab. com
Page 1 of 8
��07 � ��� E �m� � Y � �� IY � 9��� 9�y � 6so
NVLAP Lab Code 101896-0 P8�8 2 Of 8
TDH Licensed Laboratory # 30-0136
TAB�E PL� �ULEC A �A�4°�IS, PERCEN�AG � �OMF�OSi�lO� �`( VO �lJf�lE
RES Job Number: RES 1 �7704-1 ,2
Client: f�� Co���aftirag , 9s� c.
Client Project Number / P . O . : 2006
Client Project Description : 375 Fosest �d., �ai�, CO
Date Samples Received : fl�arch 3, 2010
Anafysis Type: ��.�, Short Repor�
Turnaround: 3-5 Day
Date Analyzed : �a�c� 59 2010 - t�arch �, 2010
dent a L Asbestas Ganfent on on-
Sampie !� � uar�be� A Sub _ Asbestos Fibrous
N �aenber Y Physical Part � Fibrous Components
E Description (%) �n�ner�t e vESUa' omponenfs (% )
R e Esgimate (% (%)
DV!/01 -01 �� 535596 A White compound w/ white painfi 5 �! D 0 1 C30
B White tape 5 �ED 95 5
C Vlfhite joint compound 5 Chryso�ite l°� �R 1 QQ
F�oint Coca�rt c0. 25
� Tan/white drywall 85 P� D 10 90
D1A901 -02 E�tE 535557 A White fiape 5 � D 95 5
B V�lhite joint compound 10 f� D Q 1 QO
G Whifie compound w/ white paint 25 � D 0 10Q
E3 Tan/white drywall 60 t�D 1 f3 9Q
DV►l01 -03 EM 535598 A Whifie texture vv/ white painf 2� � D 0 1C30
B Tan/uvhite drywali w/ cream paint 8Q E� D � 0 90
D�02-01 EEVE 535599 A White joint compound 5 �! � 0 1 � 0
� Whi�e tape 5 � � 9Q � Q
C White compound w/ white painf 10 P� � 0 100
D �fan/white drywal! 8� t� � 1 � 90
DVil�2-02 EfV! 535600 A White joint compound 5 � � 0 1 dE3
� VVhite compound w/ white paint 5 � � 0 9Q�
C White tape 10 � D 95 5
€� Tan/vvhite d walE 80 � D 10 9�
ND=None Detected
TR=Trace, <I°/a Visual Esrimate
Trem-Act=Tremolite-Acrinolite
Note: Further analysis by TEM is recommended for organically bound material (i.e. floor rile)
if PLM zesults az'e<I%. Q��a ��`
@��� � 8� °6 � � f'Ec7 � !'� 1f IfE� I°d � Itl 6 /'SLy F �.dm
NVLAP Lab Code 109896-0 Page 3 of 8
TDH Licensed Laboratory # 30-0136
Bk48LE PL � d1LK At�AL�S(�, ��R� E �TAC3E �OMPO� II"�ON �Y VOLUME
RES Job Number: R�� 1 �7704-1p2
Client: D� C�raseslt� ne�, Er�ce
Client Projec� Number / P . O . : 2006
Cfient Project Descriptiort : 3Z� Foresfi Rd . , Vai �, �O
Date Samples Received : ar�h 3 , 2090
Analysis Type: E�L , Sl�os� Repor�
Turnaround : 3-5 Day
Date Analyzed : �ar� h 5g 201Q - M� rch F3, 201Q
�ent a � �shestos� �m�terat on or�-
Sample tE3 Plu � ber A Sub Asbesfios Fibrous
Number Y Physical Part 1 Fibrous Components
E Description (%) nn'ne��t B �ESUat ompo�e�fis (�/a)
R ; Es�imaYe (% (%)
D�02-03 EfV6 535601 A White joint compound 3 ND 0 � 00
� White fiape 5 � D 95 5
C V�lhite compound wl white paint 10 Chrysotile TR TR � pp
P�se�� Court�' <0. 25
� Tan/white drywal! 82 �D 10 90
DW02-0� E�!! 535602 A Whife compound 3 � p p � pp
� Tan/vvhite drywall 97 � p � p g0
Dln402-05 E� 535603 � White joint compound 10 Np p � �p
�3 White tape � (} � p 95 �
C White compounci w/ white paint 10 t� p p � pp
D Tan{white drywal! 70 P� � � 0 gp
DW03-09 � �@ 535604� A Vi/hite compound w/ cream paint 33 Chrysotibe '�R TR 100
F'oi�a� Co��aa� <Oe��
� Mulfi-colored wali covering 33 �ED 60 40
C Tan/white drywal{ 34 EV � 10 90
DW03-OZ EM 535605 A White compound w/ white paint 15 Ghr�sotile i°R �R 1pp
l9oini Count �. 25
� �an/vvhi�e dry�alE 85 �p € p gp
ND=None Detected
TR=Trace, <I% V"isual Estimate
Trem-Act=Tremolite-Acrinolite
Note: Further analysis by TEM is recommended foz organically bound materiat (i.e. floor rile)
if PLM results aze<1%. �afa (u�
��a� � � V � � Ri7 � � V ' R� IV � 1 � �9 ( I� ds . ,
NVLAP Lab Code 101896-0 Page 4 of 8
TDH Licensed Laboratory # 30-0136
I TSOL� 6— L � ii6�Y0 �ItlP4L & B7lo7g f� Pi4o �6'W 0 P'�� � ir�6Bi6� �� @�I� 8�9 � B d �LVldl �
RES Job Number: ��� 1 �77a�-1y�
Client : DS �ons � ltis�g , lnc.
Client Project Number / P . C3 . : 2006
Client Project Description : 3?5 FOres� Rd ., �a � l, CO
Date Samples Received : �arch 3, 2010
Analysis Type : F'LM, � hort Repor�
Turnaround : 3-5 �ay
Date Anafyzed : R�arch 5, 20'i0 - f�areh 89 20'60
ient a � Asbes�os Con:ter�t on on-
Sample iD N �rrzber A Sub Asbestos Fibrous
�1u � �� �' Y Physical Part e Fibrous Components
E Description (%� Mineral F visuai omponents (%)
R ; Estimate (% (%)
DW03-03 ��1 535606 A Whi�e compound 10 Chs°yso�ile '�E� g f� 1 pp
Poie�t Coeere� 0. 25
� F' ink �nraEl covering 10 �D 50 5�
C Tan/white drywal9 8Q ND 10 9Q
DW04-01 �IVi 535607 A Peach wall covering 30 ND 60 4Q
� Vimifie eompound 30 � D 0 100
C Tan/white drywal[ �0 N � 1 Q gp
D11U04-02 E1C/i 535608 A ian/white drywall 15 ND 50 5Q
� Whife joint compound 15 � p p � pp
C Vlfhite tape 15 �p 95 �
[3 White compound w/ cream paint 15 N � 0 1 p �
E Pink wai! covering 40 � � 6p q.Q
DW04-03 E�!1 . 535609 A Pi�k wall covering 25 �p 6� �p
B White compound 25 ND Q � 00
C Tan/v�ehite drywafl 50 � � 10 90
ND=None Detected
TR=Trace, <1% Visual Esrimate
Trem-Act=Tremolite-Actinolite
Note: Further analysis by TEM is recouunended for organically bound materiai (i.e. floor tile)
if PLM results aze<1%. �a{� ��
l��a� � B`� Y � ' 1�� � BV V IR� iY � Itl 6 �B�y � � o ..
NVLAP Lab Code 10i896-0 PB�E 5 Of 8
TDH Licensed Laboratory # 30-0136
TPi� L� �L � 6.De��i �6Yd9L Y � �c7y B- ��ir � fY Y 6�� � 40��0- �a7B 9 F� Otl � B Y � L�J &Y11�
RES Job f�umber: R�S 1 � 7704-1 ,2
Client: DS Co �sui�� ng , 9r� �e
Client Project �iumber / � . 0 . : 2006
Client Project Descriptiora : 375 Fore�t Re� ,g Vail, CO
Date Samples Received : Mareh 3, 2010
Analysis Type: E�� , � h� rt Repor#
Turnaround : 3-5 �ay
Date Analyzed : arch 59 2010 � a �°ch F, 20 � 0
1e�� � L �s��s�ns Cmn��t�t � on on-
Sample iD � � � ber A Sub Asbes�os Fibrous
Nuenber Y Physica! Part o Fibrous Componenfis
E �escription (%) AllineraE [ v�sa,ai omponenfis (%)
R a Estima$e (% (% }
DVV05-01 EfVi 53561 Q A Whife joint compound 1 p Chryso�6ie '�!� �'� � pp
E'oin� Coc��� <�.2�
� VVhite tape 15 � D 95 5
C Multi-colored wall covering 15 RiD 70 30
� V1fhifie compound w/ white paint 15 Chryso�ile �R �'R '8 QO
Poe�at Coc��� <0. �5
E Tan/white drywal{ 45 � D '10 90
DW05-02 E� 53561 � A 1Nhife compound 10 � hryoso��l� �'R T�Z 1p0
Poiett Cocrnfi <0. �5
� EViulti-colored waI€ covering 15 � � gp . 2p
G Tan/whifie drywa!( 75 �D 1 � 90
D1lU05-03 EM 535612 A f� �alti-colored vvall covering 10 � D 80 20
C� White compound 20 � hrysotife °S� T� � Qp
P�6n� Count 0. 5
C �an/vvhite drywall 70 ►� p � p gp
DV1l06-01 E(Vi 535613 A Tan/cream walE covering 1 p �p gp ZQ
� VVhite compound 10 Chryso�ile '�� �� � �}Q
Po�rat Coa�r�t 0. 25
� Tan/ervhite drywal{ 80 �p � p 8Q
ND=None Detected
TR=Trace, <1% Visual Esrimate
Trem-Act=Tremolite-Actinolite
Note: Further analysis by TEM is recommended for organicaIty bound material (i.e. floor rite)
if PLM results aze<1%. Daf� Q�
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I � ! B White compou �d ia l�. n �y��s�aa� a �� e o • � � � � �
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B 4
� € � ��O!/9� �0(Bt1� �. 5 � � �
E � � G � anlwhite drywas� o� � atl �.p , .. � � � p
in,w.n� � � l �nn ��a �� � � � A Vllhit� oainfi w/ white combound 10 �Ct� rysotile ' �� s rs � � uu �
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I { �. {l�Oftlg ��CBFP� <0.25 � � �
� ! I � Tan/whste arywai: �a ' e� �� � u � v � �
I �.. . oA-� � ., � Fnn F � �R � 7 � A Whiie comool9nd w/ white paiCtt 10 �ChCysOt11� 6 ti � s rc � ivv �
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€ E `
r �
1 3 � ... . ,, .� . . �_. r . . ..i �r_ _ _ . .� � �i (1 ql^6v, sascee4v9� �� � �RC � �nk
� � � ��O%67f ��1JE7� <f1. 1 P � � �
( � i � i an�vvnite arywaaE � � � a � m � . .. � _ _ �
LVL-1VV1W a/�w�wu
mm—m it0/ v:......1 IIn6m..10
�1 I0ID-ACT= 1 TBR1011LC-HG➢POlIiC
. . . . _�_ . . . . � . . _ _ ni_ . � ____ � _...,._...1 /: e Fl,.,.. til.,\ ..� . .. e
if PLM results aze<1%.