REVIEWED BLD BLD2024-1280+ASBESTOS+9.27.2024_2.41.16_PM+45291005 MICRONS INC. SURVEY REPORT
BLD2024-1280
RECEIVED
5 Microns Inc. - Survey Report Sep 30 2024
CITY OF EDMONDS
DEVELOPMENT SERVICES
7100 Fort Dent Way, Ste. 100 DEPARTMENT
Tukwila, WA 98188
425-440-8787
15925 75th PI W
Edmonds, WA 98026
Prepared for: Jens Nordal
Date: September 23, 2024
Project Number:524-0842
Inspector: Pascal Jean -Baptiste
NO. 194346. Exp. Jul 11 th, 2025
E-mail: clientservices(cb_5microns.tech
...........................................
REVIEWED
BY
CITY OF EDMONDS
BUILDING DEPARTMENT::
.............................................. e
5 MICRONS INC. SURVEY REPORT
J
Contents
1. Background Information and Scope of Work............................................................................ 3
2. Building Description................................................................................................................ 4
StructuralSystem.................................................................................................................. 4
FinishingMaterials............................................................................................................... 4
Mechanicalsystem................................................................................................................ 4
Roofing...................................................................................................................................4
3. Material Sampling Information..................................................................................................5
Definitions............................................................................................................................... 5
SurveyMethodology..............................................................................................................5
MaterialsSampled.................................................................................................................. 6
4. Asbestos -Containing Material....................................................................................................................7
5. Conclusions..............................................................................................................................8
AppendixA — Certifications...................................................................................................... 9
AppendixB — Building Layout.................................................................................................. 10
Appendix C — Laboratory Report............................................................................................. 12
E
5 MICRONS INC. SURVEY REPORT
1. Background Information and Scope of Work
On September 19th, 2024, 5 Microns Inc. conducted an asbestos survey of the
residential property at 15925 75th PI W Edmonds, WA 98026 AHERA-certified building
inspector Pascal Jean -Baptiste 194346 surveyed to determine the presence of Asbestos
Containing Materials (ACMs).
The home was occupied at the time of the inspection and appeared to be in good
condition. For the purposes of this survey, the building was considered a homogeneous
area.
Potential asbestos -containing materials were located and sampled from the interior of the
building. See Appendix B for a detailed floor plan with sample locations.
Materials were located and sampled following AHERA protocol in 40 CFR 763.86, then
analyzed in-house at EMSL Analytical per 40 CFR 763.86. See section 3 for detailed
sampling information.
3
5 MICRONS INC. SURVEY REPORT
2. Building Description
The home is a two-story with a basement, 2934 square feet, built in 1971, with three
bedrooms and two bathrooms.
Structural System
The building was wood -framed construction on a concrete foundation.
Finishing Materials
The home had carpet and wood flooring.
Mechanical system
The home had gas heating, with forced air heating.
Roofing
The building had a tongue and groove roof, which appeared to be in good condition.
5 MICRONS INC. SURVEY REPORT
3. Material Sampling Information
Asbestos survey work performed by 5 Microns Inc. meets regulatory inspection
requirements enforced by federal, state, and local agencies, including Asbestos Hazard
Emergency Response Act (AHERA), WAC 296-62-077 (WISHA), and 40 CFR Part 61
(NESHAP) and 29 CFR Part 1926.1101 (OSHA)
Definitions
Homogeneous — Materials with the same appearance, texture, and color applied
during the same general construction period.
Surfacing Material — Material sprayed on, troweled on, or otherwise applied to surfaces,
such as acoustical plaster, texture, joint compound, and fireproofing materials on
structural members.
Thermal System Insulation — Material applied to pipes, fittings, boilers, breaching, ducts,
and other interior structural components to prevent heat loss or gain.
Miscellaneous Material — Building materials such as structural components, structural
members, or fixtures not included in surfacing and thermal insulation.
Survey Methodology
Before sampling began, inspectors documented the total surveyed area. A sketch of each
space was created, and the total square footage was roughly measured. The inspectors
then determined the extent of each visible homogenous material throughout the survey
area.
Materials were classified as surfacing, thermal insulation, or miscellaneous material, and
friability was assessed according to AHERA specifications.
Materials were sampled according to 40 CFR 763.86. Depending on homogeneity, square
footage, and material type, the proper number of samples needed to accurately assess the
location and extent of asbestos was determined and collected. At the point of collection,
samples were placed in an appropriate container and labeled. Location was noted on the
building floor plan, and a description of the material was recorded with the label number.
Sampling tools were then wiped clean to prevent contamination between samples. Any
suspect debris was sealed. The samples were then counted, and their label numbers were
recorded on a chain of custody form. The inspector then signed and released the form to
the laboratory with the samples. Samples were analyzed in-house at EMSL Analytical.
Below is a list of all materials sampled. Appendix C contains the laboratory report and
analytical results for each sample.
5
5 MICRONS INC. SURVEY REPORT
Materials Samplea
4-)
5 Microns Inc.
Description
Material Type
Sample Numbers and
Locations
Drywall Media Room
Drywall
01-Media Room
5 MICRONS INC. SURVEY REPORT ,
4. Asbestos -Containing Material
A homogenous material is considered ACM (Asbestos Containing Material) if one or more
samples of the material are found to have greater than 1 % asbestos. Analysis can result in
both positive and negative conclusions in materials containing less than 10% asbestos, or
materials that have very fine asbestos fibers, have been hand mixed or have asbestos
fibers tightly bound in the matrix; therefore, EPA recommends a minimum of three
samples be analyzed by PLM for these types of materials. All materials that were sampled
during the inspection were analyzed under PLM, EPA Method 600/R-93/116.
Laboratory results show the samples taken do not contain asbestos.
7
5 MICRONS INC. SURVEY REPORT
5. Conclusions
Materials sampled at the residence do not contain asbestos.
No other building materials sampled contained asbestos.
The asbestos -containing material must be abated before remodeling can continue. A
Certified Asbestos Abatement Contractor must carry out abatement.
Different materials require different abatement processes depending on the friability, type
of asbestos, and amount of asbestos present. It is important that materials are treated by a
Certified Asbestos Abatement Contractor.
0
5 MICRONS INC. SURVEY REPORT
Appendix A — Certifications
Certificate of Completion
This is to certify that
Pascal Jean -Baptiste
has satisfactorily completed
4 hours of online refresher training as an
AHERA Building Inspector
to comply with the training requirements of
TSCA Title II, 40 CFR 763 (AHERA)
EPA Provider # 1085
194346
Certificate Number
Jul 11, 2024 Expires in 1 year.
Instructor: Tracy Bodda Date(s) of Training
Exam Score: N/A
_... I • iono: (if applicable)
IFWracon 'Emil ronm.nta'
0
5 MICRONS INC. SURVEY REPORT
Appendix B — Building Layout
10
5 MICRONS INC. SURVEY REPORT
Appendix C — Laboratory Report
12
EMSL Analytical, Inc.
5900 4th Avenue S, Suite 100, 1 st Floor Seattle, WA 98108
Phone/Fax: (206) 269-6310/(206) 900-8789
M http://www.emsl.com / seattlelab@emsl.com
EMSL Order: 512403005
Customer ID: FVMR42
Customer PO:
Project ID:
Attention: Pascal Jean -Baptiste Phone: (425) 440-8787
5 Microns, Inc. Fax:
7100 Fort Dent Way, Ste. 100 Received Date: 09/20/2024 10:58 AM
Tukwila, WA 98188 Analysis Date: 09/20/2024
Collected Date: 09/19/2024
Project: 524-0842 / Jens Nordal 15925 75th PI. W Edmonds, WA 98026
Test Report: Asbestos Analysis of Bulk Materials via AHERA Method 40CFR 763 Subpart E
Appendix E supplemented with EPA 600/R-93/116 using Polarized Light Microscopy
Non -Asbestos
Asbestos
Sample
Description Appearance % Fibrous % Non -Fibrous
% Type
1-Joint Compound
Drywall - Media Room White 100.0%Non-fibrous (Other)
None Detected
512403005-0001
Non -Fibrous
Homogeneous
1-Mesh Tape
Drywall - Media Room Yellow 95% Glass 5.0%Non-fibrous (Other)
None Detected
512403005-0001A
Fibrous
Homogeneous
1-Tape
Drywall - Media Room White 95%Cellulose 5.0%Non-fibrous (Other)
None Detected
512403005-0001B
Fibrous
Homogeneous
1-Drywall
Drywall - Media Room Brown/White 30%Cellulose 65%Gypsum
None Detected
512403005-0001C
Fibrous 5.0%Non-fibrous (Other)
Homogeneous
No Asbestos Detected Between Expected Limit of Detection and Federal Above Federal EPA Recommended
EPA Recommended Limit 0 Limit
These guidance limits are typically used in most scenarios. More stringent local or project specific guidelines may apply.
Analyst(s)
Claire Byers (4)
Ehrin Stephens, Laboratory Manager
or other approved signatory
EMSL maintains liability limited to cost of analysis. Interpretation and use of test results are the responsibility of the client. This report relates only to the samples reported above, and may not
be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations. The report reflects the samples as
received. Results are generated from the field sampling data (sampling volumes and areas, locations, etc.) provided by the client on the Chain of Custody. Samples are within quality control
criteria and met method specifications unless otherwise noted. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA
600/M4-82-020 "Interim Method") but augmented with procedures outlined in the 1993 ("final') version of the method. This report must not be used by the client to claim product certification,
approval, or endorsement by NVLAP, NIST or any agency of the federal government. Non -friable organically bound materials present a problem matrix and therefore EMSL recommends
gravimetric reduction prior to analysis. Unless requested by the client, building materials manufactured with multiple layers (i.e. linoleum, wallboard, etc.) are reported as a single sample.
Estimation of uncertainty is available on request.
Samples analyzed by EMSL Analytical, Inc. Seattle, WA NVLAP Lab Code 200613, CA 2733, WA C1025
Initial report from: 09/20/2024 16:18:10
Printed: 09/20/2024 04:18:10PM Page 1 of 1
OrderID: 512403005
flMSL ANALYTICAL• INC.
Asbestos Chain of Custody
EMSL Order Number (lab use only:
#5 2403005
EMSL Analytical, Inc.
5900 4th Ave S
STE 100
Seattle, WA 98108
PHONE: (206) 269-6310
FAx: (266) 900-8789
Company Name: 5 Microns, Inc.
EMSL Customer ID: FVMFZ42
Street: 7100 Fort Dent Way, Ste. 100
City: Tukwilla
State or Province: WA
-Zip/Postal Code: 98180
Count : US
Tele hone #: 425-440-878
Fax #:
Re ortTo Name : Pascal Jean -Baptiste
Please Provide Results via:
❑ Fax mail
email Address: Clierltservices@5microns.tech
Purchase Order Number:
Client Project ID: `(
EMSL Project ID intemal us
only):
State or Province Collected: WA
CT only ❑ Commercial/Taxable
❑ ResidentiaUTax Exempt
EMSL-Bill to: ❑ Same ❑ Different - If bill to is differenta instructions in comment. Third party billing requires
written authorization from third arty
Turr nd Time(TAT) Options Please Check
❑ 3 Hirt I ❑ 446Hrt ,nt, I ❑ 6 Hirt 4 Hr I ❑ 32 Hr2 ❑ 48 Hr I ❑ 72 Hr
96 Hr ❑ 1 Week ❑ 2 Week
'Prerrrium Service charge applies for Hour TEMAHERA or EPA Level!/ TAT- you will be asked to sign an authorization form.
s 32 Hour TAT available for select tests only; sam !es must be subm tied by 11:30 am.
TEMAir3-6 Hour, please call, ahead to schedule
PCM -Air
❑ NIOSH 7400
❑ w/ OSHA 8hr. TWA
TEM — Air'
❑ AHERA 40 CFR, Part 763
❑ NIOSH 7402
❑ EPA Level II
❑ ISO 10312
TEM- Settled
ust
STM D 5755
V1 D6480
cation (EPA 6001J-93/167)
❑ Microvac -
❑ Wipe - AST
❑ Carpet Son
PLM - re ortin limit kjMr>
M EPA 600/R-931116 (<1%)
❑ PLM EPA NOB (<1%)
Point Count
❑ 400 (<0.25%) ❑ 1000 (<0.1%)
Point Count w/Gravimetric
❑ 400 (<0.25%) ❑ 1000 (<0.1 %)
❑ NYS 198,1 (friable - MY)
❑ NYS 198.6 NOB (non -friable -NY)
[] NYS 198.8 SOF-V
❑ NIO 9002 (<1%)
Soil -- Rock — I
fermiculite re ortin limit
O/R-93/116 with milling prep (<0.25%)
0/R-93/116 with milling prep (<0.1%)'
via Filtration Prep
tive via Drop Mount Prep
EPA 600/R-04/004 — PLM/TEM
TEM - Bulk
❑ TEM EPA NOB
❑ NYS NOB 198.4 (non -friable -NY)
❑ TEM EPA 600/R-93/116 with milling
prep (<O.1 %)'
❑ PLM EPA 6
❑ TEM EPA 6
❑ TEM Qualitative
❑ TEM Oualit
❑ Cincinnati Method
TEM — Water: EPA 100.2
Fibers >10pm ❑ Waste []Drinking
All Fiber Sizes ❑Waste ❑Drinking
'Lower
reporting limits avaialble do request
Other test (please
specify)-
u4op At First Po ' 've (clearly identify homogenous areas below
Filter Pore Size Air S
m les 0.8 m
❑ 0.45 m
r
Sampler's Name: G� s (� �(��r—� S
Sampler's Signature:
Sample #
Sample Description/Location
V
Homogenous
Iume, rea or
Area
Daterrime
Sampled
C
r- 6
r
�;
• y. 2-Cr
Client Sample # s : - ToU
I # of Samples:
Relinquished by (Client): S f C—C^p--,�Date — - Z
Time:
Received by (Lab): Date:
Time: ,(
: 58 /"A
Comments/Spec! nstructions: gl � r—X -qg-kVIm
s N c4r L 2S -7 s
09-2-
t.J
Controlled Document— COC-05 Asbestos — R12.1 —I V0112019
EMSL Analytical, Inc.'s (eBA: LA Testing) Laboratory Terms and Conditions are incorporated into this c ain OT Cus o y by reTiprence
in their entirety. Submission of samples to EMSL Analytical Inc. constitutes acceptance and acknowledgment of all terms anj conditions.
Page i of pages
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Orde
rID: 512403005
Asbestos Chain of Custody
EMSL Order Number (Lab use only):
sMaiaHa�vrrcaL..INC 0 3 0 0 5
Additional Pages of the Chain of Custody are only necessary if needed for
additional sample information
EMSL, Analyt;cal, Inc.
5900 4th Ave�S
57E 100
Seattle, WA 98108
PHONI=: (206) 269-6310
FAX: (206) 900-8789
Sample #
Sample Description
Volume/Area
(Air)
HA # Bulk
Date/Time
Sampled
I
�I
1
"Comments/Special Instructions:
Page of pages
Cant a5ed D=Lrn.M- tOc oe AaDeeQna— RMI-11mtnote
EMSL Analytical. Inc.'s (OBA: IA Testing) Laboratory Terms and Conditions are incorporated into this chain of custody by referen
in their entirety. Submission of samples to EMSL Analytical Inc. constitutes acceptance and acknowledgment of all terms and con
Paae 2 Of 8
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9 / 2 0 / 2 4
OrderlD: 512403005
#51 4030015
4. Performance of Work. 5 Microns Inc. is qualified and willing to perf rm the Services de cribs
above as an independent contractor in accordance with the highest stanc ards of 5 Microns ne.'s
profession or craft.
Independent Contractor. The parties to this Contract intend that an i ependent contract r-
client relationship shall be created by this Contract. The conduct and cc ntrol of the work t6 be
done under this Contract shall Iie solely within the purview of 5 Micron Inc.. 5 Microns l c. is
not to be considered an agent or employee of Customer for any purpose and no joint ventu a or
principal -agent relationship exists. Neither 5 Microns Inc. nor Custom r shall have any rijht,
power, or authority to create any obligation, expressed or implied, on b half of the other.
6. Assiznment/Subcontract. Neither Party may assign or sublicense this
ontract or any of t
�e
rights, interests or obligations hereunder, in whole or in part, without th
prior written consent
of
the other Party. Any purported assignment or sublicense in violation of
the foregoing will
be null
and void ab initio and of no force or effect. This Contract shall be bind
ng upon, and shall
inure to
the benefit of, Consultant and the 5 Microns Inc. and their respective h
rs, estate, legatees,
personal and legal representatives and permitted successors and assigns
7. Comoliance with Laws. 5 Microns Inc. represents, warrants, and agre s that, in connection with
the transactions contemplated by this Contract: (a) 5 Microns Inc. can lawfully work in the United
States; (b) 5 Microns Inc. shall obtain, at its own expense (except to the extent otherwise explicitly
stated in this Contract) any permits or licenses required for 5 Microns Inc.'s Services unde i this
Contract; and (c) 5 Microns Inc. shaII comply with all statutes, laws, or( finances, rules,
regulations, court orders, and other governmental requirements of the Uaited States, the State of
Washington, and any other jurisdiction(s) in which 5 Microns Inc. is organized or authorized to do
business("Applicable Law"). Customer shall not take any actions that -night cause 5 Mic Ions
Inc. to be in violation of any of such Applicable Laws.
S. Effect, Interpretation, and Choice of Law and Forum. This Contra
shall become binding
when signed by all of the parties hereto. This Contract supersedes all p
for or contemporaleous
communications and negotiations, both oral and written, concerning the
subject matter of
is
Contract, and constitutes the entire agreement between 5 Microns Inc. E
nd Customer with �espec
to such matters. No amendment to this Contract shall be effective, unI
s it is in writing and
is
signed by all of the parties hereto. This Contract shall be interpreted and
construed under,
d
shall be and governed by, the internal. laws of the State of Washington.
In the event of any
litigation over the interpretation or application of any of the terms or pr
visions of this Co
tract,
Microns Inc. and Customer agree that litigation shall be conducted in K
ing County, Washington,
and such parties further agree that venue in King County, Washington
all be proper, and
hat
they are subject to, or shall make themselves subject to, personal jurisd
ction in the courts of
that
venue. Any and all exhibits, schedules, and addenda attached to and re
erred to in this Contract
are hereby incorporated into this Contract as fully as if set out in their a
tirety herein, but'
the
event of any conflict between the terms of this main body of the Contra
t and the terms of
ny
exhibits, addenda, or other attachments to this Contract, the terms of this
main body of the
Contract shall control. The provisions of this Contract shall survive th
termination of this
Contract to the extent of any rights accrued or obligations incurred duri
g such term. If an.
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. A #51
provision of this Contract is held to be invalid or unenforceable, the of
affected thereby. This Contract may be executed in several counterpai
executed shall constitute one contract which shall be binding on all of
that all of the parties are not signatory to the same counterpart.
12403005
;r provisions shall not be
and all counterpa�s so
e parties, notwiths , ndin,
9. Binding Effect/Amendments. This Contract shall become binding wh n signed by the pa nes.
This Contract supersedes all prior or contemporaneous communications and negotiations, k oth
oral and written and constitutes the entire Contract between the parties i elating to the work set out
above. No amendment shall be effective except in writing signed by both parties.
10. Severability. If any provision of this Contract is held invalid, the other provisions shall not be
affected thereby.
i 1. Notices. Notices and consents under this Contract must be in writing
delivery, fax, or email to the contact persons set out in this Contract.
changed by written notice to the other party.
5 Microns Inc.
By:
(signature)
Print Name:
Title:
Customer
By: G r� w! � j s �eC l
(signature)
Print Name:
Title:
delivered by
;e addresses i
hand
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OrderlD: 512403005
f5j2403
Exhibit A
Scope of Work
Place your initials next to the service requested below:
1) Mold Testing and Inspection
o Limited
o Complete
Limited Asbestos Survey
3) Asbestos Survey
4) Drinking Water Testing
5) Lead Testing
6) Radon Testing
7) Industrial Hygiene
8) Clandestine Drug Testing
9) Air Quality Testing
10) Water damage restoration
11) $
05
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OrderlD: 512403005
Exhibit B
Payment Terms
Payment is due upon receipt of the invoice. The information will be sent by email after
/2403005
is received.
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