Asbestos SurveypscIeanair.org
Puget Sound Clean Air Agency
Single -Family Notification Case #: 201906352
This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available
for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)).
Fee Amount Paid $65.00
Credit Card Transaction # AK0A7BBA3CB0
Transaction Date
12/26/19
Owner's Name
Mark McDowell
Project Street Address 23521 75th Ave W
City
Edmonds
Contact Person
Mark H McDowell
Mailing Address
12345 Lake City Way NE #223
Seattle, WA 98125
This project includes a demolition.
Demolition Start Date 01/06/20 Completion Date 02/29/20
Demolition will be completed by the home owner
Phone (206) 949-9180
Zip 98026
Phone (206) 949-9180
I certify that:
(1) This is a single-family residence project. The structure is used by one family who owns the property as their domicile.
(2) The information I have provided is to the best of my knowledge accurate and complete.
(3) I understand the fee for this Notification is nonrefundable.
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If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
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A-T
Asbesto-Test,
Inc.
t429Ave D. 087, Snohomish, WA 98290
425-489-4040
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ASBESTOS SURVEY
Detached Garaze Only (a; 23521 75`h Ave. W., Edmonds, WA 98026
Page I of 4
B2191115
November 26, 2019
McDowell Design Build
12345 Lake City Way NE #233
Seattle, WA 98125-9401
Attn: Mark McDowell
206-949-9180
mhmcDowell lnQmail.cum
On November 21, 2019, Asbesto-Test personnel conducted an Asbestos survey (per
U.S.E.P.A./A.H.E.R.A. guidelines as designated and specified by Puget Sound Clean Air
Agency and Washington State) of the gara_e only (a) 23521 75"' Ave. W., Edmonds,
Snohomish County, Washinkgon 98026. This survey purpose is to identify any Asbestos
Containing Materials that may be present and will require professional removal prior to
demolition or renovation.
Note: Samples of suspect Asbestos Containing Materials were taken and analyzed for the presence of asbestos.
THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES TAKEN. If there is any additional suspect ACM
located prior to or during demolition (such as, but not limited to, those materials listed on the last page of this
report), that was not discovered in this survey, the material(s) must be Presumed Asbestos Containing Material
unless tested otherwise by laboratory analysis.
continue to page 2
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Page 2 of 4 November 26, 2019
B2191115 Asbesto-Test, Inc. 425-489-4040
Detached Garaxe Only C� 23521 7PAve. W., Edmonds, WA 98026
NARRATIVE OF FINDINGS
BASIC CONSTRUCTION: The structure is wood frame. The siding is wood. The vapor
barrier was sampled from beneath the wood siding. The composition roofing materials were
sampled.
INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior is drywall
with a rough surfacing paint. The drywall/taping and surfacing paint materials were sampled.
INSULATION: There was no insulation located.
ELECTRICAL SYSTEM: The power may have been "on" at the time of the inspection, thus
sampling was not safe. Any suspect asbestos containing electrical wiring insulation or any
suspect TSI (Thermal System Insulation) found in, around, or behind any located fuse or breaker
boxes should be considered to be ACM (Asbestos Containing Material), unless determined
otherwise by laboratory analysis
HEATING AND VENTILATION SYSTEM: There is no heating system.
MISC.: None.
ADDITIONAL STRUCTURES ON SITE INCLUDED IN THIS SURVEY: None.
# of structures included in survey: one garage only
Requested by: Mark McDowell
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Bill R Hulaon
Ms eellelect0riy oompbsod
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AHERA Buidin0 Inspector
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TSCA Title II, 40 CFR 763 (AHERAI
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William R. Hutson II
Inspector, Certified A.H.E.R.A.
Accred. # 170954 exp. Jan. 9, 2020
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continue to page 3
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1429Ave. D. 9187, Snohomish, WA 98290
425-489-4040;f775-665-0420
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Page 3 of 4
November 26, 2019
B2191115
Asbesto-Test, Inc. 425-489-4040
Detached Garaue Only (a), 23521 75'hAve. W.,
Edmonds, WA 98026
ANALYSIS ID
ASBESTOS//TYPEHQUANTITY OTHER MATERIAL
THERE WAS NO ASBESTOS DETECTED IN ANY OF THE MATERIALS SAMPLED
1.0 composition roofing
NAD
cellulose, tar,
black with some brown grain
non -fibrous materials
2.0 vapor barrier
NAD
cellulose, tar
beneath previous sample
3.0 mastic
NAD
cellulose, adhesive
holding composition roofing
4.0 vapor barrier
NAD
cellulose, tar
beneath exterior siding
5.0 drywall/taping compound
NAD
non -fibrous materials
interior sample 1
cellulose, gypsum
5.1 drywall/taping compound
NAD
non -fibrous materials
interior sample 2
5.2 drywall/taping compound
NAD
non -fibrous materials
interior sample 3
6.0 textured paint
NAD
paint, cellulose
interior sample 1
6.1 textured paint
NAD
paint, cellulose
interior sample 2
6.2 textured paint
NAD
paint, cellulose
interior sample 3
continue to page 4
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1429Ave. D. 4187, Snohomish, WA 98290
425-489-4040; f775-665-0420
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Page 4 of 4 November 26, 2019
B2191115 Asbesto-Test, Inc. 425-489-4040
Detached Gur(,ce (hill' (a 2 521 7 "' Ave. W., Edmonds, WA 98026
If, during demolition or renovation, any additional hidden or covered suspect asbestos containing materials are located (may include but not limited to: sheet vinyl flooring, tile
flooring, wall or ceiling texturings or paints, concrete siding or skirting, cement pipes, cement wallboard, electrical cloth, electrical wiring insulation, thermal paper, wallboard,
joint compounds, vinyl wall coverings, spackling compounds, or any other suspect TSI (Thermal System Insulation)), they are presumed Asbestos Containing Materials unless
determined to be non -asbestos by lobweoty analysis.
Analytical test method: USEPA 600/R93/116'r (PLM); WAC 296-62-07753 App. J
—One percent is the USEPA regulatory limit for asbestos in bulk samples.
Key: "FRIABLE" signifies "Easily Airborne"
ACM signifies Asbestos Containing Material'
NAD signifies "No Asbestos Detected"
END OF REPORT
ArLynn Hammond, Pres., BSc.
Analytical Chemist, AIHA proficient
Inspector, certified A.H.E.R.A.
accred#174014; exp. July 17, 2020
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1429 Ave. D. 4187, Snohomish, WA 98290
425-489-4040; f775-665-0420
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