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HOSPITAL BK 1 LT 2A-1 - ZCP 11/9/2018Kodiak Island Borough Print Form Submit by Email Community Development Department III IIIIIIIIIIIIIIII III III 710 Mill Bay Rd. Rm 205 n� Kodiak AK 99615 Ph. (907) 486 - 9363 Fax (907) 486 - 9396 23656 http://www.kodiakak.us Zoning Compliance Permit Permit No. GjFZoIQ -0Z7- The following information is to be supplied by the Applicant: Property Owner / Applicant: Kodiak Island Borough/Providence Medical Center Mailing Address: 710 Mill Bay Road Phone Number: 486-9304 Other Contact email, etc.: Legal Description: Subdv: HOSPITAL BK 1 LT 2A-1 Block: 1 Lot: 2A-1 Street Address: 1915 Rezanof Drive East Use & Size of Existing Structures: Hospital and Community Health Clinic Description of Proposed Action: Remodel interior of hospital laundry area. Add propane tanks to an unoccupied area away from the current structure. No change to building footprint. Site Plan to include: Lot boundaries and existing easements, existing buildings, proposed location of new construction, access points, and vehicular parking areas. Staff Compliance Review: Current Zoning: Public Use KIBC 17.130 PROP_ID 23656 Lot Area: 11.82 Acres Front Yard: 25 ' Lot Width: 60' Rear Yard: 25%/25 ft Prk'g Plan Rvw? Not Applicable # of Req'd Spaces: Staff Compliance Review Notes: Bld'g Height: 50' Side Yard: 10%/25ft Plat / Subdivision Requirements? No change to building footprint except for addition of propane tanks. Applicant affirms Renovations of this facility will not disturb 160 square feet, 260 linear feet, or 35 cubic feet or more of RACM Renovations of this facility will not include wrecking or taking out any load -supporting structural member of the facility together with any related handling operations or intentional burning of any facility, F-og a. -y— 4-&% s 6V; (( n sHnwn pl�c� JV`7-v(2.-ZO. Subd Case No. Plat No. 2012-20 Bld'g Permit No. TBD Bldg Dept Does the project involve YES an EPA defined facility? *Commercial buildings, installations (military bases), institutions (schools, hospitals) and residences with more than four (4) dwelling units. Driveway Permit? Septic Plan Approval: N/A N/A Fire TBD Bldg Dept Marshall: Proof of EPA notification provided (if required)? NO *Required for all demolitions, for renovations disturbing at least 160 square feet 260 linear feet or 35 cubic feet of Regulated Asbestos Containing Material (RACM), and for renovations that remove a load -supporting structural member. No permit will be issued for such projects without proof of EPA notification Applicant Certification: 1 hereby certify that 1 will comply with the provisions of the Kodiak Island Borough Code and that I have the authority to certify this as the property owner, or as a representative of the property owner. I agree to have identifiable corner markers in place for verification of building setback (yard) requirements. Attachments? Site Plan List Other: Date: Signature: This permit is only for the proposed project as d proposed project, including its intended use, prior to or during its siting, construction, or operation, contact this office immediately to determine if further review and approval of the revised project is necessary. THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED. ** EXPIRATION: Any zoning compliance permit issued is subject to the same expiration, suspension, and revocation provisions as a building permit issued for the same construction permit.** CDD Staff Certification Date: ( I /g1.201 2�' CDD Staff:ie enna- oster Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Room # 104 - Main floor of Borough Building After -the -Fact 2X the published amount Not Applicable $0.00 © $0.00 Less than 1.75 acres: $30.00 © $60.00 1.76 to 5.00 acres: E] $60.00 gsc R $120.00 5.01 to 40.00 acres: ❑X $90.00 $180.00 40.01 acres or more: ❑ $120.00 PAIR $240.00 NOV 0 8 2818 1CA��1�K►�v���JtiQ PAYMENT DATE Kodiak Island Borough BATCH NO. 11/09/2018 710 Mill Bay Rd. 2019-00000246 COLLECTION STATION Kodiak, AK 99615 RECEIPT NO. CASHIER 2019-00000564 RECEIVED FROM CASHIER ARCHITECTS ALASKA, Teresa Medina INC. DESCRIPTION KODIAK ISLAND BOROUGH/PROVIDENCE MEDICAL CENTER Zoning Compl Zoning Compliance Permit $90.00 CZ 2019 027 Payments: Type Detail Amount Check 38505 $90.00 Total Amount:I $90.00 Customer Copy Printed hv- Teresa Medina Parse 1 of 1 11/09/2018 nR-19-nR AM 9l 101 r tcE d3AgnS S.n Sq � i S Y 7 I I •OHO �! IL y��.. n ZZ lA _ a- e a 9 [R9 ti 1 P P N N ? W M W PVA O W N O O 9l 101 r tcE d3AgnS S.n Sq � i S Y 7 I I •OHO �! IL y��.. n � lA _ 9l 101 r tcE d3AgnS S.n Sq � i S Y s I I •OHO �! 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Iji i}i i'f sal i3 fEt woVo write WVW M wro.Acr Nater wrs► W*ow � -�—(�� Rw�y`a11�Mw •ahwWYN .IYwwM —1R Ou�nl arY V1/M wM'fl m N I gyp' LALwRY RENOVATION ...«....w.. * ~• $`�`�tir!� 1 ** :Y ,� �I'ft PROVIDENCE KODIAK IY MAL CTR +� qty I 1915 E REZANOF DRIVE � L i r... 1s J KODIAK ALASKA V� M&TM amm PROMT M� moot ufi ► spew WHITE � ENVIRONMENTAL JCONSULTANTS INC. Kodiak Laundry Equipment Installation 1915 Rezanof Drive E. Kodiak, Alaska 99615 Limited Asbestos and Lead Inspection Report Prepared for: Providence Kodiak Island Medical Center 1915 Rezanof Drive E. Kodiak, AK 99615 Prepared by: White Environmental Consultants, Inc. 383 Industrial Way, Suite 300 Anchorage, AK 99501 November 28, 2017 Contents Scopeof Work...............................................................................................................................................3 InspectionFindings.......................................................................................................................................4 1915 Rezanof Drive E. Kodiak, AK - Asbestos Containing Materials.............................................................4 Compliance Recommendations—Asbestos..................................................................................................5 1915 Rezanof Drive E. Kodiak, AK - Lead Containing Paint(LCP) ..................................................................5 Compliance Recommendations—Lead.........................................................................................................6 Limitations.................................................................................................................. .....7 ............................. Appendices Appendix A: Bulk Asbestos Analytical Report/ Field Collection Forms Appendix B: Lead Sample Results / Field Collection Forms Appendix C: Inspectors' Certifications 7 Scope of Work On November 16th 2017 White Environmental Consultants Inc. (WEC) performed a limited asbestos and lead inspection in support of the Kodiak Laundry Equipment Installation project. The purpose of this survey is to provide our client, Providence Kodiak Island Medical Center, with professional guidance from which they may fulfill all relevant environmental and worker health and safety obligations through compliance with applicable Environmental Protection Agency (EPA), Alaska Department of Environmental Conservation (ADEC), and the Federal Occupational Safety and Health Administration (OSHA) and the Alaska's Department of Occupational Safety and Health (AKOSH) regulations during demolition and renovation activities conducted at the aforementioned property. The interior of the building, within the project scope, was inspected and/or sampled for asbestos containing materials (ACM) and suspected lead -containing paint (LCP) to determine specific renovation and disposal activities required if these materials are present. WEC collected 39 samples consisting of 45 layers of suspected asbestos containing materials (ACM). Suspect materials identified and sampled include: a. Joint Compound b. Gypsum Wall Board C. Gypsum Wall Board Skim Coat d. Plaster e. Sprayed On Fireproofing f. Firestop g. HVAC Mastic h. Gasket i. Thermal System Insulation j. Pipe Insulation Wrap k. Water Tank Insulation I. Boiler Insulation M. Boiler Insulation Adhesive n. Cove Base Mastic o. Ceiling Tile p. Door Core The materials listed above are an inventory of suspect ACM found throughout the areas inspected at 1915 Rezanof Drive E. Kodiak, AK; sample results by material will be addressed in the findings section of the report. WEC collected 10 samples of suspect lead containing paints from various locations throughout the areas inspected. The purpose of the paint sampling was to characterize suspect paints to determine the need, if any, of lead compliance measures during the demolition and renovation process. Analysis was performed by flame atomic absorption spectroscopy EPA Method SW846-7420. Inspection Findings 1915 Rezanof Drive E. Kodiak, AK - Asbestos Containing Materials WEC personnel collected 39 samples for a total of 45 discrete layers of suspected asbestos containing materials (ACM from the interior of the building, within the project scope, located at 1915 Rezanof Drive E. Kodiak, AK. Of the 45 sample layers analyzed, 11 samples were found to contain asbestos. SAMPLE ID# MATERIAL LOCATION ASBESTOS CONTENT 637-03 Joint Compound Corridor 176 1 4% 637-07 Joint Compound Women's Locker Room, Ceiling 4% 637-10 Joint Compound Laundry Room 185, Wall, Scheduled For Removal 4% 637-12 Joint Compound Laundry Room 185, Wall 4% 637-13 Joint Compound Soiled Utility Room 184, Wall 4% 637-15 637-18 Joint Compound Joint Compound Soiled Utility Room 184, Wall Environmental Services Manager Office 182, Wall 4% 4% 637-19 Joint Compound Mechanical Room 178, Wall 4% 637-20 637-21 Joint Compound Joint Compound -------- Mechanical Room 178, Ceiling � Mechanical Room 178, Wall 4% 4% 4% 637-31 GWB Skim Coat Medical Gas Storage Room 210 Joint Compound: Fifteen samples of joint compound were taken throughout the project area within the building. Eleven of these samples were found to contain asbestos. Asbestos containing joint compound was found to be present in corridor 176, the ceiling of the women's locker room, in laundry room 185 to include the wall scheduled for removal, the soiled utility room 184, the environmental services manager office 182 and in mechanical room 178 to include the walls and ceiling. Joint compound in wall and ceiling systems is considered to be a non -friable Category II asbestos containing material by the Environmental Protection Agency, and subject to Class II removal procedures as described by the Occupational Safety and Health Administration (OSHA) in 29 CFR.1910.1011. Any disturbance of gypsum wall board within the project 4 scope, through demolition or wall penetration work, should only be performed by state certified asbestos abatement personnel. GWB Skim Coat: One sample of GWB skim coat was collected from the medical gas storage room 210. The sample collected was found to contain asbestos. GWB Skim Coat is considered a Class I asbestos containing surfacing material by OSHA and a Regulated Asbestos Containing Material (RACM) by the Environmental Protection Agency. Any disturbance of the GWB skim coat within the medical gas storage room 210 should only be performed by state accredited asbestos abatement personnel. Compliance Recommendations -Asbestos Regulatory Authority - Asbestos Code of Federal Regulations EPA 40 CFR Part 61 Subpart M (NESHAP), §61.145 Standard for demolition and renovation requires the removal of all Regulated asbestos -containing materials (RACM) from a building being demolished or renovated before any activity begins that would break up, dislodge, or similarly disturb the material or preclude access to the material for subsequent removal. Regulated asbestos containing material (RACM) is defined as (a) friable asbestos material, (b) Category 1 non - friable ACM that has become friable, (c) Category I non -friable ACM that will or has been subjected to sanding, grinding, cutting, or abrading, or (d) Category II non -friable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by the forces expected to act on the material in the course of demolition or renovation operations. EPA 40 CFR 61 Subgart M National Emission Standard for Asbestos requires the removal of regulated asbestos containing materials prior to the renovation or demolition of a building. OSHA 29 CFR 1926.1101 requires specific worker training and removal methods for all asbestos disturbances in renovation and demolition procedures. Always test building materials before disturbing the material in any way. Disturbance is defined as any activity that could disrupt the material's matrix that secures asbestos fibers within the material. Disturbance includes, but is not limited to, sanding, cutting, screwing, and nailing into the substrate. 1915 Rezanof Drive E. Kodiak, AK - Lead Containing Paint (LCP) WEC personnel collected ten samples of suspected lead containing paints from the interior of the building, within the project scope, located at 1915 Rezanof Drive E. Kodiak, Alaska. Samples were analyzed by EPA Method SW846 — 7420. A summary of the materials paint analyses is shown below. 5 Sample ID #1 Sampling Location Result Reporting Limit 637-P01 Corridor 176, GWB Wall, Above Suspended Ceiling, Tan <100 100 637-1302 Laundry Room 185, GWB Wall Scheduled For Removal, Tan 3,500 110 637-1103 Laundry Room 185, GWB Wall, Tan 4,900 100 637-PO4 Soiled Utility Room 184, Metal Door Frame, Tan/Red 1,300 110 637-1305 Mechanical Room 178, GWB Wall, White 290 110 637-P06 Mechanical Room 178, Boiler #2, Blue <200 200 637-1307 Mechanical Room 178A, Water Tank, Gray 510 100 637-P08 Mechanical Room 178A, Water Return Tank, Blue <200 200 637-1309 Mechanical Room 178/178A, Floor, Gray/Green 180 89 637-P10 Medical Gas Storage Room 210, GWB Wall, White <110 110 Compliance Recommendations - Lead The HUD/EPA term "lead-based paint" addresses the layers of paint on an applicable surface having lead equal to or greater than 1.0 mg/cm2 or 5,000 parts per million. The EPA does not indicate any safe lever of lead on painted components of a waste stream and requires a Toxicity Characteristic Leachate Procedure (TCLP) test to be performed on the waste stream to determine disposal requirements. The OSHA Lead -in -Construction standard (29 CFR 1926.62) applies to all construction work where an employee may be occupationally exposed to any detectable level of lead, including demolition or salvage of structures where lead or materials containing lead are present. Based on these results OSHA lead compliance measures will need to be implemented for the Kodiak Laundry Equipment Installation project. Detectable levels of lead were found in samples collected in the laundry room, the soiled utility room and the mechanical room. Toxic Characteristic Leaching Procedure (TCLP) samples will be required to assess the project waste stream for disposal. OSHA (29 CFR 1926.62) "Lead in Construction" has specific requirements when working in the presence of lead and where there is a potential for employee exposure to airborne lead. Employee training. Employee exposure assessments Lead compliance plan Limitations WEC performed a limited asbestos and lead inspection for the Providence Kodiak Island Medical Center laundry equipment installation project located at 1915 Rezanof Drive E. Kodiak, Alaska. Asbestos - containing or lead based painted materials may exist in areas not accessible at the time of inspection. No exterior or roof inspection and/or sampling was performed. Non-destructive testing methods were utilized. Any other suspect materials discovered during demolition or renovation not covered in this inspection report should be assumed to contain asbestos or lead and treated as such until further sampling and analysis shows materials do not contain asbestos or lead. Appendix A Bulk Asbestos Analytical Report / Field Collection Forms WHITE ENVIRONMENTAL Kw�Aq WEECONSULTANTS INC. 080 INDUSTFM WAY SUlYIt 000 AN=0=11, AX 00601 (007) 298-9881 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Report #: 635805 Client Project #: 637-17/106333-PROJ Report By. R. Briggs Report Date: 11/22/2017 Client: Providence Alaska Medical Center Collected By: R. Klaswick P.O. Box 196604 Collection Date: 11/16/2017 Anchorage, AK 99519-6999 Analysis By: G. Caudill TAT: 5 Da Sam a Count: 39 Analysis Date: 11/21/2017 Y pie Layer Count: 45 Received By: R. Briggs ProName/Location: WEC: Kodiak Laundry Equipment Received Date: 11/17/2017 � ry pment q Installation Client ID * WVL IDE Location: 637-01 AB17-8318 Corridor 176 Homogenous Material No Firestop Asbestos: None Detected Chrysotile Otter Fiberous Material Fiberous % Cellulose Trace Fdwous Glass 10% Client ID i WL ID/ Location: 637-02 AB 17-8319 Corridor 176 Homogenous Material No Plaster Asbestos: None Detected Other Fiberous Material Fiberous % Cellulose Trace Client ID 0 WL ID/ Location: 637-03 A1317-8320 Corridor 176 Homogenous Material No Joint Compound Asbestos Typo Asbestos % Chrysotile 4% Other Fiberous Material Fiberous % Cellulose Trace Color Layer RedlBladc 1 oil Other Fiberous Materials: 10% Won-Fiberous Materials: 90% Color Layer Off-white 1 of 1 Other Fiberous Materials: TRACE Non-Fiberous Materials: 100% Color layer Off -White 1 of 1 %Asbestos: 4% Other Fiberous Materials: TRACE Non-Fiberous Materials: 96% Page 1 of 12 WHITE 'J ENVIRONMENTAL mv�k WRECONSULTANTS INC. US IMDt18MUM WAY RM 380 ANCMO=r,. AX o§Wi (207) 268 -ASAI Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Client Project#: 637 -17/106333 -PROD Client ID # WL 1011 Location: 637-D4 AB174MI Corridor176 Homogenous Material No Ceiling Tile Asbestos: None Detected Other Fiberous Material Flberous % Fiberous Glass 70% Client ID # WL ID# Location: 637.05 AB17-6322 Corridor 176 Homogenous Material No Joint Compound Asbestos: None Detected Other Fiberous Material Fiberous % Cellulose Trace Client ID # VVL ID* Location: 637-06 AB17-8323 Corridor 176 Homogenous Material No Pipe Wrap Asbestos: None Detected Other Fiberous Material Fiberous % Cellulose 15% Fiberous Glass 3% Client ID # WLIDS 637-07 AB17-8324A Homogenous No Asbestos Type Chrysotile Other Fiberoua M Oriel Cellulose Location: Women's Locker Roan -Ceiling Material Joint Compound Asbestos % 4% Flberous % Trace Report #: 635805 Report By: R. Briggs Report Date: 11/2212017 Color Off -While/ Grey Layer 1011 Other Fiberous Materials: 70% Non-Fiberous Materials: 30% Color Layer Off -While 1 0f 1 Other Fiberous Materials: TRACE Non-Fiberous Materials: 100% Color Layer Black/Ofi-WhitelSilver 1 011 Other Flberous Materials: 18% Non-Fibarous Materials: 82% Color Layer Off -White 1 o1`2 %Asbestos: 4% Other Fiberous Materials: TRACE Non-Mberous Matarfals: 96% Page 2 of 12 WECCONSULTANTS WHITE��(�ENVIRONMENTAL �4 � INC. SAS INDUSTRIAL V'it7 SUI 000 AIICHQR101t, A1C 09GOiNOO7 2tid—W81 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project q: LA -026246 Report *: 635805 Client Project M 637-17/106333-PROJ Report By: R. Briggs Report Date: 11/22/2017 Client ID i WL IDN 637-07 AB17-83246 Homogenous No Asbestos: Norm Detorted Other Fibarous Material Cellulose Location: Women's Locker Room-Celling Material Joint Compound Flberous % Trace Color Layer White 2 of 2 Other Fiberous Materials: TRACE Non-Flberous Materials: 100% Client ID N WL IDN Location: 637 -Oa AB17-8325 Corridor 176 Homogenous Material Color Layer No HVAC Mastic Gray 1 of 1 Asbestos: one Detected Other Flberous Material Flberous % Cellulose Trace Other Fiberous Materials: TRACE Non-Rberous Materials: 100% Client ID N WL IDN Location: 637-09 AB17-6326 Corridor 176 Homogenous Material Color Layer No Joint Compound White 1 of 1 Asbestos: None Detected Otter Fiberous Material Fiberous % Other Flberous Materials: TRACE Cellubse Trace Non-Fiberous Materials: 100% Client ID N WL IDN Location: 637-10 AB17-8327A Laundry Room 185 -Wall Scheduled For Demo. Homogenous Material Coir Layer No Cotte Base Mastic Brown 1 of 2 Asbestos: None Detected Otter Fiberous Material Flberous •/. Cellulose Trace Otter Fiberous Materials: 8•h Wolastanke 8% Non-Fiberous Materials: 92% Page 3 of 12 WHITE 7J ENVIRONMENTAL HWU WEECONSULTANTS INC. at3s INDUSTitI1L wl7 ta7ltlt! a6o i2 011tLos, Ac "501 (QW) 268-8661 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Report #: 635805 Client Project #: 637-17/106333-PROJ Report By: R. Briggs Report Date: 11/22/2017 Client ID # WL ID/ Location: 637-10 AB17-83278 LaundryRoom 185 -Wall Scheduled For Demo. Homogenous Material Color Layer No Mud Off -While 2 of 2 Asbestos Type Asbestos X Chrysotile 4% %Asbestos: 4% Other Fiberous Material Flberous X Cellulose Trace Other Flberous Materials: TRACE _ Non-Fiberous Materials: 96% Sample Comments: Could Be Sldm Or Tedure Application Client ID i WL IDR Location: 637-12 AB17-8329 637-11 AB17-8328 Corridor 176 Material Homogenous Material Color Layer No Joint Compound White 1 of 1 Other Fiberous Material Asbestos: None Detected Cellulose Trace Other Fiberous Material Fiberous % Cellulose Trace Other Fiberous Materials: TRACE Client ID # WL ID# Location: 637-12 AB17-8329 Laundry Room Homogenous Material No Joint Compound Asbestos Type Asbestos % Chrysotile 4% Other Fiberous Material Fiberous % Cellulose Trace Client ID * WL IDN 637-13 AB17-8330 Homogenous No Asbestos Type Chrysotile Other Fiberous Material Cellulase Location: Soiled Utility Room 184 Material Joint Compound Asbestos % 4% Fiberous X Trace Non-Fiberous Materials: 100% Color Layer Tan 1 of 1 %Asbestos: 4% Other Fiberous Materials: TRACE Non-Fiberous Materials: 96% Color Layer Tan 1 of 1 %Asbestos: 4% Other Fiberous Materials: TRACE Non-Flberous Materials: 96% Page 4 of 12 WHITE ENVIRONMENTAL KWU WECCONSULTANTS INC. an INDUSTRIAL ■A7 StJiYI 200 ANC9ORLDR, Al[ 00601 (907) 268-8661 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Client Project #: 637-171106333-PROJ Cl lent ID # WL ION Location: 637-14 AB17-8331 Soiled Utility Room 184 Homogenous Material No Core Base Mastic Asbestos: None Detected Asbestos % ..-..--..._...... Ottwr Fiberous Material _ __ Flberous % Cellulose Trace Wollastonile 8% Client ID # WL IDN Location: 637-15 AB17-8332 Sailed Utility Room 184 Homogenous Material No Joint Compound Asbestos Type Asbestos % Chrysotlle 4% OftNr Fiberous Matwial Flberous % Cellulose Trace Client ID # WL ID/ Location: 637-16 AB17-8333 Laundry Room 185 Homogenous Material No Joint Compound Asbestos: None Detected OBwr Fiberous Material Flberous % Cellulose Trace Client ID # WL ID# Location: 637-17 AB17-8334 Laundry Room 185 -Line Behind Dryers Homogeraus Material No Pipe Insulation Asbestos: Nona Detected Outer Fiberous Material Flberous % Mineral Wool 99% Report #: 635805 Report By: R. Briggs Report Date: 11122!2017 Color Layer Brown 1 of 1 Otter Fiberous Materials: 81% Non-Fiberous Materials: 92% Color Layer Tan 1 oI 1 %Asbestos: 4•A Other Fiberous Materials: TRACE Non-Fiberous Materials: 96% Color Layer White 1 of 1 Other Fiberous Materials: TRACE Non-Fiberous Materials: 100% Color Layer Yellow 1 of 1 Other Fiberous Materials: 091. Non-Flberous Materials: 1% Page 5 of 12 WECCONSULTANTS WHITE�ENVIRONMENTAL KW IrJ INC. � INDUS17112AL •A7 SU 800 ANCR00011i, Alt' 006G1. (009) 268-5661 tab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Client Project #: 637-17/106333-PROJ Client ID M WL IDM Location: 637-18 AB17-8335 Environmental Services Manager Office 182 Homogenous Material No Joint Compound Asbestos Type Asbestos % Chrysollle Chrysotile 4% Fiberous % Other Fiberous Material Flberous % Cellulose Trace Client ID M WL IDM Location: 637-19 AB17-8336 Mechanical Room 178 Homogenous Material No Joint Compound Asbestos Type Asbestos % Chrysollle 4% Other Fibermn Material Fiberous % Cellulose Trace Client ID WL IDM Location: 637-20 AB17-8337 Mechanical Room 178 Ceiling Homogenous Material No Joint Compound Asbestos Type Asbestos % Chrysotile 4% Other Fiberous Material Fiberous % Cellulose Tram Client ID M WL IDN Location: 637-21 AB17-8338 Mechanical Roan 178 Homogenous Material No Joint Compound Asbestos Type Asbestos % Chrysotile 4% Other Fiberous Material Flberous % Cellulose Trace Report #: 635805 Report By: R. Briggs Report Date: 11/22/2017 Color Layer Tan 1 of 1 %Asbestos: 4% Other Fiberous Materials: TRACE tion-Fiberous Materials: 96% Color Layer Tan 1 of 1 %Asbestos: 4% Other Fiberous Materials: TRACE Non-Fiberous Materials: 96% Color Layer Tan 1 of 1 %Asbestos: 4% Other Fiberous Materials: TRACE Norr-Fiberous Materials: 96% Color Layer Tan 1 of 1 % Asbestos: 4% Other Rberous Materials: TRACE Non-Fiberous Materials: 96% Page 6 of 12 WHITE ENVIRONMENTAL iiflvU WEECONSULTANTS INC. in INDitsrstia wA-f SUl7l7< 30o WGn=z, Ar moi (007) 25a—eaal Lab Cade: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Client Project #: 637-171106333-PROJ Client ID # WL ID# Location: 637-22 A617-8339 Mechanical Room 178 Homogenous Material No GWB Asbestos: None Detected No Other Fiberous Material Fiberous % CeNubse 3% I'dwous Glass 3% Report M. 635805 Report By: R. Briggs Report Date: 11!22!2017 Color Layer Off -White 1 of 1 Other Fiberous Materials: 61/6 Non-Fiberous Materials: 94% Client ID A WL IDA Location: 637-23 AB17-8340 Steam Trap -Behind Baler #2 Mech Room 178 Homogenous Material Color Layer No Gasket Black/&hw 1 of 1 Asbestos: None Detected - - Other Fiberous Material Fiberous % Cellulose Trace Other Fiberous Materials: TRACE Non-Fiberous Materials: 1001A Client ID # WL IDA Location: 637-24 A317-8341 Between Balers 1&2 Mechanical Room 178 Homogenous Material Color Layer No Gasket Green 1 of 1 Asbestos: None Detected Other Fiberous Material Fiberous % Other Fiberous Materials: 80% Cellulose 80% Non-Fiberous Materials: 20% Client ID # WL IDA Location: 637-25 AB17-8342A Bo7er #2 Mechanical Room 178 Homogenous Material Color Layer No Insulation Off-Whiteffellow 1 of 2 Asbestos: None Detected Other Fiberous Material Fiberous % Mineral Wool 99% Other Fiberous Materials: 99% Non-Flberous Materials: 1% Page 7 of 12 WHITE ENVIRONMENTAL KWA WECCONSULTANTS INC. IIIDDSI'ftIAL, w17 I5t11Y`L '00 1N(�IOP1ot. AK 00401 (907) 268—MBI Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project 1t: LA -026245 Client Project #: 637-17/106333-PROJ Client ID I VVL IDI Location: 637.25 AB17-8342B Boller #2 Mechanical Room 178 Homogenous Material No Adhesive Asbestos: None Detected Other Fiberous Material Other Fiberous Material Flborous % 99% Cellulose Trace Client ID I WL ID/ Location: 637-26 AB17-8343A Steam Line Mechanical Roan 178 Homogenous Material No Insulation Asbestos: Nor* Detected Ott*r Fiberous Material Aberous % Mineral Wool 99% Client ID I VVI- IDS Location: 637-26 AB17-83438 Steam Line Mechanical Room 178 Homogenous Material No Lagging Asbestos: None Detected Otter Fiberous Material Flberotn % Cellulose 50% Fiberous Glass 20% Client ID I WL IDI Location: 637-27 A617-8344 Mechanical Roan 178A Homogenous Material No Insulation Asbestos: Nor* Detected Other Fiberous Material Flberous % Valera! Wool 99% Report 4: 635805 Report By: R. Briggs Report Date: 11/2211017 Color Layer Broom 2 of 2 Other Fiberous Materials: TRACE Non-Fiberous Materials; 100% Color Layer Yellow 1 of 2 Outer Flberous Materials: 99% Non-Flberous Materials: 1% Color Layer Off-WhilelSitver 2 of 2 Other Fiberous, Materials: 70% Color BANM Non-Fiberous Materials: 300/6 Layer 1of1 011ier Fiberous Materials: 99% Non-Flberoua Materials; 1% Page 8of12 WHITE ENVIRONMENTAL HWU WECCONSULTANTS INC. SSS INDUSfitLL WAY S[Jli1 300 ANCHORAGE, AX 1i460i M) 258-8661 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Client Project ii: 637-17/106333-PROJ Client ID N YYL IDN Location: 537-28 AB17-8345 Mechanical Room 178A Homogenous Material No I Insulation Asbestos: None Detected Other Flberous Material Fiberous % Mineral Wool 99% Client ID N WL IDN Location: 637-29 AB17-8346A Mechanical Room 178A Homogenous Material No Insulation Asbestos: None Detected Other Flberous Material Fiberous % Mineral Wool 99% Client ID N WL IDN Location: 637-29 AB17-83468 Mechanical Roan 178A Homogenous Material No Lagging Asbestos: None Detected Otter Fiberous Material Flberous % Cellulose 50% Fiberous Glass 20% Client ID N WL IDN Location: 637-30 AB17-8347 Mechanical Room 178A Homogenous Material No Insulation Asbestos: None Detected Other Fiberous Material Flberous % Mineral Wool 99% Report M 635805 Report By: R. Briggs Report Date: 11/22/2017 Color Layer Yellow 1 of 1 Other Fiberous Materials: 9911. Non-Fiberous Materials: 1% Color Layer Yellow 1 of 2 Other Flberous Materials: 99% Non-Fiberous Materials: 1% Color Layer Off-White/Silver 2 of 2 Other Fiberous Matarials: 70% Non-Fiberous Materials: 30% Color Layer Yellow 1 of 1 I Other Fiberous Materials: 99% Non-Fiberous Materials: 1% Page 9 of 12 EECONSULTANTS WHITEENVIRONMENTAL HW Q INC. US INDUS'C7t"MAY tiilM 000 ANCSoUCT, AX M01 (007) 268-11681 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project M LA -026246 Client Project #: 637-17/106333-PROJ Client ID # WL ID# Location: 637-31 A817 -8348A Med Gas Slorage 210 Homogenous Material No Skim Coat Asbestos Type Asbestos % Cluysotle 4% OHwr Fiberous Material Fiberous % Cellulose Trace Client ID # WL ID# Location: 637-31 AB17-83488 Med Gas Storage 210 Homogenous Material No GWB Asbestos: None Detected 00wrFiberous Material Other Fiberous Material Fiberous % Cellulose 3% Fiberous Glass 3% Client ID # WL ID# Location: 637-32 AB17-8349 Med Gas Storage 210 Homogenous Material No Cotie Base Mastic Asbestos: None Detected 00wrFiberous Material Otter Fiberous Material Fiberous % Cellulose Trace Client ID # WL ID# Location: 637-33 AB17-8350 Med Gas Storage 210 Homogenous Material No Jcint Compound _ w Asbestos: Normo Defected 00wrFiberous Material Flberous% Cellulose Trace Report #: 635805 Report By: R. Briggs Report Date: 11/22/2017 Color Layer Off -White 1 of 2 %Asbestos: 4% Other Fiberous Materials: TRACE Non-Fiborous Materials: 96% Color Layer Off-white 2 of 2 Other Fiberous Materials: 6% Color Brown Non-Fiberous Materials: 94% Layer 1of1 Other Fiberous Materials: TRACE Non-Fiberous Materials: 100% Color Layer Off -White 10(l Other Fiberous Materials: TRACE Non-Fiberous Materials: 100% Page 10 of 12 WHITE ENVIRONMENTAL KYU0 WECCONSULTANTS _INC_. SOS 1ttDt151'RIAL_ •A7 tSZ11'r1 000 ANC7lO]a1+01C, AX M01 (001') 258-0661 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Client Project M 637-17/106333-PROJ Client ID # WL ID# Location: 637-34 AB17-8351 Storage Room 151 Homogenous Material No Joint Compound Asbestos: Normo Detected Other Fiberous Material Flberous % Cellulose Trace Client ID * WL IDI Location:' 637-35 AB17-8352 Storage Room 151 Homogenous Material No Cove Base Mastic d Asbestos: None Detected Other Fiberous Material Fibsroua % Cellulose Trace Wollastoriile 8% Client ID # WL IDI Location: 637-36 AB17-8353 Storage Room 151 Homogenous Material No Fire Proofing Asbestos: None Detected Other Flberous Material Flberous % Cellulose Trace Mineral Wool 90% C11" ID # WL ID# Location: 637-37 AB17-8354 Storage Room 151 Homogenous Material No Fire Proofing Asbestos None Detected Other Flberous Material Flberous % Cellulose Trace Mineral Woo( 90% Report M 635805 Report By: R. Briggs Report Date: 11/22/2017 Color Layer White 1 of 1 Other Fiberous Materials: TRACE Non-Fiberous Materials: 100% Color Layer Brown 1 of 1 Other Flberous Materials: 8% Color Gray Non-Fiberous Materials: 92% Layer 1ofI Other Fiberous Materials: 90% Color Gray Non-Fiberous Matarials: 10% Layer 1of1 Other Fiberous Materials: 90% Non-Fiberous Materials: 10% Page 11 of 12 WACWHITEM�(jENVIRONMENTAL H l� bCONSULTANTS_ INC. U3 WDUS1`1LIAI. WAY StJl7f 000 MCnG F,. 11[ 09501 (ti07) 26E—t18d1 Lab Code: 200124-0 Bulk Sample Analysis for Asbestos WL Project #: LA -026246 Client Project M 637-17/146333-PROJ Cllent lD # WL to# Location: 637-38 AB17-8355 Storage Room 151 Honw)"nous Material No Fre Proofing Asbestos: None Detected Other Fiberous Material Flberorrs % Cellulose Trace Mineral Wool 90% Report #: 635805 Report By: R. Briggs Report Date: 11/22/2017 Color Layer Gray 1 of 1 Other Fiberous Materials: 90% Non-Fiberous Materials: 10% Client ID # WL. ID# Location: 637-39 AB17-8356 Materials Manager's Office Door 179 Homogenous Material Color Layer No Door Insulation Yellow 10(i Asbestos: None Detected Other Fiberous Material Flberous % Other Fiberous Materials: 897. Cellulose 99% Non-Fiberous Msterials: 1% l ",Ca ll Lab Analyst Joel Hicklin, Laboratory Technical Manager 11/22/2017 Date 11/22/2017 Date Analysis performed by: EPA Method 6001M4-82-020 or EPA Method 600/R-93!116, at the discretion of the client or WEC. AM quantities reported are based on visual estimation by PLM, unless point -counting method is requested and noted for the sample. Test report relates only to items tested and must not be used by client to claim product endorsement by NVLAP or any agency of the U.S. Government. Test reports must not be reproduced without the approval of WEC, Inc.. and are subject to WEC, Inc. General Terms and Conditions (available upon request). Page 12 of 12 WZCWHITE FROJECTNAME K. La�oENVIRONMENTAL LOCATION f`-a�I�-+n �/ir PROJECrNCONSULTANTS INC. C, .t -03 DATE al�G-�I? cL>ENr 383 Industrial Way, Anchorage, Alaska 99501 CLO NTPROJECr, (U{e 333 HEFrNO._LoF 3 Phone(907 258-8661 Fag 907 258-8662 CHAIN OF CUSTODY RECORD — ANALYTICAL REQUEST ANALYSIS REUMTED (Circle) PCM 1 tit TEM LEAD TURNAROUND REQUESTED NO. OF SAMPLES COLLECTION DATE: RELINQ" BY: ItKidLul* DATE /TIME SAMPLES RECEIVED BY DATE I TIME SHIPPINGo[OD b `Q�sw,c�t COURIER (si�at ) SAMPLES RECEIVED BY DATE / TIME COMMENTS 11 SAMPLE IDN MATERIAL LOCATION COMMENTS 37- 37 - bZ _ i � hk 137 - 0& toe , w p p0 Wwtcn ' S Lot* 4m 4 oq 0CALchVVLa x 4fvA lz� ( X194 Lf ekm o 3 - T5r f17 Ata .4 �omv- (out o1M m .W 4YHITE PROJECT NAMEA diak ry !t!I r 1 � ENVIRONMENTAL CONSULTANTS INC. LOCATION i6i, ,,,�1F _�(�pROCENO. �/ 1% 7-ra 6-; DATE -1 k- ZC f 383 Industrial Way, Anchorage, Alaska 99501 CLIENT PROJECTM (()(R 333' 6% SHEETNo.2—�oF-'3— Phone (907) 258-8661 Fax907 258-8662 CHAIN OF CUSTODY RECORD — ANALYTICAL REQUEST ANALYSIS RE STED (circle) PCM TEM LEAD TURNAROUND QUESTED Is NO. OF SAMPLES 3 111-1&- COLLECTION DATE: RELINC�D BY: kS WICK DATE / TIME SAMPLES RECEIVED BY DATE / TIME SHWPIN ?'1110D /41f5 COUR + to ) SAMPLES RECEIVED BY DATE/TME CO NTS SAMPLE IDA MATERIAL LOCATION COMMENTS ' o"nt o rn udA �►n lr� 1Sc 5� 37- '�? �u�5�� • o l r►1iln�(rSinew ,� -L; e- v,,a drrrs cowl, PvvqvAJ� „I nwcts A vt %.v f 04if I Y Z ramovA40%iiWw►M 17 Zo cww^ M6%41 lum ' Z ( t M %$ 6�7- Z Z— 0 vi -b u�+ � ig 3 7- 7, �7 Wt& , !� ""'C" I \t,6 O" 412 wk w/Ctl .v n 1 ' ZGDIN i hSl 4+io 1i" r,o( I wom 1-9 V 4 th'(11-60itY15010fim, - 3?' 2 $ Vxff( ff+Wvj IwK. &5abi6 Z �tG til wl co l S - Jv CO, MA,, 1w, h �Il�}r ln,(� ( g f'1 179A � WHITE PROn:cr NAnE Kad (ii l(, �..Lr uVt(+f �y e?d,'>P w�- t Ln T�4 Jls �i1A. ENVIRONMENTAL LOCATION j'cadiaK�slA.+�,R,hK PROJECT NO. 1{32- 17 ,�. CONSULTANTS INC. - ;oZol7-a?y DATE r -lb -?A17 383 Industrial Way, Anchorage, Alaska 99501 CLIENTPROJECTN �13ptr, s,EErxO.3 OF 3 Phone 907 258-8661 Fax 907 258-8662 CHAIN OF CUSTODY RECORD — ANALYTICAL REQUEST ANALYSIS R STED (circle) PCM 1. TEM LEAD TURNAROUND REQUESTED NO. OF SAMPLES -31COLLECTION DATE: RELINQUI 9 - BY: SWIi DATE /11TIME % �} l vf r SAMPLES RECEIVED BY DATE I TIME SIID'PIN ODI,' COURIER ( si ure) SAMPLES RECEIVED BY DATE I TIME COMMENTS SAMPLE IDN MATERIAL LOCATION COMMENTS 1 ' 3 A 5 � �� G.5 S -I, (q 10 f 07, 9103m 61 Vi 34 r� �o�►h 3� 3 F Appendix B Paint Sample Analytical Results / Field Collection Forms WRITE ENVIRONMENTAL WiECCONSULTANTS INC. 1161 tbtAtttif'R1AL 1/�Y t3t7tltt 100 ANC7101tWilt, Alt: *Wfli (007) 20-8681 Lead Analysis in Paint WL Project #: LA -026251 Client Project M 637-17 Client: Providence Alaska Medical Center P.O. Box 196604 Anchorage, AK 99519-6999 TAT: 5 Day Sample Count 10 Project Name/Location: WEC: Kodiak Laundry Equipment Installation Report M 635798 Report By: R. Briggs Report Date: 11/21/2017 Collected By: R. IUaswick Collection Date: 11/1612017 Analysis By: J. Hicklin Analysis Date: 11/212017 Received By: R. Briggs Received Date: 11/172017 I Joel Hicklin, Laboratory Technical Ma ager 11121/2017 Date- 11121/2017 ate- 11/21/2017 Date Preparation is performed according to EPA Method SW -846 3050B (M). Analysis performed acmiding to EPA method SW -846 7420 (M), analysis by flame atomic absorption spectroscopy. The Reporting Limit Is at least twice that of the Method Detection Urnit (MDL). The MDL (defned as the minimum conceWation of an analyte that can be reported with 99% confidence to have a concentration greater than zero) is detemrned from statistical analysis of replicate samples in a given matrix containing the analyte, as defined in 40CFR Part 136, Appendix B. Field and laboratory blanks are used to assess possible contamination and sensitivity of analos, and no blank correction is made. Unless otherwise stated, al quality control samples are acceptable. Modifications made to the previously referenced test mediods are documented in WEC, Inc. Standard Operating Procedures Manual. Supporting laboratory documentation is available upon request. Unless otherwise stated, samples ere reoeived In acceptable condition. Results relate only to the items tested. WEC, Inc. Anchorage is a current proficient participant in ft Al HA ELPAT program and is acereditted byAIHA LAP, LLC for environmenU lead (Lab ID# 102739). Test reports must riot be reproduced without the approval of WEC, Inc. and are subject to WEC, Inc. General Terns and Conditions (available upon request). Page 1 of 1 Client ID WLSample Result Result Units Reporting Limit (ppm) 637-P01 AL1 7-3797 <100 ppm 100 637 -PO2 AL17-3798 3,500 ppm 110 637-PO3 AL17-3799 4,900 ppm 100 637-PO4 AL17-3800 1,300 ppm 110 637 -POS AL17-3801 290 ppm 110 637-PO6 AL1 7-3802 <200 ppm 200 637-PO7 AL17-3803 510 ppm 100 637 -POS AL17-3804 <200 ppm 200 637-PO9 AL1 7-3805 180 ppm 89 637-P10 AL17-3806 <110 ppm 110 I Joel Hicklin, Laboratory Technical Ma ager 11121/2017 Date- 11121/2017 ate- 11/21/2017 Date Preparation is performed according to EPA Method SW -846 3050B (M). Analysis performed acmiding to EPA method SW -846 7420 (M), analysis by flame atomic absorption spectroscopy. The Reporting Limit Is at least twice that of the Method Detection Urnit (MDL). The MDL (defned as the minimum conceWation of an analyte that can be reported with 99% confidence to have a concentration greater than zero) is detemrned from statistical analysis of replicate samples in a given matrix containing the analyte, as defined in 40CFR Part 136, Appendix B. Field and laboratory blanks are used to assess possible contamination and sensitivity of analos, and no blank correction is made. Unless otherwise stated, al quality control samples are acceptable. Modifications made to the previously referenced test mediods are documented in WEC, Inc. Standard Operating Procedures Manual. Supporting laboratory documentation is available upon request. Unless otherwise stated, samples ere reoeived In acceptable condition. Results relate only to the items tested. WEC, Inc. Anchorage is a current proficient participant in ft Al HA ELPAT program and is acereditted byAIHA LAP, LLC for environmenU lead (Lab ID# 102739). Test reports must riot be reproduced without the approval of WEC, Inc. and are subject to WEC, Inc. General Terns and Conditions (available upon request). Page 1 of 1 WHITE PROJECCNAME__IIOdrQK Utvn�try �il�i,py1^!d� .�nS�ill IIti» tom- ENVIRONMENTAL LOCATION �p�I/�R� L5�(�nf� f� PROJECTNO. LOCATION - CONSULTANTS INC. - - CLQ eW c, #-7a -v3q 383 Industrial Way, Anchorage, Alaska 99501 CLIENT PROJECT# I Di[ SHEETNO.�OF__�__ Phone 90 258-8661 Fax 907 258-8662 CHIAIN OF CUSTODY RECORD — ANALYTICAL REQUEST ANALYSIS REQ UE tr PCM PLM i) TURNAROUND REQUESTED NO. OF SAMPLES o COLLECTION DATE; 1 I-/& ` REI QUISHEDBY. 14(A5wZK DATE/TIME I - - I? SAMPLES RECEIVED BY DATE/TRAE SHIPPING METHOD 26b l�a5w�G1G COURIER (S' INtirm SAMPLES RECEIVED BY DATE / TIME COMMENTS SAMPLE IDN MATERIAL LOCATION COMMENTS C 17U - ri Uw b�> 85- 401n A. ?S 0ZNye, M c ry4wn !L -71 IMA - - f 07- ___. J r►- c 5 s 11D w, N C4 0' ______..1 `� [,_... `,� , .roe '. Ll! Vid 691 LIOZ/OZ/6 it Appendix C Inspectors' Certifications