HomeMy WebLinkAboutX2017-4008 - MiscCertificate of Analysis
PLM Asbestos Identification
tel- 714-889-8900
free - 888-743-0998
fax - 714-899-7098
www.patriotial).com
1041 S. Placentia Avenue, Fullerton, CA 92831
Jackson Environmental Report Number:
7545 Irvine Center Dr Suite 200 Project Number:
Irvine, CA 92618
Project Name:
Project Location:
X2017 -JM
6223 Balboa 131vj'
669999
E Balboa Blvd
1223 E Balboa Blvd
Newport Beach CA
Date Collected: Collected By:
Date Received: 7/6/2017 Claim Number:
Date Analyzed: 7/7/2017 PO Number:
Date Reported: 7/7/2017 Number of Samples: 11
Lab/Client ID/Layer Location Material Description Color Composition (%)
669999-001 Bedroom Acoustic White 80% Carbonate
1 15% Foam
5% Paint -
Total Asbestos None Detected
669999-002 Bedroom Drywall White 85% Sulfate
2 6% Carbonate
5% Cellulose
4% Paint
Total Asbestos None Detected
669999-003 Bathroom Linoleum Tan 70% Non -
3 Fibrous Material
25% Cellulose
5% Glass. Fibers
Total Asbestos None Detected
669999-003M Bathroom Mastic Black 98% Tar
3
Chrysotile 2 %
Total Asbestos 2 %
669999-004 Roof Roofing Black 60% Tar
4 15% Glass Fibers
10% Minerals
15% Cellulose
°
Total Asbestos None Detected
°
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Certificate of Analysis
PLM Asbestos Identification
Jackson Environmental
7545 Irvine Center Dr Suite 200
Irvine, CA 92618
Report Number:
Project Number:
Project Name:
Project Location:
tel - 7.14899-8900
free - 888-7434998
fax - 7.14899-7098
www.l)atriotial).com
1041 S. Placentia Avenue, Fullerton, CA 92831
E Balboa Blvd
1223 E Balboa Blvd
Newport Beach CA
Date Collected:
Collected By:
Exterior Plaster White
Date Received: 7/6/2017
Claim Number:
Date Analyzed: 7/7/2017
PO Number:
Date Reported: 7/7/2017
Number of Samples: 11
5% Paint
Lab/Client ID/Layer Location
Material Description Color
Composition (%)
669999-005 Roof
Roofing Black
60% Tar
5
80% Carbonate
15% Glass Fibers
10% Minerals
15% Cellulose
Total Asbestos None Detected
669999-006 Roof Penetration Roof Mastic Black 95% Tar
6 5% Cellulose
Total Asbestos None Detected
669999-007 Rear Exterior Plaster White 80% Minerals
7 15% Carbonate
5% Paint
Total Asbestos None Detected
669999-008
Side
Exterior Plaster White
80% Minerals
8
15% Carbonate
5% Paint
Total Asbestos
None Detected
669999-009
Hall
Acoustic White
80% Carbonate
9
15% Foam
5% Paint
Total Asbestos
None Detected
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Certificate of Analysis
PLM Asbestos Identification
Jackson Environmental
7545 Irvine Center Dr Suite 200
Irvine, CA 92618
Report Number:
Project Number:
Project Name:
Project Location:
tel- 714-899-8900
free - 888-743-0998
fax - 7.14-899-7098
www.patriotlab.com
1049 S. Placentia Avenue, Fullerton, CA 92831
E Balboa Blvd
1223 E Balboa Blvd
Newport Beach CA
Date Collected: Collected By:
Date Received: 7/6/2017 Claim Number:
Date Analyzed: 7/7/2017 PO Number:
Date Reported: 7/7/2017 Number of Samples: 11
Lab/Client ID/Layer Location Material Description Color Composition (%)
669999-010 Bedroom Drywall White 85% Sulfate
10 6% Carbonate
5% Cellulose
4% Paint
Total Asbestos None Detected
669999-003 Sample contains mastic.
Raul Lanuza - Analyst
Ian Reyes - Approved By
Bulk sample(s) submitted was (were) analyzed in accordance with the procedure outlined in the US Federal Register 40 CFR 763, Subpart F, Appendix
A; EPA -600/R-93/116 (Method for Determination of Asbestos in Building Materials), and EPA -600/M4-82-020 (US EPA Interim Method for the
Determination of Asbestos in Bulk Insulation Samples).Samples were analyzed using Calibrated visual Estimations (CVES); therefore, results may not be
reliable for samples of low asbestos concentration levels. Samples of wall systems containing discrete and separable layers are analyzed separately and
reported as composite unless specifically requested by the customer to report analytical results for individual layers. This report applies only to the items
tested. Results are representative of the samples submitted and may not represent the entire material from which the samples were collected. "None
Detected' means that no asbestos was observed in the sample. -<1%- (less than one percent) means that asbestos was observed in the sample but the
concentration is below the quantifiable level of 1%. This report was issued by a NIST/NVLAP (Lab Code 200359-0) and CADOHS- ELAP (Cert. No.
2540) accredited laboratory and may not be reproduced, except in full without the expressed written consent of Patriot Environmental Laboratory Services,
Inc. This report may not be used to claim product certification, approval or endorsement by MST, NVLAP, FLAP or any government agency.
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Page 3 of 3
Lab Use Only
Report Number: RIM
tel - 714.099-8900
free - 808-743-0998
fax - 714-899.1098
www.patriottab.com
10415. Placentia Avenue, Fullerton, (A 921131
CHAIN OF CUSTODY
Client: Jackson Environmental
Project No.:
Contact Person: MichaelJacksnn
Project Name: - /t, -
Client Address:
Project Location: t7,23 C 6t1(ioa
7545 Irvine Center Drive Suite 200, Irvine CA 92618
,. G
Contact Phone: 949-230-9779
Sam les Collected BY:
Contact Fax:
Authorized by: Claim #: PO #:
HOW d0 you Want your report? Circle
Mail Fax Web E-mail: iecreports®gman.mm
Special Instructions:
Analysis Requested
Turnaround Time business hours/days)
RUSH (4 hours) ❑ RUSH (8 hours) ❑ 1
24 Hr,4"J1 1 48 Hr ❑ 1 72 Hr ❑ 1 Other (specify)[]
Nelas: 4HR TATavei/abla until fEK viable AMIsomles nurul. 5.7 days mmanundmialmum.aamarial cultures require minimum 30hrTAT. STL CAL-wFTami TCLPminlmum TATamr3hrs.
Asbestos PCM (fiber count) NIOSH 7400A ❑
PLM (bulk asbestos) EPA 6001R-931118 Point Count 400 0
CARS 435 Point Count 1000 f�
Gravimetric Reduction (Gravimetric Reduction Requires Minimum 10hr TAT) (�
Microbiolon
Full
Non -Viable Air - Spore Trap, SOP IV.4.lmt2m
❑ Viable (Colony ID & Enumeration) Air ❑ Swab/Bulk ❑
Non -Viable Surface Tape Lift/Swah/Bulk, SOP IV.4.3m/4m ❑ - - -
Bacteria (Samples must be received by the laboratory vAthin 24hrs GI
collection or results maybe invalid)
❑
Total Coliform and E. toll -Surfaces, Swabs, and Bulk
Solids, Liquids (non -potable, non -wastewater)— Presence 7 Absence
Chemistry
Lead by Flame AA - EPA 305oB/7420mod, NIOSH 7082mad:
Pain ❑ Air ❑ Dust Wipe ❑. Water (non -potable) ❑ - Soils/Sdids ❑
Lead Waste Profile (by Flame AA)
1: TTLC Total Threshold by EPA 30508 ❑ 2: wET I Article 5 App 2 ❑ 3: TCLP EPA 1311 ❑
mod STLC/CAL Title 22 CCR Ohl
Note: 200 Ib.) for Check here to for disposal ❑
Please provide at approx. grams (approx. % of
sample complefe pile. perform all teat necessary
Rotometer Calibration ❑
pH testing (sobs, mise. solids, d liquids) EPA 9045 ❑
Client
Sample
Sample
Date
Location Sampled
Description of Sample
Start
stop
Avg.
Total
notal vol
(Flow x
ID
Type
Sampled
qn,
(Material type, dimensions, etc)
Time
Time
(LPM)
Min.
Tat. Min)
o a
a �,,
Relin ui5hed By: Print) Michael Jackson
Sig Date:Time:
Received B (Print)
Si n: Date: Time:
Relinquished By: (Print)
Sign: Date: Time:
Received By: (Print)
Sign: Date: Time:
Method of Shiimaht i Preservation During Shipment:
o" Condit oneoYSan 111118:�Aceptabls: YES / NO
o m , eommenls: ° c
Note: Patriot's holding time for all samples submitted is 30 days for solid samples, 7 days for digests, and immediate fr,rlead in air after analytical results are
reported. Unless customer provides written instructions to extend holding time. samples will be disposed of in accordance with local, state and federal laws.
age 1 of v.8.16.2014
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