APPENDIX G
f<Il=:.l:J:iOo=tl~Cf'J!'ItW.llmr"-"'"""l'\n"'"''~""''~lm'l"l<:rJcc-JOilii'~WJ=---~"m=='"'-~'
PARTIAL HAZARDOUS MATERIALS INFORMATION
,:-lh-''"<~=•r:..-;>;:::m•:o::<7-?:r::i'i~'>l',\l!J:>i!J'Jtm'~"-"":c;JC.';:t~""'"=-"'"""""'tlrll~m.-:;"o'mt41:t:'~'w"':~=''-'"""":-;,"~=<'-';~"·":--''l
Partial information concerning Asbestos Containing Material (ACM) in Clubhouse II
was made available from the attached report prepared in June 2005.
As a part of the roofing invesbgation, samples of the roofing membrane and mastics
were taken and sent to EMS Laboratories in Pasadena for testing. No ACM materials
were found. The EMS test report is attached.
APPENDIXG
PARTIAL HAZARDOUS MATERIALS INFORMATION
Page 1 ofl
\
Subj:
Rej FW: Clubhouse 2
Date:
612912005 9:48:48 A.M. Pacific Smndard Time
From:
io:
MY HARMONY
[email protected]
Dear Miotlael,
The ACM identified in Clubhouse 2 is as follows;
1. floor tile and ma:;tic in Storage Room 1
2. floor tile and mas1ic under linoleum in hallway
3, floor tile and ma5tic in Dining room 1
summary:
Tan floor tile and black mastic where encountered is to be treated as ACM.
Copy of sample results are being FAXED.
Best Regards
Virginia
APPENDIX G
PARTIAL HAZARDOUS MATERIALS INFORJvlATION
1574 Kemter Blvd.
San Diego, C4 921 OJ
(ISH) 191·1777 FAX(619) 2914118
BULKSAMPLEANALYSISREPORT
CURNT:
Professional Community Management
P.O. Box 220
LagllllJ' woods, CA 92654
ANALYSIS:
Thirty-seven samples submitted for analysis of asbestos roataial.
ANALYTICAL
METHOD:
Polarized Light Microsmpy!Dispe!$ion Staining, EPA 600 R-931lli6
___________________________
Clubhouse 1, Building A
24351 £1 Toro Rd.
Lagun11. Woods, CA 92654
------------------~----~----RESULTS
Lab
Dnte
Lab
l.D.#
Smple
Des<:ription
01/10105
190383
Ma!Jilom>ge, plaster wall
White point wall plaster, I"' layer
Sample 11'1, Non-:friable
01/J0/05
190383-A
Main lollilgB, pia= wall
0 l/1 0/05
01/10/05
Ol/J0/05
OJ/10/05
01/10105
190384
190384-A
190385
190385-A
190386
190386-A
%by.
Volume
Asbestos
Cellulose
ND
1-2%
Filler
Matrix
ND
Sample #I A, Non-friable
Asbestos
Cellulose
Matrix
Main lounge, plastEr wall
White paint wall plaster, !"layer
Asbestos
ND
Cellulose
Sample #2, Non·ftiable
Matrix
1-2%
filler
Main loll'Oge, plliStel' wall
Whit& plastcr, 2'"'Iayer
Sample InA, Non-friable
Asbestos
Cellulos.o
ND
1·2%
Matrix
F11ler
Main lounge, plaster w~D
White paint wall plaster, t•tayer
Sampl~ #3, Non-friable
Asbestos
Cellulose
Matrix
ND
Main lotmge, plaster wall
White plaster, 2""layer
Sample #'.lA, Non-liiable
Asbestos
ND
Cellulose
Matrix
1-2%
Filler
Storage room I, floor tile
Tan floor tile, 1" layer
Sample #4, Non-liiable
Chrysot!le
Cellulose
Matrix
1·2%
Storage room 1, floor tile
Black mastic, 2"'1ayct
Sample #4A, Non-friable
Clnysotile
Cellulose
Matrix
White plaster, 2"'Jayer
01/10105
A.•h<lstos
Type
1-2%
Filler
l-2%
Filler
1-2%
Filler
3-4%
2-3%
Fill<:r
APPENDIX G
PARTIAL HAZARDOUS MATERIALS INFORMATION
-----,--~
o•
•o
Design For Health Training, Center
3574 Ke1111er Blvd.
San Dieg<>, CA 92101
(619) 291-177i FAX(619) :l91-4318
Lab
Date
Lab
LD.#
Sample
Description
Asbestos
Type
%by
Volume
01/10/05
190387
Storage room l , floor tile
Tan floor tile, 1rt layer
Safli!llc #5, Non-friable
Cluy.lotile
Cellulose
Matrix
1-2%
1-2%
Storage room 1, (loor tile
Blac:k mastic, 2.. tayer
Sample #SA, Non-friable
Chrysotile
Cellulose
Mattix
3-4%
2-3%
Filler
01/10/05
190381-A
Filler
01/10/05
190388
Eallway,linoleum
Gray linoleum, 1• layer
Sample #6, Non-friAble
Asbestos
Cellulose
Matrix
ND
1·2%
Filler
01/10/05
190388-A
Hallway, linoleum
Gray backing, 2"'1ayer
Sample #6A, Friable
Asbestos
Cellulose
Man made fillers
Matrix
ND
15-20%
5-10%
Filler
01110/05
190388-B
Hallway, linoleum
Yellow mastic, 3'"tayer
Sample #6B, Non-friable
Asbestos
Cellulose
ND
Matrix
Filler
Hallway, linoleum
l•tayer
Samplc#7, Non-friable
Asb<:!ltos
Cellulose
Matrix
ND
1-2%
Filler
01/10/05
190389
{hay linoleum,
01/10/05
01/10/05
190389-A
190390
Hallway, linoleum
Gray backing, 2"' layer
Sample #1 A, Friable
Asbestos
ND
Cellula••
Man made fibers
Matrix
5·10%
Filler
S:unple #8, NOii·friable
Chry>otile
Cellulose
Matrix
2-3%
1-2%
Filler
Hallway, 2"' layer under lino
Blaek mastic, 2"' layer
Sample #SA, Non-liiable
Chtysotlle
Cellulose
Matrix
3·4%
Hallway, ceiling
White aroustic ceiling
ASbestos
Cellulose
Matrix
ND
Hallway, 2"' layer under line
ian floor tile, 1" layer
01/10/0S
01110/05
190390-A
190391
Sample #9, Friable
01/10/0:l
!90392
Hatlway, ceiling
Asbestos
Cellulose
White aeoll$tic telling
Sample #10, Friabto
01110/05
190393
2·3%
MMrill
Hallway, telling
Whit;' &CQUAtic ceiling
Sample #II, Friable
P~trt>:
Asbestos
Cellulo.<e
Matrix
?. of 4
15-20%
2-3%
Filler
1-2%
Filler
ND
1-2%
Filler
ND
l-2%
Filler
APPENDIX G
PARTIAL HAZARDOUS MATERIALS INFORMATION
o·• Desig_n For Health Training_ Center
•o
J 574 KeitH"" Blvd.
San Diego, C4 92101
(619) 291-1'777 FAX (619) 291-4318
%by
D•te
Lab
J.D.#
Sample
:Description
Asbi5tos
Type
01/10/05
190394
Mechanical rooxn. plaster & drywall
Bro\VIl paper drywall, 1~ layer
Sample #12, Friable
A$bcstos
Cellulose
Matrix
ND
Mecbax>ical room, plaster & drywall
White drywall, 2"" layer
Sample #12A, Non-friable
Asbestos
ND
Cellulose
Matrix
5-10%
Filler
Lab
0!110/05
190394-A
Volume
85-90%
Filler
01/10/05
190394-B
Mecba!!ical room, plastc: & dtywall
Whitt: wall plaster, 3" !aye;
Sample #12B, Non-friable
Asbestos
Cellulose
Matrix
ND
1-2%
Filler
01110105
!90395
Mechomical room,. plaster & drywall
Brown paper drywall, t• layer
Sample 1113, Fri3blc
Asbestos
Cellulose
ND
85-90%
Filler
MI!Chanical room, plaster & diywall
White drywaU, 2"" layer
Sample #13A, Non-friable
Asbestos
Cellulose
Matrix
Mechanical -mom, plaster & drywall
Brown papa, 3"' layer
Sample #138, Friable
Asbestos
Cellulose
Mechanical roon1, plaster & drywall
White plaste:r, 4" layer
Sample #13C, Non-friable
ASbestos
Cellulose
Mamx
ND
Dining room I, flooring under carpet
Tan floor tile, 1• lap
Sample 1#14, Non-friable
Cbrystrtile
Ce\lulMatrix
2-3%
1-2%
Filler
Dining room 1, flooring under ~ct
Black mastic, 2""layer
Sample #14A, Non-friable
Cl:uy,<orile
Cellulose
Matrix
3-4%
2-3%
Filler
K.itthen of dining room 1
Asbestos
Cellulose
Matrix
ND
1-2%
Filler
Kitchen Qf dining room 1
Gray backing, 2"' layer
Sample #15A, Friable
Allbestos
Cellulose
Man made fibers
Matrix
ND
Kirchen of dining room 1
Yellow mastic, 3"'layer
Sample #158. N011-ftiahle
Asbestos
Cellulose
01110/05
01/10/05
01/10/05
0!110105
190395-A
190395-B
190395-C
190396
Olf]0/05
190396-A
0!110105
190397
Gtay linoleum, I" layer
Sample #15, Non-friable
01/10/05
01/!0/05
190397-A
1%397-B
Matrix
Mauix
Matrix
ND
S-10%
Filler
ND
85-90%
Filler
1-2%
Filler
20-25o/•
15-20%
Filler
ND
2-3%
Filler
APPENDIXG
D.
PARTIAL HAZARDOUS MATERIALS INFORMATION
Design For Health Training Center
II[]~~~~~~~~~~~~~~~~~~~-----------J-S-U-~-~--g--B-1~
Satt Diqo, CA 92101
(619) 291-1777 FAX (619) 291-4318
Lab
Lab
Date
t.D.#
01110/0S
\90398
01110/05
190398-A
%by
Sample
Description
Asbil!!ltOS
Type
Kit.;hen of dining room I
Gray linoleum, 1" layer
Sample/116, NoJ;I·mable
Asbestos
Cellulose
Matrix
ND
l-2%
Kiwhcn of dining room 1
Gray backing, 2"" layer
Sample #16A. Friable
Asbestos
ND
Cellclose
Man made fiberS
20-25%
15-20%
Filler
Volume
Filler
Matrix
01/108105
Ol/10/05
190398-B
190399
Asbestos
Cellulase
M;.trix
Dining room I
Tan paint vmll plaster, l"laytr
Asbestos
Cellulose
Matrix
ND
Asbestos
ND
Sample #17, Non-ftiablc
01/10/0S
190399-A
ND
Kitchen of dining IQ()Ilt 1
Yellow tnastic, 3"' laytr
Sample #l6B, Non-friable
Dining room l
White wall plaster, 2"' layer
Sample #!7P., Non-friable
2-3%
Filler
1-2%
Flller
Cellulase
1-2%
M;.tnx
Filler
Trxc ==Leu ttllit I% llj: p~mL NO .r:::o No asb~ ~ Mcll1od ofl'imit dl!tc!:dt011 it l%. R.cauHa•rt l'laMd upon-&~~mpfcssubmiW!d f« analy&is cmly. l\.~to9
indudef, e~le., amoajte, crotidoHfr!. ~lhopl'I~IHtc, ~and. iiGI.Inolim, Thje, ~JJ~IItytlcftl tepOrtrcb.tcs onlyt~:~ lire .'~mplc! todd. lt roqymt be ucd by thl:. ~licnt tn t;~itn
prudurt dldbftcn1cnt by 'NVI..AP or 1111)1 ,.~ at the U.S, Go'vtrnmnt.. l1t =:Dr'llanc.l with T'rtk! fl ar !he Oilitortri'11 C.;ule b( kca,u16ticmB, ~rm I sj:C), (k:)CB)(l), w l;lenu;'h~tl!l ~t
tm mtferhlol iF ilot ;~...bes~ conuinint~ ~1. ~le!l shall be~ ~~J: ~ in 40 CPR 763.86. Smtpeum"" ~;11 ~ ~libeled 1Jy an lc~lfd AHER.A Buildfn(t lll$fJI:C"iM
hi il1e foliowmr:
. r.onrnn:
5Hrf11Ciftj: Ma1erl:!il ('1JriJ-tlPP~ nr trmriJed..DB
t)p ltl loo ~ t"eet orm.ah:ri111; rt mir!hnUfll orlltrtc: (J) nmpb
1000 tSJ sooo r;qun: rcetoi'inail:rW: II; miftilllnm Qti1V1!!($) sample!
..
~s,_,......,
A ntfmm11m ofthrw(J) 5Jllltlt.,-,or
,_
~deDUI
M'acrrhll
ft i' the distrc!ion ofdu buildintt
~e af.mmrin.l
t.'hurr.ttMn 5000 &q1»1le- l'ectt;trl"'t.,lerbl: :a minimiDII ur$il!'ve'tl ('1) mnplcs
NOTf., Tlk:, vnl)'l rotm, pla!ltic IJfld ftrw JIO.Wdet .Q111pki rMy oontriti ~Q;f,~ fiber! of m.ch imiill ~tklfll that tibet& mVJ' DQt ke delr.Ctcd by PLNI. I(!Jt"&ler ootttmty I&
~ired. moro. Kn6itf...._ 1111;'Lf!rLbl mcdtoda slUlh ., X~y Drt'Jbction, 'T'rmlmiariuJt JilodroiL Mfcroacopy md ~nina Elemr:un Mil:m~ aJt recommended.
,..ny bb ,,wtlber
ronowcd by3lotlcrU ldcn.tifyin.gt11)'1:'1'l;d ~le. ThenBJIIbet...,.Jtt.. ~~=~~tl-all)'efof~,:mpktlllbmittcd.
This report shall not be rq>roduced except in full, and then ODly with ll;le written approval of
Health Training Centec oppreciates the opportunity to provide these services.
Sincerely,
;ta£,;-J'+
KabirShefa
Director ofTcebnical Services
"11ih: J'¢1)()1"1 Ius l)ccn revie'\llted for Qua lily Cor'IO'Ol hy!
K:tbir She(;, _ _
Virginia L. Sl'lefa _
l...arry Prost _ _
James FrtU-__
D:llf:l Bailey _ _
me DFHTC Labor.lllory.
Design For
;
!'
t RESULTS RE®ESTED V1A
VERBAI-0
FAX~
t CLIENT FAX NO·-~------­
(NO'TE: e..nrAII~ot .... ........ wi!llolloorlii..,.., IJ\aldli!OII!Ull)l priorbEjiilfllioo! \ll11lOIOI Iii<-~~
s------
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1 0 24 0 9
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10.2.11109
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A'llt!., STii,
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NOT PIVO\IiDEC
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sura.Jf.C'T:
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C-1ififornlii 'D*p•rtntwnr at l'fAlth 3ervlc::e' EnvlrDnmanr;l TMt;ng J..abornory iL.AP 1111.
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b"""'" 1"0 II> 1 JIO!"''n' 1>1' aruo llllriiS "'P""-
tiPOn me iln e~t Itt• ~ra• 'ltb&fll. ti'Wi' ~11.!J t!f ~mplfrrv and the ma!Mi ot lh• a&11'1Jl14d rl'fl1lllrl,l,
'Tt. Nllt foHLIIIl rtp~ llfW for thu n.mglll ar Uf'Tlple dtl""'f&d fD Uli: :a,d rn:ay riOI ~ru..nJ rt'IG •1\UI'I' fl!eletiPI ffmi "~ir:fl
~ ampl" ~ ••II•"· , . l!fi'A ttC:tiJnq~llllnde ltWio ~ .11r m~ bs tmk-0" ot e ·n.~~:~rntrgurlu;u~ st~mplln\1 •1111~ l:l•tCJTD ll"'llible'
rnatan•l fl. Clll'l't~ r.nrN~O&o~:Pn-.lr'll~.
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NVI-AP or -.n~ aglr'ICY t~~l me. u.s. Gowmrn•nr.
f!IOTE: ThiS repmt IMIII nat~ l'f!Prtldm:rm, "~P1 in lull, "lfltllWt '!ne- llj'f1ntn .SpPt;\flll! gf ~S !-.,'Cbo,..1l'flilil:'-. Inc.
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Canl'ii'Fmlion I)V x.FJiiiy dlftriJdiQI'I o, TEM 1~ ~mft'ltt'l~ fllv .EPA iF,aar-1 PIOghner
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QRANU\."fl MJNERNS
P1S 1