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Home My WebLink About3555 Lutheran Parkway (2019)City of Wheat Ridge Commercial Roofing PERMIT - 201902401 PERMIT NO: 201902401 ISSUED: 11/14/2019 JOB ADDRESS: 3555 Lutheran Pkwy W EXPIRES: 11/13/2020 JOB DESCRIPTION: Commercial re -roofing recovering existing roofing system with a factory mutual VSH rated hail system. System will mechanically attach to overboard with a 2 ply torch applied Mod Bit membrane cover. All new sheet metal flashings and trims. *** CONTACTS *** OWNER (303)653-3006 LHRED WHEAT RIDGE LLC SUB (303)781-5454 CRAIG GAREY 021224 WEATHERSURE SYSTEMS, INC. *** PARCEL INFO *** ZONE CODE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant USE: UA / Unassigned BLOCK/LOT#: 0 / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 476,020.00 FEES Total Valuation 0.00 Use Tax 9,996.42 Permit Fee 3,563.70 ** TOTAL ** 13,560.12 *** COMMENTS *** *** CONDITIONS *** COMMERCIAL FLAT ROOFS: In order to pass a final inspection on commercial elastomeric or similar type roofing, a WARRANTY LETTER from the manufacturer technical representative stating that "the application of the roof at (project address) has been applied in accordance with the installation instruction for (roof material brand name) roof covering" is required to be on site at the time of final inspection. LADDER MUST BE SET FOR ALL ROOF INSPECTIONS: A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. ALL PITCHED ROOFS REQUIRE A MIDROOF INSPECTION REGARDLESS OF PITCH. MIDROOF & SHEATHING: Effective December 1, 2014, asphalt shingle installations require an approved midroof inspection, conducted when 25-75 percent of the roof covering is installed, prior to final approval. Installation of roof sheathing (new or overlay) is required on the entire roof when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and Mid -roof inspections may be called in at the same time, 100 percent of the sheathing must be complete and 25-75 percent of the midroof may be complete. Asphalt shingles are required to be fastened to the roof deck with a minimum of 6 nails per shingle. A ladder extending 3 feet above the roof eave and secured in place is required to be provided for all roof inspections. REGARDING ROOF VENTILATION: Roof ventilation shall comply with Building Division Policy BD -18-001 for Balanced Ventilation Systems, or manufacturer installation instructions, whichever is more stringent. FOR ROOF PITCH 6/12 AND OVER: Midroof & Final Roof inspections for ROOFS with 6/12 PITCH & OVER: 3rd party inspection will be required for both the midroof and final inspections. The 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the Homeowner. 1, � 4 le City of Wheat Ridge Commercial Roofing PERMIT - 201902401 PERMIT NO: 201902401 ISSUED: 11/14/2019 JOB ADDRESS: 3555 Lutheran Pkwy W EXPIRES: 11/13/2020 JOB DESCRIPTION: Commercial re -roofing recovering existing roofing system with a factory mutual VSH rated hail system. System will mechanically attach to overboard with a 2 ply torch applied Mod Bit membrane cover. All new sheet metal flashings and trims. I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized bythe legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this permit. I further attest that I am le ally aut to include all entities named within this document as parties to the work to be performed and that all o s dis sed in this document and/or its' accompanying approved plans and specifications. /,-aa--1 47 Sign ure of OWNER CONTRACTOR (Circle one) Date I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, po Flans and procedures. 2. This. permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and may be subject to a fee equal to one-half of the originalpermit fee. 3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4, No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6. The issuance or grant'g of a permit shall not be construed to be a permit for, or an approval of, an violation of any provision of any appll,le code or anF14rdinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chlef Building Official Date REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. C ilV cif Wheat !)sdgc ,A)NINU IN I I Y DrVut_onNiu 4t ing & Inspection Services W. 2911 Ave., Wheat Ridge, CO 80033 ;e: 303-235-2855 * Fax: 303-237-8929 lection Line: 303-234-5933 sail: permits(d)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Fermif # Plan Review Fee: Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3555 Lutheran Parkway MOB 3 Property Owner (please print): LHRET Wheat Ridge LLC Phone: 303-653-3006 Property Owner Email: rodger.sandoval@lillibridge.com Tenant Name (Commercial Projects Only) Mutiple Property Owner Mailing Address: (if different than property address) Address: 353 North Clark Street Suite 3300 City, State, Zip: Chicago Illinois 60654 Architect/Enaineer� RDA Group Architects LLC Architect/Engineer E-mail: jlb@rda-group.com Phone: 941-383-4500 Contractor Name: WeatherSure Systems City of Wheat Ridge License #: 021224 Phone: 303-781-5454 Contractor E-mail Address: alexv@weathersuresystems.com For Plan Review Questions & Comments (please print): CONTACT NAME (please print): Alex Van Schmitt Phone: 720-530-5247 CONTACT EMAIL(p/ease print): alexv@weathersuresystems.com Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Plumbing: Mechanical: W.R. City License # W.R. City License # W.R. City License # Other City Licensed Sub: Other City Licensed Sub: City License # City License # Complete all highlighted fields. ®COMMERCIAL ❑RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. Recover exisiting roofing system with a Factory Mutual VSH rated hail system. System wil mechaincally attached coverboard with a 2 ply torch applied Modified Bitumen membrane cover. All new sheet metal flashings and trims Sq. Ft./LF 44,074 BTUs N/A Gallons N/A Amps N/A Squares N/A For Solar: N/A Kw N/A # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: Construction Type: Occupancy Load: Square Footage: Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ 476,020.00 OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT 1 hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record: that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that'l am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. 1, the applicant for this building permit application, warrant the truthfulness of the information provided on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) r A(UTHORLZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): 11/07/2019 DATE: Printed Name: Alexander Van chmitt - ` ZONING COMMMENTS: Reviewer: BUILDING DEPARTMENT COMMENTS: Reviewer: PUBLIC WORKS COMMENTS: Reviewer: DEPARTMENT USE ONLY OCCUPANCY CLASSIFICATION: CONSTRUCTION TYPE: Building Division Valuation: A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: a vN ci ❑ No one available for inspection: Time t �',~ % 0 AM/PM Re -Inspection required: Yes I When corrections have been made, call for re -inspection at 303-234-5933 Date: Inspector: a DO NOT REMOVE THIS NOTICE Z t5 5� I 'c-/--- 10�'-- '--' � _Vr- tsu Rocky Mountian Pulmonary Suite 150 REPORT ISSUE DATE 4/23/2019 Aaron Rinna TASB Technician Jure 30, M20 Denver Test & Balance Company, Inc. Testing, Adjusting, & Balancing Of Environmental Systems DENVER TEST & BALANCE COMPANY, INC. Testing, Adjusting & Balancing Of P.O. Box 9718 Denver, CO 80209-9718 Environmental Systems (303) 883-6535 CELL GENERAL INFORMATION PROJECT: Rocky Mountian Pulmonary LOCATION: 3555 Lutheran Parkway, Weatridge, CO ARCHITECT: The RTO Group, Ltd. ENGINEER: Bellman CONTRACTOR: Wray INSTRUMENTS USED AIR: Pressure, Velocity & Volume Shortridge ADM -860 S.N. M98017 AIR: Pressure, Velocity & Volume AIR: Volume Tachometer Volt / Amp Meter Volt / Amp Meter Shortridae ADM -870 S.N. M89911 Shortridge Flowhood 8405 Biddle 9915, Shimpo DT -311 Strobo Amprobe ACD -12 S.N. 01405984 Greenlee CMI -100 S.N. 010102750 Magnehelic Gauge Dwyer 0"---1.0", 0"---2.0", 0"---5.0", -0.5"---0.5" Pressure Differential Gauge Shortridge HDM-300 S.N. W97031 Pressure Differential Gauge ITT Barton 0'---40', 0"---50" Thermometer IMC, APT TIR1000 All Pressure, Velocity (FPM) & Volume (CFM) Readings Are Automatically Adjusted For Project Altitude By "Shortridge" Instruments. DENVER TEST & BALANCE RECAP / INDEX PROJECT: Rocky Mountian Pulmonary Suite 150 SYSTEM ZONE / BRANCH Required I Measured I % Address / Kfactor Note FPB -32 550 570 104 FPB -35 1500 1530 102 VAV-36 130 130 100 TF -1 200 210 105 Notes / Remarks: PAGE DENVER TEST & BALANCE AIR APPARATUS TEST REPORT PROJECT: Rocky Mountian Pulmonary SYSTEM: TF -1 UNIT DATA MAKE Twin City Fan & Blower MODEL# T200 SERIAL# 59120183 RATING DD DD Required PHASE VOLTS DRIVE DATA Motor Drive / Bore DD Fan Drive / Bore 119 Belt Quantity / Size INITIAL FINAL Drive Change DD DD TEST DATA CFM 210 VOLTS 119 INITIAL FINAL RPM DD DD AMPS PHASE VOLTS Outside Air Set @ CFM REMARKS: DATE: 4/19/2019 BY: Aaron Rinna MOTOR DATA MAKE OUT H. P. RPM FRAME TYPE PHASE VOLTS 1 120 S. F. FL AMPS 1.8 EFF. I P. F. -0.02" Atmos STARTER DATA MAKE MODEL / SIZE HEATER / RATING TEST DATA IN OUT IF—T Pressure FILTER HEATING COOLING -0.02" Atmos FAN 0.02" PAGE 2 DENVER TEST & BALANCE AIR OUTLET TEST REPORT PROJECT: Rocky Mountian Pulmonary SYSTEM: REMARKS: DATE: 4/19/2019 BY: Aaron Rinna PAGE NEEl em MEN MEN ems MEME N ■ EEME MEN ■INS■ INE ME ■ M , ENIN ■INEE■ INE ME ■ M NEW mem - - �� , �� ■�� ENE em ME ME ME® MEN ENEEM � em ME WE® MEN MEN ems . ®®®®■ ., ., �am ®®EEM■M MEN MEN ems „ �� :, :, ■ �� ems ., E ME MENE � � em - - ,. �, �. ®®■ „ „ MEN � ■mEE■ EN ME ME WEIN . mms „WEEMEE ME emM „ EE ®®■ �� ■mom■ �� ■ M ,,.. ■INS■ INEME � �� ■ �� MEN ME MWE �■ININN■INE��■�� REMARKS: DATE: 4/19/2019 BY: Aaron Rinna PAGE I i CITY OF WHEAT RIDGE 1�9�Building Inspection Division (303) 234-5933 Inspection line '(303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type:^� YV� f-_ Job Address: 2 '5'5 5 Permit Number: DL) l 1 0 U0� It, ❑ No one available for inspection: Time ' `' >_AM/PM Re -Inspection required: Yes to When corrections have been made, call for re -inspection at 303-234-5933 L 1 i Date: `i f ` Inspector:` DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE.. . Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office * (303) 237-8929 Fax INSPECTION NOTICE �.----� Inspection Type: d t t'_�L_ Job Address: Permit Number: ❑ No one available for inspection: Tin�' /PM Re -Inspection required: Yes (N� When corrections have been made, cal re -in sp t 303-234-5933 Date: -' Inspec r: DO NOT RTHIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTIO N NOTICE Inspection Type: a - �3 �,5-T L LI�/►Piy4 Permit Number: OC -3 Cir? ❑ No one available for inspec ' n: ' e C9 AM/PM Re -Inspection required: Ye No When correctfons..have been made, for re -inspection at 303-234-5933 � f ,I + Date: 7 Inspector: DO NOT REMOVE THIS NOTICE It � A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: 3 D 9 Po u4h gJece - J- LC Job Address: '35-5-25— C ,04�- -r--An Pkw ►L W (S` ' Permit Number: 0) O a -3 p q LJNo one available for inspection: Time _ ,,_ f 11 Re -Inspection required When corrections have been made, e__11 ,� Date' fiI No for re -inspection at 303-234-5933 i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: `� S 1 v 1 1. < , ,. )c t Permit Number: l _CV cs ❑ No one available for inspection: Time AM/PM Re -Inspection required: YesNo When corrections have been made, call for re -inspection at 303-234-5933 Date: _3 '?'T I {1 Inspector: DO NOT REMOVE THIS NOTICE A i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office . (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: = Job Address: `� ` 5 ':1h. d r r�k 4� y) L' Permit Number: 0 0 APV /G _ ❑ No one available for inspection: Time (1AM/PM Re -Inspection required: YeSK o When corrections have been made,,,call for re -inspection at 303-234-5933 Date: Inspector: ®O NOT REMOVE THIS NOTICE i CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office . (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: Permit Number: (L a r''(_; / iii_% r �•i ilF! i ❑ No one available for inspection: Time `� S AM/PM Re -Inspection required: Yes No When corrections have been made, call for re -inspection at 303-234-5933 Date: � f~`- Inspector: ®O NOT REMOVE THIS NOTICE City of W heat midge _ COMMUNITY DEVELOPMENT C E,d �, D Building & Inspection Services Division it 7500 W. 291h Ave., Wheat Ridge, CO 80033 Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: -303-234-5933 --- -- Email: perm its(a)ci.wheatridge.co.us I FOR OFFICE USE ONLY I Date: Add to Permit # 2019 0030 Building Permit Revision/Amendment Application *** Please complete all highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: 3 555 L VM WOE eA RK w &j s LA 17 A 150 Property Owner (please print): Liz LL1 Phone: C 3 4`2Z_ ggQ o Property Owner Email: R o to G ER . .cam Mailing Address: (if different than property address) Address: 3 M' L,uZtt'E{'#AK, 9AQ%Nm A)( S%_') tn. 170 City, State, Zip: 1, C, co Submitting Comg_any: G j3i%Lj j>Z-R j Contact Person: Ru G F_ CSA R 3�16*+,T C Phone: 7 a Contractor: 13 G i U I LtzkM j2 S. :[*,c Contractors City License #: 160 112 so Phone: -1 Zb 5 83 - 1(.1 Q Contractor E-mail Address: (3 RyCiy f a C. PeN P asa V-2 Q. Corm 91ST ._" ga Please Note: Additional valuation must include all general and subcontracted work to be performed related to the revisions and/or amendments declared in the description of work and which were not included in the original permit valuation. If revisions or amendments increase the original valuation, additional fees will be due at the time of approval. Depending on the scope of work, additional plan review fees may be due upon approval ($60.00 an hour - 2 hour minimum). Description of revised/amended work: Sq. Ft./LF Amps 64ArTi, A/&- ul.µ% V�- �'e s> i 10 w d Btu's Gallons Squares Other Additional ProjecrValue: (Mbstinclude all general and subcontracted work to be performed related to revisions/amendments described above) $ `d — OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this apptication,that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. CIRCLEONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) PRINTNAME: 0fh3 G . MGNATLiRE: AP -14A �. �� DATE: DEPARTMENT USE ONLY ZONING COMMMENTS: Reviewer BUILDING DEPARTMENT COMMENTS - Reviewer PUBLIC WORKS COMMENTS: Reviewer: PROOF OF SUBMISSION FORMS Fire Department ❑ Received ❑ Not Required Water District ❑ Received ❑ Not Required Sanitation District ❑ Received ❑ Not Required OCCUPANCY CLASSIFICATION: a Building Division Valuation: $ A i CITY OF WHEAT RIDGE -A Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office @ (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: Job Address: L1_., *1 Permit Number: Cj C I.J No one available for inspection: Time E LIU AM/PM Re -Inspection required: Yes ��No When corrections have been made, call for re -inspection at 303-234-593 Date:- - i Inspector: - I I DO NOT REMOVE THIS NOTICE e CITY OF WHEAT RIDGE Building Inspection Division (303) 234-5933 Inspection line (303) 235-2855 Office • (303) 237-8929 Fax INSPECTION NOTICE Inspection Type: � ) EKE— Job .E_Job Address: % i f:(clrs Permit Number:�` ❑ No one available for inspection: Tirrj_eja i1lU'PM Re -Inspection required: Yes When corrections have been made, caibfor re -inspection at 303-234-5933 Date: �Ains City of Wheat Ridge Commercial Remodel PERMIT - 201900309 PERMIT NO: 201900309 ISSUED: 03/12/2019 JOB ADDRESS: 3555 Lutheran Pkwy Ste 150 EXPIRES: 03/11/2020 JOB DESCRIPTION: Demo wall with minor electrical and HVAC work; 2,835 sq ft total Tenant: Rocky Mountain Pulmonary *** CONTACTS *** OWNER (303)422-9500 EXEMPLA INC. SUB (720)583-1679 BRUCE CARPENTER SUB (303)292-1116 WRAY MECHANICAL SUB (720)201-0629 KEITH CRISMAN *** PARCEL INFO *** ZONE CODE: UA / Unassigned SUBDIVISION CODE: 1 / Commr Vacant 160250 BC BUILDERS, INC. 018977 WRAY SHEET METAL, INC. 019339 CRISMAN ELECTRIC, INC. USE: UA / Unassigned BLOCK/LOT#: / *** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 48,555.00 FEES Total Valuation 0.00 Plan Review Fee 466.73 Use Tax 11019.66 Permit Fee 718.05 ** TOTAL ** 2,204.44 *** COMMENTS *** *** CONDITIONS *** All roughs to be done at Framing Inspection. Approved per plans and red -line notes on plans. Must comply with 2012 IBC, 2017 NEC and all applicable City of Wheat Ridge Municipal Codes. Work is subject to field inspections. **Prior to final inspection approval - As-builts are required before approval of the Building Final Inspection and Certificate of Occupancy can be issued. City of Wheat Ridge Commercial Remodel PERMIT - 201900309 v PERMIT NO: 201900309 ISSUED: 03/12/2019 JOB ADDRESS: 3555 Lutheran Pkwy Ste 150 EXPIRES: 03/11/2020 JOB DESCRIPTION: Demo wall with minor electrical and HVAC work; 2,835 sq ft total Tenant: Rocky Mountain Pulmonary I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with this_permit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in this document and/or its' accompanying approved plans and specifications. Signature of OWNER or cle one) Date 1. This permit was issued base 1 ion provided in the permit application and accompanying pians and specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures. 2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building Official and maybe subject to a fee equal to one-half of the originalpermit fee. 1 If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of the Chief Building Official and is not guaranteed. 4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval. 5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services Division. 6, The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject to field inspection. Signature of Chief i+ficid ,. Date REQUESTS MUST BE MADE BY'11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY. City of' h1MUNITY D VFL0PMENT E ,., Building 8, Inspection Services 4 7500 W. 2911 Ave., Wheat Ridge, CO 80033 E Office: 303-235-2855 * Fax: 303-237-8929 Inspection Line: 303-234-5933 Pei Email: Permits(o)ci.wheatridge.co.us FOR OFFICE USE ONLY Date: Plan/Permit # 603-0 Plan R view Fee: • 1-3 Building Permit Application *** Complete all applicable highlighted areas on both sides of this form. Incomplete applications may not be processed. *** Property Address: Property Owner (please print): L, (fit 6,- t H CQ(Aca,,re5,r j/,«5Tne Phone: 3o 3 -baa 9500 Property Owner Email: R oJacr.5c,n c(ro✓a,l p L, Ili h, ciao • Corte Tenant Name (Commercial Projects Only) Property Owner Mailing Address: (if different than property address) Address: City, State, Zip: VJ 1 vv (n 20033 Architect/EngineerT) rnr 0 1 D L4 -,L Architect/Engineer E-mail: rot • c.o>h Phone: 3o3 - 9d K -7g a as Contractor Name: &C CCs _t_,,V• City of Wheat Ridge License #: I (QD a-5 Q Phone: -70"W —5$ 3- I(v7 Contractor E-mail Address: .,hruce,C_at4e✓ 4e4-0 �'E1mLcc5+•n e -E - For Plan Review Questions & Comments (please print): CONTACT NAME (please print): E5r uct_ Gixc-P en -kr Phone:303 DS -a 31 cl CONTACT EMAIL(p/ease print): �'fure-rpe/1,40-f C DW&5-J_- ne'f- Sub Contractors (Must provide Wheat Ridge License No & Signed Subcontractor Authorization form): Electrical: Gf (ZMctn tt UtG-I-/'t G Plumbing: /� Mechanical: � Iv(EL',l1fNN L W.R. City License # W.R. City Liceenns� # W.R. City License #Y Other City Licensed Sub:`` Other City Licensed Sub: City License # N IA City License # WA Complete all highlighted fields. COMMERCIAL ❑ RESIDENTIAL Provide description of work: For ALL projects, provide a detailed description of work to be performed, including current use of areas, proposed uses, square footage, existing condition and proposed new condition, appliance size and efficiency, type and amount of materials to be used, etc. rA t rl o r +en cLn 4— (-eM O ct e I 11A16,*,oR CcCC1n%*-4t. A -.A "Mc, W 00k t%. Sq. FULF Amps Squares BTUs Gallons For Solar: KW # of Panels Requires Structural For Commercial Projects Only: Occupancy Type: -_ Construction Type: 118- 14 -150-141<10red Occupancy Load: 0,2 Square Footage: a g 3-' Project Value: (Contract value or the cost of all materials and labor included in the entire project) $ y 8", OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT I hereby certify that the setback distances proposed by this permit application are accurate and do not violate applicable ordinances, rules or regulations of the City of Wheat Ridge or covenants, easements or restrictions of record; that all measurements shown and allegations made are accurate; that I have read and agree to abide by all conditions printed on this application and that I assume full responsibility for compliance with applicable City of Wheat Ridge codes and ordinances for work under any permit issued based on this application; that I am the legal owner or have been authorized by the legal owner of the property to perform the described work and am also authorized by the legal owner of any entity included on this application to list that entity on this application. I, the applicant for this building permit application, warrant the truthfulness of the information provi ed on the application. CIRCLE ONE: (OWNER) (CONTRACTOR) or (AUTHORIZED REPRESENTATIVE) of (OWNER) (CONTRACTOR) Signature (first and last name): DATE: Printed Name: R u G E DEPARTMENT USE ONLY ZONING COMMMENTS: OCCUPANCY CLASSIFICATION: -`` -77 r i CONSTRUCTION TYPE: f Reviewer: dl BUILDING DEPARTMENT COMMENTS: � � p �.� c, � W A c.: p n � ^�-r p /g S� Reviewer: !� PUBLIC WORKS COMMENTS: Reviewer: Building Division Valuation: $ `4 Cl� � Occupant Name: Address: Permit Number: West Metro Fire Protection District 433 S. Allison Pkwy, Lakewood, CO 80226 (303) 989-4307 Rocky Mountain Pulmonary Contractor: (TI) 3555 Lutheran Parkway InspectionType Wheat Ridge, CO 80033 N/A Inspection Date Inspected By: The RTO Plan Review - Tenant Improvement 2/12/2019 Mark Dean 303-989-4307 Plan Type Original Pass Fail N/A Plan Review General [x] [ ] [ ] G.30 REVIEW Your plans have been approved. Follow this Link and the steps below to reconcile FEES: your invoice. 1. #19021214507 2. 3. 4. 5. R C% E- I 6: Select "Life Safety" under the Bill Type options Enter invoice number Select the associated permit type from the "Permit/ Fee Type" drop down menu Select "Construction Permit' in the "WMFR Acct#" drop down menu Enter the Job Address Enter payment amount of $290.68 Select Pay by Card to complete the transaction Once completed, send a copy of the invoice Here Once confirmation of payment is received by our office, a no-reply@mobile-eyes.com email will be sent with a link to the approved plans and permit card, with instructions for printing. Your plans have been approved. Refer to the area above for further relevant information. West Metro Fire Rescue Life Safety Plan Review Desk Status: Approved tZ.01 9.C)0307 City of X)Vh6a-t V V C C(_IXA� OMMUNITY DwaopmENT SUB -CONTRACTOR AUTHORIZATION FORM This torm must be signed b_y7e_acX sub -contractor. This form will not be accepted with missing information. Subcontractor's City of Wheat Ridge License number must be provided in the applicable space. Subcontractor's insurance and license must be up to date prior to permit issuance. Project Address 41 R, Permit #up/}to General Contractor: C' I Electrical Sub -Contractor I Company Name: State, License #: Phone#, Master #: Wheat Ridge License #: (required ficid) Signature of Authorized Agent Date Plumbing Sub -Contractor Company Name: Phone #: State License #: Master ft: Wlieut Ridge License Signature of Authorized Agent -E—it—V I Mechanical Contractor i Conipany],N, W;kW641 I dZ_ z rA i L Phoned m,,-, Wheat ift` e Li nse # OC/ 7 trV(plired field) /9 Signit'lureA c utho Agent Date ,A/ City of Wheat drIk A A k P I., COMMUNITY DEw-t .OPMENT SUB -CONTRACTOR AUTHORIZATION FORM This form will not be a Cach sub-coniractor. ccepted with missing information. Subcontracior"s City of, NN heat Ridge l-'ec"sc 111"Ilber njust be prm ided in the applicable space, Subcontractor's insurance and license must be up to date prior to permit issuance cc. Project Address: 9 Permit #: (� 0 / q0t) — La7k General Contractor: Electrical Sub -Contractor Company Name Phone #: State License #: Master #: Wheat Ridge License #: (required field) Signature orA u horized Agent Date Plumbing Stj b-Cou tractor ('0111PaHN Name: State License #: Wheat Ridge License Signature ol'Authorized''Agent Mechanical Contractor Company Name: Wheat Ridge License #: Signature of Authorized Agent ('hope P: (It q it t I v (I fiL. I( I) Date phone: required field) Date a Copyright 2018, of Alfred Renesch & Company. All rights reserved. This plan and design content is the beneschproperty of Alfred Benesch & Company. Use, reuse, reproduction or modification of this plan or des0r, information, or anv Part thereof, is strictly prohibited, except by written permission of this fire},. EXECUTIVE SUMMARY Benesch representative and State of Colorado Certified Asbestos Building Inspector Mr. John Gaddis was onsite at 3555 Lutheran Parkway - Suite 150, Wheat Ridge, CO on Monday, February 18, 2019. The Benesch representative performed an inspection for suspect asbestos containing materials (ACM) in Suite 150 based on plans developed by the R T O Group dated 1/17/2019. Benesch collected fourteen (14) samples. The samples were delivered to an independent, accredited, third party laboratory for analysis by Polarized Light Microscopy (PLM). The following materials were determined to contain greater than I% asbestos by PLM analysis and are considered AGMs per the EPA: • Asbestos was not detected in any of the samples of the suspect materials. The following materials were assumed to contain asbestos: •'• No materials were assumed to contain asbestos. The following materials contain trace amounts of asbestos (1% or less): ➢ None of the sampled materials contain trace amounts of asbestos. Further details regarding the inspection, material types, laboratory results and recommendations, are provided in the following report. The purpose of this document is to provide information related to asbestos containing materials on the property. This document should be utilized as a means of identifying suspect asbestos containing materials that could be disturbed by the removal of the roofing materials, however, this asbestos inspection report does not meet the requirements of a project design as described in Section III C. Project Design of Colorado Department of Public Health and Envi€•oument (CDPHE) regulation 8 Part B asbestos, This document is not intended to be utilized for the purposes of ars asbestos abatement scope of work or project design document and should not be utilized as such, wo benesch�___- RON TABLE CU'-'*NTE1"*N'TS EXECUTIVE SCJMPOARY ............................. 1 BUILDING ....................................................................................................................................3 2 DETAILED BUILDING DESCRIPTION ............................... 3 NAME AND ADDRESS OF CONSULTANT PERFORMING THE INSPECTION- ............ ................. 4 4 DATE(S) OF INSPECTION... ... — .................................... ...... 4 S SAMPLING STRATEGY, 6 IDENTIFICATION OF HOMOGENOUS MATERIALS .........................................................................5 s NAME AND SIGNATURE OF PERSON(S)) PERFORMING THE SAMPLING .........................................5 8 TYPES OF ANALYSES PERFORMED ...............................................................................................a NAME AND ADDRESS OF LABORATORY PERFORrOlING THE ANALYSES ......................................... 10 RESULTS....................................................................................................................................6 10.1 Homogeneous Materials of Known ACM...................................................................... 10.2 Homogeneous Materials Assumed to be ACM., .............. 6 103 Homogeneous Materials Containing Trace Amounts (1% or Less) ACM....................................6 10.4 Homogeneous Materials Where Asbestos Was Not Detected.. .... — ............... 11 PHYSICAL ASSESSMENT OF ASBESTOS CONTAINING MATERIALS...............................................6 12 DISCUSSIo N AND RECOMMENDATIONS.................................................................................... 12.1 Discussion.....,--, ........... _ ...... 8 12.2 Recommendations............................................................................................. 8 13 INSPECTION REP RTS EXCLUSION SI£ N STATEMENTS AND ASSUMPTIONS-- ....................................8 benesch :SC Bui, s, i�Ic. I RN1 Pulmonary - ::5S Lutheran Pkwy- Wheat Midge; Co 12 TABLE I DRAWINGS HOMOGENEOUS AREA LOCATIONS BULK SAMPLE LOCATIONS ASBESTOS CONTAINING MATERIAL LOCATIONS ATIACHNIENTS, ATTACHMENT 41 - GKII FOR *ETERMINING RANDOM SAMPLE LOCATIONS ANU RANDOM NUMBER DIAGRAMS ATTACHMENT #2 — CONSULTANT CERTIFICATIONS ATTACHMENT #3 — LABORATORY RESULTS AND ACCREDITATIONS benesch Pk -y , :65 Wtheran, wy — Wheat Riclilge, CO 3 B C B u i 1 d e rs, �r`u I n i on a i 3 -5 BUILDING Rocky Mountain Pulmonary 3555 Lutheran Parkway - Suite 150 Wheat Ridge, Co The building is a multi -storied commercial medical building. The interior of Suite 150 is finished with carpet, drywall, vinyl base cove and laid -in ceiling tiles. Benesch was contracted to perform a construction specific inspection for remodeling and modification of Suite 150. 3 NAME AND ADDRESS OF CONSULTANTPERFORMING THE INSPECTION Alfred Benesch and Company 7979 E. Tufts Avenue #800 Denver, CO 80237 ,;i.DATE(S) OF INSPECTION Asbestos bulk samples were collected on February 18, 2019. :�' SAMPLING -STRATEGY Benesch performed a construction specific inspection of suspect asbestos containing materials based on plans developed by the R T O Group dated 1/17/2019, in general accordance with the guidelines of the Environmental Protection Agency (EPA), National Emissions Standards for Hazardous Air Pollutants (NESHAPS), 40 CFR 763 Subpart E - Asbestos Hazard Emergency Response Act (AHERA), the Occupational Safety and Health Administration (OSHA) 1926.110 1, and Colorado Department of Health and Environment (CDPHE) Regulation No. 8, Part B. Prior to collecting samples, the Benesch representative who is an EPA accredited and State of Colorado certified Asbestos Building Inspectors performed a pre -inspection of the area. Homogeneous materials and areas were identified. Per 40 CFR 763.86, samples of these materials were collected in a statistically random manner throughout the space. A random sampling grid and corresponding random number diagrams, utilized in the determination of the sample locations, have been attached at the end of this report. Reference Attachment #1 for Grid for Determining Random Sample Locations and Random Number Diagrams benesch RI'A Pulm f'iar y — 35E 5 W`herall Pkwy -- {Beat Ric e, ("(D 14 6 IDENTIFICATION OF HOMOGENOUS MATERIALS The following homogeneous materials were identified during the performance of the inspection: ■ Drywall/Joint Compound — Composite wall system (DWI) ■ Cove Base Adhesives -white on gray cove (BCAI) and white on tan cove (BCA2) ■ Sheet Flooring/Adhesive —Sheet Flooring —Tan chip pattern with tan adhesive (SF 1) ■ Sink Coating —White undercoating (SCI) A total of 14 samples of suspect ACM were collected from these homogeneous materials. Reference Table 41 for Asbestos Bulk Sampling Surninary Reference Drawings for Homogenous Material Locations NAME AND S G i ATURE OF PE S N(S PFRFO1 MING THE SAMPLING The EPA accredited and State of Colorado certified Building Inspector(s), identified below, performed the visual and tactile inspection of suspect asbestos containing building materials (ACM). Name John Gaddis Project Scientist I1 Signature Reference Attachment #2 for Consultant Certifications ;PFS OF ANALYSES PERFORMED Asbestos bulk samples were submitted for analysis by Polarized Light Microscopy (PLM) in accordance with EPA -600/R-93/116, July 1993. Point count analysis was performed on a number of materials identified as being friable (able to be crushed or pulverized to dust via hand pressure when dry) and containing trace amounts of asbestos (1% or less). benesch BC B u i tiers, _ . _ v — 3555 Lut iera, Pkwy Wheat Ridge, CC -1 1 53 9 NAME AND ADD ESS OF LABORATORY PERFORMING THE ANALYSES Reservoirs Environmental, Inc. 5801 Logan Street Suite 100 Denver, CO 80216 Reference Attachment 93 for Laboratory Results and Accreditations 10 RESULTS TMM F-9411�* I �1-1 N The EPA has determined that any substance containing greater than 1% asbestos is considered an Asbestos Containing Building Material (ACM). The laboratory results show the following materials contain greater than I% asbestos and are ACM: 0 Asbestos was not detected in any of the samples of the suspect materials. -*.- No materials were assumed to contain asbestos. y None of the sampled materials contain trace amounts of asbestos. • Drywall/Joint Compound — Composite wall system (DWI) • Cove Base Adhesive - white on gray cove (BCA I) • Cove Base Adhesive - white on tan cove (BCA2) • Sheet Flooring/Adhesive — Sheet Flooring — Tan chip pattern with tan adhesive (SF I) • Sink Coating — White undercoating (SC 1) 11 PHYSiCAL ASSESSMENT OF ASBESTOS CONTAINING TE AHERA specifies that the Building Inspector is to conduct a physical assessment of all knowriftiable and assumed ACM as well as all knowniable and assumed thermal system insulation (TSI). The physical assessment consists of assessing the condition of the material as well as the potential for future disturbance. Three (3) values are utilized when assessing the condition of an ACM: 1) Significantly Damaged 2) Damaged 3) Good benesch BC Budders, Ific- I RM Puln-)onai'y —355-5 Ulffiel'a�l Pkwy — Wheat Ridge, C-0 16 • A material is considered Significantly Damaged if at least one tenth or greater (or one quarter if localized) of the surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded. • A material is considered Damaged if less than one tenth (or one quarter if localized) of the surface is crumbling, blistered, water -stained, gouged, marred or otherwise abraded. • A material is considered Good if there is little or no visible damage or deterioration. Determining the potential for future disturbance of a material is based on three factors: 1) Potential for Contact with the Material 2) Potential for Influence of Vibration 3) Potential for Air Erosion Following the assessment, the ACBM is placed into one (1) of seven (7) categories of condition and potential disturbance as shown in the table below: benesch RM �,t!i1i:}nar°x - 3` J a6 31uCc3[l Pkwy I f ? : i Ridge., ,C.' f CURRENT POTENTIAL FOR ASSESSMENT MATERIAL CONDITION DAMAGE (Low, VALUE (Surfacing, TSI or (Damaged, Moderate High Miscellaneous) Significantly Damaged or Good) i Potential) 1 TSI Damaged or --- Significantly Damaged 2 Surfacing Damaged --- 3 Surfacing Significantly Dania ed --- 4 Miscellaneous Damaged or --- Si-gnificantly Damaged TSI 5 Surfacing Good Moderate Potential Miscellaneous for Damage TSI 6 Surfacing Good Potential for Miscellaneous Significant Damage TSI 7 Surfacing Good Low Potential for Miscellaneous Damage benesch RM �,t!i1i:}nar°x - 3` J a6 31uCc3[l Pkwy I f ? : i Ridge., ,C.' f 12 1"ASCUSSON AND RE(--OIV,MENDATIONS The inspection was performed in a construction specific manner to facilitate planned remodeling. Inspection activities were limited to suspect materials associated with this remodeling. Mr. Gaddis did not inspect any other materials in the building. Asbestos was not detected in any of the samples collected of the suspect materials. If any new materials are discovered which per not previously identified, they should be sampled for asbestos content prior to being disturbed. 13 MSPEC'il'ON REPOT T, EXCLUSfON STATERHNTS AND AS y,' ' T101Nw This report was prepared by Benesch at the request of, and for the sole benefit and use of Mr. Sam Carpenter of BC Builders, Inc. (Client), subject to the limitations described in the report and in the agreement between Benesch and the Client. This report is intended for the exclusive use and reliance of the Client (and their assignees, if any) in the inspection and identification of asbestos containing materials associated with the building. Any use or reliance of this report by other parties is prohibited without the express written consent of the User and Benesch. This report is complete only as an entire document and no section is intended to be used separately. Any unauthorized use a third party makes of this report, or any reliance on or decision made on the basis of it, is the responsibility of such third party. The Client and Benesch are indemnified against any liability resulting from such third party use, reliance or decisions. The purpose of this document is to identify asbestos containing materials on the property which may be disturbed by the demolition process. This document should lie unlined as a mearns of identif-* suspect asbestos containing materials which may be disturbed by the roof rets o ai process, however, this asbestos inspection report does not meet the requirements ol` a project design as described in Section III C Project Design of Colorado Department of Public health and Environment (CDPHE) Regulation 8 fart B Asbestos, "Phis document is not intended to be utilized for the purposes of an asbestos abatement scope of work or project design document and should not be utilized as such. benesch _��m 2 ." d a� a� �Q 0 a� a pp N cl a. rs: r 03 � .> ci > °C7 > $C7 y 00 > 0C.7 U3 v (U 4)� 0 0 cd -0 0 0 co -0 0 o d o d o Q o Q o Q o �� VCL '� V V V e, Cd CIS �d co H H H to bo to w to to U ci c3s v1 c�G 03ri1 cn R to cos z. co y N M N m Gi Ln ei to >� z z z z z r °"cam '•C 'Q � Cr7+ U` x x C_ri� FL`�C_r7�r w:�J �I A ice+ � Q C Q z z z z Q � 1 I 1 MM I N d M �lJV tu ^^ i� y.i� ^^ sn. 3zz N w � � a�to '�; ., to to C'o tr cd co U a > ' i, «i °o 0 cit ' 0 cd U O c C5 —� z u w o w o a � N 0 c w d) v w ,-0 r. r. Con C/) 3 cn Cd cn cz rn m cn 0 cn cn cz Q Q Q Q Q ,a � O O O O O O .. ¢ V) C/)c CQ BULK SAMPLE LABELING & ACRONYMS Sample numbers are determined as follows: DWI -03 Where: DW = Homogenous Material type (Composite drywall system, etc.) 1 = Consecutive Homogeneous Material # (i.e. the first type of drywall) 03 = Consecutive Sample Number DW = Composite Drywall System BCA = Base Cove Adhesive SC — Sink Coating SF — Sheet Flooring As part of the material description, each material has a code in parentheses such as (MM, NF, G). This code indicates the category of the material, friability and condition. The acronyms are as follows: MM — Miscellaneous Material SM — Surfacing Material TSI — Thermal System Insulation F — Friable NF — Non -Friable G — Good Condition D — Damaged Condition SD — Severely Damaged Condition The quantity of the materials is measured in square feet (ft2) or linear feet Laboratory analysis of the samples determine whether the asbestos is greater than I%. Sampled materials fall into one of the following categories: ND — Asbestos was Not Detected YES — The material contains greater than 1% asbestos by PLM analysis TR — Material was determined to contain trace amounts of asbestos (1% or less) Not Analyzed — Progressive - Sample not analyzed due to progressive analysis on the material set. The laboratory was instructed to stop analyses on that material set if asbestos was detected Physical Assessment — The physical assessment value is a numerical value 1-7 assigned to each material based on the criteria presented in Section 10.0 Physical Assessment. If the material contains greater than 1% asbestos and is an ACM, a value is assigned based on the table. If asbestos was not detected in the material (ND) the material was not assessed (NA) per the AHERA Regulation. HOMOGENEOUS AREA & SAMPLE LOCATIONS .... . ..... OG I 31U15^I SON V;i90Dd IWIHM wmNNY4 N"am-Ln-i 6556 ASBESTOS CONTAINING MATERIAL LOCATIONS ASBESTOS WAS NOT DETECTED IN THE MATERIALS SAMPLED THIS PAGE INTENTIONALLY LEFT BLANK ATTACH ENS"#1 �,,IG ARES. �T--SIHAPED -AMP_! nni 7-1 RANDOM NUMBER DIAGRAMS Sampling Sampling 'sampling Sampling Sampling Sampling area Locations area Locations area Locations 2 3 m 6 9 8 1 2 7 6 5 3 4 8 7 7 3 9 5 4 2 6 4 i 7 2 9 6 8 5 3 6 1 8 5 9 3 2 7 4 6 443 3 1 5 8 9 2 7 7 4 3 6 1 5 2 9 8 7 I 10 12 I I 5 8 1 4 T 3 6 2 7 9 5 7 1 6 3 4 2 8 9 3 6 4 9 2 7 5 8 .1 5 --' 3 8 1 6 2 9 4 5 1 6 3 4 9 7 8 2 7 1 9 2 4 5 6 8 3 3-i 13 14 15 a 17 IE:j O J Z- 3 3 6 9 7 1 4 4 1 6 3 9 7 8 5 2 3 5 6 9 2 8 7 4 1 4 8 3 2 5 9 7 1 6 i 8 2 7 4 5 3 1 9 6 L 2 5 9 6 1 8 4 7 3 ATTACHMENT #2 CONSULTANT CERTIFICATIONS swf > CD �" -,` Co � � � ,iJ WDM r � �r�° ••;t t`9 O Cie .. G? pj Its C!1 Z—N �iY r ATTACHMENT #3 Reservoirs Environmental, Inc- Effective April 2, 2018 Reservoirs Environmental QA Manual Q:\QAQC\Lab\Reservoirs Environmental QA Manual.doc REI LAB Reservoirs Environmental, Inc_ February 20, 2019 John Gaddis Alfred Benesch & Co. 7979 East Tufts Ave Suite 800 Denver CO 80237 Dear Customer, Subcontract Number: Laboratory Report: Project # I P.O. # Project Description: NA RES 428493-1 00151849.00 BCB 3555 Lutheran Reservoirs Environmental, Inc. is an analytical laboratory accredited for the analysis of Industrial Hygiene and Environmental matrices by the National Voluntary Laboratory Accreditation Program (NVLAP), Lab Code 101896-0 for Transmission Electron Microscopy (TEM) and Polarized Light Microscopy (PLM) analysis and the American Industrial Hygiene Association (AIHA), Lab ID 101533 - Accreditation Certificate #480 for Phase Contrast Microscopy (PCM) analysis. This laboratory is currently proficient in both Proficiency Testing and PAT programs respectively. Reservoirs Environmental, Inc. has analyzed the following samples for asbestos content as per your request. The analysis has been completed in general accordance with the appropriate methodology as stated in the attached analysis table. The results have been submitted to your office. RES 428493-1 is the job number assigned to this study. This report is considered highly confidential and the sole property of the customer. Reservoirs Environmental, Inc. will not discuss any part of this study with personnel other than those of the client. The results described in this report only apply to the samples analyzed. This report must not be used to claim endorsement of products or analytical results by NVLAP or any agency of the U.S. Government. This report shall not be reproduced except in full, without written approval from Reservoirs Environmental, Inc. Samples will be disposed of after sixty days unless longer storage is requested. If you have any questions about this report, please feel free to call 303-964-1986. Sincerely, r Jeanne Spencer President P: 303-964-1986 F; 303-4774275 5801 Logan Street, Suite 100 Denver, CO 80216 Page 1 of 1 1-866-RESI-ENV ,h w ,reilab.com J E O c . � •a > r0i E m ami a Z O Q U U 0 0 Z 0) a) 0_ -0 0_ C o O E E 0 d CL -M 0 W ami aci m _ �? wUUUO2F�00 C j w O LO O O O co m O O O 0 O M O r- v O 00 O O O O 0 O Z U c N N U a� M M d C J o0 ?)LO a0 r co m R Q r m co 10 d' la .- C") 7 co A r 7 U)2LOm Q oM" lr_ 9L Lu Ew Q o m ti W n. li O c . � •a > r0i E m ami a Z O Q U U 0 0 Z 0) a) 0_ -0 0_ C o O E E 0 d CL -M 0 W ami aci m _ �? wUUUO2F�00 C j w O LO O O O co O O O O O O 00 N c O r- O co O 00 O O O O O O Z .0 _ O Q E O U C NN w c v O LO 0 0 0 CN 0 0 O O O O Z.2 0 d N N NC QLZ a E O U R ;; O O C G O R Z Z Z Z Z Z Z Z Z Z Z Z t7 E F i 0 C N Q W V........... 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I r71-- •t mc C4 4j U -cz 4A cr C4 it ¢ ¢ ¢ ¢ ¢ »»❑ r - Q Ml V 3 5� � p U u � O � O ti U � v on U L Co � v aH o 0 Y It .� oovi a• � c ¢ � v ^, w � U o 0�,3 ooOU vNa �j �U rno�a r - Q Ml .40,*T OF �'National Voluntary MY Laboratory Accreditation Program i #J0 J . . . . ....... ........ .. ....... . . 'V)XISS OV Reservoirs Environmental, Inc. 5801 Logan Street, Suite 100 Denver, CO 80216 Ms. Jeanne Spencer Phone: 303-964-1986 Fax: 303-477-4275 Email: jeanne@reitab.com http://www.reilab.com ASBESTOS FIBER ANALYSIS I&MMMEGUB1JUIRDS1 Bulk Asbestos Analysis Code Description 18/A01 EPA -- 40 CFR Appendix E to Subpart E of Part 763, Interim Method of the Determination of Asbestos in Bulk Insulation Samples 18/A03 EPA 600/8-93/116: Method for the Determination of Asbestos in Bulk Building Materials Airborne Asbestos Analysis Code Description I 8/A02 US. EPA's "Interim Transmission Electron Microscopy Analytical Methods -Mandatory and Nonmandatory -and Mandatory Section to Determine Completion of Response Actions" as found in 40 CFR, Part 763, Subpart E, Appendix A. t+ For the Nationq/ VdlunbkL)borat4ccreditation Program Effective 2018-07-01 through 2019-06-30 Page 1 of 1