275 SHERRY DR - DEMO At . CITY OF ATLANTIC BEACH
4 .s 800 SEMINOLE ROAD
j 7y ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-DEMO-2799
Job Type: DEMOLITION
Description: demo single-family home, garage, and two sheds
Estimated Value: $5,000.00
Issue Date: 12/27/2016
Expiration Date: 6/25/2017
PROPERTY ADDRESS:
Address: 275 SHERRY DR
RE Number: 169802-0000
PROPERTY OWNER:
Name: BCEL 5 LLC
Address: 7563 Philips HWY STE 109
GENERAL CONTRACTOR INFORMATION:
Name: Epic Custom Homes, LLC
Timothy J. Quinn, CGC1506918
Address: 6750 Epping Forest WAY
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing
activities. Contact the Inspection Line(247-5814)to request an inspection from Public Works for
Erosion and Sediment Control Inspection prior to start of construction.
Roll off container company must be on City approved list(Advanced Disposal and Realco Recycling).
Container cannot be placed on City right-of-way.
Full right-of-way restoration, including sod, is required.
All runoff must remain on-site. Cannot raise lot elevation.
Strongly suggest thorough documentation of impervious areas be recorded.
Slab and driveway to be fully removed.
Full site to be grassed.
FEES:} FFpppp ((��((�� ((��
P.RMM9liPQWPRf7Pi?D ONLY IN ACCORDANCE �1IYP QI`.1, CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
111 ILDING CODES.
�`�' � CITY OF ATLANTIC BEACH
'.t A` `I 800 SEMINOLE ROAD
,Fr ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ill TA
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
'" \:5L.A, 7;,' City of Atlantic Beach
s : APPLICATION NUMBER
S} Building Department
(To be assigned by the Building Department.)
• 800 Seminole Road 1" (� M
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
"-0,'319:- E-mail: building-dept@coab.us DEC 1 6 2016 Date routed: IS I I b
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: S'\L1(y Department review required Yes No
Building
Applicant: & C ADM 2S Planning &Zoning
Tree Aministrator
Project: (�Q e40 h1\0tA Q.. G(¢iati,� , (1(\d Public Works J �`- Pu lic Utilities
c�S
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other: —
APPLICATION STATUS
Reviewing Department First Review: Approved. Denied. /z��f"/6J
/
(Circle one.) Comments: el ,4 4 G ji,14.4j
BUILDING
PLANNING & ZONING / /
Reviewed by: / Date/2/� l
TREE ADMIN.
Second Review: ['Approved as revised. ❑Den'ed.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
e2_Ki/ii0,4 A-die — ff
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0 I
,- City of Atlantic Beach APPLICATION NUMBER
rj ! '\,J)'
Building Department (To be assigned by the Building Department.)
r' - - 800 Seminole Road 0 —a
,� Atlantic Beach, Florida 32233-5445 i �f 1�
_____)
Phone (904) 247-5826 • Fax (904)247-5845 1,S-
I l
'•;20;11 :• E-mail: building-dept@coab.us Date routed: 30
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: al- s- SV\ J(y w . Department review required Yes No
(1uilding
Applicant: &4i) k C- \D(JA.Q,S Planning &Zoning
Tree Administrator
Project: ALM-0 ha t Q Ok a-WI_ , (IN( C,Public Works
S� �� Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: ItirApproved. ❑Denied.
(Circle one.) Comments: .55_4_ .1), ..1.01\(.....‘k 6..... Lerake..0......k.r.—g7
BUILDING
PLANNING &ZONING Reviewed by: Date: tZ(ZZf t G
TREE ADMIN. Second Review: A roved as revised.
❑ pp nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
LAt
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
5 X ATLANTIC BEACH, FL 32233
(904) 247-5800
PERMIT NOTES
RESIDENTIAL DEMOLITION
December 27, 2016
275 Sherry Drive
BP # 16-DEMO-2799
OTVIC� C°21
1. It is the responsibility of the contractor to:
a. Contact JEA to disconnect electric power.
b. Disconnect and cap off water, sewer, and gas lines.
2. Silt fences must be in place and approved by Public Works before beginning
demolition.
3. All underground tanks, concrete slabs and foundations must be removed with the
buildings, unless otherwise approved by the City. The site should left graded and
clean for Final Inspection..
4. A water supply and hose may be required to control dust during demolition.
(Required for masonry structures and asbestos-containing materials.)
5. Removal of any trees requires a separate Tree Removal Permit, per COAB Code
Of Ordinances, Section 23-21.
6. Protection of trees and vegetation during construction is required, per COAB Code
Of Ordinances, Section 23-32.
7. Prior permission from the Building Department is required before blocking any part of the
Right-Of-Way.
1
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 975 -heiri, OA .1 Lt
'� 1+i '& Ji Permit Number: I % 0 eMD `c�i�i
Legalci
Description a I - 33- ((v�- -Q4-/ E- Parcel# /(e 804— DUD
Floor Area of Sq.Ft. Sq.f.t (
Valuation of Work$ 5I n.Le Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolitio pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: J n lo(nt ,Sir le '-+I kv/Yw oa erlt/l /
c tic;?c . and "T�t,� D She —5_02 �ri c ock 1110 —f c:(fl �r e r I c,r4 .EeA u i
Property Owner Information: n
Name: & L. 5 (.-L-C Address: 1-754P3 P/i I l ieS L
CityTQCISQ11Ujle. State FL Zip 32 4 Phone c1O / (17`7- (P74j
E-Mail or Fax#(Optional) p 72!n,+> z oic� 0 nol- Ctyr+r'
IContractor Information: 7
Company Name: 11C ( 'D( '- Qualifying Agent: ' 7rnUlt` e. " "-4 Address:VI50 1C I'Cresf WA.( N 41-WICity _ c sb-11/ilie Sate FL- Zip 344-t J
Office Phone RLJ- 4V-/-&Jjcf3 Job Site/Contact Number (- W-7'c 5 Fax#
State Certification/Registration# C-15- 150?/42
Architect Name& Phone# ) LE ..� V �S
Engineer's Name& Phone# i__ __ f1 ,iFee Simple Title Holder Name and Address
Bonding Company Name and Address l DEC 1 3 2016
Mortgage Lender Name and Address 11E
1- L ___ i
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for pod of six(6)months atony time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbial
ng,Signs, Wells, Pools, Furnaces, Boilers, Healers,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this application and know the same to be true and correct. .411 provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal.state, or local law regulating construction or the performance of construction.
Signature of Ow
(-_____:1-------------
~� Signature of Contra ----
Print
----Print Name T 10164,-j (,,,,;,o- tNT Print Name 11 164Qr*,u,NIN)
Sworn to and subscritd before me Sworn to and subscribed before me
this 1 Day of — l ;eint , 2010 this�/�J 3 Day of Cela ti . 20 lio
r '//4:-)(7//4:-)(7 ,L AVA J TUTEN 1�/ - . • - AVA J TUTEN
NotaryPubli. :>:' '!+
„ MY COMMISSION#GG019789 otary Pully=�,. - •, , •, ' 119799
EXPIRES September 11,2020 ','wrytt." EXPIRES September 11,2020
L Revised 0126.10
ENVIR 0 NEERING �►�.
109 AZALEA POINT DRIVE SOUTH • PONTE VEDRA BEACH • FLORIDA • 32082
December 10. 2016 111.E101 , UVE - -)N
Mr. John Adams
Adams Tractor and Landscape Service, Inc. DEC 1 3 2016L.2)
J
309 Kingsley Lake Drive _
St. Augustine, Florida 3292
•
Reference: Four (4) Single Story Structures—Asbestos Demolition Survey
275 Sherry Drive(House, Garage &Two [2] Sheds) JON # 5793
Atlantic Beach. Florida
Dear Mr. Adams:
Pursuant to your request an Asbestos Demolition Survey has been performed at the above
location for the purpose of identifying asbestos that needs to be removed prior to the planned
demolition of the structures. The purpose of the investigation was to visually identify
homogenous materials that need to have bulk samples obtained for analysis to determine the
presence of Asbestos Containing Building Materials with in the structures. The scope of this
survey was limited to the referenced four structures in Jacksonville, Florida. The buildings were
inspected for demolition. The facility has four single story structures for demolition, which are
constructed with concrete, wood, shingles, drywall, vinyl floor tile, plaster, roof mastic, duct
mastic, steel and aluminum. There were twelve (12) suspected materials that were sampled for
Polarized Light Microscopy(PLM) analysis. Based on the visual inspection, it was evident that
regulated Asbestos Material was found to he present at the facility. The scope of work for this
survey included sampling and analysis of suspect homogenous building materials. The asbestos
demolition inspection process was initiated on November 23, 2016. Materials must contain
greater than 1% asbestos to be regulated. The following recommendations are provided for the
material that was found to contain Asbestos Fibers within the referenced structure.
RECOMMENDATIONS
Recommended response actions have been selected for all Asbestos Containing Materials
identified by this survey within the facility. Recommendations for response actions, where
arrived at, arc stated as follows:
FRIABLE ASBESTOS CONTAINING MATERIALS
Friable Asbestos Material means any material containing more than one (1%) percent asbestos,
that when dry can be crumbled, pulverized or reduced to powder by hand pressure.
(904) 665-0100 (904) 61 2-1 456 • MOBILE (904) 665-0101 • FAX
Page 2 of 3
ASBESTOS DEMOLITION SURVEY
December 10, 2016
Friable Asbestos Material was found in the following area:
None.
The above material is considered friable and must be removed by a Certified Florida Asbestos
Abatement Contractor prior to any disturbance caused by renovation or demolition of the
referenced structure.
CATEGORY I,NON-FRIABLE ASBESTOS MATERIAL
HM-5 9"X9" Vinyl Floor Tile (VFT) Red with Black Mastic [Tile 5% Chrysotile
Asbestos, Mastic 5% Chrysotile Asbestos; Composite 5% Chrysotile Asbestos]
HM-6 9"X9" Vinyl Floor Tile(VFT) White with Black Mastic [Tile 2% Chrysotile
Asbestos, Mastic 2% Chrysotile Asbestos; Composite 2% Chrysotile Asbestos]
HM-8 9"X9" Vinyl Floor Tile (VFT) Brown with Black Mastic [Tile 2% Chrysotile
Asbestos, Mastic 5%Chrysotile Asbestos: Composite 3% Chrysotile Asbestos]
CATEGORY II,NON-FRIABLE ASBESTOS MATERIAL
None.
NONREGULATED BY NESHAPS—REGULATED BY OSHA
None.
The preceding materials arc considered a Category I or II Non-Friable Material and therefore,
under normal circumstances, the Category 1 material does not need not be removed prior to
demolition, because generally these materials do not release significant amounts of Asbestos
Fibers, even when damaged. Category I material must be kept wet to prevent the release of fibers
during demolition. The Category I asbestos waste must be placed in a permitted asbestos landfill
in accordance with FDEP regulations. Friable asbestos and Category II material must be
removed prior to demolition or renovation of the structure. Yet, in the event removal is deemed
necessary as a part of renovation all Asbestos Containing Material should be removed by a
Florida Licensed Asbestos Contractor.
The building materials identified in this asbestos renovation survey were in good condition to
significantly damaged at the time of the inspection. The material condition can change over time
and will degrade with exposure to water, air movement,physical damage, weather and chemical
exposure.
The structure has an address of, 275 Sherry Drive,Jacksonville, Florida. The facility was at one
time a residential house, garage and two (2) sheds. The facility has four structures for
demolition.
4
Page 3 of 3
ASBESTOS DEMOLITION SURVEY
December 10, 2016
When implementing the response actions, parties responsible for final selection should remember
that actions shall he sufficient to protect HUMAN HEALTH AND THE ENVIRONMENT, but
may also be the least burdensome method. Nothing in these recommendations should be
construed as PROHIBITING or discouraging removal. All parties shall comply with all
applicable laws, ordinanccs, rules and regulations of Federal, State and Local Governments and
Agencies relating to or affecting the proposed work in whole or in part when implementing any
response action associated with the facility. The following samples are recommended to be
further analyzed by the point count method using a positive stop approach.
None.
This asbestos survey shall not be used as a design or specification for the removal of asbestos
within the referenced structure.
RECOMMENDATIONS FOR ASBESTOS ABATEMENT: (275 Sherry Drive,
Jacksonville, Florida)
The HM-5, 6 and 7 asbestos flooring and mastic materials should be wet demolished or should
he removed by an asbestos abatement contractor keeping in mind that the most economical
method or least burdensome method can be used. These materials are regulated by the
Occupational Safety and Health Administration (OSHA) Construction Standard for Asbestos
found in Title 29 Code of Federal Regulations(CFR) Part 1926.1 101 and by the National
Emission Standards for Hazardous Air Pollutants (NESHAP) Title 40 CFR Part 61.145.
It has been a pleasure working with you and I look forward to working with you once again in the
future. I can be reached at (904) 665-0100 or mobile (904) 612-1456 if you should have any
questions.
Respectfully submitted.
— • 441-9>1\
Timothy W. Rudo , P.E., L.A.C. / Z– /0– ZQf&
Licensed Asbestos Consultant AX 0000058
Asbestos Business License ZA0000243
<ADAMS TRACTOR-ENVIRONEERING-ASBESTOS-SURVEY-JON-5793.doc>
3
� CCc� C� � �IC
ROUTINE CHAIN OF OUST 'i l� 1 3 20 0 93
ENV'IRONEERING. INC., 109 Azalea Point Drive Sou111.PontCVetiraRra<h. * ' • 32082
To Laboratory: Dove Environmental 1_ahorstorr
8910 Miran.-1r 1'irkway, Stoic 200 ROUTINE
M worw=l.FL 33025 TAT (--�
Customer Information
Date' 1112312016
Company Namc; MAIRONCTskING. INC. Phone: 400.11665-0100
Address: 109 Ar„ilea Point Drive South Fax: 19(14)665.0101
City,State,Zip: Ponte V•odza Beach.FL 32082 Prajoct: Adam. I rv.•tar& 1 an,i.cape inc.
Contact: Mr_Tim Rudolph 275 Sherry Drive
Atlantic each.FL 32233
erOC DOVE-5793-1 XLS' A
Sample# Sammi Sample Location COLOR/AREA F,'NF
14,20E3 BULK Drywall System-White White Wall NF
2-12,8 3 BULK Plaster Wall System-Two Coat-White/Gray VPhitc/Cray/Wall NF
over Metal Lathc/Drywall Board
3-1 BULK Texture Ceiling Coat-White White/Ceiling NF
4-1 BULK A/C Duct Mastic-White White/Duet NF
-i BULK 9"X9"Vinyl Floor Tile(VFT)Red with Black
Mastic RedlFloor NF
tel BULK 9"X9" Vinyl Floor Tile(VFT)White with Black
Mastic White/Floor NF
4
7-1 BULK 9"X9"Vinyl Floor Tile (VFT)Brown with Black
Mastic Brown/Floor NF
8-1 BULK Roof Mastic-Black(Around Chimneys and
Penetrations) Black/RoofTIF
ENCLOSURE (1)
ENVIRONEERING, Inc.Ltr Dtd 12/10/2016
ASBESTOS-PLM *USE POSITIVE STOPMEi'HOD•
CHAIN OF CUSTODY CHECK#2797. \CO
Date Time Relea . , Date/Titue Received
11.,23116-20.00 s.,.._
TIM RUDOLPIH t-__-
4'n'zram 9LGc',T.ticrosoft office'offiorrn rvin\COC I �"
CA "re+ia, - t t-EV:Z I b 1=09 pen
4.
gi.04- ROVE ENVIRONMENTAL CORP.
8910 MIRAMAR PARKWAY, SUITE 200 MIRAMAR FL 33025
somTel. (954) 374-9274 Fax: (954) 639-7426
ASBESTOS TEST REPORT
CLIENT : ENVIRONEERING. INC. PAGE : 1
ADDRESS: 109 AZALEA POINT DRIVE. , SOUTH
PONT[ VEDA BCH FL 32082 DATE : 11/29/16
PROJECT: ADAMS TRACTCR & LANDSCAPE. INC.-275 SHERRY SAMPLE ID : 0611406
DRIVE. ATLAPt1IC BEACH, FL 32233 (JON 5793)
CONSULT: LIN RUDOLPH NVLAP Lab Code: 102053-0
FRI/HOM YES/NO LAYERS: 03 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : DRY'WALL SYSTEM-WHITE
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 20% CELLULOSE 5% FIBER-GLASS
NON FIBERS : 65X MINERALS 10% PAINT
LAB NO. : 02 SAMPLE NO.: 1-2
FRI/HOM : YES/NC LAYERS: 03 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : DRYWALL SYSTEM-WHITE
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 20% CELLULOSE 5Z FIBER-GLASS
NON FIBERS : 65X MINERALS 10% PAINT
LAB NO. : 3 SNIPL E NC. : 1-3
FRI/NOM : YYES/NO LAYERS: 03 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : DRYWALL SYSTEM.-WHITE
ASBESTOS TYPE: NONE-DETECTED
I OTHER FIBERS : 20% CELLULOSE 5X FIBER-GLASS
NON FIBERS 65% MINERALS 10% PAINT
sYz=zax=—___szazzzszxaarzaza.azz__zrzrxsxrazsoa flcazasazszzzczcxaxz
Dore $aviros atai Corpotatios is solely responsible for analysis perforied on satple content supplied by
client and is AVL,? accrebited for detbod 40 CFI Pt, ?36, I'pp. E to Subpart 8 EPA16001e-93/11E. keasnreDent
0 uncertainty information is available by contacting the Laboratory, Laboratory Qeports will be sept for a
period of three !3F years electronically_ Pc:o utages are visually estioated. Point coact perforttd at
clients req-;est only. Units relates Orly to itex analyzed. 'this report should not be reproduces by client
or acme vitborot written pernision frac Love Inciroeient.al Corporation. All swages will be stored for a
period of i nontb. The rose of the term FYI P does not constitute eedorserent by FLAP or any agency
I of the 1laited States Go-Tensest. Ploar-Tile is non-hasogeneous and results may ro(lert sample content.
Lina......==: =aaSarr=a===Sizxx== r:L: :Lax Z=xcZaz:..2 S.--car
/e6LiCaTAJ 21ePl' W4Iiirk:iti.'4115..
I Analyst 1 R. Pepe Ramnath. PhD
IECIEDVIE,
LABORATORY MA1�tAGER
DEC 1 3 2016
_
DOVE ENVIRONMENTAL CORP.
8910 MIRAMAR PARKWAY, SUITE 200 MIRAMAR FL 33025
assissan. Tel. (954) 374-9274 FaE (954) 639-7426
ASBESTOS TEST REPORT
CLIENT : ENV:RONEERI'sa, :NC. PACE : 2
ADDRESS: 109 AZALEA POINT DRIVE. , SOUTH
PONTE VEDRA BCH FL 37G8? DATE : 11/29/16
PROJECT: ADAMS TRACTOR & LANDSCAPE, INC.-275 SHERRY SAMPLE ID : 2E1436
DRIVE, ATLANTIC BEACH, FL 32233 (JON 5793)
CONSULT: TIM RUDOLPH NVLAP Lab Code: 102053-0
LB ND. : 04 SAMPLE NO.: 2-1
FRII /HOM : NO/NO LAYERS: 02 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : PLASTER WALL SYSTEM-TWO COAT-WHITE/GRAY OVER
METAL LAThE/DR1'WAL L BOARD
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 2% CELLULOSE
NON FIBERS : 582' MINERALS 10t PAINT
30Z POLYMERS
LAB NO. : 05 --- SAMPLE NO. : 2-2
FRI/HOM : NO/NO LAYERS: 02 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : PLASTER WALL SYSTEM-TWO COAT-WHITE/GRAY OVER
METAL LATHE/DRYWALL BOARD
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 2% CELLULOSE
NON FIBERS : 58Z MINERALS 102' PAINT
30% POLYMERS
FRI/HOM : NO/NO LAYERS: 02 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : PLASTER WALL SYSTEM-TWO COAT-WRITE/GRAY OVER
METAL LATHE/DRYWALL BOARD
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 2t CELLULOSE
NON FIBERS : 58 MINERALS 10T PAINT
30% POLYMERS
-----�5 SSSSS
Dove Bnvirannestal Corporation is solely responsible for analysis`perforned an sample eonteat supplied by
client sad is SWAP accredited for Method 40 CPR Pt. 716, app. Leo Subpart 1 1PaI6004-93 116. Meanureaent
iocertairty intonation is available by contacting the Laboratory. Laboratory* Reports vill be kept for
period of. three (3L years electro;icatly. ?errentages are visually estimated. Point watt perforaed at
clients request only. Results relates ealy to it analyzed. This report should not be reproduced by client
or a:yoar ritbopt rrittea peroisiou frog Dove Bnirouontal Corporation_ .All staples rill be stored for a
period of 1 month. The use of the ten tf1'LM' does tot c nStitate endorsenent by DLO or any agency
of the leiter] States Geueronest. floor-Tile is ata-honogeneous and results only reflect sanple eoutent.
FzaisZittiGi--iR-7111•■.-l-_tt_-__-¢u---------zxxx------ =z_cs;zaciR:- - ----sx
-6262Q-(--e0 /46. Z4144/tAtorVfS
Analyst 1 R. Pepe Rainnatr1. PhD
LABORATORY MANAGER
DOVE ENVIRONMENTAL CORP.
8910 MIRAMAR PARKWAY, SUITE 200 MIRAMAR FL 33025
=low Tel. (954) 374-9274 Fax (954)639-7426
ASBESTOS TEST REPORT
CLIENT : ENVIRONFERTN,, INC. PAGE : 3
ADDRESS: 109 AZALEA FOIN' DRIVE. . SOUTH
PONTE VEDRA BCH FL 32022 DATE : 11/29/16
PROJEC1: ADAMS TRACTOR & LANDSCAPE. INC. -275 SHERRY SAMPLE 10 : D511406
DRIVE, ATLAkTIC BEACH, FL 32233 (JON 5793)
CONSULT: TIM RUDOLPH' NVLAP Lab Code: 102053-0
LAB NO. 07 SAMPLE NO.: 3-1
FRI/HOM : YES/NO LAYERS: 03 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : TEXTURE CEILING COAT-WITC
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 20% CELLULOSE
NON FIBERS : 70% MINERALS 10X PAINT
LAB 08 SAMPLE NO. : 4-1
FRI/MOM : NO/NO LAYERS: 03 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : A/C DUCT MASTIC-WHITE
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 5% CELLULOSE
NON FIBERS : 20% MINERALS 30% POLYMERS
45% RESINS
LAB NO. : 09 SAMPLE NO. : 5.1
FRI/HOM : NO/NO LAYERS: 02 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : 9"X9" VINYL FLOOR TILE (VET) RED WITH BLACK MASTIC
T1LE=5. CHRY. MASTIC-5t CHRY, COMP.-5% CHRY
ASBESTOS TYPE: 5X CHRYSOTILE
OTHER FIBERS : 5% CELLULOSE
NON FIBERS : 50% MINERALS 10X RESINS
30% POLYMERS
--XX Xi -:Zix-
Dove Bnvironneatal Corporation is solely responsible for analysis perfumed OD sanpie content supplied by
client and is MAP accredited for Nethod (C CFR Pt. 71E, App. H to Subpart B EPL/mil-S1/116. reaeurenent
ildeertainty iafortation is available by coetacting the La cratcrv. Laboratory Reports will be tept for a
period of three (3) year; electronically, Percentages are 'is:ally estiaated. point count perfornec at
clients request only. Results relates only to itte analyzed. This'report Should net be reproduced by client
or anyone withont written peraisioe fro Dove lovironoettal Corporation. Ill saaples will be stored tort a
period of 1 tooth. The use of the ten PUP does no: constitute endorsCaent bT EYIAP or any agency
of the Tuned States Government. Ploor-Tile is aoa-honogeoeoes and recalls only reflect sazple coetynt_
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Analyst 1 R. Pepe Ramnatf:. PhD
LABORATORY MANAGER
t
,�'� DOVE ENVIRONMENTAL CORP.
8920 MIRAMAR PARKWAY, SONE 200 MIRAMAR FL 33025
~OW Td.(954) 374-9274 Fax: (954) 639-7426
ASBESTOS TEST REPORT
CLIENT : ENVIRONEERINS, INC. PAGE : 4
ADDRESS: 109 AZALEA POINT DRIVE.. SOUTH
PONTE VEORA BCH FL 37082 DATE : 1:129/16
PROJECT: ADAMS TRACTOR & LANDSCAE. INC_-275 SHERRY SAMPLE ID : D611406
DRIVE, ATLANTIC BEACH, FL 32233 (JON 5793)
CONSULT: TIM RUDOLPH NVLAP Lab Code: 102053-0
LSAMPLE NO. : 6-1
FRRII/HDM : NO/NO LAYERS: 02 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : 9"X9" VINYL FLOOR TILE (VFT) WHITE WITH BLACK
MASTIC (TTn E-2% CHRY, MAST1C=2% CHRY, CAMP=21 CH)
ASBESTOS TYPE: 2% CNRYSOIILE
OTHER FIBERS : 3X CELLULOSE
NON FIBERS : 55% MINERALS 10% RESINS
30% POLYMERS
SAMPLE NO.: 7-1
FFRI/HUM : NO/NO LAYERS: 02 DATE OF ANALYSIS: 11/29/16
DESCRIPTION : 9"X9" VINYL FLOOR TILE (VFT) BROWN WITH BLACK
MASTIC (MASTIC=5% CHRY. TILE-2X CHRY, COMP=34 CH)
ASBESTOS TYPE: 3% CHRYSOTILE
OTHER FIBERS : 2% CELLULOSE
NON FIBERS : 55% MINERALS 10X RESINS
30% POLYMERS
LAB ND. SAMPLE NO. : 8-1
FRI/HOM : NO/NO LAYERS: 02 DATE OF ANALYSIS: 11129/16
DESCRIPTION : ROOF MASTIC-BACK
ASBESTOS TYPE: NONE-DETECTED
OTHER FIBERS : 5% CELLULOSE
NONE FIBERS : 20% MINERALS 20% BITUMEN
25% RESINS 30X POLYMERS
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Dove Bsvironaestal Corporation is solely responsible for analysis performed on sample content supplied by
client and is MVLAP accredited for Method 40 CFR Pt. 736, bpp. 8 to Subpart 1 ZPa/fO*/i-S3/1i6. Aeasureaent
t►ncertatty information is available by contacting the Laboratory. Laboratory teports will be kept for a
period o' tpree (3) years electralicaily. Perrent4ges are visually estioated. Point count perforned at
clients request only. eeselts relates o:ly to item mired, This report s6.onid not be reprodated by client
or anyone without written pernision troy D3Vc laviro rental COrpotatioa. All samples will be stored for a
period of 1 tenth. The use Of the tern PUP does pot constitute endorsenect by YYLAP of Fal agency
of the pnited States Goveraaent. Pioor-711e is mea-haooieaeots and resultb Only :erect sazple content.
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Analy5`� I R. Pepe Ramnath, PhD
.ABORATORY MANAGER