HomeMy WebLinkAboutOT 2022-00436 Asbestos Analysis Report LEGEN
88 Empire Drive
•' • St.Paul,MN 55103
Tel: 651-642-1150
Technical Services, Inc
BULK MATERIAL ASBESTOS ANALYSIS REPORT
Client: Jill Report Date: 11/10/2021
J.Weida Construction
5620 Memorial Avenue North—Suite I Date Received: 11/09/2021
Stillwater, MN 55082
Date Analyzed: 11/10/2021
Client Project: Carter Project No: 2105206
SAMPLE NO. LAB NO. SAMPLE DESCRIPTION ASBESTOS TYPE(%) OTHER MATERIAL(%)
1 2105206—1 Sample 1 15%Chrysotile 85%Nonfibrous
Gray,Cementitious/Fibrous
Homogeneous
8()2_ GsLivc Ciue )1 ,
OT .- 4 6
The analysis was performed in accordance with current U.S.Environmental Protection Agency(USEPA)protocols,40 CFR Appendix E to Subpart E of Part 763,"Interim Method of the
Determination of Asbestos in Bulk Insulation Samples"and"Method for the Determination of Asbestos in Bulk Building Materials,"1993(EPA 600/R-93-116). All reported percentages are by
visual estimates. In the case of nonhomogeneous samples,each material or layer is analyzed separately,and the reported percentages are based on the total sample as received. Samples
will be disposed of 30 days from the date of this report,unless other instructions are received from the client.
The samples were received in acceptable condition.
NVLAP Laboratory Accreditation Number: 102081-0
ANALYST: �—
Todd Giorgi
Microscopist
-This document cannot be duplicated,except in its entirety,without the express written authorization from LEGEND TECHNICAL SERVICES,INC.
-This report must not be used to claim product endorsement by NVLAP or any agency of the U.S.Government.
-This report relates only to the above items tested.
FORM ASB-068.5(02/21) Page 1 of 1
Page of LEGEND TECHNICAL SERVICES,INC
88 Empire Drive,St.Paul,MN 55103-Telephone: 651-642-1150,Email:info@legend-group.com
CHAIN-OF-CUSTODY RECORD
LEGEND Project#: /0 2 0 6 COC/Sample Comments:
Client Name: Bill To: rr //��
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Address: Address: /Z Normal ❑ RUSH
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't J n,e .570 -0 frt br_ pi;a I 41,4,,ivRequested Due Date:
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c /v,A "N .5e- y Condition Received:
❑Received at °C
<-../, 1/lit)C. i 71/1 N ❑Temp.from unpreserved sample
SJ d b%2 I=1 Received on ice
Attn: PO#: filo temp.b ank ANALYSIS
Received on ice pads
41
Plane: Cid EnaB: r t f l /2 t toe 6, Received on melt water
7�j j`/3 7 �( J �� o c ( Major Sample
Received ambientI;
Components
Project Name: Project:
Acceptable(IHfISO only) a E 3 (5 greatest,
Custody Seals v i X including
Item a E Collection Sample Lab ID hazardous)
No. Sample Name o
O Date r Time Matrix No.
1 SA MPL� r —. 1
2
3
4
5
6
7
8
9
10
Sample Collector(please print): Relinquished By: Date: Time: Accepted by: Date: Time: ,
I
Comments: Ret,quished By: Date: Time: ReC Lab: Date: TIR;
1/01
PLEASE REVIEW TERMS AND CONDITIONS ON BACK BEFORE 'IGNING
Form LAB-268.6(05/20) White Copy—Original Accompanies Shipment to Lab Yellow Copy—Lab Pink Copy—Customer or Field Copy