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DEMO-16-2780Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. DEMO -10-16-2780 Permit Type: Demolition Ir Ie' r Work Classification: Building Permit Status: APPROVED Issue Date: 11/16/2016 Expiration: 05/15/2017 Parcel Number Applicant 10025 BISCAYNE Boulevard Miami Shores, FL 33138-2645 1132050340040 Block: Lot: EVIDIO ARTIGAS Owner Information EVIDIO ARTIGAS Address 10025 BISCAYNE Boulevard MIAMI SHORES FL 33138-2645 10025 BISCAYNE Boulevard MIAMI SHORES FL 33138-2645 Contractor(s) ALLIED DEMOLITION INC Phone Cell Phone (305)513-4994 (954)868-9990 Phone Cell Valuation: Total Sq Feet: $ 9,000.00 3000 Type of Demo: Building Additional Info: TOTAL DEMOLITION Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee -Demo Scanning Fee Technology Fee Total: Amount $5.40 $5.25 $5.25 $1.80 $350.00 $9.00 $7.20 $383.90 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -10-16-61643 11/16/2016 Check #: 366 $ 333.90 $ 50.00 10/14/2016 Check #: 344 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Planning Review Mechanical Review Electrical Review Building Review Building Review Plumbing In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin.. Futhermore, I authorize the above-named contractor to do the work stated. Authori. Signature: Owner / Applicant / Contractor / Agent Building Department Copy November 16, 2016 Date November 16, 2016 1 tr1'O �b- ZBo• /6-.-Pertb d. Demo 1(o-2180 Dc(`°\ \n\ e BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECT! N LINE PHONE NUMBER: (305) 762-4949 II j IAI i lio 5 • FBC 20 14-4 Master Permit No. V o j t'p- ZR• a"C Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS jOO25 CirE $LVD JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: / Flood Zone: OWNER: Name (Fee Simple Titleholder):7 0ACt,.S kien6e ? /7%nkol p ()Lech Phone#: Address: / I 5 %V t' � l��III /00 s BFE: NO FFE: 7e-6- ( 74 -/gam' ti City: flt 0:V Y'1l SLO,S• State: Zip: ,3313e Tenant/Lessee Name: PJ1 one#: Email: — r, x_7573 — 9ft CONTRACTOR: CompanyName: 4/'' a 0Z?moV -Zig' • Phone#: 30P 573- I ! f 7 Address: 7 95o a/4/ S31. -.D Sr #517 City: Da?,46 Qualifier Name: State: Zip: 3)f“ Phone#: State Certification or Registration #: C.6C /•s0(S t? Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Square/Linear Footage of Work: Value of Work for thi\Permit: $ 9, Iwo Type of Work: I Addition n Alteration ❑ New I 1 Repair/Replace Description of Work: % 2 •ir 17dAlo�� o`✓ emolition Specify color of;color.#7,ru >tile;. QQ Submittal Fee $ r ` r" Permit Fee. ,5 .." -8,5 0 J4 , .1 IF .•,.raw 4b1lCli ."O 3,•1O09 �1E% f T{iar u :4y CCF $ _ 1{©31 xCO`CC$" ••wr.x�..„ ..,y Scanning Fee $ L __.%s._.. '.'.`.: a:Radon Fee$°.�"• 5.25 DBPR $ _ 5 • 2 S Notary $ .�— Technology Fee $ Structural Reviews $ (RPvisPd07/74/711141 Z0 Training/Education Fee $ 1 • Z50 Double Fee $ v Bond $®� 9� TOTAL FEE NOW DUE $ 33 3 • Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be appr,oved-and a reinspection fee will be charged. • ature r OWNER r AGENT Signature CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this rb day of Cc1 , 20 t Co by s t� P '12-0.Si is.personally known to me or who has produced cf 1 _ )J 2-O- -L9L4a5C me or who has produced identification and who did take an oath. NOTARY PUBLIC: day of 0 Sign: Print. Seal: APPROVED BY t14c.,icnrl/11/7n hm n\ IRENIA GUTIERREZ .s Notary Public • State Of Florida r Commission* FF 960737 My Comm. Expires -Feb 22. 2020 , 20 `, by who is personally known to identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: `cwQ Ina Qorhnv as ********************* Plans Examiner Structural Review CAROLINA PATINO MY COMMISSION tl FF230855 p�+**s*iXRlR6&May 4*24 a* ****** * ** 4o0390.:: 3%.. e3 'Fox '• ._ a_-ewKe.con. oning Clerk Dennis Custom Pest Control 14221 N Royal Cove Circle Davie, FL 33325 9-21-16 (954) 673-2362 Rodent Inspection Certificate To whom it may concern: a This letter is to inform you that DENNIS CUSTOM PEST CONTROL inspected property located at 10025 Biscayne Blvd, Miami'Shores,Florida, 33138. No evidence of rodents was found on the property. This property is rodent free. Also inspected property for vermins and stray animals, no evidence was found of either. If you have any questions, please call us at the number above. Thank you, Dennis Rodriguez (CPO) .. 41.11 • • • • . .. . • • • • • .. 4141. 41. • • • 410 • 00. • 0410 • .0. 41• 41 • • • 1• 41 • • • • 000 • • • • Oil • • • • • • • • • • 00 • 410 • • 00 0 0 • • • • • 0.. • • • • .00 • • • • • • • • • • • • •0110 • • • • 11 11 • 11 1111 •11 • 1111 • 110011 •• • • 001111 080 • • • 0110 • • ALLIED DEMOLITION, INC. LICENSED S. INSURED ( r tt►t ► .Stbos V►l6 "(/)1 (1Pqr i°050 ,'E L Ali rl .syaM'� pLi . 33 138' RF! 7) 6w. 677-a v i,; voSa - 1 S eify,vt, A I VJ %v /.,ri i ; j 147 e N / Kb/ CE M.‘41 c� 1. //! 7Y iX///ice . sef� 1-7'( ‘i ?got it0 / 71-/ /ce,c_n7 A-16 egiw D I1D %.‘5.1t#T11.44 • • CGC: 1506512 •• •• ••• •• • • • •J The foregoing was a n wledged before me this / Li da ri. C-4?‘tr ••• M •J!\(,�1. •. •... I /� • • • J • \` • Ns. Md �. tion 0 4 e ° mo o n ul By • who is persorlaW44ovr � ,,r MO. h4 s identif'ca produced Notary Signature: • • •• • • • • • ••• • 0 • ••• i.: OZ p"5 5e 1 • �`r49�irinnm ' o�0. ARSEnvironmental Consulting Services E'N(/1RON14ENr,4L, INC. Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 1 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Project Summary Pursuant to your request; ARS Environmental, Inc., has performed an Asbestos Building Survey on 9/23/2016 and limited to the above referenced location. The Interior/Exterior/Roof of the above referenced location was visually inspected to identify building materials that may contain asbestos. Suspect materials were collected and samples sent to laboratory for analysis. Laboratory Results Based on the laboratory analysis, asbestos was detected in amounts greater than 1% in the secured bulk samples. • • •• • • • • . • • 1ZeSards,• • It his bden a pleasure working w you. Please call on us again. • ••• • •• • • • • • •• ••• •• • • • • • •• •• • • •• • • t, • eAllSi nvit�onmental, Inc. •• • 10097 Cleary Boulevard, #305, Phgrrtationj FL 33324.• Phone 954-227-2402 • Fax 866-816-5110 www.arsenvirorime4htal:cdi1Y • gabsc -senvironmental.com • •• •• • • • •• •• ••• • • • ••• • • ARS E'N/!RoNiuEN TL, NEnvironmental Consulting Services tos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 2 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Certification I hereby certify that this asbestos survey was conducted at the above referenced Job Site on 9/23/2016, and performed by Jeffrey Montalvan, accredited by the EPA as AHERA Inspector(s), utilizing the code of the Federal Regulation Standards, 40 CFR, Part 763, Subpart E, Section 763.80-763.99 and the State Asbestos Regulations, Florida Statutes 469.003. LICENSE NUM8eR ZAOOQO 64 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ASBESTOS LICENSING UNIT The ASBESTOS BUSINESS ORGANIZATION ' Named below IS LICENSED Under, the provi&Fons of Chapter 469 FS.. Expirati n date: "NOV 30; 2017 ARS ENVIRONMENTAL INCv; ' �• "- ,TIMOTHY CAUGHEY ....., 4.------"' •, . ::.. ,,t10097'CLEARY BOULEVARD``" ' -� _ -,. -., � ._ r. ,-,- p1 ANTATION;r 0, ""„EL 33324 / ,i '''',".:w I'' ,r' ' R '4 q O, s 'NF ",04. 1ssuEO_ %COMMS DISPLAY AS REQUIRED BY LAW 7/fir Timothy F. Caughey, M.P.H. Florida Licensed Consultant •• ••• • • • • • • •• • • • • • • •• ••• • • • ••• • .•• • ••• •• • • •• • • • • • • • • • • • ••• • • • •• •• • •• • • • •• SEO I L1510060=054 • •• • • • •• 10097 Cleary Boulevard, #305, Flant3tiort, EL;33524 • Phone 954-227-2402 • Fax 866-816-5110 www.arsenvirogmptahcpr>:i • sale@3rsenvironmental.com ••• • • • ••• • • ARSEnvironmental Consulting Services E'N/IROItM4ENT,4L, INC Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 3 of 15 Prepared For. Job Site: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Technician Certification A b% t 03 Conu:' ` ting r Training jl;A :Lal 'CO4 W.$1` 4 Amur. RK Imu4wlgn. Fk. 33}71 This is to Certify that 1.1tifney Montal.van ` � .1 To Authenti I w` ert"t c UITORTI JUH -� •mwW.�.4A 1W X X X- x x— 7 3 2 5 ip00-966-9933 12 N.tG.. 179 St.. North Miami Bosch. Pt. 3316:2 a'` has successfully completed an English Attyv,eloc Ailain . 22-Jtin-I(i TQ 22 -Jan -!6 NOAAC Provider 1451 TWinerfs}. Mark Kniek T efoisE iWJrers;. %V NW 5 AV. Ion Lauderdale. FR Successful corse completion based •n tam score on: airiz This Certificate Expires: 111 1 I Irl / IIJ.I 01, mes F. Stump,r;see S�ponsoo CrrtirirnteYumhrr:'`j''ac o! Jeffrey Montalvan Certified Asbestos Surveyor ARS Environmental, Inc. •• ••• • • • • • •• • • • • • • • • •• ••• •• • • • •• • ••• • ••• • ••• •• • • • • • • •• • • ••• • • • • • • •• •• • • • • • • • • • • ••• • ••• • • •• -- a • •• • 10097 Cleary Boulevard, #305, Plantation, FL 3332 • l?hbr a 9:54.227:2402 • Fax 866-816-5110 www.arsenvironmental.com sigsdaFenviror rital.com ••• • • • ••• • ARS FNUIIZUNM ENTAL, mic. Environmental Consulting Services Asbestos Business License #ZA-0000164 Today's Date: 9/29/2016 Project Number. 20162291 Page 4, of 15 Prepared For: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Bulk Sample Itemization Sample Sample Physical Water Material Number Material Class / Sample Description / Location Condition Damage Damage Contact Sample Friability Approximate Size Asbestos Detected Sample 1 Surfacing Material Fair Yes Yes Low Friable 2,842 sq. ft. Asbestos Not Detected Layer Spray Applied Ceiling Texture; Popcorn Throughout the ceilings 1st and 2nd floor and garage. Sample 2 Seng Material Fair Yes Yes Low Friable Included Above Asbestos Not Detected Layer Spray Applied Ceiling Texture; Popcorn Throughout the ceilings 1st and 2nd floor and garage. Sample 3 Surfacing Material Fair Yes Yes Low Friable Included Above Asbestos Not Detected Layer Spray Applied Ceiling Texture; Popcom Throughout the ceilings 1st and 2nd floor and garage. Sample Surfacing Material Good None None High Non -friable 4,800 sq. ft. Asbest dNot L YC1' Interior Plaster Coat Throughout the walls 1st and 2nd floor. sample 5 Surfacing Material Good None Ili I, Vox. • • • nigh. • •• • • •N2n-ffiple • • • Included Above Asbestos Not Layer Interior Plaster Coat •• • • •• • ••• •• • • • •• Throughout the walls • • • • • •• 1st and 2nd floor. ••• • ••• • ••• • • • • • ••• • • • • • • • • • • •• • • •• • • • No insulation observed behind the walls. A/C duct fiberglass insulation. The following non suspect materials were observed during this inspection (no samples were obtained); ceramic, metal, wood. ••• • • • • ••• • • • • • • • • • • 10097 Cleary Boulevard, #305, Plantation, FL 43324 • hone 914 -Z27 -Z402 • Fax 866-816-5110 www.arsenvironmental.com o s letaa vi�Coonr3leht .tom ••• • • • ••• • • ARSENUIRONMENTAL, Environmental Consulting Services Asbestos Business License #ZA-0000164 Today's Date: 9/29/2016 Project Number: 20162291 Page 5 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Bulk Sample Itemization Sample Sample Physical Water Material Number Material Class / Sample Description / Location Condition Damage Damage Contact Sample Friability Approximate Size Asbestos Detected Sample 6 Surfacing Material Good None None High Non -friable Included Above Asbestos Not Detected Layer Interior Plaster Coat Throughout the walls 1st and 2nd floor. Sample 7Layer Surfacing Material Fair Yes Yes High Friable 5,920 sq. ft. • AsbebestecsNot Wallboard/Joint Compound Throughout the walls and ceilings 1st and 2nd floor. Sample 8 Surfacing Material Fair Yes Yes High Friable Included Above Asbestos Not Detected Layer Wallboard/Joint Compound Throughout the walls and ceilings 1st and 2nd floor. sample 9 Surfacing Material Fair Yes Yes High Friable Included Above Asbestos Not Detected Layer Wallboard/Joint Compound Throughout the walls and ceilings 1st and 2nd floor. Sample 10 Surfacing Material Fair Yes • • • • Yes ••••••• •• • ,Iligji i • Fr jple • • • • • • Included Above Asbestos Not Detected Layer Wallboard/Joint Compound• . • . • • • • • • Throughout the walls and ceilings 1st and 2nd floor. • ••• • •.• • ••• • • • . • • • . • • • ••• • • • . •• • • • • • . • . . • •. •• • • • No insulation observed behind the walls. A/C duct fiberglass insulation. The following non suspect materials were observed during this inspection (no samples were obtained); ceramic, metal, wood. ••• •• • • • •••• •• • • • • • • • • • 10097 Cleary Boulevard, #305, Plantation, FL:3332¢ it Pjte T54;2P*2402 • Fax 866-816-5110 www.arsenvironmental.com••• .@•rs••• se esaenvirommer al.com ••• • • ARS _ Ammu mEivrAc, INC. Environmental Consulting Services Asbestos Business License #ZA-0000164 Today's Date: 9/29/2016 Project Number: 20162291 Page 6 of 15 Prepared For: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Bulk Sample Itemization Sample Sample Physical Water Material Number Material Class / Sample Description / Location Condition Damage Damage Contact Sample Friability Approximate Size Asbestos Detected Sample 11 Surfacing Material Good None None High Non -friable 1,320 sq. ft. Asbestos Not Detected Layer Ceramic Tile Grout Throughout the 1st floor. Sample 12 Surfacing Material Good None None High Non -friable Included Above Asbestos Not Detected Layer Ceramic Tile Grout Throughout the 1st floor. Sample 13 Surfacing Material Good None None High Non -friable Included Above Asbestos Not Detected Layer • Ceramic Tile Grout Throughout the 1st floor. ) �e Miscellaneous Good None None High Non -friable 1 30 sq. ft. YES Layer Mirror Mastic; Black Inside bathrooms and bar area behind approximately 112 sq. ft. of mirrors. sample 15 Miscellaneous Good None a••_•••••• None •• ••• High •• •• • Non-friab •• •• •• • 6 sq. ft. YES Layer Sink Insulation; Black •• • • • Bar and kitchen sin. • ••• • ••• • ••• • • • • • • • • • • • ••• • • • • •• • • • • • • • • • • •• •• No insulation observed behind the walls. A/C duct fiberglass insulation. The following non suspect materials were observed during this inspection (no samples were obtained), ceramic, metal, wood. ••• • • • • ••• • • 10097 Cleary Boulevard, #305,. Plantation, FL 33374 • Mara 954-227-22F02 • Fax 866-816-5110 www.arsenvironmental.com ; silgsaarservirpnnwl+gl.com ••• • • • ••• • • A RS ENVIRONMENTAL, INC. Environmental Consulting Services Asbestos Business License #ZA-0000164 Today's Date: 9/29/2016 Project Number: 20162291 Page 7 of 15 Prepared For: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Bulk Sample Itemization Sample Sample Physical Water Material Number Material Class / Sample Description / Location Condition Damage Damage Contact Sample Friability Approximate Size Asbestos Detected S 16ple Miscellaneous Good None None High Non -friable 4,988 sq. ft. Asbestos Not tected ' Yer Concrete Structure Throughout the floor and exterior walls. Sample 17 Miscellaneous Good None None High Non -friable Included Above Asbestos Not Detected Layer Concrete Structure Throughout the floor and exterior walls. Sample 18 Miscellaneous Good None None High Non -friable Included Above Asbestos Not Detected Layer Concrete Structure Throughout the floor and exterior walls. Sample 19 Miscellaneous Good None None Low Non -friable 1,600 sq. ft. Asbestos Not Detected Layer Roof Material; Membrane Over this building. Sample 20 Miscellaneous Good None • v .Nona. • •• • Low. • + • • •• •• •• 4,.Frile •• •• •• • • • 1,200 sq. ft. Asbestos Not Detected Layer Blown -in Insulation; White• • •• • • • • ...... • • • , • • • • •• Throughout attic space. • ••• • ••• • •s• • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • •• • •• • • •• • • • • No insulation observed behind the walls. A/C duct fiberglass insulation. The following non suspect materials were observed during this inspection (no samples were obtained); ceramic, metal, wood. ••• • • • • ••• • • • • • • • • • • 10097 Cleary Boulevard, #305, Plantation, FL 33324.• Jhbfd 9Z4-227-2402 • Fax 866-816-5110 www.arsenvironmental.corm sole a en .i±onwlentel.com ARSEnvironmental Consulting Services E'NI/IRONIIAENTAL, INC Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 8 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Friable Asbestos Containing Material NONE DETECTED Recommendations Friable: any material containing more than one percent asbestos which has been applied on ceilings, walls, structural members, piping, duct work, or any other part of a building, which when dry, may be crumbled, pulverized, or reduced to powder by band pressure. The following work practice should be followed whenever demolition/renovation activities involving RACM occur: Notify EPA of intention to demolish/renovate, remove all RACM from a facility being demolished or renovated before any disruptive activity begins or before access to the material is precluded, keep RACM adequately wet before, during, and after removal operations, conduct demolition/renovation activities in a manner which produces no visible emissions to the outside air, and hildle••• • and dispose of all RACM in an approved manner. • • • •• • • • • • • • • • The above building material is considered friable and must be i'liriovedfldfidg Iii fnsci Asbestos Abatement Contractor, prior to any disturbance caused by renovation or demolition. • • • • • • • • • •• ••• •• • • • •• When implementing the response actions, parties responsible for final selection should remember that actions shall be 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. • • • • • • •„ • • • • ••• • • • • In the event that demolition or renovation is deemed necessaryojeties+shafl comply inth�all applici a laws, ordinances, rules and regulations of Federal, State and Local Governmental Agencies, including any i1ational Rmitsions Standard Hazardous Air Pollutants (N.E.S.HA.P.) Notification requirements 10097 Cleary Boulevard, #305, Plantation, !r3r?324 •: PitoN! 5.54-227-2402 • Fax 866-816-5110 www.arsenvironmental.ct n sAlpstoprsInvkorjiiiental.com ••• • • • ••• • • ARSEnvironmental Consulting Services E'N/IRoNi4EvT,4L, INC. Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 9 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Category I - Non -Friable Asbestos Containing Material le Num Description / Material Class Location Approximate Sample Physical Water Material Sample Asbestos Size Condition Damage Damage Contact Friability Detected Sample 14 Mirror Mastic; Black 30 sq. ft. Good None None High Non -friable YES Inside bathrooms and bar area behind approximately 112 sq. ft. of mirrors. Layer Miscellaneous Sample 15 Sink Insulation; Black 6 sq. ft. Good None None High Non -friable YES Bar and kitchen sink. Layer Miscellaneous Recommendations The above referenced Asbestos Contained Building Materials may be left in place if deemed to be in good condition and no repairs or renovations are scheduled which would disturb them. Care should be taken to ensure that the materials not be disturbed during repair, renovation or remodeling activities which could possibly release fibers into the air. To reduce the intrinsic liability to the owners, the ultimate solution may be to have the material removed. However, at the mimmum, a formal Operations and Maintenance (O&M) Program is recommended to minimize potential fiber releases, monitor any future deterioration, and to ensure proper record keeping. Under the FDEP regulations, Category I non -friable asbestos -containing materials may be left in place during demolition under wet conditions. However, OSHA regulations require that disposal of asbestos -containing materials and debris is disposed of in a leak -tight and labeled container. The container may be plastic bags so long as the holding is leak -tight. All materials must be disposed of in a Class I landfill and manifest as Category I Non -Friable Asbestos containing material. To meet the requirements of a wet demolition, it is the responsibility of the demolition contractor tpsontrol any visible emissions by adequately applying water on the structure. Furthermore, the work practices for the demolition of a•lorilding conttth�nmiel 4to4 most -be in regulatory compliance with OSHA 1926.1101. All materials must be kept thoroughly wet or saturated during the demolition to assist In ¢rdenfing•th• release of asbestos fibers. A certified asbestos supervisor must perform or supervise the work. If during the demolition process visible emi'1sjons are observcd,theasl�ege-containing materials must then be abated. • • ••• •• • • •• The regulations of the Occupational Safety and Health AdmifiStration tOSHA) applies to any detectable amount of asbestos in building materials or on facility components. This requirement covers worker training, work practices, and disposal methods. In summary, removing asbestos in a commercial setting requires training, specific work practices, and disposal methods for the asbestos and asbestos-containinh debris. • • • • • soil• •• • • • However, if Category I Materials have become friable or art in,00i conditimr they mustipererrjovedbefore demolition or renovation begins by a Florida Licensed Asbestos Abatement Contractor. When implementing the response melon', partits tnsrbl• for fmalltelection should remember that actions shall be sufficient to protect human health and the environment, but may also be 'least••durdensonre. = od. Notsing in these recommendations should be construed as prohibiting or discouraging removal. 10097 Cleary Boulevard, #305, Plantolipra, FL.333i24rPt1ont; 954-227-2402 • Fax 866-816-5110 www.arsenvironmedtaicon�l Iszile$@arseisvironmental.com :.•.. • • • •• •• • • solo • ARSEnvironmental Consulting Services E'N(J!gONii4E/tIT,4L, INC. Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements. • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 10 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Category II - Non -Friable Asbestos Containing Material NONE DETECTED Recommendations The above referenced Asbestos Contained Building Materials may be left in place if deemed to be in good condition & no repairs or renovations are scheduled which would disturb them. Care should be taken to ensure that the materials not be disturbed during repair, renovation or remodeling activities which could possibly release fibers into the air. To reduce the intrinsic liability to the owners, the ultimate solution may be to have the material removed. The above building materials are considered Category II Non -Friable and are likely to become crushed, crumbled, pulverized or reduced to powder during demolition or renovation therefore must be removed before demolition or renovation begins by a Florida Licensed Asbestos Abatement Contractor. To meet the requirements of a wet demolition, it is the responsibility of the demolition contractor to control any visible emissions by adequately applying water on the structure. Furthermore, the work practices for the demolition of a building containing asbestos must be in regulatory compliance with OSHA 1926.1101. All materials must be kept thoroughly wet or saturated during the demolition to assist in preventing the release of asbestos fibers. A certified asbestos supervisor must.perfiorm or supgt'vvse.thh %At. If during the demolition process visible emissions are observed, the asbestos -containing materials must then beabated.: • • . • • • • • The regulations of the Occupational Safety and Health A nnistretions(OSIPA) dppfie?to any detectable amount of asbestos in building materials or on facility components. This requirement covers worker training, work practices, and disposal methods. In summary, removing asbestos in a commercial setting requires training, specific work practices, and disposal methods for thesliestos and asbestos -containing debris. • . •.• • •;• • • • However, if Category II Materials have become friable ar4in pool condition, they must Zie removed before demolition or renovation begins by a Florida Licensed Asbestos Abatement Contractor. When.mplemestifg Qie r •se•ac ioi parties responsible for fmal selection should remember that actions shall be sufficient to protect human heajtji ancCate environment, but flay also be the least burdensome method. Nothing in these recommendations should be construed as prohibiting or discouraging removal. 10097 Cleary Boulevard, #305, Plani41o0, FI, 33324•• Rhon¢ 954-227-2402 • Fax 866-816-5110 www.arsenvironmetlta2.coril :•tale@arsetivironmental.com • • •••• • • • • • • • •.• • ARSEnvironmental Consulting Services E'VVIRONII4ENTI4L, INC. Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations General Terms and Conditions Scope of Work ARS Environmental's inspections are limited and non-destructive in nature. Any conditions or materials which were not able to be visually observed on the surface, or in easily accessible areas, were not inspected and may differ from those observed. It was not within the scope of this investigation to remove surface materials to investigate portions of the structure or materials which lay beneath the surface. Our selection of sample locations and frequency is based upon our observations and the assumption that like materials in the same area are homogeneous. This inspection report is the result of a diligent search of the facility for Asbestos Containing Building Materials (ACBM). The purpose of this inspection was to identify those materials which may pose a health hazard to occupants of a building and impart future liability to the owners and insurers of the property. However, we do not claim to have identified all of the asbestos containing building materials present in the facility. Materials such as underground pipes, any material inside walls, ceilings, floors, or other enclosed and inaccessible areas were not sampled and are not covered in this report. This report is designed to aid the building owner, architect, construction manager, general contractor, and potential asbestos abatement contractor in locating asbestos containing building materials. Under no circumstances is this report to be utilized as a proposal or a project specification document. This report is based upon conditions and practices observed at the property and information made available to the surveyor. This report does not intend to identify all hazards or unsafe practices, nor to indicate that other hazards or unsafe practices do not exist at the premises. In the event that demolition or renovation is deemed necessary, parties shall comply with all applicable laws, ordinances, rules, and regulations of federal, state, and local governmental agencies, including any National Emissions Standard Hazardous Air Pollutants (NESHAP) notification requirements. Right of Entry The client will provide for right of entry to ARS Environmental's personnel in order to complete the above referenced work. Invoices ARS Environmental will submit invoices to client upon completion of services. Ownership of Documents All reports, field data, field notes, laboratory tests data, calculations, estimates, and any other documents prepared by ARS Environmental as instruments of service shall remain the property of ARS Environmental. Assumptions and Limitations The results, findings, conclusions, and recommendations expressed in this report are based only on conditions which were observed during inspections by this report. ARS Environmental makes no representation or assumptions as to past conditions or future occurrences. Assigns Neither the client nor ARS Environmental may delegate, assign, sublet or transfer his duties or interest in this agreement without the written consent of the other party. Roof Cuts To obtain accurate information in a roof investigation, roof cuts approximately four inch 4" squares, may be deemed necessary. It is the responsibility of our client to make appropriate repairs to these roof cuts, using materials consistent with the roofing system and in accordance with any existing material manufacturer's warranties. A roofing contractor or maintenance personnel selected by our client should be on the roof to make any necessary repairs at the time the samples are being obtained. Although, every attempt will be made to make these repaired areas water tight, ARS Environmental will in no way be responsible for any water damage to the roofing system, building, or it's contents resulting from ARS Environmental temporary repairs. Disclaimer• • • • : : • • • : i • • • If in the course of a renovation or demolition activity, suss rtpttri$ls become exposed, ALL FURTHER ACTIVITY SHOULD IMMEDIATELY CEASE AND THE STATUS OF rum MKPFAIAj,''SHOUl BE DETERMINED BEFORE PROCEEDING. • • ••• • .• •• •• • • • • • • • ••• • • • • :. •• • • •. • 10097 Cleary Boulevard, #305, Plantation= FL•313f44•P1Sone1954-227-2402 • Fax 866-816-5110 www.arsenvironmerkal,cQrri inAlg@greltvironmental.com • •• ••• ••.• • •.• • EN(/;RONMEN /�Environmental Consulting Services T,4Lj INC Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 12 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Technician Chain of Custody Forms, Field Notes, and Photographs AssigsmswoosamiTM!M!Mo c�OODY pawL Of Z N s DM: ai2411s.. jLEsloE,-frfati ow GILA►rte, *lambs Taken Sys 43.:Mo4104-1/Ao 1007.5' 13151ayh„E Mui> • 0 I0 'o Sep 2816 08:17p 2olf.--X29 Asbestos Sie •IsMsaasawYs k Thy.I 'Ft._ Amos sIS NO IS L] AC duet tbss abs NM impel MN am IS i igg alla absaad �- OW' Q Mi Elemp MX CMNa r .-; 5 S �7. pC.oR-N� Ti�ao a- Il tc. C.Ei li i¢ � Floo n- A c, 2� �I� �y l �{ �-� 2. 5 ul 9 . Ga .6.ckG. V1 v ►...1......"—..........---. 3 5 ti h I ki .FIN ,.✓_. J ,1 1 l t4 cop- • Ptas 'TAIL.. wpt� s t qo4 - y$Z� U h/ t.! �} M It 6 5 4-\I �'} S ulAu.Bt Il'a1 1r cow4o Trific.n,..tovT~--rbrt o :s. • AND ecv.1M,N t�P 2 toot .,...n,„_- - _....I. ire.---„, ► . _._ y _ " 0- S _\ V ,,A _ .s• • �" ,5 Sti ••' _ •_ • • : • • •••-l. • ••• •� • • •: _•- • • •• • ' T.andonwi air Dow CI %13//1. fieoeMd B3v:. -. • - . DdA: 11G5111tga-- • • • • • • • ••• • @ ••• •• • • • • • • •• • . • • • • •• • 10097 Cleary Boulevard, #305, Plantatjen' FL 23324• Plione:954-227-2402 • Fax 866-816-5110 www.arsenvironmerttal:cgrrC•Mile§@amatironmental.com • •• •• ••.' ••. • • ARS EJVV,RONA4EN Environmental Consulting Services TAL, INC. Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number: 20162291 Page 13 of 15 Prepared For. George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Asbestos Survey — Technician Chain of Custody Forms, Field Notes, and Photographs • • • • •.• • • • •••• • • •• •-• • • • Aseatsros wanceliprr PWAIN OF r POW wap. 2- a � s� ow►: az • • • • f;,,,a,.T,1141W ? twur4•T�Pw iAM k;,`-, P4161;1141 • •e•• ••- N • • Of 0 0 N O. Obsereld 9-0-10 rat p14/0-L4r'-i 100225" G't S c d r. 6=-v o wrr vies to .: , ., '�' ' iiia. ++. »" . �1--- "" >.4 ` ..:. Q Ac a.�t ar.rv. , I», Id.wwd Sit npa�lM.felw� 111 - 0 MIMro. . _ . 1 • c 4120 ar Th.) etriar Mr ha Flo DA- 13t� G t,/ N AiF 13 111 ,1 v vt `'1 r , ► M gtocrt ,+ti,t.ycwt, MIS Ti 4. 5,6 )t72t)0014s 4 2 1asiAE (5,611t12<-)00141 op.2 Arms a , , ..4rrnorL-t. 3o 4igox, 1l2,f,ii i5 ih _ Z,c S v srta✓ 0404- 4/47 K^T+ "ra✓ S<Mz 6 )(0 m 604414e 5-124/E-17.414 (.44 0101.A.- Tinge Ftopz- A.vn ekwTZ- InAtu-s . `' 0 11 VI ct ei ......111 19M n . 1 Li `7 p° . � 'l 41 ^1 floor'+4'—giter‘ 0011—nrr9 �3c n I L- meta. 4, 2 /6,_ Transferred 89: Date: 10097 Cleary Boulevard, #305, Plantation, FL 33324 • Phone 954-227-2402 • Fax 866-816-5110 www.arsenvironmental.com • sales@arsenvironmental.com Today's Date: 9/29/2016 Project Number: 20162291 Page 14 of 15 Asbestos Survey — Laboratory Results ARS EVrOnEtentQ1 Environmental Consulting Services Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9/29/2016 Project Number. 20162291 Page 1 of 2 Prepared For. Job Site: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Residential Dwelling 10025 Biscayne Boulevard Miami, FL Laboratory Analysis &ample • layer Yumta • Number Gross Description • • •••• • •• • • • • • • • • • •• Estimated Asbestos Percentage Non -asbestos % Fibers Non-fibrous % Materials 1 • • • • I:oopcorq • • • No asbestos detected 2% cellulose 98% 2.• • •••• No asbestos detected • 2% cellulose 98% •••• • .•3•• • .•• • 0 C9no['r No asbestos detected 2% cellulose 98% iInteric� Plaster Coat • • • • No asbestos detected 100% 5 Interior Plaster Coat No asbestos detected 100% 6 Interior Plaster Coat No asbestos detected 100% 7 Drywall /Joint Compound No asbestos detected 30% cellulose 25% glass 45% 8 Drywall / Joint Compound No asbestos detected 30% cellulose 25% glass 45% 9 Drywall / Joint Compound No asbestos detected 30% cellulose 25% glass 45% 10 Drywall / Joint Compound No asbestos detected 30% cellulose 25% glass 45% Alex Front, Analyst 10097 Cleary Boulevard, #305, Plantation, FL 33324 • Phone 954-227-2402 • Fax 866-816-5110 www.arsenvironmental.com • sales@arsenvironmental.com Today's Date: 9/29/2016 Project Number: 20162291 Page 15 of 15 Asbestos Survey — Laboratory Results • • • • • • •••• • • • • • • • ta ARS E!von � �. w e Environmental Consulting Services Asbestos Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air Quality Testing • Mold Investigations Today's Date: 9t29/2016 Project Number. 20162291 Page 2 of 2 Prepared For: Job Site: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Residential Dwelling 10025 Biscayne Boulevard Miami, FL Laboratory Analysis Sample • Layer I • • Number• •• •• Gross Description • •i% • • Gro tt • • • Estimated Asbestos Percentage Non -asbestos % Fibers Non-fibrous % Materials No asbestos detected 100% 1e• •• Vic GiRta • • •••• • W • • •••• No asbestos detected 100% • •••• • • r1:040iit No asbestos detected 100% •aa.. • • • • •Black c ji . • • • 10% chrysotile 15% cellulose 75% 15 Black Insulation 110% chrysotile 10% cellulose 80% 16 Concrete No asbestos detected 100% 17 Concrete No asbestos detected 100% 18 Concrete No asbestos detected 100% 19 Membrane No asbestos detected 35% cellulose 20% glass 5% synthetic 40% 20 Insulation No asbestos detected 65% synthetic 35% Alex Front, Analyst 10097 Cleary Boulevard, #305, Plantation, FL 33324 • Phone 954-227-2402 • Fax 866-816-5110 www.arsenvironmental.com • sales@larsenvironmental.com 0 FPL I 1 September 16, 2016 Allied Demolition 7950 NW 53 St #337 Doral, 33166. Re: 10025 BISCAYNE BLVD. MIAMI SHORES Effective SEPTEMBER 16, 2016, FPL has removed the meter and disconnected the FPL service wire to the above referenced address. However, before demolishing the structure, you should have the premises checked by a qualified individual to assure that electricity is not being supplied to the structure from any possible source. If there are any questions, or if I may be of further assistance in this matter, please contact me at the telephone number below. Sincerely, Cam',/..d.a. 9,eze,gleop Carressa Jackson Associate Technical Specialist 305.770.7948 ....... . .. .. • • • • • . .. ••• .. • • • •• • • .••• • ••• . ..• .. • • . • .. • • •• • • • •• • • .. • .. .. .. ..• • • • • • • . • .. . •• .. • .. ...... • • • • • • ••• • • • .. • • • • .. • •••• • ••• • • October 13"' 2016 To whom it may concem: Thomas Wensjoe and Monica Kuljich have hired Allied Demolition Inc. to demolish our house located on 10025 Biscayne Blvd Miami Shores Florida 33138. If you need any further information, please call me at 786-478-1988 Sincerely S�rJensio Monica Kuljich .. 1•• • • • • . .. • • • • . -. • • • • • • • • . .. ••• .. • • • .. • ••• • ••• • ••• • • • • . • • • • • • ••• • • . • .. • • • • • • • • • • ..• ..• • .. ..• • • ••• • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • .... • • • .. .. ••• • • • ••• • • 16 to 7 THIS INSTRUMENT PREPARED BY AND RETURN TO: MARTIN L BODZIN, ESQ. TRANS -STATE TITLE INSURANCE AGENCY, LLC 18205 BISCAYNE BLVD., SUITE 2201 AVENTURA, FLORIDA 33160 Property Appraisers Parcel Identification (Folio) Number: 11-3205-034-0040 3 SPACE ABOVE THIS LINE FOR RECORDING DATA WARRANTY DEED THIS WARRANTY DEED, made the day of June, 2016, by DAVID J. BIRMINGHAM, a single man, and EVIDIO C. ARTIGAS, a single man, whose post office addresses are 280 Gurney Franklin Road, Linville Falls, North Carolina 28647 and 1130 NE 111t1 Street, Miami Shores, Florida 33161, respectively, herein called the Grantor, to THOMAS R. WENSJOE and MONICA E. KULJICH, his wife, whose post office address is 10025 Biscayne Boulevard, Miami Shores, Florida 33138, hereinafter called the Grantee: (Wherever used herein the terms "Grantor" and "Grantee" include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations) W I T N E S S E T H: That the Grantor, for and in consideration of the sum of TEN AND 00/l00'S ($10.00) Dollars and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the Grantee all that certain land situate in MIAMI-DADE County, State of Florida, viz.: Tract D, WEEKS SUBDIVISION, according to the Plat thereof, as recorded in Plat Book 71, Page 91, of the Public Records of Miami -Dade County, Florida. Subject to easements, restrictions and reservations of record and taxes for the year 2016 and thereafter. TOGETHER, with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. TO HAVE AND TO HOLD, the same in fee simple forever. AND, the Grantor hereby covenants with said Grantees that the Grantor is lawfully seized of said land in fee simple; that the Grantor has good right and lawful authority to sell and convey said land, and hereby warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever. IN WITNESS WHEREOF, the said Qt2tnttxr 1/ale �Srgned ind•sealed these presents the day and year first •above written. '. • • • .. ... .. . . . .. • ... ... • ... • . • .. . • . • ... • • • . .. . . . • . • • • • . • .. • ..• • .. .. . .• ... . • • . ... .. . • • • . • ... • . . . ..... • . • • . • • • • • . . ..• .. ALLIE-2 OP ID: HP dr -wit_ —"" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/12/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). INNOVATIVE INSURANCE PRODUCER CONSULTANTS, INC. 5461 UNIVERSITY DRIVE, #103 CORAL SPRINGS, FL 33067 BRIAN J. MAMO PHON: CONTACT BRIAN J. MAMO PHONE 954-340-9551 eu.Il�tcAli' ant): FAX No): 954-340-9456 ADDREss: BRIAN@INNOVATIVE-INSURANCE.COM INSURER(S) AFFORDING COVERAGE NAIC N INSURER A : MOUNT HAWLEY INSURANCE CO. 37974 INSURED ALLIED DEMOLITION, INC._ 7950 NW 53RD STREET #337 MIAMI, FL 33166 no,vrn. nye, __-_-_ _ __ INSURER e : BUSINESSFIRST INSURANCE CO. 11697 INSURER c:AGCS MARINE INSURANCE CO INSURER 0 : EACH OCCURRENCE INSURER E : INSURER F : 08/17/2016 • -- ' - RGY hJIVPa IY utYtDCK: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — INSR LTR TYPE OF INSURANCE -Ab'DL(S0aA INSD I WVD POLICY NUMBER POLICY EFF (MM/DOlYYYY) POLICY EXP (MM/DDJYYYY) LIMITS A X ~ X_ ^X COMMERCIAL GENERAL LIABILITY _j CLAIMS -MADE 1- Xl OCCUR BLANKET ADDL INSD EACH OCCURRENCE S 1,000,000 MGL0182085 08/17/2016 08/17/2017 ZAMAGE TO REIITEIs PREMISES (Ea occurrence) $ 50,000 BLANKET PRIMARY MED EXP (Any one person) $ EXCL. BLANKET WAIVER NON-CONTRIBUTORY PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY I OTHER LIMIT APPLIES X 1 dE PER' LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 S AUTOMOBILE '—_, _ LIABILITY ANY AUTO ALL ALL OWNED AUTOS HIRED AUTOS _ _ _ _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT ,1Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB_ EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ OED 1 RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N _ X STATUTE I I EOR" B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ' N f A 0521-13954 03/12/2016 03/12/2017 E. L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes, describe under BLANKET WAIVER .� E.L. DISEASE - EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C EQUIPMENT FLOATER OWNED EQUIPMENT SML93064119 01/19/2016 01/19/2017 EQUIPMENT 83,698 90% COINS ACV DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may M attached N more space Is required) LICENSE #CGC1506512 CANCELLATION MIAMISI MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD STATE Ur rwt iui DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CEDENO, JORGE MIGUEL ALLIED DEMOLITION INC 12040 SW 3RD ST PLANTATION FL 33325 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Departments initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENTOF BUSINESS AND PROFESSIONAL REGULATION CGC1506512 IS5UED; 06/12/2016 CERTIFIED GENERAL CONTRACTOR CEDENO, JORGEVIGUI L, — " " ALLIED DEMOLITION INC,_ IS CERTIFIED under the provisions of Ch.489 FS. Expiration date : AUG 31, 2018 L1606120001341 DETACH HERE STATE OF FLORIDA DEPARTMENT REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD KEN LAWSON, SECRETARY The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 CEDENO, JORGE MIGUEL ,, ""n ALLIED DEMOLITION INC.. 8195'NW 54TH STREET - •ti � - MIAMI _.,FL 33166 R 4 T `- m ....h..., Fes: . .A' ,.—.' DISPLAY AS REQUIRED BY LAW ISSUED: 06/12/2016 SEQ # L1606120001341 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 3967370 BUSINESS NAME/LOCATION ALLIED DEMOLITION INC 7150 NW 77 TERR MEDLEY, FL 33166 OWNER ALLIED DEMOLITION INC Worker(s) RECEIPT NO. RENEWAL 4140406 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING CONTRACTOR 3 CGC1506512 PAYMENT RECEIVED BY TAX COLLECTOR 45.00 09/16/2016 C RE DITCARD-16-054296 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles — Miami—Dade Code Sec 8a-276. MIAMFDADE For more information, visit www miamidade.gov/taxcollector JOHN IBARRA & ASSOCIATES, INC. Professional Land Surveyors & Mappers W W W.IBARRALANDS URVEYORS.COM 777 N.W. 72nd AVENUE SUITE 3025 MIAMI, FLORIDA 33126 PH: (305) 262-0400 FAX: (305) 262-0401 2804 DEL PRADO BLVD SOUTH SUITE NO. 202 UNIT 1 CAPE CORAL, FL 33904 PH: (239) 540-2660 FAX: (239) 540-2664 C .JVED OCT 14 246 i17�'7• 1 MAP OF BOUNDARY SURVEY 10025 BISCAYNE BLVD, MIAMI SHORES, FL. 33138 GRAPHIC SCALE -20 0 10 20 (IN FEE7) 1 /NCH = 20 FEET LEGAL DESCRIPTION: TRACT D, WEEKS SUBDIVISION, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 71, PAGE 91, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. CERT/F/CATION: THOMAS WENSJOE • • • Oa / • •••••• • • • • • • • • • / • J • • • / • • • •• • • • • • 1111• • • • ss• • sY • • •••L•• • ••• •'• / • // • • • ABBREVIAT/ONSAND MEANINGS A - ARC NC - AIR CONDITIONER PAD. A.E.- ANCHOR EASEMENT. AR - ALUMINUM ROOF. A/5 • ALUMINUM 511ED. ASPIC.- ASPHALT. B.C.- BLOCK CORNER BROWARD COUNTY RECORDS BLDG.- BUILDING. B.M.• BENCH MARX B.O.B.- BASIS OP BEARINGS. BS.1. - BUILDING 3ETGL1 UNE C - CALCULATED C.B - CATCH BASIN. C.BS - CONCRETE BLOCK STRUCTURE. CSW - CONCRETE BLOCK WALL. CHORD BEARING. C - CLEAR C.I.F.- CHAIN LINK FENCE. C.M.E.. CANAL MAINTENANCE EASEMENTS. CONC.- CONCRETE. C.P.- CONC. PORCH. C.5.• CONCRETE 51AB. L.U.P.- CONC. UTILITY POLE MIP.- FEDERAL NATIONAL INSURANCE P.N.- POUND NAIL. M.. IRGH InaGnT1 I.P.- IRON FENCE G.W.- CONCRETE WALK 14.4 EG.- 114GR405 AND EGRESS EASEMENT. D.E.- DRAINAGE EASEMENT . LB. Cerehate d AuthcfmaHon 1.0J7804 DRAINAGE MAINTENANCE EASEMENTS LP.- LIGHT POE. DRIVE - DRIVEWAY LF.E.- LOWEST FLOOR ELEVATION. • . DEGREES L.M.E.- UWE MNMENANCE EASEMENT • MINUTES. M.. MEASURED DISTANCE. MB • AWL BOX M.O.C.R.- MIAMI DADE COUNTY RECORDS M.E.- MAINTENANCE EASEMENTS MON. - MONUMENT UNE. MN . MANHOLE. AVL - MONUMENT UNE. N.A.P. - NOTA PART OF. MGM - NATIONAL GEODETIC VERTICAL DATUM EB • ELECTRIC BOX GT. P.- ELECTRIC TRANSFORMER PAD. ELN.- ELEVATION. NOR'. ENCROACHMENT F.H.F. PRE HYDRANT. F I.P.• POUND IRON PPE. FJ.R- POUXq IRON ROO. 11.E.- FINISHED FLOOR ELEVATION. F.N.O.• POUND NAIL N 0154. FT - FEET. N.T.S.- NOT TO SCALE. I -NO. - NUMBER 05 - OFFSET. • OVERHEAD 0.11.L.• OVERHEAD UDUTYUNI5 0.4.B. - OFFICIAL RECORDS BOOK OVH - OVERHANG PAU,. PAVEMENT. R- PLANTER. PA - PROPERTY UNE. P.C.C.- POINT OP COMPOUND CURVE. P.C.- PORT OP CURVE. PT.- POINT OF TANGENCY. POC.- POINT OP COMMENCEMENT. 104.- POINT OF BEGINNING. P.R.C.• POINT OF REVERSE CURVE PB.- PAT BOOK PG.. PAGE. MY. - PARKWAY. PRM. • PERMANENT REPEROACE MONUME P.LS.• PROP651ONAL LAND SURVEYOR R - RECORDED DISTANCE. RR. RAIL ROAD. RL5, RESIDENCE. PROP. COR.- PROPERTY CORNER RAY - RIGHTOF-WAY. RP.- RADIUS PONT. SEC, SECTION. 5TT.- STORY. 5WK.- NOCRIALK 5.1.1.- SET IRON PIPE LB. 97E0C. SCREEN® PORCH 5.• 501.1171. T - TANGENT TB - TELEPHONE BOOM T.U.E.- TECHNOLOGY UNUTV EASEMENT TSB - TROPIC SIGNAL BOX T.S.P.- TRAFFIC SIGNAL POLL NT. TRIP • TOWNSHIP. UNE- UTILITY. U.P.. UTILITY POLE. W.M.- WATER METER W.F.. WOOD PENCE. W.R. • WOOD ROOF. ' 6?O • �•` dF c' W.M.- WATER METER W.R.- WOOD ROOF. W.5.- W000 SHED. W -WEST. ry - CENTER UNE. - CEFTRAL ANGLE. - OVER AD UTILITY uNE5 - CONCRETE BLOCK WALL X X CHAIN UNKPENce IRON PENCE N lI WOOD PENCZ - BUILDING SETBACK UNE UTILITY EASEMENT UM= ACCT55 RAV • NON -VEHICULAR ACCESS RAV 0.00 - EXISTING ELEVATIONS ^�Y (\QOG .cNAZ O� MI N: P D•q CI Nt ?V" S1 NF LOCATION SKETCH SCALE =N.T..S. LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY: • THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY • THE PURPOSE OF 17115 SURVEY 15 FOR USE IN OBTAINING 1111E INSURANCE AND FINANCING AND SHOULD NOT BE USED FOR CONSTRUCTION PURPOSES. • EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY • THIS SURVEY IS SUBJECT TO DEDICATIONS, UMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORD. • LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY. • BOUNDARY SURVEY MEANS A DRAWING AND/ OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO SCALE; Ti -,0 WALLS OR FENCES MAY BE EXAGGERATED FOR CLARITY PURPOSES. • EASEMENTS A5 SHOWN ARE PER PLAT BOOK, UNLESS DEPICTED OTHERWISE. • THE TERM "ENCROACHMENT' MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS. • ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS, SETBACKS AND WILL BE RESPONSIBLE FOR SUBMITTING • PLOT PLANS WITH CORRECT INFORMATION FOR 'APPROVAL POR AUTHORIZATION' TO THE PROPER AUTHORITIES IN NEW CONSTRUCTION. • UNLESS OTHERWISE NOTED. THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTING AND/OR FOUNDATIONS. • FENCE OWNERSHIP NOT DETERMINED. • 171(5 PIAN OF SURVEY, HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED HEREON, THE CERTIFICATE • DOES NOT EXTEND TO ANY UNNAMED PARTY. FLOOD ZONE INFORMATION: THENF/P FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE SITUATED /AC FLOOD ZONE AE' BASE FLOODELEVA77ON: &OO FEET. COMMUNITY:: 120652 PANEL 0306 SUFFIX L DA7E OF FIRM: 5/11708 THE SUBJECT PROPERTYDOES UE/NA SPECIAL FLOOD HAZARD AREA. SURVEYOR'S NOTES: 1. IF SHOWN, BEARINGS ARE REFERRED TO AN ASSUMED MERIDIAN, BY SAID PLAT IN THE DESCRIPTION OF THE PROPERTY, IF NOT, BEARINGS ARE THEN REFERRED TO COUNTY, TOWNSHIP MAPS. 2. THE CLOSURE IN THE BOUNDARY SURVEY 15 ABOVE I :7500 FT. 3. CERTIFICATE OF AUTHORIZATION Ib # 7506. SURVEYOR'S CERTIFICATION: I HEREBY CERTIFY: THIS "BOUNDARY SURVEY' OF THE PROPERTY DESCRIBED HEREON, HA5 RECENTLY BEEN SURVEYED AND DRAWN UNDER MY SUPERVISION, AND COMPUES WITH THE STANDARDS OF PRACTICE AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER 5J-17, FLORIDA ADMINISTRATIVE CODE PURSUANT TO 472.027, FLORIDA STATUTES. BY" 9/9/2016 JOHN IBARRA (DATE OF FIELD WORK) PROFESSIONAL LAND SURVEYOR NO.: 5204 STATE OF FLORIDA (NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OFA FLORIDA LICENSED SURVEYOR AND MAPPER). REVISED ON: REVISED ON: L.B.# 7806 SEAL 74?nrr - /6- a 78 ARS ENVIRONMENTAL . INC Environmental Consulting Services 1 Asbestos Business License #Z 0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • indoor Air _Quality Testing • Mold Investigations Today's Date: 10/31/2016 Project Number: 20162522 Page 1 of 1 Prepared For: In Regards To: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Residential Dwelling 10025 Biscayne Boulevard Miami, FL Post Job Submittal Please find attached the paperwork for the removal and disposal of the asbestos containing material at the above referenced job site. Thank you for your business. Respectfully Submitted, Jeffrey Montalvan, ARS Environmental • • • • •• • .•.••• • •..••• •••. • • ••.• •.•••• •• •• •.••.. • • • • • • • • •• • • • •••.•• • • • •••••• • • •••• • • •••• • • •.••.. • • • • ••..•• • •.•. • . • •. • cust/doc / proj 20162522 10097 Cleary Boulevard #305, Plantation, FL 33324 •hone 954-227-2402 • Fax 866-816-5110 Wua/.arsenoironmentat.com • saes arsenotronmenta .com ...••• • • • ....•• • • •••.•. • • ..••• • • •.•••• •• • ••••.• • • •.•••• • • Oct31 16 08:21a Ghg NOTICE OF TYPE OF NOTICE (CHECK ONE ONLY) Florida Department of Environmental Protection Division of Air Resource Management DEMOLITION OR ASBESTOS RENOVATION 18668165110 p.2 MIAM1OIADE Department of Regulatory and Economic Resources Environmental Resources Management 701 NW lst Court, 2nd Floor Miami, Florida 33136-3912 T: 305-372-6925 Fax: 305-372-6954 miamidade.gov ® COURTESY ❑ ORIGINAL TYPE OF PROJECT (CHECK ONE ONLY) : 0 DEMOLITION IF DEMOLITION, IS IT AN ORDERED DEMOLITION? 1FRENOV ATICN: ❑ REVISED 0 RENOVATION 0 YES ❑ CANCELLATION ❑ ROOFING © NO IS IT AN EMERGENCY RENO VATION OPERATION? 0 YES O NO Fie it IS ITA PLANNED RENO VATION OPERATION? 0 YES 0 NO Process fl L Facility Narre Residential Dwelling Address 10025 Biscayne Boulevard City Miami State FL Zip 33138-2645 County Miami Dade Site Consultant Inspecting Site ARS Environmental, Inc. Building Size 3,296 (Square Feet) f+ of Floors 2 Building Age in Years 38+ Prior Use: ❑School/College&Universay 0 Residence 2SmaUBusiness Other Present Use: DSchool/CollegeiUniversity ❑ Residence 2 Small Business Other U. Facility Owner THOMAS R WENSJOE MONICA E KULJICH Phone Address 1135 NEE 100 ST City MIAMI SHORES State FL Zip 33138 111. Con:tactor s Narne ARS Environmental, lne Phone 1305) 710-0452 Address 10097 °tea y Blvd. State 305 City Plamanon State FL Is the contractor exempt from licensure under senior 469.032(4), F .S.? 0 YES © NO N Scheduled Dates: :Nonce must be postmarked 10 working da ys before the project start date) Asbestos Removal Immiddfyy) Start•10129/2016 Finish: 10130/2016 Demo/Renovation (mmldd/yy) Start: Finish: V Description of planned demolition cr reno nation work to be performed and methods to be employed, including demolition or renovation techniques to be used and description of affected facility components. Inside bathrooms and bar area behind approximately 112 sq. ft. of mirrors, and Bar and kitchen sink. zip 33324 V1. Procedures to be Used (Check All That Apply): fri Strip and Removal ❑ Clove Bag (] 1 Wet Method Dry Method OTHER: ❑ /Eulldozer LD Wrecking Ball ❑ J Explode ❑ Burn Down Procedur es for Unexpected RACt: Asbestos WasteTrensoorter: Name Address 790 HPltrath Dr. STOP WORK AND NOTIFY MIAMI DADE DERE. Southern Waste System Phone 561 502 6698 City Lantana State FL Zip 33462 Vlli, Waste Disposal Site: Name Monarch Hill Address 2700 NW 48th St. city Pompano Beach State FL Zip 33073 •••••• • • IX. RACM or ACM: Procedure. including analytical methods. employed to detect the presence of RACM and Category I and inion ikialle ACM • • •••••• •••••• • • • •••••• Amount of RACM or ACM' square feet surfacing material square fee: cementitious material linear feet pipe square feet resilient flooring cubic feet of RACM off facility components square feet asphalt roofing 'Identify and describe surfacing material and other materials as applicable: 30 sq. ft of Mirror Mastic, and 6 sq ft. of sink insulation ••••• • •••••• •••• • •••• •••••• •• • • • •••• • • •••• • • •••••• • •• •••••• • • ••••• • • ••••• 000000 •• • •••••• ••••• • • • • • I certify that the above information is correct arid that an individual trained in the provisions of this regulation (40 CFR Part 6t•, Subpart M) will bh• • • site during the demolition or renovation and evidence that the required training has been accomplished by this person will b! ay:al./Ott for inspection during normal business hours. I have read and understood the additional information provided on the back of this form. • • • • • • • • • • 7Er nz ey $�v*1+t • •• ;Print Name of Own e petor, 305 720-0452 REEF USE ONLY PostmarWDate Received ID $ i61_9i-t5a taint OiSTUIBIJTION: White-RER Title w -Applicant Pink.-Reserie Gold -Reserve • • •••••• • • Oct31 16 08:22a Ghg 18668165110 p.4 2-01b WASTE SHIPMENT RECORD t Work Sita Name and Mailing Address (Generator) .4 tc025 Biufl _ IAlpr.4 3 33130 2. Remover's Name and Address ACR Environmental Inc. 128E4 Biscayne Blvd., Suite 30E North Miami, FL 33181 Owner's Name TiiV AAr NcW P•" � L MtZMic.J G . v ictA Owner's Telephone No. Cl 0 513 -4q9 Remover's Telephone No. 305-944-3741 3. Waste Disposal Site (WDS) Name, Mailing Address, and Physical Site Location coiDe X1350 h11ni 4-1,, 4. Name and Address of EPA Office local, state, of regional USEPAREGION IV 345 COURTLAND STREET NE ATLANTA, GEORGIA 30385 (404) 347-2128 5. 14M Desc. of Materials Hazard Class IQ Number Packing Group # S. Containers No. Type 7. 'Total Quantity m' (yds RO Asbestos a NA2212 111 e BA Z Z s 8. Special handling Instructions and 24 Hour Emergency Response Telephone Number (provided by Generator) 1-954-546-4544 9. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and government regulations. Note: Generator must retain a copy of this form. Prir.tedrrype r‘!2'ne any 1111s Month Flay 'Yaw 10 2c tip 10. TRANSPORTER 1 (ACKNOWLEDGMENT OF RECEIPT OF MATERIALS) Note: Transporter must retain a copy of this form. Printed/Typed Name and Title 1412-5 Env; OvrIrn e_r)-)-txt 1 Inc_ Address and Telephone No. 1009"7 Ci.ear‘f eiVOI #305 Piarl+CWOn t F z_1.4 11. TRANSPORTER 2 ACKNOWLEDGMENT OF RECEIPT OF MATERIALS) Note: Transporter must retain riedbpy bf this form• • • • PrinteCLTyped Name and Title Signature °°°°° ° Morin 04y Year ••••••• Signature lionth Day Year C;• tar 1cc, • • • •••••• •.•••• • r .... Address and Telephone Flo. 790 4-i tib¢4'!-h - b 2-- • • • ••••e. • • • • • • •••••• ••• •••• •••• • • • ••• ! • •..••• •••••. . •. �.. • • :ejected, • ... L. • • •••••• • ••Yes ▪ • t do ❑ ••••'•• • • •••• 12. Problems evith Conteinmeni or Packaging 12. WASTE DISPOSAL SITE OWNER OR OPERATOR: rtification pi receipt of asbestos material covered by this manlleat except as noted in item 12. Printed/T}wed Name and Title Signature •• Month Da;r Year NOTE The Waste Disposal Site must retain a completed copy of thins norm and send a copy to the Gema ter listed in item 02. WHITE - GENERATOR CANARY - LANDFILL PINK --TRANSPORTER GOLD - GENERATOR ARS Environmental Consulting Services Asbestos Business License #ZA-000016j Asbestos Consulting iInvestigations • Raioo-x Meas�iremsnts •` Lead Asse3sments •Indoor Air Quality Testing •Mold Invee stigations Today's Date: 10/31/2016 Project Number: 20162522 Page 1 of 2 Prepared For: Job Site: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Residential Dwelling 10025 Biscayne Boulevard Miami, FL Air Sampling NIOSH / EPA Overview On 10/29/2016, the following air samples were taken in accordance with the current NIOSH and EPA guidelines as they apply to air pump operations and calibrations. The locations and/or the degree of aggressive (i.e. amount of air circulation and/or method for use of air blower device} specified by the client or the removal contractor's personnel. Analysis Method The above samples were analyzed for the fiber count on the above analysis date. Hoffman Modulation Contrast and NIOSH current procedures for visible light microscopy were used for the analysis. Laboratory Results Note: The results included here represent the standard test for air concentrations of fibers only. In no way do these tests represent or construe the quality of any remaining bulk asbestos and/or completeness of any removal operations. Based on visual observations and laboratory analysis, the above referenced jokii, has ...... passed all criteria. Readings of less than 0.01 f/cc indicates that it is sife•t'r reentry. Therefore, no further recommendations are necessary at this time. 1 • • ••• : •. •. • • • • • . • • ••• 1111•• ••1111• • 1111 It has been a pleasure working with ypy.Rlease 4160/1 as again." • • Regards, •• •1 11.11• • • • • • • ............ • • • • • •J•••• • • 1111•• •• .1111• Al '. Fro , ARS Environmental, Inc. NIOSH 582 Equivalency #0000017 • • • • • e• • •••• • • • .• • 10097 Cleary Boulevard, #305, Plantation, FL 33324 • Phone 954-227-2402 • Fax 866-816-5110 WWW.arsenvironmentaf.com • sales@arsenvironmental.com • • A RS ENVIRONMENTAL, INC Asbestos Business Li Consulting Services Business License #ZA-0000164 Asbestos Consulting • Radon Measurements • Lead Assessments • Indoor Air _Quality Testing • Mold investigations Today's Date: 10/31/2016 Project Number: 20162522 Page 2 of 2 Prepared For: George Cedano Allied Demolition 8195 North West 54th Street Miami, FL 33166 Job Site: Residential Dwelling 10025 Biscayne Boulevard Miami, FL Air Sampling NIOSH / EPA Test Number Type Sample Size Sample Date Taken Sample Analysis Date Concentration Fibers/Structures/CC 1 Final Air 1,200 Liters 10/29/2016 10/29/16 0.003 Sample Location 2nd Floor Bathroom 2 Final Air 1,200 Liters 10/29/2016 10/29/16 0.004 Sample Location 1st Floor Bathroom 3 Final Air 1,200 Liters 10/29/2016 10/29/16 0.003 Sample Location 1st Floor Bar Area • • • • • •• • 000000• •••.•• •••• • • •••••. • • •• •• •.•••• • • • • • • • • • • •• • • • •.•••1 • • • 1111•• • 000000 • • • 1111•• • • • 1.11•• •••• • • • • •.••• •••• • • • • •.••• 1111•• 1111•• •• • • • • . ••.11• •..•••• • • •11111 • •.•1 • • • • •• • 10097 Cleary Boulevard, #305, Plantation FL 33324 • Phone 954-227-2402 • Fax 866-816-5110 WWui.arsenuironmentaLcom • sales@arsenvironmenta(com