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MC-15-1761 J"�_,_ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-242276 Permit Number: MC-7-15-1761 Scheduled Inspection Date:August 26,2015 Permit Type: Mechanical - Commercial Inspector: Perez,JanPierre Inspection Type: Final Owner: , Work Classification: A/C Replacement Job Address:9723 NE 2 Avenue Miami Shores, FL 33138- Phone Number (305)949-9049 Parcel Number 1132060134210 Project: <NONE> Contractor: RB AIR CONDITIONING INC Phone: (305)216-7766 Building Department Comments 5 TON AC SPLIT SYSTEM AND DUCTWORK 2 AIR Infraction Passed Comments SUPPLY INSPECTOR COMMENTS False Inspector Comments Passed 10) Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid August 25,2015 For Inspections please call: (305)762-4949 Page 44 of 48 zzas �qs Miami Shores Village 3 3Z' { If3 3k{xxd% 'id ; 10050 N.E.2nd Avenue NEAMAt 'nJ Miami Shores,FL 33138-0000 { Phone: (305)795-2204 { ti ,,', Expiration: 01/16/2016 mea 711�'I'x 3 ExP� :< Project Address Parcel Number Applicant 9723 NE 2 Avenue 1132060134210 GATOR 9723 NE 2ND AVE LLC Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell GATOR 9723 NE 2ND AVE LLC 1595 NE 163 Street (305)949-9049 NORTH MIAMI BEACH FL 33162- 1595 NE 163 Street NORTH MIAMI BEACH FL 33162- Contractor(s) Phone Cell Phone Valuation: $ 8,000.00 RB AIR CONDITIONING INC (305)216-7766 Total Sq Feet: 0 Tons:5 Available Inspections: Additional Info:5 TON AC SPLIT SYSTEM AND DUCTWORK Inspection Type: Classification:Commercial Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $4.60 DBPR Fee Invoice# MC-7-15-56337 $4.20 07/20/2015 Credit Card $254.20 $50.00 DCA Fee $4,20 Education Surcharge $1.80 07/14/2015 Credit Card $50.00 $0.00 Permit Fee $280.00 Scanning Fee $3.00 Technology Fee $6.40 Total: $304.20 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 infQffnabon i accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-Zn- n r for to do the work stated. July 20, 2015 Authorized Signature:Owner / Applicant 7 Contractor / Agent Date Building Department Copy July 20,2015 1 ' • o `er Miami Shores Village JUL 4 2015 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 5)762-4949 y _ FBC 20 LO BUILDING aster Permit No.6z if-� 99 PERMIT APPLICATION Sub Permit No. (TJ, 45"-"d-1 G ❑BUILDING F-1ELECTRIC ❑ ROOFING ❑ REVISION F-1EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CQNTRACTOR DRAWINGS JOB ADDRESS: /�� v d✓ g&j s- City: Miami Shores County Miami Dade zip: �3 v l�v Folio/Parcel#: <103W&01 �jAlz Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: 1 FFE: p OWNER: Name(Fee Simple Titleholder): 6AV-`R. �`i'Z� L4D '0Z Phone#�`� Address: l v9 e, City: State: -Te-- Z(p: Tenant/Lessee Name: Phone#: Email: V�Z�y�Z Co /lf� (�r� CONTRACTOR:Compan Name ;E!?A C Phone#. 2 A�- / /�� Address: wv � c City:_�� � / State: Z�i�p:r�� Qualifier Name: / f f Phone#:(, State Certification or Registration#: A 'o-6-Z/ '��—Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 0(00 . = Square/Linear Footage of Work: Type of Work: ❑ o ❑ Alteratio ® ❑ Repair/Replace Demolition 1� y, Description of Wor; ' seu pu i° f' , Specify coil ; > a Q .�: - PF}' '..,�yyZ' Submittal Fee$`" w°� v� Pe ` ee$ ` CCF$ u R iQ!0~�JlVVA�ka.10/CC "a A Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 5 (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) 1A 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 ttachment. Also,a certified copy of the'recorded notice of commencement must be posted at the job site for the first inspection whi h occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be pr ved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing inst rnents acknowledged before me this The foregoin nstrument was acknowledged before me this day of 1 20 __, by `� d y of 20 l� by �G>•�r�5 �1dt��'=�tl , ,w s personally known t �Aravr�CctJGl. 'w is personally known t me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign. Print: 2A e,.e L- Print: Seal: ti Seal: Mike Vazquez Mike Vazquez �. COMMISSION 0 FF190200 COMMISSION 0 FF190M ma EXPIRES:Janmy 15,2019 EXPIRES:January 15,2019 AA112UAW.— APPROVED BY / Plan's Exa er Zoning Structural Review Clerk (RevisedO2/24/2014) PLEASt W 1 UU i UAKU tttLUVV Amu KC t ratty rum ry r unc nCrCnr_h.vc- IMPORTANT STATE OF FLORIDA Pursuant to Chapter 440.#5(14),F.S.,an officer of a corporation i Of DEPARTMENT OF FINANCIAL SERVICES who exemption Nom this by a txlrtificate election under clue section may not racm er benefits or DIVISION OF WORKERS'COMPENSATION F comp ion under tut closer. f CONsMUCTION INDUSTRY EXEMPTION O cetmgcAteOr-ELECTION tb EXEMPT rRont�ctta► L Pursuant toChapter 440.05It2LF.S..CerdecatesOfeledanto woRXEJ%IV COMPRIMTfeN LAW D be exempt.,.apply Dray Within theMopeor the business or trade EFFEe17ve DICT! 7n ar10,S L'04UTM DATE 3ltar20,7 listed on the notice of election to be exempt. �m+wttofia m oo A H Pursuant to Chapter 440.0.5(13),F.S.,Nodca of election to be FEai: e50614ess E exempt and certificates of election to be exempt shall be submit BUSINESS NAME AND ADDRESS: R to revocation t,at any time atter the Oft of the notice or the E R 8 AIR CO!IDiTIgNEq INC E issuance of the cetwicate,the person named on the notice or Certificate no larger meas the requirements oft"section for whence of a certificate.The department shall revoke a certOrate ; i 2530 WEST 78 ST SAY 1 at any time for fafti a of the person named on the certificate to HIALEAH FL 33015 meet the requirements of this section. SCOPES OF BUSWESS OR TRA HEATING,VENTILATION, WR-COND DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 STATE OF FLORIDA l DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CAC057175 :ISSUED: 08/17/2014 CERTIFIED AIR GOND CONTR BENDANA, RICARDO R BAIR CONDITIONE6 INC IS CERTIFIED under the Provisions of Ch-489 FS, Expiration date: AUG 31,2016 L1408170001972 a r s 003182rt -0,17-M-11 k sE'"r: waT .vcalrfte ,ax, °CIp " k Muar> � DdeHNOT A481L� na ? of Flar�da . ,: : T R�kY „ 7 ,k � MBf'��"v�` 4 ,�,f � vC„ p•�i J`"''M1"� �y�„�" ,y j d 'f-. > '�'' AECEIIxt`NO. BUS1Nt3S$NAME/t•OCATION r c EI`I �N' �+ TEYXP7 I )`RRE,3S% ,,20 Y" RS A1R COPCDI fl(�NED 11VG 37377/73 Must ba displaysa at place of business _ 2530W' Fur.suarvt to.Cau Codi liIALEAH FL 33015 Chapter 8A-Art.9&�0 4 ;} } SEC. E,-q"IF BU INET �AYM RTQ ECE UED '. owNE>r 196 SPIE C MECHA��CAL ONTRAC'OL� `�pY r � 1t6"Al#1 , fE /16/�Ll0i1G4CO�DITIONEDN 4, -7 5.0075C14-13HE Worker s) Is not a Tbis Local Busin tex�8eceipt aly ootrtirms p ant of the Local Business Tax The R mit any eoyernm ntai parte o a certffi ombf the hol!- 4ualifice _ to do business Hold er y ., oreon iitlsrnme psglilatoryl v requi nt�id 1plytgtlieebb�Ussh =— Thu tECFJp1 NOlebove Oustbe,isplayed cit conioemial vehiotas IVliea�i Dade C-oda Sac —* rmation, i+��idade`ovkaYcallactor_. r CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/13/2015 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(les) 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). PRODUCER CONTACT A&D ALL-LINES INS ASSOC INC PHONE (305)463-6781 AX(A/C,,,I,(305)387-2918 5600 SW 135 Ave Ste 106 E-MAIL s3I[la ori a sout .net Miami, FL 33183 INSURERS AFFORDING COVERAGE NAIC# AMERICAN VEHICLE INS CO INSURED R.B. AIR CONDITIONED, INC. INSURERB: 2530 WEST 78TH STREET BLDG-C BAY-1 HIALEAH, FL 33016 INSURERD: 305-216-8895 INSURER E, 305-216-7766 COVERAGES CERTIFICATE NUMBER REVISION NUMBER 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. ILTR TYPE OF INSURANCE s C U LICY EFF P LDI Y P LIMITS v GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 COMMERCIAL GENERAL LIABILITY 10 01000 CLAIMS-MADE M OCCUR MED EXP An one ME $ 5,000 A X GLOS11056631 1/10/151/10/16 PERSONAL&ADV INJURY 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s 2,000,000 POLICY M PRO- LOC $ AUTOMOBILE LIABILITY OMBI EDSINGL IMIT $ e ANYAUTO BODILY INJURY(Per person) $ ALLOWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED P OPER DAMAGE $ AUTOS (Pareocid UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR Id CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ WORKERS COMPENSATION I WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If ,describe under -D SRIFTON OFOP E.L.DISEASE-POLICY DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Addidonal Remarks Schedule,d more space Is required) AIR CONDITIONING INSTALLATIONS / SERVICE / REPAIRS CERTIFICATE HOLDER ALSO LISTED AS ADDITIONAL INSURED. HOLDERERTIFICATE MIAMI SHORES VILLAGE BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI, FL 33138 FAX: (305)756-8972 AUTHORIZED REPRESENTATIVE 01988-2010 ACORD ) N.All rig is reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ... ate. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305)756.8972 Notice to Owner— Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers'compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if- 1. f:1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesti g a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time empl yees or subcontractors for your project.The contractor has provided an affidavit staring that he or she will be the only person allow to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensatio ' surance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BEYOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature:_ T Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this t5 day of V By 6M U� wo is personally known to a or has produced as identification. Notary: SEAL: Mike Vazgm MMMU= 0 M� RB A/C Inc 650 West Park Dr. # 203 Miami,F1.33172 (305) 216-7766 E-mail: rbendana5l@gmail.c©m Date:7-13-2015 State of Florida Miami Dade County Before me this day personally appeared Ricardo Bendana who,being duly sworn,deposes and says: That he will be the only person working on the project located at 9723 NE 2^d ave. Miami Shores,FI 33138. wor to affirmed)and subscribed before me this&day of July,2015, Ri rdo d ersonaliyknow Or produced Identification Type of Identification Produced Sign,Print,type or stamp Name of Notary Walm (�gN��iSSM I MIUM FilPli}�S:,gowryt 10,ZOfi trasaJia architect, LETTER OF CLARIFICATION Date: June 1, 2015 To: Building Department Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 Tel. 305-795-2204 Fax. 305-756-8972 Re: Permit No. CC-14-1588 Landlord Improvements 9717 Northeast 2nd Avenue Miami Shores, Florida 33138 Dear Building Officials & Inspectors: I am the Architect for the Landlord Improvement to an existing commercial space at the above address in Miami Shores, now in for permit revision application. Please be advised of the following responses to Plan Review Comments: Building: 1. Please see revised sheet D-1 for the removal of the note that contradicts removal of the existing bathroom. Structural: I. Please see attached NOA's 09-1015.04 for the storefront door and NOA's 14- 0331.02 for the storefront windows. 2. Please see detail 2/M-1 for uplift capacity, condensing unit connections and concrete pad design. Thank you, and if you have questions or comments, please contact me directly. Please add this letter to the permanent permit record for the job. Best ar e rasgalla M 6991 West Broward Boulevard Suite 100 Plantation, Florida 33317 954.614.3801 Florida License No. AR12239 ARSEnvironmental Consulting Services &VIRamExTAL, INC. Asbestos Business Ucense#ZA-0000164 Asbestos Consulting •Radon Measurements •Lead Assessments•Indoor Air Anality Testing •Mold Inoestigations Today's Date:7/8/2014 Project Number:20142081 Page 1 of 14 Prepared For: Job Site: Sammy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach FI 33162 Asbestos Survey — Project Summary Pursuant to your request;ARS Environmental,Inc.,has performed an Asbestos Building Survey on 7/7/2014 and limited to the above referenced location. The Interior/Exterior 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. The Roof was not sampled.If the Roof system will be disturbed by renovation or demolition samples of the materials that will be affected should be obtained and analyzed to determine asbestos content prior to any disturbance. - J Laboratory Results Based On The Laboratory Analysis, No Asbestos Was Detected In Amounts Greater Than 1 % In The Secured Bulk Samples. It has been a pleasure working w'h you.Please call on us again. Regards, Fr t, ARS Environmental,Inc. z - 10097 Cleary Boulevard ® #305 a Plantation, FL 33324 o phone: 954-227-2402 o Fax 866-816-5110 www arsen#ironmentaP eom •sales @orsenvironmentat een; H I r 'ORS A ®� /�ERoTL Environmental Consulting Services m I NDE AINCE Asbestos Business License#ZA-0000164 —.,- Asbestos Consulting ®Radon Measurements a Lead Assessments•Indoor Air Quality Testing ®Mold Investigations Today's Date:7/8/2014 Project Number:20142081 Page 2 of 14 Prepared For: Job Site: Sammy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach F133162 ti Asbestos Survey — Certification I hereby certify that this asbestos survey was conducted at the above referenced Job Site on 7/7/2014,and performed by Alex Front, 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. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ASBESTOS LICENSING UNIT 7.AD=164 The ASBESTOS BUSINESS ORGANIZATION •• • ,� Named below IS LICENSED Under the provisions of Chapter 469 FS. Expiration date: NOV 30,2015 ARS ENVIRONMENTAL.INC �) TIMOTHY CAUGHEY 10097 CLEARY BOULEVARD PLANTATION FL 33324 19,3,MINN, RICK SCOTT ISSUED: 09 O 2013 SEQ# L1309030002224 KEN LAWSON GOVERNOR DISPLAY AS REQUIRED BY LAVJ SECRETARY Timothy F.Caughey,M.P.H. Florida Licensed Consultant 10097 Cleary Boulevard e #305 ® plantation, R 33324 o phone: 954-227-2402 ® Fax: 966-816-5110 _ wwwarsenvironmentat com 0 sales C,arsenvironmentat com ARS EVOROMMENTAL, Environmental Consutting Services wc. Asbestos Business License#ZA-0000164 Asbestos Consulting a Radon Measurements ®Lead Assessments®Indoor Air Ouatity Testing a MOM Investigations Today's Date:7/8/2014 Project Number:20142081 Page 3 of 14 Prepared For: Job Site: Sammy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach F133162 Asbestos Survey -- Technician Certification `Y�fjnl+� yy (fxhl NW�a�C ya +wj�l�hlw�r'o 'G�fxwv," �R Y }I. 1) Y , A.:b-,stcwzt Cwj,_r.Wgkig ,, T alodingt Sy,-, � ,j., wa..WI(TAT40 JM MW MA,nn Fonu .,a,..{MmL,`t til 9„}b1�H I �•. This is to Certify that ILII I 'I I AuNonLcn (."Oka • {J{�-y, III�N��IIIQI�I II UI�I�'ll�ll�tlllll�l�ll�l� t`-''d `w'ap at>c s�a �` Y!� A el 11991 rv.�'�/✓• S has successfully completed an English P �I�,_,,,_ � ,,G:a{G�,_�Syl��ff�'�.fli.H1ii-::�lh;'lACrn L'fflt',•;f�sd i�l � � e��'+S� 29-tan-14 TO 29-dan•14 f , 4 " NOAP ,.mel gabl i 114 I:N.: v •'u Wuieg AthWi 9Iq NN- ,tort .17 cm Wlwti-. t r..,ni aro m. i enxs F.s]mup.Cmtnm.$pponspn'Ipp .I i IIH��II�.i�IIUUN Th Is Certificate Expires: COUM-Number SE140 ' t' i -- �A Jeffrey Montalvan Certified Asbestos Surveyor ARS Environmental,Inc. 10097 Cleary Boulevard a #305 ® plantation, FL 33324 ® phone: 954-227-2402 ® Fax. 866-816-5110 www.arsenvironmental.com 9 sales@arsenvironmentatcom ARSEnvironmental Consulting Services EvOROMMENTAL, im Asbestos Business License#ZA-0000164 Asbestos Consulting 0 radon Measurements e Lead Assessments o Indoor Air Oua(ity Testing a Mold Investigations ,Today's Date:7/8/2014 Project Number: 20142081 Page 4 of 14 Prepared For: Job Site: S-mmy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach F133162 • Asbestos Survey — Bulk Sample Itemization Sample Sample Physical Water Material Sample Positive Asbestos Number Material Class/Sample Description/Location Condition Damage Damage Contact Friability Approximate Size Stop Detected Sample e Miscellaneous Good None None High I Friable 2,400 Sq.Ft. Asbestos Not Detected Layer Wallboard/Joint Compound Throughout Unit S°�piz Miscellaneous "Good None None High Friable I Included Above Asbestos Not Good Detected Layer Wallboard/Joint Compound Throughout Unit Sample Miscellaneous Good None None High Friable Included Above Asbestos Not Detected Layer Wallboard/Joint Compound Throughout Unit 5u�ple Miscellaneous Good `None None High Friable 2,400 Sq.Ft. Asbestos Not Detected Layer Wallboard/Joint Compound Throughout Unit Sample Miscellaneous Good None J None High Friable Included Above Asbestos Not $. Detected Layer Wallboard/Joint Compound Throughout Unit L. Samp a MiscellaneousI Good None None High Friable Included Above Asbestos Not 6 l Detected Layer Wallboard/Joint Compound Throughout Unit I The following non-suspect materials were observed during the survey(no samples were taken):Fiberglass insulation above ceiling tiles.No insulation observed behind drywall/plaster.Ceramic tiles,vinyl baseboard,carpeting,A/C fiberglass duct work.Rubber pipe lagging insulation. 10097 Cleary Boulevard• #305•Plantation, R 33324 a Phone: 956.227-2402 •Far $66.816.5110 wwarsenvironmental.com a sales@arsenvironmentat.com 1 d RS AExonommEN E'nvironnrental Consulting Services B �nrc. Asbestos Business License#ZA-0000164 Asbestos Consulting •Radon Measurements •Lead Assessments •Indoor Air_Ouatity Testing •Mold Investigations Today's Date:7/8/2014 Project Number: 20142081 Page 5 of 14 Prepared For: Job Site: SFmmy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,FI North Miami Beach Fl 33162 Asbestos Survey — Bulk Sample Itemization Sample Sample Physical Water Material Sample Positive Asbestos Number Material Class/Sample Description/Location Condition Damage Damage Contact Friability Approximate Size Stop Detected Sa�Ie Miscellaneous Good None None High Friable 2,200 Sq.Ft. Asbestos Not Detected Layer 2'X 4'Ceiling Tiles;Wormlike Design Throughout Unit sample Miscellaneous Good None None High Friable Included Above Asbestos Not Detected Layer 2'X 4'Ceiling Tiles;Wormlike Design Throughout Unit 9.sample Miscellaneous Good None None High Friable [--included Above Asbestos Not Detected y 2'X 4 Ceiling Tiles;Wormlike Design Throughout Unit s 101e Miscellaneous Good Ne N onone High Friable 200 Sq.Ft. Asbestos Not Detected Layer 2'X 4'Ceiling Tiles;Pinhole Design Replacement Tiles Various Areas Snm We r- _ m Miscellaneous Fatr Yes 1 None High Non-friable 2,000 Sq.Ft. Asbestos Not — - Detected Layer Carpet Floor Glue Throughout Main Area Of Unit SAmpte,Surfacing Material Good NoneNone High Non-friable 50 Ln.Ft. Asbestos Not 12 11 Detected Uyei White A/c Duct Seam Mastic Around A/c Ductwork The following non-suspect materials were observed during the survey(no samples were taken):Fiberglass insulation above ceiling tiles.No insulation observed behind drywall/plaster.Ceramic tiles,vinyl baseboard,carpeting,A/C fiberglass duct work.Rubber pipe lagging insulation. 10097 Cleary Boulevard® #305®Plantation, R 33324 9 Phone: 954.227-2402 ®Fair: 966.916.5110 _ - www,arsenvironmental.com •sales@arsenviroomentat.com RSA /p �'nvironmenta/Consultiaq Services EmmommEN�d`!�, Iyc. Asbestos Business License#ZA-0000164 Asbestos Consulting •Radon Measurements •Lead Assessments •Indoor Air Ouality Testing •Mold Investigations Xoday's Date:7/8/2014 Project Number: 20142081 Page 6 of 14 Prepared For: Job Site: Sgmmy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach F133162 Asbestos Survey — Bulk Sample Itemization Sample Sample Physical Water Material Sample Positive Asbestos Number Material Class/Sample Description/Location Condition Damage Damage Contact Friability Approximate Size Stop Detected Sample Miscellaneous Good None NoneLow Friable 150 Sq.Ft. Asbestos Not 13 Detected dyer 12"X 12"Ceiling Tiles Front Area Of Unit Mastic Above 2'X 4'Ceiling Tiles S Ole Surfacing Material Good None None Low Non-friable 100 Ln.Ft. Asbestos Not I— Detected yet Black Mirror Mastic Around Unit Sample Miscellaneous Good None None I High Non-friable 400 Sq.Ft. Asbestos Not 1S` ` Detected Lay- Ceramic Tile Grout Front And Rear Of Unit S 16!e Miscellaneous Fair Yes Yes Low Friable 2,000 Sq.Ft. Asbestos Not f I Detected Layer Ceiling Plaster Throughout Unit Sample Miscellaneous Fair Yes Yes Low Friable Included Above Asbestos Not Detected Layer Ceiling Plaster Throughout Unit Sample Miscellaneous Good None None High Non-friable 2,400 Sq.Ft. Asbestos Not 18 Detected Layer Interior Concrete Structure Throughout Unit The following non-suspect materials were observed during the survey(no samples were taken):Fiberglass insulation above ceiling tiles.No insulation observed behind drywall/plaster.Ceramic tiles,vinyl baseboard,carpeting,A/C fiberglass duct work.Rubber pipe lagging insulation. 10097 Cleary Boulevard a#305® Plantation, R 33324 • Phone: 954-227.2402 •Far:866.816-5110 - ' wwwarsetivirenmental.com •sales@arsenvironmental.com ARSEnvironmental Consulting ServicesExommmuTAL, IN Asbestos Business License#ZA0000164 Asbestos Consulting Radon Measurements e Lead Assessments a Indoor Air(Duality Testing •Mold Investigations Today's Date:7/8/2014 Project Number: 20142081 Page 7 of 14 Prepared For: Job Site: Sammy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach Fl 33162 Friable Asbestos Containing Material Sample Sample Physical Water MaterialSample Asbestos Number Description/Material Class Location Approximate Size Condition Damage Damage Contact Friability Detected 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 hand 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 handle and dispose of all RACM in an approved manner. The above building material is considered friable and must be removed by a Florida Licensed 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 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 (N.E.S.H.A.P.)Notification requirements 10097 Cleary Boulevard • #305 a Plantation, FL 33324 ® phone: 954-227-2402 ® Fax 866-816-5110 www.arsenvironmental.com ®safesCarsenvironmentaGcom ARS / Environmental Consulting Services EmoRommEN AL, C. Asbestos Business License#ZA-0000164 Asbestos Consulting a radon Measurements ®Lead Assessments a Indoor Air(Duality Testing aMold Investigations today's Date:7/8/2014 Project Number: 20142081 Page 8 of 14 Prepared For: Job Site: Sammy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach Fl 33162 Category I -Non-Friable Asbestos Containing Material Sample Sample Physical Water Material Sample Asbestos Number Description!Material Class Location Approximate Size Condition Damage Damage Contact Friability Detected "a"ONE Y"E"'EC'EID 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 remodelling 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 minimum,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 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 perform or supervise the work.If during the demolition process visible emissions are observed,the asbestos-containing materials must then be abated. The regulations of the Occupational Safety and Health Administration(OSHA)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-containing debris. However,if Category I Materials have become friable or are in poor condition,they must be removed before demolition or renovation begins by a Florida Licensed Asbestos Abatement Contractor. 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 Ieast burdensome method.Nothing in these recommendations should be construed as prohibiting or discouraging removal. 10097 Cleary Boulevard a #305 ® plantation, F'1! 33324 ® phone: 954-227-2402 ® Fax: 866-816-5110 wwwarsenvironmental.com *sales @arsenvironmental.com dgRS A Environmental Consulting Services EmoommEnAL, //�Ca Asbestos Business License#ZA-0000164 Asbestos Consutting ®Radon Measurements a lead Assessments e Indoor Air Qnality Testing e Mold Investigations r Today's Date:7/8/2014 Project Number: 20142081 Page 9 of 14 Prepared For: Job Site: Sammy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach Fl 33162 Category II - Non-Friable Asbestos Containing Material Sample Sample Physical Water Material Sample Asbestos Number Description/Material Class Location Approximate Size Condition Damage Damage Contact Friability Detected 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 remodelling 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 H 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 etdemoli tion,itis 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 tharaughly wet or saturated during the demolition to assist in preventing the release of asbestos fibers.A certified asbestos supervisor must perform or supervise the work.If during the demolition process visible emissions are observed,the asbestos-containing materials must then be abated. The regulations of the Occupational Safety and Health Administration(OSHA)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 to a commercial setting requires training,specific work practices,and disposal methods for the asbestos and asbestos-containing debris. However,if Category H Materials have become friable or are in poor condition,they must be removed before demolition or renovation begins by a Florida Licensed Asbestos Abatement Contractor. 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. 10097 Cleary Boulevard ® #305 ® plantation, A 33324 ® phone: 954-227-2402 a Fax: 566-516-5110 WWW arsenvirenmental.com 0 sales@arsenvironmental.com ufo3�17�1fa!•tlLlodlAuasdtf�sa,l9se u�oa•,�.�uauru®donuasd»MMM _ - 011S'919'999 :xvd a ZOhZ' MOS6 .auoyd ® hZ£££ M `uP')vJuvid a 50£# a Pdut)a)uOg f"80 26001 'JAIIMDOHd 9HOM UANUL WMCI gg alnOHS gMg.I,dlili E[HI 3O SfUVIS MU(INV gSdHD A'TEUVIGUPEM (I-MOHS ABAL )d HaHjLHna'T'Id`pasodxo atuoaaq sluuajuuz loadsns`Aainuoe uoTjgoumop ao uoiaunouaa a jo asanoo aqj uT jI aatelel� •snrdaa Aat,aodumaa Iejuoumonwa SHV tuoaj 2ui.linsaa sluajuoo s,jT so` u plinq`tuajsds Sugooi otp of afeuaep aajem Aut,ao;olglsuodsoi aq Arm ou uT Ilam Imuatuuoainug SHV Iggq aajem suaat, paaTrdaa asaga axz[u oa apetu aq qTm jdtuaaje Aaana`tlgnogjid pauTrago BuTaq aar saldtues aqa ataap ata Te snudai Aat,ssaaau gut,mletu of jooa aqa uo aq pinogs juogo mo Ag pajoolas lauaosaad oouuuajaietu so aoaoezauoo 8uUool d•saTjtaeaat,m s�aamlaejnuLm leuajem$uiasixa due gaTm aouupioom uT par tuaasAs 8ugooa oqj gjim auaasisuoo slrTmma Smsn`sjno;ooa osaga oa sifedal mmeudoadde o3ptu of juogo mo jo AjgigTsaodsaa aqa sl jl Aat,ssaaau pamaap aq At,ua`saarnbs„g,goua moj Alajuuantoadde rano 3ooi uo!je2gS3AUT 3ooa a UT uoquuuojn am mou umqo oZ sin0 3ooH uajaTam zip ano tm juatuaaa2e s Aaard aagjo otp jo juasuoo qa. T p ui asaaamui ao sounp stq iajsurab ao jolgns`uih su`aae8alop Auto Irauoumo,Aug SHd aou juago aqa jo jo suRINV saauaaan000 amjnj ao suoTjTpuoo jsed of st,suopdtunsse.ao uopiluosaadai ou smpm Imuomuoainug SHV•jtodaa sM dq suopoodsuT 8ulmp panaasgo aaam gaTgm suaTaipuoo uo Aluo posuq ant,uodaa sM ut possaadxa suoijt,paatutuooaa pue`suoasnloaoo`s8utpug`sjlnsaa aqy suoge;lunrg pun suogdunwV rmuoumojTAua SHd jo Aaaadoad aqa utemaa Ilegs aomms jo sivaUm.4sUT st,leauatauoainaa SHd Aq paaedaad sauaumoop aagjo Aur pat,`sa uxgso`suonvjnoluo'mup sism Aaojuaogrl`saaou plag`eaup plag`sjaodaa lid sduatunaoa;o digsaaum® saoTnaas jo uopoldtuoo uodn auago of saoionuT aitugns IlionIt,juataauoaTnag SHd sa,IOAUI �laom paouaaajaa anogr oql aaaldumo oa aapao ui lauuosaad s jujuoumagAug SW oa Aajua jo jg8u aoj apinoad Ilion jumjo atlZ Aalug]o Iq$III •sauatuatTnbaa uoquogWu(ddHHsW siumnllod msnopaezeH pat,put,jS suoissTtug IuuoTjrl�I Aur BtaTpnlouT`sat3u lejuauauaano8 leool pue`aaeas`leaapaj3o suouelaGSai per`salsa`saouuuTpio`smul alquogdde qu glim Aldtuoo llrgs saTaaed`Aarssaoau pauaaap si aoTaenouaa ao uoTjgouaap aegj auana aqj UI •sasu aaad otp je um jsTxo jou op swad apsun ao spaezeq aagjo jrgj aaeoTpuT oa aou`saoT1oead a;usun ao spaurt,q lir A4iauopi of pumui jou scop jaodaa sites•aadaA.ms otp of algelTrnu opeua uoi.3v uaojuT ptre Aaaadoid aqj jt,panaasgo saoTaoead per suoTjipuoo uodn pasrq st jaodaa sTaU •luoumoop uOueouroods aoafoad u m lusodoad u se pazqun oq of aaodaa sTp sT saotat,asaunoaTo ou aapun siruaaeua BaTppnq SuTumuoo sojsagse Suguool uT.totouquoo vot aaaegr sojsogse lanuaaod pug`aoaoualuoo Iraaua$`aa2eurua uoijotuasaoo`joajTgoae`aaumo�u.plTng aqj pir oa pauBTsap si aaodaa sTt11 jaodaa sT uT paaanoo jou eat,pue paldturs IOU aaam seaae algtssaooeui par posoloua aagjo ao`saoo9's2uTliao`sllum opisul lu4mm Aue`sodid punoa8aapun se qons sluualloN Ilmou3 aqa to auasaad sleTaajetu RtaTpimq 8utuarauoo sojsagse aqa jo lir paT3Taaapi anetl oa tuielo lou op am`aanamoH Aaaadoad aqa jo saamsui pue - saaamo aqj of AagTgrg aattjat;aaudtaaa pue 8uaplTnq u 10 wmdnom o;paezeq gjluaq a asod Aeua goigm sTopo m osogj AjnuapT of srm uoT�oadsm sTg1 jo asodand atl� (�IgOd)sleTaaae�I BuTPImEl ftuPWOD solsogsd aoI AjTITorj otp 3o tloaeas wo2i TP a 3o alnsaa aqa sT asodaa uoTjoadsuT sTtly snoaua8ouaoq aar eamu oums aqj uT slrTaajutu 23[q imp uopdtunsse otp put,suouvAjosgo mo uodn posuq sT Amonbau put,suoi of alduaus 30 uoT�oalas mO aoe�ans atp tlarauaq Aul goTgm sleua�uaa ao amlotuas aql Io suoTV aleBAsanaT o;sluTaaaeaa aoujtns anotuai oq uoTaeBAsanaT sTtla ;o adoos aqj ulpm jou sem jl•panaasgo asogj room aaRnp Am puu pajoadstn aou aaam`wale algiss000u Alisea t q io`ooe;.ms atp uo panaasgo Allensin aq of algr aoa aaam goTgm sluTaaautu ao suoutpuoo Aadamara tai QA Taonatsap-aou put,pajTtuTl aae suoTjoadsuT s,leauattaaoaTnug SHd 31aoM;o adoaS suolltpu03 pue sulja,L fulauaf) _ bi jo of a8ud I80ZbioZ:aaquanM pafoad t loz/8/L:Qltu s,Arpo,L suoi�n8/�sanul PION® bulasal i>;lvV aly,aooPRI®sauaaussassy Pva7 a sauaruadn$"W uoPLV® buf;lnsuo,3 soasagsv V910000-b2#esueoi-1 sseuisnq solsagsy °IV) � I 111 / A/ saaiAdaS bul;,nsuo3 Imuoutaodlpuy VJC � / ARSEnvironmental Consulting Services E)VOROMMENTAL, mc. Asbestos Business License#ZA-0000164 Asbestos Consulting ®Radon Measurements o Lead Assessments o Indoor Air__Quality Testing ®Mold Investigations ,Today's Date:7/8/2014 Project Number: 20142081 Page 11 of 14 Prepared For: Job Site: S#mmy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,Fl North Miami Beach F133162 Asbestos Survey — Technician Chain of Custody Forms and Field Notes flit CHAIN nOF CUSTODY PLr Analysis: of— Pails Asbestos Bulk sarrpes a PCow�t R on F e aA erieisThat Report Less Than t% Tumaround Time Requested: • 24cH!o�ur • 48 Hour • 72 Hour Sampling Date? l� Prolate Lomdon: �fli + ,k1t�L Satnples Taken 6y. W -- -P�'1 J + Y Pmlett Ni mberr _ 6 1`001' MlAal -' r-fE) - a ample Location a ,� s pie R�, "`�,i34'ti5.61�+'S lei'%\'i _^ l N � � •i. P+\ +^ S 5•.. l �� ZIA Al Fii j"�v• ,� ,�6a t !t t �� �'tC� �l,v"G,�`Lt1�C (�u�N `��;la�sa-':,15.•'1 itV�`l' C t 'XJ fA 1�ti i� d t !A �••� ./�_ '�u �� j W�:�} �l 1J u�"ryaS��l'A�1'~1-5•�l:l� ai4��{r1�4:Y facingMWWWO7�Thermal �Aa�er�, by.hmWprawvej�Po(A�edat11 owmeybe .ar ,.,: WOW? i ' ;es. Tranaiered By: _.—.Date: 7 1q— Received ay: Gtale: ;i `i 10097 Cteanv i3tttn EvvaRu•#305•Pt awranoro, L 4•ToLi FREE:$?7-227-2 •Pwme:954.227-2402•Fax:88" io I 10097 Cleary Boulevard a #305 ® plantation, FL 33324 a Phone: 954-227-2402 ® Far: 966-816-5110 WWW.arsenvirenmental.com *sales Carsenvironmentat com ARS EivaRommEwTAL, Environmental Consutting Services l/VC© Asbestos Business License#ZA-0000164 Asbestos Consulting ®Radon/Measurements a Lead Assessments®Indoor Air Qaality Testing ®Mold Investigations ,Today's Date:7/8/2014 Project Number: 20142081 Page 12 of 14 Prepared For: Job Site: Sammy Salem Vacant Commercial Space Gator Investments 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,F1 North Miami Beach F133162 Asbestos Survey Technician Chain of Custody Forms and Field Notes O Of CHAIN OF CUSTODY RLL A29Y819.Asbestos Bulk sa es p, Pohrt C�U(d RegR aw an Ttat%pott leea Tlim l% =ilr(�1'QUflt1�'j'illt8�: • 24 Hour•48 Hour • 72 Hwr Setup®ngf�ete: .I , Proled ocedon:_ *All C^i*�ta4t'firaP�lr �Nl setnplm Taken By: �E Chn ,J,C, F,0,q J E. f�rc►�ttuu�er:.,�I�� �• �i7{o °�►�`�' l SI.'. �E`� t� . Ohm > ap:slaee �` a oath T"' CALM' z. IK �: k;n�' MrM�nl ,.t�Nn fir + Y l `yt. a.-i tr•('ills a (rvF�"Zt ` J �d�; �'` '�.:t+,,'�t�f` L�f. �1�:�.�1 oi• (_}�F-f F�� P.l 1. • t � y^J.?�d.�- jC'•1 A�^,(Z f�"tit'i;Tyr � t.;.1't� L , n Of r; r LV I ry�Wlq�;-"� � ( \ L ' Its' tt r.� �.3�1,�� r �,•V :F4' r. �/V 4 t a Sa�it:�Mtafie tl l�sr:3ts BpU�dpleeBuie. UolpmPb9 `� b!'imnd d7.) Transferal By: DM.- T t RBtaiVed Sy: --.--.—Date IM7 QJEA BOUMAHD•M•PLAWAMmh 4•TQLL Fns:877-227- :954.227-2402•FAx:888-5 S 10 i 10097 Cleary Boulevard • #305 ® plantation, R 33324 0 Phone: 954-227-2402 o Fax. 866-816-5110 tvw arsenvironmental com o sates@arsentfiraiimental.com Today's Date:7/8/2014 Project Number: 20142081 Page 13 of 14 Asbestos Survey — Laboratory Results p�� ' D`ARStWORONMENTAL, Asbestos ,64 asbestos Cmsukbo®Rados AMomemots*rem Assasswom•Indoor Ali gaaft Testing rdtotd hw adfWa s Today's Date:7/8/2014 Project Nwnber: 20142081 — — Page iof2� Prepared For: Job Site. Sammy Salem _ — ^-- Vacant Commercial Space Gator Investments 9717 North Fast 2nd Avenue 1595 No 163 Stmt Miami Shores,F1 North Miami Beach F133162 Laboratory Analysis Gross Desc#dm r % 1 Drywall/Joint Compound No Asbestos Detected 30%Cellulow — �5 % -- '— -- 20%Glace L _ 2 Drywall/Joim Compwmd No Asbestos Detected 30%n Cellulose 150% L 20%Glass _L - _ _ - 3 Drywall/Joint Compound Asbestos Detected 30%Cellulose — I No ZO%Glass 4 Drywall/Joicu Compound No Asbestos Detected 30%CdW. — 1-50% L — Glass — --5- I Drywall/Joint Compound T No Asbestos Detected 3017.Cellulase 1201b Glees 61 Drywall/Joint Compound No Asbestos Dateaed 30% 'S0% - J Ceiling Tile _ I_N.AsbesWs Detected ;35%Cellar -- 445%_ 8 Ceiling Tile No Asbestos Detected 35%Cellulose 45% �. 20%Glass 9 Ce—cling 151e No Asbestos Detected 35%n Cellulose —— .45h 20%Glass 10 Ceiling Toe— _ — No Asbestos Detected 35%Cellulose 45% 20%a Glass Alex Front, Analyst 10097 Cleary Bonfivard 0305•PtantWon,R 33324 •Phone:954=227-2402•Fars 8"-916-5110 www.arsweirenmentaLcwm •sales@arsenoftamemat awn r Today's Date:7/8/2014 Project Number: 20142081 Page 14 of 14 Asbestos Survey — Laboratory Results ARS (l1� ommEwTA� wca Asbestosuy ease#� "64 -moot 64 — —AOWa Cowdebio Am&n AWwmam a Lead Assametoa lndwr Air OwNty Twdn4®AWd Inosstigattbns Today's Date:7/8/2014 Project Nth: 20142081 Prepared For: Job Site: Sammy Salem Vacant Commercial Space — Gator Invents 9717 North East 2nd Avenue 1595 Ne 163 Street Miami Shores,F1 North Miami Beach F133162 Laboratory Analysis PWMMd Asia-S6 gon-ast a Noa fibs ldamb� OmssDam*lcn _ Pamenmge %iRs %bblarials 11: Mastic No Asbestos Ducted 10% ukwe 80% — — — _— - --.10%CellSynthetic J 1 r 1. 12 Mastic No Asbestos Detected 45%a Glass `,45% 10°lo Synthetic 13', Mastic No Asbestos Detected 75%n Cellulose — t 14 Mastic — i 10�sy � 14—D% 10%Celluo1aicnysot� — _ • r--15 `�� No Asbestos Detected — ° a — 1( J Plaster --— No Asbestos Detected 100% 17 Plaster No Aslxstos Detected T — — 100% X18 Concrete No Asbestos Detected 100% Alex Front, Analyst 10097 Cleary Spahward®#305®Planta do n,R 33324 e Phone:954-227-2402®Fact:866-516-5110 aiwatarsenviranmental aom 0 saJes@arsen(IhvnMefft&J.com