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CC-16-2280 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-271511 Permit Number: CC-8-16-2280 Scheduled Inspection Date: November 23,2016 Permit Type: Commercial Construction Inspector I S fY1av-1 NQ(on`C� J Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Alteration Job Address:11300 NE 2 Avenue Wiegand &Annex Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-09 Project: <NONE> Contractor: DON BAILEY CARPETS INC Phone: (305)757-1560 Building Department Comments REMOVE EXISTING CARPET AND INSTALL VCT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CONTACT PERSON EL AL HINSON 954-294-2803 Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 22,2016 For Inspections please call: (305)762-4949 Page 18 of 32 Permit,No CC=s-1 -2 Miami Shores Village Type �imerClai Construction 10050 N.E.2nd Avenue NE W��i(e � tC?1 moo" Miami Shores,FL 33138-0000 ��- �Itus APPi OVED — �,�° Phone: (305)795-2204 �r Expiration: 2612017 RmA Issus lam; (2 /201 p Yran Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Wiegand &Am 1121360010160-09 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone Valuation: $ 9,306.00 DON BAILEY CARPETS INC (305)757-1560 Total Sq Feet: 3100 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Window Door Attachment Date Denied: Tie Beam Type of Construction:REMOVE EXISTING CARPET AND Occupancy Load: Slab Stories: Exterior: Termite Letter Front Setback: Rear Setback: Framing Left Setback: Right Setback: Store Front Attachment Plans Submitted:Yes Certification Status: Insulation Certification Date: Additional Info: Drywall Screw Bond Return: Classification:Commercial Final PE Certification Window and Door Buck Scannin :3 Gelling Grid Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Fill Cells Columns CCF $6.00 Review Planning DBPR Fee $4.19 Invoice# CC-8-16-60972 Review Electrical DCA Fee $4.19 09/27/2016 Credit Card $262.56 $50.00 Review Building Education Surcharge $2.00 08/12/2016 Credit Card $50.00 $0.00 Review Building Permit Fee $279,18 Review Plumbing Scanning Fee $9.00 Review Structural Technology Fee $8.00 Review Mechanical Total: $312.56 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 pd that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-nam co r o the work stated. September 27, 2016 Authorized Signature:Owner / Applicant Co a / Agent Date Building Department Copy September 27,2016 1 Miami Shores Village 1c,RIVE I Building Department Au ff6� �� A 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 $�: A _ \��D Tel:(305)795-2204 Fax:(305)756-8972 ' INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 "1 BUILDING Master Permit No.C�'Oj " PERMIT APPLICATION Sub Permit No. r_jBUILDING ❑ ELECTRIC ROOFING REVISION EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS I ��� JOB ADDRESS: /�l aq A ac 2- -T L T Com: Miami Shores County: Miami Dade Zip: '?I. i ( 1 Folio/Parcel#: I I '"LI*3( —10 00 `-QQL4 Q Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): EfAj� Phone#: Address: 3 City: X1Ahj '..S' State: j_ • Zip: 3 it Tenant/Lessee Name: Phone#: Email: GE0 CONTRACTOR:Company Name: S' Phone#;S O�;-"_7 7 447 0 Address: Lt o City: )l J A m i• State: Zip: �6 Qualifier Name: i"° 14 /A4x� Phone#:9<""4 C]q— 0,3 State Certification or Registration#: Certificate of Competency#: 0(a z ®® � DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 9 Square/Linear Footage of Work: i®� _S�iF Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 6' 1,I C-10 a Specify color of color thru tile: Submittal Fee$ ' Permit Fee$ 0-19 • CCF$ CO/CC$ Scanning Fee$ a Radon Fee$ 7• G DBPR$�" Notary$ Technology Fee$ Training/Education Fee$ .2—• GO Double Fee$ 10 Structural Reviews$ Bond$ 0 TOTAL FEE NOW DUE$ 2'G 2'5 (Revised02/24/2014) e , 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 approved and a reinspection fee will be charged. e Signature Signat OWNER or AGE4 CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of W!X ,20 lG ,by day of ® � 20 , by ,URN why en rsonally known to ,'fes a �' ��� ,who is p y mown to rme 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: p // Print: 1rYGw�P� a✓lf�,t/rGt.lit Netsry Public State of Florida . Jeffry J Yao Seal: +� My Commission FF 188481 "�""' HUNTER D.MARKARIAN ;YX11JC111, 11 di Expires 11/1=2018 ;2° = Notary Public-State of Florida My Camm.Expires Sep 18,2017 s**s60�missVaR ��r�+����x* as�x*x*xs� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ♦ �RES Li ' tt ••.. NJ ..,..I" Miami shores Village Building Department ALOR 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT, D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME:��_ / tf 4�7'y ix.Pct+" -5 �- rf c-, BUSINESS ADDRESS:r ( IJ 1)c CITY �' STATE ZIP 33 BUSINESS PHONE:�) j �� FAX NUMBER ) CELL PHONE ) ge�+AT03 QUALIFIER'S NAME: 1L-�� �� � d jJ ➢—� QUALIFIER'S LIC NUMBER: n L3 S 0 0 g OOM57 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT A BILL—DO NOT PAY ILBT 427476 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES BAILEY DON CARPETS.INC RENEWAL SEPTEMBER 30, 2017 14833 NW 7 AVE 427476 Must be displayed at place of business MIAMI FL 33.168 Pursuant to County Code Chapter BA-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED BAILEY DON CARPETS INC 214 RETAIL SALES BY TAX COLLECTOR Employee(s) 8 $75.00 07/19/2016 CHECK21-16-093921 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 squeiifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. <- The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec 6a-276. For more information,visit www miamidede aevAncollector 006970 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL—DO NOT PAY 5886180 \.LBT_�/ BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES BAILEY DON CARPETS INC RENEWAL SEPTEMBER 30, 2017 14833 NW 7 AVE 6139786 Must be displayed at place of business MIAMI FL 33168 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS • AYMENT RECEIVED BAILEY DON CARPETS INC 196 SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR • Worker(s) 2 06BS00859 $75.00 07/26/2016 CHECK21-16-100955 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 holders qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec 6e-276. For more information,visit www miamidade.aov/texcollector Construction Trades Qualifying Board y ` -,BUSINESS CERTIFICATE OF COMPETENCY f 06BS00859 - DON BAILEIF=CARPETS INC D.B.A.: PAINS ALBERT Is certified under the provisions of Chapter 10 of Miami-Dade County A D f=O CONTRACTli11Cs''L ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/12/2016 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 policypes)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). CONTACT PRODUCER NAME: InSource, Inc. PHONE .305-670-6111 FAQ .305-670-9699 9500 South Dadeland Boulevard E-MAIL 4th Floor ADDRESS.bswicegood@insource-inc.com Miami FL 33156-2867 INSURE S AFFORDING COVERAGE NAIC# I NSURER Pro e &Casual Ins 42579 INSURED DONBAIL-02 Nationwide Ins Co of America 25453 Don Bailey Flooring INSURERC:FCCI Insurance Company 10178 14831 NW 7th Avenue INSURER D: Miami FL 33168 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 1683317247 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. rGEN'LAGGREGATE POLICY EFF POLICY EXP LIMITS INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY ENERAL LIABILITY ACP GLZO 5926339722 10/14/2015 10/14/2016 EACH OCCURRENCE $1,000,000 DAMA E T RENTED DE X❑OCCUR PREMISES Ea occurrence $100,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 IMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X PRO- LOC PRODUCTS-COMP/OP AGG $2,000,000 JECT OTHER: -COMBINED SINGLE LIMIT A AUTOMOBILE LIABILITY ACP BAPC 5926339722 10/14/2015 10/14/2016 Ea accident $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ NON-OWNEDAUTOS P RTY DAMA E $ Per accident X HIRED AUTOS X AUTOS $ A UMBRELLA LIAB X OCCUR ACP CAP 5926339722 10/14/2015 10/14/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAS CLAIMS-MADE AGGREGATE $ DED X RETENTION$O $ C WORKERS COMPENSATION 001-WC15A-74390 12/23/2015 12/23/2016 X STATUTE ETH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑�NIA� (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000 Ifyes,describeunder E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached K more space is required) Coverage is subject to the policy terms,conditions&exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BLDG DEPT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FL 33138 AkUlMOR12ED REPRES NTATIVE W 0.0 114 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD A vat�� Municipal Contractor's Recent Miami—Dade County, State of Fiori a THIS IS NOT A BILL - DO NOT PAY MC 06BS00859 BUSINESS NAtMSA,OCATiON k,, RECEIPT NO. EXPIRES BAILEY DON CARPETS INC 7473807 SEPTEMBER 30, 2016 14833 NW 7 AVE MIAMI FL 33168 ' ' Pursuant to County Cade <: 8900-24 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED BAILEY DON CARPETS INC SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR Category(s) i 06BS00869 8175,00 10/07/2015 CREDITCARD-16-001277 For more Information,visitwww Ioddada.QMdtaxaapectar RECEIVED a l a k — 16 ' UG � 2 20 t Ato I f - f. I ® � I I i ; k • i I -U�� __ •vu � t� • I • • • • • - • " - --- - 1 N I � ( L • • • � r• •�• � vr.crus-rFa.N^. _ _IF � .egg ,e F.mncwu aEo rE% ••iii• • • • • • _ __,__-.-_-- - • • •• • lL4F STwEli F%ff • • .asA,�Ta'w.miio�T ••ii1• ii•• • • ,.x,u�,m w,r .` '%,xr s,nmwxDrx�noN „x, EDN • -. I -. n%,T SBn FwRTHfAEEN %ILr#g,NJDMDF%CELON r>%F 55Gl GYFNK PFD %,MES,ANDAFpFWLCx! —;AWVnT VG rMSPoA,n VR gAwYEtxCMJ�rNPWAI TF d ,x'%vSeFBgM%ty Bx�NVN nctwLvrai�nL Ll ENLARGED _1— _ —� �_t �t;NRN,'�tBTALLA iMFNnW 51Ml>wt EAof CvfWNi. _— _ o'�seo,D�oEvcv�niaiz®umoaocz�Em+ ■ OENLARGED .�Em x '� WmFPoga n�ro u w A FLOOR PLANS PROPOSED VCT LAYOUT NIEGAND,3g � BcuryUaiversity 15 • . . . • . . • . • • •• • � • �`�<� � ����^awn iii a`� • ••• •• • • • • • • • • • •a, 0 0 • • • • • • • tc see AVP 'OR" ' CMC%4 RESOURCES MIA-NAGEh4ENTF— \ o CORE;REVtEV,ER, LLN'F): rave O LLJ �1GNitT9JRE:— IAIE � _IFDADE F �M �. E Process,No: ll'uuicipsal d^_sp No: Project Tv`atne: «-- Address: 0 INITIAL REVIEW DATE ApprovLd Disapp Not Applicable Revisi®n process NO: DATE Approved Disapp Not Applicable I .F;leai, ,1.i :C'TTON. r Indw, .__.rlal Hygiene Services n C. ri All Facets -'f Industrial Hygiene Service ONV/ C-1 P August 10, 2016 17 RE. 11301-1 - Page I of 4 pages Mian-!i UG 12 2016 [REIL( Attn: R-,: for Asbestos-C!,ntaining Building Materials-"Weigand Building Barry Univers-, 11300 NE 2nd Avenue, Miami Shores, Florida Advancu,'..' _L jluslciaH-y�gi.,ac Services, Inc. (�_­HS) is pleased to submit the following report for Flooring Materials (ACFM) conducted Augus 10,?0 survey was performed to meet the asbestos survey � ­ -,� 1 � .;,Iced facility. Thi -;eqLl;,. regula:6on and _'1-.Mi-Dade County Department of Environmenut i tx; Reso u.rc;t�.M n ag�a _riT -i to conducting a rmed renovation of the subject facility. -1p & Froject Rapp -psel _-I dil- piamied ren.,.-I ution entails removal and replacement of carpet floorrC �2, 21- 49, & 254. .,5ected materials include wall-to-waft carpet and associ.--,t c: L:s-4`..c -Ihe area of affe,.:i-C-1 floor finishes was measured at approximately 2,551 ft- , 'The V"Is 10 st�niple an .,,,-.r.tify any ACEM that may be present in the treat--nent pric or during the planned renovation activity. samphl jStrategy 11.e --,Ja*:c,; As)ez.._: (Sulopart M40 :-'FR Part 61.141 to 157 anti:' ,. fd Appen1 Stan* for Hazardous Air Pollutants (NESHAP) deals G - With 'ainhw, Mate_.i:.1,i (RACM) during renovation and demolition activitl,- Accon,:irc; tc, -NESHAP, onl, -,,le PUXM and R-ACM that may become friable need ? i u--gs that are .-duled for complete demolition. To meet the kj. CaE;orory I .-friable ACIIA including resilient vinyl flooring -a'so �:,:.:.ed as part of this vir(ject. F2o-__,:-. 3362,vl �,Te'.1 (305)854-7554 0 (954) 431-9005 Pre-Dernoi:;-.-ii Sua vv ion August 10,2010 "Weigand AIHS Project 9 1777-138 Barry Urui,, 11300 NE 2" Miami,Flo-J"a rill a-.;_.__1 ci`ty were inspe,:-;Jt. Bulk sample specimens of materials suspected of coilected and su'--.-..%"led for analysis by Polarized Light Microscopy in coi-,iL,;.1cti,-.n w*J --',r. staining as ou.--. -i,-d in 40 CFR, Part 63, Subpart F dated January 1987. Anal- viliD.- by Advan(,­4 Industrial Hygiene Services, Inc. AIRS, Inc. is accred it_=�d fl-:--as`oec: a,-.-;?,Iysi-q through participation in the National Voluntary Labcr+.. C,7 C (TINLAP -A meets the req-drements of section 206(d) Title 11' .:Jr- `Zk`:-­ 15,TSCA as stat-,: .a 40 CFR 76') dated April 30, 1987. All .Jf:cted by the ..4anned renovation activity are classified as mise,: sl,:;:'_, Ss.rnples C" ....O.aterials suspectt-d of containing asbestos were pa This -.3 Ocoustical :...-:.�-.n(y tiles, wallbo_�zd, joint compounds, resilient Vinyl .etc. (bas; -- 'y, anything that does not fall into the first two ' cater;':; 1"llaterial:. !-,re sampled in such a manner as to evaluate; whetli-vi- o., i-xii asbestos. -� number of samples collected of a given "a, the discret* of the inspector. Asa rvl --�s thn= e sarni- of is-ch distinct -,ype= of suspect miscellaneous :nates:, 7 ­. Bulk s su-sp. -A of containing asbestos were collected and submi-. ai� ts- :armed Light M ..,3copy in conjunction with dispersion staining as outlh-, Subpart F January 1987. Analysis was conducted by Inc. is accredited for asbestos fiber analysis through succes 1 Tational Volu.._1-:..­y Laboratory Accreditation Program (NVLAP) and n-1. r.. _n 206(d' Title 11 of the USC Chapter 15, TSCA as stated 92 7 in 40 n gc Thos,. L ing materials were present in the subject facility are listed be lov,- Floor el.C'. Affec:,_ Roo- finishes consist of adhered wall-to-wall -?/ert co!lzcte:: the carpet with nastic and all Avere reported by quanti.. of asbestos. August 10,2016 "Weig'17m 1: Allis Project 9 1777-135 Barry lhli� 113011 Ni- to Mimi,F io.1_: Nv/ Sum.m: of ACM No ori:As were idem; which may become disturbed or damaged as a result activity in th,. _,ility. Y P-rform, Bulk Sample Analysis 3611 On of .­ction is the National Voluntary Laboratory J Agri: AP la'� ory �I.Intification number(101006-0) that was assigned , M ih..' _:_)on entry into, _::7 NV`AP. A copy of the certificate of NVLAP, AIMS _s sections asbestos-containidg materials in buildings under an C F' ;as !.;cen'sc 0000058) and is qualified by Bruce Marchette, ­�� --Ise TA 000- 1). OcsLE- A rng!rks T rats -ior ACE. intended for thesole use of Barry University. The in executi, )f this investigation may not be appropriate to sadsf-, or re and any -use of this document or the findings, i�: it the sole Fisk of said user. Opinions and apply site conditions existing at the time of our inves-: -Yap?ly :.ite changes of which this office is unaware and has r; Drior oj-,c Federal Lcii.v; requires that the local EPA c u-ce Management, 701 NW 1" ent of I 1---orimmtal Resod 3'-!3 6) be I w-vitinor a --a st 10 working days prior to -,isbestc, _,:)ordinato-I's Office also requires a copy of the notif, ?.sbestm Coon. tor, State of Flo---ida Environmental Regulation, 2600 ­.'. Pre-Demo;.i Sia i*c.i August 10,2016 "Weiganc AIHS Project#1777-138 Barry Unr. 11300 NF cn.. Miami,Ficr AIRS' ..".."zaed with lim, --..)ns inherent to visual inspections. AIHS has conduc'..:c-,, -..­. s ,aul reasonable c and has perfon-ned this study within general industr,,, :,'--a:'.­:am'. study of this Y.re limitations are inherent. This ii: n of a dil- ...It search of the renovation area for asbestos- purpose of insiection was io identity asbestos-containing mater'. n,*- tril f..' t­cP:tnv,,nc or to proccedino wit1h, the planned renovation oper_- was cond-. i pri.-ol.- to a planned renovation operation, only _qg -erials c: aed to be disturbed as a result of the renovation PC.]-,(-Stos content, However tified all of the asbestos- COMII.: ;n it do, :)t claim to have id,-n Conta,*a.-._:L; i c, i'J's oMce sl;) -,Id- you!-ave any questions or COMIM'..'.7 V relarelate. :atter. 0. aR IFICANI Ft r Re e !Mfvrida s sbi:s CO 0058 Enclo-; ' :Call R;4u!Ts Surri-, nt;a,, _a'S knalytical Rt- Log# 18055 Table: If --3LE TOS�,INALYT. ...L RESULTS SUM711A1tY Barry Ur...i.,-slty,Miami Shores,Florida 33161 NESHAP Asbestos Description Classification [1777 Carpet&Mastic NAD 6 1 777 249 Carpet&Mastic NAD 6 777--,,"5 5-3 6 254 Carpet&Mastic NAD 6 KEY- 2. 3. 4. 'C-?.i'BN� 5. N 0 T NAD f<lu: •,:,�:` t:.•;' r:r.:,^ KEN LAWSON,SECRETARY STATE F FLORIDA DERA<T NT OF BUSINESS AM*PRO REGULATION ASBESTOS LICENSING UNIT ZAOOWD56 k The ASBESTOS BUSMESS ORGAN#ZfinQN �- Named below 1S LICENSED0 Under,the proiasions of Chapter A69 FS. Expiration date- NOV 36.Xl b 17, gp+��g 4 e-"0 no ADVANCED INDUSTRIAL HYGl $ERViGES iNC BRUCE E' -MARCHET i E �* 3611 N l 07 AU- ro o �c. :t.*.. .. !?!GPLAYASt ^'•.TIRED BY LAW SEOa L150903003233± RICK SCOL-GOVERNnZ _ KEN LAWSON,SECRETARY `" is.:t Eh :ii's'•-s D!SPL.AYASR'-'Q IEDBYLAW SE86 L1409230Q MO E I ,o.Cwanec d. Indy ,tepid Hygiene Services, Inc. Cooper City, tai, r.rc'ited b, tl;,11r.;ir,:; t irolunl&ry'.boratoty kccreditafion Program for specific services, listed on the Scope of Accreditation,for. Asbest®s Fiber Analysis This laboratory is accredited in accordance with the recognized International Standard ISOREC 17025:2005. This accreditation demonstrates technical competence for a defined scope and the operation of a laboratory quality management system(refer to Joint ISO-ILAC-IAF Communique dated January 2009). oFN 1016,04-111 through 2017-03-31y-- iiwl;crive Dates ` �a��� For the National Volonta(y Laboratory Accreditation Program Appen. Hiygiene Services, Inc. IAii Facets --",'ndustrial Hygiene Service Accoun'�4 i Date: 10/AUG/16 Page 1 of 6 pages Barry i.. Sample Log# 18055 11300 NVLAP Lab Code 101006-0 Miami S aorc a3-',.'*.:5 Attn: A-,is-i: Collected by:Bruce Marchette,CIH Sampk: -vf- Sample Analyzed: 10/AUG/16 -i-'iu-signation: Bulk -aple Submitted for Analysis Weiga:--. 30ding -:--YJ1ca" r-esul,�s: . -ESTOS CONTENT Saniio)l, 7— 'a' Iviastic (F. -n 132' '.,..i,/tar/'brown looped carpet with an off-white Pliven backing and yellow/tan mastic residue 1 4. - T,s-M! sy-,Tthetic f ibets resins(mastic) Synthetic birefringence:m,� ;;i:i glue pleochroic,parallel extinction Labwork iw: 5'C This analysi.,, i. iaj!n i1cir�aropl. 777,-U05j-1 only. Advanced is Hvatzne 'S is accredited for asbc-c: fiber analysis through participation in the NIST National Voluntary. Laboraton, . i .I"j aiii meets the require. of 40 CFR Part 763.87,Vol.52,No.210 Dated Friday,October 30, 1987.Acc*-�-! ,3;:�- ",21,1'7. Analytical N1 hoc .]PA-6."3'. IS -.0- a".-nin Method for the D< .;.i:.;nation of Asbestos in Bulk Insulation Samples"&EPA/600/R-93/116: "Method fa .heDc :i-BcIkBuildingMateril- J VLAP Lab Code 101006-0). Analyzec 6 3w-f,`1rL11-1',tC. ill Laboraton -A i i c U ..4 11 i es,Inc..3 611 NW S' .-enue,Cooper City,Florida 33024,Telephone:(954)431-9005 This repo-[ c;! i%,pvo'l in :without the xvritv :: -roval of Advanced Industrial Hygiene Services,Inc.Furthermore,this report ina., ,i i)f:c aii--. i`etierrtt by NVLAP or z z-,ncy of the U.S.Government. Respectfully Submitted, Bruce Marchette, CIH Authorized Signatory AIRS,Inc. 361 i 1- CR Florid,,; --':124 0 Tel(954)431-9005 FAX(954)431-9202 www.< .. ine.com Accau : `= . Date: 10/AUG/16 Project Page 2 of 6 pages Bang Sample Log# 1805 5 11301; NVLAP Lab Code 101006-0 Mlarnu Attn: r;; ;-, A:' ;, Collected by: Bruce Marchette,CIH Snh :. :.:r. i,;., Sample Analyzed: 10/AUG/16 J-.-F gnation:Bull: ---nple Submitted for Analysis Weig,-c 3uilding v icai;exults: -ES" GS CONTENT t--— t I Suis:;; t 6S--fi.4astic ( n 132) 1 Sa ,, :.j!mn/brown looped carpet with an off-white ven backing and yellow/tan mastic residue i2. 4.Nr.:-=ss: .: .:; ci'i: !� syn hetic fibers i 5. _ alu: resins ;ma.6c) Synthetic ., so;:c.; :.ga'rmi birefringence:m. :.pleochroic,parallel extinction may`,.. Lab,aorl:st a,7 r.i:.:acrau::-:=5 This ani,;:> r'i a r'.'•"77-18055-2 only. Advancc:i . [:.::,: n accedieed for asl- liber analysis through participation in the NIST National Voluntary Laboraxu f r•-. rs: -' :,d:nee',the requir . ..;of 40 CFR Part 763.87,Vol. 52,No.210 Dated Friday,October 30, Analytical 1.:'.(to. 'i., (:.' 4 i :e:im Med,od for the I. .tination of Asbestos in Balk Insulation Samples"&EPA/600/R-93/116: .iMcthca ii: nu::::i. .•1' in Bulk Building Mater: -iVLAP Lab Code 101006-0). Analvz:,d Labora:ot: :.:c ::. _: `:es,Inc..3611 KW venue.Cooper City,Florida 33024,Telephone:(954)431-9005 This repos. :a l I::11,without the writ -)oval of Advanced Industrial Hygiene Services,Inc.Furthermore,this: report ma, .:::: aaa :na rsttnent by NVLAP of gency of the U.S.Government. Respectfully Submitted, Bruce Marchette,CIH Au".-,.arized Signatory AIFS,Inc. 011H Accoi:,.nz. _U 7 Date: 10/AUG/16 � ` Projec .4 113Page 3 of 6 pages Barry Sample Log# 18055 11300 NIE2­ NVLAP Lab Code 101006-0 Miami S r.- F,, Attn: Ar;slCollected by:Bruce Marchette,CIH r.:- il Sam-pli- Sample Analyzed: 10/AUG/16 t- Bulk i. nple Submitted for Analysis weigai._ . gilding - 3ESTOSCONTENT Sam,.! f7- &lvlastic (F 249) 1. Sar ill e x: )DC al'Z=rt: y/tazibrown looped carpet with an off-white ­•ven backing and yellow/tan mastic residue 1 4. No­--.,' S-'­ '310syrf-hetic fibers a , 5.N,_;; ,.Ylu-- --esins(mastic) Svnthetic birefringence:mz pleochroic,parallel extinction Cab workai_,:un is . `C This anL!h 7- ..2nO vz.J fc: ;7-15055-3 only, Advance k accredited for asb> fiber analysis through participation in the NIST National Voluntary r - the require! of 40 CFR Part 763.87.Vol. 52,No.210 Dated Friday,October 30, Laboratc�. �i.d meets 1987.Acc%.-4_i'zt1.c,­.)-euc%,a-ld_c 114. .. ..'C_7. Analytic.!! i _.?A­,*iU) !.Ae_ra Methad for the D. ..'nation of Asbestos in Bulk Insulation Samples"&EPA/600/R-93/116: -Method. f .;,,R-*Building Materia .-.:',/LAP Lab Code 101006-0). Analyzed',. ;1'ni, Labozatcs,,.!- i!nc*.u:ti. .. :ccs,Inc.,3611 NW enue,Cooper City,Florida 33024,Telephone:(954)431-9005 This rep,)-! i :!i Ail, A­.mout the writta -roval of Advanced Industrial Hygiene Services,Inc.Furthermore,this report ma', --c to 1;:, ­v.-aent m,NVLA-Por- -cncy ofthe U.S.Government. Respectfully Submitted, Bruce Marchette,CIH Aut.orized Signatory AIHS, Inc. 0 ri 1\7/ 7 7 Date: 10/AUG/16 Pr(*ci Page 4 of 6 pages Ban-) : 1:: Sample Log# 18055 113NVLAP Lab Code 101006-0 Attn: - A. Collceted by:Bruce Marchette,CIH Samr.., : .'.': . :t_. '5 Sample Analyzed: I 0/AUG/16 1 .,gnat-on: Bullmple Submitted for Analysis Weig,- Building .Results: .3ESI-POS CONE—EENT -t& I'viaStlC f. 71 249) t. Sa ar y/tw::,./brown looped carpet with an off-white ven backing and mellow/tan mastic residue 4.T\'{ s %synthetic fibers 5. �1 _ giu::resins ;ma,..ic) Syntheti: +x;u_ac a:iott birefringence:r.', pleochroic,parallel extinction Lab works!: ,. .:peThis anz:,, , is ra:d fi, a, _ 77-18055-4 only. Advam% I.%- accre�ited for asl fiber analysis through participation in the NIST National Voluntar Labora;a: ....o,I=.r,. _ .;:d meers the regain of 40 CFR Part 763.87. Vol.52,No.210 Bated Friday,October 30, 1987.A,:.. , .., ai., .. i 7. Analytical: ,.;,:;: {, ,:,;;i; _ :: ::::m Meli'lod for the cination of Asbestos in Bwlk Insulation Samples"&EPA/600/R-9311 16: .,Method, r i >.ra<<::;_et;:: ;:r 3•>.-s i^.9ulk Building Mater. WLAP Lab Code 101006-0). ,'knalyz;:i. :. Laboraa:: ::l cts,inc..3611 NW enue,Cooper City,Florida 33024,Telephone:(954)431-9005 This regi,.. .:il, :nc a :dl, ,vit nut the writ �aroval of Advanced Industrial Hygiene Services,Inc.Furthermore,this report rt a ._..e-inert oy NVLAP of gency of the U.S.Government. Respectfully Submitted, Bruce Marchette, CIH Aut±,.oriz ed Signatory AIFIS,Inc. Advanced Industrial Plyglefte Services,Inc. Chain-of-Custedy Record All facets of Induitrial I lygienc Service 3611 NW 97'Avenue-Cooper City Flori&33024 TO:(954)431-400.5-Fax:t9541-131-IM2 Page I of I page I Analyses Requested Project Dame or Number: Project Location: I Weigand Building Room 132,249, 54 1777-138 eustonwr Name: I Sample Description(Type VOILIrne NumhLr B-arry University (check one) or COMMMS Sample --baic 'rime I Ir ape :­11.1iners [tont Ji Hulk Swab Area 4 x curpct&Mastic 1777- 1 6 18055 2016 r R, K1,