CONFIDENTIAL AND PRIVILEGED ASBESTOS INSPECTION, VISUAL INSPECTION & RISK ASSESSMENT 3275 Winter Street Los Angeles County City of Los Angeles State of California 90063 Volume I of I June 7, 2016 Prepared for: COMMUNITY DEVELOPMENT COMMISSION OF THE COUNTY OF LOS ANGELES – ECONOMIC AND HOUSING DEVELOPMENT DIVISION 700 W. Main Street Alhambra, CA 91801 NEC Project Number: 16-0718 NATIONAL ECON CORPORATION 1899 S. SANTA CRUZ STREET ANAHEIM, CALIFORNIA, 92805 PHONE (714) 978-6320 FAX (714) 978-6323 EMAIL: [email protected]This report was prepared for the Community Development Commission, by independent consultants and is based, in part on information not within the control of either the Community Development Commission, or the consultants. While it is believed that all information contained herein will be reliable under the conditions and subject to the limitations set forth herein, neither the Community Development Commission, nor the consultants guarantee the accuracy thereof. The use of this report, or any information contained herein, shall be at the user’s sole risk, regardless of any fault or negligence of the Community Development Commission, or the consultants. Use of this report or any information contained herein shall constitute a release and agreement to defend and indemnify the Community Development Commission, and consultants from and against all liability (including, but not limited to, liability for special, indirect or consequential damages) whether arising in contract or due to the Community Development Commission, and/or consultant’s negligence, strict liability or otherwise.
Transcript
CONFIDENTIAL AND PRIVILEGEDASBESTOS INSPECTION, VISUAL INSPECTION &
RISK ASSESSMENT
3275 Winter Street
Los Angeles CountyCity of Los Angeles
State of California 90063
Volume I of IJune 7, 2016
Prepared for:
COMMUNITY DEVELOPMENT COMMISSION OF THE COUNTY OF LOSANGELES – ECONOMIC AND HOUSING DEVELOPMENT DIVISION
700 W. Main StreetAlhambra, CA 91801
NEC Project Number: 16-0718
NATIONAL ECONCORPORATION
1899 S. SANTA CRUZ STREETANAHEIM, CALIFORNIA, 92805
This report was prepared for the Community Development Commission, by independentconsultants and is based, in part on information not within the control of either the CommunityDevelopment Commission, or the consultants. While it is believed that all information containedherein will be reliable under the conditions and subject to the limitations set forth herein, neitherthe Community Development Commission, nor the consultants guarantee the accuracy thereof.The use of this report, or any information contained herein, shall be at the user’s sole risk,regardless of any fault or negligence of the Community Development Commission, or theconsultants. Use of this report or any information contained herein shall constitute a releaseand agreement to defend and indemnify the Community Development Commission, andconsultants from and against all liability (including, but not limited to, liability for special, indirector consequential damages) whether arising in contract or due to the Community DevelopmentCommission, and/or consultant’s negligence, strict liability or otherwise.
Asbestos Survey3275 Winter Street, Los Angeles, CA
Project #16-0718Page 1
June 7, 2016
Community Development CommissionOf the County of Los Angeles700 W. Main StreetAlhambra, CA 91801
Attn.: Ms. Maria OrtizProgram Specialist
Re: 3275 Winter StreetLos Angeles, California
Dear Ms. Ortiz:
Pursuant to your request, National Econ Corporation’s Representative, Mr. Felipe Ruiz(Certified Site Surveillance Technician #09-4532) has completed an Asbestos Survey on May26, 2016 at 3275 Winter Street, Los Angeles, California. The following report summarizes thefindings of this assessment.
1.0 INTRODUCTION
This report summarizes the findings of National Econ Corporation’s Asbestos Survey at 3275Winter Street (subject property/site) in Los Angeles, California. This survey was performed atthe request of the Community Development Commission of the County of Los Angeles –Economic and Housing Development Division.
2.0 PURPOSE AND SCOPE OF SERVICES
Asbestos Surveys are performed to identify visible and/or readily accessible suspect friableand non-friable Asbestos Containing Building Materials (ACBMs) at a subject property.Friable ACBM as defined by the U.S. Environmental Protection Agency (EPA) and South CoastAir Quality Management District (SCAQMD) is material that when dry, can be easily pulverized,crushed or reduced to powder by hand pressure. Non-friable ACBM that can potentially bebroken, crumbled, pulverized or reduced to powder in the course of demolition or renovationactivities, are classified as either Class I or Class II, non-friable ACBM. These surveys aretypically accomplished by, and limited to, a cursory site reconnaissance, a review of readilyavailable building records, and a review of readily available asbestos Operation andMaintenance (O&M) plans.
In the event that suspected or known ACBMs exist at a given site, samples of the potentialACBMs may be obtained and analyzed. If, based upon the results of the Asbestos Survey, thepresence of ACBMs are confirmed, recommendations for further investigations to evaluate thequantity and characteristics of these ACBMs and/or to manage their impact are required.
Asbestos Survey3275 Winter Street, Los Angeles, CA
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This Asbestos Survey was conducted in accordance with the Scope of Services authorized bythe Community Development Commission of the County of Los Angeles – Economic andHousing Development Division.
3.0 HISTORICAL DATA
No prior asbestos related documentation for the subject property was reviewed and/or madeavailable.
4.0 VISUAL SURVEY AND SAMPLING METHODOLOGY
To identify suspected friable and non-friable ACBM, as required under California law, CaliforniaOccupational Safety Health Administration (CAL-OSHA), Certified Site SurveillanceTechnicians (CSST) and/or Certified Asbestos Consultants (CAC) conducted a visualinspection and survey of the subject property.
During the survey National Econ Corporation identified homogeneous areas of suspectedACBMs for purposes of sampling in accordance with current CAL-OSHA requirements. Theseareas were defined with respect to similarities in appearance, age, use, type, color, and/ortexture. The condition and estimated quantity of the suspected materials were also assessed.Based upon National Econ Corporation’s observations, eleven (11) homogeneous materials ofsuspected ACBMs were identified. The materials in these areas include plaster/texturecoat/joint compound, button board, attic insulation, resilient flooring (linoleum), cove base andmastic, built-up roofing, roof mastic and stucco.
To evaluate the presence of asbestos in these suspected ACBMs, National Econ Corporationobtained fifteen (15) bulk samples which appeared to represent each homogeneous area (seeTable I).
Amended water-spray wet methods were used during the collection of each friable sample,such as suspended ceiling tiles. National Econ Corporation conducted limited destructivesampling. After obtaining each sample, the sampling equipment was cleaned with a moisttowelette. Each sample was sealed in a sample container and assigned a discrete sampleidentification number.
5.0 ANALYTICAL PROCEDURES AND RESULTS
The fifteen (15) samples obtained from the subject property were delivered to LA Testing(under chain-of-custody procedures) for analysis. LA Testing, located at 11652 Knott Street,Unit F5, Garden Grove, CA 92841, telephone (714) 828-4999, is accredited by the NationalInstitute of Standards and Technology (NIST) through participation in the National VoluntaryLaboratory Accreditation Program (NVLAP, Lab Code #101384-0). The samples wereanalyzed for asbestos by PLM, using dispersion staining in accordance with U.S. EPAProcedures outlined in 40 CFR 763, Subpart F, Appendix A (AHERA). Asbestos volumeestimates were made by the laboratory analyst using a stereomicroscope.
Based upon the analytical results, asbestos is present in four (4) of the samples analyzed,three (3) of which are non-friable material. These samples were obtained from resilient flooring(linoleum), roof mastic and stucco.
Asbestos Survey3275 Winter Street, Los Angeles, CA
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Asbestos content of less than 1% (which is the federal standard utilized by testing laboratories)is detectable only in trace quantities utilizing PLM methods. The California (CAL/OSHA)definition of ACCM is materials that contain 0.1% of asbestos or any detectable asbestos mustcomply with all applicable provisions. A more definitive analytical method, such asTransmission Electron Microscopy (TEM) analysis or Point Count methods utilizing PLManalysis, which is capable of detecting asbestos below 1% and analysis of materials that aredifficult to analyze through routine PLM analysis is available upon request. TEM analysis isoften recommended in samples such as floor tile, which is found to be negative for asbestoscontent through PLM analysis.
6.0 DISCUSSION
Fifteen (15) bulk material samples were collected from 3275 Winter Street, Los Angeles,California, during the survey. Ten (10) of the fifteen (15) samples collected are considerednon-friable.
Based upon the analytical results, asbestos is present in the resilient flooring (linoleum), roofmastic and stucco. The ACBMs in these compounds are in fair to poor condition and two (2)are considered non-friable. However, these materials may become friable if damaged ordisturbed, i.e.: removal, chipping, etc. A summary of the friability evaluations, condition ratingsand material accessibility for positive samples is presented in Table I.
7.0 CONCLUSIONS
The building materials identified as asbestos containing material by this assessment are in fairto poor condition and two (2) are considered to be non-friable. These materials have a lowpotential for future disturbance if they are not damaged or disturbed, i.e.: removal, chipping,etc.
8.0 RECOMMENDATIONS
Due to the potential hazards of exposure, an Asbestos Management Program (AMP) should beprepared, and implemented, to avoid incidental, and/or accidental disturbance of ACM. TheAMP should set forth operational and maintenance guidelines to minimize fiber release whichmay be caused by age, normal wear and tear, delamination, building maintenance, repairs,renovation and other activities which may disturb ACM.
Prior to demolition, or major construction, specifications should be properly modified toincorporate the removal of ACM.
If removal of ACBM is required in connection with demolition, renovation, or building repair,such work should only be performed by personnel who are appropriately trained, experienced,and registered. Intentional disturbance of ACBM should be performed in a manner such thatemissions are controlled. Control measures should include, but not be limited to, wet methods,encapsulation, removal with HEPA-filter equipped vacuums, and appropriately labeledpolyethylene bags. HVAC systems in work areas where asbestos is to be abated should bedeactivated and the register closed and temporarily sealed. Air monitoring relating to suchwork should be performed by or under the direct supervision of a California State CertifiedAsbestos Consultant before, during, and after the abatement work, as required by EPA andother regulations.
California law requires a building owner to provide tenant, employee and vendor notificationwithin fifteen (15) days of receipt of information identifying the presence of ACBM in theirbuilding(s) and annually thereafter. Specific notification requirements are outlined in AssemblyBill 3713 and California Health and Safety Code 25915-25919.7.
Asbestos Survey3275 Winter Street, Los Angeles, CA
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There are potential liabilities associated with the presence, and removal, of ACM.Precautionary measures, as outlined herein, should be taken in accordance with the guidelinesset forth by the EPA, the Occupational Safety and Health Administration (OSHA) and otherregulatory agencies.
9.0 LIMITATIONS
The conclusions presented in this report are professional opinions based solely upon visualobservations at the site and laboratory analysis of the tested samples. They are intendedexclusively for the purpose outlined herein, and for the site location and project indicated.
This limited report is intended for the sole use of the Community Development Commission ofthe County of Los Angeles – Economic and Housing Development Division. The use or re-useof this document or the findings, conclusion or recommendations presented herein, by anyother party or parties is at the sole risk of said user.
Services performed by National Econ Corporation were conducted in a manner consistent withthat of the care and skill ordinarily and currently exercised by members of the same professionthat even the most comprehensive Scope of Services might fail to detect environmentalliabilities on a particular site. Therefore, National Econ Corporation cannot act as insurers andcannot "certify" that a site is free of environmental contamination.
No expressed or implied representation or warranty is included or intended in our reports,except that our services were performed, within the limits prescribed by the Scope of Services,with the customary thoroughness and competence of our profession.
Information and opinions presented herein apply to the existing and reasonable foreseeablesite conditions at the time of our investigation. They cannot necessarily apply to site changesof which this office is unaware and has not had the opportunity to review. Changes in theconditions of this property may occur with time due to natural processes or works of man onthe subject property or on adjacent properties. Changes in applicable standards may alsooccur as a result of legislation of the broadening of knowledge. Accordingly, the findings of thisreport may be invalidated, wholly or in part, by changes beyond our control.
National Econ Corporation trusts that the information presented herein provides the data yourequire. Should you have any questions or comments, please contact National EconCorporation.
Respectfully submitted,NATIONAL ECON CORPORATION
_____________________________Mark S. Ervin, PresidentCertified Asbestos Consultant #92-0141
LEGEND:
(1) HOMO= Homogeneous Material (2) S= Surface Material (3) F= FriableY=Yes (Homogeneous Material) T= Thermal System Insulation NF= Non-Friable1-6=Homogeneous Area M= Miscellaneous Material
NOTE: Unless otherwise specified, sample results above were determined by Polarized Light Microscopy (PLM) with dispersion staining.
TABLE ISURVEY SUMMARY
CLIENT: Community Development Commission of the County of Los Angeles DATE: June 7, 2016LOCATION: 3275 Winter Street, Los Angeles, CA SHEET: 1 of 2
Note: Be advised that any materials found to be asbestos containing are not limited to the areas in which the samples were collected. All like materials are to be included in anyactions implemented.
LEGEND:
(1) HOMO= Homogeneous Material (2) S= Surface Material (3) F= FriableY=Yes (Homogeneous Material) T= Thermal System Insulation NF= Non-Friable1-6=Homogeneous Area M= Miscellaneous Material
NOTE: Unless otherwise specified, sample results above were determined by Polarized Light Microscopy (PLM) with dispersion staining.
TABLE ISURVEY SUMMARY
CLIENT: Community Development Commission of the County of Los Angeles DATE: June 7, 2016LOCATION: 3275 Winter Street, Los Angeles, CA SHEET: 2 of 2
15B Stucco Exterior Y None Detected N/A N/A N/A N/A N/A N/ANote: Be advised that any materials found to be asbestos containing are not limited to the areas in which the samples were collected. All like materials are to be included in anyactions implemented.
3275 Winter Street
NOT TO SCALE
Closet
Window
Room 7(Bedroom)
Closet
Room 6(Storage)
Room 8(Bedroom)
Room 4(Hall)
Room 5(Bathroom)
Room 9(Bathroom)
Room 3(Kitchen)
Room 10(Bedroom)
Room 2(Dining Room)
Room 1(Living Room)
Closet
Closet
°01
°02
°03
°04
°05
°06
°07
°08°09
°10
°11
°12
°13°14
°15
LA Testing11652 Knott Street Unit F5 Garden Grove, CA 92841
Carolynn Tom (33) Michael DeCavallas, Laboratory Manager
or Other Approved Signatory
EMSL maintains liability limited to cost of analysis . This report relates only to the samples reported and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no
responsibility for sample collection activities or analytical method limitations. Interpretation and use of test results are the responsibility of the client. This report must not be used by the client to claim
product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government . Non-friable organically bound materials present a problem matrix and therefore EMSL
recommends gravimetric reduction prior to analysis. Samples received in good condition unless otherwise noted. Estimated accuracy, precision and uncertainty data available upon request. Unless
requested by the client, building materials manufactured with multiple layers (i.e. linoleum, wallboard, etc.) are reported as a single sample. Reporting limit is 1%
Samples analyzed by LA Testing Garden Grove, CA NVLAP Lab Code 101384-0, CA ELAP 1406
Initial Report From: 05/31/2016 14:33:09
Page 3 of 3PLM - 1.69 Printed: 5/31/2016 2:33 PM
OrderID: 331609695
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EXECUTIVE SUMMARY
1.0 INTRODUCTION
This report presents the results of the visual inspection and risk assessment of the subject propertylocated at 3275 Winter Street, Los Angeles, CA (Subject Property). The inspection was performed inaccordance with the Housing and Urban Development (HUD) Guidelines for the Evaluation andControl of Lead-Based Paint Hazards in Houses (2012 Edition). This document is prepared for thesole use of the Community Development Commission of the County of Los Angeles – Economic andHousing Development Division, and any regulatory agencies that are directly involved in this subjectproject. No other party should rely on the information contained herein without prior written consentof the Community Development Commission of the County of Los Angeles – Economic and HousingDevelopment Division. The scope of services, inspection methodology and results are presentedbelow.
2.0 SCOPE OF WORK
The purpose of this limited inspection is to identify LBP present in lead dust/soil at the subjectproperty.
On May 26, 2016, National Econ Corporation performed a lead dust/soil inspection at the subjectproperty. Settled dust/soil areas were tested. The intent was to ascertain the presence of leaddust/soil above specified HUD or local levels. If lead was found, the inspection would identifyindividual architectural components and their respective concentrations of lead in such a mannerthat this report would be used as a basis for subsequent abatement or renovation activity.
3.0 PROPERTY DESCRIPTION
The subject property is a single family residence.
4.0 INSPECTOR’S QUALIFICATIONS
Inspector(s) are state certified California Department of Public Health (CDPH) LeadInspector/Assessor or Sampling Technician, and have completed an EPA sponsored curriculum inLead Inspector/Assessor or Sampling Technician Training.
At the time of this report, CDPH-Childhood Lead Poisoning Prevention Branch (CLPPB) hasimplemented a State Certification Program.
5.0 METHOD OF TESTING
Wipe samples were collected to identify the levels of lead dust at random locations throughout of theresidence (see enclosed Lead Wipe Sample Analysis sheet).
Current state-of-the-art protocols for wipe sampling were followed by National Econ Corporationduring this inspection.
LA Testing of Garden Grove, California conducted analysis of the lead samples.
The EPA’s standards for lead assessment are as follows:
40 µg/ft2 interior floors250 µg/ft2 interior horizontal surfaces400 µg/ft2 exterior floor and exterior horizontal surfaces400 µg/g or ppm bare soil in play areas1,000 µg/g or ppm bare soil in non-play areas
Project #16-0718
6.0 TESTING PROTOCOL
Testing was conducted in compliance with the Housing and Urban Development (HUD) Guidelinesfor the Evaluation and Control of Lead-Based Paint Hazards in Houses (2012 Edition).Representative surfaces of each painted or surface coated component were tested. The HUD levelfor lead based paint is 1.0 mg/cm2. However, Los Angeles County Code Title 11, Health and SafetyChapter 11.28 define “dangerous level of lead-bearing substances” as any painted, varnished, orsimilar coating or structural material which contains lead or its compounds in excess of 0.7 mg/cm2,when measured by a lead-detecting device. San Diego Municipal Code, Chapter 5, Article 4,Division 10 requires any person who disturbs or removes paint from any interior or exterior surfaceof a dwelling unit or structure constructed prior to January 1, 1979, or from any surface on a steelstructure shall use lead safe work practice standards as set forth in Section 54.1006, or inRenovation, Repair and Painting (RRP), 40 CFR Part 745, whichever is more stringent, unless aCertified Lead Inspector/Assessor determines, prior to the commencement of activities which disturbor remove paint that the Concentration of Lead in the paint is below 1000 ppm or 0.5 mg/cm².
7.0 SUMMARY OF RESULTS
At the time of this visual inspection, most painted components were in intact. However, deterioratingwindows, if impact is necessary, should be stabilized in accordance with applicable regulations. Soiland wipe results are within the regulatory guidelines and at acceptable levels. Based on theseresults, no action is required.
Composite lead wipe sample analysis indicated the samples to be below the regulatory level.
The composite soil sample collected was below all regulatory levels.
8.0 LEAD HAZARD EVALUATION REPORT
Included herein, is a copy of the State of California’s Department of Public Health (CDPH) “LeadHazard Evaluation Report”, Form CDPH 8552 as required by Title 17, California Code ofRegulations, Division 1, Chapter 8.
National Econ Corporation has sent a copy of this form to the CDPH, and where applicable, to theCity of San Diego Environmental Services Department.
9.0 RECOMMENDATIONS
Since deteriorated lead based paint was identified on various interior and exterior buildingcomponents, immediate response actions should be implemented to reduce the risk of tenant’sexposure to lead contaminated dust. Response actions should include repair or removal andreplacement of components where lead based paint was identified. These response actions mustonly be conducted by personnel certified in accordance with Title 17, California Code ofRegulations, Division 1, Chapter 8 Accreditation, Certification, and Work Practices For Lead-BasedPaint and Lead Hazards and Title 8 California Code of Regulations Section 1532.1. Additionally,NEC recommends that all units not tested during this lead-based paint inspection be visuallyinspected to determine the condition of components identified as containing lead-based paint. Anylead-based paint containing components identified with conditions other than “Intact” should beincluded in these response actions. Once response actions have been implemented NEC furtherrecommends that clearance testing be conducted in all areas where response actions wereconducted in accordance with Chapter 15 of the HUD Guidelines.
For multi-family or commercial properties, a Lead Management Program should be prepared, andimplemented, to avoid incidental, and/or accidental disturbance of LBP, found at 3275 Winter Street,Los Angeles, California. The program should set forth operational and maintenance guidelines tominimize lead exposure which may be caused by age, normal wear and tear, delamination, buildingmaintenance, repairs, renovation and other activities which may impact LBP.
Project #16-0718
Prior to demolition, disturbance of LBP, or major construction, specifications should be properlymodified to incorporate the removal or handling of LBP in accordance with all applicable Federal,State and local regulations to include 40 CFR Part 745 when disturbing LBP during renovation,repair, painting or any other activities that disturb LBP.
According to CAL-OSHA any detectable level of lead can result in occupational exposure. NationalEcon Corporation recommends that personal and ambient area air monitoring be conducted duringabatement, renovation, repair or painting that involves lead removal, disturbance, handling and/ordemolition. Any signs of paint deterioration should be immediately repaired in accordance with allapplicable, Federal, State and local regulations, including, but not limited to, 40 CFR Part 745.
10.0 INSPECTION LIMITATIONS
This inspection was planned, developed, and implemented based on National Econ Corporation‘sprevious experience in performing lead-based paint inspections. This inspection was conducted incompliance with Chapter 7 of the HUD guidelines as published in 2012. National Econ Corporationutilized state-of-the-art-practices and techniques in accordance with regulatory standards, whileperforming this inspection. National Econ Corporation‘s evaluation of the relative risk of exposure tolead, identified during this inspection, is based on conditions observed at the time of the inspection.National Econ Corporation cannot be responsible for changing conditions that may alter the relativeexposure risk or for future changes in accepted methodology.
The floor plans (Not to Scale) and actual test results for each of the tested components arecontained within this report.
National Econ Corporation assumes no responsibility for the identification of “atypical” lead, used inthe construction trade. Other components that may contain lead not adequately addressed by thisreport and are excluded from the testing guidelines in Chapter 7 of the HUD Guidelines may include,but are not limited to ceramics, including tile in flooring, countertops, walls, toilets, sinks, drinkingfountains, cookware, dishes and lead soldered plumbing.
There are potential liabilities associated with the presence, and removal, of lead containing material.Precautionary measures should be taken in accordance with the guidelines set forth by the EPA, theOccupational Safety and Health Administration (OSHA) and other regulatory agencies if applicable.The removal or disturbance of components containing lead in any quantifiable amount should onlybe conducted in accordance with CAL-OSHA Construction Safety orders Title 8 CCR Section1532.1 (March 6, 2007).
Please feel free to call National Econ Corporation with any questions you may have in connectionwith the inspection, contained herein.
Mark S. Ervin, President Felipe RuizCertified Lead Inspector/Assessor #705 Certified Sampling Technician #17084
National Econ Corporation National Econ Corporation
LEAD HAZARD EVALUATION REPORT
California Department of Public HealthState of California—Health and Human Services Agency
Section 1 — Date of Lead Hazard Evaluation _____________________
Section 3 — Structure Where Lead Hazard Evaluation Was Conducted
Lead Inspection Risk assessment Clearance Inspection Other (specify) _____________________________
City County Zip Code
Construction date (year) of structure
Type of structure
Multi-unit building School or daycare
Single family dwelling
Section 4 — Owner of Structure (if business/agency, list contact person)
Address [number, street, apartment (if applicable)] City State
Name Telephone number
Section 5 — Results of Lead Hazard Evaluation (check all that apply)
No lead-based paint detected
No lead hazards detected
Intact lead-based paint detected
Lead-contaminated dust found
Section 6 — Individual Conducting Lead Hazard EvaluationName
Name and CDPH certification number of any other individuals conducting sampling or testing (if applicable)
CDPH certification number Signature Date
Section 7 — Attachments
A. A foundation diagram or sketch of the structure indicating the specifc locations of each lead hazard or presence of lead-based paint;B. Each testing method, device, and sampling procedure used;C. All data collected, including quality control data, laboratory results, including laboratory name, address, and phone number.
First copy and attachments retained by inspector
Second copy and attachments retained by owner
Third copy only (no attachments) mailed or faxed to:
California Department of Public HealthChildhood Lead Poisoning Prevention Branch Reports850 Marina Bay Parkway, Building P, Third FloorRichmond, CA 94804-6403Fax: (510) 620-5656
CDPH 8552 (6/07)
Zip Code
Address [number, street, apartment (if applicable)] City State Zip Code
Telephone number
Section 2 — Type of Lead Hazard Evaluation (Check one box only)
Michael Chapman, Laboratory Manageror other approved signatory
Sample received in acceptable condition unless otherwise noted. Reporting limit is 10 ug/wipe. The QC data associated with these sample results included in this report meet the method quality control requirements, unless specifically indicated otherwise. Unless noted, results in this report are not blank corrected . This report relates only to the samples reported above and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities.
* slight modifications to methods appliedSamples analyzed by LA Testing Garden Grove, CA AIHA-LAP, LLC--ELLAP Accredited #101650, CA ELAP 1406
Michael Chapman, Laboratory Manageror other approved signatory
*Analysis following Lead in Soil/Solids by EMSL SOP/Determination of Environmental Lead by FLAA. Reporting limit is 40 mg/kg based on the minimum sample weight per our SOP. Unless noted, results in this report are not blank corrected. This report relates only to the samples reported above and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities. Samples received in good condition unless otherwise noted. Results reported based on dry weight. "<" (less than) result signifies that the analyte was not detected at or above the reporting limit. Measurement of uncertainty is available upon request. The QC data associated with the sample results included in this report meet the recovery and precision requirements unless specifically indicated otherwiseSamples analyzed by LA Testing Garden Grove, CA AIHA-LAP, LLC--ELLAP Accredited #101650, CA ELAP 1406
Form 5.0 Questionnaire for a Lead Hazard Risk Assessmentof an Individual Occupied Dwelling Unit. (Page 1 of 2)
(To be completed by risk assessor via interview with owner-occupant or, if a rental unit,an adult resident and, for questions 15 & 16, the owner.)
Property address 3275 Winter Street, Los Angeles, CA 90063
Apt. No. N/A Unit is X Owner occupied Renter occupied
Year of construction 1917 Prior LBP testing? Yes XNo
Name of owner interviewed Stephanie Celaya Owner interview date: 05/ 26 / 16
Name of resident interviewed (if rental unit) N/A Interview date: / /
Name of risk assessor Mark S. Ervin
Children and Children’s Habits
1. Do any children under age 6 live in the home or visit frequently? Yes X No(If no children under age 6, skip to Question 5.)
2. If yes, how many? 1
3. Please provide the following information about each child under 6 to the extent you can.
Child 1 Child 2 Child 3 Child 4
(a) Age:
(b) Blood lead level :
(c) Month/year of blood lead test:
(d) Location of bedroom:
(e) Main room where child eats:
(f) Main room where child plays:
(g) Main room where toys are stored:
(h) Main locations where child playsoutdoors:
(If a resident child under age 6 has had an elevated blood lead level, an environmental investigation may be
necessary [see Chapter 16 of the HUD Guidelines].)
4. (a) Do any children tend to chew on any painted surfaces, such as interior window sills? Yes No
(b) If yes, where?
5–99
CHAPTER 5: RISK ASSESSMENT AND REEVALUATION
Form 5.0 Questionnaire for a Lead Hazard Risk Assessmentof an Individual Occupied Dwelling Unit. (Page 2 of 2)
Property address 3275 Winter Street, Los Angeles, CA 90063 Apt. No. N/A
Other Household Information and Family Use Patterns
5. Do women of child-bearing age live in the home? X Yes No
6. If this home is in a building with other dwelling units, what common areas in the building are used by children?
N/A
7. (a) Which entrance is used most frequently? Front Entry
(b) What other entrances are used frequently? Room 6 (Storage)
8. Which windows are opened most frequently? All Windows
9. (a) Do you use window air conditioners?* XYes No
(b) If yes, where? Room 7 (Bedroom), Room 8 (Bedroom)
*Condensation underneath window air conditioners often causes paint deterioration.
10. (a) Do you or any other household members garden? X Yes No
(b) If yes, where is the garden? Front Yard, Back Yard and Side Yard
11. (a) Are you planning any landscaping activities that will remove grass or ground covering? Yes X No
(b) If yes, where? N/A
12. (a) Which areas of the home get cleaned regularly? All Rooms(b) Which areas of the home do not get cleaned regularly? N/A
13. (a) Are any household members exposed to lead at work? Yes X No
(If no, go to question 14.)
(b) If yes, are dirty work clothes brought home? Yes No
(c) If they are brought home, who handles dirty work clothes and where are they placed and cleaned?
14. (a) Do you have pets? Yes X No
(b) If yes, do these pets go outdoors? N/A
Building Renovations15. (a) Were any building renovations or repainting done here during the past year? Yes X No
(b) If yes, what work was done, and when? N/A
(c) Were carpets, furniture and/or family belongings present in the work areas? Yes X No
(d) If yes, which items and where were they? N/A
(e) Was construction debris stored in the yard? Yes X No
(f) If yes, please describe what, where and how was it stored. N/A
16. (a) Are you conducting or planning any building renovations? Yes XNo
(b) If yes, what work will be done, and when? N/A
5–100
CHAPTER 5: RISK ASSESSMENT AND REEVALUATION
Form 5.1 Building Condition Form for Lead Hazard Risk Assessment.
Property address 3275 Winter Street, Los Angeles, CA 90063 Apt. No. N/A
Name of property owner Oscar & Stephanie Celaya
Name of risk assessor Mark S. Ervin Date of assessment: 05 / 26 / 16
Condition Yes No Comments
Roof missing parts of surfaces(tiles, boards, shakes, etc.)
X
Roof has holes or large cracks X
Gutters or downspouts broken X
Chimney masonry cracked, bricks looseor missing, obviously out of plumb
X
Exterior or interior walls have obviouslarge cracks or holes, requiring more thanroutine pointing (if masonry) or painting
X
Exterior siding has missing boardsor shingles
X
Water stains on interior walls or ceilings X
Walls or ceilings deteriorated X
More than “very small” amount ofpaint in a room deteriorated
X
Two or more windows or doors broken,missing, or boarded up
X Several Windows Are Broken
Porch or steps have major elementsbroken, missing, or boarded up
X
Foundation has major cracks, missingmaterial, structure leans, or visibly unsound
X
** Total number 1 11
* The “very small” amount is the de minimis amount under the HUD Lead Safe Housing Rule (24 CFR 35.1350(d)),or the amount of paint that is not “paint in poor condition” under the EPA lead training and certification (“402”)rule (40 CFR 745.223).
** If the “Yes” column has any checks, the dwelling is usually considered not to be in good condition for thepurposes of a risk assessment, and conducting a lead hazard screen is not advisable. However, specificconditions and extenuating circumstances should be considered before determining the final condition ofthe dwelling and the appropriateness of a lead hazard screen. If the “Yes” column has any checks, and a leadhazard screen is to be performed, describe, below, the extenuating circumstances that justify conducting a leadhazard screen.
Notes (including other conditions of concern):
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02
Form 5.2 Report of Visual Assessment (for Lead Hazard Risk Assessment).Form 6.0 Report of Visual Assessment (for Ongoing Lead-Safe Maintenance).
Property address 3275 Winter Street, Los Angeles, CA 90063 Apt. No. N/A Page 1 of 1
Name of property owner Oscar & Stephanie Celaya
Name of risk assessor Mark S. Ervin Date of assessment 05 / 26 / 16
Area Description Deteriorated PaintFriction
orImpact
Surface?(F or I)
VisibleTeeth
Marks?(Y or N)
PaintTestingResults4
Notes [e.g., paint testing (e.g., XRF,lab analysis) indicates paint is or is notlead-based paint; cause(s) of hazard
control failures]
Location ofBuilding
Component, Dustor Bare Soil
BuildingComponent,Dust, or Bare
Soil Play Area/Non-Play Area
Area(sq. ft.)
Is AreaSmall?2
(Y or N)
Probable Cause(s)of Deterioration if
Known3
Exterior Bare Soil 250 N Time I N/A N/A
Front Yard Bare Soil Included N Time I N/A N/A
Back Yard Bare Soil Included N Time I N/A N/A
Side Yard Bare Soil Included N Time I N/A N/A
1 Include room equivalent or exterior side or wall, as appropriate.2 Lead-safe work practices and clearance/cleaning verification are not required if work does not disturb painted surfaces that total more than
✦ For assisted housing: HUD’s de minimis area of: 20 ft2 or less on exterior surfaces, 2 ft2 or less in any one interior room or space, or 10 percent of the total
surface area on an interior or exterior type of component with a small surface area (such as trim, window sills, baseboards);
✦ For unassisted housing, and for child-occupied facilities, EPA’s minor repair and maintenance activities threshold of: 6 ft2 or less per room; or 20 ft2 or less
for exterior activities; provided that no prohibited or restricted work practices were used and no window replacement or demolition of painted surfaceareas is to be done.
3 Common causes of paint deterioration are: moisture (indicate source if apparent), mildew, friction or abrasion, impact, damaged or deteriorated substrate,and severe heat.
4 If paint testing results are obtained on site, use this column to record the result. If a paint chip sample is sent to the laboratory, use this column to record thesample number (or other unique identifier) as a reference to another record containing the sampling data and laboratory results.
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Form 5.3 Field Paint Chip Sampling Form.
(Use a separate form for each housing unit, common area, or exterior. Sample all layers of paint, not just deteriorated paint layers.) Page 1 of 1
Property address 3275 Winter Street, Los Angeles, CA 90063 Name of property owner Oscar & Stephanie Celaya
Apt. No. N/A Common Area, Housing Unit, or Exterior N/A
Name of risk assessor Mark S. Ervin Date of assessment 05 / 26 / 16
SampleNumber Location Room Equivalent
BuildingComponent
Size of Sample(cm x cm)*
Lead(mg/cm2) Lead (µg/g) Notes
None
Federal standard 1.0 5,000
*Samples submitted to the laboratory for analysis must include the area in square centimeters for the result to be reported as mg/cm2.
Total number of samples on this page 0
Date of sample collection / / Date shipped to lab / / Shipped by (signature)
Received by (signature and date)
Reviewed by (signature and date)
Date results reported (by lab) / / Reviewed by (signature and date)
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04
Form 5.4a Field Sampling Form for Dust. (Single-Surface Sampling)
(Use a separate form for each housing unit, common area, or exterior. Sample all layers of paint, not just deteriorated paint layers.) Page 1 of 1
Property address 3275 Winter Street, Los Angeles, CA 90063
Name of property owner Oscar & Stephanie Celaya Apt. No. N/A Common Area, Housing Unit, or Exterior No. N/A
Name/Firm of risk assessor Mark S. Ervin Date of assessment 05 / 26 / 16
SampleNumber
Room orEntryway
SurfaceType1
ExactLocationof WipeSample
Is surfacesmooth &cleanable?
SampleArea2
(inches xinches)
SampleArea3 (ft2)
Lab Result4
(µg/ft2) Notes
L-01 Room 1 S D Side Yes 3 x 48 1.0 50L-02 Room 2 S A Side Yes 4 x 36 1.0 <10L-03 Room 3 S B Side Yes 3 x 48 1.0 <10L-04 Room 4 HF C Side Yes 12 x 12 1.0 12L-05 Room 6 S C Side Yes 4 x 36 1.0 11L-06 Room 7 S B Side Yes 4 x 36 1.0 <10L-07 Room 8 S D Side Yes 4 x 36 1.0 18
x
x
x
1 Hard Floor (HF), Carpeted Floor (CF), or Interior Window Sill (S)2 Measure to the nearest 1/8th or 1/10th of an inch. [1/8 = 0.125, 2/8 = 0.25, 3/8 = 0.375, 4/8 = 0.5, 5/8 = 0.625, 6/8 = 0.75, 7/8 = 0.875]3 Calculate sample area in square feet as follows: Calculate square inches, then divide by 144.4 Provide areas, direct laboratory to report the dust lead result in µg/ft2.NOTE: EPA standards: 40 µg/ft2 (interior floors); 250 µg/ft2 (interior window sills) for Risk Assessment; 25 µg/ft2 and 125 µg/ft2 for screen.
Total number of samples on this page 7 Date of sample collection 05 / 26 / 16
Shipped to lab by See Chain of Custody & Lab Report / / (signature and date)
Received by See Chain of Custody & Lab Report / / (signature and date)
Reviewed by See Chain of Custody & Lab Report / / (signature and date)
Date results reported by lab 05 / 31 / 16 Reviewed by See Chain of Custody & Lab Report
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Form 5.4b Field Sampling Form for Dust. (Composite Sampling)
Property address 3275 Winter Street, Los Angeles, CA 90063 Page 1 of 1
Name of property owner Oscar & Stephanie Celaya Apt. No. N/A Common Area, Housing Unit, or Exterior No. N/A
Name/Firm of risk assessor Mark S. Ervin Date of assessment 05 / 26 / 16
SampleNumber
Type ofSurface
Location of Subsamples Is surfacesmooth andcleanable?
Area of EachSurface Sampled1
(inches x inches)
Total SurfaceArea
Sampled2 (ft2)
LabResult3
(µg/ft2) NotesRoomExact Locationon Component
NONE
Hardfloors
x
x
x
x
NONE
Carpetedfloors
x
x
x
x
NONE
Interiorsills
x
x
x
x
NONE Entryway x
1 Measure to the nearest 1/8th or 1/10th of an inch. [1/8 = 0.125, 2/8 = 0.25, 3/8 = 0.375, 4/8 = 0.5, 5/8 = 0.625, 6/8 = 0.75, 7/8 = 0.875]2 Calculate sample area in square feet as follows: Calculate square inches for each surface sampled, add together, then divide total by 144.3 Provide areas, direct laboratory to report the dust lead result in µg/ft2.
NOTE: EPA standards: 40 µg/ft2 (interior floors); 250 µg/ft2 (interior window sills) for Risk Assessment; 25 µg/ft2 and 125 µg/ft2 for screen.
Total number of samples on this page Date of sample collection / /
Shipped to lab by / / (signature and date)
Received by / / (signature and date)
Reviewed by / / (signature and date)
Date results reported by lab / / Reviewed by / /
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06
Form 5.5 Field Sampling Form for Soil.
(Composite sampling only. Use a separate form for each residential building in a multi-building property.) Page 1 of 1
Name of owner Oscar & Stephanie Celaya Name of risk assessor Mark S. Ervin Date of completion of this form 05 / 26 / 16
Type of AreaSampled
SampleNumber
Location of Composite Sample(s)Approximate Area of
Bare Soil Represented byComposite Sample (ft.2)
LaboratoryResult
(ppm or µg/g)
Bare Soil in PlayAreas
Bare Soil inNon-play Areas
in Dripline/Foundation Area
S-01
Front Yard, Back Yard & Side Yard 250
160
Bare Soil inNon-play Areas
in the Rest of theYard
Weighted average of soil-lead concentration in non-play areas of dripline/foundation areas and the rest of the yard:
NOTE: EPA hazard standard for bare play area soil is 400 ppm or µg/g; for bare non-play area soil is 1,200 ppm or µg/g.
Total number of samples on this page 1 Date of sample collection 05 / 26 / 16
Shipped to lab by See Chain of Custody & Lab Report / / (signature and date)
Received by See Chain of Custody & Lab Report / / (signature and date)
Reviewed by See Chain of Custody & Lab Report / / (signature and date)
Date results reported by lab 05 / 31 / 16 Reviewed by See Chain of Custody & Lab Report / /
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Form 5.7 Format for an Executive Summary of a Lead Hazard Risk Assessment. Page 1 of 2
Property address 3275 Winter Street, Los Angeles, CA 90063 Date of risk assessment 05 / 26 / 16
Building or Apt. Designation N/A
Summary of Results: (either) No lead-based paint (LBP) hazards were found -or-Lead-based paint (LBP) hazards were found; below is a summary of findings.
Paint-Lead Hazards: (if applicable)
Unit Number CommonArea, or Exterior Location
Room or RoomEquivalent
Building Component Type of Hazard*Lead Level
2(mg/cm orµg/g)**
Options for Corrective Action
N/A
* LBP on friction surface with dust-lead hazard beneath, impact surface, chewable surface with teeth marks, or other deteriorated LBP.** Milligrams per square centimeter (mg/cm2), or micrograms per gram (µg/g; parts per million; ppm).NOTE: EPA standard for LBP: 1.0 mg/cm2, or 5,000 µg/g.
Dust-Lead Hazards: (if applicable)
Unit Number orCommon Area
Room or Room Equivalent Surface*Lead Level(µg/ft2)**
Summary of Results: Soil-Lead Hazards (bare soil only): (if applicable)
Type of Area* LocationLead Level
(ppm or µg/g)**Options for Corrective Action
NONE
* Play area, dripline/foundation area, or rest of the yard. ** Parts per million, or micrograms per gram.EPA standards: 400 ppm (play areas); 1,200 ppm (non-play areas in the dripline/foundation area or the rest of the yard).
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Form 5.7 Format for an Executive Summary of a Lead Hazard Risk Assessment. Page 2 of 2
Property address 3275 Winter Street, Los Angeles, CA 90063 Date of risk assessment 05 / 26 / 16
Building or Apt. Designation N/A
Intact Paint Surfaces With Lead-Based Paint: (if client has requested additional testing)
Unit Number,Common Area, orExterior Location
Room or RoomEquivalent Building Component
Lead Level(mg/cm2)* Options for Corrective Action
N/A
* NOTE: EPA standard for LBP: 1.0 mg/cm2, or 5,000 µg/g.
Contact Person for Further Information (name, address, phone number) Oscar & Stephanie Celaya, 3275 Winter Street, Los Angeles, CA 90063 (323) 263-4586
Person Who Prepared This Summary (printed name, firm/agency, address, phone number, state/EPA RA certification number and expiration date)
Mark S. Ervin, National Econ Corporation, 1899 S. Santa Cruz Street, Anaheim, CA 92805 – (714) 978-6320 - #705, 9/14/16
