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D <br />0 <br />3 <br />m <br />c <br />3 <br />0- <br />Ay <br />i ierracon <br />Inspector: <br />License: <br />Date: <br />Chris Kell <br />12487 <br />Asbestos Survey Form <br />12/1/2010 <br />Job Name: Old Bethel ES <br />Job Number: 71107 <br />Area: C Buildin <br />Sample <br />No. <br />Homogeneous Material Description <br />Sample Location <br />Floor <br />Condition <br />4uantity <br />Friable! <br />Nan- Friable <br />32 <br />4" Black Cove Base Board <br />Vinyl Floor Areas off Classrooms <br />1 <br />33 <br />4" Black Cove Base Board <br />Floor Areas off Classrooms <br />1 <br />34 <br />- Vinyl <br />Plaster Skim Coat <br />Throughout <br />1 <br />G <br />9,O0o ft <br />Friable <br />35 <br />Plaster Skim Coat <br />Throughout <br />1 <br />36 <br />Plaster Skim Coat <br />Throughout <br />1 <br />37 <br />Plaster Skim Coat <br />Throu hout <br />1 <br />38 <br />Plaster Skim Coat <br />Throughout <br />1 <br />39 <br />12 "x12" Brown Floor Tiie <br />Storage Areas off Classrooms <br />1 <br />G <br />200 <br />Non- Friable <br />40 <br />12 "x12" Brown Floor Tile <br />Storage Areas off Classrooms <br />1 <br />41 <br />12 "x12" Brown Floor Tile <br />Storage Areas off Classrooms <br />1 <br />42 <br />12 "x12" Black Floor Tile <br />Storage Areas off Classrooms <br />1 <br />G <br />50 ff <br />Non-Friable <br />43 <br />12 "x12 " Black Floor Tile <br />Storage Areas off Classrooms <br />1 <br />44 <br />12'°x12" Black Floor Tile <br />Storage Areas off Classrooms <br />1 <br />45 <br />12"x12" White Floor the <br />Storage Areas off Classrooms <br />1 <br />G <br />300 <br />Non - Friable <br />46 <br />12 "x12 " White Floor the <br />Storag Areas off Classrooms <br />1 <br />47 <br />12 "x12" White Floor tile <br />Storage Areas off Classrooms <br />1 <br />48 <br />Carpet Adhesive <br />Classroom Carpets <br />1 <br />G <br />5,000 ft <br />Non - Friable <br />49 <br />Carpet Adhesive <br />Classroom Carpets <br />1 <br />50 <br />Carpet Adhesive <br />Classroom Carpets <br />1 <br />51 <br />Car et Adhesive <br />Classroom Carpets <br />1 <br />52 <br />Carpet Adhesive <br />Classroom Carpets <br />1 <br />53 <br />Roof Membrane <br />Roof <br />1 <br />G <br />8,800 ft <br />Non - Friable <br />54 <br />Roof Membrane <br />Roof <br />1 <br />55 <br />Roof Membrane <br />Roof <br />1 <br />56 <br />Root Flashing <br />Roof <br />1 <br />G <br />500 ft' <br />Non- Friable <br />57 <br />Roof Flashing <br />Roof <br />1 <br />58 <br />Roof Flashing <br />Roof <br />1 <br />G = Goad <br />D = Damaged <br />SD = Significantly Damaged <br />G -6 <br />P�g'Q , 32SDf 2 <br />