ASBESTOS SURVEY
AND
LEAD PAINT REPORT
For the Koinonia House located at:
633 SW MONTGOMERY STREET
PORTLAND, OREGON
Prepared for:
PortlandStateUniversity
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
12806 NE 40TH CIRCLE
VANCOUVER, WASHINGTON 98682
Prepared by:
Tom Thompson
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
EXECUTIVE SUMMARY
Dear Mr. Cooper,
Enclosed are the results of the asbestos survey conducted by C.E.C., Inc. for the Koinonia House located at 633 SW Montgomery Street, in Portland, Oregon. This survey was coordinated with you and conducted on February 8, 2006, by Tom Thompson, an AHERA certified inspector. Please note that there were some areas of this building that were inaccessible (locked with no key available) and could not be surveyed. The suspect materials in these areas must be assumed to be asbestos containing until they are tested. There is pipe joint insulation in the basement restroom, behind walls, and other inaccessible areas, which must be assumed to be asbestos containing until they are tested.
All samples were taken in a random manner as required by EPA AHERA rules and analyzed using polarized light microscopy with dispersion staining according to EPA and OR-OSHA Methodology.
Asbestos was identified in the CAB panels, 9x9 white floor tile and mastic, yellow sheet vinyl, 12x12 green floor tile black mastic, beige sheet vinyl, kick plate, and duct tape (See sample data sheet attached). There are suspect fire doors in this location that were not tested. These must be assumed to be asbestos containing until they are tested.
The following survey is divided into the following sections:
Summary sheet - details the type and construction of the building with approximate amounts of asbestos in the building.
Sample result sheet - contains sample numbers and results, description of materials and homogeneous areas of material.
Assessment of materials - contains an assessment of asbestos materials.
Response actions recommended - contains the response actions we recommend.
Laboratory analysis sheet - contains the results of our laboratory analysis.
Inspector’s certifications
Lead paint report
C.E.C. has investigated accessible areas of this facility in locating suspect ACM. The current extent and condition of the ACM was detected through on-site observation and physical determination.
NOTE: This asbestos survey report is available to PortlandStateUniversity, and not to be reproduced in total or part without written consent of PortlandStateUniversity .
We appreciate the opportunity to have worked with you. If you have any questions or if
we can be of any further service, please contact our office.
Sincerely,
Rene Garrett
President
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
SUMMARY SHEET
Owner or Representative: Chuck Cooper
Address: Koinonia House at 633 SW Montgomery Street
City:PortlandState:Oregon
Owner's Representative: PortlandStateUniversity
Mr. Chuck Cooper
630 SW Mill Street
Portland, Oregon97201
Owner/Rep. Telephone Number: (503) 421-1733
Surveyed by: Tom Thompson - Accreditation Number: 1020749
CONSTRUCTION DATA:
Year Built:Approx: 1960’sSize : Approx: 6,600 SQ FT
Construction Type:Masonary
Roof Construction:Asphalt Roofing Material
Heating System: Gas, Forced Air
Attic Insulation: Fiberglass
Pipe Insulation: Non-insulated, Foam
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
SUMMARY DATA
KOINONIA HOUSE, 633 SW MONTGOMERY STREET, PORTLAND, OREGON
PRODUCT / AMOUNT / FRIABLE / CONDITION / SAMPLE # / RESULTSCAB PANELS / APPROX.
1,500 SQ FT / NO / GOOD / 1 / 25% CHRYSOTILE
9X9 WHITE FLOOR TILE AND MASTIC / APPROX.
14,600 SQ FT / NO / GOOD / 3 / 2% TO 3% CHRYSOTILE
YELLOW SHEET VINYL / APPROX.
265 SQ FT / NO / GOOD / 5 / 20% CHRYSOTILE
12X12 GREEN FLOOR TILE BLACK MASTIC / APPROX.
1,400 SQ FT / NO / GOOD / 8 / 3% CHRYSOTILE
BEIGE SHEET VINYL / APPROX.
1,200 SQ FT / NO / GOOD / 10 / 20% CHRYSOTILE
KICK PLATE / APPROX.
120 SQ FT / NO / GOOD / 11 / 6% CHRYSOTILE
DUCT TAPE / APPROX.
500 LF / YES / GOOD / 13 / 65% CHRYSOTILE
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
SAMPLE RESULTS
KOINONIA HOUSE, 633 SW MONTGOMERY STREET, PORTLAND, OREGON
SAMPLE # / SAMPLE DESCRIPTION / SAMPLE LOCATION / HOMOGENEOUS AREA / ASBESTOS CONTENT1 / CAB PANELS / MANSARD / 25% CHRYSOTILE
2 / ASPHALT ROOFING MATERIAL / ROOF / ENTIRE ROOF / NONE DETECTED
3 / 9X9 WHITE FLOOR TILE AND MASTIC / UNDER CARPET 2ND FLOOR / BASEMENT (SOME UNDER CARPET), KITCHEN, BASEMENT / FLOOR TILE:
2% CHRYSOTILE
MASTIC:
3% CHRYSOTILE
4 / COVE BASE MASTIC / 2ND FLOOR BATHROOM / THROUGHOUT / NONE DETECTED
5 / YELLOW SHEET VINYL / 2ND FLOOR MEN’S RESTROOM / 2ND FLOOR WOMEN’S RESTROOM, 1ST FLOOR RESTROOMS / 20% CHRYSOTILE
6 / GYPSUM WALLBOARD WITH TAPE AND MUD / 2ND FLOOR / THROUGHOUT / NONE DETECTED
7 / CEILING TILE / 2ND FLOOR / SELECTIVE THROUGHOUT / NONE DETECTED
8 / 12X12 GREEN FLOOR TILE WITH BLACK MASTIC AND TAN MASTIC / EAST STAIRWAY / BLACK MASTIC:
3% CHRYSOTILE
FLOOR TILE:
NONE DETECTED
TAN MASTIC:
NONE DETECTED
9 / 12X12 MOTTLED FLOOR TILE AND MASTIC / TOP LAYER 1ST FLOOR BY ENTRY / SELECTIVE THROUGHOUT THIS AREA STAIRS WEST? / NONE DETECTED
10 / BEIGE SHEET VINYL / BOTTOM LAYER 1ST FLOOR BY ENTRY / SELECTIVE THROUGHOUT THIS AREA STAIRS WEST? / 20% CHRYSOTILE
11 / KICK PLATE / WEST STAIRWAY / 6% CHRYSOTILE
12 / KICK PLATE MASTIC / WEST STAIRWAY / NONE DETECTED
13 / DUCT TAPE / BASEMENT MECHANICAL ROOM / SELECTIVE THROUGHOUT / 65% CHRYSOTILE
14 / STAIR TREAD MASTIC / WEST STAIRWAY / NONE DETECTED
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
ASSESSMENT OF MATERIALS
Building: KOINONIA HOUSE, 633 SW MONTGOMERY STREET, PORTLAND, OREGON
Sample #'s / Functional Space / Asbestos Type / % / Material & Condition / Comments / Sq. & Linear Footage1 / MANSARD / CHRYSOTILE / 25% / CAB PANELS
(GOOD) / SEE RESPONSE ACTIONS / APPROX.
1,500 SQ FT
3 / UNDER CARPET 2ND FLOOR, BASEMENT (SOME UNDER CARPET), KITCHEN, BASEMENT / CHRYSOTILE / 2% TO 3% / 9X9 WHITE FLOOR TILE AND MASTIC
(GOOD) / SEE RESPONSE ACTIONS / APPROX.
14,600 SQ FT
5 / 2ND FLOOR MEN’S RESTROOM, 2ND FLOOR WOMEN’S RESTROOM, 1ST FLOOR RESTROOMS / CHRYSOTILE / 20% / YELLOW SHEET VINYL
(GOOD) / SEE RESPONSE ACTIONS / APPROX.
265 SQ FT
8 / EAST STAIRWAY / CHRYSOTILE / 3% / 12X12 GREEN FLOOR TILE BLACK MASTIC / SEE RESPONSE ACTIONS / APPROX.
1,400 SQ FT
Inspector: Tom Thompson - Accreditation Number: 1020749
Signature: ______Date: February 15, 2006
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
ASSESSMENT OF MATERIALS
Building: KOINONIA HOUSE, 633 SW MONTGOMERY STREET, PORTLAND, OREGON
Sample #'s / Functional Space / Asbestos Type / % / Material & Condition / Comments / Sq. & Linear Footage10 / BOTTOM LAYER 1ST FLOOR BY ENTRY, SELECTIVE THROUGHOUT THIS AREA STAIRS WEST / CHRYSOTILE / 20% / BEIGE SHEET VINYL
(GOOD) / SEE RESPONSE ACTIONS / APPROX.
1,200 SQ FT
11 / WEST STAIRWAY / CHRYSOTILE / 6% / KICK PLATE
(GOOD) / SEE RESPONSE ACTIONS / APPROX.
120 SQ FT
13 / BASEMENT MECHANICAL ROOM, SELECTIVE THROUGHOUT / CHRYSOTILE / 65% / DUCT TAPE
(GOOD) / SEE RESPONSE ACTIONS / APPROX.
500 LF
Inspector: Tom Thompson - Accreditation Number: 1020749
Signature: ______Date: February 15, 2006
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
RESPONSE ACTIONS RECOMMENDED
Building: KOINONIA HOUSE, 633 SW MONTGOMERY STREET, PORTLAND, OREGON
MATERIAL / LOCATION / RECOMMENDED RESPONSE ACTIONSCAB PANELS / MANSARD / CAB panels are a non-friable material, which is currently in good condition and poses no significant health hazards. This asbestos containing material should be disposed of properly. Do not sand on, drill through, or otherwise damage material. Must be removed prior to renovation or demolition.
FLOOR TILE AND MASTIC / UNDER CARPET 2ND FLOOR, BASEMENT (SOME UNDER CARPET), KITCHEN, BASEMENT / Floor tile and mastic are non-friable materials that are currently in good condition. Do not drill through, sand on, break or otherwise disturb material. Must be removed prior to renovation or demolition.
SHEET VINYL / 2ND FLOOR MEN’S RESTROOM, 2ND FLOOR WOMEN’S RESTROOM, 1ST FLOOR RESTROOMS, BOTTOM LAYER 1ST FLOOR BY ENTRY, SELECTIVE THROUGHOUT ONLY THIS AREA STAIRS WEST / Sheet vinyl is a non-friable material currently in good condition and poses no health hazards in its present state. Do not drill through, sand on, tear, remove or otherwise disturb material. Must be removed prior to renovation or demolition.
Management Planner: Tom Thompson - Accreditation Number: 1020758
Signature: ______Date: February 15, 2006
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
1
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
RESPONSE ACTIONS RECOMMENDED
Building: KOINONIA HOUSE, 633 SW MONTGOMERY STREET, PORTLAND, OREGON
MATERIAL / LOCATION / RECOMMENDED RESPONSE ACTIONSFLOOR TILE MASTIC / EAST STAIRWAY / Floor tile mastic is a non- friable material that poses minimal health or environmental risks in its current state. Non-asbestos floor tile with asbestos containing mastic must be assumed to be contaminated. Do not drill through, sand on, puncture, break or otherwise disturb material. Must be removed prior to renovation or demolition.
KICK PLATE / WEST STAIRWAY / Kick plate is a non-friable material currently in good condition. Do not nail through, sand on, cut, or otherwise disturb. Must be removed prior to renovation or demolition.
dUCT TAPE / basement mechanical room / Duct tape is a friable material that is currently in good condition. Must be maintained in an intact condition and kept encapsulated with a high vehicular latex paint. Do not drill through, sand on or otherwise disturb material. Must be removed prior to renovation or demolition.
Management Planner: Tom Thompson - Accreditation Number: 1020758
Signature: ______Date: February 15, 2006
12806 N.E. 40TH CIRCLEVANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
1
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
BULK SAMPLE ANALYSIS REPORT
PORTLANDSTATEUNIVERSITY / SOURCE: / KOINONIA HOUSE,633 SW MONTGOMERY STREET,
PORTLAND, OREGON
ATTN: CHUCK COOPER / SAMPLED BY: / TOM THOMPSON
630 SW MILL STREET / LAB #: / R-283/06-99
PORTLAND, OREGON97201 / ANALYZED BY: / TOM THOMPSON
DATE SAMPLED: 02-08-06
DATE RECeived: 02-08-06
DATE COMPleted: 02-13-06
ANALYTICAL METHOD: EPA, 40 CFR Part 763, Section 1, Subpart F,
Appendix A, PLM/Dispersion Staining
SAMPLEID # / SAMPLE DESCRIPTION / SAMPLE LOCATION / ASBESTOS CONTENT / OTHER MATERIAL
1 / CAB PANELS / MANSARD / 25% CHRYSOTILE / CEMENT
2 / ASPHALT ROOFING MATERIAL / ROOF / NONE DETECTED / 30% FIBERGLASS,
5% CELLULOSE,
TAR, CLAY
3 / 9X9 WHITE FLOOR TILE AND MASTIC / UNDER CARPET 2ND FLOOR / FLOOR TILE:
2% CHRYSOTILE
MASTIC:
3% CHRYSOTILE / CALCIUM CARBONATE,
VINYL, BINDER, TAR
4 / COVE BASE MASTIC / 2ND FLOOR BATHROOM / NONE DETECTED / ADHESIVE, CLAY
5 / YELLOW SHEET VINYL / 2ND FLOOR MEN’S RESTROOM / 20% CHRYSOTILE / 5% CELLULOSE,
VINYL, CALCITE, ADHESIVE
ANALYST:______REVIEWED BY:______
DEVIATION FROM METHOD: NONE.
PERCENTAGES ARE ESTIMATES.
TEST RESULTS PERTAIN ONLY TO ITEMS TESTED.
* DETECTION LIMIT IS LESS THAN 1% ASBESTOS.
NON ASBESTOS MATERIALS ARE NOT NECESSARILY LISTED.
12806 N.E. 40TH CIRCLE VANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
BULK SAMPLE ANALYSIS REPORT
PORTLAND STATE UNIVERSITY / SOURCE: / KOINONIA HOUSE,633 SW MONTGOMERY STREET,
PORTLAND, OREGON
ATTN: CHUCK COOPER / SAMPLED BY: / TOM THOMPSON
630 SW MILL STREET / LAB #: / R-283/06-99
PORTLAND, OREGON 97201 / ANALYZED BY: / TOM THOMPSON
DATE SAMPLED: 02-08-06
DATE RECeived: 02-08-06
DATE COMPleted: 02-13-06
ANALYTICAL METHOD: EPA, 40 CFR Part 763, Section 1, Subpart F,
Appendix A, PLM/Dispersion Staining
SAMPLEID # / SAMPLE DESCRIPTION / SAMPLE LOCATION / ASBESTOS CONTENT / OTHER MATERIAL
6 / GYPSUM WALLBOARD WITH TAPE AND MUD / 2ND FLOOR / NONE DETECTED / 20% CELLULOSE,
CALCIUM SULFATE,
CALCIUM CARBONATE,
BINDER
7 / CEILING TILE / 2ND FLOOR / NONE DETECTED / 95% CELLULOSE,
BINDER, PAINT
8 / 12X12 GREEN FLOOR TILE WITH BLACK AND TAN MASTIC / EAST STAIRWAY / BLACK MASTIC:
3% CHRYSOTILE
FLOOR TILE:
NONE DETECTED
TAN MASTIC:
NONE DETECTED / CALCIUM CARBONATE,
VINYL, BINDER, ADHESIVE
9 / 12X12 MOTTLED FLOOR TILE AND MASTIC / TOP LAYER 1ST FLOOR BY ENTRY / NONE DETECTED / CALCIUM CARBONATE,
VINYL, BINDER, ADHESIVE
10 / BEIGE SHEET VINYL / BOTTOM LAYER 1ST FLOOR BY ENTRY / 20% CHRYSOTILE / 5% CELLULOSE,
VINYL, CALCITE, ADHESIVE
ANALYST:______REVIEWED BY:______
DEVIATION FROM METHOD: NONE.
PERCENTAGES ARE ESTIMATES.
TEST RESULTS PERTAIN ONLY TO ITEMS TESTED.
* DETECTION LIMIT IS LESS THAN 1% ASBESTOS.
NON ASBESTOS MATERIALS ARE NOT NECESSARILY LISTED.
12806 N.E. 40TH CIRCLE VANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
CERTIFIED ENVIRONMENTAL CONSULTING, INC.
BULK SAMPLE ANALYSIS REPORT
PORTLAND STATE UNIVERSITY / SOURCE: / KOINONIA HOUSE,633 SW MONTGOMERY STREET,
PORTLAND, OREGON
ATTN: CHUCK COOPER / SAMPLED BY: / TOM THOMPSON
630 SW MILL STREET / LAB #: / R-283/06-99
PORTLAND, OREGON 97201 / ANALYZED BY: / TOM THOMPSON
DATE SAMPLED: 02-08-06
DATE RECeived: 02-08-06
DATE COMPleted: 02-13-06
ANALYTICAL METHOD: EPA, 40 CFR Part 763, Section 1, Subpart F,
Appendix A, PLM/Dispersion Staining
SAMPLEID # / SAMPLE DESCRIPTION / SAMPLE LOCATION / ASBESTOS CONTENT / OTHER MATERIAL
11 / KICK PLATE / WEST STAIRWAY / 6% CHRYSOTILE / VINYL, CALCITE, ADHESIVE
12 / KICK PLATE MASTIC / WEST STAIRWAY / NONE DETECTED / ADHESIVE, CLAY
13 / DUCT TAPE / BASEMENT MECHANICAL ROOM / 65% CHRYSOTILE / 15% CELLULOSE,
CALCITE, ADHESIVE
14 / STAIR TREAD MASTIC / WEST STAIRWAY / NONE DETECTED / SILICONE CEMENT
ANALYST:______REVIEWED BY:______
DEVIATION FROM METHOD: NONE.
PERCENTAGES ARE ESTIMATES.
TEST RESULTS PERTAIN ONLY TO ITEMS TESTED.
* DETECTION LIMIT IS LESS THAN 1% ASBESTOS.
NON ASBESTOS MATERIALS ARE NOT NECESSARILY LISTED.
12806 N.E. 40TH CIRCLE VANCOUVER, WASHINGTON 98682
PORTLAND (503) 221-7904 VANCOUVER (360) 254-9385 Fax (360) 891-9633
1