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Home My WebLink About2601 STATE ST; ; CB143009; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-19-2014 Demolition Permit Permit No: CB143009 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Occupancy Group: 11/19/2014 PC#: # Dwelling Units: Bedrooms: Project Title: 2601 STATE ST CBAD DEMO Full Demo: Y Lot#: 0 Reference #: CT130005 0 Structure Type: O Bathrooms: 0 STATE STREET TOWNHOMES-DEMO Status: Applied: Entered By: Issued: Inspect Area: 1 COMMERCIAL BUILDINGS IN PREPARATION FOR GRADING Applicant: TAYLOR MORRISON OF CALIFORNIA STE 1450 8105 IRVINE CENTER DR IRVINE CA 92618 949 341-1289 Building Permit Plumbing Fee Other Fee Additional Fees TOTAL PERMIT FEES $20.00 $0.00 $45.00 $0.00 $65.00 Owner: ISSUED 11/04/2014 RMA Plan Approved: 11/19/2014 PY Total Fees: $65.00 Total Payments To Date: $65.00 Balance Due: Clearance: $0.00 NOTICE: Please take OTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-19-2014 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW140359 Job Address: Permit Type: 2792 HIGHLAND DR CBAO SWPPP Parcel No: 1561411600 Lot#: 0 Reference #: CB#: CB142769 Project Title: MARKHAM RES -352 SF GARAGE #2 Applicant: DANIEL-BRIAN CO INC 28358 AERIE RD VALLEY CENTER CA 92082-6444 760-749-4458 Emergency Contact: DANIEL PERSICHETTI 760-533-5214 SWPPP Plan Check SWPPP Inspections Additional Fees TOTAL PERMIT FEES Owner: MARKHAM TISHA 2792 HIGHLAND DR CARLSBAD CA 92008 Status: Applied: Entered By: Issued: Inspect Area: Tier: Priority: ISSUED 10/16/2014 SKS 11/19/2014 1 M $53.00 $224.00 $0.00 $277.00 Total Fees: $277.00 Total Payments To Date: $277.00 Balance Due: FINAL APPROVAL ~ $0.00 THE FOLLVWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: []PLANNING [] ENGINEERING 0BlllLDING QFIRE □HEALTH D HAZMA TIAPCD c·cityof Building Permit Application Plan Check No. (B { L{ -3ac.q 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value I Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. l}e~osit email: building@carlsbadca.gov www.carlsbadca.gov Date tlftl-/1 \ lsWPPP JOB ADDRESS SUITE#/SPACEI/UfllTll rf1'1203 2601 State Street -054 -19 - GT/rr<vJe~ 11 rOT# r.-,ASt# l"""JN"" r=v~w .. ,~ #SA ,~vvMS 1·-.. -··-·-,=~•R ·L 1=C.=wP 13-05 DESCRIPTION OF WORK: Include Square Ffff of A"""""' Area(11) Demolition of 2601 State Street-Commercial Space EXISTING USE rROPOSED USE 11GARAGE (SF) PATIOS (Sfi I DECKS (SF) FIREPLACE rR CONDITIONING rRE SPRINKLEHS Commercial Residential Live/Va YESD NcQ YES □NO □ YES□NO(J APPLICANT NAME Taylor Morrison of California, LLC PROPERTY OWNER NAME Taylor Morrison of California, LLC P .... •-"An+aot ADDRESS ADDRESS 8105 Irvine Center Drive, Suite 1450 .. , .. , ... c1TY· ··· iiP ····-______ , _____ 8105 Irvine Center Drive. Suite 1450 ----·---STATE CITY STATE ZIP Irvine CA 92618 Irvine CA 92618 PHONE IFAX PHONE rAX 949-341-1289 94g..341.1289 EMAIL EMAIL atornillo@taylormorrison.com atomillo@taylormorrison.com DESIGN PROFESSIONAL .......................... A~.~-~ .. ~~!~~~~!.f .. i_yil .. ~~-~-il'!~.~~ .... , .... ____ .. _ .. , ... CONTRACTOR BUS. NAME Tavlor Morrison Services. Inc ........................................................... , ....... ADDRESS ADDRESS---·-·-·······-·-·-·-·-·"··" ... _._._._._,., ..... -. 15 Corporate Park 8105 Irvine Center Drive, Suite 1450 CITY STATE ZIP CITY STATE ZIP Irvine CA 92606 Irvine CA 92618 PHONE IFAX PHONE \FAX 949-47 4-2330 949-341-1289 EMAIL EMAlL mabadi@adam-streeter.com atornillo@taylormorrison.com I STATE LIC. 42615 STATE UC.# !Cl.ASS B I c11Y eus. uc.1231907 519465 (Sec. 7031.5 Bus1ne,;,; and Professions Code: Any City or County which 1equ,res a P!lrm1tto construct, alter, ;mprove. demok$h or repair an~ structure. p,,orto its issuance. also r!'(luires the applicant for such permit to file a signed statement tl\at he is licensed pursuant to the p,ovisioos of the Contractor's License Law ICnaP!er 9. commending with Section 7000 of ~vision 3 of the Business and Professions Code) or !hat he is exemot therefrom, and the basis for the alleged e)<emption. Any v~ation of Section 103i.5 by ar,y applicant for a permit subjects the applicant to a civil penalty or not more than five hundred dollars {$500)). Worker,· Compenwion Oecllll'ation: I /Jeraby affilm under penatty of pe/ftuy me oflhe following declarations: 0 I have and will maintain a certtticate of consent to self-insure for WO!kers· oompensation as pro"lio:led by Sedion 3700 of the Labor Code, for the performance of the WOik tor which this permit is issued. llJ I have and will main lain work,ra' comDttnsation, as feQIJired bv Section 3700 of the Labor Code. for Ire perbmance of the worn ror which )his ll8rntit is iS5Ued. My WO!kers" coff"4)00Sation instzance carrier and policy number are: Insurance Co ........... -·--·-······· .. -.. --·-... , XL SPeclalty -·-------.. , ... _ Poley No ... ____________ Ellpiration Date ________ _ ~ se<:lio11 need not oo completed if the pe,n,t is for one hundred dollars ($100j or le$. U Certificate of Exemption: I certify that in the ))efflllmente of Ille work for whidl this permit is issued, I sliail not employ any person in any manner so as to become &Jbject to lhe worker.;' Compensa~on Laws of California. WARNING: Failure to se<.ure workef11' compensalioo covorage is unlawful, and lhall subjoct an ef!lployar to criminal penalties and civil fines up lo one hundred lllousand dollars (&100.000). in addition to Iha cost of compensation. dam proJid r In Se 3700 of the Labor code, Interest and attorney's'-· a CONTRACTOR SIGNATURE I hereby affirm that I am eKempt from Colllractol"s License Law for tile to/lowing reason: D I, as owner of the property or my employees with wages as their so1e cornpensatiori, wdl do !he wO!ll and the &11.lctlff& is 001 inlended or offered for sale (Sec. 7044, Business 11nd Prolessions Code: The Cootractor's License Law does not apply to an OWl1llf of property woo builds or impr0"11es !hereon. and who does such wmk mmsett or 1trough tis own erri:,klyees. provided that such improlltlmen\s in not intended or offered ror sale. If, however. the buiding or improvement is SOid within one year of completion, the owner-builder wil have Ille burden of proving lhal he did not build or improve for Ille purpose of sale). 0 D I, as owner of the properly, am exciLisively contracting with lcensed contractors lo oonstruel the project (Sec. 7044, Busriess and Proles$im1s Code: The Contractor's License Law does not apply to an owner of property who builds or improves tt1ereon. an<! oontra~'ts for such projects With comractor(s) licensed pursuant to the Cootractol's License Law). I am exempt under Section ............ _ ........ -... · .. -·-·-· Business and Proressions Code for lhis reason: 1. I personally plan lo provide lhe major labor and marenl!ls for construction of lhe proposed property improvement 0Yes Do 2 I (have I have not) signed an application for a buflding permrt for the proposed wor11. 3. I have cornracled wilh lhe following per.;m1 (firm) to provide lhe proposed constl\lction (inckide name address I phone / l:IJ!Ttraclors' license ntJlnber): 4. I plan to provide portions of Ille work. but I have hired the foOOW1ng perron lo coordinate, supervise and provide Ille major woo: {inciude name I addre5s I phone/ conlradors' license number): 5. I will provide some of !Ire wolk. but I have contracted (hired] the following persons to provide the wolk inditaled (indude name I addreSG I phone I type of work): ........ ,,-, .. •---· .. · .. ·------.. --,------·--------·--------·------------.------·-.----- ~ PROPERTY OWNER SIGNATURE OATE lt I ;, I✓ ----------------------·· ... ,.__ ·------· ... · . -·-· I OOf1lfy that I llave read the application and state that ttla allow Information Is correct and that the lnfonnatlon on the plans Is accurate. I agree to oomply wllll al I Cily ordlnanoos and St.ate laws feiaUng to building construdion. I hereby authorize representative of lh8 City of Garlsbacl to enter upon 1he above menooned ~ for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAIO CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA AA OSHA permit is required for excavatioos over 5'0' deep and derrolition or construction of structures over 3 stones in heighl EXPlRA TION: Every permit issued by 1he Buildmg Official under 1he pro\l!Sions of U,is Gode sl\all expire by limitallOn and become null and void r the building or WOik aulholizoo bysudl pem1i1 is not commenced 'M1hin 180 days from the date of such permit or if building wOII( ai.11hoozoo by such permil is suspended orabar,:Joned at any U118 after lhe -.wrk is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code} . .Ji!S APPLICANT'S SIGNATURE DATE Inspection List Pennit#: CB143009 Type: DEMO Date Inspection Item 12/01/2014 22 Sewer/Water Service 12/01/2014 22 Sewer/Water Service 12/01/2014 29 Final Plumbing Tuesday, December 02, 2014 Inspector Act SP SP RI AP Fl STATE STREET TOWNHOMES-DEMO 1 COMMERCIAL BUILDINGS IN PREPARA Comments Page 1 of 1 ~' «?~ ~ CITY OF CARLSBAD PLAN CHECK REVIEW TRANSMITTAL DATE: 11/09/2014 PROJECT NAME: 2601 STATE ST DEMO PLAN CHECK NO: 1 SET#: 1 ADDRESS: 2601 STATE ST Bl.Ml.DING DEP' 11 Co ~ 'le Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carlsbadca.gov PROJECTID:CB143009 APN: 203-054-19 rg:J This plan check review is complete and has been APPROVED by the FIRE Division. By: GR A Final Inspection by the FIRE Division is required □ Yes ~ No D This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check Comments have been sent to: A. Tornmo You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checklist please contact the following reviewer as marked: ,,. PLANNING ENGINEERING FIRE PREVENTION 760-602-4610 h 760-602-27,50 760-602-4665 ' ,,. ,. .. □ Chris Sexton □ Kathleen Lawrence ~ Greg Ryan 760-602-4624 760-602-27 41 760-602-4663 Chris.Sexton@carlsbadca.gov Kathleen.Lawrence@carlsbadca.gov Gregory.Ryan@carlsbadca.gov □ Gina Ruiz □ Linda Ontiveros □ Cindy Wong 760-602-4675 760-602-2773 760-602-4662 Gina.Ruiz@carlsbadca.gov Linda.Ontiveros@carlsbadca.gov Cynthia.Wong@carlsbadca.gov □ □ □ Dominic Fieri 760-602-4664 Dominic.Fierl@c!;;!rlsbadca.gov DEMOLITION ASBESTOS CERTIFICATION ADDREss: .z0ol S-lBfr~ gm:r USE OF BUILDING TO BE DEMOLISHED: WM~tfc!A\ . SQUARE FEET {jJX) tp X NUMBER OF STORIES L PROPERTY owNeR: fA'fv:>e, hlJit2.tLt4'aN ct osUfd?::lv]f\, LLG ADDRESS: 5101; ltevlWE CEcN:Jtl2: taz,. }}l<JS&> PHONE w,;i.,~~0WVJ APPLICANT: I~. nu>t;£1ru-v at=-<el 1tat2Ma1 J ,LL ✓ ADDRESS: ~jo!, l~VlNt. ~j'Z., ptz. lrfA..15() PHONE ~~~---0~ ___________ 112-vl~L-~~--j~_(6 __________ _ Section 19827 .5 of California Health and Safety Code states in part: "A demolition permit shall not be issued by any city ... as to any building or other structure except upon receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project." -------------------------------------------------------- As applicant for a demolition permit in the City of Carlsbad, I certify that; I have read the excerpt from Section 19827.5 of the Health and Safety Code provided above; the information I have provided on this form is true and correct; and I further certify the following: ( ) On the attached __ pages are copies of all written asbestos notifications regarding the above referenced building that are required to be submitted to the United States Environmental Protection Agency or to Part 61 of Title 40 of the Code of Federal Regulations, or successor to that part. I declare that the written asbestos notification is not applicable to the scheduled demolition project . • ✓---~------ SDf!f " ~ Sempra Energy u1mrt Notice of Service Discontinuance PERMIT DEPARTMENT, CITY OR COUNTY OF: Carlsbad SERVICE WILL BE DISCONTINUED TO: ADDRESS: 2579, 2599 & 2601 State St BY: (Date) November 14, 2014 t2:I ELECTRIC METER NO. 5552627, 6578666 & 5565954 ~ GAS METER NO. 0067337138 & 0067337081 ALL SERVICE LINES WILL BE REMOVED. THIS BUILDING CAN BE MOVED OR RAZED AFTER THE ABOVE DATE SAN DIEGO GAS & ELECTRIC f®i ~lit,+iRM BY: Debi Wilhelm PHONE: 760-480-7753 DATE: November 13, 2014 PM Forms: 3x19689-NoticeofServ1ceDiscontinuance Revised: 6/20/06 Taylor Morrison November 3, 2014 City of Carlsbad 1635 Faraday Avenue Carlsbad, CA 92008 TAYLOR MORRISON OF CALIFORNIA, LLC 8105 Irvine Center Drive Suite 1450 Irvine, CA 92618 taylo rmorrison. com Re: State Street Demolition Letter from Property Owner Dear Sirs, Please accept this letter as Taylor Morrison's formal request that the City of Carlsbad approve the demolition of the commercia I building at 2601 State Street. Best regards, Tom Baine Vice President of Operations Taylor Morrison Homes • 1ence sociateiTECHNICAL AND ADVISORY SERVICES. ENVIRONMENTAL HEALTH AND SAFETY October 31, 2014 PROJECT REPORT Client: Submitted to: Leighton and Associates, Inc. 1 7781 Cowan, Suite 200 hvine, CA 92614-6000 Ms. Brynn McCulloch Description: Industrial Hygiene asbestos PCM air clearance evaluation related to the Surf Shop located at 2601 State Street, Carlsbad, CA; performed on October 28, 2014; HSA Project Number 150045LA. Abatement Contractor Scope of Work: The contractor's Scope of Work was defined by others. HSA's Scope of Work: Conduct visual inspection of work area and perform asbestos PCM air clearance sampling. HSA's Project Monitors: Kirk A Cavalier, Sr., California Certified Site Surveillance Technician (CSST) Methods: Asbestos air sampling and analysis -NIOSH 7400 Laboratory (LA Testing) accreditations: California ELAP No.: 1406 AIHA Accreditation No.: 101650 NVLAP Accreditation No.: 101384 AIHA ELLAP Accreditation No.: 101650 LAUSD Lab No.: 10125 SUMMARY The majority of this report is composed of the attached Summary of Daily Activity sheet, Air Sampling Results table, and Laboratory Report with Chain of Custody, etc. Prior to the collection of samples for the air clearance evaluation, a visual inspection of the Surf Shop was performed. The inspection did not identify residual ACM materials within the contained work areas that had been identified during HSA's previous survey. A total of three (3) PCM area air clearance samples were collected for this evaluation. Additionally, two field blank samples were submitted for quality control purposes. The results were compared to the EPA PCM Clearance criterion of0.01 fibers per cubic centimeter (flee). All of the samples were determined to be below this criterion, as welJ as, the lower limit of detection for the analytical method. A Veteran Owned Certified Small Business Enterprise 10771 Noel Street, Los Alamitos, CA 90720 714/220-3922 FAX 714/220-2081 www.healthscience.com Ms. Brynn McCulloch HSA Project No.: l 50045LA October 31, 2014 Pagel This report was prepared for use by Leighton and Associates. Inc in evaluating the subject location. The information contained within this report is as factual as possible and the opinions related herein are based on HSA's experience in similar investigations. No warranty. therefore, is made to any persons other than Leighton and Associates, Inc regarding the conclusions or recommendations included within this report. HSA will not release copies to a third party without prior written consent of Leighton and Associates, Inc. For any questions or clarifications please call us at 714 220 3922. Prepared By Ja e Bailey Lead and Asbestos Services Reviewed By :J~;J.~ Ka~y S. fJnes, Cb{, CAC, CIAQM, Lead Project Designer Vice President • 1ence ssociote~TECHNICAL AND ADVISORY SERVICES. ENVIRONMENTAL HEAL TH AND SAFETY SUMMARY OF DAILY ACTIVITY USA Project Number: 150045LA Project: Surf Shop 2601 State Street Carlsbad, CA Date: October 28, 2014 Abatement Contractor: N/ A Abatement Contr. Jobsite Superv.:N/ A No. of emp(s) of Abatement Contr. including superv.: NIA Ind. Hyg.: K. A. Cavalier, Sr. Name of other contractor(s) & no. emp.(s) from each contr.: NIA Summary of ACM/Lead-related work performed today: HSA performed visual inspection and collected 3 PCM area air samples inside the Surf Shop at the front of the store, counter area, and display area work areas. Significant problems & actions: None. A Veteran Owned Certified Small Business Enterprise 10771 Noel Street, Los Alamitos, CA 90720 714/220-3922 FAX 714/220-2081 www.healthscicncc.com • 1ence ssociate~TECHNICAL AND ADVISORY SERVICES . ENVIRONMENTAL HEALTH AND SAFETY ASBESTOS AIR SAMPLING RESULTS BSA Project Number: l 50045LA Project: Surf Shop 2601 State Street Carlsbad, CA Date: October 28, 2014 Sample No. Location/Description 141028-CLI Surf Shop, Lobby area at front of shop on floor 141028-CL2 Surf Shop, display area at south side of shop on floor 141028-CU Surf Shop, counter area at north side of shop on floor 141028-CL4 Blank 141028-CL5 Blank Standards Cal and Fed/OSHA Permissible Exposure Limit Cal and Fed/OSHA Excursion Level EPA PCM Clearance Level Time (min) 0700-1500 (480) 0700-1500 (480) 0700-1500 (480) --- --- Ind. Hyg.: K. A. Cavalier, Sr. Air Results Volume flee* (liters) 1200 <0.002 1200 <0.002 1200 <0.002 ---<5.5 fibers per 100 fields ---<5.5 fibers per 100 fields 0.1 1.0 0.01 Abbreviations: flee* = fibers longer than 5 micrometers per cubic centimeter of air; < = less than; <5 .5 fibers per l 00 fields = lower limit of analytical sensitivity A Veteran Owned ertified Small Business Enterprise 1077 1 oel Street, Los Alamitos, A 90720 714/220-3922 ·AX 714/220-2081www.healthcience.com Laboratory Repots with Chain of Custody ·A LA Testing Phone/Fax: (714) 828-4999 / (714) 828-4944 LA Testing Order: 331419446 CustomerlD: 32HEAL56 CustomerPO: 150045LA 4 • 11852 Knott Street Unit FS, Garden Grove, CA 92841 TESTING http·11www LATesting com aardengroyefab@la\estjng cg ProjectlD: Attn: Kirk A. Cavalier Health Science Associates 10771 Noel Street Los Alamitos, CA 90720 Project: 150045LA Phone: Fax: Received: Analysis Date: Collected: (714) 220-3922 10/29/14 8:00 AM 10/2912014 Test Report: Fiber Count by Phase Contrast Microscopy (PCM), NIOSH 7400 Method, Revision 3, Issue 2, 8/15/94* Volume LOD Fibers/ Fibers/ Sample Location Sample Date (liters) Fib<'Ts Fields (fib/cc) mm' cc Notes 141028-CL 1 Surfshop, lobby area. 331419446-0001 front or shop on floor 141028-CL2 Surfshop, diplay area, S 331419446-0002 side of shop on floor 141028-CL3 Surfshop, diplay area. N 331419446-0003 side of shop on floor 141028-CL4 Blank 331419446-0004 141028-CLS Blank 331419446-0005 The results reported have been blank corrected as applicable. Analyst(s) Jeffrey Deboo (5) 1200.00 <5.5 100 0.002 1200.00 <5.5 100 0.002 1200.00 <5.5 100 0.002 <5.5 100 <5.5 100 <7.0 <0.002 <7.0 <0.002 <7.0 <0.002 <7.0 Field Blank <7.0 Fleld Blank Michael DeCavallas, Laboratory Manager or other approved signatory Limit of detection Is 7 fibers/mm'. Intra-laboratory Sr values: 5--20 fibers= 0.52, 21--50 fibers= 0.31, 51-100 fibers= 0.22. Inter-laboratory Sr values (Average or EMSL round robin data)= 0.29. The laboratory Is not responsible for data reported In fibers/cc, Votllch Is dependent on volume collected by non-laboratory personnel. Results have been blank corrected as apptlcable. LA TesUng maintains llablllty limited to cos1 of analysis. This report relates only to the sa"l)les reported above and may not be reproduced, except In full, without written approval by LA Testing. LA Testing bears no responslblllty for sample collection activities 0< analylleal metl1Qd limitations. Interpretation and use ot test results are the responsiblllty of the client. Samples received In acceptable condition unless otherwise noted. Samples analyzed by LA Testing Garden Grove, CA AIHA-LAP, LLC-IHLAP Accredited #101650 Initial report from 10/29/2014 08:33:35 Test Report PCM-7.22.0 Printed: 10/29/2014 8:34:07 AM THIS IS THE LAST PAGE OF THE REPORT. 1 th . c1ence sociat~ I 077 I oel Street · Los Alamito , CA 90720 Office: (714) 220-3922 · Fax; (71 4)210-20 1 ----033141944 Page __ of __ AIR SAMPLING DATA SHEET TAT Project Mana1ter: ksjones 3 hour Project Location: State Street, Carlsbad, CA ,"<_u S/, Client Reference: Surf Shoo □IAQ D OSHA Compliance 1111 AbatemeQ(fClearance XI Routine Inspection - mpleT pe n I)' I Flow Rate (Lpm) ample# 1etbod tart (filter, tube. b dge) Time Requested Pre Post 25mmMCEF PCM '2.(' :l. --~7(1'0 / y /Q2R-cl:,/ g: / ~-J 9-.{ 0 7c::rv I -CG2 ,,-/ vg: :i.-s-~. r a_7cn> Gt..3 g: / . -; -4-Y g: 1 ' ' ' ea; ~ vg Avg: !. ...... 1.1 • tn I ,.h, \D <j<. <j< O'I rl <j< rl ('t') ,.,, Relinquished by: Time: .. 0 H H Q) 'O H 0 Date: Time: BSA Project#: 150045LA Date: Oct. 28, 2014 Industrial Hvoienist: K. Cavalier Rotameter: ~ erial # :I Zlf v Expiration Date: li:y/J- Total Total top Time Volume Location/0 ription/R marks Time (min) (L) l\1SV sa.e~'::Jl:K>f-?1 LC~ sy P':UA, µ.nr- / ~ ,vS"'.) (),-<; (-ro ,-(J,N ~~~ '~ i!f1) XLU 511()/"1 Ot} ,c.tfJf' ~, s. >ltf. / fl> , -z_.Ji> a1,,s~ q;.,.~ JJ. "'Cu Sae,£-51/0~ {!.t6U,A.7~L,.,HV!-11/-S {Of:,, I / 10 ,~ a ~ 5 ,t.,;,,, I' ,r;v /:-U7.J'1',, -✓ ' ----13., -,,, -. I? r ~-~ ,-- "'" 0