HomeMy WebLinkAbout1099 BUENA VISTA WAY; ; CB091878; Permit02-01-2010
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Demolition Permit Permit No: CB091878
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Occupancy Group:
PC#:
# Dwelling Units:
Bedrooms:
Project Title:
1099 BUENA VISTA WY CBAD
DEMO
1552510200
Full Demo:
Lot#:
Reference #:
1 Structure Type:
0 Bathrooms:
DEMO 1909SF RESIDENCE
Status: ISSUED
Applied: 11/10/2009
Entered By: JMA
Plan Approved: 02/01/2010
Issued: 02/01/2010
Inspect Area:
Applicant:
RICHARD J.SMERUD
2835 PROGRESS PLACE
ESCONDIDO
CA 92029
760-801-2498
Owner:
BARKER FAMILY SURVIVORS TRUST
C/O FRANKIE R JONES
2513 VIA ESPARTO
CARLSBAD CA 92010
Building Permit
Plumbing Fee
Other Fee
Additional Fees
TOTAL PERMIT FEES
$0.00
$0.00
$65.00
$0.00
$65.00
Total Fees:$65.00 Total Payments To Date:$65.00 Balance Due:$0.00
Inspector
FINAL APPROVAL
Date.Clearance:
NOTICE: Please take NOTICE 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.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE similar to (his, or as to which the statute of limitations has previously otherwise expired.
CITY OF
CARLSBAD
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717 / 2718/2719
Fax: 760-602-8558
www.carlsbadca.gov
Plan Check No.
Est. Value
Plan Ck. Deposit
Pate t(ftQ/o«\
JOB ADDRESS f SUITE#/SPACE#/UNfT#
CT/PROJECT ## OF UNITS * BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK: Include Square F**t of Afflicted Ana(s)
p-
_
PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE
YES D # NO D
AIR CONDITIONING
YES D NO D
FIRE SPRINKLERS
YES D NOD
CONTACT NAME (It Dltfmont Fom AppUcsnt)APPLICANT
ADDRESS ADDRESS
CITY STATE ZIP
PHONE FAX
EMAIL EMAIL
PROPERTY OWNER NAMI 7T*CONTRACTOR BUS. NAME
ADDRESS ADDRESS
CITY S ZIP CITY STATE ZIP
PHONE FAX PHONE FAX
EMAIL K *EMAIL
ARCH/DESIGNER NAME &CITY BUS. UC.*
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires theapplicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the
Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to acivil penalty of not more than five hundred dollars ($500)).
WORKERS COMPENSATION
Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations:
O I have and will maintain i certificate of consent to terMnwre for workers' compensation as provided by Section 3700 of the Labor Code, tor the peftbrmance of the work for which this permit is issued.
O I h«v« and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy
number are: Insurance Co. Policy No. Expiration Dale
This section need not be completed if the permit is for one hundred dollars ($100) or less.
O Certificate of Exemption: I certify that in Sw performance of the work for which this permit is issued, I shall riot employ any person in any manner so as to rjeoorro
California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney's fees.
Jf$ CONTRACTOR SIGNATURE OAGENT DATE
O W N E 17 B U I L D E 17 DECLARATION
I hereby aKrm that I am exempt from Contractor's UcerseUiw for the following reason:
O 1,-as owner o* the property or my employees VMthwao^ as their sole compensatwn, will cto the work and t^
sate. If, however, the building or improvement is sold within one year of complerkm, tte owner^xjikto wiH have ttw burdan rf
I, as owner of Ine property, am exclusively contracting with Hcereed cortractors to constnidtne project (Sec. 7044, Business an^ not apply to an owner of
property who buMs or imprmesthenKW, and contract fa such p
D I am exempt under Section Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for obstruction erf toe proposed prop^ improvement. OYes ONo
2.1 (have / have not) signed an application for a building permit for the proposed work.
3.1 have contracted with the foHowmg person (firm) to provide the proposed conslnictkxi (ireJude name address / prKxie / contractors'lk»nse rnxnbw
5.1 will provide some of the work, but I have contracted (hired) the following persons to provioerJie work inctotedfindurJe name/a*Jre»
>C!f PROPERTY OWNER SK3NA'C3AGENT DATE //-
COMPLETE THIS SECTION FOR N O N - R E S I D E N T I A L BUILDING PERMITS ONLY
Is lh« applicant or future buldirig occupant required to sub^
Prestoy-Tanner Hazardous Substance Account Ad? OYes a No
fe the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? OYes ONo
Is the faciHty to b«cor«lructedwthin 1,001 feet oflrwoutw boundary o( a school site? a Yes a No
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name Lender's Address
OSrW: An OSHArjem*ereaA«Bdf«excavalioi«overs'"'deepa^
EXPIRATm Every pern* issued tytwBu*^
180 days Iron** date of such permilaiftobUklingQCJMiirSuInr^
APPLICANTS SIGNATURE DATE
City of Carlsbad Bldg Inspection Request
For: 05/04/2010
Permit* CB091878
Title: DEMO 1909SF RESIDENCE
Description:
Inspector Assignment:
Type: DEMO Sub Type:
Job Address: 1099 BUENA VISTA WY
Suite: Lot: 0
Location:
OWNER BARKER FAMILY SURVIVORS TRUST
Owner: SMERUD FAMILY TRUST 03-27-97
Remarks: DEDJNSPECTION: DE^DJ
Total Time:
CD Description
19 Final Structural
Act Comments
Phone: 8589975866
Inspecto
Requested By: MARTIN VOLT
Entered By: CHRISTINE
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp Comments
City of Carlsbad
Building Department
DEMOLITION PERMIT REQUIREMENTS
A demolition permit may only be issued to the owner of the property
or the State Licensed Contractor that is doing the work. The
contractor must provide use with a letter, signed and dated by the
property owner, giving permission for the building to be demolished.
'IP The fee for a demolition permit is $65.00. The attached Demolition
Asbestos Certification application must be completed, signed and
have the correct square footage of the structure being demolished,
as well as its use.
Applicant must provide a letter from San Diego Gas and Electric
stating that the utilities have been disconnected.
Arrange for appropriate Water Authority to remove water meter
unless construction of replacement structure is to begin shortly.
Contact the Planning Department at (760) 602-4610 to determine if
the structure is in the Redevelopment area or if it is in the Coastal
Zone.
Contact the Engineering Department at (760) 602-2773, 602-2775 or
602-2741 to determine if a Haul Route or Right-of-Way Permit is
required.
Contact the Engineering Department at (760) 602-2773, 602-2775 or
602-2741 to determine the Storm Water requirements.
Notify the Fire Department at (760) 602-4666 to see if they need the
use of the building for training purposes.
h:\word\front counter handouts\demolition permit requirements.doc
REV October 30, 2008
1635 Faraday Avenue • Carlsbad. CA 92008-7314 • (760) 602-2700
Building Counter • (760) 602-2719 • FAX (760) 602-8558
DEMOLITION ASBESTOS CERTIFICATION
ADDRESS:f 7
USE OF BUILDING TO BE DEMOLISHED:
SQUARE FEET /V O ( X NUMBER OF STORIES
PROPERTY OWNER:
ADDRESS:
ADDRESS: _ ; _ PHONE
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.
Date
h:\word\front counter handouts\demolition permit requirements.doc
REV October 30, 2008
^fr
INDOOR AIR QUALITY EVALUATIONS, ASBESTOS, MOLD, BACTERIA TESTING AND
MOISTURE MANAGEMENT ASSESSMENTS
LIMITED ASBESTOS REVIEW
FOR
Mr. Richard Smerud
Project Location
1099 Buena Vista Way
Carlsbad, California 92008
Conducted on
May 27, 2009
3784 Mission Avenue, PMB 609, Suite 148 Office: (760) 433-9394 Fax: (760) 433-9396
Oceanside, California 92058 Email: jinl22@sbcglobal.net
^ INC.
INDOOR AIR QUALITY EVALUATIONS, ASBESTOS, MOLD, BACTERIA TESTING AND
MOISTURE MANAGEMENT ASSESSMENTS
TABLE OF CONTENTS
1.0 INTRODUCTION 3
2.0 DESCRIPTION 3
3.0 SAMPLING PROTOCOL & MATERIALS ASSESSED 4
4.0 ANALYTICAL RESULTS 4
5.0 CONCLUSIONS 5
6.0 RECOMMENDATIONS 5
7.0 LIMITATIONS 6
8.0 ENCLOSURES
TABS
Certified Asbestos Consultant I.D. for Mr. John Niebuhr 1
Floor Plan for Sample Locations Testing Positive 2
Floor Plan for Sample Locations Testing Negative 3
Laboratory Results 4
Chain of Custody 5
3784 Mission Avenue, PMB 609, Suite 148 Office: (760) 433-9394 Fax: (760) 433-9396
Oceanside, California 92058 Email: jinl22@sbcglobal.net
INDOOR AIR QUALITY EVALUATIONS, ASBESTOS, MOLD, BACTERIA TESTING AND
MOISTURE MANAGEMENT ASSESSMENTS
1099 Buena Vista Way
Carlsbad, California 9Z008
1.0 INTRODUCTION
On May 27, 2009, Mr. John Niebuhr of Health and Safety Services, Inc. conducted a limited
asbestos review of the subject property. The purpose of this review was to conduct a limited
asbestos review of various building materials, collect samples of suspect Asbestos-Containing
Materials (ACM), and submit them to a qualified laboratory for analysis by the PLM method.
The analysis will determine if asbestos materials are present, estimate the concentration of
the asbestos, and determine if the sampled material is considered to be Friable or Non-
friable. This report is based upon the results of the review and the laboratory results.
ASBESTOS-CONTAINING MATERIALS
Asbestos-containing material (ACM) is defined by the Environmental Protection Agency (EPA)
as any.material with an asbestos concentration greater than 1%. The State of Califbrnia
considers ACM to be any material with a concentration greater than one tenth of 1%.
Friable ACM refers to materials that can be crumbled, pulverized, or reduced to powder by
hand pressure. Friable materials, when improperly handled or controlled, are more likely to
become airborne. Airborne asbestos fibers, when inhaled in sufficient quantities, pose a
serious health hazard.
Non-friable ACM refers to such items as Transite shingles, roofing mastics, floor tiles, floor
tile mastics, and Transite flue gas vent pipes. These materials are less likely to become
airborne when found in their original manufactured condition. Care must be taken; causing
non-friable materials to become friable will not only pose a potentially serious health hazard,
it may also trigger requirements for compliance with the EPA's NESHAP regulations.
However, for demolition projects, these materials will need to be properly removed and
properly disposed of.
2.0 DESCRIPTION
This structure is a single family residence constructed of wood, stucco exterior, with interior
wall constructed of drywaJI and stucco. The roof is a three-tab gray shingle with a very thick
base felt sheet There is a small roof over the carport which is covered, with a built-up
roofing system.
3784 Mission Avenue, PMB 609, Suite 148 Office: (760) 433-9394 Fax: (760) 433-9396
Oceanside, California 92058 Email: jinl22@sbcg1obal.net
HEALTH AND SAFETY SERVICES, INC.
INDOOR AIR QUALITY EVALUATIONS, ASBESTOS, MOLD, BACTERIA TESTING AND
MOISTURE MANAGEMENT ASSESSMENTS
3.0 SAMPLING PROTOCOL & MATERIALS ASSESSED
Samples of the suspect materials were collected and placed in labeled sealed plastic
containers. Each sample was given an identification number. A Chain of Custody record was
completed and accompanied the samples to the laboratory. The Chain of Custody record is
enclosed. All samples were submitted to LA Testing for analysis. LA Testing is a certified
laboratory for the testing of suspect asbestos materials. Analysis of the suspect asbestos
samples was performed via the Environmental Protection Agencies 600/R-93/116 Method
using Polarized Light Microscopy.
The following suspect samples were collected from various locations:
* Drywall and drywall mudd * Wall paper * Roofing materials
* Attic insulation * Floor coverings * Stucco wall material
* 12" x 12" floor tile * Ceiling spray * Window putty
4.0 ANALYTICAL RESULTS
LA Testing performed a total of fourty-one (41) analyses on twenty (20) samples. Based
upon the analytical results, see enclosed laboratory report, asbestos was found.
MATERIALS NOT SAMPLED
Previous assessments and laboratory tests confirmed that the Transite exhaust flues contain
asbestos, therefore, these materials were not tested and are assumed to be positive for
asbestos. Also there is an asbestos insulator in the ceiling light fixture in the Bathroom next
to the Kitchen. Roof penetration mastic is assumed to be AC containing.
3784 Mission Avenue, PMB 609, Suite 148 Office: (760) 433-9394 Fax: (760) 433-9396
Oceanside, California 92058 Email: jinl22@isbcglobal.net
HEALTH AND SAFETY SERVICES, INC.
INDOOR AIR QUALITY EVALUATIONS, ASBESTOS, MOLD, BACTERIA TESTING AND
MOISTURE MANAGEMENT ASSESSMENTS
5.0 CONCLUSIONS
The following materials tested positive for asbestos:
Sample 1099-8 Red Floor covering under the ceramic kitchen tiles 2% Chrysoitle
Sample 1099-9 Beige Floor covering under the ceramic bathroom tiles 2% Chrysoitle
Sample 1099-19 Window putty 3% Chrysotile
6.0 RECOMMENDATIONS
The following recommendations are suggested:
Properly remove and properly dispose of ail asbestos-containing materials prior to the
demolition of the structure. Test any newly discovered suspect buifdirig materials before they
are removed and/or disposed of. There is always a potential for the discovery of additional
asbestos-containing materials as the demolition process progresses and exposes interior
cavities of the building and/or any other materials not included and/or tested with this
review.
For those entering the building prior to the abatement of the .identified ACM, educate all
those personnel i.e. maintenance and repair workers, as to the locations of the identified
materials including the following precautions when work is required on or near the identified
ACM.
Ensure they fully understand,
> They are not to cut into, grind, sand, or in any way disturb any ACM to include any
removal, encapsulation, or enclosure, without implementing proper handling
procedures, and they are too
> Comply with all federal, state, and local regulations for the proper methods and
procedures for handling, removal, encapsulation, enclosure, labeling, storage,
replacement, transporting, and disposal of ACM.
3784 Mission Avenue, PMB 609, Suite 148 Office: (760) 433-9394 Fax: (760) 433-9396
Oceanside, California 92058 Email: jinl22@sbcglobal.net
HEALTH AND SAFEty SERVICES, INC.
INDOOR AIR QUALITY EVALUATIONS, ASBESTOS, MOLD, BACTERIA TESTING AND
MOISTURE MANAGEMENT ASSESSMENTS
7.0 LIMITATIONS
Conclusions, recommendations, and opinions presented in this report are professional
opinions based upon the conditions existing at the time of this review, the information
provided by the client at the time of the review, and the data described in the laboratory
report. The sample data used in this report is limited to the date and time in which the
samples were collected and to the specific area(s) and/or locations addressed by this report.
Health & Safety Services, Inc. reserves the right to re-visit the project to conduct further
testing and/or assessments should new and relevant information become known and made
available to Health & Safety Services, Inc.
Changes in the conditions of the property may occur at any time without warning and/or by
the works of man. Changes in applicable standards may also occur as a result of legislation
or the broadening of knowledge. Accordingly,, Health and Safety Services, Inc. shall <not be
responsible should the findings of this report be invalidated, wholly or in part, by changes
beyond the control of Health and Safety Services, Inc.
If you have any questions, please do not hesitate to call.
Sincerely,
J&Wi Niebuhr
Certified Asbestos Consultant, Certification No. 92-0253
3784 Mission Avenue, PMB 609, Suite 148 Office: (760) 433-9394 Fax: (760) 433-9396
Oceanside, California 92058 Email: jinl22@sbcglobal.net
Asbestos Samples Testing Positive for:
1099 Buena Vista Way
Carlsbad, California 92008
Floor plan is not so scale
June 5, 2009
AV.
A
* 4)
n
Asbestos Samples Testing Negative for:
1099 Buena Vista Way
Carlsbad, California 92008
Floor plan is not so scale
June 5, 2009
LA Testing
159 Pasadena Avenue, South Pasadena, CA 91030
Phone: (323)254-9960 Fax: (323)264-9982 Email: p8s«d«osltbffilitMtlna.con
A«n johnNlebuhr
Health & Safety Services, Inc.
3784 Mission Avenue, Suite 148
PMB 609
Oceanslde, CA 92058
Fax (760)433-9396 Phone: (760)433-9394
Project: SDA 911125-2 / Mr. Smerud • 1099
Customer ID: 32HEAL52
Customer PO:
Received: 05/29/09 9:00 AM
LA Testing Order: 320905393
LA Testing Proj:
Analysis Date:6/3/2009
Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Sample Oe*criptlon Appearance
Non-Aabortoe
% Fibrous % Non-Fibrous
Aaboetos
%Type
1099-f-Finish Coat Drywall with mudd Green
noaos3iioooi Non-Fibrous
Homogeneous
100% Non-fibrous (other)
No drywall ft. JC present
None Detected
1099-1 -Base Coat
320SOS3S3-0001A
Drywall with mudd White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
1099-2-FinishCoat Drywall with mudd White
32osos3W«wz Non-Fibrous
Homogeneous
100% Non-fibrous (other)
No drywai & JC present
1099-3-Flnlsh Coat Drywall with mudd White
52090539^0003 NOO-FibrOUS
Homogeneous
100% Non-fibrous (other)
No drywall & JC present
None Detected
1099-2-BaseCoat
320SOS3934002A
Drywall with mudd White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
None Detected
1099-3-BaseCoat
320906393-0003A
Drywall with mudd White
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
Analyses)
Wendy Liu (41)Derrick Tanner, Laboratory Manager
or otfier approved signatory
Due to magrffleatlon limitations Inherent m PLM, asbestos flbenj In dimensions below the resolution capability of PLM may not b« detected. Samples reported as <1% or none detected
may require addlUonal testing by TEM to conflim asbestos quandtes. Tna abova test report palates only to the Items tested and may not be reproduced in any torn without the wpress
written approval of LA Telling. LA TeiUng'i liability. Is limited to Vie coil of analysis LA Testtngbears no responsibility for umple collection actvdisa or analytical method limitations
IntaipnMon and u*e of test resuHt are the responsibility of the client. The teal mutts contained within this report meet the requirements of NELAC unlwi atrwrwite noted. Samplei
racolMd In good condition urttss otherwise noted. Samples received In good condition unless omeiwlee noted.
NVLAP Lab Code 2002324. AIHA ULAP 102ei^. CA ELAP2283
Test Report PLM-7.12.0 Printed: 6AV200911:14:35 AM
LA Testing
159 Pasadena Avenue, South Pasadena, CA 91030
Phone: (323) 254-99CO Fax: (323) 254-9982 Email: oa8ad«nalabClateatinn.eom
Attn: JohnNiebuhr
Health & Safety Services, Inc.
3784 Mission Avenue, Suite 148
PMB 609
Oceanslde, CA 92058
Fax: (760)433-9396 Phone: (760)433-9394
Project: SDA 911126-2 / Mr. Smenid -1099
Customer ID: 32HEAL52
Customer PO:
Received: 05/29/09 9:00 AM
LA Testing Order: 320905393
LA Testing Proj:
Analysis Date:6/3/2009
Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Sample
1099-4
3208053934004
1099-5-Orywall
3208053934005
1099-5-Plaster
3209053*3-00054
1099-6
3209053934009
1099-7
3209053934007'
1099-8-FloorTile1
32090533&006*
1099-8-Mastic 1
370995393400M
Description
Wall paper with
glue
Drywall
Drywall
Insulation - brown
Wallpaper with glue
Various layers of
floor coverings
Various layers of
floor coverings
Non-Aabeatoa
Appearance % Fibrous % Non-Flbrou»
Tan/While 50% Cellulose 50% Non-fibrous (other)
Fibrous
Heterogeneous
Brown/White 10% Cellulose 90% Non-fibrous (other)
Fibrous
Heterogeneous
White 100% Non-fibrous (other)
Non-Fibrous
Homogeneous
Brown/Black 90% Cellulose 1 0% Non-fibrous (other)
Fibrous
Heterogeneous
Brown/White 90% Cellulose 10% Non-fibrous (other)
Fibrous
Heterogeneous
Red 98% Non-fibrous (other)
Non-Fibrous
Homogeneous
Clear 100% Non-fibrous (other)
Fibrous
Homogeneous
Asbaatot
%Type
None Detected
None Detected
None Detected
None Detected
None Detected
2% Chrysotlle
None Detected
Anaiyst(s)
Wendy Liu (41)Derrick Tanner, Laboratory Manager
or other approved signatory
Ouelo magnfficatlon limitations inherent in PLM. atbeetoa fibers In dimensions below the resolution capability of PLM may not be detected. Samplet reported s» <1% or none detected
may require additional tasting by TEM to confirm asbestos quantities. The abova test report relates only to the Itami lestad and may not be reproduced In any form without the raprws
written approval of LA Tatting. LA Tailing's liability IB limiied to the cost of analysis. LA TesiingDeerj no respomiDiiily for sample collection aclMties or analytical metro) limitations.
Intaiprttaton and use of tot result* are the responsibility of the client. The tect results contained within this report meet the requirement* of NELAC unless otherwise noted. Samples
received In good condition unless otherwise noted. Samples received In good conation unless otherwise noted.
NVLAP Ub Code 200232-0, AIHAIHLAP102814, CA ELAP 2283
Test Report PLM-7.12.0 Printed: 6/3/2009 11:14:36 AM
LA Testing
159 Pasadena Avenue, South Pasadena, CA 91030
Phone: (323) 254-9960 Fax: (323)264-9982 Email: pasadenalabflHatMtlnQ.com
Attn: johnNiebuhr
Health & Safety Services, Inc.
3784 Mission Avenue, Suite 148
PMB 609
Oceanside, CA 92058
Fax (760)433-9396 Phone: (760)433-9394
Project: SDA 911126-2 / Mr. Smertid -1099
Customer ID: 32HEAL52
Customer PO:
Received: 05/29/09 9:00 AM
LA Testing Order: 320905393
LA Testing Proj:
Analysis Date:6/3/2009
Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Sample
1099-8-FloorTile2
32090S3S>3-OOOeB
1099-fl-Mastic 2
32000S393-0009C
1099-8-Linoleum
32090S3W-CW9D
1099-8-FloorTlle1
3209653X3-0003
1099-9-Mastte 1
32090S3H3JXXXA
1099-9-FloorTHe2
32000S393400iB
1099-9-Mastic2
320S0539M009C
Description
Various layers of
floor coverings
Various layers of
floor coverings
Various layers of
floor coverings
Various layers of
floor coverings
Various layers of
floor coverings
Various layers of
floor coverings
Various layers of
floor coverings
Appearance
Beige
Non-Fibrous
Homogeneous
Beige
Non-Fibrous
Homogeneous
Tan/Green
Fibrous
Heterogeneous
Beige
Non-Fibrous
Homogeneous
Yellow
Non-Fibrous
Homogeneous
Tan
Non-Fibrous
Homogeneous
Clear
Non-Fibrous
Homogeneous
Non-Asbestos
% Fibrous % Non-Fibrous
100% Non-fibrous (other)
100% Non-fibrous (other)
40% Cellulose 60% Non-fibrous (other)
98% Non-fibrous (other)
100% Non-fibrous (other)
1 00% Non-fibrous (other)
100% Non-fibrous (other)
Asbestos
%Type
None Detected
None Detected
None Detected
2% Chrycotlle
Nona Detected
None Detected
None Detected
Analyses)
Wendy LJu (41)Derrick Tanner, Laboratory Manager
or other approved signatory
Due lo magnification Imitations inherent m PLM, ubestoe flben In dlmeralont below the nuolutlon capability of PLM may not be detected Samples reported « <1H or none detected
may raqUm sdetttonal (axing by TEM to confirm atbestos quantities. The above tell report relitx only to In* itamt lasted and may not b« reproduced In any forni without the cpnu
wriHen approval of LA Tetllrg. LA TMting'i liability la limited to the eoit of anely«». LA To.tingbear. no reeporwibllily for Mmple collection adivitl*. or analytical method limitation*.
Inlarpratafon and uu of tott multi an tne nuponslbillly of ha diem. The test resJts contained within this report meet the requirements of NELAC unless otherwise noted. Samplesreceived In good condition unl«i otherwise noted, grnnplo* received in good condition unle>» otheiwla* noted.
NVLAP Lab Code 200232-0, AIHA HLAP 102614, CA ELAP 2263 •
Test Report PLM-7.12.0 Printed: 6/3/2009 11:14:36 AM
T A / T T A f
LA Testing
159 Pasadena Avenue, South Pasadena, CA 91030
Phone: (323)254-9960 Fax: (323)264-9982 Email: DasadenalabiSlatB8tlnQ.com
A«n JohnNiebuhr
Health & Safety Services, Inc.
37^4 Mission Avenue, Suite 148
PMB 609
Oceanside, CA 92058
Fax: (760)433-9396 Phone: (760)433-9394
Project: SOA 911126-2 / Mr. Smerud -1099
Customer ID: 32HEALS2
Customer PO:
Received: 05/29/08 9:00 AM
LA Testing Order: 320905393
LA Testing Proj:
Analysis Date: 6/3/2009
Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Sample Description Appearance
Non-Asbestos
% Fibrous % Non-Fibrous %Typt>
1099-9-Llnoleum3
320905393-0009O
1099-9-Mastte3
320S05393-0009E
1099-10
31C90S3S3-O010
1099-11 -Floor Tile
320 905393-00* (
1 099-1 1-Mastlc
J20«05393-00(M
1 099-1 2-Drywall
320905393-0012
1 099-1 2-Jolnt
Compound
320KS3S3JX12A
Various layers of
floor coverings
Various layers of
floor coverings
Ceiling spray
12X12 floor tile
w/blk mastic
12x1 2 floor tHe
w/blk mastic
Drywall wtth mudd
Drywall wtth mudd
Tan 40% Cellulose 60% Non-fibrous (other) Nona D»tecte<l
Fibrous
Heterogeneous
Brown 100% Non-fibrous (other) Nons- Dstectsd
Non-Fibrous
Homogeneous
White 100% Non-fibrous (other) "°nB D«toctod
Non-Fibrous
Homogeneous
Gray 100% Non-fibrous (other) None Detected
Non-Fibrous
Homogeneous
Black 100% Non-fibrous (other) Mono Detected
Non-Fibrous
Homogeneous
White 100% Non-fibrous (other) None Detected
Non-Fibrous
Homogeneous
White 100% Non-fibrous (other) None Detected
Non-Fibrous
Homogeneous
Analyses)
Wendy Liu (41)Derrick Tanner, Laboratory Manager
or other approved signatory
Ou« to magnHlealion limitations Inherenl In PLM. asbestos fibers In dimensions below the resolution capability of PLM may not ba datactad. Sample* reported as <1% or nona detected
may mquln additional tailing by TEM to confirm esbestos quanlito. TTw ataova loit report ra/«tw only to the ltom« tested md miy not oe mproducad In any forni without tha ejpntt
wrlttan approval of LA TatUng. LA Tatting's liability ia limited to the cost of analysis. LA Teslingbsan no responsibility for sample collection adMtfae or analytical method limitation.
bitarprataf on and use of last rasuNs an the responslblltty of the client. The test results contained within this report meal the requlremtnts of NELAC unless otherwise noted. Simples
received In good oondUon unless omerwlse not«l Samples mcoivefl in gooa condition unless otheiwlso noted.
NVXAP L«b Code 200232-0, AIHAIHLAP102814. CA ELAP 2263
Test Report PLM-7.12.0 PrintsxJ: 6/3/2009 11:14:37 AM
LA Testing
159 Pasadena Avenue, South Pasadena, CA 91030
Phone; (323)254-9360 Fax:(323)264-9982 Email: patBdenalabfllatertinQ.com
Att" John Niebuhr
Health & Safety Services, Inc.
3784 Mission Avenue, Suite 148
PMB 609
Oceanslde, CA 92058
Fax: (760)433-9396 Phone: (760)433-9394
Project: SDA 911125-2 / Mr. Smerud-1099
Customer ID: 32HEAL52
Customer PO:
Received: 05/29/09 9:00 AM
LA Testing Order 320905393'
LA Testing Proj:
Analysis Date:6/3/2009
Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Non-A«b«sto8 Aabtstos
S»mplo Description Appearance % Fibrous % Non-Fibrous % Typs
1099-13-Sklm Coat Stucco siding
320905393-0013
White
Non-Fibrous
Homogeneous
100% Non-flbrous (other)Nona Detected
1099-13-Finish Coat Stucco siding
32030S3934013A
Tan
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
1099-13-Base Coat Stucco siding
320POS3B3-OOWB
Gray
Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
1099-14-Skim Coat Stucco wall material White
320S0539J-00M Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
1099-14-FinishCoat Stucco wall material Tan
320sossa3-cai4A Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
109(M4-Base Coat Stucco wall material Gray
320305393401*8 Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
1099-15-Drywall Drywall with mudd Brown/White
32090S3i±001S NOD-FibrOUS
Heterogeneous
10% Cellulose 90% Non-flbrous (other)None Detected
Analyst(s)
Wendy Liu (41)Derrick Tanner, Laboratory Manager
or other approved signatory
Du< to magnification limitation Inherent In PLM, asbestos fibers in dimensions below DM resolution capability of PLM may not bt delected. Samples reported » < 1 % or none detected
may nqUit tddHlonil taring by TEM to conflrm asbestos quantities. The above test report relates only to the Items tested and may not be reproduced In any form without the eipnui
written approval of LA Testing,. LA Testing'! liability i< limited to the cost of analyst*. LA Te*tinjbeen> no responsibility for temple collection activities or analyticol method limitation*.
• Interaretaliofl and use of test raiulti are the reaponBlblltty of the client The lest results contained within this report meet the requirements of NELAC unless otherwise noted. Samplei
received in good condition unless otherwise noted. Sample* received in good condition urdeH otherwise noted.
NVLAPLab.Code200232-O.AIHAIHLAP1028M,CAELAP2283
Test Report PLM-7.12.0 Printed: 6/3/2009 11:14:37 AM
LA Testing
159 Pasadena Avenue, South Pasadena, CA 91030
Phone: (323)264-9960 Fax: (323)264-9982 Email: Da»ad»nalabd8late«tlno.com
Attn: johnNiebuhr
Health & Safety Services, Inc.
3784 Mission Avenue, Suite 148
PMB609
Oceanside, CA 92058
Fax: (760)433-9396 Phone: (760)433-9394
Project: SDA 911129-2 / Mr. Smerud -1099
Customer ID: 32HEAL52
Customer PO:
Received: 05/29/09 9:00 AM
LA Testing Order: 320905393
LA Testing Proj:
Analysis Date:6/3/2009
Asbestos Analysis of Bulk Materials via EPA 600/R-93/116 Method using Polarized
Light Microscopy
Non-Aaboatoi. Asbestos
Sample Description Appearance % Fibrous % Non-Fibrous % Type
1 099-1 5-Joint
Compound
320aOS3»34013A
1099-16
320XIS393-OOie
1099-17
320X53934017
1099-18
32090539*00)8
1099-19
32090S393-OOU
Drywall with muctd White
Non-Fibrous
Homogeneous
Window putty White
Non-Fibrous
Homogeneous
Roofing material Black 20% Cellulose
Fibrous
Homogeneous
Roofing material Black 50% Cellulose
Fibrous
Homogeneous
Window putty Brown
Non-Fibrous
Homogeneous
100% Non-fibrous (other) None Ducted
1 00% Non-fibrous (other) None 0«t»ctod
80% Non-fibrous (other) Nono Dieted
50% Non-fibrous (other) Non» Dieted
97% Non-fibrous (other) 3% Chrysolite
1099-20-Flnlsh Coat Stucco wall material Tan
32090*3*3-0020 Non-Fibrous
Homogeneous
100% Non-fibrous (other)None Detected
1099-20-Base Coat Stucco wall material Gray
J20905393-0020A NOO-FlbrOUS
Homogeneous
100% Non-fibrous (other)None Detected
Analyses)
Wendy Uu (41)Derrtck Tanner, Laboratory Manager
or other approved signatory
Due lo nwpMceUon limitations inherent In PLM. esbastoa fibers In d^enslons.bolow ttw resolution capability of PLM may not be det*ct*d. Samples reported a» <1 % or none Detected
may reqUra additional (ailing by TEM to confirm asbestos quantilias. Tha above lest report relate* only (o lha Hams lettad end may not be reproduced in any form without the express
written approval of LA Testing. LA Testing'! liability li limited lo the cent of analysis. LA Testlngbaan no responsibility for sample collection actlvlgea or analytical method llmltatloni.
IntuprstaSon and ua* of t»it mulli ant the responsibility of the dlenl Thi tut rttultt contained within this report meet the raqulrementt of NEL^C unleaa otheiwlie noted. Samples
recelvad in good condition unless otherwise noted. Samples received in good condition unless othenvlse noted.
NVLAP lab code 200232-0. AIHA IHLAP 102814. CA ELAP 2283 ;
Test Report PLM-7.12.0 Printed: 6/3/2009 11:14:38 AM
SWMS3B3 320905393
Mission Avenue, PMB 609, Suite 148, Oeean^de,
Phtne:
vte.
TECHNIOAN/CONfTACT PERSON:
CHAIN. QF.CUSJ&DY
Received by:
Number of Samples:
Sample ID NumtDers; From
Turnaround Time:
TO
CHAIN QFCUSTDDY
Date:
Sample ID Numbers: From
Tuflftarpund Time: ..
TO
Please place results on the Web
• V DOCtf 2009-0219995
RECORDING REQUESTED BY:
Advantage Tille
AND WHEN RECORDED MAIL TO:
AND MAIL TAX STATEMENT TO:
Richard and Cynthia Smerud
3667 Camino Marglesa
Escondidp, CA 92025
Order No. 1065293-40
Escrow No. 104-10024-SC
Parcel No. 155-251-02-00
8501
ZP
WP
UF
APR 28, 2009 2:45 PM
OFFICIAL RECORDS
SAN DIEGO COUNTY RECORDER'S OFFICE
DAVID L BUTLER. COUNTY RECORDER
FEES: 22.00
OC: OC TAX: N.D.
PAGES:
SPACE ABOVE THIS LINE FOR RECORDER'S USE
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S) THAT DOCUMENTARY TRANSFER TAX IS $non disclosure
X computed on full value of property conveyed, or
_ computed on full value less liens or encumbrances remaining at the time of sale.
_ unincorporated area: X City of Carlsbad
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Frankle R. Jones, Successor Trustee of the Survivor's Trust under the Barker Family Trust
hereby GRANTS to Richard J. "Smerud and Cynthia G. Smerud, Trustees of The
Smerud Family Trust dated March 27, 1997
the following described real property in the County of San Diego. State of California:
The Easterly Half of Lots 10, 11, and 12 in Block B in the Resubdivision of a portion of Sunny
Slope Tract of Carlsbad, in the County of San Diego, State of California, according to Map No. 995,
filed In the County Recorders Office of San Diego County, June 6, 1906. Together with all of Tuttle
Avenue, vacated, adjoining said property on the East. Excepting therefrom the Westerly 100 feet
of the Easterly half of said Lots 10, 11, and 12.
Date April 8. 2009
The Survivors Trust under the Barker Family Trust, pA«a> FeBRV*>«"|f
Successor Trusteey
STATE OF CALIFORNIA
COUNTY OF
On ftfiRlL 2) . 1 OOt , before me,
, Notary Public, personally appeared,
who
proved to me on the basis of satisfactory evidence to be the person(X) whose
to the within instrument and acknowledged to me thatOj^sheAhey executed the same irfl5e>hor/lheir-
authorized capacity(les7, and that by(E5frhct/>hofr signature^ on the instrument the personfcr, or the
entity upon behalf of which the person(afacted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
y hand and offiqtel seal.
r\ T? 1
/ L OIA^LU_ A\-i_»v^//* JXL
WITNESS my Ijend and offlqhjl seal
Signature (Seal)OFFICIAL SEAL
KAREN ROCHAMBEAU
COMM. NO. 1668397 -
SAN DIEGO COUNTY IMY COMM. EXPTMJG. 18. 2D10J
, » ' Order No. 500-1085293-40
Exhibit "A"
The Easterly half of Lots 10, 11 and 12 in Block B in the Re-subdivision of a portion of Sunny Slope Tract of Carlsbad, in the County
of San Diego, State of California, according to Map thereof No. 995, Hied in the Office of the County Recorder of San Diego County,
June 6, 1906. Together with all of Tuttle Avenue, vacated adjoining said property on the East Excepting therefrom ihe Westerly
100.00 feet of Ihe Easterly Half of Lots 10, 11 and 12.
Pager
Please print or type. (Form designed for use on elite (12-pitch) typewriter.)Form jOMBNo.205(M)Q39
UNIFORM HAZARDOUS
WASTE MANIFEST
1. Generator ID Number
C A D 9 8 1 4 0051
2. Page 1 of
1
3. Emergency Response Phone
800 451-SM6
4. Manifest Tracking Number
004273237 JJK
and Mailing Address Generator's Site Address (if different than mailing address)
2&3§ Progress Rae*
EflooncKdo CA 92028
Generator's Phone: ? 6 0
Carlsbad CA 92QQS '? *i i
6. Transporter 1J&nu*U.S. EPA ID Numberi C A L 0 0 0 1 9 0 7 5'
7. Transporter 2 Company Name
EC T.I
U.S. EPA ID Number
[ C A R 0 0 Q Q 4900 4
and Site Address
iw/«a,Mil*p0«#l28
Parker- A2 8S344
Facility's Phone:
U.S. EPA ID Number
A'Z C 9 S 0 8 3 1 t T
9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number,
and Packing Group (if any))
10. Containers
No.Type
11. Total
Quantity
12. Unit
Wl/VW.13. Waste Codes
V
ERG#i? i Avoid contact, -*s w'^?r PPE ***n h^vllinu rnaterrals. F or
oh*fifteal ermrgertfv: Spi, leaJ-., fire eeposufo o« ac«<tenf, cat! s^uQi 451-8349 If i,it'id*iw»rj3fcte. return to
g*ni»rator SCAQMO. 21865 E Copt*';,- Of. Dsao-wnd Bar, CA Q-f?56
15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged,
marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment and I am the Primary
Exporter, I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent.
I certify that the waste minimization statement identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true.
Generator's/Offerer's Printed/Typed Name £ (}{{ {/-
Q *:>£••
"\ __Signature f-V{. Gf1-,r-AC'i::.*W;;'tI ' t2£~-^~
Month Day Year
16.lntemationa,Shipmen.s Qmpofttou.s.
Transporter signature (for exports only):
CD Export from U.S. \ Pott of entry/exit: _
'TJate leaving U.S.:
17. Transporter Acknowledgment of Receipt of Materials
TransporteUsPrinted/Typed Name Signature ,-•</Month Day Year
Transporter 2 Typed Name Signature Month Day Year
I I I
18. Discrepancy
18a. Discrepancy Indication Space Quantity Jlype O Residue
Manifest Reference Number:
nFull Rejection
18b. Alternate Facility (or Generator)
Facility's Phone:
U.S. EPA ID Number
18c. Signature of Alternate Facility (or Generator)Month Day Year
19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems)
1.2.3.
20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a
Printednyped Name Signature Month Day Year
EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete.GENERATOR'S INITIAL COPY
11:10:12 08-27-2009 2/24386280 sempra
SDGj
A j/j Seinpra Energy utility'
Notice of Service Discontinuance
PERMIT DEPARTMENT, CITY OR COUNTY OF: Carlsbad
SERVICE WILL BE DISCONTINUED TO:
ADDRESS: 1099 Buena Vista Way
BY: (Date) August 27th, 2009
268657
IEl ELECTRIC METER NO.
86109
GAS METER NO.
ALL SERVICE LINES WILL BE REMOVED. THIS BUILDING CAN BE MOVED OR
RAZED AFTER THE ABOVE DATE.
SAN DIEGO GAS & ELECTRIC
BY:
Anessa R Rohde
PHONE: 760-476-5619
DATE: August 27, 2009
PM Forms: NoticeofServiceDiscontinuance.doc Revised: 6/20/06
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