B22-1385 - 31401 VIA LAS PALMASFINAL
05/10/24
CHANGE OF BUILDING PERMIT RECORD
Complete the appropriate section below when there is a change of
record AFTER issuance of a Building Permit.
1.Type of Request (Select all that apply):
Change of Owner (complete sections 2 and 3)
Change of Contractor (complete sections 2, 4, 6, and 8)
Change of Permit Holder (complete sections 2 and 7)
Change to Owner-Builder (complete sections 2, 8, and 9)
Change of Licensed Design Professional (complete sections 2, 4, and 5)
2.Existing Project
Address (including building or Suite No.):3HUPLW:
Phone:Email Address:
3.New Property Owner
Name:
Address:City:State:Zip Code:
Declaration: By submitting this change of record I certify that I have a legal or equitable interest in the property where the construction project is
proposed. I assume full responsibility for satisfactory completion of all work authorized under the permit, including work performed prior to assuming
ownership, and agree to assume full responsibility for payment of any monies owed or due to the City of San Juan Capistrano for this project.
Date:Signature:
4.Change of Contractor/Licensed Design Professional
Property Owner Authorized Agent of Property Owner Permit HolderMust be completed by (check one):
Effective date: , the Design Professional (listed in item 5) and/or Contractor (listed in item 6) shall be the new
Signature:
contractor and/or Licensed Design Professional.
Name:
5. Design Professional (if required, check one):Architect Engineer
Name:Phone:
Address:City:State:Zip Code:
Declaration: I assume all of the responsibilities and obligations related to that portion of the documents the original architect or engineer of
record prepared and will submit alternate plans/reports for any revisions to documents prepared by the previous architect or engineer of record
subsequent to the date of hire. in addition, I will perform structural observations as defined in Chapter 17 of the California Building Code if
specified in the plans.” This modification pertains solely to architectural plans. Structural plans remain unchanged
Date: Print Name:
Signature:
6.New Contractor Information
Licensed Contractor’s Declaration: I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
Print Name:Date:
Contractor Signature or Authorized Agent:
Name:Phone:
License Class:
Address:City:State:Zip Code:
CSLB License No.:
Email Address:
City o of San Juan Capistrano
Development Services Departmentrt
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
building@sanjuancapistrano.org
www.sanjuancapistrano.org/building
CA License No.:
Email Address:
Contractor
LL 05/24/23
Cole Bergquist, AS OWNER/BUILDER
7.New Permit Holder: This is the property owner, person, or entity that is granted authority by the property owner to be responsible for
scheduling inspections, receiving notices of failed inspections, permit expirations or revocation hearings, and who has the right to cancel the
approval (in addition to the property owner).
Name:Phone:Email Address:
Address:City:State: Zip Code:
8.Workers’ Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
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.
A.I have and will maintain a certificate of consent to self-insure for workers’ compensation, issued by the Director of Industrial Relations as
provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
B.I have and will maintain workers’ compensation insurance, 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 Carrier:Policy No.:Expiration Date:
Name of Agent:Phone:
C.I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be-
come subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers’ compensation
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions
A separate Owner-Builder Verification form must also be signed by the owner.
9. Change to Owner-Builder: Effective Date:
Owner-Builder Declaration: I hereby affirm under penalty of perjury that I am exempt from the Contractors’ State License Law for the reason(s)
indicated below by the checkmark(s) I have placed next to the applicable item(s). (Section 7031.5, Business and Professions Code: Any city or
county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor’s State License Law (Chapter 9
commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five
hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do all of or portions of the work, and the
structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors’ State License Law does
not apply to an owner of property who, through employees’ or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the
Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale). I, as owner of the property, am
exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor’s
License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s)
licensed pursuant to the Contractor’s License Law).
I am exempt from licensure under the Contractors’ State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to
completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been
constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions
Code, is available upon request when this application is submitted or at the following web site: www.leginfo.legislature.ca.gov/
Print Name:Date:
Owner Signature or Authorized Agent:
LL 05/24/23
NVLAP Lab Code: 200548-0
Inspection Date: Report Date:
Limited Asbestos Survey
Customer:True Home Builders Job Location:31401 Via Las Palmas
14 Hughes Suite B204 San Juan Capistrano, CA 92675
Irvine, CA 92618
1.0 Introduction/ Laboratory Summary:
Please read entire report prior to initiating any action.
•None
Positive Results:
#Notes Friable Condition Sq. Ft.*
No asbestos detected in the samples tested
Negative Results:
#Notes
1 N/A
1.1 N/A
2 N/A
3.1 N/A
3.2 N/A
4.1 N/A
4.2 N/A
5.1 N/A
5.2 N/A
6 N/A
The sampled materials that exceeded the EPA definition of Asbestos Containing Material (ACM) of >1% and/or the Cal-OSHA definition of Asbestos
Containing Construction Material (ACCM) of >0.1% and/or found as Trace for asbestos content were:
3/20/20233/15/2023
Types of Asbestos
Present
Total % Asbestos
Location
Family Room (1st Floor)Drywall Mud
Material
MaterialLocation
2211 West Orangewood Avenue
Orange, CA 92868
Tel: (714) 937-0750
Fax: (714) 937-0755
www.envirocheck.com
(800) 665-7586
Dining Room (1st Floor)Drywall
Exterior Stucco
Drywall Mud
Family Room (1st Floor)Drywall Mud
Garage (1st Floor)Drywall Mud
Office Room (1st Floor)Drywall Mud
Office Room (1st Floor)Drywall
Master Bathroom (1st
Floor)Drywall
Master Bathroom (1st
Floor)Drywall Mud
Dining Room (1st Floor)
This report presents the analytical results of the Limited Asbestos Survey of specified materials and locations as requested and directed by the client that was
performed at the subject property listed above by Envirocheck, Inc. If suspect asbestos materials are uncovered and/or discovered during the renovation and/or
repair activities, suspend all activities, secure, stabilize the area until the newly discovered suspect materials are tested. Unless noted, this survey excludes
sampling of the concrete slab/foundation, ceramic tile systems and masonry products.
6.1 N/A
7 N/A
7.1 N/A
8 N/A
8.1 N/A
9 N/A
9.1 N/A
10 N/A
10.1 N/AExteriorStucco
Exterior Stucco
Exterior Stucco
Exterior Stucco
Exterior Stucco
Exterior Stucco
Exterior Stucco
Exterior Stucco
Exterior Stucco
2.0 Background, Sampling Protocol, and Test Methods
Testing by: Engaged by Representative:
Survey by:
Purpose of inspection:
Structure:
Exterior: Roof: Occupied?:No
Roof Condition: Year Built:1991
Exterior Debris Pile(s): No. of Stories:2
Debris Pile Location(s): Approx. SQ FT:3,962
Debris Pile Size: Foundation:
Debris Pile Contents: Air Handling:
●
●
●
●
●
●
●
●
●
Slab
Asbestos testing and inspection was performed by Brian W. Fullaway, CSST# 19-6578, of Envirocheck, on 3/15/2023, under the direction of Vinh Q.
Pham, CAC# 03-3356.
HVAC
Envirocheck personnel identified all accessible and recognizable types of suspect ACM and PACM that were anticipated to be impacted by the
renovation and/or repair. Suspect materials which were not anticipated to be impacted were not sampled.
The inspector performed an inspection for suspect asbestos containing materials listed above following the provisions of 40 CFR Part 763.86.
True Home BuildersBrian W. Fullaway, CSST# 19-6578
Envirocheck, Inc. NVLAP Lab Code: 200548-0.
Stucco
N/A
The samples were submitted to Envirocheck's in-house laboratory, located at 2211 W. Orangewood Avenue, Orange, CA 92868, (800) 665-7586.
Modified AHERA (Asbestos Hazard Emergency Response Act) sampling methods and protocols were used.
The inspector is Cal/OSHA certified and conformed to procedures outlined in the EPA Building Inspector Course.
N/A
Vinh Q. Pham, CAC# 03-3356
No
DamagedDamaged
N/A
Exterior Condition:
When Non-Friable Asbestos Containing Material (ACM) has suffered Damage and/or Disturbance, the Debris that is the result of the damage and/or
disturbed ACM will be considered to be Friable ACM and shall be disposed of as Asbestos Containing Waste Material (ACWM).
Each asbestos sample collected was analyzed utilizing the methods specified in EPA – Appendix E to Subpart E of 40 CFR Part 763: "Interim Method
of the Determination of Asbestos in Bulk Insulation Samples" and EPA/600/R-93/116: "Method for the Determination of Asbestos in Bulk Building
Materials", by a NVLAP-accredited laboratory.
Single Family
Purpose of inspection was to test certain building materials that will be impacted due to planned renovation.
Tile
3.0 Applicable Actions:
●
●
●
●
●
●
Notice 3: Asbestos NESHAP Requirement to Perform Point Counting (May 8, 1991) – This applies to all regulated asbestos containing materials (RACM) as
defined in 40 CFR Section 61.141.
• “First, a sample in which no asbestos is detected by polarized light microscopy (PLM) does not have to be pointed counted. However, a minimum of three slide
mounts should be prepared and examined in their entirety by PLM to determine if asbestos is present. This process should be carefully documented by the
laboratory.”
• “Second, if the analyst detects asbestos in the sample and estimates the amount by visual estimation to be less than 10%, the owner or operator of the building
may (1) elect to assume the amount be greater than 1% and treat the material as asbestos-containing material or (2) require verification of the amount by point
counting.” If no election is made, then the materials shall be presumed to be ACM.
• “Third, if a result obtained by point count is different from a result obtained by visual estimation, the point count result will be used.”
• It is the responsibility of the building owner, operator, and/or owner representative to determine the desired course of action and communicate the information
to the relevant parties and request the laboratory to perform additional point count analysis as applicable. Point count laboratory analysis is not part of the
standard procedure of PLM analysis and is considered an additional service.
Notice 1: According to AHERA, 40 CFR, 763.87 (c)(1),(2) - (1) A homogeneous area is considered not to be Asbestos Containing Material (ACM) only when
all required samples collected from a homogeneous area indicate levels below regulated limits and (2) a homogeneous area is considered ACM when at least one
of the required samples collected indicates levels above regulated limits. According to AHERA, 40 CFR , 763.83 - A homogeneous area means an area of
surfacing material, thermal system insulation material, or miscellaneous material that is uniform in color and texture.
Notice 2: Cal-OSHA (DOSH) defines asbestos containing construction materials (ACCM) as manufactured materials containing asbestos in amounts greater than
0.1% by weight. Cal-OSHA requires that contractors be registered with DOSH when disturbing ACCM. Note that if "any level" of asbestos is detected, Cal-
OSHA still requires applicable worker protections, training, communication, notification and engineering controls in accordance with CCR Title 8 Section 1529,
even if it is determined to be less than or equal to 0.1% asbestos by weight, however the contractor would not be required to be "registered" with DOSH if the
level is at or below 0.1% asbestos by weight. The EPA defines asbestos containing materials (ACM) as materials containing asbestos in amounts greater than 1%.
Polarized Light Microscopy (PLM) analysis has a limit of quantification of <1%. PLM samples determined to contain levels of less than or equal to 1% can be
presumed to contain levels greater than 1% or can be submitted for 400 point count for a more accurate result (Limited to a qualified <1%). In order to determine
if materials are less than or equal to 0.1%, the 1000 point count method and/or Transmission Electron Microscopy (TEM) method will be needed to determine
levels with quantification limits of a minimum of 0.1% in accordance with EPA/600/R-93/116. The 400 point counting method assists in determining proper
waste handling and appropriate jurisdiction of regulatory agencies (such as: EPA, NESHAP, APCD, AQMD) and cannot be used to determine DOSH registration
requirements (where a combination of 1000 point counting and/or TEM analysis will be required as per EPA 600/93-R/116 Method). Request for additional
types of analysis must be made by the client and additional analytical costs will apply.
Repair or removal for materials found in Damaged Condition
Periodic surveillance for materials found in Good Condition
As applicable, materials found to be in Good Condition can be left and managed in place under a proper Operations and Maintenance (O & M) Plan
Removal for materials found in Significant Damage
Removal prior to renovation activities that may cause disturbance
Prior to any renovation or planned disturbance of any ACM, the contractor should be furnished with a copy of this survey report
Note: Interpretations of the regulatory language regarding wall system (i.e., drywall, gypsum board, wallboard, plaster and stucco) multi-layer
composite sampling vary; therefore, it is important to be familiar with the local NESHAP (South Coast AQMD) enforcement and local OSHA
enforcement agencies' individual interpretations of the standards to avoid citation and fines.
4.0 Asbestos-Related Terms
4.1 Laboratory Report Terms
4.2 Laboratory Accreditation
NIST/NVLAP
National Institute of Standards and Technology
National Voluntary Laboratory Accreditation Program
NVLAP Lab Code: 200548-0 NVLAP Lab Code: 200548-0
For a detailed explanation of our accreditations and quality assurance program, contact Envirocheck.
ND – None Detected
TEM – Transmission Electron Microscopy
BK – Blank (Used for quality assurance)
APCD – Air Pollution Control District (Local division of NESHAP)
CFR – Code of Federal Regulations
PLM – Polarized Light Microscopy (also known as “Bulk” sample)
CCR –California Code of Regulations
OSHA – Occupational Health and Safety Administration
NIOSH – National Institute of Occupational Safety and Health
DOT – Department of Transportation
EPA – Environmental Protection Agency (Regulates environment and waste stream)
NESHAP – National Emissions Standards for Hazardous Air Pollutants
P – Personal Sample (Employee monitoring type sample)
AA – Area After (Clearance type sample)
EX – Excursion (Employee monitoring type of sample during peak activities)
A – Area Sample (Air monitoring)
AIHA – American Industrial Hygiene Association
PCM – Phase Contrast Microscopy
NVLAP – National Voluntary Laboratory Accreditation Program
AQMD – Air Quality Management District (Local division of NESHAP)
Trace – Asbestos was detected in the PLM analysis, but not in the point count.
CAL-OSHA a.k.a. (DOSH) Division of Occupational Safety and Health (California governing body regulating worker protection)
PACM – Presumed Asbestos Containing Materials (Materials considered asbestos containing without laboratory analysis)
AHERA – Asbestos Hazard Emergency Response Act (Regulates school facilities)
ASHARA – Asbestos School Hazard Reauthorization Act (Includes public and commercial buildings under AHERA regulation)
ACCM – Asbestos Containing Construction Materials (CAL-OSHA’s term for materials containing greater than one tenth of one (0.1) percent by weight)
ACM – Asbestos Containing Materials (Materials containing greater than one (1) percent by weight)
CSST – Certified Site Surveillance Technician (Allowed to perform all aspects of asbestos related inspection, management, and work under the direction of a
CAC)
CAC – Certified Asbestos Consultant (State of California certified individual allowed to perform all aspects of asbestos related inspection, management,
planning, and design work and to direct CSST(s) and review and execute asbestos reports under state law)
Negative – No asbestos detected, however it doesn't mean that there isn't any asbestos.
California Water Boards ELAP
Certificate 2723
5.0 Limitations
6.0 Certified Asbestos Consultant Signature
Any individual performing services as an asbestos consultant or site surveillance technician as referenced and defined in section 1529(b) of Title 8 of the
California Code of Regulations must be certified by the State of California, Division of Occupational Safety and Health (DOSH). Asbestos consultant shall
maintain copies of AHERA training certificates for management planner, abatement project designer, abatement contractor and supervisor, and all subsequent
annual refresher courses. The complete abatement project designer course certificate is only required for certifications provided after July 1, 1994. Site
surveillance technician applicants shall maintain copies of AHERA training completion certificates for inspector, and abatement contractor and supervisor, and
all subsequent annual refresher courses. Certificates for abatement worker and abatement project designer may be utilized in lieu of the abatement contractor
and supervisor certificate. Specific qualifications are required pursuant to section 1529(o) of Title 8 of the California Code of Regulations for certification.
The educational qualifications, (diploma, official transcript, or other proof), and qualifying work experience as specified in Business and Professions Code
sections 7184 and 7185 have been met by the individual(s) performing asbestos related consulting activities or activities. Qualifying work experience includes
technical work associated with asbestos consulting activities. Written site surveillance technician references attesting to the applicant's qualifying work
experience which are certified under the penalty of perjury as required.
vinh@envirocheck.com
The findings set forth in this report are strictly limited to the time, date and scope of the investigation. The results presented in this report are based on the
analytical testing performed by the certified laboratory. The results from the sampled locations are representative of the entire homogeneous material/areas and
not just the locations sampled. According to AHERA, 40 CFR, 763.87 (c)(1),(2) - A homogeneous area is considered not to be Asbestos Containing Material
(ACM) only when all required samples collected from a homogeneous area indicate levels below regulated limits and a homogeneous area is considered ACM
when at least one of the required samples collected indicates levels above regulated limits. This report does not guarantee that all inaccessible, hidden, or
indistinguishable materials will be identified or sampled. Samples were limited to the materials and locations listed on the chain of custody. Materials/areas that
were not sampled shall be presumed to be asbestos containing until proven otherwise by appropriate sampling procedures. Square footages are estimates only and
should not be used for bidding purposes.
______________________________
Vinh Q. Pham, CAC# 03-3356
NVLAP Lab Code: 200548-0
Customer:True Home Builders Job Location:31401 Via Las Palmas
14 Hughes Suite B204 San Juan Capistrano, CA 92675
Irvine, CA 92618
1123032049 1123032049
Sub-sample 1123032050 1123032051 1123032051
Sub-sample
1123032051
Sub-sample 1123032052 1123032052
Sub-sample
1123032052
Sub-sample 1123032053
Sample #1 1.1 2 3 3.1 3.2 4 4.1 4.2 5Point Asbestos No No No No No No No No No No
Total N.D.N.D.N.D.N.D.N.D.N.D.N.D.N.D.N.D.N.D.
1o Type
2o Type
3o Type
Location Family Room
(1st Floor)
Family Room
(1st Floor)
Garage (1st
Floor)
Office Room
(1st Floor)
Office Room
(1st Floor)
Office Room
(1st Floor)
Master
Bathroom (1st
Floor)
Master
Bathroom (1st
Floor)
Master
Bathroom (1st
Floor)
Dining Room
(1st Floor)
Material Drywall Mud Drywall Mud Drywall Mud Drywall & Mud
Composition
Drywall Mud Drywall Drywall & Mud
Composition
Drywall Mud Drywall Drywall & Mud
Composition
Notes
Color Off-White White Off-White Off-White,
White Off-White White Off-White,
White Off-White White Off-White,
White
Homogeneous Yes Yes Yes No Yes Yes No Yes Yes No
Components:
Non-fibrous
Material x x x x x x x x x x
Paint x
Tar
Cellulose 2%2%2%3%2%4%4%2%5%3%
Fiberglass
Synthetic
Fibers <1%<1%
Other 1
Other 2
Comments/
Method
Departures
None None None None None None None None None None
Received:3/16/2023 Analyzed:3/16/2023
Analyst:Admin QC:VG
Hunter Ittes Lab QC:EE
2211 West Orangewood Avenue
Orange, CA 92868
Tel: (714) 937-0750
Fax: (714) 937-0755
www.envirocheck.com
(800) 665-7586Asbestos Laboratory Report, Page 1 of 3
**Various sample locations combined for composite purposes. ***Not covered by NVLAP accreditation. Standard Deviation is ± 45.5% of asbestos concentration (1 Standard
Deviation).
Report Date: 03/16/2023
California Water Boards ELAP Certificate 2723
Samples were analyzed in accordance with EPA - Appendix E to Subpart E of 40 CFR Part 763: "Interim Method of the Determination of Asbestos in Bulk Insulation Samples" and
EPA/600/R-93/116: "Test Method for the Determination of Asbestos in Bulk Building Materials". The limit of detection for asbestos is <1%, and the limit of quantification is 1.0% or
greater. The State of California defines an asbestos-containing construction material as having more than 0.1% asbestos. All samples are disposed of after 30 days unless the
customer requests otherwise. This report shall not be reproduced except in full, without the written approval of the laboratory. This report must not be used by the client to claim
product certification, approval, or endorsement by NVLAP, NIST, or any agency of the U.S. Government. Test results apply to the sample as received. Asbestos percentage
obtained through calibrated visual estimate. Components of inhomogeneous samples not analyzed separately unless listed as a sub-sample.
PLM Report GDrive ver 2.3, RAM 3/12/2023
NVLAP Lab Code: 200548-0
Customer:True Home Builders Job Location:31401 Via Las Palmas
14 Hughes Suite B204 San Juan Capistrano, CA 92675
Irvine, CA 92618
1123032053
Sub-sample
1123032053
Sub-sample 1123032054 1123032054
Sub-sample 1123032055 1123032055
Sub-sample 1123032056 1123032056
Sub-sample 1123032057 1123032057
Sub-sample
Sample #5.1 5.2 6 6.1 7 7.1 8 8.1 9 9.1Point Asbestos No No No No No No No No No No
Total N.D.N.D.N.D.N.D.N.D.N.D.N.D.N.D.N.D.N.D.
1o Type
2o Type
3o Type
Location Dining Room
(1st Floor)
Dining Room
(1st Floor)
Exterior Exterior Exterior Exterior Exterior Exterior Exterior Exterior
Material Drywall Mud Drywall Stucco Stucco Stucco Stucco Stucco Stucco Stucco Stucco
Notes
Color Off-White White Gray Red Gray Red Gray Red Gray Red
Homogeneous Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Components:
Non-fibrous
Material x x x x x x x x x x
Paint
Tar
Cellulose 2%3%2%2%2%2%2%2%2%2%
Fiberglass
Synthetic
Fibers
Other 1
Other 2
Comments/
Method
Departures
None None None None None None None None None None
Asbestos Laboratory Report, Page 2 of 3
**Various sample locations combined for composite purposes. ***Not covered by NVLAP accreditation. Standard Deviation is ± 45.5% of asbestos concentration (1 Standard
Deviation).
California Water Boards ELAP Certificate 2723
2211 West Orangewood Avenue
Orange, CA 92868
Tel: (714) 937-0750
Fax: (714) 937-0755
www.envirocheck.com
(800) 665-7586
Samples were analyzed in accordance with EPA - Appendix E to Subpart E of 40 CFR Part 763: "Interim Method of the Determination of Asbestos in Bulk Insulation Samples" and
EPA/600/R-93/116: "Test Method for the Determination of Asbestos in Bulk Building Materials". The limit of detection for asbestos is <1%, and the limit of quantification is 1.0% or
greater. The State of California defines an asbestos-containing construction material as having more than 0.1% asbestos. All samples are disposed of after 30 days unless the
customer requests otherwise. This report shall not be reproduced except in full, without the written approval of the laboratory. This report must not be used by the client to claim
product certification, approval, or endorsement by NVLAP, NIST, or any agency of the U.S. Government. Test results apply to the sample as received. Asbestos percentage
obtained through calibrated visual estimate. Components of inhomogeneous samples not analyzed separately unless listed as a sub-sample.
PLM Report GDrive ver 2.3, RAM 3/12/2023
NVLAP Lab Code: 200548-0
Customer:True Home Builders Job Location:31401 Via Las Palmas
14 Hughes Suite B204 San Juan Capistrano, CA 92675
Irvine, CA 92618
1123032058 1123032058
Sub-sample
Sample #10 10.1Point Asbestos No No
Total N.D.N.D.
1o Type
2o Type
3o Type
Location Exterior Exterior
Material Stucco Stucco
Notes
Color Gray Red
Homogeneous Yes Yes
Components:
Non-fibrous
Material x x
Paint
Tar
Cellulose 2%2%
Fiberglass
Synthetic
Fibers
Other 1
Other 2
Comments/
Method
Departures
None None
2211 West Orangewood Avenue
Orange, CA 92868
Tel: (714) 937-0750
Fax: (714) 937-0755
www.envirocheck.com
(800) 665-7586 California Water Boards ELAP Certificate 2723
**Various sample locations combined for composite purposes. ***Not covered by NVLAP accreditation. Standard Deviation is ± 45.5% of asbestos concentration (1 Standard
Deviation).
Asbestos Laboratory Report, Page 3 of 3
Samples were analyzed in accordance with EPA - Appendix E to Subpart E of 40 CFR Part 763: "Interim Method of the Determination of Asbestos in Bulk Insulation Samples" and
EPA/600/R-93/116: "Test Method for the Determination of Asbestos in Bulk Building Materials". The limit of detection for asbestos is <1%, and the limit of quantification is 1.0% or
greater. The State of California defines an asbestos-containing construction material as having more than 0.1% asbestos. All samples are disposed of after 30 days unless the
customer requests otherwise. This report shall not be reproduced except in full, without the written approval of the laboratory. This report must not be used by the client to claim
product certification, approval, or endorsement by NVLAP, NIST, or any agency of the U.S. Government. Test results apply to the sample as received. Asbestos percentage
obtained through calibrated visual estimate. Components of inhomogeneous samples not analyzed separately unless listed as a sub-sample.
PLM Report GDrive ver 2.3, RAM 3/12/2023
1
Building Department
From:engcounter <engcounter@smwd.com>
Sent:Monday, March 6, 2023 10:32 AM
To:Michelle Yahav; Building Department
Cc:Webster, Tanner; engcounter
Subject:RE: Sanitization Clearance for B22-1385 31401 Via Las Palmas SJC
[The e-mail below is from an external source. Please do not open attachments or click links from an unknown or
suspicious origin.]
Good morning,
This address has been cleared by SMWD. No impacts to Public Water and Sewer.
Thanks
Catherine Aamodt
Administrative Assistant
O: 949-459-6505
M: 949-540-5342
smwd.com
From: Michelle Yahav <michelle@truehomebuildersca.com>
Sent: Friday, March 3, 2023 3:47 PM
To: engcounter <engcounter@smwd.com>
Subject: Re: Sanitization Clearance for B22-1385
yes
Michelle Yahav
CO-Founder and CMO - True Home Builders Inc.
949.241.1577
On Fri, Mar 3, 2023 at 3:44 PM engcounter <engcounter@smwd.com> wrote:
Hi Michelle,
Is this address in San Juan Capistrano?
You don't often get email from michelle@truehomebuildersca.com. Learn why this is important
2
Thanks1
Betsy Parkinson
Administrative Assistant
O: 949-459-6612
M: 949-433-6933
smwd.com
From: Michelle Yahav <michelle@truehomebuildersca.com>
Sent: Friday, March 3, 2023 2:22 PM
To: engcounter <engcounter@smwd.com>
Subject: Sanitization Clearance for B22-1385
1. B22-1385
2. 31401 Via Las Palmas
3. 13025
4. 104 SF addition, 2,000 SF interior remodel with kitchen and bathroom remodel.
5. Yes, plumbing changes involve remodeling the kitchen and 2 bathrooms.
6. The plumbing changes will be remodeling the kitchen complete and 2 bathrooms.
7. There will be no additional connections to the existing public sewer or water mainlines in the street.
8. Michelle Yahav 949-241-1577
Michelle Yahav
CO-Founder and CMO - True Home Builders Inc.
949.241.1577
You don't often get email from michelle@truehomebuildersca.com. Learn why this is important
3
***** Please note that email correspondence with the City of San Juan Capistrano, along with attachments, may be
subject to the California Public Records Act, and therefore may be subject to disclosure unless otherwise exempt.
3.5
CSG 09/08/23
SEE ATTACHED NARRATIVE LETTER