B22-1655 - 27553 VIA FORTUNA 19FINAL
01/11/2024
Letter of Transmittal
3707 W Garden Grove Blvd. Suite 100, Orange, CA 92868
phone 714.568.1010 fax 714.568.1028 www.csgengr.com ORA – BPR - 160801
To: City of San Juan Capistrano Date: 3/6/2023
32400 Paseo Adelanto CSG #: 431550
San Juan Capistrano, CA 92675 Agency Plan Check #: B22-1655
Attn: Building Department Job Address: 27553 Via Fortuna
Status: Hours:
X Plan is approved. 1st plan check
Plan is approved with conditions. See remarks. 2nd plan check
Plan is approved with redlines. See remarks. 3rd plan check
Plan is approved with redlines and conditions. See remarks. 4th plan check
Plan requires corrections. See attached list. Total:
Other:
We have reviewed the following documents ( Digital review only):
X Plans Energy Calculations
Structural Calculations Specifications
Soil Report Special Inspection Form(s)
Geotechnical Letter
Truss Calculations
Special items to note:
X Plan has been stamped and signed by CSG
Environmental Health Services approval required
Special inspection required for
Hardship Form included
Remarks:
Recommend for approval
From: Jensen Ku S.E.
CSG Consultants
1
Building Department
From:Parkinson, Elizabeth <betsyp@smwd.com>
Sent:Thursday, March 23, 2023 11:01 AM
To:andrew@walgrovellc.com; Building Department
Cc:engcounter; Webster, Tanner
Subject:RE: 27553 Via Fortuna -Sanitation Clearance
[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. There are no impacts to public water and sewer.
Thank you,
Betsy Parkinson
Administrative Assistant
O: 949-459-6612
M: 949-433-6933
smwd.com
From: andrew@walgrovellc.com <andrew@walgrovellc.com>
Sent: Wednesday, March 22, 2023 11:51 AM
To: engcounter <engcounter@smwd.com>
Subject: 27553 Via Fortuna -Sanitation Clearance
Hello,
I am requesƟng a sanitaƟon clearance for our project at 27553 Via Fortuna in San Juan Capistrano, below is the answers
to the quesƟons for this request.
1. City of San Juan Capistrano plan check number B22-1566
2. 27553 Via Fortuna San Juan Capistrano, CA 92675
3. APN: 931-540-36
4. Interior remodel
5. No changes to plumbing/sewer
6. No changes to exisƟng public connecƟons
7. Contact: Andrew Wernicke (360) 536-7611
Thank you,
You don't often get email from andrew@walgrovellc.com. Learn why this is important
2
Andrew Wernicke
Executive Assistant
PO Box 693
Dana Point 92629 CA
Office: 949-201-1299
Cell: 360-536-7611
***** 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.
Loma Vista Owners Association
Managed by Optimum Professional Property Management, Inc.
230 Commerce, Suite 250, Irvine, CA 92602
Office (714) 508-9070 / Fax (714) 665-3000
www.optimumpm.com
January 18, 2023
842
Anthony & Lori Marie Garisto
2859 E Arabian Dr
Gilbert, AZ 85296
Property:27553 Via Fortuna
Regarding:Architectural Request ~ Multiple Assignments
Dear Homeowner:
The Architectural Review Committee reviewed your architectural application, received in our office for:
Kitchen & Bath remodeling. Removing on wall between kitchen & dining room. Remove rotted facia in
front of house.. Your application has been approved with the following conditions:
All exterior work is approved. Please be advised that the interior work did not require an
architechural application.
This modification must be completed within 365 days ; failure to comply may result in you being required
to resubmit your application. All work and future upkeep is to be done at your expense and shall be
performed at a time and in a manner to minimize interference and inconvenience to other homeowners.
You shall assume all liability and will be responsible for all damage and/or injury that may result from
performance of this work . If applicable, the required architectural deposit will be held pending completion
and a final inspection by the architectural committee to ensure all requirements were met and common
area(s) of the association was not damaged.
When the work is completed , please complete the attached “Notice of Completion” form and return to
Optimum Professional Property Management, Inc. Upon Receipt of the Notice of Completion, the
Architectural Committee will be notified that the above referenced modification has been c ompleted and
is ready for inspection.
Furthermore, you are responsible for complying with all applicable federal, state and local laws, codes
and regulations and requirements in connection with this work, and shall obtain any necessary
governmental permit s and approval for the work. The Board of Directors, its agent and the Committee
have no responsibility with respect to such compliance and the Board of Directors or its designated
Committee's approval of this request shall not be understood as making of a ny representation or warranty
that the plans, specifications or work comply with any law, code, regulation or governmental requirement.
Should you have any questions, please do not hesitate to contact us using your owner portal at
http://portal.optimumpm.com . Click on “My Items” and leave a comment on the ARC. We appreciate the
opportunity to be of assistance and thank you for wo rking with us to ensure your community remains the
best that it can be!
At the Direction of the Board of Directors
Loma Vista Owners Association
Loma Vista Owners Association
NOTICE OF COMPLETION
A rchitectural A pproval for : Multiple Assignments must be completed within 365 days ; failure to comply may
result in losing your refundable deposit (if applicable). All work and future upkeep is to be done at your
expense and shall be performed at a time and in a manner to minimize interference and inconvenience to
other homeowners. You shall assume all liability and will be responsible for all damage and/or injury that
may result from performance of this work.
When the work is completed, please submit this “Notice of Completion” form and return to Optimum
Professional Property Managemen t, Inc. 230 Commerce, Suite 250, Irvine, CA 92602. Upon Receipt of the
Notice of Completion, the Architectural Review Committee will be notified that the above referenced
modification has been completed and is ready for inspection. Please note: failure to return this form may
result in a fine.
Additional Comments: All exterior work is approved. Please be advised that the interior work did not
require an architechural application.
Notice is hereby given that:
The undersigned is the Owner of the property located at:
Street Address
City State Zip
The modification for the above property was COMPLETED on ______ day of __________________,
20____, in accordance with the Architectural Review Committee’s written approval of the above owner’s
Architectural Application and plans.
_________________________________________
NAME OF PROPERTY OWNER
_________________________________________
SIGNATURE OF PROPERTY OWNER:
DATE: ____________________________
DO NOT WRITE BELOW THIS LINE
Architectural Review Committee Approval
Modification Verified and Deposit Released (if Applicable)
Committee Member Date
Committee Member Date
Committee Member Date
LIMITED ASBESTOS
SURVEY REPORT
FOR
27553 Via Fortuna
San Juan Capistrano, CA
Prepared for
Andrew Wernicke
DATE
03/28/2023
Report # 2303-281-962746
CONDUCTED BY
Jackson Environmental
120 Tustin Ave C-1121
Newport Beach, CA 92663
949-230-9779
Mjacksonenvironmental@gmail.com
TABLE OF CONTENTS
INTRODUCTION
SECTION I ASBESTOS SURVEY SUMMARY
Executive Summary
Facility Description
Survey Findings
SECTION II BUILDING INSPECTION FOR ASBESTOS
Bulk Sampling
Bulk Sample Analysis
Quality Assurance
Limitation of Sampling Suspect Asbestos Containing Materials
SECTION III LABORATORY REPORTS
Asbestos Laboratory Reports
INTRODUCTION
Jackson Environmental was retained by Andrew Warnicke to conduct a LIMITED
Asbestos survey for the property located at 27553 Via Fortuna, San Juan Capistrano,
CA, on March 25th, 2023. The purpose of this survey was to identify Asbestos
Containing Material (ACBM) in all areas of the building. Work consisted of collecting
bulk samples of All materials suspect of containing asbestos.
THE REPORT
The survey report is divided into three major sections, which provide identification of all
suspected ACBM.
Section I presents a summary of the Asbestos Survey and a general description of the
area inspected. Survey findings are also provided in this section.
Section II describes the methodology used to perform the survey and includes Jackson
Environmental, and our Analytical quality control procedures.
Section III of this report summarizes the locations and materials which were identified
as containing asbestos. Results of the bulk samples are included in this section.
SECTION I
ASBESTOS SURVEY SUMMARY
EXECUTIVE SUMMARY
Jackson Environmental was retained by Jeff Fay to conduct a LIMITED Asbestos
Survey for the property located at 27553 Via Fortuna, San Juan Capistrano, CA. The
sampling was conducted by Michael Jackson an Osha certified asbestos consultant #
04-3635
FACILITY DESCRIPTION
The subject property is a single family, 1 story, wood frame building set on a foundation.
While on-site the Certified Personnel noted the condition of the materials. This is noted
in the survey findings below. NOTE: Testing Limited to areas slated for demoltion.
SURVEY FINDINGS
The following building materials were identified and or assumed as containing
asbestos:
Building Material Location Friable/Non-
Friable/
Condition SQ’ Approximate
None detected
**Please note square footages are approximate estimates only and should not be used
as a basis for bidding purposes**
RECOMMENDATIONS:
All Significantly Damaged and Damaged areas should be repaired or removed as soon
as possible to avoid any potential hazards that may result from further disturbance of
ACM. SCAQMD's Rule 1403 requires a Procedure 5 Work Plan for any unscheduled
asbestos fiber release episode involving ACM or Class II non-friable ACM.
SECTION II
LIMITED ASBESTOS INSPECTION
BULK SAMPLING
Bulk samples of areas containing suspect ACBM were collected. A homogeneous area
is defined as surfacing material, thermal insulation, or miscellaneous material that is
uniform in color, texture, or date of application.
Samples were collected using wet methods; where they are deemed appropriate, to
minimize fiber release. Prior to sampling, the location is misted with water from a spray
bottle. A sample of the suspect material is then collected using a chisel, core borer,
knife, or other appropriate tool. After the sample was collected, the bulk material was
placed in a sample bag which was sealed to prevent fiber release or contamination by
outside sources. Samples are documented by entering the sample data on a bulk log,
including a description of the material, a unique sample number is assigned to each
sample and the sample bag was labeled with that number. During the survey, the
technician also notes the condition of the material being sampled, its location, condition,
and friability.
Note: The amended National Emission Standard for Hazardous Air Pollutants
(NESHAP), November 20, 1990, included a requirement that when the asbestos content
of a bulk sample material is determined using procedures outlined in the Interim Method
and the asbestos content is estimated to be less than 10% by method other than Point
Counting, the parties legally responsible for a building (owner/operator) may elect to
assume the amount to be greater than 1% and treat the material as a regulated
asbestos containing material. If the owner or operator does not want to assume the
material is asbestos containing, verification of the amount of asbestos by the Point
Counting method may be required. The purpose of this procedure is to minimize false
negative analysis, and false positive. Point Counting was included in NESHAP in
response to an HEPA study that found unacceptable amounts of false positive and false
negative analyses by methods outlined in the Interim Method. Unless otherwise
directed, American Analytical will assume that PLM analysis is acceptable for this
survey.
CLASSIFICATION OF BULK BUILDING MATERIALS
"S” Significantly Damaged Material with one or more of the following characteristics:
The surface is crumbling or blistered over at least one tenth of the surface if the
damage is evenly distributed :( one quarter or more if the damage is localized).
One tenth (one quarter or more, if localized) of material hanging from the surface,
deteriorated, or showing adhesive failure.
Water stains, gouges, or mars over at least one tenth of the surface if the
damaged is evenly distributed (one quarter or more if the damage is localized).
Accumulation of powder, dust, or debris similar in appearance to the suspect
material on surfaces beneath the material can be used as confirmatory
evidence.
We recommend immediate removal of Significantly Damaged material and clean
up of the area by a Licensed Asbestos Abatement Contractor.
"D" Damaged Material with the following characteristics:
The surface is crumbling, blistered, water-stained, gouged, marred or otherwise
abraded over less than one tenth of the surface if the damage is evenly
distributed (less than one quarter if the damage is localized).
Accumulation of powder, dust, or debris similar in appearance to the suspect
material on surfaces beneath the material can be used as confirmatory
evidence.
We recommended removal of damaged material and clean up of the area by a
Licensed Asbestos Abatement Contractor.
"G” GOOD Material with no visible damage or deterioration, or showing only very
damage or deterioration.
We recommended materials identified as in good condition be placed on an
Operations and Maintenance Program (O & M).
BULK SAMPLE ANALYSIS
All bulk samples were analyzed by Patriot Laboratory 1041 S. Placentia Ave, Fullerton,
CA, 92831. Phone # 714-607-5227, an NVLAP accredited laboratory. The laboratory
accreditations are as follows:
NVLAP #200642-0 National Voluntary Laboratory Accreditation Program (Federal)
Approximately 10% of the bulk samples were split for quality control purpose.
All bulk samples were analyzed by Polarized Light Microscopy (PLM) with dispersion
staining in accordance with the EPA Method #600/R-93/116. 40 CFR 783.87. The
reliable limit of detection for PLM is 1.0%. Where "None Detected" or ND appears in the
report, it should be interpreted as meaning that no asbestos was observed in the
sample. Samples containing, "Trace" level of asbestos indicates a possible
contamination and is considered ACBM.
NOTE: If a sample contains greater than 1.0% asbestos, it is a regulated material by
Federal Government Standards. Under the California State Education Code, materials
containing greater than 0.1% in asbestos content are considered regulated.
QUALITY ASSURANCE
Statement of Quality Assurance
At Jackson Environmental Quality Assurance is priceless! Jackson Environmental is
committed to providing analytical services and data to its clients that are of the highest
quality and legally defensible.
Quality Assurance (QA) procedures were employed to ensure reliable results for
analysis of bulk samples as follows:
The laboratory is currently participating in the NVLAP Quality Assurance
Program.
Quality control is processed on at least 10% of all bulk samples on a daily basis.
Laboratory results of samples submitted to the laboratory were within 3% of the original
side by side sample.
LIMITATION OF SAMPLING OF SUSPECT ASBESTOS CONTAINING MATERIAL
Reasonable effort is made by Jackson Environmental ‘s staff to locate and sample
suspect materials. However, for any facility the existence of unique or concealed
asbestos containing material and debris is a possibility. In addition, sampling and
laboratory analysis constraints typically hinder the investigation. American Analytical
does not warrant, guarantee, or profess to have the ability to locate or identify all
asbestos containing materials in any given facility. This report is intended to be used in
planning for construction or demolition. This report is not intended to be a construction
document.
Jackson Environmental is not, and has no responsibility as, a generator, operator,
treater, storer, transporter or disposer of hazardous materials or waste found or
identified as a result of Jackson Environmental’s work.
STATE REQUIREMENTS
In accordance with State of California Regulation, all surveys are conducted by
personnel holding a minimum of a Site Surveillance Technician certificate. This
certificate is awarded to individuals who have fulfilled specific educational and
experience requirements, as well as having completed extensive training in asbestos
specific courses. Additionally, the State also mandates these individuals pass a
rigorous examination. This examination is prepared, proctored, and graded by State
officials. The Certified Asbestos Consultant must fulfill all the education and experience
requirements as the Site Surveillance Technician but must have additional and more
extensive asbestos related training. Candidates for Certified Asbestos Consultant must
also pass a more rigorous examination before being approved by the State of California.
In compliance with State of California Requirements surveys and reports prepared by a
Certified Site Surveillance Technician are reviewed, approved, and signed by a Certified
Asbestos Consultant.
Certified Asbestos Consultant
Michael Jackson
Project Manager
CAC # 04-3635
949-230-9779
Report # 2303-281-962746
PLM Asbestos Identification
Certificate of Analysis
Jackson Environmental
120 Tustin Ave C-1121
Newport Beach, CA 92663
Date Received:3/25/2023
Number of Samples:11
Material DescriptionLab/Client ID/Layer Location Color Composition (%)
Report Number:962746
Project Name:27553 Via Fortuna
Date Reported:3/27/2023
Claim Number:
Project Number:
Project Location:27553 Via Fortuna
San Juan Capistrano, CA
Date Analyzed:3/27/2023 PO Number:
Date Collected:Collected By:
962746-001 Living Room
1
100% Non-
Fibrous Material
WhiteTape and Mud JC
None DetectedTotal Asbestos
962746-002 Kitchen
2
100% Non-
Fibrous Material
WhiteTape and Mud JC
None DetectedTotal Asbestos
962746-003 Bathroom
3
100% Non-
Fibrous Material
WhiteTape and Mud JC
None DetectedTotal Asbestos
962746-004 Living Room
4
85% Non-
Fibrous Material
8% Cellulose
7% Glass Fibers
WhiteDrywall
None DetectedTotal Asbestos
962746-005 Kitchen
5
85% Non-
Fibrous Material
8% Cellulose
7% Glass Fibers
WhiteDrywall
None DetectedTotal Asbestos
Page 1 of 3
PLM Asbestos Identification
Certificate of Analysis
Jackson Environmental
120 Tustin Ave C-1121
Newport Beach, CA 92663
Date Received:3/25/2023
Number of Samples:11
Material DescriptionLab/Client ID/Layer Location Color Composition (%)
Report Number:962746
Project Name:27553 Via Fortuna
Date Reported:3/27/2023
Claim Number:
Project Number:
Project Location:27553 Via Fortuna
San Juan Capistrano, CA
Date Analyzed:3/27/2023 PO Number:
Date Collected: Collected By:
962746-006 Bathroom
6
85% Non-
Fibrous Material
8% Cellulose
7% Glass Fibers
WhiteDrywall
None DetectedTotal Asbestos
962746-007 Side
7
85% Cellulose
15% Non-
Fibrous Material
BrownTar Paper
None DetectedTotal Asbestos
962746-008 Side
8
85% Cellulose
15% Non-
Fibrous Material
BrownTar Paper
None DetectedTotal Asbestos
962746-009 Side
9
85% Cellulose
15% Non-
Fibrous Material
BrownTar Paper
None DetectedTotal Asbestos
962746-010 Side
10
100% Non-
Fibrous Material
GreyExt Plaster
None DetectedTotal Asbestos
Page 2 of 3
PLM Asbestos Identification
Certificate of Analysis
Jackson Environmental
120 Tustin Ave C-1121
Newport Beach, CA 92663
Date Received:3/25/2023
Number of Samples:11
Material DescriptionLab/Client ID/Layer Location Color Composition (%)
Report Number:962746
Project Name:27553 Via Fortuna
Date Reported:3/27/2023
Claim Number:
Project Number:
Project Location:27553 Via Fortuna
San Juan Capistrano, CA
Date Analyzed:3/27/2023 PO Number:
Date Collected: Collected By:
962746-011 Side
11
100% Non-
Fibrous Material
GreyExt Plaster
None DetectedTotal Asbestos
Kwin Sheena Legaspi - Lab Manager - Approved ByJose Quinones - Analyst
Bulk sample(s) submitted was (were) analyzed in accordance with the procedure outlined in the US Federal Register 40 CFR 763, Subpart F, Appendix
A; EPA-600/R-93/116 (Method for Determination of Asbestos in Building Materials), and EPA-600/M4-82-020 (US EPA Interim Method for the
Determination of Asbestos in Bulk Insulation Samples). Samples were analyzed using Calibrated Visual Estimations (CVES); therefore, results may not be
reliable for samples of low asbestos concentration levels. Samples of wall systems containing discrete and separable layers are analyzed separately and
reported as composite unless specifically requested by the customer to report analytical results for individual layers. This report applies only to the items
tested. Results are representative of the samples submitted and may not represent the entire material from which the samples were collected. “None
Detected” means that no asbestos was observed in the sample. “<1%” (less than one percent) or Trace means that asbestos was observed in the sample but
the concentration is below the quantifiable level of 1%. This report was issued by a NIST/NVLAP (Lab Code 200358-0) and CA Water Board ELAP
(Cert. No. 2540) accredited laboratory and may not be reproduced, except in full without the expressed written consent of Patriot Environmental
Laboratory Services, Inc. This report may not be used to claim product certification, approval or endorsement by NIST, NVLAP, CA-ELAP or any
government agency.
ASB_Rep_2.23
Page 3 of 3