B24-0158 - 27493 PASEO FIESTA09/13/24
LIMITED ASBESTOS
SURVEY REPORT
FOR
27493 Paseo Fiesta
San Juan Capistrano, CA
Prepared for
Steve Waldon
DATE
3/26/2024
Report # 2403-262-1023508
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 Steve Waldon to conduct a LIMITED Asbestos
survey for the property located at, 27493 Paseo Fiesta, San Juan Capistrano, on March
15th, 2024. The purpose of this survey was to identify Asbestos Containing Material
(ACBM) in all areas of the building. Work consisted of collecting bulk sam ples 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 Steve Waldon to conduct a LIMITED Asbestos
Survey for the property located at 27493 Paseo Fiesta, San Juan Capistrano, CAThe
sampling was conducted by Michael Jackson an Osha certified asbestos consultant # 04-
3635.
FACILITY DESCRIPTION
The subject property is a single family, two 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 renovation.
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 bore r,
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, conditio n,
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. Jackson
Environmental 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 # 2403-262-102508
PLM Asbestos Identification
Certificate of Analysis
Jackson Environmental
120 Tustin Ave C-1121
Newport Beach, CA 92663
Date Received:3/15/2024
Number of Samples:6
Material DescriptionLab/Client ID/Layer Location Color Composition (%)
Report Number:1023508
Project Name:27493 Paseo Fiesta
Date Reported:3/20/2024
Claim Number:
Project Number:
Project Location:27493 Paseo Fiesta
San Juan Capistrano, CA
Date Analyzed:3/20/2024 PO Number:
Date Collected: Collected By:
1023508-001 Dining Room
1
100% Non-
Fibrous Material
WhiteTape and Mud JC
None DetectedTotal Asbestos
1023508-002 Kitchen
2
100% Non-
Fibrous Material
WhiteTape and Mud JC
None DetectedTotal Asbestos
1023508-003 M Bedroom
3
100% Non-
Fibrous Material
WhiteTape and Mud JC
None DetectedTotal Asbestos
1023508-004 Dining Room
4
85% Non-
Fibrous Material
15% Cellulose
WhiteDrywall
None DetectedTotal Asbestos
1023508-005 Kitchen
5
85% Non-
Fibrous Material
15% Cellulose
WhiteDrywall
None DetectedTotal Asbestos
1023508-006 M Bedroom
6
85% Non-
Fibrous Material
15% Cellulose
WhiteDrywall
None DetectedTotal Asbestos
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PLM Asbestos Identification
Certificate of Analysis
Jackson Environmental
120 Tustin Ave C-1121
Newport Beach, CA 92663
Date Received:3/15/2024
Number of Samples:6
Material DescriptionLab/Client ID/Layer Location Color Composition (%)
Report Number:1023508
Project Name:27493 Paseo Fiesta
Date Reported:3/20/2024
Claim Number:
Project Number:
Project Location:27493 Paseo Fiesta
San Juan Capistrano, CA
Date Analyzed:3/20/2024 PO Number:
Date Collected: Collected By:
Kwin Sheena Legaspi - Lab Manager - Approved ByJorge Castillo - Analyst
Bulk sample(s) submitted was (were) analyzed in accordance with the procedure outlined in the US Federal Register 40 CFR Appendix E to Subpart E of
Part 763; 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_8.23
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