1 1 o 1, .. !J 1955) 1 ;rtrn~ r .t of Hcusing c:11d Con:; truction, VI C
~; SBESTOS t\CT I Of·-! REPORT · ~> Report No ......... .... ......... c. ·
( 1) St t~t l!:J Code [£]
(Z) r-;~J Product Type ~-
Stel u3 Dnte
Location Extc-rn~l -· E [ZJ lntf.'rnal- I Both ·8
!:l t t Add r e ~ s /1. {f. ?.6~ ....... &..e../?.X .. ... ~.~t?.. .~E .... ~:[/-!..~ ....... ::?.el~/ (:(. q .. .. :?.. ?~ ...... 9...~. e.t;.~:; .... 1. ....... ... .. mp l e, Ho: ..
:mplc [~-1.---F-, r-1_.-,-:- LJ __ [~_J::·=-]/:2.[~] c-1~~--~-~-[-v_j_0LJ~~t?JiiJ.dLlvl &; []
~cse~i~n r-=:.:=r~~ [.t.. ]{::·.I;~<l ~=I£JZ[~_[~.3JZ.Ll.. I 1-r-r=r--1---,cr--J (l~o Asb C! slos based materi a ls detected ••.• ) Inspector s re coc;,.nenda tion .•..•
if1Gi tivr. ( d., m<:~g<>) L.~J Wetcr Dti lntged [~ Expo~ed Surfe.ce Arce He> ne-0, <10%-1, > 10%-4
[JZJ ;; n~-o, 11c.d- 2, Sevrrc--5 tk.nr- 0, 11inw-1, 1'1c·u- 7.
c\ivity/l-i :JVt intf1t [0] 0i~ l/ r , c. \'j~r:t t ion-0 ~ -: · ~9 v it;ralion- 1
. ~"hie;~ vi~ra \ion-4
t>.cce!!~i t. ilit.\l
1\i r Plenum No <. ir pbwm no dirrd air stn2.m-O Air r>l ~n u:-n or din·ct .;,ir slrE>am-1
Semtll f: T'eken 'liN
Exp c ct ~d Life sp an ...•.. y ... ar~
Fri!Jhilitv . CZJ Difficult to dam;}<] <.> by hand-1 E.lsy t" dislodg(.> or crush-2 Fluffy, spon9y, fhk in 9,.3
Surveu Dete 12. I D I I I 0 IJ[] ~;· j
Iuspector( s) • 9. ~ ?-;-. /.. ,;;1. N .. ---~-"· ----- ~----" --···------ ·-··-~· -·~---·· -·- -------------·
Scope (5) [ - - -,
: !; ~ ·t.t c <: o~--,-rT-J--1 Dblt cf E ~ t irr. de 1 1 -rj-r-r~ "' ,':.; ! u: c,f L r. :~t c--, r-r=r=o Detc of le~t \'-,':Jrk I I l I I I _ _] Work Pe rformed s Perf o nned ( \'/ 3 0/-1 )
Vcl:1e 0! Cunwi:.J.ive c-=r L ·I I ·-] Df\1 e of le,:,t I·:J i on LI~ [ _ __)
Wc:k :~ $ -· --~~---·---~ ---------------------------------~-~~
~~'J~&
l n s t <1..~:-::..:= r: ~ rl eo
C • Ci ~ -,..rd {) - De l c t'<!-~1 ;l.cti;:;r, H -HH':h Ri:;k G .. )\ ~!: -:· ~:;rn l·t,t G!'t-..:n R -W :> ;~ ; spcr.c:mtnc~;c1cd
E -[~t::.~r-H: r<:qucSt!:!dliilclud'"d 0 • i'r;,r,r~;.w. ~..:•j ~.'ith R ~ !YI l'r••tl< ; . - \ 1 t1 ..:.·z~·!: ,~ . j:? roY.i! !r.c:kt ~ll!d
h -\',1':li', .': L ·~ ~:--~'f:~"'.! ~:;
L1- ~ /~~r,it r..:. :r~:J !>rJ~; t ~:. ·! :r'i ~ d , ") ' ! .-.~ Jl) ·.L.~ :~!. _]~·:-';!_': s- ~ , .... i. ·~·.:<~ F- lv:,,Li!
l- c~s lPo.b le T- TeX1.ile 1.1- 1 ·tilibo(l..>~ c -).::bc.:::tos c..,rn'!t:t P- Pc!J'.:'Ir:r fl cUilG
R- P.t. lnov~J
E ·· Er,c: .;;;_<:t/. 'iN\ L-S£:rJ:.:.t .l;_..;t I!. - f, t-:-.it-: r
(-1) f!.iori~
1- lrn rndioJ. e: H -Hi;;h II.- t/,; diur:1 L - Low
('\' • } r r·o n -. ~-- -"-'
4 . ~) ·J.!J l"f!q a -r.ec: <) -~,·;-~ .:..rh'o+:;
~lSI ll) i{.\ ~1 :; t<)35) / i SBESTGS ACT I on !~E PORT t)C'~>.r t m~nt o ( Hou5.ing <:n d Const ruc\ic:t, '\'IC
A55tl I D tlur:1ber [2JL 13 I I [:~fl-::jZ J7J DeFt . D o<:'-&.. A .>
•••• • ••••••••• t •••
Sheet ll umber [~]~] of
(1) Statu3 Code CEJ
(2) Product T~~c @l
Re}JOrt No ••••••••••••••••••••••
Location E:.d ernal- E [2J bti:roal- l Both -8
A::~tt /:.J<tre~!) l/{{,~.lf ... ... /l~~~-:~·.r. .... . 0..t:!.!:..t .. .. ~~l/::~§.: .. .... ~~t'.l?:/!Y.(ri. ... ;~ .. r ...... ?!..f.q_c;/~ .. .. t .......... . Saq .. l •~ l~o: •.
Dsc(;~·; ',: ~..-::-. _r-tr-· ~ -,~s- J ... JJ~±~~r~-r Lc.~~tJ.LJ!.: .. Ji-~I_\~j_'-.;1 --J ~I~?_.J_:'~u .,- 11 l~t~(. I_"l L oc·t~ i cr, Eri--·· .~:~-J- ~:;·J .:;.lf:-r - r-7"r'7rKJ'r -I3 TZ:J_D_ -~---,-r-J -r-T-J····-·c- J L!_.L_ - --~· ________ _l_~.JL...~~-- --- --- .--L. . . __ ___j_ - --· --
(No Asb e>s tot> baseJ matc· :.-ials d c> t ~'c t cd •••• ) Inspectors l' CCOt:l.mendati u n .•.••
Condition (rJ;:Jm:.g::) [ . I Wnter Dsrnuqed D Expo:; ed Surf3ce Areu [~J flc il~- 0 J t1 vd -2, s t•Y o.' r€- -5 Nvrw-0 1 r~l!ncr-1 I Mocl-2 N:w.·-0 I ( 1 OS-1, ) I 0$:;-4
Activi\1~/l ' i ·JY t incn t CJ Quid/r. :, vitJ r~tior.-0 H od/r(-9 v ibrati:.;)" l
,/hi<;;h vi~r<~\i e: fl · ·4
J....ccr::. s ::; i bi 1 itu tlot-0, t; ::. t RHC: ih)-i /,cc?:: si~ l c- - ·1
D
1\ir Plenum D ~; o air· ph•nurn t l(• dir~ ct air s\r t-am-0 /.i1· r/1~num or clir ~d air s\rc·am-·1
SerntJ I p, Tut:en '-{ m D Exp ~ cted Life span ...... years
Fri 1:1bilit y [ .J DilficuH to dama tJ~ by hano .. l E:Jsy \ .1 di$lo~<;c or crush-2 FluffiJ 1 !: !· '-'n9l) 1 fld~i;"~~r3
Survt:u Dntc 12 ji!_U Tofk.I~J I , s ' Ct ( ) c.?. z. /. /~-,t I \/ .1 pc or s . . . . • . • . . • . . . : ..
----··-~----· ·-------~-----·---~,.--····--·--------;=:::;:::::::;=:;=::-·---·--~
_A!Jl.L':f.~l;!.. /1:sLe:>\v:; Con tent [=-- ] A~bts lo~ Tl)pe G Anolu~i::~ Dole [DJ 4[{__L!JE]LJ --.. -- .. -- ---- ·-··. ---·- --·~-.---~-----.. -A./+-;fi-- .·--~--0 -~---.. -----
l-1 c:J-. Lll: /J.JTi-1 0~ \!TY n E POr-n
P. ·' ) r •• , I r• r· d., ( 1. C n (J) I..\...., • •II• ; 4 >~ ol r . ·t (4J r--, ll('r. I' L_J
fsti rnu \~ $
Y e I u ~ c· f Los t 'r'fcrl: Ptr fc nned
D~~ !_J_]_]_j
s· O _TI=.--.I_l_ I .J V~ !.Jt c•l Cumul:.Ji•tc Wc:b$
c ~ ( i~t·.r.:.d
D · Dd t.:r.! d },<;tion
G ... ),~~c:"iSt :" :(.~;,t (! \"C:n
R -\'!~V~~ ·.s t'\'?.(.·ornrnr·r,de C: E -t: .::ti:~> .. :.i, rec;u.:::.: .tr- Jiir,clw:kd 0 · ?n~r. ! ~ i:lu ~~~ d \:.' ith i ; :::. t .. ~ \ 1-IC~i~~
A-~;.'~:::~ .. \p;·Ho'. .·1 ir:~. !udc· d 1;.1· '.' :'r,::~ :- ir: rr~ ere· ·. J .1 .. r. ~ ... ~·. ::. ~, i:. ~ !:.,-;.. ~; ... ~·: r \ :ii ;;G
s- sf·'. i:~ J F·L vc::c.l;\1 L> -.; ... ':; l
I. - Cll.slr,f,!t: T- TexJ.:!e 1..1-Milb<J(Id C -J . .::br-::!.0:: Ce1:1<:nt i' - Pc,l~ ·~ ;·,u f.::otmd
E- t: ;,( 1 ... :J:;l!l~ !ir)n
l-Sc:c.J :.:. I.thd
C. - C~\:;,._. f\~\;~·:,
~~~ · ( J ;)~Jr:J l\,' t~;:·y Cor,-.:.c l;u1: 1
Report Dale U
( <1) Pllc·~it·~
l-1£n me: di~Ll e
H -High t .~-l-.1..:dillin
L -Low
1 -Mr. or !nr.:n~rnr.J\C •~
4 ... sub~~ <. -H eq ~~ - t· .. ~.jo r V'l' o! ·:~ .-:-
:iS 1 1 Q i (.\;!G 1 933) .. ~S5E:STOS ACTIOt-1 REPOl~r '<'P ~r~mdot c,( Hous :o 19 <nd Con::truction, VIC
,~:-t:t 10 llumbcr [:Ji·li-LLI~Tl/"[0 D - . {J.::>t'-t:i..A-5 e}) L. ••••••••••• • • • • • • • Owned/Leased
~J:[J of o - J
( 1) Stntu;, Code; ceJ
(2) r~1 Product Type~
Rc }J or t No • • , o •••••••• ~ ••••• , •••
std u:.J Dute Lrl_..I__.]~_~ ___ L=J
Location External- E [!] Internal- I 8oth ·B
t.~ se t .~oJre :~j f/·.1.~.6· ... .. . /.(_(:~~·:..?.: ..... 0..et.?~ .... ~.r.B$.. ...... .:!:.8.?:/«.~'~ .... ~.:r ...... .?;~-~~-~-t;;/::; .... l ... ...... .. SanpJ0 Ho : •.
)esc I .c c. Lli cn
(Ho AsL2sto~ bQ~Pd w~terials detected . •.. ) Inspector s r ec o~T>~n d atic n ..•..
[-0 ~~ \•'c.i.c··l· D~,.,.._ , en~d lo,;;;l ::ondit!o n (d ;,m<:,9(') _ fu Ul! l ') • L:::::-1 Expo:;ed Su rfiJce An:e Lf-l tl ;:lf)i.' -0' f'-1od-2 , s t Yo:' I' I! -5 r·!vn!!-0 I l-1irwr-11 11od-2 floroe-0, <10 %-1, > 1093-4
/\ir Plenum @] Fri~bilitl) W 11d iv:\•J/IIovemci: l [9] Quid/no vibr .ot ion-0 1'-'ld/re:; vibrali ~ J, - 1
1~o air plE num no din·cl air :;trC'am-0 Air plerrurn or dir .:d air stn·.3m-t
Difficult to dam.-,9t- by hand- ! LlSlj b disloc!gC' or crush-2
lh i<J~' \' i!:l n li e ro-t:. Fluffy I Sf'OOI<JY I n aking:-3
[JJ Sem pI r; Te ~en 'Uri CE.l Surv ev Dele ( 2. _l ..:;t [(J c.IT]~~;J
Expected Life span ••.... years In , . t ( ) cJ. 2. / ..c.: /V .sp.~c or s ·······<"'··· ··•···· ·
=-~:-LY-~l~ ·---~- -~~~3 \ .~~( or:.~en~--·~--~-~~~~r r:~---An~lu ~~~te (Q~~~~-~~- T~-~] --· H l:/.L Tl! /-,UH! O i \l T'( r:EPOHT ---- --~----------·- - ··--- ··--··--·---P.<:cc;nrnendetion (3) L_] l) ' '\ (4)0
11 :>r. \y
E ~ti r'i:::tc S
v~~ w: of Lc ~ t ITl-=.l=r I I --1 Ylr.:r l: Pt:rfo rmd ~ -->--'-
\' :.:b~ t•f Cumulr..U · .'~ We-:~:~$
[_LC L __ l · L __ D
Ll'-0{· rod
(1) Si. .-.:i!,_.. Corl 1-
C-C: c: rrd 1.1 -vdtn·~d Acti ::. n II - H~ C.::itf~i5k G -}- ~ :..\.. -: !: r:-1\:r.: ~:v~~ ~ n- \ t1'C· I~~:; I CC4..1fi)! ;~·- i~~t: d
E- Lst! :;·.~o.:C! r>:q cH .. :'t~ r ; /i;·,;:-:,:d-~d
0 • l'r': [n: !i'ltncd ": :::~ n I. f,~ ~' l o1",:
A- \•! :; ; ·~: :.: , l.~:)~o·,-~:1 i."':t:h..!d~d \\l .. l. '/r_, 1 ~:~ i !~ pr:; ,.:;:. :::; L1- i;:·')r.iv r'ng ! =·n.·~Ji' .... (,·;.t-d
s ~ 5 rr·-~·.: d r -lc-:..·-c!i.! [ )- ~ ;L';~
L- Cc!:t r .. "l!<:: T • Te ~1. ile M-lv!i !:J~c.t d c -i. ::tocc:tos c~r.1er.t
P • Poly.;;cr 8ounci
( ~, ' .. ..... J !J.g_c~~~~i?-~-~5.! ?_;·: ..
£:- r:. ;,C i•.p::ul,:.l.i-:-·~
l- SuJ~:. L: L•: I
.. . ;' . ~· · c,)r ':'.'':--~ \'/ "'"c.rit:( t: ~. n
"' ,
Report Dcle D.
Dele cl bl!mrl e CCCl--r=J~~J
Dbte ofle~t Work [ "J=r Per1orrr,ed (W30A)
1 ·o~J
D~le clle.:Jt kticn 0_ ..... 1 _ _._
( '1) PriorilY_
1-lmmt: di~le H -Hi;Jh f yi-~lcdium
I. -Low
[ 5 } Se;o'1c
1 • h~ncrt~~·jnt~n cnc(: ·1· Sub :"":..:G ? - ~~~ q 9 -t>'Hjorh'e>;,:s:
;! 10 ' JI~~:;J ).;r·:rr."' t of Hc- ~s in'] ;;nd Co n:drudion, VIC
ASBESTOS ACT I on REPOf~T )-- .. F\.eport No ... .•. •...• •. •.. •..•• .• ~- v
0\vncd /L e ased
CIIfl of cr --J
( 1) Stotu:J Code IJ2J
(2) Prodl!d Type IS' I
stw u:J Dote! ~.-._··-...._r-_-L..,--_....,.o--....-1. - _ ..... _L--.1
Locetion E~ternal- E [2] Internal - I 8oth -B
,, e t t.adr r:-:; /?\{ -!-:.tt ..... /} C-:~.t ..... ~s.·:e.f<.t .... ~~?.~/>~(f. ....... .?..!.~f//Y01. .... ~ . .r: .. .... .?:/.t~~.:?.(;/-:: .... !. ........... . ~; ''f' le t_,o : • • . / Ji pi[; ;jC I .crJivn
(N o Asbestos b ~~Pd mat eri als detected .•.. )
• f ; ~ititJft (u,:,rn.:\9<') I 0 I Water Dem eq ed [ o] :·:,;:-0
1 t"'\o d-2, Sevl're-5 Non<·-0 1 11inor - 1
1 Mr.-d-2
: tivi tv / t·l v'h mt nt Ji e\ /r,o vit.n ti ~ n-0 o-: /r-- 9 yitJra ti or.-1 _J :9h vl~:--a tl ~ n-4
·.C res :, it,; 1 i 'l\1 oi-0 , :(c. t 1:\: ~d il~ -1
timol :! $
J~J!: Of (~U i'!)U!c!i\'C !o.,.,..::J S
Air rlt:: 11um No Qir pl ;:m;;-n no direct ai, · !:tream-0 Air· pl~num or din•ct ;,i r f;',re-1 rn-1
Sam pie Tcken 'Uti l1:J Expected Life sp an ...... years
nr--] Scor:c ., L_
o_--=co=c-[J [_T]_~ I L=r==:J
_.___.l=J=-0
Inspectors
Expo:ed :3urfcce Mea Non~-o, <! G:t.:: -1 .. > I 0%-4
. Friability . [Z] Difficult to damage> by h~nd-1 E.lsy tJ di ~ l v d<]Q or crush-2 Fluffy 1 spon9y, tlakin9-3
Survey Dute (j._l.s LLJ or&~ I ~J c.; -.. /./' " Inspectod s ) .. . ~1--:-• •• • .ft.('! ..
----- ·- ---n·• .. Anal u~i~ Date (Q_[ 4-l-t r (___lxJil
·-----~-----~-----
~-----·~· ···-~~-.~~·~-· .. --~--------------·~-----·---~---~-~-~
- l.l~f r~d - (Jd trn:d ,l,cticll
-J\ ~5c~:;iri ~ t·lt ~:-.t.:n
.\ ~\· ~~r~~ :; ) ~<. ::.tttL,C i lC~Cd
... E s th·H·~· ,:_ ; ,:: {jd (; 5te dtir1.:lvd~ d · • ?rc)t.Jfl.:h;(,:.._ d , .. :~. h R f.. ll· ~ \':'·· ~~ ~
· \;\'')·~ ~ ),_;.· ;.l ;"~'.-r· ! !;;c)·>dt;d .~ .. i, :' 'J t~:-- i:'; i·~ !·;: (.·:: _.;
i · ! .'u~. i\( ' !;r.;: :Jr~r; r;";.1:1 ;no.;J ., . J l:.. . ~ :.; . i __ I·:l,-..~-~.
' . -~ ..... .; .
) -l.N~l
L -Cnstr-.ble T- Te11.ilc 1.1 - ) .. ;:l ~oa.t J C · / . .sl: ::.:to :; Cci11er.t r - p o! ~I: :"'IH Bo\lli~
t.:- Er ~c,:;J:;u} .;liN;
L -S ""-' ;;·, Lo;b,:i L~-}.~)l'::,cr
c. . <>)'-~ !,c r;.?,;,'.'i ;:,_,·' r ," ?·.,;''·-' .. ,it y Co:-. l! (; l~or.
(4) ~ority
1-lmmediGJ(: H -Hioh /li- ~/.: diL!!I1
L -Low
(~}Se er~~ 1 .. Mnor!nr.intenaJ\CC 4-Su~r ·' 'l ~ -R~~q 9- t-/T<jC( r\'d-;_::
/
t·,\ S I I 0 I(..',~/~ t 9 :!5 ) t-\SfJESTOS ACT f Ofi ~(E PORT Dl·~~rtrY . .:-1•\ u{ Hvl!5in') ~nd Cc•n:;t;uclion 1 VIC r\,eport l~o ... ................ . .. .
A'J~tt ID t l:~rnu e r [~§-p--·~5--/-[~:r.;~ 1-r1 stutu3 Cod~(lJ [_P_] -- _____ l._j _____ , _________ _j
• {;! ~.? ~ (.~ /~f _,;-D~rt ••.•.. • ••••••••••.
r·:;-·?1 L2..L .... of l.ocnlion External- E r;:-1 Internal-! ~
(2) -Product Typt: [~J
Both -8
A!~et /1ddn~' /-'l¢f./!-:.f/ ... ... . //.~!.?.~.T.. ..... ~'!~.<-':?.f(..?:. .... ~.'t(~~?i. ...... ~f.J!?:/.:'Y.§ .... ~.:r.. ..... Ift~--~.c;;-~~ .... 1 .......... .. Sample No: ••
(S) I:Je• ~-i:l/e L~ !/:;· [~~L}].j"]{[_j lU_ - r.::;I~]]J.:~~ l! I tV J£lj __ ]_c G~l_~,ili~_L(jil:;~.c=:J l. o cJ~i Grl BE u=r~:~J.~~-:JZJ--·=r.~J.?J~L~J 3_J£f=rJ ___ I ~-J=r-l--1 IJ~--~J
(llo l.sbes to s h."lsecl mate:-ia ls dete c: te:d •••• ) Inspectors r.ecoJT:.'"ct: ndat ion ... , .
ConG ition (d.:;r,1:.gt·) [Q] Woter [ J!l fl~ f: J t: d ~ Expc~ed Surl:~ce ~. rea [~- ~ r: :~ rw-0 I t·1< J-2, St>Y<·re-5 N c n~·- {j I t·lino r-11 Mod<~ Non c--O
1 <\ 0%-1
1 > 1 0';)~ 4
Air Plenum rri~bility I rJ Ac\i vity/t·io'leintfit c~J o~id/no vi :.ratic:,-0 t'i .:>d/reg vibr;,~i::,n-1
No ;;ir · pl ,_•nurn no clired .:ir ~dr.-am-0 l>ir pl ~num or direct .lir sl.rec,m-1
Difficu.H to damaJe- by hand- I E.:Jsy t.J dislodge or crush-2
/h i9!1 v i~nl icn-4 Fluffy 1 spon9y 1 fla 1<in :r-3
/;.,ccr:. ~ ~i bi I i tu [7] Semple Teker1 'fm W 5urve1J Dele [2. I ~) I i fSJ [ &l L'2J /"' 7' / /
'n' p<>ctor·(··) (.,.,1, --- ./ ,Ll /\ - ~ - u ••••••• ., ••• ::-t •.... Expected Life span ...... y=a~·~
- ---- · - ----· · -. ~ .. ~--~--.. --· - -~ - .... ---• .,-......... -~ . . ~-- ,._-~_.,... .. , ... :a.. ........ . . ..-. --_ ........ _.,. __ " __ .. _..._. __ -----------..-... .. -~- --
CJ Report Dale IT~_l_l --[_=]
~~~;~~,t:tho:il}' [_ r -_j_-. ___ -__ 1_1 _[_ l r----r~l l_ _L - --'------LI_:L_LJ_L_..!_ . j_ L I I . I lll-=.l
~ . .. __ ..._. _ ,.._...._ , , ___ .~---·-~----"'-------··--------~- .... . ......... ________ ... _ _ O!J _ .. ___ ___ ... - - ... _ _. .., .. . - ... . .......:
CT T _ _l ,- ]_~IJ~l--:ll_LL_r=LJ TJ:=I_--I.~J Rcf~re nee:~ Fi1'· Uo . . f ,,1i :- . D ,.., c; t-1 o s ( ~- i ; c- r· c:. 11 \ .1 c t s ( \c:
--··---·" · ---~- · --··-···-----·· · -·~ ·----~~--~-----.. -·-------·----·-·----.---------------·--"' .. ... .. ..
Fsti mete ~;
V1;, u~ of Le3 t Yforl: rtrfvr riiCd $
V::Jut of Curnul:.live Wc;b$
C_O_l _"""l ___ Ll_] [~~r- I I J~] I J cc--=r=c-[-J-~~
Du.te ct E~t !rnd e n~·~LLJ
Dete of l!i~t Wor k ~.-I ---~-' _.1..1-..l.l CL] Per1ol1T1ed (V/301\)
Dd e or le_jt .Action CI~ 1.=r-=c=:1 ·---· ~----~~--...-. -... -... -..... ....-.-..-..~ .. ~----···-----.. -·-·-· ----- ·---~----~--' - -·-
!:.£.lj r.- n d
( l) SL!i: ·-~~ f':>~ 0 C~<.:lc?.rd
[) -(>r;lttr -d i .c lion
G -J.. ~ s t: S:...:~··.C i l ~ s:v\:n f"i -\·r cr'> S !'?·~C:ifil (!l lded F: -Esti::~ t~£.: r.·c;l.f(: 5 t t d!i J a ::!~d(: d 0 .. Proc:l;\Jnii :t:: (: ~ ... ~~ t J ~. H r~ Li V;·'-:.:-'t< )... - ¥? ~·, r :~,." ;1
:: ,Jf v ' r~~ ~ ~ j; I C h~d '-. .:1
\ '•' -\'J' r;(', ;~ \!: ;...: :- ~ !'"( ~::;
1,1- t.';··r.i:..J ;; ~ 0 !J :· .. ~~; · ~·:i'~lll':d
S - Sl ·i· ··J·' d f - l.v, ; C,!: l !J- Jd:.\
L- Cns lf;!J!r; l- To1.i!e }-.1 .• ;,;/:boud c -/.s bt: ~t o s c( rnr:n t P- Pol; '::'ler Oo:.ntc:
R - Hnn (l v ~ J
S - S t.! t-J E ~ Er-,~ '"{' ·:'.ii·JI ir.·n l - .S u.J & I. r.i, ::!
(4) P.-iorh_y
1- !lnrne:diu.te~
H-High M-lY.t: ~ium
l-Low
·~- Su~ rcq
2 - n~q 9 - hJr• jiJt l\1o;-(s
is1 1, _.t.;: ,Jt93S) ~~.SBESTOS ACT 101'-1 REPORT ~ .. ~;, r l r n .?rt t o( HoJ5ir, g ;: r; d Cons~ruc:t kn , VIC P~epor· t No ••••••••••••••••••••••
. . [)O~ G.A5 De pt .•...... . •....•. . •
Shr·ct H~mb:: r [3 . 1~] (2)
Product Ty pe ~ Location E.xtrrnal- E lntr rr, :Jl - I
. Be~th ~a
.•. - :. · ~t(·:f.'.F-/ 4-t·'- ~- ~- 6;0r/r c7-~~·(:; .>PRiivt_.;· sr z;,c.~cl< f A:.5CI 1'\ c,d, ... .J !J /. . . ... . .. ... . ; .... . . . . .... . ..... . . . .............................. .. ... . ................................................. . ...... . .. . .. .. . .. ........... ... .. ..... .. S<l :1lpl. e: No: ••
st. J.'I j.-~t [ :;~JF; ·.L.:~]~Jl]J:Jr) f-=.J~:-_liTZ[Z-IZJ:Y I t: :~_[-] c.: J,,o<j .EI-/- LLJ_~.Y-.1.~:~~0 fc;;~~[~ i ~: · , c-=~rt~L~]:~?··- ~ ~;;-rzLL.l3J;:jw_l- 1 ~~J-J-·-a=r l~- Ll=I.-~-o
(no AsL t:s t o s b ase>d ma terials detecte d ••.• )
Cortdition (damac; c) I b I WGter Du n16 tjtd [QJ r~ c-nr:-G I t1od-2 1 S c· 'o'c~ · e-5 Nor.~>-0 I l"linot· - 1 I !'1od-2
Acti vi\,Jit·iov(;it'tr,l [ 0] l1ir Plenum
Ins pee tors r e c ou;mc:nd at :i.cn ••.•.
Expoeed Surf~ce Area Nonr:-0 1 <! 0 %-1, > 1 053·-4
[ij
Frio b i 1 it y . I I ] Qu id/n:> ·d.ntion-0 , .. .; ; ,.,. 9 vibratio n .. !
No air p1;:nu;n no dirE:ct <>ir str<-am-0 Air pl~nur.1 o1· dirc·ct .\ir ~v~~m- 1
Difficult ~o dam<J<) <' by hand-! E.::tsy tJ di s lodg e or crush-2
./hi jh vit.n\ic.w ·'i Fluffy I Spvrt •Jl) I n akifiCJ,-3
Seill[ll e Taker. '1'/r! Surn~ Dote G~:.J-· :;; ]7JoJ f·.> -l .:.·;j .h.cccs~ibilitu Nct - 0, ~lot R~:~dil~!-· 1
Expe cted Life s p Rn .•.•.. years ( ) Ci "';.J>' / /!- ,v In spcc to~ s ... ~~ ........ ,. ·.: ..
"J) P. l' C. ui OCG tL du\iGf) l·
. (S)r--J ~lCODC L
CI---"---CJ~ITI Vu lt·~ of Lo:> t Yfc.r'< Pcrfcrm cL:
(., [ I 1. ~-.Ij_ __ D ··' co.-- ·r-r=J~D \'~ ~ !: cA Ct.:mul:.li\;t:
We:':-.::$
-------~---· ----------~
----------------~ -----~-----·~· --
Dale ci E5t!rnrJe C1--LIT:=-[.J Date of 1 esl \'Y .)rk []
Pcrtom1ed (\'/30A ) 1 rr L_J
Dele o( le.:; t ,~ti on o=r==r=~L_l]
--~_..__......._, _ ___..._ , .. ~---------~·
l~~£-rH5
r1) St;d:u_!!. C:£ft.
C -Ci~t-r<. G D- Dc/ ~; n-:e d J.~ tl 'rJ ~ l -1-: ~ c.!Lh Rid.: G -J. ::~:e:;:::I;- :~<r.t ( 'A I\ Fl - \\cc: ::::: l.;::corr.rn -:i:J~ d E - E!:t::nl·~ t: r~qul:~lul{ j ;, clud<:d
o. P".-::;!'d;': '.)"d l'!itl ~ n z. t.1 \'ron~ ) , - \':' :.>1~::;; ,\. ; ·, pm·,·~! i: . c.l..!~.:;d
\-'·,' . ~.-:r:. J~':'~ i:--, p :~·c r·. :.'--4
11~ .. ; ~-~~ito;:r.a !) T\; ~~:- ... ·.:tli••~ci
(:") J .. E.::!~.:.iD.!_I'~':~:.:
L - Ccst~b!a T- TC<:o'.'.i!c M- lvW'Joc.Jd C- )..~)c o:t os CE.m cnt P- Pol~·\:'lE.r [lc,.und
S-SL d [;:- [r,C'c.p.c\;ful i<:>ll
L - Sr·.: I::. L::u'"l h~\- j .-'·;;·;;f :...r c. .. c·/.:.11"'· r,~~ ~. ; :~ ·,:.' ~· .. (},..,~'')f. ~-~·"'!;t y C. ;.),·,-c ct:~r: . .
(4) PrioritY,_
1-l:nrnE:dir...Le H -High 1,"- ~. ~..!divrn L- l. ('IW
4- Sui.; r.~q ~ - lie() 9- t .~ .je;r h',.r\~s
l:l S!l OI{.l.uc;t<;5S) /;SUESTOS t .. CTlOf-1 REPORT Ol'fl ~i'\rrll? r,t o (Housing ;u,d CC' r.~ \ru cti·.> n, VIC
1 • [)OG-.?jL;; l C' pt • •••••••••••• •• •••
Shed llumb.:;r
(1) fiil Stotus Code ~
r2J r·z] Product T~·pe ~
1\e por t l~ o . , ........... , • , .... , . .
Location E:.dE>rnal- E r;l ln\.,n'lal- I ~J 8oth- D
j . ..; -r..~. ,. Fl> /l V s~ -,.- (;::-o l-" -..- C 7- r.• t_:::: ...:;f:J -:"I /V' C. :S T ;-:~;· !.. C c:: / -;t ~1 A::!d Add rc ~3 ' · . . ~. ~,·; . . "::'. ~ ,--' .. .. ....... \ . .. • ~· .•...•.•.. . . . .-.... .. . .. ~ ............. .":: . .-:~' ........ --:: .... I;::-......... ~ ...... .. .. .... . ... ~ :· ................. : . . •. ;,, ........... . Sc;,,,iJ lc !~o: ..
St:n.plt Dc sc / L0cc.tic,r1
(No t~sbestos h.::s ed mc:teri.:Jls detected ••.• )
Co1 : ~itio n (d .:~rn.:Js;c- ) @] Vhttr Dorneqed [~J 1kr1~·0 , 11utl - 2, Slvt> re-5 Non('-0 1 t'-ljro.:>r-1, t1od-2
Adi vily/Movcn:tit t ['2__) Q..;id/r:? v it>nti vn- 0 1 -":cd/r~ IJ vjbr;,ti ..., n- 1
./ h i9h vit.n\i or:- 4
/>,-:ces ~ i bi 1 i t.u tl a t-0, 1l o t Rt>acil•rl
[[]
1-\i r Pl enu m No <~ir pll-nu::1 no di r ect .::ir ~\n•am-0 Air pl ~nur>o or dir·c-ct -.it· s tre.;rn - 1
Se:mpl r.: Ta kc il '{ m Expected Life span • • . . • . years
--·---- ___ , _______ ··-···-~----·-·~--~~-----------~
Rcfer .: r.ccJ F i1~ fl o .. fc•lio, [) '.'.' ~ I: 0 s ::.it-. ~ ,. (' (' :t \ ;) c t:: ('I c
-· --#-- ~----- ---... --- ... - --· -... ~ .... -- --... -------------·
Insp cr: tors recollliJlc nd;;t· iun . •.••
Expo:::~<1 Sut·f~ce Areo [ 9] Norw·O 1 '1 0 %-1, > 1 0%-4
friubility []] Difficult \o dom.:19t> by h ~r~d- 1
Easy b disbdq<.- or cru;;h-2 Fluffy, spcn9lJ 1 tl.:~xin:r-3'
Sun· e \l DB t e [2. LD I I I (?J s· [ t-;··J
I ( ) CJ z. / /.c' /\/ nspector 1:> • : . ~ • • • ,/. •• : · •••••
-----·-···----~
---~~--------~-~·--·---·--- ··· ~--- ~ (")
Scope " [ ] Dcscrip~ icn CTT-f"TILILT--r-·'1-J
Y<: l u~0 fl es t
Wed: Ptrforrned S \':.1~::: o{ Cumul rJ iYi! Wc:b$
rr=L._..i....-1 --'-1 _ I I J Dele cl E~l! ~ncl e j_]_lj ____ l ~I_-=]
cr=.t =r 1 ~__ ___ o cr· _~]~J
_____ .__...._~,~-~---..... ';)o.·-=-----..-... -~----------~--·.,__,..~.._.. ...... ,., .--..
l!_'jt·nd
(1 l Shi:u~-~0.0.!:. c -C:i~~o:.J [) -l>d e:n-<:d .J. . ~..-ti;. rl
H- HuJ<h Ri::-i: G ... ) \:.. s c:=.s c:tr)t £:.: .1·•.-n n .. \','cr):s n:.CC !o~'>•t:~ 1 dC:d
f. · Esti ~.-. t.:r: r..:q ·.~.::!;tr.dlit,cl~.<cid 0 - r·rccroil) ,,)\·d v- ;t.J--; P. <:. l 'f1'J ~-.!c-t~
l . . :.'i :>r: :s: },i;r::•"JY:-.1 i .• cktdcd \·1' - '~.'? t~ ~s in;. i ·-:· ,-.. i=:-·: ~:
l r J ~ ( ' );,-:itu ... ; ; I 0 !; '\. ~;r::t :f"!!Pt:d
(2} .!.:.!~n (! ~i ~- ~-]~·~ ·~~: s- ~~)fl.~-,; d r-L tJ~",~~Lil
!J. 211-it
L -Cc,st ,..b JP. T- Tc.>:.tik h1-~·. j~ :b(l~!d C -,.l . :;~c,:;tcs C<:t!1l::;t
P- P o:~~:'ler Oound
( ') l 1 • -; !J~f:_0_~~~.!ES.!.!1:l.~ ~U'l
E- Er,:: f·.p .-: u:~tj(,n
L -S.::.I-~~ l.d.lt!!
( -C',·t:Lc. P.e\}::',-1
~ - (-,'l~ ')f1'.'t~!l\/ Cn:·,"'Qr l;r.,J "'
(4) P;·iority_
1-lmmcdi•l~: H -High M-htdiu;n L -Lor,-
~~ .... ~;~Jb r'!G
2 -Re. q ~! - !/,.jcr\-\'d ;:;
t ;~s 1 1 ..., 1 (.!. ~'" 10::15) 1-\ SBESTOS t~ CT I ON REPORT (J .C:>'lr trnw~ o( Hou:>'r19 .lnQ Cvr.s \i· uclion, VIC
A:J::t t 1 D Num ber [:t - [~~ -J~~- L( l ?.J:X~tT'] ( 1)
St tJt l:s C:ode [2] Report No .... r ••• 8 ••• .., • .: ........ ..
D t • p ,? C- C.. A 5 c p ••.•..............
Sheet !lumber of Owne d/Lensed
LI~J (2)
Product Tvp(; @] Location E:dern::~l- E [2] lnt<>r:Jal - I Both -B
~Q,. ~ . jr/(/.!_1. ) ,Lft,"_S' T C.::Otll-- C / t'..:.·r:i 5Fi!.IAI~ -~~ l3L.C'CI< .f " ~ '~t hddre3 s ....... ..... .... .. .............. .......................... ... . .......... .............. ......................................... .................. rl. .. . .... . .. .. S <mpl e Ho : •. s u n1l,e r?~-~-;1~-,- ~~-,-:--::- ·r·-::::-r;:;-rT:~-:---1 ;-J7-"1-r0~:. 1 -,-:;:-r-;;-r A L·r,-Jv'--:::-T---,
L..::..'_JC.~.' .. ~-----'' ... _ _:; __ ~. ::.-l!._:_L_~.:: .. J..:::--.=. __ _ , _ _ _ l _:_l~-~~-1~.2 ---~:_LC:::~J ~ ~ U~. _1 --~- __ _ _ _ J
D (;5 ;: / r:-:-·:-r /~[:;~ -- , (-:~- - - ! (_?l;·:~:-r-·· -··-z-T·71e-r-=-r_3-Tgi'-l Ll . 1---rc--c--I-I ___ l Lo~ ulic.n ~-- -~ .. --- -- --~--1-~~---- ---- __ l.LL ... .L_ _L _ .J_____ --·-- -- ---
(No Asbesto s b~s~d materials detected .•. . ) Inspectors reco~~endation .....
Condition (d.:mJgc-) @] Water [)Wlc•Jtd @] ~-] Expo:;ed Surf~cc Arco LL:. rl o n~-o, t-1ud-2, St·v~r;_;-5 Ncn .. -0, J•1incr-l, Mc-d-2 Non~-n, < 1 05:>-1, > 1 0;!3"-4
i~ ctivi \l)/llovtmcnl [~] Air· Plenum friebilit\) [lJ Ou ic- t/r1o v iLr .Jtion-- 0 t·1c,d /n-g v i t-r;;ti ~ l,-1
No ~ i r p1en ·J~n no dir e-ct <~ir strean~-0
Air pl~nllm or dirc- c l a i!· slream-1 Dimcvlt to damage- b•J hand- I E:~!:l) t.1 di~lodge or cru:;h-2
/t , i9h v iLr <l t i '· r.-4
Vnll! ~ cflr. ~ t
\'/vr k Pt:rformd S
[[] Serl!td t: Teker1 'in!
Expected Life sp~n
[-]
(SJ r--] ~cope L_
D=.=I=:l_ITD Cl~--LI-l I _I
...•.. years
Fluffy, spon<J\), f1akin9 -:~
Surveu Dtlle ~~fl I I 0 [E_[::lJ Inspcctor(s) .9.~?.. /..ft.(~(.
DW. e cl E:~tlrnd c cr=r=r Dnte of le~t \Vorl: o-,--, _L[~J
Pcrtom1ed (\'/3 0/i )
Dr..t e ol i&.'lt kti en
-.--.--..,,---~-~===-1..~-.--~·-.--...-..:--------· ---- --~·---~---·-~--,---..--~:.n...o:a.r& .. -· ... ~ ... LE=''Jf.!l.1
(1) S t ai:~1~ c~~c. ~.
c -<:l.::~d [J - Dd u-rd )..eli on H -H>:i>J:h F:L;;: ( : -A~::.t:SS !n'.r; ~ ~:\'~;-, f1- 1'\c.r',:::; r._c,•;n rr. 2n d~d
c - Es l ii:'li..~r: ,.,_q;.;e::; le dlir.d '.'d<: :J 0 · F''->Cr 'Jm:r.e:ri l'' ith R f., L" \' iork A· \"l1 ~.~~~. i .r-•r:.~ ·uytJ i1.cl...td :: d \).i - \J :''~'J'~~ i. ·. ;_,r.: r; ·-c~ :;
J rj -};L;r".it ~r;;,~ !'-;j :' l}r:t..i' l;ltC(~
s . ~~ ~ : .. '/1: .~
F · l <J·"' !' f::i
L -Ccs tB!J i e: l - Te:r!:le f , 1-~ · .. 1 !l~ owd C ·A!:"bc::tcs c.-, r,1C'nl P- P:·ly.:;er 8ovnd
P:r n_.: c:o~'2--':'l!~~~ri('.!!..
S<)l! i'J E- r:r.::><psld,ll ie>n L-S et!& l :i;d
!4) Priotii:y
l-lmr.1tdlo.! e H -1-ii;;l. M - 1.-'li. diul;1 L - Lo·:1
(~) ~~~1_£ 1 -1.-~rKI !fiPji1\':t1al'iC(~ 4 - S "J ~ r>:q 2 -Heq 9 - - ! ,'njor\ 'l' ~ : ~:::
1 1 u, .. 1 ~: I 'J3 j) '-~ .. ./ 1\SBESTOS .4CTIOH ~(EPORT . ..; .~drn~: , ', o( H0usin9 ;.nu Ccn-;~rudion, VJ.C Report i~o ....•......••.........
3tt 1 D 11u1nuer· CI-_Ii-~[.:~_L(] -~~ r.:~~:.Trl stf.ttt:l ccde(1) Le.J Stel~!:J Dete CLL[_[ __ [=J
. fj 0 :'- c';.:, /J.j pt •......••••....••.
of
0'.-'TIC d /L e. as e cl
[_]~~ (2) r7.:-]
p,·oduct Ty rc t.:=:_
(N o AsLeslos based materials detected ••.• )
ndi ti r, t, (ci 2rnJ<jt> ) @J Wrkr DnrnrJgtd [~] Expo~ed Surf(lce ~reo Non ~-o, <I 0 %-· 1 , > 1 0%-4 r[)<;•U I 1·1::-d -·2 , St-v~n - S Nnn<>-0 J 1·1incr·- 1 J r·~ od-2
1\i r Plenum . frio hility · []] :tivi\y/l'lwcment @1 Jit> \/no vi:.:ntion-0 :.d/ug vitr;,\ion- 1
No air plenum rw dir t>ct air s\rcdm-0 Air plenum or dirN·\ .:~ir s tr eam-!
Difficu1t to dam.j9~ ~I} hand- I E.:l!:l) tJ dislodg<> or cru.sh-2
~ ~~~ vi!Jra t ion-1
.C CC5 Sl t,j 1 i t\ l CL.l Semr.l!! Tekert '( tri Cl \ -0, :i"\ R\"adi ll) - I
Expect ed Life span . . . . . . years
Fluffy, spor.9t;, tl~kin <r3
s•xyeu D[Jtc [.2. [ :; [t=rQ}?. [ .£1 . . . ( ,, ) (,.5. ;?_ /. ,..;:;) /'/ Inspector " • . . • . • . • ••• -r ..•. .
·-·----- .. ._ ___ , ____ ....... ------------------~ ·-.. ··--· __ .. ···-·-----·-··-····-~~·-·-----·-----·-··-· --- -·
!=-~~~· -5~~;_. ___ ::~~~~-~: ~~:-~~~~~] --~~b~~~~~l ~·~~-~n_:'u~i~ o~c 0±rr--r~_TI·_-_I~~----l:Jd .-t'l: /.UTH O!~Il Y r ·: I ~ POI'H t"·~
[~]
(5) Scor-e [~
ti tr:d; ~;
1 u~ of L b ~t
ork hl'fcr!ned $
Pri:-. a/'1) D Rcpo1t Dclc I.___.__I__.._~
cr=~o-=.=r--~r 1 _L~~ 1 1 _c:J Dcl <: cf f:5 Prr,EJ c o---0-~~J-·]
Date cf le~t \'/ork 01~-~--[J Performed (\'/3iJA)
:.Jue t•l Curnulclive ,.----,----r--r-r -l L_j _ _L_L_J. __ .._ _ _,____._ DtJe oflut ktion rr~r=r=c-c-1 _ ............. _ ... --.-..-_...-~--·----,...--....__,, _ __.._ ... -..o=-_~---- ----------.-............ - .... -. .,. t.0 !:..0.ti ) ~!/( \1::-__ ,Cn<!l"
-D <'IL!r .·d Ac\ior. -H c.·!:!t fiis !: - ).:;.:; -..:s s::: ~ r,t G:vc.;-, - Wor~·~ rc:: v:nmenC:c d - Es\ i;,·,....:e ro~q ue:;; i Nlln·,clud<:.C:: - f' r.:~\it~:rH,'lC: d Y~ tth ~ i ~ ~ .. 1 \"/~)(:.: · \'i ;,::;_ . t >i·;·i.'r>d ir. chi. ;ed
,~ ~ '/,·- ::·:.: i:-, J· • -_.:n~S!:
1 - tv~· •:u t;:.J !)l"''(;f~, ; •. .:.~
l r· · · · J t .,._ -~ •. • -l't 1- t' •. l .... ... - -. --··· --·- -' ·--. ~:;_~, ,·~· ,., - L. ·.:- .. :fd .. 2'·- .. t
L- CLt.StrJ:>!e T- To:3.flc lv1-:.,.!!!bo~:Jd C -),.sb c-::; to5 <>,rr",er.t P - P::-ly.-:'le:r Bc·c:;,d
L -Sccl ::', l.r ;; :·.!
C. .. C ·;'·;!i~., ; ,-_ ·-,1: ·.·;
( .• (; ;1,':' '-· ·' .: ~y ~or, t G l ~\'.ri
(II) !:_r;on_!y
1-lrn : n~::di"..l.~ H -High M-IY>i:dium L -Low
'1 • St~b :..;q (; - f-kC] 9 - k~-,:~_) r 'n'o! k~: