1999, 04-15 Critical and Hazardous MaterialsSPOKANT CourCOUlgY
Critical and Hazardous B 27
Materials
Division of Building and Planning
To assure permanent protection of our primary
source of drinking water, the Spokane County Code re-
quires many non-residential building permit applications
to include a Critical and Hazardous Materials List,
which is a listing of any chemicals (solid or liquid) used
or stored in or on the site. If a sufficient quantity of
chemical is present, measures need to be taken to pre-
vent contamination of the aquifer in the event of a spill:
1) Facilities need to be designed so that any spilled or
leaked materials are contained on site and cannot infil-
trate into the ground; and, 2) No permanent disposal of
any waste containing critical materials shall be allowed
on a site within the ASA. When underground storage of
any critical materials is included n the design of any facil-
ity, the storage vessel and associated piping and transfer
equipment needs to be protected by a secondary contain-
ment system.
In addition, many commonly used chemicals or
other materials may be designated as a physical and/or
health hazard as defined by UBC Chapter 3 and UFC
Article 80. For example, gasoline is classified as a flam-
mable liquid with a I -B rating (physical hazard); motor
oil is classified as a combustible liquid with a III -B rating
(physical hazard). Some materials may be a multiple haz-
ard. An excellent example of a multiple hazard is
chlorine. Chlorine is classified as a physical hazard in
UBC Table 30D (oxider) and also as a health hazard in
UBC Table 3-E as a corrosive, an irritant, a sensitizer,
and other health hazards.
Requirement for report
The building official may require a technical opin-
ion and report to identify and develop methods of pro-
tection from the hazards presented by the hazardous
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material. The opinion and re i rt shtit be p ared by a
qualified person, firm or corpoi6tionigh)pro4d by the
building official and shall be prcded without charge to
the enforcing agency.
The opinion and report mayCbe included, but is
not limited to, the preparation of a hazardous material
management plan (HMMP); chemical analysis; recom-
mendation for methods of isolation, separation, contain-
ment or protection of hazardous materials or processes,
including appropriate engineering controls to be ap-
plied; the extent of changes in the hazardous behavior to
be anticipated under conditions of exposure to fire or
from hazard control procedures; and the limitations or
conditions of use necessary to achieve and maintain con-
trol of the hazardous materials or operations. The report
shall be entered into the files of the code enforcement
agencies. Proprietary and trade secret information shall
be protected under the laws of the state or jurisdiction
having authority.
EXCEPTION: When an HMMP is required, the
applicant may submit the report(s) used for compliance
with requirements of 40 CFR "Hazardous Chemical Re-
porting and Community Right -to -Know Regulations"
under Title III of the Superfund Amendments and
Reauthorization Act of 1986 (SARA).
Additional information may requested if it is
determined that critical, hazardous, or toxic
materials are used and/or stored at your location.
For more information or an appointment contact:
Spokane County Division of Building and Planning
Permit Center - 1026 W. Broadway
Spokane, WA 99260-0050
(509) 456-3675
SPOKANE COUNTY PRINTING DEPT. (827) try!
Instructions
All chemicals maintained on the site must be listed
for the purpose of determining occupancy requirements
as they relate to the use or storage of hazardous or toxic
materials under UBC Chapter 3, Sec. 307, Table 3D and
3E and determining "critical material" containment re-
quirements under Chapter 3.15 and 14.706 of the
Spokane County Code.
Please include the following on the list:
a. The proposed type of chemical by name, including
common chemical names generally associated with
the material, including waste chemicals; and
b. The total amounts of each chemical along with con-
tainer sizes; and
c. Material classification under UBC Tables 3D or 3E
(UFC Table 8001.13A or 8001.13B);
d. MSDS Sheets: attach MSDS sheets, flash point or
other information pertinent to the chemical to this
list; and
Critical Materials Example:
e. Areas of the building where the product is used or
stored; and
f. Methods of storage: if critical materials are known
to be involved, proposed methods of containment
should be noted.
Make sure to list all items such as process and other
chemicals, pesticides, fertilizers, cleaning solutions, haz-
ardous solids and other substances. The department will
then review the list to determine the applicability of criti-
cal material/ hazardous material requirements. Critical
materials requires double containment design, clean up
procedure, and name of hazardous material disposal
company to be submitted. Please be as complete as
possible.
a. Product and/or Chemical Name: Prestone - Antifreeze (Ethylene Glycol)
b. Maximum Quantity (Gals, Lbs, Cu.Ft): 8 Gallons (8-1 Gallon)
c. Material Classification: (UBC Table 3D, 3E) : None
d. MSDS Sheet, etc: None
e. Area Storedand/Used: Stored - storage room, Used - repair shop
f. Proposed Method of Storage: Storage room - metal pan - double containment, area of shop with
sealed concrete and no floor drains
Hazardous Materials Example:
a. Product and/or Chemical Name: Quaker State 10-40 (Motor Oil)
b. Maximum Quantity (Gals, Lbs, Cu.Ft): 110 Gallons (2-55 gallon barrels)
c. Material Classification (UBC Table 3D, 3E): Combustible Liquid -III - B
d. MSDS Sheet, etc: 5 (Attached)
e. Area Stored an/or Used: Stored - storage room, Used repair shop
f. Proposed Method of Storage: Storage room - concrete diked floor with resistant vinyl liner (see
details) Shop sealed concrete with no floor drains.
Critical and Hazardous Materials List
Please fill out the following list as per instructions, return to the Department of Building and Planning, and retain a copy at
your place of business. Feel free to make copies, attach additional pages, and/or add explanatory notes, if appropriate.
Company Name: 1 t S T (2-ooS
PRODUCT 1
Property Address: / 5 6 25- 6ee�ildg
99oi
Product and/or Chemical Name: Gl}ac• e %%70771%L Qi
Maximum Quantity (Gals, Lbs, Cu.Ft): 5.5 //er,�
Material Classification (UBC Table 3D, 3E):
MSDS Sheet etc.:
LsJ--(r - /, �� 3
Area Stored and/or Used:
Proposed Method of Storage:
5710 Gl .SA o, — w O ✓/L a -&e
5-5 c/o-,) 6 l
PRODUCT 2
Product and/or Chemical Name:
,-74r 5, ././/5 ST Cvk
Maximum Quantity (Gals, Lbs, Cu.Ft): 14,1S
C L 4- \
Material Classification (UBC Table 3D, 3E):
MSDS Sheet etc.:
Area Stored and/or Used:
Proposed Method of Storage:
PRODUCT 3
Product and/or Chemical Name: » 0 e?,iD Q /C
Maximum Quantity (Gals, Lbs, Cu.Ft): Q C /
Material Classification (UBC Table 3D, 3E): &9.7.1
Ia-ea Z7 -4-4-4--c, _ g
MSDS Sheet etc.:
Area Stored and/or Used:
Proposed Method of Storage:
PRODUCT 4
f- C I Q' / (-1 .acy, QJtfLGL
Quoc)i/l c -it i - zee -'t4
Product and/or Chemical Name:
C4A6
Maximum Quantity (Gals, Lbs, Cu.Ft):
Material Classification (UBC Table 3D, 3E):
/2 sfr> e�•y
MSDS Sheet etc.:
Area Stored and/or Used:
Proposed Method of Storage:
she t used )17 5 o,
57-0,007
PRODUCT 5
Product and/or Chemical Name:
qGI-
Maximum Quantity (Gals, Lbs, Cu.Ft): 5 (%lam 1
Material Classification (UBC Table 3D, 3E):
MSDS Sheet etc.:
Area Stored and/or Used:
Proposed Method of Storage:
PRODUCT 6
l/5e i 5 lore 1 / s off &.)Lasot_
docC26/.e c°�rz ��i�c�� 'eek ,re -P f��-•
Product and/or Chemical Name:
Maximum Quantity (Gals, Lbs, Cu.Ft):
Material Classification (UBC Table3D, 3E):
MSDS Sheet etc.:
Area Stored and/or Used:
Proposed Method of Storage:
PRODUCT 7
Product and/or Chemical Name:
Maximum Quantity (Gals, Lbs, Cu.Ft):
Material Classification (UBC Table 3D, 3E):
MSDS Sheet etc.:
Area Stored and/or Used:
Proposed Method of Storage:
PRODUCT 8
Product and/or Chemical Name:
Maximum Quantity (Gals, Lbs, Cu.Ft):
Material Classification (UBC Table 3D, 3E):
MSDS Sheet etc.:
Area Stored and/or Used:
Proposed Method of Storage:
The above is a true and correct accounting of the chemicals intended to be used and/or stored at the referenced facilities.
Signed by: Date:
Owner or Authorized Representative
FOR OFFICE USE ONLY Activity SIC Code:
Designation: Critical Use Activity Not a Critical use Activity
Reviewed By Date
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SECTION V11 ETP.IRONMENTAL DATA
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SECT/ON X - PRODUCT LABEL
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P AAmING
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PAOLONO COKTAC:T WW1 AtS.,1 ih TEAIPVsAA"
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awastnlng snit turnout yea-, Ittpa ire. Nei/tee gino67 ticn te-avr,;
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Vol CASE OF CHEMICAL FlitROINC71, Coll Ciiitellttc day Alr• Airt ets:eltmce &no
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CAS NO = 107-21.i; 10213-7M.1, 710+11-t4,-, 1303.44-4;
Neale in U.$ A
industriel and Peft* Chealc67
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ENVIRONMENTAL TOXICITY DATA •
Aquatld toxidtty ratInc • Slwegi'i; A.O;Pcm!2;
VO noun Static LCW, i400
Insign4ftcant hazard
ILL AND LEAK .PROCEDURES.
Spills showid be orIttt;har.;4„ ar.17,dfie0. and paced sn ,:tmltsoners
for disposal Tnts matersT not rocutatsd order RCRA, r,".r
P'Suport4hd', cLockl!w 'WC solls art s st?Poing nazarT:',
HAZARDOUS SUBSTANCE- S.,:;PE5:Nr1: /frio RQ
—
WASTE DISPOSAL METHOD
:ncineratt Or bury fn 1)cerssed Jacs'tty
Do not discharge fr,.tc wateys 7.,:',nargo to sewer systoms
pr-ior approvals is accop.zaLIe,
HAZARDOUS WASTE 40CFR2611 A4RDOL;S WASMBE:
CW4TAMNER DISPOSAL:
dispose rkf tn licensed fani)1,y
Recommend drusnlas or. (2,atr moans p,overt Ls,,,itm.rtzed rat,Nsw
" }NQ NAME 49i.t7J-IA T72. 1021—i4AZARZ'OLIS SUBSTANCE
41.5C,FR CERCLA JS
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PRIMARY SECON:)ARY
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Nome l' Itaohe RtiA
BILL
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&ntifeeszo PrebaroOens, Procata;.y
Etnylosno Glycol Siiss
DATE PREPARED7-1(77r=
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PRO0u4CT NUMBER: $4702a Artiframillie
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CONTAINS ETHYLENE 'GLYCOL ,CAS No G721 1
CONTACT MAY CAUSE TEMFCRAAr ret WO SKIN IIIR:TAT7;ON
INGESTION MAY RES7.;0' IN AJ' E PCISMINC CHAkACTERIZED tr: SEVtef
OISTURIIANCES. CENTRAL NERVOUS SYSTtY CEMESSION AN trOssf AEsaIRATo, us
RENAL FAILURE.PROuGHGED INHALATIC* Ce VAPOR:, MA'r RESULT 'Os ERRII,14 CP
ut4CONSCIOWSNESS CHRONIC OVEREXPOSOK *AY LEA.: T.0 LI!R ANC K!Ohtt 0,40AGE
ETHYLENE GLYCOL WAS TERA1'04iNIC IN 1.X.iCRATORY ANTRAL ST=Iti;
FIRST AID:
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Ingett)on
Immediately vesh teies ronnIng water foi' SONL;t.;kti
if irritetipr deveiopl, get medicil attention
wesn effecteo arelet at:44p ano witer
Remove conteminstac, end ie,undair Defzp.* neiwa
If irritation develops. gia7 mienvizie etten'ziv.,
If swallowed. ei14.‘tit, .-e..n water VIO l'16* -*OW1',ih14
Never give fluids oY. *oel,tin9 tne vr.;-el. is
wICOISCIoUS Or has -4
Get immedia4e. aet:ita' attetin.
Move to frost: i0e. .: neesseP-y -Aix;
get medicel
HANDLING AND STORAGE: Keep zonts;naWA
owickIy as product it slippier:7' latan avvy etioAH
Absorb :arils Amounts with absorbent tteterial OF
PrOPer Inoinetate er trut4 in An aptro
04locel IPA. Preyiert run-off ento
tr cans of -.L.:.e*r up
amount* *.th
1IRa at°10 Pump irkta .t4ruise for
yod 'endfl'l use'
or thto W3tW,StAY4-
114 CASE or FIRE: Use weter fog, ,okuricl team CO2 *ry eiricel
sating finetigfito-s shoado Oe sigi.J,Operr.1 sotrTh self-coa,neZ
breatning apparatue *NO turnout gear ylipons from heated product c4:n tneve
to souring, of ignition and fIaan Dada.. doctorate exp;osion haraini4 wow', expoand
to flame.
EMPTY CONTAINERS: Ail ladie4d priecutkAr, must da OCSPC
storing and transporting emp.tydoi-ttners due • prtOuct reuid,...pei Co r
rouse this container uniesa It protetstpna!ly tileanoo arid riec7exitioac
DISPOSAL: Spill eatef.1si ahualac und empty corta,ners oast Pm
disclosed o4 in scOordance with local. stet* ehd federal regulistons OtbfOr
to ow alAterlAI SSfarty Date Sneet 4,31- speci;iC d'sposal inatructiolix.
IN CASE Of CHEMICAL EMERGENCY: Car, CHESTREC day or ntght +or savistsnom ono
inforeatton concerning spilled meteriel, 4ire. exposure an0 tAnal- choeoujpi
eseetteehtl. 4100•424-0300.
ATTENTION: TniS PrOdUCt In said solely for Wm dy induttrie! IMettUtootio
ineeer to our TeChnical aullet'n anal Inaterte: Swiety Dote Sheet rielprOing
safety, uslige, applications nazerds, prove/curve and disoexti of lzh!a onacksvz
Consult your supervisor for iscid.t1c•rA.7. !rtforeetioh
CAS No, 107.21-1 77511, 71531 -41? -4; 1/1134-02., 240'2 36'4: 2$3436-43-'4
Made in U.S.A.
industrial and Performance Chiemica',2
0111
tvIATERIAL SAFETY ! etASP
1..*; t -
DATA SHEET
PRODUCT htUMBER_ 5,4,727s Arra,,e-tt
•
SIECTON
TRADE WIRE: Zerex Artfripaat
CHEMICAL NAME Innibited Etim:,,Temo Oivco?
SYNONYMS' Peenewant Ar,tfr-eze. FORMULA, 01! tkx
0142,ew Coolant
BA
C14EMICAL FAMILY. a: c. -.0:s MOL WC.:;T N. A
SECTION! if — INGREDIENTS
COMPONENT
Zer-ex Ahtfmeeze
Cort.
Ethylene gyt.61
Phosphates
Proprietary. addit“,e
Water.
.0.1elnyerle GJytol
CAS NO
- SOURCE
,to.W,smO
,94 YC oP-o- AtOIN. OShA
4 SK.:,",
SECTION it! — PHYSICAL DATA
BOILINGIMEL1ING PnINT *740 mm ph 4 O-il 0
••••••maerwor•-••••••.+0.•••••••1•* •••••••,46‘..- •••••••••••••.....
vAPOR P*ESSURE mm Mg *20 C IS
•,.••••••i•
sPtctrze. GiftbVITY OA SpLK EINSI7-f: L138 i
......—
SOWSILITY IN WAIER Inlinito
APPEAR/414CE: Green Dyad 4.liutd .:,100A, .70vpof INTENSITY; feIrit
r.--- SECTION 7117:iiiii Aiiii'liiLolioN'4Aiikiiiiiiii,1A
. . .
i 1
PLASH POIWI YlIEST MET4M; 240°1° C,C.0 1 ALITOINITION TEMP: 775°P
FLAMMASILITY LIMITS Iff AIR t% SY VOL, UPPER N/A
i EXTINGUISMIN4 . US* water fog, e‘cproI VCAM, CI= ,,:,,-. dr* cinowoca
i MIECIUM
1 eatitagulahing Melia WA ' 1/1/0
Ptrofiviers Should be eiLOpperof 41th Self-comtainec
breathing APParalus and turnout gear Avoid Omeathing
r ! nested or Purning ProOuct.
vapors from Aea 04 ,above tlasr point, product may travel -tri; '–'
it Source of gno' flash bac*
SPECIAL.
FIREFIGN/ING
PAOCCOURCS
UNUSUAL FIRE
ANO EXPLOSION
HAzAROS
ENCY TELEPKONE NUMBER
ChEMT.4..EC 30C-424-4300
______ T.m1S NUmSER iS
-.Ai,tS-20CY,Ii
'f.. SECTiON V - H A111.4 DATA
._.., . .......______ „ „ ...,..._....,...„....,.... ,................._ , .._
T.E„ST tIA:TA, REVc.Y.T.
.!,' :.iv "lane !:;,..41!,..0.e....e" c.74',',.a •
Q.mr Olk'o': 11%40 ,#:'' ,::,--',"2.• ),Y,f-.,..-i- ; .,. 2::
Alat!!!!.t . "!** 7 f*, ; r' r 1 4j,*i. I -t''' * 1 ',"::', '';'• '!. .'" f'''' ': t '41. ',', '-' it -,,7i1
AA4b 1 t Ey* 4.!.
;''i,,(:i
,*.xman kepdrttm. 1,0,-,..,4.. ,,..:5....':
CisISP.EXPOIRE.
trrpant ,,j1yeeT ,F!
AC4.!!!.
ev,ere abeem ap.ti
eessoe 1 44A-)
11
may trr7
1,tnyE4,2,7-* ;r7t
4nd
. . . •
:41.0 PROCEbtjEIES:
C7vsi-immotio.ltey wa:th.
,rr'!tAtter!! e***Yel.a.OS f!.,!)7,5„,..0.t a C
4. 41it4'.f tette a.!-eAti 4. •1 Aarm1t,0
• dor, n4t tott f e rr t4t dkIt'ye t,ps .
,4.-:4/1Suit a pelysr.‘,c1•Ad.. •
;,:dgt.stlov-If SwalIow0dr ..efeetal!!!*.t.el i!loute
Ne*er1 4J1 41
ae-t.
t teA 1 ,
: e4,4 • to f .0'en d ereat!l.i t7,0W14-4 LT Y
n.d. gel !!..mmel7ate!!!!!teeZ.,1 t; a '1 or
SECTION V REACTIViTY DATA
STASIL,ATY: Staele.
CONDITIONS TO AVOID:
CRNI)CL INCOMP':
HAZARDOLIS DECOMPOSiTION PROD:jOIS
8AZARDOUS POLYMERIZATION41z
CONDiTIONS TO AVOID: N/A
COCIROSiVE TO METAL; XID°Z.ES,
•-• • SECTION VII - SPECIAL PROTPCTION
RESPIRATORY PROTECTION:
14 ****r* *r mtste *rib gigmer•at.**6 ***Iv! Nte,”,0S/USOA approv** yepor' !
e!!'s-t! rlitt.t4r ,
EYE PROTECTION: Cremlea! qoigees. '..****r * 1,14.e* 142.1.**4,-!IIT, hoz:v-4
**tele
PROTECTiVE CLOTHNG: '4".*164" on -1
ZZOttlidli )mmtV,Ma'Atlx ari3O !!!oas'!! rae‘ere
OThEFNiA
•• !-;.. • • •tott....,
SE CI
; EN v Xi•CiIII7If t
• ••
tze • t
r1;;;4.,.`
ME4Ot.:,t
• ",••
4. • •
vq 0.• "
SECTIONC.
PROPER Sp•OPPINCi. NAMil • •.
D 0 T (:ILASSIFICATION IC
prurviAPv
1 AES RcQUIRED
PILL OF LADING DESCRIPTION
t. t-etti,tte .
' CC IN':
2
JATE PR EPAREC 2 8 8
•••
. .
A 1-
...15 , .
;;;),
, • 4ciCIPI.I.t.
•-4.ket
P DA T 7,0 , •12
:] •• ;; • • .. ; .
e'"•—• tEI‘T
!•!
Fincorxi
FTRST
EYrS'IMMOta'.40Zel'c ,,,, 4
MD
de,,e!oos, :or!
contvr..-taed clotnirJ.:1 ,,,!!,:we 14-
cortsu a Orys1Clar!
swai;cwed. watey- ,,mmoodate*,,e
vomiting. Never give fluudic or ineh..u.iit vomiting if the cictom
vs unconscious orraet immedtate
attentlor-,
Irinaatlor -bow* to fheSh aor bNisetning '!!4
And get 'immediate atterlYon.
MANOLNO ANO STORACE Keep cnriaters olosed cisee 424 spfl, clean L4;
quldxly aS CroduOt vS SI1PPerY WAV' away SmaH amounts ultr cool water
Absore large amounts w!tr! advor-- eht Itaterla7 o eLlke and pumc tr'to
proper disposal Inclne-Axe or an. apprnwed land!Th unOer Pu'oAnde
of lodal EPA Pheveht pu.011,z la710 c?r ,nto. waterways
IN cASEC FIRE. use ei4ctef- eir.y Ct'reMIC.41
4C...tings-UShIr9 media, Firefighte should oe equipped efth self-coriA'ned
Preatmtng apparatus and 1:u -rho -At gear, Yapors from heated produc car trayk7
tQ sOurae cf 19riton Art.! flash 4oderate exposion hazartd '!.414tr! ef.poseZ
to flame
EXPTY CCMTAINERS' All labeled must oe ooser,,ee wmen naneiln9
storing an41 tran,sPorng erct7 dat tO drOduct reslluts ruts r,ot
reuse tnis contaner Lin.?*8$ is phsfei,sionaiiy 4ieAmed aho meoohciflohed
DISPCSALSpill materia unused conte.;ts and eMPti o.or'tifloer4 must be
disposed of )r, iC„-Cordance with Idc.'e‘l state and federal ritglatIons Refee
T.p our eaterla Safety Oatwa Srwtet soecflc im5fmuotiohli,
EMEW;ENCI :HZMIREC day or nicelt fcr assistance and
niformittlen COnCehning s oswre and other chelilqa
act-It:sent% 300-424-230C.
Refer to our TectInica7 tiuMavo. anC AAterlal SAflety Oat* Sheet regarotN9
Si"etY aPPliCst4:ons, ?laZa^d5, procem4res and, diSpos40 of this PrOdL t
Consult 7r-o‘Ir soPerfiAor fcr AildifiorA! informatIon,
CAS No 107-21-1. Etylere COycvL nlootass,wo phosipetate;
7732-18-5. Wate- 111 -4E -i D,optr,,y-larm
Made in USA
Sced;alty Phoducks
0290
kr2
,• N,.- a-
RHOUR
1 ,-
NATEPAL
DATA SimiEET 324-11-
2
JOE 37 * 7 0 #7S -2C3, 475204
yl„cls r1.50E, 4.,441%tE,, .‘,1!"1"N 1410„)ZOU ti117. HAZARD COMAUNI,:aT1,..; SIANDAROI
ite******4,414i-ev*,5*-at ig.44.41-444rtd,4=4-1-44,4-04.4A
Pr0Ourt Atat.le", ATB -I0,1%, t75 -,g4,
„,.
LINDA CASE?
ENYIBONIBNTAt. A “EA:„.<14. ArFATK.
SE -2
INTER -0001PANN.-
C75. •ati• 5.52 4; .7.61 -"ENEE 5.58.
PTE050.21" ;
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t EtTE,E7E77„ TE 0E5E755 •-'65.
7-77. •
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1 Prie;f4r*d: L
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.4.Nr.ot-41 4erwuric lb.! fittiteitIti RAZE . ;57-• ''• • ;7,
DOI kazgrd Ciattsitiati,„"n", NOT A0P1,Ic'„AaLi„,"
440,0000;"
T F
. • BA„iliENEA Pg.750,..7
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Spec if ic 5t4t5,,t,r Oitrit; :
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LOST YE t 1117” CAEEE. ET Vt. L,E .27,r7PONEEE1 tro•EtEE 504.
UTENWISHING MEDIA; REGULAR FaM CAREA*N o4v CBEMICAL
HAZABOOUt UECOmP9SITICAN PROOMI.,g2 AAY tqwm to'< -2 MATER„EALB,"„ CARBO 0:0XDO.I„ AND CARBIA4 MONOKIDE, VARIDUS
ftY Rc,-; ARE; oris
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RRESERAC DEBAND MOCE AH1,14 i,IGNTIN,;
SAYER OR EDAM MAY CAUSE BODARTNG BRIDH CAN BE v:"IiENT RMSIBAY ENDANGER IRE t..,:qF Of. THE FIP,EFTGSTER
ESPECIALLY
I' %PRAYED IWO CONTAiNIAI, Of BOY,1G LIJIt
SPE FIRE A EX,LMTON NAZABITS, MtvER uSi,„ *ti,::ttsG oPs CJ! AINA3 TORCH ON OR NEAR DRUM !EVEN EMPTAI BECAUSE'
8)gal:10C:A E V EN .1L,E577 WEST 51,4 T,7>ET f f t .
NFPA CODES; HEA.L- 1 FLAMMAPA;'.„2,,IA-
i;7-5,7aITLXZ2
pparis,17 r. XpOSLME LINEL ; 257.4EN.,E5H7 7",:t 5E725127' . 70_ F. r :ot)tt
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Dev-CO Enterprises
PO BOX 1388
VERADALE, WA 99037
(509) 921-9759
Project Address: 1 S6 - - wt
Project #:
Project Name: �.�---- '-�
Phone:
Project Owner:
Special Inspector: Michael DeVlemin Div -Co Enter irises Phone: (� 91 9215 s�7
Address: P_-8 / Veradale. WA 99037
Project Contact Name / Phone: �!
. i�"► • Pyr ,.- �7,1� - I4 L9
STATEMENT OF UNDERSTANDING
Strom
We hereby acknowledge that we have by
been
o eche purpose of conducting field i pections on
the referenced project pursuant to the provisions of the 1994 Washington State
d tNon-
Residor
dential Energy Code (NREC) as it relates to the above stated project
aware that as a Special Inspector, our duties and responsibilities include:
Review of project plans for conformance with the requirements of the Washington
State NREC and / or
Observation of work for conformance with the approved design drawings,
specifications and the NREC.
All discrepancies shall be brought to the immediate attention of the designer / contractor
for correction, then, if uncorrected, to the proper design authority and to the building
official. In addition, a final signed report is required to be submitted prior to the issuance
of a certificate of occupancy. This report must stat whether with ork and the project
the approved plans
was, to the best of our knowledge, completed in conformance
and specifications and the applicable provisions of the Washington State NREC. Any
work identified as not being in conformance is required to be brought into conformance,
as is acceptable to the Special inspector, prior to the issuance of a certificate of
occupancy.
I
Special Inspector Signature: ,�..r..
S. sort
Owner:
rchitect !Designer
�9�
1,RF'-29-98 WED 08:5T WI TFiS FIELD=• t1-iF'C!UE'=.8
F. i=i 1
TASThchnical Assistance Services 325-44715 Ax 9):� 45s7
;arden Court Building, 222 W Mission Avenue, Suite 235, Spokane, WA 99X01 (509)
____----_____ \____LO; ________
\iPs
/.S-- Q
i)ate:...-_ /PC.1 L #-'77- .I"4
Project Address:
Project Name:1IM /0 1..t A+p1r
1'ro'cct Owner: 11 004-
Address:
Project No.
Phone:`V*4414
Contact Namc/Pltone:
STAI EMF NT Or 11Ni)ERSTANDING
We hereby acknowledge that we have been engaged by 111��—! '��PQ��d �►
for the purposes of conductin plan
review and/or ti field inspection (check as applicable) on the referenced project pursuant to
the provisions of the 1994 Washington State NRC as it relates to the above stated project
and that we are aware that as a special pians exaiiiiner/inspector, duties and responsibilities
include (check below as applicable):
)4Review of project platys for conformance with the rcgr►ire►►rents of the Washington
State NREC; and/o►
ti Obsc .' ration of work for conformance ance Ivr'th the approved design drawings,
,specifications and the NREC.
All discrepancies shall be brought to the irninediate attention of the designer/contractor for
correction, then, if uncorrected, to the proper design aultulrity and to the building official.
)rr nrittition, n final sighed report is required to be submitted Prior- to the i.sstunuce of A
certificate of occupancy. This report must state whether- the work and the project was, 10
the best of our knowledge, completed in conformance with the approved plans and
specifications and the applicable previsions of the Washington State NREC. Any n•otk
identified yrs 1101 being in c0nforntnnce is required to be brought into man as is
ncceptnble to the special inspecto ,prior 10 11 isStrsttire of n certificate of occupancy.
�� ltiiity/rte signature__
y. Owner