REPORT OF FINDINGS IAQ ASSESSMENT BRADFORD COUNTY EMERGENCY MEDICAL SERVICES BUILDING 945 NORTH TEMPLE AVENUE, BUILDING C STARKE, FL

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1 P.O. Box Jacksonville, FL (O) (F) REPORT OF FINDINGS IAQ ASSESSMENT BRADFORD COUNTY EMERGENCY MEDICAL SERVICES BUILDING 945 NORTH TEMPLE AVENUE, BUILDING C STARKE, FL PROJECT NUMBER: 4571 ASSESSMENT DATE: NOVEMBER 15, 2012 & NOVEMBER 27, 2012 Prepared for: BRADFORD COUNTY MR. RON HARPER 945 NORTH TEMPLE AVENUE STARKE, FL LISA ROWELL, CIAQP, CIEC, RPIH Industrial Hygienist

2 TABLE OF CONTENTS 1.0 INTRODUCTION... 2 PURPOSE... 2 SCOPE OF SERVICES... 2 REPORT BASIS INVESTIGATIVE WORK... 4 CONCLUSIONS... 4 INTERVIEW... 4 GENERAL DESCRIPTION... 4 OBSERVATIONS... 4 SAMPLING TECHNIQUE RECOMMENDATIONS... 7 IMMEDIATE RECOMMENDATIONS... 7 HOMEOWNER MAINTENANCE RECOMMENDATIONS... 7 WORK AREA PREPARATION... 7 GENERAL RECOMMENDATIONS... 8 SPECIFIC RECOMMENDATIONS POST REMEDIATION ASSESSMENT HVAC SYSTEM REQUIREMENTS PERSONAL EFFECTS LIMITATIONS APPENDICES APPENDIX A: APPENDIX B: APPENDIX C: APPENDIX D: SITE PHOTOGRAPHS SAMPLING RESULTS DEFINITIONS AND TERMINOLOGY RESUME OF INDUSTRIAL HYGIENIST

3 1.0 INTRODUCTION LAW Environmental Health and Safety Solutions, Inc. was retained to evaluate the facility located at 945 North Temple Avenue, Building C, Starke, Florida. PURPOSE The purpose of our assessment was to determine the presence, if any, and extent of microbial growth and/or unusual moisture conditions in the facility to provide a microbial remediation plan, if warranted. SCOPE OF SERVICES The site was inspected on November 15, Additional sampling was performed on November 27, The scope of services included an interview of the property representative; a visual assessment of the interior and exterior of the structure; a moisture survey; HVAC system evaluation; development and implementation of an onsite sampling strategy; measurement of interior and exterior temperature and relative humidity; and other environmental parameters as required. A visual assessment on the interior and exterior of the building was performed. Photographs were taken to document our observations. Selected photographs may be included in the report to depict specific observations; however, all photographs are available for review upon request. Moisture measurements and temperature and relative humidity readings were obtained using a Protimeter MMS BLD5800 moisture meter. Moisture measurements are obtained by inserting the pins of the moisture meter into the material being tested, or by placement of the flat surface of the meter onto the material being tested. For wood, the moisture percentage is expressed as percent moisture content (%MC); for other materials the measurement is expressed as percent moisture equivalent (%WME). Generally, %MC or %WME measurements of less than 17 are considered to be dry ; measurements between 17 and 20 are considered to be at risk for moisture damage; and measurements of 20 percent or greater are considered to be wet. Thermal imaging was conducted utilizing an infrared camera known as the Flir ThermaCam B-Cam. Thermal imaging is a diagnostic aid used by the investigator to view the surface of a building material and identify temperature differences across that surface. Temperature variations may identify potential water intrusion and/or air infiltration. Following the identification of an area of concern, further investigative equipment can be utilized such as a borescope, moisture meter, and/or smoke tubes to confirm if the presence of microbial growth, water damage, or air leakage exists due to the unusual moisture issues and/or air infiltration. The infrared technology, with proper interpretation, allows the user to identify unusual moisture conditions and/or air leakage within a structure that may otherwise be undetectable to the naked eye.

4 Evaluation of the HVAC system included an inspection of the exterior and interior components of the air handler and supply ducting. An evaluation of the condition, owner maintenance, and presence of contaminants assist in determining if indoor air quality issues exist. Sampling will be discussed in detail in Section 2. REPORT BASIS This report is based upon information obtained at the time of the assessment. Should additional information be presented or discovered, we reserve the right to review and, if necessary, revise this report and our conclusions in light of the new information. The report is based on the following: o Interview conducted with the property representative, Ron Harper. o A visual assessment on the interior and exterior of the building. o A moisture survey of the building substrates, including areas around plumbing, windows, doors, or other areas of moisture sources. o A thermal imaging assessment was performed. o Temperature and relative humidity measurements inside and outside of the building. o Sampling inside and outside the building. The samples were shipped to a laboratory that participates in the American Industrial Hygiene Association Environmental Microbiology Laboratory Accreditation Program (AIHA EMLAP). The laboratory results were reviewed upon receipt from the laboratory. 3

5 2.0 INVESTIGATIVE WORK CONCLUSIONS The following conclusions are based on our findings, laboratory results, and the observations as noted in this report: 1. The locations and patterns of microbial growth identified in various areas within the facility are indicative of the occurrence of condensation resulting from significant air infiltration from the exterior. INTERVIEW An interview was conducted with the property representative, Ron Harper, and the following information was obtained: Due to a previous microbial issue, the wall finish material in the building has been removed and replaced. During the removal and replacement of wall finish material, air infiltration from the exterior was discovered along the exterior walls. An attempt was made to seal the exterior walls to prevent air infiltration. GENERAL DESCRIPTION The building is a single-story, commercial structure of concrete block construction with a brick exterior covering. The interior walls are finished with gypsum board. The ceilings are finished with acoustic ceiling tiles. The floors are finished predominantly with commercial carpeting. The building is constructed on a slab-on-grade foundation. Furnishings and personal effects were present within the facility at the time of the assessment. The floor elevation of the building is higher than the street elevation and curb and gutter streets provide the primary drainage for the property. For the purpose of this report, the front of the facility faces primarily to the south. OBSERVATIONS In the SE Office, water staining was noted on the ceiling tile in close proximity to the A/C supply (photo #11). In the Men s Sleeping Area, water staining was noted on the ceiling tile (photo #14). In the Janitor s Closet, water staining was noted on the ceiling tile around the vent (photo #16). In the Kitchen, a brownish stain was noted on the floor between the refrigerator and wall (photo #22). No unusual moisture conditions were recorded on the wall finish material surrounding the refrigerator at the time of the site assessment. 4

6 Therefore, we could not determine if a leak in the refrigerator exists or the stain is associated with something that was spilled on the floor. In the Women s Bathroom, an active plumbing leak was noted beneath the sink (photo #19 & 20). Standing water was also noted on the tile floor below the sink plumbing (photo #19). No elevations of moisture were recorded on the tile wall behind the sink. Therefore, the active leak is dripping directly onto the tile floor and does not appear to be impacting the tile wall behind the sink. In the HVAC Closet, heavy microbial growth was identified on all walls from floor to ceiling height (photo #32-37). Bacteria growth accumulation was noted on the floor drain where the A/C condensate lines drain into the floor drain (photo #50). No sealant was noted around the plumbing and/or electrical penetrations in the ceiling finish allowing air infiltration from the ceiling cavity (photo #49). The south air handler appeared to be in good condition, free from the accumulation of dust and debris (photo #44 & 45). Significant water damage and microbial growth was identified on the inside lining of the return plenum (photo #46). The west air handler appeared to be in good condition, free from the accumulation of dust and debris (photo #39 & 40). Significant water damage and microbial growth was identified on the inside lining of the return plenum (photo #41 & 42). Inspection of the ceiling cavity revealed visible microbial growth on the wall finish material above the ceiling tiles adjacent to the location of a metal electric box and on the backside of ceiling tiles below the location of A/C ducting (photo #23-25). The rigid foam insulation and batt insulation installed along the south exterior wall had collapsed in several areas allowing significant air infiltration from the exterior into the ceiling cavity (photo #26-30). Evidence of the occurrence of condensation was noted in various areas inspected throughout the ceiling cavity indicative of the air infiltration occurring from the exterior (photo #23-25). SAMPLING TECHNIQUE Two (2) types of sampling techniques were used in the investigation: Air-O-Cell- this sample is designed to identify type and number of viable and non-viable organisms suspended in the air. The Air-O-Cell sample was collected using a SKC Inc. Air-O-Cell cassette and a vacuum pump. Spore trap air samples are collected by drawing a known volume of air through a sampling cassette that contains a glass slide coated with an adhesive to collect airborne particulate that impacts onto the slide. The samples are collected at a flow rate of 15 liters per minute for 5 minutes for a total sample volume of 75 liters. Elevated airborne spore concentrations may indicate an indoor microbial reservoir(s), or that cleaning of personal effects or the HVAC system(s), is a necessary 5

7 component of a microbial remediation plan. At the completion of the sampling period the cassettes are sealed and shipped to the laboratory for analysis that participates in the American Industrial Hygiene Association Environmental Microbiology Laboratory Accreditation Program (AIHA EMLAP). Six spore trap air samples were collected during our site visit. Five samples were taken within the facility to acquire inside data and one was taken outside the facility to acquire relative data. The laboratory report is attached (see Appendix D). According to the laboratory results, the total airborne microbial spore concentrations detected inside the Kitchen, Women s Dorm, and Men s Dorm were higher than that of the outdoor air. Additionally, elevated concentrations of Cladosporium sp. and Aspergillus/Penicillium sp. were detected in the Kitchen, Women s Dorm, Men s Dorm and EMS Director s Office indicative of a reservoir(s) of microbial growth inside the facility. Airborne Stachybotrys sp. was also identified in the EMS Director s Office, Women s Dorm, Men s Dorm and Kitchen, a microbial species not identified in the outdoor air. The second method of sampling performed was dust sampling of porous furnishings. Dust samples were taken to determine the quantity of microbial matter within furnishings. The samples were collected using a sample cassette with an MCE filter and a vacuum pump. An adequate amount of dust is collected in the cassette to identify the presence of microbial matter per area analyzed (6 in. 2 ). At the completion of the sampling period the cassettes are sealed and shipped to the laboratory for analysis that participates in the American Industrial Hygiene Association Environmental Microbiology Laboratory Accreditation Program (AIHA EMLAP). The general guidelines for dry fungal bulk samples are that less than 10o,000 spores/gram are within normal range; 100,000-1,000,000 spores/g is considered possible contamination; and microbial fungal concentrations more than 1,000,000 spores/g has the potential of significantly contributing to airborne populations. The quantity and types of microbes also need to be considered when making this determination. Based on the dust sampling results, the total microbial concentration within the Men s Dorm mattress was 134,454 spores/gram; 32,000 spores/gram within the Women s Dorm mattress; 41, 600 spores/gram within the Living Room sofa; and 38,400 spores/gram within clothing stored by an A/C vent. All contents were significantly less than the level of concern (i.e. 100,000 spores/gram), except the Men s Dorm mattress. Based on the sampling results, the microbial levels within the Men s Dorm mattress were considered possibly contaminated. The highest concentration of microbial matter recorded was Ascospores. 6

8 IMMEDIATE RECOMMENDATIONS 3.0 RECOMMENDATIONS No immediate recommendations. Although there was microbial contamination identified within the facility, the areas can be removed and precautions can be taken to avoid any further growth. Suggestions for remediation are included in the Specific Remediation Recommendations. It is recommended that completion of the remediation process be verified by conducting a final inspection with a post remediation inspection, including sampling. MAINTENANCE RECOMMENDATIONS 1. In the HVAC Closet, the plumbing and electrical penetrations in the ceiling finish should be sealed utilizing an expandable foam sealant or equivalent to prevent air infiltration from an unconditioned environment. 2. The ceiling cavity should be completely sealed from the exterior to prevent air infiltration of warm, humid air causing condensation and microbial issues. 3. In the Women s Bathroom, the plumbing leak should be repaired promptly to prevent water damage or microbial issues. WORK AREA PREPARATION The HVAC system serving the work area should be deactivated and critical barriers consisting of two-layers of 6-mil polyethylene sheeting should be placed over all light fixtures and non-movable items. Personal items and furnishings should be removed from the work areas and stored in a climate-controlled environment for the duration of the work. Negative pressure should be established through the use of HEPA filtered air filtration devices (AFDs). Due to the significant amount of air infiltration occurring from the exterior, negative pressure will be difficult to maintain in work areas. Therefore, all contents will most likely require removal prior to beginning any remediation. A sufficient number of AFDs must be used to provide at least 4 air changes per hour inside the containment. The work area will include various areas throughout the facility. Access to the work area should be restricted to workers performing the work. Critical barriers or other methods that restrict access to the work area should be implemented to prevent unauthorized access. 7

9 The contractor should maintain relative humidity in the work area of less than 60 percent for the duration of the work. Relative humidity measurements should be recorded at least twice daily, a minimum of 4 hours apart. If two consecutive measurements are recorded above 60 percent, additional dehumidification equipment should be installed in the work area to reduce humidity levels below 60 percent. A log of the measurements should be submitted upon completion of the project. Portable cooling equipment may be necessary to provide a comfortable work environment for workers and reduce the risk of heat stress. GENERAL REMEDIATION/RESTORATION RECOMMENDATIONS The remediation/restoration should be conducted in accordance with industry accepted practices and guidelines, including but not limited to the following: 1. Institute of Inspection Cleaning and Restoration Certification (IICRC) S520, Standard and Reference Guide for Professional Mold Remediation, First Edition, December NYC Department of Health, Guidelines on Assessment and Remediation of Fungi in Indoor Environments. 3. U.S. Environmental Protection Agency, Mold Remediation in Schools and Commercial Buildings. The contractor s professional judgment should dictate the appropriate course of action if conflicts exist between industry practices and guidelines and the recommendations contained herein. Removal of contaminated materials must be conducted in a controlled manner whereby microorganisms are not disseminated during the abatement process. Ventilation should be established within the work area, if required, to reduce the possibility of an accumulation of harmful volatile organic compounds. Ceiling tiles, wall and ceiling textures, joint tape and mud, linoleum, vinyl flooring, roof shingles and felt, if any, and other building materials may contain asbestos. Sampling of suspect materials is recommended. Remediation should include the following: cleaning contaminated materials; removing, cleaning, and reinstalling previously contaminated materials; and/or replacing contaminated materials. Non-salvageable or non-structurally sound materials or contents should be discarded. Salvageable contents within the contaminated area should be remediated. 8

10 The removal of all material should be monitored by a certified remediation supervisor/project manager in order to ensure all contamination has been removed. Removal should continue beyond the water-damaged and/or mold contaminated sections of paneling, sheetrock, or other types of wall and ceiling finishes. Professional judgment should dictate the need for further removal if additional microbial growth is identified beyond the specific recommendations listed below. The insulation should be removed and discarded, if present, within the areas of removal. If fungal contamination is identified within wall cavities, the wall finish should be removed from floor to ceiling height and the wall cavity should be thoroughly cleaned. If contamination exists on cabinetry, it should be removed for cleaning and evaluation or discarded depending on the extent of damage and the material. Non-porous fixtures (tubs, shower stalls, marble counter tops, sinks, refrigerators, etc.) may be cleaned within the work area in preparation of re-install. All contaminated materials should be contained by double bagging in 6-mil poly bags and HEPA vacuumed prior to removal from the containment area. Dust suppression methods, such as misting surfaces prior to remediation, are not recommended. Techniques such as wiping with a damp cloth should be used to prevent the dissemination of microbial spores into uncontaminated areas. All contaminated surfaces should be wiped with a cloth or sponge lightly dampened with an antimicrobial solution and allowed to dry. If microbial growth is embedded in structural wood (wall studs, floor/ceiling joists, etc.) should be lightly sanded, wire brushed, and HEPA vacuumed. The wipe down and HEPA vacuuming process should be repeated and the surface be allowed to dry. The remaining containment areas should be HEPA vacuumed and wiped down with an antimicrobial solution. The air-scrubbers should continue for 48 to 72 hours following remediation. Personnel responsible for remediation must be instructed on the proper procedures on clean up methods, personal protection equipment (PPE), potential health hazards for microbiological organisms, time limits for working inside containment (typically 1-3 hours depending on internal conditions), and location of all exits in case of emergency, etc. Respiratory protection should be in accordance with the Occupational Safety and Health Administration (OSHA) Respiratory Protection Standard (29 CFT ). During periods of high heat and humidity, dehumidification equipment and temporary/portable HVAC systems may be necessary to maintain humidity and temperature levels inside the containment area(s). Anti-fungal paint or sealant shall not be applied to any surface until a post remediation assessment has been conducted and found acceptable. 9

11 If an on-site dumpster is utilized, care should be given in evaluating its proximity to building doors, windows, ventilation, and unprotected personnel such as an outside break area or walkway. Currently there are no regulations governing the disposal of mold-ridden materials. However, contaminated materials should be wrapped or bagged in two layers of 6-mil poly and disposed of in an outdoor trash receptacle. Care should be taken to identify hazardous components of the waste being disposed of such as solvents and other chemicals that may be present with the waste material. Disposal of the hazardous components may be subject to local, state, and Federal regulations. These items should be discarded at a landfill capable of accepting hazardous items. Generally, water-damaged materials can be removed and/or repaired without special controls or establishment of containment. Water-damaged materials that are delaminating, deformed or have otherwise lost their integrity should be removed and discarded. Where materials are stained but have not lost their integrity, the materials can generally be repaired by repainting or refinishing. General dust control measures should be implemented during removal of waterdamaged material that does not contain visible microbial growth. Dust control measures may include, but not be limited to, removal of personal effects and furnishings from the work area, covering floors and non-movable items with polyethylene sheeting, and the use of local exhaust ventilation equipment. When removing water-damaged materials, care should be taken to initially remove small amounts of the material while evaluating the back sides of the material or exposed cavities for the presence of visible microbial growth. If microbial growth is observed during removal of water-damaged material, work should stop and the microbial growth evaluated in terms of degree of growth, quantity and remediation methods required prior to proceeding. Often, if the amount of microbial growth is small (i.e. less than 10 square feet) a HEPA vacuum or damp wiping with a detergent solution can be used to remove the microbial growth without establishing containment prior to the removal of the material as water-damaged material. However, where any amount of microbial growth is removed, it is recommended that access to the work area be restricted to those performing the work and that personal effects be removed or protected as necessary during the work. Previously unidentified areas of microbial growth larger than 10 square feet in area should be evaluated prior to removal. If no microbial growth was observed during the evaluation, yet hidden growth is encountered during removal of water-damaged or wet materials, a postremediation assessment may be necessary prior to restoring the work area. SPECIFIC REMEDIATION/RESTORATION RECOMMENDATIONS All ceiling tiles should be removed to allow for a thorough assessment of the entire ceiling cavity. 10

12 The water damaged insulation within the ceiling cavity should be removed and discarded. Investigative cutouts should be performed in various areas on the exterior walls, preferably where electric lines are located, to ensure no microbial growth exists on the backside of the wall finish material. If microbial growth is identified, removal should continue 2 feet beyond the areas of growth. In the HVAC Closet, all wall finish material should be removed from floor to ceiling height due to heavy microbial growth. POST REMEDIATION ASSESSMENT A post remediation assessment including sampling is suggested to ensure that the removal of affected building materials is completed satisfactorily. The re-inspection is recommended not to question the capability of the contractors, but because of the critical nature of the quality required for this process to be successful in reducing any exposure risk to the occupants. HVAC SYSTEM REQUIREMENTS AND CLEANING The A/C system servicing the area of the remediation should be sealed prior to beginning remediation. Environmental control equipment (portable A/C, dehumidifiers) may be necessary to maintain the proper environment during remediation. Based on the microbial growth observed in the HVAC Closet and evidence of ongoing condensation occurring within the A/C ductwork, the air handlers should be thoroughly cleaned. Cleaning should include the diffusers, blower compartment and all other accessible components. Contaminated porous A/C materials must be removed and replaced. The A/C ducting, including the supply and return plenums, should be removed and replaced. Fogging of the system should not be performed. Upon completion of A/C system cleaning and final work area cleaning and sealing, the A/C system may be returned to operation. In conducting the contamination evaluation during the cleaning process, the contractor should consider visible growth as cause for removal of porous items. The mere fact that contamination existed within the structure does not typically warrant the removal of porous HVAC components. According to ACR 2002 published by the National Air Duct Cleaners Association (NADCA), an HVAC system is considered contaminated when evidence of significant particulate debris and/or microbial growth exists. Further, the guideline suggests that porous materials with biological growth be removed. The HVAC cleaning contractor must also maintain proper pressurization of the system during the entire cleaning process. According to the ACR 2002 an appropriate pressure differential shall be maintained between the portion of the HVAC ductwork system being cleaned and surrounding indoor occupant spaces. 11

13 In conducting the system cleaning the contractor must consider the impact of indoor microbial levels on the entire HVAC system. HVAC system components to consider include the entire heating, air-conditioning and ventilation system from the points where the air enters the system to the points where the air is discharged from the system, including the return air grills, return air ducts to the air handling unit (AHU), the interior surfaces of the AHU, mixing box, coil compartment, condensate drain pans, humidifiers and dehumidifiers, supply air ducts, fans, fan housing, fan blades, air wash systems, spray eliminators, turning vanes, filters, filter housings, reheat coils, and supply diffusers. The HVAC system may also include other components such as dedicated exhaust and ventilation components and make up air systems. Further, the contractor should be familiar with and follow all other requirements of the ACR 2002: Assessment, Cleaning & Restoration of HVAC Systems published by the National Air Duct Cleaners Association. PERSONAL EFFECTS Personal effects and furnishings should be removed from the work areas and stored in a climate-controlled environment for the duration of the work. Non-porous and semi-porous personal items and furnishings with visible microbial growth should be HEPA vacuumed and wiped down with a detergent solution. In general, porous items with visible mold growth should be discarded. Semi-porous items, such as wood should be evaluated on a case by case basis and a determination made as to whether the items can be cleaned or should be discarded. Non-porous materials such as metals, plastic and fiberglass can usually be cleaned. 12

14 4.0 LIMITATIONS The assessment was conducted following standard practices and guidelines. LAW Environmental Health and Safety Solutions, Inc. has conducted what it believes is the applicable standard of care ordinarily exercised by a duly qualified industrial hygienist in the industry in conducting this assessment. No other warranty, express or implied, is made regarding the information contained in this report. Readings taken are only representative of the conditions existing as of the time the evaluation and sampling are conducted. LAW Environmental Health and Safety Solutions, Inc. is not responsible for any conditions that existed prior to the time the investigator performed the work set forth in the Scope of Services or for any conditions that came into existence after the investigator performed such services. We provide no guarantee the readings will not change since environmental concerns such as mold, fungus, radon, allergens, etc. are naturally occurring. The client should understand that the readings are true and accurate only as of the date and time collected. Regardless of the thoroughness of an assessment, the total extent of water damage, environmental contamination, unusual moisture conditions, or other indicators of environmental concerns may not have been evident or were inaccessible during the assessment. The amount of time between the site assessment and the completion of the assessment recommendations combined with environmental conditions in and around the structure are crucial elements in the successful resolution of the issues identified. If no environmental controls exist and an excessive amount of time elapses between the receipt of the report and the completion of the recommendations, the entire dynamic of the issues can and will change. Should additional information be presented or discovered, we reserve the right to review and, if necessary, revise this report and our conclusions in light of the new information. This report has been prepared for the sole and exclusive use of the client subject to previously agreed-upon terms and conditions. This report may not be suitable for the needs of others. Therefore, any reliance by other parties on the contents of this report is not granted and any such reliance shall be at the sole risk of the user. 13

15 REFERENCES 1. American Conference of Governmental Industrial Hygienists: Bioaerosols: Assessment and Control. ACGIH Cincinnati, OH. (1999) 2. Institute of Inspection Cleaning and Restoration Certification (IICRC) S5200: Standard and Reference Guide for Professional Water Damage Restoration (1999) 3. Shirley J. Hansen, Ph.D.; H.E. Burroughs, CIAQP: Managing Indoor Air Quality Second Edition. The Fairmont Press, Inc. Lilburn, GA (1999). 4. Suzanne Gravesen; Jens C. Frisvad; Robert A. Samson: Microfungi. Special-Trykkeriet Viborg a-s Denmark (2001). 5. Libero Ajello, PhD; George Barron, PhD; Deborah L. Jaeger, MS; George K. Morris, PhD; Charlotte M. Patton, MT (ASCP), MS; brian G. Shelton, MPH: Microbes in the Indoor Environment: A Manual for the Indoor Air Quality Field Investigator First Edition. PathCon Laboratories, Norcross, Georgia, (1998) 6. Aerotech Kalmar Laboratories: IAQ Microbiology : Reference Guide. Aerotech Laboratories, Inc. Phoenix, AZ (2000). 7. ASHRAE: ASHRAE Standard Ventilation for Acceptable Indoor Air Quality. American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. Atlanta, GA (1999). 8. NADCA: Mechanical Cleaning of Non-Porous Air Conveyance System Components. National Air Duct Cleaners Association. Washington, DC (1992). 9. AIAQC: Strategies for Conducting Meaningful Microbial Investigations. American Indoor Air Quality Council. Phoenix, AZ (2001). 10. IAQA. Certified Indoor Environmentalist-Course Materials. Indoor Air Quality Association. Annapolis, MD (1999). 11. AIAQC: Certified Microbial Remediation Supervisor-Course Materials. American Indoor Air Quality Council. Phoenix, AZ (2001). 12. EPA: Mold Remediation in Commercial Buildings and Schools. Environmental Protection Agency, Office of Air and Radiation Indoor Environments Division (2001). 13. New York City Department of Health. Guidelines on Assessment and Remediation of Indoor Environments. New York City Department of Health-Bureau of Environmental & Occupational Disease Epidemiology (2000) 14

16 APPENDIX A SITE PHOTOGRAPHS 15

17 1-BRADFORD COUNTY EMS FACILITY LOCATED AT 945-C NORTH TEMPLE AVENUE, STARKE, FLORIDA/2-ENTRY DOOR TO FACILITY 3-LOBBY AREA OF BRADFORD COUNTY EMS FACILITY /4-PLACARD DEPICTING WOMEN S RESTROOM IN LOBBY AREA 5-OVERVIEW OF WOMEN S RESTROOM IN LOBBY AREA 16

18 6-PLACARD DEPICTING MEN S RESTROOM IN LOBBY AREA/7- OVERVIEW OF MEN S RESTROOM 8-PLACARD DEPICTING COMMUNICATION COMMO ROOM/9- OVERVIEW OF COMMO ROOM 10-OVERVIEW OF SE OFFICE CONNECTED OFF LOBBY AREA AND ACROSS FROM SHERIE JEWETTS OFFICE/11-WATER STAINING NOTED ON CEILING TILES IN OFFICE 17

19 12-PLACARD DEPICTING MEN S DORM/13-OVERVIEW OF MEN S DORM 14-WATER STAINING NOTED ON CEILING TILES IN MEN S DORM/15- OVERVIEW OF JANITOR S CLOSET 16-WATER STAINING NOTED AROUND VENT IN JANITOR S CLOSET 18

20 17-PLACARD DEPICTING WOMEN S RESTROOM/18-OVERVIEW OF WOMEN S RESTROOM 19 & 20-ACTIVE WATER LEAK DETECTED UNDER SINK IN WOMEN S RESTROOM TOILET AREA 21-OVERVIEW OF KITCHEN/22-BROWN LIQUID NOTED ON FLOOR UNDER REFRIGERATOR 19

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