HomeMy WebLinkAboutDEMO2008-00091 1005 EARL RUDDER FWY S DEMO PERMITDEMOLITION PERMIT
CITY OF COLLEGE•STATZON
1101 TEXAS AVE
COLLEGE STATION, TX•77840
PHONE: (979) 764-3570 FAX: (.979a 764-3496
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Application Number . . . . .
Application pin number . . .
Property Address . . . . . .
Property ID:
R #•
Tenant nbr, name . . . . . .
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . .
Application valuation . . . .
08-00000091 Date 1/15/08
409401
1005 EARL RUDDER FWY S
305500-0101-0010
R89892
DEMO EXISTING GOLF OFFICE
DEMOLITION, COMMERCIAL
GREENSWORLD SUBD PHS 1
COMMERCIAL INDUSTRIAL
6000
Owner Contractor
REGENCY PARKWAY INC REGENCY PARKWAY,INC
ATTN: MICHAEL K DAVIS OUTSIDE CITY LIMITS-BL
4002 ASPEN ST COLLEGE STATION TX 77840
BRYAN TX 778014705 (979) 229-1959
--- Structure Information 000 000 DEMO EXISTING GOLF OFFICE & SHED
Construction Type . . . . . COMBUSTIBLE (UNPROTECTED)
Occupancy Type . . . . . . BUSINESS
Other struct info . . . . . TRAFFIC IMPACT ANAL (TAZ) 209.00
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Permit . . . . . . DEMOLITION PERMIT
Additional desc . . KW
Permit pin number . 545038
Permit Fee . . . . 25.00 Plan Check Fee .00
Issue Date . . . . 1/15/08 Valuation . . . . 6000
Expiration Date . . 7/13/08
Qty Unit Charge Per Extension
BASE FEE 25.00
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Special Notes and Comments
*ELECTRICAL SHALL BE INSTALLED PER 2005 National Electrical
Code & LOCAL AMENDMENTS
CONSTRUCTION ACTIVITY BETWEEN THE HOURS OF 10:00 PM AND
7:00 AM MUST COMPLY WITH THE NOISE ORDINANCE (MAX. 55 DBA)
*POST PERMIT CARD ON JOB SITE TO BE VISIBLE FROM ROAD
*ALL PLUMBING, ELECTRICAL, AND HVAC (mechanical) WORK MUST
BE PERFORMED BY LICENSED CONTRACTORS. CONTACT BUILDING
DEPARTMENT FOR INSPECTIONS PRIOR TO COVERING ANY WORK
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
---------------------------------------------------------
--- --------
BUILDING ----------------
BUILDING DEPT REPRESENTATIVE:
APPLICANT: dJZ�
DEMOLITION PERMIT
CITY OF COLLEGE'STATION
1101 TEXAS AVE
COLLEGE STATION, TX-77940
PHONE: (979) 764-3570 FAX: (,979) 764-3496
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Page 2
Application
Number . .
. . . 08-00000091
Date 1/15/08
Application
pin number
. . . 409401
Permit Fee
Total
25.00 25.00
.00 .00
Plan Check
Total
.00 .00
.00 .00
Grand Total
25.00 25.00
.00 .00
-------------------
BUILDING DE
APPLICANT:
1`
o
APPLICATION FOR BUILDING PERMIT
CITY OF COLLEGE STATION
1101 TEXAS AVENUE
COLLEGE STATION, TX 77840
CITY OF COLLEGE STATION (979) 764-3570•(979) 764-3496 FAX
Planning d Development Servant
WWW.CSTX.GOV
Fr OK a Onlyg
DATE: ' " �� � REG
APPLICATION #
TEMP POLE #
ADDRESS/LOCATION: /aO_lr L z. -st�
LOT BLOCK SUBDIVISION
SEC/PH
BUSINESS/OWNER NAME: NSG✓orAL
[&/tC-e_�
PHONE:9219,
CONTRACTOR/HOMEOWNER: 2C Lodi
PHONE:
CONTACT PERSON FOR REVIEW COMMENTS:
PHONE: 19 Z-I-
;429• I9S 9
FAX:
ELECTRICIAN:
HVAC:
EMAIL:
PLUMBER:
GOOD CENTS (Residential only):
ACCESSORY/STORAGE MOVING RE -ROOF
ADDITION NEW CONSTRUCTION` SHELL ONLY
DEMOLITION (ASBESTOS SURVEY) PORTABLE STORAGE (RESIDENTIAL) SLAB ONLY
DUPLEX (LANDSCAPE PLANS REQUIRED) PORTABLE STORAGE (NON-RESIDENTIAL) SWIMMING POOL
LOCATION REMODEURENOVATION" TENTS
DESCRIPTION OF WORK: &A
PROPOSED USE:
STRUCTURE USE:
HOMEOWNER ASSOC IATION/ARCHITECTUAL OR DESIGN REVIEW COMMITTEE APPROVAL:
TEXAS ACCESSIBILITY STANDARD (TAS) PROJECT REGISTRATION# EABPRJ
VALUATION: $ 6, ' U , m d
TOTAL AREA: HEATED AREA:
�. (Cost of Labor and Materials)
PUBLIC SEWER
NUMBER OF BEDROOMS:
SEPTIC/TREATMENT SYSTEM
NUMBER OF BATHROOMS:
❑ SEWER TAP:
INTERIOR WALL TYPE:
SIZE
WATER TAP:
EXTERIOR WALL TYPE:
SIZE
OTHER TAP:
FOUNDATION TYPE:
SIZE
❑ TEMP POLE
ROOF TYPE:
GARAGE TYPE: SINGLE F__1
DOUBLE a TRIPLE a
ATTACHED F1
DETACHED F__] CARPORT
SIGNATURE OF APPLICANr:
*If proposed work involves new commerce construction or facade improvements/renovations to an existing
commer ial property, building elevations are required.
............................................................
—111 01 4e�
Official Use Only
N/ Co ments:
T ES r NO
Plans Examiner Zoning Official
Energy Code Compliance Information
% Glazing of exterior walls
Insulation R value of exterior walls
Insulation R value of ceiling 1 (flat areas)
Insulation R value of ceiling 2 (vaulted areas/no attic)
Glazing SHGC (Solar Heat Gain Coefficient)
Glazing U-Factor
R value of ductwork
A/C SEER Rating
Protection Against Subterranean Termites
❑ Chemical Termiticide Treatment (Soil Treatment)
❑ Chemical Termiticide Treatment (Field Applied Wood Treatment)
❑ Physical Barriers
❑ Other
* Verification of Application shall be submitted to the City of College Station
Building Division prior to issuance of the Certificate of Occupancy.
r
Building Inspection Report for
Asbestos -Containing Building Materials
Vacant Building and Storage Shed
1005 E. Earl Rudder Freeway
College Station, Texas
Prepared for:
Mr. Mike Davis
4002 Aspen
Bryan, Texas 77801
PROJECT NO:
AE08-13
Prepared by:
Austin Environmental, Inc.
Environmental Consultants
P.O. Box 3725
Bryan, Texas 77805-3725
979-778-2699
979-778-2730-Fax
January 11, 2008
AUSTIN ENVIRONMENTAL, INC. P.O. BOX 3725 BRYAN, TX 77805 (979) 778-2699
TABLE OF CONTENTS
REPORT..................................................................................1-4
Section 1 PLM Report
Section 2 PLM Detail Report
Section 3 Chain of Custody Forms
Section 4 Asbestos Licenses
AUSTIN ENVIRONMENTAL, INC. P.O. BOX 3725 BRYAN, TX 77805 (979) 778-2699
AUSTIN ENVIRONMENTAL, INC.
r P.O. Box 3725
Bryan, Texas 77805-3725
r 9 (979) 778-2699
( 79) 778-2730 Fax
January 11, 2008
' Mr. Mike Davis
r 4002 Aspen
iCollege Station, Texas 77801
RE: Asbestos Inspection -Vacant Building and Storage Shed-1005 E. Earl
Rudder Freeway, College Station, Texas
Dear Mr. Davis:
On January 9, 2008, at the request of Mr. Red Scarmardo, Mr. Brent Plant, M.P.H.,
R.S., of Austin Environmental, Inc., conducted an asbestos inspection of the above
referenced buildings.
The purpose of the inspection was to determine the presence and location of suspect
friable and non -friable asbestos -containing building materials (ACBM) prior to
demolition activities.
The federal National Emission Standard for Hazardous Air Pollutants (NESHAP) 40
Code of Federal Regulations (CFR) Part 61, subpart M, and the Texas Asbestos
Health Protection Rules (TAHPR) requires that prior to any renovation or demolition of
a commercial or public building that it must be inspected for the presence of suspect
ACBM.
AUSTIN ENVIRONMENTAL, INC. P.O. BOX 3725 BRYAN, TX 77805 (979) 778.2699
January 11, 2008
Page 2
' The scope of work and services provided include:
' ♦ Field investigation and visual observations
♦ Define homogeneous areas and sampling strategy
! ♦ Sampling of suspect asbestos -containing building materials
I♦ Analysis of suspect asbestos -containing building materials
♦ Collect information on the friability of asbestos -containing building' materials
I
Suspect ACBM was physically handled to determine friability and bulk samples were
obtained for analysis. The inspection involved sampling of eleven 01) suspect
asbestos -containing building materials. The samples were analyzed utilizing
Polarized Light Microscopy with Dispersion Staining (PLM/DS), EPA Method 600 /R-
93/ 116. The PLM results are attached to this report.
OBSERVATIONS
The vacant building consists of a wood frame construction built on a concrete slab
foundation. The storage building consists of a wood frame construction.
SURVEY
The inspection was conducted on a homogenous -area basis with the construction
materials sampled and tested that are suspect to contain asbestos and that may be
disturbed during demolition activities. Suspect materials sampled included; drywall
texture, 12" x 12" floor tile and mastic (two types) and roofing shingles (two types).
AUSTIN ENVIRONMENTAL, INC. P.O. BOX 3725 BRYAN, TX 77805 (979) 778-2699
January 11, 2008
Page 3
RESULTS
All samples collected and analyzed were "none detected" for asbestos.
1
REQUIREMENTS
r_
• A ten (10) working day notification is required to be submitted to the
Department of State Health Services (DSHS) prior demolition of the
t buildings.
f
All materials detected/uncovered during present or future renovations or demolitions
that are not listed, as being sampled on the Chain of Custody Form and will be
disturbed, must be sampled and analyzed prior to disturbance. All additional samples
I
and assessments are to be conducted by properly licensed individuals.
LIMITATIONS
This report only applies to the scope of work described herein. This report describes
existing conditions at the time of services. This report applies only to accessible areas
observed during our field services. Asbestos -containing materials may exist in
concealed inaccessible enclosures, such as areas enclosed by permanent partitions,
chases, shafts, equipment etc. Material locations and quantities may vary.
Although a good -faith effort was made to locate asbestos -containing materials in the
area within the scope of work, extensive destructive inspection and/or testing was not
conducted due to the expense, potential exposure hazards and regulatory violations.
AUSTIN ENVIRONMENTAL, INC. P.O. BOX 3725 BRYAN, TX 77805 (979) 778-2699
January 11, 2008
Page 4
All surfaces, paints, wire insulation, electrical panels, fire rated doors and panels,
furnishings, Heating Ventilation and Air Conditioning (HVAC) Systems, fibrous glass
containing products, fixtures and similar materials and equipment were not sampled
and analyzed due to safety concerns and expense.
Inspection and testing for fungi, lead -based paint, PCB containing light ballasts and
other hazardous or regulated materials was not included in the scope of work of this
project. Austin Environmental Inc. makes no warranty and assumes no liability for the
inappropriate use or misuse of this document.
We appreciate
pp crate the opportunity to provide you with this asbestos Inspection. Should
you need any further environmental services please contact us at (979) 778-2699.
Respectfully Submitted,
AUSTIN ENVIRONMENTAL, INC.
500,0 �: Rr
* •• •00-009
i■i BRENT W. PLANT
....................
, 10-5636
Brent W. Plant M.P.H., R.S. 9�et:�;Ql c ph.
���`
Individual Asbestos Consultant License No. 10-5636
Asbestos Consultant Agency License No. 10-0313
AUSTIN ENVIRONMENTAL, INC. P.O. BOX 3725 BRYAN, TX 77805 (979) 778-2699
PLM Summary Report
Steve Moody Micro Services, Inc. NVLAP Lab No. 102056
2051 Valley View Lane TDH License No. 30-0084
Farmers Branch, TX 75234 (Phone 972-241-8460)
Client: Austin Environmental, Inc. Lab Job No.: x8B-00273
Project : Vacant Bldg & Storage Shed, 1005 E Earl Rudder Fwy, CS Report Date : 01/10/2008
— —Project-# : AE08-13 Sample Date : Not Provided
Identification : Asbestos, Bulk Sample Analysis
Test Method : Polarized Light Microscopy / Dispersion Staining (PLM/DS)
EPA Method 600 / R-93 / 116 Page 1 of 2
On 1/10/2008, eleven (1 1) bulk material samples were submitted by Brent Plant of Austin Environmental, Inc. for asbestos analysis by PL.M/DS. The
P1..M Detail Report is attached; additional information may be found therein. The results are summarized below:
Sample Number
Client Sample Description / Location
Asbestos Content
OlA
Drywall, South, Kitchen, Ceiling
None Detected - Drywall Material
None Detected - Texture
OlB
Drywall, Inside East Door, Wall
None Detected - Drywall Material
None Detected - Texture
O1C
Drywall, Storage Room, Outside Wall, North
None Detected - Drywall Material
None Detected - Texture
02A
12" x 12" Floor Tile (Green) and Mastic, Kitchen, Center
None Detected - Floor Tile
None Detected - Clear Mastic
None Detected - Debris
02B
12" x 12" Floor Tile (Green) and Mastic, Kitchen, at South
None Detected - Floor Tile
Wall
None Detected - Clear Mastic
None Detected - Leveling Compound
02C
12" x 12" Floor Tile (Green) and Mastic, Kitchen, at East
None Detected - Floor Tile
Entry
None Detected - Clear Mastic
03A
12" x 12" Floor Tile (Brown) and Mastic, Storage Room,
None Detected - Floor Tile
at Entry
None Detected - Clear Mastic
03B
12" x 12" Floor Tile (Brown) and Mastic, Storage Room,
None Detected - Floor Tile
Center
None Detected - Clear Mastic
03C
12" x 12" Floor Tile (Brown) and Mastic, Storage Room,
None Detected - Floor Tile
at Back Wall
None Detected - Clear Mastic
04
Roof Shingle, Southeast Corner of Vacant Building
None Detected - Aggregate
None Detected - Roofing Shingle
05
Roof Shingle, Storage Shed, West Side of Roof
None Detected - Aggregate
None Detected - Roofing Shingle
I
I
I
PLM Summary Report
Steve Moody Micro Services, Inc. NVLAP Lab No. 102056
2051 Valley View Lane TDH License No. 30-0084
Farmers Branch, TX 75234 (Phone 972-241-8460)
Client: Austin Environmental, Inc. Lab Job No.: x8B-00273
Project : Vacant Bldg & Storage Shed, 1005 E Earl Rudder Fwy, CS Report Date : 01/10/2008
Project # : AE08-13 Sample Date: Not Provided
Identification : Asbestos, Bulk Sample Analysis
Test Method : Polarized Light Microscopy / Dispersion Staining (PLM/DS)
EPA Method 600 / R-93 / 116 Page 2 of 2
On 1/10/2008, eleven (11) bulk material samples were submitted by Brent Plant of Austin Environmental, Inc. for asbestos analysis by PLM/DS. The
PLM Detail Report is attached; additional information may be found therein. The results are summarized below:
Sample Number
Client Sample Description / Location
Asbestos Content
These samples were analyzed by layers. Quantification, unless otherwise noted, is performed by calibrated visual �^ —��
estimate. Results may not be reproduced except in full. This test report relates only to the samples tested. These ti��//J
test results do not imply endorsement by NVLAP or any agency of the U.S. Government. Accredited by the 'p
National Voluntary Laboratory Accreditation Program for Bulk Asbestos Fiber Analysis under Lab Code 102056.
Analyst(s): Michael Mcleister
Lab Manager: Bruce Crabb Approved Signatory: _
~��G� ��1'���y — — —
Lab Director: Steve Moody Approved Signatory:
— — — — — — — — — — — Thank you for choosing Steve Moody Micro Services — — — — — — — —
Steve Moody Micro Services, Inc. PLM Detail Report TDH License No. 30-0084
2051 Valley View Lane Supplement to PLM Summary Report NVLAP Lab No. 102056
Farmers Branch, TX 75234
Client: Austin Environmental, Inc. Lab Job No.: x8B-00273
Project : Vacant Bldg & Storage Shed, 1005 E Earl Rudder Fwy, CS Report Date : 01/10/2008
Project # : AE08-13
Sample Number
OIA
O1B
O1C
02A
Layer
Drywall Material (White)
DW Paper Facing (Tan)
Texture (White)
Drywall Material (White)
DW Paper Facing (Tan)
Texture (White)
Drywall Material (White)
DW Paper Facing (Tan)
Texture (White)
Floor Tile (Green)
Clear Mastic (Clear)
Debris (Beige)
Note: Incidental Debris Attached To Mastic
02B Floor Tile (Green)
Clear Mastic (Clear)
Leveling Compound (Beige)
02C Floor Tile (Green)
Clear Mastic (Clear)
03A Floor Tile (Brown)
Clear Mastic (Clear)
03B Floor Tile (Brown)
Clear Mastic (Clear)
% Of
Sample
Components
65%
Cellulose Fibers
Gypsum / Binders
10%
Cellulose Fibers
25%
Calcite / Talc / Binders
30%
Cellulose Fibers
Gypsum / Binders
15%
Cellulose Fibers
55%
Calcite / Talc / Binders
65%
Cellulose Fibers
Gypsum / Binders
20%
Cellulose Fibers
15%
Calcite / Talc / Binders
90%
Calcite / Vinyl Binders
5%
Glue Binders
5%
Cellulose Fibers
Aggregate/Calcite
Glass Wool Fibers
Nonfibrous Particles
90%
Calcite / Vinyl Binders
5%
Glue Binders
5%
Aggregate
Calcite / Binders
95%
Calcite / Vinyl Binders
5%
Glue Binders
95%
Calcite / Vinyl Binders
5%
Glue Binders
95%
Calcite / Vinyl Binders
5%
Glue Binders
Page 1 of 2
% of
Analysis
Layer
Date
Anal}
5%
01/10 MM
95%
100%
100%
5%n
01/10 MM
95%
100%
100%
5%
01/10 MM
95%
100%
100%
100% 01/10 MM
100%
55 %
30%
5%
10%
100% 01/10 MM
100%
60%
40%
100% 01/10 MM
100%
100% 01/10 MM
100%
100% 01/10 MM
100%
Steve Moody Micro Services, Inc.
PLM Detail Report
TDH License No. 30-0084
[2,05MI Valley View Lane
Supplement to PLM Summary Report
NVLAP Lab No. 102056
arers Branch, TX 75234
Client: Austin Environmental, Inc.
Lab Job No.: x8B-00273
Project : Vacant Bldg & Storage Shed,
1005 E Earl Rudder Fwy, CS Report Date
: 01/10/2008
Project # : AE08-13
Page 2 of 2
Sample Number Layer
y
% Of
Components
% of Analysis
ample
Analyst
Layer Date
03C Floor Tile (Brown)
95%
Calcite / Vinyl Binders
100% 01/10 MM
Clear Mastic (Clear)
5%
Glue Binders
Aggregate
100%
100%n 01/10 MM
04 Aggregate (Black/Brown) 25%
Roofing Shingle (Black)
75%
Glass Wool Fibers
15%
Calcite
25%
Tar Binders
Aggregate
60%
100% 01/10 MM
05 Aggregate (Black/Brown) 25%
Roofing Shingle (Black)
75%
Glass Wool Fibers
15%
Calcite
25%
Tar Binders
60%
11
.^ ...� .. 3, .....t ,Tr - = I,-,,,--- .
ce?
SMMS Asbestos Chain of Custodv Page_of 2
PIA -Balk: Rush=1 day ♦ gNormal-2 day • ❑ Extended PCM-Air- ❑ Rush=same day • ❑ 1-2 day Lab Job# - 0 h R
ANALYZE ALL ♦ ❑ P0snwE STOP TEM-Air. ❑ 6 hr • ❑ 12 hr • ❑ 24 hr Lab Job#
TEM-BuUUWipeJWac: ❑ 24 hr • ❑ 48 hr ♦ ❑ 72 hr Lab Job#
•*Plme call in advance for after -hour do weekend rush analysis" TEM-7402/Modified: ❑ 24 hr ♦ ❑ 48 hr • ❑ 72 hr
Company Name and City:Austin Environmental, Inc.
Submitter's Name: Brent Plant U J Sample date: P.O. No:
Project: '%,I g�aa, �ebS E - rL�r-( R�r�� C. - °/, Project No: l4eop,i i
Contact Information: Name: Brent Plant Phone #: 979,778,2699
E-mail: (address): brentplant@yahoo.com Mobile #: 979.492.5104
Hard copy: (address): P.O. Box 3725, Bryan, Texas 77805 Fax #: 979.778.2730
Invoice Address (if different):
••• Please review paperwork an♦ smWies before su&m1A l to lab. UaconAd ml /iwproperly poekagd sampler or ercesdn dnbdstrablve rgres& may incur ddidonel fegm • • *
Sample Description
Location Notes
�Wv
Dim s� _ I
► • Ial
••
f'11 n
Rela
Dat ,
Received By:
6)la
DatdTime:
Released by.
Dal ime:
Received By:
Datd/Time:
Notes:
Steve Moody Micro Services. Inc. - 2051 Valley View Ln. - Farmers Branch. TX 75234 - (972) 241-8460 / FAX (972) 241-8461 NVLAP Lab 9102056 TX DSHS License 9 30-0084 /COC 2007)
kyA
W !—III
"F_-_ .'I.x'. 1)F.a�C•k': - t!rG'; +.R"i,' l�^." .. .%T - , _. v .. —.117_ .-. v _ .
p
It
.s 1
SMMS Asbestos Chain of Custody
PLM-Balk: ❑ Rush=1 day • XNormal=2 day ♦ ❑ Extended
ANALYZE ALL • ElITI POSVE STOP
ase •"Plecall advance for after -hour & weekend rush analysis"
Company Name and City:Austin Environmental, Inc.
PCM-Air: ❑ Rush=same day • ❑ 1-2 day
TEM-Air. ❑ 6 hr ♦ ❑ 12 hr ♦ ❑ 24 hr
TEM-BnWWipe/Wac: ❑ 24 hr • ❑ 48 hr • ❑ 72 hr
TEM-7402/Modified:❑ 24 hr ♦ ❑ 48 hr ♦ ❑ 72 hr
Page _ of
Lab Job#2�3_
Lab Job#
Lab Job#
Submittees Name: Brent Plant r4 ys Sample date: P.O. No:
Project: Id S £, ar Project No: 08 —13
s
ConUct Information: Name: Brent Plant Phone #: 979,778,2699
E-mail: (address): brentplant@yahoo.com Mobile #: 979.492.5104
Hard copy: (address): P.O. Box 3725, Bryan, Texas 77805 Fax C 979.778.2730
Invoice Address (if different):
• •• Please redew paperWrk and samples Were sabmini g go" Uaconrdaed /lwproperly packaged sawples or escenbe zdaftfWa6v requests may Incur addWmelfieem to
Sample No.
Sample Description
Vol. / Area
Location / Notes
RA t CA r•
c
LJe
a
Re
Dat
Received By:
�
Duelrime:
•-/av 8 ��� aO�
Relaxed by:
Dalril.
Received By:
Deterrime-
Notes:
Steve Moody Micro Services. Inc. - 2051 Valley View Ln. - Farmers Branch, TX 75234 - (972) 241-8460 / FAX (972) 241-8461 NVLUP Lab #102056 TX DSHS License # 30-0084 (COC 20071
Control No:
20�=TEXAS OS(ervices 9312 Department of State Health Sen ices certifies that:
'W -PLANT
Individual Asbestos Consultant
icenke,Number: 105636
VV25/2006'..
To: 05/24/2008
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
AUSTIN ENVIRONMENTAL INC
is cen ed to perform as a
Asbestos Consultant Agency
in the State of Texas within the purview of Texas Occupations Code, chapter 1954, so long as this license is not
suspended or revoked and is renewed according to the rules adopted by the Texas Board of Health.
License Number: 100313
Control Number: 96035
DAVID LAKEY, M.D.
COMMISSIONER OF HEALTH
VOID IF ALTERED NON -TRANSFERABLE
Expiration Date: 6/5/2009
(Void After Expiration Date)
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
* it kn"ft tfwt
SnV19 MOODY NUCRO SERVICES, INC
A certifud to pwftnn as a
Asbatog Laboratory PLM, TEM, PCM
A the State oy Taw within the purview of Texas Occupations Code, chapter 1954,
so long as this license Is no-1 suspended or revoked and is rengwed- according to the
rules gdoptedy MV e-w Board of Health,
be .
'Eduatdo 1, e, 5WTjr.O., 9V-
1mroz
cafflmwkw qfy4&fi
Liatm,Wum&r. JQ0Q9
(Effective Oats WD1006
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("Aftff Evimdou Otte)