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, � - ' Minnesota Pollution Control Agency <br /> Notification of Intent to Perform a Demolition <br /> 1 : v �� Type of NotiGcation [ J Original [ ]Amended [ ]Project Cancellation ` <br /> Demolition Contractor: Building Informatinn� <br /> Name: Building Name: <br /> Address: Address/Location: <br /> Ciry,State,Zip: <br /> Ciry,State,Zip: County: <br /> Contact Person: � Phone Number(s): <br /> Phone Numbor(s): Age of Bldg.(yean): Size of Bldg.(sq.ft.): <br /> Number of Floors Including Basemont Level(s): <br /> Building O�vner: PresentUseofBld <br /> s• <br /> Name: Prior Use of Bldg.: <br /> Address: <br /> Dates when demolition or intentional burning <br /> will Begin & End <br /> City,State,Zip: <br /> Notification must be pomnarked or rcceived ten(10)working days <br /> Contact person: before demolition begins. 'See item#S for emergency demolitions. <br /> Phone Number(s): Both Beginning and Ending dates should be amended in writing as <br /> nzcessary to rcflect current project dat.s. <br /> If there is>2601inear feet or>160 square feet of Regulated Asbestos-Containing Material (RAC� in the building <br /> to be demolished,it must be removed by a licensed asbestos contractor prior to demolition. The State of NI�Y- <br /> Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal. <br /> Is nonfriable AC�I present in the structure to be demolished ? [ ] YES [•J NO <br /> If YES complete items 1-9. If NO complete items 3-9. <br /> 1. If ACM will be left in place for the demolition indicate the amount of Category I and/or Category II <br /> nonfriable ACI�I left in place. <br /> Categ.I Linear Feet Categ.II Linear Feet <br /> Square Fcet Squarc Feet <br /> Cubic Feet Cubic Feet <br /> CateQo�y_,j nonfriable ACM means asbestos-containing packings, ateQ�ii nonfriable A .M means any material,excluding <br /> gaskets,resilient floor covering,and asphalt roofing products Category I nonfriable AC�1,containing more than one percent <br /> containing more than one percent asbestos. asbestos that,when dry,cannot be crumbled,pulverized,or <br /> •Category I nonfriable ACIi is not allowed to remain in place rcduced to a powder by hand pressure. <br /> foc demolition if it is in poor condition. •Category II nonfriable AC`f is not allowed to remain in place <br /> for demolition if it has s high proba6ility of becoming crumbled, <br /> pulverized,or reduced to a powder during demolition,transport, <br /> • or disposal. (ez transite,cement,slate roofing) <br /> 2. Description & Location of AC�I remaining in place (including floor#and room#): <br />