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� ,. <br />� ' ` Minnesota Pollution Control Agency <br /> Notification of Intent to Perform a Demolition <br /> V'� Type of Notification [ J 4ri inal <br /> g [ ]Amended [ ]Project Cancellation <br /> Demolition Contractor: . Building Information• <br /> Name:-W I�n pN �4 u S P� l)c�.o ✓�'�'.'�� Building Narece• <br /> Addras:�7�iL7 = �� �l u �R�✓ Address/Location:_ ��et 5 S��K i!t,� ��1� ,p� <br /> C��a,aNe n'I/� -�53a 2 O�o�,� �/U .sS �s 6 <br /> - c�cy,sc�c�,z�p:_ <br /> c�ty,srace,zip: � councy: �v�e�J;,�,.� � <br /> Contact Penon: D a�✓N ' Phone Number(s): <br /> Phone Number(s): QS�''yd�� 56 S 3 Age of Bldg.(years):�v? Size of Bldg.(sq:R): <br /> Number of Floon Including Bascment Level(s): � <br /> Building Owner: p J / <br /> �/ Present Use of Bldg.: l�P 5 i d P�/7 ,-a <br /> N��: �a� � C,�r�l y �vP2 p <br /> p Prior Use of Bldg.:_ I��s i�l ti��� <br /> Address•_f /�S S,pfl r'�{,� ����l��, , <br /> Dates when de olition or intention 1 urning <br /> will Begin /A o Z- & End �/ s o2 <br /> ciry,stac�,zip: ORv�vv /�?,/l� S5 35G � <br /> Notification must be postmarked or rcceived ton(10)working days <br /> Contact penon: before demolition begins. •See item#S for emergency demolitions. <br /> Phone Number(s):_�� 3 - �7 3- a 6�3 Both Beginning and Ending dates should be amended in writing as <br /> nccessary to reflect current project dates. <br /> If there is>2601inear feet or>160 square feet of Regulated Asbestos-Containing l�iaterial(RAC1Vn in the building <br /> to be demolished,it must be removed by a licensed asbestos contractor prior to demolition. The State of MN. <br /> Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal.� <br /> Is nonfriable ACM present in the structure to be demolished ? [X]YES [ ]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 I� <br /> nonfriable ACM left in place. �^ Y:__`_ <br /> , . <br /> Categ.I Linear Feet Categ.II Lineaz Feet � . � <br /> Square Feet Square Feet <br /> Cubic Feet Cubic FeeC <br /> Cate��i nonfriabie ACM means asbestos-containing packings, at Porv Ii nonfriable AGI�"means any material,excluding <br /> gaskets,resilient floor covering,and asphalt roofing products Category I nonfriable ACM,containing more than one percent <br /> containing more than o.ne percent asbestos. asbestos that,whrn dry,canciot be cnimbled,pulverized,or <br /> •Category I aonfriable ACM is aot allowed to remain in place reduced to a powder by hand pressure. <br /> for demolition if it is in poor condition. •Category II nonfriable AChf is not allowed to remain in pl�ce <br /> for demolition if it has a hiQh probability of becoming crumbled� <br /> pulverized,or reduced to a powder during demolition�trsnsport, <br /> - or disposal. (ex transite,cement,slate roofing) <br /> 2. Description & Location of ACM remaining in place(including tloor#and room#): <br /> �c CC l�PM G J� B,� I/'e;� f�.�;�d.�,v �� <br /> 2 38v� .�,,,e�� K;u` g�r� <br /> .Sk� � l0 <br /> i k--.-->>. �`°�W /�'�N .� � . . <br />