Laserfiche WebLink
. <br /> . � <br /> 3. Company and/or individual that conducted the building inspection and the procedure used to determine the <br /> presence or absence of ACM (inc(uding analytic method): '�Prior to demolition all buildings must be inspected by an EPA <br /> accredited inspector. <br /> /./G/�/G`� <br /> 4. Description of planned demolition and the specific method(s) that will be used: T'c'"<<,,-.;�. ,>z. �•—/� � <br /> � ' ��`� /S4`!� v s' C-'� v r.���--��../i <br /> 5. If the demolition was ordered by a government agency, please identify the agency and attach a copy of the <br /> order: <br /> Name: Title: Authority: <br /> Date of Order(M/D/Y): Date Ordered to Begin(MID/Y): <br /> * Notification for an emergency demolition must be submitted as early as possible before demolition begins,but not later than the <br /> following working day. A demolition is considered an emergency ONLY when the facility has been deemed structurally unsound and <br /> in danger of imminent collapse. If the structurally unsound building is known to contain any regulated ACbt or is suspected to <br /> contain any regulated ACNI,special procedures bfLJST be followed. If you are unaware of the special procedures, <br /> instructions/regulations can be obtained by contacting the NfPCA at the address or phone number listed below. <br /> 6. Description of procedure to be followed in the event that unespected R.ACM is found or Cat. II nonfriable <br /> ACM becomes crumbled, pulverized or reduced to powder: <br /> ' � f' �)�-�-„ - ,'r..��� ' � t � - - <br /> �Ll.v%�'�� �S�L:Tv/lJ ' Nir�-''� �� ��.+�/ ///�['�3-.�f'+-y <br /> `_r <br /> v�� <br /> J7 � �i � Si� ..� • <br /> 7. Waste Transporter Information: 8. `Vaste Disposal Information: <br /> Transported�Name: � ��%w�' W'�`�"'�C �� �'C /�"�`Y��'^=�- Landfill Name: �-'4"�`�'2�i- ��✓ <br /> Transporter Contact: ������ � �'`1(��f�� Owner/Operator: __ <br /> Transporter Address:1�'�;C� � /v r i ff .1>�_c f`% AddresslLocation: <br /> City, State,Zip:__/`��-w�-- � ,•��-i��� . cti �'� {1 y-�� City, State,Zip: ,i�--��,�cr L', •�• •✓ <br /> Phone Number: ��� - i/`��� - L' y� `/ Phone Number: <br /> 9. I cee-tify that the above informati ' c rrect and I am a bonafide representative of the demolition <br /> contractor or building o�vner d author'�y to enter into agreements for my employer. <br /> Signature of Contractor/Owne Date <br /> Send or FaY to: For questions call: <br /> Asbestos Coordinator-Air Quality Division 612-296-7300 <br /> Nfi�1 Pollution Control Agency 1-800-657-3864 <br /> 520 Lafayette RaadNorth Fax: 612-215-1593 <br /> St. Paul, �1 55155-4194 <br />