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, . Minnesota Pollution Control Agency <br /> Notification of Intent to Perform a Demolition <br /> �� Type of Notification [ ] Original [ ] Amended [ ] Project Cancellation <br /> Demolition Contractor• Building Iaformation• <br /> Name: T� � � <br /> Building Name: <br /> Address: - Address/Location:_ /� �-r �.�.�jtt�/�,� �� �� <br /> City,State,Zip: L-.D /�--� L.�-/��, ��'l.' - ''�' S'� <br /> ! . ,� <br /> City,State,Zip: County: <br /> Contact Penon: � Phone Number(s):_ F���'-�Z�— �`7� 3 <br /> Phone Number(s): Age of Bldg.(years): Size of Bldg.(sq.ft.): <br /> Number of Floors Including Basement Level(s): <br /> Building Owner• <br /> I Present Use of Bldg.: <br /> Name: Z � � / �� <br /> Prior Use of Bldg.: <br /> Address: ���� <br /> o Dates when demolition or intentional burning <br /> .� will Begin I & End % C,��2L� <br /> City,State,Zip: _ <br /> � Notification must be postmarked or received ten(10)working days <br /> Contact person: before demolition begins. 'See item#5 for emergency demolitions. <br /> Phone Number(s): ����'ZZJ'-Z `} [�� Both Beginning and Ending dates should be amended in writing as <br /> necessary to reflect current project dates. <br /> If there is>260 linear feet or>160 square feet of Regulated Asbestos-Containing 1�laterial (RAC1V� in the building <br /> to be demolished,it must be removed by a licensed asbestos contractor prior to demolition. The State of M1i I- <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 ? ( ] 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 ACM left in place. <br /> Categ. I Linear Feet Categ.II Linear Feet <br /> Square Feet Square Feet <br /> Cubic Feet Cubic Feet <br /> �t gorv I nonfriable 4Ch�means asbestos-containing packings, at EorY II nonfriable A .M means any material,excluding <br /> gaskeu,resilient floor covering,and asphalt roofing products Category I nonfriab(e AC�f,containing more than one percent <br /> containing more than one percent�sbestos. asbestos thac,when <br /> *Category I nonfriable ACii is not allowed to remain in place reduced to a powder by�hand pressur�bled,pulverized,or <br /> for demolition if it is in poor condition. *Category II nonfriable AC�1 is not allowed to remain in place <br /> for demolition if it has a high probability of becoming crumbled, <br /> pulverized,or reduced to s powder during demolition,transport, <br /> or disposal. (ez transite,cement,slate roofing) <br /> 2. Descriptio� & Location of ACM remaining in place (including floor#and room #): <br />