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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 Information• <br /> Name: Building Narne: <br /> Address: Address/Location: <br /> City,State,Zip: <br /> City,State,Zip: County: <br /> Contact Person: � Phone Number(s): <br /> Phone Number(s): Age of Bldg.(years): Size of Bldg.(sq.ft.): <br /> Number of Floors Including Basement Level(s): <br /> Building Owner: Present Use of Bldg.: <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 postrnarked oc received ten(10)working days <br /> Contact person: before demolition begins. 'See item#5 for emergency demolitions. <br /> Phone Number(s): 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 I�Iaterial (RACI� in the building <br /> to be demolished, it must be removed by a licensed asbestos contractor prior to demolition. The State of��- <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 [ ) NO <br /> If YES complete items 1-9. If NO complete items 3-9. <br /> 1. If AC1�I will be left in place for the demolitio❑ 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 /> Cateporv I nonfriable A M means asbestos-containing packings, at Eorv II nonfriable ACM means any material,excluding <br /> gaskets,resilient floor covering,and asphalt roofing produc�s Category I nonfriable ACM,containing more than one percent <br /> containing more than one percent asbestos. �sbestos that,when dry,cannot be crumbled,pulverized,or <br /> *Category I nonfriable ACr1 is not allowed to remain in place reduced to a powder by hand pressure. <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 a powder during demolition,transport, <br /> or disposal. (ex transite,cement,slate roofing) <br /> 2. Description & Location of ACi�1 remaining in place (includiog floor# and room #): <br />