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11/09/2006 12:10 9524721810 PAGE 04 <br /> Nov-08- 1:24am Fo - TY OF ORONO +95x9494616 T-022 P.O10/O10 F-299 <br /> •2006-�.r11.1:242., <br /> 1-� »»» m�r��.mCIur+suai nun conducted the building inspection and the procedure used to determine the <br /> presence or absence of ACM(including analytic method): 'prior to demolition ail buildings must be inspected by an EPA <br /> accredited Inspector. <br /> ____4..0.41 4 W<1 06C1 1 <br /> -.._.____ _ <br /> 4. Description of planned demolition and the specific method(s)that will be used:, <br /> 5. If the demolition was ord d b a government agency,please identify the agency and attach a copy of the <br /> order; <br /> Name; Tltle:_�, <br /> �... Authority: <br /> Date of Order(111./D/11' . _ Date Ordered to Begin---- $ CM/D/ . <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 a-,ryeturally unsound end <br /> in danger of imtninemt collapse. If the structurally unsound building is known to contain any regulated ACM or is suspected to <br /> contain any regulated ACK.special procedures MUST be followed. If you are unaware of the special procedures. <br /> instructions/regulations can be obtained by eontactiing the MPCA at the address or phone number listed below. <br /> 6. Description of procedure to be followed in the event that unexpected RACMVI is.found or Cat.II nonfriable <br /> ACM becomes;rumbled,pulverized or reduced to •owder_ <br /> 7 la. .,1,-. . z r. ', <br /> i",,toi A <br /> 7. Waste Transporter Infer. ation: ,. <br /> 8. Waste Disposal Information: <br /> Transported Name; ' !; 11 <br /> ��P�Q''�' Landfill Name• <br /> TranspotterContact• tTh <br /> Transporter Adams' .4:6•54... . .. ,1 <br /> Address/Locadon• y ,- r .* <br /> City.State,Zip: , ' ►/, ;_ k --IX LL <br /> I City.Stats.Zip. ^ 0;,L p` � • <br /> Phone Number�,., Phone Number. �a w- er— . <br /> 9. I certify that the above information is correct and I am a bonafide representative of the demolition <br /> contractor or building owner and li ut, ,rity to enter into agreements for my employer. <br /> ill,mile <br /> Signature of Contractor/Ownetr ' <br /> Date <br /> .._ <br /> _._ <br /> rSend or Fax to: <br /> Asbestos Coordinator-Air Quality Division For 296-73tts call: <br /> bN Pollution Control Agency 61x-09657-38 <br /> . 64 <br /> 520 Lafayette Road North a.c 6 2-21 -1 <br /> St.Paul,I.ei 55155-4194 Fax: 612-215-1593 <br />