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' Minnesota Pollution Control Agency <br /> Notification of Intent to Perform a Demolition <br /> e �� Type of Notification �j Original [ ]Amended [ ]Project Cancellation <br /> - pemolition . ntractor• �iuilding Informallon• <br /> Name:_.l�D/�s GJi4 s�•��� �Kfip✓/i�7'✓G Building Name: ��//JE�c� <br /> Address: Address/Location: `�a o 3 �/�Tl�Sh�p�r� O/� <br /> —�� City,State,Zip:__ f�6�o,✓d , �.-�../ ��y <br /> City,State,Zip: /� C QU�^-�-�'GPUN �^�✓ � County� �/��/� ' ' <br /> Contact Person: �'9�`yt i�G Q�.�-- Phone Number(s): ��f� <br /> Phone Number(s): ��a���S ��09 Age of Bldg.(years):� Size of Bldg.(sq.R): ��� <br /> Number of Floors Including Basement Level(s): � <br /> Building Owne_r� � <br /> Present Use of Bldg.:�c�r�DL�'l✓LC <br /> Name: ./�`�` G l/r7'�4,F'.sor� <br /> Priot Use of Bldg.:_�t�J /OC��� <br /> Address: `1 �-'e� 1'�2EZ s�G-� lf�� ' <br /> � Dates when demolition or intentiona burning <br /> c. �/� will Begin `�' zS a,T & End 26� <br /> Clry�J'�C�Zip:SP��A/G �/r"Dli� /�1N v �(�y <br /> Notification must be postrnarked or received ten(10)working days <br /> Contact person_��`� ��e�'w-s�! _ before demolition begins. *See item#5 for emergency demolitions. <br /> Phone Number(s): ��� Y�/— D.� '/ 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 Material(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 ? [ ] 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 II <br /> nonfriable ACM left in place. <br /> Categ.I Lineaz Feet Categ.II Linear Feet <br /> Square Feet Square Feet <br /> Cubic Feet Cubic Feet <br /> Categ�_I nonfriable AGM means asbestos-containing packings, Categ�II nonfriable A M 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 one percent asbestos. �cbestos that,when dry,cannot be crumbled,pulverized,or <br /> ''Category I nonfriable ACM 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 ACM is not allowed to remain in place <br /> for demalition if it has a high probability of becoming crumbled, <br /> pulverized,or reduced to a powder du�ing demolition,transport, <br /> • or disposal. (ex transite,cement,slate roofing) <br /> 2. Description& Location of ACM remaining in place(including floor#and room�: <br />