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CITY OF ORONO IN 6124730510 08/28/98 14:13 [5 :12/12 NO:689 <br /> 3. Company and/or individual that conducted the building inspection and the procedure used to determine the <br /> t.- presence or absence of iCM(including analytic method): *Prior to demolition all buildings must be inspected by an EPA <br /> accredited Inspector. <br /> 4. Description of planned demolition and the specific method(s) that will be used: IJ`mkt i 0/12 a‘i-e <br /> t <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: of t /2— <br /> Title: Authority: <br /> Date of Order(M/D/Y): f Date Ordered to Begin(M/D/Y): <br /> * Notification for an emergency demolition must be submitted as early es 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 ACM or Is suspected to <br /> contain any regulated ACM,special procedures MUST be followed. If you are unaware of the special procedure; <br /> instructions/regulations can be obtained by contacting the MPGA at the address or phone number listed below. <br /> 6. Description ofproceduto be followed in the event that unexpected RACM is found or Cat.II nonfriable <br /> ACM becomes crumble,pulverized or reduced to powder: , <br /> AC6_ <br /> f <br /> 7. Waste Transporter Information: 8. Waste Disposal Information: <br /> Transported Name: S ( t- T/ tk-CctVevf( Landfill Name: 9 .44,‘ Co IA _ <br /> Transporter Contact: <br /> f _ Owner/Operator. <br /> Transporter Address: 38'710, 44.2 ( wap° U& Address/Location: <br /> City.State,Zip:_ W Q',O S 4-Q-V- ill <br /> N <br /> City,State,Zip: �-9 Fes. - <br /> Phone Number. <br /> I.„' I/ 65,2-- 2-/0Q <br /> Phony Number: <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 have, uthority to enter into agreements for my employer. <br /> Signature of Contractor/Ow1ner /✓ Date /7-7/ , <br /> Send or Fax to: For questions call: <br /> Asbestos Coordinator-Air Quality Division 612-296-7300 <br /> MN Pollution Contrdl Agency 1-800-657-3864 <br /> 520 Lafayette Road North Fax: 612-215-1593 <br /> St. Paul,MN 551554194 <br /> .c <br />