Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2001, 07-25 Notice of Intent
JUL-30-01 03:44PM FROM-SCAPCA 40947763a T-419 P.01/02 P-335 • D l' © � Agency Ilse Only I I uI west College, Smte 403, Spokane, WA 99201 �..,(b NOTICE OF INTENT 1 ! ERFCRM: ' (. ` µVaE (� 1 fl / p�v� E j� LJ JIJ f7L 55e2aM A. Project Type: 1. Q Asbestos Removal 2. Asbestos Removal & Demolition 3. 0 Demolition, No Asbestos Removal bPUAATIF I r)UNIYAJlt B. Property Owner: it ��'yU pho De Ict THORIT Property Owner's ��- Mailing Address: /m/ S • / is /./5�jilvi p City: �f 1Z7 e 6#55 State Zip.cW:e2 C. Asbestos etgener�` rxnxlt4 a6 /ovaeerceeeoleeet. Contractor: a/inf. I SIefleaf Contractor /� Owner/CEO:1 /t_ t%G Mailing Address: /3 6,,/ 2 / 'Vej/Ts uc.1 j.. M � .S'7 j` Phone: ( j71/ 1 Contractor lob No.: Ciw: f4 t6'nn.r �di/-•t� State: ( 1" �zip:9 OL-S Fax: Cc -pc) 2z6 -t'' ts-St3 / ,25/ D. Site Address:/62/ f 2 C/jtteL5. //�o CityJle r Stare:(0- Zip.%I2IC Project Manager or �J Contact Person: d� h / 2 (! [Phone; ( ) '/ — ?s-7rr E. I(YAsbestos Survey or Cl Mat, Presumed: No. of Structures: Date Survey wars / Conducted: [ 1aep f Was Asbestos Fotmd?v�'Yes Q If No, Attach Survey AHERA Building .v. 'rt. WUFP$, iSALINIRRO&FC 41.4,e401177oN fl Cra ate TAt Inspector Name: s Cp � /Jr(f/�z O raofMeSt 51,2 tie Certification No.: �6 — Cl 3 / Expirat on Date: F. F. Demolition Information: No. of Structures: Start ,p o Date: / / U Training Fire (List Fire Dept. as demolition contractor below) Cl Ordered Demolition (attach copy of Order) Demolition MRKTnet BEAK &VT elle,apDRsss M Box I L K IF TR.U.vwG Age Lto FIRE DEP/NW Cootraaor. e JC, v 7>A4A0e/ J7B,y Phone: ($6Ii)S3.S 54- G. Asbestos Project Information: No. ofStructures:if> 1)es: ,t (see back if> / Start � , Date: D Complete/ Date: 2 6 / Wk. Days: M T W Sa Su Hours: 409,r ' Total Quantity to be Removed: Linear Ft./t9 Square Ft. Will au asbestos material be Q 'i es removed by projec completion? 0 No Thermal System Insulation: I U BoilerWurnacc Ins. U Duct Ins. U Pipe Ins. Other. Surfacing Mafl j U Fireproofing U Paints U is ter UTextured emirin>;s Omer; Misc. Mat'I: _ Cement Ed. U Cement Pipe Qljoaring Matz Q Roofing Mat'' Other H. Asbestos/Demolition Project Categories: Notification Proieet Fee Waiting Period NON-REFUNDABLE 1. Q Owner -Occupied Residential Asbestos Removal & Demolition Project 0 Owner -Occupied Residential Demolition Project, No Asbestos Removal Prior Notice S25 2. U AllDemolitions With No Asbestos Removal Project 10 Days SISO 3. Q 259 linear feet or 48 -159 square feet (see back of form for options) 3 Days 4. 260 - 999 linear feet or 160 - 4.999 sgyare feet 10 Days $3pp 5_ U 1,000 - 9,999 linear feet or 5,000 - 49,999 feet square 10 Days 0 6. U > 10,000 linear feet or> 50,000squ are feet 10 Dais S1,500 7. 0 Emergency Asbestos Project or ❑ Emergency Demolition Project Prior Notice Twice Project Fee 8. Q Alternate Means of Compliance for friable materials or U Demolitions 10-Day Review Period Twice Project Fee 9. U Akemate Means of Compliance for notifriable asbestos materials Concurrent with Project Twice Project Fee L 1 do h " that die information contained in this notification, and supplaneivat data described Flavin. is to the belt of my Completeness Review kdgc c and complete. I shall not cause or allow aoy asbestos project or demolition activities to begin until the Performed B appropn ' ng period has elapsed.• By Signature Ponce of Intent (66.160811/1/98, 11/99 rgtte)/V6cy IS J Representing 7/1 ram_ my se Only ��V JUL-30-01 03:45PM FROM-SCAPCA 5094776828 T-419 P.02/02 F-336 The:Spokane County Air Pollution Control Authority (SCAPCA) is the local air pollution authority for Spokane County, SCAPCA Regulation 1, Article IX and Article X, Section 10.09, requires advance notification be submitted to SCAPCA, on an Authority approved fon for any asbestos project involving materials equal to or greater in size than 10 linear feet or 48 square feet and for any demolition projec regardless of asbestos content, involving structures with a projected roof area greater than 120 square feet. Notices of Intent should be mails or hand delivered to SCAPCA (address on reverse side) with the appropriate project fee. A SCAPCA representative will review tt notification, and if it is completed correctly, a copy will be returned by mail to the mailing address entered in box C and box J. The retume copy will be your valid notification. Asbestos and demolition projects involving materials and structures below the notification threshok listed above are still subject to all other requirements of SCAPCA Regulation 1. Article IX and Article X, Section 10.09. J. Demolition Contractor: l/•L aSt P^a'7RAhU rnra(eI SSE /o/ld Nt90Avuyq.O,.,ta Mailing Address: 7o/ 5 e€ City: Sar'Ar"s? State: (N7) Zip:�J�J'�Cl`C'/ Owner/CEOs-Jr-err tflj Q'T Contractor ($z Job No.: Phone: s V - Fax: (- ) >'S^ _ g .40 GUIDELINES FOR SUBMITTING AN ASBESTOS/DEMOLITION NOTIFICATION Box A. Check the appropriate project type. Box B. Enter the legal property owner information. Box C. Enter the asbestos contractor and mailing address or other properly trained company or person performing the asbestos project Contact the Washington State Dept. of Labor & Industries or OSHA for worker training/certification requirements. Box D. Enter the project sire address for the asbestos project or demolition. Include a designated projea manager or contact person. Box E. Check asbestos survey or material presumed. If asbestos survey is checked, fill out all information requested. Except as provided for in Anicle IX, Section 9.03, all demolition with or without an asbestos removal must have an asbestos survey performed by an AHERA Building Inspector. Demolition with no asbestos discovered in the survey must submit a copy of the survey along with the notification. Asbestos removal projects only may check the material presumed box if all materials are to be removed and disposed of as asbestos -containing materials in accordance with SCAPCA Regulation t, Article IX and Article X, Section 10.09_ Box F. Enter the demolition project information. If the structure is to be used in a training fire, list the fire department responsible for conducting the bum as the demolition contractor in box J. If the property owner has been ordered to perform a demolition by government official, submit a copy of the order from the appropriate official. Box G. Enter all asbestos project information requested. All multiple structure asbestos project notifications must be submitted with a work plan including a map of the area, site address for each structure, type and amount of asbestos in each structure, and a detailed work schedule. Box H. Check one project category in boxes #1-6. The project fee includes the demolition fee. Asbestos removal projects and demolition with an asbestos removal involving less than 10 linear feet or 48 square feet may be filed as project category #3. An emergency asbestos project or demolition may be requested by checking the appropriate job size category in boxes #2-6 and then checking the applicable emergency box in category #7. Emergency asbestos project notifications must be submitted with a lever from the property owner explaining the necessity for the emergency. Emergency demolition notifications must be submitted with a letter from an authorized government official or a licensed structural engineer documenting that the structure is in imminent danger of collapse. To request an alternative means of compliance for friable or nonfriable materials, check the appropriate job size category in addition to the applicable box in categories #8 and #9. A work plan must be submitted by an appropriately Trained individual along with the notification. Box I. Sign the notification certifying the accuracy and completeness of the information provided on the form. Box J. Enter demolition contractor mailing information (on back). Mandatory amendments are required for changes that increase the project type, job size category, the types of asbestos materials to be removed -and work schedule changes. No fee is required for work schedule ;flanges if the contractor is participating in the Agency work schedule fax program. A $50.00 processing fee is required for all other amendments. For technical assistance, contact SCAPCA ar 477-9727 Nonce Of MIEWr r66.16058, 2/98 12/99