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HomeMy WebLinkAboutCabot Blvd. #20 Bldg.142 - 3/18/2000INSTRUCTIONS I. All sWiens of IIds, lolnl mull be eer"'10.1 In wi to o.epl,will Iho nepulnl till of Lrwlre ulm"IN l Pml ud l ml llNilieal lue IehubaneNs of h 10 CIAII 7.15 Ilea nvlAlnp dos prior I oilh Ilion is ItNIIJ1.1 ill any,twollolX plink and lbt No mhnmll of Ldmr .,,it hewfilea nelilicallnnleenhaoe 1, n1451 CIAll 0,12 (tan don prier n rliliullinn 6 ,,,lilt IIANY aAa(emnllfNatat p mre, U." Ibret Bela n, agUale 114 z Sill lMelxat mill, It. Commonwnollb of Mvsatbu,e AsU. fiwl os Pmunm P.e.11., MA,2 0mlon, Inn Oti 11 0067 il�ne—uitnnm) — xv J�i.11l�n reauil%eahaei- Commomvealth of Massachusetts Ashesfos Notification Form — ANF 0f71 540188 /Isbes(osAhalcnrenf eescripflan _j 1. Faclllly li canon: JA 1f11 2 Llqlb Oryltmm llp mb /elllen I, _ S Nr>QNaxwdll,4ranwgDnllAn ._.....__._. _. _.. .._._.-... _... Unarm, /, xGru lgvv, noun 2. Is Ills facility rocuplod7 fLLYas Cl 140 :l. Asboslos Contractor: De NI'nnl Co rpu rit tun 10 Lowe 11. .Ice. Mild ARAmaf _ .._ .. _...... .... Andover __.....__ 0I810 (976) 470-21160 I lelnll one AC000035 14 r.l. l: ten ' fnnlrxN lyln(xtllbMleMA. ——..... _-.._.. /A'llkmJv/ A. OmSllo Ptojecl Supervlsor/rarelnnn: R-S �USo Nmn nu remaan,m/ J. Project Monllor. U-R5 APr 6o0 l �)2 G. Asheslos Analytical l.ab: some as 5 — ---------- ._ ---- . _ .. . Met. 7. Pmjecl stall Jnlo3/f�/Udonddalo.3/Ii!/OPepeclllc wnrkhonrs (Mon: frL��o_�__( ill �un.)i) 7>_� _,.._ 0. What type of project Is tills? (clielu ono): nrnxvinwl mpm rmxlnlAur nlnn trmumA 9. Describe Iho asbaslos nlalarnonl procudums Ia to used (circle): uxnv n,o—Atsela elr.YeuLrlFxl ingatnl milt nleor(u�pflrn C nEX {� C41 a2/LIt25 �Jerfir%2 10. Is Iho 101) beln0 conduclod 17 Indoors ❑ o lldnom 7 11. Total announl of earl, type of Aslestas CmdaldnO Materials (ACM) In bo flandled on pipes or dllcts(Nnmu 11.)-___.--_of miler sulfates (sglmre II.)- 7L., (� to bo romovod, oncfosoJ nr oncolmilalod: linoar/squnra loaf Aolle,, Urard,619. JiM, Lmkswl ell cualinys... ' _ /_ lhmnul, seAhl ew All, h.... A l........ ennllgalnf o,F.gmnilnpn, plpn lnsulaUnn.... ._ .......... ........12. Ouscrlle lilt doconlanlnnllmr cyslam(s) In b Ise : ------- 19. Ditsclila Iho conlahnwltollmddlspnsil mrlhods In comply will, 91)Will 7.15 and 453 CMFt G. M(2)(II): - watL1-ng_mI.CesaI1-w.LCI_amended_wn to c_mul._PI.nui.ng_Ln._doobl.o- u1x ..nl.l_L.poly.. prism ,. iahr:].acl_I?aDS_fu_Las:._l r0nnpor Ced_.Cu_ml_n RViuvad_lundL111_Ln_a _aanlmI_l nclulblA, .. .. 14. ror EmolUtncy Aslluslec Abolemmil 0perallons, the DEP nod DIA olllcfalc, who ovalunlo l the omototncy: c rn.l 1 c r IY.Am/ Mlle IAMMAdIurNalM1ur __. __._ IYlpur/ .- ._ Ib v rh? 15. Do plevallillp walla falls apply ns per W.B.L. C. 149, Cl 26, 27. or 27A - F In Iltls projecl9 1'.-1 Yes XIlu I. Cuff bill of plior usb of laclllly:.t -...--- -..-..-....... ._. lvlr c. 2. Is Ilia lacllily uWlmo-nccuplbI maldutllal W11114 tells or lass? CI Yes ,L4 No - _- - ......_- --- � - - 3. facility Willa: Aokitf ------ - __. a _fv SUO �-<n6 'I. filf.111y's ffW11C1'¢ l)II :ilia M:umua: o�k_ llff(rAU/le �. Gonblal Couhaclol: �---� A✓Jnn ,New Ilnmpslliru Llsu sauce Ilp lQd, %.bpnarH WC5825620— Ganlradal111'vrAerzCanar.lnsvrol -- 12/28/NO �. W1181 S II10 sIW of Ills 10C111}'? 5( II l'ol/q/ E.tv. ease UI IIUOIS) © fI sGeslus Trmrspurfa(lon and U/spasal 1. Tlmis JOB a(tollll offml aoe-conlalnlnt v/ada emimlal Iwln JU71 ¢Ila la lamp ory slotaUb slia (II n¢cacsalY) to list _ dlcpacal ells; eo Box 6037 l:hl.'1.51'EI lk7l;t —' 02150 (617) 7II7-1415 2. Tmnapoear of w Woos�coNnhlln0 West. 1.1n1m lei Molt —_'---- raelovnl/laolpormy on"le ZIS abovo ¢Iotauo slla to HOW dlspoaal ¢Ito: Nola: $/Jflflllt Irlfltl comply m/lb //,✓ 3. Ouluso Imnslar clnllon anll ovamr (If appllceblb): Solid lvjr lb nil'islon logo!". kale -._. ...__ ._ _ .... 111(Ill , _.___.........._ city/mar-._ ... 4. Plnal Ulspoanl Site: In./wurr. _._ .._...__._..__._... 1C0c•��1lA�C��j -- Curl/Ilrat/on 711a undarslUnod hamby clnlbs, undor Iho ponallias of palely, Ihal Ila/sha Ilas read Ilia Colmmm�voalih of Massachusoll¢ ❑atulallonc lot Ilia ❑comval, Colllahlm¢ut of Encapsulalloe of Asbestos, 463 CMII 1100 and 310 . Co mom o Ihls nallllclloll Is Ina and carrot( to Ilia hest Ilavucomialnad e, v.. 111 IMm Inlonnlse,1 of hls7lmr knowladuo and hbllsl �- irno-/N. _ /l� n l /5InlNanu 7 / Gc Nola: ar .// Aaa rm<dsgr„/ae u� nnuf sign Ibis ZVI, INS hom for Gl.! 11/b�)�� -- //�� Gec-Tam Cot'p. iWliWVIlp•%�--`�-=��`-t: nn1111caflon - _ (9711) 1170-2860 pelposes 10 Lowell JcC, Road Idrydrww---'--- Andover 01810 --- fao exempt (Clay, Tatvu, dls0lcl, IuunlclVal htosltp Wholly, oWnoroccopled lesllleilllal of lout oullsnof less)7 L'I yes ❑ no Sllckar 1 (1lunl Will of form):