HomeMy WebLinkAboutEast St. #250 - 1/16/2002cram1t ifulaaftSnvivhusetts
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Asbestos Abatement nescrlpllorr
i. Facility location:
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2. Is the facility uaupied? tpyyes 0 No
3. Asbestos Contractor:
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Project Monllar.
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P,03. 120097
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Deal
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Asbestlos, Analytical Lab:
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Project stall dales 4�- ,ddale��D_'{specilicworkhours(Mon:
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What tyve of project Is this? (circle one): owwdco nple rexnem atxr/agtakJ
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Describe the asbestos abatement procedures lobe used (circle): ob-ov nobr-n• fwa .d d.me
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Is the job being conducted F„7\indoors 0 outdoors ?
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Tatalamounl of each type of Asbestos Containing Materials (ACM) to be handled on pipes or ducts (linear N.) orolher
surfaces (square ft.) 17 U0 to be removed, enclosed or sr x psulated: ,
linear/square teet
boiler, Drmrhinp, Oud. W* surf" ma6Ms... —J tie'mal, solacourie0oNlalkn...... —J
syrnrpaleda6)e'edpaforDlps Laulafkn...._J iaruwinp cornea..................—1
spay -on 6reoroofirp ..................... rmlll+s)wcoaMses.............. —J
ditto, Waver 6Wis..................... t.1 90 tamW Dowd. wad board............. _l
Vitae (Dkne describe) ...................
12.
Describe the deconlaminailon system(s) to be used:
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13.
..__._ ..................................... _.._...... __................. .................. .._.......... ._......
Describe the cuntalnerilatlon/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6A,1(2)(g):
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For Emergency Asbestos Abatement Operations, the DEP end OLI officials who evaluated the emergency:
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45: Do prevailing wage rates apply as per h1.G.L. c. 149. § 26, 27, or 27A - F to this project? Yes 0 No
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Facility Description
1. Current or prior use of facility:
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2. Is the lacllhy owner -occupied residential with 4 units or kss? ❑ Yes � Ro
3. Facility Owner,- e
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4. Facility's Owner's On-SheMaanager
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5. General Contractor.
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6.. What Is the sue of the facility? door (sq It) i (r of Iloors)
Ui Asbestos Transportation and Disposal
1. Transporter of as tesloscontulning waste material from she to temporary storage she (h necessary) to final disposal she:
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2. , Transporter of asbestos -containing waste material from removal/ temporary storage silo to final disposal site:
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Note: Tmnster uh'na,n...---..._................................................................................._.__�
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Stations must comply with the 3. Refuse transfer station and owner IN applicable):
Sond Waste
D;Wson repula- wun _..___�..__ ...__.....__.... _.._._.____
Oons 310 CAIR xss+a
18.00
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4. Final Disposal Site:
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10cos, Woo,
i Certification
The undersigned hereby states, under the perahies of perjury, that he/she has read the Commanweahh of Massachusetts Regulations
for the Remwal. Containment or Encapsulation of Asbestos, 453 CMR 6.00 and 310 CMR 7.15. and that the Information contained In
this notification Is We and correct to the best of his/her knowledge and betiel.
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Xgfr. Contractor
must slyn this L
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formforilLf ---._r `l._-�•�_—__._..._....._..... __`_.... .SM
notification PoraeGrvns. 1 1 ` Pu+erexxq ' ;y��_- r✓enwnv'...—(_'..�^
purposes _ .__1 �±Jfl;l'1C_" '.)._S. Gry ,1 ,..._. 1,U�.f^na-!_...._.........-6....._V_fi!J 1
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Fee exempt (City, Town, district, municipal housing authority, owner -occupied residential of four units or less) ? es ❑ no
Slicker r (from front of form): oto