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Home My WebLink AboutWare St. #571 - 3/28/1994lnsmuctlous 1. ABsmllmenllhis tonn lined lw complclnl In mba In rmoply will, Ili. Uoparlmenl of Grvhmnnemal PMloeltmumlilkallon IMuimmnAs of 310 CMn 7.15 Pen ewdhrgdays pilot'whokalion Is leonHMnlanyahttrawtg ilepnlmm Dep"IOa d ill tither slid induslder mlilkallnn r<grhrnelds o1453CMRf.12 Pit, oar, ndiliralinr is oaga&ddANY RUM.#Pviml QMIf/ Ihv, IfxM fnov of some hill. 2. SrAmil UriOLul ram To: Cnmmonweaille el Massachesolls Asbestos program PAR. 12nD8l Boston, MA 02112. ODR2 R. Ihisrmmmay be read for rmlilying Ilw U S. (evilwovoMl Pioloclion Afrrey Ileginn I of asbedns d:eodalmrf IMewliar uperalions s iblrrl to UFSIZAPS (40 CIU Suhpvl Mi, Commonwealth of Massachusetts Asbestos NoUAcation form — ANF•001 I. Facility location kAft, .. v�WG . SiYC,.................................... Nxue ArAlrtaa W�c u.F..\.a..,........_..............................o..aou......................................... I:irygemn )Hrnxk felN4xxrc &racwAk V4A voo,le Skvee} ` rrv,<r?Pi.A n« 2. Is the facility orlmined? ffm; ❑ No 3. Asheslos Conirnntm: i I:nvLronmenLit SolliLLang Inc. 50 Cu Lnnn Street WnIthfit, MA .............................................................................. 021.54 bl7-899-3370 ....................................................................................... 61TAmrn ..... .................... ................................. .:... yyrnxk lelN:h'we AC 000042 liwhxlIn, l:YtllWYkrhY) 4. OroSite Project Srpmviso/Foreman: 5�.0.t .......�'.r...4�-.......................... ................. .s.F..9._2._!.!........................ : Nxm .....•.............................. ........................ _..... Ills fnlilHaPoxr/ S. Project laonilol: xux'M.��.e.5........_u,cy.........�c5r..(Y ie�anr.�n�.l..l................................................................... lxl G. Asbestos Analytical Lab: I /I /1 &— j4.ia fy'vJePA ne)ta\.............................../...�L.L ...... .. .�%...�..a.. .......... NMI^' 77 pparss,�'� �� Iall:aAM1'adrxr/ � � � y� 7. Pro jectsMddateJ / A_]mddale 3/,MI/�Ispecilkwolkhoms((mr:Fl) %Dft)— (SaLSun.)_I-71F'1 g. whal typo of project Is Ilia? (circle one): rWeca'Rw eNWi rerovtbe oalo'b"oN) 9. tlascribe tha Ashaslos abalemerd procedums to ba used (circle): pWwA, eecAlowe mdrmdMkd Nnmm rrcfin4MHw dbparaWwly Mf"'prregAir 1G. IS flee job being conducted _ Ileng Ll outdoors? It. Tolalamolndnleaclltyp�4LoAshesosContaining MnImlals(ACM) to ba handfed on Pipesat (liters (linear lL) or Diller sndaces (square II J i $ to be removed, molosed or enenpsulaled: Ihlearlmove reef hnikv. Aleachhq. tire. still smWcemalops..,_/ Ilwlnul, snlMMleplry. Ireulalfnn...... _/ — mtmgafMol horompapee PIP#hoahlwr.... spray. No drMlooftor..................... _ / houn11. rrot11 .....• / rklhs, worn Woks ..................... ogkt(pleass almodf) ................... 1 12. Oescdbe Ilia deconlatnlnallon syslem(s) to be nsed: TII'@..._YI"6n't:I(it l: it t1611 ZpAin 1:IN?!13._isY_4.7.3.CMR_fY15Fys@. Ul,;dd A npprohri.aLe. .'.........•• ....... .... ........... ......... . 13. Iksyrlbe the conlainethat�on/die s I jolliods to coo I will, 310 CCMN 77 1' am 453 CMII p I 2)(g s )eSLOS wngLe wt ... Ile welLLe(i an( � doulil'e l�ynggecl I.h � IM Intl •ln Ire l: ted_. bn p sv.........They....wi: t t--be--pla c wl ..by....ES.I..... try ....a-'.40-' cvbtc' - ynrrl--••.. cloned Incked container ror ciLSisosnt.,nn"11jjn tiptseeilt(I"'n50rSstrsS'13x71ftt1 1d. For Emergency Asbestos Alnlemmd Opmatlons, the DEp mId OLI n111cUis w�o ebnlualed the emergency; Ink NAuIMgL�:...Yl....................................... ................. .........IlMirry/.....................,.lL.A ......................... .............. .............. .........•......... _....... ......................... . NxrrMMIINMWI Nakr4Ardlmkar4w """""' 15. Oo ptewlll,ll) wage tales apply As pet M.G.L,c. 149, 526, 27. or 2?A-F to Ilia pmjecl? LI yes M16; gev. GM7. r FacUlly Uescrlpllon 1. Cooed or Z list of tact ily: ..........�e.5. �.e......F�u1.........N.QwIc.................................................. ............ ....... ....................................... :.................. ................. 2. Is ilia facility 1lwller-occlipled leshlnallat Willi A mllis a, less? Ia Yes I I No 3, raclllly Owner: J........au.rs.......�, sic ..................... .. L.1.............._u dry_e.........S..Ev..............,........................ Nuue A'Ah"I e M�15......a..1.............._!N. ................................. .......... hl"A. s.!............... f%pmn 1 nnk A. racllitys Owners oil site Mannpei: Nxru A4bn4 N..I.!.................................................................................._N..L.......................,..,_r........................................., fihylrnn lhup.k Irlrlhxx ,F, Gmmlal Cnoharlm: • :......................N........................._.._........ Nwn. ...... AdNra l I................... .................. .................... ,.............. ..................................................................................................... ah'nmin '14'*..................................................._...........,.............._.._....... 1Mrmr .... .......... .................. G. What Is file silo of the facility? yo0 1 Ashaslos TransporlalloN and Ulsposal I. Tlnnspode of asheslos caldnlnlnu wasle osaleslal halo site to lmnpmaly s101a00 site (it oncessaly) to llnal dlgmsal life: Raw i. rot mC n L it 1. Sol II11oun Inc. 50 Gut tillII SCI cc ..............................................................................................._............_................................................................................................... ......... .........�.. Nra AiM1M1<II Waltham, MA 02154 61.7-899-3370 rlhOrrxn !punk IrklvFrxu 2. banspodm of asheslos.coliblolou waste nmlollal bnnueumwall lempowly s10110e silo to HIM disposal site: .....itecovel..Y....I:x)x.cn.^.z...J fk:a...... ........a97 lAwd l ixl ,'SCrc4............................................................. ........................ ............................ Nrrm A4bm Ibstoil 1 RIA M.II/1 617 — 52f — 7760 ......._. . ....................... Nato; burly cWJ1r+n JNar.k klovxxx Slaflens n11,thn cnnpr!}r irllh I3. Ilefnhnm se siel station and ownel(it applicable): solUl Waste Ilivhelrrnm uG-.............................._N................... .................................... ............................ ...................{................................ .......................................... p Nnu AM1Aos rloms VO cMll 10.00 ............................................................... ............. ...................... ..... .................................................................... ................................................... cMOms" IM,Nore Innv.xx 4. rival bisposal Site: S & 5 4indf11.1."` :S Gradl.rig, Inc., ...................................... ...... ....... ................................................. ................................... ........................ ...... ....... Ikrun N�ru Route 5, fbx 559 Clarkslxlrg, • w 26301 (304). 745 -. -3234- .I. -. ,elryJNre A Cerllllcation ' Ilia Inxlelsfullet lie, thy stales. IIIIIIeI[lse pellallles III Ilfl(Illy,thatImAlle Ilan land Ilia Colol1011weallh o)Mnsnall sells NEpllhllelle lot Ihn Removal, CmlWhoneld at 6¢aptubilot of Asbestos, 453 I'M ] 6.00 mul310 Win 7.15, nod that [Ile lulnnpallot emdalned In this Imllllcallml Is hoe and tooecl to the best of MsMet knowledge and holler• { { .............. S,ke.(�k...._..:..FE�.`...'L........1�......_........,..�'? .............r....�...:..14.9.�1 ISfnlN+xx 1 AnRxxhnl rynrne IMk Note; fmdmtlul most sfpn IAis 1$llvl rollillent 111 Sol,u 1 i 99- 70 ronNfor N 1 a4rn 4lw Q ...1 1Qat� } v...........................................................................................4.1 hole'o...d..t..t ...,.....{k............. . 4 nonFw mr u krr,r, Aa ,Nino x nnfilicaaon ' porposas ,50 Cui.nan Street • WalthnlliA„ MA,„___,,,,,_,,.,. 02154 ...............................................................................,. Argbox rllyglMn JAr rivk ree exempt (City, town, dlsiticl, uuudcipnl houslug mahollly, ovnmr-occupleA IesGlenllnl of lour Inlfis tt less)? yes i] no Slicker) (hot, lsont of loom):