HomeMy WebLinkAbout0036 RENDEZVOUS LANE - Health 36 RENDEVOUS LANE, BARNSTABLE
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Asbestos Abatement Description '
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1. Facility location:
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hat.11oor Wm W 2. Is the facility occupied?. Yes O No °
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3 Asbestos Contractor_
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Oqulmud of Libor war _
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sW"kal. 4. On-Sde Project Supervisor/Foreman:
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It. RM DUCaskarml
Unmeeveelth of
Yuucaaetto 5. .Project Monitor
Mesta Program ,s
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6. Asbestos Analytical Lab:
3.This lam maybe —
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Pi*cdon Affry Region '/
lolasbedosdemollion/ 7. Project start dalel/&A-end dale-J29bspecificworkhours(Mon:F►i.) (SaLSun.)
rr¢vrtien op%dions
'bled a HE9WS tw it What type of project Is this? (circle one): damoeton lwak
CEA Subpal tA.
9. Describe the asbestos abatement procedures to be used (circle pbq b Q ru/rodfnrned d-W
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di1D"i 10.�It the job being conducted yludoors O outdoors?
It. Total amount of each type of Asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft.) 60 or otter r
surfaces(square fl.)`1S?�to be removed,enclosed or encapsulated:
linear/square feet
boar,braal!%rq,d4!cant su boor coalirps..._l ftmst,solid core pie I stAslion......_J
tan g*d car b)eed pups pia ksu/atian....1 J_ 6wlafi79 tsrwv.................. _I
*I)`a kwoo°rp....................._/ tMilspra)srcoatings _�
Obb rove Wks. .................._� sanslk Dowd,wall bona.............
o0r(ilk=dssoibo)...................
12. Describe the decontamination system(s)to be used:
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_.........._...._......___............ ........... .
13. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g):
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14. For Emergency Asbestos Abatement 70eratlons.the DEP and DLI officials who evaluated the emergency:
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W►d WMttirn Word
45, Do prevailing wage rates apply as per M.G.L.c.149.§26.27.or 27A-F to this project? 0 Yes KNo
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Facility Description
1. Current or pAor use of facility:
_ ..._._............_____._._. ......_.___..._._...._.._._......_.___ .........
Z Is the facility owner-occupied residential with 4 units or less? O Yes O No
3. Facility Owner.
Ste'~ ______......._.........._................:........ _...................._.........._........_..._......__......._...__
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4. Facility's Owner's On-Sits Manager.
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5. General Contractor
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Norma AOOrrtr
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OVUM I�coe� Akplonr
earwact"wodars cmp.eurmr Polcyi Erp.ara
6. What Is the size o1 the facllity9'?oop(sa 11) 3 (I of ibors)
Asbestos Transportallon and Disposal
1. Transporter of asbestos-containing waste material Irom she to temporary,storage site(lt necessary)to final disposal the:
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2.• Transporter of asbestos-containing waste material Irom removall temporary storage site to final disposal site:
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Note:Transfer Gq/ros 1lowdr tMrp1aw
Stations must 3. Refuse transfer station and owner(11 appliable): ..
comply laity the
Solid Waste
Divlsknrepuls- Ab,,, ---_ _ ..__..._._. __ ....._._......._.___.._..._...._...........__..____.._ - -
tlons 310 CMR
1800 —_.. ___.......___...._............................._........__._..............................
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4. Final Disposal Site:
or S r I e h�n1�s Land
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Certification
The undersigned hereby stales,under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts Regulations
for the Removal.Containment or Encapsulation of Asbestos,463 CMR 6.00 and 310 CMR 7.15.and that the Information conlained in
this notification Is true and correct to the best of h1s.1her knowledge and belief.
.._.._................ .........
I1hrAravx� Auto* idwr Oak
Notr.Contractor yy� f -7r
must tips this 1`"l rlr' • _lam_ 1�1_�-. ' ' I �'�'P �L•-33 !-�117
rprm for DLI -- ___..__... _...:.:..._..... _ ._. ..._..__.
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notrTiatian
Purposes
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Fee exempt(City.Town,distrkl,municipal housing authority,owner-occupied residential of four units or less)7 O yes O no
Slicker I(from front of form):_71 Li SAS