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Home My WebLink AboutBuilding Correspondence 2013-7-8 asDVOSB a ENVIRONMENTAL FEiNEOlA110fi V'h YT n .'�� cVe A VERIFIED SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS Environmental Remediation Asbestos/Lead/Mold/Drug Labs/PCBs/Heat & Moisture Detection/CO2 Dry Ice Blasting • A COMMITMENT TO EXCELLENCE 23525 Hwy. 99 E. Harrisburg, OR 97446 CCB #64090 PH 541-995-6008 FX 541-995-1015 Email atezatezinc.com Website www.atezinc.com PROJECT COMPLETION NOTIFICATIONASBESTOS Date: 07/08/2013 Client: Mr. Jim Polston City of Springfield 225 5th Street • Springfield, OR 97477 ATEZ, Inc. Project Control Number: 130627 • Project: Remove asbestos containing floor tile and mastic Former Booth Kelly Mill Site Suite #153 • 7r)..//_ 5 �03 d/Sy( • 3035 5th St. Springfield, OR 97477 • Attention: Mr. Polston, Attached please find all the documentation pertaining to the proper removal and disposal of: VATM REMOVAL IN SUITE 153 ON PARTICLEBOARD UNDERLAYMENT 1. Removed and disposed of TWO THOUSAND.FIVE HUNDRED SIXTY square feet (2,560 SF) of vinyl asbestos floor tile and mastic on Underlayment, by removing the Underlayment 2. Removed Covebase from all walls in the room REMOVE & REINSTALL EXISTING PLYWOOD ACCESS RAMP 3. Removed and disposed of all asbestos containing material from underneath the ramp METHOD OF REMOVAL • 4. Removed Covebase, VAT and mastic as friable inside a negative air containment creating and maintaining a minimum of-0.02 negative pressure on the-WC until clearance passed, used Wet-Methods, HEPA vacuumed and Wet-Wiped abated surfaces. 5. Removed the VATM and Mastic by removing the underlayment AIR CLEARANCE 6. Provided the Independent, Third Party Post Abatement PCM Air Clearance UNDERLAYMENT REPLACEMENT 7. Replaced TWO THOUSAND FIVE HUNDRED SIXTY square feet (2,560 SF) of • Underlayment 8. Paid attention to the installation requirements noted in this Work Plan DISPOSAL RECEIPT . 9. Properly disposed of waste and provided the DEQ ASN-4 disposal receipt 1 This Work was completed as a Class II, Full-Scale, Friable, Non-Prevailing Wage, Commercial, Pre-Renovation, LRAPA Asbestos Abatement Project. If additional hidden asbestos containing materials are uncovered during the renovation process you must cease work and contact an asbestos abatement contractor to properly remove and dispose of the additional materials per DEQ, LRAPA and EPA regulations. • The asbestos work was completed on 07/0/13 by a certified asbestos abatement supervisor and certified asbestos abatement workers. The work was completed without incident in compliance with EPA, DEQ/LRAPA regulations. The waste was stored on site in Springfield, Oregon until it was transported under cover to Short Mountain Landfill for disposal. See attached ASN-4 form showing the waste was disposed of in compliance with appropriate regulations. Included under this same cover, please find copies of the DEQ Notice, Contractor's License and Employee Certifications, Air Monitoring results, and ASN-4 (disposal document) to follow. If any further information is required please call our office at 541-995-6008. • Thank you. St y / fl ..ert inyon, 'r- ;fit TE , nc. • • • • • 2 STATE OF OREGON CONSTRUCTION CONTRACTORS BOARD LICENSE CERTIFICATE , H LICENSE NUMBER: 64090 I _ This document certifies that: • ATEZ INC I' • 23525 HIGHWAY 99 E HARRISBURG OR 97446 I I I is licensed in accordance with Oregon Law as a Residential General Contractor and a Commercial General '1 l3 Contractor Level 1 << i License Details: !; , EXPIRATION DATE: 02/02/2015 I ENTITY TYPE: Corporation H 1 .ii INDEP. CONT. STATUS: NONEXEMPT } I RESIDENTIAL BOND: $20,000 i I COMMERCIAL BOND- $75,000 INSURANCE: $1,000,000/ $2,000.000 RMI: ROBERT R KINYON I! HOME INSPECTOR CERTIFIED: NO I f 1 , , DEQ FULL SCALE ASBESTOS ABATEMENT CONTRACTOR LICENSE Department of Environmental Quality 1550 N.N. Eastman Parkway, Suite 290 - Gresham, OR 97030 Telephone: (503)667-84I4 ext. 55072 Issued in Accordance with the Provisions of ORS 468A.710 ISSUED TO: LICENSE NUMBER: ATEZ INC FSC535 23525 HWY 99 E HARRISBURG OR 97446 EXPIRATION DATE: MARCH 1, 2013 INFORMATION RELIED UPON: Asbestos Abatement Contractor Lirence Application submitted JANUARY 06, 2012 ISSUED BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY • David Monro Air Quality Manager Date Norihwcst Region/Gresham Office • The contractor named above is hm-ewith authorized to conduct asbestos abatement in the State of Oregon subject to the terms and conditiotis of Oregon Administrative Rules(OAR) Chapter 340 Division 248,including the conditions listed below. 1. The contactor shall ensure that each worker performs asbestos abatement work in compliance with OAR 340-248-0010 through 340-248-0290 and other applicable state and federal asbestos abatement regulations. TEN-DAY AND NON-FRIABLE NOTIFICATION OF INTENT TO REMOVE OR ENCAPSULATE For LRAPA Use: ASBESTOS IN LANE COUNTY, OREGON • Lane Regional Air Protection Agency Project: . 1010 Main Street Fee Recd: $ Springfield, OR 97477 (541) 736-1056, Fax: (541) 726-1205, toll free(877) 285-7272 Check#: Type of Abatement Project Category and REQUIRED Fee • ❑ Demolition ❑ Emergency Waiver (Add 50% to required fee) $ ❑ Removal $ 52 ❑ Non-Friable (5-Day Notice) ❑ Encapsulation $ 52 a Residential Project (Occupied Residence, not for Demolition) oRenovation $ 52 ❑ < 40 lin/80 sq ft (Small Scale, Short Duration) Maintenance/Repair $ 110 ❑ > 40 linear/80 square feet; < 260 linear/160 square feet Other_ $ 443 o > 260 linear/160 sqft; < 1,300 linear/800 sqft $ 556 a > 1,300 linear/800 sqft; < 2,600 linear/1,600 sqft Has a survey been $ 962 y`;• > 2,600 linear/1,600 sgft; < 5,000 linear/3,500sqft completed? $ 1,109 a > 5,000 linear/3,500 sqft; < 10,000 linear/6,000 sqft . Yes jq No a $ 1,776 a > 10,000 linear/6,000 sqft; < 26,000 linear/16,000 sqft If Yes By Whom? $ 2,961 ❑ > 26,000 linear/16,000 sqft; < 260,000 linear/160,000 sqft .A IE\ .�\,L4C- $ 3,701 .❑ > 260000 linear/160000 sqft Sccwm 196.-L., Is this a revision to a previous notification? Yes a No a ABATEMENT PROJECT INFORMATION f Site Name 'ray iv'-o-- (h0uL V.t .L Phone ( Site Address : � S rte- _ r City)y ;rc c, 4 (2 e1- Location of Asbestos at the site 5:..;: L � 1 S -5 r t rn-f Site Category: a s hoot ❑ residence a college ❑industrial ❑ commercials �❑"othher� r Start Date a Completion Date 1- -13 Hours on Site__________ Days on Site tit^(- Emergency project notification requested: a No a Yes -- Discussed with i Date TYPE OF ASBESTOS MATERIAL Type a Percent of Asbestos q'10� ' /0 C\1 Y(J` �L& a Estimate Lab Quantity of asbestos in project ago ❑ Linear)/,Square a Cubic feet o pipe insulation ❑ tape ❑cementatious(eg:transite) *floor tile ❑ roofing ❑ felt ❑ sprayon ❑valve packing X mastic ❑ sheet vinyl ❑ other . WORK PRACTICES AND REMOVAL PROCEDURES (•wet method ❑ dry methods with air filtering ❑ glovebag Xcontainment %negative air p,HEPA vacuum ❑vacuum truck with HEPA filter o other Ambient air monitoring to be performed: a yes ❑ no DISPOSAL PROCEDURES a chute to dropbox a hand-load dropbox wetted and double bagged ❑ other ❑waste stored on site in secured container Xwaste secured off site at Pa€2 •OA,.r 5\-.,..e %waste removed daily a other DISPOSAL SITE ❑Short Mountain s(Coffin Butte a other ABATEMENT CONTRACTOR rr ��ll _--. Contractor Name ,T5 %l,kQ n C, License No. V77 C�3 zi -- Mailin Address c� It I,2Cn City State` ZIP�2�1 PhhOP 5 i 1 cf c_ �nC2LD_ Competent Person W (in Certificate No. 1 3 OW Cell/Pager No.' 4(- 5D(-C t{[ PROPERTY W ER Name Vt .( • vv-19\c,,--e C CO Mailing Addres� _ _ -s. *A-)Cit c o rr cic StateN_ ZIPg141T Phone5t11- 7r2(o Coat Name (Please Pr,' ■ �=•• At* ' t\ a 1 i Organization - f r) , teC'41 C. Signature !-2'— �i/ jii�ui _Phone - • - . Email Date OM L.----" Asb:07/01/72: Form Available on LRAPA website: www.lraoa.org . O I C > t .. @@@i Itl O `1 i 7r Z 9 Q c M' S� p Y13 pm N- N .' at q }ayym to.0 , ^ ,j o ith i Q V] M. N _ g 33w• LN, cT dg LO a > " ' 3N g§w s4 n„_a giro . o w 0 a 0 ..� .- . . wcn k.,,',', '3� ,.'r: .. U OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY Certified Worker for Asbestos Abatement Projects ,n•s Sean C. Schoen E: G* U v nAffdtMO. ' F 18154 06 1 s 14 cr6 'f@�Z— I 10'DAi tj- s 04.05 13 04 05.13 "" 1 P Ems.aC E 5 CiE.EF6 E O 1"•5 �•r' r j Safety Directions TTC - 541 .266.9077 ATIN T eerwwn a, ned his cer'r sc 1neEe IECIN 'v'r 4fx ° f cNren uanmy Tor asdes es cert t cat on and s cereNec i tr•a..e ay.vie Oecarment el Environmental Quality utter OAR ''r: zu._,cr ? _ Onus _fn Dmsio1_8 am.uncer TSCA rya 11. OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY Certified Worker for Asbestos Abatement Projects NAME — Naulfer B. Morales N. E it trn rvo E!aTALCN 0a,N -- r. ; F 18152 p6,Q 14_ It, 04.05.13 04.05.13 i' " lea a00Pnnh Ana rLE Np.c NO Ant' Safety Directions LLC 541 .266.9077 5s :10 the person ass r.ea:nic-end ca has conics.en he e$ oy he Ce ann raging En mannenL Qux:v uncer CAR Cnacter 340.Omaron 240 and under T604 tine II Environmental Testing & Training NorthWest PCM - Air Sampling Report NIOSH 7400 Client: ATEZ, INC. Date Received: 06.28.13 INV#4305 Client Address: 23525 HWY 99E Date Analyzed: 06.28.13 City, State: HARRISBURG, OR 97446 Report Date: 07.01.13 Analysis Type: PCM Project Name: MILL OFFICES Analysis Turnaround: Same day Project Address: 305 SO 5TH ST Page No.: 1 of 1 City, State: SPRINGFIELD, OR Sample . Sample Minutes Flow Rate Total Air Fibers per Date Location Activity Sampled LPM Volume Fibers Fields CC (f/cc) 06.28.13 EAST END ROOM CLEARANCE 85 15 1275 12 100 0.0046118 06.28.13 MIDDLE ENTRY CLEARANCE 90 15 1350 11 100 0.0039926 06.28.13 WEST END ROOM CLEARANCE 68 18 1224 9 100 0.0036029 06.28.13 BLANK#1 0 100 Analysis Performed By: James Samter NIOSH 582E Certified Analyst Signature: Date: 07.01.13 Environmental Testing & Training NorthWest 2266 McGilchrist Street SE Suite#220 Salem, OR 97302 541.870.4331 jim @ettnw.com • 9' 13v• ASN 4 ASBESTOS WASTE SHIPMENT REPORT FORM _erg. PLEASE PRINT OR TYPE!If you have questions,contact your local DEQ Regional Office in Portland at(503)229- DEQ 5364,Salem at(503)3784240 ext.272,Medford at(541)776-6010 ext.235,or Bend at(541)388-6146 ext.226,OR call(800)452-4011 for the location of your local regional DEQ office. WASTE GENERATOR: (Contractor,Facility,or Operator) I. Asbestos removal site name and address: ." I !a sb e C CLYv` td) �/L in& 11 C' '7 -11 Stree J c74'J ST1.LfY/Sate County Zip Contact person: ,Qa56 5\, . )76)rrw_- 1,.rQn4 SKI- 'C147l Phone: '?milI - - ')C.,`)7. 2. Operator's name and address: ATEZ, Inc. Phone: 541-995-6008 23525 Hwy 99 E. - Harrisburg,OR Linn 97446 Street City/State County Zip , 3. Waste disposalsite:;e.,)!KCs 2.:t M)t A' c`C �1 Phone: 541-�In'- �`, gy 1 --- ci_�_�C1 Prcc¢_� 'a . (t_.2 c vt e 4 ea_ LCzNlx. q 14 Street I f�nCity/State 3 County Zip 4. Describe asbestos materials: r - - r,L a c4 a + Ice" c. 5. Containers: Number: ` Type: ccl f{ t 6. Total quantity(cubic yards): Q fl - 7. OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packaged,marked and labeled,and are in all respects in proper condition for transport according to all government regulations. All movement of this asbestos-containing material is recorded on this Waste Shipment Record Form. Name: Ro. Li, �,_ Pr- '•en Company: ATEZ,Inc. Signature/ j 4.70S�7t� Date: ,y- OD TRANSPORTER(S): 8. Transporter#1: (Acknowledgment of receipt of materials) Agent: Robert It Kenyon Company: ATEZ,Inc. Address: 23525 H .99.r Harrisb • OR L Y�1 f get C- Phone: 541-995-6008 Signature: $ A r i`G� Date: I', 3 9. Transporter#2:(Acknowledgment of recetp oials)- Agent Company: Address: Phone: Signature: Date: DISPOSAL: (Certification of receipt of asbestos materials covered by/this manifest,except as noted in item I I below.) 10. Waste Disposal Site: SA•rt rev/ Lo-.iLG 470 Name and Title $O A r',r f Z (R Yh 3 Date: 2 ,2- 13 Signature:_( "` `� ) Phone: 541-745-2018 11. DISCREPANCY SPACE: (Add attachments as needed) (Revised 6/03) • • Environmental Testing & Training NorthWest PCM - Air Sampling Report NIOSH 7400 Jobsite Copy Client: �� Date Received: 6-a513 Client Address: AI�� Date Analyzed: -2/5--13 City, State: Report Date: Analysis Type: PCM Project Name: Analysis Turnaround: Same day Project Address: 735 sxriel Page No.: 1 of 1 City, State: v&f Sample Sample Minutes Flow Rate Total Air Fibers per Date Location Activity Sampled LPM Volume Fibers Fields CC (f/cc) /p.ZFS �5 CLEARANCE 6,4 {O ,a)Io 9 /r�'O , boa • Piitht CLEARANCE 90 %J i so /1 /n, /0-03 6 l�Gf CLEARANCE Sr; IS j 47j /Z /CD ,V,/ eft: BLANK#1 6;2c. BLANK#2 X/ . /ro Analysis Performed By: NIOSH 582E Ce• -d Analyst Signature: 1m, i �1�� Date: Cf 2gr ii Environmental Testing & Training NorthWest 2266 McGilchrist Street SE Suite# 220 Salem, OR 9730 • • 541.870.4331 •