HomeMy WebLinkAboutPermit Demolition 2007-8-22
Apr-03-09 09:22A
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Joe Balaty Rentals . . ~ b~
Commercial and Residential
33328 Howe Lane
Creswell, OR 97426
_ Phone: 541-895-5071
Fax: 541-895-5072
E-mail: escind@msn.com
To: . 1../.5;9 #~.,.ppe,l{
From: JOe.
Fax No: 7:2 t - ,36 7 6
Date:
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Pages: If
Notes:
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Apr-03-09 09:22A
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A SEAVJa:-DISAlU..ED VETERAN-OWNED HUS-ZONED SMALL aUSllltEs&
environmental Iamedlatlon Asbestos/Lelld/Mold/Drut Lab.
A COMMITMENT TO EXCELLENCE CCB 11408O
23521 Hwy. H E. ..rrisbu...., OR .7446
PH 541.H5..... PX 541-.....1015
E....il ._..tulnc.com
CERnFlCAll Qf COMPL~ I &ON ..
.***VACANT RESID.ENCE 1483 MAIN ST. SPRINGFIELD, OR....
ATEZ, Inc. has sucr-c..fully completed the removal of approxlmatety 950 square feet of
as:' ....:....oi containing roofing from the south end of the house, 140 sQuare feet-of asbestos
containing sheet vinyl, Bnd 300 square feet of asbestos containing floor tile from the vacant
residence located at 1483 Main Street Springfield, OR. (See attached LRAPA notifications)
The work was completed on Friday August 17, 2007.
ATEZ, Inc. has property removed all aSbestos containing materials we contracted to remove.
If additional hidden asbestos containing materials are uncovered during the demolition 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.
All work was completed bv a certlf'ted asbestos abatement supervisor and certified asbestos
abatement workers.
The work was completed without Incident.
AI/ waste is being stored at 23535 HwV 99 E Harrisburg, OR until it is transported under cover
to Coffin Butte landfill for diSposal. At that time you will receive an ASN4 form showing the
waste was disposed of properly. . -
So Certified
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ItObert It. ltinyon, ~l.. .
END
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Apr-03-09 09:22A
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rfN-DAY AND NON-FRIA8LE NOTIFICATION OF INT'ENT TO REMOVe: OR ENCAPSUI.ATE
ASBESTOS IN LANl COUNTY. OREGON
L..ne Relion.1 Air Protllctton AJll'ncy
1010 Mafn St,...t
Spnnafteld. OR 97477
(541) 736.1056, ...x: (541) 726-12.05. toll fr.. (877) 285.1272
For U'\APA Use:
'Project
- ^ . ^
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. Cneck 11
Typ~ of Abiat.me"t
Project CatelOry and REQUIRED Fee
07o~~i:; .'. .
J,: ~,' Demolition .1i- Emergency WaIver {Add 5096 to required feel S
tJ' Removal S 42 ~ Non-rriable (S-Day Notice)
~ 0 Encapsulat10n S 42 0 Residential Project (Occupied Al!t$idence. ~ for Demolition)
: 0 R~novatfon S 42 0 ~ 40 Un/80 sq ft (Small Scale, Short Duration)
~ 0 Maintenance/Repafrs 90 Q,. 40 linear/80 ~quare feet; ~ 260 hnear 1160 square feet
f 0 Ocher. S 364 0,. 260 linelll'/160 sqft; ~ 1,300 linear/BOO sqft.
' S 457 0 >1 ,~OO linear/BOO sq'Cj ~ 2,600 lilleBr/1 ,600 sQft
J S 790 '0 > 2,600 Uneilrl1,600 $qftj .:!. 5,000 Lineor/3,500 lQft
I .... Hillll survey belitn . S 912 CJ" 5,000 linear/l.SOO sq(t; ~ 10,000 linellr/6,OOO sqft
l completed? S 1,460 0:> 10,000 linear/6,OOO sQft; ~ 26,000 linear I 16,000 $(lft
:!
. Yes 0 NoD SZ,434 0 >26.000linear/16,OOOsqftj~260.000li"ear/160,OOOSqit
Is 3,041 O! 260000 Linear/160000 sqft
If Yes By
. Whom? .. Is tnis a re'lision to. previous notification? V~ 0 No 0
r ".~~~:: ~;,; :~"i'43'~~" ,\, ~ ~ "- . Phone . _ "
~ Sit", Address { '1 ('I '"J, rY\....... Jt.1. Cfty ...:> Pl'. 'I...., t-l .. L , \.
i Location of Asbeftos at th~ sfte p.,~C ~ l C~ _ I (
Site Category: 0 school JXre$idence 0 collep 0 industrial 0 Commercf~ 0 other
Stare Date q. tLe....:... '.)(\. CompletiOn Dllte 91-~. 61) Hours on Site ~A .~, Days on Site J}., r.-..
EmeriE'ncy project notiffcation request~; 0 No 0 Yes .. DiSCUSSed with _ Date
TYPE OF ASBESTOS MATERIAL . , .< 1 . .
TYPe'a Percent of Asbestos ~ ""2.. [J1 ('c. . ""iC}J... ( c. . }ill Estimate 0 Lab
Quantity of asbestos in project_ I ~ ~ f . 0 li~r ,-,Square 0 Cubic feet
o pipe insulation 0 tape 0 cltmentatfous(4l'g: trr"'slt~) )'l(..floor tUe ~rooflni 0 felt 0 sprayon
o valve packIng 0 mastic 0 sheet vfnyl 0 other
J
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l
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("1..,1 '
I
i
! WO~K PRACTICES AND ItEMOVAL PROCEDURES
l LJ wet method 0 dry methodS with air fUterins 0 Jloveba~ 0 containment 0 r\eiative air
I C HEPA vacuum 0 vacuum truck with HfPA fflter Ji{other' ~ kc en " ,..:,~ 0(1": 1, ,).: ,,:,'"
Ambient atr monttOrint to be performed: ~e 0 no . I
DISPOSAL PkOCEDURES . ,
o chute to dropbox 0 hand-load dropbox )t"wetted and double ballged 0 other ]
Dwasl:estoredonsfteinsecut'E'dcontatner )(iNastesecuredofhiteat 23525 Hwv 99 E 'HarrisburCl. OR.]
""wasce removed daily 0 other \
O';O...L <rrr .i
o Snort Mountain 'Ilif' Coffin Butte 0 other
ABA TfMtNT CONTRACTOR -... ~._"""-"....~_..."...........-.,~--.~"..._,,,.
Contractor Name_ ATEZ. Inc. . U~nse No. F'pC 535
Mailing Address .23525 Hwy 99 E ._
City ~,.....; ...J..."....,. State OR ZIP 97446_ Phol'!! 541-995-60()B
comP9tentperson....:.L.1... ;,W.'.'\ /.~. _~ertffk~te.No. "'51-;~...S Cell/PagerNo. "Sc;\ 1...'-'..:.1'-\
PROPERTY OWNER ""\. \ )lv.....JI f)u.'\<l~c:~ <;' ill tiy OC'-6Z,.,
f Nam~ ,)'\;\........ . \,- . ~ ''I ,', ;.~ ' ~
I Maili,~ Address 3 :r~.)~ ~J.._'" w-t' 1- "4..... o. . . . .. _.
, CIty." .1' ';"';' . ..... ~ _ Stllte I~. ZIP ~/7i.(J~ Phone1tft - b"'1~-- .J")....)7 /
f Name IPlease Printt...-:8.(' ~(~t 1}.;:.~iG" V'\.lJ ("\1"\ Organizatfon A ff:. 2 \ ~..Q t"l ~ ~ . . 1
LSignature .:.d7/.... "(~~ rt. ~~~ ?hone~l AC') ,:.,'1 C'-lC', V Date '..,-"/ 'if/ .
..' AsO:070107.1
"
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Apr-03-09 09:23A
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;'EN-DAY AND NON-FRIABLE NOTIFICATION OF INTENT TO REMOVE OR ENCAPSULATE
AS6ESTOS IN LANE COUNTY, OREGON
For l~APA USe?:
~--_.,
l.an. Re!lonal Atr Prot.~Ual'l ",enc::y
. 1010 Main Street
Sp"nafleld, OR 91477
(5~') 736-1056, FilX: r!541) 726-1205, toll f,.. (877) 285-7271
P.roject
;: t!t! ".,.... '" ~
Check P
"J'{.
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C1
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o
Demo \ i lion
RernoYClI
En(;apsull'.ltion
Renovatfon
Ma1n(enance/Repair
Other
Proiect c.teaory and REQUIRED Fe.
D Emergency Waiver iAdd'SO% to required fee) S
o Non-Friable (5-Day NCltke)
D Re5idential Project (OcCIIClted Residence, n!! for DemodtiOl1\
Q ~.ro Un/SO sq ft (Small Scale, Short Ouratfon)
~ ~ 40 lInear/80 square feet; ~ 260 linellr/160 square feet
o ::0 260 l1rle'lIt I' 60 sqft; " 1,300 lfn@ar/8oo sqft
a :. 1,300 l;near/800 sQft'i ! 2,600 Ifnear/(6C)(hqft
o ~ 2,600 Iinear/f.600 sqft; ~ ',000 lInNl'l3,SOO saft
o ,. 5,000 lInellr/3,500 sqftj ~ 10,000 linear/6,OOO ~Qft
o :> 10,000 linear/6;OOO sqft; ~ 26.000 linear / I 6.000 SOft
o :> 26,000 lInear/16.000 sqft; ~ 260,000 lill~Zlr/'60.000 ~Qf(
o ~ 260000 tineor/16OQOO sqft
- _.._~-- ..,
07060l\p
Type of Abatement
...
Has a !",rvey b.en
~ompl41ted?
Y'~ No 0
S 42
$42
S "2
S 90
S 364
S "'57
S 790
S 912
S 1,460
S 2.434
S 3,041
If YE'S 8)1 ll-r.e""
. Whoml~ r ~ tAZ..... c _ .. Is this a r...,iJI;on to a previoUl nottflution? Yes 0 No 0
A8ATEMENT PROJECT I"OR~nON
SIte Name lLJl C. r._ An J... . fi.c.,A\ "..1. Jl~_... It Phone
Sitl& Address t ,-{ 't ~ r'n~ ~, Cfty 5...,.. {..... r'1 ~ ~ (' .1
LOCation of Asbestos at [he site~ I_;J . I ~,......../
Site Cotegory:. ~ SChO. 01 )(""dan",: d etA'"'} -!i"::..~'1 0 comm."'~.1 0 o~'a'
Star, Oate-:.zs..:.!I", ~n7 CompletIon Date -. Hours on Site.sl.A ~ (! Days on Site
Emergency project notification requested: 0 No .. OfsCU5sed with . . Date
iYPE OF AS8ESTOS MATERIAL . c ~
Type & Percent of Asbestos C;;"" C '^... f:~"~~. (......L
Quantity of asbenosin project t!1.t;t
o pipe insulation 0 ~ape OcernentattousleJ: transIt.)
o valve packing R(mastic.R' sheet vtnyl 0 other
(I.., ~,_,
. !( fstfm21te 0 Lab
o Ltnear )(Squar. O"Cubic feet.
o floor ttle 0 rooffn8 0 felt 0 sprllycn
.wORK PRACTICES AND ~EMOVAl P'tOCEOURES
b wet metllOd 0 dry methods With air filterIng 0 glovebag
G HEPA vacuum 0 vacuum trU(:k with HfPA filter 0 other
Ambient atr mOl'litorina to be perlormed: )f YlI$ 0 no
DISPOSAL PROCEDURES
o chute to dropbo.ll 0 hand-load dropbox
i.J waste stored on site in secured container
O'waste removed daily 0 other
)if containment 'flI negative air
~ wetted and double baRged 0 other .
);fwIIstesecuredoffsiteat23525 Bwv 9-9 E Harr1sburQ, OR;
OISPOSAL S'1"( \ .
o S.hort MountaIn ,~C.offin Butte 0 other
ABATEMENTCOHTRACTOR
.Concractor Name ATE~" Inc.
MaHIn!! Address 23525 Hwv 99 E
City r:}Xri liDU-J Stllte OR ZIP 97446 Phone 541-995-6008
Competent Person~ 1L_~~~_ . Certlfkate No. :.;d.1.:~ Cell/Pager NO. .:~.~ ,J',;:.~
PfitOPERTYOWNER. . ,...,..~. V\..~~ I'\u.....~d() 5'1l1'-lV
Name M.t..... :1[,.; L h .t. \.-0. ) 0
M~ili~, Address ~3 ~;J . '"'" I ('" .,J
C!ty . . t ~ -<;'. .,1': ': . State /') i , Z'P (( 'M..ua. Phone "'::;-Yt - ':;"1",-~ :')- i '':":
Name "I.... P"nt~ ,..8.) 9<>.' +. .~ '" l~ Orpnlllltlo"...a.T~ . '. .,Q 0 0 . . .
Slsnc.ture . " .~ ~-~.(/"/.R ,.~~ ~~ Phon.~C1 '-'((J()':':V ))cte.1" ..-"
'.~
-... ,....... ......1
"-II -_'II'''IiIiiiIiiIlII
License No,
FSC 535,
c.J..s,-6 L
~D:070107'T
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