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ASIV-~ OREGON DEQ NOTICE OF INTEIVT <br />~ TO REMOVE QR ENCAPSULATE FRIABLE <br />ASBESTOS-CONTAINING MATERIAL <br />Precision Industrial Constructors, Inc. <br />ATTENTIONI 7his notification must be complete and received by DEQ at least 10 days hefore the start date of any asbzstos <br />abatement project and accompanied by the notification fee. (PLEASE TYPE OR PRINT CLEARLY) <br />PROJECT CATEGORY AND NOTIFICATION FEE <br />X Emergency IEmergency notlficetione require e 50% tee increase) <br />A. $35 for aach project wi[h less than 40 linear or BO square feet of asbes[os-con[aining ma[orial and for each residential abatement projec:. <br />B. 970 for projocts from 40 [0 259 lineer feet or 80 to 159 square (eet of asbestos-containing materiel. <br />C. 9275 for projects from 260 [0 1299 linear feat or 180 [0 799 square feeC of esbesms-containing material. <br />D. 9375 for projec[s from 1300 to 2599 linear feet or 800 to 7599 square foet of asbestos-con[aining meterisl. <br />E. $650 for projec[s from 2600 to 4999 linanr fea[ or 1600 [0 3499 square fae[ of asbestos-con[aining material. <br />F. X $750 for projects from 5000 to 9999 linear leet or 3500 [0 5999 square fee[ of esbostos-conlaining meteriel. <br />G 91,200 for projects from 10,000 to 25,999 linaer feef or 8000 to 15,999 squere faet of esbestos-containing ma[ariel. <br />FI. 32,000 for projec[s from 26,000 to 259,989 lineer fae[ or 16,000 to 159,999 squera fae[ of esbestos~containing metarial. <br />I. _ $ 2,500 for projects 260,000 lineer faet or mora or 160,000 square feet or more of asbesms-con[eining material. <br />1. Is this a revision to a previous notificationl Yes No a ~ <br />2. Asbestos abatement project starting date: 6-10-97 Completion date: 6-12-97 <br />3. Project site name: Carmunity Developnent BuildinG Address: 285 Church Street Salem ~'arion C& 97301 <br />- - ~sveeu ~ary~ lG..+r~ ¢P1 <br />4. Property Owner: M~rion County 11. Abatement Coniractor Name: <br />Property Owner Address: 100 Hiqh Street VE <br />Salem OR 97301 <br />IGryI ISla~el IZIPI <br />. Site Contact: ~ve Hartwig Phone: ~03-373-4424 <br />6. Describe physical structure of facility: Nood, Hrick and <br />Concrete Structure <br />7. Give present and prior use of facility: ~arion County <br />9uilding - Currently Vacant <br />8. Will ihis be a complete demolition7 Yes: X No: <br />If yes, give demolition start date: 6-9-97 <br />9. Describe type and percentage of asbesfos material and <br />where it is located in facility: ~ ChrVOSlite Tile & Yiastic <br />25% Cltrysolite Fittinqs <br />? 0. Quantity of as6estos material to be removed or <br />encapsulated: <br />I.inear feet: 50 Square feet: 3,600 <br />7 7. Name of owner <br />ignature: <br />Contracior mailing address: <br />1395-D ~ownriver Drive Woodland, WA 9c674 <br />tcni ~s~a~i 23: <br />Phone: 3E0-225-7955 <br />For DEQ use oru'y <br />oa~a Re~e~~ed _ <br />Amount Received <br />Check N~mber _ <br />Project Numbar _ <br />DEQ Iicense number: ~-~45 <br />12. Describe method of removal or encapsulation: <br />F1i11 \egative Pressure Enclosure - Wet ,'ethocs <br />73. Days of week and hours of day to be worked: <br />'1lzesday - 'i:iursday <br />B:OOam - <br />74. Oregan Certified Supervisor on this project: <br />Jim Kcenig <br />Ore. Certified Supervisor number: ~07780 <br />15. Asbestos disposal site: Hror.m Island <br />16. Waste Hauler. Precision Industrial Constn:ctcrs, Inc. <br />Phone: 360-225-7955 <br />or abatement contractor: Precision Industrial <br />Inc. <br />Date: 6-9-9~ Phone: 360-22 7955 <br />Sign this form and send with the appropriate fee to: DEQ Business Office, <br />811 SW Sixth Avenue, Portland, OR 97204. Make checks payable to "DEQ". <br />IRevised 5/98) <br />