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Home My WebLink AboutMiscellaneous - 22 HAMILTON ROAD 4/30/2018 (2) 22 HAMILTON ROAD 210/016.0-0029-0000.0 i j 1 f I I I I f I I � AIR QUALITY EXPERTS, INC. 40 LQWELL ROAD, UNIT 1 SALEM, NH 03079 608-894-6465 SEPTEMBER 12, 1995 JOS NO. ANDOVER BOARD OF HEALTH 120 MAIN STREET NO. ANDOVER, MA 01845 DEAR SIR: SIR: ENCLOSED PLEASE FIND A COPY OF NOTIFICATION SENT TO THE STATE FOR AN ASBESTOS ABATEMENT PROJECT. THE JOB WILL TAKE PLACE ON SEPTEMBER 20, 1995. PROJECT: 22 HAMILTON RD. ANY QUESTIONS CONCERNING THIS MATTER SHOULD BE DIRECTED TO MY ATTENTION. SINCERELY, CHRISTOPHER THOMPSON PRESIDENT Commonwealth of Massachusetts Asbestos Notification Form— ANF-001 - _ -a•<: 1 i e Asbestos Abatement Description 1. Facility location: JAY .AUS.T.IN.................................................... .... 22 HAMILTON..RD• .. ... __.. INSTRUCTIONS Name Address 1 All sections of this ANDOVER MA1..84-5........._..........5..0.$.-..6..8.3...-..2.4.2.1......_.._.. form must be completed rI 0.y uw7r lip rale Telephone n order to comply with the Department ofu ..ddild-in.......re..........in. ...........r....r..n........................................................................................................................................ Environmental IYIa17sNkikAaili 7hprar ,/,wg,lluu,uu Protection notification 2. Is the facility occu d? Tes No requirements of 310 CMR 7.15 7.15(ten working days prior notification is 3. Asbestos Contractor: required of any ndthe abatement .AIR QUALITY EXPERTS, INC. 40 LOWELL ROAD, UNIT 1 proiec):and the .......:........................................................................................... ............................................ .......................................................................... . Department of Labor NaW Address and li notil cationationrequirements SALEM, NH 03079 603-894-6465 ..................................................................................................... ...................................................... ............................................................ o1453CMR6.12 (fen Ciry/Jowrl lip ade Telephone days prior notification is requiiedolANY AC 000167 WRITTEN abatement project greater Oflfkense/ CoulrxJTy,e(wrilrCn/vetal) than INee liver or square leel). 4. On-Site Project Supervisor/Foreman: 2.Submit Original Form CHRISTOPHER THOMPSON SF07797 ..................................................................................................... ..................................................................................................................... . . To: Name 011 Cenifiraliou/ Commonwealth of Massachusetts 5. Project Monitor: Asbestos Program P.0.6,120087 FINAL NAL CLEARANCE ANALYSIS AA0000 8 5 Boston,MA 02112• Name D(ICediriralmn/ 0087 6. Asbestos Analytical Lab: 3.This lormmaybe SAME used for notilying the ......................................................................................... . ................................................................................................................ U.S.Environmental Nanr OfIGerfierahou/ Protection Agency Region qq� (� rr,, 7-12 lolasbestos demolition/ 7. Project start A94095end date09/299%ecificwork hours(Mon.•Fri.) (Sat.Sun.) enovalion operations subject to NESHAPS(40 Yy CFR Subpart M). 8. What type of project is this? (circle one): dernotiihon re,sir ReAJ+rhoo omer(explam) F::!'.d DnIr 9• Describe the asbestos abatement procedures to be used (circle): uloverap enaosure .onlainrrem ueaoupeX41511lallai diafxxsafonly other(explain) n Ioar 10. Is the job being conducted moo ❑outdoors? X PamirAwveWDeiee 11. Total amount of each type o s es os Containing Materials(ACM)to be handled on pipes or ducts(linear ft.)c_of other surfaces(square ft.) to be removed,enclosed or encapsulated: son .6eo G le lineadsquare feet boiler,breaching,duct,tank surface coatings... 15thermal,solid core pipe insulation...... corrugated or layered paper pipe insulation. insulating cement................ .. sprat'onfireproofing....................._/ boweLlspvayercoatings.............. _! cloths,woven Fabrics....................._/ Iransife board,wall board............. other(please describe).................... 12. Describe the decontamination system(s)to be used: FU.LL.....C.O.NTAI-NMEN.T............................................................................................................................................... .. .......... . .................... . . . 13. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMP,a.14(2)(g): WET....REMOVAL....I.N.T.O....6MIL....P..OL.Y...ASBESTOS...LABELED....BAGS..........'___........ 14. For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: * INSPECTOR Narre of"P udrrial Title ... ............................................................................................. ....................................................................................................................`...`....... Oak d AudiorUXion "Wr/ nu? aciia';Kiii ......................................................................... .nue......................:.........I..NSPECT.O.R....... ......... .._....... .... ......................................................:............... .............................................................................................................................. Qa1BdAulrxlrQal,rnl Wuwr/ / 15. Do prevailing wage rates apply as per M.G.L.c.149,§26,27,or 27A•F to this project? ❑Yes �tJo Rev.6,92 facility Description 1. Current or prior use of facility: ........................................................................................................................................................................... x ............................................................ 2. Is the facility owner-occupied residential with 4 units or less? es No 3. Facility Owner: Nafif y-ME............................................................................... . ........ Address ............................................................................ leldwne .............................. lip rode ............................................................... re 4. Facility's Owner's On-Site Manager: Address ...................................................................................................... firy/lurn ..................................................... .........................._............................................ All rune relerdrone 5. General Contractor: v `rj 7 i 1.................................................................................. ....:...... . ............................................................................................................. . Address ..................................................................................................... Civ?own .....................................................Zip code Telephon T.ale... .....,.......................... _............__..... e Contractor's workers Comp.Insurer Policy/ &&.Date 6. What is the size of the facili V'�-�Iz I ty (sgft)_•(M of floors) Asbestos Transportation and disposal 1. Transporter of asbestos-containing waste material from site to temporary storage site(if necessary)to final disposal site: AIR QUALITY EXPERTS, INC. 40 LOWELL ROAD, UNIT 1 One.................................................................................................... AOdress SALEM, NEW HAMPSHIRE 03079 603-894-6465 Cily/rown lip rale relephune 2. Transporter of asbestos-containing waste material from removal/temporary storage site to final disposal site: SAME ..................................................... .......... Adrhesr Note:Transfer Ciry/luwr lipfale lelep/xme Stations must comply with the 3. Refuse transfer station and owner(if applicable): Solid Waste Division re ula- tions 310 CMR Address 18.00 .............................................................................................. Zip rale lele,hune 4. Final Disposal Site: TURNKEY LANDFILL WASTE MANAGEMENT OF NEW HAMPSHIRi-: . ............ati............................................... .................................... . ......................................................................................................... loUlion Narne (Avners Name "`- 90 ROCHESTER NECK RD. .................................................................................................................................................... Address ............_................ ... .......... . ROCHESTER, NEW HAMPSHI.. RE 03867 603-332-2386 ......... ... r:irvAnwn . lin axle leler'hone Certification The undersigned hereby states,under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts Regulations for the Removal,Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310 CMR 7.15,and that the information contained in this notification is true and correct to the best of his/her knowledge a belief. Nate:Contractor AudwrveJSipnalwe CHRISTOPHER THOMPSON y �/"—� PrinlName . . ......... .. .........................................Dale .... ........ ..... ..... , .......... -- - mustsignthis PRESIDENT AIR QUALITY EXPERTS, INC.603-894-6,;6 form for DLI Vosilkin/ride ........................................ ........on.......................... notification Represenliny -- le/ep/rode Purposes 40 LOWELL ROAD, UNIT 1 .............................SALEMNH 03079 Address ............................................................... .......... Fee exempt(City,Town,district, Clry/ruwrr . Iq,nx/e municipal housing authority,owner-occupied residential of four units or less Ye C no Sticker I(from front of form): O S /