HomeMy WebLinkAboutMiscellaneous - 250 MAIN STREET 4/30/2018tt Air Quality Experts, Inc.
Asbestos Removal
Christopher Thompson 40 Lowell Road, Unit 1 Residential-Commercial -Industrial
(603) 894-6465 Salem, NH 03079 1-800-621-1189
May 10, 1999
North Andover Health Department
120 Main Street
North Andover, MA 01845
Dear Sir:
Enclosed please find a copy of notification sent to the state for an Asbestos
Abatement Project.
The job will take place on May 19, 1999.
Project: 250 Main Street
Any questions concerning this matter should be directed to my attention.
Sincerely,
Christopher Thompson
President
MAY 13 1999
_____ _. _ ._ _A
INSTRUCTIONS
1. All sections of this
form must be
completed in order to
comply with the
Department of
Environmental
Protection
notification
requirements of 310
CMR 7.15 (ten working
days prior notification
is required ofany
abatementprojectf.
and the Department
of Labor and
Industries
notification
requirements of 453
CMR 6.12 (ten day's
prior notification is
required ofANr
abatement,oroject
greater than three
linear or square feet).
2. Submit Original
Form To:
Commonwealth of
Massachusetts
Asbestos Program
P.O.B. 120087-0087
3. This Form may be
used for notifying the
U.S. Environmental
Protection Agency
Region 1 of asbestos
demolition/renovation
operations subject to
NESHAPS (40 CFR
Subpart M).
u
Receive date
Receiver
Permit Approve/Denied
Decision date
Commonweafr/�ofhlassac/iusens
AsbeslosNorificalioaform —AA F-991
1. Facility location:
Trinatarian Church
250 Main Street
Name Address
North Andover, MA 01845 (978) 683-0164
cloy' Town Zip code Telephone
Basement
What is the worksite location. Bui/ding name, #, wing, floor, room
2. Is the facility occupied? ® Yes ❑ No
3. Asbestos Contractor:
Air Quality Experts, Inc. 40 Lowell Road Unit 1
Name Address
Salem, NH 03079 (603) 894-6465
cloy' Town Zip code Telephone
AC 000167 Written
DLI License # Contract Type (Written or Verbal)
4. On -Site Project Supervisor/ Foreman:
Joseph Sharpe AS 30725
Name DLI Certification #
5. Project Monitor:
NorthEast Environmental
Name
6. Asbestos Analytical Lab:
Same
Name
AA000153
DLI Certification .#
DLI Certification #
7. Project start date 05/19/1999 end date 05/19/1999 specific work hours (Mon. -Fri.) 7am3pin (Sat. -Sun.)
8. What type of project is this? demolition repaFi`renouation of/ier(explain)
9. Describe the asbestos abatement procedures to be used: glove bag enc/Osure ft//containment
Cleanup encapsulation disposal only other (explain)_" -
10. Is the job being conducted ® indoors ❑ outdoors?
11. Total amount of each type of Asbestos Containing Materials (ACM) to be handled on pipes or ducts (linear ft.) 160 or other
surfaces (square ft.) 30 to be removed, enclosed or encapsulated:
Linear Square feet Linear Square feet
Borlerbleaching, duct, tank surface coatings 30 Thermal, so/id corepipe insulation
Corrugated or layered paper pipe insulation 160 Insulating cement
sp2y-on Fireproofing Trowe%sprayer coatings
LYoths, woven fabric Transrte bowid wal/baaid
Other (please describe) Other (please describe)
12. Describe the decontamination system(s) to be used:
13. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g):
Wet remnvnl into 6 mil Poly Asbestos labeled Raps.
P
faCf//tyD'BSC!/pt%a
1. Current or prior use of facility:
Church
2. Is the facility owner -occupied residential with 4 units or less? ❑ Yes ® No
3. Facility Owner:
Trinatarian Church 250 Main Street
Name Address
North Andover, MA 01845 (978) 683-0164
City/Town Z/p cnde Telephone
4. Facility's Owner's On -Site Manager:
CIVTown
5. General Contractor:
Name
Address
Z/p code
Address
clk Town Z47 nide
Te%phone
Te%phone
Contractors Wol*eis Comp. Insurer Po//cy f Erp. Date
6. What Is the size of the facility? 8.000 (sq ft) 2 (# floors)
LS AsmstosTianspo�tatioaaadDisposa/
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
Name Address
Salem, NH 03079 (603) 894-6465
coy Town Z/p cnde Telephone
2. Transporter of asbestos -containing waste materials from removal/temporary storage site to final disposal site:
J.O.B. Rolloff P. O. Box 6037
Name Address
Chelsea MA 02150 (617) 387-1495
Ck Town Z/p nide Telephone
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