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Air Quality Experts, Inc.
Asbestos Removal
Christopher Thompson 40 Lowell Road, Unit I Residential -Commercial -Industrial
(603) 894-6465 Salem, NH 03079 1-800-621-1189
March 3, 2000
North Andover Health Department
146 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 March 16, 2000.
Project: 266 Main Street
Any questions concerning this matter should be directed to my attention.
Sincerely,
Uk r"'rj-
Christopher Thompson
President
MR / 6
— — — — — — — — — — — — —
I
Commonwealth of Massachusetts AffIXAS&-Slios
Notlllcatlio(7 ObCalhelle
Asbestos Notification Form —ANF -001
B t -A L
10 ------------
1. Facility location:
INSTRUCTIONS
1. All sections of this
form - ust be
competed in order to
corri with the
Department of
Environmental
Protection
notification
requirements of 310
CM R 7.15 (ten 14VI*Ing
d7)1S,a1i0r -006-
/5 -qUlred OfanV
and the Department
ofLaborand
Industries
notification
requirements of 453
CMR 6.12 (ten day�7
'ayor nomfcation
leoulreootANr
preater 0�n three
hnsar or squme &-et)
2. Submit Original
Form To:
Commonwealth of
Massachusetts
Asbestos Prog m
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).
For Official Use Only
Notification
Receive date
Recelver
Permit Apprwe]D�Ied
Decision date
Donald Elliot 266 Main Street
NFMe Aodheu
North Andover, MA 01845 978-664-5504
00ro-7 zip code rdlepl?cne
Basement
w1vt Is the Plorkgte lbeazzon;'BuIldIng lume, 9, wIng, t7oor rxm
2. Is the facility occupied? N Yes E] No
3. Asbestos Contractor:
Air Quality Experts, Inc. 40 Lowell Road Unit I
lvyme Address
Salem, NH
00�Town
AC 000 167
DLI license 0
4. On -Site Project Supervisor/Foreman:
03079 (603) 894-6465
z/0 code TelePI70-
Written
contiact TY,06 (W17ften or verbal)
Joseph Sharpe
AS 30725
11'ame
DLI C"fir2170n 0
5. Project Monitor:
Final Clearance Analysis
AA000085
Ivame
DU C&1t17r2170n Af
6. Asbestos Analytical Lab:
S me
Ndfl7e
19Lr C"&317017 0
7. Project start date 03/16/2000 end date 03/16/2000 specific work hours (Mon. -Fri.) 7am4pm (Sat. -Sun.)
8. What type of project is this? demolitloin repaIr renovatlbn offieri(expl8lq)
9. Describe the asbestos abatement procedures to be used; glove bag enclosure full contamment
cl-nuo en-psulatlon d1sposal only offier (explwn)
10. Is the job being conducted M indoors D outdoors?
11. Total amount of each type of Asbestos Containing Materials (ACM) to be handled on pipes or ducts (linear ft.) 4 10 or other
surfaces (square ft.) _ to be removed, enclosed or encapsulated:
Linear Square feet Linear Sguare feet
81,1er bk3ch,,g d-4 t k s,,f�e �vng, - 7hen-1 �IAY�plpe ubzon
C,-.gated-I.y,-dp,p�,plpe,-,Iaton 410 1�bbng --t
SP-y,7-f-kv
cl'th" __ &&" T-&' bw'd
Other (Pk-- di-lbe) Other (Plwse d��be)
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 removal into 6 mil Poly Asbestos Labeled Bags.
14. For Emergency Asbestos Abatement Operations, the DEP and DLI officials who evaluated the emergency:
11'ame OfDEP offiba/
L53tv OfAu0cluallon
Name 0fDLrCffC1,31
Late 0fA1Ay70nZd&017
71be
Wd/V&/- 4F
Rev. 6/92 15. Do prevailing wage rates apply as per M.G.L. c. 149, § 26, 27, or 27A -F to this project? [-I Yes Z No
Note., Transfer
St,7tibns must
COM'D/Y wiffi &7e
solid waste
Division /WU/8-
tons 310 CMR
18,00
U- AMINW&SCON11
1. Current or prior use of facility:
Residential
2. Is the facility owner -occupied residential with 4 units or less? F] Yes M No
3. Facility Owner:
Donald Elliot 219 Park Street
Ngme Ado'tW
North Reading, MA 01864 978-309-2042
clo�T zip code Tele,017017e
4. Facility's Owner's On -Site Manager:
AddfeM
co�/Town Z/p code Telephone
5. General Contractor:
A�7me
Aob'feSS
ClWrown Z/0 code Tele'0170-
0017"CMI-5 ftl*&Y COM,0 117SUIL-1- Po/fcy �- Btp. LIM�
6. What is the size of the facility? 3,000 (sq ft) 2 (# floors)
a ISP-PSAPS
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 I
Name AddlesS
Salem, NH 03079 (603) 894-6465
ao�To Z/o code Telephone
2. Transporter of asbestos -containing waste materials from removal/temporary storage site to final disposal site:
J.0.13. Rolloff P. 0. Box 6037
Name Addre-,U
Chelsea, MA 02150 (617) 387-1495
otyl7own Zo code Telephone
3. Refuse transfer station and owner (if applicable):
Ivame
4. Final Disposal Site:
Vallev Landfill
Lord&017 lVame
Pleasant Valley Road
Addless
Irwin, PA
CO/To-n
Z/0 cooe Telephone
OW17efs Name
15642 (724) 744-7446
zip code Te/echone
Up
The undersigned hereby states, under the penalties of pedury, 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 and belief.
Sticker # (from front of form): 536817
Christopher Thompson
03/02/2000
P17nt Awne
ALaY70f7Z&d59n3&ffL
Dute
Note, Con"acr
President
Air Quality Experts, Inc.
(603) 894-6465
qn this
mustsl
POSI&OWTIble
Rgo—en&qq
Telephone
form for DU
notIll'COMon
40 Lowell Road, Unit I
Salem, NH
03079
P111poses
Addtess
00�TO-17
Z/p code
Fee exempt (City, Town, district, municipal housing authority, owner -occupied residential of four units or less)? [:] Yes 0 No
Sticker # (from front of form): 536817
A
NORTH ANDOVER,
COMPIAINT FORM
ADDRESS: PHONE#
OWNER:
ADDRESS: PHONE#
ON: I I
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