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Home My WebLink AboutMiscellaneous - 37 KIERAN ROAD 4/30/2018r N O � ', �D 0 0 0 0 0 0 ENVIRONMENTAL SPECIALISTS November 24, 1997 No. Andover Health Department 146 Main Street North Andover, MA 01845 Attn: Health Agent RE. Asbestos Abatement 37 Kieran Road Dear Sir/Madam: 10 LOWELL JUNCTION ROAD ANDOVER, MASSACHUSETTS 01810-5906 508-470-2860 FAX 508-470-1017 Please be advised that Dec -Tam Corporation will be performing an asbestos abatement project at the above referenced location on the following scheduled dates: Scheduled Start Date: December 10, 1997 Scheduled Completion: December]], 1997 All applicable state and federal agencies have been notified If you need any additional information, please contact me. Sincere , Michael -S. M is— Sales Estimator X,i,i,�,C��;`i pry, iii`, :i\?C'^la;� .. `>�.1!...,..f� iii t• •.t•. .�, ��, 1 � • .., .. .. e �., aye. �..'�i •— S t,t�.:. �,�_ � .. �i 11:'.` .. , A ASBESTOS ABATEMENT k A LEAD ABATEMENT d INDOOR AIR QUALITY A ,IN INSMUCTIONS 1, All sections of this fount must be completed in older Io eomplywill) the Depailnlenl of Iwhonmonlal Prolecllon notification Iequiremenls 01310 CMA 7.15 (len n•alking days prior notification is required ofanyabatement pro)ec4; and the Doparlmenl of Labor and Induslrlos 11ofiticalion 1equiremeuls 01453 CIAR 6.12 (len days prior notification is required of AN l abalement pioied grealei than lhiee thrar or squire feed, 2. SubmilOriginal Form 10: Commonwealth of Massachusetts Asbestos Program P.O.B. 120087 Boston, MA 02112- 0007 3. 1his lour maybe used for nolil)ing file U.S. Environmental Prolecf ion Agency Region I of asbestos demolition/ renevallon operalions subject to NESIIAPS (40 CFR Suhparf M). I Ix IAIKuI e:c lMly i nlea�uual Iln.nol flute I'd�uA Ipl„Wnl/eU�RV bnr�,ron I :ia Itev. 602 t' Commonwealth of Massachusetts Asbestos Notification Form -- ANF -00,1 Asbestos Abatement Description 1. Facility location: . Kersian Residence ................................................. ............................ IIJIItC No. Andover ....................................................................................... (:dy/I own basement and garage ........................................................................................ Iriral is IBe wulAsile loraliun2 building name, /, wing, fuer, rumn 2. Is the facility occupied? 9) Yes O No 37 Kieran Road .................... ..................... ....—............... ,............... ........................... Address 01845 (978) 682-3748 ......................................................................................................... Ilp axle 1 clephone ,v 3. Asbestos Contractor: Dec—Tam Corporation ....................................................................................................................................................................................................................................... 1.0 Lowell Jct. Road Molle Address Andover 01810 (508) 470-2860 .............. ..................................... .................................................. 01).110ear ............... .................. ..................... ........ .............................................................a... lip m Ie lelrp/rone AC000035 .. written .. ... ..... ............................................... V1 Iirease / I:onlra'd l yle (wrillruMthai) 4. On -Site Project Supervisor/Foreman: Charles Brewer AS30504 .......................................................................................................................................................................................................................__..-- N.tnm U(I rrrlilirahurr 1 5. Project Monilor. ERS AA0000122 --- ....................... ...................................................................... Mime ........ .......... .................................................... ....................... ............................ U1l l:eltilirlliUlll G. Asbestos Analytical Lab: same as 5 ............ —...--- ...... ........................................................ ................ ..................... .. Namv ............................................. ......................................................... 011 Cedifiralion / i' 12 10 97 12 �1 97 7. Project start dale _/_/ end date— —/—specific lam-4pm workhours(Mon.-Fri.) (Sat. Sun.)' 0. What type of project Is this? (circle one): dernugtton repa/r renovation orher(explaln) 9. Describe the asbestos abatement procedures to be used (circle): glurehan enall5vte full containment dralup. encapsulation disposal only other(erplain) 10. Is the job being conducted pit indoors ❑ outdoors ? 11. Total amount of each type of Asbestos Containing Materials (ACM) to be handled on pipes or ducts (linear IL) cr other surfaces (square ft.) 700 to be removed, enclosed or encapsulated: linear/square feet boiler, breaching, dud, lank surlace coatings. , . _/ thermal, solid core pipe insulation...... corrugated or layered paper pipe insulation.... _� insulating cement .................. _> spray -on frreproofinp ..................... _/ bowellsprayercoatings .............. � cloths, woven fabrics ..................... lransito board, wall board ............. other (please describe) .................... 12. Describe the decontamination system(s) to be used: three stage ........................................................................................................................................................................................................-- ..._ .. .........I..". I.....— . I ....... ...... ....... ..................... .. ... ....... .. ........... .. .....................................-.......... 13. Describe the containerization/disposal methods to comply Willi 310 GMR 7.15 and 453 CMIR 6.1.1(2)(g): wetting material with.,.amended.„wa...... . 11d....p.1.ating...in.... double ...6...mil ....poly.._pso.lab¢1ed bags to be transported-- to an approved landfill "'iri""a" sealed"l6ckablec•6EEWine•F 14. For Emergency Asbestos Abatement Operations, the DEP and DLI officials who evaluated the emergency: Narrr of DEP Udidal Ilpe Vale cl Aulhonraliou Iva/IV/ / ................................................................................................................................... /Lula of D11 llllirial 11116 ............................................................................................................................................................................................................... (Idle of Autburilalion IYdi Iry / 15. Do prevailing wage rales apply as per M.G.L. c. 149, § 26, 27, or 27A - F to this project? (-J Yes 00 No :(wlol 10 lual Moil) d l013!IS 96££ZL oub saA c3i (ssal Jo shun Inol )o lelluoplsal paldnaao•1auMo'1(ploglne 6uisnoq ledlolunw'lolllslp'uMol'AliO) idwaa gal ;.. ,,•..•.....•..........I..•....... i1xrJ 141 ................•...••..•... lu+.........•,.,,......,,•..••...,.....•..............•.......... ssa.PPV. OHIO `.zanopuV Paoli 'aoC TTaMO1 OT auogdalal liuquasajday oll.Uodq!so,. ..................................................................................................................................................................................................................................... . 098Z-00 (81.6) •dao0 way—oaa •AzaS ajoddnS PTaT3 Woa1 eltllls panlolpa........................................ aweN lolld ................77� L6/7Z/TT ............... lailaq pup o6palmowl Jag/slil to lsaq Bill of loa11oo pup ani) sl uo!lu!plou sial u) pouleluoo uopewlolul Bill le41 PUB '91-L HW0 0 l pup oo'9 dW0 e9b'solsogsV to uopelnsdeou3 Jo luawuleluo0'lenouley aql lol sualleln6ay sllosngoesseµl 10 ylluomuowwo0 aql peal seq MOM legl'Am(lad to sailleuad Bill lapun'solels Agalaq pou6!slapun Bill uo/l eoUlpa9 a auugdaN/ alga ..j .............. uMnJig1:1 Z9EL—'78C (ZT7) L£09T Vd tlaagezTT3 MOW ............... ........................... .................................. .:................................................................................................. ........... ............... ............................... .. g3noS TS aanou ;well WOW) amrN linger I .................................................................................... �.................n................................................................................................................. swa3SA. 019e alTu UOT3e1TueS unu STTax :aj!S lesodsi0 feu! j y amup!alal ofm 1P7 ..................................................... usnl/N!a. .................................................................................................................................................................... fsaippymurN ...................................................................................................................................................................................................................... :(algco!lddu li) laurno pue uopcls salsuml osnlou -C aun�pla/al Bpm �pj .. .. uwnl/AI!:1 Z8ZL-966 (008) 9ZSSZ AM `aueoiaan}i swippv amrN '.........................................................:................................................................................................................... ......................................................P 2T u 0 F H 6T eo aaz aueO a�n a.zodsuezy SMR :alis lesods!p leu!I of ails a6eaols Aaelodulal /Ienowal wO11 leilalew alspm 6uluieluoo-solsagse to Japodsucll 'Z aungdapl alw 0l lwoy,(pa ...........................1 .... ... _ .. .. ... .. .. . ..............., 5W—IRC (LT9) OSTZO easTayO tsaippv;unyl ....................... ................................... ...................................................... .................... .................. .............. ................................ ..... 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L£09 XOG Od 330 TTOU 90T :ails lesodslp leuil of (Alessaoau 11) alis a6elols Aleaodulal of ails woJ1 lepolew alsem aululeluoo-solsogse to lallodsuell ' l i lesodsli7 pue uolleliodsueil solsagsd (sloop to d) (II bs) OMLAI!Iloel Dill to azis aql sl PRIM -9 alea'dr3 /X0110d lamsul'dwo3 slayaayl s•iolorquoj 16/9Z/ZT 890LZ8SOM 'o0 aoue3nsul HN owfidalaJ ;poo dlZ.......... w�aLNi.7 .............................................................................................................................................................................................................. .. . pv .................................................................................................................t..ta...i.p................................................................................ . . aumry V/m :JOl3esluo01elauo0 'g .. , i. mJrplalal ai...a...�j ..... stwppv aa6eueW al!S•u0 s•Iaumo s•Agpoej 'y ........auogdalal. ...........................................Bpm.1r7...................................................................................... u.xnU.Q!.l 87L£—Z89 (8L6) 5"T0 JanopuV •Oil ssalppvamrN . • •.. • • . •.............................................................................................................................................................................................................................. Peou uela-EX L£ uaTSzax sa1UPf :laumo Alglou j E ON ❑ saA ® Lssal to sliun'y ql!M lepuap!sal pa!dn000-1auMo Al!l!ael aql sl 'Z ........... ................................................................... .................................................. :.......................................................................................................... aauaPtsaz ;A19!oe1 to asn lo!1d 10 lualln0 l uollduasa p 7fl► wu `3btt6L -OR aaolaTOS sasodind uopeoppou 170 JO/ WJOI s141 uols 1snW Joloeilu03 :$ION 00'91 LOU 01P suop -elnbaJ uolslnlo o1sum PHOS ayl Ql!M Aldwoo lsnul suopel3 JalsuvJl :BION v MIiTMOIGN 1. AA sections of the loan must be complmW in arch to comply with the Deputmenl of Erwlrorutrertal rrotectlon notllicatim requl www of 310 CMR 7.15 (1n "44 dr), picrnwicaian is rr�ured oJa'q'a'r�"r�cM P104 and the Department of fsba en4 ktduatrlee notili Aion requitettwisa of 453 CAW 6.12 (In drys pour x6fira w it row isd olANY abauarwrr proisd praetor s uare4• 2. Subm1 OrigirW Fam To: commonvowth of Maaaslrwetb AAWn rrepren r.oa. tzaos� Iatea,1AA 02112• 4007 3. This loan nWy be used br railying the US. Enviombttal Ptoisdion Apancy Region 101 asbestos drmoltion/ INVWXitxr pr r3finn wbiod to NEStiiWS (40 CFR Subprrt 4. (as onw uw oar wZ, jo 7 ;; a, lir r`Nw.r hev. 6192 Commonwealth of Massachusetts Asbestos Notification Form — ANF -001 Asboslus Abalonront tlondpllull 1. Facitity location: Jim Keshian 37 Kieran Road ...........»»...........».»........»......».».................»»..»........................................................................................................_..»»._.._.. r .».... N" A0W No. Andover, MA 01845 (978) 682-3748 Gy/rau Ipway rM�r>nr Front Entrance » .................................... »................................................................. .................. ......... .... »..... ».»»..»..................... »..... 109 k nM Kvak be#=? b4dxV am. ft lea, room 2. Is the facility occupied? (a Yes p No 3. Asbestos Contactor•. Asbestos Free, Inc. 42 Droadwa MineAOW .........».».»....._.....». Wakefield, MA 01880 (781) 245-4403 AC000133 �'............................................. ............................... ........ ...Written.......................................................................................... CaaAad [no (r►tMryhrarrl 4. On -She Project Supervisor/Foreman: TerrMSharkey_ — AS 510,70 Naw W Crtric" I ............................. »» .... _»».».» . .�.— 5, Project Monitor: ...................».................».............................................. aic rr4aia,i................................................................._............_.._.._._.- 6. Asbestos Analytical lab: Environmental Remf.4A&t.,;,Q11..',ZPP, .e Qu C0110ca0oo 7. Projectslatldate �� 1nd0ale_Lp2 j00specificworkhours(Mon.-Fri.)7-5._„—,,,..(Sal. Sun.)_ 9. what type of project Is this? (circle one): aMmoLI'm nn,r nnor/iaa arnrlawuhJ A. Describe the asbestos abatement procedures to be used (circle): pm ayr luAcMr+narrd d#Xvp e"y°a'q'horl dyparar an►y ae'wr (upwnJ 10. Is the job being conducted ® indoors p outdoors ? 11. total amount of each type of Asbestos Containing Materials (ACM) to be handled on pipes or ducts.(linearh.) or other surfaces (square iQ 70 to be removed,'enclosed or encapsulated: lineadsquare feet Doily, baso ng. dui. Ont soba coatings... _/ permel, sold core °0�u a bP pPe nsu4rrrovr ... _ __J p ruu6l.:p oerr�a+x . � iruu4ran ..... `J J M)4n bnproob►p z: ► -:-466 ........... gp.............. abtb wow b6rkt . . . . . .. . ............ _-,_/ remit bowrl, all bond . , a� hw (Aw dru iw. . sheetrocked waff ''—"�js- 12. Describe the decontamination systems) to be used: ..................................................»3—Ste a Decon . ...............................................................:.......... ........,....... —.............................;.:....;........................................................................�..........~ 13. Ocscdbe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(p): »All ... ACM...to...be...doubled... bpgged.... As saes tos...� emaual..l,a &s..__ .......................................................................................... 14. For Emergency Asbestos Abatement Opealions, the DEP and DLI officials who evaluated the emergency: iaori a....................................................................... .pN......................................,............................................................................... giliWAuurtorVyan.......».».................»»..... »............................... .w...ri.......................................»............................ _.».._...._.... IWrni;aau............................... ..................................... .liu.................................................. ....................................... _....... _._........ _ 15. Do prevailing wage ales appy as per M.G.I. c.149, § 26, 27, or 27A - F to this project? p Yes []No r� Note. Tnnshr Stations must compty with the Solid Wash Division regula- tions 310 CMR 1100 Note: Contractor must sign this Juan for DU 1wUlcation purposes Facility Description 1. Current or prior use of facility: ... Residential............»....._...»»._...._..___.........»_.._................................................_...»..... ............. _»_....__.». ». 2. Is the facility owner -occupied residential with 4 units or Iris? ® Yes [I No 3. Facility Owner: SAME ..........................................._.......................................................................................................»........:....... .................................. ....... ....... Nrow Adgnss city/ram .......................».....» ._ � �•• •burrrxr 4. Facility's Owners On -Site Manager. N........ ....................................................................................................................................... Nrrw Aatr,s� lib/row...,............................................._ .............. ��..........................•.......... t��. ............_... .................._... 6. General Contractor: ....................................................»........„.........,......................,.............._................ ..............................................................,......»..,.......»,..»..»......, lhirtne ,wane • Credit General Insurance Co. SWC 709-357-0 5/20/2000 coMM001 s wwaa Camp. suuer Peal 6, What Is the Ita of the facility? (sq It) (1 Of Iloo(s) ` Asbaslos Traasportallon and Disposal 1. Transporter of asbestos -containing waste material from site to temporary storage site (d necessary) to final disposal site: AsbestosFree, Inc............................................................42...BzQa�dwa.y................................................................................ Man Adm Wakefield, MA 01860 (781) 245-4403 .............................................................................................................................................................................................................................. Gp•Aora Ip wdi IM,t>tiorr 2. gc LiC to fraaf disposal cit".: RecoV'ery Express, Inc. 180 Canal Street ................»..........»»»...... ...._............ ....... ................................. ........................................ ........... »........... _............. ......... . ».._.......... Bos...ton,MA ...............................................02114............ (611).... .-..... .............................. .G/n........................I..p...a.d.r... . .. ...... .. 1#10"a. 3. Refuse transfer station and owner (if applicable): .........._..............................................................................._............................................................................................ _._.. .................................................................................................................................... .................................................................._................. utrnow" 14100 [NOUN 4. Final Disposal She, Green Ridge Reclamation �.....`.':...».............. »........ »...... »�.......... :......: t:.:.......,........ ............`:.............. .............................................................. taarrce A" Orna Mama Landfill..Road Sottdale,_)?� _5b,$3 .......................................................................................................w..'............._._......................... Ad*M .............................................................. .......I ........................ ........ . GdAow &A4 104004 �� CarfJticatluu . The undersigned hereby stares, under the penalties of perjury, that he/she has read the Commonwealth of Massachusdts Reputations 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. Frank ...L.:...Arsenault................._............ '!.!.`:. J M.�.?.............2000.........._..__.... Rnf Mam1 Auealt,d S+pmwr Do President Asbestos Free, Inc. (781) 245-4403 ItsMaxN�14........................... ......... ........... ................ ............ ...............luq.... .... ................................... .......... ........................... ............. _..__.._ 42 Broadway Wakefield, MA 01860 ..»..»........................................._........................... »..... ............................. ...................... ....................... ................................... _............. ...... Aaunst GryAorn 1pooW Fee exempt (City, Town, district, municipal housing authority, owner -occupied residential of four units or less) 7 ® yes p no Sticker 0 (from front of form): 739891 A 42 Broadway Wakefield, MA 01880 Tel: 781-245-4403 • 800-649-6160 • FAX 781-245-1892 Dear Health Officer, Please find enclosed copy of the DEP Notification which is verification of an Asbestos Removal being performed in your district. If you require any further information, or have any questions, please contact Asbetos Free, Inc. at (781) 245-4403. Thank you, Frank L. Arsenault FLA/b MAY 4 9 WATERSHED RESIDENTS QUESTIONNAIRE 1. Name A ne-r T '_ 1 C_ �hhi Ir 2. Street Address -77 ,11' e t-a a 1 4 . 3. How many members are in your household? 61 4. What type of sewage disposal system do you have? ❑ cesspool V septic tank and leaching area ❑ connection to municipal sewer ❑ other (describe) ❑ do not know 5. Are the plans (d awings) for y9 ur sewage disposal system on file with the Board of Health? ❑ yes C no [Y do not know 6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years 11-20 years ❑ over 20 years ❑ do not know 7. Has your sewage disposal system been rebuilt or repaired? ❑ yes [iVno ❑ do not know If yes, approximately how long ago? years. What was done? 8. How frequently is your sewage disposal system pumped out? ❑ annually ❑ every 2-4 years Rr every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? ❑ yes Lino If yes, what problems? ❑ repeated pump -outs needed ❑ system clogs, backs up, or drains slowly ❑ odors ❑ sewage surfaces through ground 10. How many of each appliance are connected to yours wage disposal system? washing machine dishwasher ' garbage disposal dehumidifier drain sump pump toilet 3 roof/pavement drains shower/bathtub 2 11. Please state the brand and type (liquid or powder) of detergent you use for: dishwasher �c� ° tom( clotheswasher C' (O( G tom' 12. Does your property have a lawn? [yes ❑ no If yes, approximately what si e? El less than 1/4 acre 71/4 acre ❑ 1/z acre ❑ 3/4 acre ❑ 1 acre ❑ more than 1 acre (Specify) acres 13. How often do you fertilize your 1 wn? No. of applications per year Season(s) of the year 14. Please state the brand and type (liquid or granular) of lawn fertilizer you use: C�G►h'4u�h [a' Check here if your lawn is maintained by a professional landscape contractor. SEPTIC SYSTEM INSPECTION FORM ADDRESS DATE INSPECTED <� ' b `P PROPERLY FUNCTIONING? N WEATHER CONDITIONS COMMENTS: WATER QUALi T Y TES Eb ? lZEsULTS? DYE TEST PERFORMED? Y N DATE? SKETCH: