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Home My WebLink AboutMiscellaneous - 64 GREENE STREET 4/30/2018 64 GREENE STREET __ - .210/043.0-00240000:0 T `` ` ) � � Air Quality Experts, Inc. 349 Sm. Broadway, Suite 6 Salem, N.H. 03079 603-094-6465 AUGUST 19, 1994 NO. ANDOVER BOARD OF HEALTH � 120 MAIN STREET NO. 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 SEPTEMBER� 6 1994' . PR0JECT: 64 GREEN STREET NO. ANODOVER, MA ANY QUESTIONS CONCERNING THIS MATTER SHOULD BE DIRECTED TO MY ATTENTION. SINCERELY, CHRISTOPHER THOMPSON | PRESIDENT � � { Commonwealth of Massachusetts >' ' Asbestos Notification Form ANF-001 Y� ,T r - � Asbestos Abatement Descr/ptlon •tx s ,r $�£ oyC� 1. Facility location: _.-.. asTRticTto►u kane•(aR.N.E=ST R:OI`'IAI�O Er4 6.REEN STREET REE.T .................................................................................................... AMJress 1.All sections of this MO..-......t"iNDQ ERE ......................... /i 11.C. + i 508-68'x2-8093 .............................................................................. form must be completed' cllvAasvr IUr axle in order to comply with ldeplprr Ore Department of »..• •n''1 Ia! ttt.. Wr r`sa i e�xa7 Guild,r ruff,,/.w etnv foo o.............................'»........................................................... EnilionmWal Protection notification 2, y occupied?Is the facilit Q Yes O No requiem"of 310 CMR 1.15(ren working days prior ndilkadona, 3. Asbestos Contractor: Wo*4;acrd the abaremeM AIR QUALITY. EXPERTS, INC. 349 S0. BROADWAY #8 ».»....................»».........................__........................................ ................................... e Department of Labor Naw »»._»»_.»»».».».._.._»................................_.................. and industries rroOlicationrequuemenls SALEM, NH'.,. 03079 603-894-6465 of453 CMR 6.12 (ren ci»r7own....................................................................................... ...................................................... ..... days prior ndirrcation is requiredolANY AC 000167 WRITTEN abaramentpoled pearer ................................:............................................... .............. Otltkense/ ......................................................................................... Man free Bear of cunurl ry/r(wrirlerwertw) square' 4. On-Site Project Supervisor/Foreman: 2.Submit D iginal Form CHRISTOPHER THOMPSON SF07797 To: ...............ow ..................................__.»........,................ ......... . Cmonwsalth of DUfendrau'aN _.._........................_ Massaohuutts 5. Project Monitor: waatos Program F C A s INC. PAL 120087 Boston,AAA 02112• .................................................... 0087 DU cenrrrrapun/ 6. Asbestos AnaI is I Lab: I.This loan may be S M used for notifying Ore US.Env'uaurrsrtal ............................................................................................................................»......................................................... Harr Oticerpprapwd Protection Agency itepion 090694 09 t-1&_)4 IofasbestosdemolgioN 7. Project start date_/•_/ •_ end date_ /_specific work hours(Mon:Fri.) (Sat.Sun.) ienovaOm operations subject to NEWS(40 X X I CFA Subpart M). 8, What type of project Is this? (circle one): dernddion ,spar refs oMrr(erpWn) rcaoyus,wvr 9. Describe the asbestos abatement procedures to be used (circle' pare mxlosure lug C001114010111 d-W . rrg7000ir arwrpsuldan disposdordy odrr(exppin) Asw "'Dm 10. Is the job being conduct • O In1oors O outdoors? t� 11. Total amount of each typ Asbe 0ntaining Materials(ACM)to be handled on pipes or ducts(linear ft.) 50 or other Dooso _ surfaces(square ft.) Ci to be removed,enclosed or encapsulated: linearlsquare feet boiler,bteaMing,duct,tank surface Coatings..... J Marmal,solid core pipe insulation....... corrugated or layered'paper pipe in3ulation.... 9i fI/ insulating c&mnl.................. ^/ sptay-on Gteproorurg....................._,_J Mowel/spt;)w coatings..............._ elorhs,woven 13brics...........:.........._J Mansiteboard,wallboard............. oder(pkass describe).................... 12. Describe the decontamination systems)to be used: .............................................................................................................................................................................. 13. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(8): WET....REMOVAL....I.N.T.O....6XIL....P..OL.Y....ASBESTOS LABUED MAGS-:1................................... ............................................................,................................................ 14. For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: ......................................... INSPECTOR! Naar dtrci gaga, nMe Q74 dAurru.W..... _..............»_...»...»_......»........................_»» .14hlrar%.. ........ .......................:....................................................... ............................................................................................»—......_. Naar dOtl or" .........: Tido .................................:.................................. . Dap dAudsrltd uu Wdw/ 15. Do prevailing wage rates apply as per M.G.I.c.149,§26,27,or 27A-Flo this project? O Yel0 Rev.692. Facility Description 1. Current or prior use of facility: 1< � i D N� ........................................................................................................................................................................................................................................... 2. Is the facility owner-occupied residential with 4 units of less? 0 Yes 3. Facility Owner: i S IE ..................................................................................................... ................................................................................................................................... Nane Addrus ..................................................................................................... ...................................................... ............................................................................ Ciry/luatl lip code 4. Facility's Owner's On-Site Manager: NIP, Nerve Addrrss' ...........................................:........................................................ ..................................................... ........................................................................... . fill/(uwu !ip rola rele(dxx�e S. General Contractor: ............................................. .......................................... ....... ............................................................................................................................ Name Address - ..................................................................................................... ...................................................... ........................................................................... Ciry/To*n lip code Telephone Con(raclor's lvo,kers Comp.Insurer -:'C'. {-)j`J ,•.. Volley/ Up.0ale 6. What is the site of the lacility? (sq ft)_(I o1 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. 349 SO. BROADWAY #8 ............................................................................................. ............................................................................................................................._ Nine Address SALEM, NEW..HAMPSHIRE 03079 603-894-6465 CiryAu� lip rale releWux e 2. Transporter of asbestos-containing waste material Irom removal/temporary storage site to final disposal site: SAME .............................................................................. ................ ....................................................................................................................... Name Adrnrss Note:Transfer Ci4/rum, lip rale lvlelkme Stations must comply with the 3. Refuse transfer station and owner(if applicable): Solid Waste Division reD ula- .....................:.................:.:................ A ................................... ........................................................................................................................... ....... Nirm ddresT lions 310 CMR 18.00 ..................................................................................................... ....................................................... ......................................................................... Cirylroan � Iiprak fele(axxrc 4. Final Disposal Site: TURNKEY LANDFILL WASTE MANAGEMENT OF NEW HAMPSHIRE . ..................................................................................................... ................................................................................................................................... Imiluxi A'xne (Wets Nim 90 ROCHESTER NECK RD. ......................................................................................................................................................................................................................................... AUd�rss ROCHESTER, NEW HAMPSHIRE 03867 603-332-2386 Cilrnnrn lip rale felervione Certification The undersigned hereby slates,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 CMF 1.15,and that the information contained in this notification is true and correct to the best of his/her knowledge and beliyf. CHRISTOPHER THOMPSON 1 ............................. ...................................... ........................................................ Vrud Niue Aodprved Sipuiure Oak Note:Contractor must sign this PRESIDENT AIR QUALITY EXPERTS, INC.603-894-6465 formfor DCI ............................................................................. ......................................................................... ........................................................ Pw'iliu,Vlide Ae(uesenli,lp releplxxrc nolilicafion purposes 349 SO. BROADWAY #8 SALEM, NH 03079 .................................................................................................... .................. Cill/fuku h:axle Fee exempt(City,Town,district,municipal housing authority,owner-occupied residential of four units or less . y s ❑no Sticker#(from front of form): ✓ 03 li (�