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Home My WebLink AboutMiscellaneous - 69 HEATH ROAD 4/30/2018 (2) 69 HEATH ROAD / _ 210/0600000.0 DECTA- M - W ENVIRONMENTAL SPECIALISTS 10 LOWELL JUNCTION ROAD ANDOVER, MASSACHUSETTS 01810-5906 508-470-2860 September 9, 1997 FAX 508-470-1017 No. Andover Health Department 146 Main Street No. Andover,MA 01845 Attn:Health Agent RE: Asbestos Abatement 69 Heath Road To Whom It May Concern: Please be advised that Dec-Tam Corporation will be performing an asbestos abatement project at the above referenced location on the following scheduled dates: he Sc duled Start and Completion: September 24, 1997 All applicable state and federal agencies have been notified If you need any additional information,P lease contact me. I Sin /John a ey Sales Estimator i ASBESTOS ABATEMENT LEAD ABATEMENT INDOOR AIR QUALITY Facility Description 1. Current or prior use of facility: Q residence ............................ .................................................................................................................... 2. Is the facility owner-occupied residential with 4 units or less? ❑Yes Q No 3. Facility Owner: Paul Ferguson 72 Saw Mill Road . ......................................................................................................................... Name Address No. Andover 01845 (978) 975-2684 Cilyllnwa li n axle I elephone _ 4. Facility's Owner's On-Site Manager: N/A Name A,IJress .............. .................................................... ............................................................................ ,:......................................................................................... lip m:.a '.m, 5. General Contractor: N/A ..................................................................................................... .................................................................................................................... Nwne Address ........................... ..................................................... ........................................................................... C ylTonm Zip code Telephone Hanover Ins. Co. WC5827068 12/28/97 contractor's Workers Comp Insurer Policy l Exp.Date 6. What is the size of the facility?1800 (sq fl) 2 (1 of Iloors) Asbestos Transportation and Disposal 1. Transporter of asbestos-containing waste material from site to temporary storage site(if necessary)to final disposal site: JOB Roll Off PO Box 6037 .............................................................................. ..............................................•.,,................................... Name Address ' Chelsea 02150 (617) 387-1495 Cdypown lip axle !elephone 2. Transporter of asbestos-containing waste material from removal/temporary storage site to final disposal site: UWS Transport 19 Hurricane Creek Road ..................................................................................................... .................................................................................................................................... Name Address Hurricane, WV 25526 (800) 996-7282 Note:Transfer Lrly/lown lip tole Ie/rpfrone Stations must 3. Refuse transfer station and owner(if applicable): comply with the Solid Waste ............................ ..... .................. . . .......... ...i ..... . ..................................................................................................... ..... . ........ ...................... . Division regula- Na,,,e Add..-essress- ............. tions 310 CMR 18.00 ........... ..............................................I.............. Cilyll own An rule relephnnc 4. Final Disposal Site: Kelly Run Sanitation United Waste Systems -........................................................................................... .................................................................................................................................... Lu-alion Name Owners Narne Route 51, South ...........................................>............... ............................................................................................................................................................. . Addiess Elizabeth PA 15037 (412) 384-7382 ............................ ..................... ................ .............. ......_ _ . ..........__ ............._...................._.... Cily,W1 lip(VIP. reJPphnnn. Certification The undersigned hereby slates,under►he 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 and belief.. Betty Lacharite J 9/9/97 ....................................................................................... .... t�i2 t ................... ........................................................ Print Nano ufllorval 'nal re Date Note:Contractor Field Support Serv. Dec—Tam Corp. (978) 470-2860 must sign this ............................................................ . . ............................................ .................................................................................................................... form for DLI Posilioallille Representing telephone notification 10 Lowell Jct. Road Andover, 01810 purposes ....................•................•...,......................................y.......,..........................................................• .................................•............•,...••.., Adrlresr fll/town lip rLxle Sticker No. Fee exempt(City,Town,district,municipal housing aufhority,owner-occupied residential of four units or less)7❑yes ❑no 522311 Sticker#(from front of form): 522311 \ : Commonwealth of Massachusetts Ashestos Notification Form— ANF-00.1 Asbestos Abatement Description 1. Facility location: Ferguson Residence 69 Heath Road I.. ......... .......... ......__......... ........................... .................................................................................................................................. INSTRUCTIONS Name Address '% No. Andover 01845 N/A 1.All sections of IhisI........................................................................................... ....................................................... .......................................................................... term must be completed Ciry/fuwn lip axle Telephone _ in order to comply wilh basement theDepartment of .......................................................................................................................................................................................................................................... Environmental Vflrar is the woi&ile location?building rem,/,wing,floor.room Protection notilication 2. Is the facility occupied? 0 Yes 0 No fequiiemenls o1310 CMR 7.15(ten working days Prior notification is 3. Asbestos Contractor: requiiedolanyabatement Dec-Tam Corporation 10 Lowell Jct. Road projecQ:and tire ..................................................................................................... ................................................................................................................................... Department of Labor Narne Address and Industries Andover 01810 778g ,and Industries 470-2860 ........................................................................................ ...................................................... .......................................................................... ol453CMR6.12 (fen Chy/lawn lip code _ _ telephone days prior notification is iequtred ofANr AC000035 written abatement project greater D(I(irense/ conhxl type(wrillenherba/) than three linear or square leeo. 4. On-Site Project Supervisor/Foreman: 2.Submit Original FormPeter Rodrigues AS31238 ..................................................................................................... .................................................................................................................. ---- To: Na,ue D(I Ceniliratim,l Commonwealth of Massachusetts 5. Project Monitor: Asbestos Program ERS AA000122 P.O.B,12008T ......................................... ..................................................................................................... ..........................-........................................... .......... —_ Boston,MA02112• Name 0(I cedifiraliurr/ 0087 6. Asbestos Analytical Lab: 3.This dorm may be same as 5 used lot notifying the .............................................................................................. ................................................................................................................... __..—. U.S.Environmental Narne p(Icerfifirarior/ I E Protection Agency Region 9 2497 9 24 97 7am-lpm Sat.Sun. 1olasbestos demolition/ 7. Project start date_/_/_end date_/_1_speciilcworkhours(Mon.-Fri.) ( ) renovation operations subject to NESNAPS(40 CFR SubparI M). 8• What type of project Is this? (circle one): demolition repair renovation other(explain) ra WoMuse omr 9. Describe the asbestos abatement procedures to be used (circle): gtovemy eodusure lull containment dcaiup, encapsulation disposal only other(explain) HdA�oUarl narromwie 10. Is the job being conducted g indoors 0 outdoors? . gear ei � voanan�warua m 11. Total amount of each type of Asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft.) 12 cur other surfaces(square ft.) to be removed,enclosed or encapsulated: linear/square feet boiler,breaching,dud,lank surface coatings... thermal,solid crone pipe insulation...... corruga(ed or layered paper pipe insulation.... / insulating cement.................. _J spray-on(reproo(ng.....................—J bowellslaayercoatings.............. cloths,woven fabrics.....................—� transiteboard,wallboard............. other(please describe).................... 12. Describe the decontamination system(s)to be used: two stage ................................. ....- ............................................................................................................................................................................. --.. ............ ... ..._ ..........................._.......... 13. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 UAR 6.1.1(2)(g): wetting material with.,amended.,,wa,;e,z...k>1d.,..p.lac.ing...in....do.uhie...6...mil....po.1,y..-pre•lahe:led bags to be transported to an approved`landfill 'in"a' seared"lo'ck'a1ile"con'[airie'r' 14. For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: ........ ....I.......... ....... _..................:............... ...... .............,............................ ......... Narne of DEP Official Tine Dale olAullrarllafioit IVal rer/ ........................................................ .........................................................................................................----- Naar ul Dtl U/lirlal Illle ............................................................- -- Dale of Aulhuriraliun VYainr/ 15. Do prevailing wage rales apply as per M:G.L.c.149,§26,27,or 27A-F to this project? 0 Yes XXNo nev.02 / ' � AIR QUALITY EXPERTS, INC~ 40 LOWELL ROAD, UNIT 1 SALEM, NH 03079 603-894-6465 JUNE 07 1997 , , uv8�8 \ ( `` . \` ^ .�"� | | NORTH ANDOVER HEALTH DEPARTMENT | 146 MAIN STREET / NORTH ANDOVER, MA 01845 ' DEAR SIR: i ENCLOSED PLEASE FIND A COPY OF NOTIFICATION SENT TO THE STATE | FOR AN ASBESTOS ABATEMENT PROJECT. THE JOB WI�ljjj;qzl UNE 19, 1997. PROJECT: T � � 0 ! ANY QUESTIONS CONCERNING THIS MATTER SHOULD BE DIRECTED TO MY ATTENTION. SINCERELY, | CHRISTOPHER THOMPSON | PRESIDENT / � Commonwealth of Massachusetts ` „;skit` — Asbestos Notification form— ANF-001 iY i� ;, r.i .w».. .. `. �3Ylt! ('..� ,i N''•'-;fit„? €rr _4"",t Y� t/ AsbeslosAb�tement:Descrlpdon /� � r-r �� ``��,sr• 1, Facility location JAYNE SNOWDALE 69 HEATH RD. _........:...................................................... INSTRUCTIONS AWne ....................................................................... ..................._........,.......... • Address _...._ 1.All section$Of thisN0. ANDOVER. 01845 508-681-0954 ..........................................................................:......................... ......... .. ......................... _.......... loan must be completed . .................. . ily own Zin r«�e ;epnw.re in tide,to comply with the Department of BASEMENT............................................................................ .........................................................................................._...... Environmental �>alisOnwvrbllelaYa�iwi7Guildilry�Ye wirrb,llwr,arnnPquire en notification2, Is the facility occtj�ie 30 No requirements 01310 CMR 7.15(ten working days prianotification is 3. Asbestos Contractor: reouifedleco:andtany AIR QUALITY EXPERTS, INC. 40 LOWELL RD. , UNIT 1 projecQ:and Ore .................................................... ........... Department of Labor Address and IndusUles notification requirements SALEM,. NH'- 03079 603-894-6465 of453 CMR 6.12 (ten ............................................................:.......................... .... days prior notification is Bp 00 relepnone reouinedolANY AC 000167 abatement project greater - WRITTEN Man ifree lima,or Ott rloense/ GUNW lyre(wrirlenherlery Squirm feel) 4. On-She Project Supervisor/Foreman: 2.Submit Original Form CHRISTOPHER THOMPSON SF07797 To: ........................._......................................................................... ....................... Na Commonwealth of DtI Cenilirariwu Massacbusatta 5. Project Man' Asbestos Program P.O.B.120087 Boston,ASA 02112• .»«.»......a...f..........:............................::.................. ................................................................................................ 0067 3.This form maybe 6. used for notifying Ore ..Asbestos An ...................... .............................................. U.S.Environmental warne ........... ..................... ................................................................................................................... (MI I:aniliraliwr/ PrmedionAgencyRegion 061997 061997 7—8AM I of asbestos demolition/ 7, .Project start date_J_J end dale_/_/_specific work hours(Mon.-Fri.) (Sat.Sun.) renovation operations subject to NESHAPS(40 CFR Subpart M). 8. What type of project is this? (circle one): demwirion epau renovation Vito(eiplain) ror9. Describe the asbestos abatement procedures to be used (circle rover ermwsure muromaiwoenl Ueamrp +aaoomr _ 11911sa(1m dAPosdonly ouwlexpiain) a'R"ad mk 10. Is the job being conducte indo)0 outdoors 7 Pam�xs,up ,� 11. Total amount of each type of Asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft.) 10 or other surfaces(square ft.) D to be removed,enclosed or encapsulated: linear/square feet boiler,broaching,dui,tank swf"e0afmps------_/_ thermal,solid core pipe insulation...... carupatedOrgyenOpaper pipeinsulation....Lf / insulating cement................ .. clo ft,sr 6m AiIii. ::-:..:;;.'....,i.:...:_% uoweUspayer coaling$............. / ci0th$,W019nJibrki........`:............ J. bamileboard,wal/board............. oft(PleasedmaIWI.:...............:...=J_ 12. Describe the'degntamination system($)to be used: GLOVE:SHAG ,: : . • .. ._ ...»...� .............................................................................................................................................. ..... ....... ............... ..q+ .. . ....... .. .. 13 Describe the containerl2atioyl;! pouf methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(g): LaET....REM>1Y ::I.N.TA:...6MIL..,.P..OL.Y..:.AS B ES.T.OS....LAB ELE13....BAGS.............'............................... ....... ...... ... .. 14: For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: * INSPECTOR wam aarrrmKav _.... ... • fide .....»..............:.....:.« ................................................................. auaArinair,Na, waimi/ AWnddtl ....... . . INSPECTOR *.. WYaAW1 ear .. .............. .. 15: Do prevailing Wage rates apply as per M,G.L.c.149,§26,27,or 27A•F to this project? 0 Yes Rev.6r92 U* Facility Description 1. Current or prior use of facility: ......... .................................................................................. .......................... .......... 2. Is 1he facility owner-occupied residential with 4 units es 0 No 3. Facility Owner: :?MMk. .............................................................. .......................................................................................... .V" Address rry hp axle e el1,0 1 1 e.......................................... 4. Facility's Owner's On-Site Manager: Name N/A Address ,,"**,,*"* , -----1 -* 4; 5. General Contractor: Nam;N-/A.......................................................................... Address T-el-ep-h-one Contractor's Workers Comp.tq$uret policy Date 6. What is the size of the facility72 0 0 0 (sq 11) 2 (1 of floors) 13 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 i ............................................................ ......................................................................... ............ �;;� Address SALEM, NEW HAMPSHIRE 03079 603-894-6i165 Ciry/lown lip axle Telephone 2. Transporter of asbestos-containing waste material I rom removal/temporary storage site t o final disposaI site: SAME .. l'e** * *............. ............... A.,h//-� Note:Transfer 6Y/71.11 Stations must comply with the 3. Refuse transfer station and owner if applicable): Solid Waste Divisionregula- NyeN./A............................................................................. .................................................................................... .............. .... .......... tions 310 CMR Address 18.00 ............:.................................. ............................ ............ ........ ....... All rale 4. Final Disposal Site: TURNKEY LANDFILL WASTE MANAGEMENT OF NEtl HAMPS141,pE ....... ....... ..... ....... i owimi N.............................................. W)e f S Marne 90 ROCHESTER NECK RD. ............................... .............. Address ROCHESTER, . NEW HAMPSHIRE 03867 603-332-2386 CirygUwn till axle. .r I elentione 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 iri this'notilicatlibn litr6i and correct to the best of his/her knowledge and belief. CHRISTOPHER THOMPSON06/06/97 ................ P�inl Name Note:Contractor must sign this PR YDENT AIR QUALITY EXPERTS, INC.603-891'1—(D';,;�_ form for DLI .......................... .............. • notification Purposes 40, LOWELL RD. UNIT 1 SALEM, NH 03079 .......................................................................I..................................................I.......... Fee exempt(City,Town,district,municipal housing authority,owner-occupied residential of four units or less)?/Yes D no Sticker I(from front of form): -72-0 3 0