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HomeMy WebLinkAboutAsbestos Abatement Notification Form - Correspondence - 445 WOOD LANE 4/11/2023 * INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY ** TIME RECEIVED REMOTE CSID DURATION PAGES STATUS April 11, 2023 at 4:57:45 PM EDT 19783831097 432 5 Received To: Page:1 of 5 2023-04-11 20.50:29 GMT 19783831097 From:Economic Enviro Techs,Inc, FAX COVER SHEET TO COMPANY North Andover Board of Health FAX N U MB E R 19786889542 FROM Economic Enviro Techs,Inc. DATE 2023-04-11 20:50:06 GMT RE 445 Wood Lane COVER MESSAGE GoodAfternoon, Following please find a copy of the DEP/DOS notification forms for the asbestos abatement at445 Wood Lane. The project is an emergency scheduled for April 12, through April 14 2023. Please contact Jeff Pace (978) 423-3998 or myself if you have any questions. I will fax all final paperwork once job is completed_ Thank so much, Rhonda Economic EnviroTechs,Inc. Phone (978)Fax (9 8) 383 109718 Q1�G�\��4 www.ecoenvirotech.net J�Q+ To: Page:2 of 5 2023-04-11 20:50:29 GMT . 1978.3831097 From:Economic Enviro Techs,Inc. Massachusetts Mpg",ent of Environmental Protection• 100371314 = Asbestos Notification.F0.rni Prc�}Mt.Revision.. . LL..,..... .. .: r .Praject.Cancellatian - A►. Asbestos Aha.tement Description .l.Facility 445 WOOD LANE 445 WOOD LANE €nstructi8ns I.-All a,Nam e of.Facility sections of this farm NORTH ANDOVER must be Completed in. ". MA ..01845 07M70274 . " order to cornpfy.with c,Citytrown. Al. T MassbEP rxFttficaticx3 e..Zip.G.ac1e ... .#, elephone State , VIf7ORfcfAFt1C7T71 qW tERREFFESENTATIVE roquiremeDis.of31Q »_ +:iviit.r.i6atxi ' 3•.Fueiiit}Gantat7€:1?er ai~.Nsinei `h.,�46INYWnail TiQa Department of.Labor .... Worksile 1.okation: FIRST 1 LC?L3R BATFiIiAIJNORY RC1C}tvt. Standards.(DLS) .... notifirafion. . . L Building Name,Wang,Flaar;Rponi.,etc, Tequiremants.of 453 21-is.the facility occupied? .:a,Yes.,r.7b..No CMR 6,12. . ls.thisa.foe eXeMpt€1Otif€CCafjo i(G.l.#�l,fo1AJi}, district—municipal ItOttSiflg<31J.t11UC1E ,Stilt@ f.BCtllt}r,or oWF1;o1'-occul led rssidentlal Xd . p P . Y of font u-its'Qr less.}? ...' :ta, Y`� ..17 b.:Afo . M-m.DEP Use Only : A,Rl y'ket Permit Prc>iect Afrprtzval,if ap tic a#?ie; . Approva1117#. ,... .5..Non.,traditional Astlest�is.Abatetnenl l�Vtlrk Practice Ap irstyal, if applicable. Approval.l.f ;# 6. Asbestos C'ontxactc�r; EC( 1 C F:,tiVIROTECHS 381NTERVALE ROAD #,Nine. ' b.Addross Fi►CH 3RG MA 01420 9T83481118 .. •. .. c.CitylToNm A.State .e,ZP Code . . ":.f.Telephone... .... AC000459 h.Contract Type: W .j.`; g.'DLS Llc:ens # 7 HENRY MOSEa AS0.31082 ..a,'Name of Gontmctor`s-On-$iteSy rvisorlForeman ' b.OLS Cer€ifiCation# " - . OLGA.RO.SARIO AM9G'0790 a.Name of Project Manitnr b.OL§.Certification# 9 :�IEbMROWENTAL W. AAoaulaa a.Name of A&bastos Anafykis al Lab. b..QLS Ceitificatian# .4112/2023 4/14/2023 . a,.Proyect:Stdri Datp Nf><i1DQfyYYY) b.End Date{MMQ.b1YYYY} 7A.5P.. . NIA. •. . .. c..WOK.NourS r..Monday.Through f riday d.Wa(k.Hour '. .Saturday.8 Swiday 1,< What type of pro ect i%:this?. .. . ;A.l_1artoution' . b.xeno•'ation a.R4.pair z.t.Other-1}base apecify; ......... ...... Revise& 11/1312013 Page 1 k)F4 To Page:3 of 5 2023-04-11 20:50:29 GMT 19783831097 From:Economic Enviro Techs,Inc. ka5suhustttS j7qprtixj�tlt of Envrri3 tv>«ial Yrott=ctlon :10037I3 t4 f B P AO 04 (ANF-001). PrQ ec .t . Asb>vstos:NoOficafi Farm �b�Std5 �"''. Project Cancellation . r#.Atiksrzxte►s,4b>3ttrtt�etit.Clescr ption;(cout.) 12.ibatetneni.pxoct duits.4check 311.tltat.apply): a.Glove ag'l'"' b..Encapsulation P C, Enclosure T"`; 'd..L2isposal Only. Cleanup f. Full.Contaitiment l". g.'.Oihor�-,Please.Sp 13.job is,behi,g corOuc:ted:... .'a. Indoors"" {"; k:Outdacars... `14.a.Total amottrit of.each.type of (ACM)jobe xztnove(L enclosed,Or, • ��tcapsulate�i;. . ` ... • 7.Llrfearfeet jUn.Ft j 2.Squats Feet(5g..Ff) b.Boiler.Breaq ing..Durt, c.'Fransite Pipe " 7:attk:SurftlGe Caattigs.. 1.Lig.Ft. : 2 Sq.Ft f.Lin.Ft... 2,'SQ.Ft. d..Pipe Insulwiun. e.Tran.ite.Shingles 2 Sq. t ,. F f.tilt.Ft, 2 Sq.Ft t-:Spray-Qtr�'ixeprt}o�itig. . '. .. _. . `g:Tt�ttsitc Panels. . , 1..Lirx Ft S.q• 1,Un. :.. h.'Cloths,Woven Fabrics ... i,(Other-Please Speciky.: ".f.4in.:Ft:`. 2.5q.Ft.... 1.tttsttlating Cement JCl1NT.CCaMPCJUNQINSfItA11tMt 596 it Lin.Ft, 2.Sq.Ft .15..kscxibe the.dec oftt tmination systeln(,, to.iae.used:. 3.CwAns . W.Dcsprib� the c. ntainerizatio dispo5al.InathQds 1a rnInlsty vyith 3�0 CMR.7.I5 and 453.C lit 6.1.4(2). (2l 6 M1L...F3AGS 11YE'iTEb. 17..For Emergen-cy AsbetstoS Operations,the Mas D P and ILLS officials w•ho evaluated the..mggertCy: ANDFtEW CM. KAS NVE (7C•i�1G uTAL ANALYST ... a.Name oflw %. EPOff4cial. '. .. . :. b..Titie.cf:tviasaC�P.t?fficial 4/11l2023 : N.AW2304039 r..Date of Autttarizat'son(MW.DD/YYYY)_ ii.Waiver#. MELBSABUrTS ENVfF NNIENTALANALYST ' e.Na"ofOLSOfficial. TTitia,of.Ots, )ificial .. 411 t/202$ 37009-2023 g...lsate.of Author{xat1Qn.4MttttQDM'tW). h.Waiver# .1.8.Do preV4ing wage Tales its per M.GF.L,.P. 149,§26,27..6r 27A-4 apply to this � 's.Yes �. .h,No ReviReAI- 1 i,1 1/'.).(5)T 1 .a Pave 2 of To Page:4 of 5 2023-04-11 20:50:29 GMT 19783831097 From:Economic Enviro Techs,Inc. 1blassachu..set%Department of Envirmic tal.PwN.rtion w _. 110037.1514 BW Asbes>145.Project# : Asbestos Noi catian Form ` .. � ._ .. � :.Project.I{evi iota . Pro ject Cancellation - 3. Facility Description. .. RF:ILEitiiTIAl. 1._.Curren-t or:prior trse.of.: ility, 2,;Is the'faciiity arvr�er-uccttpi.esl.xesid4n,taal with 4 units yr.lee '? a,�tes, b.Na 'FRANK GOUVELA "SNV .013 LANE :a.Facility Owner Name. b.Address . . NORTH ANDOVER MA 01.W .97$38-70274 c.City,Town d.State. e: p q.0de, Telephone MCTORMARtOT17 - SAME 4,a.:N ame of F'agility t3wner s Z3rr5ite AAa nagor.. b.Address- 'MA. 01845 9789870274 c.city rgwa d.State. e,Zip Code t_Telephone... - .. ECONOMIC ENVIRO TEC:HS,INC, 381NTERVALE ROAD S. d,Name.0f General Cariiractnr b..AdrItss FITCHBURG MA 01420 97$348111.8 ... c.GitylTov�rt _ d,State. e._Zip:Cade f,:Tslepttone . - STAR INSt,RMCE COMRNNY Q.Cantracfa s Worker's Compensation Ensurer . WCOM369 9115/2023 i.Expiration Date(MIl4`DDlYYYY) 6.What is the.size of this faciiity'? 1922 3 a.Square Feet b.#'.of.Flom Note.,Tempgrary . stnrage.at Ashxstos C.Asbestos 'Transportation & Disposal aaRtalning waste. 1.Transgarte yi'.asi�cstos-egntttining waste trio.terlut.fiato.si��c�t'.getie..raitun: maler0lisonly . . :allowed at the Piece .. n � .a y . . a �` �a Direclt t .Landfill Pr. ..�:. :b.`I'o 1�txt ora .Stara c l.ocatianl7.'ransl'er Station Y.. .. P rJ`. �. .. o .fwsioe.4s.of a 13L. .. .... ' ,. licensed Asbestos contractor ora transfer ECDNOMIC:ENVRO TECHS;INC. 38INTERVALE ROAD station that is .c.Narne of.Transparter d.Address.. .: , permitted by MS$SDEP and FtrCH"Ci MA ' ' 01420 r+78WIM8 :..operated In 8..Cttyl1 wort .. .f.State V.Zip:Code h.Tetapti" .:campllanc- with Sr#Itd . Waste Regulations 310 CtytF;19.000 a.tetTlporaty.st.Ctrage tstation".U.mi,.fi�it12iYTle.O.�:tTdrt$j?t?rttC,U�.ilSbf'StpS.G�gte�il lip � �vastir ffiattrnal.lirsnx tctnE>�r�1ry atarisgc.lacation;tran$for suttiwta final dispu a1 sate: . TfJ NSWASTE.INC- 3 BARKER DRIVE ..a.rtarne.of Transporter b,Address NEW:CASTLE I:E- 06482 203?.638300 d.:GityTown d•S.tate `e,:Zlp Code f.Telephony. R.evis4 It/1 312013 .. . .. . . . . . . .. .. .... . . .. .. .. .. . . . . . . .. .. .. .. .. . . . . . . .. .. .. .. .. . . . . . 'Page 3 of 4 . . . Pace:5 of 5 2023-04-11 20:50:29 GMT 19783831097 From:Economic Envirc Techs,Inc. Massachu, t�s I)ep,,Oxncnt o Lnv.ironmental Protection .: t10037 .1314 B.WP..AQ 04.(ANF...00.1) Asbr�stos m�ee� sl�ie�tps Notiftcatzon kom . t'rojept Revision... • ... .. ... . .. 1�:ruject�'dncat .. .. C:..Asbfistox ransppt 400n.&SUislr+►sia1:.(cauf..) ;3.Narric Mid address of tenlfsmai stora�c:lu4ati .n/trans#'er sfatiait_fyr. the a5b.�etas t ontaining waste tnatzrial; ._ ECONOMIC Eta MO MC*SRiC. 38 fNTEFtVAt E ROAD a.Temporary Stomge.Locatbnrr Nam, h.A.ddress. FrrrHI3 RG 1v1A ... ..01420 . M3481118 c,CiiyiTowri d,State: e.Zip.Code t4,I+-ame and:tocataon of{u.►sl dz`.spp,aS site(asherttss landfill): MtiRVAENTERPRISES MINF2VAENT SES a,finallt spQ.aW Site Ni" b.Final.t7isposal.Site Owner blame. g000 MINEM!A S.E .. 0.Address. .44688 .3308663435 ;NAYNESBtJFLG.. CH •, .• . d..Cityjawn e.,.State f.Zip Code 9.Tgleptmna. NO*Contractor must :slgn.this form for OILS. ... - notificaibon purposes . . . .Cearta0cation • f^IENE'fY ft9C1S'ES 1.certify that 4 have erscy jail Y 1,Name 2.Authorized 5ignafura . . . . . examined the foregoing and am .. .. PrESDENT .. familiar.with IN information. coptained.in this dopument and 3..Pasitbn/Tfhe .. 4,.Date:(M.4U[)t7JYYYY) all attachments and that.based 8784233999 ECC 1tXAQ EhJVERO.IECHS,tNC. on:my.lnquiry.of those S.T. k;,hon fi.Representing individuals irrfm+~dlately. 38.1C4T.ER1(ALE R01 l�TCG responsible far obtaining the... 7,Addrssi a(1itylTown iinf4rff ormatinn, l believe that the MA 0.142p prrttatiQn is true.accurate,and eornQiete.1iYt a aware that there 19.State I0..71p+ 7de are sign f cant.penalties.for .submitting false informat)on,. ii.ncluding possible fines and... imprisonment.The undersigned .,hereby atates ttlat f.have read the Carnmon*palfh.of ':Massachusetts regulations governing.asbesttts abatement. .. . (453 CMR 6.00.pram.olgated.b :. ... • h? Department 4f Lobar Standards.and 310 CMR T.15 prpmuigated by the Oepartment. Environmental Proteotion) and that!e m aware that this permit appficatfon or notificaiion shall not be deemed-valid unless-payment of the appj!c ble fee is.made." Rtvised: 11./13i2013 Page 4 of 4