HomeMy WebLinkAboutALL DOCS - 12-00249 - 135 S 1st W - DemolitioniTH,q-$TJRG
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Applicant Information
Name
Applicant's Address: &-4 e Crty/ST/Zrp:
Business Phone: 403 '(5-/ O CellPhone: .3!3 -51J/
Contact Information
City/ST/Ztp:
Businessphone: t/D3- qS-/ O Cell Phone:
Demolition Inform ation
Property Owners
SiteAddress: 135 s /srtC
Start Date:
Summary of what is being demolished
The U.S. Environmental Protection Agency (EPA) tegulates the abatement and disposal of asbestos-containing materials from any
public or pdvate building involving demolition, renovation, repair, construction, and maintenance activrties.
http:/ /deq.idaho.gov/airlprog issues/pollutants/asbestos.cfm
EPA certifies and licenses asbestos-removai contractors, inspects asbestos-abatement proiects, and enforces laws regardrng the proper
removal and disposal of asbestos-containing materials.
Curently, EPA and DEQ contract with Industrial Hygiene Resources in Garden City, Idaho, to regulate asbestos removal and disposal
projects in Idaho.
For more information about asbestos abatement and disposal in Idaho, contact:
Industrial Hygiene Resource
206 Murray St
Gatden City ID 83714
208-323-8287
www.indus trialhvsieneresources. com
I understand the EPA requirements regarding asbestos removal and agree to provide information showing
compliance with the regulations ryJhg Citypf Rexburg prior to demolition.
Sigoature of Applicant:
Cl|y of Rexburg
Phone: 208.372.2326
Fox: 208.359.3022
$25.00 Fee Paid: Yes/No Permit Approved: Yes/No
www.rexburg.org
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Person or Company doinq the demolition:
Address: tgt/ €:"s13:^)
Application for Demolition
Permit #:
Completion Date:
Receipt Number: 124318
35 North 1st East / Rexburg, lD. 83440
Phone (208) 359-3020 / Fax (208) 359-3022
RPRRXBl048 Demolition Permit Processing Fee
CHECK 688 $ 25.00
Total:
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genpmtrreceipts Page 1 of 1
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U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF'I PNOTIFICATION OF DEMOLITION AND RENOVATION
TYPEOFNOTIFICATION: COURTESY x ORIGINAL REVISED
II. FACILITY DESCRIPTION:
NOTDATE RECEIVED
Building Name: Vacant house
Address: 135 South l" west,
Zio Code: 83460 CountY: Madison
Site Location : Demo ofentire house and trailer
Building Size (Square Feet) house-2000, trailer- 500 #ofFloors: I and basement-house, single level trailer Age in years: aprox 95, trailer 30
III'TYPEoFoPERATIoN:-x-DEMo-oRDEREDDEMo-RENoVATIoN_EMERGENCY*ENo@
IV. Is Asbestos Present? (check one) -Yes
Owner Name: NG Rexburg Housing LLC
Address: 2880 North 55 West
Removal Contractor Name: Great Basin Services, Inc License: CSR 012012-29
P. O. Box 238
Zip Code:83221
Dave Price Telephone: 208-785-1767 Fax:208-785'4053
OtherOperator(demolition/general) StreamlinedHomesLLC
Address: 160 South,3ed West
Telephone: 208-4034510
procedure, incruding anarytical methods, employed to detect the presence of and to estimate the quality of RAGM and category I and category II
non-fiable PLM Lab testing
V11. Approxinate Amount of Asbtstos Materials:
Nonfriable Asbestos Material
Not to be RemovedNonfr iable Asbestos Material
to be Removed
Facility Components (cubic feet)
VIII. Scherluled Datcs Demolition or Renovationt Stutt' -lv1ay-31-20D
Complete: June-l 5-20 I 2
IV. Dates for Asbestos Removal (MM/DD/YY) t Stu
x. Description ofplanned Demolition or renovation work to be preformed and method(s) to be employtd, includine demolition or renoYation
techniques to be used and description of affected.faciltty ;;;;J;- Asbestos *."".0'p?i. t" demo'
'complete derio using track-hoes' loaders'
*ili i. i.pt *.t to keep down dusi during demo and loading of debris'
XI. Description of work practices and engineering contrors to be used to comply with the requirements, including asbestos removal and waste
hand|ingemissioncontrolprocedures:Allasbestosremovedpriortodemo'
XII. Waste Transporter #l: General Construction debris
Name: Streamlined Homes LLC
Address: 160 South, 3ed West
Zip Code: 83440
Contact: Cory Sorensen Teleohone: 208-403-45 I 0
XII. Waste DisPosal: ASBESTOS ONLY
Name: Madison CountY Solid Waste
Address: 530 AirPort Rd
Teleohone: 208-356-3102 Fax: n/a
Emergency Demolition (complete item.XIV and all other sections, only if this project is an Emergency Demo)
I . Attach a copy of the Order to this notice'
2. Name of Authority Issuing Order: NA
3. Authority of order (Citation orCoatl' o*. OiIl-J i6 FIEii4. DateofOrder(MMIDD/YY) , , = ,,' ,t ,,,t -^.,"".^.,,ri.i" r
EmergencyRenovationte.tu.risEmergencyRenovation.)
Date and Hour of Emergence N/A
Description of Sudden, Unexpected Event'ffi#,'H:;ffiiil ]"il'h; """r' '""oi'i""' "'
Description of procedures to be followedin the cvent that unexpected RAcM is found or nonfriable ACM becomes crumbled' pulverized or
ACM, enolose area, posr wamings and contain Stop tpttud 'f uit-bo* fibtt *
theprovisionsofNESHAPS(40cFRPART6|,SUBPARTM)wi|lbeonsiteduringthedemolitionor
jged training has been "".or'priri.i
nJirti, p.rron will be available during normal business hours'
Date TYPe or Print Name and Title
May-17-2012 Dave Price / Owner Secretary
Fohibiting the submission offalse or misleading statements and I certify that facts contained in this
typ. o. Print Name and Title
etenworkingdsys(Monday-Fridayexcludingweekends)beforedemolitionorrenoVation
begins, except emergency *.qlt'i"" t"d ttt'gtt
Great Basin Services, Inc
P.O. Box 238
Blackfoot,Idaho 83221
Office: 208-785-1767
Cell: 208-681-6462
May-30-2012
RE: Vacant House located at 135 South, I't West, Rexburg' Idaho
To Whom it may concern:
Great Basin Services has removed the asbestos materials found in the Inspection report.
Sheet vinyl flooring, duct tape. All Asbestos materials were disposed of at an EPA Approved
landfill as required by EPA. The remaining material my be disposed of as non asbestos waste.
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Daveprice l/f*