HomeMy WebLinkAboutALL DOCS - 12-00252 - 165 S 1st W - DemolitionBuilding Sofety Depo
Application for Demolition
Permit #:
)qrrme'nr -'R\ .r,! i.ri,city of Rexburr /iffi\. i '
:.r,:WH#*:'
$25.00 Fee Paid: Yes/No Permit Approved: yes/No
Applicant Infonnation
N^ .t 9i;%tt;1t-tl(i ED
Applicant's Address: rc4 d k)Ciry/ST/Zip:
Business phone: 748 -#7 D Cell Phone: -313 -5/J/
Contact fnformation
4/*'*-t
Person or Company doine the demoliti
Address: /5t/' SZ4art City/STlZip.
BusinessPhone: lOg- 95-t O Cell Phone:
Demolition f nform ation
Property Owners:
Site Address:
StartDare: lD'5*lZ-Completion Date:
Summaly of what is being demolished:
The U-S' Envlonmental Protection Agency @'PA) regulates the abatement and disposal of asbestos-containing materials from anypublic or private building involving demolition, renovation, repait, constnrct-iorr, and maintenance activities.
htto://deq.idaho.gov/airlorog issues /pollutants /asbestos.cfm
EPA certifies and licenses asbestos-removal contractots, inspects asbestos-abatement proiects, and enforces laws tegarding the properremoval and disposal of asbestos,containing materials.
Currendy, EPA and DEQ contract with Industrial Hygiene Resources in Garden City, Idaho, to regulate asbestos removal and disposalprojects in Idaho.
For more information about asbestos abatement and disposal in Idaho. contacr:
Industrial Hygiene Resource
206 Muray St
Garden CiBl ID 83714
208-323-8287
www.industrialhygieneresources.com
I understand the EPA tequitements regatding asbestos removal and agree to provide information showingcompliance with the regulations qth: ciry2f Rexburg prior to demolition.
Stgnature of Applicant:
U. S. ENVIRONMENTAL PROTECTION AGENCY. STATE OF IDAHO
NOTIFICATION OF DEMOLITION AND RENOVATION
OPERATOR PROJECT #POSTMARK DATE RECEIVED NOTIFICATION
I. TYPE OF NOTIFICATION: COURTESY x ORIGINAL REVISED CANCELED
II. FACILITY DESCRIPTION:
Building Name: Vacant house
Address: 165 South, l" West
City: Rexburg State: Id Zip Code: 83460 County: Madison
Site Location : Demo ofentire house and trailer
Building Size (Sq. Ft) ) 1200 first floor #ofFloors: I and full basement Age in years: aprox 50
Present Use: vacant Prior Use: residential
III. TYPE OF OPERATION: x DEMO ORDERED DEMO RENOVATION EMERGENCY RENOVATION FIRE TRAININC
IV. Is Asbestos Present? (check one) _Yes _x_No Asbestos will be removed prior to demo
V. Facility Information:
Owner Name: NG Rexburg Housing LLC
Address: 2880 North 55 West
City: Idaho Falls State: ld Zip Code: 83402
Contact: David Dance Teleohone: 208-528-6635 Fax: N/A
Removal Contractor Name: Great Basin Senices, Inc License: CSR 012012-29
Address:P. O. Box 238
City:Blackfoot State: Idaho Zip Code:83221
Contaot:Dave Price Telephone: 208-785-1767 Fax: 208-785-4053
OtherOperator (demolition/general) Streamlined Homes LLC License: n/a
Address: 160 South,3ed West
City: Rexburg State: Idaho Zip Code:83440
Contact: Cory Sorensen Telephone: 208-403-4510 Fax: n/a
VI. Procedure, including analytical methods, employed to detect the presence of and to estimate the quality of RACM and Category I and Category II
non-fiable PLM Lab testing
Vl l. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfr iable Asbestos Material
Not to be Removed
Category I Category ll Category I Category Il
Pipes (linear feet)
Surface Area (Square feet All asbestos will be removed prior to
demo
Faciliry Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: May-June-S-2012 Comolete: June-15-2012
- IV. Dates for Asbestos Removal (MM/DD/YY) : Start: Asbostos removal will be complete prior to demo Complete:
Days/Week I Monday Tuesday I Wednesday Thursday Friday Saturday Sunday
Hrs of Operation | 8am-5pm 8am-5pm | 8am-5pm 8am-5pm 8am-5pm
X. Description of planned Demolition or renovation work to be preformed and method(s) to be employed, including demolition or renovation
techniques to be used and description of affected facility components: Asbestos removed prior to demo. Complete demo using track-hoes, loaders Debris
will be dept wet to keep down dust during demo and loading ofdebris.
XI. Description of work practices and engineering controls to be used to comply with the requirements, including asbestos removal and waste
handling emission control procedures: All asbestos removed prior to demo.
XII. Waste Transporter #l: General Construction debris
Name: Streamlined Homes LLC
Address: 160 South,3ed West
City: Rexburg State: ldaho Zip Code: 83440
Contact: Cory Sorensen Telephone: 208-403-45 I 0 Fax:N/a
Waste Transporter #22
Name:
Address:
City: Rexburg State:Zip Code:
Contact:Telephone:Fax:
XII. Waste Disposal: ASBESTOS ONLY
Name: Madison County Solid Waste
Address: 530 Airport Rd
City: Rexburg State: ldaho ZipCode 83440
Contact: Scale house Telephone: 208-356-3102 Fax: n/a
XIv. Emergency Demolition (Complete item XIV and all olher 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 of Code):
4. Date of Order (MM/DD/YY Ordered to Begin
-XV. Emergency Renovation (Attach separate sheet with the following information if projectis Emergency Renovation.)
l. Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
3. Explanationofhowtheevencausedunsafeconditionsorequipmentdamageoranunreasonablefinancialburden.
xvr.Description ofprocedures to be followed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled'.pulverized or
reduced to powder.
Evacuate arg,-i\t down ACM, enclose area, post wamings and contain . Stop spread of air-bom fiber release.
xvll. I certiry ttffinald
renovatioy'and evideng
Signatqre otOryrct
1r {t ^inglin the provisions of NESHAPS (40 CFR PART 61, SUBPART M) will be on site during the demolition or
! tnft tydrequired training has been accomplished by this person will be available during normal business hours.
.--1.-.1 T.,^- ^- D-:-+ N^ha dh/ Ti+'[r<
May-21-2012 Dave Price / Owner Secretary
XVIL L.ilorrl.9/rnlqr.y', "f f /*. prohibiting the submission of false or misleading statements and I certify that facts contained in this
notilicatioil are true, {cfiratey'nd complete,
l' *.,/ {-/' t
| :/ f -.7 Mav-21-2012 D^ve Price Qwner I secartaw
Signaturt offwner/Op6rato-r Date Type or Print Name and Title
Original Notification must be mailed or hand delivered at lease ten working dsys (Monday-Friday excluding weekends) before demolition or renovation
begins, except emergency demolition and emergency renovations which must be submitted as soon as possible before operations begin. (Form rev.3/24/99
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 165 South, 1'1 West, Rexburg, Idaho
To Whom it may concern:
Great Basin Services has removed the asbestos materials found in the Inspection report.
110 sq ft of floor tile. 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.
Dave Price