HomeMy WebLinkAboutALL DOCS - 12-00253 - 63 W 1st S - DemolitionB uilding Sofely Deporlme-n
Cify of Rexburg
www.rexburg.org
Person or Company doing-tb-e 6roto1l6on r -- tTEtf
Address: E'/ 5"*rt2
Rijx"l4L"iJ{.fi
$25.00 Fee Paid: Yes/No Permit Approved: Yes/No
Applicant Information
Et> -//*.*^
Name
Applicant's Address City/ST/Zrp
Business phone: 4D3 ^1{d1 D CellPhone: .313 -5/J /
Contact fnformation
City/ST/Zip:
Businessphone: lOe- qS-/ O
Demolition Infiormation
Propetty Owners
Site Address:
Start Date:
Summary of what is being demolished
The U.S. Environmental Protection Agency (EPA) regulates the abatement and disposal of asbestos-containing materials from any
public or private buildrng involving demolition, tenovation, repair, construction, and maintenance activiries.
http:/ /deqjdaho.govlairlprog issues/poliutants /asbestos.cfm
EPA certifies and licenses asbestos-removal contractors, inspects asbestos-abatement projects, and enfotces laws regarding 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 Muray St
Garden City lD 83714
208-323-8287
www.indus trialhystienere s outce s. com
I understand the EPA requirements regarding asbestos removal and agree to provide infotmation showing
compliance with the regulations 14/,tJn: City2f Rexburg prior to demolition.
Signature of Applicant:
Application for Demolition
Permit #
o_aU. S. ENVMONMENTAL PROTECTION AGENCY.BTATN OF'IDAHO
ND RENOVATION
DATE RECEIVED
I. TYPE OF NOTTFICATION: _COURTESY _x_ ORIGINAL
II. FACILITY DESCRIPTION:
Building Name: Vacant house
Address: 63 West I"tSouth
Site Location : Complete demo of each house
Building Size (Sq. F0 ) 2000 main floor #ofFloors: I and small basement Age in years: aprox 68
Prior Use: residential
III. TYPE OF OPERATION:_x_DEMO _ORDEREDDEMO - RENOVATION _ EMERGENCY RENOVATION _ FIRE TRAININGIV. Is Asbestos present? (check one)_x_No Asbestos has been removed
V. Facility Information:
Owner Name: NG Rexburg Housing LLC
Address: 2880 North 55 Wesr
Telephone: 208-528-6635
Removal Contractor Name: Great Basin Services, Inc License: CSR 012012-29
Zip Code:83221
Dave Price Telephone: Z0g-7gi_1:,67 Fax:20g_785_4053
Other Operator(demolitionlgeneral) Streamlined Homes LLC
Address: 160 South, 3ed West
Telephone: 208403-4510
ffinon-Iiable pLM Lab testing
Vl1, Approximate Amount of Asbestos Materialsl
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Surface Area (Square feet All asbestos removed prior to demo
Facility Components (cubic feet)
VIII. Scheduled Dates Demolition or Renovation: Start: June- I g-20 I 2 Complete: July-l 8-20t 2
IV. Dates for Asbestos Removal (MM/DD/yD :
X' DescriptionofplannedDemolitionorrenovationwork tobepreformedandmethod(s)tobeemployed,includingdemolitionorrenovationtechniques to be used and description of affected facility components: Asbestos removed prior to demo. complete demo using track-hoes, loaders.will be dept wet to keep down dust during demo and loading ofdibris.
XI' Description of work practices and engineering controls to be used to comply with the requirements, including asbestos removal and wastehandling emission contror procedures: Ail asbistos removed prior to demo.
XII. Waste Transporter #l: General Construction debris
Address: 160 South,3ed West
Zip Code:83440
Contact: Cory Sorensen Telephone: 208-403-4510 Fax:N/a
XII. Waste Disposal: ASBESTOS ONLy
Name: Madison County Solid Waste
Address: 530 Airport Rd
ZipCode: 83440
Telephone: 208-356-3102 Fax: n/a
XIv' 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 of Code):
4. Date of Order (MM/DD/yy)
XV.EmergencyRenovation1attact'sepii@rojectisEmergencyRenoVation.)
l. Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
3' Explanation ofhow the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
xvl' Description of procedures to be followed in the event that unexpected ITACM is found or nonfriabte ACM becomes crum bled, pulverized orreduced to powder. ^
ACM,enclosearea,post warnings andcontain. Stopspreadofair-bomfiber release.
XVII. I certify that an
renovation and evidence
the provisions of NESHAPS (40 CFR PART 61, SUBPART M) will be on site during the demolition orired training has been accomplished by this person will be available during normal-business hours.
Date Type or Print Name and TitleJune-4-2012 Dave price / Owner Secretary
XVIL I acknowledge the submission offalse or misleading statements and I certify that facts contained in this
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 renovationbegins, except emergency d.T9lfttol and emergency renovations which must be zubmitted * ,oon us porri-bl. before operations begin. (Form rev.3/24/99
-Gr eat Basin Services" Inc
P.O. Box 238
Blackfoot,Idaho 93221
Office: 208-7g5-1767
Cell: 209-6gt-6462
May-5-2012
RE: Vacant House located at 63 West, l,t South, Rexburs
To Whom it may concern:
Great Basin services has removed the asbestos materiars found in the Inspection report.sheet vinyl flooring, aprox 140 sq ft. All Asbestos materials were disposed of at an EpAApproved landfill as required uy ina. The remaining material my be disposed of as nonasbestos waste.
Dave Price