HomeMy WebLinkAboutALL DOCS - 12-00256 - 68 W 2nd S - DemolitionBuilding Sofety
City of Rexburg
Application for Demolition
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Applicant Information
Name:
Applicant's Address
Business Phone: +CI3 '15-/ o
$25.00 Fee Paid: Yes/No Permit Approved: yes/No
Ciry/ST/Zip:
CellPhone: 3i3 -5/J/
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Contact fnformation
Person or Compaoy doine the demolition
Arr_-... / A4'-=WZ/i-looress:.€ ' -,Crry/ST/Zip:
BusinessPhone: t/OZ- tlS-l O Cell Phone:
Demolition fnformation
Property Owners:
Site Address
Start Date:*rl-lL Completion Date:
Summary of what is being demolished:
The U'S' Environmental Protection Agency (EPA) regulates the abatement and disposal of asbestos-containing materials from anypublic or private building involving demolition, ,..rorr"tiorr, repair, construction, and maintenance activities.http: / /deq.idaho.gov /airlorog issues /pollutants /asbestos.cfiir
EPA certjEes and licenses asbestos-removal contractors, inspects asbestos-abatement projects, and enforces laws regarding the properremoval and disposal of asbestos-containing materials.
Curtendy, E'PA and DEQ conffact with Industrial Hygiene Resoutces in Garden City, Idaho, to regulate asbestos removal and disposalprotects in Idaho.
For more information about asbestos abatement and disposal in Idaho, contact:
Industrial Hygiene Resource
206 Murray St
Garden Crry ID 83714
208-323,8287
www.industrialhJrgieneresources.com
I understand the EPA reqrirements tegarding asbestos removal and agree to provide information shouringcompliance with the regulations yth: city/rf Rexburg prior to demolition.
Stgnature ofApplicant
OaU. S. ENVNONffiNTAL PROTECTION AGENCY. SrArN Or <.^,,TI
-.- REVISED
I. TYPE OF NOTIFICATION: _-.-COURTESY _x* ORIGINAL
II. FACILITY DESCRIPTION:
Building Name: Vacant house
Address: 68 West 2d South
Zip Code:83460
Site Location : Demo of entire house
Building Size (Sq. F0 ) 3000 #ofFloors: I and full basement Age in years: aprox 39
Prior Use: residential
III. TYPE OF OPERATION: _x_DEMO -ORDEREDDEMO -RENOVATION - EMERGENCY RENOVATION - FIRE TRA]NINGry. Is Asbestos present? (check one)_x_No AsbEstos to be removed prior to demo
Owner Name: NG Rexburg Housing LLC
Address: 2880 North 55 West
Removal Contractor Name: Great Basin Services, Inc License: CSR 0120t2-29
Zip Code:83221
Dave Price Telephone: 208-785-1767 Fax:20g_785_4053
OtherOperator(demolition/general) Streamlined Homes LLC
Address: 160 South,3ed West
Telephone: 208-403-4510
ffinon-fiable pLM Lab testing
Vll. Approximate Amount of Asbestos Materials:
RACM to be Removed Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
Asbestos to be removed prior to demo
Facility Components (cubic feet)
VIII. Schedufed Dates Demolition or Renovation: Start: June-lth _2012 Complete: J une-22-20 12
IV. Dates for Asbestos Removal (MM/DD/yy) : Stfi: done prior to demo
X' Description of ptanned Demolition or renovation work to be preformed and method(s) to be employed, including demolition or renovation
::,]l#r:t:s,::j:^"::1_"1:.,*:.-:to1io,n orarfected.facilitv components: Asbestos removed prior to demo. complete demo using track-hoes, loaders.will be dept wet to keep down dust during demo and loading ofdlbris.
XI' Description ofwork practices and engineering controls to be used to comply wifh the requirements, including asbestos removal and wastehandling emission contror procedures: AII asbestos removed prior to demo.
XIL Waste Transporter #l: General Construction debris
Name: Streamlined Homes LLC
Address: 160 South,3ed West
State: Idaho ZipCode:t344l
Telephone: 208-403-4510 Fax:N/a
Waste Transporter #2:
State: Zip Code:
XII. Waste Disposal: ASBESTOS ONLY
Name: Madison County Solid Waste
State: Idaho ZioCode 83440
Telephone:208-356-3102 Fax:nla
XIV. Emergency Demolition (Complete item XIV and all other sections, only if this project is an Emergency Demo)I . Attach a copy ofthe Order to this notice.
2. Name of Authority Issuing Order: NA Title3 ; *lT'ly^"f ,9'9::J9:*:l :t c
4. Date of Order (MM/DD/Y4. Uate or urder (MM/DD/YY)
Emergency Renovation (Attach separate sheet with the followingiforrnatlon iiproi.rt is erergency Renovatio-n.)l. Date and Hour of Emergence N/A
2. Description ofSudden, Unexpected Event.
3 ' Explanation of how the even caused unsafe conditions or equipment damage or an unreasonable financial burden.
XVL Description ofprocedures to be followed in the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized orreduced to powder.
wet down ACM, enclose area, post wamings and contain . stop spread of air-bom fiber release.
XVII. I certify fained in the provisions of NESHAPS (40 CFR PART 61, SUBPART M) will be on site during the demolition ort the required training has been accomplished by this person will be available during normal business hours,
Type or Print Name and Title
Dave Price / Owner Secrotary
oflaws prohibiting the submission offalse or misleading statements and I certify that facts contained in this
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 renovationbegins, except emergency demolition and emergency renovations which must be submitted as soon as possible before operations begin. (Form rev.3/24199
Great Basin Services, Inc-
P.O. Box 238
Blackfoot,Idaho 83221
Office: 208-785-1767
Cell: 208-681-6462
l|.ar-31-2012
RE: Vacant House located at 68 West 2nd South, Rexburg, Idaho
To Whom it may concern:
Great Basin Services has inspected the house at 68 West, 2nd South. There was NO
asbestos materials found in the Inspection. The remaining material my be disposed of as non-asbestos waste.
DavePrice pp