HomeMy WebLinkAboutALL DOCS - 12-00258 - 52 W 2nd S - DemolitionBuilding Sofety Deportm
www.rexbutg.org
Application for Demolition
permit #:
$25.00 Fee Paid: Yes/No Permit Approved: yes/No
Ciry/ST/Zip:
Cell Phone: 3i3 -€r/J /
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City ol Rexburg
Phone: 208.372.2326
Fax: 208.359.3022
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Applicant Information
Name
Applicant's Address:)-+
Business Phone' ffi3 ^/-a-t o
Contact Infotmation
Demolition Information
ED -/L.*'
Person or Company doing_the 4emohtlon@
.\ddress: t54 <;-slY-/-City/tT/Zip:
Business phone: z/D3 - q57 O cet phone:
Property Owners
Site Ad&ess:
Start Date:U 7*IZ Completion Date:
Summaq' of what is being demolished:
The U's' Environmental Ptotection Agency @PA) regulates the abatement and disposal of asbestos-containing materials from a,.,y
l*i:;r'-f;::.^ !!$S;"""t"t.,g d.Loliio.,, ..r,o-ririor,, ,.p"ir, .o.,rt ...rior,, ,ra maintenance activirres.
:"*.|"1T"TTi*,5n:T:H:::;:'rHH;#ffi^'inspects asbestos-abatement proiects, and enrorces raws regarding the proper
currendy' EPA and DEQ contract with Industriai Hygiene Resources in Garden city, Idaho, to regulate asbestos removal and disposalprojects in Idaho.
For more information aLrout asbestos abatement and disposal in Idaho, contacrIndustdal Hygiene Resource
206 Murray St
Garden City ID 93774
208-323-8287
www.industrialhygieneresources.com
I undetstand the EPA tequirements regarding asbestos removaland 1g_... to provide information showingcompliance with the re gurations jf, ttt. cityl nexburg pJ",," dem olition.
Signature of Applicant:
rrcnrYi,-.-^ I oU. S. ENVIRONMENTAL PROTECTION AGENCY. }T.q.TT OF IDAHO
D RENOVATIONOPERATOR PROJECT #DATE RECEIVED
I. TYPE OFNOTIFICATTON:_COURTESY _x_ ORIGINAL
II. FACILITY DESCRIPTION:
Building Name: Vacant house
Address: 52 West 2"d South
Site Location : Demo ofentire house
Building Size (Sq. Ft) ) 2400 #ofFloors: I and partial basement Age in years: aprox 60-70
III. TYPE OF OPERATION: _x_DEMO -ORDEREDDEMO -RENOVATION- EMERCENCY RENOVATION - FIRE TRAININC
IV, Is Asbestos present? (check one)_x_No Asbestos found in Asbestos Inspection
V. Facility Information:
OwnerName: NG Rexburg Housing LLC
Address: 2880 North 55 Wesl
ZipCode: 83402
Contact: David Dance
Removal Contractor Name: Great Basin Services, Inc License: CSR 012012-29
P. O. Box 238
Zip Code:83221
Dave Price Telephone: 20g-7g5-1767 Fax:20g_785-4053
OtherOperator(demolition/general) StreamlinedHomesLLC
Address: 160 South,3ed West
Contact: Cory Sorensen Telephone: 208-403-4510
ffinon-fiable pLM Lab testing
Vll. Approximate Amount of Asbestos Materials:
Nonfriable Asbestos Material
to be Removed
Nonfriable Asbestos Material
Not to be Removed
VIII. Schedulcd Dates Demolition or Renovation: Start: June-7th _2012 Complete: June-22-2012
IV. Dates for Asbestos Removal (MMiDD/yy) : Start: N/A
X.Descriptionofp|annedDem.olitionorrenovationworktobepreformeduno'.*
ffiiT:tHT,?:#::rT"1"1':,:',tffil r:[.J::ltj**rnp";fi;- fi;,i". *"'*.0 piio, ro o.nio. "co,fi.,. a.,o usins track_hoes, roaders.
handling emission control proceduresl All urUZr,o, ,urou.d prior to demo.
XII. Waste Transporter #l: General Construction debris
Name: Streamlined Homes LLC
Address: 160 South,3ed Wesr
Telephone: 208-403-4510
waste Transporter #2:
XII. Wasre Disposat: ASBESTOS ONLY
Name: Madison County Solid Waste
Address: 530 Airport Rd
Telephone: 208-356-3102 Fax: n/a
xry' ru;?:f,?.Hillrfi:ti::ffi':fiJ:'#,Xt and arr other sections, onrv irthis project is an Emergency Demo)
2. Name of Authority Issuing Order: NA,4,,.L^-;!--^^i -,-3. Authority of Order (Citation of Codel4. Date of Order (MM/DD/yy
Emergency Renovation (Attach sepa.ute sf,G with the following information if pro:ict isE ergency Renovatron.)Date and Hour of Emergence N/ADescription of Sudden, Unexpected
Explanation ofhow the even 'caused
unsafe conditions or equipment damage or an unreasonable financial burden.
ffireduced to powder.
wet down AcM, enclose area, post wamings and contain . stop spread of air-bom fiber release.
XVII. I certify tldfan ual fained in the provisions of NESHAPS (40 cFR PART 61, suBpART M) will be on site during the demolition or'.Y:^'!" required training has been accomplished ny tt i, p..ron will be avallable during normal business hours-yljjj Date Type or print Name and-fiueMay-24-2012 Dave price / Owner Secretary
laws prohibiting the submission offalse or misleading statements and I certify that facts contained in thisand complete,
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 renovati;soonaspossibIebeforeoperationsbegin'(Formrev.3/24/99
Great Basin Services, Inc
P.O. Box 238
Blackfoot,Idaho 93221
Office: 208-785-1767
Cell: 208-68t-6462
June-1-2012
RE: vacant House located at 52 west 2nd south, Rexburg,Idaho
To Whom it may concern:
Great Basin Services has Inspected and tested the house at 52 West, 2nd South, RexburgIdaho and found No Asbestos. The remaining material my be disposed of as non asbestoswaste.
Dave Price Q7