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Home My WebLink AboutASBESTOS REMOVAL REPORT - 20-00957 - 57 S Center - DemolitionGreat Basin Services, Inc P.O. Box 238 Blackfoot, Idaho 83221 Office: 208-785-1767 Cell: 208-681-6462 12-7-2020 RE: Asbestos removal on Vacant apartment building, 57 South Center, Rexburg, Idaho To Whom it may concern: Great Basin Services has removed the Asbestos ceiling texture in apartments 2 and 3, as identified in the inspection report done by Materials Testing and Inspection. All asbestos materials were removed by trained and certified asbestos workers Attached are copies of the EPA notification for asbestos removal, a signed landfill manifest showing proper disposal, the Letter of Removal stating that the asbestos materials identified in the report were removed and properly disposed of as per EPA regulations. Also, you will find copies of the asbestos workers certifications. Dave Price, Owner, Great Basin Services, Inc U. S. ENVIRONMENTAL PROTECTION AGENCY - STATE OF IDAHO NOTIFICATION OF DEMOLITION AND RENOVATION OPERATOR PROJECT # 1 POSTMARK _7DATE RECEIVED NOTIFICATION 1. TYPE OF NOTIFICATION: COURTESY _x_ ORIGINAL REVISED CANCELED 11. FACILITY DESCRIPTION: Building Name: Vacant house / apartment Address: 57 South Center City: Rexburg State: Idaho Zip Code: 83440 County: Madison Site Location: ceiling texture Building Size (Square Feet) aprox 1300 main floor Sof Floors: 2 Age in years: aprox 70 Present Use: Vacant Prior Use: Single family house 111. TYPE OF OPERATION: x DEMO ORDERED DEMO RENOVATION EMERGENCY RENOVATION FIRE TRAINING IV. Is Asbestos Present? (check one) x Yes No V. Facility Information: Owner Name: City of Rexburg Address: 299 East, 4" North City: Rexburg State: Id Zip Code: 83440 Contact: Joel Gray Telephone: 208-716-1331 Fax: N/A Removal Contractor Name: Great Basin Services, Inc License: CSR 110220-01 Address: P. O. Box 238 City: Blackfoot State: Idaho Zip Code: 83221 Contact: Dave Price Telephone: 208-785-1767 Fax: 208.7854053 Other Operator (demolition/general) Unknown at this time, demo to be at a later date and filed by demo contractor License: Address: City. State: Zip Code: Contact: Telephone: Fax: VI. Procedure, Including analytical methods, employed to detect the presence of and to estimate the quality of RACM and Category I and Category 11 non-fiable PLM Lab testing VI 1. Approximate Amount of Asbestos Materials: RACM to be Removed Nonfriable Asbestos Material to be Removed Nonfriable Asbestos Material Not to be Removed Category I I Category Il 1 Category 1 I Category II Pipes (lincar feet) Surface Area (Square feet Aprox 800 sq R of ceiling texture Facility Components (cubic feet) VIII. Scheduled Dates Demolition or Renovation: Start: Unknown Complete: IV. Dates for Asbestos Removal (MM/DD/YY); Start: Nov -23 2020 Complete: Deal 2020 Day& Veek Monday Tuesday Wednesday Thursday Friday Saturday Sunday Ilrs of Operation 1 8-5 8-5 1 8-5 1 8-5 8.5 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: Complete demolition of house using back hoes, loaders and excavators. Asbestos to be removed prior to demolition. Demo to file his own notification 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: Asbestos abatement only, Post area with warning signs, limit access to public. Ceiling texture to be removed using, critical barriors, negative air Inclosure, hand removal methods using water to keep material adequately wet during removal. All materials removed will be double bagged, labeled, and transported in an inclosed trailer for disposal. Containment will be incapsulated upon completion. All asbestos materials will be taken to an EPA approved landfill for disposal. XII. Waste Transporter #I: ASBESTOS ONLY Name: Great Basin Services, Inc Address: P.O. box 238 City: Blackfoot State: Idaho Zip Code: 83221 Contact: Dave Prix Telephone: 208-785-1767 Fax:208.785.4053 Waste Transporter 022: Name: NIA Address; City: State: Zip Code: Contact: Telephone: Fax: XII. Waste Disposal: ASBESTOS ONLY Name: Bannock County Landfill Address: 1500 North Fort Hall Mine Road City: Pocatello State: Idaho Zip Code: 83204 Contact: Scale house Telephone: 208-236-0607 Fax:208- 236- 0609 XIV. Emergency Demolition (Complete Item XIV and all other sections, only If this project Is an Emergency Demo) 1. Attach a copy of the Order to this notice. 2. Name of Authority Issuing Order. NA Title 3. Authority of Order (Citation of Code): 4. Date of Order (MM/DDDate Ordered to Begin /YY) XV. Emergency Renovation (Attach separate sheet with the following information if project is Emergency Renovation.) 1. Date and Hour of Emergence N/A 2. Description of Sudden, Unexpected Event. 3. Explanation of how the even caused unsafe conditions or equipment damage or an unreasonable financial burden. XVI. Description of procedures to be followed In the event that unexpected RACM is found or nonfriable ACM becomes crumbled, pulverized or reduced to powder. Evacuate =>Awkdown ACM, enclose area, post warnings and contain. Stop spread of air-born fiber release. XVII. 1 certify at an indlvf a traine n the provisions of NESHAPS (40 CFR PART 61, SUBPART M) will be on site during the demolition or renovation and eviden that th a lulred training has been accomplished by this person will be available during normal business hours. Signatu a of Date Type or Print Name and Title 11-6-2020 Dave Price / Owner Secretary XVII. I ackno ge the s ace of I prohibiting the submission of false or misleading statements and I certlry that facts contained in this notiSca on are , a urat d complete. 11 2020 Price Owner Signa re of Owner/ rater 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, accept emergency demolition and emergency renovations which must be submitted as soon as possible before operations begin. (Form rev.3/24M U.S.EP,A WASTE SHIPMENT RECORD FOR REGULATED ASBESTOS WASTE MATERIAL R.Q. Hazardous Substance: Solid N.O.S. (asbestos): ORM-E NA -9188 GENERATOR 1 Work site name: kA A R vnr Location: S7 ,(;bu-1A Ce,vf� re Rcxb uRg 2'dA AD , g3yyb , Mailing Address: � C— yA AORIA Owner's Name: Owner's Phone• % / 2 Operator's Name: Grkat Basin Services, lncJp I Contractor I.D. Number: Mailing Address: P.O. Box 238 C$/Z l 1OZZO —O/ Blackfoot, ID 83221 Contact Person: Dave Price Operator's Phone: 208-785-1767 3 Waste Disposal Site (WDS) DESTINATION: Name: Bannock County Landfill WDS Phone: 208-236-0607 Mailing Address: 1500 N. Fort Hall Mine Rd. Pocatello, ID 83201 Site Address/location: 1500 N. Fort Hall Mine Rd. 4 Name and address of responsible agency District or EPA Office where degloli 'on/renovation otif cation was sent): a 5 Descri tion of waste materials 6. Containers 7. Total Quantity Number Type (Cubic Yards) rj $ Special Handling Instructions and additional information: 9 OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are full4nd ace:tely described above by proper shipping name and are classified, packed, marked and labeled, and are in all respects in proper co tion transport highway according to applicable international and government regulations. (Obtain signature in Item 10 before taking Gold sheet for rec ) Dave Price Owner Printed/typed Name Title Signature - Date (m"Drvv) TRANSPORTER 10 Transporter 1 (Acknowledgement of receipt of materials) Name: Great Basin Services, Inc. Phone: Address: P.O. Box 238 Blackfoot, ID 83221 Printerthyped Name Dave Prtce Title Owner Signature - - Date U&NDDNY) 11 Transporter 2 (Acknowledgement of receipt of materials) Name: Phone: Address: Printed/typed Name Title Signature Date (mmmuryy) WASTE DISPOSAL SITE 12 Discrepancy indication space: 13 WASTE DISPOSAL SITE CERT INICATION: I hereby certify that the above named material bas been accepted and to the best of my knowledge the foreg g is tore, accurate and complete except as noted in Item 12. �i s-n�� D�T� i i 12-51 Pri�ped Name Name Title Date (m Drcv) Upon transfer: Owner/operator retains GOLD, Transporter retains PINK, VMS retains YELLOW and sends completed WHITE copy to operator in item 2. mm� r�uw sK. • es�aroos ro nssi • twat tas.osso V U D&D ENVIRONMENTAL CONSULTING, INC. CERTIFICATE OF TRAINING This is to Certify That CHRIS EARLY 6040 Has Successfully Completed an EPA/AHERA Asbestos Refresher Training Class Under Section 206 of the Toxic Substance Control Act, Title Il. In: CONTRACTOR/SUPERVISOR Course Dates: December 9. 2019 No. of Hours: 8 Certificate No:CSR120919-38 Expires: December 9. 2020 Douglas A. Aldinger, D ector of Training D&D Environmental Consulting, Inc. 7345 South Pierce Street, Suite 104 Littleton, CO 80128 (303) 870-1032 D&D ENVIRONMENTAL CONSULTING, INC. CERTIFICATE OF TRAINING This is to Certify That BOBBIE CHAVEZ 2956 Has Successfully Completed an EPA/AHERA Asbestos Refresher Training Class Under Section 206 of the Toxic Substance Control Act, Title II. In: CONTRACTOR/SUPERVISOR Course Dates: December 9. 2019 No. of Hours: 8 Certificate No:CSR120919-37 Expires: December 9. 2020 d. /-,/- ��'CC.�1 / Douglas A. Aldinger, Director of Training D&D Environmental Consulting, Inc. 7345 South Pierce Street, Suite 104 Littleton, CO 80128 (303)870-1032 D&D ENVIRONMENTAL CONSULTING, INC. CERTIFICATE OF TRAINING This is to Certify That DAVID PRICE 0919 Has Successfully Completed an EPA/AHERA Asbestos Refresher Training Class Under Section 206 of the Toxic Substance Control Act, Title H. In: CONTRACTOR/SUPERVISOR Course Dates: December 9. 2019 No. of Hours: 8 Certificate No:CSR120919-36 Expires: December 9. 2020 Douglas A. AldingerCbirector of Training D&D Environmental Consulting, Inc. 7345 South Pierce Street, Suite 104 Littleton, CO 80128 (303) 870-1032