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ASN- ~ OREGON DEQ NOTICE OF INTENT TO REMOVE OR, ENCAPSULATE FRIABLE ASBESTOS-CONTAINING MATERIAL ~ ~~~ For DEQ use only Date Recelved Amount Roceived Chack Number Project Number ATTENTION! This notification must be complete and received by DEQ at least 10 days before the start date of any asbestos abatement proJect and accompanied by the notification fee. (PLEASE TYPE OR PRtNT CLEARLY) PROJECT CATEGORY AND NOTIFICATION FEE Emergenoy (Emeryency notHications nquir~ ~ b096 f~~ incr~ase) A_ $35 fo~ oach proJect with less tha~ 401inear or 80 square feet of aabostot-aontaininp mats~fal and for eaoh residentisi abatoment project. 3._ 970 fo~ projacts from 40 to 259 linear feet or 80 to 159 squa~e feet of acbe~tos-containinp matstial. ~ l275 for p~oJsots from 260 to 1298 linsar fest or 160 to 799 squars fset of aabsstot-contatninp material. ~._. 5375 for projecu from 1300 to 2599 linea~ teet or 800 to 1599 =quare faet of a~bestoroo~taininp mats~tai. :_ $850 for proJecta from 2600 to 4999 linaar feet or•1600 to 3499 squa-e fsst of asbesto;-oontaini~p mate~ial. ~. 5750 for projeats from 5000 to 9999 Unear feet or 3500 to 5999 squars fest of ~sbestos-oontalnlnp'matsrtal. 3.~ t1,200 fo~ projects from 10,000 to 25,999 Ilnear feet or 6000 to 15,999 squan feet of asbettos-aontatniny materlai. H•_ 52,000 fbr p~oJects from 26,000 to 258,898 qnesr feet o~ 16,000 to 168,898 squars fset ot asbestos-oo~teininp materiai. _ 12,500 for projects 260,000 linearfest or mors or 180,000 square fest or mors of asbestos-oontainlnq material. 1. Is this a revision to a previous notificationl Yes No X 2. Asbestos abatement project starting dafe: April 21, 1997 Completion date: June 23, 1997 3. Project site name: Ccmmunity Development Bldg. Address: 285 Church ST. NE. Salem, Marion 97301 ~sv«u icur- ~c«,~H~ " a~v~ Property Owner: Mr~r;.~,i Coimty 11. Abatement Contracto~ Name: • ~ PropertyOwnerAddress:_Marion Countv Courthouse *To be named as a revision unon award of contract. 100 Hi~h St. NE. Salem, Or 97301 Contractor mailing add~ess: IGw) lStwi {ZIp~ 5. Site Contact: David Hartwig Phone: C503 373-4424 ~~~~A~ . ~suu •` N/a 6. Describe physical structure.of facility: _ Wood, Brick Phone• N/.A* and Concrete Structure 1. Give present and prior use of facility: Prior: Marion County Community Development, Present:' Vacant 3. Wiii this be a complete demolitiont Yes: No: _ If yes, pive demoiition start date: May 1, 1997 Describe type and percentage of asbestos material and where it is located in.facility:TSI Acoustical 8%Chry ,Sta r~ Duct Insulation 10%Chr 6 aChry, heet iny , C;l;ng T;1a l% h y Dr F1oor.Tile Assumed, Fire assumed Ceiling__ re as ic e remo, VibrationJoin Cloth , eve ing om. o ry, vwall/Tanin~ Com. 2%, Doors Assumed 0. auantity of asbestos material to be removed o~ encapsulated: Linear feet: 500 Square feet• 10, 385 DEO..license number:~ N/A* 12. Describe method of ~emovat or encapsulation: Full Containments, Wet Methods 13. Days of week and hburs of day to be worked: Mon-Fri; Dav Shifts. Swinz Shifts and Grave Yard Shifts will be used. 14. Oreeon Certified Supervisor on this project: N/A* ~ Ore. Certified Supervisor number: N/A-; 15. Asbestos disposai site: N/A* 16. Waste Hauler: _ N/A* Phone• N/A* 7. Name of owner, operator, o~ abatement contractor: CMarion Countv R~ Mana~amontl navi rl uarrw; g 8.Signature:_~~~liz~ - Date: ~ l ( Phone:~503)373-4424 Sign thls form and send with the appropriate fee to: DEa Buslness Office, 811 SW Sixth Avenue, Poniand, OR 97204. Make checks payable to "DEa". ~eviced 5/98)