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ASN-1 ~~~ OREGON DEQ NOTICE OF INTENT TO REMOVE OR, ENCAPSULATE FRIABLE ASBESTOS-CONTAINING MATERIAL ~ For DEQ use only Date Recafvod ~ Amount Received I Chack Number Projeat Number ATTENTIONI This ~otification must be complete and received by DEQ at least 10 days before the start date of any asbestos abatement p~oJect and accompanied by the~notification fee. (PLEASE TYPE OR PRINT CLFARI.Y) PROJECT CATEGORY AND NOTIFICATION FEE _ Emergency (Emerqency nottticattons nquk~ ~ b096't~~ Incr~as~) ~._ $35 for each proJact wlth lass than 401inear or 80 squa~e feet of acbestoa-oontatninp mats~iel and for eaoh resldant(sl ebatament project. _ S70 for projeats from 40 to 259 linear feet o~ 80 to 159 square feet of asbeatos•containinp matarial. ~_ 5275 for proJeota from 260 to 1299 linear feet'or 180 to 799 squars fest of arbsstos-contatninp material. ~._ 3375 for p~ojacts from 1300 to 2599 Ilnea~ fset or 800 to 1599 squars fost of asbestowoontaininp mats~tal. _ SebO for proJects from 2600 to 4999 I(nea~ fset or1800 to 3499 ~quar~ fset of asbesto;-oonteininp material. ._ ~750 for proJacts from 5000 to 9999 Unear fe~t o~ 3500 to 5999 squars fsst of asbestos-oontetninp'meter(al. ~. 31,200 for proJoota from 10,000 to 25,999 Un~ar f~~t or 6000 to 15,999 squars feet of asbestos-oontalninp materie~. ~.~, 42,000 for projects from 26,000 to 259,898 Iinear f~~t or 16,000 to 169,898 squsr~ fest of asbeatoa-aonteintnp materlel. _ i2,500 for projaots 260,000 Iinear fest or mon o~ 180,000 square feat or mors of sabestos-oontaininp materlal. . Is this a revision to a previous notification? Yes No X '. Asbestos abatement project starting date: _April. 21, 1997 Completlon date• June 23, 1997 t. Project site name: Senator Bldg. Address: 220 High St. NE.• Salem, Marion 97301 (5tr»U (CiNI (Counql fZIP! •. Property Owner: Mriri.~ri County 11. Abatement Contractor Name: ~ Property Owner Address:_ Marion Countv Courthouse *To be named as a revision unon award of contract. 100 HiRh St. NE. Salem, Or 97301 Contractor malliny address: lGryl lSat~l IZ~P~ ' Site Contact: David Hartwig Phcne• C503 373-4424 ~~,~A~ . S~lu'° N/(Z,r~ ~. Describe physical structure. of facility: Wood, Brick ~ and Concrete Structure ". Give present and prior use of facility: Prior: Marion County Housing Authority, Present: Vacant Phone• N/A* DEa.license nUmber:~ N/A* 12. Describe methad of remova! or encapsulation: Full Containments, Wet Methods ~. Will this be a complete demolition7 Yes: X No: 13. Days of week and hours of day to be worked: If yes, give demolition start date: _May 1, 1997 Mon-Fri; _ Dav Shifts, Swin~ Shifts and Grave . Describe type and percentage of asbestos material and Yard Shifts will be used. where jt is locat d facili~y~ TSI Assumed, Ceiling Acoustical 3-~ 2~Chr F ~4. Oregon Certifled Superviso~ on this project: . y , oo -, y o r Tile Mastic 10-15%Chr ,Sheet Vin 1 15-20%Chry, N/A* ~ Silver Paint Roof 5%Chry,Flashing 20%Ctiry,Roofing Or C rtifi N/A-; d S i Y' x ei ing Tile s r ~ e. e e uperv so~ ~umber: - Mastic 3%Chry,Fi e Doors Assumed 15. Asbestos disposal site: N/A* 0. Quantity of asbestos material to be removed or . 16. Waste Hauler _N/A* encapsulated: ' ~ ~inear feet: 9,100 Square feet: 57 004 N/A* Phone: 7. Name of owner, operator, or abatement contractor. _ CMario 8. Signature: l/ ~ ~` ~ Date: ~~~5~~~_Phone:~503)373-4424 Sign this form and aend with the approprtate fee to: DEa Business Office, 811 SW Sixth Avenue, Portland, OR 97204. Make checks payable to "DEQ". eviced 5/98)