HomeMy WebLinkAboutFile Documents.1130 Black Birch Dr.0096.2018 (3).ARBKColorado Department of Public Health and Environment
Air Pollution Control Division — Indoor Environment Program — Asbestos/IAQ Air Unit
4300 Cherry Creek Drive South, APCD-IE-B1
Denver, Colorado 80246-1530
Phone: 303-692-3100 —Fax: 303-782-0278
E-mail: asbestos@state.co.us
This approval notice is granted subject to Colorado Air Quality Control Commission Regulation
No. 8, Part B, adopted December 21, 2007, and effective January 30, 2008 and the Colorado Air
Pollution Prevention and Control Act C.R.S. (25-7-101 and 25-7-501 et seq). This notice signifies
that the structure was inspected for asbestos, luminous exit signs (containing radioactive material),
and Ozone -Depleting Refrigerants and the demolition contractor has properly notified the
Colorado Department of Public Health and Environment pursuant to Regulation No. 8, Part B.
As a contractor, you may be subject to other demolition licenses and permits, depending on the
requirements of the county and municipality in which the work is being performed. The Colorado
Department of Public Health and Environment, Air Pollution Control Division, strongly suggests
that you check with county and municipal authorities in order to determine any other local
building/permitting requirements that must be met.
Please note that certain asbestos -containing materials (ACM) may remain in the structure
during demolition. Therefore, any demolition debris left behind after the completion of post -
demolition site cleanup may constitute a "reason to know of asbestos -contaminated soil' at
the site, subject to the requirements of Section 5.5 of the Solid Waste Regulations (6 CCR
1007-2, Part 1).
THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES.
Immediately notify the Asbestos/IAQ Unit of project modifications byfa.v (number above) or e-mail
(address above) and the appropriate county health department by fax. Project modifications include
changes in the scope of work or the scheduled work dates, etc.
This demolition approval notice is valid beginning 11/1/2018.
The actual scheduled work dates are from 11/1/2018 through 11/30/2018.
Approval issued on: 9/21/2018
Record number: 141761
Notice Number: 18PI6046D
For the location specified below:
Garage Structure
1130 Black Birch Dr.
Aspen
Pitkin County
This notice has been issued to:
Korn, Ltd.
417 Main St. Suite Y
Carbondale, CO 81623
Fee Paid: $55.00
Check number: 1967
Asbestos Building Inspector:
Douglas A. Close
Cerification No.: 2930
Inspection Date: 11/27/2017
Issued b ��
Colorado Department
of Public Health
andEnvironment
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DEMOLITION NOTIFICATION APPLICATION FORM
APPLICATION FEE MUST ACCOMPANY THIS FORM
INCOMPLETE APPLICATIONS WILL BE RETURNED
(Notice will be mailed to the demolition contractor unless specified otherwise)
Fee: $50 + $5 per 1000 ft2 of area to be demolished = $
(See instruction #1 on reverse. side)
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SVeet:
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City: %U 1�f➢��
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Zip Code:
T ephone #
Fax #
P(eject Manager.
V1 "NIV
Ce I Phone #
I certify (hat the Certified A basics Building Inspector has informed me
about any remaining asbestos -containing materials in the facility to be
demolished.
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C cvti � Cir
Pr tName: a
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Landrdl Receiving Bu) ng Debris:
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General Abatement Contractor (GAC)
COPHE Asbestos Permit#
Total Aarifity of Asbestos Removed
Dale Removal Completed
Telephone #
Type($) ofAsbestos-Containing Material Removed:
vn�,Lr.l
Submit form to:
Permit Coordinator
Colorado Dept. of Public
Health and Environment
APCD-IE-B1
4300 Cherry Creek Drive
South
Denver, CO 80246.1530
Phone: 303-692-3100
Fax: 303-782.0278
Asbestos@state.co.us
F6,oare,,�tage of footprint f f dliry or portion of fadlity o be
9�_Wrecking ❑ Burning' Tj Implosion . ❑ Moving ❑ Other, specify:
tBurnt ng requires additional authorization - Please call (303) 692-3100 and ask
Owner's Name:
31n\
O Street: l�lb
m
C City:
m Contact's Name
State: Zip Code:
With my signature below. I certify that I possess current AHERA accreditation and state of Colorado certification as
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stos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed
molition Site block above, sampled all suspect materials, had all samples analyzed for the presence of
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0 by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the
c I also certify that I have informed the owner/operator of the facility or the demolition contractor that any
n o -containing material allowed to stay in the facility must remain non -friable during demolition. Specify type(s)
emaining, below: (check appropriate box(es)):
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Q asbestos floor tile (VAT) ❑ VAT mastic ❑Tar/asphalt impregnated roofing ❑Asphaltic pipe coatings
a U -applie ngs ❑Caulking ❑Glazing ❑Other, specify:
T) Signature: (In nk) Printed Name: /
d
U Date o Fina I on C Cert # Expiration Da Telephone # Cell Phon
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I ver at all refrigerants from air conditioning/fe tiger tion appliances have been properly recovered in accordance with AQCC RegulationNo.
15 (for information on CFC requirements call 692-3100). 1 further verify that all luminous exit signs (containing radioactive material) have been
O` disposed of in accordance with 6 CCR 1007-1 subpart 3.6.4.3 (for information on luminous exit sign requirements call 303-692-3320).
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L CHECK THE APPROPRIATE BOX:
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U U ❑ Building Ovmer Q Contractor ❑ Other Dale: O b l p
Signature: Print Na``�e��
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THIS Box IS FOR CDPHE U Nor:
Postmark or Hand Delivery Date: �� Approved By: Code: initial -310 ❑transfer -360
Form of Payment & #:
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` Regulated asbestos -containing materi Is means (a) friable asbestos -containing material, (b) Cateoory I nonfriable ACM that has become friable, (c)
Category I nonfriable ACM that vrill be or has been subjected to sanding, rindin cuttinc, or abrading or (d) Cateoory II nonfriable ACM that has a %W9
probability of becoming or has become crumbled, pulverized or edce�J kokpotvder by the forces expected to act on the material in the course of(F�� 0
demolition or renovation operations regulated by this re`1 oar. tet/Asbest ont rnmg sheet vinyl and linoleum must be properly ��1
abated/removed prior to demolition. �' I�z(/ Z OPHE
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