HomeMy WebLinkAboutFile Documents.1130 Black Birch Dr.0096.2018 (4).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 properlynotified the
Colorado Department of Public Health and Enviromnent pursuant to Regulation No. 8, Part B.
As a contractor, you may 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.
Innnediately notify the Asbestos/IAQ Utiit of project n:odifieatimas by fax (number above) ore -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 begimiing 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: 141760
Notice Number: 18PI6045D
For the location specified below:
House Structure
1130 Black Birch Dr.
Aspen
Pitkin County
This notice has been issued to:
Koru, Ltd.
417 Main St. Suite Y
Carbondale, CO 81623
Fee Paid: $65.00
Check number: 1967
Asbestos Building Inspector:
Douglas A. Close
Cerification No.: 2930
Inspection Date: 11/27/2017
Issued by: JW
(1
and Environment
o`
U
W
CL
N
C O
0.0
O +
to U
d w
at
Q�
a Z'
r
U
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)
00
Fee: $50 + $5 per 1000 ft2 of area to be demolished = $ (nS
(See instruction #1 on reverse side)
3 v5J1-
) 3(�
Projectanager: Cell Phone#
i I certify that the Cedked Nsbeslos Building Inspector has informed me
about any remaining asbestos -containing materials in the facility to be
General Abatement Contractor (GAC)
CDPHE Asbestos Permit # I Total OLantity, of Asbestos Removed
Date Removal Completed I Telephone #
Type(s) of Asbestos -Containing Material Removed:
w
0
O
dl
❑
Submit form to:
Permit Coordinator
Colorado Dept. of Public
Health and Environment
APCD-IE-Bt
4300 Cherry Creek Drive
South
Denver, CO 80246-1530
Phone: 303-692-3100
Fax: 303.782-0278
Asbestos@state.co.us
Building Name:
Square footage or footpprint or la5typrpodion oflac ky to be demolished
Street:/I30 U/C/VVr``k`Jk00
Dale
1�1 Wrecking ❑Burning E] implosion Q Moving C] Other, specify:
+Burning requires additional authorization - Please call (303) 692-3100 and ask
7SVeet
O en Burning Permit Coordinator
:
1 _ Stale: Zip Code:
Contact's Name:
F%V,l`TfL�w a
#
With my signature below, I certify that I possess current AHERA accreditation and state of Colorado certification as
an Asbestos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed
in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the presence of
asbestos by a-NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the
facility.' I also certify that I have informed the owner/operator of the facility or the demolition contractor that any
asbestos -containing material allowed to stay in the facility must remain non -friable during demolition. Specify type(s)
of ACM remaining, below: (check appropriate box(es)):
Vinyl asbestos floor tile (VAT) ❑ VAT mastic ❑ Tar/asphalt
N
roofing ❑ Asphaltic pipe coatings
20 S S
I verify that MI refrigerants troth air coniuuomnyneniycidrwn dpPucnwo tl VVr ,----•-•-- ----
15 (for information on CFC requirements call 692-3100). 1 further verify that all luminous exit signs (containing radioactive material) have been
p p 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).
G O CHECK THE APPROPRIATE BOX:
❑ b3 Ib �$
to O Q ❑ Building Owner Contractor Other Date:
U Signature: Print Nam
THIS BOX Is FOR CDPHE USE ONLY:
Poet, mirk or Hand Delivery Date: Approved By: Code: initial -310 L] transfer -380
>
Form of Payment & #: - ��� �5 pt/ P t _ Record # ate Issued:
`Regulated asbestos -containing material means (a) friable asbestos -containing material, (b) Category I nonfriable ACM that has become friable, (c)�,�
Category I nonfriable ACM that will be or has been subjected to sanding, grinding, cutting, or abrading or (d) Category II nonfriable ACM that ha�,ss,,�"{11tdh ,0
probability of becoming or has become crumbled, ulverized, or-repd t0�prros�der� y -t force expected to act on the material in the cours4 ,LQ
demolition or renovation operations regulated by this regulatio( bN_N �j7Cs4yesi�s(-ps aih�ing sheet vinyl and linoleum must be properly
abated/removed prior to demolition. PH QC��
ci^i�O<ce1