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HomeMy WebLinkAboutFile Documents.1130 Black Birch Dr.0096.2018 (52).ARBK Colorado 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 1EMOLITIONAPPROVAL Ned TICS This approval notice is granted subject to Colorado Air.Quality Control.Comnmission 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. (25-7-1;0.1 and 25-7-501 et seq). This notice signifies that the structure was inspected foriasbestos, luminous exit signs (containing radioactive material), and Ozone-Depleting Refrigerants`and the`demolition`contractor has properly notified the Colorado Department of Public,Health.and Enviromnent pursuant to Regulation No. 8,Part B. • As a contractor, you may be subject,to other.deinolition licenses andpermits, depending on the requirements.of the county and municipality in,which the,work is being performed. The Colorado Departrnent of Public Health and Environment,Au Pollution'Control Division, strongly suggests that you check with county and municipal authorities.in`ordei•to'determine any other local building/permitting requirements that must.be net. Please note that certain asbestos-containing'nlaterials (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 by fax(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: 141760 Fee Paid: $65.00 Notice Number: 18PI6045D Check number: 1967 For the location specified below: Asbestos Building Inspector: House Structure Douglas A. Close Cerification No.: 2930 1130 Black Birch Dr. Aspen Pitkin County Inspection Date: 11/27/2017 This notice has been issued to: Koru,Ltd. 417 Main St. Suite Y Carbondale,CO 81623 Issued by: JW J / Ii Submit form to: Permit Coordinator ° DEMOLITION NOTIFICATION APPLICATION FORMColorado Dept.of Public ;• Health and Environment >F APPLICATION FEE MUST ACCOMPANY THIS FORM APCD-IE•81 ' s* _ INCOMPLETE APPLICATIONS WILL BE RETURNED 4300 Cherry Creek Drive South uolorado Department (Notice will be mailed to the demolition.contractor unless specified otherwise) Denver,CO 80 246-1 53 0 of Public Health Phone:303-692-3100 0� Fax: 303.782-0278 and Environment Fee: $50 + $5 per 1000 ft2 of area to be demolished = $ �or7 Asbestos@state.co.us (See instruction#1 on reverse side) gramomassuirm!w Company Name: , i building Name: ill-OU ? r1,tGrC Street Square footage of footprint o f tyAor ortion ofacilit�be demolished Ci State: Zip Code: Street: 0 C{ i. t4aAir t^� CS 1130 /zc'k Et rAv' ''' Telephone# Fax# U) City Count , Zi Code: E� ) V163 . OC41. (TN ) (136. `130 p e i ii d-/ j 0 P posed-St dIB Prop ion Date Project anager: Cell Phone# w ‘,,'7)=0,1)�1 0.® 1LA,.ka�k ) 214• i _`1_ o \h���� , I•�oarAcyAf3v, . I certify that the Certi ed Asbestos Building Inspector has informed me c tv thr.4/Means of De4litiaa! o about any remaining asbestos-containing materials in the facility to be E demolished. ' ]wrecking Q Burning.' O Implosion 0 Moving ©Other,specify_ 0 s(gna j P mtName: r\ Ari/Y.A.4 . Landfill Receiving ilding Debris: +Burning requires additional authorization-Please call(303)692-3100 and ask / j/n l �V' to speak to the Open Burning Permit Coordinator General Abatement Contractor GAC Owner's Name: O cb -, CDPHE Asbestos Permit# total( ',enlihy oofAsbestos Removed O Street: ` �/ t�r F� ��'‘ N O RI Vito SJ t. E)F Slate: Zip Code: O FCO 0 Date Removal Completed Telephone# City: WO ,��` 4.6 • Type(s)of Asbestos-Containing Material Removed: m Contacts• Name: Telephone# . I 15c1N1V2S-ANI 'D lt_t~Ol 1 (1)(5 ) 31U,` t>Bo 1 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 5 in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the presence of Q- asbestos by a-NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the le C facility.* I also certify that I have informed the owner/operator of the facility or the demolition contractor that any 0 o asbestos-containing material allowed to stay in the facility must remain non-friable during demolition. Specify type(s) N '-tis, of ACM remaining, below: (check appropriate box(es)): ca • ut I El Vinyl asbestos floor tile(VAT)❑VAT mastic❑ Tar/asphalt impregnated roofing ❑ Asphaltic pipe coatings Q 0 ❑ Spray-applied tar coatings❑ Caulking❑ Glazing ❑ Other, specify: -- .__ Signature:(in Blue Ink) Printed Name: 4 47_ 5 4i._ (765, . 7 U Date Of final Ins 7 CO Ce3 0 Expiration I--c— /1 g Telephone#(970 ) 7`c) 33 i Ce',Pho(e�Q ) ��O f li 1 veri y that !refrigerants from air conditioning/refrigeration appliances have been properly recovered in accordance with AQCC Regulation No. 15(for information on CFC requirements call 692-3100).1 further verify that all luminous exit signs(containing radioactive material)have been o 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). :Oa— m Ei CHECK THE APPROPRIATE BOX: a � 63 . 16, l•a mO c ❑ Building Owner Rs. Contractor Other Date: U Signature: _ V+ Print Na mT • 2 ! _ _ _.. Ak....,„....... r .„.....xd^�Y Y,H' . :...4.„ .a-gf< . aL+ THIS BOX IS FOR CDPHE USE ONLY: Pmlrk or Hand Delivery Date: i, By yj Approved By: 7, L Code: initial-310 ❑transfer-3.80 • Form of Payment&#: 1�U, }- 6(07 / 0 EL/ P i - _ Record# ate Issued: 'Regulated asbestos-containing material means(a)friable asbestos-containing material,())Category I nonfriable ACM that has become friable, (c),1 ,9 Category I nonfriable ACM that will be or has been subjected to sanding,grinding,cutting,or abrading or(d)Category Il nonfriable ACM that hat'(141-1 probability of becomingor has become crumbled,pulverized,or r d ce teipoo derr y-t e�forces expected to act on the material in the courseBf e P Y P � �11��'7C' � �a• .'� ,� ��1 demolition or renovation operations regulated by this re uiatio{�4 N t , s st4f-g_:) ai ing�et vinyl and linoleum must be properly �� '\ abated/removed prior to demolition. t E � /4 CDPHE _ p.4C��`