Enter the name of the owner of the facility, the owner's mailing address including box number, street, city, state, zip code, contact name and telephone number. Complete the building name for the facility to be renovated or demolished, the physical address including street number, street name, city, state, and county. Complete building size in square feet, number of floors in the building, the age of the building, and its present and prior use. Where demolition of the facility immediately follows the removal of ACM, complete the demolition contractor's name, mailing address including box number, street, city, state, zip code, contact name and telephone number. Enter the approximate estimated amount of Nonfriable Asbestos NOT to be removed.
Asbestos removal start date and complete date.
Complete the demolition start and complete date. Describe work practices. This includes asbestos removal and waste handling emission control measures. Complete the name, mailing address, including city, state, zip code, contact person and telephone number of the waste transporter contracted to transport the waste to an approved landfill. Complete the name, mailing address, including city, state, zip code, contact person and telephone number of any second waste transporter contracted to transport the waste to an approved landfill.