HomeMy WebLinkAbout170 Kensington Dr - Correspondence/Demolition - 06/25/2015Colorado Department of Public Health and Environment
Air Pollution Control Division — Indoor Environment Program — Asbestos/IAQ Air Unit
4300 Cherry Creek Drive South, APCD-IE-I31
Denver, Colorado
Phone: 303-692-3100 —Fax:ax: 303-783-782-0278 `7
E-mail: asbestos@state.co.us
DEMOL
This approval notice is g:
No. 8, Part B, adopted D,
Pollution Prevention and
that the structure was ins
and Ozone -Depleting Re
Colorado Department of.
As a contractor, you r.
requirements of the cc
Department of Public
that you check with ci
building/permitting rc
ibject,tciC.olorado:A
21`; 2007aid effec
cted for<•ash'estos loin"iri
ge ants andhe-demoliti
iblic`Health<and•`Env cor
e% to other de no
and'inuriicipolityin whi
th and :Erivir6hment. Aii
Please note that certain asbestos-co.ntal,
during demolition. Therefore, an3lo
demolition site cleanup may constitute:
the site, subject to the requirements of
1007-2, Part 1).
'°OVAL NOTICE
Quality. Control Commission Regulation
*7arivary 30; 20:0:8 and the Colorado Air
arid25;-..75,01 et'seq). This notice signifies
pxif sigi .'(containing, radioactive material),
_...
ontraetorlas properly, notified the
it pursuant to;.Regulation No. 8, Part B.
licenses'a icl=perrriits, ,=depending on the
,,,.. ..
a6:work;is b;ein performed. The Colorado
lut'ion`;Coritrol Divisign, strongly suggests
c iri�er tni' ie rmineanv other local
ig>materias'(AC1bL) may'remain in the structure
tion debris'.left`.beliinil after the completion of post-
reasom to ki<aow.-of asbestos -contaminated soil' at
:t bn` dfdf-the Solid Waste Regulations (6 CCR
THE ORIGINAL APPROVAL NOTICE MUST BE POSTED ON SITE AT ALL TIMES.
Immediately notify the AsbestosIL4Q 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 6/29/2015.
The actual scheduled work dates are from 6/29/2015 . through 8/3.1/2015. -
Approval issued on: 6/25/2015
Record number: 108782 Fee Paid: $60.00
Notice Number: 15LR3558D Check number: 6081164/CC3032
For the location specified below:
Office with Apartment
170 Kensington
Ft. Collins
Larimer County
This notice has been issued to:
Dunrite Excavating
21506 WCR 1
Berthoud, CO 80513
Asbestos Building Inspector:
Andrew Dunnell
Cerification No.: 15895
Inspection Date: 05/05/2015
Ql�__
T
Issued by: RK
'}s •r
�• . lAy 7
Colorado Department
of Public Health
and Environment
DEMOLITION NOTIFICATIION APPLICATION FORM
APPLICATION FEE MUST ACCOMPANY THIS FORM
INCOMPLETE APPLICATIONS WILL BE RETURNED
(Notice will be mailed to the demolition contractor unless specled oWvise)
Fee: $50 + $5 per 1000 ft2 of area to be demolished = $-5&64-
(See Instruction #1 on reverse side)
21506 WCR I
State: Z,p Code:
CO 80513
Fax 9
about any remaining asbestos-cantainin0 mate als Inr1a5sniormea me
the facility to bo
demolished.
Contractor (GAC)
Asbestos Removed
Completed I Tetephoneif
o!Pbeslos-Containing fdaleda! Removed:
E
3
O
CI
6
M
submit form 107
Permit Cocrdlnator
Colorado Dept. of Public
Health and Environment
APCD-IE-Bi
4300 Cherry Creels Drive
South
Denvar. CO 80246-1530
Phone:303-692.3100
Fax: 303-782.0278
Asbestas@stnte.co.us
building Name: Office with Apartment
Square footage Of faolpdnt Of f'forlllty or portion of
1127 SOFT
170
19
80525
0 wrecking ❑ Burning' 13 Imp!asion 13 h4oving El Other, specify-.
tSurn!ng requlr,
to sneak to the
owner's Name:
Street
City:
additional authorization — Please catl (303) 692-3100 and ask
Ft, Collins
Contact's Name:
Mark Pederson
Stale: 21p Code:
CID 1 80525
Mark Pederson 1 (970) 222-1605
With my signature below, I certify that I possess current AHERA accreditation and state of Colorado certification as
`o an Asbestos Building Inspector. I also certify that I have thoroughly inspected the facility to be demolished, as listed
0 1 in the Demolition Site block above, sampled all suspect materials, had all samples analyzed for the presence of
in
C asbestos by a NVLAP-accredited laboratory, and have determined that no Regulated ACM exists anywhere in the
C facility.* I also certify that I have infonned the owner/operator of the facility or the demolition contractor that any
(ao asbestos -containing material allowed to stay in the facility must remain non -friable during demolition. Specify type(s)
w I of ACM remaining, below: (check appropriate box(es)):
❑ Vinyl asbestos floor tile (VAT) ❑ VAT mastic ❑ Tar/asphalt Impregnated roofrn
ElSpray-applied tar coatings ❑ Caulkinnk) 9 El Asphaltic pipe coatings
4 signature: pn ema I-g ❑ Glazing Q Other, specify:
_ 1 Printed fJanto'
V
d 'l �— Andrew E. Dunnell
Date of Final InspeUlon I Co Can # Expiratfch 5010 Tolo 11 hone
05/05/2015 1 15895 I 10/14/2015 I p roam ��o LOAr. Cell Fhone #- -
L
C OL U
•pa`
to
Ov
15 (for information on CFC requirements call 692-310(
disposed of in accordance with 6 CCR 1007-1 subpart
CHECK THE APPROPRIATE BOX:
❑ Building Ownor
"ostmark or Hand Delivery Date:
u1Uuu[1 1,
er verify that all luminous exit signs (containing radioactive material) have been
(for information on luminous exit sign requirements call 303-692-3320).
® Contractor ❑ Other
Fri t
THIS SOx Is FOR CDPH
Approved By: ..
ortn of Payment & #: C.K (.e,C`� I ((C,.1 /38 ill
Dute: 6/15/2015
Code:
Record # Date Issued:
(?r1Taa7
Pughfirip-
transfer•380
-a ........ une,nung materials means (a) Indble esbesles-cnnlafninn materla', b ACM that has become Triable, (c)
of I nonhiable ACM that vrill be or has been subjected to sandin nn t () �ateooty I nonfriabts
probability of becoming or has become crumbled, pulverized• or reduced I�wder by a forces expor ectedor dt)o act an material 11 in hele hcourse of a high
m II i n or renovation operations regulated by this regulation. Note: Asbestos -containing sheet vinyl and linoleum must be property
abated/removed prior to demolition.
DATE �j z-`►/_ CDPHF_�