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Sep 29 2005 3: 24PM WRLKER SPECIflLTY COnST 4258�67383 P• 2 <br /> PUGE'P SOUND CL[AT �1R AGFKCI' Date Recci�'ed <br /> Agenry Casc No. ��p�;���n Svcct.Suitc 5��0 <br /> Scaitic.WA 95101=U3R <br /> �!:;� <br /> .`,,.,fL':�i� �v���v.pscleanair.org <br /> ^�•aa�`�e \OTIC'F. OF IMTEi�T .ax<•,,,rr;,�o,�l,� <br /> as.�„�� u.,�o»rr - <br /> 1 YroJcct 7�pc I 1 0 Asbcstov Rcntuvnl ❑ Asbestos Rcmmal S Demolition 3 ❑ Dcmolilion.?10 Asbes[os Remm'al <br /> H. Phonc: -135-327-6G13 <br /> Pro crq• ONncr: DC�nariC Vdcrth <br /> Cit �: Lverett <br /> State WA 98201 <br /> �tailinc Address: 3503 Hoct Avcnue <br /> C. Asbcstar r.t;+. .�:���v �.�-�nu: .vr:u .nn v axFasa. �uu.�., - - Own:dCLO: Bill �ValkCf <br /> Contractor: WALKFRSPLCI�I:►1`CONSTRUCI'ION, INC. Con!ractor <br /> Phone: ('_061361-S91i ]ob No.: <br /> Mailing Address: PO BOX 469 <br /> Cit �: SNOHOh11SH Statc: \VA 7_i : 9R291-0469 r:uu: (425 8U6-7383 A3402 <br /> u. Sitc Citv Everctt 98201 <br /> Address: 3216 Oakcs A�'e <br /> Sitc Local Phonc 4251 327-G613 <br /> A4anuecr: Demnric Werth <br /> �;1�C ASI)C5�05 SUfYC\' 1Yus Ashestos Pnwid? �Yes <br /> F, ;�sbcctos Surccy or No. of� 1 ❑ 1(No Att+d�survev <br /> Q p1aC� Prcsumed Structures was Conducted: ��'1 <br /> Na ufSwctm'cs Sun'e}'ed: <br /> (Attnch ma if multi le unitsl <br /> AI IERA Auildin� lus cctor: <br /> Ea�. Da:e Siale: WA <br /> C:crtificatiun No.: <br /> �� ��- �, Trnining Pire(List Pire Dept.i <br /> F. Ucmoli�ion Start 5�mctures 2. ❑ Ordered Ucmolition(attach copy a('Order) <br /> Infurmation: Date <br /> llcmolilion P11017C <br /> Contractor. <br /> �Vork Da)'s: �7 T \V 'Pf F Sa Su <br /> G, Aslxsins Yruject <br /> Inl'ormnUon: Start Da�e: 09/30/OS Completion Da�c: 9/3Ui05 Nouaf StrucmresSu�rveyzd <br /> S uaro Ft 45 SP Actach ma ifnwlti Ic units <br /> Tolal Qn•. lo be Rcmo�•ed: Lincar Pt. � icces%dcbris I in on round <br /> Thcnu�d Syslcm Insulation: Uoilcr\Pun:acc Ins. »��=���ti� ����''�°' a puncl l ouse�`c.,�rimetcr Y � � <br /> $utfacing Mnl'l: 1'ircprooting Prmta Platicr l'c�lured Coatings ���''.�r <br /> �1isc. �da:'I 0 Cen�ent 13d. Ce:ncn;1'ipe Pciahlc Flooring or liuofinF hlat'I <br /> Olhcr <br /> H. AsbestosNe+nolitinn PraJcct Cntegorics: NoNfication Pcriod Proicct F���0�� <br /> S 25 Non-Refundablc <br /> I. Singlc-Family Kesidence:(Check box A b Il fnr asbestos remov:d S;,demolition) n prior?lotice 1'ee Co�crs Asbestos <br /> A. �7Asbeslos Removal Yrnject B. 10 Davs Removai K Dcmolition <br /> 13. ❑ Dcmnlition Pro'cct 10 Dovs 5150 <br /> � U All Othcr Dcmnlitions Wi11i No Asbcstos Retnuval Pro'cct Yriurhoucc �15� <br /> ;. > �p -259 linear feel ur>JR- I Sy s uarc 1'ect of asbestos sec 6ack �0 Davs F300 <br /> 4. '_60-999 line�r tccl or l60-4.999 s uare (ect of s+bestos ��n� ,S 5750 <br /> 5 � ppp _y,999 lincar feM er 5.000 -�19,999 s uare feri ol'nsbestas 'p D�vl g?.000 <br /> ti. ;� 10.000 linc.+r feet or>50.000 s u•sre feei ot':+sbestos Yrior Nwice T�cice Pro'oct Y'ec <br /> 7. �U F.mer�encv AsUestos Prn'ec�or Emer enc � Drniolition Pro'ect <br /> 1. I du hacbyµ����7�hat C�c m(�numien cunuuned in this nulificotion fi a�pplen!ent¢I du:�JescriFed hercin is,to J�e best of my Ageney Use Only <br /> knowlc�lgc,accmatc R�����pl�tc. <br /> �'�� +� _ Walkcr Snccialtv Constrpction,Inc. 09/29/OS <br /> \ Oafc Rc���eerd Rr <br /> J A ! (!rprtser.linA• <br /> pSANGA P:irtn No.6fi46p IHcvi+rd 9;Oi'i.Aht <br />