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Puget Sound Clean Air Ager+cy <br /> '' ' 110 Un�on Street, �uile 500 <br /> �~� Seattle, WA 98101 -2038 <br /> _- _ — — phone 206-343-880011 -800-552-3565 <br /> fax 206-343-7522 www.pscleanair.org <br /> Asbestos Inspection Form <br /> Cnse Nu: 300>00093 DatelTime: 9-27-0�/ 3:25pm Inspector. RDH <br /> Locatiun: 331 G Oakcs ,\�c S[, [�crett. \\'A 9S'_O1 <br /> Person(s) contacted: <br /> \�A\1G:\�D ADDR[SS TITLG :IVD PHONI3 \U\113ER AFFILI:\TIO\ <br /> Andrew and Demarie Property Owner Hired Jim Carpenter under <br /> Werth Andrew cell- 425-327-6613 contract to perform partial <br /> 3503 Hoyt Ave Andrew work- 425-349-6441 demolition <br /> Everett, WA 98210 Demarie work- 425-252-0486 <br /> Lawrence Daly Laborer, 425-252-3646 will Hired by Jim Carpenter to <br /> '215 Oakes Ave have cell phone on 10-1-05. remove materials from <br /> Everett, WA 98201 W�II advise Agency of new both the interior and <br /> cell phone number. exterior of structure <br /> Christopher McCourt Laborer, 425-258-6412 Hired by Jim Carpenter to <br /> 3402 Rucker Ave remove materials from <br /> both the interior and <br /> Everett exterior of structure <br /> Jim Carpenter Contractor, 425-252-2828 Hired under contract by <br /> 566 Moe Rd Werths to perform a partial <br /> demolition of structure at <br /> Camano Island, WA 3216 Oakes, Everett. <br /> 98282-8548 Removed CAB from <br /> structure w/o certified <br /> 3501 Hoyt Ave workers, multiple work <br /> Everett, WA 98201 practice violations. <br /> han�louts givcn: no persons on sitc <br /> asbesros survey present and complete? Yes ❑ No � N/A ❑ <br /> nutific�tion present:' Yes ❑ No � Checked Agency database using Candi <br /> eniering 2316 and Oakes, no record of <br /> asbestos notiFication filed <br /> obscr�ations/work practiccs <br /> r„��.�„ �,��-i.u.i i _�u� ��iu <br />