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Puget Sound Cl�an Air Agency <br /> • � y���,•_-,•. ,, 110 Union Slreet, Suile 500 <br /> � --�"�i Sealtle, WA 98101 -2038 <br /> -- - — phune 206-343-8800/t -800-552-3565 <br /> fax 206-343-7522 www•pscleanair.org <br /> Asbestos Inspection Form <br /> Cas� No: ?00500093 Date�Time: 9-27-OS/ 325pm Inspector. RDH <br /> Location: 3216 Oakes Ave SG G�erett. «'A 9S_'O1 <br /> Persun(s) contactcd: <br /> NA�1G :\ND ADDRGSS TITLH :��D PHONE VU\1E3HR APFILIATION <br /> Andrew and Demarie PropeRy Owner Hired Jim Carpenter under <br /> Werth Andrew ceil- 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 /> 3215 Oakes Ave have cell phone on 10-1-05. remove materials from <br /> Everett, WA 98201 Will advise Agen�y 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 st�ucture at <br /> Camano Island, WA 3216 Oakes, Everett. <br /> g8282-8548 Removed CAB from <br /> structure w/o certified <br /> 3501 Hoyt Ave workers, multiple work <br /> Everett, WA 98201 practice violations. <br /> handouts eiven: no persons on sitc <br /> asbestos survey present and complete? Yes ❑ No � N/A ❑ <br /> notification present? Yes ❑ No � Checked Agency database using Candi <br /> entering 2316 and Oakes, no record of <br /> asbestos notification filed <br /> oUscn ationshvork practices <br /> I'��rtn\o nr,.111-I I '_'US V71) <br />