Document DMQry8QRZ4O34XZEnnZOkDLdo

union :ak3;:e corporation TEXAS c:TV p.ant 3' jn :ce: a : ta Orient z' NC'!C OR *NTENT10N TQ OEMCLISR SR PENCVAT; A S'R'JC'UR: PACEw ITT CONTAINING ASBESTOS MA'SRI A_ Description of the facility: A'c / /jiL ? .JZUtL* o s u. Estimate of approx-imate amount cf friable ascestos materials c.-esj^t: (Area in ft. o' ii'ear ct.) / Est'mat'cn technique used: Estimated age cf ascestos materia': Location of facility: yyy,- / yp 7 S'-?'* Sc"'e:w'ed completion cay- ,-Z ^ C/^ Nadu'S Ce c'annec demc-t i t:cn or rsnovat'on: jA /<. Z , Zl "/.... ( Method to be used (negative pressure enclosure, glove tag, et: > - j(ZName of perso.. that prepared the form: Location and telephone number: P/p / C<J- /, : r 3"y, r Date: /y~ij- ~~ NOTE: This form must be completed and delivered to the EP Department (Bi<Jg. #D at least 30 days ahead of the scheduled starting day of the plannee demolit'cn or enevat'on. or 3: vcn possi., a following an emergency rj'iovat'on operation, . April 1985/Revised November 198? UCTC 18180 Texas Air Control Board ASBESTOS DEMOLITION/RENOVATION NOTIFICATION FORM (THIS SECTION FOR TACB USE ONLY) ADD CHANGE DELETE * ASTERISKED ITEMS TO BE FILLED IN BY TECHNICAL SERVICES DISTRIBUTION Blue - Region/Local Green * Region/Local Canary - Data Entry Pink - Dept, of Health CNTY: * SOURCE: * PTNO: * APST: * TACB ACCOUNT: -- FEDERAL FACILITY: (Y/N) CMST: * NOTIFICATION RECEIVED DATE (MMDDYY): / /_____ POSTMARK: // INVESTIGATION DATE: // INVESTIGATOR STAFFCODE: INVESTIGATOR JURISCODE: ____________ INVESTIGATION TYPE: _________ NOV SENT DATE: // COMPLAINT: / / PSDB INV NO: COMPLIANCE STATUS (C,N,U): ____ _ REVIEWER: 1) Removal Contractor: Catalytic Industrial Maintenance Company Mailing Address: P. 0. Box 35 Phone:: (409) 948-5723 City: La Marque State: Texas Zip: 77568 TDH License No.: Job Site Phone: ( 409 ) 948-5723 Project Supv.: C. L. Snell TDH License No.: 2) Other Contractor: Mailing Address: n/a Phone: ( )_______________ : City: State: Zip: 3) Faci1ity Owner: Mailing Address: Union Carbide . Drporation P. 0. Box 471 Phone: (409) 945-7411 City: Texas City State: Texas Zip: 77592-0471 Principal Business:: Chemical Plant 4) Description of Facility Name: Union Carbide Corporation Address: 3301 5th Avenue South City: Texas City County: Galveston State: Texas Zip: 77590 Size: ________ sq. ft. Age: 48_ yrs. Prior Use: S3 Deaerator and storage tank 5) Demolition: X Renovation: _ Encapsulation: _ Non-Friable: 5) Noti ficat' on Type: _ Planned __ 10 Day ___ 20 C:y X__ Renovation ___ Emergency ____ Ordered Ordered By: 7) Amount Asbestos: ___ linear feet (pipes) 500_ sq. ft. (other) 8) Method of Removal: negative pressure enclosure 9) Scheduled Start Date: 01-05-90 10) Scheduled Completion Date: 01-25-90 11) Disposal Site: Gulf Coast Waste Disposal Site Address: __ Campbell Bayou Road off Loop 197___ City: Texas City County: Galveston State: Texas Zip: 775% Phone: (409) 935-4783 TDH/TWC Permit No. : 39035___ Andrew F. Jackson Industrial Hygienist i 2^14 %9 (Date) _ (409) 948-5589 (Telephone Number) APY:IW:ASC10590 UCTC 18181 Texas Air Control Board ASBESTOS DEMOLITION/RENOVATION NOTIFICATION FORM (THIS SECTION FOR TACB USE ONLY) ADO CHANGE DELETE * ASTERISKED ITEMS TO JE FILLED IN BY TECHNICAL SERVICES DISTRIBUTION Blue - Region/Local Green - Region/Local Canary - Data Entry Pink - Dept, of Health CNTY: * SOURCE: * PTNO: * APST: * TACB ACCOUNT: -- FEDERAL FACILITY: NOTIFICATION RECEIVED OATE (MMDDYY): / / (Y/N) CMST: * POSTMARK: ___ l___ / INVESTIGATION DATE: / /________ INVESTIGATOR STAFFCODE: _____ INVESTIGATOR JURISCODE: _____ INVESTIGATION TYPE: NOV SENT DATE: // COMPLAINT: / / PSDB INV NO: COMPLIANCE STATUS (C,N,U): _________ REVIEWER: 1) Removal Contractor: Catalytic Industrial Maintenance Company Mailirq Address: City: La Marque P. 0. Box 35 State: Phone:: (409) 948-5723 Texas Zip: 77568 TDH License No.: Job Site Phone: ( 409 ) 948-5723 Project Supv.: C. L. Snel 1 TDH License No.: 2) Other Contractor: Mailinq Address: City: n/a State: Phone: ( )________________ Zip: 3) Facility Owner: Mailinq Address: Union Carbide Corporation P. 0 . Box 471 Phone:: (409) 945-7411 City: Texas City State: Texas Zip: 77592-0471 Principal Business: Chemical PI ant 4) Description of Facility Name: Union Carbide Corporation Address: 3301 5th Avenue South City: Texas City County: Galveston State: Texas Zip: 77590 ize: _____ sq. ft. Age: 48_ yrs. Prior Use: Steam 1ines to and from #1 Powerhouse. 5) Demolit ion: X Renovation: Encapsulation: Non-Friable: 6) Notification Type: _ Planned _ 10 Day 20 Da\ X__ Renovation Emergency Ordered Ordered By:_________________________________________________ __ ________ 7) Amount Asbestos: 200 linear feet (pipes) ____ sq. ft. (other) S) Method of Removal: negative pressure enclosure 9) Scheduled Start Date:__ 01-20-90 ` 10) Scheduled Completion Date: 02-20-90 Disposal Site: Gulf Coast Waste Disposal Site_ Address: County: Campbell Bayou Road off Loop 197 Galveston State: _____ Texas City: Zip: Jexas_Citv 7 7 590 Phone: 935-4783 TDH/TWC Permit No.: 39036 Oa A. Andrew F. Jadkson Industrial Hygienist 12-14-39 (Date) (409) 948^5589 (Telephone Number) APY:IW:AS012090 UCTC 18183 JhN I'd '30 1!:I4 FROM K I MM I NS -r-lOUS TON Texas Air Control Board ASBESTOS DEMOLITION/RHNC ATION NOTIFICATION FORM PhGc . >302 ADD I |CHANGE DELETE (THIS SECTION FOR TACB USE ONLY) DISTRIBUTION Blue - Region/Local ASTERISKED ITEMS TO BE FILLED GtSen " R^^zon/Loosl IN BY TECHNICAL SERVICES Canary - Data Entry Pink - Dept, of Health . * cAiiDfp. * TACB'ACCOUNT: ____--__ PTNO t * APST: * FEDERAL FACILITY: ___(Y/N) CMST: * NOTIFICATION RECEIVED DATE (MMDDYY) :____/ /____ POSTMARK:____/ ~"7 INVESTIGATION DATE:____/____ /___ INVESTIGATOR STAFFCODE: ________ INVESTIGATOR JURISCODE: _________ INVESTIGATION TYPE: _ NOV SENT DATE:____/ / COMPLAINT:____/ /___ PSDB INV NO: ____ COMPLIANCE STATUS (C,N,U): ___ _ REVIEWER:____________________ ____________ 1) r'emoval Centractor:_Kimmitis Abatement Corp. Mailing Address: 3555 Timiaons , Suite 1250 City: Hocston. S fca _ : tx Phone: (713 ) 623-0282 _Zip:_7_Z'32_7 TDH License No.: 80-0053 Pro}ect supv. : Linda Francis Job Site Phone:(____ ) iuH license no. : i ri 2) Other Contractor:______ Mailing Address:______ _Fhone: (_ City State: ____ _Zip:^ 3) Facility Owner: Union Carbide Coi-p. Mailing Address: p.o. Box 8361 Phone: ( 304 ) -3-4 7 1 City: South Charleston State: wv Zip: 25303 Principal Business: Petro-Chenical Manufac \z Facility 4) Description of Facility Name: Union Carbide Texas City Plant /Address: p.o. Box 4 7 1___________________________ _Clty: _Tgx3.5 . City County: Gal vase on,S tate: tx_ Size:sq.ft. Age: 5Q yrs. Zip: 7 7 59,2 Prior Use: ________________________ 5) Demolition: _x_ Renovation: ____ Encapsulation: ___ 6) Notification Type: _____ Planned x 10 Day Renovation ____ Emerg /icy _____ Ordered Non-Friable: _____ 2 0 Day Ordered By: ______________ 7) Amu .nt Asbestos: 9500. linear feet (pipes) ___ 3) /Method Of Removal: Glover Sag with Secondary Enelosu: sq.ft. (other) Double Bagged,___ end. Trlr._____________________________________ 3) Sch -.duled Start Date: 01 / 18 / 90 10) Scheduled Completion Date: 11) Disposal Site: Gulf Coast Was: r Di no-sal Address: !60G Cambdl Hav<`u Rd City: ~exas Citv County: r-dv^i- State: tx Zip: 7d9u Phone: ( ) bid- TDH/TWC Permit No: HWV i (Signature, Title of Contact) 0 1 <'03/90 (Date) I 31 62 7-0282 (Telephone Number) ACB-99 UCTC 18185