Document g1Voam58KQjZzO89vz1RGGL3

**8 002169 GRACE Policy and OrganizationGuide Asbestos Action Notification Information 1. Date of notification <3C,r~c><3/Z. 2 /*??/ /o $ g- 2. Group *- c/wD a cwt<*>, r 3* Division ^ " rr. /<a.ry 4. Facility involved a. *m*> -r C s**. & b. street address ^*3 c. city a, /v r 0 , w d. county /sj ct <?. ^ _ >c. e. state />* a rr. f. country ^ g. postal code oiai/ X -vc'. S*r 9EXHIBITMb S. Facility Manager a. name two^^r -77 b. business phone number ~ &jl&- $3*0 -< /J"7 6. Primary Contact a. namf C/ J. b. business phone number 6/7 - 8z& - c. facsimile phone number 7 .. gzg - J/c>v * <->/ 7. Type of material--check all applicable: a. Rteproofiag b. Boiler insulation c. Pipe insulation d. Corrugated siding ; shinties agPtatc j g. Ceiling tiles h. Floor dies L Wallboerd j. Other ___ .8 Location within facility 3^,<_?//</ ! ^2 9. Approximate date of installation (if brown) 003196 10. Approximate quantity/extent of material /(J< /t?' 11. Present condition; description of inspection/testing to date Cj sfs*2* AX. ** J Do*"* A/^/Q 12. Action is (check one): not yet commenced, in progress, completed, rot recommended /At P*lO&*6f$ C'lO^ 13. Description of scope and cost of action taken/ploaned to be taker. BL4r**0& P*~*.Srf<.fArQt\'rt< 4/V0 PslAtH' 14. Date(s) action taken/plaxuted to be taken S//3&/9/ 15. Reason(s) for action (check-off with added description): a. Product performance failure b. Quality/appearance deterioration c. Replacement of machinery d. Building demolition e. Renovation (ACM removal mandatory) \ f. Renovation (ACM removal optional) g. Emergency repair oP A' f, 16. Other evidence attached (e.g. photographs, inspection reports, test results, etc.) 17. Contractor(s) involved (name, address, phone, function of each) * < /. es*t?/A <_ P. o. 3o< 2-0^ *J ozsb? 003197