Document jyMyRqLv5v724G698wyj901ek

4 4 Ik/V 10002 TEXAS DEPARTMENT OF HEALTH DEMOLITION / RENOVATION NOTIFICATION FORM NOTE: CIRCLE ITEMS THAT ARE AMENDED. NOTIFICATION# TDH 1) Abatement Contractor Harla S.o.utluiesiJta.cTDH License Number 8(1-0055 Address: j6l3.8_Xa.quiWayCity: El Paso State: TXZip: .79925 Office Phone Number: 1915). 772-8181 Job Site Phone Numberf ') N/A_____________ Site Supervisor . TDH License Number: 80-3154 Site Supervise' . . TDH License Number. 80-3789 ,,________ ___ Trained On-Site NESHAP Individual:____N/A____________ Certification Date:_NZA Demolition Contractor N/A , .......Office Phone Number( ) N/A Address: N/A.City: ` N/AState: N/A 2ip: . N/A 2) Project Consultant or Operator: Sun Ci I License Number - iQ-non City:___ El Pam . State: JX Zip: 79902 Office Phone Number: (.9-15) 533-8840 3) Facility Owner: ...Asarco Incorporate ...________ Attention: Peggy Munsell___________________________________________ !____________ Mailing Address: P.O. Bor lltl . ............ City:. El Paso State: TX Zip 79999 Owner Phone Number: ms) 521-3640 4) Description or Facility Name: Power House BldgVRcvcrb Physical Address: 2301W. Eaisano__________________ County: Et Paso. .. City:___ El Paso................. ... Zip: 79922 Facility Phone Number: (914)441-1800 _____ Facility Contact Person: . .Peggy Munsell Description of Area/Room Number: Througho.ut.JBMg Prior Use: Power House\ReverbFuture Use: Power Housc\Rcvcrb Age of Building/Facility: 77Xra__ Size: is.nnfte f. School (K-12): DYES [x] NO Number of Floors: 2 Story 5) Type of Work: Q Demolition [x] Renovation (Abatement) Annual Consolidated Work will be during: [x] Day Evening Night Description ofwork schedule: Mondny- Friday S:00 to 5:0ft p.m. Phased Project .... v 6) Is this a Public Building? YES [xj NO Federal Facility? YES [x] NO Industrial Site? [x] YES NO NESHAP-Oniy Facility? [x]YES NO Is Building/Facility Occupied? YES [xj NO 7) Notification Type CHECK ONLY ONE [x] Original (10 Working Days) Cancellation Amendment Emergency/Ordered If this is an amendment which amendment number is this? N/A (Enclose copy of original) If an emergency, who did you talk with at TDH? nmEmergency# "n/a .. Date and Hour of Emergency (HH/MM/DD/YY):n/a ___________________ _!1 Description of the sudden, unexpected event and explanation of how the event caused unsafe conditions or would cause equipment damage (computers, machinery, etc.): N/A ------------------------------ 6) Description of procedures to be followed in the event that unexpected asbestos is found or previously, non-ffiable asbestos material becomes crumbled, pulverized, or reduced to powder: _AJ&tcd.*rea will be immediately restricted.with barrier tapes sing and poly. ACM will be cleaned np by.Hepa Xac*And wet wiped. Air monitoring will be.indicatcd. Local authorities to he contorted.______________________________ . 9) Was an Asbestos survey performed? [x] YES NO Date: .04/28./39.. TDH Inspector License No:._ 60-1889. Analytical ethod: [xj PLM TEM Assumed TDH Laboratory License No: 3MM1-- (ForTAHPA (public building) projects: an assumption must be made by a TDH Licensed Inspector) 10) Description of planned demolition or renovation work, type of material, and method(s) to be used: Abate ACM pipe ftwwlaffan & pipe insulation using appropriate Methods & procedure replace with NON-ACM,------------------ ) Description of work practices and engineering controls to be used to prevent emissions of asbestos at the ASARCO ELP 0013122 oemoiraon/renovation site: --Ana-restricted, full containment with negative pressure, wet removal methods. HF.PA veenm 12) ALL applicable items in the following table must be completed: IF NO ASBESTOS PRESENT CHECK HERE Asbestos-Containing Building Material Type RACM to be removed RACM NOT removed Interior Category t non-friable removed Exterior Category 1 non-friable removed Category 1 non-friable NOT removed Interior Category II non-friable removed Exterior Category II non-friabie removed Category II non-friable NOT removed RACM Off-Facility Component Approximate amount of Asbestos Pipes 3,500 Surface Area 800 1 Check unit of measurement FiLn Ln SQ 1 SQ Ft M i Ft i M Ft M 1 XX XX _ 1sr- * * a 1 Hz P wr*.r-'-*:-- . 1 * -| i -1 l Ikjbl/yK'.itI.V4-.<*. nl Mi inm 3) Waste Transporter Name: DARLA Southwest! fNC. TDH License Number 40-0117 Address: 6138Ya<puJYai!________ City:ELPnso __________State: TX Zip:. 79925 Contact Person: ... .lay Block . . ______________ Phone Number X9.l5).IKdUJBJ 4) Waste Disposal Site Name: . ..Otero Lincoln County. Landfill Address: Miles Smith-nn Hwy 54__________ _____ City: AlamogordoState: NM. Zip: . Telephone: (505) 439.4355_________ TNRCC Permit Number. ,_SWNJ90103 88310___ 5) For structurally unsound facilities, attach a copy of demolition order and Identify Governmental Official below: Name:N/A_,,_______________ Registration No:N(A_............ ....... _T Title: :U1A ... Date of order (MM/DD/YY)_____LN/A /_____ Date order to begin (MM/DD/YY) / N/A/ 0 Scheduled Dates of Asbestos Abatement (MM/DD/YY) Start_____06101/99 Complete:_______ Q4/2s/qo ) Scheduled Dates Demolition/Renovation (MM/DD/YY) Start /N/a/ Complete:____/N/A/ Note: If the start date on this notification can not be met, the TDH Regional or Local Program office Must be contacted by phone prior to the start date. Failure to do so Is a violation in accordance to TAHPA, Section 295.61. ** sreby certify that all information I have provided is correct, complete, and true to the best of my knowledge, t acknowledge that t responsible for all aspects of the notification form, including, but not limiting, content and submission dates. The maximum penalty 510,000 per day per violation. nature of Building owner/ Operator Delegated Consultant/Contractor) _ Peggy Munsclt (Printed Name) 0S/J3/-99.. (Date) 1LTO: ASBESTOS NOTIFICATION SECTION TOXIC SUBSTANCES CONTROL DIVISION TEXAS DEPARTMENT OF HEALTH EXCHANGE BUILDING, SUITE N320 8407 WALL STREET AUSTIN, TX 78754 r dig 1521-3540 (Telephone) (PIS) S41.1811 (Fax Number) :es are not accepted* PH: 512-634-6600.1-800-572-5548 'Faxes are not accepted* n APBS5, dated 12/08/08. Replaces TDH torn dated 09/15/97. Forassistance In completing form, call 1-800-572-5548 ASARCO ELP 0013123 Sun City Analytical Inc. ENVIRONMENTAL SERVICES 1409 Montana El Paso, Texas 79902 (915) 533-8840 Fax (915) 533-88430 E-Mail = SCAI@riash.net ASARCO ELP 0013124