ࡱ> NPM%` c<bjbj"x"x .@@@b T48<` #lT"""""""$S$h&"uTTT"W#T"T"h!h!t ;^T !"m#0#!'`<' !'!(hZJ<t"" #TTTT` ` ` ` ` `   Asbestos Project Annual Facility Notification 2009State of Maine Department of Environmental Protection Lead & Asbestos Hazard Prevention Program 17 State House Station, Augusta, ME 04333 TEL (207) 287-2651 FAX (207) 287-6220FORM A Page 1 of 1Important Notice A facility* that files this annual facility notification may provide the Department with 24-hour notice of any asbestos abatement projects that: (1) involve less than 160 square feet or 260 linear feet of asbestos-containing material; and (2) are necessitated by the need to repair or perform maintenance on facility equipment. A facility that has filed an annual notification with the Department can opt to pay its notification fees at the time notification is submitted or on a quarterly basis. If you have questions on fee payment, please contact Sandy Moody at 287-7751. Please note that you must still notify the Department of each asbestos abatement project conducted in your facility using the DEPs Asbestos Project Notification Form N. This includes projects conducted under the Annual Facility Notification program that require 24-hour notification, asbestos abatement projects involving at least 160 square feet or 260 linear feet of asbestos-containing material that require 10-day notification, and emergency projects. *Facility means an institutional, commercial, public, industrial, or residential structure, installation, or building or set of buildings at a single geographic location, including those containing condominium units, or individual dwelling units operated as a residential cooperative, military or company housing, or ship.1. Reporting Calendar Year 2009 2. Facility Code  FORMTEXT       (assigned by ME DEP) 3. Facility Type (description)  FORMTEXT       4. Notification Submitted by Name  FORMTEXT       Company  FORMTEXT       Mailing Address  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip  FORMTEXT       TEL  FORMTEXT       FAX  FORMTEXT       5. Facility Location Facility Name  FORMTEXT       Mailing Address  FORMTEXT       Physical Address  FORMTEXT       Contact  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip  FORMTEXT       TEL  FORMTEXT       FAX  FORMTEXT       Information to be included with this notification To be considered valid and complete, this annual facility notification form must be completely filled out and the following information must be included: A facility diagram including all buildings in which asbestos abatement projects may take place. A description of written method to be used to communicate project dates to the Department at least 24 hours prior to the start of each project. A description of the facilitys standard operating procedure to ensure that 10-day notification is provided to the Department for any project impacting at least 160 square feet or 260 linear feet that is not an emergency as defined in Maine DEP statutes and regulations. A description of the method or copy of the form that will be sent to the Department quarterly which compiles a list of all projects completed and payment of corresponding fees. A description of the method(s) that will be used to ensure that standard variances are received no later than 24 hours prior to the project and that non-standard variances are not implemented prior to receipt of Department approval..Certification /034     Z [ S T ! :<>RTV`|ljh8CJUmHnHuj*h8h8CJUjh8CJU h'>*CJ h85CJ h85CJ h856CJ h86CJ h86CJ h8h8CJ h8>*CJ h85 h85CJ4 h85CJ0 h85CJ h8CJh'h8 h8CJ */05Dk $Ifgd8 $$Ifa$gd8 $Ifgd8 $Ifgd8 $$Ifa$$If$If$If c<   Z [ S T ! ysssmsdd\x$If $$Ifa$$If$If$Ifkd$$IflF~ #+ !b0    4 la :<d $$Ifa$gd8 $$Ifa$$If\kd$$Ifl4+m+04 laf4`b<>JL`bdnp&(<>Rjh8h8CJUjh8h8CJUj4h8h8CJUjh8h8CJUjh8CJUmHnHujh8h8CJU h85CJ h8CJ h8CJjh8CJU.<>r46vmmmm dh$Ifkd$$Ifl4F2 &+  0    4 laf4$If RTV`brt246TVjlnxzϿϯϟϘϒςrjh8h8CJUjdh8h8CJU h8CJ h85CJjh8h8CJUjxh8h8CJUjh8h8CJU h8CJjh8CJUmHnHujh8CJUjh8h8CJU,6|N`bd`zn & Fx$If$Ifokd $$Ifl40J+04 laf4$If dh$If &(<>@JLZ\prt~&(8:Nj h8h8CJUj( h8h8CJUjh8h8CJUj<h8h8CJUjh8h8CJUjh8CJUmHnHujPh8h8CJU h8CJjh8CJU,NPR\^`d_`455H5I5S5T56 6 666668<@<ϺϺϺϺϺɶϣojϭ h8>* jh85>*UmHnHu!j h8h85>*U h85>*jh85>*Uh8h85>*U h85CJ h8 h85CJh8h8>* h8CJ h8CJjh8CJUmHnHujh8CJUj h8h8CJU'`555666uu $$Ifa$gd8 $$Ifa$$If$If\kd" $$Ifl4+m+04 laf4 & Fx$If I certify that to the best of my knowledge, the information contained in this notification is true and accurate and that this facility has an up-to-date Operations & Maintenance Plan that includes procedures for the proper notification and removal of asbestos containing materials. _______________________________________  FORMTEXT       Signature Date ME DEP USE ONLY Postmark ________________________ Date Received ____________________ Notification Complete ________________ Additional Information Requi666(7t77<4<a<b<c<zxokd $$Ifl40P+04 laf4 dh$If$If$If red ___________________________________________ Asbestos 2009 Annual Notification Form A.doc @<A<a<b<c< h8CJ h85CJ h8CJ h'CJ,/R / =!"# $ % $$If!vh5 5!5b#v #v!#vb:V l05 5!5b4$$If!vh5m+#vm+:V l405m+4f4tDText2tDText3$$If!vh5 5 5#v #v #v:V l405 5 54f4tDText4tDText5tDText6tDText7tDText8tDText9vDText10vDText11vDText12vDText13vDText14vDText15vDText16vDText17vDText18vDText19vDText20$$If!vh55#v#v:V l40554f4$$If!vh5m+#vm+:V l405m+4f4vDText21$$If!vh55#v#v:V l40554f4<@< NormalCJ_HmH sH tH >@> Heading 1$$@&a$CJ>@> Heading 2$$@&a$CJ <@< Heading 3$@&5CJ <@< Heading 4$@&5CJ>@> Heading 6$$@&a$5D@D Heading 7$$@&a$ 5>*CJDAD Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List <B@< Body Text$a$5CJ@Q@ Body Text 3$a$5CJ6P@6 Body Text 2CJb@ zb/05DkZ[ST !fg9V{>d0 1 2 d ` \]mn3`ad0*GV  GV v:IIIIIv:YGVB*v:*GV*v:*GV*v:*GV*v:*GV*v:z# v: v: v: v: GV v: v: v: v: GVv:v:v:v:GV@ v:GVWWWWv:v:v:GVWWWWWv:GV*v:*v:*GV*v:*v:*v:*v:*v:$v:GVv:v:v:v:v:GVv:GVWWWWWWޞ0*^/05DkZ[ST !fg9V{>d0 1 2 d ` \]mn3`ad0@0@0@0 @0@0@0@0@0 @0@0@0@0 @0l@0@0@0@0@0@0@0@0@0 @0l@0@0@0@0@0 @0@0@0@0@0 @0@0@0@0@0 @0l@0@0@0@0@0@0@0@0 @0@0@0@0@0@0@0@0@0 @0@0@0@0 0 0 0 0 0 U@*ityt-l@0@0@0@0@0@0@0@0 @0@0@0@0@0@0@0@0 @0 @0`RN@<c< 6`6c<c<%17BNTgsy*6<P\bu   ( . bFFFFFFFFFFFFFFFFFFFFText2Text3Text4Text5Text6Text7Text8Text9Text10Text11Text12Text13Text14Text15Text16Text17Text18Text19Text20Text21&Ch+Qv  d 8Uz=c / d14=1L01:1\41:14 1 >>:dCCEd>*urn:schemas-microsoft-com:office:smarttags PersonName>*urn:schemas-microsoft-com:office:smarttags PostalCode8*urn:schemas-microsoft-com:office:smarttagsCity9*urn:schemas-microsoft-com:office:smarttagsplace9*urn:schemas-microsoft-com:office:smarttagsState i %8BUgz*=Pcu   / ad%8BUgz*=Pcu   / ad334%8BUgz*=Pcu   / TT?Gadd W qEmq .- %l# BJ hh^h`5o(.hh^h`.hh^h`. hh^h`OJQJo(hh^h`o(. 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