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COMPLETED BY: Type the company
business name and DBA as shown in the CSLB contractor license, name
and phone number of the person completing the notification form, the
date, check number, fee amount, and the contractor's project number
(if any).
NOTIFICATION TYPE: Circle
ORIGINAL for first time notification. Circle REVISION DATES to change
the START or END project schedule dates. REVISIONS are for updating
information on Notification in which the project End Date has not
expired. Revision of site location address requires a new
notification. Circle CANCELLATION to cancel a prior notification.
PROJECT TYPE:
Circle a project description. For annual notifications and progress
reports circle PLANNED RENOVATIONS.
SITE INFORMATION: Provide
detailed information about the facility site location and/or
building(s) where the asbestos removal or demolition is to occur,
including a cross street. DESCRIBE WORK AND LOCATION by providing the
specific work and areas within the facility or building. Examples:
remove VAT from main lobby, demo Monroe Hall, remove mastic from
kitchen of Bldg. #2.
PRESENT and PRIOR USE: Circle
the present and prior use of the facility. For condominiums and
apartments circle Public Bldg. For rental property circle
Commercial. Circle House only for single family homes that owner
occupied.
SITE OWNER: Name and address of
the site legal owner, and name and telephone number of owner or
contact person for owner.
REQUIRED BUILDING INFORMATION:
Circle a YES or NO answer for each question. Asbestos Surveys are
required prior to renovation and demolition. Asbestos must be removed
prior to activities that may disturb it and/or prior to ALL
demolitions.
PROJECT DATES: The actual start
and end dates and work shifts of the Asbestos Removal or Demolition
project. This includes set-up and clean-up. Changes of Renovation or
Demolition project scheduled dates require a Revision Notification.
* ASBESTOS AMOUNT
TO BE REMOVED: Enter the amount (in square feet) in the boxes
labeled Friable, Class I, and Class II, and add the row to calculate
the TOTAL REMOVED. Fee varies according to the total asbestos amount
to be removed.
To convert linear feet to square feet
multiply the factor 3.14 times the pipe diameter times the pipe
length, all in feet.
* ASBESTOS REMOVED
FROM: Circle surfaces, pipes or components to indicate from
where the asbestos to be removed.
* DESCRIBE TYPE(s)
AND AMOUNT(s) OF ASBESTOS: Enter the amount(s) under each type
of material(s) to be removed.
CONTRACTOR INFORMATION: Name and
DBA as shown in the CSLB contractor license and Company physical
address - No P O Boxes. Notifications should be filled and submitted
by the contractor performing the actual removal or demolition.
Provide your California Contractor State License Board (CSLB),
Cal/OSHA Registration, and AQMD identification number (ID). CSLB
Abatement License and OSHA Registration are required to perform
asbestos removal. The AQMD ID # is found in the contractor's District
permits or invoices. For your convenience mail your notification and
do not hand carry to AQMD because there is no designated staff to
receive it. Mailing saves you valuable time, gas money, car wear and
tear, and reduces traffic and air pollution.
WASTE TRANSPORTS: Name the
companies transporting the asbestos and/or demolition waste to a
landfill or any off-site storage.
LANDFILL: Name and address of
the landfill where the waste will be sent. This includes demolition
construction waste.
* WASTE Storage
Site: Provide the site location if the asbestos is going to a
storage site prior to sending it to a landfill.
* CONTROLS:
Enter the Rule 1403 Procedure Number (1, 2, 3, 4, or 5) or describe
the asbestos work practices and engineering controls. Procedure 1 is
required for removing friable asbestos materials (i.e., acoustic,
linoleum, stucco, etc.) Procedure 2 is for small-scale, short
duration jobs using glovebag or minienclosures. Procedure 3 is for
manual removal methods using adequate wetting. Procedures 4 and 5
require PRIOR written AQMD approval. Refer to Rule 1403 for specific
procedural requirements.
* ASBESTOS
DETECTION PROCEDURES: Describe the methods and procedures used
to determine whether asbestos is present at the facility, including a
description of the analytical methods used.
For DEMOLITIONS state when and who
removed the asbestos. Demolitions require proof of prior asbestos
survey and removal.
ORDERED DEMOLITIONS require a copy of
the government agency legal notice ordering the demolition. Ordered
demolitions require proof of prior asbestos survey, removal and
disposal; and/or prior written approval from AQMD. See Procedure 5
Plan.
* EMERGENCY
REMOVAL: Give the name and phone number of the person
authorizing the emergency. Explain the reason(s).
CONTINGENCY PLAN: List actions
to be followed if unexpected asbestos is found or nonfriable asbestos
is rendered friable.
TRAINING AND INFORMATION
CERTIFICATION: Use a "wet" or stamp signature to certify that your
company provided the required asbestos training to the persons at the
asbestos work site, and that the information given in the notification
form is complete and accurate. Notifications must be signed by the
contractor doing the work, or its authorized company representative.
KEEP A COPY OF YOUR NOTIFICATION.
STATE LAW REQUIRES THAT YOU PROVIDE A COPY OF THE DEMOLITION
NOTIFICATION TO BUILDING AND SAFETY BEFORE ISSUANCE OF A DEMOLITION
PERMIT.
Forms, instructions, and Rule 1403 can
be obtained from web site
http://www.aqmd.gov
ASBESTOS/DEMOLITION RULE 1403 GENERAL
INFORMATION
SURVEY REQUIREMENT: Asbestos surveys are required prior to
all renovation and demolition. Asbestos must be removed prior to
renovation activities that may disturb the asbestos containing
materials. All asbestos must be removed prior to building demolition.
NOTIFICATION REQUIREMENTS: Postmark notifications 14
calendar days prior to starting any asbestos removal of 100 ft2 or
greater or any demolition. Notifications shall be filled, signed,
paid, submitted and mailed by the contractor performing the removal
and/or demolition job. Notifications without signature(s) will be
returned. Renovations without asbestos do not require notification.
Los Angeles City and Palm Springs Fire Departments, and CALOSHA
require a separate Notification.
FEE REQUIREMENT:
Rule 301 (s) requires all notifications to be submitted with
appropriate fees. Fees are per notification and are not refundable.
Notifications submitted without appropriate fees will be returned,
deemed incomplete, and referred to the compliance unit for follow-up.
Projects conducted without a valid notification are subject to local
and federal enforcement. Cancellation of notifications and removal
projects less than 100 square feet are exempt from fees - other
requirements may apply.
MAILING REQUIREMENT: Mail the notification and fee to:
SCAQMD, ASBESTOS NOTIFICATIONS
FILE # 55641
LOS ANGELES, CA 90074-5641
Mailing saves time, money and reduces traffic and air pollution.
REVISIONS: Fax revisions to 909-396-3342. Update the
notifications as necessary, pencil in the change(s), write the reason
for the revision at the top of the notification. Fees are per
notification and multiple service charge fees may apply. Revisions
increasing the asbestos amount or demolition size but remaining in the
same amount/size category stated in a previous notification(s) require
only a revision fee. Revisions in amount/size category require a
revision fee and the entire fee for the applicable amount/size
category.
EMERGENCY NOTIFICATIONS: Fax emergencies to 909-396-3342.
Emergencies are for immediate asbestos removals due to unsafe
conditions, breakdowns, flood, earthquake, fire, and site
contamination; and require a formal letter from the person confirming
or agency authorizing the emergency. For Ordered Demolitions fax a
copy of the legal notice or Building and Safety “red tag”. For
emergency site contamination to clean-up disturbed asbestos fax a
Procedure 5 for prior written approval. See Procedure 4/5/Plans.
FAX NOTIFICATIONS. Fax notifications are required for
Revisions, Emergencies, Ordered Demolitions, Electronic Notifications,
and Cancellations. Fax notifications to 909-396-3342 and within 48
hours of fax-time, postmark/mail the Original Notification with the
fee to SCAQMD, ASBESTOS NOTIFICATIONS, FILE # 55641, LOS ANGELES, CA
90074-5641. Fax notifications are not instead of the Original signed
notification required by local and federal law. For Emergencies
include the letter authorizing the Emergency. For Ordered Demolitions
include proof of asbestos survey, removal and disposal. For Ordered
demolitions without prior asbestos removal submit a Procedure 5 Plan
for prior written AQMD approval. Cancellations do not require mail
follow-up.
DEMOLITIONS require 4 PRIOR steps:
-
Asbestos Survey,
-
Asbestos Removal,
-
AQMD Notification,
-
B&S permit. ALL demolitions require a notification by the
contractor doing the demolition. Demolitions without prior asbestos
removal require prior written approval from AQMD (See Procedure 5
Plan). Demolition is defined as the wrecking or taking out of a
load-supporting structural member of a facility or the intentional
burning of a structure. Dismantling of partitions and installation
of windows and doors through load-supporting walls without asbestos
is exempt from notification.
DEMOLITION BY INTENTIONAL BURNING require 4 prior steps
above plus 2 more steps:
-
Rule 444 “training burn notification” to SCAQMD at
800-442-4847 the day prior to burning, and;
-
Conduct the training burn on a burn day. Fire departments are
responsible for obtaining an asbestos clearance, copies of the
demolition notification, phoning AQMD the Rule 444 notification the
day prior to the training burn, and coordinating with the demolition
contractor to clean the site right after the training burn is
completed.
RENOVATION is the removal, stripping, or altering of
asbestos containing materials, and/or any activity involving the
associated disturbance of asbestos in a facility. Renovations require
an asbestos survey and removal prior to any activity that would
disturb the asbestos. Building remodeling or renovations without
asbestos do not require notification. See survey requirement.
PLANNED RENOVATION NOTIFICATIONS (PRN): There are two types
of PRN, The first type is to notify for Nonscheduled Asbestos Removals
(AKA annual notifications). Nonscheduled Asbestos Removals are
expected to occur based on past experience, but no exact date can be
predicted for them. These notifications account for the cumulative
asbestos amount removed from a facility during a calendar year in
aggregated increments of less than 100 square feet each due to
equipment breakdown or maintenance requirement. These notifications
must be postmarked by December 17th, each year. Individual Removals
of 100 ft2 or more require separate notification.
The second type is to notify for a series of Scheduled Asbestos
Removals within a large facility, where each removal is greater than
100 square feet. These notifications require an attachment listing
each individual project planned within the facility detailing the work
locations/areas/buildings involved including its sizes, floors, ages
and uses, the amounts and types of asbestos at each
location/area/building, project scheduled dates, and asbestos types
and amounts. Any project schedule change requires a Revision.
PROCEDURE 4/5 PLANS: These plans require prior approval by
AQMD. To obtain approval fax the plan and notification to
909-393-3342 attention Asbestos Supervisor. For after hours fax and
leave a message at 1-800-CUTSMOG for the asbestos supervisor. Within
48 hrs of Plan approval, postmark the hard copies of the plan,
notification, and fees. Procedure 4 Plans are for dry removals.
Procedure 5 plans are required for asbestos disturbances, site
clean-ups, decontaminations, excavations, and demolitions with
asbestos.
KEEP A COPY OF YOUR NOTIFICATION. State law requires you
give a copy of the demolition notification to Building and Safety
before issuance of a demolition permit. This law does not require
proof of receival or approval by AQMD. For your convenience, please
mail the notification. Mailing saves you time, money, gasoline, and
reduces traffic, energy use, and air pollution.
For questions call the asbestos hotline at 909-396-2336. For
Forms, instructions, and Rule 1403 go to our web site at
http://www.aqmd.gov
(SV1403
instructions 2004 rev Jun 27
* DEMOLITION notifications do not
require this information. Asterisked information is required for
asbestos removal notifications. |
