HomeMy WebLinkAboutX2017-3690 - MiscXII -3610
309 Ins Ave
South Coast Air Quality Management District
..., 21865 Copley Drive, Diamond Bar, CA 91765-4182
�- Phone: (909) 396-2336
.......... _.
www.aqmd.gov
Rule 1403 Notification of Procedure 12 3 Asbestos Removal
Please maintain a copy of this Notification at the job site, either electronic or paper.
Notification Number
49'1082
Site Owner Bubion Investment Properties, LLC & Owner Address 1 Corporate Plaza Drive Suite 110
Nich
City
Newport Beach
State
CA
Zip
92660
r.
Project Start Date
10/26/2017
Project End Date
10/27/2017
Project Work Shift(s)
Day
Building Size in Sq.ft
Project Type
Asbestos Removal
Project Urgency
Routine
69
Completed By
Richard Jackson
Phone Number
(949) 836-3761
Asbestos Survey
Infprmatiak:
Asbestos Found
Yes
Contra4br.
,ru a i
fi
.
Describe Work Location
Linoleum flooring located in kitchen and
bathroom
Company Name
JONATHAN JACKSON
Address
2681 DOW AVE
City
TUSTIN
State
CA
Zip
92780
CSLB License #
486266
OSHA REG #
1130
Supervisor #1
Darrell Rose
Phone
(714) 404-8447
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SIYe Inferstt {IOn
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Site Name
Iris
Project #
Site Street #
302
Street Name
Iris Ave
Cross Street
4th Street
Site County
Orange
City
Corona DI Mar
State
CA
Zip
.. ................. .......... ....
92625
Site Owner Bubion Investment Properties, LLC & Owner Address 1 Corporate Plaza Drive Suite 110
Nich
City
Newport Beach
State
CA
Zip
92660
Project Start Date
10/26/2017
Project End Date
10/27/2017
Project Work Shift(s)
Day
Building Size in Sq.ft
2168
Number of Floors
2
Building Age (years)
69
Number of Building/Dwelling Units
1
Building Prior Use
House
Asbestos Survey
Yes
Asbestos Found
Yes
Asbestos Removed
No
Building to be Demolished
Yes
Describe Work
Abatement of linoleum flooring
Describe Work Location
Linoleum flooring located in kitchen and
bathroom
pro'je'ct information. ..x .' .." P: _ ...., ,. ..
Asbestos Information
Amount of Asbestos in each type in Sq.Ft
Linoleum 396•, Insulation ,. 0 ;I Fire Proofing
0 IDry Wall 0 Mastic (Non -friable) O 1 Floor Tiles (Non -friable) 0
0 ,Roofing 0 iStucco 0 Plaster 0
Coal Tar Wrap 0 Mastic (Friable) 0 1 Floor Tile (Friable) 0
Other(non-friable) 0
Asbestos Amount to be Removed in Sq.Ft
FRIABLE 396
CLASS I 0
CLASS II 0
Total 396
Asbestos Removal From Surfaces Control Procedures 1, 2 , 3
Asbestos Detection Procedure(s) Survey, Bulk Sampling, Inspection,
PLM
Waste Transporter
BDC SPECIAL WASTE SERVICES
Address
1211 WEST GLADSTONE AVENUE
City
AZUSA
State
CA
Zip
91702
Landfill
Azusa Land Reclamation
Address
1211 W Gladstone St
City
Azusa
State
CA
ZIP
91702
Total Amount of Asbestos to be Removed in sq.ft 396
Project Size Fee 60.85
Additional Fee 0
By clicking the Sign & Submit button, I certify that an individual trained in
the provisions of SCAQMD Rule 1403 and the Asbestos NESHAP (CFR
Title 40, Part 61, Subpart M) will be onsite during the demolition or
renovation and evidence that the requiredtraining has been accomplished
by this person will be available for inspection during normal business
hours. In addition, I certify that all of the information contained herein
and information submitted with this Notification is true and correct