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153 Asbestos Date:Or/ /6/Qy' ITime: 300,0.L IMap: Name of Complainant: Address: /S-r7 Parcel: ` Fes- heL AAA/Ant; NATURE OF COMPLAINT: Location: Owner: Address: Taken by: I Date of Inspection: INSPECTOR'S REPORT: Tel: I Time: Action Taken: Inspector Signature mk•aPr C1 Lfiaivav! O FREE ESTIMATES Date:✓Y �� Time: 7 Map: Parcel: eiL! —F' Name Co lamant: 7---L,, %"mil- Address' Tel:,)/9-9/57 /�.- NATU E OF COMPLAINT: n . �/i Location: Owner: Address: I Tel: Taken by: I Date of Inspection: I Time: INS P�ECCTOR'S REPORT: . / ^�V 9 i i _ Gov '� H/� fa 60-7(.3-31 I i�✓ �^^/� a46 3553 thwui P1.1019 T.,F. Action Taken: Inspector Signature at a municipal landfill are as follows: a- The Board of Health must approve dis posal at the local landfill in writing, b- A special area of the landfill must for disposal of asbestos containing be designated A trenc materials. h for burial of asbestos materials must be created at the la the arrival of fining the containers of landfill prior to d, asbestos siding_ The operator of the landfill must be adequate advance notice prior to given the delivery of the asbestos siding to the landfill . e- The asbestos siding must be immediately trench. with soil after being placed in covered n the assigned f. The location of the buried asbestos materials must be clearly of containing the landfill . Y designated on a site g. The location of the oburied asbeestos containing materials must be eliminaateiohe possibitityaof tfuture dexcava ticl atio i to e n at 6. The Department recommends that respiratory protection protection for any personnel worn involvede minimum personal siding removal . involved in asbestos mhetappropriate or Should the estos_ regusq`tion question regarding t) , s please ce tact you have any Ep regional office. 715) , Please contact Northeast Re ion Southeast Re ion Central Re ion Western Re ion September 1993 John MacAuley John Winkler Gregg Levins Robert Shultz (617) 935-2160 (508) 946-2770 (508) 792-7693 (413) 784-1100 William F. Weld Governor Trudy Coxe Secretary, EGEA Thomas B. Powers Acting Commissioner Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection Western Regional Office ASBESTOS SHINGLES GUIDANCE DOCUMENT With regard to the removal and handling of asbestos-contain- ing cementitious siding material and shingles, the Department of Environmental Protection (DEP) offers the following guidelines : • 1 . A notification must be sent to DEP on the Department- approved form 10 working days prior to the commencement of the siding removal. Contact DEP at (617) 338-2255 for a copy of the "Asbestos Abatement Notification Package ANF-001" . A notification fee is required for non-owner occupied residences . 2 . A drop cloth must be used under the work area and periodically cleaned up during the siding removal . Doors and windows must be closed and covered with 6 mil polyethylene in proximity to where the removal is taking place. 3 . The asbestos siding must be wetted prior to and during removal to minimize the possibility of asbestos fiber release to the ambient air. In addition, the siding must be -removed—insuci3 a Manner—as--to avoid breakage. Sanding, sawing and drilling of asbestos-containing cementitious siding is not allowed. Siding must be carefully lowered to the ground. 4 . After removal, the siding must be placed wet in leak- tight containers. These containers must be properly sealed to prevent fiber release and must be appro- priately labelled. The Department recommends that siding be packaged in fiber drums or sturdy boxes lined- with 6 mil polyethylene. Bagging of siding is not recommended because the sharp edges may tear the bags. Siding may not be bulk loaded into a truck, dumpster or trailer for transport or disposal. 5 . Properly sealed, leak-tight containers of asbestos siding may be disposed of at either an approved commercial landfill or, if the following conditions are met, a municipal landfill. The conditions for disposal d96 Dwight *1091-1C Massachusetts 01103 • FAX • Telephone ASBESTOS ABATEMENT NOTIFICATION GUIDE 1. What are the Commonwealth's notification requirements for asbestos removal? Prior notification of asbestos abatement work is required by regulations of two Commonwealth Agencies, the Department of Environmental Protection (DEP) and the Department of Labor and Industries (DLI). Under 310 CMR 7.15, DEP requires notification 10 working days prior to commencement of work involving the removal of any amount of asbestos. Under 453 CMR 6.12, DLI requires 10 day prior notification for all work involving the abatement (removal, encapsulation or enclosure) of amounts greater than three square feet or three linear feet. The purpose of the notification requirements is to protect public health, worker safety, and the environment by preventing the threat of release of asbestos emissions to the ambient and indoor air. 2. Who must notify? Any owner/operator, asbestos abatement contractor, or other entity performing asbestos abatement in the Commonwealth must notify the intent to perform asbestos abatement. For DLI notification purposes, the asbestos abatement contractor is required to notify. 3. Is there a specific notification form? Yes. Notification must be made using the Commonwealth's "Asbestos Notification Form ANF-001". Timely Submission of the form satisfies the basic requirements of both DEP and DLI regulations. For a copy of the notification package which includes the notification form contact either the DEP Information Service at (617) 338-2255 or the DLI at (617) 727-1933. Regional offices of both these departments will also have copies of the asbestos notification package and can answer questions relative to completing the notification form. 4. What is the notification fee for asbestos removal? The notification fee required by DEP regulations 310 CMR 4.00 (Timely Action Schedule and Fee Provisions) for asbestos removal is $50.00 per notification. However, owner-occupied residential properties with four or fewer units, cities, towns, counties, districts of the Commonwealth, municipal housing authorities or other state agencies are kLit subject to asbestos removal notification fees. 5. How and when do I pay the notification fee? _ In order to pay the asbestos removal notification fee, notification fee decals must be purchased from the Commonwealth and affixed to the'Asbestos Notification Form ANF-001" when notifying. Decals may be purchased by filling out the'Purchase (attached to this guide)and sending it with a check for the amount of decals form (attached to the address on the Purchase Request'form. Decals may also be DEP's cashier on the fourth floor of One Winter Street, Boston. For fee-exempt directly removal jobs, 'Exempt*notification decals may be ordered (free of charge) using the same form or they may be picked up at DEP's cashier or the regional DEP offices. Commonwealth of Massachusetts Asbestos Abatement Notification Package Contents: • Asbestos Abatement Notification Guide • Commonwealth of Massachusetts Asbestos Notification Form - ANF-001 • Purchase Request for Notification Fee Decals Revised July I, 1992 10. What project changes require a separate asbestos removal notification and a separate notification fee decal? A separate asbestos removal notification and a separate fee decal is required when any amount of asbeetoecontaining material glom the estimate on the original notification form is planned, and when there is a change in location from that on the original Separate notification is also required when an asbestos removal notification is opostponed more than thirty (30) days from the start date appearing on the notification form. 11. What if I need an emergency waiver from the ten (10) day notification requirement? Both DEP and DLI must provide authorization for an emergency waiver. Contact the rem:opal DEP office and DLI to determine if an emergency waiver is warranted. Where deemed appropriate, an emergency waiver number will be Sued by each agency. Where emergency waiver status is granted by both DEP and DU, the contractor or other entity may proceed with the work. The completed 'Asbestos Notification Form ANF-001• and notification fee decal must be sent to the address given in answer to Question 6. of this guide within one working day of the beginning of an asbestos removal job with the emergency waiver. Applicants shall supply waiver numbers from each agency with other required information in Section A, part 14 of the 'Asbestos Notification Form ANF-001• Failure to provide the fee and/or notification in a timely manner may result in an enforcement action, which may include administrative and/or criminal penalties. 12. How long is the asbestos removal notification in effect? This notification is in effect mily until the job-end date on the Commonwealth's 'Asbestos Notification Form ANF-001' or as properly revised by written notification. 13. What can I do to avoid the most common mistakes in submitting this asbestos removal notification? a. Fill in g_Ia information required on the 'Asbestos Notification Form ANF-001'. The notification must be completed and signed by the authorized person. b. Make sure to attach the appropriate notification fee decal in the upper right hand corner of the 'Asbestos Notification Form ANF-001'. c. Be sure to make a copy of the 'Asbestos Notification Form ANF-001• with the notification fee decal affixed in order to retain for your records or in the event that a revision must be submitted to the Commonwealth. d. Submit the 'Asbestos Notification Form ANF-0o1' with the notification fee decal attached to: Commonwealth of Massachusetts Asbestos Program P.O. Box 120087 Barton, MA 02112-0087 EL Where do I send the completed notification form? When the "Asbestos Notification Form ANF-001' is completely filled out, and the appropriate decal is affixed to the form, send the form to: Commonwealth of Massachusetts Asbestos Program P.O. Box 120087 Boston, MA 02112-0087 7. What are the Department of Environmental Protection (DEP) and Department of Labor and Industries (DLI) timelines for notification review? After the 'Asbestos Notification Form ANF-001• is received by DEP and DLI the form will be reviewed by both agencies. The notifier will be contacted only in case of deficiencies in the submitted notification form. Where the notifier is appraised of deficiencies in the notification form by either DLI or DEP, said notifier shall not proceed with the asbestos work for which notification was made and shall have thirty (30) calendar days from the date of being informed of said deficiencies in which to respond. Where the notifier responds to the deficiencies in the original notification form within the 30 day period, a second administrative/technical completeness may be conducted by either agency within the respective 10 working day or 10 day prior notification periods. The result of the second review will be: - a determination of administrative/technical completeness, or -a stop order to not proceed with the job. The notifier will be contacted only in the case of when an order is issued to not proceed with the job. Should the notifier wish to pursue asbestos removal on the same site after a stop order has been Sued, a new "Asbestos Notification Form" and notification fee decal for the job must be submitted to the Commonwealth. 8. Is the asbestos notification fee decal refundable? In the event that an asbestos notification is withdrawn, the notification fee decal will not be refunded. The decal fee be refunded if the unused and intact decals are presented to DEP's cashier on the fourth-floor of One Winter Street, Boston. Lost decals are ngt.eligible for a refund. 9. Can I revise my'Asbestos Notification Form' Yes. Revisions to the original notification form may be made utilizing the following procedure. On a copy of the original notification form, write'REVISION• under the notification fee decal, and on the form, indicate the revisions being made to the original notification. Note: Separate notification is required when an asbestos removal notification is postponed more than thirty(30) days from the start date appearing on the notification form. 3 fl Facility Description I Curren!or pane use ill tacaiy. J she lacthly ownero¢upied residential with 4 units or less? 0 Yes r?) No Facility Owner 5. General Contractor Nalle relenbne ?0 Codi i••mo• CanI?,Cro •wornn Conp L1:uTr Poky f 6. What is the size of the facility? (so It) (I c(I of loots) hp Da 13 Asbestos Transportation and Disposal 1. Transporter of asbestos-containing waste material from silt to temporary slorage she(il necessary)to al disposal sea Notes Transfer Sea lions must comp win,the Solid Waste Division repot. tons 3lOCUR Boo Note:Contractor must sign this loam for al notaication purposes cno.■ Tpmk Ty F. Transporter of asbestos-containing waste material Iron,removallemporary stomps site to fiat disposal site: Arkfral [+rani+ Ina* 3. Refuse transfer station and owner(it applicable): .wee ?Ptak «m Co! Anal Disposal Site Certification perjury.that he/she The the Removal.Containment t or Encapsulation of Asfbestos.453C R600aand 310L R115,Commonwealth d that ft Massachusetts Information conanediin this notification is true and correct le the best of his/her knowledge and belief. Faust Pa,Arm kkfrns Fee exempt(City,Town.list Slitter l(from Ironi of Irrmv AauptltyVm Me awent Orrno.n _. froth unkipal housing authority,owner.occupied residential of tour units or less)?0 yes C no laSTRUCIIOILS All Sonar GI len -ttewmwNN n outer la COOWY.am it Department of tmitDaman% requun eno oI310 CIAR I 15(fen rtwte7 Nn ono,nJAL∎m it re0uved of YryiltnTMx Deprattttt lnl m Wulf Wm. aura!Mammies requitement Wow] o f ailcle1 512 ll (I^' .1u▪ vedoI ANY o+n uµtltW ANY NLewt I pals Ina/or et Bun ww so-we n 3.Waal 0geuliam IXI4tiw/ to wre Cenuree+ealt■el 5 Purled Monitor Maartkwlu Westu0egrw munauaunl P.0.a.1100(I maw Whet Mk 02112 maw ObO 6 Asbestos AnaMical Lab: Commonwealth of Massachusetts Asbestos Notification Form— ANF-001 Asbestos Abatement Description 1 Facility!outran: Pepow Marie..ve/aaseRe Wbp Nra.l eM aux morn Is the Iacility occupied? °Yes 0 No 3. Asbestos Contactor uae a. On-Site Proied Supetvlsof oremen: to nW Anv Asbestos Nomrt Mao n d cu Here I I Friefegee rises]lotrnJwrr,wrJJ 1 Inn Wm maybe used au acttlrni the US.Im'kt^'Mal PrmMUn Spry Pavan tat aSttlmamoMW tmmiol am*Gas smlm to HEWS 140 CHISWWIMI lo neume fro Rev 69} WM alceniattcui (Sal Sun) 7. Project sttaM1daleI IenddaleII_specnic wakhours(Mon-Fri) rn,, renae>on mw Nq+r^I 6_ What type of project is this"( (circle one?: onmtw dove 9. Describe theasbestos statement procedures to be used (circle): WreNP eraam tarob� onn/in aitcal WI coo(opal/ 10. Is the job being conducted ❑indoors ❑Outdoors? t t Totalamount of each type of Asbestos C Materials(ACM)to handled on pes or ducts(linen t.) surfaces(square It.) oo be Containing enclosed or es dled n _ linear/square Ieel permit Sold m'epc.✓sula'm. .. comply: *awl suffice arnuanps...J— i�M .................. —I— wore( .. . ..nobat....J— rottM,mc°N'"m.... .... .... J- twmwww J —L- aw __ '___� rraNeWre,nnmvd ._.... aw .otm ma .. - J- oey fobse eeort4_. _._._.. 12. Describe the decontamination system(s)to be used: 13. Desntbe the contaMetitatiOnfdispOsal methods lo comply with 310 CMR 7.15 and 453 CMR 614(21(41 14. For Emergency Asbestos Abatement Opentims.the DEP and DU officials who e,aluated the emergency: lw Ha PEI(Meal ■e J AJrovam woe I 6e at 4ruu/e^ 15. Do prevailing wage ates apply as pet M.G b.c149.§26.27.or 21A-F to this pojedt Cyes CI No of Nttee QUANTITY COMMONWEALTH OF MASSACHUSETTS PURCHASE REQUEST ASBESTOS NOTIFICATION DECALS CONSTRUCTION/DEMOLITION DECALS C A x C BWPAQ04 Asbestos Removal Notifications BWPAQ05 Asbestos Blanket Plan BNotifications (for DEP- Approved BWPAQ06 Construction/Demolition Notification GRAND TOTAL : $ Pleases be payable to this request t MASSACHUSETTS. o; Department of Environmental Protection P.O. Box 4062 Boston, MA. 02211 DO NOT use this address to file notifications. RETURN ADDRESS: NOTE:• The Department of Environmental Protection will not be held liable for any lost or stolen decals. FOR DEP USE ONLY: SERIES ISSUED DATE jCovino Environmental Auoelales,Inc, :300 Wildwood Ave,Woburn, MA Asbestos Bulk Chain of Custody - Paga < or �c.... :Phone 781.9332555 Fax 781.932.9402 Email mail®covinoinc,eom - Client: DEPART&H4ftOFENVIRONMENTAL PROTECTION ' Turnaround(Nree)eeme.l elan dvd(S I day) Covtue Nolen No.QQ,OpXXf 476DWlGNTSTNgT Contact PO®SNULTZ 9mplea Collected� 1,2,4' (ft /�— SPFINGFIBLD,Mq 0.1103 k. of Lieen,e X J}�AO Project Name and London: /kj " rro- `' Cr--� Phone 413.77527IX a Da e)Collected: 4—R-ae/ ,�/ , •1i3 i�., + '. - ��-1 � ' 7 ✓1'U i,TLt(/nr.. LtL1: Fax Ill-144.1119 a.m,�t,': c.a h. 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A. 1 .fi _ . i, IR RI 436 DWIGHT SflEET Contact- A�wAn,r� Sarin ProjectItdby:.QQ�04�J SPRINGFIELD,MA 0119$ 4/ -� / e Samples Ulm led by e b � Pra§eat Nunn 8,-/-4,.. d'✓- ri4'l+,O4I �fHl�`r.+� ,�, and Location: n P**)R *-rte No, .en >`� Fa-<13784- 1 r. _ i� AI{tS aIV s1 01 ITAIM4 Co n"' Stemo!c7 WantPrepulet B .(•A;1'P 031 IAEI �.:.•I r t _-_ _ : : iilC `rf. YYisa{e�ptt� �pd� {{p� tiY � FleId IDN DESCR►p7'ION : xie 1 '11 2ibeteth:T walnut.: AN�2n Verne /11111111111111111111111111111 i P ��f�iF dIM1 �SYSrLtM-i, �HY+i° III y1 a MA FERIAE: e41._..Jars ffoJN� ME.._ Ili .. ill t f .r ti _ :.. TWN: !� / I 1.11 I 111111111 MATERIAL: idrOLU+dsg/7 i f tam 11�211111_.I- .: ION: i v+'�, �-. wcAT y✓ T M_ .-' .•' / 11,11 .Iq ��1 ��� A, .�� T �y� 11111111115111g111 :1 � �s t MATERIAL: ✓(L't+'+ t� ^ e / jr LOCATION; 0-' Q64 C- Iy J rt c- .�,�65 moo ©m�0�111111111 Imo . -1 ��� RU : f",pan fi 'lit. 6�u/uY Brv/t, + ill�����l z S Gee! uI tiS 'L ��F LOCATION: Dn. /�'r+�e- ee U.� ...�.. l�l < co t ✓7F/'i-/hr 0�/ 70 tit f f' ;�OyO�u LOChT10N: do ZP V� PIIIIiiiiiiiiiiiii 6,; r� ef,?1. .....'-' "I ::- 4- rr.� . _Date: - J -oY - t �" ��' Date: (�7 Re:xJved by:�--- `ea c .�.4. _ ,� D.te�r�Analyaee: AtcoPtulnbed by: a AnnlyN'r Sf�ator< G AoeaPty �RaJee1T__RenonfCommeott: r Rev 9/4211 1 &RD OF HEALTH MEMBERS OFFICE OF THE BOARD OF HEALTH IARIE KARPARIS,R.N.,MPH JAY FLEITMAN,M.D. STAFF J.Mathieu,R.S.,M.S.,C.H.O. hector of Public Health rczywor,R.S.,Sanitary Inspector bbott,R.N.,Public Health Nurse Madeline Heon,Clerk CITY OF NORTHAMPTON MASSACHUSETTS 01060 212 MAIN STREET NORTHAMPTON,MA 01060 (413)587-1214 FAX(413)587-1221 Memo to the File: 153 Bridge Street From: Ernest I. Mathieu,Director of Public Health Date: April 16,2004 at 4:50 A.M. Re: Illegal asbestos siding removal at 153 Bridge St. On April 16, 2004 at approx. 3.00pm, I responded to a complaint of illegal asbestos siding removal at 153 Bridge Street. The contractor was: Norman Zaleskey 37Chesterfield Road P.O. Box 5325 Williamsburg,MA Tel 413-268-3553 Upon arrival I introduced myself to Von Dauber, Police Officer, and the contractor. I verified that the siding was asbestos. Stanley Szewczyk,Assistant Building Inspector suspended the building permit. Also, a verbal cease and desist order was given to the contractor. Asbestos on the ground was covered with plastic tarps. Asbestos in cardboard boxes with the covers closed were placed along the house to be removed later in compliance with applicable laws. Returned to office to call D.E.P. and OSHA. Contacted Steve Ellis at DEP who said he would have Bob Shultz call me Received a call back from Bob Shultz(w-784-11000) (H-786-80260) (fax 783-1149) from DEP who was at home. I explained the entire situation to him in detail. I faxed him all my phone numbers via a copy of my business card. I provided with all the information about the contractor doing the work. He said he would call the contractor and make a site visit tomorrow morning and follow through. He also said he would contact Bill Sparks from the DLI. He will call me on Tuesday. PAGE 2 Below are photos I took on 04/16/04: •