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5 Asbestos Notification Form 1999 LI • Fatuity Description 1. Current or pilot use ul lacllily: Reeidentiai 2. Is the Iacilily ownm-uccupled residential wilh 4 nulls or loss? n Yes CI No 3. facility Ownol: Marcus Barrows 5 5th Avenue Thine A,✓,es Nor thamptoni_ Ma 01060 C0%lmu, 4. Iacilay's Owner's(51-Site Manner: Marcus Barrows VSne apwoim r. General Gonbaclur N/A Name 413-584-96 lelr;Nwr,e Same as above A✓✓,es, in awe lenen n ✓✓,u (Ur/loon Ip code Reliance NaLlya91 NWA1795179-00 contractor's n'o,aen Camp.humus' Pony/ G. What Is the see ul lire lacllily? (se II) (r ul flows) Asbesfus TranspultalPon and Disposal ieep,on, 11/04/99 lip Vale I. 1mnspmler of asheslus-conlaIuley waste material hum sire to tempulmy&lunge sire(II necessary)to final ills Accu'rech Insulation & Contract lug, Inc. Uumut_Street, Delta 1' Nate Amen Chicopee, MA 4'lry/loan 01013 (413) 592-5326 /6 nee Imµies 2. Transporter of asheslus-coi dalniny waste material hum renewal/temperer),stooge silo to final disposal slier Lozano Trucking Company, Inc. 25 Silver Street r (140 0.90 ar:1;C %Mid 10g111DU?a :(ano?*1101 Ls!II sl I.10(nld 10 oIZI lath vi CIO S all (unSIeS) Nd 00:7 lT l J un )slnnl mma :orlsc67 77MPWIIPlla 66/ZZ OTapp imp inlay L lmMaIAI WV 0£:L ■ a Inal u gZ9 T000 No/ Ios a' WI l0311kcnV snlsagsy '0 /001r44rs7 al aueN_ •ZI •Jn7 •seletaossV 01d SOOOOVV `H11V3H d0 a O2 'lnpuoyT lla�aH 'y 1 Ia �f'r°,(�T{!1C` 7p aueN {' /unPr>Ir110.1110 mm1 T^0 C66I c 7___a2 — -- - 8111011 ua IIEQ —� s^^a1741W LOIZLSV . : :irmalnj/nslnlatnS laalnls{ajS-ll0 •I? C -51 I 0'r Inmllrr ) rrl rvlmp rmmarrn mom 1 I ,TI I rl $I --- s000000V nrrvu..l err.,ry1 n n✓gn eon -_'/14 'an dnaT'I sails -- gzcs-z65 (Ci71tmin_._ rramvv aura "qs a7sed e1TaI 'laaalS lodan _.- -and '2n1]oi110o0 g uoF1fTnsnT qPa•rnaop peue)e :lnlae 11100 snlsa9s9 'E sf0?r, on 0 sDA gI LloPiroan RIIIIoe{mp sl 'z 1","„g 11)11M IPAux/'aueu OyNnp duoOtY allqury D ru N _ OT57-n-0-is-7uawaeg__ 10 @ aruWmPl ?none wIA01.1 T POO ow •uo TdmegaaoN__ EPA TZ96-795 -£ 7 090 i0 mWPV rum SNA ____ — anuany gig S.._ - a soon_.. "Inneaol Lr!I!oeJ ' •l IIn ji4i7Sag JUIDIIairgvsnmagsv .,p,r ,�{��� 0859 £ 5 0 1011-1NV — nifty anpeal/pnN snjsags , rt1 A��� / %nf spasngsessr141jwiJeeaumnem Ia Note:lousier Stations must comply with Ilia Solid Waste Division regula- tions'310 GAIR ‚Lou Fiala;CWJIracfor must sign This form for ULI notiUcallon purposes Wane Portland_CT Wow 3. Rehm Daimler station and owner(II applicable): N/JRN. na.. Mann 06480 bp rude Bp wilt (860) 342-0667 ItIrp'PIne ... lelr�+nvn... Won Southern A 71e ha ill USA W a sSe Servis esi?nc q. Final site: rwnnn+ e WPM B43 Miller P1 kid AJd,est Davidsville,?A cw,lonn _ 15928.- Da ...�814Z 429-2532-.-- Idep'n+n ►j' ccrtificaUmr aeathat lhassaci lion the undersigned hereby slates,under the penalties of Vei)wy,that helshe has read the Cuuunmiweallh of Massachusetts lidslnoWlcation Is Containment or Encapsulation ul Asbestos,493 Cf4110PU to the best of his/her knowledge and belie!J 31U c /. IOL ._ Analia St. Gear e Arnim e Administrative Assistant (WWII. 010 I� Delta Park Chicopee, t1A 2010 Depot Street, CI Porn - feeep g y 0 11ci.occupied i esidenital vi lout units ut less)1 f ea exempt(Cllri iuwn,JIs01c1,municipal housing aulhmil , Slicker I ilium Bout ul lours)'. S36S4-(' Au kw!SWmAMI Aceutech Insulation & Contractin mpemnino we (413 592- trepirane • On saA 0 LWa(md gpll alJ-VIZ la',I'Oz 5'Bpi :i•T'J'W lad se Aldde salei ahem Aujdeneld no 'Sl • Palm 6Z 1-0667 _ aw aepMp Ca -- 'OZ-31 On .— — lePpal liana,/°oM ueiig- /raRll . .-. . ._ ahlXpaypgp can T_ _ DM IMMO/]np aura :Aauadseme MO pe lea lene aiM SCaI n plus za inns—go p I II II line dil egl'enepemd0 pleualegV salaam AamNaug rp{ •yl •e nT Pa.xaAT TOP pee Lied um try a]Fa nun 03 a aT an. .Cuedwpa pa— aeas (A)( Tap Bpe Lied 9 paddeam. ao pa88eq aTgno� al1I1W0 AIEiIIIM AIdwon al spoglaw lesotls1P/unpeapolyeplro eq (Hyman NOV 'Cl •. • • _ - - _ pay]aw _egano : .]nssasd BAT]e$au a 4 ern sn :pasn an nl(s)walsAs unpeupnepmoep eql eq i sop •Zl OS / sTig ap 46oi3 -aP•.t:•s.'d..'n.o'adi"adlm P oseAOeapa____r__ PIe Preapalaree olio imam Inlop�— W!qeo awafgam4 - -....................'ba puieuk r— " wawa admgnnp `—• 'Miran aaGd laded yia(gio)14eenna pal .T" ..ugepr/wd'envier] wmp i '••'Mama ane/apiq l+apNgip®Ip ppaq lawn O :polelnsdeona JO pesnlane panomei eg o UM • Z9 ('li mann)spnp in sadld un palpnege nl( 0 selee Auneno sosaq�nAj iplea In;anoweens —� q WV) II IW III 9 I I I 1 *it L mown moan P Ifll Palanpuna Ngaq got an sl in e0 (Ietwoog flap r10 P chimp pnauar 'uar irsipoi ON Aloe-lap gseagla'gil g 6 � I 1 7 peso en el sempcamd mamma snlsa se ai s msa __rwnwp