81 Project Revision Notification 2007 fit
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention —Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
A. Facility Location
VACANT HOUSE
1.Name of Facility
100050233
Decal Number
:ct
Iew
2 Street Address
NORTHAMPTON
3.City
6.Telephone Number
B. Project Cancelled
0 Check here if this project is/was cancelled.
C. Project Dates
01124/2007
1.Ori•teal Start Date mm/d
3.Latest Revised dMyN)
MA
4.State
01)26/2007
Ori.in-I E d Date mmld
01(2912007
4.Latest Revised End Date(mmlddlyyyy)
D. Revised Project Dates
1.Revised Start Date(mm/ddrywy)
E. Other Project Revisions
5.Zip Code
2.Revised End Date Date(mmlddl
F. Revision Histo
EDEP:01/25/2007 11:00:08 AM
EDEP: 01/2512007 12:00:12 PM OTHERPROREV: JOB WILL BE PUT ON HOLD 1126(07 DUE TO
FRIGID CONDITIONS.
l.doc rev.215/04
JAN 3 0 2007
NORTHAMPTON BOARD OF HEALTH
Massachusetts Department of Environmental Protection
Bureau of Waste Prevention —Air Quality
Project Revision Notification
For Asbestos Notification ANF-001 and AQ 06
'100050233
Decal Number
G. Certification
The undersigned hereby states, under the penalties of perjury,that he/she has read the Commonwealth of
Massachusetts regulations for the Removal,Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310
CMR 7.15,and that the information contained in this notification is true and correct to the best of his/her knowledge
and belief.
'JUDY CROWLEY
1. Name ¢etl innature
'OFFICE MANAGER 19 /28/20 7
2. Position/Title Date(mmmdOmnd
'ACCUTECH INSULATION &CONTRACTING 1 '(413) 583-5500
5. Telephone
4. Rapresentinn
'100 STATE STREET P.O.BOX 376
6. Address
'LUDLOW
7. City/Town
n.doc•rev.2)5/04
101056
6. zip code