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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