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10 CEDARVIEW ROAD - ASBESTOS & PEST CONTROL DOCUMENTS CORE CONTRACTING SERVICES, INC. Invoice ENVIRONMENTAL SPECIALISTS Date Invoice# 195 Massachusetts Avenue Lexington,MA 02420 2/20/2020 14504 Bill To Brenna McNiff 37 Woodbury St Beverly,MA 01915 P.O. No. Terms Project Quantity Description Rate Amount Asbestos Abatement at 10 Cedarview Rd,Salem 1,720.00 1,720.00 Asbestos Air Test 350.00 350.00 Asbestos Abatement Notification Fee 100.00 100.00 Generator/Gas Usage 100.00 100.00 Portable Water Usage 100.00 100.00 I Phone# Fax# Total $2,370.00 781-721-4540 LlMassachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: JJMAHONEY Transaction ID: 1171736 Document: AQ 04-Asbestos Removal Notification Form ANF-001 Size of File: 230.77K Status of Transaction: In Process Date and Time Created: 21412020:6:28:34 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. IMM Massachusetts Department of Environmental Protection BWP AQ 04 (ANF-001)PreForm Asbestos Notification Form I` This is a revision to an existing form. Project 1D for existing form to be revised: This job is being conducted under a Blanket Permit. MassDEP assigned Blanket Authorization 1D: r This job is being conducted under a Non Traditional Abatement Work Practice Pen-nit. MassDEP assigned Non Traditional Work Practice Authorization 1D: I This job does not require the use of an asbestos contractor licensed by the MA Department of Labor Standards because(please check one box below): F This job involves breaking,shearing or slicing of non-friable asbestos-containing material only(e.g.cement shingles/panels,cement pipe,asphalt roofing or siding,vinyl floor tiles,etc.)in a manner that does not generate asbestos dust or render the material friable,as allowed by the Department of Labor Standards(DLS)at 453 CMR 6.13(2)(a)5.All work must be done in compliance with the applicable regulations at 310 CMR 7.15;or r This job involves work on asbestos containing material that is classified by the Department of Labor Standards (DLS)as a`Small-Scale Asbestos Project,'an`Asbestos-Associated Project',or an`Asbestos Response Action' by qualified'in-house' personnel as allowed by the Department of Labor Standards(DLS)at 453 CMR 6.00,and will be performed in accordance with all the requirements of 453 CMR 6.13(1)(a),453 CMR 6.13(2)(a)l.and 3., and 453 CMR 6.14(1)(a),as applicable. All work must be done in compliance with the applicable regulations at 310 CMR 7.15, G None of the above conditions apply,generate a new form. Revised: 11/13/2013 Page 1 of 1 Massachusetts Department of Environmental Protection i 100323551 ` BWP AQ 04 (ANF-001) Asbestos Project# r Asbestos Notification Form f— Project Revision T` f` Project Cancellation A. Asbestos Abatement Description 1.Facility Location: 10 CEDARVIEW RD 10 CEDARVIEW RD Instructions 1.All a.Name of Facility b.Street Address sections of this form SALEM MA 01915 9784739655 must be completed in order to comply with c.City/Town d.State W.Zip Code f.Telephone MassDEP notification BRENNAMCNIFF PROJECTMANAGER requirements of 310 9 Facility Contact Person Name h.Facil'ity Contact Person Title CMR 715 and Department of Labor Work-site Location: 10 CEDARMEW RD Standards(DLS) i.Building Name,Wing,Floor,Room,etc, notification requirements of 453 2. Is the facility occupied? rV a.Yes r b.No CMR 6.12 3. Is this a fee exempt notification (city,town, district, municipal housing authority, state facility, or owner-occupied residential property of four units or less)? W a.Yes I— b.No MassDEP Use Only 4.Blanket Permit Project Approval,if applicable: Date Received Approval ID# 5.Nun-1'raditional Asbestos Abatement Work Practice Approval; if applicable: Approval ID# 6.Asbestos Contractor: CORE CONTRACTING 3 OAKLAND STREEM a.Name b.Address WOBURN MA 01801 7817214540 C.City/Town d.State e.Zip Cade f.Telephone AC000754 h.Contract Type:P 1.Witten 1-2.Veibal g.DLS License# 7. ALGELISM.CAMPUSANO AS901676 a.Name of Contractor's On-Site Supervisor/Foreman b.DLS Certification# EDWIN G.MORGAN JR. AM051114 $ a.Name of Project Morritw b.DLS Certification# 9. ASBESTOS NOTIFICATION LABORATORY AA00208 a.Name of Asbestos Analytical Lab b.DLS Certification# 10. 2/14/2020 3/14/2020 a.Project Start Date(MM/DDA r") b.End Date(MMIDWYYYY) 7AM-7PM 7AM-7PM c.Work Hours-Monday Through Friday d,Work Hours-Saturday 8 Sunday 11.What type of project is this" r a.Demolition rw-o b.Renovation I— c.Repair r- d.Other-Please Spccify: Remised: 11/13/2013 Page 1 of Massachusetts Department of Environmental Protection 100323551 _ ' BWP AQ 04 (ANF-001) Asbestos Project# Asbestos Notification Form r Project Revision I— Project Cancellation A.Asbestos Abatement Description: (cont.) 12.Abatement procedures(check all that apply): r a.Glove Bag I- b.Encapsulation T_ c.Enclosure I— d.Disposal Only r e.Cleanup V f.Full Containment r g.Other-Please Specify: 13.Job is being conducted: IV a.Indoors 'I— b.Outdoors 14 a. Total amount of each type of asbestos Containing materials(AGM)to be removed,enclosed,or encapsulated: 120 1.Linear Feet(Lin.Ft) 2.Square Feet(Sq.Ft) b.Boiler,Breaching,Duct, c.Transite Pipe "Tank Surface Coatings 1 Lin.Ft. 2.Sq.Ft 1.Lin.Ft 2.Sq.Ft d.Pipe Insulation e.Transite Shingles 1.Lin.Ft. 2.Sq.Ft. 1.Lin.Ft 2.Sq.Ft 1'.Spray-On Fireproofing g.'Transite Panels 1.Lin.Ft. 2.Sq,Ft 1.Lin.Ft. 2.Sq.Ft. h.Cloths.Woven Fabrics i.Other-Please Specify: 1.Lin.Ft. 2.Sq.Ft. j.Insulating Cement TLEF LINOLEUM 120 1.Lin.Ft 2,Sq.Ft. 1.Lin.Ft 2.Sq.Ft 15.Describe the decontamination system(s)to be used: THREE CHA ABERDECON 16.Describe the containerizationldisposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): wEf TO DOUBLE BAG 17,For Emergency Asbestos Operations.the MassDEP and DLS officials who evaluated the emergency: a.Name of MassDEP Official b.Title of MassDEP Official c.Date of Authorization(MM/DDNYYY) d.Waiver# e.Name of DLS Official f.Title of DLS Official g.Date of Authorization(MM/DDNYYY) h.Waiver,# 18.Do prevailing wage rates as per M.G.L.c. 149,§26.27 or 27A—F apply to this f- a.Yes W b.No project? Revised: 11/13/2013 Page 2 of 4 Massachusetts Department of Environmental Protection `100323551 sb A BWP AQ 04 (ANF-001) Asbestos-_._-_-- _estos Project# Asbestos Notification Form 1" Project Revision Project Cancellation B. Facility Description HONE 1.Current or prior use of facility.- 2. is the facility owner-occupied residential with 4 units or less?9— a.Yes b.No BRENNAMCNIFF 1 o CEDARVIEW RD a.Facility Owner Name b.Address SALpyl MA 01915 9784739655 c.City/rown d.State e.Zip Code f.Telephone 4 BRENNA MCNIFF 10 CEUARVIEW RD a.Name of Facility Owner's On-Site Manager b.Address SALEM MA 01915 9784739655 c.Cityrrown d.State e.Zip Code #.Telephone CORE CONTRACTING 3 OAKLAND ST 5.a.Name of General Contractor b.Address WOBURN MA 01801 7817214540 c.City/Town d.State e.Zip Code t Telephone TRAVELERS g.Contractor's Worker's Compensation Insurer 4/20/2020 1 K32069 h.Policy# i.Expiration Date(MMIDONYYY) 2000 2 6.What is the size of this facility? a.Square Feet b.#of Floors Note:Temporary C. asbestos Transportation & Disposal storage of Asbestos containing waste 1.Transporter of asbestos-containing paste material from site of generation: material is only allowed at the place r a.Directly to Landfill or W 1 ' Storage Location/l'ransfer Station of business of a DLS licensed Asbestos 3 OAKLAND ST contractor or a transfer CORE�C' station that is c.Name of Transporter d.Address permitted by MA 01801 78172'14540 MassDEP and WOBU�1 operated in e.City/Town f.State g.Zip Code h.Telephone compliance with Solid Waste Regulations 310 CMR 19.000 2.if a temporagl%olage lvcation:transfer station is used.list name of transporter of asbestos containing waste material from temporary storage location/transfer station to final disposal site: TRANSWASTE 3 BARKER DRIVE a.Name of Transporter b.Address WALLINGFORD Cr 06492 2032698300 c.City7rown d.State a Zip Code f.Telephone Revised: 11/13/2013 Page 3 of 4 `71 Massachusetts Department of Environmental Protection 100323551 L BWP AQ 04 (ANF-001) Asbestos Project# Project Revision Asbestos Notification Form f F Project Cancellation C.Asbestos Transportation&Disposal: (cont.) 3.Name and address of temporary storage location/transfer station for the asbestos containing waste material: MINERVA 9M MINERVA RD a Temporary Storage -ocation Name b.Addr ms WAYNESBURG OH 44688 3308663435 c.Cityfrown �­S­tate -�.-bp—Cod. 4.Name and location of final disposal site(asbestos landfill): MINERVA FRANK STUFANO a.Final Disposal Site Name b.Final Disposal Site Owner Name 9000 MINERVA RD c.Address WAYNESBURG CH 44688 3308663435 T— — d.City[Town State FZip Cod. g.Telephone Note:Contractor must sign this form for DLS notification purposes D. Certification joHN MAHONEY JOHN MAHONEY "I certify that I have personally 1.Name 2.Au rized Signature examined the foregoing and am PRESIDENT 2/4/2020 familiar with the information 3.Positionfritle 4.Date(MMIDD/YYYY) contained in this document and 7817214540 CORECONTRACTING all attachments and that,based 6.Representing on my inquiry of those 5.Telephone individuals immediately 3 OAKLAND ST WOBURN responsible for obtaining the 7.Address 8.C own information,I believe that the MA 01801 information is true,accurate,and 9.state 10.Zip Code complete.I am aware that there are significant penalties for submitting false information, including possible fines and imprisonment.The undersigned hereby states that I have read the Commonwealth of Massachusetts regulations governing asbestos abatement (453 CMR 6.00 promulgated by the Department of Labor Standards and 310 CMR 7.15 promulgated by the Department of Environmental Protection), and that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised: 11/1312013 Page 4 of 4 Dennis the Mennis "The King of Pest Control" Termite and Pest Control Specialists MAIN OFFICE AND LABS 29 Locust Street Lynn, Ma. 01904 Boston Lynn Lowell Woburn Newton Peabody Lawrence 567-1038 592-0023 459-2950 935-DEAD 332-5853 532-3443 689-0697 PEST 1 PET2 Date: December 13, 2019 Location: 10 Cedarview Street, Salem,Ma Service Date: Our men serviced here on December 13, 2019. General Comments: We serviced the above location for demo baiting per State and Federal regulations. All baiting stations are in place. Conditions/Observations:N/A Materials utilized: Contrac Soft Baiting Packets—EPA# 12455-146 Al%@ 0.005 Bromadiolone Please call if you need anything thing additional. Thank you, Dennis Mastrolia James Duffy Mark Hudson. 781-592-0023 800-649-3028