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<br />~~A <br />ra <br /> <br />... . ....'lI <br /> <br />...... . . ~ <br /> <br />Florida Department of <br /> <br />Environmental Protection <br /> <br />r21''''~._I)' <br />tit" <br />.... , all <br /> <br />Twin T..... Ollle. BIq. . :600 Blair ~'_.a...l . T.II-L....- 'I'F. FWWa J2S~ <br /> <br />NOTICE OF 'ASBESTOS REMOVAL PROJECT <br /> <br />TY'fI! OP NOTICE: C Original 0 Revised 0 CanceJled 0 Demolition <br /> <br />L Fal;llrty Name East Pasco Medical Center <br />Add~~ 7050 Gall Blvd. <br />Ci:v Zeohvrhills. Sm. FL CountY Pasco <br />Site Surveyed by <br />Bulding:)~ 12 X 40 ( Square Feet) # of Roars 1 Age in Y e~ 9 Prior' Use CatS can <br /> <br />II. Fee Receipt Wi" Be Sent to Address in Block Below: (Print or Type) <br /> <br />, OWNER PROJeCT NUMBER <br />I i Fee CheCK Number <br />I Other <br />. <br /> <br />III Faolitv Owner East Pasco Medical Center <br />~dd~ 7050 Gall Blvd. <br />~. Zephvrhill~. <br /> <br />State FL <br /> <br />Phone (813 ) 788-0411 Ext./11311 <br />Zip 33541 <br /> <br />___.u__.........___.._____....___;..,~..._..._._.__. <br /> <br />IV. ContrClc:tor'S Name L.::i. w ~J.son t"av~ng <br />Add~ Wilson Drive <br />Gty: Zephyr hills, <br /> <br />Phone ( <br /> <br />State FL <br />Ronda license No.: <br /> <br />Zip: <br /> <br />33541 <br /> <br />V, DEMOUTION 0 <br /> <br />REMovAl C <br /> <br />DEMOUr:ON WITH NO A01If] <br /> <br />Em~ency 0 <br /> <br />,~nua! 0 <br /> <br />Removal: Start Date <br /> <br />Finish Date <br /> <br />! Demolition: Start Date 08/"'/98 <br /> <br />Finish Due 08/';t98I <br /> <br />VI. ReMovALlDEMCUTlON P~OCEDUP.fS TO Be useo <br /> <br />Strip & Removal <br />V\let MettlOd i -Dry Method <br />'"MUST OaTAI'I ~R DEP A/IfIf4.0V/4A... BEFoRE USING..... DRY METHOD! <br /> <br />VlL w~ Disposal Site ~e <br />Address <br /> <br />VIII. Fee Calculation & Type of RACM in Renovations 0" ACM in Demolitions <br />RA01~ <br />(cirda Yes 0,. No) <br />Square Feet Surfacing Matenal_._._.~._ Yes ____NoX_ <br />Linear Feet P"lpe.________oo.____Yes___Nox.. <br />SQUare Feet Cementitious Material.__ Yes.___NoX_ <br />Square Feet Resilient Roonng......__....__..Yes_Nox... <br />Square Feet Asphalt Rooting.,_____.._ Yes ...___._.NoX_ . <br />Total MCM (square + linear feet) <br />$ Endosed (See Fee Schedule) !Xl O1eck if Demolition Only <br /> <br /> <br /> <br />Bulldozer <br />Exclode <br /> <br />Wrecking Ball <br />I Bum Down <br /> <br />City <br /> <br />Oan <br />S1ate <br /> <br />IX Asbestos Wasra Transporter' <br /> <br />Name <br />Phone ( <br /> <br />X. Procedures (or Un~ected MCM <br /> <br /> <br />l'" <br /> <br />July 29. 1998 <br />(Date) <br /> <br />Postmark <br />Fee ReceIVed $ <br />GO'd <br /> <br /> <br />00ll18- <br />Date Received <br /> <br />~:G't <br /> <br />'.. <br />86. 8 [n[ <br /> <br />8SU9-U17L-~!8:xe.:l <br /> <br />lsra lS~lnnS ~~~ <br />