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►� "' "'. Florida Department of DEP Form 62.257.900(1) Effective 10-12-08 Environmental Protection Pagetol2 RORFDA li Division of Air Resource Management Imail NOTICE OF DEMOLITION OR ASBESTOS RENOVATION TYPE OF NOTICE (CHECK ONE ONLY): 1 ORIGINAL ❑ REVISED ❑ CANCELLATION ❑ COURTESY TYPE OF PROJECT (CHECK ONE ONLY): ® DEMOLITION ❑ RENOVATION IF DEMOLITION, IS IT AN ORDERED DEMOLITION? OYES IS NO IF RENOVATION: IS IT AN EMERGENCY RENOVATION OPERATION? OYES 0 NO IS IT PLANNED RENOVATION OPERATION? OYES ❑ NO 1. Facility Name Whataburaer Restaurant Address 7809 Gall Boulevard City Zephyrhills State FL Zip 33541 County Pasco SiteParcel ID: 34- 25 -21- 0150 -0000 -0020 Consultant Inspecting Site (pre - demolition) Building Size 3,100 ( + / -) (Square Feet) # of Floors 1 Building Age in Years 5 Prior Use: ❑ School/College/University ❑ Residence ® Small Business ❑ Other Present Use: ❑ School/College /University ❑ Residence ❑ Small Business ® Other Vacant building 11. Facility Owner Fifth Third Bank Phone ( ) Address 38 Fountain Square Plaza City Cincinnati State OH Zip 45263 III. Contractor's Name KEL Constructors Phone (407) 513 -1903 Address 124 Terra Mango Loop, Suite 6 City Orlando State FL Zip 32835 Is the contractor exempt from licensure under section 469.002(4), F.S.? ❑ YES ® NO IV. Scheduled Dates: (Notice must be postmarked 10 working days before the project start date) Asbestos Removal (mm/dd/yy) Start:N /A Finish:N /A Demo/Renovation (mm/dd /yy) Start: 11/17 Finish:12 /01 V. Description of planned demolition or renovation work to be performed and methods to be employed, including demolition or renovation techniques to be used and description of affected facility components. Standard demolition of existing on -site building. No asbestos found per ore- demolition inspection performed by a FL licensed asbestos inspector. Proce es to be Used (Check All That Apply): C4 Strip and Removal ❑ Glove Bag - 13d Bulldozer 0 , Wrecking Ball y id' W et Method 0 Dry Method ❑ Explode _ ❑ Bum Down OTHER: VI. Procedures for Unexpected RACM: Activities will cease and suspect RACM will be sampled or material will be wetted. VII. Asbestos Waste Transporter: Name N/A (no asbestos found) Phone ( ) Address City State Zip VIII. Waste Disposal Sit?: Name \()..-., tG (vjc 1 (;j �''1i -T ICI t C V6 Address - 9 l.,`L �q 3 J City LA r ii 1`. State { Zip . L9 IX. RACM or AC*: Procedure, including analytical methods, employed to detect the presence of RACM and Category I and I1 nonfriabie ACM. Pre- demolition inspection by FL licensed asbestos inspector, samples analyzed via PLM, Amount of RACM or ACM* X. Fee invoice Will Be Sent to Address in Block Below: (Print or Type) 0 square feet surfacing material Fifth Third Bank o linear feet pipe 0 cubic feet of RACM off facility components 38 Fountain Square Plaza o square feet cementitious material Cincinnati, Ohio 45263 0 square feet resilient flooring 0 square feet asphalt roofing `Identify and describe surfacing material and other materials as applicable: I certify that the above information is correct and that an individual trained in the provisions of this regulation (40 CFR Part 61, Subpart M) will be on -site i during the demolition or renovation and evidence that the required training has been accomplished by this person will be available for inspection during norp3alu me rs. r t� c• / � I ?CL' / (Date) /14//c( C A G.v k ( rtnt aI r @ edOp a 11 1/' � L_ 1 /5// 0 (Signature of Owner /Operator) (Date) DEP USE ONLY Postmark/Date e X ., . F 5 WC' I �pp x � 1-4 .