PSCAA Notification.pdfasclean air.org �\ e,
'uget Sound Clean Air Agency (D JJA
P 1fication Case #: 201800034
Phis page must be printed. A printout of the notification, all amendments to the notifica Ion, and the asbestos survey shall be
ivailable for inspection at all times at the asbestos project or demolition site (Reg III, 4 03(a)(6)).
Fee Amount Paid $65.00
Credit Card Transaction # AIOF75DIEFCC
Transaction Date 01/04/18
Owner's Name Cummings Dev LLC Phone (425) 890-3397
Project Street Address 20904 72nd Ave W
City Edmonds Zip 98026
Contact Person Mark Cummings Phone (425) 890-3397
Mailing Address 9718 Slater Ave NE
Kirkland, WA 98033
This project includes a demolition.
Demolition Start Date 02/15/18 Completion Date 03/01/18
Demolition will be completed by a demolition contractor
Demo Contractor Slater Homes Corp Contractor Job #
Contact Mark Cummings Phone (425) 890-3397
Mailing Address 9718 Slater Ave Ne
Kirkland, WA 98033
(1) I certify that the information I have provided is to the best of my knowledge true and accurate.
understand that I must file an Amendment to this Notification if:
• The type of project has changed. The project types are asbestos and demolition
• The quantity of friable asbestos to be removed meets a larger project category.
• The project's start or completion date has changed.
(3) I understand one Notification must be filed for each stru
a single-family residence that includes multiple ancillary strl
garage or other outbuildings having the same street addres!
I have used a building number.
(4) I understand the fees for this Notification are nonrefund
Create Another Notification
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If you have questions, contact us at asbestos@pscleanalr.org or 206.689.4058.
:ture. The only exception is for
ctures, such as a detached
. If there is no street address,
ble.
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Contractor Demolition
Before you start any demolition project, you must check for asbestos 3nd then follow our requirements
carefully — failure to do so can result in deadly health problems, or a notice of violation and monetary
penalties. Also, check with the local building department: they may have additional requirements for
demolishing structures.
1.Obtain the summary results of the asbestds survey.
The property owner or owner's agent must have an AHERA-certified building inspector survey the
structure for asbestos and communicate the results to you and to anyone who may come in contact with
the material. Please keep a copy of the survey at the project site.
2. File an Asbestos/Demolition Notification
Regardless of whether any asbestos is identified, an Asbestos/Den
lition Notification and filing fee must
be submitted to this agency before any friable asbestos removal or demolition begins. This applies to all
structures, including mobile homes, with greater than 120 square fe �t of roof area. Make a copy of the
Notification you submit and keep it available for inspection.
. Asbestos/Demolition Notification Form
• Please refer to Regulation 111, Section 4.03 (PDF , for full details ',about notification and fees
3. Verify that all asbestos is properly removeid.
All friable asbestos -containing material must be removed prior to de olition. Nonfriable asbestos -
containing material may be left in place during the demolition, provi ed it remains nonfriable, but must
be promptly transferred to a disposal container with a sign identifyin - the material as "nonfriable
asbestos waste".
The Washington Department of Labor and Industries has stricter asbe tos removal and specific training
requirements for those who come in contact with asbestos. Please cor tact them for assistance, or call 1-
800-547-8367.
4. Properly dispose of the asbestos.
Take friable asbestos -containing waste to an Asbestos disposal facility authorized to receive the waste.
Complete and bring an Asbestos Waste Material Shipment Record (P F). to dispose of the friable
asbestos waste at the disposal site. Nonfriable asbestos -containing waste must be promptly transferred
to a disposal container labeled "nonfriable asbestos waste." Please c ntact your local disposal company
for further instructions.
5. Demolish the structure.
You must wait 10 days after filing an Asbestos/Demolition Notificatio to demolish the structure, whether
or not there is an asbestos project
For more information:
• Email Us
• Phone:206-689-4058
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