PSCAA#5/12/22, 3:49 PM Approved Transaction
RECEIVED
pscIeanal r.org
Puget Sound -kean Air Agency May 20 2022
CITY OF EDMONDS
DEVELOPMENT SERVICES
Notification Case #: 202202266 DEPARTMENT
This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the
asbestos project or demolition site (Reg III, 4.03(a)(6)).
Fee Amount Paid $275.00
Credit Card Transaction # AA0A5E18C80D
Transaction Date 05/12/22
Owner's Name Glacier Environmental Services, Inc Phone (425) 355-2826
Project Street Address 7500 212th Street SW
City Edmonds Zip 98568
Contact Person lauren Golembiewski Phone (425) 355-2826
Mailing Address PO Box 1097
Mukilteo, WA 98275
This project Includes asbestos removal.
Project Size linear feet / 191 square feet
Project Start Date 06/01/22 Completion Date 07/30/22
Asbestos will be removed by a licensed asbestos abatement contractor
Contractor Affordable Environmental Contractor Job #
Contact Vicki Boser Phone (425) 512-8750
Mailing Address PO Box 40
Mountlake Terrace, WA 98043
This project includes a demolition.
Demolition Start Date 06/01/22 Completion Date 07/30/22
Demolition will be completed by a demolition contractor
Demo Contractor Property Owner Contractor Job #
Contact Phone
Mailing Address
(1) I certify that the information I have provided is to the best of my knowledge true and accurate.
(2) I 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 structure. The only exception is for a single-family
residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the
same street address. If there is no street address, I have used a building number.
(4) I understand the fees for this Notification are nonrefundable.
Create Another Notification
If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
https.1/secure.pscleanair.org/AsbestoslApproved.aspx 1 /1