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lbk-l TEXAS DEMOLITION / RENOVATION NOTIFICATION DeptTwrtof FORM INSTRUCTION GUIDE StaWHealEh Servtces The Department of State Health Services Demolition/Itenovation Notification form combines the requirements ofthe National Emission Standards for Hazardous Air Pollutants, 40 CFR, Subpart M(NESI-IAP) aitd the Texas Asbestos Health Protection Rules (TAHPR). Both of these regulations require that written notification be submitted before beginning renovation projects which include the disturbance of any asbestos-containing building material in a public building or the disturbance of the NESHAP threshold amount of asbestos-containing material in a facility. A notification form is required before the demolition of a building or facility, even when no asbestos is present. This form must be used to fulfill either orihese requirements. Please call either 512-834-6610 or 1-800-572-5548 (within Texas), or your local regional office for assistance in completing this fonn. This form must be used whether you are notifying in accordance with NESHAP, TAHPR, or both. The notification fonn must be postmarked at least ] 0 working days (not calendar days) prior to the project start date (except for emergencies or ordered demolitions). Notifications that do not meet the 10-day requirement or are incomplete are considered to be "improper" and may result in enforcement proceedings. If an item on the form is not applicable to the project iv question, you must write "N.A." in that space, which shows that you have considered the item, but it does not apply to your operation. INSTRUCTIONS 1) The contractor's name, address, aiid office phone number must be provided. The Department of State Health Services (DSHS) Contractor License Number is required if the project falls under TAHPR. The contractor's address must match that which was submitted on the DSHS license application, ifthe company has more than one office. The site supervisor must be stated and the DSHS Supervisor License Number is oiily required for public building projects as defined in TAHPR. Two site supervisors may be listed, if there are two work shifts, etc. For a demolition in which the building does not contain asbestos, or in which the non-friable asbestos will not be removed prior to demolition, write "N.A." in the spaces provided for the abatement contractor infonnation. The trained on-site NESHAP individual and the certification date must be stated for NESHAP projects. The site supervisor and the trained on-site NESHAP individual may be the same person, if qualified. List the individual's name in both spaces. Since the DSHS License satisfies the requirements for NESHAP training, provide the supervisor's name and DSHS License Number and write "N.A." in the spaces for the NES.HAP individual aiid certification date. The demolition contractor's name, address, and office phone number must be provided for all demolition projects. An ame»dment must be submitted ifthe abatement contractor, the abatement supervisor, or the demolition contractor is changed. 2) A DSHS licensed asbestos project consultant is required to design all asbestos response actions in public buildings. A DSHS licensed asbestos project consultant is also required to design all asbestos abatement projects which involve non-friable asbestos-containing building materials in quantities greater than 160 square feet, 260 linear feet, or 35 cubic feet, in accordance with TAHPR. Provide all other information. The consultant's address must match that which was submitted on the DSHS license application, ifthe company has more than one office. lftlie project is not in a public building, the general contractor, or any other person who controls the project site, may be listed as the "operAtor." 3) Provide information on the legal owner of the facility. The invoice for the notification fee will be sent to the owner of the building and the billing address for the invoice will be obtained from the information that is provided in this section. The company's name should be written on the first line. A specific person's name should be written following "Attention..." on the second line. This person will be receiving the notification fee information. 4) Provide the name ofthe building or an identifying description. Example: vacant warehouse. A physical address must » ODU21l