Determination of No RACM Present /Amount of RACM Present is Below Established Thresholds for Demo Project (see Section I) Inspector’s Name Certified Lab Name Lab Accreditation No. Inspector’s Accreditation No. Inspection Date (mm/dd/yy) Analysis Date (mm/dd/yy) Procedure, including analytical method, if appropriate, used to detect the presence of asbestos material Attach the following copies: Signature page of inspection report for inspection date indicated (above) • Lab Analysis Report for analysis date indicated (above) • NOTE: The will not be processed without these attachments. Asbestos Negative Declaration Demo Notification Form AAC-2(b) Asbestos Containing Material (ACM) Not to be Removed from Structure Prior to Demolition (if ACM is present) RACM Non-regulated ACM TSI Fireproofing VAT Asphalt Roofing Type of Asbestos Material Ceiling Tile Other Mastic Other linear feet linear feet Amount of Asbestos square feet square feet Material Not Removed cubic yards cubic yards Demolition Contractor Contractor Name Contact Name Mailing Address Contact Email City State Zip Phone ( ) Scheduled Demolition Dates Start Date (mm/dd/yy) Completion Date (mm/dd/yy) Governmental Agency-Ordered Demolition (Complete only if you answered “Yes” in Section II) Agency Representative Name Title Agency Date Issued (mm/dd/yy) Date Ordered to Begin (mm/dd/yy) Attach a copy of the Demolition Order from the governmental agency identified (above). NOTE: The will not be processed without this attachment. Asbestos Negative Declaration Demo Notification Form AAC-2(b) Emergency Demolitions (Complete only for emergency event indicated by checked “Emergency” box on page 1) Date of Emergency (mm/dd/yy) Time of Emergency Describe the sudden, unexpected event requiring immediate attention
Determination of No RACM Present /Amount of RACM Present is Below Established Thresholds for Demo Project (see Section I) Inspector’s Name Certified Lab Name Inspector’s Accreditation No. Lab Accreditation No. Inspection Date (mm/dd/yy) Analysis Date (mm/dd/yy) Procedure, including analytical method, if appropriate, used to detect the presence of asbestos material Attach the following copies: • Signature page of inspection report for inspection date indicated (above) • Lab Analysis Report for analysis date indicated (above) NOTE: The Asbestos Negative Declaration Demo Notification Form AAC-2(b) will not be processed without these attachments. Asbestos Containing Material (ACM) Not to be Removed from Structure Prior to Demolition (if ACM is present) RACM Non-regulated ACM Type of Asbestos Material TSI Ceiling Tile Fireproofing Other VAT Mastic Asphalt Roofing Other Amount of Asbestos Material Not Removed linear feet linear feet square feet square feet cubic yards cubic yards Demolition Contractor Contractor Name Contact Name Mailing Address Contact Email City State Zip Phone ( ) Scheduled Demolition Dates Start Date (mm/dd/yy) Completion Date (mm/dd/yy) Governmental Agency-Ordered Demolition (Complete only if you answered “Yes” in Section II) Agency Representative Name Title Agency Date Issued (mm/dd/yy) Date Ordered to Begin (mm/dd/yy) Attach a copy of the Demolition Order from the governmental agency identified (above). NOTE: The Asbestos Negative Declaration Demo Notification Form AAC-2(b) will not be processed without this attachment. Emergency Demolitions (Complete only for emergency event indicated by checked “Emergency” box on page 1) Date of Emergency (mm/dd/yy) Time of Emergency Describe the sudden, unexpected event requiring immediate attention
AAC-2b.docx