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HomeMy WebLinkAboutDM070042 - ASBESTOS REPORT �z Asbestos Disclosure for Demolition Project Date: Applicant Name: SQ62Z Qj /" Applicant Address: s°cll'Ae ?Ob . C-5;. 42,6/L Applicant telephone Number:_!?j � Job Address:__t V Unincorporated Area of Orange County Zip Code Demolition Permit Application Number: I declare that the demolition of the structure which job address is listed above does not involve demolition or removal of any asbestos material. Written asbestos notification is not applicable to the demolition project. ❑ I declare that the demolition of the of the structure which job address is listed above does involve demolition or removal of asbestos material, and attached is a copy of each written asbestos notification regarding the building that has been required to be submitted to the U.S. Environmental Protection Agency. Signature of Authorized Agent or Owner: County Of Orange Planning and Development Services Department ASBESTOS DISCLOSURE Central Office Inspection Office for P.O. Box 4048 22921 Triton Way 300 N.Flower Laguna Hills,CA 92653 Santa Ana,CA92702 (949)472-7979 DEMOLITION PROJECT (714)834-2626 ez:asbestos.doc(05/20/02)