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ASBESTOS DUST MITIGATION PLAN APPLICATION CONSTRUCTION AND GRADING (Bay Area Air Quality Management District)

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BAY AREA AIR QUALITY MANAGEMENT DISTRICT
375 Beale Street, Suite 600
San Francisco, California 94105
(415)
771-6000
ASBESTOS AIRBORNE TOXIC CONTROL MEASURE FOR
CONSTRUCTION AND GRADING OPERATIONS
§ 93105, Title 17, California Code of Regulations
ASBESTOS DUST MITIGATION PLAN APPLICATION
For the Discovery of Asbestos, Ultramafic Rock, or Serpentine
1. Company and Project Information
Company Name and Address Project Location
Name Location
Address Address
City/State Zip City/State Zip
Contact
Date of Discovery of asbestos, ultramafic rock, or
serpentine:
Phone Fax Estimated Completion Date: Start Date:
The following information is requested to assist in the evaluation of your Asbestos Dust Mitigation Plan. Omission of this
information may result in a delay of the completion of the evaluation and approval of the plan. Please provide the
information requested below; place a checkmark in front of each of the categories that applies.
2. Detailed Project Information
Type of Project: (Check all that applies)
Road or Railway Construction
Road Maintenance
Housing Development
Commercial Property Development
Trenching / Utilities Work
Other (please describe)
3. Detailed Site Information
Areas and Facilities within a quarter mile (400 meters) of the Project: (Check all that applies)
Residential
Commercial
Industrial
Rural
Hospital / Nursing Home
School
Park / Playground
Other (please describe)
For District Use Only
Date
Rec’d
File #
Press here to clear form
ASBESTOS DUST MITIGATION PLAN APPLICATION
BAY AREA AIR QUALITY MANAGEMENT DISTRICT 375 Beale Street, Suite 600, San Francisco, CA 94105
Page 2 of 5
4. Addition Information
The following information MUST be included:
Map(s) clearly indicating:
If available, please attach the
following information:
Property lines / boundaries
Rights of way / easements
Areas to be cleared or graded
Trenching areas
Excavation sites
Storage areas / piles
Track-out control
Staging areas for removal
Truck routes
On-site parking lots
Geologic Information
Topographical Maps
Meteorological Data
CONSTRUCTION AND GRADING OPERATIONS CHECKLIST FOR
PROJECTS GREATER THAN AN ACRE
ELEMENTS THAT MUST BE INCLUDED:
Each of the following sources of dust emissions MUST be addressed in the Asbestos Dust
Mitigation Plan:
Track-out onto the paved public road;
Active storage piles;
Inactive disturbed surface areas and storage piles;
Traffic on unpaved on-site roads;
Earthmoving activities;
Off-site transport of materials; and
Post-project stabilization of disturbed soil surfaces.
ASBESTOS AIR MONITORING PLANS:
If required by the District, complete an Asbestos Air Monitoring Plan for District approval.
An air monitoring plan MAY BE
required if one or more of the following lies within a quarter mile (400
meters) of any boundary of an area to be disturbed:
Residence;
School / Daycare center;
Industrial Facility
Business;
Park / Playground;
Hospital / Nursing Home
Development of an Asbestos Air Monitoring Plan does not constitute a requirement to
implement air monitoring.
However, if the District would like to determine the effectiveness of the application of the dust
mitigation measures listed in your dust mitigation plan, the plan would be required to be implemented
within one business day of notification from the District.
Page 3 of 5
5. Track-out onto the paved public road
Please mark the box preceding each measure that will be implemented:
THIS MEASURE MUST BE ADDRESSED:
Any visible track-out on a paved public road at any location where vehicles exit the work site MUST be removed;
Removal MUST be done using wet sweeping or a HEPA filter-equipped vacuum device at the end of the work day
or at least one time per day.
AND installation of one or more of the following track-out prevention measures:
A gravel pad designed using good engineering practices to clean the tires of exiting vehicles
A tire shaker
A wheel wash system
Pavement extending for not less than fifty (50) consecutive feet from the intersection with the paved public road
Any other measure(s) as effective as the measures listed above: (Briefly describe below)
6. Active Storage Piles
THIS MEASURE MUST BE ADDRESSED:
Keep active storage piles adequately wet or covered with tarps.
7. Inactive Areas and Storage Piles
Please mark the box preceding each measure that will be implemented:
Control for disturbed surface areas and storage piles that will remain inactive for more than seven (7)
days shall include one or more of the following:
Keep the surface adequately wet;
Establish and maintain of surface crusting sufficient to satisfy the test in subsection 93105(h)(6);
Apply chemical dust suppressants or chemical stabilizers according to the manufacturer’s recommendations;
Cover with tarp(s) or vegetative cover;
Install wind barriers of fifty percent (50%) porosity around three (3) sides of a storage pile;
Install wind barriers across open areas;
Any other measure(s) deemed as effective as the measures listed above. (Briefly describe below)
ASBESTOS DUST MITIGATION PLAN
APPLICATION
BAY AREA AIR QUALITY MANAGEMENT DISTRICT 375 Beale Street, Suite 600, San Francisco, CA 94105
Page 4 of 5
8. Traffic on On-Site Unpaved Roads, Parking Lots, and Staging Areas
Please mark the box preceding each measure that will be implemented:
THIS MEASURE MUST BE ADDRESSED:
A maximum vehicle speed limit of fifteen (15) miles per hour or less;
AND one or more of the following:
Water every two ho
urs of active operations or sufficiently often to keep the area adequately wetted;
Apply chemical dust suppressants consistent with manufacturer's directions;
Install wind barriers of fifty (50) percent porosity around three (3) sides of a storage pile;
Maintain a gravel cover with a silt content that is less than five (5) percent and asbestos content that is less than
0.25 percent, as determined using an approved asbestos bulk test method, to a depth of three (3) inches on the
surface being used for travel; or
Any other measure(s) deemed as effective as the measures listed above. (Briefly describe below)
9. Earth Moving Activities
Please mark the box preceding each measure that will be implemented:
Control for earthmoving activities must include one or more of the following:
Pre-wet the ground to the depth of anticipated cuts;
Suspend grading operations when wind speeds are high enough to result in dust emissions crossing the property
line, despite the application of dust mitigation measures;
Apply water prior to any land clearing; or
Any other measure(s) deemed as effective as the measures listed above. (Briefly describe below)
ASBESTOS DUST MITIGATION PLAN APPLICATION
BAY AREA AIR QUALITY MANAGEMENT DISTRICT 375 Beale Street, Suite 600, San Francisco, CA 94105
Page 5 of 5
10. Off-Site Transport
Please mark the box preceding each measure that will be implemented:
THIS MEASURE MUST BE ADDRESSED:
The owner or operator must ensure that no trucks are allowed to transport excavated material off-site
unless:
Maintain trucks such that no spillage can occur from holes or other openings in cargo compartments; AND
Loads are adequately wet;
AND Either of the following measures:
Cover with tarps; or
Load such that the material does not touch the front, back, or sides of the cargo compartment at any point less
than six inches from the top and that no point of the load extends above the top of the cargo compartment.
11. Post Construction Stabilization of Disturbed Areas
Please mark the box preceding each measure that will be implemented:
Upon completion of the project, disturbed surfaces shall be stabilized using one or more of the
following:
Establish a vegetative cover;
Place at least three (3.0) inches of non-asbestos-containing material;
Paving; or
Any other measure deemed sufficient to prevent wind speeds of ten (10) miles per hour or greater from causing
visible dust emissions.
(Briefly describe below)
ASBESTOS DUST MITIGATION PLAN
APPLICATION
BAY AREA AIR QUALITY MANAGEMENT DISTRICT 375 Beale Street, Suite 600, San Francisco, CA 94105
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Completed 27 January 2021

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