Fillable Indiana Demolition and Renovation Requirements Pursuant to 326 (City of South Bend)

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Indiana Demolition and Renovation Requirements Pursuant to 326 (City of South Bend)

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Indiana Demolition and Renovation Requirements
Pursuant to 326 IAC 14-10-1,prior to the commencement of a demolition or renovation activity, the
owner or operator of a facility shall use an Indiana licensed asbestos building inspector to thoroughly
inspect the affected facility, or any part of the facility where the demolition or renovation operation will
occur, for the presence of asbestos, including Category I and Category II non-friable asbestos-containing
material.
Prior to performing any renovation or demolition, the owner or operator is required to submit a
notification of demolition or renovation to IDEM-OAQ. Pursuant to 326 IAC 14-10-3, the owner or
operator of a facility where demolition or renovation activity will take place shall provide the Indiana
Department of Environmental Management Office of Air Quality with written notice of the intention to
demolish or renovate on a form provided by the department and update such notice as necessary. A
notification is required even if no asbestos is present.
• Information regarding asbestos inspections can be found at:
https://www.in.gov/idem/asbestos/2334.htm
• Information regarding notifications can be found at:
https://www.in.gov/idem/asbestos/2333.htm
• The notification with instructions as well are located under “Asbestos” at the following address:
https://www.in.gov/idem/5157.htm#oaq_compliance_asbestos
• The completed notification should be emailed to: AsbestosDemoReno@idem.In.gov
Please direct any questions to:
Adrianne Lenyo,
Office of Air Quality
Compliance Inspector
Northern Regional Office
574-245-4882 or by email at a lenyo@idem.IN.gov
Thank you for your attention to this matter.
I
)
NOTIFICATI
ON
OF
DEMOLITION AND RENOVATION OPERATIONS
State Form 44593 {R3 / 9-18)
INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
I.
TY
PE
OF
NOT
IF
ICA
TI
ON
(check one):
I 0 Orioinal 0 Revised
0 Canceled
--
·~
II. FAC
ILI
TY
I
NFO
RM
AT
I
ON
-
·-
Owner I Operator:
Address: City:
Contact: Telephone:
Asbest
os
Removal Contractor:
Demolition Contractor:
Address:
Address:
Citv: Stat
e:
I ZIP: City:
Contact: Teleohone:
Contact:
E-mail: E-mail:
- -
- - - -
·-
..-
·-
IN License Number: Expiration:
~
- -
Licensed
Asbestos lnsoector: Proiect Desianer:
Address: Address:
Citv: State:
I ZIP: Citv:
Contact: Teleohone: Contact:
E-mail: E-mail:
IN License Number: Exoiration: IN License Number:
-
Il
l. TY
PE
OF
OPERAT
I
ON
-
-·-
0 Demolition
I 0 Renovation I 0 Ordered Demolition I 0 Emeroency Renovati
on
IV
.
IS
ASBEST
OS P RE
SENT?
0Yes
I
ONo
-
I 0 Courtesy
-
State: I ZIP:
E-mail:
State: I ZIP:
Teleohone:
..
-
t
Stat
e:
I ZIP:
Telephone:
Expiration:
-
I 0 Intentional Burnino
V.
PROCE
D
UR
ES I
ANA
L
YT
I
CAL
M
ETH
ODS
U
SED
TO
D
ETEC
T T
HE
P
RESENCE
AND
AMOUN
T
OF
ASBESTOS
MA
T
ERIALS
VI.
A
PPR
OX
IM
ATE A MO UNT OF
AS
BE
ST
OS
TO B E
RE
MOV
ED
A
ND
/OR
NO
T
TO
B E
REMOVED
Regulated ACM to be
- -
--
..
--
---
--
~ removed Nonfriable Asbestos Material to be removed Nonfriable Asbestos Material NOT to
be
removed
..
Cateoorv I Cateoorv II Cateoorv I Cateoorv
II
Pioes (Ln. Ft.J
Surface Area (Sa.
Ft.J
Total Volume (Cu.
Ft.J
Total amount on or off all facility
components where length or
area could not be measured
previously
VII
.
SC
HE
D
UL
ED
D
AT
E
OF
STR
I
PP
IN
G I
REMOVA
L
I Start (mmlddlyy):
I
End (mmlddlyy
):
·-1
·-
- -
--
-
-.
- -
VIII
.
SCH
E
DULED
DAT
ES
OF
RENOVATION
I
DEMO
LI
TI
ON
-
··-
-
..
-
Renovation Start (mmlddlyy): End (mmlddlwJ:
·-~
-
·-
-
-
·-
--
-
..
-
Demolition
Start (mmlddlyy):
End
(mmldd/yy):
·
~
_
..
.
'"
t
-
-- - - - - - -
IX.
FACI
LI
TY
D
ESCRI
PTI
ON
~
- -
~
•.
.-
~;
Buildino Name:
Street Address:
Citv: I State:
I County:
Location of removal within building
(includina floor
and
room numbers):
Buildino Size (Sa. Ft.): I Number
of
Floors: I Aoe I Year Buil
t:
Present Use:
I Prior Use:
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of
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Indiana Demolition and Renovation Requirements Pursuant to 326 (City of South Bend)

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Completed 16 July 2020

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