Intent to Remove Asbestos Application    Asbestos Help? 

Instructions

Submit an original application and payment here for a Asbestos project. This project may or may not include asbestos removal. A signed Asbestos notice will be emailed once our staff has approved your application.

Please review the entire web page for content you may need before beginning the application. Online application requires a credit card or check payment- no cash is accepted. In addition to the SWCAA Demolition fee our payment acceptance company assesses a small transaction fee.

Non-Emergency notices must be submitted 10 calendar days prior to the Demolition Start Date. Asbestos removal must be completed before the Demolition Start Date.

NOTE: Javascript and Cookies must be enabled to process your Online Notice.

* Optional fields marked with asterisk

EMERGENCY STATUS AND FEE AMOUNT

Emergency (call SWCAA at 360-574-3058 immediately for notification period waiver)
NO
YES   Fees are doubled for Emergency Demolition projects! Fees are doubled for non-owner occupied and non-small projects!
 
Fee amount due is: $

PROJECT SCOPE

Type of Operation:
Quantity to be removed: square feet and/or linear feet
Project Starting Date: Completion Date:
Was asbestos identified in this structure? NO YES
If asbestos is present on the facility to be demolished, a separate Asbestos Removal Notice must be submitted.
 
No demolition work can begin until the asbestos is removed.
 
If you have not already submitted an Asbestos Removal Notice, click  Asbestos Removal  to submit an online Notice.
 
After submitting the Asbestos Removal Notice return to this form and be sure to complete the Asbestos Removal section below.
The removal will be performed by an Certified Asbestos Contractor
I am the Owner and Occupant of the property, and I will be removing the asbestos material myself

FACILITY DESCRIPTION

Demolition of Structure? Yes  No    
Remodel/Repair? Yes  No
Site Name or Description of Facility:
Owner Name:
Site Address:
Site Extra Address:  *
Site Parcel Number:  *
City / State / Zip / County:            
Facility Type:
Present Use:
Previous Use:
Workshift Days: Su M T W Th F Sa Workshift Hours:
Work Location: Location of Asbestos:

MATERIAL DESCRIPTION

Material to be Removed:  (Check all that apply)
Fireproofing Popcorn Ceiling CAB Sheet Vinyl Boiler Insulation
Duct Tape Duct Paper Mag Pipe Insulation Air Cell CA Pipe
VAT Other Required if Other is checked
Control Methods: (Check all that apply)
N.P. Enclosure Glove Bag Mini Enclosure Wrap & Cut Water
HEPA Vac Other  Required if Other is checked

OWNER/INSPECTOR/CONTRACTOR/DISPOSAL

Property Owner Name:    Phone #:
Mailing Address:
City:    State:     Zip:

Asbestos Inspection Conducted or Samples Taken?
YES - Include Ahera Inspection Summary or Samples Results and other documents, or check the NO button and supply a reason for no samples/inspection:

NO - Provide reason:

AHERA Inspector:
     If Owner Occupant category, not required or select Owner Occupant from this list

Inspection Summary, other documents, and photos:






Asbestos Contractor:
       If Owner Occupant category, not required or select Owner Occupant from this list

Supervisor/Contact Name:    Phone #:

Asbestos Disposal Site / Landfill Address:



DEMOLITION PROJECT PLAN

Demo Contractor:  Owner of site may be selected
    
         <- OR ->
     Enter Demo Contractor/Company or Owner Name:
 
Description of planned demolition work, method(s) to be used:

Fugitive emission prevention method to be used:

Asbestos containment method if asbestos is present:
Project comments:
 

PAYMENT

Amount to Pay NOTE: you will be charged a payment service fee which will range from $2 to $32 USD based on the transaction amount.

 Pay by Debit Card, Visa, Mastercard, American Express, or Discover
 Pay by Electronic Check

After submitting this notice, you will need to complete your payment via our Point and Pay portal. Please complete this form, then follow instructions on the next page.
Card Number:   16 digits, no dashes/spaces MM/YY Expiration Date:   CVV:
Name on Card: Company Name or CardHolder Name as it appears on the card
Billing Address: Extra Address:
City: State:    Zip: 
Cardholder Phone: Cardholder Email:

CERTIFICATION

I DO HEREBY CERTIFY THAT THE INFORMATION CONTAINED IN THIS NOTIFICATION IS, TO THE BEST OF MY KNOWLEDGE, ACCURATE AND COMPLETE.

Your Name:   Dated: 7/2/2024 6:29:56 PM

Your Title:   *    Representing:

Your Email Address:     Your Phone No.:

It make take a few moments to process your application. Click SUBMIT once to avoid additional charges.


this completed page for your records before clicking SUBMIT.