Storage Notice Details for Case No.: 10-004 Amendment No.: 0

This page shows the details for a Storage Notice Case.

APPLICANT

Applicant Name: Keystone Contracting Phone No.:
Applicant Address: 417 NW 209th St Date Received: 1/12/2010
Applicant Extra Address: Date Approved:
City/State/Zip/County: Ridgefield, WA  98642   CLARK COUNTY Date Paid: 1/13/2010


STORAGE FACILITY DESCRIPTION

Storage Facility Name: Keystone Contracting
Storage Facility Site Address: 417 NW 209th St
Storage Facility Site Extra Address:
City/State/Zip: Ridgefield, WA  98642
The exact location of stored Asbestos Containing Material (ACM) at the facility:
Locked dumpster at shop


PROJECT DATES

Effective Date:
Expiration Date:


SIGNATURE

Submitted By: Dated:
Email Address: Phone No.: