Annual Notice of Intent to Remove Asbestos  Annual Notice Help? 

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This notice is valid for one calendar year. A new notice must be requested for subsequent calendar years.

The total amount of asbestos-containing material (ACM) for all asbestos projects from each structure, vessel, or building in a calendar year under this section shall be limited to less than 260 linear feet on pipes and 160 square feet on other components. Projects over these values are subject to the notification requirements of SWCAA 476-050(1) and 476-050(2). Quarterly reports must be submitted to SWCAA within fifteen (15) days after the end of each calendar quarter using the online page at Quarterly Report.


YEAR / ASBESTOS DISPOSAL

Calendar Year: Do you have on site storage: Yes    If No, select Disposal Site below * Optional field
  Asbestos Disposal Site:

PROPERTY LOCATION INFORMATION

Property Owner Name: Phone No.:
Physical Address: Extra Address:  *
City/State/Zip/County:         
ACM Storage Location:

COMPANY INFORMATION

Company Name: Phone No.:
Mailing Address: Extra Address:  *
City/State/Zip/County:         

CONTACT

Responsible Person: Title: Phone No.:
Site Contact: Title: Phone No.:

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

Card Number:  16 digits only - no spaces or dashes 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: 4/19/2024 1:17:45 AM
Title: Representing:
Your Email Address: Your Phone No.:
 

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