2^nd Story Construction, Inc.

2106 Pacific St. #101

Bellingham, WA 98229

(360)-734-1515

Job Address:__________________________________________________________________

HOMEOWNER

ASBESTOS CERTIFICATION

IN ORDER TO COMPLY  WITH WASHINGTON STATE LAW WE NEED THE FOLLOWING INFORMATION WHICH WILL BE POSTED AT THE WORK SITE PRIOR TO THE COMMENCEMENT OF ANY WORK AS OUTLINED IN WAC 296-62-07707.

1.             BEFORE AUTHORIZING OR ALLOWING ANY CONSTRUCTION, RENOVATION REMODELING, MAINTENANCE, REPAIR, OR DEMOLITION PROJECT, AN OWNER OR OWNER'S AGENT SHALL PERFORM, A GOOD FAITH INSPECTION TO DETERMINE WHETHER MATERIALS TO BE WORKED ON OR REMOVED CONTAIN ASBESTOS.  THE INSPECTION SHALL BE DOCUMENTED BY A WRITTEN REPORT MAINTAINED ON FILE AND MADE AVAILABLE UPON REQUEST.

PLEASE ATTACH COPY OF THE INSPECTION REPORT

OR

COMPLETE THE FOLLOWING INFORMATION

2.             THE OWNER OR OWNER'S AGENT SHALL MAKE AVAILABLE TO ANY CONTRACTOR SUBMITTING A BID TO UNDERTAKE ANY CONSTRUCTION, RENOVATION, REMODELING, MAINTENANCE, REPAIR, OR DEMOLITION PROJECT, THE WRITTEN STATEMENT EITHER OF THE  REASONABLE CERTAINTY OF NON DISTURBANCE OF ASBESTOS OR OF ASSUMPTION OF THE PRESENCE OF ASBESTOS.

(PLEASE INITIAL THE APPLICABLE PARAGRAPH BELOW)

WE ARE REASONABLY CERTAIN THAT THE REMODELING PROJECT WILL NOT INVOLVE ANY AREAS THAT MAY CONTAIN ASBESTOS.

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OR

WE ASSUME THAT ASBESTOS MAY BE PRESENT IN THE PROJECTED WORK AREAS.  THE CONTRACTOR WILL NEED TO HANDLE MATERIALS IN THESE AREAS IN ACCORDANCE WITH WAC 296-62-077 THROUGH 296-92-07753

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3.             ANY OWNER OR OWNER'S AGENT WHO FAILS TO COMPLY WITH SUBSECTIONS (1) AND (2)  OF THIS SECTION SHALL BE SUBJECT TO A MANDATORY FINE OF NOT LESS THAN TWO HUNDRED FIFTY DOLLARS FOR EACH VIOLATION. EACH VIOLATION THAT CONTINUES SHALL BE CONSIDERED A SEPARATE VIOLATION.   IN ADDITION, ANY CONSTRUCTION, RENOVATION, REMODELING, THAT STARTED WITHOUT MEETING THE REQUIREMENTS OF THIS SECTION SHALL BE HALTED IMMEDIATELY AND CANNOT BE RESUMED BEFORE MEETING SUCH REQUIREMENTS.

4.             NO CONTRACTOR MAY COMMENCE ANY CONSTRUCTION, REMODELING, MAINTENANCE, REPAIR, OR DEMOLITION PROJECT WITHOUT RECEIVING A COPY OF THE WRITTEN RESPONSE OR STATEMENT REQUIRED BY SUBSECTION 2 OF THIS SECTION. ANY CONTRACTOR WHO BEGINS ANY PROJECT WITHOUT THE COPY OF THE WRITTEN REPORT OR STATEMENT SHALL BE SUBJECT TO A MANDATORY FINE OF NOT LESS THAN TWO HUNDRED FIFTY DOLLARS PER DAY. EACH DAY THE VIOLATION CONTINUES SHALL BE CONSIDERED A SEPARATE VIOLATION.

WAC 296-62-07707

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