STATE OF DELAWARE

DEPARTMENT OF NATURAL RESOURCES AND ENVIRONMENTAL CONTROL
APPLICATION FOR DEMOLITION VIA FIRE FIGHTING INSTRUCTION / AQM-OB01
Page 1 of 2
Approval of this application does not relieve the applicant from complying with all applicable federal, state or local regulations, health, safety codes, and legal restrictions, (e.g., Class A materials shall be used per Chapter 4 of SFPC Live Fire Training Regulations).
Applications for Demolition via Fire Fighting Instruction MUST BE SUBMITTED to DNREC-AQM a MINIMUM of 30-days prior to training exercise in order for DNREC-AQM to process and verify asbestos abatement if necessary.
/ OB #
Date Rec'd
FIRE COMPANY INFORMATION
Name:______
Address:______
Contact Name: ______Title: ______
Telephone: ______Fax#:______E-mail: ______
FACILITY DESCRIPTION: To be completed by Property Owner.
 Agricultural  Commercial  Industrial  Institutional  Public  Residential
Location/Address of Burn: ______Tax Parcel: ______
Property Owner: ______Phone#:______County:______
Property Owner’s Address:______
Property Owner’s Signature: ______Date: ______
BUILDING DESCRIPTION (describe structure (house, shed, chicken house), dimensions (square footage) and building materials (wood, brick, vinyl siding, other). If more than 4 buildings are demolished add additional pages: STRUCTURE DIMENSIONS BUILDING MATERIALS
Building #1______
Building #2______
Building #3______
Building #4______
SITE MAP: Please provide a site map. Draw a sketch of the buildings to be burned on the property and indicate distance from the nearest road or highway as well as the nearest neighbor or structure not involved in the training exercise. ATTACH ADDITIONAL PAGES IF NECESSARY.

STATE OF DELAWARE

DEPARTMENT OF NATURAL RESOURCES AND ENVIRONMENTAL CONTROL
APPLICATION FOR DEMOLITION VIA FIRE FIGHTING INSTRUCTION / AQM-OB01
Page 2 of 2
DEMOLITION ACTIVITY BY INTENTIONAL BURNING VIA INSTRUCTION FIRE FIGHTING EXERCISE:
Date of Demolition/Burn: ______Start Time & Duration of Demolition/Burn: ______
Describe Training Exercise ______
______
ASBESTOS-ENVIRONMENTAL SURVEY/ABATEMENT INFORMATION
Please complete & attach to this application the Asbestos Survey Assessment(s) for ALL structures to be demolished during Instructional Fire Fighting Exercise. q Yes q No
Name of Professional Service Firm conducting the Asbestos Survey ______
Name of Licensed Asbestos Abatement Contractor______
EPA Region 3 ASBESTOS/DEMOLITION Notification: DEN______#
EPA requires all facilities that are to be demolished provide EPA with a notification a minimum of 10 working days prior to commencing demolition (40 CFR 61.145(b) – Notification Requirements). EPA defines demolition to include the intentional burning of a structure. (40 CFR 61.141). Notification can occur via DELAWARE’s ONLINE ASBESTOS NOTIFICATION SYSTEM. (see https://egov.dnrec.state.de.us/egovpublic/)
CERTIFICATION STATEMENT
I,______(Fire Chief) certify that all refuse and other non-building components have been removed from all buildings that are to be burned. The building(s) have been inspected by a Delaware licensed professional service firm certifying there are no known or suspect asbestos containing materials present in the aforementioned structures to affect the instructional burn. (see attached documentation).
Signature of Fire Chief: ______Date: ______
Name of Official:______Title: ______
Please be aware your training exercise may be terminated if it causes any unreasonable interference with a person’s health, safety, comfort, or use or enjoyment of his or her real property.
(See Reg. No. 13, Section 3.4 a-c.)
Submit application and all attachments to the Air Quality Management Section at the address or fax number listed below. If you have any questions, please call (302) 739-9402. The Department will notify you of its decision.
Division of Air and Waste Management AND USEPA-Region 3
Air Quality Management Section Attn. Asbestos Coordinator
156 South State Street 1650 Arch Street
Dover, DE 19904 Philadelphia, PA 19103
PHONE (302) 739-9402 PHONE (215) 814-2136
FAX (302) 739-3106

FOR DNREC USE: Asbestos Survey Attached q Yes q No Site Plan Attached q Yes q No

Reviewed by ______Approval #: ______

Processed by: ______Date: ______Approval Faxed: ______(date)

Revised 04/07/06