Official Illinois Apc 430 Form in PDF Open Editor

Official Illinois Apc 430 Form in PDF

The Illinois APC 430 form is a critical document used for notifying authorities about demolition and renovation activities that may involve asbestos. This form ensures compliance with federal regulations concerning asbestos management, thereby protecting public health and the environment. Completing the APC 430 accurately is essential to avoid potential violations and ensure safe handling of asbestos-containing materials.

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The Illinois APC 430 form serves as a crucial document for notifying the state about planned demolition or renovation activities that may involve asbestos. This form is a requirement under the National Emission Standards for Hazardous Air Pollutants (NESHAP), specifically aimed at ensuring that proper procedures are followed to protect public health and the environment. It encompasses various sections that gather essential information, such as the type of notification—whether original, revised, or canceled—and the nature of the operation, which can include renovation, demolition, or emergency actions. The form also requires detailed facility descriptions, including the building's name, address, and current and future uses, along with specific inquiries regarding the presence of asbestos. To facilitate compliance, it asks for work schedules, contractor details, and waste disposal information, ensuring that all parties involved are properly informed and accountable. A critical aspect of the form is the certification that trained personnel will be present on-site during the work, highlighting the importance of safety and adherence to regulations. Additionally, a filing fee is required for initial notifications, underscoring the form's role in formalizing the notification process. Overall, the Illinois APC 430 form is an essential tool for managing asbestos-related risks in construction and renovation projects.

Frequently Asked Questions

What is the purpose of the Illinois APC 430 form?

The Illinois APC 430 form serves as a notification to the Illinois Environmental Protection Agency (IEPA) regarding planned demolition or renovation activities that may involve asbestos. This notification is crucial for ensuring compliance with federal regulations under the National Emission Standards for Hazardous Air Pollutants (NESHAP). It helps protect public health and the environment by managing the risks associated with asbestos exposure.

Who needs to fill out the APC 430 form?

Any individual or organization planning to undertake demolition or renovation work that may disturb asbestos-containing materials must complete the APC 430 form. This includes property owners, contractors, and demolition companies. It is essential to provide accurate and complete information to avoid delays or violations.

What information is required on the form?

The form requires detailed information, including the type of notification (original, revised, or canceled), type of operation (renovation, demolition, etc.), facility description, presence of asbestos, scheduled dates for demolition and asbestos removal, and contractor details. Additionally, a description of the planned work practices and engineering controls is necessary to ensure safe handling of asbestos.

What happens if asbestos is found unexpectedly during the project?

If unexpected asbestos is discovered during demolition or renovation, it is important to follow specific procedures outlined on the form. This includes ceasing work immediately and notifying the appropriate authorities. The form should detail these procedures to ensure compliance with safety regulations and minimize health risks.

Is there a fee associated with submitting the APC 430 form?

Yes, there is a filing fee of $150 that must accompany each initial notification. This fee is required to process the form and is payable to the Illinois EPA. It's important to note that cash and credit cards are not accepted; only checks are permissible. Failure to submit the fee will result in the notification being considered improperly filed.

What should I do if I need to revise or cancel my notification?

If you need to revise or cancel your notification, you must indicate this on the form by selecting the appropriate type of notification (revised or canceled). Ensure that all relevant sections are updated or marked as canceled. This will help maintain accurate records with the IEPA and prevent any misunderstandings regarding your project.

How should I submit the APC 430 form?

The completed form should be mailed to the Illinois Environmental Protection Agency, Attn: Asbestos Unit, at P.O. Box 19276, Springfield, IL 62794-9276. Ensure that you allow sufficient time for processing, especially if your project has specific deadlines. It is advisable to send the form via a method that provides confirmation of receipt.

Who can I contact for assistance with the APC 430 form?

If you have questions or need assistance with the APC 430 form, you can reach out to the Illinois EPA's Asbestos Unit. They can provide guidance on completing the form, understanding the requirements, and ensuring compliance with regulations. It is always better to seek help than to risk submitting an incomplete or incorrect form.

Form Specifications

Fact Name Description
Governing Law The Illinois APC 430 form is governed by the National Emission Standards for Hazardous Air Pollutants (NESHAP) under 40 CFR Subpart M, specifically section 61.145.
Purpose This form is required for notifying the Illinois Environmental Protection Agency (EPA) about demolition and renovation activities that may involve asbestos.
Filing Fee A filing fee of $150 must accompany each initial notification. This fee is essential for processing the form and must be paid by check.
Notification Types The form allows for three types of notifications: Original (O), Revised (R), and Canceled (C), ensuring proper tracking of the demolition or renovation process.
Completion Requirement All sections of the form must be completed to avoid a notice violation. Incomplete submissions may lead to delays or rejections.
Asbestos Presence The form requires a declaration regarding the presence of asbestos in the structure, which is crucial for determining the necessary safety measures during demolition or renovation.
Emergency Renovation For emergency renovations, specific details about the unexpected event must be provided, including the date and hour of the emergency and a description of the situation.

Common mistakes

  1. Incomplete Sections: One common mistake is failing to complete all sections of the APC 430 form. Each part of the form is essential for compliance, and missing information can lead to a notice of violation.

  2. Incorrect Notification Type: Selecting the wrong type of notification (Original, Revised, or Canceled) can create confusion and may delay the process. Ensure that the correct option is checked before submission.

  3. Inaccurate Facility Information: Providing incorrect details about the facility, such as the address, building name, or size, can result in complications. Always double-check this information for accuracy.

  4. Missing Asbestos Information: Failing to indicate whether asbestos is present can lead to significant issues. It is crucial to answer this question accurately to ensure proper handling and safety measures are in place.

  5. Improper Submission of Fees: Not including the required filing fee of $150 is a frequent error. If the fee is not submitted with the notification, the form will be deemed improperly filed, causing delays.

  6. Lack of Required Signatures: Neglecting to provide the original signature of the owner or operator can invalidate the submission. Ensure that the signature is present, as photocopies are not accepted.

Form Preview

REC. NO. NOTIFICATION OF DEMOLITION AND RENOVATION

IL 532 1296 APC 430

Illinois Environmental Protection Agency

P.O. Box 19276, Springfield, IL 62794-9276

Rev.06/03

THIS INFORMATION IS REQUIRED; NESHAP-40CFR-SUBPART M-61.145, Rev. Nov. 20, 1990

ALL SECTIONS MUST BE COMPLETED TO AVOID NOTICE VIOLATION

1.TYPE OF NOTIFICATION (O-Original/R-Revised/C-Canceled):

2.TYPE OF OPERATION (R-Renovation/D-Demo/A-Annual/O-Ordered Demo/E-Emergency Renovation):

3.FACILITY DESCRIPTION (Building Name):

Address:

City:

 

County:

 

 

State:

 

ZIP:

 

 

 

 

 

 

 

Location of Asbestos Containing Material (ACM) in structure:

 

 

 

 

 

 

 

 

 

 

 

 

Bldg. Size:

 

# of Flrs.

 

Age:

Present Use:

 

 

 

 

 

 

 

 

 

 

Prior Use:

 

Future Use (Demo):

 

 

 

 

 

 

 

 

 

 

4. IS ASBESTOS PRESENT?

Y N

5. WORK HOURS:*

a.m.

 

p.m.

 

 

 

 

 

6. SCHEDULED DATE DEMOLITION:

 

Start:

Complete:

 

 

 

 

7. SCHEDULED DATE ASBESTOS REMOVAL:

Start:

Complete:

 

 

 

 

 

8. REGULATED ASBESTOS

 

NONFRIABLE ASBESTOS NOT

NONFRIABLE ASBESTOS TO BE

 

TO BE REMOVED (Demolition):

REMOVED:

 

 

CONTAINING MATERIAL TO BE

 

 

 

 

 

 

 

 

REMOVED (RACM):

 

CATEGORY I

 

CATEGORY II

CATEGORY I

 

CATEGORY II

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pipes (Ln. Ft.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Surface Area (Sq. Ft.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Volume (Cu. Ft.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. ASBESTOS REMOVAL CONTRACTOR:

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

 

State, Zip:

 

Contact:

 

 

Phone:

 

 

 

 

 

 

 

 

 

10. DEMOLITION CONTRACTOR:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

 

State, Zip:

 

Contact:

 

 

Phone:

 

 

 

 

 

 

 

 

 

 

11. OWNER NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

 

State, Zip:

 

Contact:

 

 

Phone:

 

 

 

 

 

 

 

 

 

 

12. WASTE TRANSPORTER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

 

State, Zip:

 

Contact:

 

 

Phone:

 

 

 

 

 

 

 

 

 

 

13. WASTE DISPOSAL SITE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

City:

 

 

 

 

 

 

 

 

State, Zip:

 

Landfill Permit #:

Phone:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-AGENCY USE ONLY-

 

 

 

Date Received:

Input to ACTS:

 

To Region 1 2 3

 

 

 

 

 

 

 

 

Post Mark Date:

To Cook/City:

 

Champaign:

 

LaSalle:

 

 

 

 

 

 

 

Springfield:

Rockford:

 

 

Moline:

 

Marion:

 

 

 

 

 

 

 

 

 

14.PROCEDURE, INCLUDING ANALYTICAL METHOD, USED TO DETECT THE PRESENCE OF ASBESTOS.

ILLINOIS LICENSE NUMBER OF INSPECTOR: NAME OF ANALYTICAL TESTING LABORATORY:

15.DESCRIPTION OF PLANNED DEMOLITION OR RENOVATION WORK:

METHODS TO BE EMPLOYED INCLUDING DEMOLITION OR RENOVATION TECHNIQUES.

16.DESCRIPTION OF WORK PRACTICES AND ENGINEERING CONTROLS TO BE USED TO PREVENT EMISSIONS AT THE DEMOLITION OR RENOVATION SITE:

17. IS DEMOLITION ORDERED BY A GOVERNMENTAL AGENCY?

Y N (If Yes, a signed copy of Order must be attached.)

 

 

Governmental representative ordering the activity:

 

 

 

 

Title:

Date of Order:

Ordered Demolition Date:

18.FOR EMERGENCY RENOVATIONS: Date and Hour of Emergency:

Description of the Sudden, Unexpected Event (e.g. structure in danger of eminent collapse):

19.DESCRIPTION OF PROCEDURES TO BE FOLLOWED IN THE EVENT THAT UNEXPECTED ASBESTOS IS FOUND OR PREVIOUSLY NONFRIABLE ASBESTOS MATERIAL BECOMES CRUMBLED, PULVERIZED, OR REDUCED TO POWDER.

20.I CERTIFY THAT AT LEAST ONE REPRESENTATIVE, TRAINED IN THE PROVISIONS OF 40 CFR PART 61, SUBPART M, SHALL BE ON-SITE DURING DEMOLITION OR RENOVATION, HAVING IN HIS OR HER POSSESSION, FOR INSPECTION, EVIDENCE THAT THE REQUISITE TRAINING HAS BEEN ACCOMPLISHED.

I CERTIFY THE ABOVE INFORMATION IS CORRECT.

Signature of Owner/Operator Date

(Original Signature Only, Photocopy Not Valid)

A FILING FEE OF $150 MUST BE PAID WITH EACH INITIAL 10-WORKING DAY NOTIFICATION REQUIRED BY THE ASBESTOS NESHAP. MAKE CHECKS PAYABLE TO ILLINOIS EPA AND MAKE NOTATION THAT IT IS FOR THE 10-WORKING DAY NOTIFICATION FEE. CASH AND CREDIT CARDS ARE NOT ACCEPTABLE. IF THE FEE IS NOT SUBMITTED WITH THE NOTIFICATION, THE NOTIFICATION WILL BE DEEMED IMPROPERLY FILED.

*Not required under NESHAPS.

Mail this form to: IL Environmental Protection Agency, Attn: Asbestos Unit, P.O. Box 19276, Springfield, IL 62794-9276

Dos and Don'ts

When filling out the Illinois APC 430 form, it's essential to pay attention to detail. Here are six things you should and shouldn't do:

  • Do ensure all sections of the form are completed. Incomplete forms may lead to violations.
  • Don't forget to include the correct type of notification (Original, Revised, or Canceled).
  • Do specify the type of operation clearly, whether it’s a renovation, demolition, or emergency situation.
  • Don't overlook the requirement to provide accurate facility details, including the building name and address.
  • Do confirm the presence of asbestos and provide relevant information about its location and type.
  • Don't neglect to attach any required documentation, such as a signed order from a governmental agency if applicable.

Documents used along the form

The Illinois APC 430 form serves as a crucial document for notifying relevant authorities about demolition and renovation activities, especially concerning asbestos. In conjunction with this form, several other documents may be necessary to ensure compliance with local regulations and safety standards. Below is a list of additional forms and documents often used alongside the Illinois APC 430 form.

  • Asbestos Inspection Report: This report provides the findings of an inspection conducted to identify the presence of asbestos in a building. It details the location, type, and condition of any asbestos-containing materials.
  • Asbestos Abatement Plan: This plan outlines the procedures and methods to be employed during the removal of asbestos. It includes safety measures and compliance strategies to minimize exposure during the abatement process.
  • Demolition Permit: A permit issued by local authorities allowing the demolition of a structure. This document typically includes conditions that must be met before and during the demolition process.
  • Renovation Permit: Similar to a demolition permit, this document grants permission for renovation activities. It may specify guidelines for handling hazardous materials like asbestos during the renovation.
  • Living Will Form: This essential document allows individuals to express their medical treatment preferences in case they are unable to communicate their wishes. For more information on completing a Living Will, visit California Templates.
  • Waste Disposal Manifest: This document tracks the disposal of hazardous materials, including asbestos. It ensures that waste is transported and disposed of in accordance with environmental regulations.
  • Notification of Asbestos Removal: This notification informs relevant authorities about the planned removal of asbestos. It often includes details about the contractor and the timeline for the removal process.
  • Emergency Response Plan: This plan outlines procedures to follow in case unexpected asbestos is discovered during demolition or renovation. It details immediate actions to ensure safety and compliance.
  • Training Certification: A document verifying that individuals involved in the demolition or renovation have received the necessary training in asbestos handling and safety protocols.

Utilizing these documents alongside the Illinois APC 430 form helps ensure that all necessary safety and regulatory measures are taken during demolition and renovation projects. Proper documentation not only facilitates compliance but also promotes a safer environment for workers and the public.

Misconceptions

Here are five common misconceptions about the Illinois APC 430 form:

  1. Only Demolition Projects Require the Form: Many believe that the APC 430 is only necessary for demolition projects. In reality, it is also required for renovation activities that disturb asbestos-containing materials.
  2. Filing the Form is Optional: Some think that submitting the APC 430 is optional. This is incorrect. Completing and filing the form is mandatory to comply with federal regulations regarding asbestos.
  3. The Form Can Be Submitted Without a Fee: It is a common belief that there is no fee associated with filing the APC 430. However, a filing fee of $150 must accompany each initial notification.
  4. Asbestos Testing is Not Required: Some individuals assume that testing for asbestos is not necessary if the presence of asbestos is suspected. This is a misconception; an inspection must confirm the presence of asbestos before proceeding with demolition or renovation.
  5. Any Signature is Acceptable: People often think that any signature can validate the form. In fact, the form requires an original signature from the owner or operator, and photocopies are not valid.