Get Illinois Apc 430 Form

Get Illinois Apc 430 Form

The Illinois APC 430 form is a notification document required by the Illinois Environmental Protection Agency for demolition and renovation activities involving asbestos. This form ensures compliance with federal regulations regarding asbestos management and requires detailed information about the project, including the presence of asbestos and the timeline for removal. To ensure proper filing, complete the form accurately and submit it by clicking the button below.

Modify Form

The Illinois APC 430 form is a crucial document for anyone involved in the demolition or renovation of buildings that may contain asbestos. This form serves as a notification to the Illinois Environmental Protection Agency (IEPA) and ensures compliance with federal regulations regarding asbestos management. When filling out the APC 430, individuals must provide detailed information about the facility, including its location, size, and current and past uses. It is essential to indicate whether asbestos is present and to outline the planned demolition or renovation work. The form also requires specifics about the contractors involved, including those responsible for asbestos removal and demolition. Additionally, it addresses procedures for handling unexpected asbestos discoveries and mandates that a trained representative be present on-site during the work. A filing fee is associated with the submission of this form, and failure to comply with the requirements can result in the notification being deemed improperly filed. Understanding the significance of the APC 430 form is vital for ensuring safety and regulatory compliance in any project involving potential asbestos exposure.

Document Breakdown

Fact Name Details
Purpose The APC 430 form is used to notify the Illinois Environmental Protection Agency about demolition and renovation activities involving asbestos.
Governing Law This form is governed by the National Emission Standards for Hazardous Air Pollutants (NESHAP), specifically 40 CFR Subpart M, Section 61.145.
Required Information All sections of the form must be completed to avoid a notice violation. Incomplete forms may lead to delays or penalties.
Filing Fee A filing fee of $150 is required with each initial 10-working day notification. Payments must be made by check, as cash and credit cards are not accepted.
Asbestos Presence The form requires a declaration of whether asbestos is present in the structure. A simple 'Yes' or 'No' response is needed.
Emergency Renovations In cases of emergency renovations, the form asks for details about the unexpected event that necessitated the work.
Contractor Information Details about the asbestos removal contractor and demolition contractor must be provided, including contact information.
Signature Requirement The form must be signed by the owner or operator, certifying that the information provided is correct and that trained personnel will be on-site during work.

Common PDF Forms

Illinois 171 371 - Failure to meet conditions outlined in the form may result in denial.

Understanding the intricacies of financial planning is essential, and utilizing a Texas Durable Power of Attorney form can greatly enhance this process. By allowing a trusted individual to manage affairs if necessary, individuals can ensure their wishes are respected even during incapacitation. For more information on setting up this important document, visit TopTemplates.info, which provides valuable resources to guide you through the process.

Il-1040 Form 2023 - Report the total Illinois Property Tax paid during the tax year.

Misconceptions

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

  • It is only for demolition projects. The APC 430 form is required for both demolition and renovation projects that involve asbestos. It must be completed regardless of the type of operation.
  • Only large projects need to file this form. Any project that involves asbestos, regardless of size, requires the submission of the APC 430 form. This includes minor renovations.
  • Asbestos presence is not a concern if it is not visible. Asbestos can be present in materials that are not easily visible. The form requires a thorough assessment to determine if asbestos is present, even if it is not apparent.
  • The filing fee is optional. A filing fee of $150 is mandatory for each initial notification. If the fee is not submitted, the notification will be considered improperly filed.
  • Only the owner needs to sign the form. The form must be signed by the owner or operator of the project. This ensures that the responsible party is aware of the requirements.
  • Emergency renovations do not require a notification. Even in emergency situations, the APC 430 form must be completed. This includes detailing the unexpected event and the procedures to follow.

Example - Illinois Apc 430 Form

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 crucial to follow specific guidelines to ensure compliance and avoid delays. Here’s a list of what you should and shouldn’t do:

  • Do complete all sections of the form to avoid a notice violation.
  • Do provide accurate information regarding the facility description, including the building name and address.
  • Do indicate whether asbestos is present and detail the type of operation being conducted.
  • Do ensure that all scheduled dates for demolition and asbestos removal are clearly stated.
  • Don’t submit the form without the required filing fee of $150.
  • Don’t forget to attach any necessary documentation, such as a signed order from a governmental agency if applicable.
  • Don’t use photocopies for the signature; only an original signature is valid.
  • Don’t leave any sections blank, as this could lead to improper filing.

Illinois Apc 430: Usage Instruction

Completing the Illinois APC 430 form requires careful attention to detail. This form is essential for notifying the appropriate authorities about demolition and renovation activities, especially when asbestos is involved. Follow the steps below to ensure that you fill out the form correctly and submit it on time.

  1. Determine the type of notification: Indicate whether this is an original, revised, or canceled notification by selecting the appropriate option.
  2. Select the type of operation: Choose whether the operation is a renovation, demolition, annual, ordered demolition, or emergency renovation.
  3. Fill in the facility description: Provide the building name, address, city, county, state, ZIP code, and details about the asbestos-containing material (ACM) in the structure, including building size, number of floors, age, present use, prior use, and future use (if applicable).
  4. Indicate if asbestos is present: Answer yes or no to the question about the presence of asbestos.
  5. Specify work hours: Fill in the start and end times for the work, indicating whether it is in the a.m. or p.m.
  6. Provide scheduled dates: Enter the start and completion dates for both demolition and asbestos removal.
  7. Detail asbestos removal: Specify the type of regulated and non-friable asbestos to be removed, including measurements for pipes, surface area, and volume.
  8. List the asbestos removal contractor: Provide the contractor's name, address, city, state, ZIP code, contact person, and phone number.
  9. List the demolition contractor: Fill in the contractor's name, address, city, state, ZIP code, contact person, and phone number.
  10. Provide owner information: Enter the owner's name, address, city, state, ZIP code, contact person, and phone number.
  11. List the waste transporter: Include the transporter's name, address, city, state, ZIP code, contact person, and phone number.
  12. Provide waste disposal site information: Fill in the address, city, state, ZIP code, landfill permit number, and phone number of the disposal site.
  13. Describe the procedure for detecting asbestos: Include the analytical method used and the Illinois license number of the inspector, along with the name of the analytical testing laboratory.
  14. Describe the planned demolition or renovation work: Provide details about the methods and techniques that will be employed.
  15. Outline work practices and engineering controls: Describe the measures to be taken to prevent emissions at the site.
  16. Indicate if demolition is ordered: Answer yes or no, and if yes, attach a signed copy of the order, including the representative's name, title, and order date.
  17. For emergency renovations: Provide the date and hour of the emergency and describe the unexpected event.
  18. Describe procedures for unexpected asbestos: Detail the steps to be taken if unexpected asbestos is found or if previously non-friable asbestos becomes compromised.
  19. Certify the information: Sign and date the form, confirming that a trained representative will be present during the demolition or renovation.
  20. Prepare payment: Include a $150 filing fee with the initial notification. Make checks payable to the Illinois EPA and note that it is for the 10-working day notification fee.
  21. Mail the form: Send the completed form to the Illinois Environmental Protection Agency, Attn: Asbestos Unit, P.O. Box 19276, Springfield, IL 62794-9276.

By following these steps, you can ensure that your APC 430 form is filled out correctly and submitted in compliance with regulations. Take your time and double-check your entries to avoid any delays or issues.