Loomis, CA · Placer County
Asbestos NESHAP Declaration of Notification Compliance
This form helps property owners or project applicants determine whether asbestos notification is required for a renovation or demolition project.
What this form is
Use this form to determine whether a residential building or other facility qualifies for an exemption from Asbestos NESHAP notification requirements. Answer the questions in Part A or Part B, as applicable, and sign and date the declaration. If notification is required, the form says to attach copies of the completed notifications sent to the listed agencies to the Demolition/Renovation Permit Application.
Who needs it
Applicants for residential or other building renovation, demolition, or remodeling projects use this form to determine whether Asbestos NESHAP notification requirements apply.
How to submit it
Attach this form to the Demolition/Renovation Permit Application. If notification is required, send the original to U.S. EPA Region IX and a copy to the California Air Resources Board, then attach copies to the permit application.
About notarization
This form is signed and dated without a notary; the applicant declares the answers true under penalty of perjury and attaches copies of any required notifications.
How to submit this form
- 1
Download The Form
Download the Asbestos NESHAP Declaration of Notification Compliance.
- 2
Complete The Applicable Part
Answer the questions in Part A for a residential building or Part B for another facility, as applicable.
- 3
Gather Required Notifications
If notification is required, send the original to U.S. EPA Region IX and a copy to the California Air Resources Board.
- 4
Sign And Attach
Sign and date the declaration, then attach it and any required notification copies to the Demolition/Renovation Permit Application.
Frequently asked questions
- Do I need a notary for the Asbestos NESHAP Declaration?
- No. The applicant signs and dates the form without a notary and declares the answers true under penalty of perjury. Attach copies of required notifications if applicable.
- How do I submit the Asbestos NESHAP Declaration?
- Attach the completed form to the Demolition/Renovation Permit Application. If notification is required, send the original to U.S. EPA Region IX and a copy to the California Air Resources Board, then attach copies to the permit application.
- What does this form determine?
- Its questions help determine whether a residential building or other facility qualifies for an exemption from Asbestos NESHAP notification requirements.
- When is asbestos notification required?
- The form says any “Yes” answer requires a thorough asbestos inspection by a California DOSH Certified Asbestos Consultant. It also describes notification requirements for demolition and certain renovation projects.