Daqa 424 12 is an Arabic form that is used to request information from a third party. The form includes the name of the requester, the person or entity being contacted, and a brief summary of the inquiry. This document can be used for business or legal purposes. The use of Daqa 424 12 is common in Saudi Arabia, where it is used to contact companies and government agencies. In other countries, such as the United States, this form may also be used to request information from businesses or individuals. It is important to understand how to properly complete this form so that all necessary information is included. By doing so, you can ensure that your inquiry will be processed in a timely manner.
| Question | Answer |
|---|---|
| Form Name | Form Daqa 424 12 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | notdemo utah division of air quality 10 working day notification form |
UTAH DIVISION OF AIR QUALITY |
Postmark Date: |
195 North 1950 West, 4th Floor |
Initials: |
P.O. Box 144820 |
Fee Received: |
Salt Lake City, UT |
Check Number: |
10
1 Fee |
$75 +$50 for each 5,000 sq. ft. of floor space above 5,000 sq. ft. |
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2Facility Name
Address
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Part of Facility Involved,( e.g. floor #, room #, area etc.) |
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Age of Facility |
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Present use |
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Prior Use |
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Facility Owner/Operator Name |
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Demolition Contractor Name |
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Dates of Demolition |
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Start Date |
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Ending Date |
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Asbestos Inspection Information |
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Date of Inspection |
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Name of Utah Certified Inspector |
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ID Number |
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Name of Utah Certified Asbestos Company |
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ID Number |
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Analytical Method used for asbestos analysis |
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Is asbestos present? |
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Was it sampled or assumed? |
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7 |
Asbestos Containing Material to be left in the facility during demolition, (list types and amounts). |
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roofing |
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flooring |
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other |
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8Description of procedures to be followed in the event that unexpected RACM is found or generated during the project.
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attach additional sheets as necessary
I certify that the all the information in this notification is true and correct.
Signature of Owner/OperatorDate Print name and title of Owner/Operator
OFFICIAL USE ONLY!
Date Accepted |
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Date Rejected |
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Acts #: |
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Reviewers Initials |
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Rejection Comments: |
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Revision 7/1/12 |