Form MO780-1225 "Asbestos Post-notification" - Missouri

What Is Form MO780-1225?

This is a legal form that was released by the Missouri Department of Natural Resources - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2015;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MO780-1225 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

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Download Form MO780-1225 "Asbestos Post-notification" - Missouri

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MISSOURI DEPARTMENT OF NATURAL
RESOURCES AIR POLLUTION CONTROL PROGRAM
ASBESTOS POST- NOTIFICATION
GENERAL INSTRUCTIONS
Persons who perform asbestos abatement projects are required to submit post-notification to the department within 60 days of the
completion date indicated on the initial notification. This post-notification shall include signed and dated receipts of asbestos disposal as
well as final air clearance results (if applicable). These documents, along with the completed post-notification form shall be mailed to the
following address*:
MISSOURI DEPARTMENT OF NATURAL RESOURCES
AIR POLLUTION CONTROL PROGRAM (ASBESTOS)
P.O. BOX 176
JEFFERSON CITY, MISSOURI 65102
*For projects under the jurisdiction of a local agency, send post-notification to the appropriate office.
PART A. ASBESTOS PROJECT INFORMATION
PROJECT NAME
PROJECT ID ASSIGNED BY THE AIR POLLUTION CONTROL PROGRAM
ADDRESS
CITY
STATE
ZIP CODE
START DATE
COMPLETION DATE
PART B. CONTRACTOR INFORMATION
NAME OF CONTRACTOR
MO ASBESTOS CONTRACTOR REGISTRATION NUMBER
CONTRACTOR CONTACT PERSON
EMAIL
TELEPHONE NUMBER WITH AREA CODE
PART C. WASTE DISPOSAL INFORMATION
NAME OF LANDFILL
ADDRESS
CITY
STATE
ZIP CODE
NOTE:
INCLUDE COPIES OF ALL WASTE SHIPMENT RECORDS AND DISPOSAL RECEIPTS
PART D. AIR SAMPLING INFORMATION
NAME OF AIR SAMPLING PROFESSIONAL
CERTIFICATION NUMBER
COMPANY NAME
TELEPHONE NUMBER WITH AREA CODE
NOTE:
INCLUDE COPIES OF FINAL AIR CLEARANCE RESULTS (IF APPLICABLE)
PART E. AUTHENTICATION
I CERTIFY THAT THE INFORMATION LISTED ABOVE AND ENCLOSED IS TRUE AND ACCURATE.
SIGNATURE OF ASBESTOS ABATEMENT CONTRACTOR
DATE
MO 780-1225 (03-15)
MISSOURI DEPARTMENT OF NATURAL
RESOURCES AIR POLLUTION CONTROL PROGRAM
ASBESTOS POST- NOTIFICATION
GENERAL INSTRUCTIONS
Persons who perform asbestos abatement projects are required to submit post-notification to the department within 60 days of the
completion date indicated on the initial notification. This post-notification shall include signed and dated receipts of asbestos disposal as
well as final air clearance results (if applicable). These documents, along with the completed post-notification form shall be mailed to the
following address*:
MISSOURI DEPARTMENT OF NATURAL RESOURCES
AIR POLLUTION CONTROL PROGRAM (ASBESTOS)
P.O. BOX 176
JEFFERSON CITY, MISSOURI 65102
*For projects under the jurisdiction of a local agency, send post-notification to the appropriate office.
PART A. ASBESTOS PROJECT INFORMATION
PROJECT NAME
PROJECT ID ASSIGNED BY THE AIR POLLUTION CONTROL PROGRAM
ADDRESS
CITY
STATE
ZIP CODE
START DATE
COMPLETION DATE
PART B. CONTRACTOR INFORMATION
NAME OF CONTRACTOR
MO ASBESTOS CONTRACTOR REGISTRATION NUMBER
CONTRACTOR CONTACT PERSON
EMAIL
TELEPHONE NUMBER WITH AREA CODE
PART C. WASTE DISPOSAL INFORMATION
NAME OF LANDFILL
ADDRESS
CITY
STATE
ZIP CODE
NOTE:
INCLUDE COPIES OF ALL WASTE SHIPMENT RECORDS AND DISPOSAL RECEIPTS
PART D. AIR SAMPLING INFORMATION
NAME OF AIR SAMPLING PROFESSIONAL
CERTIFICATION NUMBER
COMPANY NAME
TELEPHONE NUMBER WITH AREA CODE
NOTE:
INCLUDE COPIES OF FINAL AIR CLEARANCE RESULTS (IF APPLICABLE)
PART E. AUTHENTICATION
I CERTIFY THAT THE INFORMATION LISTED ABOVE AND ENCLOSED IS TRUE AND ACCURATE.
SIGNATURE OF ASBESTOS ABATEMENT CONTRACTOR
DATE
MO 780-1225 (03-15)