Project # 8488-2017

Contractor: American Construction
Contact Person: Bob Black
Phone: (417) 850-5887

Owner: Flex-O-Lators
Project Site: Flex-O-Lators
Project Address: 1460 Jackson
City: Carthage
County: JASPER
Regional Office: SWRO
Demo Start Date: 06/05/2017
Demo Complete Date: 06/10/2017
Total # of Days: 5

Comments: revise start date from 6/5 to 6/6;

Present Use: Office and Tool Room
Prior Use: Office and Tool Room
Asbestos Type: -
Asbestos Qty: -
Amendments: N/A
Inspections: N/A
Postmark Date: 05/24/2017
Date Received: 05/24/2017

Paid: Yes