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866-GOT-WASTE
GLES Job Application
Employee Portal
HOME
866-GOT-WASTE
GLES Job Application
Employee Portal
Notification information
Facility Owner Information
Owner Name
*
Owner of Facility
Owner's Mailing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Contact Person
*
Owner's representative
First Name
Last Name
Contact Email
*
Contact Phone
*
(###)
###
####
Owner's Project Number
(if any)
Facility Information
Facility Name
type "residence" if the facility is a single family home
Location Address
*
Address of work site
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
County
*
where work is to be performed
Specific location(s) in facility
If apartment, # of units
Nearest crossroad
Size (sq ft)
*
Number of floors
*
year built
*
present use
prior use
Asbestos Info
Procedure used to detect the presence of asbestos
*
Testing or sampling method
Name, address and phone # of company performing the asbestos survey
*
Inspector Name
*
First Name
Last Name
Accreditation #
*
Asbestos Accreditation License #
Date of Inspection
MM
DD
YYYY
Project Info
Estimated quantity of regulated asbestos containing materials to be abated
approximate measurements
Estimated Start Date
must be at least 10 business days after notice is submitted
MM
DD
YYYY
Schedule Contact Person
Schedule Contact Phone
(###)
###
####
Form Submission
Name of person submitting this form
Email address
Thank you!
