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Project # 10930-2021

Contractor: Boone Construction Company
Contact Person: Susan Ball
Phone: (573) 474-1011

Owner: Ray County
Project Site: bridge over Mud Creek
Project Address: Mary Lois Rd
City: Cowgill
County: RAY
Regional Office: KCRO
Demo Start Date: 08/02/2021
Demo Complete Date: 09/03/2021
Total # of Days: 32

Present Use: bridge
Prior Use: bridge
Asbestos Type: none
Asbestos Qty: N/A
Amendments: -
Inspections: -
Postmark Date: N/A
Date Received: 07/19/2021
Paid: Yes

Comments: typo on form for year, no landfill info provided