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'Date: l Q> 1--L- Vie
-Contractor Name: 'MATTHEW O'LE WYNNE
business Dame: '1t YNNE.BUILDING CORP.
Address: 8000 S:O.t1TH US,HWY..1' SUITE 402
-City: PORT ST. LUCIE State: FL
Zip Code: •34952'
Re: Job Address: \�— �C�-�e-+�.�.�.r+tom c�.�o►c`'� ��`'a�
Itis your responsibility to comply with-the.proVisions of Section 469.003,'florida Statutes
and to notify-the Departrrienfof Environm�ental,Protection.of'any intentions to remove
asbestos when•applicable.in accordance-with state and:federal°law:
Signature Date
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