Appendix E– CERTIFICATION LETTER FOR ASBESTOS CONTAINING MATERIALS
Prior to sampling by the DOT, submit a letter of certification for ACM to the District Materials Engineer. The letter should be signed by an authorized representative from the RAS Supplier.
(SAMPLE ACM CERTIFICATION LETTER)
TO: _______________________(District Materials Engineer)
FROM: _______________________(Supplier’s authorized representative)
SUBJECT: Certification of ACM
The recycled asphalt shingles in pile number ________ located at _______________________________ (source) have been certified asbestos free. The ACM testing protocol outlined in the ________________ (Supplier name) quality control plan was followed and records are available upon request.
________________________________(Authorized Representative’s Name)
________________________________(Authorized Representative’s Signature)