41 JOHN STREET 1075701, 78/7502

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (cpntinued) a _____,

NYS DEC Permit # U1 - 44L_,, Tel.# C1t 8 5522 - 26. Asbestos Hauler __L 6t N?

BWE~i~G~—lAl&~~lL PO_B01S _ 39_ SCoTSDA~IE — 25 Disposal Site(s) Department of Buildings) 27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration a) 0 Demolition e) 0 Fireproofing Replacement f) ❑ Other_(Describe) ___----__-- --------------

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure 0 Encapsulation 0 Repair ® Clean up

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application

JU. LVI.NI IVrw jr MGM I G1YIG1v1

DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING• CONTAINING ACM PERFORMED Floor(s) OF FLOOR SQUARE LINEAR (e.g. running cable, installing fire sprinklers, (e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum FEET replacing boilers, etc.) FEET removing and reptacing boiler room, lobby. etc) ducts, storage tanks, decking. etc.) s -ze.Yae BLDG Pc.o dNo £ CF Pt F SR-FACL-S 5119 MAt o tzoo F TtW SUAa Sr Y.a►CKS ST BAC Q~1F SUQ.FAC2S 24SO ►+ern._ 'Pane SuacAcE RoO F .S A-+. o pcc I St Ll G " Ts %000

a Duels 4 METAL. S: c 1250 7iCQA4.E ODD M METAL SrplR 7 8ACt ~~II WAu S 48TO ecc U:4"s -orzi, G'cf'ft

FArAOE I,)catu 4 400 W1tJDptssS Q LEDGES . -Y 1340 avNINCiS Sir.4S 11 Scvr1•i (Jo KA Sr') VACADTc Suet-AC15

of my knowledge. I am familiar with Federal, 31. 1 hereby declare that the information provided herein is true and complete to the best Ctnta nnri NYC laws anri renulatinns annlicable to asbestos related work.

WAGP•E-N @ PAuZerz E►361PEEPS $ . tra_ez_Anl _ SoN _u•_.oL_ bes s contractor —_ Print Name of Applicant (If other than Owner) int Name of Air nilor 7t Nam fof

/ SI nature Signature d~ Signatu

e8 -15 -02 OS-lS- _ -_ Date — Date Date

responsible for the performance of 32 I understand that as the owner of a building where asbestos abatement activity occurs, I am have contracted the third party air Program Rules. I the asbestos abatement activities in accordance with the Asbestos Control declare that I have authorized the monitor who is completely independent of all parties involved in the asbestos project. I hereby filing of this notification for the work specified herein. fJYC tJEA 08-rs-o7. signature Date --- Print Name of Owner g AVAILABLE AT THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE writin direct) to the NYC DEP ACP. An modification of information rovided on this form must be re orted immediate) in not be lawfully avoided or lessened The requirements of the Asbestos Control Program Rules may piecemeal fashion. through the performance of work in incremental or Acp7

NYC-WTC 000092898