44 JOHN STREET 1001110, 67/30

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler_ tt _ N V _______ NYS DEC Permit # N J -4 62 __ Tel.# Ct tS' S 22- 22.63

Disposal Site(s) E3wE 2t_06S _L.ANDFILL PO Boy, 399 _ 5coT5t>a.r.E ps. tT2S4

27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) ' a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement f) ❑ Other (Describe)

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

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

'ln I (1(ATIr1NC r1F ARATFMGAIT 2aoF NortcTLiA4l : poor Mt- r/c3t..A T~Q DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinklers, boiler room, lobby. etc) FEET FEET removing and replacing boilers, etc.) ducts, storage tanks, decking, etc.)

FACADE Nceni (30N14 S-) GA cot SuP-t~sarEs 2530 ti So , y% Fdc`o7E Sil 2GG'S Z $O 5 Gru'iuo 5v¢-cs+.c~ 6 e.0—J io s3,aut~o cu 3

eZoof PA z.nat 20oF Root= s 5 10 SET IZ.00F k'oot= S.-i ISO

Ft►CArJC- a cs- FscP 4565

AST FAGA Or S Jci p. C I T83 PorzriAL ccA.D~? W E' 'l t,w I cOU2I~'jaPA Cc:JLTYO Wu—rtAkiw tttcor- IT60 CAST Fta~U(~ />•rlt~D. cG:r~'(A2 ►JEn~ s vi_T•~A Z.D E.-ocrz ice 6E.e•orari sur_, G. it GT1'5p 88( A.+p 4-^ T

31. I hereby declare that the information provided herein is true and complete to the best of my knowledge. I am familiar with Federal, State and NYC laws and regulations applicable to asbestos related work.

PAN21Z ENc i jeeeS 3CNJt.M u , `SON LcuR Print Name of Air Monitor Prin Name of Asbesto Contractor Print Name of Applicant (If other than Owner)

Signature Signature Signature

ORlo-11 O2 __ o.P o r (02 -- — Date Date Date

32. I understand that as the owner of a building where asbestos abatement activity occurs, I am responsible for the performance of the asbestos abatement activities in accordance with the Asbestos Control Program Rules. I have contracted the third party air monitor who is completely independent of all parties involved in the asbestos project. I hereby declare that I have authorized the filing of this notification for the work specified herein. -_N_rc-D~r oaIo-r (0z _ Print Name of Owner Signature Date

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened through the performance of work in incremental or piecemeal fashion. ACP7 2!2001

NYC-WTC 000092956