Asbestos project notification form, 33 Liberty Street

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) Asbestos Transportation 1A-371 26. Asbestos Hauler r te . NYS DEC Permit # TEL.# 631-924-5050

DisposalSite(s) Imperial/POB 47, 11 Boggs Rd., PA; Southern Alleghenies/Rd 3 Valleyview Dr., PA 27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) a) 0 Demolition .b) 0 Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) 0 Fireproofing Replacement I) ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair El Clean up 29. ABATEMENT PROCEDURE (Check all appropriate. boxes) El Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application

,in I nrATIONs nG ARATFPACAIT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTI N OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM (e.g. entire, east wing, room K, SQUARE PERFORMED (e.g. Pipe lagging, ceiling, plenum LINEAR (e.g. running cable, lcin instating file s. nk)ers, boiler room, lobby,etc ducts, storage tanks, decking. etc. FEET FEET removing and re do boilers, etc.) Cooli g Item No. 6 Gravel Roof 7,000 Tower Item No. 3 Dunnage/Pipe: .: : 7,600 (partial)

pper Item No. 3 Roof (partial) 50.0 Roof

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.

Warren & Panzer Eng. Trio Asbestos Removal NYC Print Name of A r Monitor 9nl. e of ios Contractor Cor. Print Name of p t (If other than Owner)

6 S lure Signature Signature

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 p oject. I hereby declare that I a;7d the filing of this notification for the work specified herein. / Federal Reserve Bank c/o NYC 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. of the Asbestos Control Program Rules may not be lawfully avoided or lessened ACP7 ugh the performance of work in incremental or piecemeal fashion. 2/2001

NYC-WTC 000093356