Chain of custody form for asbestos samples, 33 Liberty Street

NYC 9/11 Public Portal Document

• NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION TOTAL FEET: 15100 0 • ASBESTOS INSPECTION REPORT Basis of Inspection: ff6LrtIIt48E~Mt:F °°I 7,000 0 TRU0968MN02 I t 0 ONLY TYPEWRITTEN FEE EXEMPT: Yes APPLICATIONS WILL BE NOTE: ASBESTOS INSPECTION REPORT SHALL BE SUBMITTED I 7,600 i 0 ACCEPTED TO NYC DEP NOT LESS THAN ONE WEEK IN ADVANCE 1. $0.00 upro. 500 0 OF START OF THE WORK (ABATEMENT ACTIVITIES)

START DATE: 6/27/02 COMPLETION DATE: 7/27/02

I. FACILITY ADDRESS: 33 LIBERTY STREET BORO: MANHATTAN ZIP: 10005

TYPE OFFACILITY: BLOCK: 66 LOT: 1

II. BUILDING OWNER NAME: FEDERAL RESERVE BANK TEL. #: ADDRESS: 33 LIBERTY STREET CITY: NEW YORK STATE: NY ZIP: 10045

IV. ASBESTOS ABATEMENT CONTRACTOR NAME: TRIO ASBESTOS REMOVAL CORPORATION TEL. #: (718) 961.4100 FEDERAL EMPLOYER IDENTIFICATION #: PII ADDRESS: 1420 129TH STREET CITY: COLLEGE POINT STATE: ]N ZIP: 11356

V. THIRD PARTY AIR MONITOR NAME: WARREN & PANZER ENGINEERS, P.C. TEL. #: (212) 922.0077 ADDRESS: 228 EAST 45TH STREET CITY: NEW YORK STATE: NY ZIP: 10017 VI. LABORATORY FOR SAMPLE ANALYSIS NAME: WKP LABORATORIES C/O WARREN & PANZER E NYS ELAP #: 11251

ASBESTOS WORK SCHEDULE Vi DAY I EVENING W NIGHT V: WEEKENDS !I WEEKDAYS

INSPECTOR NAME: R. RC~/~z a e own r SQUAD #: I BADGE #: ,4079

DATE OF INSPECTION: 7/ / /02_ TIME OF INSPECTION: From: Q n r+a AM I PM

~ To: S P3 AM PM Contact at site: VT 'yy (JO(rc-tFpvjlC S,, ff Yv c.,.o7- / •r o -r y0("-C Inspection disclosed that the following sections were complied with: (Check all that apply) 151 - Notifications, Reports, Pla I ( 1.71 . Air Sampling and Monitorin 1.91 . Worker Protection

1.101 • Materials and Equipment j ( 1.116. Work Place Preparation 1.117 . Worker Decontamination System

1.118. Waste Decontamination System ; 1126. Engineering Controls 1.127 . Entry/Exit Procedures 1 1 i 1.129. Maintenance of Barriers 1.138 . Encapsulation j 1.139 • Enclosure I

1.140 . Glovebag ! j 1141 . Tent I 1.137 . ACM Disturbance, RemoveL, Handling

1.146 • Preliminary Cleanup I I 1147 . Final Cleanup Project not started • . Inspection

revealed all ACM to be intact. New start date: / / i~ Project ongoing, expected completion date: / /

Project completed on or about / / . All surfaces, including abated surfaces are free of visible ACM and encapsulat

I I Follow up necessary on / /

Samples taken: No I Yes 1 2 3

4 5 6 Photos taken: ; Yes No

Additional comments: C51 ~. x I _a SQY s.4( ' ttn 4

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RESULT CODE BORO 1 = MANHATTAN 2 = BRONX 3 = BROOOKLYN 4 = QUEENS 5 = STATEN ISLAND I 2 , RESULT CODES 1 = VIOLATION ISSUED 2 = NO VIOLATION ISSUED 3 = NO ACCESS I SUPERVISOR INITIALS 4 = PROJECT NOT STARTED (NO NOV) 5 = PROJECT COMPLETED (NO NOV) PPP !

NYC-WTC 000093363