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: IF.L~ lsFFA~ IIt~IirA TRU0968MN02 COOII 7,000 \ o0 ONLY TYPEWRITTEN APPLICATIONS WILL BE I NOTE: ASBESTOS INSPECTION REPORT SHALL BE SUBMITTED ! FEE EXEMPT: Yes 7,600 I 0 ACCEPTED upro 500 i 0 I TO NYC DEP NOT LESS THAN ONE WEEK IN ADVANCE ! 1. $0.00 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) 9614100 FEDERAL EMPLOYER IDENTIFICATION H: PII ADDRESS: 14.20 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/0 WARREN & PANZER E NYS ELAP #: 11251

ASBESTOS WORK SCHEDULE ;V DAY I I EVENING V NIGHT VI WEEKENDS ill WEEKDAYS

INSPECTOR NAME: R- RCAla r~ a ruD hcxjr1 SQUAD #: r BADGE #: f{0- tg

DATE OF INSPECTION: 1 / I g /©Z TIME OF INSPECTION: From: g C..,wI AM I PM

To: G rr AM I I PM Contact at site: 3.iy1 LsJoj kowI c L/i y E, r l

Inspection disclosed that the following sections were complied with: (Check all that apply) 1-51 . Notifications, Reports, Pla j 1.71 - Air Sampling and Monitorin I 1.91 • Worker Protection ~ I 1.101 - Materials and Equipment I 1.116 • Work Place Preparation I 1.117 - Worker Decontamination System

1.118. Waste Decontamination System j 1.126 - Engineering Controls 1-127 . Entry/Exit Procedures

i I 1.129 - Maintenance of Barriers 1.138 - Encapsulation j i 1-139- Enclosure

I 1-140 - Glovebag I 1.141 . Tent i 1.137 . ACM Disturbance, RemoveL, Handling

I 1.146. Preliminary Cleanup 1147 . Final Cleanup I 1 Project not started . Inspection

revealed all ACM to be intact. New start date: _ / /

Project ongoing, expected completion date: / /

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

Follow up necessary on / /

Samples taken: No j Yes 1 2 3

4 5 6 Photos taken: j Yes No

Additional comments: — S+e Pwr rnA ~w } • Pvt~. ¢a ~- 1 r,?~ dec i cLQcQ -Fo Td I tom- " cQvxk kZ L -e 'v-_. raj 3'I h n $»r n s C_Y r S1---4e)

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RESULT CODE BORO 1 = MANHATTAN 2 = BRONX 3 = BR000KLYN 4 = QUEENS 5 = STATEN ISLAND

RESULT CODES 1 = VIOLATION ISSUED 2 = NO VIOLATION ISSUED 3 = NO ACCESS SUPERVISOR INITIALS 4 = PROJECT NOT STARTED (NO NOV) 5 = PROJECT COMPLETED (NO NOV)

NYC-WTC 000093364