License agreement for exterior cleaning, 65 Liberty Street

NYC 9/11 Public Portal Document

. I ASBESTOS INSPECTION REPORT (continued) Asbestos 26. Asbestos Hauler Transportation CO.' NYS DEC Permit# 1 A-371 J *TEL.# 631 -924-5050 ' DisposalSite(s) Imperial/POB 47, 11 Boggs Rd., PA: Southern Alleghenies 27. This asbestos abatement is part of a (Item a through e requires filing of this form Valleyview Dr., PA with NYC Department of Buildings) a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement I) ❑ Other (Describe)

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

30. LOCATIONS OF ABATEMENT UhSCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM Floor(s) DESCRIPTION OF WORK BEING OF FLOOR CONTAINING ACM (e.g. entire,.east wing, room #,. (e.g. Pipe lagging, ceiling, plenum SQUARE PERFORMED LINEAR (e.g. running cable, installing fire sprinklers, boiler room, lobb , etc ducts, story a tanks, deckin . etc. FEET FEET removin and re lacin boilers, etc. acad ..Item No. 8 Partial Facade 40000 .I I,

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

Warren & Panzer Trio Asbestos Rvl.Crp. Print Name of Air Monitor Tam Asbe ontractor Pri 'I}lame f li nt er n Owner)

Signature e Signat e

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____________ 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. 55 Liberty Owners Corp. c/o NYC nn `

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 requ 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 000093413