WTC Debris Clean-up Permit Application, Jun 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) ti. Asbestos Transportation 26. Asbestos Hauler ,j,-. NYS DEC Permit # 1A-371 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) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement 1) ❑ 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

30. LOCATIONS OF ABATEMENT -~~'~"~► 0 q(O!5 / L1.O y DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTI N OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing, room it, (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinklers, boiler room, lobby. etc) ducts, storage tanks, decking, etc.) FEET FEET removing and replacing boilers, etc.) Cooling Item No. 6 Gravel Roof 7,000 Tower Item No. 3 Dunnage/Pipe,` .:., 7,600 (partial)

Upper 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 Air Monitor nLN a of tos Contractor C or Print Name of p t (If other than Owner) lr .,/

Si alure Signature Signature

%;:; Date 7 /z i ( '

Date

32. I understand that as the owner of a building where asbestos abatement activity occurs, I am responsible for the performance of Date

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;jd th filing of this notification for the work specified herein. Federal Reserve Bank C/o NYC VL a Z Print Name of Owner Signature Date

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

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

NYC-WTC 000093682