WTC Debris Clean-up Permit Application, Jun 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTIONREPORT continued dsbestos Ir(anspor'tation 26. Asbestos Hauler Co. NYS DEC Permit # 1 A— 371 TEL. 31 — 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) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration e) ❑ Fireproofing Replacement 0 ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure . 0 Encapsulation ❑ Repair ❑ Clean up 29. ABATEMENT PROCEDURE (Check all appropriate. boxes) ❑ Full Containment ❑ Glovebag ❑ Tent 0 DEP Variance Application 30. LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF. ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM (e.g. entire. east wing. room #. (e.g. Pipe lagging, ceiling, plenum SQUARE PERFORMED UNEAR (e.g. running cable. installing fire sprinklers. boiler room, lobby. etc) duds, story a tanks, decking. etc.) FEET FEET removing and replacino boilers, etc.) Roof Item No. 2 3250

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 o Trio Asbestos Removal NYC Print Name of Air Monitor Print Name of As cos Co cap Pri Name f Applicant (If other than Owner) */ Signature Signature Signature

/L (\q5/az _________ 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 t asbestos project. I hereby declare that I have 1uthorized the filing of this notification for the work specified herein. Time Equities C/o NYC /HIC3Z.. Print Name of Owner Signature Date A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. LA ny modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. The Asbestos Control Program Rules may not be lawfully avoided or lessened ACP7 e performance of work in incremental or piecemeal fashion. umot

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