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Asbestos control emergency notification request, Sep 2002

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NYS Department of Labor form requesting emergency asbestos control action at a site in Albany on September 23, 2002.

NYC-WTC_000097275–000097278

Folder label: “124 Liberty St

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NYC 9/11 Public Portal Document

SEP-30 02 08:,14 FROM:NYS DOL ACB NYC 2123526902 TO:7185953T44 PAGE:06

STATE OF NEWYORK- DE►ART 3ENT OF IA90R EMERGENCY.NOTIFICATION NEOUESTEO 01VISiON Of $AFETY AND HEALTH r A$RSSTOS CONTROL etJA11J ~- S. Call of RagI aft b. Titsla ofDay SteW 0(1k. Comp~!~, 9/23/02 2sS0pm YgllditiE 12- Rons 'or~c':S ~,•

a. O Paspenea O Gno cP A1bariY, N.Y. 1224* • :' SEP 4 2O8 . Fisher

dr. N.w$tut 04N - — t: NowI(nd Daa d. Submhted By ASBESTOS PROJECT NOY AtTLCN auto 1. NAME AND ADDRESS QF CONTRACTOR 7, FEDERAL EMPLOYER 10ENTiRCATION NO. 1. ASBESTOS LICENSE NQ 02-0356 JVN Restoration Inc. 47 Foster Road 4. MAILING AOORBSE. (If dHltrent than Iitt.d in ITEM I) Staten Island, N.Y. 10309 LL. NAME AND ADDRESS 0? PARTY FOR WHOM THE PROJECT IS IIING PERFORMED Fire Dept. of N.Y. Engine Co.10/Ladder Co.10 6. a. NAME AND TITLE Of DULY AUTHORIZED REPRESENTATIVE b. TELEPMONG NO. John Tardy, Project Manager (718)605-6256 PROJECT INFORMATION P40VIDEALL WFORMAT?ONRfOUF.STEOVOR THE eUrLDJNGfltTJrATW#fICrf THEA$USTOSPROJECT WN2 if CONOUCTtb. 7. ADDRESS (INCLUDE NAME OF BUILDING.ROOM NO., CITY. TOWN. VILLAGE) $. NAME OF BUILDING OWNER 124 Liberty Street City of New York

0. COUNTY to. CURRENT USE OF BUILDING 11. AGE OF BUILDING t 2. ro TAL CONTRACT AMOUNT Manhatten Commercial 50+ TBD 11. PROJECT DATE(S) - Litt 14. TYPE OF ASBESTOS WORK (CHECK i 9. WILL WORK ON THE PROJECT BE CO U FO UNDER A VARANCE? . If phased project d.tes In AML NMJCHAPPLY) yet. specify the type of variance; REMARKS (it1A110 Ct APPLICABLE VA14ANGE - NO.: JJ £. 12 tl 0 Plea Related O INDMPUAL VARIANCE - PETITIOIN NO.: a. ACTUAL STARTING DATE Cl Sprayed on tlltedation 9/24/02 II Roeftn FISMIF0 O Mass( covee(sp O $4034 16. Witt WSCONTI 04CTORS BE ed5W ON THE PROJECT) 20 NO C YES b. PROJECTED [ RDiNG DATE N VAT O Oarnoltlon U yab.pleuolist name and federal employer Identification numberof each 10/01/02 p Other (4podfy/ subcontractor ii RiBMRKS (item 25) on raverlle of fetM, xargtir- 1 i. ASBESTOS PROCEbURI(S) YOU USED is. TYPE OF ASBESTOS i9. AMOUNT OF ASBESTOS INVOLVED - CHECKALL APPLICABLE AOX(ES) PCNECKALL P KHAPPLP7 MATERIAL UNEAR 1 G Lest an ©tats than l 0 REMOVAL O DEMOLITION r— a FRIABLE V O($100) 260.429 O (11100) 16075' N ENCLOSURE O DISTURBANCE C (1200) 430444 a (12001 260499 ENCAPSULATION pl NANOLING ) I BSQ OR MORE Cl ($5 D OTMI R (Specify) C ($M01 (S i fom SIWO Oa M NON'fit1ABL.E

20, METHODS TO BE USED AT PROJECT SITE TO PREVENTASBE$TOS DISSEMINATION (INCLUDING TYPE OF IQVIPMENY AND VENTILATION S fSTEM/S USED) HEPA-filtered negative air filtration units. Wet methods, HEPA-filtered vacuums, decontamination facility with showers.

21. I verify that the 6nformatlg/tghdfijd'4n this notNicatlon is true ad accurate and that the project will ne tondueed In compilance with INS IQGUIramant

John Tardy 9/23/02 a. pn taro tJreCo+ s arBarr► orlsedhlepretSMs Project Manager 6. 1e

PREPS APPUCATION IN!RIPUCATE AN 5U8MIT: Asbestos o An Grp nal andane copy (with an Ink denature on both eoples) to the New York State Department of Labor, Division of Safety and health. Control Bureau, State OfAca Campus. Building 12-Raven 157, Albany, NY 12240; relit+ one copy for your records. e A check or money order, made Cambslonerof Labor, for the 1te due based on the project ii;, as shown to Item 19 able to the m Thh noWkatAsn must be = at Juaf f0 days pflor to thisatar1Jnp date of oa asbesaarpvoje~t ....•, 'I*'

NYC-WTC 000097275

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NYC-WTC_000097275Source: NYC Law Department, mirrored locally

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