Asbestos cleanup scope letter, 65 Nassau Street, Sep 2001

NYC 9/11 Public Portal Document

~~ - ESTOS INSPECTION REPORT (continued) 26. Asbestos Hauler ATC NYS DEC Permit # _1A371 TEL# (5th6) 9245050 Disposal Slte(s)S. Alleghinies landfill, RD3 P.O. Box 310, Hollsopple, 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) 0 Sprinkler Replacement d) ❑ Renovation/Alteration e) 0 Fireproofing Replacement f) El Other (Describe) Emergency Asbestos dean up

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation 0 Repair El Clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) d/ / `4 / ❑ Full Containment 0 Glovebag ❑ Tent El DEP Variance Application ~!

30. LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing. room #. (e.g. Pipe lagging. calling. plenum SQUARE LINEAR (e g. running cable, installing to sprinkles, boiler room lobby, sic) ducts, storage tanks, dedd etc.) FEET FEET removing and repladng bdlers etc.) Bsmt Entire all affected surfaces 4,500 0 ACM dean up only 1st Hallway & APT A,B,C,D all affected surfaces 4,750 0 ACM dean up only 2nd Hallway & APT A,B,C all affected surfaces 4,500 0 ACM clean up only 3rd Hallway & APT A,B,C all affected surfaces 4,500 0 ACM clean up only 4th Hallway & APT A,B,C all affected surfaces 4,500 0 ACM clean up only 5th Hallway & APT A,B,C all affected surfaces 4,500 0 ACM dean up only 6th Hallway & APT A,B,C all affected surfaces 4,500 0 ACM dean up only 7th Hallway & APT A,B,C all affected surfaces 4,500 0 ACM clean up only 8th Hallway & APT A,B,C all affected surfaces 4,500 0 ACM dean up only 9th Hallwat & APT A,B,C all affected surfaces 4,500 0 ACM clean up only

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.

Central Environmental Inc. Black Rock Construction Co. Tony Brown Prin ame of Air or Print Name of Asbestos tractor Print Name of Applicant ho than Owner)

t"t nature Signature Si1 re

12/10/01 12/10/01 12/10/01 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 'n the asbestos project. I hereby declare that I have authorized the filing of this notification for the work specified herein. 65 Nassau Owners Corp. 12/10/01 Print Name of Owner Signature Date A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

I Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened through the performance of work in incremental or piecemeal fashion. ACP7 22001

NYC-WTC 000098007