Invoice for work at 116 Nassau Street, July 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) ~ •V

26. Asbestos Hauler J. J jf NYS DEC Permit # M-1 — 46 2. Tel.# (118 ) 5 22-2Z. 3 Disposal Site(s) t3ts3E rZ tp~E t o Np PO BOX 3S ScoTs OALE P,s, 1T254 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 I e) ❑ Fireproofing Replacement f) ❑ 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 ABATEMFtNT A 4f/ DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM Floor(s) . OF FLOOR DESCRIPTION OF WO K BEING (e.g. entire, east wing, room p, CONTAINING ACM PERFORMED (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinklers, boiler room, tobb , etc ducts, storage tanks, decking, etc.) FEET FEET removing and 1ep1ac1n9 boilers, etc.) FACADE So3T1.t 5460 (uS t DE FACAt South ('ate ) 2$ 2T6

FACADE. No(zt1.1 2o000 FAC-ADG BAST IS000

FACADE t 'T" ft 7Oo FLUE ( INSIDE Ccts. 2400 FIRE EsCAr-E5 1650 Due. t K 4 Alc uFr-j5 9( O SET ~.ctc 12cc* 1125

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

Print N e of Air Mon r Prin Name sbesto ontractor Print Name of Applicant (If other than Owner)

Signature Signature Signature

-- ~~Date — 03 112 Date Oate 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.

Print Name of Owner Signature oIo41oz 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 immediate) in writingdirect) to the NYC DEP ACP. the Asbestos Control Program Rules may not be lawfully avoided or lessened I the performance of work in incremental or piecemeal fashion ACP7 212001

NYC-WTC 000098849