Invoice for exterior cleanup services, October 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued) 26. Asbestos Hauler LO _a NYS DEC Permit TEL /-O_ —X72— 6'0 7 // Disposal Sites) O eka~ l? •es *~ !"~ f (E 27. This asbestos abatement is part of a (Item a through a requires filing of this form with NYC Department of Buildings) a) 0 Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation!A teratipn e) ❑ Fireproofing Replacement f) 0 Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure ❑ Encapsulation ❑ Repair ❑ clean up 29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag 0 Tent 0 DEP Variance Application 3n LnCOTInPJq r Aaereueur ♦. ~ ~tttr DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g enure. east wing. mom $, (e.g. Pipe iagging, cuing. Plenum SQUARE !.NEAR (e.g nrrvW baler room bby, etc cable. installing fre aprinkler&. ducts, Storage tanks, . etc. FEET ' FEET nQ ILO'b fl f) remm and replacing boilers. etc.)

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31. 1 hereby de;tare 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.

surer Pnnt N ~atr.t fE itor 25T7 Pnn Name y_c17 A3tstos Contractor ! 7,4. Print Nan•+ of App ant (M Deer than Owner)

Signature gnaturo Signature

OC'- 03-o -3-02 Oate Date Oate 32. 1 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 ' f this notificajip for the wo ti .

Pent flame r signettre Onto A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. An modification of information provided on thisformmustbereportedimmediately in writin direct) 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. ALP? trt or

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