Asbestos work permit application for 87 Nassau Street, Nov 2002

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler __—_ iESis HIV —____—_ NYS DEC Permit # )j -dk2 --_ Tel.# _071$) S22-22.3

Disposal Site(s) [3U1E W D6E LAsADFtt.c — P 0 B x, _3~9-- C 2 t om'A _1 72

of Flt This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department Buildings) a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration

e) ❑ Fireproofing Replacement f) 0 Other (Describe) _------_—__-------_----------

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure 0 Encapsulation 0 Repair ® Clean up

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment

ou. • /1n ATI^LIC f 0 Glovebag

A 0 ATCAAC&IT

~vv^ I Iv,DESCRIBE SECTION 0 Tent ❑ DEP Variance Application

DCOF

r RA_aT~IDi

AFFECTED SURFACES AL. .~ LV01" ME -4

AMOUNT OF ACM E -ic-€ f4l9€f/fJ) DESCRIPTION OF WORK BEING PERFORMED Floor(s) OF FLOOR CONTAINING ACM SQUARE LINEAR (e.g. running cable, installing fire sprinklers, (e.g. entire, east wing, room #, (e.g. Pipe lagging, ceiling, plenum FEET ducts, storage tanks, decking, etc.) FEET removing and replacing boilers, etc.) boiler room, lobby, etc) Pw— 1a4 XD F s u ¢EAC E S 1700 1130 DC -S M 'UM_ L*M2 & µ0(y`5 RAF fnf ti NGuuDES METAL 4 lE'DG2 rzvc>F (21~oF —5

Ii PewNWSis E'. . WALLS 3300

F1CADE S0Oi ffC"E &- X 7'65

It if fi PE CAPES 7400 rum LOCIA-(mot s

4aaaoE U~Csr ~DE Su2F 5400 TK FAcAvC— ►4Et1a— St1t31TE 20700 (30111 SIDE-S Sc

t' 4tTN- St7rtQs ;-.L.€ 2 (0"O

SCT EAC7c P22?0 F S tUs2F € 1200

~ {' P-CAGE Fs~CAi~E SC4~.Ffi~<'-C' i 200

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

(13 PRFzE sn-4ip Wez Soa Cwo Pr t Name of Air Monitor Print Na a of Asbestos tractor Print Name of Applicant (If other than Owner)

Signature Si9nature Signature

09-12-02 O .-(2 —02 Date Date Date

responsible for the performance of 32. I understand that as the owner of a building where asbestos abatement activity occurs, I am contracted the third party air the asbestos abatement activities in accordance with the Asbestos Control Program Rules. I have 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. NYC©EP ~sy-1 .-02- -- Date — Print Name of Owner Signature

AVAILABLE AT THE WORK SITE. A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE writing directly to the NYC DEP ACP. Any modification of information provided on this form must be reported immediately in avoided or lessened The requirements of the Asbestos Control Program Rules may not be lawfully throuoh the performance of work in incremental orpiecemeal fashion. ACP7 212001

NYC-WTC 000099352