License agreement for debris cleanup, 85 Nassau Street, 2002

NYC 9/11 Public Portal Document

SS t3 AsSA'3 5 T-P_e' '-r ASBESTOS INSPECTION REPORT (continued) , Asbestos Hauler IESI,NY _ NYS DEC Permit # NJ-462 - Tel.# (718) 522-2263 /~6. Disposal Site(s) BlueRidge Landfill PO Box 399 Scotsdale, Pa 17254

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) 0 Boiler Replacement c) 0 Sprinkler Replacement d) 0 RenovationifAlteration e) 0 Fireproofing Replacement t) El Other (Describe) _-

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) /~/► No 2„ 'in ❑ Full Containment ❑ Glovebag

LOCATIONS OF ABATEMENT ❑ Tent 0 DEP Variance Application

Poosm S iP. QooF ► e*48(ZA4JE , 7 9 `•~ DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) j OF FLOOR CONTAINING ACM i PERFORMED (e g entire. east wing, room it leg Pipe lagging, ceiling, plenum SQUARE LINEAR (e g running cable. installing fire sprinklers, boiler room, lobby etc) FEET FEET removing and replacing boilers. etc oucts, storage tanks decking. etc

ROOF ROOF Su2t=s+c 5 3619 rer accrc; - 200 ecoF Se.. AGE 28 P rr R.00R 4 WAcs_ suttcAcES ; 1260

:ABC, r,AEr*1_ 4 MESP.L FV E" 4000 j I F 2400

t-ACADI I13TE1Zd012 e a e.p~ —S Su~FAQc 3850 i

i 3 960 j N O R.TU u

SocTit a 1 5320 N UDt : It 2150

_ j w 12430 l 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.

WAGRE"A+ C rANiER FMt.INesms B. %4"A►1 4s 1t1C

I12I or Print Print Name of Applicant (if other than owner)

£4 nl rne c

iT1 Signaature Signature

`O'tt 102 10111102

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. f 101 f I b2 Pnnt Name of Owner Signature Date

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

LA ny 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. V2001

NYC-WTC 000099415