NYC 9/11 Public Portal Document
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NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, 8 Floor, Corona, NY 11366-5107
au&ring Dept. o TTRu No
ONLY FOR OFFICIAL USE ONLY
s i r ASBESTOS PROJECT NOTIFICATION • L
(ASBESTOS INSPECTION REPORT)
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When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original
signatures are required. Submittal at the NYCDEP requires one copy of the fom► with original signatures. This
form must be submitted to the NYC DEP not less than one week In advance of the start of abatement activities.
I. FACILITY
2. Address 10 Maiden Lane • Borough anhattan Zip10005
AKA 3. Block 64 4. Lot 21
5. Type of Facility 6. Name of Building
If. BUILDING OWNER
7. Name Lillian Seril c/o LPB Mgmt. Co. 8. Contact Person
9. Tel. # Fax #
10. Address City State Zip
Ill. GENERAL CONTRACTOR
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan
--------------------- ---------------,
14. Federal Employer ID. # P11 L. 15. TeL # 71 8-961-4100 Fax # 71 8-961-4103
16.Address 14-20 129th Street CCollege Point State NY zip 11356
V. THIRD PARTY AIR MONITOR
Warren & Panzer Engineers, P.C.
17. Name 18 Contact Person Michael Nolan
19. Federal Employer ID. # 20. Tel. # 212-922-0077 Fax# 212-922-0630
228 East 45th Street city New York
21. Address State NY Zip 10017
22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 1 1 251
VI. PROJECT INFORMATION
24. Starting date for this portion of work et- Projected completion date
Asbestos work schedule ❑ Monday 0 Tuesday 0 Wednesday ❑ Thursday 0 Friday P9 Saturday IN Sunday
Shift from: am ❑pm to Dam, pm
If other.
specify f i to
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to
Access to inspect the premises must be provided during the work schedule indicated hi this Item.
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25. Total amount of asbestos-containing material to be abated during this work i? T3$/Lt„!.•
Son Square Feet, and/or Linear Feet Ti u
...
~ Z ACP 7
?!2001
NYC-WTC 000101902
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