Asbestos roof cleanup invoice for 10 Maiden Lane, July 2002

NYC 9/11 Public Portal Document

4 c~ ASBESTOS INSPECTION REPORT (continued) _ Asbestos 26. Asbestos Hauler Transportation NYS DEC Permit# 1A-371 Co. TEL# 631-924-5050

DisposalSite(s) Imperial/POB 47, 11 Boggs Rd., PA: Southern Alleghenies Valleyview Dr., PA 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) ❑ Sprinkler Replacement d) ❑ RenovatioNAlteration a) ❑ Fireproofing Replacement f) ❑ 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 ❑ Tent ❑ DEP Variance Application / y/ 41a 30 LOCATIONS OF ABATEMENT DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. entire, east wing, room N. (e.g. Pipe lagging, ceiling. plenum SQUARE LINEAR (e.g. running cable. installing fire sprinklers, filer room, lobby, etc) . storage tanks. decking. etc SET FEET and boilers. eta)

Roof IRA 0. 3 / S SQ S acadi 8 1,C1(i

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.

Warren & Panzer Trio Asbestos Rvl.Crp NYC 1 ame of Air kar tin an~~f Contractor Print Name of Applicant (I! other than Owner)

41 J Si nature Signature Signature

-711,310z- 7/i: 102— > LIZ.. Date to Date

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. Lillian Seril c/o LPB Mgmt Co. A.. P.inl Name of Owner NYC Signature Date do

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

I Any modification of information provided on this form must be reported immediately in writing direct!y to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened ACP1 through the performance of work in incremental or piecemeal fashion. 21200+

NYC-WTC 000101903