NYC 9/11 Public Portal Document
EMEPcNCy z iv.,.,
"
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59- 7 Junction Boulevard, 8m Floor, Corona, NY 11368-5107 SWIft or TRU No
rASB USE ONLY
ONLY
ASBESTOS PROJECT NOTIFICATION
FO WJLL BE~ 9 I (ASBESTOS INSPECTION REPORT) 1 $1200
(See tee schedule)
~►l1 When submitting this form at a NYC Department of Buildings, the original form and three (3) copies with original
lttai at the NYCDEP requires one copy of the form with original signatures. This
form must be submitt not less than one week in advance of the start of abatement activities.
1. FACILITY
2. Address 15 Maiden Lane Borough Manhattan Zip 10038 —
AKA Atlantic Bank 3. Block 65 4. Lot 7 __
5. Type of Facility-Commercial -- 6. Name of Building
If. BUILDING OWNER
7. Name Relied Realty Corp. 8. Contact Person Fran
9. Tel. # (212) 964-3180 Fax #
10. Address 15 Maiden Lane City N.Y. State NY — Zip 10038
111. GENERAL CONTRACTOR
11. Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
Corp.
Stevenson Contracting --------~-------_—_
12. Name ----_—__-- 13. Contact Person Enos Stevenson
----_--
14. Federal Employer ID. #i.-.-.-.------ !1!- L_ 15. Tel. # (718) 433-4633 Fax# (718) 729-0614
16. Address 37-38 13th Street --~—__ -- City L.I.C. State NY Zip 11101
V. THIRD PARTY AIR MONITOR
17. Name Commercial Lab Enterprises ^__—__ __-18. Contact Person Victor Escalona
19. Federal Employer ID. _ _ _ _ _ _ _ PII 20. Tel. # (718) 392-2832 Fax # (718) 904-9117
21. Address 270 Swinton Avenue -- City Bronx State NY Zip 10465
22. Sample Analysis Laboratory_Commercial Lab Enterprises 23. NYS DOH ELAP # 11708
V1. PROJECT INFORMATION
24. Starting date for this portion of work 9/28/01 .~ Projected completion date 9/30/01 ---
Asbestos work schedule ❑ Monday ❑ Tuesday 0 Wednesday ❑ Thursday 0 Friday 0 Saturday 0 Sunday
Shift from: 6:00 p✓ am 0 pm to :2 00 ❑ am El pm
if other, • ,;`. . ,,
specify — ----- -- n
I~CFIV D
Access to Inspect the premises must be provided during the work schedule Indicated In this Item.
_ OCT n 2001
25. Total amount of asbestos-containing material to be abated during this work r' ~•
7,000 Square Feet, and/or 0 Linear Feet \'\\ r r(
p.
ACP 7
212001
NYC-WTC 000102072
OCR can misread numbers and units. Confirm readings against the page image before using them.