Asbestos project notification, 15 Maiden Lane

NYC 9/11 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler Tristate Transfer NYS DEC Permit # 1A 375 —_ Tel.# (718) 617-0771

Disposal Site(s) Greenridge Landfill, One Landfill Road, Scottsdale , PA 27. This asbestos abatement is part of a (Item a through a requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) ❑ Boiler Replacement C) ❑ Sprinkler Replacement d) ❑ Renovation/Alteration Emergency Clean Up e) ❑ Fireproofing Replacement f) lEl Other (Describe)

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application 4n ._. nl: ARATFUENT t fV`ATIfMC

DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinklers, (e.g. entire, east wing, room #, boiler room, lobby, etc) ducts storage tanks, dedung, eta) FEET FEET removing and replacing boilers, etc.)

IstFloor Lobby,Main Floor Floor,Walls 7,000 Emergency Clean Up

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.

Commercial Lab Enterprises Stevenson n 'rig Corp. Stevenson g Corp. ,", Pri of Air Monitor Print mgt Contractor Print Name oj er than Owner)

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Signature Signature Signature

9/28/01 9/28/01 9/28/01 Date Date 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 in v the asbestos project. I hereby declare that I have authorized the filing of this notification for the work specified he ' Relied Realty Corp. _ _ Print Name of Owner Signature Date

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

An modification of information rovided on this form must bereportedimmediately in writingdirectly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened through the erformance of work in incremental or piecemeal fashion. ACP7 2/2001

NYC-WTC 000102073