NYC 9/11 Public Portal Document
07/17/02 10:23 $' 2 002
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NYC DEPARTMENT OP ENViRONMENTAL PROTECTION
(9" Aebestoe Control Program 1.
W17 Junction BauIevard, ai* Floor Gerona, NY 11368,5107 t rrc nppoe.
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is m':nr *IilT NOT AN ASBESTOS PROJECT I acpsr s~
FOAMS 11//LL lM±.TPser N t
IEACCEPTSD Wh0n V To at the NYC Depwpnm t of &&*%e, the of OW To and Three (3) Gopee WM original
9wdtunt and weft ere ro ulted. Submittal at e NYMEA mou! s one coav of Iha form with ariafnrl skrAM o and gear.
2. Facility Address 1S Maiden Lane Borough Manh:attan Zip 10038
AKA 18 John Street 3. Block 86 4. Lot 7
6. Buftd'rngOwner. Reiae Corn fly Tale. 212 964-3190
6. Address 15 Maiden Lane yts% NY Zip 10038
7. contact Peron Mehdn Heiler 8.74. S (212)90-3185)
9. Description of the Entire Scope of Work
10. fat. Stilt Dats M As seat as peps* approved EsL comptetlon Date 8131!02 of the Entire Scope of Work
11. I, PJChgM P. Mi109Ui have conduoted an asbestos inv6etigabaan on 816102 it accordance with
Seciorts 1-16 and 1'27 of the NYC DEP Asbestos Control Progreso RUIN and dedare that at said fad0#y address, the
C3 a posrnise to be demotbt>ed Is tree of any asbestos containing material (ACA.
Q b. Premiss to be damoished vontslns 10 square feet or has or 25 linear foal or loss of M M.
® a cumulative surfeoas of structure(s) affected by the work are free of ACM. .
❑ cL cumutalive surfaces of etructure(s) affected by the work contain 10 square feet or less or 20 snear feet or less of ACM
-friable ACM shall be d altsbed/ emoved. Spay amount_.
C]e. notmaNY flan square feet
©f. ACM tN8 not os afstumed during the scope of work. specstv amount of ACM present: square fast linear feet
A11 ACAA epeaNled lr'b"."d, o m va In atowrdanea vulttt the fl Asbestos Rules or NY3 DOL I0*6e'
12. REMIL''S Of JO-DINfi SURVEY AND HAZARD ASMESS1f1ENTt
FLOOR DESCRIBE SECTION ALiM klAL8
01' FLOOR ASSUMED TO CONTAIN ACM SAMPLES PRESENT ASSUMED
to y aetrs aeee,ws ,mnste,moe..omn.roper,rta1 ANDIOR SAMPLED ANALYZED YES NO ACM
13th Fl. East Parapet Waft on North Roof Rubber Caulking I ✓
Roof North Parapet Wall on Main ld WaS Mastic 2 ✓
SW & SE Comers on Main Roof Flashing 2 if
13. Analytical Laboratory Tesdnu Mechanics Corp,
14. EtAP d 11018 1b. Pate(s) Samples Analyzed
r r—
Ia. I harsby formation provided heraIn Is trees and pompipte.
7a3S1 8110102 (917) 828-2727
AttGoePA~ara t,~reew cgrBrds, e. sae abyW~.eTdsdonKather
(mm bda_
Any moOtkadon or nnediatpra%sded an refs form roust to reported hnmodcly In
I ppr"M
_ _ J
willingdira to pts NY . The .sq*emaas of the Asbestoo Control Program Rube may not be sn'c Ni'
arrrriVf[jt 5WIOi+ii or the peifoimorlim of wart in frronernena1or lemon
•/,►ptenrepemleee,MAorMOQil►BS83.1dl0fe0.asr pamasdblN Yat . JtS8~ST06
NYC-WTC 000102077
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