Invoice for roof cleanup, 25 Maiden Lane, September 2002

NYC 9/11 Public Portal Document

r. ASBESTOS INSPECTION REPORT (continued) 26. Asbestos Hauler (esl, MY NYS DEC Permit # W - A62 Tel.# (Zt5) f22 2263 ,. +` r Disposal Sites) 8We VA DGE (A30 Flu. Po Psax 39~' ScarsD~c Qsa tt2

27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) ❑ Boller Replacement c) ❑ Sprinkler Replacement d) ❑ Renovation/Alterâtip v e) ❑ Fireproofing Replacement f) ❑ Other (Describe) _

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

29. ABATEMENT PROCEDURE (Check all appropriate boxes) 0 Full Containment 0 Glovebag ❑ Tent ❑ DEP Variance Application

30 LOCATIONS OF ABATEMENT l2OF MAT AE A( - QI0f MtE i5RM (TA ~i""" a/✓ /~ Z 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 UNEAR (e.g. running cable, installing fire sprinklers, (e.g. entire, east wing, room #, boiler room, lobby. etc) ducts, storage tanks, decking, etc.) FEET ' FEET removing and replacing boilers etc.)

ROOF R+t~OF Svt2F,&c 3525 Dt.)CCS 2$t3CO

METAL. Sven toad

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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.

WARMiets 4 PANZEta ;EMClMEERS B. Ku N g Ce3T~Otr Contractor Print Name of Applicant (If other than Owner) Print Name of Air Monitor Pri N e of be

- ~31/~ ..lA 3~ Signature Signature Signature

05-2-a2 o8-2T- o2 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 involved in the asbestos project. I hereby declare that I have authorized the filing of this notification for the work specified herein.

Print Name of Owner Signature Date

STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE. writinQdirectly to the NYC DEP ACP. fl Aiy modification of information provided on this form must bereportedimmediately in writing The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened throw h the rformance of work in incremental or iecemeal fashion. ACP7

NYC-WTC 000102173