Invoice for asbestos roof cleanup, 90 Maiden Lane, Jun 2002

NYC 9/11 Public Portal Document

ASBESTOS IN EgiT3ON REPORT continued Ysestos Tr~nspor> 26. Asbestos Hauler Co - ation NYS DEC Permit # 1A-'371 TEL.# 631-924-5050 DisposalSite(s) Imperial/POB 47, 11 :Boggs Rd. , PA; Southern AlDleghenies/Rd 3 27. This asbestos abatement is part of a (item a through e requires filing of this form with NWC'DepjarYmentof gu5dutbs)PA ~+ a) ❑ Demolition b) ❑.Boiler Replacement c) ❑ Sprinkler Replacement d) ❑ RenovatloNAlteratkm e) 0 Fireproofing Replacement f) ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal ❑ Enclosure ❑ Encapsulation ❑ Repair ❑ Clean up 29. ABATEMENT PROCEDURE (Check all appropriate.•boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application

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 0. (e.g. Iipe lagging, cea►g. plea SQUARE LINEAR (e.g. mmning cable. Installing free sprinklers, boiler room. lobby. etc) ducts. storage tanks. decking. etc.) FEET removIng and reptadnq boilers, etc. Roof Item No. 2 ?erimeter and 4,95 localized areas

Roof Item No. 4 Gravel Roof 90

Facad Item No. 7 North Facade 4,751

31. 1 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 Eng. Trio 1Asbestos Removal NYC. Print Name of Air Monitor nt Nar or Stns contraotoCorp Print N'me C$~ (N oilier than Owner)

Sig ure Signature Signature

I/DV/i(24 Date (L /i/ 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 lr monitor who is completely independent of all parties involved in the asbestos project. I hereby declare that I have a rizeqthe filing of this notification for the work specified herein. AM Property Holding .Co. c/o NYC (.. Print Name or Owner Signature Date A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

L Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. ACP7 212001

NYC-WTC 000102472