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Asbestos project notification form, February 2003

Machine-extracted title · confidence 85%

Asbestos project notification and inspection report form required for NYC DEP and Department of Buildings submittal.

NYC-WTC_000102602–000102604

Folder label: “SCOPE OF WORK ADDENDUMS WORK SCHEDULE

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NYC 9/11 Public Portal Document

FEB, 26. 2003 6:02PM ETS INC, NO, 543 P. 2 NYC DEPARTMENT OF ENVIRONMENTAL, PROTECTION • '> ' "k4s Asbestos Control Program 59.17 Junction 5ouieveed, 3' Floor. Corona, NY 14388.5107 Cep. OrTRU ONLY 1 QI u68 ON&Y TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION meets w" BE 4" k~"" (ASBESTOS INSPECTION REPORT) ACCEPTED rwwr sYc.Qa. s» t t {See eameuI.} When subml tng this form at the NYC Department of 8ufdings. the oetginet form and three (3) co0ias with original elgnaturee we regvl►ed. Submittal at the NYCC6P requires one Dopy of the torn» with original 519nabsre5. This L form must be submitted to the NYC 0EP not less than one week In advance of the start of abatement aedvities . I. FACILITY 2. Adder _114 Liberty Street Borough Manhattan Zip 10006

AKA 3. Block b2 4. Lot 7502 S. Type of Facility Condominium 6. Name of Building 114 Liberty Street

11. Name Not Applicable Tel. # IV. ASBESTOS ASATSMENT CONTRACTOR

12. Name ETS Cotmecting, Inc. 13. Contact Pelson Robert Middleton ----------------PEI.-.-.-.-.--.- , 14. Federrt Employer ID. # 18. Tel. # (718) 706-6300 Fex# (718) 708-1032

16. Address •1 f.'ley Street Cy ~rooidyn State NY ZP T1222 -

V. THIRD PARTY AIR MONITOR

17. Name JLC Environmental Consultants, Inc. 18. Contact Person Jeniffer Carey 19. Federet Employer !D. -PI 20. Tel. # (212) 420-8119 Fax # (212) 420-6092 21. Address 200 Park Avenue South city New York state Mr zip 10003 22. Sample Analysts Laboratory JLC Environmental, Inc. 23. NYS DOH FLAP a 11029

Vt. PROJECT INFORMATION 24.Statting date for this portion of work 3/7/03 Projected completion date 4130/03

Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday 4 Thursday 0 Friday 0 Saturday 0 Sunday

Shift from: 8: 0 0 am 0 pm to 500 0 am 0 pm

If other, specify

Access to Inspect the premises must be provided diu9ttg the wmtc schedule Indicated +n this Item.

26. Total amount of asbestos-containing material to be abated during this work 69 ' °0 _ Square Feet and/or 0 Linear Feet J ACP7 ?120C1

NYC-WTC 000102602

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NYC-WTC_000102602Source: NYC Law Department, mirrored locally

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