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Asbestos project notification form, February 2003

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Asbestos project notification and inspection report form dated February 26, 2003 required for NYC DEP and Department of Buildings submittal.

NYC-WTC_000102617–000102619

Folder label: “SCOPE OF WORK ADDENDUMS WORK SCHEDULE

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NYC 9/11 Public Portal Document

.4 FEB. 26. 2O3 5:27PM ETS INC. O. 54C P. 2 NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 juncdon Boulevard. 3e Floor. Corona NY 11368-6107 SuHdng Dept. TR:! No ONLY FOR OP At. use ONLY TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION FORMS WILL SE (ASBESTOS INSPECTION REPORT) ACCEP1EO (See INsawn*

when suluntaing G1ia form at the NYC bepanment of 8ui1dinga. the original form and three (3) copies with original signaWnas are required. Submittal at the NYCOEP requires one copy of ire form with original signatures. This form must be submitted to the NYC DEP rot less then one week in advance of the start of abatement aedvides . ,

1. FACILITY

2. Address 114 Ub erty Street Borough Manhattan ZiA 10006 G1 3.9lock 52 4. Lot 7502 6. Type of Facility Condominium 6. Name of Building 114 liberty Street

11. Name Not Applicable TeL # M. ASBESTOS ABATEMENT CONTRACTOR 12. Name ETS CQt "Cling. Inc. 13. Contact Person Robert Middleton

14. Federal Employer f0. 15. TeL # (718) 708$300 Fax# (71~ 706-9032

18. Address •160 CiSy Street C;ty Brooklyn 8tte NY Mp 11222 V. THIRD PARTY AIR MONITOR

17. Name JLC Ertvironrnental Consultants, Inc. 18. Contact Person Jeniffer Carey 19. Fedeisl Employer lb. #` P I I-._._._._._.. 20. Tel. # (212) 4208119 Fax # (212) 420-6092 21. Address 200 Park Avenue South Cky New York State NY ZIp 10003 22. Sample Apetysis Latloratory JLC trrlvironmentat, Inc. 23. NYS DOH FLAP #11029

VI. PROJECT• INFORMATION 24. Starting date for this ponion of work 317/03 Projected completion oate 4/3O/03

Asbestos work schedule ® Monday Q Tues40y Q Wednesday ® Thursday 0 Fri Shift from: 8:00 0 am ❑ pr to 5:00 © am ®pm if other, spec* Aeeess to kispoct the p emivee must be provided dwin6 afire work srhedufe endtaeted /n lbws itenv.

25. Total amount of asbestos.contair*ng material to be abated during this work 69,000 Square Feet, and/or 0 Unger Feet 7 91

NYC-WTC 000102617

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NYC-WTC_000102617Source: NYC Law Department, mirrored locally

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