Asbestos inspection report header, DEP Box 35, undated

NYC 9/11 Public Portal Document

f NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION TOTAL FEET: 72000 0 ASBESTOS INSPECTION REPORT Basis of Inspection: FL SF to tat 6,O0o 0 TRU0273MN03 2nd 6,000 0 oNLYTYPEWRIT7EN APPL/CA7TONSWu1BE FEE EXEMPT: Yes 3rd 6,000 0 NOTE: ASBESTOS INSPECTION REPORT SHALL BE SUBMITTED ACCEPTED th 6,000 TO NYC DEP NOT LESS THAN ONE WEEK IN ADVANCE 1• $0.00 0 OF START OF THE WORK (ABATEMENT ACTIVITIES) 5th 6,000 0 8th 6,000 START DATE: 3/712003 COMPLETION DATE: 4/30/2003 7th 6,000 0 1. FACILITY 8th 6,000 0 ADDRESS: 114 LIBERTY STREET BORO: MANHATTAN ZIP: 10006 9th 6,000 0 tot 6,000 0 TYPE OFFACILITY: RESIDENTIAL BLOCK: 52 LOT: 7502 11t 8,000 0 II. BUILDING OWNER 12t 6,000 0

NAME: LIBERTY, LLC C/O EPIC, LLC TEL. #: (212) 633-6500 ADDRESS: 12 east 44th street CITY: new York STATE: ny ZIP: 10017

IV. ASBESTOS ABATEMENT CONTRACTOR NAME: ETS CONTRACTING, INC. TEL. #: (718) 706-8300 FEDERAL EMPLOYER IDENTIFICATION #: I-------------- ------------------ ADDRESS: 180 CLAY STREET CITY: BROOKLYN STATE: NY ZIP: 11222

V. THIRD PARTY AIR MONITOR NAME: JLC ENVIRONMENTAL CONSULTANTS, INC. TEL. #: (212) 420-8119 ADDRESS: 200 PARK AVENUE SOUTH CITY: NEW YORK STATE: NY ZIP: 1003 VI. LABORATORY FOR SAMPLE ANALYSIS NAME: JLC ENVIRONMENTAL CONSULTANTS INC. NYS ELAP #: 11029

ASBESTOS WORK SCHEDULE 0 DAY © EVENING D NIGHT ❑ WEEKENDS © WEEKDAYS

INSPECTOR NAME: R. Rq/Y~72)tOI)44 1 SQUAD #: BADGE #: __^_ f DATE OF INSPECTION: 03 02 7"0/3 TIME OF INSPECTION: From: j' A 7s - ' AM PM / //~y ~ ( ~() ( ) To: 1.26W AM PM Contact at site: /' 4 Saes c/ L/ / fit/) ~n N I(Cn c in.l t a I_"T. A

Inspection disclosed that the following sections were complied with: (Check all that apply) 1-51 - Notifications, Reports, Plan 1-71 - Air Sampling and Monitoring 1-91 - Worker Protection

1-101 - Materials and Equipment 1-116 - Work Place Preparation 1-117 - Worker Decontamination System

1-118 - Waste Decontamination System 1-126 - Engineering Controls Ll 1-127 - Entry/Exit Procedures

1-129 - Maintenance of Barriers 1-138 - Encapsulation 1-139 - Enclosure

1-140 - Giovebag 1-141 - Tent 1-137 - ACM Disturbance, RemoveL, dandling

1-146 - Preliminary Clean-up 1-147 - Final Clean-up

Project not started . Inspection

revealed all ACM to be intact. New start date: Project ongoing, expected completion date:

Project completed on or about: / / All surfaces, Including abated surfaces are free of visible ACM and encapsulate

Follow up necessary on Samples taken: No Yes 1 2 3

4 5 6 Photos taken: Yes = No

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RESULT CODES 1 = VIOLATION ISSUED 2 = NO VIOLATION ISSUED 3 = NO ACCESS SUPERVISOR INmnLs 4 = PROJECT NOT STARTED (NO NOV) 5 = PROJECT COMPLETED (NO NOV) _J'

NYC-WTC 000102705