Laboratory report cover page, 196 Broadway, Feb 2002

NYC 9/11 Public Portal Document

FROM : SEAY YARBROUGH INC PHONE NO. : 2128689293 Apr. 18 2002 10:38AM P2

ONLY TYPEWR)rrrN I DEPARTMENT OF ENVIRONMENTAL PROTECTION Page 1 do AJa$UCAYICMS WILL 0E ACCEPTED voxovchhee v lhwoaesaav NOT AN ASBESTOS PROJECT S NOTE: THIS FORM 18 TO BE COMPLETED IF THERE IS NO FRIABLE ASBESTOS CONTAINING MATERIAL t+rc PRESENT OR IF THE TOTAL AMOUNT OF FRIABLE ASBESTOS CONTAINING MATLAIAL 18 10 SQUARE FEET OR LESS, OR 28 uNEAA FEET OR LESS, OR IF NORMALLY NONFRIABLE ACM (AS PER 40 CFR ACPS Fee $ PAAT41.141)iSPRESENTINANYAMOUNT. WrrcdP►a0"iwa wfancier

A FACILIIYADDRESS 126 Broadway BORO Manhattan bE 20038

AKA 3. BLOCK N 79 4. LOT 4 16 S BUILDING OWNER TLS NYC Real Estate LLC TEL. # 212 t 563 - 7440 560 5th Avenue A STATE N.Y. CzODE 10036 7. CWACT emo Gary Tritnarchi 8 TEL #( 212 1 563 7440

B.D RIFrKNOF ENTIRE SCOPE OF WORK. No Work

10 ES7l1AATED. START DATE _WA EBTiNATEDCOMPLET ION DATE! OF THE ENTIRE SCOPE bF WORK

11: I______________ HAVE CONDUCTED AN ABBESTOe INVESTIGATION ON 2/25/&01 p ACCORDANCE WITH THE PROCEDURES REQUIRED BY THE NYC DEP ASBESTOS .CONTtaOL PROGRAM.REGULAT(ONS AND DECLARE THAT AT SAJO FACILITY ADDRESS, THE Da p'en eesio be demolished are free of any asbestos aonLahaigmater)el (ACM) Qb. premises to be demolished• contain 10 square feet or less or 25 ar feet or less at triable ACM or of normally nonhiable ACM that may make friable: • e( /ACM shall beremad according to the NYS DOL ICR 56 or the NYC DEP Aa i aloe

C. c mulatNe elefat es of relevant structures) •affected, by an alteration or plumbing repair are tree of any triable ACM and free of normally t *lHble ACM that ,iteration or plumbing repair Mroes.may make triable O d. ambiNve surfaces of relevant slruclure(s) affected by en aneraton or plumbing repair contain 10 square feet or less or 251iriear feet :O Laseotldable ACM or of rhaimally nonhiabie ACM that a taraflonor pknabing repair forces may make•fdable. removal as in ¢. Ie. normal nonfriable AC~16shq(i_ darww diremovsd In accordance with the NYS DCL ICR S8 or the NYC DEP Asbestos 118: Sq. FL 87733 ~1IiS4~2 1 .. D. teb(e•ACM and/or normally nodriable ACM will NOT he disturbed during akeraUontplumbing repair/moditicalkur renovstioa: Friable ACM Sq Ft Lin Ft Nontriable ACM Sq Ft 12 COMPLETE AND TNGROUGéI ASBESTOS INIVESTIGATION PERFORMED OF

STORY .0E$ClbM 36C11ON Oe ►LOOK ALL ie_ame iYIlEA11le VATERY4S IIUMBEti ASBESTOS • hi satin,, rA wbtq, toga r' INCLIDNB FRIAELE ACM AND OF SANFLES mof38EMt tad tMa~tet isrer ram, lsbbw eta,) S NNUAW NONPRIABLEACB RNAiy o o.of Ent a . Chrsotiie ACM 11% 3 X rtd.Floor. • Entire S None 8 X itd Floor Entire • None 6 X st r Entire None 5 X :411ar . Entire None 7 X tub Cellar -Entire None 5

13. NAME OF LABORATORY THAT ANALYZED SAMPLE$ Scientific Laboratories ,Inc. " --- - - 14 Et/

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nt,au a P15Oeeto4 aoruaming Maleryal - Materiel COntalnlna Greater then ¶% Asbesos .ANY MODIFICATION OR VARIANCE PROW1NPORMATION PROVIDED ON THIS FORM MUST BE REPORTED 1fiMEOIATELY IN WRITING DIRECTLY TO THE NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION ASBESTOS CONTROL PROGRAM! NYC 'DEPT.OP I;NVIAQMMENTAL PROTECTION. • 52a17 JUNCTION RLVO:-ath•FLOOR, ELWWRST, NEW YORK 1/$734107

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NYC-WTC 000105855