NYC 9/11 Public Portal Document
61
JUN-19-2002 13:26
P.Od
ASBES ro INSPECTION REPORT
(oontinuectj
Asbestos Transportation
Hamer NS __ ___
DEc Permits1A'
D~pa~tsita(s) Zmpetial/pOB 47, 11 Boggs Rd., PA;
Southern Alleghenies/Rd
27• TMs asbestos abatement 3
s part orb (tem a through a 310 , c(
a} 0 Demolition requires filing tam
of INs eyvi @W,
with WyGXDePa►ir^ent d Buildings)
b) ❑ Goiler Reptaument
e) ❑ FiroWooirt9 Rev cement
0 0 Other (Describe)
o) ❑ Sprinkler RepteCement d) 0 Re t+ortJAttc
.
ltim
28. 'TYPE OF ABATEMENT
(Check en appropriate boxes)
D Removal 0 Enclosure Q EncapsutaGon
❑Repa.r ❑ Clean up
29. ABATEMENT PROCEDURE
(Check an approt ate boxes)
❑ Fun Containment 0. Glovebag Q
Tent ❑ D_ t:P Variance
30. LOCA'nom$ OF Application
ABATEMENT
•
F KS)
D~o tF SECTION
OF FLOOR
A FECTEO SU ACES
qtAOU~t ACM
09 /JO
DESCRIPTION OF Wp(~(8E1NCs
l
Z
room t ta? CONTAINING
ripe
ACM
nxm t e rues:. iae 9. tMcnum
a lank.. oeeki
S ET LR4CLR
le.g. nKy~;rpPERFORMED
. ere ?ET FEET taw. ncy~60
Roof Item No. 3
Walls Item No. 8 11 56
3,63
Air haf
oof Item No. 3
Walls Item No. 8 1 SO
24,10
31. t hereby declare
that the
State brut NYC taws and infonnatioo P ded herein is sue and complete to
ro9ulations applicable to asbestos the best of my lu~o►dedge.
I am famrTar with
related work. Federal,
Warren & panzer
Pan rrr,~ da. Ma,aar Trio Asbestos
P ,r Removal NYC
t0""'oOfCorp a;nr er a►Kr man
s
FL , sstw„=
32. 1understand that as tha ala
t►►easbestos abatement owner of a building where asbestos abatement activity ,
monitor who is basemen activities in a000rctar,ca with the Asbestos oc~xrrt, 1 am re
Program for the performance of
mn9 of this notirestion fory andependent o! all parties involved a Rules. I have
contraded
the work speeir-ed herein. a ect I reby deetsre that t the third party air
120 Liberty have a hori;etl the
Str. LLC c/o NYC
Nrvr r orow„ar
scnat~a O 2
A STAMpWG COPY OF THIS FORM Oaa
INCLUDING AMENow p fS MUST BE
AYAug AT THE WORK SITE.
modKrcationn of infemi,.tt'.,...,.._.~ -- -- . -
requirements of the
may not or
AcP7
NYC-WTC 000108057
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