NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY
ti 4 Asbestos Control Program
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DA p ,! 55-17 Junction Boulevard, 8m Floor. Corona. NY 11368-5107
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ASBESTOS PROJECT AMENDMENT FORM
~........ -- F13RFORM ACP7
A modtl on Is valid only it it is received by the NYCDEP prior to the previously filed r
• completion except for start date changes that must be received by the original start da
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..;P7 TRU/BN# q I ti O acility Address J ~- e~A~ T BoroJ9
Date ACP7 was filed Variance # (If any)
Was this ACP7 amended before? ❑ Yes [ No If yes, specify date
Original Start Date Original Completion Date from ACP 7. #24.
PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notification may be modified i
Only the building owner may ar
IV. ASBESTOS ABATEMENT CONTRAC R The original applicant or buildin
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12. Name L `~ \ \'L 2'> l^' I~e^^" J" `~ ~~ • 13. Contact Person
14. Federal Employer ID. # ._._._. r tt 15. Tel. #' Lr g) 0[ i - ~}t ~ Fax #
1 ) ° / `
16. Address f '4' - - city C' %, S k- n\ '' State"l Zip ) 1 ~ S
V. THIRD PARTY AIR MONITOR
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17. Name ~^' t ° ^^ '~ ` ~" 18. Contact Person
19. Federal Employer ID. # 20. TAI. # Fax #
21. Address City State Zip
22. Sample Analysis Laboratory 23. NYS DOH ELAP #
VI. PROJECT INFORMATION
❑ Project Cancelled
24. Starting date for this portion of work / 0Z 1~ 0 Z
Projected completion date ❑ Project Postponed
Asbestos work schedule Monday Tuesday ' Vednesday -Thursday Friday ,❑=Saturday,Sunday
Shift from: E am ❑ pm to 0 am pm If other, specify
25. Additional asbestos-containing material to be disturbed during this work 3 ' ,4 06 Square Feet, and/or Linear Feet
Reduction in the amount of ACM to be disturbed during this work __ Square Feet, and/or 'O Linear Feet
29. Abatement Procedure for Additional Material (Check all appropriate boxes)
❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application
Other Changes
30. Locations of abatement modified by above ° ~^- r^c c, a-'t--
(For each floor list ACM quantity a// typ )
31/32. Name of Applicant / Owner Tel. # T ('
Name of Company (If any) _ Fax #
Address City tat Zip
I hereby declare that the information provided herein is true and complete.
~o` E Signature of Applicant /Owner Date
VIE1?1Q\Op~1 ACP •
?12001
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NYC-WTC 000108069
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