NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION I FOR OFFICIAL USE ONLY
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, Asbestos ControlProgram F (if $
• ~D~~ 1 59`17 Junction.Boulevard, 8 Floor, Comma, NY 11368-5107
AL BE _ ASBESTOS PROJECT AMENDMENT FORM ict
D .............. ' FOR FORM ACP 7 Only 'Yes ❑ No
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<': • I A modification is valid only If it is received by the NYCDEP prior to the previously filed detect
Completion, except for start date changes that must be received by the original start dat
ti Cedo S -t Borough I,y EEVED
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iP' Date ACP7 was filed Variance # (If any) s JUL .11 200'1
Was this ACP7 amended before? ❑ Yes ( No If yes, specify date \
Original Start Date Original Completion Date from ACP 7. #24. _.a
PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notification may be modified no morethan twice.
Only the building owner may amend Items Wand V.
IV. ASBESTOS ABATEMENT CONTRACrQR T11e original applicant or building owner may amend all other items.
12. Name :13. Contact Person Ge Q ov~ p 1r
14. Federal Employer ID. ~._ _._. P '}l'>y
15. TeI. # &Q)~a C Fax #________________
16. Address I 'tt ' *2 J 1 X of _h - City C"' L \ State "1 Zip ) 3 S
V. THIRDPARTY AIR MONITOR
17. Name ~`'d` ~` `°" 18. Contact Person
19. Federal Employer ID. # 20. Tgl. # Fax #__________________
21. Address City State Zip
22. Sample Analysis Laboratory 23. NYS DOH ELAP
VI. PROJECT INFORMATION ❑ Project Cancelled
-7
24. Starting date for this portion of work / O/ L Projected completion date
. 1 O Z O Project Postponed
•Asbestos work schedule Monday uesday Wednesday Thursday I 1tday Saturday,QSunday
_
Shift from: f.Zt am ❑ pm to O am pm If other, specify
25. Additional asbestos-containing material to be disturbed during this work 3 ' , 4o Square Feet. and/or Linear Feet
Reduction In the amount of ACM to be disturbed during this work O ' _ 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 °w e c.
(For each floor list ACM quantity apry type)
31/32. Name of Applicant / Owner /l l Tel. #_' '
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Name of Company (If any)
Address
T12, ) y ' Fax #
City tat Zip
I hereby declare that the information provided herein is true and complete.
iE•` <^ aN Signature of Applicant /Owner Date
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NYC-WTC 000108081
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