WTC Site Data Form for Building Inspection

NYC 9/11 Public Portal Document

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TOTAL FEET: 40805 0

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Basis of Inspection: ASBESTOS INSPECTION REPORT L TRU0929MN02 FEE EXEMPT: Yes ONLY TYPEWRITTEN APPLICATIONS WILL BE NOTE: ASBESTOS INSPECTION REPORT SHALL BE SUBMITTED 1. $0.00 ACCEPTED TO NYC DEP NOT LESS THAN ONE WEEK IN ADVANCE Variance OF START OF THE WORK (ABATEMENT ACTIVITIES)

START DATE: 6/20/02 PROJ. COMPLETION DATE: 6/30/02

L FACILITY ADDRESS: 120 LIBERTY ST./ 125 CEDAR ST. BORO: MANHATTAN ZIP: 10006

TYPE OFFACILITY: BLOCK: 52 LOT: 21

11. BUILDING OWNER NAME: 120 LIBERTY STREET, LLC Contact _

TEL. N: ADDRESS: N/A CITY: STATE: ZIP:

W. ASBESTOS ABATEMENT CONTRACTOR NAME: #Error TEL. #: (7.18)961.4100 FEDERAL EMPLOYER IDENTIFICATION N: P 11 ADDRESS: 14-20 129 STREET CITY: COLLEGE POINT tiAYE: NY ZIP: 11356 VI. LABORATORY FOR SAMPLE ANALYSIS NAME: WKP LABORATORIES C/O WARREN & PANZER E NYS ELAP #: 11251

ASBESTOS WK SCHEDULE WIG DAY rlr EVENING GG NIGHT Gl WEEKENDS 1tL WEEKDAYS c_ INSPECTOR NAME: ' _ETC ' 'D t I Vt SQUAD N: t BADGE #:

DATE OF INSPECTION: / ). ( Off' TIME OF INSPECTION: From: _ AM ) ..PM ❑

To: 1. 0.3 AMC PM Contact at site: J W 0 L,')z *%j. 'L Z & Yo15 Inspection sclosed that the following sections were pliedcom with: (Check all that apply) 1.51 - Notifications, Reports, Pla U' _ 1.71 - Air Sampling and Monitorin •91 • Worker Protection

1.101 - Materials and Equipment 0 1.116 • Work Place Preparation J • 17 - Worker Decontamination System 1 [_j 1.118 • Waste Decontamination System 0 1.126 • Engineering Controls ~ 1i27 - Entry/Exit Procedures

11-129- Maintenance of Barriers 0 1.138 - Encapsulation L 1.139. Enclosure

1.140 - Glovebag 1.141 - Tent 1.137 - ACM Disturbance, RemoveL, Handling

1.146 • Preliminary Clean-up 1-147 - Final Clean-up

Project not started _—_ Inspection

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

U Project completed on or about / / . All surfaces, including abated surfaces are free of visible ACM and encapsulat I j Follow up necessary on _ Samples taken: [ No Lii Yes 1 2 3

4 5 6 Photos taken: O Yes = No

Additionall_comment p —_

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RESULT CODE BORO 1 = MANHATTAN 2= BRONX 3 = BROOOKLYN 4= QUEENS 5 = STATEN ISLAND RESULT CODES I = VIOLATION ISSUED 2 = NO VIOLATION ISSUED • 3 = NO ACCESS 4= PROJECT NOT STARTED (NO NOV) 5= PROJECT COMPLETED (NO NOV)

NYC-WTC 000108285