WTC Site Data Form for Building Inspection

NYC 9/11 Public Portal Document

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NYC DEPARTMENT OF ENVIRONMENTAL PROTECT!Y)N Basis of Inspection: ASBESTOS INSPECTION REPORT r~ TRU0929MN02 929 __ FEE EXEMPT: Yes ONLY TYPEWRITTEN APPLICATIONS WILL BE , NOTE: ASBESTOS INSPECTION REPORT SHALL BE SUBMITTED I 1. $0.00 ACCEPTED i 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

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

TYPE OFFACILITY: BLOCK: 52 LOT: 21

1I. BUILDING OWNER NAME: 120 LIBERTY STREET, LLC Contact

TEL. #: CITY: STATE: ZIP: ADDRESS: N/A IV. ASBESTOS ABATEMENT CONTRACTOR NAME: #Error TEL. #: (718)961.4100 FEDERAL EMPLOYER IDENTIFICATION N: ; P11 ADDRESS: 14-20 129 STREET CITY: COLLEGE POINT STATE: NY ZIP: 11356

VI. LABORATORY FOR SAMPLE ANALYSIS NAME: WKP LABORATORIES C/O WARREN & PANZER E NYS ELAP #: 11251

ASBESTOS WOK SCHEDULE W- DAY e2 EVENING GG NIGHT Fe WEEKENDS WS WEEKDAYS INSPECTOR NAME: A1( I_ w4c UVA w I SQUAD #: _ BADGE #: A'O

DATE OF INSPECTION: b / 1 Z / 0 7- TIME OF INSPECTION: From: O AM F-fM J

Contact at site: Tpr") L) o (. {GO W ~IFr~ QI To: s AM 0 PM lnspectio isclosed that the following sections were complied with: (Check all that apply) L 1-51- Notifications, Reports. Pla i Air pIing and Monitorin L~ 1.91 - Worker Protection

1.101 - Materials and Equipment 1.116 - Work Place Preparation [ 1i17 - Worker Decontamination System; 0 1-118 -Waste Decontamination System 1-126- Engineering Controls j '1r127 - Entry/Exit Procedures

1.129 - Maintenance of Barriers a 1.138 -Encapsulation O 1-139. Enclosure wn n,.......~.. h 1.1A1 . Tnnt 1.137. ACM Disturbance. RemoveL. Handllne I

_J 1.146 • Preliminary Clean-up 1.147 - Final Cleanup 1

Project not started - Inspection [] — 1 revealed all ACM to be intact. New start date: / /

ii Project ongoing, expected completion date: / /

J Project completed on or about / / . All surfaces, including abated surfaces are free of visible ACM and encapsulat

/ [_j Follow up necessary on _ / Samples taken: ~_ 1 No Li Yes 1 2 3

4 5 6 _ Photos taken: Yes No

Additional comments: WSJ

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) RESULT CODE BORO 1 = MANHATTAN 2 = BRONX 3= BROOOKLYN 4 = QUEENS 5 = STATEN ISLAND

RESULT CODES 1 = VIOLATION JSSUED 4 = PROJECT NOT STARTED (NO NOV) 2= NO VIOLATION ISSUED 3 = NO ACCESS 5= PROJECT COMPLETED (NO NOV) L SUPENISOR INITIALS

NYC-WTC 000108286