WTC Site Data Form for Building Inspection

NYC 9/11 Public Portal Document

TOTAL FEET: 40805 0

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Basis of Inspection: ASBESTOS INSPECTION REPORT r- - - -- i TRg0929MN02 FEE EXEMPT: Yes ONLY TYPEWRITTEN 1. $0.00 APPLICATIONS WILL BE TNOTE: ASBESTOS INSPECTION REPORT SHALL BE SUBMITTED ACCEPTED l 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

It. BUILDING OWNER NAME: 120 LIBERTY STREET, LLC Contact

TEL. #: N/A CITY: STATE: ZIP: ADDRESS IV. ASBESTOS ABATEMENT CONTRACTOR NAME: #Error _ TEL. #: (718)961.4100 FEDERAL EMPLOYER IDENTIFICATION #: 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 WO K SCHEDULE W- DAY e2 EVENING WG NIGHT W WEEKENDS 6-G WEEKDAYS

INSPECTOR NAME: A'K . L~7_C 1f wI Wc. SQUAD #: BADGE #: t DATE OF INSPECTION: G / 2 / 0 TIME OF INSPECTION: From: p AM —PM E

Contact at site: T pr 1 W O l {Go W ic-1 q 4I To: AM [] PM Inspectio isclosed that the following sections were complied with: (Check all that apply) 1.51 - Notifications, Reports, PIa 1.71 - Air Sampling and Monitorin I_ _J 1.91 • Worker Protection j L~ r J 1.101 - Materials and Equipment 1.116 • Work Place Preparation [ '1i17 - Worker Decontamination System

1-118 -Waste Decontamination System 1.126 - Engineering Controls [127 - Entry/Exit Procedures r 1.138 - Encapsulation O 1-139- Enclosure 1.129 - Maintenance of Barriers wn n•.....,,.~.. I i 1.1A1 . Tnnt 171 1.137 . ACM Disturbance. RemoveL. Handling

J 1-146 -Preliminary Clean-up LII 1.147 - Final Clean-up [ - 1 Project not started Inspection

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

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

[ _j Follow up necessary on Samples taken: El No l~i Yes 1 2 3

4 5 6 _ Photos taken: LI] Yes [ ] No

Additional comments: w+_

i RESULT CODE BORO 1 = MANHATTAN 2 = BRONX 3 = BR000KLYN 4 = QUEENS 5 = STATEN ISLAND i

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

NYC-WTC 000108286