NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION FOR OFFICIAL USE ONLY
—. Asbestos Control Program Fed (if any)2S
59-17 Junction Boulevard, 8°i Floor, Corona, NY 11368-5107 _
ONLY 1
TYPEWRITTEN
FORMS WILL BE • "'
—"`~O` ASBESTOS PROJECT AMENDMENT FORM Information Only: ❑ Yes ❑ No
ACCEPTED :.ww.ny[.aorr FOR FORM ACP 7
A modification is valid only If it is received by the NYCDEP prior to the previously filed date of
completion, except for start date changes that must be received by the original start date.
ACP7 TRU/BN# 12UD (0 7Facility Address 3t), bJES S O )A1 Borough __ Zip _\
Date ACP7 was filed Variance # (If any)
Was this ACP7 amended before? ❑ Yes ❑ No If yes, specify date
Original Start Date a-- V-1-OriginalCompletlon Date '°D-- from ACP 7, #24.
PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: A notification may be modified no more than twice.
Only the building owner may amend items IV and V.
The original applicant or building owner may amend all other items.
IV. ASBESTOS ABATEMENT CONTRACTOR I
12. Name I ¢ ►Q~e_ C-,= a t Q— ~-- 13. Contact Person t 1a r 1 CAq i A
tg I — 3 a8 Z
16. Address 3a L P& City VIAL t t ( State _Zip t1
V. THIRD PARTY AIR MONITOR
17. Name_"'C Q'r __tNSe f G 18. Contact Person !"t 1 C `. P rL
l
19. Federal Employer ID. # 20. Tel. #1~1< ) dI 24 C) C J / Fax #4) c } ~ — O, 3
,, 11 1
21. Address • Ca - 4 City N State Zip t 00 % T
22. Sample Analysis Laboratory SC r'ciN lIFt L r ZPt o Q1~$ aCP3. NYS DOH ELAP # Ll.
VI. PROJECT INFORMATION ❑ Project Cancelled
24. Starting date for this portion of work Projected completion date ❑ Project Postponed
Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday 0 Thursday 0 Friday 0 Saturday 0 Sunday
Shift from: 0 am ❑ pm to ❑ am ❑ pm If other,
25. Additional asbestos-containing material to be disturbed during this work uare fit, a Li Feet
Reduction in the amount of ACM to be disturbed during this work 29 1405 uar t, a Line et
29. Abatement Procedure for Additional Material (Check all appropriate boxes)
0 Full Containment ❑ Giovebag 0 Tent 0 DEP Variance Application \ Bros conrrak
Other Changes
30. Locations of abatement modified by above
(For each floor list ACM quantity and ty )
31/32. Name of Applicant! Owner Tel. #~~1
Name of Company (If any) C -b-c 1 Fax #
Address City State ZIP
I hereby declare that the information provided herein is true and complete. jl O~
Signatu of Applicant /Owner D to
°`e "~r ACP 8
2)2001
NYC-WTC 000109776
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