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Document / 6 pages

Asbestos project notification form, 30 West Broadway, Aug 2002

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Asbestos Project Notification form for an inspection at 30 West Broadway submitted to the NYC Department of Environmental Protection.

NYC-WTC_000109848–000109853

Folder label: “30 WEST BROADWAY; 1001414, 127/11”

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NYC 9/11 Public Portal Document

`~ " NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59.17 Junction Boulevard. e°' Floor. Corona, NY 113684107 ONtY y Da ` oRo ~ TRW se ohLv2 BE ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) 1.

When submitting this form at the NYC Department of Buildings. the original loan and three (3) copies with original signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. form must be submitted to the NYC DEP not less than one week in advance of the start of This abatement activities. 1. FACILITY

2-Address )Q~~ES I p~20A,-b W ~ 1 ( Borough N` 1 Zip t o o 07 — AKA 2 S- a'y _'n b.) tc 3. Block 4. Lot 5. Type of Facility 6. Name of Building II. BUILDING OWNER

7. Name __C -L& ' 8. Contact Person 9. Tel. # 17 f ____ Fax # 10. Address S 1' /v ` City State p /00 Ill. GENERAL CONTRACTOR

11. Name _ Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name _ €.L GY?J 11'O —_-- 13. Contact Person O~ (~~ _._._._._._.- 14. Federal Employer ID. # PII...... C 15. Tel. # J f~ e ?d ... - V 'c3~OO Fax # c )~_ 16. Address 0&)s_— City .J /(u/ /f4 State N Zip I0- V. THIRD PARTY AIR MONITOR 1 A `r 17. Name ~ Qd9 kr(ZECL ~, r pC 18. Contact Person alt L 4 O (—& 19. Federal Employer ID. # 20. Tel. # a «_a - 00 L. Fax# 2L _'2a -O6 3 O 21. Address City t^t ~~J G~?l~ OO State ~ Zip / 22. Sample Analysis Laboratory Sc(~c( (F(L I A7gC A rr(E$ try 23. NYS OOH ELAP # if cfg-(.? VI. PROJECT INFORMATION 24_ Starting date for this portion of work (p 'I/C) o . Projected completion date 7 (30 O~

Asbestos work schedule ❑ Monday ❑ Tuesday O Wednesday O Thursday O Friday ❑ Saturday 0_ Sunday Shift from: ❑ am ❑ pm to ❑ am 0 pm If other, t:... ,- `\. specify ' r.

Access to inspect the premises must be provided during the work schedule indicated in this item.

25. Total amount of asbestos-containing material to be abated during this work _ \.. % _/ Square Feet, and/or Linear Feet . 1 ="

t:.c ?11001 tSdiaJSC'.i~RC4~7 tru 7

NYC-WTC 000109848

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NYC-WTC_000109848Source: NYC Law Department, mirrored locally

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