Asbestos project notification form, 30 West Broadway, Aug 2002

NYC 9/11 Public Portal Document

''p ci Yv4r NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59.17 JunWon Boulevard. e°i Floor. Corona. NY 11368,5107

BE wrniriIR`'_ ASBESTOS PROJECT NOTIFICATION L FOROFFICULUSE

o (ASBESTOS INSPECTION REPORT) 1.

When submitting this form at the NYC Department of Buildings, the original form and three (3) copies wIth original 'I signatures are required. Submittal at the NYCOEP 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 abatement This activities. 1. FACILITY

2. Address )Q 6R-O" A. —( Borough N 1 zip 10 00 7 ]AL,>=S1~ (' AKA 23 15 a'y `L v b.) lCk 3. Block 4. Lot 5. Type of Facility 6. Name of Building II. BUILDING OWNER

7. Name __C -LL 8. Contact Person 9. Tel. # 1~ ____ S Fax# 10. Address ~'~ g0 S ~' City -- /v ` State Al QU III. GENERAL CONTRACTOR

11. Name Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name ,F e ( /► ___ ___13. Contact Person ~Q/J (~~ 14. Federal Employer ID. #L C e . P~.~._._._.._._ r ,._.j5. Tel. # J ~ - 7~~'3~ 0 0 Fax 16. Address 1~- v t _ City J 7C}/ State IQ Zip 10 ?_ V. THIRD PARTY AIR MONITOR 11~( 17. Name L' V ~ kr(ZElL &14r7="J Cp 18. Contact Person t L (.fo 19. Federal Employer ID. # ' 20. Tel. # o «_a - OD q- Fax # P4a ' '2a -O6 3O 21. Address g IES% 1L ( ELC City Ct, I- ) ~G7'?l~ 00 ( . State Zip 22. Sample Analysis Laboratory i(.tee((F(L IA e l T(ES v( 23. NYS OOH ELAP # f' VI. PROJECT INFORMATION

24_ Starting date for this portion of work U oa Projected completion date 7 (3O OQ

Asbestos work schedule ❑ Monday ❑ Tuesday 0 Wednesday 0 Thursday 0 Friday ❑ Saturday D Sunday

Shift from: ❑ am 0 pm to 0 am 0 pm If other, specify

I 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 quare Feet, and/or Linear Feet I I I (ooO ACP 7 JpiA!18f r'e P^qA~' . Y% Y ?11001 eaa:gas aa,;p~q

NYC-WTC 000109848