Asbestos project notification form, 30 West Broadway, Aug 2002

NYC 9/11 Public Portal Document

FOR OFFICIAL USE ONLY NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program Feg (if any) 58.17 Junction Boulevard. 8"' Floor. Corona. NY 11368-5107 ONLY ll'men - ,'? -a TYPEWRITTEN RMS WILL 8 E MS ASBESTOS PROJECT AMENDMENT FORM Information Only. ❑ Yes ❑ No CCEPTED FOR FORM ACP 7

A modification is valid only lift 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.

12 n ACP7 TRU/BN# ~L 0W Factity Address _ % 3 ES1 OP IJ WA Borough _t Zip O t~

Date ACP7 was filed : 5 Variance # (If any)

Was this ACP7 amended before? ❑ Yes ❑ No If yes, specify date

Original Start Date 'a- \D).Onginal Completion Date yI 'a Z from ACP 7, #24. ii 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. IThe original applicant or building owner may amend all other items. IV. ASBESTOS ABATEMENT CONTRACTOR ~I &1Z_ C~ tb t e -m t-- 13. Contact Person N —1 C 1s t A 12. Name

14. Federal Employer ID. # 11—,-~S I # 1 15. Tel. 4S 1 6 ` ) g I " 3 0 ~ DFax k ^1 ~'~ l 9 1' 3a8~ r*&4)~ 16. Address 30 (C Cr`1dVtt )a.. .t E City %A A-wl t ACt H State L Zip I V7I 3

V. THIRD PARTY AIR MONITOR

17. Name -at 3W U 1 If G 18. Contact Person r•[ 1 C. i 20. Tel. #~ ~,~ Q Z2 0 ID 7 7 Fax # c7 } — Oro 19. Federal Employer ID. # City State I Zip 001'" 21. Address 3.& S '

• 22. Sample Analysis Laboratory SCtE P I is C_ hrill6u.(tPt Q1~ 1'3 3. NYS DOH FLAP # I I '-4' "

VI. PROJECT INFORMATION 0 Project Cancelled

24. Starting date for this portion of work Projected completion date 0 Project Postponed

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

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

Square a Li Feet 25. Additional asbestos-containing material to be disturbed during this work

Reduction in the amount of ACM to be disturbed during this work .'9 ,1%05 Sq~itar t, a r -Line t Ups 29. Abatement Procedure for Additional Material (Check all appropriate boxes) !, i ~•. ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application ` rosroe ~

Other Changes

30. Locations of abatement modified by above (For each floor list ACM quantity and )

31/32. Name of Applicant! Owner Tel. #~ l 1

Name of Company (If any) C -b e Fax #

Address City State ZIP

• I hereby declare that the information provided herein is true and complete. O~ Signatu of Applicant /Owner D to 212001

NYC-WTC 000109853