Asbestos fiber analysis report, ATC Associates, July 2002

NYC 9/11 Public Portal Document Aug 02 02 12:46p RCTIOM/FIBER 5167613085 p.1 WY0 K CITY Notification of Staging And Outrigger Beam ' Use By Special Riggers Please the 2 copies 'or Cranes and UEVNNTMENT OF Derncks. pus copies for your own :ise R II I I.I17I IN (1 S Aneileatier. Must Ba Tvoewntten

1. Location of Jab Borough: Manhattan House No(s).: Street Nate: 30 Special Place Name: ri ttrm. rL R ii No. al S:Dries:

are protection; anc the entrances and driveways to the building A) Building outline; setbac<s; building I-•eights: adacent buildings; s:cewalk bridge/other :) Location o me equipment. D) Tie-bacKs, safely lines and how they are secured 8) Label the streets and traffic direction. 2. Side view and front view of equipment show'ng- A) Max toad picked. staying, overhang, etc. B) Material, size and dimension of the equipment, ;r._tuding :he outrigge• beam, the clamps, bolts and oulteys. etc.) C) Size and details on all rigging hardware and connections ti.e. tie-downs, blocks. shacictas, hooks, counterweight E) Planking / support order legs. 0) The make-up and weight of the are used, show blocking to prevent lateral movement. G) All relevant nforriation and rotes. F) If wheels or rollers

Gescr;ne & Sketch E;uien nt Sc,ch As Pipe Staging and Dutnggers Beams To Be Used 14sacn Ske:c,, a This Form)

3. Spedal Rigger Information First Name. M i.: Last Name: Fa .r,15 orth F.dW rd License No.: P_II _ Business Name: Fiber C s Inc Address: 42-14 City: Long S.ata. cl>a: 11101 Phone, Fax. 516-781-3083

4. Owner or Managing Agent Information First Name: M I.: Lest Name: BueneesName: orpugh of Manhattan Community College Address: 30 West Broadway City w York state•: NY zip: 10007- 192 Phone: Fax:

I certify mat the subject work and setup of equipment will be done under my supervision or under the supervision of • (Supervisor. Foreman or Specia Rigger) The work wit, be done -n a sale and workman like manner or imprisonment, or both. • Falsification of any statement is a misdemeanor under Sectbn 26-124 of the Administrative Coda and is punishable by a fine accept. any benefit, monetary or otherwise, either as a gratuity for properly performing the • It is unlawful to give to a city employee, or for a city employee to job or In exchange for special consideratfor. Violation is punishable by imprisonment or fine or both. Signature of Ucerisea Rigger Oete

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NYC-WTC 000109969