60 WILLIAM STREET; 1001012, 41/22

NYC 9111 Public Portal Document

ASBESTOS INSPECTION REPORT (continued)

26. Asbestos Hauler ABESTOS TRANS_CO_ NYS DEC Permit# J LI. Tek# (631) 924_5050__-- _VALLEYVIEW DR , PA—_ Disposal Site(s) IMPERIAL P.O_47, 11 BOGGS RD., PA_/ SOUTHERN ALLEGHANIES

27. This asbestos abatement is part of a (Item a through e requires filing of this form with NYC Department of Buildings) a) ❑ Demolition b) ❑ Boiler Replacement c) ❑ Sprinkler Replacement d) 0 Renovation/Alteration

e) 0 Fireproofing Replacement f) ❑ Other (Describe)

28. TYPE OF ABATEMENT (Check all appropriate boxes) ❑ Removal 0 Enclosure 0 Encapsulation 0 Repair 0 Clean up

29. ABATEMENT PROCEDURE (Check all appropriate boxes) ❑ Full Containment ❑ Glovebag ❑ Tent ❑ DEP Variance Application

JV. L

DESCRIBE SECTION AFFECTED SURFACES AMOUNT OF ACM DESCRIPTION OF WORK BEING Floor(s) OF FLOOR CONTAINING ACM PERFORMED (e.g. Pipe lagging, ceiling, plenum SQUARE LINEAR (e.g. running cable, installing fire sprinklers, (e.g. enure, east wing, room N. FEET ducts, storage tanks, decking,etc.) FEET removing and replacing balers etc.) boiler room, lobby, etc)

ROOF EAST SETBACK ROOF 1,300 ITEM #2

ROOF EAST SETBACK FACADE 1,500 ITEM# 8

ROOF WEST SETBACK ROOF 1,300 ITEM #2

ROOF WEST SETBACK FACADE 270 ITEM #8

ROOF MAIN ROOF ROOF 1,208 ITEM #2

ROOF BULKHEAD ROOF GRAVEL ROOF 450 ITEM #4

FACADE WALLS, WINDOWS 7,600 ITEM #8

31. I hereby declare that the information provided herein is true and complete to the best of my knowledge. I am familiar with Federal, State and NYC laws and regulations applicable to asbestos related work.

WARREN & PANZER ENG, P.C. TRIO ASBESTOS REMOVAL STEVEN PARMIGIANI Print Name of AirMonitor Print Name of Asbestos contactor Print Name of Applicant (N other than Owner)

I Signature nature —~—_ S4lature

'ffI/o2 Date Date Date

32. I understand that as the owner of a building where asbestos abatement activity occurs, I am responsible for the performance of the asbestos abatement activities in accordance with the Asbestos Control Program Rules. I have contracted the third party air monitor who is completely independent of all parties involved in the asbestos project. I hereby declare that I have authorized the filing of this notification for the work specified herein.

Print Name of Owner Signature Date

A STAMPED COPY OF THIS FORM INCLUDING AMENDMENTS MUST BE AVAILABLE AT THE WORK SITE.

Any modification of information provided on this form must be reported immediately in writing directly to the NYC DEP ACP. The requirements of the Asbestos Control Program Rules may not be lawfully avoided or lessened through the performance of work in incremental or piecemeal fashion. ACP7 1/2001

NYC-WTC 000110261