NYC 9/11 Public Portal Document
FOR OFFICIAL USE ONLY
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbsabs Control Program Fee (if any) $
ONLY
TYPEWRITTEN
(DP)) 59-17 Junction Boulevard, a Floor, Corona, NY 11368-5107
Amendment
FORMS WILL BE ,►rtoR~ ASBESTOS PROJECT AMENDMENT FORM Information Only. ❑ Yes 0 No
ACCEPTED . .n <. orlaea FOR FORM ACP 7
A modification is valid only if it 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.
ACP7 TRU/BN# 1048MN02 Facility Address 156 William St Borough Manhattan Zip
Date ACP7 was filed 6/3/02 Variance # (If any)
Was this ACP7 amended before? 0 Yes El No If yes, specify date
Original Start Date 7/8/02 Original Completion Date 88/02 from ACP 7, #24.
A notification may be modified no more than twice.
PLEASE ENTER THE INFORMATION THAT IS BEING CHANGED: Only the building owner may amend items IV and V.
The original applicant or building owner may amend all other items.
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name 13. Contact Person —
14. Federal Employer ID. # 15. Tel. # Fax #
16. Address City State Zip
V. THIRD PARTY AIR MONITOR
17. Name 18. Contact Person
19. Federal Employer ID. # 20. Tel. # Fax #
21. Address — City State Zip
22. Sample Analysis Laboratory 23. NYS DOH ELAP #
VI. PROJECT INFORMATION ❑ Project Cancelled
24. Starting date for this portion of work Projected completion date 0 Project Postponed
Asbestos work schedule 0 Monday ❑ Tuesday 0 Wednesday 0 Thursday 0 Friday 0 Saturday 0 Sunday
Shift from: ❑ am ❑ pm to ❑ am ❑ pm If other, specify__,_________________—_
12,240 Square Feet, and/or Linear Feet
25. Additional asbestos-containing material to be disturbed during this work
Reduction in the amount of ACM to be disturbed during this work Square Feet, and/or Linear Feet
29. Abatement Procedure for Additional Material (Check all appropriate boxes)
❑ Full Containment ❑ Glovebag ❑ Tent 0 DEP Variance Application
Other Changes ---
of building
30. Locations of abatement modified by above Facade, Windows on Southside & Westside
(For each floor list ACM quantity and type)
31/32. Name of Applicant / Owner Louie lannico Tel. # (718) 531-2900
Name of Company (If any) Benjamin Kurzban & Son
Control Fax # (718) 209-1808
City Brooklyn State NY Zip 11236
Address 1248 Ralph Ave
I hereby declare that the information provided herein is true and complete.
Signature of Applicant /Owner Date
ACP 8
2!2007
NYC-WTC 000110683
OCR can misread numbers and units. Confirm readings against the page image before using them.