NYC 9/11 Public Portal Document
ft ~~ N1~f C DEPARTMENT OF ENVIRONMENTAL PROTECTION
x an ii•,yl
I I v ~% ~°~' ;1"` Asbestos Control Program
~^ 59-17 Junction Boulevard, 81° Floor, Corona, NY 11368-5107 .
ONLY ~r Building Dept. or TRU No
I
fire ASBESTOS PROJECT NOTIFICATION FOR OFFICUI. USE ONLY
JFORMSWL BE c
TYPEWRI'TFETI
CML
....~r<..~ (ASBESTOS INSPECTION REPORT)
çtfEPTEO 1 $1200
1 Lit ,, (See fee schedule)
vvnen suomlalrlgtrnsfptm at the NYC Department of Buildings, the
original form and three (3) copies with original
signatures are required. Submittal at the NYCDEP requires one copy of
form must be submitted to the NYC DEP not less than one week in the form with original signatures. This
advance of the start of abatement activities.
I. FACILITY
2. Address 3 World Financial Center
Borough Manhattan Zip 10007
AKA
3. Block 16 4. Lot 140
5. Type of Facility Commercial Office 6. Name of Building American Express Tower
II. BUILDING OWNER
7. Name American Express Co. — 8. Contact Person Mr. Greg Gutierrez
9. Tel. # 212-640-9075 — Fax.# 212-640-9204
3
10. Address World Financial Center City New York State NY___ Zip 10007
III. GENERAL CONTRACTOR
11. Name Mc Clier, Inc. ____________ — Tel. # 973-623-9270
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name ETS Contracting, Inc. _------------- 13. Contact Person Mr. Robert Middleton
14. Federal Employer ID. &.,.-,-,_._._.PIL__._._._. -- 15. Tel. # 718-706-6300
Fax # 718-706-1032
16. Address 160 Clay Street City Brooklyn State NY Zip _11222
Zi
V. THIRD PARTY AIR MONITOR
17. Name Ambient Group, Inc. -----`----
18. Contact Person Mr. Jack Springston
19. Federal Employer ID. #-------P--______ -- 20. Tel. # 212-944-4615 Fax # 212-944-4618
21. Address 55 West 39th Street City New York State YN __ Zip _92.!...__.....
22. Sample Analysis Laboratory Ambient Group, Inc_ ---
23. NYS DOH FLAP # 10865
VI. PROJECT INFORMATION
24. Starting date for this portion of work 122/14/01
Projected completion date 331/02
Asbestos work schedule I Monday ❑✓
Tuesday ❑✓ Wednesday 9 Thursday 0 Friday 9 Saturday 9
Sunday
Shift from: 7:00 700
❑ am ❑ pm to _:--- ❑ am ❑ pm ` l
If other,
specify _
Access to inspect the premises must be provided during the work schedule indicated in this
RECEwEO
item.
UCG1
25. Total amount of asbestos-containing material to be abated during
this work
Square Feet, and/or Llnear Feet
NYC-WTC 000110954
OCR can misread numbers and units. Confirm readings against the page image before using them.