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Asbestos Project Notification Form, Corona NY

Machine-extracted title · confidence 95%

Formal notification of asbestos abatement activities submitted to the NYC DEP for a Corona site.

NYC-WTC_000111190–000111194

Folder label: “Zone I Originals

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Scanned page image, NYC-WTC_000111190
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NYC 9/11 Public Portal Document

PROTECTION NYC DEPARTMENT OF ENVIRONMENTAL Asbestos Control Program 0 39-17 Junction Boulevard. 8" Floor, Corona. NY 11368-5101 sr TRU PM Use ONLY

TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION FORMS WILL BE " N4- (ASBESTOS INSPECTION REPORT) 1. ACCEPTED " "-r'!' • • .

the original form and three (3) ooplaa'Mfh original When submitting this corm at the NYC Deportment of Buildings, of the fonts with olglnal signatures. This signatures are required. Submittal at the NYCDEP requires one copy advance of the Start of abstament settvtiies . form must be submitted to the NYC QEP not lea than one week in

I. FACILITY ` --~E C g ~— 1 Borough _ —._ Zip 2. Address _ __ ---- _ -----__._ ._ ----------- —_ 3, Block ` 6 —..- 4. Lot r AKA_- KA -------- ------- --

5. Type of Facility 8. Name of Building ,_— —_-- —

it.. BUILDING OWNER

7. Name 6 Contact Person ..~--- -----

9. Tel. # 1 S? )- tJ max --------

10. Address _lid --- -- S --_— City _ — - - State -.--

III. GENERAL CONTRACTOR Tel. #----------- 11,

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name (~ -- I---------------------__._ -340 13. Contact Person

14. Federal employer ID. i t PII -15. Tel. # orb_- ~E~_ O ---- Fax # ~S~I35 - ~'~ /1 16. Address /~ old_ 1Jy_-- -- City _ Ci, r~"-'4~--- State IV zip ~.LZ -

V. THIRD PARTY AI MONITOR , r 17. Name 2.?G i~ Ec_,._ 16. Contact Person

19. Federal Employer ID. # - _____--_-— __ 20. Tel. # ? as _a — o __ Fax # _213 - _ bi r -- ,n - ~~f-r City -CLAW ----- State L= _ zip _ 21. Addressg rte- -- 0 oX(E 23. NYS DOH ELAP 22. Sample Analysis Laboratary__ _~. ( '"~

V1. PROJECT INFORMATION 0 Z I _QZ Projected completion date — 24.. Starting date (or this portion of work

Asbestos .vcrk schedule 0 Monday 0 Tuesday 0 Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday 2 3 ~ Shift from. ❑ am ❑ pm to __ ❑ am Q pm It other, specih' —_------- ---------- — ;;' Rt 0 \ Access to inspect the Arei'rii.t mutt be provided during the work schedule Indicated in this item. JUN 28 2002 a> during this work 25. Total amount of asbestos.containing material to be abated M TRUE V Square Feet, and/or __ __— Linear Feet ACP7 Fi 212001 e,n AU or EMnx1wN a l~irrryLr►;t;w- V-30BY U7rA "j Inn

NYC-WTC 000111190

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NYC-WTC_000111190Source: NYC Law Department, mirrored locally

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